0.1 mV. The rabbits were randomly divided into 4 equal groups of 12 animals in each group: Ⅰ control group in which normal saline 0.2-0.3 ml?kg-1 was injected through epidural catheter; Ⅱ epidural group in which 1% lidocaine 2-3 mg?kg-1 was injected epidurally; Ⅲ propofol group in which propofol was infused iv at 20 mg ? kg-1 ?h-1 for 30 min; Ⅳ combined epidural-propofol group in which epidural 1% lidocaine and propofol iv were both administered. Blood samples were taken before and 4 h, 8 h after ligation for determination of serum concentrations of myocardial troponin I (cTn I ) and MDA and serum SOD activity.The myocardial tissue was taken from the infarct area for determination of the apoptotic myocyte count (TUNEL) and p53 and Bcl-2 protein expressions (LSAB) . Results In control group serum cTn I and MDA increased and SOD decreased significantly after ligation of LAD. Thoracic epidural anesthesia, propofol iv infusion and especially the combination of them suppressed the increase in serum cTn I and MDA and decrease in serum SOD induced by ligation of LAD.In epidural-propofol group and propofol group the apoptotic myocytes count and p53 protein expression significantly decreased, the Bcl-2 protein expression increased as compared with those in control group. Conclusion Thoracic epidural anesthesia combined with propofol can significantly protect myocardium from injury induced by myocardial infarction. This action is mediated by the depression of myocyte apoptosis and the generation of oxygen-derived free radicals.

Objective To investigate the effects of right or left transaction of cervical sympathetic trunk (TCST) on left ventricalar remodeling (LVRM) after acute myocardial infarction in rats and the mechanism. Methods Sixty-four adult mule pathogen-free SD rats (230-250 g) were randomly divided into 4 groups (n=16 each): group Ⅰsham operation (group S) ; group Ⅱ LVRM; group Ⅲ left TCST and group Ⅳ right TCST. Myocardial infarct was induced by ligation of left anterior descending branch (LAD) of coronary artery in group Ⅱ, Ⅲ and Ⅳ. Left and right TCST were performed immediately after myocardial infarct was successfully induced in group Ⅲ and Ⅳ respectively. In group S LAD and cervical sympathetic trunk were exposed but not ligated and transected. The animals were killed at 4 weeks after ligation of LAD and TCST. The weight of left ventricle was measured and left ventricle weight index calculated, Left veatricular myocardial tissue volume (V_t), the volume density of myocardial cells (V_v) and myocardial cell volmne (V_c) were quantitatively analyzed by stereological method. The c-fos mRNA expression in myocardium was determined by RT-PCR. Results The left ventricle weight index, V_t, V_c and c-fos mRNA expression were significantly increased in group LVRM (Ⅱ), left and right TCST (Ⅲ, Ⅳ) as compared with group S. Left ventricle weight index, V_v, V_t, V_c and c-fos mRNA expression were all significantly decreased in fight TCST group (Ⅳ), while left ventricle weight index, V_t, V_c and c-fos mRNA expression were significantly increased in left TCST group (Ⅲ) as compared with LVRM group (Ⅱ). Conclusion Right TCST down-regulates the increase in c-fos mRNA expression after acute myocardial infarction and inhibits the left ventricular remodeling while left TCST up-regulates the c-fos mRNA expression and promotes the development of left ventricular remodeling.

Objective To know the nursing countermeasures for the catheter associated complications during the course of hemofilitration by observation critical patients who had accepted hemofilitration.Methods Retrospective analyzed the nursing points and treatment effects among 68 critical patients with hemofilitration from June 2005 to October 2008.Results There were no venous catheters droped off,no blocked and obvious infection.6 cases with exudation,57 cases with vitro cogulation,35 cases with hypotension,21cases with hypothermia,2 cases with hypoglycemia.Conclusions Apropriate anticoagulant,observe the body temperature and keep the comfortable temperature can increase efficiency and reduce the venous catheter associated complications during the hemofilitration.

