ObjectiveTo observe the effcacy of isoflurane supplemented with ropivacaine for sacral block in indirect inguinal hernia.Methods120 cases of children who were going to be operated in inguinal hernia repairs were randomly divided into isoflurane group( A),ropivacaine group( B ),and isoflurane supplemented with ropivacaine group(C).Sacral block was performed after induction with different anesthetics.Haemodynamics( MAP、HR 、SpO2 ) in three groups were compared,and anesthesia effect,waking time,drug dosage and adverse reactions were analyzed.ResultsHaemodynamics in isoflurane supplemented with ropivacaine group were more stable than the other two groups,and anesthesia effect was better than isoflurane group and ropivacaine group( all P ＜0.05).Moreover,waking time,drug dosage and adverse reactions in group C were statistical differently conpared with controls( all P ＜ 0.05 ).ConclusionIsoflurane supplemented with ropivacaine for sacral block was helpful for respiration and circulation management applied in indirect inguinal hernia and could be a perfect anesthetic methods.

With Chira's proposal of building an innovative country and implementing national intellectual property strategy,the rapid development of intellectual property,reward system of science and technology had a profound effect.This article made preliminary discussion from the level of scientific and technological achievements,the evaluation system and the types of science and technology rewards.

Objective:To investigate the expression of protein kinase C (PKC) isoforms ?,? in diabetic rats and evaluate the relation between altered PKC ?,? expression and the pathogenesis of diabetic retinopathy (DR).Methods:Wistar rats were randomly divided into control group and diabetic group induced by streptozotocin;osmotic shock method was used to isolate the retinal vessels of rats;and PKC isoforms ?,? espression were determined after 2 weeks,2 months,4 months and 6 months follw-up.DR was assessed by quantitative morphometry of capillary bed.Results:Diabetes could induce the translocation of PKC isoform ? from cytosol to membrane pool after 2 weeks,2 months,4 months and 6 months,but ? isoform translocated from membrane to cytosol pool in retinal vessels of diabetic rats after 2 weeks,2 months,4 months and 6 months.Diabetic rats showed pericyte decrease and capillary basement thickening in deep capillary bed of retina after 6 months follow-up.Conclusion:The expression of PKC isoforms ?,? varies in different stages of DR,and the effect of PKC isoforms on the pathogenesis of DR is different.

It is generally considered that the experiment of radioligand binding assay ( RBA) of receptors with frozen tissue sections is difficult. In this study the conditions involved in the RBA of ?-adre-nergic receptors with rat brain sections on the superior colliculus level was investigated. 3H-Dihydroalprenolol (3H-DHA), a ?-adrener-gic receptor antagonist, was used as the labeled ligand. The data obtained from this experment are as follows: Bmax=17.3?4.5fmol/mg of dry tissue, Kd=5.8?0.6nM, association rate constant=0.112?0.025 nM-1 ? min-1,dissociation rate constant=0.69?0.07min-1, the IC50 of propranolol=1.00?0.15?10-8M, IC50 of practolol=1.67?0.22?10-5M, IC50 of isopreterenol=1.32?0.31 ? 10-6M.These results are in agreement with those obtained from RBA with homogenate, which indicates that the frozen tissue sections are useful preparations in the RBA of ?-adrenergic receptors.

Internship is an important stage in which medical students utilize and develop their aca-demic theory to inform clinical practice. In this stage, practical teaching combining the theoretical study with clinical practice to refine interns' clinical skills is the only way to train qualified clinicians. The teach-ing during orthopaedic internship is facing the following problems, such as complex anatomy and difficult learning curve associated with orthopaedic clinical practice. In addition, interns face the employment pres-sure, and the clinical practice time may be occupied by job hunting or preparation for postgraduate entrance examination. For teachers, since clinical doctors are tired of clinical work and scientific research, they can-not devote more time and energy to teaching. In this study, the author summarizes the problems of orthopedic practice teaching in recent years and presents a series of solutions, such as standardizing clinical thinking, improving the students' clinical participation, standardizing teaching assessment and so on, which have improved the teaching quality of orthopedic clinical practice.

