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Table of Content

    25 August 2019, Volume 40 Issue 8
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    Study on differentiation from bone marrow mesenchymal stem cells overexpressing GATA4 into cardiomyocytes
    ZHANG Yanan1， CHEN Wei1， ZHANG Jinping1， QI Lili2， ZHANG Lei1， ZHAO Chunfang1*
    2019, 40(8):  877-881,901.  doi:10.3969/j.issn.10073205.2019.08.003
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the role of Bone Marrow Mesenchymal Stem Cells(BMSCs) that overexpression GATA4 gene in differentiating into cardiomyocytes.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Rat BMSCs were isolated from the whole bone marrow and cultured.After multiple passages and purification，the GATA4 (pVP22GATA4/mycHis) gene was transiently transfected into SD rat BMSCs by liposome transfection with the help of the cellpenetrating peptide VP22. After 3 days, BMSCs was induced by a suitable concentration of 5aza for 1 day. The expression of GATA4 and myc were examined by Western blotting. Expression of cardiac troponin T(cTnT) and GATA4 were determined with immunocytochemistry and Western blotting after 21 days.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓GATA4 and myc were expressed in experimental group after 2 days of transfection. After 21 days, Western blotting and immunocytochemistry results indicated that the expression of GATA4 and cTnT in experimental group was significantly higher than those other groups.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Overexpression GATA4 gene could promote BMSCs differentiate into cardiomyocytes during 5aza induction.
    The protective effect of Salidroside on chronic renal failure in rats#br#
    HUANG Yuzhe1, LIU Lixia2, QIU Yutong3, JIN Bo4, YIN Liyong5*
    2019, 40(8):  882-885,910.  doi:10.3969/j.issn.10073205.2019.08.004
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the effect of the Chinese herb Salidroside on chronic renal failure in rats, and to explore its possible mechanism.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Experimental animals were randomly assigned as chronic renal failure（CRF） group with 5/6 nephrectomy, Salidroside treatment group and shamoperated control group. Animals in the former two groups were subjected to 5/6 kidney resection to construct CRF rat models. Salidroside group received Salidroside for 4 weeks. The other two groups were given distilled water. At the end of the 4 weeks, kidney tissues were assessed by histopathologic analyses. The levels of serum creatinine(SCr) and blood urea nitrogen(BUN) were measured by automatic biochemical analyzer to estimate the renal function. Malondialdehyde(MDA) and superoxide dismutase(SOD) levels in the kidney tissues were measured by the kit. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with control group, the levels of serum BUN, SCr and MDA in the other two groups were significantly increased, whereas the level of SOD was declined(P＜0.05). Compared with CRF group, the levels of serum BUN, SCr and MDA in the Salidroside group were obviously lower, whereas the level of SOD was higher(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Salidroside supplementation can effectively alleviate the oxidative stress level and provide protective effect in CRF rats, which may be achieved by the suppression of the antioxidant enzyme activities.
    The therapeutic effect of argatroban on early patients with acute cerebral infarction after thrombolytic therapy#br#
    GU Juxian1, LI Yiming2*, AN Zexin1, WANG Yan1, ZHAO Li1, LYU Jianping1
    2019, 40(8):  886-889.  doi:10.3969/j.issn.10073205.2019.08.005
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    ［Abstract］〓Objective〖HTSS〗〓To observed the clinical effect of argatroban on early acute cerebral infarction patients treated with alteplase thrombolytic therapy, and to explore the best drug and treatment after thrombolytic therapy for acute cerebral infarction patients.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty early acute cerebral infarction patients treated with alteplase thrombolysis were randomly divided into control group and experimental group, 30 cases in each group. The control group received edaravone by intravenous drip, 30 mg/time, 2 times/d for 7 days. The experimental group received  argatroban by intravenous drip on the basis of the control group, 60 mg/d for the first 2 days and 20 mg/d for the next 5 days. Before treatment, 7 and 30 days after treatment, the linical therapeutic effect of the two groups was evaluated by “Evaluating Criteria for the Clinical Efficacy of Stroke Patients”, the degree of neurological impairment was assessed according to the National Institutes of Health Stroke Scale(NIHSS), the Daily life quality was assessed by Activity of Daily Living Scale(ADL), the state of cerebrovascular recanalization was evaluated by transcranial Doppler ultrasound.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After treatment, the NIHSS score of the two groups showed decreased gradually trend, the ADL score and blood flow velocity of middle cerebral artery showed increased gradually trend, the NIHSS score of the experimental group was lower than that of the control group, the ADL score and blood flow velocity of middle cerebral artery were higher than that of the control group. There were statistical significance in the differences among intergroup, time point, intergrouptime point interaction（P＜0.05）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Comparing with edaravone, the combination treament of argatroban and edaravone  for early acute cerebral infarction patients treated with alteplase thrombolysis could effectively reduce the neurological impairment degree, improve the daily life quality and cerebral vascular recanalization, increase therapeutic effect.
