Objective To study the sedation efficacy of propofol combined with midazolam and /or fentanyl in fibreoptic choledochoscope. Methods Ninty outpatients were randomly divided into three groups. Group PF (n=31)was given fentanyl 0. 05 m.g plus propofol 1 mg/kg intravenously, group PM (n=29) midazolam 2 mg plus propofol 1 mg/kg, and group PMF(n=30) fentanyl 0. 05 mg, midazolam 2 mg and propofol 1 mg/kg. Propofol 20 mg was used when needed. HR,MAP,SpO_2,sedation scores and amnesia were recorded. Results All patients were awakened in 20 minutes after procedures. The recovery time was shorter in group PF than that in the other two groups. There were 21(67. 70%) patients in group PF, who were aware of surgery. Fifteen(48. 4%) patients were satisfied in group PF. Conclusion Propofol combined with midazolam and /or fentanyl in fibreoptic choledochoscope has better sedation without any obvious side effects.

This study is to investigate the effect of recombinant hFGF-10 adenovirus on the proteome of HaCat cells, and to speculate further the possible mechanism of the effect of hFGF-10 on HaCat cells via differentially expressed proteins identified. Two-dimensional gel electrophoresis (2-DE) combined with tandem time-of-flight mass spectrometry was applied to identify the differentially expressed protein spots on the 2-DE maps of the whole-cell proteins from Ad infected and rAd-hFGF-10 infected HaCat cells. The mRNA and protein levels of the differentially expressed proteins were confirmed with semi-quantitative RT-PCR and Western blotting. The results showed that the 2-DE maps with high resolution were obtained, and four selected differentially expressed proteins involved in cell apoptosis, cytoskeleton regulation and protein degradation were identified with MALDI-TOF/TOF. The mRNA and protein levels of one of the differentially expressed proteins, VDAC2, were up-regulated in HaCat cells infected with the recombinant hFGF-10 adenovirus. The differentially expressed protein, VDAC2, may be related to the bioactivities of hFGF-10.

Objective To understand the changes of the coverage of medical insurance and the utilization of medical services from 2000 to 2009.Methods The data on medical insurance and utilization of medical services were obtained from China Nutrition Panel Survey conducted by University of North Carolina,Chapel Hill.The trend of medical insurance and use of preventative medical services were examined.And a Logistic regression model was used to estimate the relationship between some social economic status and the enrollment of medical insurance and use of medical services.Results The coverage of medical insurance expanded dramatically from 20％ in 2000 to 89％ in 2009.The rural population experienced higher expansion.The gap between rural and urban populations in terms of insurance coverage was closed.The use of preventive services remained low in both rural and urban populations,with 3.72％ and 4.62％ respectively.Conclusions Both coverage of medical insurance and use of prevention medical services imoroved from 2000 to 2009,which has provided solid foundation for further reforms.

Objective To investigate the protective effects of continuous norepinephrine infusion and its mechanism in early stage of lipopolysaccharide induced septic rats.Methods Forty SD rats were randomly divided into 5 groups (an external jugular vein catheterization was performed in every rat a day before intraperitoneal injection):saline control group (n =8),endotoxin group (n =8),low dose norepinephrine therepy group(n =8),middle dose norepinephrine therepy group (n =8),and high dose norepinephrine therepy group (n =8).Saline control group received intraperitoneal injection of 0.9％ saline 10 ml/kg,and then received an infusion of 0.9％ saline 1 ml/h.Endotoxin group animals were intraperitoneal injected with lipopolysaccharide 10 mg/kg,and then received an infusion of 0.9％ saline 1 ml/h.Therapy group animals received an infusion of norepinephrine solution 1 ml/h after being intraperitoneal injected LPS 10 mg/kg.The doses of norepinephrine were 0.06,0.3,0.6 μg/(kg· min) respectively.Blood samples were taken 2 h and 6 h later and the levels of serum TNF-α、IL-1β and IL-10 were detected by enzyme-linked immunoadsorbent assay.The membrane potential and three tricarboxylic acid cycle key enzyme activity [isocitrate dehydrogenase(IDH) and pyruvate dehydrogenase (PDH) activity] of isolated liver mitochondrion were detected 24 h later,and the morphologic changes of mitochondria in liver were observed by electronic microscopy.Results In endotoxin group,the levels of serum TNF-α JL-1 β and IL-10 all increased significantly(P ＜ 0.05) and liver mitochondrial membrane potential,PDH and IDH activity decreased significantly compared with control group(P ＜0.05,P ＜0.01).In the middle dose of norepinephrine therepy group,the levels of serum TNF-α and IL-1β all increased significantly (P ＜ 0.05,P ＜ 0.01),the level of serum IL-10 decreased significantly compared with endotoxin group (P ＜ 0.05) ; In the high dose norepinephrine therepy group,the liver mitochondrial membrane potential,PDH and IDH activity increased significantly compared with endotoxin group (P ＜ 0.05).The mitochondrial ultrastructural changes in every group were not obviously.Conclusion In the early stage of septic rats,reversible liver mitochondrion injury can be observed.Norepinephrine infusion can protect early septic rats through attenuating inflammatory reaction and enhancing tricarboxylic acid cycle key enzyme activity and mitochondrial membrane potential level.