Objective: To study the risk factors of postoperative hematoma after craniotomy and to reduce the occurrence of post-operative hematoma.Methods: The clinical data of 687 cases of intracranial neoplasms(meningioma,glioma,aneurysm) were analyzed retrospectivel.Results: Meningioma surgery carried a higher risk for postoperative hematoma than other intracranial neoplasms.The incidence of post-operative hematoma showed no significant difference between patients with glioma and these aneurysm.The incidence of post-operative hematoma in the elder was higher than that in the young or the middle-age with.The incidence of postoperative hematoma in patients with dysfunction coagulation was higher.Conclusions: The incidence of postoperative hematoma was higher for craniotomy in neurosurgery.The morbidity of postoperative hematoma in patients undergoing intracranial surgery was different regarding types of operation,age of patients and alteration of coagulation.

It is very difficult to distinguish infectious lung diseases from no-infectious ones,and a correct practice guideline is of great significance.There are several important principals for physicians in dealing with the situation:collection of a detailed patients' history and physical examination information,objective evaluation of laboratory findings,an ability of imaging diagnosis and differential diagnosis,prompt invasive procedure with caution,and skillful empiric treatment.Different pathogens should be tested for infectious lung diseases.The non-infectious lung diseases should be handled with strong sense of caution,so as to avoid misdiagnosis and missed diagnosis.

Detrusor intability is one of the most common micturation dysfunction diseases in clinic. Detrusor is a kind of excitable tissue. High excitability of detrusor plays a major role in the cause of DI. The increase in excitability is myogenic in DI, and it is not directly related to neurogenic factors. The transmembrane potential, ion channels and signal transmission between cells are the main factors in the production of cell excitability changes. It is worth to study the myogenic factors to explore the treatment of detrusor instability. Proper treatment of the primary diseases, depress the excitability and block the signal transmission would be effective therapeutic strategies.

Objective To study the clinical application of 3-dimensional arterial spin labeling technology (3D-ASL) in brain tumors.Methods Twenty patients with the pathological diagnosis of brain tumors were selected in this study,with low grade glioma in 4 cases,the high grade glioma in 2 cases,lymphoma in 1 case,metastatic tumor in 7 cases,meningioma in 6 cases.All patients were appLIed preoperative 3D-ASL and dynamic contrast-enhanced perfusion magnetic sensitive (DSC) MR imaging line two methods,to analyze the value of 3D-ASL in brain tumors.Results 3D-ASL examination lesions in patients with brain tumors might be displayed in high or low perfusion; 3D-ASL and DSC were obtained from tumor tissue blood supply,the local relative cerebral blood flow (rCBF),there was no significant difference (P ＞ 0.05).The high grade glioma in 3D-ASL image showed a high perfusion,rCBF was 3.0 ± 1.3; Low grade gliomas showed low perfusion,rCBF was 0.6 ± 0.2,the rCBF between the high-and low-grade gliomas was significantly different (P ＜ 0.01).Metastatic tumor 3D-ASL showed ring high perfusion,central necrosis and edema area of low perfusion.Lymphoma 3D-ASL showed slightly higher perfusion.Meningioma showed high perfusion,and highest rCBF,3.5 ± 1.9.Conclusions 3D-ASL in the diagnosis of brain tumors,has high repeatability,non-invasive,without contrast agent.3D-ASL can be further developed into the brain blood flow dynamics of conventional evaluation methods,and can be used for brain tumors level assessment,has broad application prospects.

The adenosine triphosphate-binding cassette subfamily member 4 (ABCB4) gene encodes multidrug resistance rotein 3 (MDR3),which is expressed on the cannalicular membranes of hepatocytes and translocates major phospholipids from the inner to the outer leaflet.Phospholipids are the major carrier and solvent of cholesterol,and in combination with bile salts form mixed micelles.Defects in ABCB4 function cause a low phospholipid content in bile,resulting in cholesterol supersaturation and crystal formation.Low phospholipid-associated cholelithiasis (LPAC) is characterized by the association of ABCB4 mutations and a low biliary phospholipid concentration,resulting in symptomatic gallstones starting before age 40 years,a high serum gamma glutamyl transferase (γ-GT) activity,intrahepatic microlithiasis,and recurrent biliary symptoms despite cholecystectomy.LPAC is an autosomal recessive condition caused by a rare single-gene mutation,commonly occurring in ABCB4,and can include homozygous and heterozygous point mutations in introns,coding exons,and 5 UTR regions.