0.05). Pretreatment with intrathecal prazosin (30 ?g) significantly reduced the antinociception of ketamine 10 min after injection but not 10?g (P

The article reviewed of the origin of the social practice teaching in master of public health(MPH) program and gave the introduction of the social practice in American MPH education. Through the definition, positioning and feedback of specialized social practice in full-time MPH program, we can get some experiences and enlightenments of specialized social practice in full-time MPH educa-tion, which will provide references for social practice teaching in full-time professional degree education.

Aim To investigate the relationship between spinal cord noradrenergic neurons ? 1 adrenoceptors and the spinal analgesia of ketamine. Methods Kunming mice were used. Analgesia tests were investigated with warm water tail flick test. The effects of intrathecal injection (ith) of ketamine (50,100,200 ?g)on tail flick latency of animals were observed. And the effect of pretreatment with intrathecal 6 hydrodoapa(6 OHDA, 6?g ) and ? 1 adrenoceptor antagonist prazosin (5, 15 ?g) or terazosin (5, 15 ?g) , respectively on the spinal analgesia of ketamine (100 ?g,ith) was studied. Results Dose dependent analgesia was observed following ith ketamine (100,200 ?g, P

Objective To investigate the differences of EUS images between stromal tumors and leiomyoma in esophagus and cardia. Methods EUS image of 13 cases of stromal tumors and 11 cases of leiomyoma diagnozed immunohistochemically were collected. Information of gray scale including mean value and dissociation of lesions and submucosal layer were analyzed. Gray scale values of lesions were calibrated according to that of the submucosal layer. Results The mean value of corrected gray scale of stromal tumors was 0. 285, which was significantly different from that of leiomyoma (0. 185, P ＜ 0. 05). Dissociation of gray scale of stromal tumors was 8. 14, which was also significantly different from that of leiomyomia (4. 59,P ＜0. 05). Conclusion In esophagus and cardia, stromal tumors exhibits higher and more inhomogeneous ultrasound echo than leiomyoma.

Objective To investigate whether preoperative proton pump inhibitor (PPI) would increase the risk of bacteremia after endoscopic ultrasonography guided fine needle aspiration (EUS-FNA).Methods Dogs were randomly divided into experimental group ( n = 8) to take 20mg of omeprazole orally twice a day for 3 days before EUS-FNA, and control group (n = 10) to take placebo.EUS-FNA was performed to puncture the pancreas, and blood was collected before and after the procedure for culture.Bacteremia incidence of the two groups were compared.Results Bacteria culture was positive in 11 edogse.After excluding contamination, 1 dog in experimental group and 3 in control group were authentical bacteremia.There was no significant difference on the incidence of bacteremia between 2 groups based on Fisher test ( P = 0.383).Conclusion Aplication of PPI before EUS-FNA is not likely to increase the incidence of bacteremia.

ObjectiveThe efficacy and safety of nitrous oxide-sedated transnasal gastroscopy for high-risk patients of intravenous anesthesia were evaluated. MethodsA total of 157 patients were randomly assigned to the nitrous oxide group ( n =80) and the oxygen group ( n =77). Heart rate, blood oxygen saturation, blood pressure and electrocardiogram were monitored. Complications in both groups were recorded.Satisfaction degrees of patients and endoscopy physicians were evaluated with a questionnaire and visual analog scale (VAS) score. The questionnaire questions for physicians included the procedure evaluation ( steady, ok, unsteady). Patients' questionnaire questions included discomfort (light, moderate, severe), the patients' tolerance ( fine, moderate, weak) and the patients' willingness to undergo a second procedure. Statistical analysis was performed between the two groups. ResultsSix of the toal 157 patients were removed because of the operation failure (difficulty in access to nasal cavity in 5 patients and nose bleeding in one patient), 151 patients underwent the transnasal gastroscopy successfully and completed the questionnaires. In experimental group, there were 37 males and 41 females (mean age was 67.7 years, ranging 16-88 years, 7 patients were grade 1 of ASA, 61 were grade 2, and 11 were grade 3). In the control group, there were 36 males and 37 females (mean age was 67.9 years, ranging 17-86 years, 6 patients were grade 1 of ASA, 57 were grade 2, and 9 were grade 3). There was no differences in sex, average age and ASA grade between the two groups (P ＞ 0. 05 ). There was no difference in the mean operation time between the two groups, either (200. 1 s vs 200. 3 s) ( P ＞ 0. 05 ). There were no significant differences between the two groups in changes of blood oxygen saturation, blood pressure, electrocardiogram and complication rates ( P ＞ 0. 05 ).Both physicians' and patients' positive evaluations of the experimental group were more than that of the control (P ＜ 0. 05 ), while physicians' and patients' negative evaluations of the experimental group were less than the control (P ＜0. 05). VAS of physicians' satisfaction in the experimental group was higher than that of the control group (84 vs 70, t =14. 67, P ＜ 0. 05), and VAS of patients' satisfaction in the experimental group was superior to the control group (82 vs 71, t =11.56, P ＜ 0. 05). The number of patients wiring to undergo a second procedure in the experimental group was higher than that of the control (89. 7％ vs 69. 9％, P ＜ 0. 05). ConclusionNitrous oxide-sedated transnasal endoscopy is an effective and safe procedure for high risk patients of intravenous anesthesia.

