加味黄连温胆汤治疗代谢综合征早期肾损害的临床疗效观察

目的:观察加味黄连温胆汤治疗代谢综合征(Metabolic Syndrome,MS)早期肾损害的临床疗效。方法:选择40例MS痰瘀互结证患者,随机分为两组,对照组进行常规基础治疗,包括改善生活方式,增加运动,其中有高血糖、高血压、高血脂的患者分别对症给予控制血糖、血压、调脂治疗,治疗组在常规治疗基础上加用加味黄连温胆汤,治疗6周后观察两组患者中医证候及尿微量系列的变化情况。结果:两组患者治疗后中医证候积分较治疗前明显下降,且治疗组优于对照组(P<0.05);临床疗效方面,治疗组总有效率达95.0%(19/20),对照组总有效率85.0%(17/20),治疗组优于对照组(P<0.05);两组患者治疗后AIM、TRU、MA均较治疗前明显改善(P<0.05),且治疗组优于对照组;对照组治疗后与治疗前比较IGU无统计学意义(P>0.05),治疗组治疗后IGU较治疗前明显改善(P<0.05)。结论:加味黄连温胆汤可有效降低MS患者的尿微量白蛋白系列,改善临床症状,防治肾脏早期损害。

公路路面早期损坏的原因浅析及对策

公路路面早期损坏是一个老问题,牵涉到管理、设计、施工、监理以及路政等各个方面,必须在每一个环节上从严入手,科学合理地做好设计,按规范规程进行施工,密切配合施工单位做好质量检测,在管理上与路政等有关单位携手,彻底根治超限运输。只有这样,才能从根本上解决路面早期损坏的问题。

公路工程沥青路面施工技术与质量控制策略

影响沥青路面施工质量的因素非常多,原材料生产、设备性能的稳定性、温度控制、级配离析及施工作业等都很重要,其中施工作业最为关键。本文提出沥青路面施工必须控制好原材料质量,做好级配试验,合理选择压路设备,增强施工工艺,以提高沥青路面的耐久性和均匀度。

公路工程沥青路面施工技术及质量控制要点探究

随着我国城市现代化进程的加快,道路交通项目的建设需求和功能要求不断增加,建设单位必须努力确保道路的总体结构具有良好的平坦性和流动性,为人们的出行安全提供重要保障。影响沥青路面施工质量的因素很多,如原材料生产、设备性能稳定、温度控制、级配离析、施工操作等,其中施工操作最为关键。提出沥青路面施工必须控制原材料质量,做好级配试验,合理选择路面压实设备,加强施工工艺,以提高沥青路面的耐久性和均匀性。

Improvement of the zygote utilization and reduction of the seedling loss in the early stage of seedling production of Sargassum thunbergii (Fucales, Phaeophyta)

Artificial seedling production of Sargassum thunbergii is an effective way to relieve pressure on natural resources.In order to improve the utilization of zygotes and reduce the loss of seedlings,studies on the characteristic of the zygotes release,the development of rhizoids,the attachment of germlings,and the influence of jet washing were conducted.Results show that the percent of zygotes released was increased with time in the first 60 h.The capacity of germlings attached to the substratum was significantly increased,especially coincident with the time of the new rhizoids emerged and elongated.The detachment rate of germlings significantly decreased with the delay of starting time of jet washing or the reduction of jet washing velocity.However,the jet washing at any level applied in the experiment could cause considerable loss of germlings within the 20 days after the attachment.Our study provided some parameters to optimize the operation in the early stage of seedling production.

The Role of Heat Shock Protein 70, IgE and MMP-9 in Detecting Early Minor Myocardial Damage and Evaluating the Efficacy of Coronary Artery Bypass Grafting （CABG）

