Objective To evaluate the efficacy of continuous incision analgesia with 0.2％ levobupivacaine for postoperative analgesia in parturients undergoing cesarean section.Methods Thirty ASA physical status Ⅰ or Ⅱ parturients who were at full term,aged 20-30 yr,weighing 60-80 kg,undergoing elective cesarean section,were enrolled in the study.The parturients received 0.2％ levobupivacaine 2 ml/h via a continuous incision analgesia device at the end of surgery.Pain was evaluated by visual analogue scale (VAS).Additional tramadol 50 mg was given when VAS score was above 3 and the consumption was recorded.The effective analgesia within 48 h after surgery (no addition of tramadol,VAS score ≤3) was recorded.The serum prolactin level was measured at 30 min before cesarean section and 24 and 48 h after cesarean section.The colostrum time was recorded.The toxic reaction and side effects were recorded.Results The effective analgesia rate was 80 ％.The consumption of tramadol was (95 ± 15) mg.The colostrum time was (24 ± 6) h.No toxic reaction was found.The serum prolactin level was significantly higher at 24 and 48 h after surgery than that at 30 min before surgery (P ＜ 0.05).Conclusion Continuous incision analgesia with 0.2％ levobupivacaine provides better efficacy,earlier colostrum time and fewer side effects for postoperative analgesia in parturients undergoing cesarean section.

The application of medical network education system has created favorable conditions for the network education in our hospital. This paper describes the system and resource database construction, educational application and some problems confronted. Construction improvement and widely application of the system are also thoroughly discussed.

BACKGROUND: Angong niuhuang wan consists of mercury and arsenic, which has drawn the attention on its safety. It is necessary to carry on the research on evaluation in its availability and safety.OBJECTIVE: To study the mechanic differences of angong niuhuang wan in the organic body physiologically and pathologically.DESIGN: Randomized controlled experiment based on the experimental animals.SETTING: Institute of clinical pharmacology affiliated to a university.MATERIALS: The experiment was performed in Institute of Clinical Phar macology affiliated to Guangzhou University of Traditional Chinese Medicine from March to April in 2001. Guangdong Medical Experimental Animal Center provided 24 SD male rats, weighted varied from 250 g to 300 g.METHODS: SD rats were randomized into 4 groups, named as normal group, normal & angong niuhuang wan group(normal & wan group), model of cerebral infarction group(model group) (The middle cerebral artery embolism was induced in rats by photochemistry. ) and model of cerebral in farction group & angong niuhuang wan group (model & wan group), 6 rats in each group. Medication instruction: gastric feeding was applied once daily, 0. 13 g/kg, totally for 7 days. MAIN OUTCOME MEASURES: contents of lactate dehydrogenase (LDH) isoenzymes, LDH1-5.RESULTS: Contents of serum LDH1-3 in normal & wan group were significantly increased than those in normal group( P ＜ 0.01 ), of which, the values of LDH1, LDH2, LDH3 were(17.02 ±0.46)%, (14.70 ±0. 18)%,(15.47±0.13)% successively in normal & wan group, were(11.25 ± 0. 70) %, (8.26 ± 0. 90) %, ( 12. 86 ± 0.90) % successively in normal group. Content of serum LDH3[(15.51 ±2.60)% [ in model & wan group was significantly increased compared with that in model group[(10.93±2.10)% ] (P ＜ 0.01) . The contents of LDH4 were[(22.62 ±3.00)% ] and(28. 18 ±0. 80)% respectively in two groups, indicating significantly reducing( P ＜ 0.01 ).CONCLUSION: The organic injury of angong niuhuang wan is less in pathological state of focal cerebral infarction than that in physiological state,suggesting that the mechanic differences of angong niuhuang wan in organic body present in physiological and pathological states.

Objective To design a multi-signal bio-feedback instrument in order to treat related diseases.Methods Based on the principle of bio-feedback and ARM microprocessor,an instrument was designed which not only feedbacked RSA,EMG,skin thermal and skin conductance;but also provided a relaxation training method through deep breathing.Results The system could finish bio-feedback and relaxation training.Conclusion The instrument is easy to use and possesses powerful functions.It can be used for the treatment of psycho-physiological diseases and some psychoneuroses.

