Objective To investigate the impact of propofol and midazolam on the time course of extubation in patients with mechanical ventilation.Methods The patients were randomly divided into the propofol group(n=37)and the midazolam group(n=52),which were further divided into three sedation stratums.The administration of two drugs were stoped immediately while weaning from the ventilator.The awakening time and extubation time of the two groups were recorded and compared with each other.Results Both awakening time and extubation time of the propofol groups were shorter than those of the midazolam group(P

Objective To explore the relationship between phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt)/mammals target protein rapamycin (mTOR) signal transduction pathway and Barrett esophagus genesis.Methods A total of 140 rats were divided into sham operated group (n=10),iron group (n =10),esophageal duodenal side anastomosis group (n =30),esophageal duodenal side anastomosis plus iron group (n-30),esophageal gastric duodenal side anastomosis group (n=30) and esophageal gastric duodenal anastomosis plus iron group (n=30).In the end,10 normal esophagus tissue specimens,62 reflux esophagitis tissue specimens and 34 Barrett's esophagus tissue specimens were obtained.The expression levels of epidermal growth factor receptor (EGFR),Akt,phospho Akt (p-Akt),phospho-mTOR (p-mTOR) protein were detected by immunohistochemistry.Single factor analysis of variance,SNK between two groups and nonparametric correlation analysis were performed for statistical analysis.Results The protein expression levels of EGFR,Akt,p-Akt,p-mTOR in Barret(s esophagus tissues were higher than those in reflux esophagitis tissues and normal esophagus tissues (EGFR 0.1799±0.0367 vs 0.0438±0.0025 and 0.0277±0.0069,q=6.79,4.13; Akt 0.1874±0.0250 vs 0.0986±0.0093 and 0.0383±0.0048,q=6.51,3.56; p-Akt 0.1418±0.0130 vs 0.0592±0.0027 and 0.0281 ±0.0017,q=7.68,3.99; p-mTOR 0.1591±0.0275 vs 0.0674 ±0.0059 and 0.0112±0.0017,q=5.62,4.11; all P＜0.05).The protein expression levels of EGFR,Akt,p-Akt,and p-mTORin reflux esophagitis tissues were higher than those in normal esophagus tissues(q=4.67,4.29,4.27,4.03; all P＜0.05).Conclusion PI3K/Akt/mTOR signal transduction pathway were activated in reflux esophagitis and Barrett's esophagus,which provided theoretical basis for clinical multi-target treatment for diseases.

In this paper,the teaching in medical microbiology experiment to the first group of foreign students in our college is analyzed and summarized,which will give us many experiences for later teachering.

Objective To determine the efficacy and safety of acarbose in the treatment of senile postprandial hypotension (PPH). Methods Forty three senile in-patients with PPH were recruited. Blood pressure and heart rate(HR) were recorded for 120 minutes by using non-invasive ambulatory blood pressure monitoring system. The participants had semiliquid standard meals with or without acarbose on two following days. The ejection fraction(EF) and fractional shortening(FS) were measured by two dimensional echocardiography before treatment. Results The magnitudes of the falls in systolic, diastolic and mean arterial blood pressure (SBP、DBP、MAP) (all P

Objective To study the antagonistic effects of grape procyanidin(GPC)or lipoic acid(LA)to the rat liver cell peroxidative damage induced by~(60)Co ? radiation.Methods The cultured rat liver cells(1?10~9/L)were prepared from 10 rats aged 1 week,the survival rate was above 85%.The cultured liver cells were divided into the negative control group(without radiation), GPC group(75 mg/L),LA group(100 mg/L)and the positive control group(containing no antioxidants),which were radiated by (60)~Co ? radiation(2.5 Gy,90 cm,10 s).The SOD,GSH-Px activity,MDA level and comet assay were determined.Results Compared with the positive control group,in the GPC group and LA group,the activity of hepatic SOD and GSH-Px were significantly higher (P

Objective To study the antagonistic effect of N-acetyl-L-cysteine(NAC)and ?-lipoic acid(LA)to the oxidative damage in the liver and kidney of rats induced by the condensate of cooking oil fume(COF).Methods SD rats were randomly divided into 4 groups,8 in each,the blank control,COF group(10 ml/kg,subcutaneous injection),COF plus NAC(2 mmol/kg, intraperitoneal injection)and COF plus LA(0.35 mmol/kg,intraperitoneal injection).Forty-eight hours after treatment,the activity of SOD,GSH-Px and MDA level in the livers and kidneys were determined.Results In the kidney,compared with the COF group, both of NAC and LA could increase the activity of kidney SOD and GSH-Px and decreased the MDA level significantly,the same results were seen in the liver.Conclusion Both of N-aeetyl-L-cysteine and ?-lipoic acid has an obvious antagonistic effect to the oxidative damage in the liver and kidney of rats induced by the condensates of cooking oil fume.

