Virtual Reality is just emerging as an accepted scientific discipline. It has been widely used in medicine. The major applications of virtual reality for medicine are introduced from three areas :virtual humans,the fusion of virtual humans with real humans and virtual telemedicine. The advanced graphics behind medical virtual reality,such as computational demands,hardware and software environments is briefly discussed. This article also gives a summary of existing distributed VR systems.

Objective To investigate the relevance of liver function and neurobehavior of offspring of SD rats ex-posed to sodium valproate in the second trimester. Methods 30 SD rats at 12. 5 d of pregnance were randomly di-vided into three groups: low-dose group (300 mg/kg VPA was injected into abdominal cavity), high-dose group (600 mg/kg VPA);control group (normal saline). The offspring of low-dose groupe were grouped as VPA-low-dose;the offspring of high-dose groupe were grouped as VPA-high-dose; and the offspring of control group were grouped as control group. Then, we tested the liver and neurological function of each group of offspring, respective-ly, and analyzed their relevance. Results The levels of serum total protein and albumin of the high-dose group were considerably lower than these of the low-dose group which were significantly lower than these of control group ( P<0. 01 for both total protein and albumin);the levels of ALT, AST and blood ammonia of the high dose group were drastically higher than these of the low dose group, which were dramatically higher than these of control group ( P<0. 01 ) . The duration and of stereotyped movement disorder in experimental group was markedly longer than this of the control group, while this of the high-dose group was notably longer than this of the low-dose group ( P<0. 01 );the frequency of the stereotyped movement disorder of experimental group was significantly more than this of the control group, while this of high-dose group was obviously more than this of the control group (P<0. 01). In the Morris water maze, the escape latency of the high-dose group was remarkably longer than this of low-dose group, which was observably longer than this of control group (P<0. 01);the swimming distance of the high-dose group was tremendously shorter than this of low-dose group, which was considerably shorter than this of control group ( P<0. 05 , P<0. 01 ) . Correlation analysis of liver function and neural behavior showed that the neurobe-havioral abnormalities were negatively correlated with level of total protein and albumin, and were positively related with the level of blood ammonia, ALT and AST ( P<0. 01 ) . Conclusion The VPA exposure in the second tri-mester leads to the decrement of serum albumin and total protein and to the increment of AIL, AST and blood am-monia;and it also causes the neurobehavioral abnormalities of offspring. The reduction of synthesis of liver albumin and the rise of ALT, AST and blood ammonia can influence the neurobehavioral abnormalities. And there were both of the factors which result in the neurobehavioral abnormalities of offspring exposured to VPA in the second trimes-ter.

Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery.Methods Fifty ASAⅠorⅡ patients undergoing elective cesarean delivery were randomly divided into the two groups,Ephedrine group (n=5 1 ):intrave-nous injection of 10mg ephedrine before anesthesia;Dopamine group(n=52):continuous intravenous infusion at the speed of 5μg·kg-1 ·min-1 .During the whole process,we investigated the incidence rate of adverse effects,com-pared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein.Results Compare to the dopa-mine group,the incidence rate of hypotension was lower in the ephedrine group (43.1% vs 69.2%,χ2 =7.06,P=0.00).The pH value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22 ±0.03)vs (7.27 ±0.06),t=0.62,P=0.02],there are no significant difference of 5 min Apgar score in the two groups.Conclusion Compared with dopamine,ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine.Ephedrine has transient effect on the neonate,while the effect of dopamine is minor.

Objective To assess the risk of emergent endotracheal intubations in pediatric intensive care unite (PICU ) and to de-termine the risk factors of complications .Methods A prospective study was conducted with unified tables to collected data of all e-mergent intubations occurring in PICU between November 2011 and May 2012 .All the children were divided into group of any com-plication and group of no complication .Results (1)69 .1% children of emergent intubations had complications including desatura-tion(67 .9% ) ,bradycardia(29 .8% ) ,vomiting (16 .7% ) .(2)Emergent endotracheal intubations were 1 .7 times more likely to occur off-hours .Off-hours intubations were associated with 2 .7 times the risk of complications as on-hours intubations .(3)In a multivari-ate logistic regression analysis ,the nasal tracheal intubation ,two or more attempts at intubation ,and off-hours intubation were asso-ciated with complications .Conclusion Emergent endotracheal intubation are 1 .7 times more likely to occur off-hours .off-hours in-tubations ,the nasal tracheal intubation ,two or more attempts at intubation ,are associated with complications .