Objective To investigate precise and regulable animal model of benign bile duct strictures.Methods Mini pigs were divided into four groups as sham surgery group, conventional surgery group, small caliber group and large caliber group according to random number table, with 6 pigs in each group.For the small caliber group, outside diameter 3.0mm catheter were inserted into bile duct and partial sutured.For the large caliber group, outside diameter 6.0mm catheter were inserted into bile duct and partial sutured.Conventional surgery group were treated with 5-0 absorbable suture on distal bile duct and controlled stricture severity visually.For sham surgery group, bile duct were exposed without suture.Observe the general condition of four groups.Test liver function on 1st, 3rd, 7th, 14th, 21st and 28th day postoperative.Perform cholangiography on 30th day postoperative.All four groups were put to death to observe the histological changes of liver and bile duct.Results Liver function of sham surgery group showed no obvious change during observation.On 28th day postoperative, compared to conventional surgery group, the liver enzymes ALT, AST, γ-GT, ALP, bilirubin level of small caliber group elevated(P<0.05)and the liver enzymes ALT, AST, γ-GT, bilirubin level of large caliber group elevated(P<0.05),while ALP level lowered(P<0.05).Cholangiography showed bile duct stenosis of different degree on 6 pigs of small caliber group with average diameter 2.7mm (from 2mm to 4mm).As for large caliber group, 5 pigs showed stenosis with average diameter 5.5mm (from 5mm to 7mm).3 pigs of conventional surgery group showed no obvious bile duct stenosis.The 6 pigs of sham surgery group showed no bile duct stenosis.According to designed stenosis standard, the success rate of small caliber group and large caliber group are both higher than conventional surgery group.(P<0.05).30 days after surgery, all 6 pigs of small caliber group had postoperative intraperitoneal adhesion, hepatomegaly, obvious expansion of intrahepatic bile duct and gallbladder expanded by 4~5 times.5 pigs of large caliber group had hepatomegaly, slight dilation of intrahepatic bile duct, obvious expansion of gallbladder, clear choledochal edema, sutured tissue thickening and visible bile duct stenosis.HE staining with the small caliber group showed hepatocyte spotty degenerative necrosis, expanded cholestatic intrahepatic small bile duct, swelling hepatocyte and fibrous septa.HE staining with the large caliber group showed intrahepatic small bile duct slightly expanded and hepatocyte arranged basically normal.VG staining with the small caliber group showed excessive accumulaton of collagen fibers outside bile duct mucous cells, randomly and densely arranged and irregularly shaped.VG staining with the large caliber group showed increased collagen fibers in bile duct submucosa, densely and banded arranged.Conclusion This animal model of mini pig is an relatively ideal large animal model of biliary stricture with high surgical success rate and few postoperative complications.

Objective: To analyze the expression of mecp2 gene at mRNA and protein;Cerebral cortex level in the cerebral cortex of the normal Wistar rat throughout development. Methods: We chose the 15th day (E15), 17th day (E17), 19th day (E19) of embryo period, the day of birth (P0), the 7th day (P7), the 14th day (P14), the 28th day (P28) of postnatal period, and adulthood as analyzing time points. The expression of mecp2 gene at mRNA level was analyzed by real time PCR and Northern blot. The expression of MeCP2 protein was analyzed by Western blot. Results: There was one type of mecp2 mRNA transcript (approximately 10 kb) expressed in the cerebral cortex of the normal Wistar rat. The expression level of mecp2 mRNA varied subtly during the development. There was one type of MeCP2 protein (75 000) expressed in the cerebral cortex of the normal Wistar rat. The expression level of MeCP2 protein remained the lowest on E15, from E19 to adulthood the expression levels of MeCP2 protein increased dramatically compared with that on E15. From P7 to adulthood, the differences of expression between two time points were subtle. Conclusion: The expression level of MeCP2 protein increases as the neurons in the cerebral cortex of normal Wistar rat grow mature. This indicates that MeCP2 protein is very important to neuron's maturation, and probably has relationship with maintaining maturation state of neurons.

Objective To study the alteration of telomerase activity of MCF 7 cell line of breast cancer in the presence of different anticancer drugs. Methods The hyperplasia and viability of MCF 7 cell were detected by cell counting and trypan blue exclusion, and the telomerase activity was measured by TRAP.The alteration of MCF 7 cell and its related factors of telomerase activity were observed on cell growing in different condition. Results In abscence of drug, there was a positive correlation between hyperplasia and telomerase activity of the cell(r= 0.901 ). Adriamycin, paclitaxel and cisplatin could obviously inhibit the growth and reduce the telomerase activity of the cell in a dose-dependent and time-dependent fashion, and this reduction in telomerase activity closely correlated with the reduction in the number of viable cells. Conclusions Adriamycin, paclitaxel and cisplatin can inhibit the growth of MCF 7 cell, which may be correlated with the reduction in telomerase activity and cell viability.

