This paper reports that in order to study the changes of lipoperoxidation rate in children with viral myocarditis, serum lipid peroxide (LPO), vitamin E (VE) concentration, and hydrogen peroxide hemolysis percentages of red blood cell (RBC H_2O_2 hemolysis %) were determined in 71 cases with viral myocarditis and it was found that LPO levels and RBC H_2O_2 hemolysis % in these patients were higher than in normal children(LPO levels in these patients were also higher than in the children with upper respiratory tract infection), LPO concentration of the patients presented light-level positive correlation to their RBC H_2O_2 hemolysis % (r=0.37, P

In clinical practice,we have adopted the methods such as intensifying the knowledge of preclinical medicine,learning to collect case history,training medical check-up,understanding the significance of auxiliary examination and encouraging the students to form the clinical thinking ability,and thus achieved satisfactory effect and obtained the positive opinion of students.

Sepsis is still a major cause of death among neonates and its morbidity rate remain high nowadays.Because of the atypical symptoms and extremely dangerous progress in neonatal sepsis,early diagnosis and treatment are requisite.But the unique biomarkers are lacking meanwhile.Recent study shows that PBEF influences individual susceptibility,severity and outcome in sepsis.This review synthesizes the research of PBEF in neonatal sepsis in order to provide the evidence of reliable biomarker to diagnose and treat neonatal sepsis in the early stage.

The integrated courses in pathophysiology have been implemented for clinical medicine in Nanfang Medical University with experimental contrast method since 2006 to compare the advantages of the teaching effect of the integrated courses with traditional learning in pathophysiology with the questionnaire. The results have showed that the students on the integrated track are more positive in the knowledge learning,problem analysis and solving as well as the subsequent clinical knowledge learning.

Objective To investigate the relationship between the C161T polymorphisms in peroxisome proliferators-activated receptor γ (PPARγ) gene and atherothrombotic infarction (ATI) in a Chinese Han population.Methods The patients with atherothrombotic infarction and controls,who without histories of stroke,transient ischemic attack and myocardial infarction were enrolled.Genotypes of the PPARγ C161T polymorphisms were determined using the polymerase chain reaction-restriction fragment length polymorphism.The frequencies of genotype and allele in patients with ATI and controls were compared.Results A total of 112 ATI patients and 112 controls were enrolled.There were no significant differences in the age (67.9± 11.73 years vs.66.5 ± 10.35 years; t =0.386,P =0.701) and the proportion of male (61.61％ vs.58.04％ ;x2 =0.297,P =0.586) in the ATI group and the control group.The proportions of hypertension (59.82％ vs.44.62％ ;x2 =5.171,P =0.023),type 2 diabetes mellitus (26.79％ vs.9.82％;x2 =10.778,P =0.001) in the ATI group were significantly higher than those in the control group.Body mass index (25.13±1.86 kg/m2 vs.24.11 ± 1.81 kg/m2; t =3.543,P=0.001),systolic pressure (158.84 ± 20.15 mm Hg vs.135.82 ± 19.58 mm Hg; t =7.350,P =0.000),diastolic pressure (76.90 ± 13.64 mm Hg vs.68.90 ± 8.52 mm Hg; t =4.374,P =0.000) and the level of fasting blood glucose (6.523 ± 2.831 mmol/L vs.5.706 ± 2.177 mmol/L; t =2.026,P =0.044) in the ATI group were significantly higher than those in the control group.The genotype frequencies of CC,CT and TT in the ATI group were 77.7％,17.0％ and 5.4％,respectively,and in the control group were 69.6％,22.3％ and 8.0％,respectively.There were no significant difference between the two groups (x2 =1.909,P =0.385).The allele frequencies of C and T in the ATI group were 86.2％ and 13.8％,respectively,and in the control group were 80.8％ and 19.2％,respectively.There were no significant difference between the two groups (x2 =2.331,P =0.127).Conclusions PPARγ C161T polymorphisms may be not associated with the onset of ATI in a Chinese Han population.

Objective To observe the effects of propofol or sevoflurane combined with remifentanil on cerebral blood flow (CBF) and cerebral autoregulation in patients undergoing gynecologic laparoscopic surgery. Methods Forty patients were randomly divided into two groups: the propofol group (group P, n=20) and the sevoflurane group (group S, n=20). Anaesthesia was induced with target-controlled infusion (TCI) of propofol and remifentanil in group P, with an inhaled induction of sevoflurane and TCI of remifentanil in group S, respectively. The depth of anesthesia was regulated according to bispectral index (BIS). The pressure of end-tidal carbon dioxide (P_(ET)CO_2) was kept at 35-40 mmHg by mechanical ventilation. The mean arterial pressure (MAP), heart rate (HR), pressure of arterial carbon dioxide (PaCO_2), P_(ET)CO_2, time-averaged peak flow velocity (TAP) and the transient hyperaemic response ratio (THRR) were recorded at 7 different time points: supine position (T_1) and supine lithotomy position before induction (T_2), the instant and 5 min after tracheal intubation (T_3,T_4), the instant and 15 min after abdominal CO_2 insufflation and trendelenburg-lithotomy position (T_5,T_6), and 10 min after the deflation abdomen (T_7), respectively. Results Compared with the baseline values at T_1, TAP was not significantly changed at T_2, T_5, or T_6 in group P, but was markedly decreased at T_3, T_4 and T_7. TAP in group S only decreased at T_4 and T_7, while it was much higher than that in group P at T_3. In group S, THRR was markedly lowered at T_3 compared with that at T_1; but in group P, it showed a significant increase at T_3. Conclusions Combined with remifentanil, propofol decreased CBF, but has no effect on the brain self-regulation. When inhaled in high concentrations, sevoflurane significantly reduces the brain self-regulation. Intraoperation pneumoperitoneum and postural factor significantly increase CBF, playing a stronger role than the narcotic drugs in clinical dosage (propofol, sevoflurane), without any influence on the brain self-regulation.

