The biophysical climate mitigation potential of riparian forest ecosystems in arid Northwest China.

Forests influence climate through both the biochemical and biophysical processes, and the impacts of the latter on local climate may be much larger than the former. However, the biophysical effects of afforestation in arid regions have received little attention compared with afforestation in the tropic, temperate and boreal zones. In this study, we combined in situ eddy covariance flux measurements from a neighboring pairs of forested and background desert sites with the decomposed temperature metric (DTM) method to characterize the impacts of arid forests on surface temperature (Ts). A clear-sky, one-dimensional planetary boundary layer (PBL) model was used to estimate the impacts of afforestation on state of regional climate. We showed that despite absorbing more net radiation (35.4 W m-2) the riparian forests tended to cool Ts (-1.28 °C) on annual basis, but with a significant seasonality. Specifically, afforestation may lead to a net cooling effect from March to September and a slightly warming effect in other months. The DTM method revealed that evapotranspiration played a dominant role in cooling surface temperature, while surface albedo (α) and incoming longwave radiation (L↓) acted together to increase forest surface temperature. From June to September, a shallower, cooler and wetter boundary layer was developed over the forest due to high plant transpiration. In other months, the PBL was slightly deeper and warmer over the forest than that over the desert. Therefore, the riparian forests were important in moderating warming trends in arid regions.

Comparison of Protein Binding Rate of DPP- 4 Inhibitor LGT- 6 in Different Species of Plasma / 中国药房

OBJECTIVE：To establish the method for determining protein binding rate of dipeptidyl peptidase- 4 inhibitor LGT- 6 in different species of plasma ，and to compare their difference. METHODS ：By equilibrium dialysis ，LGT-6（3，30，300，3 000 nmol/L）was equilibrated in rat ，monkey and human plasma （i. e. internal dialysis solution ）for 48 h，using phosphate buffer as the external dialysis solution. The concentration of LGT- 6 in internal and external dialysis solution was determined by UPLC-MS/MS using tolbutamide as internal standard ，and the plasma protein binding rate was calculated. The determination was performed on ACQUITY UPLC HSS T 3 column with water （containing 0.01％ formic acid ）-acetonitrile（containing 0.01％ formic acid ）as mobile phase at the flow rate of 0.6 mL/min. The column temperature was 40 ℃，and the sample size was 2 μL. The ion source was electrospray ion source ，and the multiple ion monitoring mode was used to carry out positive ionization scanning. The ion pairs for quantitative analysis were m/z 487.0→434.3（LGT-6），m/z 271.1→172.0（internal standard ），respectively. RESULTS ：At the concentrations of 3，30，300，and 3 000 nmol/L，the protein binding rates of LGT- 6 in rat plasma were （96.25±0.97）％，（84.16± 1.24）％，（78.25±0.61）％，（66.63±0.95）％；the protein protein binding rates in monkey plasma were （98.54±0.58）％，（87.27± 1.01）％，（79.35±0.86）％，（66.69±0.54）％；the protein binding rates in human plasma were （99.40±1.03）％，（84.48± 1.15）％，（77.62±0.77）％，（66.93±0.48）％. At the same concentration ，the protein binding rates of LGT- 6 in rat ，monkey and human plasma had no significant difference （P＞0.05）. In the same species of plasma ，there were significant differences in the plasma protein binding rates of different concentration of LGT-6 among those groups （P＜0.05），and it decreased with 才〔2016〕4015） the increase of drug concentration. CONCLUSIONS ： The method for the determination of plasma protein binding rate of LGT-6 is successfully established. The data revealed that the protein binding rate of LGT- 6 is concentration-dependent ， there was no obvious spec ies difference on protein binding rates of LGT- 6 in rat ，monkey and human plasma under the same concentration.