ObjectiveTo assess the diagnostic value of EUS for pancreatic neuroendocrine tumors.MethodsClinical data of 26 patients with final diagnosis of pancreatic neuroendocrine tumors,who had underwent EUS and EUS-FNA,were retrospectively analyzed.Results On EUS,pancreatic neuroendocrine tumors presented as hypoechoic masses with clear margins and rich blood flow.Of the 26 pancreatic lesions,3 were in the head,2 in unicate process,2 in neck,11 in body and 8 in tail.The tumors presented with function in 16 ( mean size 9 mm),and on function in 10 ( mean size 29 mm).EUS-FNA yeilded positive results in 22 patients and negative in 4.The accuracy rate of EUS for preoperative localization was 100％ in 23 patients who underwent surgery.ConclusionEUS can provide accurate preoperative localization and pathologic evidence for pancreatic neuroendocrine tumors.

Objective To investigate the expression of ADAM8 in patients with hepatocellular carcinoma (HCC) and its clinical significance.Methods The protein expression of ADAM8 in HCC tissues was analyzed using immunohistochemical analysis.Serum levels of ADAM8 were measured by ELISA in 126 patients with HCC,50 patients with liver cirrhosis (LC) and 50 healthy individuals.The relationship between patients' pathological features and serum ADAM8 level was analyzed.Results Immunohistochemical analysis showed that ADAM8 expression was associated closely with serum AFP elevation,tumor size,histological differentiation,and tumor stage.The ELISA assay showed that the serum levels of ADAM8 in the HCC were significantly higher than those in LC and healthy groups.Kaplan-Meier survival analysis showed that high expression of serum ADAM8 exhibited a significant correlation with poor prognosis for HCC patients.Multivariate analysis revealed that serum ADAM8 expression is an independent prognostic parameter for the overall survival rate of HCC patients.Conclusion ADAM8 expression was closely associated with tumor size,serum AFP elevation,tumor differentiation,tumor stage and prognosis in hepatocellular carcinoma.Therefore,ADAM8 expression may serve as a biomarker for predicting the prognosis of patients in hepatocellular carcinoma.

Acute respiratory failure (ARF) after operation for esophageal carcinoma is a serious challenge to medical management and usually accompanied by a high mortality rate. This paper present author's experience on the management of 10 such cases. It is emphasized that advanced age, long-history of smoking, COPD are predisposing factors and in-trathoracic surgery and its complication may trigger the ARF,which usually occurs within 48-72 hours after operation. Besides assist mechanical ventilation, thorough clearance of the secretion from the respiratory tract, control of pulmonary infection and early eradication of the intrathoracic complications are the key points of the successful treatment. Preoperative pulmonary functional studies with careful analysis in correlation with patients condition is mandatory especially in elderly patients. Prevention is more important and valuable than treatment for the patients with postoperative acute respiratory failure.