Objective To observe the changes of heart rate variability (HRV) in patients with essential hypertension (EH) and EH associated with impaired glucose tolerance (IGT),and explore the change of autonomic nerve function in EH or EH associated with IGT patients.Methods A total of 166 individuals were enrolled from the physical examination center and divided into three groups,EH group (62 patients),EH associated with IGT group (56 patients) and control group(48 healthy individuals).HRV and its correlative biochemical indexes were detected.Results Compared with that in control group,the standard deviation of NN intervals (SDNN),standard deviation of average NN intervals in all 5 min segments of the entire recording (SDANN),standard deviation of average NN intervals in all 5 min segments of the entire recording index (SDANNi),the percentage of R-R intervals differing ＞ 50 ms (PNN50) decreased and C-peptide,high sensitivity C-reactive peptide (hs-CRP) level increased in EH group,and there was significant difference (P ＜ 0.05).Compared with that in control group,SDNN,SDANN,SDANNi,root mean square of successive differences (rMSSD),PNN50 decreased and C-peptide,insulin,hs-CRP level increased significantly in EH associated with IGT group,and there was significant difference (P ＜ 0.01).Compared with that in EH associated with IGT group,rMSSD,PNN50 decreased,C-peptide,insulin and hs-CRP level increased in EH group,and there was significant difference (P＜ 0.05 or ＜ 0.01).Conclusions HRV decreases in patients with EH and EH associated with IGT,reflecting the damage of autonomic function.Moreover,it suggests that the damage of autonomic function may associate with the increased insulin and hs-CRP.

AIM To explore effects of policosanol on depressing cholesterol in hyperlipidemia rats and the correlated biochemistry mechanism. METHODS The rats were randomly divided into normal control, policosanol 4 mg·kg~(-1) prevention, hyperlipidemia model, policosanol 4, 6 and 8 mg·kg~(-1) and lovastatin positive control groups. The later 5 group rats were fed with high-cholesterol diets for 4 weeks in order to make hyperlipidemia model and beginning from the 5th week, in addition to the normal control and model groups, other groups were ig given policosanol or lovastatin once a day for 6 weeks, respectively, and policosanol protection group rats were ig given with policosanol 4 mg·kg~(-1) once a day for 10 weeks, together with high-cholesterol diets everyday. Total cholesterol(TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) concentrations in the serum and fecal bile acid (FBA) in the exrement were determined by auto-biochemistry analyzer. The activity of 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase in hepatocellular microsomes was detected by ultraviolet spectrophotometric analysis and activity of low density lipoprotein receptor (LDL-R) in peripheral blood lymphocyte was detected by fluorescence labelled integrator method. RESULTS Compared with hyperlipemia model group, the levels of TC decreased (39.1%-46.4%), LDL-C decreased (66.6%-80.7%), and FBA increased (9.7%-19.0%), the activity of HMG-CoA reductase decreased （13.8%-23.6%）, and activity of LDL-R increased (27.5%-129.6%) in policosanol prevention, policosanol 4, 6 and 8 mg·kg~(-1) and lovastatin groups, respectively; HDL-C increased （12.2%-16.7%） in policosanol prevention and policosanol 8 mg·kg~(-1) groups; TG decreased in lovastatin group. CONCLUSION Policosanol has significant effects on decreasing cholesterol. The decreasing cholesterol mechanism should include: ① increasing FBA excretion; ② decreasing the activity of HMG-CoA reductase; ③ increasing activity of LDL-R.

