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.

0.05).Their a verage values were 6.47?0.80,4.36?0.68,9.89?0.73,5.83?1.63, 3.55 ?0.69 an d 6.81?0.93 respectively. In the male and famale LRa-TC was 3.84?1.16 and 3.1 5?0.76(P0.05).Their average v alues were 5.44?1.03,4.09?1.58,3.75?0.75,4.20?0.84 and 7.70?1.13 respective ly. In the male and famale URa-PC was 7.14?1.16 and 6.62?0.88(P0 .05).Their average values were 6.06?0.91,3.20?1.48,4.52?0.69 and 8.53?0.98 r espectively. In the male and femal URa-PC was 7.49?1.01 and 6.94?0.74(P

Objective To evaluate the relationship between abnormal lipid metabolism and the pathogenesis of pregnancy induced hypertension (PIH). Methods A prospective cohort study was carried out in 500 pregnant women. They were followed in the antenatal care outpatient clinic. Amcing them. 20 cases of mild PIH, 23 cases of moderate and severe PIH, 30 cases of normal pregnant women were studied. Serum lipid levels were measured before and after the onset of PIH (baseline and follow up). Data were analysed with F test. Results TG, VLDL, LP(a),FFA and FFA/Alb levels in all patients of PIH were significantly higher than those in the control group( P

In order to explore the effect of glial cell line derived neurotrophic factor (GDNF) on the motor neurons of the spinal cord, the present study investigated the localization of GDNF in the lumbar segment of the spinal cord on postnatal 1、3、7、10、14 and 28 days in rats with immunohistochemical staining method. The results showed that the positive GDNF immunoreactivity was present in the motor neurons of the ventral horn on postnatal 1、7 and 28 days, the motor neurons on postnatal 3 days were also weakly stained in rats,and some neurons of the dorsal horn and some glial cells had positive immunoreactivity. Furthermore, GDNF was found in the glial cell of the dorsal root in all groups of the postnatal spinal cord. The present results suggested that GDNF might play important roles in the development and function of the motor neurons of the spinal cord. More experiments should be done to explain why there is no positive immunoreactivity in the motor neurons between postnatal 7 and 28 days.

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.

BACKGROUND:Gait analysis enable to convert qualitative analysis and description used for a long time in orthopedic examination and rehabilitative treatment into objective and precise quantitative assessment. At the present, with the development of science and technology, three-dimensional (3D) gait analysis is more and more widely, extensively used in orthopedic surgery and rehabilitation medicine abroad, while much less in China.OBJECTIVE: To study the parameters of time-distance, kinematics, kinetic and electromyography (EMG) in healthy subjects and patients with backbone, hip, knee or ankle joint diseases.DESIGN: Comparative observation and control study.PARTICIPANTS: From December 2004 to July 2005, 40 healthy subjects and 112 patients suffering from backbone and hip, knee, ankle joint disease were selected from the Department of Rehabilitative Medicine, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University and analyzed by three dimensional gait analysis system (VICON 612 system made by Britain VICON Company). 112 patients including 42 males with the mean age of (46.2 ± 2.3) years and 70 females with the mean age (41.2 ± 3.5) years were screened by skilled clinicians after surgical and rehabilitative treatment.Among them there were 21 patients with cervical vertebra, 26 patients with prolapse of lumbar intervertebral disc and lumbar spinal stenosis. The number of hip, knee, ankle joint disease was 12, 34, 19 respectively. Total hip replacement was included in hip joint disease, anterior cruciate ligament (ACL) reconstruction was included in knee joint disease, talipes equinovarus was included in ankle joint disease. Meanwhile, 40 healthy subjects who were 20-40 years old, male or female, without any clinical symptom of backbone and limbs volunteered in the study.METHODS :Gait analysis were carried out on 40 healthy volunteers and 112 operational and rehabilitative treatment patients with spinal and lower limb diseases using VICON 612 system made by Britain VICON Company.MAIN OUTCOME MEASURES: The time-distance parameters (cadence, step length, walking speed), kinematics parameters (knee flexion/extension degree, hip flexion/extension degree, ankle dorsi/plantar degree), kinetic parameters (knee force in Z axis, hip force in Z axis, normalized force in Z axis) and EMG parameters (vastus lateralis SEMG) of lower limbs were examined.RESULTS: A total of 40 healthy subjects and 112 patients were involved in the analysis of results. ① Time-distance parameter: Cadence, as well as step length and walking speed of patients with backbone disease, patients with hip joint disease, patients with knee joint disease, and patients with ankle joint disease were lower than those of healthy subjects,and the difference between two groups was significant (P ＜ 0.05-0.01). ② Kinematic and kinetic parameters of all joints in upper limbs: One year after left ACL knee reconstruction, the extension of left knee in initial contact phase was 9° less than that of right one and the stress in Z axis of left knee was much less than that of right one; One year after left THA,the flexion of left hip in initial contact phase was 8.5° less than that of right one, the extension of left hip in terminal stance phase was 3° less than that of right one, during stance phase the stress in Z axis of left hip was much less than that of right one; As to an infantile paralysis patient with talipes equinovarus, the dorsiflexion of left ankle in initial contact phase was 12° less than that of right one, the plantar flexion of left ankle in terminal stance phase was 5° less than that of right one. The stress in Z axis of left ankle during stance phase was much less than that of right one. However, the difference in range of motion and stress in Z axis was not significant between the left and right knee joint in healthy people. ③ One year after left total knee arthroplasty, the dynamic surface electromyogram signals of left vastus lateralis is much lower than that of right vastus lateralis in a gait cycle.CONCLUSION: 3D gait analysis enables tprovide objective basis for making operation scheme for orthopedic surgery and after-operation rehabilitation therapy, and assessing curative effect of rehabilitation therapy.

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 compare magnetic beads kit,agrose gel recovery kit and heparinase I three methods to purify the micro DNA from crude heparin, then use q-PCR to identify the species origins and select the best method.Methods Using magnetic beads kit,agrose gel recovery kit and heparinase I to purify micro DNA from crude heparin and combined the porcine,bovine and ovine identification kits to identify the species origins and conformed the minimum detection limit of different percentage of ovine crude heparin in porcine crude heparin.Results Three pretreatment methods all can solve the pretreatment difficulties and we found that the haparinase was the best method; the minimum detection limit was 0.01%of ovine crude heparin in porcine crude heparin.Conclusion The heparinase method is the best pretreatment method and can successfully solve the pretreatment difficulties.Heparinase combine the porcine, bovine and ovine identification kits can identify the species origins from crude heparin.

AIM: To establish the quality standard for Jieeryin Effervescent Tablets (Fructus Cnidii, Folium Artemisiae Argyi, Radix Sophorae Flavescentis, Cortex Phellodendri, etc.). METHODS: Radix Sophorae Flavescentis、Cortex Phellodendri、Radix Scutellariae and Fructus Gardeniae in Jieeryin Effervescent Tablets were identified by TLC. The content of geniposide was determined by HPLC. RESULTS: The average recovery was 99% and relative standard deviation was 1.6%. CONCLUSION: The precision and reproducibility of the method are good. The method can be used for quality control of Jieeryin Effervescent Tablets.