    Enriched environment promotes poststroke neurological function recovery through regulation ERK1/2 pathway#br#
    RAO Chubing1, YANG Yong2*
    2019, 40(8):  890-894,919.  doi:10.3969/j.issn.10073205.2019.08.006
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    ［Abstract］ Objective〖HTSS〗〓To investigate the effects and the mechanism of enriched environment on the neurological function recovery after stroke.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Adult rats were subjected to ischemia induced by middle cerebral artery occlusion(MCAO) followed by reperfusion, rats were assigned Ischemia & EE group, Ischemia & SC group and Sham & SC group. Ladder rung walking test, forelimb placing test, limbuse asymmetry test and paw reaching test were used to assess the recovery of rat behavior before surgey and on postoperative days 3, 5, 7, 14 and 21, respectively. Expressions of phosphorylated ERK1/2(pERK1/2) and total ERK1/2(tERK1/2) were examined by western bloting, and electron microscopy was used to evaluate the astrocytes morphology surround in the perivascular 21 days after MCAO.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓On the third day after MCAO, the scores of ladder rung walking test, forelimb placing test, limbuse asymmetry test and paw reaching test in Ischemia & EE and Ischemia & SC group were significantly increased, and then, those test scores were decreased from 5 to 21 days after surgery. However, the rats in the Ischemia & EE showed lower test scores compared to the rats in the Ischemia & SC group. The test scores mentioned above were fluctuated on postoperative days 3, 5, 7, 14 and 21, however, those changes were no significant difference. The differences of ladder rung walking test, forelimb placing test, limbuse asymmetry test and paw reaching test score were statistically significant for the effect of time, group and group by time interaction(P＜005). Ischemia & SC group showd increased pERK1/2 level compared to Ischemia & EE group, however, the level of pERK1/2 among Sham & SC group is lower than that among Ischemia & SC group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Enriched environment could promote rehabilitation of rat after ischemia via inhibition of ERK1/2 signal pathway.
    Application of the artificial submucosal edema in transurethral resection of bladder tumors#br#
    WANG Xin1, QI Jinchun1, MENG Qingsong1, LIU Wenjun2, GENG Yushan3, WANG Dongbin1*
    2019, 40(8):  895-897,906.  doi:10.3969/j.issn.10073205.2019.08.007
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    ［Abstract］〓Objective〖HTSS〗〓To explore the clinical value of artificial submucosal injection to form local edema in transurethral resection of bladder tumors.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Twentythree eligible patients with bladder cancer were selected. Submucosal edema was induced by artificial injection of 2% lidocaine hydrochloride diluent into the bladder mucosa of the tumor basement,and then do the operationtransurethral resection of bladder tumors to record the operation time, amount of bleeding, smoothness of the section, bladder perforation, obturator nerve reflex and pathological.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓All the patients successfully have completed the operation, the average operation time was (38.8±15.6) min,the average bleeding volume was (5.4±4.3) mL, the incision margin was smooth and round like, and the occurrence rate of obturator nerve reflex was 8.7%(2/23), the occurrence rate of bladder perforation was 0(0/23), and the positive rate of tumor basement was 0(0/23).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The artificial submucosal edema is safe and effective in transurethral bladder tumor enucleation, and can effectively reduce obturator nerve reflex and avoid bladder perforation.
