The inappropriate use of norepinephrine(NE) in hypovolemic shock may be deleterious with potentially adverse vasoconstriction and subsequent hypoperfusion.Dramatically,based on the sufficient fluid resuscitation,high doses of NE administered rather increases the blood flow and oxygen delivery during sepsis.The mechanism may contribute to the reverse of vascular hyporesponsiveness and realization of microcirculation resuscitation.However,the optimal time,dosage and combination of NE with other vasoactive agents still necessarites further investigation.

The per-diem payment is a unit packaged payment used for the medical cost of hospitalization. At present some areas in our country explored the per-diem payment in hospitalization and have received obvious effect. The experiences of different areas carrying out the per-diem payment in our country were compared to find the strengths and weaknesses, and provide references for other areas.

The regularity and the preventive and curative measures about the post-operative infections in 3 orthotopic cardiac transplant recipients were reviewed.The results showed that the bacterial infections and the opportunistic fungal infections were common within 1～2 months after the cardiac transplantation.The sensitive antibiotics could completely control the infections.More than 3 months after surgery,the infections were gradually reduced.It was suggested that the prevention and treatment of the post-operative infections should be reinforced in the early stage of transplantation.

To investigate the risk factors for intracerebral hemorrhage in general population.Methods:The related research was searched through English Medical Current Contents (EMCC),China Hospital Knowledge Database (CHKD),MEDLINE,and Chinese Biomedical Literature Database (CBM).The search terms were intracerebral hemorrhage,factor,and case-control study or cohort study.Results:There were 8 literatures with original data were in accordance with the inclusion criteria.All the data could not be combined because there were some differences in counting and metrology in the risk factors included in all the studies.Hypertension,family history of cerebrovascular disease,high salt diet,alcohol consumption,diabetes mellitus,high diastolic pressure,high systolic pressure,smoking,snoring disease,and increased weighted mean difference of body mass index (BMI) (95% confidence interval) were 5.71 (4.00-6.79),3.54 (2.44-5.14),2.58 (1.94-3.43),2.80 (2.29-3.43),2.78 (1.83-4.23,1.90 (1.35-2.70),17.76 (16.60-18.92),30.43 (28.61-32.25),5.42 (5.15-5.70),1.90 (1.34-2.69),6.88 (4.61-10.26,and 5.42 (5.15-5.70),respectively.There were significant differences between the patient groups and control groups among the above indexes (all P<0.000 01).Conclusions:The risk factors for intracerebral hemorrhage include hypertension,family history of cerebrovascular disease,high salt diet,smoking,alcohol consumption,snoring disease,diabetes mellitus,overweight,high diastolic blood pressure,high systolic blood pressure and increased BMI.

This article was aimed to study the chemical constituents in groups of effective components extracted from Xiaoxuming Decoction. Twelve compounds were isolated and purified by dynamic axial compression column chromatography. Their chemical structures were identified by spectral analysis. The results showed that twelve compounds were isolated and identified as octacosanoic acid(1), cetanol(2), oroxylin A(3), wogonin(4), baicalein(5), tetrandrine(6), fangchinoline(7), wogonoside(8), baicalin(9), paeoniflorin(10), amygdalin(11), manntol(12). It was concluded that all compounds were isolated from this compound prescription for the first time.

Objective To investigate the current application of teaching cadavers and attitudes of medical students towards body donation and anatomy practicum and to make proposals on teaching and learning of human anatomy.Methods A on the spot questionnaire survey among 300 students studying in Hebei Medical University was conducted and the acquired data were contrasted analyzed.Results The teaching cadavers were insufficient and the quality of anatomy education was directly affected.Medical students took unfavorable attitudes towards anatomy practice and knew little about body donation.The main factors affected body donations were traditional concepts,lack of humanistic concern and complicated procedures of donation.Conclusions The short of teaching cadavers would be relieved by enhancing propaganda and legislation,emphasizing humanistic concern,simplifying procedures of donation.By means of anatomy teaching reformations,the learning interest and humanistic literacy of medical students are supposed to be improved.

Objective To measure the mandibular thickness relative to the osteotomy line of mandibular angle plasty so that to provide the anatomical basis for operation.Methods 37 youth women patients mandible were scanned by spiral CT,then the three-dimensional reconstruction was done,the thickness of the mandible around osteotomy line were measured on the planes corresponding to the posterior margin of mandibukar ramus,the middle part of the mandibular ramus,the posterior line of the third molar,the line between the second and third molar,the line between the second and first molar and the line between the first molar and the second premolar.The data were analyzed by Spss 11.5.Results The thichest bone around the osteotomy line was under the second and third molar,then the bone thickness became thinner forward and backward.The thinnest bony was on the middle part of the mandibular ramus.Conclusion The result of this study is of significant for guiding operation and reducing the complications.