AIM:The homologous recombination takes place in E.coli BJ5183 between shuttle vector and adenoviral backbone vector.Recombinants are selected for kanamycin resistance,and the linearized recombinant plasmid is transfected into 293 cells.In this study,AdEasy system was used to generate recombinant adenovirus vector carrying rat interleukin-10(IL-10) gene.METHODS:The experiment was conducted in Department of Microbiology,Qingdao University Medical College from August 2006 to May 2007.①The materials included five clean-grade SD rat,a shuttle vector pAdTrack-CMV,an adenoviral backbone plasmid pAdEasy-1,E.coli.BJ5183 and DH10B,and human embryo kidney 293 cells,which were given as a present by professor Luo.All animal treatment was accorded with the ethical standards.②Total RNA was extracted from spleen cells of rat stimulating by lipopolysaccharide.IL-10 cDNA was amplified by using RT-PCR.The gene of interest was firstly cloned into a shuttle vector pAdTrack-CMV.The resultant plasmid was linearized by digesting with restriction endonuclease Pme Ⅰ,and subsequently transformed into E.coli.BJ5183 cells with an adenoviral backbone plasmid pAdEasy-1.Finally,the linearized recombinant plasmid was transfected into adenovirus packaging cell lines 293 cells.Recombinant adenovirus vAd-IL-10 was obtained.The expression of green fluorescent protein(GFP) was observed under fluorescent microscope.293 cells were cultured in 96-well culture plate with 1 ?104 cells per well.Condensed virus stock solution was added into the plate at different ratios.Recombinant adenoviruses titer was determined.Three days later,total RNA was extracted from 293 cells by TRIzol one-step method,and contaminant DNA was digested by DNaseⅠ.Electrophoresis detected the expression of IL-10 mRNA.RESULTS:①GFP expression was observed 16 hours after packing of the linearized recombinant adenoviruses in 293 cells.The amplification product of replicationdeficient Ad-IL-10 virus was transfected into adenovirus packaging cell lines 293 cells.When the fourth and fifth generations were seeded in virus for 24-48 hours,fluorescence was found in almost cells,and 5.5?108 pfu/mL titer of Ad-IL-10 was obtained.Titer of vAd-GFP was 9.0?108 pfu/mL.②Total RNA was extracted from transfected 293 cells.Electrophoresis showed that 580bp amplification product was expressed obviously and recombinant adenovirus was duplicated in 293 cells.CONCLUSION:The recombinant adenoviral vector carrying IL-10 gene is successfully constructed using AdEasy system.Moreover,vAd-IL-10 recombinant adenovirus with high titer is prepared and transcribed in 293 cells.

Objective To investigate the possible contribution of PPAR-? coupled signaling pathways to rat liver regeneration (LR) at transcription level.Methods The above signaling pathways-related genes were obtained by collecting database data and retrieving pertinent literatures. The gene expression during LR was checked by Rat Genome 230 2.0 array, and LR-associated genes were identified by comparing difference between partial hepatectomy (PH) and operation control (OC) groups.Results Sixty four genes were found to be LR-associated. The number of initially and totally expressed genes occurring in initiation phase of LR, G0/G1 transition, cell proliferation, cell differentiation and structure-function reconstruction was 28, 4, 34, 2 and 72, 41, 247, 90 respectively. Classification of their expression patterns into 11 groups reflected diversity and complexity of gene expression alteration in LR. Conclusion PPAR-? coupled signaling pathways may promote glycogen synthesis in forepart, prophase and anaphase of LR, cell proliferation and migration in the whole LR, while inhibits inflammation during LR.

