This study was undertaken to compare the effects of acute hemodilution (AH) induced separately by three solutions on blood properties and hemodynamics. Sixty-six patients, ASA grade Ⅰ to Ⅱ, aged 18 to 54 years, having open heart surgery with fentanyl-pancuronium anesthesia, were acted as subjects. During the induction of AH, blood 10-12ml?kg~(-1) was drawn from internal jugular vein in each subject, as Ringer's lactated injection (RL) at equivalent volume was infused intravenously, afterwards, all subjects were randomly allocated to being intravenously infused with RL at a dose of two times as many as the blood volume drawn (BVD) (group RL), Haemaccel 35 (R35) (group H35) or hydroxyethyl starch (Hes) (group Hes) at a dose equal to BVD, respectively. All patients were observed for 30 mins following the status of AH. The results showed that plasma colloid osmotic pressure was descended markedly in these three groups, but more significantly in group RL immediately after induction of AH, and was kept at low level in group H35 and RL and continued to decrease in group Hes during AH. The hemodynamic values of these three groups were within normal range during whole procedures. Prothrombin time and activated partial thrombin time were prolonged in each group, but within normal range. No anaphylactic reactions occured in all subjects. It is suggested that H35 can be applied more safe to acute moderate hemodilution in clinical anesthesia.

Objective : To investigate the mechanism of puerarin in the treatment of rheumatoid arthritis(RA) by network pharmacology and animal experiments. Methods : Traditional Chinese Medicine Systems Pharmcolog Database(TCMSP) and SwissTargetPrediction database were used to collect puerarin targets, and the targets of RA were obtained from GeneCards database and OMIM database. The PPI network was established by Cytoscape 3.7.2 software. Gene ontology(GO) function and Kyotoencyclopedia of genes(KEGG) enrichment analysis were performed through the Metascape database. RA rat-collagen-induced arthritis(CIA) model was reproduced using type Ⅱ collagen emulsion, 49 Wistar rats were randomly assigned to seven groups: control group, CIA model group, low-dose, medium-dose and high-dose puerarin group, methotrexate group, Tripterysium Glycosides Tablets group. Except for the control group, the other groups were given continuous gavage for 28 days after the CIA in rats model were prepared. The redness and swelling of the joints and ankle joint pathological changes were observed in each group. Western blot was used to detect the expression of Glycogen synthase kinase3β(GSK-3β), beta-catenin(β-catenin) proteins in the synovium. Real-time quantitative polymerase chain reaction(qPCR) was used to detect the expression of GSK-3β, β-catenin and c-Myc mRNA in the synovium. Results : Puerarin had 134 targets genes, RA had 5 821 target genes, and there were 102 overlapping target genes of puerarin and RA. It involved 184 signaling pathways, including JAK-STAT signaling pathway, NF-κB signaling pathway, Wnt signaling pathway, et al. The results of animal experiments showed that after the intervention of M-puerarin and MTX, the symptoms of redness and swelling of the hind foot were alleviated, the inflammatory cell infiltration in the synovium of the joint was significantly reduced, and the damage of cartilage and bone tissue was reduced. Compared with CIA group, the expressions of GSK-3β, β-catenin protein and GSK-3β, β-catenin and c-Myc mRNA in synovial tissue of rats after M-puerarin intervention decreased(P<0.05). Conclusion Puerarin has the characteristic of multi-components, multi-targets and multi-pathway intervention in RA. Puerarin may alleviate synovial hyperplasia, reduce articular cartilage erosion and bone destruction in CIA in rats by inhibiting Wnt/β-catenin signaling pathway.