Objective to evaluate the clinical efficacy and safety of ADSCs infusion in patients with type 2 diabetes mellitus(t2DM). Methods Autologous ADSCs were cultured and identified. totally 48 cases of type 2 diabetes patients were divided into two groups:24 cases in A group re-ceived ADSCs and conventional treatment,while the other 24 cases in B group received conventional treatment. With 15 months′follow-up,FPG,2h-PGh,HbA1c,FC-P,AUCC,insulin medication changes and security on post-treatment 3,6,12 and 15 months were calculated. Results the AD-SCs which cultured met the clinical application of standards. FPG,2h-PGh and HbA1c in both groups were significantly decreased,and the values in A group were more impressive than B. there were significant improvement in FC-P,AUCC and insulin of A group compared with B group. there was not treatment related adverse events. Conclusion the clinical data demonstrate that the treatment with ADSCs can improve metabolic control and beta cell function in patients with t2DM. Moreover,the safety of the treatment method was considerable.

Objective To study the value of detection of C- reactive protein(CRP), serum glucose concen-tration and APACHE Ⅱ grade for estimating inflammation, pathogenetic condition and prognosis of systemic inflam-matory response syndrome (SIRS) patients.Methods 50 SIRS patients in ICU were selected and were divided into S1 and S2 subgroup according to SIRS diagnosis standard, and 18 patients developed MOBS.30 patients without SIRS, were selected as control group.Detection of CRP, serum glucose concentration and APACHE Ⅱ grade were per-formed.Results CRP(76.19±11.98 mg/L vs.14.04±5.70 mg/L) ,serum glucose concentration(7.10±1.30 mmol/L vs.5.32±1.09 mmol/L) and APACHE Ⅱ grade (20.06±6.39 vs.7.90±3.54) of SIRS group were higher than that of non-SIRs group (P<0.01).CRP, serum glucose concentration and APACHE Ⅱ grade all are higher in group S2 than that of group S1 (91.25±9.89 mg/L vs.62.29±10.38 mg/L,8.32±2.40 mmol/L vs.7.10±1.69 mmol/L,26.72±5.14 vs.18.37±5.70).MOBS incidence and case fatality in S2 subgroup (12/15 and 6/35) were higher than that of S1 subgroup(10/15 and 3/35 ) (P<0.01 ).Conclusion CRP, serum glucose concentration and APACHE Ⅱ grade are increased in SIRS patients and with their increasing, MOBS incidence and case fatality were also increasing.CRP, serum glucose concentration and APACHE Ⅱ grade are significant factors in estimating SIRS patients pathogenetic condition and their prognosis.

Objective To evaluate the value of MRI in diagnosing the bucket handle tear (BHT) of the knee meniscus.Methods Eighty four knees which underwent both MRI and arthroscopy (AS) examinations were analyzed. Results of AS were used as golden standard to evaluate the results of MRI. The evaluating criteria included primary reports, central displaced fragments of meniscus (CDFM), double posterior cruciate ligament sign (DPCLS) and the absent bow tie sign (ABTS). Results For MRI diagnosing BHT, the sensitivity and specificity of primary reports were 43% and 87%, respectively; the sensitivity and specificity of CDFM were 72% and 87%, respectively; the sensitivity and specificity of the DPCLF were 31% and 97%, respectively; and the sensitivity and specificity of the ABTS were 71% and 69%, respectively.Conclusions When MRI was applied to diagnose BHT, the CDFM had higher sensitivity and specificity, while the ABTS had higher sensitivity and lower specificity. The DPCLF had the highest specificity and the lowest sensitivity.

BACKGROUND:Evaluation plan for the neuro-musculo-skeletal system model and motor function was little.However,the three-dimensional gait analysis can transfer qualitative analysis and object description which widely used in orthopedics and rehabilitation medicine to quantitative evaluation with more objective and precise.OBJECTIVE:To evaluate gait kinematics and kinetic changes after total knee replacement based on 12 months follow up using three-dimensional gait analysis.DESIGN,TIME AND SETTING:The comparative observation and case-control study was performed in the Gait Analysis Room of the Department of Rehabilitation Medicine in the Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University from January 2007 to May 2008.PARTICIPANTS:Ten patients with knee osteoarthritis following total knee replacement were chosen as treatment group;concurrently,ten patients whose baseline data were matched with the treatment group without problems in nerve,muscle,skeletal system and equilibrium were selected as the control group.METHODS:Ten patients in the treatment group underwent rehabilitation training,then compared time-distance,kinematic,and mechanical parameters which were measured at 3,6,12 months after total knee replacement with the control group.MAIN OUTCOME MEASURES:Time-distance parameter,kinematic parameter,mechanical parameter and knee functional scores.RESULTS:Pace,step frequency,gait speed,and time of injured leg standing were notably decreased,while time of uninjured leg standing,duration of gait cycle were obvious prolonged compared with the control group(P