Objective:To observe the sedative effect of epidural anesthesia assisted with target controlled infusion(TCI) propofol.Methods:45 ASA Ⅰ～Ⅱ patients,who would accept hysterectomy,were randomly allocated to group Ⅰ (without propofol),group Ⅱ(Target blood propofol concentration was set at 1.0?g/ml when epidural anesthesia level was confirmed) and group Ⅲ(Target blood propofol concentration was set at 1.5?g/ml).Heart rate and blood pressure were determined at the different moment from pre-operation to the end of the surgery.And the sedation degree was evaluated by the Observer's Assessment of Alertness/Sedation (OAA/S) Scale.At the same time,efficacy of antitraction response and perioperative awareness were investigated.Results:In three groups,blood pressure significantly decreased when epidural anesthesia level was confirmed.Goup Ⅱ and Goup Ⅲ showed significantly lower than group Ⅰ in 5 min after propofol infusion.HR gradually decreased with operative courses,and no difference was significantly found in the three groups.53.3% of patients fell asleep;53.3% had effective antitraction response and 33.3% were aware in group Ⅱ.And the patients in goup Ⅲ all fell asleep;86.7% could prevent traction response during operation but no perioperative awareness.Conclusion:Target controlled infusion of propofol as an adjuvant for epidural anesthesia is applicable and can prevent viscus traction response during surgical exploration.And the sedative effects of blood propofol concentration of 1.5?g/ml are better than 1.0?g/ml through OAA/S Scale.

Inverse agonist is a new type of drug acting on receptors.Its research has experienced several stages, including discovery of ethylβ-carboline 3-carboxylate,activity study,proposal of the concept,two-state model,and constitutive activity theory in succession.Most G protein-coupled receptors possess constitutive activity,i.e.a proportion of receptors are in active state and can produce effects without any agonist.Inverse agonist has an affinity to receptors,but no intrinsic activity,so it cannot activate receptors.However,it can antagonize the constitutive activity of receptors,and produce an opposite effect on the corresponding agonist.Both agonist and inverse agonist can produce their effect alone with different mechanisms.Agonist activates its receptors,but inverse agonist antagonizes them.Both inverse agonist and antagonist can antagonize receptors.However,inverse agonist and antagonist antagonize the constitutive activity of receptor and the agonist’s effects,respectively.Inverse agonists can be used to treat diseases with enhanced constitutive activity,up-regulate and sensitize receptors with constitutive activity.Moreover,endogenous inverse agonists can maintain a specific physiological function.The study on inverse agonist has a theoretical significance in perfecting receptor theory as well as a clinical value in diagnosis and treatment of diseases with enhanced constitutive activity.

In recent year , there are some questions about abortion of disposal .Though the aborted fetus is un-born, the aborted fetus in different stage has the different attribute of ethics .It should be considered with the hu-man right and the personality right .The value in embryonic stem research and organ transplantation of aborted fetus has raised some problems , such as ethical review , the choice of test sample .The existing legal provisions are not sufficient to solve practical problems .We should disposal aborted fetus of different stage through the way of more moral significance .

Objective To observe the distribution and drug resistance of pathogenic bacteria causing pulmo-nary infections in cardiology department of general hospital ,and to provide advices for infection control and selection of drugs.Methods 110 sputum specimens of patients with pulmonary infections in cardiology department were col -lected.The distribution and drug resistance of pathogenic bacteria were analyzed .Results In the 110 sputum sam-ples,83 cases(75.5%) were infected by gram-negative bacterias,21 cases(19.1%) were infected by gram-positive bacterias,6 cases(5.4%) of fungal infection .The Escherichia coli and the Pseudomonas aeruginosa after the antibiot-ic resistance analysis were found a trend of multi resistance .Conclusion The major pathogenic bacterias causing pulmonary infections in cardiology department are gram-negative bacterias ,and they show a trend of multi resistance .