The objective of this research was to identify levels of heat shock protein 70 （Hsp 70）, total immunoglobulin E （IgE） and matrix metalloproteinase-9 （MMP-9） before and after coronary artery bypass grafting （CABG） surgery. Hsp 70, IgE, MMP-9, creatine phosphokinase-MB （CPK-MB）, and lactate dehydrogenase （LDH） levels were measured in normal subjects （n = 20）, and in patients with chronic stable angina pectoris who were referred for elective CABG, before and after performing CABG-surgery （n = 20）. Compared with normal subjects, increased Hsp 70 and IgE levels, unchanged MMP-9 level, and activities of CPK-MB and LDH were found in the pre-operative patient group. Hsp 70 and IgE levels in the post-operative period were significantly reduced when compared to pre-operative period. Hsp 70 and IgE might be used as markers for detection of early minor myocardial damage, and coronary insufficiency with less overt damage than myocardial infarction, as significant changes in their levels appear before occurrence of in any changes in the levels of MMP-9, CPK-MB and LDH. Besides, Hsp 70, and IgE returning to the normal levels after CABG surgery, suggest that they could be helpful to evaluate the effect of CABG surgery.

Recent Possibilities for the Diagnosis and Pharmacological Control of Pregnancy Loss in Dairy Cow

One of the most recent techniques for the diagnosis of EP （early pregnancy） in cattle on the farm is B-mode ultrasonography. Under field conditions, acceptable results may be achieved with ultrasonography from days 25 to 30 post-AI. The reliability of the test greatly depends on the frequency of the transducer used, the skill of the examiner, the criterion used for a positive PD （pregnancy diagnosis） and the position of the uterus in the pelvic inlet. Pregnancy protein assays （PAG, PSPB） may provide an alternative method to ultrasonography for determining EP or LEM/EFM （late embryonic/early foetal mortality） in the cow. Although early pregnancy factor is the earliest specific indicator for fertilization, its detection is entirely dependend on the use of the RIT （rosette inhibition test）, therefore its use in the field needs further inventions. Preventive pharmaceutical treatments with hCG （human chorionic gonadotropin）, GnRH （gonadotropin realising hormone）, PRID （progesterone-releasing intravaginal device） or CIDR （controlled internal drug release） inserts at different time periods at or post-AI may have some benefit in decreasing PL （pregnancy loss）, however further examinations are warranted to determine how and when these treatments may influence PL in the field.

Single-strand DNA damages and its relationship with morphological change of neurons at early stage of rat cerebral ischemia/reperf usion

Objective：To discuss the DNA-strand breaks at early stage of middle cerebral artery occlusion/reperfusion (MCAO/R). Methods: Neurons number and morphologic change were observed by Nissl stain method, and DNA strand breaks were in situ detected by using DNA polymerase- I Klenow fragment-mediat-ed nick end-labelling method (Klenow method). Results: Six hours after reperfusion, a few neurons in dam-aged regions appeared morphologic changes while a few Klenow-positive cells were detected (P<0. 01). Twenty-four hours after reperfusion lots of neurons showed morphologic change while the number of Klenow-positive cells immediately and remarkably increased (P<0. 01). Seventy-two hours after reperfusion the number of neurons decreased significantly and the number of Klenow-positive cells was also less than that in 24 h (P<0. 05). Conclusion: ① 24 h after reperfusion when the number of Klenow-positive cells reached peak value, DNA single-strand breaks (SSBs) took place in many Klenow-positive cells, and presumed that DNA SSBs might be an important step in DNA-damage procession which might be induced by free radicals. ② At the same time when lots of DNA SSBs were produced, many neurons in the damaged regions showed morphological change, which indicated that lots of neurons had already progressed to irreversible damages when DNA SSBs took place.

SIOOB protein and its clinical effect on craniocerebra injury

Objective： To explore the role of S100B protein in the early diagnosis, treatment, and prognosis judgement of craniocerebral injury. Methods： In this study, we reviewed the domestic and foreign research reports about the relationship between S100B protein and craniocerebral injury. Results： The concentration of S100B protein had a different increase based on the degree of injury in early stage after craniocerebral injury, and the increasing degree of S100B protein showed a positive correlation with the grading of pathogenetic condition and prognosis of craniocerebral injury. Conclusions： S100B protein may be taken as a specific index of early diagnosis, grading of pathogenetic condition, and prognosis judgement after craniocerebral injury. To grasp and regulate the mechanism of neurotoxicity and to elucidate the therapeutic effect of S100B protein will be a research direction in clinical treatment of craniocerebral injury.

