L-tetrahydropalmatine (THP) & verapamil ( Ver ) antagonized CaCl2-induced positive chronotropic response in spontaneously beating right atria of guinea pig, and noncompetitively antagonized CaCl2 -& isoprenaline ( Iso ) -induced positive inotropic effects of the left atria electrically driven at 1.5 Hz & Iso-induced positive chronotro-pic effects of the right atria. THP & Ver had dose-dependent & frequency-dependent inhibitory effects on contraction of the left atria, and inversed the frequency-contraction curve from positive staircase into negative staircase,but had only slight inhibitory effects on postrest potentiation. The results suggest that THP, similar to Ver, has inhibitory effects on isolated guinea pig atria, which might be related to antagonizing Ca2+ via blockade of Ca2+ influx.

Objective]Training students to consult literature, teamwork, language expression, report writing and other aspects of the ability to develop professionalism, improve the overall quality.[Methods] We review reflections of the current situation on teachingChinese Medical Historycurriculum, put forward a set of time as the main line, physicians investigating and studying as the center, set questionnaires, group discussions, class reporting, comprehensive evaluation of integrated interactive solutions.[Results] By strengthening the self-study and discussion, to stimulate students' enthusiasm for learning and exploration, so that students master the initial medical history of the life, works and academic achievements, for the future in-depth study of traditional Chinese medicine professional knowledge and lay a good foundation. [Conclusion] After preliminary practice, it achieved good results, to be promoted in Tianjin University of Traditional Chinese Medicine.

Objective To explore the management of Ttube following laparoscopic common bile duct exploration.Methods A total of 420 cases of extrahepatic with or without intrahepatic bile duct stones were given laparoscopic common bile duct exploration with T-tube drainage from July 1997 to October 2004 in this hospital.The common bile duct stones were identified and then a laparoscopic choledochotomy was carried out to remove the stones.After stone clearance,the choledochotomy wound was closed with primary duct suture or with T-tube drainage.Results The primary closure of the bile duct was performed in 27 cases((6.4%)) while the T-tube drainage was conducted in 393 cases(93.6%).The stones were completely removed during the operation in 236 cases(56.2%).Stone removal under choledochoscope was required in 184 cases(43.8%) after operation.The T-tubes were removed in 209 cases after a T-tube cholangiogram at 3~4 postoperative weeks showing no residual stones.Follow-up examinations for 3(months ~ 6) years(mean,47.5 months) in 420 cases revealed 3 cases of recurrence.Conclusions After laparoscopic common bile duct exploration,the T-tube should be removed at 3~4 postoperative weeks in the absence of residual stones on T-tube cholangiogram.However,if residual stones were found on T-tube cholangiogram,a choledochoscopy is needed for stone removal at 6 postoperative weeks after the tubes clamped for 2 weeks.

Objective To detect IgG and IgM antibodies in the sera of SARS patients, in order to find the possible causative association between new coronavirus and SARS; to compare IgG and IgM antibody titers of acute phase with those of convalescent phase, in order to find specific serological reaction of SARS virus and its clinical significance. Methods Clinical specimens of SARS patients in 4 hospitals of Guangdong Province were collected and then detected by IFA and ELISA. The specificity and cross-reaction of each specimen for confirming the new coronavirus were evaluated. Results One hundred and seventeen of 130 clinically diagnosed SARS patients showed viral specific serological reaction, with the positive rate of 90%. The IgG titer increased significantly 10 days after the onset of infection and reached a higher level (above 320) 15 days later, while IgG titer reached the highest level on the 20 th-30 th day. The specific antibodies were negative in all 119 individuals with close contact with patients and 100 normal controls. Conclusion Viral specific IgG antibody was detected in the sera of SARS patients, confirming that the patients were infected by the virus; persistent high titer of IgG antibody in the sera of convalescent patients might probably be a protective mechanism in general population.