    Clinical observation of EVLT combined with high ligation of great saphenous vein in the treatment of varicose veins of lower limbs#br#
    XIE Zemin, CUI Wei*
    2019, 40(8):  898-901.  doi:10.3969/j.issn.10073205.2019.08.008
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    ［Abstract］ Objective〖HTSS〗〓To observe the clinical curative effect of endovenous laser treatment(EVLT) combined with high ligation of great saphenous vein in the treatment of varicose veins of lower limbs.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Ninety patients(116 limbs)with varicose veins of lower limbs were divided into observation group(given EVLT combined with high ligation of great saphenous vein, 48 cases, 61 limbs) and control group(high ligation of great saphenous vein and stripping, 42 cases, 55 limbs) according to the treatment methods. The general condition of operation, incidence of postoperative saphenous nerve injury, incidence of complications, healing rate of ulcer, reduction rate of hyperpigmentation and recurrence rate of varix were compared between the two groups. The chronic venous insufficiency questionnaire(CIVIQ) was performed to evaluate the postoperative quality of life.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The operative time, intraoperative blood loss, incision length and hospital stay in observation group were significantly shorter or less than those in control group(P＜005). There were no significantly differences in healing rate of ulcer, reduction rate of hyperpigmentation and recurrence rate of varix between two groups(P＞005). The incidence rates of postoperative poor incision healing, subcutaneous hematoma and pain of affected limb in observation group were significantly lower than those in control group(P＜005). There were no significant differences in the incidence rates of postoperative fever, edema of ankle and foot dorsum and saphenous nerve injury between two groups(P＞005). The scores of pain, social activities, physical fitness and mental psychology and total score of CIVIQ in observation group were higher than those in control group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓EVLT combined with high ligation of great saphenous vein has short operative time, little intraoperative blood loss and few postoperative complications in the treatment of varicose veins of lower limbs, and its CIVIO scores are higher than those of high ligation of saphenous vein and stripping, thus it is worthy of clinical promotion.
    Clinical observation of GnRHa combined with LNGIUS in the hysteroscopic treatment of uterine adenomyoma#br#
    DU Jiexian1, QIN Shan1, ZHANG Xinjing2, KOU Liyan3, WANG Kang1, TIAN Cai1
    2019, 40(8):  902-906.  doi:10.3969/j.issn.10073205.2019.08.009
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the clinical efficacy of gonadotropin release hormone agonist(GnRHa） combined with levonorgestrel releasing intrauterine system(LNGIUS) in the hysteroscopic treatment of uterine adenomyoma.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fifteen cases of uterine adenomyoma who underwent hysteroscopic resection combined with GnRHa and LNGIUS treatment were selected. The operation time, intraoperative and postoperative complications were recorded. The improvement of dysmenorrhea， the changes of menstrual volume, uterine volume and the relapse of uterine adenomyoma were compared before and after surgery.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓All patients completed the operation successfully. The operation time was 38-75 min, with an average of 46.3 min，and there was no intraoperative or postoperative complications. Postoperative followup lasted for 12 months,with the extension of time, the menstrual score and VRS score showed a gradually decreasing trend, and the uterine volume, hemoglobin and serum CA125 level also showed a decreasing trend, slightly increased at 12 months after treatment. The difference was statistically significant(P＜0.05). After operation, 2 cases had much more vaginal discharge than before, 4 caseshad a bit of vaginal bleeding, 1 case mirena fallen off, 1 case had weight increase, 1 case had ovarian cyst.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The effect of GnRHa combined with LNGIUS is significant in the hysteroscopic treatment of uterine adenomyoma.
