CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

EXPERIMENTAL AND CLINICAL RESEARCH OF THE EFFECTS OF ISOFLURANE ON CIRCULATORY FUNCTION

The purpose of this study was to observe the circulatory effects of Isoflurane on animals and patients, using both invasive and noninvasive methods and to evaluate the possibility of application of this general anesthetic during cardiac operation. According to various MAC. the results were divided into two groups in experimental research (8 dogs ). i.e. group Ⅰ(n=41)<1 MAC, group Ⅱ(n=27)>1 MAC, and in clinical study (31 patients), there were 3 groups, group Ⅰ(n=104)<1 MAC, group Ⅱ(n=59)>1 MAC≤2 MAC, group Ⅲ(n=15)>2 MAC. The main changes following isoflurane were as follows: 1. Preload (CVP, PCWP) CVP elevated both in animals and patients (P>0.05), PCWP increased significantly in Clinical Ⅰand Ⅱ(P<0.05), 2. Afterload (MAP, SVR, PAP, PVR) MAP and SVR decreased in both animals and patients MAP (P<0.01), SVR (P>0.05), but PAP and PVR elevated in both group (P>0.05) except in Clinical ⅢPAP and PVR were increasing (P<0.01, P<0.05); 3. Myocardial contractility, with no variation in all patients (P>0.05), but depressed in animals (P<0.05); 4. HR increased (P<0.01) but no arrhythmia; 5. SV showed no change in animals (P>0.05) but decreased in patients (P<0.05), and CO had no change in both animals and patients. It demonstrated that the effects of Isoflurane on cardiovascular function in animals or patients with noncardiac diseases were quite minimal. Although the deteriorative effect on myocardial function in patients with heart disease was less than that of Enflurane and Fluothane, during administering Isoflurane in open heart surgery especially in poor cardiac function, Isoflurane combined with intravenous anesthesia was suggested.     

APPLICATION OF XIANG CHENG SAN IN TREATMENT OF CHRONIC PROTRACTED DIARRHEA IN CHILDREN

One hundred and sixty-two children suffering from chronic protracted diarrhea were randomly divided into two groups and observed clinically. In the Chinese herbal medicine group (HM group), Xiang Cheng San was externally applied to the umbilicus of patients, while in the western medicine group (WM group), western drugs were routinely given. The results showed that the therapeutic effects were markedly better in the HM than in the WM group. Animal experiments showed that external application of Xiang Cheng San may inhib-it hyperperistalsis of the intestine in mice, suppress peristalsis of the isolated smooth muscles in rabbits, and dilate micro-vessels and thus improve micro-circulation of the mesentery in rats.     

IMMUNOSUPPRESSIVE TREATMENT OF CHILDHOOD APLASTIC ANEMIA WITH ANTITHYMOCYTE GLOBULIN (ATG) AND CYCLOSPORIN A (CSA)

This paper described the therapeutic efficacy of immunosuppressive (IS) treatment agents (ATG and CSA) and androgens in the treatment of childhood aplastic anemia (AA). The results showed that the overall curative rate was 52.4% in the ATG therapy group (21 cases) and 58.3% in the CSA therapy group (12 cases) respectively. The effective rate of all patients (SAA and CAA) was 58.1% in the IS group (18/31) and 40.4% in the androgens group (42/104), P>0.05. But, in the childhood patients with SAA, the clinical effective rate was 68.4% in the IS group and 7.9% in the androgens group, P<0.01. The laboratory tests revealed that the majority of the AA patients displalyed abnormal immunological states: inversed CD4/ CD8 ratio and increased IL-2 activity. These abnormal immunological states could be normalized in several patients when clinical response was abtained following IS therapy with ATG and CSA.     

THERAPEUTIC EFFECT OF NON-SURGICAL TREATMENT OF CHRONIC PERIODONTITIS IN DIABETIC CHINESE

Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese with chronic periodontitis. Methods Moderate to advanced chronic periodontitis (CP) was studied in 36 diabetes mellitus （DM) patients ctassified as 20 with hihg and fluctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PII), gingival index (GI), bleeding on probing (BOP), probing depth (PD) and clinical attachment loss ( AL ) of all patients were recorded at 6 sites on each tooth at the baseline and 1,3 and 6 months after oral hygiene instruction ( OHI) , scaling and root planing. Results It was found that the short-term effect of non-surgical periodontal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.     

