Objective:To observe the sedative effect of epidural anesthesia assisted with target controlled infusion(TCI) propofol.Methods:45 ASA Ⅰ～Ⅱ patients,who would accept hysterectomy,were randomly allocated to group Ⅰ (without propofol),group Ⅱ(Target blood propofol concentration was set at 1.0?g/ml when epidural anesthesia level was confirmed) and group Ⅲ(Target blood propofol concentration was set at 1.5?g/ml).Heart rate and blood pressure were determined at the different moment from pre-operation to the end of the surgery.And the sedation degree was evaluated by the Observer's Assessment of Alertness/Sedation (OAA/S) Scale.At the same time,efficacy of antitraction response and perioperative awareness were investigated.Results:In three groups,blood pressure significantly decreased when epidural anesthesia level was confirmed.Goup Ⅱ and Goup Ⅲ showed significantly lower than group Ⅰ in 5 min after propofol infusion.HR gradually decreased with operative courses,and no difference was significantly found in the three groups.53.3% of patients fell asleep;53.3% had effective antitraction response and 33.3% were aware in group Ⅱ.And the patients in goup Ⅲ all fell asleep;86.7% could prevent traction response during operation but no perioperative awareness.Conclusion:Target controlled infusion of propofol as an adjuvant for epidural anesthesia is applicable and can prevent viscus traction response during surgical exploration.And the sedative effects of blood propofol concentration of 1.5?g/ml are better than 1.0?g/ml through OAA/S Scale.

Objective To investigate the incidence and the risk factors of the vascular disease in lower limbs of patients with type 2 diabetes(T2DM).Methods To retrospectively analyze 318 cases with T2DM patients.All the patients were checked on both lower limbs by color ultrasonic Doppler.The differences of ordinary and biochemical indicators between PVD group and non-PVD group were compared.Results There were 67.2％ (205/318) patients who had vascular disease in lower limbs with type 2 diabetes.Age,course of disease,HbAlC,TC,TG,SBP,DBP and BMI in PVD group were significantly higher than those in non-PVD group( P ＜ 0.01 ).Conclusion There was higher incidence of the vascular disease in lower limbs of patients with type 2 diabetes.And the independent risk factors were hypertension,hyperglycemia,hyperlipemia.It could help to prevent the development of lower limb blood vessel pathological changes in DM patients by controlling the levels of blood pressure,lipid and blood sugar strictly.

60 yr ( n = 225) and group Ⅱ 0.05 ) . Conclusions The results suggest that the higher incidence of postoperative neurological complication in elderly patients is associated with higher rate of cerebral desaturation during operation and preoperative cerebrovascular diseases, but is not related to the number of microemboli passing through MCA during CABG.

There are multiple types of inhibitory immune cells in tumor. Among these cells, Treg (regulatory T cell) plays an extremely important role in tumor development and progression. Treg exihibits potent inhibitory effects on effector cells by a variety of mechanisms, which might be the the key factor for tumor immune escape. These mechanisms include inhibiting the effector cell function by inhibitory cytokines, killing effector cells by granzyme and profrin, interfering effector cell metabolism, and affecting Treg differentiation and proliferation by regulating the function of dendrtic cells, etc. The research on Treg has provided new strategies for tumor immunotherapy. Tumor immunotherapies targeting Treg and related immunosuppressive factors, such as deleting Treg nonsepcificlly or sepcificlly controling the numbers and functions of Treg, might have a bright future in clinical application.keyword regulatory T cell(Treg); neoplasms; immune escape; immunotherapy

BACKGROUND:Basic fibroblast growth factor (bFGF) can enhance fibroblast proliferation and col agen deposition, and vascular endothelial growth factor (VEGF) can improve blood perfusion and metabolic level of pathological tissues. Additional y, both of them can boost the alkaline phosphatase activity under given conditions. OBJECTIVE:To evaluate the effect of bFGF combined with VEGF on the periodontal ligament fibroblast proliferation and alkaline phosphatase activity in rats. METHODS:Rat periodontal ligament fibroblasts were cultured in vitro, its embryonic origin was identified and passage 4 cel s were used for the fol owing experiments. Effects of bFGF and VEGF with different concentrations on the rat periodontal ligament fibroblast proliferation were detected to determine the minimum and maximum effective concentrations. Cel s were divided into five groups:group A (control group) with DMEM containing 2%fetal bovine serum;group B as maximum effective concentration of VEGF group;group C as maximum effective concentration of bFGF;group D as minimum effective concentration of bFGF combined with minimum effective concentration of VEGF group;group E as maximum effective concentration of bFGF combined with maximum effective concentration of VEGF group. At 3, 7 and 14 days, the alkaline phosphatase activity in each group was detected. RESULTS AND CONCLUSION:Rat periodontal ligament fibroblasts derived from the mesoderm grew wel . Rat periodontal ligament fibroblast proliferation was increased with the VEGF and bFGF concentration increasing (P<0.01). The maximum and minimum effective concentrations of VEGF were 100 and 10μg/L, and the maximum and minimum effective concentrations of bFGF were 10 and 0.1μg/L. The absorbance values in the groups D and E were higher than those in the group A. The absorbance values of the group D were significantly lower than those of the group E at 3 and 7 days (P<0.05), but did not significantly differ at 14 days (P>0.05). To conclude, the combination use of the maximum effective concentration of VEGF and bFGF can play a significant synergistic effect on the alkaline phosphatase activity at a given time, but the minimum and maximum effective concentrations show no significant differences if not in the given time, which may be related to the time-effectiveness of these two factors and the receptors of periodontal ligament cel s. Subject headings:Fibroblast Growth Factor 2;Vascular Endothelial Growth Factors;Alkaline Phosphatase;Tissue Engineering