OBJECTIVE:To provide reference for improving the pharmacy self-taught undergraduate course system in general universities in China. METHODS:According to comparative study and researching related literatures,the situation of pharmacy self-taught undergraduate course system in general universities in China was analyzed,and reform ideas and programs were present-ed. RESULTS & CONCLUSIONS:Based onchemistry-biology-psychology-society-medicine-pharmacyin the overall framework of pharmacy undergraduate self-examination course system,it was designed with target of cultivating applied talents;related con-tents in public basic courses,humanities basic course and professional ethics course should throughout the whole teaching process;professional main course should be pharmaceutical knowledge-based,supplemented by medical related courses;the school should set vocational elective course to reform based on combining with the own teaching research direction,characteristics and career ori-entation of different self-taught students. The reform can develop applied talents with ability and political integrity,which meets the needs of social development.

OBJECTIVE:To discuss the solution of therapeutic contradictions of bleeding and hemostasis in pulmonary embo-lism patients receiving warfarin anticoagulation. METHODS:The risk evaluation and dissolution of bleeding and embolism induced by warfarin anticoagulation were summarized by analyzing therapeutic duration of INR abnormal elevation in a pulmonary embo-lism patient receiving warfarin anticoagulation. Case analysis was based on foreign and domestic guideline and information. RE-SULTS:Referring to INR value,based on HAS-BLE,Caprini scale,China Expert Consensus on Anticoagulant Therapy of Warfa-rin,China Expert Suggestions on Prevention of Venous Thrombosis in Internal Inpatients and Guidelines of Prevention of VTE in Nonsurgical Patients of American College of Chest Physicians,clinical pharmacists and physicians adjusted the dose of Warfarin tablet timely. The patient was recovered after symptomatic treatment of anticoagulation,relieving cough and asthma,reducing phlegm,etc.,and then disagreed from hospital with drugs. CONCLUSIONS:The risk of bleeding and embolism for this type pa-tients can be evaluated and resolved on the basis of HAS-BLED,Caprini scale and relevant guidelines. At present,there still are some problems as deficient evaluation method,lack of large-scale high-level evidence and quantitative study. It is needed to carry out multiple center clinical study and drug interaction quantitative study actively,and develop suitable risk evaluation method so as to provide high-quality and valuable decision-making evidence.

The study explores the current situation of the burden of chronic poor patients and the core essence of the accurate health poverty alleviation policy.More specifically, it aims to analyze the existing problems and practical dilemmas in the implementation of the accurate health poverty alleviation policy, and conveying recommendations for the policy formulation.The analysis shows that the problems in the implementation of the accurate health poverty alleviation policy in China are: the empowerment of the poor population is not accurate;the dynamic management and assessment mechanism is not accurate;and the allocation of poverty alleviation resources is not rational.In view of these problems, the following suggestions were put forward: the establishment of a multi-dimensional poverty identification system, the improvement of poor households through building up their card information;improve the accurate poverty alleviation dynamic supervision and assessment system;rational allocation of poverty alleviation resources, promote the supporting policies and institutional innovation.

12 gestational-week uterus) were treated in our hospital by LAVH. The operation time,intraoperative blood loss,and postoperative recovery of the patients were compared to another 110 cases that underwent TAH. Results The operation time in the TAH group was significantly shorter than that in the LAVH group [(109?27) min vs (130?22) min,t=-6.441,P=0.000]. During the operation,the LAVH group had a mean of (121?70) ml blood loss,which was significantly lower than that in the TAH group [(141?73) ml,t=-0.903,P=0.368]. After the operation,the patients in the TAH group had longer recovery time for gastrointestinal function and longer hospital stay than those in the LAVH group [(45?13) h vs (24?6) h,t=15.778,P=0.000;and (7?2) d vs (5?2) d,t=7.530,P=0.000]. Conclusions Compared to TAH,LAVH results in shorter hospital stay and fewer postoperative complications. It is a feasible and safe treatment for large uterus.