Objective To investigate the effects of penehyclidine hydrochloride (PHCD) pretreatment on expression of NF-κB and iNOS in rats with LPS-induced brain injury. Methods One hundred and five male SD rats weighing 200-220 g were randomly divided into 5 groups (n=21 each): group Ⅰ normal saline (NS);group Ⅱ LPS (L);group Ⅲ,Ⅳ,Ⅴ PHCD 0.05, 0.15, 0.45 mg/kg (D1,2,3). The animals were anesthetized with chloral hydrate 350 mg/kg. Brain injury was induced by intra-arterial LPS 150 μg administered via left internal carotid artery in group Ⅱ-Ⅴ. In group Ⅲ,Ⅳ, and Ⅴ PHCD 0.05, 0.15 and 0.45 mg/kg were given intraperitoneally (IP) at 10 min before intra-arterial LPS. The animals were decapitated at 4, 6 and 12 h after administration of PHCD (n=7 at each time point in each group). The brains were immediately removed for determination of water content, expression of NF-κB and iNOS protein and examination with light and electron microscope. Results Water content of the brain and expression of NF-κB and iNOS protein were significantly higher in group L, D1, D2 and D3 than in group NS and were significantly lower in group D2 and D3 than in group L. Intra-arterial LPS produced severe damage to the brain which was significantly attenuated by PHCD in group D2 and D3. Conclusion PHCD 0.15,0.45 mg/kg pretreatment can attenuate LPS-induced brain injury by inhibiting the up-regulation of expression of NF-κB and iNOS.

Objective To evaluate the effect of remote limb ischemic postconditioning (RLIP) combined with electro-acupuncture postconditioning (EAP) on focal cerebral ischemia-reperfusion (I/R) injury in rats.Methods Seventy male Sprague-lDawley rats,weighing 220-250 g,were randomly assigned into 5 groups (n =14 each) using a random number table:sham operation group (group S),group I/R,RLIP group,EAP group and RLIP combined with EAP group (group RLIP +EAP).Focal cerebral I/R was induced by middle cerebral artery occlusion (MCAO).MCAO was maintained for 120 min.The animals were subjected to 3 cycles of 15 min ischemia of bilateral hind limbs followed by 30 s reperfusion starting from onset of reperfusion.Dazhui and Baihui acupoints were stimulated with electric stimulator (frequency 15 Hz/2 Hz,intensity 1 mA) for 30 min starting from onset of reperfusion.Neurological deficit scores (NDSs) were evaluated at 24 h of reperfusion.The animals were then sacrificed and brains were removed to measure the infarct size and for microscopic examination of pathological changes in hippocampal CA1 region.The number of survival neurons was counted.The apoptosis in neurons was determined by TUNEL.Apoptosis index was calculated.Results Compared with group S,the NDSs,percentage of cerebral infarct size and AI were significantly increased,and the number of survival neurons was decreased in the other four groups.Compared with group I/R,the NDSs,percentage of cerebral infarct size and AI were significantly decreased,and the number of survival neurons was increased in EAP,RLIP and RLIP+EAP groups.Compared with RLIP and EAP groups,the NDSs,percentage of cerebral infarct size and AI were significantly decreased,and the number of survival neurons was increased in group RLIP+ EAP.Conclusion The combination of RLIP and EAP provides better efficacy than either alone in attenuating focal cerebral I/R injury in rats.

Tracheal intubation is an important part in clinical teaching of anesthesiology,it is also the basic skill that each anesthesiologist must master.The distinctive feature of visual technology is intuitive visual,meaning operation process and anatomical structure can be seen directly and clearly.Our department tried to teach tracheal intubation with visual technology.Teachers firstly demonstrated standard incubation with video laryngoscope and explained the related basic theoretical knowledge.Then students practiced the intubation in models until becoming skilled,finally students can practice in real patients.The teaching effect of the modified method was better compared with that of traditional method.

Objective To investigate the effects of pretreatment with different concentrations of sufentanil of ketamine on the differentiation of human helper T cells in vitro. Methods Twenty-two healthy volunteers (11 males, 11 females) aged 20-45 yrs were enrolled in this study. In each volunteer 20 ml of blood was taken from peripheral vein and divided into 7 groups: control group (0.9% NaCl), 3 sufentanil groups (0.05, 0.5, 5.0 ng?ml-1) and 3 ketamine groups (100, 500, 2 500 ng?ml-1) .Whole blood and mononuclear cells from peripheral blood (PBMCs) were incubated in the presence of 0.9% NaCl or different concentrations of sufentanil or ketamine for 24 h. Then the stimulants-phorbolmyristate + lonomycin + glgistap (inhibitor of intracellular protein transport) were added to whole blood and phytohemagglutinin (PHA) was add to PBMCs. The whole blood was incubated for another 4h and PBMCs were incubated for another 48 h. Then the T-lymphocytes were collected for determination of intracellular level of IFN-?(as a marker of Th1 cells) and IL-4 (as a marker of Th2 cells) in the whole blood using three-color flow cytometry and the expression of CCR5 + (as a marker of Th1 cells) and CCR3 + (as a marker of Th2 cells) in PBMCs. The Th1/Th2 ratio was calculated. Results In sufentanil 0.5 and 5.0 ng?ml-1 groups the percentage of Th2 cells was significantly increased while the percentage of Th1 cells and Th1/Th2 ratio were significantly decreased. In ketamine 500 and 2 500 ng?ml-1 groups the percentage of both Th1 and Th2 cells were significantly decreased and the Th1/Th2 ratio was significantly increased. Conclusion Sufentanil can encourage helper cells to differentiate into Th2 cells while ketamine inhibit the helper cells to differentiate into Th1 and Th2 cells, especially the Th2 cells in a dose-dependent manner.

