Objective To investigate the influence of propofol and isoflurane on insulin resistance and proinflammatory cytokines.Methods 42 patients underwent abdominal surgery were randomly divided into group A and group B.All cases were given conventional endotracheal intubation anesthesia.Group A (21 cases) was given propofol anesthesia,group B (21 cases) was given isoflurane.The levels of glucose (Glu),insulin (IN),interleukin-6 (IL-6) and tumor necrosis factor alpha(TNF) were detected before anesthesia,2h after anesthesia and postoperative 24h.Insulin sensitive index(ISI) and insulin resistance index(IRI) were calculated.All data were analyzed.Results 2h after anesthesia,Glu level of group B was obviously increased compared with before anesthesia(P ＜ 0.05).But it of group A was slightly increased (P ＞ 0.05).Postoperative 24h,Glu level of the two groups was obviously increased compared with before anesthesia (P ＜ 0.05).2h after anesthesia and postoperative 24h,IN,IRI,IL-6 and TNFαdevels of the two groups were obviously higher than before anesthesia(P ＜ 0.05).ISI level of the two groups was obviously lower than before anesthesia (P ＜ 0.05).2h after anesthesia,IRI,IL-6 and TNFα levels of group B were obviously higher than those of group A,and ISI level was obviously lower than group A (P ＜ 0.05).Conclusion Compared with isoflurane,propofol anesthesia can lessen stress reaction and insulin resistance caused by surgical trauma to some extent.But both propofol and isoflurane can not completely relieve stress reaction and insulin resistance

Objective To investigate the effects of nitric oxide synthase inhibitor L-NAME on two tone fear extinction design in rats.Methods In AAA design,the rats received fear conditioning,extinction training and extinction test in the same context.In AAB design,the rats received fear conditioning and extinction training in context A,extinction test in context B.In each task,40 male rats were randomly divided into 4 groups (n =10 per group),and L-NAME(10,20 and 40 mg/kg) or saline was injected intraperitoneally (i.p) 30 min prior to extinction training.Percent freezing was used as an index for fear memory during extinction test phases.Further experiments were used to test state-dependency effects or nonspecific changes of locomotor activity that followed L-NAME injection.Results In AAA design,percent freezing was (27.42 ± 6.52) ％ in saline group,and (30.83 ±7.15) ％,(32.49 ± 8.55) ％,(38.94 ± 11.48) ％ in 10,20,40 mg/kg L-NAME group respectively.There was no significant difference in the level of percent freezing among the four groups (P＞0.05).In AAB design,percent freezing was (30.32 ± 6.15) ％ in saline group,and (32.83 ± 6.64) ％,(39.49 ± 8.74) ％,(49.94 ± 10.83) ％in 10,20,40 mg/kg L-NAME group respectively.Compared with saline,only rats with L-NAME 40 mg/kg showed more levels of freezing (P ＜0.01).In state-dependency effects test,compared with Sal-Sal group ((26.73 ±5.62) ％) which received both saline injections 30 min before extinction training and extinction test,respectively,both NAME-Sal group((48.44 ± 10.46) ％) and NAME-NAME group((61.25 ± 13.24) ％) showed more levels of freezing (P＜0.01,respectively).Conclusion These results show that L-NAME produces a task-dependent impairment of fear extinction,and implies that nitric oxide signaling is involved in memory process of certain extinction tasks.

BACKGROUND:Accumulating evidence shows that, low molecular heparin can prevent and treat early osteonecrosis of femoral head, but the mechanism remains unclear. The heparin exhibits a dynamic balance with heparanase in vivo, and inhibits heparanase expression.
OBJECTIVE:To observe the changes of heparanase and tissue factor pathway inhibitor expression level in plasma and femoral head of patients with idiopathic osteonecrosis of femoral head, and investigate the pathophysiological role of heparanase in the progression of idiopathic osteonecrosis of femoral head.
METHODS:A total of 36 patients with idiopathic osteonecrosis of femoral head were randomly divided into four groups according to ARCO I-IV period, with nine patients in each group. Patients with fresh femoral neck fracture for hip arthroplasty were included in the control group. Heparanase and tissue factor pathway inhibitor levels in preoperative venous plasma were measured by ELISA, and in subchondral necrosis bone of ARCO II-IV groups were observed for western blot analysis and hematoxylin-eosin staining.
RESULTS AND CONCLUSION:In plasma, heparanase and tissue factor pathway inhibitor levels were significantly increased along with the development of idiopathic osteonecrosis of femoral head compared with control group, the highest levels were found in ARCO III period, and then slightly decreased in ARCO IV period, showing significant differences. The protein levels of heparanase and tissue factor pathway inhibitor in necrosis bone were increased significantly compared with control group, the highest levels occurred in ARCO III period, no obvious difference was found between ARCO II and IV periods. Heparanase and tissue factor pathway inhibitor levels are gradual y increased along with the development of the necrosis, and heparanase plays an important role in idiopathic osteonecrosis of femoral head.

