Objective: To compare the efficacy of bupivacaine alone or combined with fentanyl, midazolam or tramadolduring PCEA. Methods:Sixty patients scheduled for abdominal hysterectomy under combined epidural and spinal anesthesiawere randomly divided into four groups. Group A received 0. 125 % bupivcaine, group B 0. 125 % bupivacaine + fentanyl(2.5tg/ml), group C 0.125 % bupivacaine + midazolam(0.5mg/ml), group D 0. 125 % bupivacaine + tramdol(3mg/ml).PCEA parameters were a loading dose of 6mi, a bolus dose of 3mi, a lockout interval of 30 min and continuous infusion of2ml/h. The total drug dosage was recorded for up to 24h after operation. The number of PCEA demand, visual analogue painscales(VAS), sedation scales, the incidence of nausea and vomiting, respiratory rate (RR) and mean arterial pressure (MAP)were measured at 4h, 8h, 12h and 24h postoperatively. Results: The total drug dosage, number of button pressed and VAS ingroup A were significantly higher than those in the other groups( P < 0.01 ), which was the least in group D. The sedationscales were the highest in group C. There was a higher incidence of nausea and vomiting in group B. Conclusions: Bupivacainecombined with fentanyl, midazolam or tramadol used for PCEA produces higherquality of pain relief than bupuvacaine alone.

OBJECTIVE:To evaluate the efficacy of clarithromycin in the treatment of upper respiratory tract mycoplasmal infections(URTI)in children METHODS:68 cases were divided into two groups according to different therapeutic schemes:observation group(38 patients)received clarithromycin,10～15mg/(kg?d),bid,po,double the first dose;control group(30 patients) were treated with erythromycin,20～30mg/(kg?d),tid,po or iv drip qd for 7 days RESULTS:Observation group had significantly higher overall effective rate(P

Objective To investigate the correlation between the recruits' gastrointestinal hormone level and military stress.Methods 150 army recruits were included for the study.The gastrointestinal symptom and mental status of army recruits were investigated with questionnaires as well as Symptom Checklist 90(SCL-90).Serum gastrin,vasoactive intestinal peptide(VIP),cortisol,?-endorphine(?-EP)levels were determined with radioimmunological techniques before and after live ammumition shooting training.All the army recruits underwent endoscopic and abdominal ultrasonographic examinations,and the presence of Helicobacter pylori(Hp)was detected by rapid urease test(RUT).Results 17 army recruits developed erosive gastritis or peptic ulcer after shooting training.Hp was detected in 94 army recruits(62.7%),the infectation rate was significantly higher than that of normal people(55%,P

Abstract Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive dysfunction and behavioral impairments. Currently, the treatment mainly relies on pharmacotherapy, yet its effectiveness is limited and accompanied by adverse reactions. Multimodal non-pharmacological interventions (MNPI), which combine two or more non-pharmacological intervention approaches, can synergistically improve cognitive function, neuropsychiatric symptoms, activities of daily living, and quality of life in AD patients, and offers advantages of safety, cost-effectiveness and simplicity. This article reviews MNPI-related literature published domestically and internationally from 2018 to 2024, and focuses on the application of cognitive training, physical activity, and other combined intervention methods in MNPI, providing the reference for developing personalized interventions for AD.

Objective Investigations regarding the status of pediatric emergency and relevant facilities distribution in our province represent a crucial prerequisite for further setting up emergency network and improving our first aid capabilities.Methods We had conducted relevant surveys on the medical institutions within our province,including lever 2 and lever 3 hospitals as well as maternal and child care service centers.Results The feedback from 151 institutions indicated that they had 4485 pediatric beds and treated 5 308 severe patients in 2010.Among all,38 hospitals had ventilators for children and 4 hospitals could perform pediatric blood purification treatment.However,no one had mastered the children ECMO technique.Conclusion There is an inadequacy of some emergency equipments and the development in emergency and first aid is uneven.There is a strong request to launch and develop the blood purification and bronchfiberscope techniques,in combination with improvements in the first aid capabilities and emergency network.

