Objective To observe the effect of Shengxian Decoction (Decoction for lifting the depressed organs) in the treatment of 38 patients with obstructive sleep apnea hypopnea syndrome (OSAHS) in the TCM syndrome of qi deficiency of the lung and spleen. Methods Totally 68 patients were randomized into a control group (30 cases) treated by Duxil for oral taking and a treatment group (38 cases) treated by Duxil and Shengxian Decoction for 10 days. The changes in the symptom scores of both groups after treatment were observed. The polysomnogram (PSG) was applied before and after treatment to record the total sleep time,hypopnea total time,and average heart rate to calculate the times when oxygen saturation was less than 90% in each hour sleep time,the total continuous time when oxygen saturation was less than 90% in the whole night,apnea-hypopnea index (AHI),and hypopnea index (HI). Results After treatment,the main symptoms in the treatment group were significantly improved (P

ObjectiveTo evaluate axillofemoral bypass(AxFB) for the treatment of chronic severe lower limb ischemia. Method Consecutive AxFB performed in Anzhen Hospital from January 1995 to November 2002 was retrospectively analysed, with 31 patients of aortoiliac occlusive disease undergoing axillobifemoral bypass (AxBFB) and 32 axillounifemoral bypass(AxUFB) respectively. Result On discharge, rest pain disappeared in 44 cases and intermittent claudication in 19 cases, with average ankle/brachial index changing from preoperative 0.18(0～0.49) to postoperative 0.68(0.29～1.04). Rate of limbs salvage was 87.4%, amputation rate was 7.9%. Three cases died with a perioperative mortality of 4.8%. The patency rate of 1,3,5 years were 93.2%,79.8% and 64.1%, respectively. Conclusion AxFB for aortoiliac occlusive disease is considered to be acceptable procedure in high-risk patients with poor femoral run-off and chronic critical lower limb ischemia.

Objective To assess the efficiency,safety and indications of permanent inferior vena cava filters (VCF) placement for prevention of pulmonary embolism in cases of deep vein thrombosis (DVT). Method In this study 71 cases were treated with permanent inferior vena cava filters by way of the internal jugular vein and the common femoral vein. Cavography was performed routinely before inserting the VCF to confirm no thrombosis in IVC and access veins. The insertion site for filters is the subrenal vena cava. Results The procedure was successful in all cases. There was no case of symptomatic PE occurred during 1～41 months of follow-up. There were 2 cases of IVC thrombosis at the site of insertion and 5 cases of filter tilting less than 15?. There were no other complications. Conclusion Permanent IVC filter placement is an effective method for preventing fatal PE due to DVT. Imaging of the vena cava and access vein by venous ultrasound and cavography, strict anticoagulation therapy after VCF insertion are key to perform VCF placement, provide protection from recurrent life-threatening PE and reduce complications. The filter placement indications should be strict.

PurposeTo evaluate the feasibility and clinical values of CT scan with iterative reconstruction and low radiating dose in craniocerebral trauma.Material and Methods 120 patients suffered from craniocerebral trauma were randomly assigned. All the subjects underwent CT scan using route dose of filtered back projection (FBP) and low dose of iDose (? dose and ? dose), respectively. The quartering were used to subjectively evaluate noise of imaging, skull base artifact, contrast of gyrus-white matter and lesion display in each group. Imaging noise, signal and noise rate (SNR), contrast and noise rate (CNR) of gyrus-white matter and dose length product (DLP) were compared.Results The image quality of both? iDose and ? iDose groups were lower than that of FBP group, but still met the requirement of diagnosis. The image noise of both? iDose and ? iDose groups were higher than that of FBP group (P<0.05). The SNR and CNR of both? iDose and ? iDose groups were lower than those of FBP group (P<0.05). The DLP of both? iDose and ? iDose groups were lower than that of FBP group. There was statistical difference between iDose groups and FBP group (F=2751.46,P<0.05).Conclusion Application of iDose could effectively decrease radiation dose in craniocerebral trauma. Although iDose technique has higher noise level and lower SNR and CNR, the imaging qualities and capability of displaying abnormity meet diagnosis requirement. So that iDose has clinical significance.