Systemic lupus erythematosus (SLE) is a serious multisystem autoimmune disease with different clinical manifestations.Childhood-onset SLE (cSLE) is similar to adult-onset SLE, while its morbidity and mortality are higher than adults, and it is prone to damage important organs.Therefore, early diagnosis and treatment are very important.With the in-depth exploration of the pathogenesis and the development of cell and molecular biology, the progress of drug therapy for SLE has been promoted.Immunosuppression still remains the cornerstone of treatment, and glucocorticoids still plays a leading role.Biologics bring the gospel to SLE patients, and non-specific immunotherapy gains treatment time for refractory and severe SLE patients.Treatment options are led by the level of disease severity.It is of great significance to understand the treatment progress of cSLE and combine theory with practice together to control the disease activity and improve the prognosis.This article reviews recent advances regarding the update on the treatment of cSLE in recent years.

Objective To investigate perioperative antimicrobial prophylaxis in arthroscopic surgery in a hospital before and after intervention,evaluate intervention efficacy,and provide evidence for the rational clinical antimicro-bial application.Methods From August 2012,measures were taken to intervene perioperative antimicrobial use, perioperative antimicrobial use and surgical site infection(SSI)in 312 patients undergoing arthroscopic surgery be-tween September 2011 and August 2013 were retrospectively surveyed.Results A total of 312 patients were investi-gated,pre-and post-intervention were 150 and 162 cases respectively,SSI rates were both 0 before and after inter-vention. Antimicrobial usage rate after intervention was lower than before intervention (26.54% vs 100.00% ,χ2=1.781,P<0.001). Irrational antimicrobial use dropped obviously;average expense of antimicrobial agents dropped from (1165.69±756.33)yuan (RMB)before intervention to (32.71 ±119.29)yuan (RMB)after intervention (t= 3.330,P<0.001).Conclusion Perioperative antimicrobial usage rate in arthroscopic surgery at this hospital decreased significantly after intervention,rational use of antimicrobial agents has improved,SSI rate still remains zero.

Juvenile idiopathic arthritis (JIA) is the most common chronic arthropathy in childhood. Immune and genetic factors take part in the development of JIA and influence its consequence. Studies have identified association between JIA and genes encoding the human leukocyte antigens (HLA) . In this article we discuss the principles behind genetic studies of complex traits like JIA, and comprehensively catalog HLA candidate gene associated with JIA to date, and review several validated associations. Studies indicate that the HLA-Ⅰ, Ⅱ gene and their products play an important role in JIA pathogenesis, clinical course, hormonal effect and prognostic judgment. Studies in different ethnic groups indicate the main relationship between JIA and HLA is concentrated upon A, DR and DQ loci, especially the HLA-Ⅱ gene and some haplotypes. The different type of JIA is always with different HLA susceptible locus and protective locus. Different race, different region and different social environment also affect the JIA's susceptible gene polymorphism. Finally we discuss the problems existed in the study of JIA susceptibility and HLA polymorphism.

Objective Using second duplication checking to prevent academic misconduct of accepted papers ,and to improve the academic quality of journals for the consolidating credibility of academic journal and brand establishing .Methods Academic Mis-conduct Literature Check(AMLC)system developed by CNKI was applied to check possible academic misconduct of 90 accepted pa-pers for Chongqing Medical Journal ,then the contribution time ,duplication checking time ,words repetition percentage of the accept-ed papers with academic misconduct and similarity literature were analyzed compared with the source papers .Results After chec-king 90 accepted papers ,9 of them were suspected with academic misconduct ,including 5 papers with 30 .1% -40 .0% of coinci-dence rate ,1 paper with 40 .1% -50 .0% of coincidence rate ,and 3 papers with more than 50 .1% of coincidence rate .Most of the academic misconduct were multiple contribution of same manuscript or duplicate publication .Conclusion To avoid the multiple con-tribution of the same manuscript or duplicate publication ,we should shorten peer review and publishing period ,carry on multi-dupli-cation checking ,punish academic misconduct ,and work together with other sci-tech periodicals to eliminate academic misconduct .

Objective To observe the clinical effect of Chi nese herbs Biejia Ruangan pill(BRP)on fibrosis in chronic hepatic B.Methods Ninety -eight patients with liver fibrosis of chronic hepatitis B were ra ndomly divided into two groups of BRP ,treatment group and co ntrol group,in which clinical manif estation scoring,liver function an d serum marker of hepatic fibrosis were obse rved.Results BRP could obviously improve the clin ical manifestation scoring,liver function and serum marker of hepatic fibrosis as compared with the contro l group.Conclusion Chinese herbs BRP could treat liver fibrosis of chronic hepatitis B effectively.