Effect of Dermabrasion and ReCell? on Large Superficial Facial Scars Caused by Burn,Trauma and Acnes

Objective To explore the effects of dermabrasion combined with ReCell? on large superficial facial scars caused by burn, trauma and acnes. Methods Nineteen patients with large superficial facial scars were treated by the same surgeon with dermabrasion combined with ReCell?. According to the etiology, patients were classified into post-burning group (n=5), post-traumatic group (n=7) and post-acne group (n=7). Fifteen patients completed the follow-ups, 5 patients in each group. Healing time, complication rate, the preoperative and 18-month-post-operative assessments using Patient Satisfaction Score (PSS), Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) of each group were analyzed to compare the effect of the combined therapy on outcomes. Results The healing time of post-burning group (19.6±4.0 days), post-traumatic group (15.8±2.6 days), and post-acne group (11.4±3.1 days) varied remarkably (F=7.701,P=0.007). The complication rates were 60%, 20%, and 0 respectively. The post-operative POSAS improved significantly in all groups (P<0.05), where the most significant improvement was shown in the post-acne group (P<0.05). The post-operative PSS and VSS improved only in the post-traumatic group and post-acne group (allP<0.05), where the more significant improvement was also shown in the post-acne group (P<0.05). Conclusions The combined treatment of dermabrasion and ReCell? has remarkable effect on acne scars, moderate effect on traumatic scars and is not suggested for burn scars. POSAS should be applied to assess the therapeutic effects of treatments for large irregular scars.     

VALUE OF ANGINA PECTORIS AFTER MYOCARDIAL INFARCTION IN PREDICTING EXTENT OF CORONARY ARTERY DISEASE

Clinical , hemodynamic, and angiographic data were examined in 53 patients who underwent catheterization within 6 months of documented acute transmural myocardial infarction (MI). The patients were divided into two groups on the basis of presence (23 patients ,group I) or absence (30 patients. Group II ) of angina pectoris 1 month after MI. Group I patients had more severe coronary artery disease and a greater prevalence of multivessel disease than group II patients. Partial preservation of segmental left ventricular wall function in group I was related to the presence of collateral vessels. In patients with single vessel disease , incidence of spontaneous recanalization of the infarct – related artery was mote common in group I as compared with those in group II .It is concluded that angina pectoris after MI suggests multivessel disease or infarct – related artery recanalization .Coronary angiography may be advised in these patients in order to select adequate therapeutic interventions and improve prognosis.     

Serum metrix metalloproteinase-9 combined with homocysteine, IL-6, TNF-α, CRP, HbA11c and lipid profile in the incipient diabetic nephropathy with or without macrovascular diseases

Objective: To evaluate the changes of serum matrix metalloproteinase-9 (mmp-9) in patients of incipient diabetic nephropathy with or without macrovascular disease and to analyze the factors associated with homocysteine(hcy), interleukin-6(IL-6), tumor necrosis factor-alpha (TNF-α), highly sensitive C-reactive protein (hsCRP), HbA1c and lipid profile in those patients in order to know whether this marker or other factors are more important to induce diabetic macrovascular disease. Methods: Type 2 diabetes mellitus(T2DM) subjects with incipient diabetic nephropathy with or without macrovascular disease were selected for participation and divided into 2 groups. The patients in group 1(n= 38) used insulin, and patients in group 2 (n = 34) were treated with an oral antidiabetic drug. Then serum mmp-9, hcy, IL-6 and TNF-αin these patients were measured, and compared to the healthy subjects as control (n= 16). The results were analyzed by SPSS13. Results: Serum mmp-9 and hcy of the patients having incipient diabetic nephropathy with macrovascular disease were higher than that of patients without macrovascular disease (P<0. 01). For insulin-injected patients, whether they accompanied with macrovascular diseases or not, the serum levels of mmp-9, hcy, IL-6 and TNF-αwere all lower, but no significant statistics compared with non-insulin used patients or the healthy subjects. The serum level of mmp-9 was more correlated with the serum hcy in antidiabetic drug used patients. (P<0. 000) Conclusion: The serum level of mmp-9 plays an important role of pathogenesis in the macrovascular disease in the incipient diabetic patients, and the serum level of hcy also can reflect the severely degree of macrovascular disease in these patients, insulin can reduce these markers.     

CLINICAL STUDY OF PATIENT-CONTROLLED EPIDURAL ANALGESIA WITH TETRACAINE HYDROCHLORIDE AFTER PULMONARY LOBECTOMY

Objective. To investigate the efficacy and safety of tetracaine hydrochloride in patient-controlled epidural analgesia (PCEA) after pulmonary lobectomy.Methods. Forty-three patients scheduled for elective pulmonary lobectomy under general anesthesia were randomly allocated into either tetracaine group (22 patients) or ropivacaine group (21 patients) . In the tetracaine group, 0. 15% tetracaine was used for postoperative PCEA, while 0. 3% ropivacaine was used in the ropivacaine group. The duration of postoperative analgesia was 48 h. The PCEA included a bolus of 6 ml with a lockout time of 1 h. Postoperative pain score was measured by visual analogue scale (VAS). Forced expired volume at the 1st second (FEV1.0), forced vital capacity (FVC), FEV1.0/ FVC and peak expired flow (PEF) were measured preoperatively and daily after surgery. Hemodynamics were monitored and recorded before and after each administration of local anesthetics during the period of the study.Results. VAS scores in both groups decreased