Objective To investigate the primary target of injury resulting from cold preservation/reperfusion after liver transplantation in rats. Methods Male SD rats were divided into three groups randomly: sham group,UW 1-h group and UW 12-h group. Orthotopic liver transplantation was performed by using the technique described by Kamada with a modification. Survival rate of rats within 168 h postoperation was observed. Liver tissue specimens and blood samples were collected at 8 time points predetermined as 1,6,12,24,48,72,96 and 168 h postoperation. Six animals were used per time-point. The liver function was evaluated by serum ALT,AST and HA levels. Morphology was observed under light microscopy and TEM. Additionally,the incidence of apoptosis (AI) in hepatocytes and sinusoidal endothelial cells (SECs) were measured separately by TUNEL method.Results The survival rate at 168 h in UW 12-h group was 50 %,significantly lower than that in UW 1-h group (F= 6.39 ,P

Objective To explore the characteristics of clinic and epidemiology of neonatal respiratory syncytial virus(RSV) pneumonia in newborn infants.Methods Three hundred and nine neonates(male 196,female 113) who were admitted to children's hospital of Fudan University and identified as having RSV pneumonia from Jan.2004 to Dec.2008 were enrolled.RSV antigen was detected in exfoliated respiratory cells by direct immunofluorescence.All the clinical data were collected and subjects and they were divided into different groups based on path of infection,gestational age and RSV status.Results From case notes over the 5 years,309 eligible neonates with RSV infection were identified.Male term neonates were more likely to acquire infection,as compared to female,1.71.0.The incidence of RSV infection peaked in winter and spring.Compared with community acquired infection group,hospital acquired infection group had more premature infants(23.2% vs 8.7%,P=0.002),lower birth weight[(3 010.8?852.8) g vs(3 153.2?943.4) g,P=0.026],much longer mean length of hospital stay[(19.0?8.0) d vs(12.2?4.5) d,P=0],more expensive cost[(5 646.4?3632.2) RMB vs(4 175.8?2 879.2) RMB,P=0] and later occurrence day[(21.3?8.6) d vs(15.8?6.0) d,P=0].Compared with simple RSV infection group,mixed infection group had more expensive cost[(6 063.1?3 085.4) RMB vs(4 513.2?3 860.8) RMB,P=0.047] and more oxygen use(40.0% vs 25.7%,P=0.006).The clinical characteristics of patients with RSV pneumonia varied.Preterm group compared with term group more frequently exhibited apnea and cyanosis(20.0% vs 0.7%,42.9% vs 22.7%),respectively.Forty-two percent of them had bacterial infection,while 13.3% of them had infection of other part of body.The prognosis of most RSV(99.0%) infections was good.Conclusions RSV was an important cause of respiratory tract infections during the last five years.Clinical characteristics of RSV infections were atypical.Hospital acquired RSV infection was more severe than the community acquired infection in neonates.There are no specific,effective interventions for treating RSV infections,so preventive measures are most important.

Objective To explore the effect of transcranial magnetic stimulation combined with acupuncture point injection on children with mental retardation at early stage. Methods 120 children with mental retardation were divided four groups: groups Ⅰ, Ⅱ, Ⅲ, and Ⅳ, 30 cases in each group including 10 mild, 10 moderate and 10 severe, respectively. Group Ⅰ received intelligence training by their parents. Group Ⅱ was treated by transcranial magnetic stimulation and intelligence training. Group Ⅲ was treated by acupuncture point injection of monosialotetrahexosylganglioside and intelligence training. Group Ⅳ was treated by transcranial magnetic stimulation, acupuncture point injection of monosialotetrahexosylganglioside and intelligence training. 3 months was a course. DQ of 4 groups was tested by Gesell Development Scale before and after the treatment. The effective rate and different intelligence levels of 4 groups were compared. Results DQ of mild vs. severe and moderate vs. severe improved significantly in group Ⅱ, Ⅲ and Ⅳ (P<0.01). The DQ of moderate vs. severe improved very significantly in group Ⅳ (P<0.01). Conclusion Transcranial magnetic stimulation combined with acupuncture point injection may facilitate to improve the intelligence level of children with mild and moderate mental retardation.