Effect of Xin-Gui Gel Plaster on Peripheral Neuropathy in Diabetic Rats / 中药新药与临床药理

Objective To observe the effects of Xin-Gui Gel Plaster(Cinnamomi Cortex,Asari Radix et Rhizoma,Euodiae Fructus,Chuanxiong Rhizoma,Borneolum Syntheticum)on peripheral neuropathy in diabetic rats.Methods A single intraperitoneal injection of 1%streptozotonic(STZ,35 mg·kg-1)was used to replicate a type 2 diabetes mellitus(T2DM)rat model followed by the induction of diabetic peripheral neuropathy(DPN)in combination with a long-term(8 consecutive weeks)high-fat and high-sugar diet.SD rats were randomly divided into normal group,model group,Mecobalamin group and Xin-Gui Gel Plaster group,with 6 rats in each group.The rats in the Xin-Gui Gel Plaster group were given Xin-Gui Gel Plaster at acupoints once a day for 8 weeks;the rats in the Mecobalamin group were given Mecobalamin solution by gavage(0.045 mg·kg-1),and the rats in the normal group and the model group were given physiological saline by gavage.Body mass and fasting blood glucose(FBG)were measured at weeks 2,4,6 and 8;the latency of thermal withdrawal latency(TWL)was measured at weeks 4 and 8;nerve conduction velocities,including motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV),were measured at week 8;and serum total cholesterol(TC),triglyceride(TG),fasting blood glucose(FBG)were measured using a fully automated biochemical analyzer.Fasting insulin(FINS)levels were detected by ELISA,and the index of insulin resistance(HOMA-IR)was calculated;and pathological changes in the sciatic nerve tissues of rats were observed by HE staining.Results Compared with the normal group,rats in the model group had significantly lower body mass and FINS levels(P＜0.01),significantly higher levels of FBG,TC,TG and HOMA-IR(P＜0.05,P＜0.01);TWL,MNCV and SNCV were significantly decreased(P＜0.01),and sciatic nerve fibres were disorganized and loosely aligned,with demyelination,axon atrophy and vacuole-like phenomenon.Compared with the model group,there was no significant change in body mass and levels of FBG,TC and TG in the Xin-Gui Gel Plaster group(P＞0.05),FINS level was significantly increased(P＜0.05),and HOMA-IR levels was significantly decreased(P＜0.05);TWL,MNCV and SNCV in the Mecobalamin group and Xin-Gui Gel Plaster group were significantly increased(P＜0.05,P＜0.01),sciatic nerve lesions were improved to different degrees,nerve fibre arrangement was more regular,myelin deficiency and axonal atrophy were significantly improved.Conclusion Xin-Gui Gel Plaster can improve insulin resistance,relieve thermal stimulation sensitivity,improve sciatic nerve conduction velocity to a certain extent in DPN rats,and have a protective effect on peripheral nerves in diabetic rats,but the hypoglycemic and hypolipidemic effects are not obvious.

Research progress on indicators for early diagnosis of diabetic kidney disease / 沈阳医学院学报

Diabetic kidney disease(DKD)is one of the most serious microvascular complications of diabetes and a common cause of end-stage renal disease.Early kidney injury lacks typical clinical symptoms and its onset is insidiously.The common clinical indicators of kidney injury are urine microalbumin,glomerular filtration rate,etc.Due to their lack of sensitivity and specificity,it is easy to cause missed diagnosis,misdiagnosis,and delay the disease.Therefore,it is of great significance to find more convenient,stable,and less invasive detection indicators for the early diagnosis of DKD.This paper reviews the research progress of biological indicators related to glomerular and tubular injury,oxidative stress,inflammatory response,microRNA and proteomics,which provides a certain reference value for the early diagnosis of clinical DKD.

Correlation of gene mutations and microsatellite instability in colorectal cancer tissues with clinicopathological features of patients / 肿瘤研究与临床

