Objective To observe the effect of Modified Zhenxuan Granules (MZG) on blood pressure, synthesis and bioavail-ability of nitric oxide (NO), and plasma angiotensin I1 (Ang II) contents of spontaneously hypertensive rats (SHR). Methods Fiftymale SHR were randomly assigned to 5 groups: high-, middle-and low-dose MZG groups(at the doses of 37.50, 18. 70,and 9. 35 g/kg respectively), captopril (25 mg/kg) group and SHR control group. The rats received gastric gavage of corre-sponding medicine according to the experimental design for 12 weeks. Blood pressure from the tail was recorded at the beginning oftreatment and every 4 weeks during 12-weeks treatment. At the end of the experiment, the plasma NO and Ang II concentration,and aortal nitric oxide synthase (NOS) activity and aortal cyclic guanylic acid (cGMP) concentration were measured. ResultsMZG could decrease blood pressure and plasma Ang I1 concentration, increase plasma NO content, and enhance aortal NOS activ-ity and cGMP concentration ofSHR (P <0. 05, compared with the SHR control group), and high-dose MZG had the best effect.After treatment for 12 weeks, high-dose MZG had a similar effect on decreasing blood pressure compared with captoril group,had a better effect on increasing aortal cGMP (P< 0. 05), and increased the bioavailability of NO. Conclusion MZG can de-crease blood pressure, and its mechanism may be related to the improvement of NO/NOS/eGMP system and the decrease of plas-ma Ang Ⅱ concentration in SHR.

Objective:To compare the three effects of lidocaine in the prevention of general anesthesia in elderly patients.Methods:A total of 120 elderly patients (65-85 years old) underwent anesthesia with general anesthesia (ASA) Ⅰ ～ Ⅱ were randomly divided into thyrocricocentesis group (group H),throat surface anesthesia group (Group Y),intravenous injection group (group J) and control group (group D).Group H was injected with lidocaine for surface anesthesia;group Y used laryngeal spray for laryngeal sprayed lidocaine for surface anesthesia;group J was anesthetized induction of intravenous lidocaine to prevent intubation reaction;group D the control group was not treated with lidocaine.(SBP) and heart rate (HR) were measured before and after induction (T0),tracheal intubation (T1) and 1 (T2),3 (T3) and 5 min (T4),the changes of hemodynamics related indexes were compared.Results:Compared with the same group of T0,the SBP and HR of four groups of T1 moments were significantly decreased (P ＜0.05);In the other three groups,SBP was significantly increased at T2 and T3 (P ＜0.05),HR ofT2 was significantly increased (P ＜0.05);Compared with group D,SBP and HR in group H,Y and J were significantly different at T2,T3 and T4,he difference was statistically significant (P ＜0.05);but there was no statistically significant difference between the three groups (P＞ 0.05).Conclusion:The three ways of lidocaine can be used to prevent the general anesthesia reaction in elderly patients,the effect of three ways is parallel.However,cricothyroid membrane puncture increased the patient's pain,throat spray method increased the cumbersome operation and enhanced the cost of the patient,and intravenous injection method is simple and worthy of popularization and application in clinic.

BACKGROUND:How to effectively reduce al ogeneic blood transfusion volume after knee arthroplasty has become a new clinical problem, but predictors of perioperative blood loss and al ogenic blood transfusion after replacement have not been wel defined. OBJECTIVE:To establish the prediction model of al ogeneic transfusion volume after total knee arthroplasty by analyzing the preoperative and intraoperative related factors that influence the postoperative al ogeneic transfusion volume, so as to provide a theoretical basis for the clinical selective application of the autologous blood retransfusion device. METHODS:The materials of 120 postoperative al ogenic transfusion patients who treated with unilateral total knee arthroplasty at Baodi Clinical Col ege of Tianjin Medical University from January 2012 to December 2013 were retrospectively analyzed. Each patient’s gender, age, height, body weight, preoperative hemoglobin value, operation time, intraoperative blood loss volume and postoperative al ogeneic transfusion volume were recorded in detail, and accordingly a prediction model of al ogeneic transfusion volume was established after total knee arthroplasty. From January 2014 to December 2014, we applied this model in clinic. A total of 90 patients who predicted need for al ogeneic transfusion after unilateral total knee arthroplasty were randomly divided into two groups. Autologous blood retransfusion device was used in the observation group. Conventional drainage was used in the control group. The blood transfusion volume of patients in these two groups was analyzed, and the prediction accuracy of the prediction model in these two groups was detected. RESULTS AND CONCLUSION:Al patients completed the experimental observation. Pearson analysis showed that the patient’s age, height, body weight, preoperative hemoglobin values, operation time and intraoperative blood loss volume associated with postoperative al ogeneic transfusion volume (P<0.01). Multivariate regression analysis showed that the patient’s preoperative hemoglobin values, operation time and intraoperative blood loss volume associated with postoperative al ogeneic transfusion volume (P<0.01). Clinical application test results showed that the postoperative al ogeneic transfusion volume in observation and control groups was respectively (611.30±191.14) mL and (571.55±200.53) mL, prediction accuracy was respectively (71.50±22.20)%and (70.94±19.23)%, the difference was not significant (P>0.05). There were significant differences in al ogeneic transfusion volume and total blood transfusion volume (including autologous and allogeneic blood transfusion volume) of patients in these two group (P<0.01). The al ogeneic transfusion volume in the observation group was significantly lower than that in the control group. These results suggest that the prediction model can successful y predict the al ogeneic transfusion volume after total knee arthroplasty. The application of autologous blood retransfusion device in those patients who predicted need for postoperative al ogenic transfusion after the replacement can effectively reduce the al ogenic transfusion volume.