Objective To study the ches t X-ray and CT appearance of pulmonary nontuberculosis mycobacteria (NTMB) Methods The chest X-ray findings of 22 cases with cultures positive for pulmonary nontuberculosis mycobacteria were reviewed, 10 cases had CT scans simultaneously All abnormalities and predominant lobar involvement were recorded The findings of chest X-ray and CT were compared Results The chest X-ray showed that air space consolidation ( n =19) and cavities ( n =18) were most frequently seen, nodules ( n =12) and linear disease ( n =14) were observed too The abnormalities involved bilateral multiple lobes, the right lung was more frequently involved than left, and upper lobe was involved more than lower ones Multiple manifestations were often co-existing ( n =19) On CT scans, nodule was the most frequent finding ( n =10), air space consolidation ( n =8) and cavity ( n =8) were other common findings In addition, bronchiectasis ( n =5), “tree in bud” sign ( n =3), and mediastinal lymphadenopathy ( n =2) were also seen on CT but not on chest X-ray Conclusion Air space consolidation, cavity, nodule, fibrosis, bronchiectasis, and “tree in bud” are major abnormalities of chest image The image abnormalities of pulmonary NTMB are indistinguishable from those of secondary pulmonary TB Multiple co-existing manifestations may be the characteristic findings of pulmonary NTMB infection

Objective To investigate the molecular epidemiology of human immunodefieiency viruses (HIV)-1 infected individuals in Honghe district,Yunnan Province and provide the evidence of molecular biology features of HIV-1 infection.Methods HIV-1 pol gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR).Then sequencing and phylogenetic tree analysis were employed tO determine HIV-I subgenotype.The sequence alignment was performed in the database of international drug resistance tO identify resistance-associated mutations.Results The samples from 60 HIV-1 infected individuals were investigated:39 were male,21 were female,with average age 35.5 years old.Thirty-four cases were infected with HIV-I through intravenous drug abuse,12 by sexual contacts,2 were contaminated blood/blood products transfusion and 12 with unknown transmission routes.Phylogenetic analysis revealed that 53 cases (88.3%) were subtype 08-BC,6 (10.0%) were subtype 07-BC and 1 (1.7%) was subtype 01_AE.The total rate of drug resistance associated mutations was 33.3%.The major mutations in protease (PR) and reverse transcriptase (RT) regions accounted for 5.0% and 3 1.7%,respectively.The major mutations in PR region were I541M,V82VFIL,M46MI,which were found in 1 case,respectively.The mutations in RT region were as follows:4 cases were T69D,6 were A62V,1 was D67DE,1 was E44D,3 were V179D,1 was V179E.1 was K238KN,1 was L234T+P236S and 1 was V106E.Conclusions The major transmission route of HIV-I infection in Honghe district,Yunnan Province is through drug injection.The major HIV-1 subtype of HIV-infeeted individuals is 08_BC.PR inhibitor and RT inhibitor drug resistance associated mutations in HlV-1 gene have already existed.

Objective To investigate the current status of type 2 diabetic patients who failed to achieve the glycemic control target, and provide theoretic evidences for making corresponding strategies. Methods The 2 diabetic patients who failed to reach the glycemic target were recruited from 181 hospitals in 26 cities and received a standard questionnaire, the conditions of their blood glucose level, lifestyle intervention, blood sugar monitoring, and drug therapy were recorded. Totally 3 861 questionnaires with complete information were collected. And the causes which account for glycemic control status were analyzed. Results Among these patients, the mean HbA1c was 7.9%, the mean fasting plasma glucose was 8.2 mmol/L, and the mean postprandial plasma glucose was 11.5 mmol/L. Only 25.6% of patients take their diet control strictly as prescribed and 44. 5% of patients have little exercise. 35. 8% and 47.8% of patients did not monitor their fasting and postprandial plasma glucose,respectively. Glycemic control in the patients aged ＞ 60 years was similar to the younger patients, but the hypoglycemia incidence in the elder group reached 35.5%, which was higher than those in the other 2 groups (20.8% and 21.4%, both P＜0. 05 ). The proportion of patients with mono-therapy and combination therapy was 46. 1% and 51.7%, while the proportion with combination therapy rose in the patients aged ＞60 years (58.7%;Compared with the other age-groups, all P＜0.05 ). 75 % of patients have adjusted their drug administration regimen since initial treatment. Conclusions Inadequate or inappropriate drug therapy regimen is a major cause responsible for this poor glycemic control status. In addition, the unhealthy life styles, insufficient blood sugar monitoring, and poor compliance were also important causes. Thus, for these patients, it is necessary to further enhance patients' education, to improve life style intervention, as well as to select more effective, safer, and compliant drug therapy regimens. Finally, the glycemic control target for the elder patients should be more flexible.