Objective To enhance the oral bioavailability of breviscapine and investigate the feasibility of preparing the proliposome of breviscapine by fluidized bed coating method. Methods The fluidized bed coating method was used to prepare breviscapine proliposome and ultrafiltration-HPLC was applied to determination of the encapsulation efficiency. The influence factors on encapsulation efficiency including carriers, drug-lipid weight ratio, inlet air temperature, spray rate, and spray air volume were investigated. Results When the carrier was sorbitol and the drug-lipid weight ratio was under 1∶3, the encapsulation efficiency could be higher. Inlet air temperature, spray rate, and spray air volume had some effects on the encapsulation efficiency. By the method, the fluidity of the proliposome granules was well and the particle size distribution ratio of them was uniform; the mean particle size of liposomal formulation of breviscapine after rehydration was 98 nm, and the encapsulation efficiency was (63.1?2.8)% (n=3). Conclusion It is feasible to prepare the breviscapine proliposome with fluidized bed coating method.

Objective To summarize our surgical experience on 187 patients undergoing open repair of abdominal aortic aneurysms (AAAs). Methods Data of 187 patients with infrarenal AAA who were treated electively with open repair between January 1992 and February, 2004 were retrospectively reviewed. Results One patient (0.54%) died perioperatively due to ventricular premature beat, ventricular fibrillation 6 hours after. The mean duration of operative procedure was 3.8 hours. The mean blood loss was 445 ml. Perioperative complications included heart failure in 17 cases, respiratory failure in 8, acute myocardial infarction in 2, cerebral infarction in 1, and acute renal failure in 3. The 1? 3? 5-year survival rate was 97.0%? 84.6% and 78.3%, respectively. Conclusion The aneurysm diameter is not the absolute operative indication. Risk factors for open operation of AAA are old age, severe cardial, pulmonary diseases and renal desfunction. Open surgery is still the treatment of choice for AAA.

Objective To study the characteristics of patients with low body mass index (BMI) chronic obstructive pulmonary disease(COPD). Methods A total of 38 clinically stable patients with moderate-to-severe COPD were enrolled. They were divided into two groups: underweight (UW) group (n=16,BMI<20);normal weight(NW) group(n=22, 20≤BMI<26). Body height and weight, smoking indexs, and six minutes walk distance (6MWD) were assayed. The British Medical Research Council (MRC) dyspnea scale was used to assess the degree of dyspnea. St. George's Respiratory Questionnaire (SGRQ) and Short Form 36 item Questionnaire (SF-36) were used for health-related quality of life (HRQoL) evaluation. The serum concentrations of leptin and ghrelin were detected by enzyme-linked immunosorbent assay (ELISA). Results Compared with the NW group, the inspiratory eapacity(IC), forced expiratory volume in one second (FEV), vital capacity (VC) ,most ventilate volume (MVV) and peak expiratory flow(PEF) were lower(P<0. 05) in the UW group. Residual volume-to-total lung capacity ratio (RV/TLC), smoking indexs and MRC score were higher (all P<0. 05) and 6MWD was significantly lower (P<0. 05) in the UW group than in NW group. Activity scores,impact scores and total scores of SGRQ showed significant deterioration in the UW group (P<0. 05). SF-36 also showed significantly worse scores for the parameters of the emotional and social functioning (P < 0. 05 ). Serum leptin was significantly lower ( P< 0.01 ) and ghrelin was higher in UW group than in NW group (P<0. 05). Stepwise multiple regression analyse showed that lC,mental health(MH) and physical function (PF) of SF-36, leptin,6MWD and smoking indexs were independently correlated with BMI. Conchtsions The pulmonary function, nutritional status, PF and life quality of COPD patients with low BMI were more deteriorative. The most significant influencing factor for BMI in COPD patients was IC. M H,exercise capacity,leptin level and smoking indexs were independently correlated with BMI in COPD patients. It is important to retrieve low BMI in the management of COPD patients.

AIM:To investigate the autophagy induced by sepsis and acute kidney injury , and the regulation of phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway in this process.METHODS: The rats were subjected to cecal ligation and puncture ( CLP) or sham operation .Histopathologic changes of the renal tissues were examined by HE staining .Blood urea nitrogen ( BUN) and serum creatinine ( SCr) were measured by chemical colorime-try.The protein expression of microtubule-associated protein light chain 3 I/II (LC3 I/II), beclin-1 and p-Akt at different time points after CLP was detected by Western blotting .In vitro, human proximal tubular epithelial cell line HK-2 were treated with LPS to induce autophagy .The protein expression of LC 3 I/II and p-Akt in the HK-2 cells after LPS treatment at different time points and different concentrations was detected by Western blotting .These molecules in HK-2 cells and apoptosis of HK-2 cells treated with LPS plus PI3K inhibitor or Akt inhibitor were also detected .RESULTS: Compared with sham group , the severe changes of renal histopathological injuries in CLP groups were observed , the levels of BUN and SCr in CLP groups were significantly increased .LC3 I/II, beclin-1 and phosphorylation of Akt gradually increased after CLP.After treatment with LPS, the expression of p-Akt (308) in the HK-2 cells gradually increased in a dose-and time-dependent fashion.The expression of beclin-1 and p-Akt (472) reached a peak at 8 h or 10 mg/L LPS treatment.Treat-ment with PI3K or Akt inhibitor down-regulated the expression of LC3 and promoted the apoptosis of HK-2 cells.CON-CLUSION:Autophagy in the kidney is induced by sepsis and acute kidney injury .PI3/Akt signaling pathway may be in-volved in this process .

