Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery.Methods Fifty ASAⅠorⅡ patients undergoing elective cesarean delivery were randomly divided into the two groups,Ephedrine group (n=5 1 ):intrave-nous injection of 10mg ephedrine before anesthesia;Dopamine group(n=52):continuous intravenous infusion at the speed of 5μg·kg-1 ·min-1 .During the whole process,we investigated the incidence rate of adverse effects,com-pared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein.Results Compare to the dopa-mine group,the incidence rate of hypotension was lower in the ephedrine group (43.1% vs 69.2%,χ2 =7.06,P=0.00).The pH value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22 ±0.03)vs (7.27 ±0.06),t=0.62,P=0.02],there are no significant difference of 5 min Apgar score in the two groups.Conclusion Compared with dopamine,ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine.Ephedrine has transient effect on the neonate,while the effect of dopamine is minor.

Objective To investigate the possible contribution of PPAR-? coupled signaling pathways to rat liver regeneration (LR) at transcription level.Methods The above signaling pathways-related genes were obtained by collecting database data and retrieving pertinent literatures. The gene expression during LR was checked by Rat Genome 230 2.0 array, and LR-associated genes were identified by comparing difference between partial hepatectomy (PH) and operation control (OC) groups.Results Sixty four genes were found to be LR-associated. The number of initially and totally expressed genes occurring in initiation phase of LR, G0/G1 transition, cell proliferation, cell differentiation and structure-function reconstruction was 28, 4, 34, 2 and 72, 41, 247, 90 respectively. Classification of their expression patterns into 11 groups reflected diversity and complexity of gene expression alteration in LR. Conclusion PPAR-? coupled signaling pathways may promote glycogen synthesis in forepart, prophase and anaphase of LR, cell proliferation and migration in the whole LR, while inhibits inflammation during LR.

OBJECTIVE:To discuss the solution of therapeutic contradictions of bleeding and hemostasis in pulmonary embo-lism patients receiving warfarin anticoagulation. METHODS:The risk evaluation and dissolution of bleeding and embolism induced by warfarin anticoagulation were summarized by analyzing therapeutic duration of INR abnormal elevation in a pulmonary embo-lism patient receiving warfarin anticoagulation. Case analysis was based on foreign and domestic guideline and information. RE-SULTS:Referring to INR value,based on HAS-BLE,Caprini scale,China Expert Consensus on Anticoagulant Therapy of Warfa-rin,China Expert Suggestions on Prevention of Venous Thrombosis in Internal Inpatients and Guidelines of Prevention of VTE in Nonsurgical Patients of American College of Chest Physicians,clinical pharmacists and physicians adjusted the dose of Warfarin tablet timely. The patient was recovered after symptomatic treatment of anticoagulation,relieving cough and asthma,reducing phlegm,etc.,and then disagreed from hospital with drugs. CONCLUSIONS:The risk of bleeding and embolism for this type pa-tients can be evaluated and resolved on the basis of HAS-BLED,Caprini scale and relevant guidelines. At present,there still are some problems as deficient evaluation method,lack of large-scale high-level evidence and quantitative study. It is needed to carry out multiple center clinical study and drug interaction quantitative study actively,and develop suitable risk evaluation method so as to provide high-quality and valuable decision-making evidence.

12 gestational-week uterus) were treated in our hospital by LAVH. The operation time,intraoperative blood loss,and postoperative recovery of the patients were compared to another 110 cases that underwent TAH. Results The operation time in the TAH group was significantly shorter than that in the LAVH group [(109?27) min vs (130?22) min,t=-6.441,P=0.000]. During the operation,the LAVH group had a mean of (121?70) ml blood loss,which was significantly lower than that in the TAH group [(141?73) ml,t=-0.903,P=0.368]. After the operation,the patients in the TAH group had longer recovery time for gastrointestinal function and longer hospital stay than those in the LAVH group [(45?13) h vs (24?6) h,t=15.778,P=0.000;and (7?2) d vs (5?2) d,t=7.530,P=0.000]. Conclusions Compared to TAH,LAVH results in shorter hospital stay and fewer postoperative complications. It is a feasible and safe treatment for large uterus.

The virtual reality teaching system of human skeletal anatomy developed in this paper is based on the advanced personal computer and uses the stereo glasses of ELSA 3D REVELATOR, mouse and keyboard to make up the human-computer interface. Using this system, students can take apart and assemble the skeleton, grasp single bone to rotate and zoom, learn the human skeletal anatomy in a vivid environment, and thus know more about motion physiology.

Virtual Reality is just emerging as an accepted scientific discipline. It has been widely used in medicine. The major applications of virtual reality for medicine are introduced from three areas :virtual humans,the fusion of virtual humans with real humans and virtual telemedicine. The advanced graphics behind medical virtual reality,such as computational demands,hardware and software environments is briefly discussed. This article also gives a summary of existing distributed VR systems.