Objective:To explore KRAS, NRAS, BRAF gene mutations and microsatellite instability(MSI) in colorectal cancer tissues as well as their correlation with the clinicopathological characteristics of patients.Methods:The clinicopathological data of 473 colorectal cancer patients in Shanxi Province Cancer Hospital from October 2020 to May 2021 were retrospectively analyzed. The mutation status of KRAS, NRAS and BRAF gene in the paraffin tissues were detected by using amplification refractory mutation system (ARMS) method. Polymerase chain reaction (PCR)-capillary electrophoresis was used to analyze MSI status, and the correlation of the clinicopathological characteristics of patients with gene mutations and MSI status was analyzed.Results:The mutation rates of KRAS, NRAS and BRAF were 45.03% (213/473), 2.96% (14/473) and 5.50% (26/473), respectively in 473 patients with colorectal cancer. No case harbored both 2 gene mutations was detected. The mutation rate of KRAS gene in well differentiated adenocarcinoma was higher than that in poorly differentiated adenocarcinoma [47.4% (175/369) vs. 36.5% (38/104), χ2 = 3.89, P = 0.049]. NRAS mutation rate in female was higher than that in male [5.0% (10/202) vs. 1.5% (4/271), χ2 = 4.86, P = 0.027], and the NRAS mutation rate in patients with tumor diameter ≤ 3 cm was higher than that in those with tumor diameter >3 cm [7.1% (7/98) vs. 1.9% (7/375), P = 0.013]. BRAF mutation rate of tumors located in colon was higher than that in rectum [11.7% (20/171) vs.2.0% (6/302), χ2 = 19.81, P < 0.001]; BRAF mutation rate in poorly differentiated tumor was higher than that in well differentiated tumor [10.6% (11/104) vs. 4.1% (15/369), χ2 = 6.62, P = 0.010]; BRAF mutation rate in patients with mucus was higher than that in those without mucus [10.9% (11/101) vs. 4.0% (15/372), χ2 = 7.19, P = 0.007]; BRAF mutation rate in patients with lymphatic metastasis was higher than that in patients without lymphatic metastasis [8.2% (15/182) vs.3.8% (11/291), χ2 = 4.29, P = 0.038]. The incidence of high frequency MSI (MSI-H) in 473 colorectal cancer tissues was 7.19% (34/473). The incidence of MSI-H in colon was higher than that in rectum [14.0% (24/171) vs. 3.3% (10/302), χ2 = 18.82, P < 0.001]; the incidence of MSI-H in patient with poor differentiated tumor was higher than that in those with well differentiated tumor [17.3% (18/104) vs. 4.3% (16/369), χ2 = 20.46, P < 0.001]; the incidence of MSI-H in patients with mucus was higher than that in those without mucus [11.9% (12/101) vs. 5.9% (22/372), χ2 = 4.24, P = 0.039]; and the incidence of MSI-H in patients without lymphatic metastasis was higher than that in patients with lymphatic metastasis [10.0% (29/291) vs. 2.7% (5/182), χ2 = 8.75, P = 0.003]. In addition, the incidence of MSI-H was on the rise in patients with BRAF mutation ( P < 0.001). Conclusions:KRAS, NRAS, BRAF gene mutations and MSI status are correlated with the clinicopathological characteristics of patients with colorectal cancer; there is a close relationship between MSI-H and BRAF mutation.

Brain-specific TRAF7 deletion ameliorates traumatic brain injury by suppressing MEKK3-regulated glial inflammation and neuronal death.

Neuronal death and neuroinflammation play critical roles in regulating the progression of traumatic brain injury (TBI). However, associated pathogenesis has not been fully understood. Tumor necrosis factor receptor-associated factor 7 (TRAF7), as the unique noncanonical member of the TRAF family, mediates various essential biological processes. Nevertheless, the effects of TRAF7 on TBI are still unclear. In this study, we showed that TRAF7 expression was markedly up-regulated in cortex and hippocampus of mice after TBI. Brain-specific TRAF7 deletion markedly ameliorated neuronal death in cortical and hippocampal samples of TBI mice, accompanied with cognitive impairments and motor dysfunction. Moreover, the aberrant activation of astrocyte and microglia in cortex and hippocampus of TBI mice was significantly restrained by TRAF7 conditional knockout in brain, as indicated by the increased expression of GFAP and Iba1. In addition, the releases of pro-inflammatory factors caused by TBI were also considerably diminished by brain-specific TRAF7 knockout, which were largely through the blockage of nuclear factor-κB (NF-κB) and mitogen-activated protein kinases (MAPKs) signaling pathways. Importantly, mitogen-activated protein kinase kinase kinase 3 (MEKK3) expression levels were greatly enhanced in cortex and hippocampus of mice with TBI, while being dramatically ameliorated by TRAF7 knockout in brain. Mechanistically, we showed that TRAF7 directly interacted with MEKK3. Of note, MEKK3 over-expression almost abrogated the capacity of TRAF7 knockout to mitigate neuronal death and neuroinflammation in the isolated primary cortical neurons and glial cells upon oxygen-glucose-deprivation/reperfusion (OGD/R) stimulation. Collectively, TRAF7 may be an important molecular switch that leads to TBI in a MEKK3-dependent manner, and can be served as a therapeutic target for TBI treatment.

