A series of reforms on the teaching of analytical chemistry experiment has been carried out in accordance with the characteristics of medicine examination and the actuality,which includes the content of course,the teaching method,and the inspection method.Good results have been achieved in the aspect of development of students' comprehensive quality and practical ability.

Objective To study the employment of noninvasive ventilation with nasopharyngeai airway in coma patients with cerebral stroke.Methods One hundred and fifty-five stroke patients treated with noninvasive ventilation admitted from May 2011 to May 2013 were studied.There were 88 male and 67 female,aged 30-95 years with mean age 73 years,The patients suffered from stroke with APACHE Ⅱ score 5-13 and Glasgow coma score 7-13.There were 78 cases in the nasopharyngeal airway group,and 77 cases in oropharyngeal airway group as control.SBP,DBP,HR,SpO2 and PCO2 were observed in the two groups at the time of beginning of noninvasive ventilation with neither airway (T0),and after placement of either airway and noninvasive ventilation for 10 min (T10),20min (T20),and 30 min (T30),respectively.The differences in rate of endotracheal intubation and the incidence of pulmonary infection were compared between the two groups.Results PaO2,SBP,PCO2 were improved after 30 minutes of noninvasive ventilation in the oropharyngeal airway group,and SBP DBP,HR decreased which were associated with improved respiration,less stress response,and then good blood circulation system.The better improvement of respiration was observed in nasopharyngeal airway group after 30 minutes of noninvasive ventilation.More improvements in PaO2,PCO2,SBP,DBP,HR were observed 30 minutes after noninvasive ventilation with nasopharyngeal airway compared with control group (P ＜ 0.05).The endotracheal intubation was used in 31 cases (40.3％) in the oropharyngeal airway group,and among them,19 cases (24.7％) suffered pulmonary infection.But there were 15 cases (19.2％) with endotracheal intubation in the nasopharyngeal airway group and 11 cases (14.1％) with pulmonary infection.The length of ICU stay,incidence of endotracheal intubation,and rate of pulmonary infection were lower in nasopharyngeal airway group (P ＜ 0.05).Conclusions The nasopharyngeal airway used in noninvasive ventilation can effectively ameliorate ventilation dysfunction in stroke patients,correct hypoxia and lessen accumulation of carbon dioxide,also reduce the pulmonary infection and the rate of endotracheal intubation.Nasopharyngeal airway used in noninvasive ventilation is a effective modality to solve upper airway obstruction and offer effective ventilation in stroke patients.

Objective To evaluate the effects of treatment with different fluids on systemic inflammatory response in newborn rabbits with septic shock. Methods One hundred New Zealand white rabbits (3-5 days, 45-70 kg) were randomly divided into 5 groups (n = 20 each):group Ⅰ sham operation (group S); group Ⅱ sepsis (group CLP); group Ⅲ lactated Ringer's solution (group R); group Ⅳ 6% HES (group HES) and group V (group R+ HES). The animals were anesthetized with intraperitoneal ketamine and midazolam. Sepsis was induced by cecal ligation and puncture (CLP). The animals in group R and HES received lactated Ringer's solution and 6% hydroxyethyl starch (HES) 30 ml/kg infused iv over 1 h respectively immediately after CLP,while group R+ HES received Ringer's solution 20 ml/kg and 6% HES 10 ml/kg. Nio fluid was infused in groups S and CLP. Carotid artery and jugular vein were cannulated for MAP monitoring, blood sampling and drug and fluid administration. MAP was recorded immediately (T1) and at 0.5, 1, 2, 4, 8 h (T2-6) after CLP. Arterial blood samples were collected at T6 for determination of plasma IL-6 and IL-10 concentrations. Results Compared with those at T1, MAP decreased significantly after CLP at T4-6 in group CLP and at T5.6 in group R but hypotension did not develop after CLP in group HES and R + HES. Plasma IL-6 concentration was significantly higher in group CLP and R than in group S. There was no significant difference in plasma IL-6 concentration between group S and group HES and R + HES. Plasma IL-10 concentration was significantly lower in group CLP and higher in group HES than in group S. There was no significant difference in plasma IL-10 concentration between group S and group R and R + HES. Plasma IL-6 concentration was significantly lower, while plasma IL-10 concentration was significantly higher in group R + HES and HES,and plasma IL-10 concentration was significantly higher in group R or6% HES infused iv alone in maintaining the balance between pro-and anti-inflammatory cytolines in newborn rabbits with septic shock.