Study on Metabolic Stability of Foretinib Derivative LWK- 126 in Liver Microsomes of Different Species / 中国药房

OBJECTIVE：To establish the metho d for the concentration det ermination of foretinib derivative LWK- 126 in liver microsomes，and to study its metabolism stability in liver microsomes of rats ，Beagle dogs and human. METHODS ：In the in vitro incubation system of liver microsomes ，LWK-126 was dissolved in liver microsomal incubation systems of rats ，Beagle dog and human initiated by reduced nicotinamide adenine dinucleotide phosphate solution. After incubation in water at 37 ℃ for 0，5，10，20， 30 and 60 min，the reaction was terminated with acetonitrile containing internal standard （1 μg/mL tolbutamide）. UPLC-MS/MS method was applied to determine the concentration of LWK- 126 in the incubation systems. The determination was performed on Waters BEH C 18 column with mobile phase consisted of water （containing 0.1％ formic acid ）-acetonitrile（containing 0.1％ formic acid）by gradient elution at the flow rate of 0.4 mL/min. The column temperature was 30 ℃，and the sample size was 2 μL. The mass spectral analysis was performed in a positive electrospray ionization mode ，and the full MS experiment was run with the selective reaction monitoring mode with a scanning range of m/z 50→1 200. Taking the concentration of LWK- 126 at 0 min as reference，the remaining percentage and the enzyme kinetic parameters were calculated. RESULTS ：The linear range of LWK- 126 was 0.05-15 μg/mL（R 2＝0.999 2）；the lower limit of quantification was 0.05 μg/mL，and the lowest detection limit was 0.01 μg/mL. The precision，accuracy，extraction recovery and matrix effect all met the analysis requirements of biological samples. The remaining percentage of LWK- 126 in liver microsomes of human ，rats and Beagle dogs for 60 min were （33.17±4.52）％，（3.14± 6.73）％，（1.38±5.85）％；t1/2 of them were 33.15，11.76，5.62 min；the clearance rates were 38.45，118.81，245.76 μL（/ min·mg）， respectively. CONCLUSIONS ：The method for the content ； determination of LWK- 126 in liver microsomes is established successfully. The order of metabolic stability of LWK- 126 in 〔2016〕4015） liver microsomes of different species is human ＞rats＞Beagle dogs.

Stability Study of Novel Hypoglycemic Compound LSM- 13 in Rat Liver Microsomes and Its Metabolites Analysis / 中国药房

OBJECTIVE：To i nvestigate the metabolism stabilities of novel hypoglycemic compound LSM- 13 in rat liver microsomes，and to analyze the possible metabolites. METHODS ：LSM-13 was dissolved in rat liver microsome incubation system initiated by reduced nicotinamide adenine dinucleotide phosphate ，and was incubated in water at 37 ℃. The reaction was terminated with acetonitrile at 0，5，10，15，30，45 and 60 min，respectively. Using indomethacin as internal standard ，the concentration of LSM-13 in incubation system was determined by HPLC. The residual percentage and enzyme kinetic parameters of LSM- 13 were calculated at different incubation time points with the concentration of LSM- 13 incubated for 0 min as reference. UPLC-Q-TOF/MS was used to analyze and speculate the metabolites of LSM- 13 in rat liver microsomes. RESULTS ：After 60 min incubation ，the remaining percentage of LSM- 13 was（56.07±0.95）％，the half-life was 42.78 min，and the intrinsic clearance was 0.032 4 mL/（min·mg）. Compared with total ion flow diagram of rat liver microsome blank samples ，three chromatographic peaks were added in the samples incubated for 60 min；the corresponding molecular ion peaks were m/z 505.133 8，417.102 4，293.111 7 [M+H]+；the possible metabolites may be dehydrogenation ，O-debentylation and hydrolysis products of LSM- 13. CONCLUSIONS ： The compound LSM- 13 has moderate stability in rat liver microsomes ，and may undergo dehydrogenation ，O-debentylation and hydrolysis.

