It's essential to investigate an effective learning method in order to cultivate qualified anesthetic residents Discussion learning method has the characteristics of purposiveness and systematicness, and can promote learning activeness and cultivate creativity in clinical traning.The apllication of discussion learning method depend on the topic,preparation,style of discussion.In addition,the discussion should be guided and enlightenad by experienced senior doctors and a definite conclusion must be made after discussion

ve To investigate the effects of different doses of diltiazem alone or combination with isoflurane on stunned isolated rat heart. Methods Adult male Wistar rats weighing 325-350g were anesthetized with intraabdominal pentobarbital sodium 60mg?kg-1. Heparin 200IU was injected into femoral vein. Chest was then opened and heart was removed and connected to Langendorff preparation. The isolated rat heart was perfused at 100cm H2O with Krebs-Hensleit buffer(KHB) balanced with 95%O2 and 5%CO2 at 37℃ and electrically paced at 300 bpm. Global myocardial ischemia was produced by suspension of perfusion. The isolated rat heart underwent 20 min ischemia followed by 30min reperfusion. 40 rat hearts were randomly allocated to one of 5 groups of eight each, group Ⅰ received no treatment and served as control; group Ⅱ: the isolated heart was perfused with 0.1/?mol?L-1 diltiazem for 10 min before the onset of ischemia; group Ⅲ: with 0.5?mol?L-1 diltiazem; group Ⅳ: with 0. 1?mol?L-1 diltiazem + 1.5MAC isoflurane; group Ⅴ: with 0.5?mol?L-1 diltiazem + 1.5MAC isoflurane. Left ventricle developed pressure(DP) was measured from a fluid-filled Latex balloon placed in left ventricle. The volume of the fluid in the balloon was regulated to maintain the left ventricle end-diastolic pressure at 5-8 mm Hg. Peak systolic pressure(PSP), end-diastolic pressure(EDP) and developed pressure(DP) were measured after the isolated heart was stabilized for 10min (baseline value) and 5, 10, 15, 20, 25, 30min after reperfusion. Maximum intraventricular pressure was measured during ischemia when the isolated heart was not paced and at a stand still. Results There was no significant difference in DP, EDP, + dp/dtmax and - dp/dtmin after the isolated hearts were stabilized for 10min, before ischemia among the five groups. Perfusion with 0.1?mol?L-1 diltiazem did not affect DP significantly but 0.5?mol?L-1 diltiazem significantly decreased DP (P

Objective To evaluate the effect of intervention strategy and measures for intestinal parasite control in Zhejiang Province. Methods The protective rate (PR) and the index of effectiveness (IE) on the overall prevalence of parasites after and before interventions for intestinal parasitic infections were compared in 30 villages of 10 counties randomly selected as investigation spots. Results After the implementation of the interventions in the past decade, the total parasite prevalence declined significantly from 77.0% in 1989 to 22.84% in 1998 in the Province, the PR was 70.34%, the IE was 3.37. In each of the 10 counties, the PR was above 45%, the IE was between 1.85 and 14.47. Lavatory improvement, socioeconomic development and health education were among the first three factors that affected the effectiveness of the intervention. Conclusion The comprehensive intervention combining the socioeconomic development, health education, environmental improvement with mass chemotherapy has been proved an effective strategy.