Objective: To evaluate the therapeutic effect and security of Buyang Huanwu decoction in treatment of the ischemic stroke recovery. Methods: We retrieved the relevant articles of random and semi- random control trials in treating ischemic stroke recovery using Buyang Huanwu decoction, published in China National Knowledge Infrastructure (CNKI), the Wanfang Data, the Weipu Information Resources System, the Chinese Biomedical Literature Database (CBM), Cochrane Library, PUBMED and MEDLINE from the date of establishment until to March 2018. The quality of studies was evaluated according to the Cochrane Reviewers?? handbook 5.1, and the study was carried out using Cochrane system assessment methods. Statistical analysis was performed with Rev Man 5.3. Results: Altogether 39 studies and 3539 cases of ischemic stroke recovery were enrolled. In terms of clinical efficacy, the difference between Buyang Huanwu Decoction and Western Medicine conventional therapy in the treatment of ischemic stroke was significantly different from that of conventional western medicine therapy [RR =1.26, 95％CI (1.20, 1.31), Z =10.05, P ＜ 0.00001], and the difference between Buyang Huanwu Decoction and other Chinese patent medicines was statistically significant [RR =1.12, 95％CI(1.06, 1.19), Z =3.82, P =0.0001]; neurological deficit NIHSS score [MD =-2.55, 95％CI (-3.10, -2.01), Z =9.20, P ＜ 0.00001]; clinical neurological deficit score (CSS) [MD =-3.85, 95％CI (-5.21, -2.50), Z =5.56, P ＜ 0.00001]; limb motor function score (FMA) [MD =6.10, 95％CI (1.19, 11.01), Z =2.43, P =0.01]; Barthel Index of Daily Living Activity Scale [MD =9.09, 95％CI (6.95, 11.23), Z =8.33, P ＜ 0.00001]; In terms of improving blood rheology index, serum peroxide lipid (LPO), serum superoxide dismutase (SOD) and other biochemical indicators, due to the small number of studies, it may have a certain effect. Most studies did not report adverse reactions. Conclusion: Based on the existing clinical evidence, combination of Buyang Huanwu decoction and western medicine has higher clinical efficacy than western medicine alone for the ischemic stroke recovery. Due to the limited methodological quality of the included studies, more high- quality RCTs with large scale are needed to increase the strength of the above evidence.

【Objective】 To study the yielding rate and distribution of unexpected antibodies in blood transfusion children with thalassemia in Yunnan province, and to explore the blood transfusion strategies. 【Methods】 From January 2016 to December 2021, 298 children with thalassemia, who received blood transfusion treatment in Kunming, Xishuangbanna, Wenshan, Dehong, Yuxi and Baoshan hospitals across Yunnan Province, were selected. The unexpected antibodies of blood plasma were screened by microcolumn gel card. The samples with positive antibodies were identified for alloantibody specificity. 【Results】 Unexpected antibodies were yielded in 67 out of 298(22.48%) transfused children with thalassemia. The positive rates of unexpected antibodies in boys and girls were 16.55%(24/145) and 28.10%(43/153), respectively. The positive rates of unexpected antibodies in Han, Dai, Zhuang, Yi, Bulang, Jinuo and Miao people were 14.06%(18/128), 30.80%(32/104), 35.71%(10/28), 36.36%(8/22), 50.00%(4/8), 60.00%(3/5)and 66.67%(2/3), respectively, with statistically significant differences between each other. The positive rate of unexpected antibodies in ethnic minorities was higher than that in Han. The positive rates of unexpected antibodies in children who received the first transfusion at birth-one year old, 1~3 years old, 3~6 years old and above 6 years old were 12.50%(3/24), 10.14%(7/69), 24.54%(40/163)and 40.48%(17/42), respectively. The positive rates of unexpected antibodies in children with first transfusion after 3 years old were significantly higher than those before 3 years old. The positive rates of unexpected antibodies in children with one transfusion, 1~3, 3~10, 10~20 and more than 20 transfusions were 4.76%(1/21), 12.07%(7/58), 23.71%(23/97), 28.16%(29/103)and 36.84%(7/19), respectively, with statistically significant differences between each other. The number of blood transfusions was positively correlated with the unexpected antibody yielding. The yielding rate of unexpected antibodies in children with α thalassemia, βthalassemia, δ+ βthalassemia and untyped thalassemia was 7.50%(3/40), 17.62%(34/193), 53.70%(29/54)and 9.09%(1/11), respectively(P<0.05). The yielding rate of unexpected antibodies in transfused children with δ+ βthalassemia was the highest. And 57 unexpected antibodies of Rh blood group system were yielded, 6 anti-M antibodies, 2 anti-N antibodies and 2 undetermined. 【Conclusion】 The positive rate of unexpected antibodies in transfused children with thalassemia in Yunnan province is high. Routine antibody screening should be carried out for transfusion children with thalassemia, and blood units, compatible with ABO, Rh and MNS typing results, should be selected to ensure the safety and effectiveness of clinical blood use.