Inhibitory Effects of Cajanonic Acid A on 5 Kinds of Common CYP 450 Enzyme in Human Liver Microsomes in vitro / 中国药房

OBJECTIVE：To study the inhibitor y effects of cajanonic acid A on 5 kinds of cytochrome P 450（CYP）enzyme，in human liver microsomes in vitro . METHODS ：By Cocktail probe substrate method ，50.0，15.0，5.0，1.5，0.5，0.15，0.05 μmol/L cajanonic acid A were added into liver microsomes ， and incubated with mixed probe substrates [including phenacetin ， dextromethorphan，omeprazole，testosterone and toluenesulfonbutylurea （probe substrates of CYP 1A2，CYP2D6，CYP2C19， CYP3A4，CYP2C9，respectively）]. On the basis of setting up blank group and positive control group [ α-naphthalene brass ， quinidine，（+）-N-3-benzyl vanillin ，ketoconazole and sulfabendazole （specific inhibitors of CYP 1A2，CYP2D6，CYP2C19， CYP3A4，CYP2C9，respectively）]，using puerarin as internal standard ，UPLC-MS/MS method was adopted to determine the contents of corresponding metabolites （acetaminophen， dextrophane， 5-hydroxy omeprazole ， 6 β-hydroxytestosterone， hydroxytolbutamide）. The determination was performed on ACQUITY UPLC ® BEH C 18 column，with mobile phase consisted of 0.01％ formic acid aqueous solution- 0.01％ acetonitrile formic acid （gradient elution ）at the flow rate of 0.4 mL/min. The column temperature was 40 ℃，and the sample size was 2 μL. An electrospray ionization source was used to conduct positive and negative ion scanning in the multiple reaction monitoring mode. The data acquisition range was m/z 100-1 200，the collision gas was argon ， the atomized gas was nitrogen ，the gas flow rate of the cone hole was 50 L/h，the desorption gas flow rate was 800 L/h，the capillary voltage under positive and negative mode was 2.0， 1.5 kV，and the ion source temperature was 120 ℃，110 ℃， respectively. The desolvent temperature were 400 ℃ and 450 ℃ ， respectively. Non linear regression analysis was performed by using Graphpad Prism 5.0 software and IC 50 wascalculated. RESULTS ：The linear ranges of above metabolifes were 0.26-8.35，0.36-34.56，0.10-3.09, 3.67-117.37，0.15-4.88 μmol/L（R2＞0.99）. The limits of quantitation were 0.26，0.36， 0.10，3.67，0.15 μmol/L，respectively. The IC 50 values of specific inhibitors in positive control group to CYP 1A2，CYP2D6， CYP2C19，CYP3A4 and CYP 2C9 in human liver microsomes were all within the acceptable range reported in the literature. The IC50 values of cajanonic acid A to CYP 1A2，CYP2D6 and CYP 3A4 in human liver microsomes were all more than 50 μmol/L，and the IC 50 values of CYP 2C9 and CYP 2C19 were 4.94 and 18.00 μmol/L，respectively. CONCLUSIONS ：Cajanonic acid A has no inhibitory effect on CYP 1A2，CYP2D6 and CYP 3A4，but has a certain inhibitory effect on CYP 2C9 and CYP 2C19.

Study on Metabolic Differences of Cajanonic Acid A in Different Species of Liver Microsomes by UPLC-MS/MS / 中国药房

OBJECTIVE： To establish a determination method for the concentration of cajanonic acid A （CAA） in liver microsome incubation system， and to compare the metabolism characteristics of it in different species of liver microsomes. METHODS： CAA was dissolved in liver microsome incubation system of rat， Beagle dog and human initiated by reduced nicotinamide adenine dinucleotide phosphate （NADPH）， and was incubated in water at 37 ℃. The reaction was terminated with acetonitrile at 0， 5， 10， 15， 30， 45 and 60 min， respectively. Using genistein as internal standard， the concentration of CAA in  different incubation systems was determined by UPLC-MS/MS. The determination was performed on Waters BEH C18 column with mobile phase consisted of water （containing 0.1％ formic acid）-acetonitrile （containing 0.1％ formic acid） （45 ∶ 55， V/V） at the flow rate of 0.25 mL/min. The column temperature was 30 ℃， and the sample size was 2 μL. The electrospray ionization source was used to the select reaction monitoring mode for negative ion scanning. The ion pairs for quantitative analysis were m/z 353.14→309.11 （CAA）， m/z 269.86→224.11 （internal standard） respectively. The residual percentage and enzymatic kinetic parameters of CAA in different incubation systems were calculated according to the mass concentration of CAA at 0 min. RESULTS： The linear range of CAA was 0.05-20 μg/mL； the limit of quanti- tation was 0.05 μg/mL， and the lowest detection limit was 0.01 μg/mL. RSDs of intra-day and inter-day were lower than 10％； relative errors ranged －4.83％-8.94％； extraction method and matrix effect did not affect the determination of the substance to be measured. At 60 min of incubation， residual percentages of CAA in rat， Beagle dog and human liver microsomes were（62.79±9.99）％，（64.07±11.59）％，（96.66±5.71）％， respectively. The half-life period （72.19， 68.61 min） of CAA in rat and Beagle dog liver microsomes were significantly shorter than human liver microsome （364.74 min）. The clearance rates [0.019 2， 0.020 2 mL/（min·mg）] were significantly higher than human liver microsome [0.003 8 mL/（min·mg）] （P＜0.05）. CONCLUSIONS： Established UPLC-MS/MS method is simple， rapid， specific and sensitive， and can be used for the determination of CAA concentration in liver microsome incubation system and the study of metabolism stability in vitro. The stability of CAA metabolism in rat and Beagle dog liver microsomes are poorer than human liver microsome.

