Objective To investigate the clinical effect of Shenfu injection in the treatment of patients with post - cardiac arrest syndrome(PCAS),to analyze the patients' blood C - reactive protein (CRP) and early mean arterial pressure. Methods From September 2013 to September 2016,80 patients with PCAS in the No. 98 Hospital of PLA were randomly divided into study group and control group according to the digital table,with 40 cases in each group. The study group was treated by Shenfu injection,the control group was treated by saline. The changes of CRP,mean arterial pressure and GCS score at 4h,12h,1d,2d and 3d after resuscitation and the 90d survival rate were observed. Results At 4h,12h,1d,2d and 3d after resuscitation,the peripheral blood CRP levels in the study group were (22. 01 ±2. 16)mg/ L,(34. 68 ± 4. 95)mg/ L,(62. 51 ± 3. 68)mg/ L,(98. 65 ± 6. 57)mg/ L,(100. 67 ± 10. 03)mg/ L, respectively,which in the control group were (25. 16 ± 3. 54)mg/ L,(41. 52 ± 5. 31)mg/ L,(75. 09 ± 4. 58)mg/ L, (120. 48 ± 10. 61)mg/ L,(128. 26 ± 9. 64)mg/ L,respectively,there were statistically significant differences between the two groups(t = 4. 804,5. 959,13. 542,11. 063,12. 543,all P < 0. 01). At 4h,12h,1d,2d and 3d after resuscita-tion,the mean arterial pressure in the study group were (78. 03 ± 8. 65)mmHg,(88. 34 ± 10. 20)mmHg,(97. 05 ± 9. 57)mmHg,(105. 29 ± 10. 45)mmHg,(112. 14 ± 9. 46) mmHg,respectively,which were higher than those in the control group [(68. 21 ± 8. 03)mmHg,(74. 01 ± 10. 59) mmHg,(83. 09 ± 11. 25) mmHg,(98. 25 ± 9. 17) mmHg, (104. 68 ± 3. 14)mmHg](t = 5. 262,6. 164,5. 978,3. 203,4. 733,all P < 0. 01). At 4h,12h,1d,2d and 3d after resuscitation,the GCS scores of the study group were (5. 21 ± 1. 12) points, (5. 78 ± 2. 05) points, (6. 85 ± 1. 68)points,(7. 91 ± 2. 57)points,(9. 98 ± 2. 07) points,respectively,which were higher than those of the control group [(4. 01 ± 2. 14) points, (4. 22 ± 3. 75) points, (4. 39 ± 3. 89) points, (4. 41 ± 2. 86) points, (5. 06 ± 4. 14)points](t = 3. 142,2. 309,3. 672,5. 757,6. 723,all P < 0. 05). The survival rate of the study group was 50％(20 / 40) at 90d after resuscitation,which was higher than that of the control group [23％ (9 / 40)](χ2 = 6. 545,P =0. 011). Conclusion Shenfu injection has protective effect on the function of patients with CRP after surgery,and can improve the prognosis of patients,it is worthy of clinical use.

The main contents of doctor - patient consensus, including that the history of human diseases is much earlier than the history of medical science; in the process of medical progress, diseases are also constantly e-volving; people generally pay more attention to medicine and have prejudice to the disease; doctors focus more on"diseases" while what patients feel is"sickness"; the power of medicine is always limited and the evolution of dis-ease is infinite. On this basis,this paper analyzed the obstacles in the formation process of doctor - patient consensus and put forward the improvement countermeasures from the angle of doctor, patient and society respectively.

The scenario simulation teaching method created a novel teaching mode for medical ethics and explored the new methods to enhance the teaching level.Through 6-year practice teaching,the authors made a comprehensive summary,refined the process,and resolved the existing problems.Several experiences gained in the process.The form of scenario simulation is novel,which is loved by the students.It is helpful to achieve the teaching goal that class should be led by students,cultivate medical students' humanistic quality,and make teaching benefits teachers as well as students.

