Objective:To investigate the clinical effects of levonorgestrel-releasing intrauterine device(LNG-IUD) in the treatment of adenomyosis in perimenopausal period. Methods: A total of 92 patients with adenomyosis in perim enopausal period were treated with LNG-IUD and followed up at the 3rd,6th, 12th,24th month. Change of menses, uterine volume,visual analogue scale (VAS) of dysmenorrhea,the serum CA_(125) level and degree of satisfaction with the treatment were observed. Results:The dysmenorrhea was alleviated along with the follow-up time in all of the pa tients after insertion of the LNG-IUD ( P<0.05). The menstrual volume, uterine volume and serum CA_(125) level were decreased significantly(P<0.05) .Conclusions:LNG-IUD is a safe, effective and simple treatment of adenomyosis in perimenopausal period.

OBJECTIVE:To establish a HPLC method for determination of total coumarins in Angelica dahurica and to develop a CO 2 supercritical fluid extraction(SFE)method for its extraction.METHODS:Orthogonal design was used to in?vestigate the influence of extraction pressure,temperature,time length and pulverized degree of medicine on extraction rate of total coumarins.The contents of imperator and isoimperator in the extract were analyzed by HPLC.RESULTS:The Liner ranges of imperator and isoimperator were29.4～235.2?10～80?g/ml respectively.The average recoveries were(100.46?1.42)%?(99.94?1.18)%(n=3)respectively.The relative standard deviations were1.76%and1.62%respectively.When alcohol was used as a modifier,the extraction rate of total coumarins was the highest when the sample was pulverized into60mesh and had been extracted at35MPa and45℃for3hours.CONCLUSIONS:The extraction pressure,pulverized degree and extraction length all have significant effects on extraction rate of total coumarins.The established method is precise,convenient and can be used for determination of imperator and isoimperator.

BACKGROUND: It has been reported that the ischemia preconditioning (IPC) had credible protective efficiency on ischemic injury of the spinal cord during aorta operation, but the mechanism of the protective efficiency of IPC had not been clarified.OBJECTIVE: To study the protective effects of repetitive IPC on ischemic injury of spinal cord and its mechanism in rabbits.DESIGN: A completely randomized controlled study based on the experimental animals.SETTING: Department of anesthesiology in a university hospital.MATERIALS: The experiment was completed in the Department of Anesthesiology, Renmin Hospital, Wuhan University during September and December 2002. Twenty-four Japanese rabbits were randomly and double-blindly divided into sham-operation group, ischemia-reperfusion group and IPC group with 8 rabbits in each group.INTERVENTIONS: In sham-operation group, abdominal aorta was not clamped. Spinal cord ischemia was induced by infra-renal aortic cross-clamp for 45 minutes in ischemia-reperfusion group. Before the 45 minutes ischemia, the rabbits in the IPC group underwent four cycles of ischemia preconditioning, i.e. clamping abdominal aorta for 5 minutes then reperfusion for 5 minutes.MAIN OUTCOME MEASURES: The concentrations of calcium, magnesium, copper and zincum in spinal cord were measured in the 7th day after operation. Postoperative neurological function, EMG of rear limb, and spinal cord histopathological changes were assessed in all groups after operation.RESULTS: The concentrations of calcium and copper in spinal cord in ischemia-reperfusion group were significantly higher than those in sham-operation group( P ＜ 0. 05 or 0. 01 ), but magnesium and zincum significantly lower( P ＜ 0. 05). Compared with IPC group, calcium in ischemia-reperfusion group was significantly higher( P ＜ 0.01 ), but zincum significantly lower( P ＜ 0.01 ) . The neurological function and histopatholohical changes in ischemia-reperfusion group were much lower than those in sham-operation group and IPC group ( P ＜ 0.05 or P ＜ 0.01) . And there was significantly worse change of EMG in ischemia-repeffusion group than that in IPC group(P ＜ 0.01).CONCLUSION: Repetitive ischemic preconditioning can protect rabbit spinal cord from ischemia reperfusion injury quickly, and one possible reason for its protective effect is to maintain the balance of calcium, magnesium,copper and zincum in ischemic region.

OBJECTIVE:To determine content of paeoniflorin in shaofuzhuyu superfine powder granules by HPLC. METHODS: The separation was performed on C18 chromatographic column, the mobile phase was methanol -0.05mol/L KH2PO4(40∶65)with a flow speed at 1ml/min, detection wavelength at 230nm and column temperature at 30℃. RESULTS:The linear range of paeoniflorin was 15.04～752.00?g/ml(r=0.9 998,n=6),the mean recovery rate was 103.3%(RSD=1.53%,n=3).CONCLUSION:This method was simple, accurate, good in recurrence and high in precision, and which can be used for the contents determination and the quality control of the shaofuzhuyu superfine powder granules.

The aim of this study is to prepare self-microemulsifying drug delivery system (SMEDDS) of the mixture of paeonol (Pae) and borneol (Bor). Solubility test, ternary phase diagrams and simplex lattice method were employed to screen and optimize the formulation of the mixture of Pae and Bor-loaded SMEDDS. After formed into microemulsions, the particle diameter (PD) was determined and a TEM was employed to observe the microemulsions' morphology. The contents of Pae and Bor were determined by gas chromatography. As a result, while ethyl oleate (EO) as the oil phase, cremophor EL35 (EL35) as surfactant and Transcutol HP (HP) as cosurfactant, the range of the microemulsion on the ternary phase diagram was larger than other combinations. And at a ratio of 20:45:35, the microemulsions' PD was about 34 nm and the polydispersity index (PI) was about 0.2. There were 16% of Pae, 2% of Bor, 16% of EO, 37% of EL35 and 29% of HP in the prepared SMEDDS. The preparation process of the Pae and Bor-loaded SMEDDS based on Xingbi Fang is simple and feasible. This study provides a reference for the researches on the related traditional Chinese medicine and the related components.

