Objective To evaluate the efficacy of nalmefene in preventing sufentanil-induced cough during induction of general anesthesia.Methods One hundred American Society of Anesthesiologists physical status Ⅰ orⅡ patients of both sexes,aged 21-62 yr,weighing 45-82 kg,undergoing elective laparoscopic cholecystectomy under general anesthesia,were divided into 2 groups (n =50 each) using a random number table:nalmefene group (group N) and control group (group C).Nalmefene 0.25 μg/kg was injected intravenously at 2 min before anesthesia induction in group N,and the equal volume of normal saline was given instead in group C.Anesthesia was induced with target-controlled infusion of propofol,and sufentanil 0.5 μg/kg was injected over 5 s when bispectral index value reached 55.The number of patients who developed cough within 2 min after sufentanil injection and severity of cough were observed.Other iv anesthetics were given for induction after the end of observation.Results The incidence of sufentanil-induced cough was 8％ in group N and 48％ in group C.Compared with group C,the incidence and severity of cough were significantly decreased in group N (P＜0.05).Conclusion Nalmefene 0.25 μg/kg injected at 2 min before induction of anesthesia can effectively decrease the development of sufentanil-induced cough during induction of general anesthesia.

Objective To investigate the status of the level of hope and depression with the elderly in a welfare institution in Henan Xingyang city,and to explore the relationship between them. Methods A total number of 200 elderly people were recruited conveniently from a welfare institution in Henan Xingyang city. They were investigated by General Material Questionnaire, Herth Hope Scale and Geriatric Depression Scale. Results The total score of hope and depression with the elderly in a welfare institution were (21.28±3.07) , (13.15±2.77) points respectively, the depression detection rate was 82.38%(159/193);the level of hope was negatively related with depression (r=-0.447,P<0.01). Conclusions The hope of the elderly in welfare institution is not optimistic,and the depression detection rate is high,the level of hope is positively related with their depression,so we should take effective measures to improve their mental health according to the emotional state to give emotional care and improve the level of their hope.

Objective To understand the human resources of the grassroots institutions of schistosomiasis control and pre?vention so as to provide the evidence for formulating the standards of institutional capacity?building. Methods By using the combination of quantitative and qualitative methods the hierarchy of schistosomiasis control institution workers structural fea?tures of workers and benefits of workers were investigated and the results were analyzed statistically after the 2004 reform. Re?sults The constituent ratios of personnel≤30 years old 30 to 45 years old and≥45 years old were 6.8% 64.0%and 29.2%respectively with an average age of 43.1 years. For education levels 61.35%of the personnel had secondary or high school lev?els. At the city level the structural proportion of the senior professional medium professional and primary professional titles was 1.4∶5.6∶3.0 and at the county level the proportion was 0.5∶6.1∶3.4. There was 14 200 yuan per capita at the township schistosomiasis control institutions. Conclusion The technology of the personnel in schistosomiasis institutions of Hubei Prov?ince is weak the average age of personnel is old and the salary is low.

Objective To investigate the current situation of management of institutions of schistosomiasis prevention and control in Hubei Province so as to explore the probable competency building standards for these institutions at the county and township levels. Methods By using a combination of quantitative and qualitative methods the institutions of schistosomiasis prevention and control at county and township levels were investigated for the institutional setup staffing and fulfillment func-tions since the reform of 2004. Results Among 63 schistosomiasis endemic counties cities districts of Hubei Province there were 26 independent schistosomiasis control institutions 41.27% there were 24 institutions which were incorporated in-to CDC 38.10% and there were no institutions in 13 counties 20.63% . Among 518 endemic towns there were 299 institu-tions 57.72% . The total staffing size were 1 932 but there were 1 586 82.09% people actually working in the post and therefore there were 346 17.91% empty positions. The average rates of carrying out the six functions were 91.48%-71.19%but only 19.23%of the institutions participated in the comprehensive schistosomiasis control management project and its effect assessment. Conclusion According to the management model for schistosomiasis control institutions under the current institu-tional mechanisms we need a rigorous industry standard to constrain guide and standardize the management and capacity-building of the institutions in different historical periods.

