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:With the development of microelectronics and the microsurgery,it becomes possible to directly extract all kinds of information from the brains of organisms.How to establish a communicative pathway that does not dependent on human brain and human tissues between human brain and computer?Hence,we explored a design project of an implantable system that could be reasonably applied in the extraction,transmission and control of the cranial neural electric signals in brain computer interface(BCI). METHODS:To bring out a design project of an implantable electric system for the extraction,transmission and control of the cranial neural electric signals through the application of the latest microelectronic techniques into the domain of the extraction of brain electric signal and to discuss in detail the key technique,difficulty and possible solutions involved in the projects. CONCLUSION:The proposed project can collect cranial neural electric signals from different depth within 16× 16 with the data precision of 12 bit,which is a closed loop control system.

Objective To evaluate the role of signal transducer and activator of transcription 3 (STAT3) signal transduction pathway in diazoxide cardioplegic solution-induced reduction of ischemia-reperfusion (I/R) injury in isolated rat hearts.Methods Sixty adult male Sprague-Dawley rats,aged 2-3 months,weighing 240-260 g,were used in this study.Their hearts were excised and perfused in a Langendorff apparatus and then randomly divided into 5 groups (n=12 each):control group (group C),group I/R,cardioplegic solution group (group P),diazoxide cardioplegic solution group (group DZX),and STAT3 signal transduction pathway blocker Stattic group (group Stattic).The hearts were continuously perfused for 90 min after 15 min of equilibration in group C.Perfusion was stopped after 15 min of equilibration and restored 30 min later in I/R,P,DZX and Stattic groups.In P and DZX groups,the hearts were perfused with the cardioplegic solution containing 0.4％ dimethyl sulfoxide and 50μmol/L diazoxide,respectively,before perfusion was stopped.In group Stattic,the hearts were perfused with 10μmol/L Stattic for 5 min before perfusion with diazoxide.At 60 min of reperfusion,the hearts were sliced and stained for determination of myocardial infarct size (IS) as a percentage of area at risk (AAR) (IS/AAR),cell apoptosis and expression of phosphorylated STAT3 (p-STAT3) protein (by Western blot) and STAT3 mRNA (using RT-PCR).Apoptotic index (AI) was calculated.Results Compared with group C,the IS/AAR and AI were significantly increased in the other four groups,the expression of p-STAT3 and STAT3 mRNA was down-regulated in I/R and Stattic groups,and the expression of p-STAT3 was down-regulated and STAT3 mRNA was up-regulated in P and DZX groups (P ＜ 0.05).Compared with group I/R,the IS/AAR and AI were significantly decreased,and the expression of p-STAT3 and STAT3 mRNA was up-regulated in P and DZX groups (P ＜ 0.05),and no significant changes were found in the parameters mentioned above in Stattic group (P ＞ 0.05).The IS/AAR and AI were significantly lower,and the expression of p-STAT3 and STAT3 mRNA was higher in DZX group than in P group (P ＜ 0.05).Conclusion STAT3 signal transduction pathway is involved in diazoxide cardioplegic solution-induced reduction of I/R injury in isolated rat hearts.

Objective To investigate the long-term effects of propofol postconditioning on cerebral ischemia-reperfusion (I/R) injury in rats.Methods One hundred and forty-four healthy male SD rats,aged 7-8 weeks,weighing 250-280 g,were equally and randomly divided into 4 groups:sham operation group (group S),I/R group,propofol postconditioning group (group P) and intralipid group (group I).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Focal cerebral ischemia was induced by occlusion of middle cerebral artery for 60 min using a nylon thread with a rounded tip which was inserted into internal carotid artery in groups I/R,P and I.Two hour infusion of propofol was started at 20 mg· kg- 1· h- 1 immediately after the onset of reperfusion in group P,while the equal volume of normal saline was given instead in S and I/R groups,and 10％ intralipid was given instead in group I.Five rats in each group were chosen on day 1,14 and 28 after operation for assessment of neurological behavior and detection of cerebral infarct volume.Six rats in each group were chosen to perform Morris water maze test at day 9 and 23 after operation for 6 consecutive days.Five rats in each group were sacrificed on day 1,14 and 28 after operation and the hippocampal tissues were isolated for determination of the expression of GluR1-containing AMPA (GluR1-AMPA) receptor and GluR1-AMPA receptor in cell membrane.The ratio of GluR1-AMPA receptor in cell membrane/GluR1-AMPA receptor was calculated.Results Compared with group S,neurological behavior scores and the number of animals' swimming across the platform were significantly decreased,cerebral infarct volume was significantly enlarged,escape latency was significantly prolonged,and ratio of GluR1-AMPA receptor in cell membrane/GluR1-AMPA receptor was significantly increased ( P ＜ 0.05),while no significant change in the expression of GluR1-AMPA receptor was found in I/R group ( P ＞0.05).Propofol postconditioning inhibited cerebral I/R-induced changes mentioned above ( P ＜ 0.05).Conclusion The brain protection against focal I/R injury by propofol postconditioning can last for 28 days after operation and the inhibition of trafficking of GluR1-AMPA receptor from cytoplasm to cell membrane may contribute to this long-term brain protection.

Objective To evaluate the role of signal transducer and activator of transcription 3 (STAT3) signaling pathway in the reduction of myocardial ischemia-reperfusion (I/R) injury by diazoxide postconditioning in rats.Methods Sixty adult male Sprague-Dawley rats,aged 3 months,weighing 240-260 g,were randomly divided into 5 groups (n =12 each):sham operation group (S group),I/R group,vehicle group (V group),diazoxide postconditioning group (D group),and STAT3 signaling pathway inhibitor Stattic group (St group).Myocardial I/R was produced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion.In V and D groups,0.4％ dimethyl sulfoxide and 7 mg/kg diazoxide (in 1 ml of 0.4％ dimethyl sulfoxide) were injected through the femoral vein at the onset of reperfnsion,respetively.In St group,Stattic was injected through the femoral vein 10 min before reperfusion,and the other procedures were the same as those in D group.The infarct size (IS) and myocardial apoptosis were detected by TTC staining and TUNEL,respectively.Apoptotic index (AI) was calculated.STAT3 mRNA expression in myocardial tissues was detected using RT-PCR.Western blot was used to detect the phosphorylation of STAT3.Results Compared with S group,the IS and AI were significantly increased and the expression of STAT3 mRNA and phosphorylation of STAT3 were decreased in I/R group (P ＜ 0.05).Compared with I/R group,the IS and AI were significantly decreased and the expression of STAT3 mRNA and phosphorylation of STAT3 were increased in D group (P ＜ 0.05).There was no significant difference in IS,AI,expression of STAT3 mRNA and phosphorylation of STAT3 between V group and St group (P ＞0.05).Compared with group D,the IS and AI were significantly increased and the expression of STAT3 mRNA and phosphorylation of STAT3 were decreased in St group (P ＜ 0.05).Conclusion STAT3 signaling pathway is involved in the reduction of myocardial I/R injury by diazoxide postconditioning in rats.