Objective To compare the cerebral blood flow (CBF) and intracranial pressure (ICP) during laparoscopic gynecologic surgery performed under propofol and sevoflurane combined anesthesia.Methods Forty ASAⅠ orⅡ patients aged 20-59 yr weighing 44-69 kg were randomly divided into 2 groups(n=20 each):propofol group (group P) and sevoflurane group (group S).Anesthesia was induced with TCI of propofol (Ce 4μg/ml) in group P or 8% sevoflurane in group S combined with TCI of remifentanil (Ce 6 ng/ml).Tracheal intubation was facilitated with cis-atracurium 0.15 mg/kg.The patients were mechanically ventilated.PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with TCI of propofol or sevoflurane.inhalation combined with TCI of remifentanil.BIS value was maintained at 45-50 by adjusting Ce of propofol or concentration of sevoflurane.Intraabdominal pressure (IAP) was maintained at 12-14 mm Hg.Transcranial Doppler monitoring wag used.Cerebral blood flow velocity (CBFV) and pulsatility index (PI) were recorded at 5 min after supine position(T1)and 5 min after supine lithotomy position before induction(T2),while tracheal tube was being inserted(T3),5 min after tracheal intubation(T4),immediately and 15 min after abdominal CO2 iusnfflation in trendelenburglithotomy position (T5,T6) and at 10 min after deflation of abdomen(T7).Results CBFV was significandy decreased at T3,T4 and T7 in group P and at T4 and T7 in group S as compared with the baseline at T1.CBFV at T3 was significantly lower in group P than in group S.PI at T3,T4 was significantly decreased in group P as compared with the baseline at T1 and was significantly lower than in group S.PI at T5,6 was significantly increased as compared with the baseline in both groups but was not significantly different between the 2 groups.Conclusion When combined with remifentanil.propofol could decrease CBF and ICP while sevoflurane has no significant effect on CBF and ICP after induction.CBF and ICP are significantly increased in both groups after abdominal CO2 insufflation.

OBJECTIVE:To investigate the cognition of clinical pharmacists on the clinical pharmacy practice and their profes-sion,and provide reference for further developing clinical pharmacy practice. METHODS:A questionnaire was designed,and ran-dom sample was conducted for the clinical pharmacists from 30 secondary and tertiary hospitals in Shanghai,and the investigation results were analyzed statistically. RESULTS:Totally 130 questionnaires were sent out,and 102 were effectively received with valid response rate of 78.46%. 94.11% of the investigated subjects were willing to be a clinical pharmacist,but 17.65% of them consid-ered that they were incompetent for their work;29.41% of them thought the current situation of clinical pharmacy practice was not ideal;all the respondents considered that the clinical pharmacist system should be implemented in medical and health institu-tions;the cognition and evaluation of investigated subjects in tertiary hospitals on clinical pharmacy practice and their profession was generally higher than those in secondary hospitals(P<0.05). CONCLUSIONS:The clinical pharmacists in medical and health institutions in Shanghai showed high cognition on their profession,and the clinical pharmacy practice has already made some achievements,but many work still need to be improved. Therefore,clinical pharmacists should continuously study their profession-al knowledge and improve their professional skills and quality;hospitals and universities should strengthen the subject construction and personnel training of clinical pharmacy and deeply carry out the clinical pharmacist system;health administration departments should strengthen the related laws and regulations of clinical pharmacy;colleges and universities should strengthen the discipline construction and personnel training.

[Objective]To explore the experience of the correction of severe kyphosis and kyphoscoliosis by total spinal osteotomy.[Method]To correct kyphosis and kyphoscoliosis by total spinal osteotomy and screws-rods internal fixation apparatus,then graft the bone.[Result]From 1984 to 2005,50 patients were cured with the way above.There were no neural injury observed.The clinical symptom was improved in some extent.All patients were follow up from 2 months to 15 years,averaged 2.4 years,and the postoperative X ray and CT scans verifies all screws were in a proper position.No cases of implant failure were observed,and all the patients had a solid bone fusion on radiographs taken 3 months after surgery.[Conclusion]The operation to correct severe kyphosis and kyphoscoliosis by total spinal osteotomy with efficient screws-rods internal fixation apparatus,not only have a larger operate area which made opreation easier and more safe,but combine osteotomy with internal fixation and finished at the same time,it is an efficient way to correct kyphosis and kyphoscoliosis.

Objective To study the feasibility and reliability of median nerve somatosensory evoked potential monitoring in neurosurgery around the brain stem. Methods in selected 43 patients SEP N20, waveforms were recorded after stimulation of left and right median nerves respectively. Anesthesia was maintained with intravenous anesthetics throughout the operation. As soon as N20 waveform changed significantly, the surgeon was informed and the operative procedure was modified whenever possible. Results SEP waveforms were almost stable during maintaining with total intravenous anesthesia (TIVA). Within 43 cases, SEP waveform of & patients significantly changed. In these cases, SEP of 5 patients returned to normal gradually and no further neurologic dysfunction happened postoperatively. The other 3 cases did not recover, and postoperative neurologic complications happened. There was no false-negative or false-positive result. The correlation between intraoperative SEP changes and postoperative neurologic alterations was significant statistically. Conclusions SEP recording is a reliable technique for intraoperative monitoring during neurosurgery around the brain stem. TIVA is helpful for SEP monitoring.