OBJECTIVE To investigate the effect of berberine on differentiation of rat bone marrow mesenchymal stem cells (MSCs) to adipocytes and its mechanism. METHODS Rat MSCs were isolated and cultured, adipocytic differentiation was induced with adipogenesis-inducing medium (AIM). Cells were assigned into 6 groups:normal control, AIM group, AIM+berberine 0.1, 0.3, 1 and 3 μmol·L-1 groups, respectively. Morphology characteristics of mesenchymal stem cells were observed under an inverted microscope and adipocyte levels were analyzed by oil O staining. Alkaline phosphatase (ALP) activity was detected using p-nitrophenyl phosphate as a substrate. The cell survival was determined by MTT assay. Expressions of peroxisome proliferator activated receptor γ (PPARγ), fatty acid binding protein (aP2) and CCAAT enhancer-binding protein α (C/EBPα) mRNA were detected by semiquantitative RT-PCR. RESULTS Compared with normal control group, MSCs adipogenic differentiation, PPARγ, aP2 and C/EBPα mRNA expression significantly increased in AIM group (P<0.01), ALP activity in AIM group significantly decreased (P<0.01). Compared with AIM group, berberine inhibited MSCs adipogenic differentiation (P<0.01) and berberine 0.1, 0.3, 1 and 3 μmol·L-1 increased ALP activity by 26%, 54%, 81% and 122%, respectively. Berberine 3 μmol·L-1 significantly downregulated PPARγ expression (0.91±0.10 vs 1.34±0.06) (P<0.01), aP2 (1.05±0.10 vs 1.53±0.09) (P<0.01) and C/EBPα mRNA (1.24±0.06 vs 1.54±0.09) (P<0.01). Berberine had no effect on proliferation of MSCs. CONCLUSION Berberine inhibits differentiation of MSCs into adipocytes, which might be closely related to the downregulation of PPARγ, aP2 and C/EBPα mRNA.

Tumor necrosis factor-like weak inducer of apoptosis(TWEAK)is a new member of the tumor necrosis factor family.After TWEAK binding to its receptor Fn14.it induces extensive biological activities.TWEAK-Fn14 pathway participates in pathophysiological mechanisms of cell apoptosis,regulation of the blood-brain barrier permeability and inflammation in central nervous system,and it is closely correlated with the diseases such as ischernic stroke.multiple sclerosis and gliocytoma.

Thrombolysis can effectively treat ischemic stroke, but it has the risk of resulting in hemorrhagic transformation. A number of studies have suggested that hemorrhagic transforma-tion is closely correlated with matrix metalloproteinase mediated disruption of blood-brain barrier and the increase of vasopermeability. The increase plasma matrix metalloproteinase(MMP) -9 can be used as an independent predictor of hemorrhagic transformation. Using MMP inhibitors during the early cerebral ischemia may reduce the incidence and severity of hemor-rhagic transformation, however, it needs to be further validated.

Obiective To construct the manageable, stable and reliable computer terminal environment for the hospital. Technology was successfully applied to the outpatient doctor workstation and the student electronic reading room in one hospital, and the system was running well.Conclusion The technical application can not only ensure the system security and stability, but also realize centralized management and improve efficiency.

Objective To investigate the clinical guiding significance of lymphoscintigraphy with 99mTc-DX for radical lateral lymph node dissection with pelvic autonomic nerve preservation(PANP) in lower rectal cancer.Methods In 67 patients with pathologically proven lower rectal cancer,37MBq/0.8ml 99mTc-DX was injected into submucosa of the rectum through rectal endoscopy.At 0.5h,1h,2h,3h,4h,6h,12h,and 24h after the injection,the patients underwent pelvic and lower abdominal lymphoscintigraphy. The operative method was determined according to the imaging results,and the results of lymphoscintigrams were correlated with postoperative lateral node histologic examination.Results The scintigrams were postive in 37 cases,and all were unilateral.The positive patients underwent PANP.The image results were compared with histological lymph node examination in all patients operated upon for rectal cancer.Histologically,the cases in conformity were 26(70.3 %),false positive in 11 cases(29.7 %),and 2 of 30 false positive patients who demonstrated metastases to lateral node were operated by PANP,while the others underwent only PANP(type Ⅰ) without lateral lymph nodes dissection.The percentage of good sexual function of the two groups of cases after operation was 74.4 % and 71.4 % respentively.The percentages of mild dysuria and good function of urination were both 100 %.Conclusions Lymphoscintigraphy with 99mTC-DX has particular guiding significance in selection of PANP for lower rectal cancer.