Study on Plasma Protein Binding Rate of Cajanonic Acid A with Different Species of Plasma by Ultrafiltration Combined with UPLC-MS/MS / 中国药房

OBJECTIVE： To compare plasma protein binding rate of cajanonic acid A with different species of plasma. METHODS：Using UPLC-MS/MS as the detection means. Plasma protein binding rate of low， medium and high concentrations of cajanonic acid A （2.5， 5， 20 μg/mL） with rats， rabbits and human plasma were determined by ultrafiltration method. The chromatographic conditions included that Waters BEH C18 as chromatographic column， WatersVanGuard BEH C18 as guard column， mobile phase consisted of ultrapure water solution containing 0.01％ formic acid （solvent A） and acetonitrile solution of 0.01％ formic acid （solvent B） gradient elution， at the flow rate of 0.15 mL/min， column temperature of 30 ℃， sample size of 2 μL. Mass spectrum condition included that ESI， negative ion mode acquisition， capillary voltage of 1.5 kV， cone voltage of 30 V， ion source temperature of 100 ℃， desolvent gas temperature of 400 ℃， cone gas flow of 50 L/h， desolvent gas flow of 800 L/h， scanning range of m/z 50→1 200. RESULTS： At the concentration of 2.5， 5 and 20 μg/mL， the plasma protein binding rates of cajanonic acid A were （75.63±0.90）％， （98.30±0.03）％ and （99.42±0.01）％ in the rats plasma； （79.61±1.08）％， （98.48±0.10）％ and （99.42±0.03）％ in rabbits plasma （n＝3）； （76.74±1.22）％， （97.99±0.11）％ and （99.37±0.01）％ in human plasma （n＝3）. At the concentration of 2.5 μg/mL， plasma protein binding rates of cajanonic acid A in plasma of rats and human were significantly lower than that in plasma of rabbits （P＜0.05）. CONCLUSIONS： The plasma protein binding rate of 5，20 μg/mL cajanonic acid A with rats， rabbits and human plasma are higher than that of 2.5 μg/mL cajanonic acid A. There is significant difference in plasma protein binding rate of 2.5 μg/mL cajanonic acid A with different species of plasma，and there is no significant difference in plasma protein binding rate of 5， 20 μg/mL cajanonic acid A with different species of plasma.

Effect of Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina on scapulohumeral periarthritis / 针灸推拿医学（英文版）

Objective: To investigate the effect of Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina on scapulohumeral periarthritis (SP). Methods: A total of 30 cases with SP were randomized into an observation group and a control group. Those in the observation group practiced Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina therapy; whereas those in the control group received only tuina therapy. Tuina therapy was conducted every other day, 20 min every time for 1 month and Yi Jin Jing (Sinew-transforming Qigong Exercises) was conducted once a day for 1 month. The therapeutic effects were assessed by visual analogue scale (VAS) and Constant-Murley scale. Results: After treatment, the VAS score and Constant-Murley scale were substantially improved, showing statistical significances (P<0.01); the Constant-Murley scale in the observation group was better than that in the control group, showing a statistical significance (P<0.01); the effective rate in the observation group was higher than that in the control group, between-group comparison showed a statistical significance (P<0.01). Conclusion: Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina and tuina alone have a verified effect in treating SP, and the former can achieve a better effect than the later.

