Objective To investigate the relationshp among Gp Ⅱ b/ⅡⅢ a、CD62p in platelet activation mark-er and high-sensitivity C-reactive protein (hs-CRP) in elderly patients with chronic cor pulmonary exacerbation. Methods The subjects were divided into four groups (42 elderly patients with cor pulmonary exacerbation,42 eld-erly patients with cot pulmonary remission,30 cases of healthy elderly subjects and 30 cases of healthy non-elderly subjects) . The expression of Gp Ⅱ b/Ⅲ a and CD62p were measured with tricolor flow cytometry. Hs-CRP levels were measured by nephelometry and turbidimetry in patients and normal controls. Results Compared with cor pul-monary remission group,healthy elderly group and healthy non-elderly group, the levels of Gp Ⅱ b/Ⅲ a, CD62p and hs-CRP increased significantly in patients with chronic cor pulmonary exacerbation ( all P < 0.001 ). Gp Ⅱ b/Ⅲ a and CD62p results of the elderly patients with cot pulmonary remission were higher than those in healthy elderly subjects (P <0.05) and healthy non-elderly subjects (P < 0. 001 ) . The expressions of both Gp Ⅱ b/Ⅲa and CD62p in healthy elderly subjects were statistically higher than that in healthy non-elderly subjects ( P < 0.05 ). There was a positive con'elation between the Gp Ⅱ b/Ⅲ a、CD62p and hs-CRP in elderly patients with chronic cot pulmonary exac-erbation(r =0.59,P<0.01 ; r=0.54,P<0.01 ). Conclusions The platelet in elderly patients with chronic cot pulmonary exacerbation is overactivated,which is correlated with hs-CRP.

Objective To evaluate the effectiveness of EEG bispectral index (BIS) as the feedback control variable of target-controlled infusion (TCI) of propofol for sedation in patients undergoing laparoscopic hysterectomy under epidural anesthesia. Methods A total of 60 patients for selective operation of laparoscopic hysterectomy under epidural anesthesia were randomly divided into two groups: the feedback TCI group (FTCI) and the TCI group (TCI),with 30 patients in each group.The target blood concentration of propofol was set up at a level of 2 mg/L.It was maintained unchanged in the TCI group throughout the surgery.The BIS value,as the control variable,was set up at 70 in the FTCI group.The highest and lowest BIS values,mean arterial pressure (MAP) and HR during the operation,the standardized unit dose of propofol,time for orientation recovery,the degree of amnesia during the operation and patient's satisfaction were recorded and compared between the two groups. Results Of the two groups: the maximum of BIS values were 76 1?6 4 and 86 0?8 6,respectively,with statistically significant difference ( t = -5 058, P =0 000),and the minimal values were 69 0?4 5 and 60 9?11 8,respectively,with significant difference ( t =-3 513, P =0 000); the highest MAPs were (90 9?14 2) mm Hg and (100 4?11 6) mm Hg,respectively,with significant difference ( t =-2 838, P =0 006),and the lowest,(74 2?12 5) mm Hg and (63 8?13 8) mm Hg,respectively,with statistical significance ( t =-3 059, P = 0 003); the time for orientation recovery was (440 8?141 0)s and (576 4?120 5)s,respectively,with significant difference ( t = -4 004, P =0 000).Total dose of propofol in the FTCI group [(510 48?82 75)mg] was statistically lower than that in the TCI group [(620 65?76 79)mg; t =-5 345, P =0 000],the same was the standardized unit dose of propofol [FTCI: (5 08?1 26)mg,TCI:(6 02?0 86)mg; t =-3 375, P =0 001].No significant differences were seen between the two groups in the degree of amnesia during the operation and patient's satisfaction. Conclusions BIS is feasible to be used as a feedback control variable in propofol anesthesia.It offers less propofol consumption,appropriate sedation,rapid recovery of orientation and more stable blood pressure.

Objective To evaluate the clinical effectiveness of direct coronary stenting without predilatation in acute myocardial infarction (AMI) Methods Intracoronary stent was directly deployed without ballon predilation in 22 patients within 12 hours from onset Single vessel disease was in 12 patients (54 5%),double vessel disease in 4 patients(18 2%) and triple vessel disease in 6 patients(27 3%) Infarct related arteries (IRA) were left anterior descending artery in 12 patients (54 5%), left circumflex in 5 patients (22 7%), right coronary artery in 5 patients (22 7%) Thrombolysis in myocardial infarction TIMI 1 flow in 5 patients (22 7%), TIMI 2 flow in 13 patients (59 1%) TIMI 3 flow in 4 patients (18 2%) Results Twenty two stents were implanted (1 stent/patient) Post stenting residual stenosis decreased to 3 2?2 9%, stent deployment was successful in 100% of the cases, There were no complications, no death, no Q wave or non Q wave myocardial infarction and no repeated recanalizations during the hospitalization Conclusion Direct coronary stenting without predilatation can be performed in AMI with its high successful rate and low complication

Internal medicine(IntMed) is one of the major subjects in medical undergraduate courses.With the transformation of medical mode from experience medicine to EBM,EBM shall be melted into IntMed teaching to change traditionary teaching mode and improve the teaching quality of IntMed,which helps to culture more new medical talented persons.