Increasing the production and secretion of endogenous opioid peptide by immune cell can significantly induce myocardial protective effects against ischemia-reperfusion injury. Gene therapy is promising to increase endogenous enkephalin (ENK). However, classical viral and plasmid vectors for gene delivery are hampered by immunogenicity, gene recombination, oncogene activation, the production of antibacterial antibody and changes in physiological gene expression. Minimalistic immunologically defined gene expression (MIDGE) can overcome all the deficients of viral and plasmid vectors. The exon of rat's preproenkephalin (PPENK) gene was amplified by PCR and the fragments were cloned into pEGFP-N1 plasmids. The recombined plasmids were digested with enzymes to obtain a linear vector contained promoter, preproenkephalin gene, RNA stable sequences and oligodesoxy nucleotides (ODNs) added to both ends of the gene vector to protect gene vector from exonuclease degradation. A nuclear localization sequence (NLS) was attached to an ODN to ensure the effective transport to the nucleus and transgene expression. Flow cytometry, laser confocal microscopy and Western blotting demonstrated that PPENK-MIDGE-NLS can transfect leukocyte of rat in vivo, increase the expression of proenkephalin (PENK) in tissue, and the transfection efficiency depends on gene vector's dosage. These results indicate that PPENK-MIDGE-NLS could be an innovative method to protect and treatment of myocardial ischemia-reperfusion injury.
Animals ; Cloning, Molecular ; Enkephalins ; genetics ; Gene Expression ; Genetic Therapy ; Genetic Vectors ; Leukocytes ; Plasmids ; Promoter Regions, Genetic ; Protein Precursors ; genetics ; Rats ; Transfection ; Transgenes

Objective:To evaluate the role of spinal cord in anesthesia of isoflurane. Method:The animal models of head bypass were established,which were used to preferentially anesthetized spinal cord, after 9 goats were anesthetized with isoflurane.MAC was determined using tail clamp at prebypass,druing bypass and postbypass. Electroen-cephalogram(EEG),brain stem auditory evoked Potential (BAEP) and visal evoked potential(VEP)were monitored constantly. Result:MAC of isoflurane,the relative power(RP)of ? wave and the latencies of BAEP and VEP were decreased when spinal cord was preferentinally anesthetized (P

Abstract On March 12, 2022, a case with Plasmodium vivax malaria was reported in the First Hospital of Jiaxing City. The case sought healthcare services due to persist, sharp distending pain of the brain and fever on February 25, 2022, and the symptoms showed no improvements following symptomatic treatment. Microscopy identified malaria parasites on March 12, and the case was definitively diagnosed as P. vivax malaria on March 13. The case was discharged from hospital on March 16 and relapsed on June 15. The case was a veteran from the China-Myanmar border, where malaria is highly prevalent, and had no history of travel after returning to Jiaxing City on October 2021. Based on epidemiological history and laboratory tests, the case was diagnosed as a cross-border mosquito-borne imported case of P. vivax malaria. The case was given treatment with mosquito vector isolation, and the case's family members, neighbors and colleagues were all tested negative for malaria parasites. There was no Anopheles sinensis detected in the case' residence; however, Anopheles was detected in the neighboring areas, indicating a risk of re-establishment. Returners from high-risk regions including borders and labor exporters are recommended to be included in malaria surveillance, and the sensitivity of malaria surveillance requires to be maintained and the diagnostic and treatment capability of malaria requires to be improved in medical institutions.

0.05),the escape latency was longer(P

Objective:To ascertain the endemic status of paragonimiasis in Zhejiang Province.Methods:From 2005 to 2020, 2-3 villages in 1-2 counties (cities, districts, hereinafter refferred to as counties) in historical endemic areas of paragonimiasis in Zhejiang Province were selected for monitoring each year. In each village, 50 to 150 local residents were selected as monitoring subjects, venous blood samples were collected, and serum Paragonimus antibody was detected by enzyme-linked immunosorbent assay (ELISA). Fifty to 100 intermediate hosts crabs or crayfish were collected in each village, and the infection of Paragonimus metacercaria was detected by crushing precipitation. Results:The positive rate of Paragonimus antibody was 2.9% (94/3 297); 3 929 crabs or crayfish were divided into 2 749 groups, 790 of which were found to have Paragonimus metacercaria infection, with a Paragonimus metacercaria infection rate of 28.7%. Conclusions:Paragonimus transmission chain exists in some counties of Zhejiang Province, which still has the potential risk of Paragonimus epidemic. Therefore, it is necessary to strengthen monitoring and carry out extensive health education to improve residents' self-protection awareness.