Effect of heat-sensitive moxibustion on facial function score in patients with facial paralysis / 针灸推拿医学（英文版）

Objective:To observe and compare the therapeutic efficacies of heat-sensitive moxibustion plus Western medication, dry Western medication, and acupuncture plus TDP in treating peripheral facial palsy (FP). Methods:Ninety FP patients were randomized into a Western medication group, a heat-sensitive moxibustion group, and an acupuncture group by using sealed envelope, 30 cases in each group. The Western medication group was intervened by conventional Western medication; the heat-sensitive moxibustion group was by heat-sensitive moxibustion in addition to the same Western medication; the acupuncture group was by the Western medication plus acupuncture and TDP radiation. For the three groups, 6-day treatment was taken as a treatment course, with a 2-day interval between 2 courses, and totally 4 treatment courses were observed. Results: After intervention, the modified Portmann scores were changed significantly in the three groups (P<0.05), and the improvements in the heat-sensitive moxibustion group and the acupuncture group were both superior to that in the Western medication group. The recovery plus markedly effective rate of the acupuncture group was significantly different from that of the Western medication group (P<0.05), and there was a significant difference in comparing the recovery plus markedly effective rate between the heat-sensitive moxibustion group and acupuncture group (P<0.05). Conclusion: Heat-sensitive moxibustion is effective in treatment peripheral facial paralysis, and this method is free of pain, causing no adverse reactions, and worth promotion in clinic.

The effectiveness evaluation of helicopter emergency medical services on transporting critical patients / 中华急诊医学杂志

Objective To explore the advantages and disadvantages of helicopter emergency medical services of South China in the long-distance transport for critical patients.Methods A total of 30 patients who received helicopter emergency medical services by Guangdong Generral Hospital from August 2004 to December 2014 were selected as the observation group,and the other 30 patients with similar conditions who received ground emergency medical services were selected as the control group.To analyses the difference between the two groups in the disease,transport distance,transportation time,costs and compliction by χ2-test,t-test and nonparametric test according types of data.Results There were significantly difference between two groups in transport distances (km) [578.0 (313.0,707.5)vs.214.5 (101.5,313.5),P 0.05).Conclusions Helicopter emergency medical services could shorten the transportation time of critical patients on long distance transportation,and improve the efficiency of first-aid.However,there were many disadvantages that need to be improved in the helicopter emergency medical service of China.

The effect of hypertonic saline on notch signaling pathway in experimentally induced cerebral ischemic rats / 中华急诊医学杂志

Objective To explore whether hypertonic saline would partake in regulating Notch signaling in microglia in experimentally induced cerebral ischemic rats.Methods Male SD rats were randomly divided into sham group, cerebral ischemia group, normal saline group ( NS group ) , 10%hypertonic saline group (10%HS group) , the model of cerebral ischemia were established in all rats except the sham group by using middle cerebral artery occlusion ( MCAO) .After 2 hours of MCAO, the rats were through reperfusion for 24 h.In addition, rats in the normal saline group and 10% HS group were respectively treated with a continuous intravenous injection of normal saline (0.3 mL/h) and 10%HS (0.3 mL/h) by tail vein for 24 h.Immunofluorescence methods, RT-PCR and Western blot were used to detect the expression of Notch1 and intracellular Notch receptor domain ( NICD) .All data was analyzed by one-way analysis of variance ( ANOVA) , The intergroup comparisons were analyzed by the least-significant-difference (LSD) tests.Differences were considered statistically significant if P<0.05.Results Immunofluorescence showed that the expression of Notch1 and NICD were significantly increased in the microglia around peri-ischemia area in cerebral ischemia group and normal saline group compared to sham group;the expression of Notch1 and NICD in the microglia around peri-ischemia area were significantly reduced in 10% HS group compared to ischemia group and NS group.RT-PCR showed that the mRNA expression of Notch1 was significantly increased in ischemia group and NS group compared to sham group ( sham group: 1.000 ± 0.076; ischemia group: 2.203 ±0.283; NS group: 1.616 ±0.185; P <0.01 ); however, it was significantly reduced in 10% HS group compared to ischemia group and NS group ( ischemia group:2.203 ±0.283; NS group: 1.616 ±0.185; 10%HS group: 1.202 ±0.177; P <0.05 ) .Western blot showed that the protein expression of Notch1 was significantly increased in ischemia group and NS group compared to sham group ( sham group: 0.290 ±0.079; ischemia group: 0.750 ±0.029; NS group:0.765 ±0.182;P<0.01);but was significantly reduced in 10%HS group compared to ischemia group and NS group ( ischemia group:0.750 ±0.029; NS group:0.765 ±0.182;10%HS group:0.390 ±0.195;P<0.05 ) .The protein expression of NICD was significantly increased in ischemia group and NS group compared to sham group ( sham group: 0.401 ±0.196; ischemia group: 0.906 ±0.359; NS group:0.847 ±0.153;P<0.01);but was significantly reduced in 10%HS group compared to ischemia group and NS group ( ischemia group:0.906 ±0.359; NS group:0.847 ±0.153;10%HS group:0.561 ±0.165;P<0.05 ) .Conclusion Our results suggest that HS markedly suppresses Notch signaling in microglia around the ischemia tissue area in experimental induced cerebral ischemic rats.