Objective To investigate the effect of nuclear factor-?B (NF-?B), NF-?B-inducing kinase (NIK) and I-?B in basic fibroblast growth factor (bFGF) promoting gene expression and signal transduction of tenocyte NF-?B. Methods Tenocytes isolated from rabbits were divided into 3 groups with 8 dishes: no bFGF (Group A), 2 ng/ml bFGF (Group B) and 10 ng/ml bFGF (Group C). Cells in all dishes were cultured for 5 days. The effect of bFGF on tenocytes proliferation was examined by means of growth curve analysis. The mRNA was isolated after 5 days and the gene expressions of NIK,IKK? and IKK? induced by NF-?B investigated by reverse transcription-polymerase chain reaction (RT-PCR). Results The growth curve moved forward with the dosage increase of bFGF. Gene expressions of NF-?B,NIK, I?B kinase (IKK)? and IKK? were 0.4? 0.2 , 0.4 ? 0.1 , 0.3 ?0.1 and 0.2?0.1 respectively in the Group B and 1.8?0.5,1.0?0.3, 0.8 ? 0.2 and 1.5 ? 0.4 in the Group C. Gene expressions were all up-regulated in the Groups B and C posterior to adding of bFGF. Conclusions bFGF stimulates tenocyte proliferation and up-regulates gene expression of NF-?B,NIK,IKK? and IKK?, as indicates that the signal transduction of promoting tenocyte proliferation by bFGF may be through NF-?B pathway.

OBJECTIVE:To provide reference for improving the pharmacy self-taught undergraduate course system in general universities in China. METHODS:According to comparative study and researching related literatures,the situation of pharmacy self-taught undergraduate course system in general universities in China was analyzed,and reform ideas and programs were present-ed. RESULTS & CONCLUSIONS:Based onchemistry-biology-psychology-society-medicine-pharmacyin the overall framework of pharmacy undergraduate self-examination course system,it was designed with target of cultivating applied talents;related con-tents in public basic courses,humanities basic course and professional ethics course should throughout the whole teaching process;professional main course should be pharmaceutical knowledge-based,supplemented by medical related courses;the school should set vocational elective course to reform based on combining with the own teaching research direction,characteristics and career ori-entation of different self-taught students. The reform can develop applied talents with ability and political integrity,which meets the needs of social development.

Objective To analyze the performance of a rapid immunofluorescence assay for plasma NT-proBNP. Methods Human plasma NT-proBNP was measured by RAMP in 264 healthy cases and 78 patients with heart failure. The precision, stability, linearity and interference factors of RAMP were evaluated according to the protocold from America CLSI. Meanwhile, the results were compared with those obtained by Elecsys. Results Functional sensitivity of RAMP in 20% CV and 10% CV were 48 ng/L and 57 ng/L respectively. The linear range was 18-8 000 ng/L. NT-proBNP in plasma samples detected by RAMP were stable at room temperature for 24 hours, 4 ℃ for 3 days and - 20 ℃ for 20 days. No influences on results were observed throughout three freeze-thaw cycles. The results measured by RAMP were compared between EDTA-K2 anticoagulant plasma and heparin anticoagulant plasma, which showed that YEDTA-K2 =0. 953 9 Xheparin + 0. 365 2 ( R2 = 0. 982, P < 0. 01, n = 40 ). The results of EDTA-K2 and heparin anticoagulant plasma using RAMP and Elecsys showed no significant difference( P ＞0. 05). Slight hemolysis( Hb 2 g/L)had small effect on the results of PAMP and Elecsys assays and deviations of them were below 5%. However median and heavy hemolysis( Hb 3-4 g/L )obviously influenced the results with deviation were more than 15%. The values measured by RMAP fell from 390 ng/L to 82 ng/L, and those measured by Elecsys method fell from 390 ng/L to 178 ng/L when 3 different concentrations of triacylglycerol were added, the values measured by two methods fell from 7 777 ng/L to 7 741 ng/L when bilirubin ( 16-330 μmol/L) was added. The anti-interference ability of RAMP method was similar to Elecsys. Results detected with two methods in 45 EDTA-K2 anticoagulant plasma samples were analyzed with Passing and Bablok regression.The regression equation was YRAMP = 0. 972 8XElecsys - 0. 035 2 (R2 = 0. 994, P ＞ 0. 05, n = 45 ). When heparin anticoagulant plasma samples increased to 78 samples, Passing and Bablok regression equation showed:YRAMP= 0. 983 2XElecsys - 0. 037 6 ( R2 = 0. 991, P ＞ 0. 05, n = 78 ). NT-proBNP levels in healthy adults were elevated along with age and related to the gender. The median value of female[105(60-120) ng/L] was higher than that of male [59 ( 44-91 ) ng/L, Z = 3. 264, P < 0. 01] significantly. Conclusions RAMP method has good repeatability, outstanding stability, and broad linear range. The results detected by RAMP is consistent with results detected by Elecsys.

Objective To explore the effects of self-management strategies on self-efficacy and selfmanagement behavior in female college students with primary dysmenorrhea.Methods Implementing the plan that the interventional group (n=195) received self-management strategies,while the control group (n =196) did not received any intervention.Followed up six months,the self-efficacy and self-management behaviors and Visual Analogue Scale/Score (VAS) of dysmenorrhea pain were compared between two groups before and after the intervention.Results At the 6th month of observation period,the scores of self-efficacy in the intervention group (2.61 ±0.48) were significantly improved compared with the baseline (2.37 ± 0.36) and the control group(2.43±0.46) (both P＜0.05).Besides taking medicine to alleviate dysmenorrhea,other items in the self-management behaviors were significantly higher than baseline and control group (both P＜ 0.05).The mean of dysmenorrhea pain VAS of 6th menstrual period in the intervention group was lower than baseline and the control group (P＜0.05).Conclusion The self-management strategies can effectively improve the self-efficacy and self-management behaviors among female college students,and alleviate the degree of dysmenorrhea pain.