Objective: To investigate the efficacy and the nursing experience of vacuum sealing drainage (VSD) combined with topical oxygen therapy on healing of pressure ulcers in intensive care unit. Methods: Totally 44 cases of patients in intensive care unit with pressure ulcers on stage Ⅲ and Ⅳ bedsore, from May 2015 to October 2017, were divided into 2 groups according to the random number table.22 cases, as the control group, were treated with routine methods and VSD.22 cases, as the test group, were treated with topical oxygen therapy on basis of the treatment of control group, 10 days for a cycle. The effects of the two methods were compared according to the wound healing rate, the bacterial quantitative, the cell apoptosis rate and the capillary density after a treatment cycle. Results: The average wound healing rates of the control group and the test group were (16.5±6.7)% and (26.2±5.6)% respectively, between which there was a significant difference (t=5.09, P<0.01). Before treatment, the bacterial quantitative, cell apoptosis rate and capillary density in the control group were (2.7±0.8) ×10⁷CFU/g, (9.3±1.5)%, 13.43±3.21 respectively, and in the test group were (2.9±1.1) ×10⁷CFU/g, (10.1±1.1)%, 11.51±2.75, there was no significant difference between the two groups (all P>0.05). After treatment, the bacterial quantitative, cell apoptosis rate and capillary density in the control group were (4.9±1.4) ×10⁴CFU/g, (5.5±0.8)%, 38.64±10.14, and in the test group were (2.5±0.7) ×10⁴CFU/g, (2.9± 0.9)%, 41.09±9.28. The differences before and after treatment in the control group were statistically significant (q=1 967.75, 3.51, 6.12, all P<0.01 or 0.05), and the differences before and after treatment in the test group were statistically significant (q=3 912.32, 5.22, 8.07, all P<0.01). There were significant differences in the bacterial quantitative and cell apoptosis rate between the two groups after treatment (q=3.85, 3.78, all P<0.01), however, there was no significant difference in vascular density (P>0.05). Conclusion The vacuum sealing drainage combined with topical oxygen therapy can enhance wound healing and control infection significantly, is a safe and effective therapeutic method.

Objective:To determine the incidence of adrenal incidentalomas(AIs) in patients with diabetes mellitus and the metabolism profiles.Methods:A total of 615 hospitalized patients with diabetes mellitus in the Department of Endocrinology and Metabolism of Peking University People′s Hospital from March 2020 to May 2021 were retrospectively included in this study. AIs were screened by unenhanced chest computed tomography(CT) retrospectively and subsequently confirmed by multiplanar reconstruction. Participants′ physical indicators, metabolic profiles, and adrenal function parameters were collected. Unpaired t test, Mann-Whitney U test, and Chi-Square test were adopted to compare the metabolism profiles between diabetes mellitus patients with or without AIs. Regression models were used to estimate the correlations between AIs and the metabolism profiles such as blood glucose, blood lipids, blood pressure, and the adrenal function parameters.Results:Twenty-seven out of 615 participants were detected with AIs(4.4%). Patients with AIs had higher body mass index, waist circumference, and hip circumference than patients without AIs [(29.4±5.1)kg/m 2vs(26.8±3.8)kg/m 2,P=0.018; (102.3±11.7)cm vs(95.8±10.3)cm, P=0.002; (107.3±10.1)cm vs(101.4±7.6)cm, P=0.008]. The levels of serum uric acid and urinary albumin/creatinine ratio were also significantly increased in patients with AIs [(409.6±118.1)μmol/L vs(357.4±100.6)μmol/L, P=0.009; 21.25(7.49, 180.24)mg/g vs 8.60(4.71, 34.56)mg/g, P=0.010]. Besides, individuals with AIs were also associated with a higher risk of co-existing hypertension( P=0.045). Conclusion:The incidence of AIs in patients with diabetes is 4.4%. The presence of AIs in patients with diabetes may associated with increased risk of obesity and hypertension.