    Clinical and electrophysiological study of highdose intravenous drip of human immunoglobulin combined with mechanical ventilation in the treatment of severe GuillainBarre syndrome in children#br#
    WANG Lili， WANG Hongfang， WANG Wei， LU Yangrui， LIU Liming
    2019, 40(8):  907-910.  doi:10.3969/j.issn.10073205.2019.08.010
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    ［Abstract］ Objective〖HTSS〗〓To investigate the clinical effect and electrophysiological changes of intravenous drip of human immunoglobulin combined with mechanical ventilation nerves and muscles in children with severe GuillainBarre syndrome treated by highdose intravenous drip of human immunoglobulin combined with mechanical ventilation.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Selection of 34 patients with severe GuillainBarre syndrome. All the patients were treated with routine treatment, pulse therapy with highdose intravenous immunoglobulin(IVIG) and mechanical ventilation. Observation of clinical efficacy, especially neurological function.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After the treatment, the clinical score of nerve function in the patient was significantly lower than before the treatment, and the conduction speed of the median nerve, fibular nerve, ulnar nerve, limb pain and tibial nerve was significantly higher than before the treatment(P＜005). After treatment, the abnormal rate of myoelectric examination was significantly lower than before treatment, and the loss of nerve potential was significantly different before treatment. The transport unit potential raising type significantly decreased the pure type and pathological electrostatic type, the interference wave decreased, and the total interference type increased significantly compared to the pretreatment(P＜005). Patients with limb weakness, muscle tension recovery, respiratory paralysis, tendon reflex recovery,  and sensory disorders use time are all shorter. After treatment, there was one patient who had no autonomous breathing, had difficulty withdrawing, and parents gave up treatment and eventually died.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The combined mode of mechanical ventilation and IVIG can remarkably increase the clinical efficacy, shorten the course of the disease and improve the nerve damage. It is worthy of clinical promotion.
    Changes and significance of TLR4 and NFκB expression in peripheral blood of children with hand, foot and mouth diseases
    ZHANG Zhongfu, CHANG Haixia, LI Qinghua, JI Yingchun, ZHENG Shaomin, HAO Gailing
    2019, 40(8):  911-914.  doi:10.3969/j.issn.10073205.2019.08.011
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the relationship between the inflammatory pathway of Tolllike receptor 4(TLR4)/nuclear factor kappa B(NFκB) and the pathogeny and severity of hand, foot and mouth disease(HFMD).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 78 children with HFMD were selected and divided into EV71 infected HFMD group(34 cases) and nonEV71 infected HFMD group(44 cases). According to the existence of neurological complications, they were divided into 47 cases of HFMD common type group and 31 cases of HFMD severe type group. Thirtyfive healthy children were selected for physical examination at the same time. The levels of TLR4 and NFκB in peripheral blood of all subjects were detected by enzymelinked immunosorbent assay. The relationship between TLR4 and NFκB in peripheral blood and enterovirus typing and severity of HFMD was analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The levels of TLR4 and NFκB in peripheral blood of EV71 group and nonEV71 group were higher than those of control group, the levels of TLR4 and NFκB in peripheral blood of EV71 group were higher than those of nonEV71 group(P＜005), and the levels of TLR4 and NFκB in peripheral blood of severe group were higher than those of normal group(P＜005). The pathogen and severity of HFMD were positively correlated with the levels of TLR4 and NFκB in peripheral blood(P＜005). After controlling the severity of the variables, the levels of TLR4 and NFκB in peripheral blood of children with hand, foot and mouth disease in nonEV71 and EV71 groups were positively correlated(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓EV71 infection is associated with the development and severity of TLR4/NFκB inflammatory signaling pathway.
    Analysis of clinical features of serum lipid and fasting bloodglucose in the patients with psoriasis
    WANG Jingyuan1, HAN Dan2, XU Xin1, WANG Bo3, WANG Lijuan2, ZHOU Yan2*
    2019, 40(8):  915-919.  doi:10.3969/j.issn.10073205.2019.08.012
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    ［Abstract］ Objective〖HTSS〗〓To analyze the clinical feature of lipid metabolism and glucose metabolism in the patients with psoriasis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The total cholesterol(TC), triglycerides(TG), highdensity lipoprotein cholesterol(HDLC), lowdensity lipoprotein cholesterol(LDLC) and fasting plasma glucose(FPG) of 268 psoriasis patients and 298 healthy controls were analyzed retrospectively and compared in different genders, ages and psoriasis types.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with healthy controls,the serum levels of TC, TG, LDLC and FPG were significantly higher, while the levels of HDLC were significantly lower in patients with psoriasis(〖WTBX〗P〖WT〗＜005). HDLC levels in male patients with psoriasis were significantly lower than those in female patients(P＜005). But there were not significant differences of serum TC, TG, LDLC and FPG between males and females(P＞005). TC in the agebracket 40-49 and 50-59 were higher than those in group under 30 years old, and TC in agebracket 50-59 were higher than those in 30-39 years old. TG in group over 70 years old were lower than those in other age groups; HDLC in the agebracket 40-49 and 50-59 were higher than those in group under 30 years old; HDLC in the agebracket 50-59 were higher than those in 30-39; HDLC in the group over 70 years old was lower than those in other age groups(P＜005). LDLC in the agebracket 40-49 and 50-59 were higher than those in group under 30 years old, while LDLC in the group over 70 years oldwere lower than those in other age groups(P＜005). There were no statistically significant differences in FBG among all age groups(P＞005).TC and LDLC levels in erythrodermic psoriasis were significantly higher than those in other types of psoriatic patients(P＜005). However, there were no significance in TG, HDLC and FPG levels among different types(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Abnormal lipid and glucose metabolism can be observed in psoriasis patients. The incidence of hyperlipidemia is very high. Additionally, HDLC is related to gender, while TC, HDLC and LDLC are related to age. The patients with erythroderma psoriasis are more susceptible to hyperlipidemia.
