Aim To investigate the effect of fenofibrate on focal cerebral ischemia injury in rats and its mechanism.Methods The rat model of global cerebral ischemia/reperfusion injury was established by bilateral common carotid arteries occlusion combined with hemorrhagic hypotension.Fenofibrate (33, 100, 300 mg·kg~(-1)) was intragastriclly administered 30 min before the operation, MK886 (6 mg·kg~(-1)) was given intraperitoneally 30 min before administration of fenofibrate (300 mg·kg~(-1)).Morris water maze was used to evaluate the ability of spatial learning and memory function.HE staining was used to observe pathological morphological changes of hippocampal neurons. NF-κBp65 expression was detected by immunohistochemistry, SOD activities and MDA contents were analyzed by biochemistry, and IL-1β, IL-6, IL-10, TNF-α levels were detected by ELISA.Results Fenofibrate remarkably improved the spatial learning and memory function, obviously prevented the hippocampal neurons from karyopycnosis and losing induced by I/R. Fenofibrate significantly blunted the increase of MDA, NF-κBp65, TNF-α, IL-1β, IL-6, and the decrease of IL-10 and SOD activities of I/R rats.Conclusions Fenofibrate has an obviously neuroprotective effect on global cerebral ischemia/reperfusion damage by activating PPARα.The anti-inflammation and antioxidative stress of fenofibrate may be involved in the protective mechanism.

The academic orientation determines the development direction of the subject, and also puts forward the corresponding requirements for the professional teaching. The deep development of anes-thesiology, perfect preoperative evaluation, refined management of clinical anesthesia and ultimately improv-ing the prognosis of patients are the total development directions of anesthesiology. Perioperative patient home (PSH) advocates taking patients as the center, dominated by anesthesia, based on evidence-based medicine in the perioperative period, solidarity and cooperation of multiple disciplines, the integration of a variety of medical resources, and providing continuous and efficient medical services for patients. PSH is required to ensure the safety of clinical anesthesia, reduce the incidence of anesthesia mortality and serious
complications, and improve the long-term survival rate and quality of life by improving the clinical work of the department of anesthesia. Practicing PSH, the anesthetic doctors should have the academic idea of the treatment of anesthesia. The concept requires making comprehensive use of a variety of teaching methods, putting emphasis on the training of basic knowledge, and in the teaching of basic knowledge, infiltrating the overall and local thinking and using lecture method in cooperation with the case teaching. To make solid promotion of PSH concept, we should use CBL teaching, strengthening the management of clinical anesthesia, and striving to promote the clinical practice of PSH.

Objective To investigate the effect of propofol on the intracellular calcium ion concentration ([ Ca2+ ]i) in isolated rabbit tracheal smooth muscle cells (TSMCs).Methods The single rabbit TSMC was isolated by acute enzymatic isolation method as described by Cheng et al.The isolated TSMCs were randomly divided into 3 groups ( n =5 each):propofol group (group Ⅰ ),propofol + 2-aminoethoxy-diphenylborate (2-APB) group (group Ⅱ ) and propofol + the blocker ryanodine group (group Ⅲ).In group Ⅰ,the cells were incubated with propofol with the final concentration of 300 μmol/L for 15 min,followed by washing with calcium-free Hank's balanced salt solution (HBSS) for 3 times,acetylcholine 1 μmol/L was then added to the culture medium and [ Ca2+ ]i was recorded.In group Ⅱ,the cells were incubated with 2-APB with the final concentration of 40 μmol/L for 15 min,propofol with the final concentration of 300 μmol/L was then added,the cells were incubated with 2-APB and propofol for another 15 min,followed bywashing with calcium-free HBSS for 3 times,and acetylcholine 1 μmol/L was then added.In group Ⅲ,the cells were incubated with ryanodine with the final concentration of 10 μmol/L for 15 min,propofol with the final concentration of 300 μmol/L was then added,the cells were incubated with ryanodine and propofol for another 15 min,followed by washing with calcium-free HBSS for 3 times,and acetylcholine 1 μmol/L was then added.[ Ca2+ ]i in TSMCs was measured using the fluorescent Ca2+ indicator fluor-3/AM.Results Compared with group Ⅰ,no significant change was found in [Ca2+ ]i in group Ⅱ (P＞0.05),while [Ca2+ ]i was significantly decreased in group Ⅲ (P＜0.05).Conclusion Propofol can decrease the [Ca2+ ]i in isolated rabbit TSMCs,and the mechanism may be related to inhibition of inositol 1,4,5-trisphosphate pathway,but not ryanodine pathway.

It is found in clinical practice that decisions made by agents on hehalf of the patients without capability of independent choice may sometimes conflict interests of the patient in question. The author summarized by categories common dilemmas faced by clinicians, and came up with the ethical principles to resolve the problems, as proven in case studies. Doctors should fully respect reasonable decisions of agents of such patients. Furthermore, to make a reasonable decision on their behalf, the agent is expected to make medical decisions in the interests of the life and health of the patient, with adequate knowledge of the disease, therapeutic measures and outcomes, and without any damage to interests of the patient they represent. Such a reasonable decision should neither violate laws of the state, nor infringe on interests of other individuals, collectives and the society at large for benefits of the patient in question. In addition, it should conform to the medical ethics of fair distribution of health resources.