Tracking and forecasting milepost moments of the epidemic in the early-outbreak: framework and applications to the COVID-19

BackgroundThe outbreak of the 2019 novel coronavirus (COVID-19) has attracted global attention. In the early stage of the outbreak, the most important question concerns some meaningful milepost moments, including (1) the time when the number of daily confirmed cases decreases, (2) the time when the number of daily confirmed cases becomes smaller than that of the daily removed (recovered and death), (3) the time when the number of daily confirmed cases becomes zero, and (4) the time when the number of patients treated in hospital is zero, which indicates the end of the epidemic. Intuitively, the former two can be regarded as two important turning points which indicate the alleviation of epidemic to some extent, while the latter two as two "zero" points, respectively. Unfortunately, it is extremely difficult to make right and precise prediction due to the limited amount of available data at a early stage of the outbreak. MethodTo address it, in this paper, we propose a flexible framework incorporating the effectiveness of the government control to forecast the whole process of a new unknown infectious disease in its early-outbreak. Specially, we first establish the iconic indicators to characterize the extent of epidemic spread, yielding four periods of the whole process corresponding to the four meaningful milepost moments: two turning points and two "zero" points. Then we develop the tracking and forecasting procedure with mild and reasonable assumption. Finally we apply it to analyze and evaluate the COVID-19 using the public available data for mainland China beyond Hubei Province from the China Centers for Disease Control (CDC) during the period of Jan 29th, 2020, to Feb 29th, 2020, which shows the effectiveness of the proposed procedure. ResultsResults show that our model can clearly outline the development of the epidemic at a very early stage. The first prediction results on Jan 29th reveal that the first and second milepost moments for mainland China beyond Hubei Province would appear on Jan 31st and Feb 14th respectively, which are only one day and three days behind the real world situations. Forecasting results indicate that the number of newly confirmed cases will become zero in the mid-late March, and the number of patients treated in the hospital will become zero between mid-March and mid-April in mainland China beyond Hubei Province. The framework proposed in this paper can help people get a general understanding of the epidemic trends in counties where COVID-19 are raging as well as any other outbreaks of new and unknown infectious diseases in the future.

Value of droplet digital polymerase chain reaction in detecting epidermal growth factor receptor mutations in peripheral blood circulating tumor DNA of patients with non-small cell lung cancer / 肿瘤研究与临床

Objective:To analyze the value of droplet digital polymerase chain reaction (ddPCR) in detecting epidermal growth factor receptor (EGFR) mutations in peripheral blood circulating tumor DNA (ctDNA) of patients with non-small cell lung cancer (NSCLC).Methods:Peripheral blood samples of 63 patients with NSCLC who were treated in Shanxi Provincial Cancer Hospital from August 2018 to March 2019 were collected, and EGFR sensitive mutations in peripheral blood of patients were detected by ddPCR, and the results were compared with the results of amplification refractory mutation system polymerase chain reaction (ARMS-PCR). Kappa test was used to analyze the consistency of the two methods.Results:The EGFR sensitive mutations were found in 31 cases (49.2%) by ddPCR in peripheral blood of 63 patients with NSCLC. Among them, 1 case (1.6%) had G719X, 12 cases (19.0%) had E19-Del, 11 cases had T790M (17.5%), 7 cases (11.1%) had L858R. Seven cases (22.6%) of the patients had double mutations. In comparison, the above 4 mutations were found in 26 cases (41.3%) by the ARMS-PCR method, with 0 case, 12 cases (19.0%), 6 cases (9.5%), and 8 cases (12.7%), respectively, including 5 cases (19.2%) with double mutations. L858R in one case was positive when detected by ARMS-PCR, while it was negative when detected by ddPCR. The consistency rate of the two methods was 90.3% (κ = 0.8, P < 0.05). The median abundance of EGFR mutations in peripheral blood ctDNA of 31 cases was 1.7% (range 0.04%-23.60%). The median abundance of E19-Del was 2.50% (0.35%-22.70%), that of T790M was 0.6% (0.04%-14.00%), and that of L858R was 2.3% (0.20%-23.60%). Ten cases with the abundance of EGFR mutations < 1% when detected by ddPCR, accounting for 32.6% (10/31) of total patients with mutations, but only 5 cases of them were detected by ARMS-PCR. The detection rate of T790M by ddPCR in patients who had received tyrosine kinase inhibitor (TKI) and had acquired drug resistance was 57.9% (11/19), while it was 0 in patients without TKI treatment. Among patients with T790M mutation, 1 case had a mutation abundance < 0.1%, 7 cases had a mutation abundance of 0.1%-2.0%, 3 cases had a mutation abundance > 2.0%.Conclusions:The ddPCR provides a non-invasive, highly sensitive and absolutely quantitative method for detecting EGFR mutations in peripheral blood ctDNA of NSCLC patients. It provides a new detection method for EGFR-TKI targeted therapy in NSCLC patients with difficult sampling or with acquired drug resistance who need to repeatedly sample. The approach provides an important basis for the individualized targeted therapy.