Objective To study the application value of laparoscopic-assisted radical gastrectomy in elderly patients.Methods 114 elderly patients with gastric cancer were randomly divided into observation group and control group.55 patients in the observation group received laparoscopic-assisted radical gastrectomy ,59 patients in the con-trol group received traditional open radical gastrectomy .The operation time,blood loss,postoperative ambulation time, postoperative hospital stay and other information were compared .Results The operative time ,blood loss and postop-erative ambulation ,postoperative hospital stay in the observation group were significantly better than those in the con -trol group(t=12.195,8.562,8.072,10.252,all P<0.05).In the observation group,18 patients had marked effect, effective in 33 cases,ineffective in 4 cases,the total effective rate was 92.7%.In the control group,21 cases had marked effect,effective in 34 cases,ineffective in 4 cases,the total effective rate was 93.2%,the difference between the two groups was not significant (χ2 =0.069,P>0.05).Conclusion The efficacy of laparoscopic-assisted radical gastrectomy is similar with traditional open radical gastrectomy ,and laparoscopic-assisted radicalgastrectomy has ad-vantages of minimally invasive ,faster recovery ,especially suitable for elderly patients with gastric cancer .

Risk factors related to malnutrition were prospectively studied in 82 cases with acute ischemic stroke in our hospital during December 1,2007 and December 31,2008. The incidences of malnutrition on the first and ( 14 ± 1 )th day were 18% (15/82) and 30% (25/82). Study showed that age ( P = 0. 007 ), dysphagia ( P = 0. 043 ), malnutrition on admission ( P = 0. 003 ) were risk factors related to malnutrition on the ( 14 ± 1)th day after admission; there was no interaction between dysphagia and the other two factors, dysphagia was an independent risk factor related to malnutrition after acute ischemic stroke.

Objective To establish an HPLC method for determination of the content of paeoniflorin in in Anwei Granules.Methods With Phonomenex C18,150mm?4.60mm,5micron,acetonitrile-water-phosphoric acid(15∶85∶0.2)was used as the mobile phase,The flow rate was 1.0ml/min.The detection wavelength was 230nm.Results The linearity was obtained from 2.52-20.14 ?g(r=0.9990).The average recovery was 99.17 % with RSD=0.91%(n=6).Conclusions The method is sensitive,simple,specific and accurate for determination of astragaloside in Tangshenkang Granules.

The roots ofApium graveolens L. have been widely used in Uighur Medicine. Research has shown that roots ofApium graveolens L. has good clinical efficacy in the aspects of liver protection and lipid decreasing, hyperlipidemia treatment and so on. This article reviewed research on the chemical components, extraction process, and pharmacological action of roots ofApium graveolens L. so far, with purposes to better develop and utilize roots of Apium graveolens L., and provide references for follow-up study.

Currently our medical colleges have no uniform competency standards for teachers teaching,and the assessment of teaching ability is vaguely defined.Through the content and effect analysis of foreign teaching competency standards assessment,according to the particularity of medical colleges,and by carding several aspects of the teacher ability content system,the author of the article put forward recommendations of building our medical colleges teacher teaching competency standards and improve medical colleges teachers' teaching ability and level.

The application of PET-CT could not only play a part in the diagnosis of clinical stage for NSCLC on PET, but also make full use of the discrimination of anatomical structure on CT. The precision of target contouring could be increased and the normal tissue and risk organ are also protected efficiently.

Malnutrition is significantly correlated with the high mortality and other poor outcomes of stroke;in turn,stroke can increase the incidence of malnutrition.Old age and swallowing dysfunction are independent risk factors of post-stroke malnutrition.The sequential nutritional support with enteral nutrition and parenteral nutrition can reduce or avoid the complications of both malnutrition and stroke,and therefore should be considered for stroke patients,especially those who are critically ill.