The formation of Staphylococcus epidermidis biofilm on the surface of medical biomaterials may resist the antibiotics treatment and cause chronic infection,which has become a research focus in recent years.Multiple genes constitute complex regulatory network which affect the biofilm formation,and play different roles in the different stages of biofilm formation.Accessory gene regulator (agr) is one of the most important genes in the process of biofilm formation.The process of bacterial biofilm formation,research status of regulation mechanism of agr system and its related genes in the formation of biofilm are reviewed,to provide reference of using agr as a target for the treatment of staphylococcus epidermidis biofilm related infections.

Objective To investigate the level of homocysteinemia in type 2 diabetes mellitus with neuropathy,and observe the effect of medical intervention of hyperhomocysteinemia on diabetic neuropathy.Methods 200 patients with type 2 diabetes mellitus plus neuropathy and 200 control were collected.Patients with diabetic neuropathy plus hyperhomocysteinemia were divided into two groups:medical intervention group(15mg/d folic acid,20mg/d vitamin B6)and control group.The level of homocysteinemia in plasma was measured,and neuropathy score was evaluated by clinical and electrobiological methods before and three months after treatment.Results The morbidity of hyper-homocysteinemia in type 2 diabetes mellitus with neuropathy was 40%,and the levels of homocysteinemia was higher in treatment group than in control(P<0.05).Compared with the control,the levels of homocysteinemia in group of medical intervention was lower(P<0.01),and neuropathy score and nerve conductive velocity showed an obviously improvement after 3-month-treatment(P<0.05).Conclusions Hyperhomocysteinemia is an independent risk factor for diabetic neuropathy in humans.Efficiently intervening the levels of homocysteinemia could improve the electrobiological activity and neuropathy score.

AIM: To investigate the antinociceptive effect of anticholinesterase agent physostigmine at different postoperative time, and the interaction of intravenous physostigmine with intrathecal morphine in rats. METHODS: Six groups of rats were operated on for intrathecal and intravenous catheterization. Nociceptive responses of hind paws of each animal were measured with "plantar stimulation" test 1-3 h and 3 d postoperatively. Animals received intravenous (iv) physostigmine, intrathecal (ith) morphine, or combination of both. The antinociceptive effect of each group was converted to the percent maximum possible effect (% MPE). RESULTS: Administration of physostigmine 1-3 h after operation resulted in dramatic increase in % MPE. The effects of combinations of iv physostigmine and ith morphine were more pronounced at early postoperative time. The potency of low dose combination was significantly greater than that of double doses of both drugs. The % MPE of the observed effects of all combinations was significantly higher than that of the expected additive effects. CONCLUSION: The antinociception of physostigmine occurs at early postoperative time. The interaction of iv physostigmine with ith morphine indicates their synergistic effect.

Salvia miltiorrhiza is dry root or rhizome of the labia-tae plant Salvia miltiorrhiza, whose water-soluble ingredients are recognized as its bioactive components in cardiovascular disea-ses. Based on researches at home and abroad in recent years, this article summarizes pharmacological effect resisting myocardi-al ischemia of Salvia miltiorrhiza ’ s water soluble compounds in multi-level from the prevention, treatment and anti-reperfusion damage, to provide theoretical basis for the research and devel-opment of the active monomers in Salvia miltiorrhiza and com-pound preparations.

Objective To evaluate the efficacy of manually controlled jet ventilation with Manujet Ⅲ apparatus (VBM Co, Germany) for removal of airway foreign body in children. Methods One hundred and twenty ASA Ⅰ or Ⅱ children aged 10 months-12 yr, weighing 8-35 kg undergoing removal of airway foreign body were randomly divided into 3 groups (n=40 each) : group Ⅰ spontaneous respiration (SR) ; group Ⅱ intermittentpositive pressure ventilation through the short side tube of the rigid bronchoscope (IPPV) and group Ⅲ manually controlled jet ventilation with Manujet Ⅲ (JV). Anesthesia was induced with methylprednisolone 2 mg/kg, propofol 2 mg/kg and γ-OH 70 mg/kg in group SR (Ⅰ) and with methylprednisolone 2 mg/kg, propofol 4-5 mg/kg, fentanyl 1.5 μg/kg and succinylcholine 2 mg/kg in group IPPV and JV (Ⅱ,Ⅲ). The bronchescope insertion condition, the occurrence of hypoxia during and after operation, body movement during operation, the rate of successful removal of the foreign body, the duration of operation, anesthesia emergence time and perioperative side effects were recorded. Resulls The rate of good bronchescope insertion condition and successful removal of airway foreign body were significantly higher, the rate of hypoxia during and after operation, body movement, breath holding and restlessness were significantly lower and duration of operation and anesthesia emergence time were significantly shorter in group IPPV and JV than in group SR (P<0.05). The rate of intraoperative hypoxia was significantly lower in group JV than in group IPPV (P<0.05). Conclusion Jet ventilation with Manujet Ⅲ can reduce the occurrence of hypoxia during removal of airway foreign body in children and does not interfere with the operation.