Expression of costimulatory molecules B7H3 and B7H4 in T lymphoblastic lymphoma/leukemia and clinical significance / 中华病理学杂志

Objective@#To investigate the expression of B7H3 and B7H4 in T lymphoblastic lymphoma/leukemia (T-LBL/ALL) in correlation with clinicopathological parameters and patient prognosis.@*Methods@#Immunohistochemistry (IHC) was used to detect the expression of B7H3 and B7H4 protein in 100 cases of T-LBL/ALL(test group) and 30 cases of lymph node reactive hyperplasia (LH) (control group), diagnosed at Shanxi Cancer Hospital from January 2001 to June 2017. Real-time RT-PCR was used to detect the mRNA expression of B7H3 and B7H4 in 50 cases of T-LBL/ALL and 30 cases of LH (control group).@*Results@#There were 79 males,21 females. Immunohistochemical results showed that the expression rates of B7H3 and B7H4 were 23%(23/100) and 54%(54/100), respectively. By real-time RT-PCR, the relative expression of B7H3 mRNA in the T-LBL/ALL group was 2.5 times of that of the LH group. The expression levels of B7H4 mRNA in T-LBL/ALL group and LH group were extremely low.Single factor analysis showed that B7H3 protein expression in T-LBL/ALL group was associated with B symptoms and primary nodal disease (P<0.05). B7H4 protein expression was associated with mediastinal broadening and bone marrow involvement (P<0.05). B7H3 protein, B7H3 mRNA, B7H4 protein expression and IPI score were associated with prognosis (P<0.05), and the combined expression of B7H3 and B7H4 was associated with T-LBL/ALL prognosis (P<0.05). Multivariate Cox regression analysis showed that overexpression of B7H3 mRNA was an independent risk factor for the prognosis of patients with T-LBL/ALL (P<0.05).@*Conclusion@#Expression of B7H3 and B7H4 is closely corelated with clinicopathological parameters and prognosis of patients with T-LBL/ALL, suggesting that B7H3 and B7H4 expression play an important role in the development of T-LBL/ALL.

Analysis of the related factors of spontaneous clearance of hepatitis B virus DNA in patients with chronic hepatitis B virus infection / 中华传染病杂志

Objective To observe the incidence of spontaneous clearance of hepatitis B virus (HBV) DNA in chronic hepatitis B (CHB) patients ,and to investigate the related factors of the spontaneous clearance of HBV DNA and to determine the time to start antiviral therapy .Methods Patients who met the inclusion criteria were recruited from the follow-up cohort of chronic HBV infection from January 2008 to August 2017 for observation .The liver function including alanine aminotransferase (ALT) levels ,HBV DNA load and serum markers of HBV were measured at baseline ,month 1 ,month 3 and month 6 of follow-up . Evaluation index included cumulative HBV DNA negative conversion rate and cumulative HBeAg negative conversion rate .Multivariable analysis was used to analyze the factors associated with the spontaneous clearance of HBV DNA .Results A total of 116 patients were recruited in this study .All the patients showed ALT level elevation at baseline .Without antiviral treatment ,the cumulative HBV DNA negative conversion rate was 12 .9％ after 6-month observation .HBeAg negative conversion rate was 22 .5％ .Multivariable analysis showed that patients without a family history of HBV infection ,baseline ALT level >3 times the upper limit of normal (ULN) and HBV DNA level <6 lg copies/mL had higher cumulative HBV DNA spontaneous clearance rate .HBV DNA negative conversion rate in patients whomet all the above three conditions was up to 75％ .Conclusions In CHB patients and ALT level elevation for the first time , some patients could achieve spontaneous clearance of HBV DNA without antiviral therapy .Patients without a family history of HBV infection ,baseline ALT level >3 ULN and HBV DNA level <6 lg copies/mL have higher rate of cumulative HBV DNA spontaneous clearance .

Postoperative Complications and Related Risk Factors in Neurosurgery Patients during Anesthesia Recovery / 中国康复理论与实践

Objective To investigate the characteristics of postoperative complications and related risk factors in neurosurgery patients. Methods A retrospective study was carried out in neurosurgery patients during anesthesia recovery period from March, 2009 to November, 2013. The recorded complications included respiratory and circulatory system complications, pain, shivering, nausea and vomiting, agitation and delaying recovery. Multivariate logistic regression analysis was performed to screen the risk factors for these complications. Results Da-ta of 13,495 patients were available for analysis. The general incidence was 48.8%. Post-operative complications included post-operative nausea and vomiting (PONV) (14.5%), agitation (13.5%), hypertension (13.4%), arrhythmia (9.3%), shivering (8.9%), pain (5.9%), hypox-emia (2.5%), delayed recovery (1.9%), airway obstruction (1.7%) and hypotension (0.3%). Regression analysis showed that the risk factors for hypoxemia included male,<59 years old and infratentorial tumor (P<0.05);the risk factors for PONV included male, supratentorial tu-mor, infratentorial tumor, cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and tramadol (P<0.05);and the risk factors for postoperative restlessness included male, infratentorial tumor and cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and no use of patient-controlled analgesia (PCA) pump (P<0.05). Conclusion Patients with different neuro-logical diseases showed different post-operative complications and exhibited different risk factors for these complications. Anesthesiologists should closely monitor patients receiving various neurosurgery and provide timely treatment.