Objective To investigate the long-term programming effects on pubertal reproductive function by immunological challenge in early life. Methods Female Sprague-Dawley rats were administered by endotoxin (lipopolysaccharide, LPS) at a dosage of 50 μg/kg and saline intraperitoneally on postnatal day 3 and 5. Body weight was measured weekly. Puberty onset ( vaginal opening) and oestrous cyclicity were monitored from postnatal day 30. At the age of 6 weeks, bilateral ovariectomy was performed. The histological and morphological change of the ovaries (the thickness of the theca interna and the number of different kinds of follicles) were observed and the immunoreactivity of the ovarian sympathetic nerve markers (low affinity receptor of nerve growth factor, p75NGFR) was evaluated by immune staining. Results Immunological challenge (exposed to LPS) in early life delayed vaginal opening significantly [LPS-treated (40.6 ±0.7) days versus controls ( 38. 6 ± 0. 5 ) days, P ＜ 0. 05], decreased the percentage of normal oestrous cyclicity ( LPS-treated 26. 1% versus controls 66. 8% , P＜ 0. 05 ) , decreased the total number of different types of follicles (primordial follicles: LPS-treated 610 ±47 versus controls 1181 ±57, P ＜ 0. 05; primary follicles: LPS-treated 624 ±41 versus controls 960 ± 30, P ＜ 0. 05 ; preantral follicles: LPS-treated 183 ± 16 versus controls 260 ± 14, P ＜ 0. 05; antral follicles: LPS-treated 32 ± 4 versus controls 79 ± 7, P ＜ 0. 05) and increased the thickness of the theca interna [LPS-treated ( 15. 8 ±0. 4) μm versus controls (11.4 ±0. 3) μm, P ＜ 0. 05]. The immunostaining of p75NGFR was obviously enhanced in the LPS-treated ovaries when compared with that of controls ( P ＜ 0. 05 ) . Conclusions Immunological stress during early critical developmental windows could have long dysfunctional effects on the pubertal reproductive function. It delayed puberty onset, reduced the percentage of the normal oestrous cycles, decreased follicles reserve and increased the thickness of the theca interna which might involve the up-regulation of the local ovarian sympathetic nerve activity.

0.05). Conclusions Bacterial biofilm formation on the surface of the catheter is an important pathogenetic factor,which contributes to the recurrence and antibiotic resistance of urinary tract infection. Shortening the period of catheter dwelling and using closed drainage remain the predominant prevention and treatment of urinary tract infection.

Objective To evaluate the necessity of concomitant bladder cuff and the possibility of distal ureter sparing surgery during radical nephroureterectomy of low-level upper urinary tract tumors. Methods Clinical data of 73 patients with low-level (Tis-T3 M0 N0 ) tumors of the proximal upper urinary transitional epithelial cancer treated in radical nephroureterectomy in our hospital from 2000 to 2007 were analyzed retrospectively. The medical charts and pathologic specimens of 35 patients with, and 38 patients without, concomitant bladder cuff were reviewed. Results In the 35 patients with concomitant bladder cuff resection, 8 cases (22.9%) recurrence was observed; in the 38 patients without concomitant bladder cuff resection, 8 cases (21.1%) recurrence was observed. There was no difference between both groups(P>0.05). In the 19 patients suffered renal pelvis tumors with concomitant bladder cuff resection, 4 cases (21.1%) recurrence was observed; In the 16 patients suffered ureter tumors with concomitant bladder cuff resection, 4 cases (25 %) recurrence was observed.There is no difference between patients of renal pelvis tumors and of ureter tumors with concomitant bladder cuff(P>0.05). In the 27 patients suffered renal pelvis tumors without concomitant bladder cuff resection, 3 cases (11.1 %) recurrence was observed; in the 11 patients suffered ureter tumors with concomitant bladder cuff, 5 cases (45.5%) recurrence was observed. There was significant different between patients of renal pelvis tumors and of ureter tumors without concomitant bladder cuff (P<0. 05). Conclusion Concomitant bladder cuff resection confers a favorable prognosis to the patients with ureter tumors, but not to the patients with renal pelvis tumors.

ObjectiveTo compare the clinical effects of extracorporeal shock wave lithotripsy (ESWL) and ureteroscope holmium laser lithotripey(URL) in emergency patients with ureteral calculi.MethodsTwo hundred and forty emergency patients with ureteral calculi were retrospectively analyzed,including 110 patients undergoing ESWL (ESWL group) and 130 patients undergoing URL (URL group).Results The success rate of fragmentation and calculi-free rate were 90.0％ (117/130) and 80.8％(105/130) in URL group,of which were 88.2％(97/110) and 75.5％(83/110) in ESWL group with no significant difference between two groups (P ＞ 0.05 ).The success rate of fragmentation and calculi-free rate of upper ureter in ESWL group were much better than those in URL group[93.1％(54/58) vs.84.3％(59/70),77.6％ (45/58) vs.70.0％ (49/70),P ＜ 0.05 ],those of middle-lower ureter in URL group were much better than those in ESWL group[96.7％(58/60) vs.82.7％(43/52),93.3％(56/60) vs.73.1％(38/52),P＜0.05].ConclusionESWL and URL both have good curative effects in emergency patients with ureteral calculi,and ESWL has better effects for upper ureter while URL for middle-lower ureter.