Objective To observe the effect of Rosuvastatin on apolipoprotein A1 (Apo A1),apolipoprotein B(Apo B) and Apo B/Apo A1 patients with acute coronary syndrome.Methods One hundred and fifty hospitalized patients with acute coronary syndrome were randomly divided into three groups,A group (Rosuvastatain,5 mg/d),B group (Rosuvastatain,10 mg/d),and C group (Simvastatin,20 mg/d).Before and at 4,8 weeks after treatments tested the three groups' cholesterol (TC),glycerin(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol (LDL-C),Apo A1,Apo B.Compare the blood lipids aforementioned before and after treatments in three groups.Results (1) After treatments for 4 weeks,TC,LDLC in three groups are significant lower than before (P ＜ 0.05).After treatments for 8 weeks,TC,LDL-C,Apo B,Apo B/Apo A1 of three groups are lower than before and HDL-C 、Apo A1 is higher than before (P ＜ 0.05).(2)After treatments for 8 weeks,comparing to A and C groups,TC,LDL-C,Apo B,Apo B/Apo A1 in B group were lower while HDL-C、Apo A1 were higher (P ＜ 0.05).(3)The incidences of liver damage has no significant differences among three groups (x2 =1.25,P ＞ 0.05).Conclusion Effects of 10 mg/d rosuvastatain were better than 5 mg/d rosuvastatain and 20 mg/d simvastatin in increasing Apo A1 and decreasing Apo B,Apo B/Apo A1,and then effectively control of ACS.

Objective:Study on the clinical application and analysis of structured electronic medical records in our hospital in last.Methods: Discharged patients data selected from July 2012 to June 2014, using statistical methods for data processing, 8000 case files were divided into two groups: Group A and Group B.Results: After comparing the two groups of two groups of data, and ultimately disease coding accuracy rate 94.88%, fill in the correct rate increased 88.38%, missing rate decreased 4.63%, two groups had no significant difference data; The quality of writing the doctor increased gradually, the error rate tends to be stable, structured clinical application to control.Conclusion: Sequential specification writing medical doctor, scientific analysis of medical record information, the clinical application of structured electronic medical records the error rate is reduced in the operation, improve the accuracy, more standardized, accurate, standardized.

Objective To investigate the correlation between Epstein-Barrvirus (EBV) and H.pylori (Hp) infection and gastric cancer. Methods The EBV infection was examined by polymerase chain reaction (PCR) and in situ hybridiza-tion (ISH) in 100 samples of gastric cancer tissue and 82 samples of gastritis tissue. The Hp infection was detected by PCR. The correlation between EBV and Hp infection and clinical and pathological features was analyzed in patients with gastric cancer. Results The positive rates of EBV and Hp were significantly higher in gastric cancer tissues than those in gastritis tissues (9.0%vs 0 and 56.0%vs 40.2%, P＜0.05). There was significantly higher infection rate in EBV in cardia gastric can-cer than that of gastric cancer (16.3%vs 2.0%,P＜0.05). There were significantly higher infection rates in EBV and Hp in poorly differentiated carcinoma than those of well-differentiated carcinoma (15.7%vs 2.0%and 66.7%vs 44.9%, P＜0.05). There were no significant differences in EBV and Hp infection between gender, age, nationality and lymph node metastasis (P>0.05). There was no significant difference in Hp infection between different parts of gastric cancer. There was no correla-tion between EBV and Hp infection in gastric cancer tissues (r=0.137, P>0.05). Conclusion EBV and Hp infection are two independent factors in the development of gastric cancer, and both of them are associated with the malignant evolution of gastric cancer.

The global and local,goal and destination,treatment and reinjury are three common critical thinking,which has the vital significance to the teaching of anesthesiology.Through the classroom interpretation of the pathogenesis,we preliminarily cultivate the students' global and local thinking by guiding students to find the primary problem in the global and local and finding out the breakthrough point of disease treatment.Through the case teaching,we promote students to constantly strengthen their goal and destination thinking by guiding students to select target,determine the endpoint,and solve the problem in stages to make the treatment of the critically ill patient which students simulate has good operability.Through adoption of problem based learning,we make students know how to achieve the optimal treatment effect by guiding them to have extensive discussions and have access to information so as to cultivate students' treatment and reinjury thinking and enhance their global and local thinking at the same time.

With the deepening of the study on traditional Chinese medicinal quality and the rising requirements of TCM quality control, the demand of setting TCM quality were emphasized,as well as higher education course. Surrounding the purpose of exploring the related issues of the traditional Chinesemedicinal courses setting and promoting the college curriculum innovation capability,the paper mainly discussed the course open orientation, the teaching characteristics, objectives, idea, the core content and the training scheme, as well as the plan of course and teaching material construction depended on these contents.

As one of the most sensitive cells of endoplasmic retieulum stress (ERS), pancreatic β-cells have an a-bundance of endoplasmic reticulum. Fatty acids cause apoptosis of β-cells and might contribute to β-cell loss in type 2 diabetes mellitus via the induction of ERS. Glucose is an amplifier of the ERS response to fatty acid, leading to increased β-cell apoptosis. ERS response mediates glucolipotoxicity-induced β-cell apoptosis.