    Imaging characteristics of MRI in different types of placenta previa and its predictive value for major hemorrhage after cesarean section and maternal and child outcomes
    HAN Wenbin, QI Xin, YU Qiang, WANG Jianqiu
    2019, 40(8):  920-923,928.  doi:10.3969/j.issn.10073205.2019.08.013
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    ［Abstract］ Objective〖HTSS〗〓To investigate the imaging characteristics of different types of placenta previa and to analyze the value of MRI in predicting massive hemorrhage and maternal and infant outcome after hysterectomy.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Ninetyfive patients with placenta previa were divided into 24 cases of borderline placenta previa group, 18 cases of partial placenta previa group, and 53 cases of complete placenta previa group. The pregnancy outcomes of different types of placenta previa were observed. Ninetyfive patients were further divided into the bleeding group(32 cases) and the nonbleeding group(63 cases). Their age, number of births, history of caesarean section, history of miscarriage and types of placenta previa were observed, and the risk factors of postoperative bleeding were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Comparison of maternal and infant outcomes of different types of placenta previa showed that the incidence of postpartum hemorrhage and hysterectomy rate of patients with complete placenta previa were higher than those with borderline placenta previa(P＜005). In the bleeding group, the proportion of births≥3 times, previous history of cesarean section, history of abortion, complete placenta previa, placental implantation, myometrium thinning, placenta penetration into the cervix, and uneven placental signals were all higher than those in the nonbleeding group(P＜005). Logistic regression analysis showed that previous history of cesarean section, complete placenta previa, placental implantation and myometrium thinning were risk factors for postpartum hemorrhage in patients with placenta previa after cesarean section.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The imaging of placenta previa by MRI is clear and accurate. Among the patients with placenta previa, previous history of cesarean section, complete placenta previa, placental implantation, and myometrium thinning are the risk factors of bleeding after cesarean section with placenta previa.
    Experimental study of ultrasound contrast agent SonoVue injected into rabbit liver tissue by percutaneous puncture#br#
    JIA Xudong， HE Wen*
    2019, 40(8):  924-928.  doi:10.3969/j.issn.10073205.2019.08.014
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    ［Abstract］〓Objective〖HTSS〗〓To observe the diffusion rule, ultrasound changes and biological effects of ultrasound contrast agent SonoVue after percutaneous injection into rabbit liver tissue.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Thirty New Zealand healthy white rabbits were divided into experimental group and control group. Each experimental group was further divided into five subgroups according to the dose of contrast injection percutaneous injection, which were 0.1 mL group, 0.2 mL group, 0.3 mL group, 0.4 mL group, and 0.5 mL group. The control group was injected with the same dose of physiological saline. Dynamic observation of contrast agent regression in the injection area. After the contrast agent was completely ablated, the rabbit was sacrificed, and the liver tissue of the contrast area was taken for hematoxylineosin staining to observe the liver tissue damage.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The average gray value of the injected contrast agent area was significantly higher than that of the surrounding liver tissue. The average gray value of the injection area increased, the duration of angiography was proportional to the dose increase, and inversely proportional to the metabolic rate of ultrasound contrast agent. The interaction between groups, time points, and time between groups were statistically significant(P＜0.05). The observation of realtime dynamic ultrasound revealed enhanced phenomenon of arteriovenous perfusion, edge passivation in contrast enhanced area, and starshaped sign in contrast area. The pathological results showed that the liver cells in the injection area were normal, no swelling and deformation, the surrounding tissue structure was neatly arranged, and lymphocytes were found in the interstitial tissue of the liver tissue.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Percutaneous injection of ultrasound contrast agent can significantly prolong the enhancement time of rabbit liver tissue, and percutaneous injection of contrast agent is safe and feasible.