Objective To investigate the correlation of postoperative platelet counts with liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma.Methods 212 patients with hepatocellular carcinoma were enrolled in this study.The relation between postoperative platelet counts and serum levels of ALT,AST,TB and PT after operation was analyzed.Results There were 78 patients with a low (＜ 100 × 109/L) immediate postoperative platelet count in this series of 212 patients who underwent partial liver resection for hepatocellular carcinoma,and 134 patients with a normal platelet count (≥ 100 × 109/L).Based on the criteria,27 patients were categorized as having delayed postoperative liver function recovery.There was no perioperative mortality in this study.Postoperative peak levels of ALT,AST and TB were significantly higher in patients with low postoperative platelet counts than those with normal platelet counts (P ＜ 0.05).Statistical analysis showed that low postoperative platelet counts after partial liver resection for hepatocellular carcinoma correlated with increased risk of delayed postoperative recovery (x2 =9.112,P =0.003).Conclusions Low postoperative platelet counts were associated with delayed liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma.

ObjectiveTo investigate the expression of paired immunoglobulin-like receptor B (PirB) in optic nerve, visual cortex, cerebella, spinal cord and sciatic nerve of normal adult mice.MethodsTwelve healthy adult BALB/c mice were randomly and equally divided into two groups.The immunohistochemistry and Western blot were used to detect the expression of PirB in the tissues described above respectively.ResultsBoth the immunohistochemistry and Western blot test revealed that the expression of PirB was positive in the optic nerve, visual cortex, cerebella and spinal cord, but negative in the sciatic nerve.The positive signals in the sections were located in the cell bodies and the neurites were observed in some of them.Western blot showed the apparent positive band of PirB in the optic nerve, visual cortex, cerebella and spinal cord rather than in the sciatic nerve.The protein expression level of PirB was relatively high in the visual cortex (P ＜0.05) but relatively low in the optic nerves (P ＜0.01).ConclusionThe PirB expresses positively in the optic nerve, indicating that PirB protein may closely correlate with the poor regeneration of the optic nerve.

Objective To investigate the effects of rhubarb combined with glutamine on repair of gut mucosal barrier injury after gastrointestinal surgery in rats. Methods Fifty male healthy Sprague-Dawley(SD)rats were randomly divided into five groups:control(C group),enteral nutrition(EN group),rhubarb with EN(R-EN group), glutamine with EN(G-EN group)and rhubarb combined with glutamine and EN(R-G-EN group)groups(each n=10). The rats of C group received no treatment and were fed normally. Cecectomy and gastrostomy were performed in EN,R-EN,G-EN and R-G-EN groups,and in 24 hours after surgery,they were interfered with the use of amoxicillin 50 mg/d and metronidazole 20 mg twice a day. From the first day after operation,each group was treated with the same prescription of enteral isocaloric and isonitrogenous nutrition for consecutive 7 days. Seven days later, under anaesthesia,laparotomy was performed,and a specimen of 1 cm intestinal segment was taken from the terminal 5 cm long ileum for all the groups;under the light microscope,the morphological examination of intestinal mucosal epithelial tight junctions(including villus height and mucosal thickness)was carried out. For each group,enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of plasma citruline and D-lactate,and the serum concentration of TNF-αwas detected by utilizing double antibody ABC-ELISA. Results The levels of D-lactate and TNF-αin EN,R-EN,G-EN and R-G-EN groups were obviously higher than those in C group(all P<0.01). The level of plasma citruline(μmol/L:16.13±0.58 vs. 14.52±0.28)of R-G-EN group was remarkably higher than that in R-EN group(P<0.05),and its levels of serum D-lactate(mmol/L:3.12±0.56 vs. 3.62±0.52)and TNF-α(ng/L:2.82±0.62 vs. 3.54±0.49)were markedly lower than those of G-EN group(both P<0.05). The mucosal villus height(μm:126.50±6.31 vs. 175.67±11.91),mucosal thickness(μm:223.67±11.94 vs. 277.00±14.06)and the level of plasma citruline(μmol/L:13.25±0.36 vs. 15.67±0.55)in EN group were obviously lower than those of C group(all P<0.01);the above indexes of R-EN,G-EN and R-G-EN groups were higher than those of EN group (P<0.05 or P<0.01),but in the comparisons of the villus height and mucosal thickness among the three groups there were no statistical significant differences(all P>0.05). Conclusion The application of rhubarb combined with glutamine can protect gut mucosa,reduce the level of inflammatory reaction and elevate the level of plasma citruline, that is beneficial to the repair of gut mucosal barrier injury and its functional recovery after gastrointestinal surgery in rats.