This paper analyzed the main cause of the alienation of doctor-patient trust,the poor complaint channels of medical dispute,the lack of credibility for medical and judicial authentication,citizens' consciousness and other medical violence.Aiming at medical violence,we should popularize the concept of law firstly.Secondly,we should revise and perfect the act of medical violence,and promote the institutionalization of handling medical disputes.Then,we should strengthen the construction of physicianprofessionalism and perfect the medical identification.Third,we should strengthen the construction of mediation mechanism and import medical liability insurance appropriately.

AIM: To observe the effect of osthole on tricalcium phosphate (TCP) particles-induced calvarial osteolysis in vivo.METHODS:Male ICR mice were randomly divided into sham group , TCP group and osthole group .A mouse calvarial model of osteolysis was established by TCP particles .On the second postoperative day , osthole (20 mg/kg) was locally injected into the calvarium under the periosteum 3 times a week.Two weeks after osthole treatment , blood and calvaria were collected to determine the level of bone turnover markers such as alkaline phosphatase ( ALP) , osteocalcin and tartrate-resistant acid phosphatase ( TRACP) .The periosteum was performed to examine the release of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and IL-1βby ELISA.The calvaria was obtained for histological and molecular analyses.RESULTS:Data from HE and TRACP staining revealed that osthole prevented TCP particles-induced obvious increase in osteoclastogenesis and resorption area in the metaphysis of mouse calvaria .Osthole treatment increased ALP ac-tivity and osteocalcin level , and dncreased the activity of TRACP in the mouse serum compared with TCP group .Further-more, TCP particles-induced the releases of TNF-α, IL-6 and IL-1βwere significantly suppressed by osthole treatment .In addition, Western blot demonstrated that endoplasmic reticulum ( ER) stress markers such as glucose-regulated protein 78 (GRP78) and CAAT/enhancer binding protein homologous protein (CHOP) were significantly up-regulated in TCP parti-cles-implanted calvarial mice , indicating that TCP particles triggered an ER stress response in the mouse calvarial osteolysis model , which obviously attenuated by osthole .CONCLUSION:Osthole inhibits TCP particles-induced calvarial osteolysis in mice, which is mediated by inhibition of ER stress signaling pathway .

Objective To evaluate the synchrony of heart after catheter-based renal denervation by two dimensional speckle tracking imaging.Methods Each renal sympathetic nerve of 20 dogs were ablated,and the index of heart and blood pressure were detected 6 weeks later.Standard 2D images were acquired in the 2-,3-and 4-apical views.The times from QRS onset to peak-systolic strain rate and to peak-diastolic strain rate were measured for the longitudinal 16-segments in Qlab software,and the standard deviation were calculated.The time to peak longitudinal strain rate and time to peak contraction strain rate of left atrium were measured for each segment contained septal,latera,anterior and posterior in the level of the basal segments,middle sections and apical in Qlab software,and the standard deviation were calculated.Parameters were compared among the before and after of the ablation.Results The systolic pressure and diastolic pressure had no changes after the ablation of renal sympathetic nerve (P ＞ 0.05).The R-R showed a increasing trend,but no significant differences(P ＞0.05).The peak time of LV systolic and diastolic strain rate had a extended trendency too,but no differences(P ＞0.05),and standard deviations of the peak times had no significant differences(P ＞0.05).The peak time of LA longitudinal strain rate and contraction strain rate had a extended trendency,but no obvious change (P ＞0.05),and the standard deviations of the peak times had no significant differences (P ＞0.05).The size of the heart cavity had no differences(P ＞0.05).Conclusions The systolic pressure and diastolic pressure have no changes after the ablation of renal sympathetic nerve,and the synchrony parameters of LV and LA have no significant differences,demonstrate that the synchrony of heart is not affected by the renal sympathetic denervation.