Clinical observation on acupuncture combined with Chinese medicine and rehabilitation training for subacute stroke patients / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of combining acupuncture, Chinese medicine and rehabilitation training for subacute stroke. Methods:A total of 120 subacute stroke cases were randomly allocated into a treatment group (n=60) and a control group (n=60). Patients in the control group received standard rehabilitation therapy alone, whereas patients in the observation group received additional acupuncture and Chinese medicine. Before treatment, after 30-day and 60-day treatments, and 3 months after treatment, the neurologic deficit severity was evaluated using the National Institute of Health stroke scale (NIHSS); the motor function was evaluated using the Fugl-Meyer assessment scale (FMA); the activities of daily living (ADL) was evaluated using the Barthel index (BI); and the changes of traditional Chinese medicine (TCM) symptoms were evaluated according to TCM symptom scores. Results:After 30-day, 60-day treatments, and 3 months after treatment, the NIHSS, FMA, BI and TCM symptoms scores were statistically different from those before treatment in both groups (allP<0.05); and there were between-group statistical differences at same time points (allP<0.05). Conclusion:Combining acupuncture, Chinese medicine and rehabilitation training can improve neurologic deficit, motor function and ADL in subacute stroke patients and its efficacy is better than rehabilitation therapy alone.

Effects and its mechanisms of hypertonic saline hydroxyethyl starch 200/0.5 solution in rats with ischemic cerebral edema / 中华急诊医学杂志

Objective To investigate effects and its mechanisms of hypertonic saline hydroxyethyl starch 200/0.5 solution on intracranial pressure and brain water content in rats with ischemic cerebral edema.Methods All experiments were conducted in the animal experimental center of Sun Yat-sen University.The 28 male Sprague-Dawle (SD) rats were randomly (random number) divided into hypertonic saline hydroxyethyl starch group,hydroxyethyl starch group,control group and sham operation group,each n =7.Ischemic cerebral edema model was reproduced by middle cerebral artery occlusion (MCAO),followed by reperfusion after ischemia for 2 hours (If the moldel was not successful,other rats were operated to fill the missing models).Then reperfusion after ischemia 2 hours and received hypertonic saline hydroxyethyl starch and hydroxyethyl starch via tail vein at the beginning of reperfusion.The colloidal osmotic pressure (COP) and intracranial pressure (ICP) were evaluated on 0,2,6,12,18,24 hours after the surgery.The water content of the right hemisphere was measured on 24 h after the surgery.Results The ICP of hypertonic saline hydroxyethyl starch group,hydroxyethyl starch group and control group were significantly higher than that of sham operation group on 2,6,12,18,24 h after the surgery.The ICP of hypertonic saline hydroxyethyl starch group was significantly lower than those of hydroxyethyl starch group and control group on 2,6,12,18 and 24 h.But there was no significant difference in ICP of the hydroxyethyl starch group compared with that of control group at all time points.The COP of hypertonic saline hydroxyethyl starch group and hydroxyethyl starch group were significantly higher than the control group and sham operation group at each time point; There was no significant difference in COP (mmHg) of the hydroxyethyl starch group compared with that of hypertonic saline hydroxyethyl starch group at all time points.The brain water content (BWC) of hypertonic saline hydroxyethyl starch group,hydroxyethyl starch group and control group were significantly higher than that of sham operation group on 24 hours after the surgery [(81.24±0.36)％,(83.04±0.10)％,(83.14±0.41)％ vs.(78.37±0.37)％,all P=0.000],BWC of hypertonic saline hydroxyethyl starch group lower than these of hydroxyethyl starch group [(81.24±0.36)％ vs.(83.04 ±0.10) ％,P =0.000] and control group [(81.24 ±0.36)％ vs.(83.14 ±0.41) ％,P =0.000].There was no significant difference in BWC of the hydroxyethyl starch group compared with that of control group [(83.04 ± 0.10) ％ vs.(83.14 ± 0.41) ％,P =0.578].Conclusion Hypertonic saline hydroxyethyl starch solution could significantly ameliorate ischemic cerebral edema and reduce ICP,but the relationship between its elevated COP and reduced ICP has not been confirmed.