Detection of gene expression pattern in the early stage after spinal cord injury by gene chip

Objective: To study the changes of the gene expression pattern of spinal cord tissues in the early stage after injury by DNA microarray (gene chip). Methods: The contusion model of rat spinal cord was established according to Allen’s falling strike method and the gene expression patterns of normal and injured spinal cord tissues were studied by gene chip. Results: The expression of 45 genes was significantly changed in the early stage after spinal cord injury, in which 22 genes up regulated and 23 genes down regulated. Conclusions: The expression of some genes changes significantly in the early stage after spinal cord injury, which indicates the complexity of secondary spinal cord injury.

Effect of Tuina on Neurodevelopment in Premature Infants with Brain Injury

Objective： To investigate the effect of tuina on promoting neurodevelopment of premature infants with brain injury. Methods： A total of 82 cases who met the inclusion criteria were randomized into an intervention group and a control group. In addition to early conventional intervention （Chinese medicinal bath therapy and physical training）, specific tuina manipulations （aims to unblock the Governor Vessel, refresh the brain, benefit the kidney and strengthen the spleen） were combined in the intervention group, whereas comforting touch in the control group. The rehabilitation assessments were then made prior to treatment and three months after the treatment using Gross Motor Function Measure （GMFM）, Bayley Scales of Infant Development-II （BSID-II） and Gesell Developmental Schedules （GDS） based Developmental Quotient （DQ）. Results： The DQ in all GDS areas and scores of GMFM A and B dimensions were significantly increased in both groups after the treatment （P〈0.01）. The DQ and population mean of GMFM B dimension in the intervention group were higher than those in the control group, showing statistical differences （P〈0.05）. However, in terms of Mental Development Index （MDI） and Physical Development Index （PDI） in both groups, there were no statistical differences before and after treatments. Conclusion： Both methods combined with conventional early intervention can help to improve the mental and motor development of infants with brain injury. However, the specific tuina manipulations have been proved more effective in improving the infants＇ gross motor function, particularly the ＂sitting＂ item.

Microsurgical repair at early stage for soft tissue defect of limbs wounded by modern firearm

Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result. Methods: Defects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps. Results: Wounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control. Conclusions: Skin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.

Research progress of acute coagulopathy of trauma-shock

Acute coagulopathy of trauma-shock （ACoTS） occurs in 25% of patients with severe trauma in the early phase, and the mortality of those patients is four-fold higher than patients without coagulopathy. The pathophysiology of this complicated phenomenon has been focused on in recent years. Tissue injury and hypoperfusion, activated protein C and Complements play important roles in the early phase after trauma. While the use of blood products, hypothermia, acidosis and inflammation are the main mechanism in late phase. Supplementing coagulation factors and platelets to improve ACoTS are inefficient. Only positive resuscitation from shock and improving tissue hypoperfusion have expected benefits.

Simultaneous bilateral anterior shoulder dislocation： report of two cases and review of the literature

Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had satisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment.An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature.

Sodium valproate for prevention of early posttraumatic seizures

Objective： To assess the preventive effect of sodium valproate on early posttraumatic seizures in traumatic brain injury （TBI） patients. Methods： The retrospective study was based on 159 patients with TBI treated at Department of Neurosurgery, Nanjing General Hospital of Nanjing Command enrolled between January 1, 2008 and December 31, 2009. The inhospital section of the retrospectively collected database includes information on age, sex, initial Glasgow Coma Score （GCS）, results of CT scanning, operation, usage of sodium valproate, seizures in the first week after injury and outcome. Results： Seven patients （4.4%） showed early posttraumatic seizures. Although the incidence was zero in patients who received sodium valproate treatment, the difference between the treatment and control groups was not statistically significant. Of the 87 severe TBI patients （GCS3-8）, 6 patients in the control group （6.9%） suffered from early seizures during the first week after TBI and no patient who received preventive therapy suffered from seizures. The difference between the treatment and the control groups was still not statistically significant. Of the 72 mild and moderate TBI patients （GCS 9-15）, only 1 patient in the control group suffered from seizures and no patient in the treatment group suffered. Conelusions： Although the results suggest that the study is not sufficiently powerful to detect a clinically important difference in the seizure rates between the treatment and control groups, sodium valproate is effective in decreasing the risk of early posttraumatic seizures in severe TBI patients. Further prospective studies are recommended.