Objective By studying the change of the special antibodies titer IgG, IgM and nucleocaspid to SARS corona virus in family clustering cases , searching and testing the special antibody to SARS corona virus in the patients kinfolks Method Testing special antibody titer to SARS corona virus of 14 patients from 5 different families and their 10 kinfolks continuously by IFA and antigen capturing ELISA methods, taken samples in the 7 th , 14 th , 30 th , 60 th , 120 th , 180 th , 210 th ,270 th ,360 th day after SARS patients infected by SARS corona virus, dilute them, and then measure titers of three kinds of antibodies ResultsDuring the testing of IgG antibody titer of the 14 SARS patients by IFA method, in the 120 th day, the average titer is up the highest value, it is 1/1 120; in the 180 th day, the average titer begins to descend, it is 1/262 in the 360 th day, the average titer is 1/71 During the testing of IgM titer, the average titer is 1/32, it is obviously lower than it in IgG testing; the IgM titer of the most SARS patients are disappear after 120 days The average value of nucleocaspid antibody titer is lower than it in IgG antibody But there are some differences in 5 cases While IgG antibody titer begins to descend in the 180th day, nucleocaspid antibody titer begins to ascend obviously, it is up to 1/790 210 th day begins to descend In the meantime, we have tested special antibody to SARS corona virus of their 10 kinfolks (include 2 children) who have contacted with SARS patients closely The samples are taken in the 14 th , 30 th , 60 th day, and all the special IgG, IgM and nucleocaspid antibody to SARS corona virus are negative ConclusionBy testing the special IgG antibody to SARS corona virus of the 14 family clustering cases ,we find the special IgG antibody titer of the SARS patient is higher, and it can remain for a long time As for the nucleocaspid antibody titer of some SARS patients ascend obviously after 180days, we think that it provide useful information for vaccine development and it is necessary for us to study more in the clinic There is no special blood serum antibody to SARS corona virus in their 10 kinfolks of the SARS patients

Objective:To explore the effect of self-made protective clothing in tracheal intubation for the patients with respiratory infectious diseases.Methods:Self-made protective clothing were made by adult model plastic raincoat with sleeve lets and goggles. A prospective randomized controlled study was conducted. Patients with severe respiratory infectious diseases who needed tracheal intubation admitted to the department of intensive medicine of the Third Affiliated Hospital of Gansu University of Chinese Medicine from January 1st 2018 to March 31st 2020 were enrolled. According to the random number table method, they were divided into two groups. The control group was wearing standard protective clothing, while the test group was wearing self-made protective clothing for endotracheal intubation. The wearing time, infection rate of operators and costs of protective clothing were compared between the two groups. The patients were sprayed with trypanosome blue diluent before tracheal intubation, and the whole body of the operator was photographed with fluorescence before wearing self-made protective clothing and after doing tracheal intubation to take off the self-made protective clothing, in order to evaluate the permeability resistance of self-made protective clothing.Results:A total of 86 patients were enrolled. There were 46 cases in the test group, included 28 cases of influenza A (H1N1) virus infection, 11 cases of influenza B virus infection and 7 cases of adenovirus infection. There were 40 cases in the control group, included 15 cases of H1N1 virus infection, 10 cases of influenza B virus infection, 10 cases of adenovirus infection and 5 cases of unknown pathogen. There was no significant difference in respiratory etiology between the two groups ( χ2 = 3.789, P = 0.435). The wearing protective clothing time of the control group was 11.6 times than that of the test group (minutes: 22.23±1.45 vs. 1.86±0.24, χ2 = 19.023, P < 0.001). The cost of standard protective clothing was 12.5 times than that of self-made protective clothing (Yuan/set: 500 vs. 40). Fluorescent photography showed that the whole body of the operator was not stained after tracheal intubation, indicating that the protective clothing had good anti permeability and achieved the protective effect. There was no operator infection in the test group and the control group. Conclusion:Self-made protective clothing has short wearing time, low cost and equivalent isolation effect compared with standard protective clothing, which is worthy of clinical promotion.

AIM: Studying the mechanism of protective role of metallothionein (MT) in hypoxic preconditioning(HPC) of cultivated rat cardiomyocytes. METHODS: Using the model of hypoxia/reoxygenation of cultivated rat cardiomyocytes. Determing the contents of MT, malonyldialdehyde (MDA) - metabolism product of lipid peroxidation and the activities of Na+ - K+ ATPase, Ca2+ - Mg2+ ATPase of cardiomyocytes 24 h after HPC, the determining the relevant changes after using MT antibody. RESULTS: After 24 h in HPC, the contents of MT and activities of Na+ - K+ ATPase, Ca2+ - Mg2+ ATPase were obviously higher than those in the control and hypoxia/reoxygenation(P＜ 0. 05 ), and the contents of MDA were decreased remarkedly (P ＜ 0.01 ). Then after using MT antibody, the activities of two enzyme were progressively decreased and the contents of MDA were significanily higher than those in the control and MT antibody - free groups(P ＜ 0.01 ). CONCLUSION: HPC may induce excessive synthesis of MT, and MT can protect myocardial reoxygenation injury by eliminating lipid peroxidation and rising the activities of Na+ - K+ ATPase and Ca2+ - Mg2+ ATPase.