Clinical Observation of Chinese Herbal Fumigation plus Mulberry Stick Beating for Heel Pain / 针灸推拿医学（英文版）

Objective:To observe the clinical efficacy of Chinese herbal fumigation plus beating with mulberry stick in treating heel pain. Methods: Sixty patients with heel pain were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by Chinese herbal fumigation plus beating with mulberry stick, and the control group was by orally taking Diclofenac Sodium Sustained Release Tablets plus external use of She Xiang Zhen Tong Gao (Moschus Analgesic Plaster). After one treatment course, the visual analogue scale (VAS) was used to observe the change of pain, and the clinical efficacies were also evaluated. Results: After intervention, the improvement of VAS score in the treatment group was more significant than that in the control group (P Conclusion:Chinese herbal fumigation plus beating with mulberry stick can produce a higher clinical efficacy than orally taking Diclofenac Sodium Sustained Release Tablets in treating heel pain.

Tuina plus Ultrasonic Therapy for Infantile Muscular Torticollis / 针灸推拿医学（英文版）

Objective:To observe the clinical efficacy of tuina plus ultrasonic therapy in treating infantile muscular torticollis. ＜br> Methods:Seventy kids with muscular torticollis were intervened by tuina plus ultrasonic therapy, and the efficacy was evaluated after 8-month treatment. ＜br> Results: After 8-month treatment, 41 subjects were cured, accounting for 58.6%, 27 were improved, occupying 38.6%, 2 failed, occupying 2.8%, and the total effective rate was 97.2%. ＜br> Conclusion: Tuina plus ultrasonic therapy can produce a significant efficacy in treating infantile muscular torticollis, without adverse effects.

Significance of the ratio of plasma vascular endothelial growth factor level to platelet count in the prognosis of patients with sepsis / 中华危重病急救医学