China Three Gorges University(CTGU) started undergraduate medical education for foreign students since 2004. Over the years,through continuous interaction with coordinators,CTGU grad-ually transited from passive teaching to active teaching. Firstly we determined basic principles,objectives and requirements of talent training programme. Secondly,we strengthen Chinese language teaching, reasonably adjusted professional curriculum and teaching content,added basic medical courses and rea-sonably arranged clinical practice based on the concrete situation in our country. in order to make the cur-riculum system consistent with the require-ments of talent training.

Objective To investigate the clinical effects of biofeedback therapy on constipation-predominant irritable bowel syndrome(IBS-C).Methods 30 patients with IBS-C were given to biofeedback therapy,5 times every treatment course.and then their clinical symptoms,mental state and quality of life before the treatment and at the end of treatment with biofeedback therapy were respectively evaluated by symptom scores,self-rating anxiety scale (SAS),self-rating depression scale (SDS),and short form 36 health survey questionnaire (SF-36).Results Post-treatment with biofeedback therapy,there were very significant decrease in total and subscales scores of bowel symptom including abdominal pain/discomfort,abdominal distension,abnormal appearance of defecation,abnormal process of defecation((12.31±2.01) vs (19.16±2.17),(2.95±0.57) vs (5.04±1.04),(2.64±0.92) vs (4.25±1.09),(3.66±1.09) vs (5.10±0.57),(3.06±1.08) vs (4.77±0.95) respectively,P＜0.01).The integration of SAS and SDS were obviously decreased after treatment((39.53±6.39) vs (44.43±7.89),P＜0.05;(40.70±8.38) vs (46.46±8.74),P＜0.05),the SF-36 scores were also improved in five dimensions including rolephysical,social-functioning,vitality,role-emotional and mental health((74.16±21.25) vs (57.0±39.40),(86.21±13.54) vs (75.54±20.96),(75.16±13.42) vs (64.66±20.54),(78.87±28.36) vs (57.76±46.26),(81.60±16.08) vs (71.20±22.04) respectively,P＜0.05).Conclusion Biofeedback therapy can improve the clinical symptoms,alleviate the moods of anxiety and depression,and improve the quality of life in patients with IBS-C.

Objective To investigate the clinical effects of repetitive transcranial magnetic stimulation (rTMS) combined with body-weight-supported treadmill training (BWSTT) on patients with incomplete spinal cord injury (SCI).Methods Four patients with chronic incomplete SCI participated in this study.They were first treated with rTMS and then BWSTT training.They were assessed with clinical measures of function.Two of the four patients were assessed in terms of their H reflex,and using functional magnetic resonance imaging (fMRI) and a balance performance monitor (BPM).Results In two of the four patients,American spinal injury association (ASIA) clinical measures of motor and sensory function improved,as did 10 m walking speed and their sense of effort.In static balance tests,the sway path and sway area of the two patients both decreased.These improvements lasted for 3 weeks after the intervention.The two patients' maximum H reflex amplitude and the H/M amplitude ratio decreased.The fMRI results showed progressive enlargement of the activation volume of the movement-related M1 region after treatment.Conclusion High-frequency rTMS combined with BWSTT may improve motor function,elevate excitability of spinal motor neurons and improve the plasticity of the cerebral cortex in chronic incomplete SCI patients.

Objective To investigate the association among oligospermatism,azoospermatism in male sterility patients and micro-deletion in AZF gene of Y chromosome and to establish a integrate clinical diagnostic method for screening micro-deletion in AZF gene in Chinese.Methods PCR method was used to detect micro-deletion in AZF gene in 62 oligospermatism and azoospermatism patients and 20 normal male controls.Results 13.64%(6/44) of oligospermatism patients and 22.22%(4/18) of azoospermatism patients presented micro-deletion.However,micro-deletion was not found in 20 normal male controls.Furthermore,micro-deletion occur mostly in AZFc region.Conclusion Micro-deletion of AZF gene from Y chromosome is one of the major risks for oligospermatism and azoospermatism.

Objective To investigate the influence of different volumes of ropivacaine with isod-osage on diaphragmatic excursion following ultrasound-guided interscalene brachial plexus block. Methods Sixty ASA Ⅰ-Ⅱ patients scheduled for right ulnoradial fracture internal fixation removal were randomized into group A (0.5% ropivacaine 20 ml)and group B (0.75% ropivacaine 13.3 ml) (n=30,each).Diaphragmatic excursion were evaluated by M type ultrasound before,1 5 min and 30 min after drug injection. The degree and duration of sensory and motor block were recorded. Results The anesthetic effect and maintain time had no significant difference between groups;Com-pared with group A,group B had lower incidence of diaphragmatic paralysis (P <0.05).There were 28 (93%)and 22 (73%)cases of patients in group A and group B respectively showed reduction of diaphragmatic excursion more than 50% or even complete paralysis 30 min after drug injection (P <0.05).Conclusion Ultrasound-guided interscalene brachial plexus with 0.5% ropivacaine 20 ml or 0.75% ropivacaine 13.3 ml both can provide excellent block.Compared with 0.75% ropivacaine 13.3 ml,0.5% ropivacaine 20 ml is more likely to lead to diaphragmatic paralysis.