Objective To observe the clinical effect of multimodal analgesia for painless artificial abortion . Methods 150 cases of ASA Ⅰ-Ⅱ pregnancy received painless artificial abortion operation ,no contraindication for all patients,were randomly divided into the five groups ,30 cases in each group,the blank control group (group S):do not use any analgesia measure ,intravenous injection of 0.9% sodium chloride 2mL preoperation;the fentanyl group ( F group ) :intravenous injection of fentanyl 1μg/kg preoperation ;the parecoxib group ( group P ) :intravenous injection of parecoxib sodium 40mg preoperation.The patients were given painless artificial abortion after injection the above drugs.Nerve block group ( N group):the implementation of painless induced abortion operation after sleep in patients with the cervical nerve block ,injection of 1%lidocaine 2 mL.Multimodal analgesia group (group M):intra-venous injection of parecoxib sodium 40mg,fentanyl 1μg/kg,then the implementation method the same as N group . The operation time,anesthesia onset time,recovery time,time of accurate orientation and additional dosage of propo-fol;incidence rate of artificial abortion syndrome ,the incidence rate of uterine contraction pain ,10min,30min,1h,6h pain scores after operation; adverse reaction;satisfaction score of analgesic effect postoperative 24h were observed. Results The additional dosage of propofol in the group S ,group F,group P,group N and group M were (78.45 ± 20.36)mg,(15.55 ±12.33)mg,(16.75 ±13.13)mg,(14.55 ±10.25)mg,(9.35 ±8.27)mg.The incidence rates of uterine contraction pain in the group S ,group F,group P,group N and group M were 30%,10%,10%,10%,0. Compared with group M ,the additional dosage of propofol and incidence rate of uterine contraction pain in the other four groups were significantly increased (t=3.05,1.82,1.84,1.78,χ2 =72.1,68.2,68.2,68.2,all P<0.05). Pain scores after operation 10min,30min,1h,6h in the group S were (6.6 ±1.5)points,(5.6 ±1.4)points,(4.6 ± 1.1)points,(3.6 ±1.4)points.Those in group F were (5.1 ±1.5)points,(4.3 ±1.1)points,(3.1 ±0.9)points, (2.8 ±0.8).Pain scores after operation 10min,30min,1h,6h in the group P were (4.6 ±1.5) points,(4.2 ± 0.9)points,(2.9 ±0.8) points,(2.7 ±0.6) points.Those in the group N were (4.5 ±1.5) points,(4.1 ± 0.8)points,(2.9 ±0.8)points,(2.6 ±0.5).Pain scores after operation 10min,30min,1h,6h in the group M were (2.2 ±0.8)points,(1.9 ±0.7)points,(1.5 ±0.5)points,(1.2 ±0.3)points.Compared with the group M,pain scores after operation 10min,30min,1h,6h in the other four groups were significantly elevated ( t=2.03,1.96,1.86, 1.84,1.98,1.82,1.80,1.76,2.05,1.99,1.95,1.86,2.06,1.88,1.82,1.76,all P<0.05).Compared with S group,postoperative 24h satisfaction score of analgesia in the group M was improved significantly ( t =1.98,P<0.05).Compared with group M,the incidence rate of nausea in the other four groups was increased significantly (χ2 =72.2,68.9,68.1,68.1,all P<0.05).Conclusion Multimodal analgesia method can greatly reduce artificial abor-tion postoperative pain ,reduce the adverse reactions ,improve patients'satisfaction score ,ensure the safety of operation .