OBJECTIVE:To study the effects of different drying methods on the quality of North Qinglongyi,thus optimize the best drying way of North Qinglongyi. METHODS:North Qinglongyi was processed using five kinds of drying methods includ-ing drying in the shade,drying in the sun,oven drying,microwave drying,freeze drying and oven drying under different tempera-ture (40,50,60 ℃). The indicators were investigated,such as drying time,recovery rate of water,water content,alcohol ex-tract,content of active ingredients walnut quinone and juglone,in vitro anti-tumor activity of methanol extract to human gastric ade-nocarcinoma BGC823 cells and human lung cancer A549 cells. The effects of different drying methods on the quality of North Qinglongyi were analyzed comparatively. RESULTS:Among 5 kinds of drying method,microwave drying time was the shortest, and the time of drying in the shade was the longest;water content of sample with freeze drying was the highest,and that with mi-crowave drying was the lowest;the content of alcohol extract has little difference;the content of walnut quinone of sample with freeze drying was the highest,and that with microwave drying was the lowest;the content of juglone of sample dried at 40 ℃ was the highest,and that of freeze drying was the lowest;anti-tumor experiment in vitro showed that inhibition rate of sample with dif-ferent drying methods on the growth of 2 kinds of cells was in descending order of freeze drying>40 ℃ drying>drying in the shade,and the inhibition rate decreased with the increase of drying temperature. CONCLUSIONS:Different drying methods have obvious influence on the quality of North Qinglongyi. 40 ℃ drying method is the best for North Qinglongyi drying from the com-prehensive analysis including cost,the contents of effective composition,anti-tumor activity and practice.

Objective:To compare the immunogenity of the AST artificial antigen with two different carrier proteins, bovine serum albumin(BSA) and keyhole limpet hemocyanin(KLH).Methods: The hapten Astragaloside Ⅳ(AST) was linked to carrier protein BSA or KLH as immunogen,and linked ovalbumin(OVA) as coating antigen by the sodium periodate method.Then the 6-8 weeks BALB/c mice were immunized with AST-BSA or AST-KLH.The titer and specificity of the antiserum were detected by indirect enzyme-linked immunosorbent assay ( iELISA ) and indirect competitive enzyme-linked immunosorbent assay ( icELISA ) respectively.Results:The antiserum of the mice immunized with AST-KLH had better specificity than which immunized with AST-BSA.The IC50 of AST-KLH antiserum was about 5 μg/ml in the detection by icELISA.The high titer of both antiserums was about 1∶51 200 after immunizing mouse.Conclusion:The conjugate of AST-KLH was testified to have a better immunogenity in comparison with AST-BSA,this investigation would be the foundation of the further research of AST immunoassay.

Objective To investigate the underlying mutation in a late-onset Chinese patient with classic Bartter syndrome. Methods The mutation analysis of CLCNKB gene was performed by the PCR direct sequencing. The patient's parents and siblings were studied as well. Fifty normal volunteers were analyzed as control group. Results The heterozygous deletion mutation cDNA 753delG and heterozygous missense mutation G433E were detected in the patient. Her father was found to carry heterozygous G433E and her mother to carry cDNA 753delG mutation respectively. Her brother carried heterozygous G433E and her sister was normal. Conclusions Two mutations of the CLCNKB gene in this Chinese patient with late-onset classic Bartter syndrome are identified. The cDNA 753delG mutation has not been reported previously.

Objective To explore the reliability and validity of the simplified Chinese version of the Oswestry disability index (SCODI) and the curative effect of community-based rehabilitation for patients with lumbar disc herniation (LDH). Methods 165 patients with LDH received community-based rehabilitation according to the severity of their LDH. Before treatment and after 3 months, the SCODI, the Roland-Morris disability questionnaire (RMDQ) and a visual analogue scale (VAS) were used to evaluate the effects. The reliability and validity of the SCODI was thus tested. The reliability analysis included internal consistency as measured by Cronbach's coefficient,and test-retest reliability as measured by an interclass correlation coefficient (ICC). The validity analysis used Spearman's correlation coefficient (for concurrent efficacy validity) and factor analysis (for construct validity). The correlation between SCODI, RMDQ and VAS results was analyzed. Results There was statistically significant functional improvement and better QOL in LDH patients after community-based rehabilitation. The SCODI showed good validity and reliability. There was significant correlation among the SCODI, RMDQ and VAS results. Conclusion Community-based rehabilitation can significantly alleviate symptoms for patients with LDH and improve their QOL.The SCODI is a reliable and valid instrument for measuring the curative effect of community-based rehabilitation on patients with LDH.

Objective To analyze the control strategy of malsria in Sihong County for the recent 10 years and to evaluate its control effect.Methods The individual questionnaires of cases,the historical data of malaria control and the endemic situation of malaria in Sihong County from 1997 to.2007 were collected and analyzed.Results Two malaria Cases were reported in 2 towns of Sihong County in 1997,and the endemic situation rebounded in 1998 with 21 cases distributed in 12 towns.In 1999,the number of cases who distributed in 16 towns increased to 65.Endemic outbreaks occurred in some districts in 2000 and 2001 when the case number increased to 477 and 488,respectively,and the incidence increased to 4.77 and 7.78 per 10 000 people,respectively.After the comprehensive mesgures with an emphasis on infection source management and vector control were implemented,the incidence decreased to 0.99 per 10 000 people in 2007 and the endemic situation became stable.Conclusions Though the measures of malaria control in Sihong County are effective,surveillance should be strengthened to prevent the endemic situation from rebounding.

Objectives:To observe the role of hypocaloric nutrition support after major intestinal surgery. Methods:Forty cases after intestinal surgical procedure were randomly divided into hypocaloric group ( n =20),peripheral parenteral nutrition support of 15 kcal/(kg?d)+3 g Nitrogen/d) for 5 days and control group ( n =20,general infussion supports). Postoperative nitrogen balance, plasma proteins and body composition were detected. Results: Nitrogen balance of hypocaloric group was found to be improved, plasma proteins increased and body composition loss decreased. Conclusions:The hypocaloric nutrition support is a selected method for postoperative support.