Objective Perioperative fluid therapy has always been the most basic and important measure to maintain the stability of patients'cyclic system.Colloid and crystalloid,as common perioperative fluid,play different roles in clinical application due to the different molecular sizes.In the recent years,besides their contribution to maintain the stability of cyclic system,scientists have begun to pay attention to the effect on coagulation,especially their comparison.This paper mainly discusses the study status of the influence on coagulation produced by different liquids.

Objective To investigate the therapeutic effect and safety of the intratracheal instillation of sodium nitroprusside for treating persistent pulmonary hypertension of newborn (PPHN) .Methods The intratracheal instillation of sodium nitroprusside was used to 19 cases of PPHN under the mechanical ventilation ,and the pulmonary arterial mean pressure(PAMP) ,arterial mean pressure(AMP) ,transcutaneous oxygen saturation(TcSaO2 ) of the right upper and left lower limb at the basic state ,30 ,60 ,120min after intratracheal instillation of sodium nitroprusside were respectively measured and compared .Results Among 19 cases of PPHN ,17 cases had the primary lung disease .Of 17 cases ,14 cases(82 .35% ) had significant decrease of PAMP after intratracheal instillation of sodium nitroprusside ,which was most significant at 30min after therapy and the difference was statistically significant compared with before therapy [(21 .30 ± 4 .200)mm Hg vs .(30 .30 ± 4 .20)mm Hg ,P<0 .05] ,but AMP between before and after therapy had no statistical difference [(56 .00 ± 3 .00)mm Hg vs .(55 .00 ± 6 .00)mm Hg ,P>0 .05] .Conclusion The intratracheal instillation of sodium nitroprusside is the safe ,effective and economic method for treating PPHN .

Books ; Language ; Linguistics ; Medicine, Chinese Traditional ; Translations

Objective To investigate the expression of thymidylate synthase (TS) in bladder urothelial carcinoma(BUC) and its clinical significance, and to evaluate its prognostic value, thus to help predict the prognosis and choose therapy protocal. Methods The expression of TS was assessed by immunohistochemistry in 54 BUC and 15 normal bladder specimens, and all these clinical data were retrospectively analyzed after surgery. Expression of TS,clinicopathologic findings and two prognostic variances (relapse-free survival (RFS) and overall survival (OS)) were determined. The prognostic value of TS was estimated by survival curve and Cox proportional hazards model. Results Immunohistochemistry showed that 25 of 54 BUC cases (46. 30%) had high TS expression. In these cases,there was 29. 41%o (5/17) for G1 ,46. 43% (13/28) for G2,77. 78% (7/9) for G3 ;21.43% (3/14) for Ta, 26. 32% (5/19) for T1, 86. 67% ( 13/15 ) for T2,66.67% (2/3) for T3,66.67% (2/3) for T4. Expression of TS was positively associated with the grade and stage of carcinorma ( Kruskal - Wallis H, P = 0. 0 3 and P ＜ 0. 0 0 1 ). The recurrence and case - fatality of patients with high TS expression was 60. 00% (15/25) and 44. 00% (11/25) ,respectively. The survival analysis and Cox regression analysis showed that expression of TS were independent predictor for recurrence ( RR = 2. 65,95% CI was 0.80～8.81,P＜0.05) anddeath (RR=1.42,95%CIwas0. 36～5.58,P＜0. 05). Conclusions The probability of BUC progress and recurrence increases with the increasing of TS expression. Detection of TS expressing level can contribute to select appropriate treatment and follow-up schema.

Objective To observe the effect of memantine on NR1 ,NR2A ,NR2B of N‐methyl‐das‐partate receptor and learning or memory ability in vascular dementia (VaD) rats .Methods Thirty adult male SD rats were randomly divided into sham operation group ,VaD model group and me‐mantine treatment group (10 in each group) .A rat VaD model was established by permanent liga‐tion of bilateral common carotid arteries .Rats in memantine treatment group received gastric me‐mantine 10 mg/(kg · d) 1 week after operation while those in model group received normal sa‐line .Five weeks after operation ,their learning or memory ability was tested by Morris water maze test ,expressions of NR1 ,NR2A and NR2B were detected by Western blot .Results The escape latency was significantly longer whereas the percentage of target quadrant and expression levels of NR1 ,NR2A and NR2B were significantly lower in model group than in sham operation group (P=0 .001 ,P=0 .002 ,P<0 .05) .The learning or memory ability and the expression levels of NR1 ,NR2A and NR2B were significantly higher in memantine treatment group than in model group but still lower in memantine treatment group than in sham operation group ( P< 0 .05) . Conclusion Memantine can improve the learning or memory ability of VaD rats by upregulating the expression of NR1 ,NR2A and NR2B in their hippocampus .