BACKGROUND:Corneal lymphangiogenesis is beneficial to the transport of corneal antigenic materials, and accelerates the process of antigen presentation, thereby playing an important role in corneal immunity. However, due to the paral el outgrowth of corneal blood and lymphatic vessels in transplanted corneas, it is often difficult to accurately evaluate the role of corneal lymphatic vessels in allograft rejection. OBJECTIVE:To explore the development of corneal lymphangiogenesis and angiogenesis in transplanted rat corneas after the blockade of vascular endothelial growth factor C (VEGF-C). METHODS:130 rats used to establish corneal al ogenic transplantation models were equally randomized into two groups:the anti-VEGF-C group and the control group. VEGF-C was blocked in the anti-VEGF-C group by intraperitoneal injection of neutralizing monoclonal anti-VEGF-C antibody every other day for 2 consecutive weeks. Meanwhile, rats in control groups received intraperitoneal injections of saline. Corneal angiogenesis and lymphangiogenesis were characterized using whole mount immunofluorescence, and the immune rejection of the grafts was evaluated by scoring the rejection index (RI). In addition, the expression of VEGF-C was examined by real-time PCR. The relationship of corneal lymphangiogenesis and angiogenesis to RI in transplanted corneas was also characterized. RESULTS AND CONCLUSION:VEGF-C expression was markedly downregulated after VEGF-C blockade. Corneal lymphangiogenesis developed in parallel with corneal angiogenesis in the control group. While there was a mild reduction in blood vessel area (BVA) and a significant decrease in lymphatic vessel area (LVA) in the anti-VEGF-C group (P<0.05). In addition, RI was positively correlated with BVA (P<0.05) and LVA (P<0.05) in the control group. However, although RI was significantly correlated with BVA (P<0.05) in the anti-VEGF-C group, the correlation between RI and LVA was not statistically significant (P>0.05). the graft survival time in the anti-VEGF-C group was significantly increased compared with that in the control group (P<0.05). Our results show that the outgrowth of lymphatic vessels is separated from that of blood vessels in transplanted corneas by blocking VEGF-C. The blockade of VEGF-C has a significant role in preventing corneal lymphangiogenesis in corneal beds, which results in higher al ograft survival rates.

Objective To observe the effect of pulsed electromagnetic fields(PEMFs)of different daily treatment durations on biomechanical properties of femur in ovariectomized rats,so as to find out the optimal daily treatment time.Methods Fifty female Sprague-Dawley rats were randomly divided into five groups:(1)SHAM control(no PEMFs treatment),(2)OVX control(no PEMFs treatment),(3)OVX I(PEMFs treatment at 8Hz fre- quency with 3.8 mT intensity,20 min daily for 30 days),(4)OVX 11(PEMFs treatment at 8 Hz frequency with 3.8 mT intensity,40 min daily for 30 days),and(5)OVXⅢ(PEMFs treatment at 8Hz frequency with 3.8 mT in- tensity,60 rain daily for 30 days).All the rats were subject to bilateral overiectomy except those in the SHAM control group.The biomechanical properties of the femur were assessed after 30 days of PEMFs treatment.Results The values of the parameters of the biomechanical properties obtained with the OVX control group were significantly lower than those of the other 4 groups(P0.05).Conclusion PEMFs of the three different daily treatment durations can maintain the biomechanical properties of the femur in ovariectomized rats.Under certain in- tensity(3.8 mT)and frequency(8 Hz),PEMFs of the three different treatment durations can significantly maintain biomechanical properties of femur in ovariectomized rats approximately to the nomal level,but among the three groups,the difference is not significant.It was shown that exposure to PEMFs for 20 to 60 minutes daily had similar effect of maintaining biomechanical properties of the femur in ovariectomized rats.