Analysis on common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease / 中国医师进修杂志

Objective To investigate the common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease. Methods The complications during anesthesia recovery period after deep brain stimulation in 869 patients with Parkinson disease were retrospectively analyzed. Results The median recovery time during anesthesia recovery period was 15 (0 - 30) min. The complications of 869 patients with Parkinson disease were hypertension in 133 cases (15.3%), arrhythmia in 99 cases (11.4%), agitation in recovery period in 76 cases (8.7%), respiratory obstruction in 24 cases (2.8%), postoperative nausea and vomiting (PONV) in 18 cases (2.1%), hypoxemia in 17 cases (2.0%), pain in 10 cases (1.2%), delayed emergence in 10 cases (1.2%), shivering in 3 cases (0.3%), and hypotension in 1 case (0.1%). The incidence of 1 complication was 26.8%(233/869), the incidence of ≥ 2 complications was 9.9% (86/869), and the total incidence of complications was 36. 7% (319/869). In the 869 patients, the modified Aldrete score ≥ 9 scores when patients were removed away from the anesthesia recovery room was in 849 cases (97.7%), and≤8 scores was in 20 cases (2.3%). Conclusions The common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease are special. To maintain a stable circulation, preventing respiratory complications and aspiration are important to reduce the incidence and improve the prognosis.

Study on clinical effect of glargine insulin combined with glimepiride in newly diagnosed T2DM patients / 中国基层医药

Objective To study the efficacy and safety of glargine insulin combined with glimepiride therapy in type 2 diabetes mellitus(T2DM).Methods According to the random number table,100 T2DM patients with unsatisfactory efficacy of oral hypoglycemic agents were randomly divided into treament group and control group, 50 cases in each group.Then,the treatment group was dealed with glargine insulin and glimepiride,the control group were treated with insulin glargine for our treatment protocol.12 weeks after treament,the fasting blood glucose(FPG), 2 hours blood glucose(2hPG),body mass index(BMI),glycosylated hemoglobin(HbA1c),islet β-cell function index(HOMA -β),insulin resistance index(Homa -IR),insulin dosage(INS),time requirds,weight gain and so on were observed.Meanwhile,The occurrence condition of hypoglycemia was also observed.Results In control groups, the post -treatment indexes of FPG,2hPG,HbAlc,HOMA -βand HOMA -IR[(5.7 ±0.8)mmol/L,(8.6 ± 2.5)mmol/L,(6.5 ±0.7)%,(40.35 ±3.12),(2.68 ±1.41 )]were much better than those in pre -treatment [(11.7 ±1.6)mmol/L,(15.1 ±6.1 )mmol/L,(9.2 ±1.1 )%,(19.01 ±2.79),(3.42 ±1.47)](t =23.717, 6.971,14.642,36.052,2.568,P <0.01 or 0.05 for both).In the treatment group,the post -treatment indexes of FPG,2hPG,HbAlc,HOMA -β,HOMA -IR[(5.6 ±0.7)mmol/L,(7.3 ±2.3)mmol/L,(6.3 ±1.0)%,(54.18 ± 3.23),(2.12 ±1.26 )]improved obviously than those in pre -treatment [(11.8 ±1.7 )mmol/L,(15.8 ± 5.2)mmol/L,(9.3 ±1.2)%,(18.71 ±3.12),(3.36 ±1.56)](t =23.846,10.570,13.580,55.849,4.372,P <0.01 for both).After treatment,the indexes of 2hPG,HOMA -β,HOMA -IR,insulin dose,time requirds and ampli-tude of weight gain[(7.3 ±2.3)mmol/L,(54.18 ±3.23),(2.12 ±1.26),(18.06 ±1.43)U /d,(10.1 ±2.4)d, (1.1 ±0.4kg)]etc in the treatment group were significantly ameliorated than those in the control group[(8.6 ± 2.5)mmol/L,(40.35 ±3.12),(2.68 ±1.41 ),(22.46 ±1.77)U /d,(13.2 ±2.6)d,(2.1 ±0.6)kg](t =23.717,6.971,14.642,36.052,2.568,P <0.01 or 0.05 for both).Hypoglycemia events of treatment group were 4 cases(8.0%)and the same in the control group were 13 cases(26.0%),there were statistical significance between the two groups(χ2 =5.535,P <0.05).Conclusion Treatment of glargine insulin combined with glimepiride can improve blood glucose level of T2DM patients,recover their islet β-cell function,relieve the IR,shorten the time requirds,as well as reduce the insulin dosage,range of weight gain and rate of hypoglycemia events.Hence,treatment protocol of glargine insulin combined with glimepiride is an effective clinical treatment for newly diagnosed T2DMpatients.