Objective To investigate the clinical value of the ratio of plasma vascular endothelial growth factor level to platelet count (VEGF/PLT) in predicting 28-day prognosis in patients with sepsis.Methods A prospective cohort study was conducted.From September 2009 to March 2013,164 sepsis patients in Intensive Care Unit (ICU) of Guangdong General Hospital were included for study.Patients with age younger than 18 years old,the illness already reaching final stage of chronic diseases,suffering from two or more organs dysfunction within 3 days,acute pancreatitis without infection,or less than 28 days of expected survival time were excluded.Finally,135 patients were included in the further analysis.Peripheral blood samples were collected at admission.Routine blood tests were done,and then VEGF levels in plasma were measured by enzyme linked immunosorbent assay (ELISA).Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores were recorded every day for 7 days.Patients' prognosis was assessed during the following 28 days.The patients were divided into 28-day survival group and non-survival group.Comparison between two groups was done by single factor analysis.Spearman rank correlation was used to analyze the correlation between VEGF levels and PLT.Mutivariate logistic regression analysis was performed to identify the independent risk factor for 28-day prognosis.Receiver operating characteristic curve (ROC curve) was plotted,and the effect of related indexes on predicting 28-day survival was evaluated by area under ROC curve (AUC).Results There were no significant differences in VEGF (ng/L:471.73 ± 198.34 vs.383.49 ± 266.54,t=-1.918,P=0.057),PLT (× 109/L:220.40±127.60 vs.246.42± 100.72,t=1.275,P=0.204),leucocyte counts (× 109/L:12.48 ±4.62 vs.13.70 ±5.97,t=1.063,P=0.292),mean arterial pressure [mmHg (1 mmHg=0.133 kPa):86.50 ± 12.04 vs.91.03 t 13.10,t=1.557,P=0.123] and blood lactic acid (mmol/L:1.79 ± 1.30 vs.1.50 ± 0.60,t=-1.768,P=0.079) at admission between the non-survival group (n=42) and survival group (n=93).VEGF/PLT (2.59 ± 1.44 vs.1.73 ± 1.13,t=-3.756,P=0.000) as well as APACHE Ⅱ scores (15.50 ± 4.50 vs.13.28 ± 4.61,t =-2.022,P=0.045) of the non-survival group were significantly higher than those of survival group,and oxygenation index (PaO2/FiO2) of the non-survival group was significantly lower than that of survival group (kPa:32.38 ± 11.12 vs.37.04 ± 10.97,t=2.278,P=0.024).Correlation analysis showed that the concentration of VEGF was positively correlated with PLT (r=0.271,P=0.001).It was shown by multivariate logistic regression analysis that only VEGF/PLT was the independent risk factor in predicting 28-day prognosis in patients with sepsis [odds ratio (OR) was 1.591,95％ confidence interval (95％CI) 1.164-2.175,P=0.004].AUC of VEGF/PLT was 0.704 ± 0.047 (P=0.000,95％CI:0.611-0.797) for predicting 28-day survival.The optimal cut-off point was 1.32,and the sensitivity and specificity were 81.0％ and 48.4％,respectively.Conclusion VEGF/PLT can be used as one of the indicators to predict 28-day survival in patients with sepsis.

Analysis of the characteristic changes in cerebral infarction and cerebral edema induced by middle cerebral artery occlusion in rats / 中华急诊医学杂志

Objective To investigate the characteristic changes in cerebral infarction and brain edema. Method A total of 122 Healthy adult male Spraque-Dawley rats were randomly (random number) divided into three groups: normal group ( n = 12), sham operated group (n=12) and cerebral ischemia group ( n = 98). Cerebral infarction and brain edema were induced by a permanent occlusion of right middle cerebral artery (POM-CA) with ligature. According to the duration of POMCA, the rats of cerebral ischemia group were further divided into seven sub-groups, 2 h, 4 h, 6 h, 12 h, 18 h, 24 h and 30 hours. The hemispheric ratio was detected by staining with 2% 2,3,5-triphenyltetrazolium chloride solution, and brain water content was assayed by dry/wet ratio 2 h, 4 h, 6 h, 12 h, 18 h, 24 h and hours after POMCA. Results There was a focal cerebral infarction in the rats of cerebral ischemia group 4 hours after POMCA. There was no significant difference in hemispheric ratio between 4 hours and 6 hours after POMCA by One-way ANOVA (P = 0.091). Compared with 6 h sub-group, the hemispheric ratio increased significantly in 12 h, 18 h, 24 h and 30 h sub-groups (P < 0.01), and the peak was in the 24 h sub-group. The brain water content began to increase 4 hours after POMCA and aggravated 6 hours later, and reached the peak 24 hours after POMCA. The brain water content of the non-ischemic hemisphere increased 18 h,24 h and 30 hours after POMCA. Furthermore, there was a significant correlation between the hemispheric ratio and brain water content ( r = 0.834, P < 0.01). Conclusions The critical point of cerebral infarction and brain edema aggravated is 6 hours after POMCA. Both brain edema and cerebral infarction reach the most serious degree 24 hours after POMCA. It is an important experimental evidence for evaluating the milieu conducive to the pathogenesis, and choosing the suitable time window for the treatment of cerebral infarction and brain edema.