Objective To investigate the changes of platelet activating factor ( PAF) in serum from patients with hypertensive disorder complicating pregnancy .Methods The specimens from 138 women were obtained at Department of Obstetrics , Xinhua Hospital , School of Medicine , Shanghai Jiaotong Uni-versity, between June 2008 and March 2010.They were divided into two groups:women( n =63) with hy-pertensive disorder complicating pregnancy and normal pregnant women ( n =75 ) ( control group ) .All of them delivered until maturity .ELISA was used to detect the levels of PAF in those women's serum and in the umbilical cord serum .Results The levels of PAF in hypertensive disorder complicating pregnancy group (27.46 ±13.37 ) ng/ml were no significantly different from the control group (25.48 ±11.05 ) ng/ml( P >0.05 ) .With the hypertensive disorder complicating pregnancy more deteriorative , the levels of women ser-um PAF would be higher .The levels of women's serum PAF in hypertensive disorder complicating pregnancy group were significantly higher than the umbilical cord serum [0.00(0.00-8.83) ng/mL]( P <0.05). The levels of women's serum PAF in control group were also significantly higher than the umbilical cord ser -um[0.00(0.00-7.80)ng/mL]( P <0.05).Conclusion There are some relationships between PAF and hypertensive disorder complicating pregnancy .

Objective To investigate the incidence and the risk factors of the vascular disease in lower limbs of patients with type 2 diabetes(T2DM).Methods To retrospectively analyze 318 cases with T2DM patients.All the patients were checked on both lower limbs by color ultrasonic Doppler.The differences of ordinary and biochemical indicators between PVD group and non-PVD group were compared.Results There were 67.2％ (205/318) patients who had vascular disease in lower limbs with type 2 diabetes.Age,course of disease,HbAlC,TC,TG,SBP,DBP and BMI in PVD group were significantly higher than those in non-PVD group( P ＜ 0.01 ).Conclusion There was higher incidence of the vascular disease in lower limbs of patients with type 2 diabetes.And the independent risk factors were hypertension,hyperglycemia,hyperlipemia.It could help to prevent the development of lower limb blood vessel pathological changes in DM patients by controlling the levels of blood pressure,lipid and blood sugar strictly.

Objective To analyze the clinical effect of puerarin and lipoic acid in treatment diabetic peripheral neuropathy.Methods 80 type Ⅱ diabetes patients accompanied with peripheral neuropathy were selected.According to different therapy,they were divided into single drug treatment control group (lipoic acid) and combined treatment group (puerarin + lipoie acid).Total effective rate,MNCV,SNCV,FBG,HbAlc and sorbitol were evaluated after treatment.Results The total effective rate in the treatment group was higher than that in the control group (P ＜ 0.05).Compared with the control group,the recovery rates of MNCV and SNCV were faster in the treatment group(P ＜0.05).And the levels of FBG,HbAlc and sorbitol were significantly lower in the treatment group than in the control group(P ＜ 0.05).Concluslon The clinical effect of puerarin and lipoic acid in treatment diabetic peripheral neuropathy was significant.

At present,there are many problems in the cultivation for the young clinicians including lack of subjective initiative,insufficient innovation education.This paper analyzed the current status of the academic and charactersfic training of the young clinicians then put forward new training methods which can be used for reference.Developing prominent features and novelty is the most important way to implement the aforementioned training methods.

The change of T cell subsets of peripheralblood were tested in 12 patients with prematureovarian failure (POF), among them 10 patients superoxide dismutase (SOD) activity in erythrocytewas also tested. The results showed that the num-ber of T_3, T_4 cells T_4/T_8 ratio and SOD activitywas significantly lower in patients with POF thanin normal controls, which indicated that the func-tion of proliferation and differentiation of T lym-phocyte was inhibited, the immunoregulation wasinbalanced and the ability of resistance to lipid per-oxidation was lower in patients with POF. There-fore, the results suggests that T cell subsets andSOD activity testing in patients with POF have val-ue in the investigation of the cause of the deseaseas well as in the diagnose and treatment.

There are multiple types of inhibitory immune cells in tumor. Among these cells, Treg (regulatory T cell) plays an extremely important role in tumor development and progression. Treg exihibits potent inhibitory effects on effector cells by a variety of mechanisms, which might be the the key factor for tumor immune escape. These mechanisms include inhibiting the effector cell function by inhibitory cytokines, killing effector cells by granzyme and profrin, interfering effector cell metabolism, and affecting Treg differentiation and proliferation by regulating the function of dendrtic cells, etc. The research on Treg has provided new strategies for tumor immunotherapy. Tumor immunotherapies targeting Treg and related immunosuppressive factors, such as deleting Treg nonsepcificlly or sepcificlly controling the numbers and functions of Treg, might have a bright future in clinical application.keyword regulatory T cell(Treg); neoplasms; immune escape; immunotherapy