15-deoxy-Δ¹²,¹⁴-prostaglandin J₂ ameliorates endotoxin-induced acute lung injury in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A proinflammatory milieu emerging in the lung due to neutrophil accumulation and activation is a key in the pathogenesis of acute lung injury (ALI). 15-deoxy-Δ(12, 14)-prostaglandin J2 (15d-PGJ2), one of the terminal products of the cyclooxygenase-2 pathway, is known to be the endogenous ligand of peroxisome proliferator-activated receptor γ (PPAR-γ) with multiple physiological properties. Growing evidence indicates that 15d-PGJ2 has anti-inflammatory, antiproliferative, cytoprotective and pro-resolving effects. We investigated whether 15d-PGJ2 has a protective effect against endotoxin-induced acute lung injury in rats.</p><p><b>METHODS</b>Twenty-four male Wistar rats were randomly assigned into four groups (n = 6 per group): sham+vehicle group, sham+15d-PGJ2 group, LPS+vehicle group, and LPS+15d-PGJ2 group. The rats were given either lipopolysaccharide (LPS, 6 mg/kg intravenously) or saline, and pretreated with 15d-PGJ2 (0.3 mg/kg intravenously) or its vehicle (dimethyl sulphoxide) 30 minutes before LPS. Histological alterations, wet/dry weight (W/D) ratio and myeloperoxidase (MPO) activity as well as tumor necrosis factor (TNF)-α and cytokine-induced neutrophil chemoattractant-1 (CINC-1) levels were determined in lung tissues four hours after LPS injection. Immunohistochemical analysis for intercellular adhesion molecule-1 (ICAM-1) expression and Western blotting analysis for nuclear factor (NF)-κB p65 translocation and IκBα protein levels were also studied.</p><p><b>RESULTS</b>15d-PGJ2 pretreatment significantly attenuated LPS-induced lung injury, and reduced the increased W/D ratio, MPO activity, TNF-α, CINC-1 levels, and ICAM-1 expression in the lung. 15d-PGJ2 also suppressed the nuclear NF-κB p65 translocation and increased cytosolic IκBα levels.</p><p><b>CONCLUSIONS</b>15d-PGJ2 protects against endotoxin-induced acute lung injury, most likely through the reduction of proinflammatory protein levels during endotoxemia subsequent to the inhibition of NF-κB activation.</p>

Role of haeme oxygenase-1 in remote limb ischemic preconditioning-induced attenuation of lung ischemia-reperfusion injury in rabbits / 中华麻醉学杂志

Objective To evaluate the role of haeme oxygenase-1 (HO-1) in remote limb ischemic preconditioning (RLIP)-induced attenuation of lung ischemia-reperfusion (I/R) injury in rabbits.Methods Twenty-four Japanese White Rabbits,aged 4-5 months,weighing 2.0-2.5 kg,were randomly divided into 4 groups (n =6 each) using a random number table:sham operation group (S group),I/R group,RLIP group and zinc protoporphyrin (ZnPP,an inhibitor of HO-1) plus RLIP group (ZnPP + RLIP group).Lung I/R was produced by 60 min occlusion of the left lung hilum followed by 180 min of reperfusion in I/R,RLIP and ZnPP + RLIP groups.RLIP and ZnPP + RLIP groups received 3 cycles of 10 min ischemia followed by 10 min reperfusion in the bilateral hind limbs immediately before occlusion of the left lung hilum.In ZnPP + RLIP group,ZnPP 10 μmol/kg was injected intravenously 10 min prior to hind limb ischemia and the rest of the procedures were similar to those previously described in RLIP group.At the end of reperfusion,arterial blood samples were collected for blood gas analysis.The animals were then sacrificed and pulmonary specimens were obtained for microscopic examination of the pathological changes which were scored (lung injury score,LIS) and for determination of wet/dry lung weight ratio (W/D ratio),myleoperoxidase (MPO) activity,malondialdehyde (MDA) content and expression and activity of HO-1 in the lung tissues.Results Compared with group S,PaO2 was significantly decreased,and LIS,W/D ratio,MPO activity,MDA content,and HO-1 expression and activity were increased in I/R group (P ＜ 0.01).Compared with I/R group,PaO2 and HO-1 expression and activity were significantly increased,and LIS,W/D ratio,MPO activity and MDA content were decreased in RLIP group (P ＜ 0.01).Compared with RLIP group,PaO2 and HO-1 expression and activity were significantly decreased,and LIS,W/D ratio,MPO activity and MDA content were increased in ZnPP + RLIP group (P ＜ 0.01).Conclusion RLIP up-regulates HO-1 expression and enhances HO-1 activity,thus reducing lung I/R injury in rabbits.