Objective To explore the correlation between the efficacy of lamivudine (LAM)therapy and changes of T lymphocyte subsets,CD4+ CD25+ regulatory T lymphocytes (Treg),and levels of interleukin-10 (IL-10)and interferon-gamma (IFN-γ)in the peripheral blood of patients with chronic hepatitis B (CHB).Methods Ninety CHB patients were enrolled in this study.T lymphocyte subsets in the peripheral blood were detected by flow cytometry at baseline and week 52 of LAM therapy.The frequencies of CD4+ CD25+ Treg in the peripheral blood were detected by flow cytometry and levels of IL-10 and IFN-γ were detected by enzyme-linked immunosorbent assay (ELISA)at baseline,week 12,24,36 and 52.The comparisons of overall means between groups and within groups were done by analysis of variance or Dunnett's test.The comparison of means before and after LAM therapy was done by paired t test.Results In 32 complete-responders of 90 CHB patients,the proportions of CD4+ T lymphocytes,CD8+ T lymphocytes and CD4+/CD8+ ratio were increased significantly after LAM therapy (t=4.055、3.267、2.328,all P＜0.05); the frequencies of CD4+CD25+ Treg at baseline,week 12,24,36 and 52 were (5.40±0.60)%,(4.99±0.59)%,(4.54± 0.72)%,(3.86±0.95)% and (3.44±0.76)%,respectively; the levels of IFN-γ,IFN-γ/IL-10 ratio were increased,while the IL-10 level was decreased after LAM therapy.In 43 partial-responders,the proportion of CD4+T lymphocytes and ratio of CD4+/CD8+ were increased after LAM therapy (t= 3.484,2.018,both P＜0.05); the proportion of CD8+ T lymphocytes was not changed significantly after therapy; the frequencies of CD4+ CD25+ Treg at baseline,week 12,24,36 and 52 were (5.65±0.60)%,(5.23±0.63)%,(4.65±0.98)%,(4.42±0.97)% and (4.32±0.82)%,respectively;IFN-γ level,IFN-γ/IL-10 ratio were increased,while IL-10 level was decreased.In 15 non-responders,the proportion of T lymphocyte subsets,the frequency of CD4+ CD25+ Treg,the levels of IFN-γ and IL-10 were not changed significantly after LAM treatment.Conclusions In CHB patients who have achieved response after LAM therapy,the frequency of CD4+ CD25+ Treg in the peripheral blood is decreased,while ratios of CD4+/CD8+ and IFN-γ/IL-10 in the peripheral blood are increased.

Objective To observe the effects of human EP cells (hEPCs)transplantation on the function recovery of rats with spinal cord injury.Methods 24 SD rats (5 ones died in the process of operation)were firstly completed transection of T10 segment of spinal cord by using quick knife slices to complete animal model.19 rats after spinal cord transection were randomly divided into:the experimental group (10 cases)and the control group (9 cases). The experimental group with spinal cord injury was injected 7.5μL suspension of hEPCs (human Endothelial Progeni-tor Cells).Adjacent area of spinal cord injury in control group was injected equal amount DMEM(Dulbecco minimum essential medium.Postoperative intraperitoneal injection of cyclosporine A,an immunosuppressant,was administrated daily.At postoperative 1,2,4,6,8 weeks Basso Beatlie Bresnahan (BBB)score were administrated to record the neural function recovery of lower limbs in SCI rats.The transection spinal cord were removed from rats 8 weeks after operation to detect transplanted survival hEPCs in transection spinal cord of ratsby immunohistochemical and hybridization technique. Results 2 weeks after SCI model established,the BBB scores in the experimental group and the control group showed no statistically significant difference(t =0.61,0.69,all P >0.05).4 weeks postoperatively,the BBB score of the experimental group (1.67 -0.71)points was more than that in the control group (1.11 -0.60),the difference was statistically significant(t =3.16,P <0.05).Untill 8 weeks scores were respectively the (4.00 -1.41)of the experimental group and the (1.44 -0.89)of the control group,the difference was statistically significant(t =5.384,P <0.05). Finally it was concluded that 4,6,8 weeks after SCI,hind limbs function of the experimental group was significantly better than that of the control group,the difference had statistical significance (P <0.05).Hybridization and immuno-histochemical detection showed that the transplanted hEPCs not only live in the host but in partial hEPCs chimeric to SCI in rats of spinal cord and its vascular system.Conclusion After transplantation,hEPCs can survive,differentiate into vascular endothelial cell,and improvement spinal cord function recovery as compared with control group.

This study was aimed to establish a separation method for neochlorogenic acid reference substances from Lonicera japonica. Refined neochlorogenic acid inL. japonica water extract was separated and concentrated by HPD200A macroporous resin, which was isolated and purified by medium-low-pressure preparative chromatography and determined by HPLC. The structure was identified by various spectroscopic data including ESI-MS,1H-NMR and13C-NMR. The results showed that the optimal purification technology conditions were as follows: washed with 5BV of water, collected elution, concentration, drying; neochlorogenic acid crude products were eluted with acetonitrile-0.5% formic acid solution (10:90) with the flow rate of 20 mL·min-1; and the detection wavelength was 326 nm. The contents of the prepared neochlorogenic acid reached to 98.86% and the yield was 89.1%. It was concluded that the method was effective for the preparation of neochlorogenic acid with high purity. It can be used to prepare the reference substances for quantitative analysis and content determination of Chinese materia medica.