The total glycoside extracted from the root of cynanchum oiophy-llum schneid ( COS ) has anticonvulsant activity. Its effect on synap-tosomal amino acid contents and brain enzyme activities in mice were studied in this paper. After the ip administration of COS, the content of GABA was increased, and that of Glu and Asp decreased, in synaptosomes of both normal and TSC induced convulsant mice, while the content of Gin remained unchanged. A fall in the activities of GDH, glutaminase and asparaginase in whole brain was seen. No changes were observed in the activities of GPT, GOT and glutamine synthetase.

Objective To establish and stabilize a new HLA-B locus typing strategy, reference strand mediated conformation analysis(RSCA)system and to conform its advantages.Methods Of 27 hematopoitic stem cell transplant patients and 63 potential donors DNA samples were extracted from peripheral blood cells and HLA-B loci were both typed by RSCA and PCR-SSP methods. The (ambi)-(guous) results were identified by using DNA sequencing. Results Among 90 samples, 87/90 ((96.7) %) cases could be designated definitely, but one of them was disagreement with the SSP result which was confirmed by sequencing, and 67/90 ((74.4) %) cases could be typed to allelic level. 1/90 ((1.1) %) case could not be identified by RSCA for its bad PCR results. Only one allele of each 2 samples could be designated and the other could not be identified by RSCA, which were further confirmed by sequencing method, and the results confessed which were known as alleles, but there were no corresponding data in RSCA database. Twenty samples were randomly selected to identify the replication rate of RSCA, and the results demonstrated that the replication rate was 100 %. Among PCR-SSP typing results, about 10 % samples might be typed for 1-3 times to confirm their types. Conclusion RSCA had some advantages such as high resolution, high sensitivity, high accuracy, high replication, finding new alleles, large scale and low cost, and was especially suitable for unrelated donor-recipient (screening).

Objective To study the expression of transforming growth factor ?(TGF-?) and connective tissue growth factor(CTGF) in renal interslitium of patients with lupus nephritis(LN) and itssignificance. Methods Expression of TGF-?1, CTGF, CD3, CD68, proliferative nuclear cell antigen(PCNA) and ?-smooth muscle actin (?-SMA) in renal interstitium of LN patients were detected byimmunohistochemical staining. The degrees of staining in LN patients were compared to those in patients withminimal change disease (MCD) . Results Expression of TGF-?1 and CTGF in renal interstitium elevatedsignificantly in LN patients as compared to those in MCD patients. There was a positive correlation betweenthe expression of TGF-?1 and CTGF ( r = 0. 5316, P = 0. 023). The expression of ?-SMA and the numbersof CD3, CD68 and PCNA positive cells in renal intersitium were significantly increased in LN patients as compared with MCD cases. The expression of a-SMA in renal interstitium was correlated with the degree of renal interstitial lesions or fibrosis( r = 0. 436, P = 0.032) . Conclusion The increased expression ofTGF-?1 and CTGF in LN patients may be involved in the damage of renal interstitium and the infiltration ofinflammatory cells.

In constructing the system of medical functional teaching and enhancing the quality and ability of students,we adjust the content and method of teaching in practice,and try to find students'problems in study through questionnaire survey and promote teaching reform and disciplines construction.

Objective To explore the surgical methods and clinical applications of single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury.Methods From October 2011 to October 2013,using single operation hole for thorascopic surgery treating encapsulated effusion with atelectasis in 56 cases after thoracic injury,35 males and 21 females,aged 21-68,mean 34 years old.The left encapsulated effusion with atelectasis in 31 cases,the right of encapsulated effusion with atelectasis in 25 cases,atelectasis in 43 cases,partial atelectasis in 9 cases,total atelectasis in 4 cases.Before thorascopic surgery,routine thoracentesis or (and) closed thoracic drainage were performed,but ineffective.Surgical approach for anesthesia with the thorascopic surgery encapsulated effusion dissection + suction drum lung surgery.Thorascopic surgery were completed in single operation hole,postoperative chest tube into the hole from observation.Results The operation time was 55-120 min,average 75 min; blood loss was 25-150 ml,average 65 ml.All patients underwent in single operation hole.The postoperative hospital stay was 7-19 d,average 11.2 d.There were no perioperative mortality and major complications.Conclusions The single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury is exactly effective and simple.It can be used as an effective treatment.