The tumor multidrug resistance reversal effect of NPB304, a novel taxane, was studied. MTT assay was used to determine the IC50 of chemotherapy drugs. Western blotting assay was applied to analyze the expression of P-glycoprotein (P-gp). The effect of compounds on the P-gp function and P-gp ATPase activity was determined by rhodamine 123 (Rh123) accumulation assay and analysis kit, respectively. Molecular docking was employed to predict the binding force between compounds and P-gp. Transmembrane transport of NPB304 was analyzed using MDCK II and MDR1-MDCK II cell model. NPB304 displayed multidrug resistance reversal effect on KBV cells and MCF-7/paclitaxel cells, NPB304 collaborative with P-glycoprotein (P-gp) inhibitors verapamil enhanced the reversal activity, specifically, 10 μmol x L(-1) verapamil in combination with paclitaxel reversed resistance by 56.5-fold, while combined with NPB304 increased the reversal fold; NPB304 synergistically increased Rh123 accumulation in the resistant cells when combined with verapamil, and NPB304 at 0-1 μmol x L(-1) enhanced the ATPase activity activated by verapamil was observed. NPB304 existed the hydrophobic interactions with the TM regions of P-gp, and the binding force between NPB304 and the A chain of the TM region was stronger. P-gp ATPase activity assay demonstrated NPB304 at lower concentrations (0-1.5 μmol x L(-1)) could activate the P-gp ATPase, playing a role on inhibition of P-gp function. However, NPB304 did not have an obvious feature of P-gp substrate. NPB304 exerted itself and synergy with verapamil activity on reversing tumor resistance via inhibiting the P-gp function.

In the study, we used oil palm residues (empty fruit bunch, EFB) as raw material to produce cellulosic ethanol by pretreatment, enzymatic hydrolysis and fermentation. Firstly, the pretreatment of EFB with alkali, alkali/hydrogen peroxide and the effects on the components and enzymatic hydrolysis of cellulose were studied. The results show that dilute alkali was the suitable pretreatment method and the conditions were first to soak the substrate with 1% sodium hydroxide with a solid-liquid ratio of 1:10 at 40 degrees C for 24 h, and then subjected to 121 degrees C for 30 min. Under the conditions, EFB solid recovery was 74.09%, and glucan, xylan and lignin content were 44.08%, 25.74% and 13.89%, respectively. After separated with alkali solution, the pretreated EFB was washed and hydrolyzed for 72 h with 5% substrate concentration and 30 FPU/g dry mass (DM) enzyme loading, and the conversion of glucan and xylan reached 84.44% and 89.28%, respectively. We further investigated the effects of substrate concentration and enzyme loading on enzymatic hydrolysis and ethanol batch simultaneous saccharification and fermentation (SSF). The results show that when enzyme loading was 30 FPU/g DM and substrate concentration was increased from 5% to 25%, ethanol concentration were 9.76 g/L and 35.25 g/L after 72 h fermentation with Saccharomyces cerevisiae (inoculum size 5%, V/V), which was 79.09% and 56.96% of ethanol theory yield.
Alkalies ; chemistry ; Biofuels ; Ethanol ; metabolism ; Fermentation ; Lignin ; chemistry ; Palm Oil ; Plant Oils