BACKGROUND: Although angiography is the gold standard for the diagnosis of cerebrovascular disease, it cannot be used widely because of its traumatotaxis. Transcranial Doppler ultrasound (TCD) and MRA are both non-invasive examinations, which can be used to evaluate intracranial large artery vascular trunks and hemodynamics.OBJECTIVE: To investigate the reliability of diagnosis with TCD on hemodynamic changes of ischemic cerebrovascular disease (ICVD) and the relativity between TCD and MRA.DESIGN: Case analysis based on patients.SETTING: Neurological Department of the First Affiliated Clinical Hos-pital, Harbin Medical University.PARTICIPANTS: From April 2001 to February 2002,totally 45 patients with stroke,selected from outpatients and inpatients of Neurological Department of First Affiliated Clinical Hospital of Harbin Medical University,examined by CT, to be told the fact and accepted, were taken part in the study.METHODS: Patients were examined with TC-2021 TCD instrument produced by German EME Corporation and VISART1.5T superconduct MR instrument produced by Toshiba. Totally 45 patients had TCD and MRI examinations, and the alternation between two examinations was 1 to 15 days. The hemodynamics and morphological changes were observed including middle cerebral artery (MCA), end of internal carotid artery (ICA),anterior cerebral artery (ACA), posterior cerebral artery (PCA), basal artery (BA), and vertebral artery (VA).large artery vascular trunks and hemodynamic results with TCD and MRA;ty, false positive and false negative with TCD with those of MRA.TCD and MRA: Theory data was Tmin=9.91; χ2=107.92, P ＜ 0.005, it was considered that the results with the rate of TCD were related with that of MRA. The detection rate of TCD was 19.06%, and that of MRA was 15.25%. There were significant differences between the detection rate of standard, the sensibility of diagnosing abnormal vessels by TCD was 78.10%, specificity 94.22%, false positive 7.46%, false negative 23.31%,and the coincidence rate 89.36%.CONCLUSION: TCD can assess exactly the functional status of the vessels. It can also reflect early and sensitively the change of hemodynamics of cerebral blood flow. While MRA can display the change of vascular appearance directly so that the combination of TCD and MRA will be improve sensibility and specificity of diagnosis.

Aim To investigate the effect of TAL and MAPK signal transduction on alveolar macrophage (AM) apoptosis and activity of chronic bronchitis (CB) rats.Methods CB model was established by BCG+LPS method and the in vitro and in vivo experiments were used. MTT method was used to detect the AM activity,and the apoptosis of AM was observed by electron microscope.Results The number of AM in BALF of CB rats was increased than that of normal group (P<0.01).The activity of AM was increased in model group than in control group.The apoptotic rate of AM in CB group was much lower than that in the control group [(13.93±3.34)% vs (5.37±1.38)%] (P<0.01).ERK inhibitor PD98059 induced the apoptosis of cultured AM while JNK inhibitor Curcumin reduced the apoptosis.TAL could inhibit ERK MAPK phosphorylation in AM of CB rats.Further investigation showed that Bcl-2 protein expression was significantly increased while Bax evidently decreased in AM of CB rats.TAL could significantly decrease Bcl-2 expression and increase Bax protein expression, which might be the mechanism of its effect.Conclusions There is an increased activity and decreased apoptosis of AM in CB rats compared with normal rats. TAL can inhibit AM activity and increase apoptosis of AM in CB rats which may be related to the therapeutic effect of CB. ERK and JNK MAPK signal transduction participates in the apoptosis of AM. Regulation of Bcl-2/Bax imbalance and MAPK phosphorylation in AM of CB rats might be the mechanism of its effect.