Objective To evaluate the feasibility of MRI-guided vacuum-assisted breast biopsy in domestic clinical prac tice.Methods A total of 45 patients with 45 suspicious breast lesions were examined with MRI-guided vacuum assisted bi opsy.The complications were observed.And the followed-up was performed.Results In 45 suspected breast lesions,43 lesions (43/45,95.56％) were successfully sampled under MRI-guided vacuum-assisted biopsy and the pathologic diagnosis was obtained.For another 2 lesions (2/45,4.44％),the pathology diagnosis were not obtained.The time to perform MRI-guided biopsy was (45.87±8.41)min for one lesion.The 5 malignant lesions (5/45,11.11％) confirmed by biopsy pathology were consistent with postoperative pathological results.For the 38 benign lesions (38/45,84.44％) confirmed by biopsy pathology,there was no malignant performance found in MRI follow-up for 6 months.Because of successful MR imaging-guided core biopsy findings,the clinic treatments were changed in 14 patients (14/45,31.11％).Five cases (5/45,11.11％) with malignant tumors were diagnosed early.The surgical biopsy was avoided in 9 benign cases (9/45,20.00 ％) who suspected as malignant.In all 45 patients,no complications occurred,such as hematoma and infection.Con clusion MRI-Guided vacuum-assisted breast biopsy is sufficient and safe for obtaining histologic proof of lesions,and plays an important role in guiding clinic treatment of some lesions visible only by MRI.

Objective To discuss the current status of application of the four kinds of clinical decision‐making method (mode recognition method ,hypothesis deductive method ,event‐driven method and applying regulation method ) in the clinical practice of the emergency resident doctors and to understand their mastery situation of the clinical decision‐making methods and the influencing factors .Methods One thousand and thirty‐five patients collected by 207 resident doctors (5 cases were randomly collected from the patients diagnosed and treated by each resident doctor ) were divided into 3 groups according to different year systems .The clinical decision‐making methods ,diagnosis accuracy of different clinical decision‐making methods and the influencing factors of decision‐making methods were compared among different grades .Results The difference in the decision‐making methods among different year systems had statistical significance (P<0 .05);furthermore ,the difference in the diagnostic accuracy among different decision‐making methods had statistical significance (P< 0 .05) ,the differences in the defensive behaviors and different decision‐making methods were statistically significant (P<0 .05) ,the multi‐classification Logistic regression of different decision‐making methods showed that the differences in the different residency year system ,residency education ,residency clinical contacting time ,inpatient symptoms ,defensive behaviors and interrogation reliability degree had statistical significance (P< 0 .05) .Conclusion The most commonly used decision‐making method by the resident doctors is the applying regulation method .The residency year system ,resi‐dency education ,residency clinical contacting time ,inpatient symptoms ,defensive behaviors and interrogation reliability degree are the influencing factors of application of the clinical decision‐making methods in the clinical practice of the emergency medicine spe‐cialty .

Objective To investigate toxicity and teratogenic effect of Microula seed oil on embryo of rat.Methods 150 mature Wistar rats (100 females, 50 males) were selected with female∶ male = 2∶1 cage match. During the daily morning examination the sperm was discovered in the vagina as the zero day for conception.100 pregnant rats were randomly divided into 5 groups (n=20 in each group): treatment group (included 3 groups: to give Microula seed oil 2.5 g /kg, 5.0 g /kg, 10.0 g /kg body weight, ig, respectively), cyclophosphamide group(7 mg/ kg body weight, sc) and the edible oil group (to give dose, such as volume as Microula seed oil, ig). From the 7th day of pregnancy, the treatment group, the edible oil group were given intervention once a day for 10 days. From the 11th day of pregnancy cyclophosphamide group was given cyclophosphamide as intervention once a day, for 3 days. On the 20th day the pregnant rats were killed.Results The body weight of pregnant rats and the rate of live births were significantly higher in the Microula seed oil dose group than in the cyclophosphamide group (P<0.01), stillbirth rate and birth rate of absorption was significantly lower in the Microula seed oil dose group than in the cyclophosphamide group (P<0.01), and no significant difference from the edible oil group (P> 0.05); the fetal rat, body weight, body length, tail length in all groups of Microula seed oil was no significant difference from the edible oil group (P> 0.05). There was no malformation in appearance, viscera, bones in the treatment group and the edible oil group while there were 112 fetal rats with deformity in 140 in the cyclophosphamide group.Conclusion Microula seed oil at doses of 2.5 g /kg, 5.0 g /kg, 10.0 g /kg body weight had no significant role in the toxicity and teratogenicity on embryos of pregnant rats.