Objective To evaluate the security of catheter-based renal denervation by two dimensional speckle tracking imaging.Methods 20 dogs was ablated,whose indicies of heart and blood pressure were detected 6 weeks later.Standard 2D images were acquired in the 2-,3-and 4-apical views as well as the parasternal short-axis views at the level of the mitral valve and papillary muscles.The time to peak-systolic strain of each segment in the level of the mitral valve and papillary muscles,the standard deviation of the time to peak-systolic strain,the peak strain of the longitudinal 12-segment were recorded.Parameters were compared among the before and after ablation.Results Compared with before ablation of renal sympathetic nerve,the systolic pressure and diastolic pressure didn't reduced significantly after the ablation of renal sympathetic nerve (P ＞ 0.05),while there were no significant difference in the peak strain of the longitudinal 12-segment,the dyssychrony parameters and the size of the heart cavity before and after ablation(P ＞0.05).Conclusions The pressure had no change after the ablation of renal sympathetic nerve while without harmful effect on the the size of the heart cavity,the function of the myocardial contraction and the dyssychrony parameters.The ablation of renal sympathetic nerve can' t lower the normal blood pressure and be safe for heart at the same time.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) are few in bone marrow, and they are easily mingled with other cells, especially red blood cells. Therefore, intervention needs to be depleted in the process of isolation of red blood cells so as to obtain highlypurified BMSCs as many as possible.OBJECTIVE: To isolate and culture BMSCs of rats with red blood cell lysis method, and perform biological identification.DESIGN: Observation and controlled trial.SETTING: Laboratory of Aerospace Cell Molecular Biology, Scientific Research Training Center for Chinese Astronauts.MATERIALS: Fifty 30-day-old male SD rats, weighing about 100 g, of SPF degree, were purchased from Beijing Experimental Animal Center (License No. SCXK (Jing) 2002-0003) and involved in this trial. DAB condensed chromogen (hydrogen dioxide included, Zhongshan Company), rabbit anti-ret polyclonal antibody (Boster Co.,Ltd., Wuhan), fetal calf serum (PAA, Austria) and LG-DMEM medium (Sigma Company, USA) were used in this trial.METHODS: This trial was carried out in the Laboratory of Aerospace Cell Molecular Biology, Scientific Research Training Center for Chinese Astronauts during September 2004 to September 2005. The rats were sacrificed by dislocation to expose bone marrow cavity. Cell suspension was collected. BMSCs were isolated and cultured primarily by whole bonemarrow culture method. ① Red blood cells lysis test: A, B, C and D 4 tubes were chosen and filled with 0.5 mL bonemarrow rinse solution which was filtered and fully beat upon. Then, red blood cell lysis buffer of 2 mL, ammonium chloride of 2 mL, phosphate buffer normal saline of 2 mL and 0.04 volume fraction acetic acid of 0.5 mL were correspondingly added into the 4 tubes. In each tube, absorbance and hemoglobin concentration were measured and cell growth was observed. ② Observation of growth curve, doubling time and surface marker molecule expression of BMSCs: Based on the formula, population doubling time (TD) =t[lg2/(lgNt-lgN0)] (NO and Nt represented the cell number after inoculation and t hours after culture ,respectively), cell population doubling time was calculated and traced and growth curve of the 2nd, 4th and 6th generations of BMSCs were analyzed; The proliferation of BMSCs was measured by methylene blue staining method; Surface marker molecule expression of BMSCs was detected with immunocytochemical staining.MAIN OUTCOME MEASURES: ①Observation of isolation and culture of bone marrowmesenchymal stems of rats. ②Effect of different methods on the lysis of red blood cells and the growth of BMSCs. ③ The growth curve and cell doubling time of the 2nd, 4th and 6th generations of cells. ④Surface marker molecule expression of BMSCs of rats.RESULTS: ① Results of isolation and culture of BMSCs of rats: After 48-hour primary culture, most of the cells had adhered to the wall, and 72 hours later, division growth of the adherent cells presented. Seven to eight days later, cell colonies formed obviously, and then increased quickly, expanded incessantly and fused with each other. On 14 to 16 days, cell clones grew densely. Immediately generative cells presented ball-shape, subsided and adhered the wall verysoon. Some few round cells suspended. Adherent cells distributed evenly and proliferated quickly within 3 to 5 days. Although cell morphology of generative cells did not change after passage, cell proliferation was speeded up obviously and cells covered the bottom of the whole bottom on about 6 days. ② Effect of different methods on red blood cell lysis and the growth of BMSCs: hemoglobin concentration in the red blood cell lysate-treated group, ammonium chloride-treated group and 4％ acetic acid-treated group was significantly higher than that in the phosphate buffer normal saline-treated group, with significant difference (P ＜ 0.01). ③ Observation of growth curve of different generations of BMSCs: The growth curves of the 2nd, 4th and 6th generations of the cells were basically the same: latent period about 1 to 2 days, then logarithmic growth phase, peak on the 5th day and finally plateau phase (about on the 5th to 7th days). The latent period of the 6th generation of BMSCs was not obvious and the population doubling time of BMSCs was about 34 hours. ④ldentification of immunophenotype of different generations of BMSCs: Both CD44 and CD106 staining of each generation of cells were positive, presenting brown granule sediments, and CD34 staining was negative.CONCLUSION: Inoculation of red blood cells lysate-treated bone marrow rinse solution can boost the adherent rate of BMSCs, and does not influence its post-adherent growth, so it is a feasible separation method. Cell surface marker staining confirms that thecells isolated in this study are BMSCs.