Analysis of postoperative residual paralysis and respiratory function of patients undergoing neurosurgical anesthesia / 中国医师进修杂志

ObjectiveTo investigate the incidence of postoperative residual paralysis and respiratory function of patients undergoing neurosurgical anesthesia.Methods Three hundred andtwenty-eight patients undergoing neurosurgical anesthesia (ASA Ⅰ - Ⅱ ) were divided into vecuronium group (135 cases) and rocuronium group (193 cases) by random digits table.Anesthesia was maintained with propofol in combination with sevoflurane and intermittented intravenous infusion boluses of muscle relaxatant.Extubation of the intratracheal tube in operation room was performed under clinical criteria.The neuromuscular function were detected by acceleromyography with supramaximal train-of- four(TOF) stimulation of the ulnar nerve,and pulmonary function were measured in postanesthesia care unit(PACU).The TOF ratio and pulmonary function were compared between two groups.ResultsThe incidence of postoperative residual paralysis was 31.9％(43/135) in vecuronium group,and 14.5％(28/193) in rocuronium group.Hypoxemia and hypercapnia occurred in vecuronium group with TOF ＜ 0.9 were higher than in those with TOF ≥0.9[7.0％(3/43) vs.4.3％(4/92) and 44.2％(19/43) vs.18.5％(17/92),P ＜ 0.01 ],while in rocuronium group with TOF ＜ 0.9 were higher than in those with TOF ≥ 0.9 [ 3.6％( 1/28 ) vs.1.2％ (2/165) and 39.3％( 11/28 )vs.17.0％ (28/165),P ＜ 0.01 ].ConclusionsThere is a high incidence of postoperative residual paralysis according to the clinical criteria of recovery of neuromuscular function of patients undergoing neurosurgical anesthesia,which would impair respiratory function.

Comparison of preventive effects of tramadol and ketamine on remifentanil-induced postoperative hyperalgesia after neurosurgical anesthesia / 中国医师进修杂志

ObjectiveTo compare the preventive effects oftramadol and ketamine on the patients with postoperative hyperalgesia after remifentanil-induced neurosurgical anesthesia.MethodsOne hundred and fifty patients undergoing craniotomy were assigned to tramadol group,ketamine group and normal saline group with 50 cases each by random digits table.Anesthesia was maintained with infusion of remifentanil [0.1-0.2μ g/( kg· min ) ],propofol and sevoflurane.Tramadol ( 1.5 mg/kg),ketamine (0.5 mg/kg) or normal saline was given before skin closing.The emergence time,trachea extubation time,patients required analgesia and tramadol consumption,reverse effect were recorded.The visual analog scale (VAS),Ramsay scores at 15,30,60,120 minutes after emergence were performed.ResultsPatients required analgesia and tramadol consumption in tramadol group and ketamine group were significantly lower than those in normal saline group (P ＜0.01 or ＜0.05 ).The occurrence of shiver in tramadol group was lower than that in normal saline group (P ＜0.05).VAS scores in tramadol group at 15,30 minutes and in ketamine group at 30 minutes after emergence were significantly lower than those in normal saline group (P＜ 0.05).Ramsay score in ketamine group at 15 minutes after emergence was higher than that in tramadol group and normal saline group [ (2.9 ±0.6) scores vs.(2.3 ±0.7) scores and (2.3 ±0.9) scores](P＜0.01).ConclusionTramadol has a goodpreventive effect for postoperative hyperalgesia induced by remifentanil in neurosurgery compared with ketamine.

Postoperative Complications after Intracranial Neurosurgery in the Postanesthesia Care Unit / 中国康复理论与实践

@#ObjectiveTo investigate the complications after intracranial neurosurgery in the postanesthesia care unit (PACU). Methods2166 patients enrolled into PACU after intracranial neurosurgery were reviewed. ResultsAmong the complications, the most frequent ones were hypertension (14.0%), arrhythmia (13.9%), pain (13.7%), shivering (10.5%), nausea and vomiting (9.3%), and delirium (8.6%). The least ones were hypoxemia (3.4%), respiratory obstruction (1.9%), delayed recovery (1.5%), and hypotention (0.5%). Abnormal temperature and residual block occurred at 7.2% and 22.8% in the patients who were monitored. All complications were treated immediately, and all the patients transferred to neurosurgical ward with modified Aldrete score over 9～10. ConclusionThe patient in PACU need well management to insure safe and smooth recovery from anesthesia after intracranial surgery.