Objective To observe the distribution and drug resistance of pathogenic bacteria causing pulmo-nary infections in cardiology department of general hospital ,and to provide advices for infection control and selection of drugs.Methods 110 sputum specimens of patients with pulmonary infections in cardiology department were col -lected.The distribution and drug resistance of pathogenic bacteria were analyzed .Results In the 110 sputum sam-ples,83 cases(75.5%) were infected by gram-negative bacterias,21 cases(19.1%) were infected by gram-positive bacterias,6 cases(5.4%) of fungal infection .The Escherichia coli and the Pseudomonas aeruginosa after the antibiot-ic resistance analysis were found a trend of multi resistance .Conclusion The major pathogenic bacterias causing pulmonary infections in cardiology department are gram-negative bacterias ,and they show a trend of multi resistance .

Objective To investigate the changes of platelet activating factor ( PAF) in serum from patients with hypertensive disorder complicating pregnancy .Methods The specimens from 138 women were obtained at Department of Obstetrics , Xinhua Hospital , School of Medicine , Shanghai Jiaotong Uni-versity, between June 2008 and March 2010.They were divided into two groups:women( n =63) with hy-pertensive disorder complicating pregnancy and normal pregnant women ( n =75 ) ( control group ) .All of them delivered until maturity .ELISA was used to detect the levels of PAF in those women's serum and in the umbilical cord serum .Results The levels of PAF in hypertensive disorder complicating pregnancy group (27.46 ±13.37 ) ng/ml were no significantly different from the control group (25.48 ±11.05 ) ng/ml( P >0.05 ) .With the hypertensive disorder complicating pregnancy more deteriorative , the levels of women ser-um PAF would be higher .The levels of women's serum PAF in hypertensive disorder complicating pregnancy group were significantly higher than the umbilical cord serum [0.00(0.00-8.83) ng/mL]( P <0.05). The levels of women's serum PAF in control group were also significantly higher than the umbilical cord ser -um[0.00(0.00-7.80)ng/mL]( P <0.05).Conclusion There are some relationships between PAF and hypertensive disorder complicating pregnancy .

Inverse agonist is a new type of drug acting on receptors.Its research has experienced several stages, including discovery of ethylβ-carboline 3-carboxylate,activity study,proposal of the concept,two-state model,and constitutive activity theory in succession.Most G protein-coupled receptors possess constitutive activity,i.e.a proportion of receptors are in active state and can produce effects without any agonist.Inverse agonist has an affinity to receptors,but no intrinsic activity,so it cannot activate receptors.However,it can antagonize the constitutive activity of receptors,and produce an opposite effect on the corresponding agonist.Both agonist and inverse agonist can produce their effect alone with different mechanisms.Agonist activates its receptors,but inverse agonist antagonizes them.Both inverse agonist and antagonist can antagonize receptors.However,inverse agonist and antagonist antagonize the constitutive activity of receptor and the agonist’s effects,respectively.Inverse agonists can be used to treat diseases with enhanced constitutive activity,up-regulate and sensitize receptors with constitutive activity.Moreover,endogenous inverse agonists can maintain a specific physiological function.The study on inverse agonist has a theoretical significance in perfecting receptor theory as well as a clinical value in diagnosis and treatment of diseases with enhanced constitutive activity.

In recent year , there are some questions about abortion of disposal .Though the aborted fetus is un-born, the aborted fetus in different stage has the different attribute of ethics .It should be considered with the hu-man right and the personality right .The value in embryonic stem research and organ transplantation of aborted fetus has raised some problems , such as ethical review , the choice of test sample .The existing legal provisions are not sufficient to solve practical problems .We should disposal aborted fetus of different stage through the way of more moral significance .

At present,there are many problems in the cultivation for the young clinicians including lack of subjective initiative,insufficient innovation education.This paper analyzed the current status of the academic and charactersfic training of the young clinicians then put forward new training methods which can be used for reference.Developing prominent features and novelty is the most important way to implement the aforementioned training methods.