Objective To compare the hemodynamics and respiratory mechanics between flexible reinforced laryngeal mask airway (FRLMA) and tracheal intubation (TI) in functional endoscopic sinus surgery. Methods Forty-six patients (ASA) scheduled for selective functional endoscopic sinus surgery under general anesthesia were allocated randomly to either flexible reinforced laryngeal mask airway group (FRLMA, n=23) or tracheal intubation group (TI, n=23) with mechanical ventilation. MAP and HR were recorded before anesthesia induction, before intubation, after intubation immediately, before extubation and after extubation immediately. Parameters for respiratory mechanics included peak inspiratory pressure (PIP), plateau airway pressure (P_(plateau)), mean airway pressure (P_(mean)), positive end expiratory pressure (PEEP), peak inspiratory flow (FI_(max)), peak expiratory flow (FE_(max)), and end tidal CO_2 (P_(Et)CO_2). All of the above indicators were recorded 5, 10 and 15 minutes after intubation. Meanwhile, arterial gas analysis was examined. Complications such as aspiration, coughing, pharyngeal pain, hoarseness, muscular soreness and unseal of FRLMA were followed up 24 hours after extubation. Results MAP and HR were significantly higher in group TI than those in group FRLMA after intubation and extubation (P<0.05). PIP, P_(plateau), P_(mean) and VD/VT were significantly higher in group TI than those in group FRLMA (P<0.05). Complications such as coughing, pharyngeal pain and muscular soreness were significantly lower in FRLMA group than that in TI group (P<0.05). Conclusions The application of FRLMA on functional endoscopic sinus surgery is a simply handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory mechanics and low incidence of postoperative upper airway complications.

Currently,the incidence of breast cancer ranks first at home and abroad of female cancer and the age of onset tends to be younger.Due to the local changes of the tumor residual cavity after the breast conserving surgery,we can't accurately delineate the irradiation range using traditional breast conserving surgery combined with external irradiation of whole breast and tumor bed plus the amount,and the course of treatment is longer.Intra-operative radiation therapy (IORT) can avoid the impact of respiratory motion and postural changes.Meanwhile,it can immediately irradiate the tumor bed intraoperative accurately.For patients,IORT can shorten the cycle of radiotherapy and reduce irradiation on the skin and subcutaneous tissue.So IORT is convenient,easy to be accepted,and it has relatively few complications,good cosmetic results and so on.In recent years,more and more Cancer Center choose breast conserving surgery combined with IORT for the treatment of early stage breast cancer and do researches to the indications,methods,dosage,efficacy and prognosis of IORT.

The experiment was designed to investigate the effect of salvia miltiorrhiza (Danshen ) and its effective composition, phenyl lactic acid (Danshensu )on the hypoxic pulmonary vasoconstriction (HPV). Acute hypoxia was induced by replacing mixed gas 95%O2+ 5 %CO2 with 95%N2 + 5 %CO2. Hypoxic pulmonary vasoconstriction was diminished by injectic Danshen, Injectic Danshen compound and Danshensu with concentration dependently. Tile effect of Danshensu was the most,and Injectic Danshen Co was second by comparison. The results suggested that Danshen can antagonist HPV which was mainly produced by Danshensu, one of the effective composition of Danshen,and that more potent inhibitory action on HPV was by Injectio Danshen compound compared with Injectio Danshen,and this may be related to the addition of Dalbergia odorifera , the other composition of Injectic Danshen compound.

Objective Increasing evidence shows that excitatory amino acids (EAAS) play an important role in the development of brain ischemia/reperfusion damage EAAS accumulation in ischemic tissues induces a sequence of biochemical reactions and eventually leads to cell death The aim of this study was to investigate the effects of propofol ,midazolam and thiopental on amino acid accumulation in ischemic areas in rats subjected to focal cerebral ischemia Methods Male SD rats weighing 240 260g were anesthetized with 10% chloral hydrate 350mg/kg and middle cerebral artery (MCA) occlusion was performed according to the method of Longa The animals were divided into 5 groups of 6 7animals each: group A (ischemia group) received 3 h MCA occlusion without reperfusion and medication; group B (ischemia/reperfusion group) received 3 h MCA occlusion followed by 3 h reperfusion without medication; group C,D and E received propofol or midazolam or thiopental 50mg/kg intrapentoneally after MCA occlusion but before reperfusion Commom carotid artery(CCA),external carotid artery (ECA) and internal carotid artery(ICA) were exposed through a longitudinal incision in the neck A 4 0 nylon thread with rounded tip was inserted into ICA through ECA and threaded cranially until slight resistance was felt The distance from the bifurcation of CCA to the tip of the nylon thread was about 22 cm In this way MCA was occluded After 3 h MCA occlusion the nylon thread was withdrawn to allow reperfusion After 3 h reperfusion the animals were sacrificed with lethal dose of chloral hydrate Brain was removed immediately Hemispheres of both sides were weighed separately and kept at -75℃ Concentrations of various amino acids (aspartate,glutamate,glycine,taurine and GABA) of each hemisphere were measured with high performance liquid chromatography Results Propofol and midazolam significantly reduced aspartate and glutamate accumulation in ischemic areas during reperfusion Propofol augmented but midazolam diminished GABA accumulation Thiopental had no significant effect Conclusions Propofol and midazolam may provide neuroprotection through acceleretion of excitatory amino acid elimination during reperfusion but thiopental does not

Objective To investigate the effect and safety of the application of radiofrequency ablation(RFA) and ethanol injectionunder the different guidance means for105 patients with primary and metastatic hepatic cancer.Methods Aretrospective study was accom-plished on the radiofrequency ablation and ethanol injection for105 patients with primary and metastatic hepatic cancer under the guidance ofultrasound(56 cases),CT(12 cases),laparoscope(9 cases),open surgery(26 cases) and ultrasound associated with laparoscopic(2cases).Results The operations of RFA with the shortest time were guided by ultrasound(0.8?0.3) h,while the longest operations wereguided by open surgery(3.6?2.5) h(P