Incidence and Prevention of Postoperative Hypoxemia in Transsphenoidal Pituitary Tumor Resection / 中国康复理论与实践

@#ObjectiveTo observe the incidence and mechanism of postoperative hypoxemia in the patients after transsphenoidal pituitary tumor resection.Methods579 postoperative patients in postanesthesia care unit (PACU) in March, 2009～June, 2010 were investigated retrospectively using PACU databank. The incidence and mechanism of hypoxemia were analyzed.ResultsThe incidence of hypoxemia was 5.2%. Upper airway obstruction, change of breath mode, residual effects of anesthetics, bronchiospasm, aspiration, acute pulmonary edema and lung disease were the main reasons of postoperative hypoxemia after transsphenoidal pituitary tumor resection.ConclusionCareful monitor and treatment are the key to prevent hypoxemia after transsphenoidal pituitary tumor resection.

Effects of fluid resuscitation on hemodynamics of the dogs with hemorrhagic shock at initial stage of entering the area of high altitude / 中华急诊医学杂志

Objective To investigate the effect of fluid resuscitation on hemodynamics in dogs with hemorrhagic shock at the initial stage of getting high altitude. Method he models of severe hemohagic shock were established in 13 mongrel dogs after they were brought to the high altitude a/ea and were mndondvvided inIo 3 group: LR group(n=3),6% HES group(n=5)and control group(n=5).The dogs in LR group wefe intravenously infused with lactated Ringers solution in 1.5 limes exsanguinated volume;those in 6% HES group were given hydroxyethyl starch in equal volume of exsanquination. A drop of solution waft noven to dogs in con,trol group.One hour after restritation,lactated Ringers solution waft infused at 5 Ilps as maintenance dose.The hemodynmnic variables were recorded.Results All animals in control group died two hour later.In LR group,the hemedynamie variables including MAP,CO,PAWP,CVP,LVSWI and RVSWI two hours after infiion were signifieantly higher than those.one hour after infusion(P<0.05),while HR,SVRd PVR were significantly lower(P<0.05).In dogs of 6% HES group,CO,PAP,PAWP,CVP,SVR and PVR two hours after infusion were significantly higher than those one hour after infusion(P<0.05),but MAP.HR.CI,LVSWI and RVSWI were not significantly different(P>0.05).Conclusions All of three doith hen rhagic shock would die(3/3)at the initial stage of being brought to high altitude alles without fluid resuscitation. Fluid resuscitation with LR solution 1.5 times the exsanquinated volume was effective and safe. The infusion of 6% hydroxyethyl starch at equal volume of exsanqination may easily cause heart failure or pulmonary edema.

Effect of Preoperative Aprotinin Infusion on Blood Loss and Brain Edema in Patients Undergoing Meningioma Resection / 中国康复理论与实践

@#Objective To observe the effects of preoperative aprotinin infusion on blood loss and brain edema in patients undergoing meningioma resection.Methods 80 were randomized to receive intravenous normal saline(control group) or aprotinin 2.0×106 KIU(aprotinin group) before operation.The intraoperatively hemostatic appearance was assessed by the surgeon in the form of quantitative scoring.The postoperative degree of brain edema was assessed by radiologist according to the appearance of computer tomography.Results There were no statistic differences in general information,intraoperatively infused volume,urine volume,and the quantitative score of postoperatively brain edema(P>0.05).The operation duration was(209±63) min and(305±93) min,blood loss was 420(150～3270) ml and 610(110～2430) ml in the aprotinin group and the control group respectively(P<0.05).There was statistic difference in the score of intraoperatively hemostatic apperance(P<0.05).Conclusion In the resection of meningeoma,aprotinin was infused with a dose of 2.0×106 KIU preoperatively can shorten the duration of operation and reduce the intraoperative blood loss,but it cannot relieve the degree of postoperatively brain edema.

Effect of Ambient Air SO_2 on Mortality of Respiratory Diseases in Shenyang / 环境与健康杂志

Objective To assess the effect of ambient air SO2 on mortality of respiratory diseases. Methods Based on the ecological theory, after the adjustment of seasons, temperature, humidity and air pressure, the observed individuals were divided into eight groups. The association between SO2 exposure and mortality rate of respiratory diseases was analyzed using Poisson regression and local auto-regression method. Results SO2 concentration increased by 0.05 mg/m3, the mortality of respiratory diseases increased by 5.90% (95%CI: 2.26%-9.68%) in all groups, in children by 10.23% (95%CI: 2.07%-19.04%), in young-middle-male group by 1.10% (95%CI: -9.51%-12.96%), in young female group by 9.58% (95%CI: -2.57%-23.23%), in young group by 10.23% (95%CI: 2.07%-19.04%), in aged male group by 5.26%(95%CI: 0.01%-10.78%), in aged female group by 8.07% (95%CI: 3.45%-12.89%) and in aged group by 4.66% (95%CI: 1.44%-7.99%) respectively. Conclusion SO2 exposure is found to be associated with the increase of mortality of respiratory diseases, especially in children, aged people and elderly females.