    Protective effect of dexmedetomidine against oxidative stress response and myocardial injury caused by lower limb tourniquet surgery in diabetic patients#br#
    WANG Li1， LIU Xiuye1*， GUO Qiongmei1， HAO Xuelian1， SUN Yuan1， WU Bojuan2
    2019, 40(8):  929-932.  doi:10.3969/j.issn.10073205.2019.08.015
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    ［Abstract］ Objective〖HTSS〗〓To observe whether application of dexmedetomidine can reduce the oxidative stress response of diabetic patients and reduce the myocardial injury caused by lower limb tourniquet surgery.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty patients under general anesthesia were accepted lower limb orthopedic surgery, forty patients with type 2 diabetes, forty patients without diabetes, were randomly divided into four groups using a random number table: diabetes dexmedetomidine group(D1, n=20), nondiabetic dexmedetomidine group(D2, n=20), diabetic nondexmedetomidine group(C1, n=20) and nondiabetic nondexmedetomidine group(C2, n=20). In the test group D1 and group D2，dexmedetomidine 1μg/kg(initial dose) was given(15 min) after induction of anesthesia， followed by continuous infusion at 0.5 μg·kg-1·h-1, until the end of operation. The equal volume of normal saline was given instead of dexmedetomidine in control group C1 and group C2. Before the tourniquet(T0), after loose tourniquet  15 min(T1), 1 h(T2) and 24 h(T3), blood samples were collected for determination of malondialdehyde(MDA), superoxide dismutase(SOD), interleukin1β(IL1β), cardiac troponin I(cTnI) concentrations.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The concentration of MDA in the four groups were firstly increased at T0~T2 and then decreased at T3, there were statistically significant differences between groups and time points(P＜005), while there was no significant difference between their interactions(P＜005). The SOD were gradually decreased at T0~T2 and then increased at T3, while the levels of IL1β and cTnI were firstly increased at T0~T2 and then decreased at T3 in the four groups, there were statistically significant differences between groups, time points and their interactions(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓dexmedetomidine can reduce the oxidative stress response of diabetic patients, reduce the myocardial injury caused by lower limb tourniquet surgery, and produce effective myocardial protection.
    Comparison of anesthetic effects of acupuncture combined with basic anesthesia and simplebasic anesthesia for peritoneal dialysis catheterization#br#
    YANG Qiang1, QU Min1*, YAO Zhongyan1, ZHANG Xiuqing1, LI Chenchen1, LI Lei2
    2019, 40(8):  933-936.  doi:10.3969/j.issn.10073205.2019.08.016
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    ［Abstract］ Objective〖HTSS〗〓To compare the efficacy and safety of acupuncture combined with basic anesthesia and simple basic anesthesia in peritoneal dialysis catheterization.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixtynine patients with firsttime peritoneal dialysis catheterization were selected. By random number table method the patients were divided into acupuncture combined basic anesthesia group(AA group) and simple basic anesthesia group(BA group).  Acupuncture at Neiguan and Sanyinjiao points with electrical stimulated at 20 minutes before start of surgery in AA group. The same position paste the electrode connect the point of electrical stimulation instrument in BA group. Both groups of patients were sedated with intravenous injection of 0.3 μg/kg dexmedetomidine 20 minutes before the start of surgery. In AA group, bilateral Neiguan and Sanyinjiao acupoints were stimulated continuously until the end of operation. If intraoperative Visual Analogue Scale(VAS) score was greater than 5 points, intravenous fentanyl 1 μg/kg could be administered. If the VAS score was greater than 5 after total fentanyl 5 μg/kg, general anesthesia was used to complete the operation.The VAS scores of the two groups were recorded during surgical incision, traction and incision of the peritoneum, establishment of subcutaneous tunnel, suture, 2 h after surgery, 12 h after surgery and 24 h after surgery. The additional amount of analgesic fentanyl, the surgeon′s satisfaction with the anesthetic effect, the general anesthesia during surgery, and the adverse reactions associated with anesthesia were recorded.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The intraoperative VAS score of the two groups decreased gradually from the beginning of surgical incision to the suture, and the postoperative VAS score of the two groups decreased gradually. The interaction differences between the two groups of intraoperative and postoperative VAS score were statistically significant(P＜005). The total dose of fentanyl was significantly lower in the AA group than in the BA group(P＜005). Compared with the BA group, the satisfaction of surgeons in the AA group was higher, and the rate of general anesthesia was lower, the difference was statistically significant(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Acupuncture combined with basic anesthesia in peritoneal dialysis surgery is more safe and effective than basic anesthesia.