The metabolic characteristics of ligustrazin (TMPz) in liver microsomes were investigated in the present study. The reaction phenotyping of TMPz metabolism was also identified by in vitro assessment using recombinant human cytochrome P450 enzymes (CYP) and UDP glucuronosyltransferases (UGT). TMPz was incubated at 37 degrees C with human (HLM) and rat liver microsomes (RLM) in the presence of different co-factors. The metabolic stability and enzyme kinetics of TMPz were studied by determining its remaining concentrations with a LC-MS/MS method. TMPz was only metabolically eliminated in the microsomes with NADPH or NADPH+UDPGA. In the HLM and RLM with NADPH+UDPGA, t1/2, K(m) and V(max) of TMPz were 94.24 +/- 4.53 and 105.07 +/- 9.44 min, 22.74 +/- 1.89 and 33.09 +/- 2.74 micromol x L(-1), 253.50 +/- 10.06 and 190.40 +/- 8.35 nmol x min(-1) x mg(-1) (protein), respectively. TMPz showed a slightly higher metabolic rate in HLM than that in RLM. Its primary oxidative metabolites, 2-hydroxymethyl-3, 5, 6-trimethylpyrazine (HTMP), could undergo glucuronide conjugation. The CYP reaction phenotyping of TMPz metabolism was identified using a panel of recombinant CYP isoforms (rCYP) and specific CYP inhibitors in HLM. CYP1A2, 2C9 and 3A4 were found to be the major CYP isoforms involved in TMPz metabolism. Their individual contributions were assessed b) using the method of the total normalized rate to be 19.32%, 27.79% and 52.90%, respectively. It was observed that these CYP isoforms mediated the formation of HTMP in rCYP incubation. The UGT reaction phenotyping of HTMP glucuronidation was also investigated preliminarily by using a panel of 6 UGT isoforms (rUGT). UGT1A1, 1A4 and 1A6 were the predominant isoforms mediated the HTMP glucuronidation. The results above indicate that the metabolism of TMPz involves multiple enzymes mediated phase I and phase II reactions.

Aim To investigate the inhibitory and in-duction effects of the active components of SIWU de-coction on cytochrome P450 enzymes ( CYP ) and as-sess the CYP based drug interaction. Methods Ac-tive components fructose, ferulic acid, paeoniflorin, li-gustrazine and their combinations were incubated sepa-rately with human liver microsomes ( HLM) and probe substrates. Metabolites of the CYP probe substrates were determined by LC-MS/MS to assess the inhibitory activities on human CYP1 A2 , 2 B6 , 2 C9 , 2 C19 , 2 D6 and 3 A4 . Sandwich-cultured rat hepatocytes model was used to evaluate the CYP1 A2 and CYP3 A1/2 induc-tion. Results The inhibitory rates on CYP1A2, 2B6, 2 C9 and 2 C9 by the test groups at 100 μmol · L-1 were all < 62%, while the activities of CYP3 A4 and 2D6 were not affected. The CYP1A2 activities in the test groups of peoniflorin and its combinations ( 50μmol·L-1 ) were significantly enhanced, with the in-creasing fold more than 40% of positive control group. No significant induction on rat CYP3 A1/2 was ob-served for four principles and their combinations. Con-clusions The active components of SIWU decoction do not show significant inhibitory effects on six CYP isoforms. Peoniflorin could induce the CYP1A2 activity in rat hepatocytes. The induction activity is enhanced by the concomitant use of peoniflorin with ferulic acid and/or ligustrazine.

Objective Identify CT signs of breast cancer and evaluate the value of the shaded-surface display technique in spiral CT diagnosis of breast cancer.Material:33 cases of breast cancer were analysed.Methods All of patients underwent spiral CT contrast enhanced scans in SSD technique.Results The CT appearances of breast cancer were round or irregular mass,spiculated border,duct retraction,involved coopers lignment,microcalcification,deformed adipose space and axillary lymph nodes contained metastases.Conclusion The SSD technique has proved to be of great value in spiral CT diagnoses and differential diagnoses of breast cancer.