    Comparison of effects and safety of oxycodone and morphine for postoperative analgesia after combined spinalepidural anesthesia for pregnant women undergoing cesarean section
    PENG Jibin, FANG Mingxing, MA Jiao, ZHANG Qi
    2019, 40(8):  937-939,945.  doi:10.3969/j.issn.10073205.2019.08.017
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    ［Abstract］ Objective〖HTSS〗〓To analyze and compare the effects and safety of oxycodone and morphine for postoperative analgesia after combined spinalepidural anesthesia for pregnant women undergoing cesarean section.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 68 cases of pregnant women with cesarean section who underwent combined spinalepidural anesthesia in our hospital were retrospectively analyzed. They were divided into oxycodone group(36 cases) and morphine group(32 cases) according to the postoperative analgesia methods. The Visual Analogue Scale(VAS) and levels of serum cortisol(Cor) and serum prolactin(PRL) were compared between the two groups at 6 h(T1), 12 h(T2), 24 h(T3) and 48 h(T4) after operation, and the occurrence of adverse reactions of postoperative analgesia was compared between the two groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The VAS score and Cor level in the two groups at different time points after operation showed gradual downward trend, and VAS score and Cor level in oxycodone group at different time points after operation were lower than those in morphine group(P＜005), and the PRL level was decreased first and then increased, and there were significant differences in the betweengroup effects, timepoint effects and interaction effects of betweengroups and timepoints of VAS score, Cor level and PRL level between the two groups(P＜005). The total incidence rate of adverse reactions of postoperative analgesia in oxycodone group was significantly lower than that in morphine group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Oxycodone has more advantages in analgesia and adverse reactions control, and it also has positive effects on improving postpartum lactation function.
    Study on HPLC fingerprint of Cortex Fraxini and its confusable species#br#
    ZHANG Jian1, FU Shan2，3, LIU Xin2, GAO Yanhua2, TIAN Yuhuan2, WANG Qiao2*
    2019, 40(8):  940-945.  doi:10.3969/j.issn.10073205.2019.08.018
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    ［Abstract］〓Objective〖HTSS〗〓To establish the high performance liquid chromatography(HPLC) fingerprint of Cortex Fraxini and its confusable species and to provide a new basis for quality control of Cortex Fraxini.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The chromatographic separation was carried out on an Agilent Zorbax SBC18 column(250 mm×4.6 mm, 5 μm) with solvent A (methanol) and solvent B(water containing 0.5‰ acetic acid) as the mobile phases in gradient elution. The detection wave length was 230 nm. Using the similarity evaluation system of chromatographic fingerprints of traditional Chinese medicine, taking aesculin as reference peak, the fingerprints of 52 batches, 4 cultivars of Cortex Fraxini samples and 3 batches of confusable species were established respectively.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Ten common peaks were found in 52 batches of Cortex Fraxini, and the 52 batches of samples could be divided into 3 categories, with similarities ranging from 0.8 to 1.0, 0.6 to 0.8 and 0.4 to 0.6, respectively. The similarity within 4 cultivars of Cortex Fraxini was higher, but there were differences among cultivars. The similarity of the 3 batches of confusion species was less than 0.47, and there were only two peaks, which showed great difference compared with the genuine products.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The established HPLC fingerprint method of Cortex Fraxini could distinguish Cortex Fraxini with confusable species, which could be used for the quality control of Cortex Fraxini.