Objective Calcineurin-NFAT pathway in the regulation of VSMCs proliferation induced by catecholamines.Methods Primary VSMCs from rat aorta were used as the experimental model.Proliferation of VSMCs was measured by MTT assay and cell count.Calcineurin protein and its activity were assayed with immunoblotting and free inorganic phosphate content analysis respectively.Localization of NFATc1 was detected by immunofluorescence staining.Results Phenylephrine(PE,an ?1-adrenoceptor agonist) increased VSMCs proliferation.Prazosin(an ?1-adrenoceptor antagonist),cyclosporin A(CsA,an inhibitor of calcineurin) and chelerythrine(an inhibitor of PKC) decreased PE-induced absorbance and cell number.Timolol(?-adrenoceptor antagonist) has no effect on absorbance and cell number induced by PE.Additional treatment with CsA further inhibited PE-induced absorbance and cell number compared with the chelerythrine pretreatment group.CsA and chelerythrine alone had no significant effect on either absorbance or cell number.CsA decresed PE-induced alcineurin level and its activity.NFATc1 was translocated from cytoplasm to nucleus upon treatment with PE.This translocation was reversed by CsA.Conclusion CsA partially inhibits PE-induced VSMCs proliferation via inhibiting calcineurin activity and NFATc1 nuclear translocation.Calcineurin-NFATc1 pathway is involved in hyperplastic growth of VSMCs induced by catecholamines.

Objective To investigate the effects of case-based learning (CBL) applied in the clinical probation of anesthesiology.Methods Totally 313 undergraduates from the department of anesthesiology were randomly divided into 2 groups:CBL group (n =157) and LBL group (n =156).CBL methods were used to teach students in CBL group while traditional teaching methods were used to teach students in LBL group.After the causes being finished,a combination of theoretical examination and questionnaire were used to evaluate the teaching effectiveness between the two groups and a questionnaire was used to evaluate the recognition of teachers on CBL method.Data were managed by SPSS 17.0 software package.Quantitative data between groups were compared by t-test,enumeration data between groups were compared by chi-square test.Results Students in CBL group acquired higher score (86.7 ± 5.4) than those in LBL group (75.8 ± 4.5).82％ students in CBL group considered that their overall quality was improved while 42％ students in the LBL group thought so (P ＜ 0.05).75％ of faculties preferred the CBL methods.Conclusions Effect of CBL methods is better than traditional teaching methods and it's preferred by faculty and students.

BACKGROUND:Both microfracture and osteochondral transplantation are effective tools in the clinical treatment of articular cartilage defects.
OBJECTIVE: To observe the implementation results of microfracture and osteochondral transplantation in the treatment of articular cartilage defects.
METHODS:The clinical data of 50 cases (50 knees) of articular cartilage defects were retrospectively analyzed. There were two groups according to surgical repair methods: autogenous osteochondral transplantation+ microfracture in observation group (n=25), and microfracture in control group (n=25). Patients in the two groups were folowed up for over 24 hours to compare the Hospital for Special Surgery scores, clinical efficacy, adverse effects and complications.
RESULTS AND CONCLUSION:The number of patients whose Hospital for Special Surgery score was > 85 points and 60 to 85 points in the observation group was significantly larger than that in the control group (P< 0.05), and the total treatment effective rate of patients in the observation group was significantly higher than that of the control group (92%vs. 60%,P < 0.05). No complications occurred in both two groups. These findings indicate that osteochondral transplantation has better implementation results in the treatment of articular cartilage defects than microfracture.

[Objective]To analize the complications in the treatment of the fractures around the knee joint with less invasive stabilization system(LISS).[Method]From July 2005 to October 2007,89 patients with 91 fractures around knee joint were treated with the LISS,including 45 fractures of distal femur and 46 fractures of proximal tibia.[Result]All patients were followed up for 13 to 29 months.The average time to union was 16 weeks(ranged,11-25 weeks).The functional outcome: 45 had an excellent result,35 had a good result and 11 had a fair result,with 87.9% excellent to good results.There were 10 patients(11%) with symptomatic hardware irritation,2 of them had soft-tissue disruption.Seven cases(8%) had malalignment,2(2%) loss of reduction,1(1%) delayed union,1(1%) failed fixation,1 superficial peroneal nerve injury and 1 profound peroneal nerve injury.Cold-welding occurred in 9 cases(10%) which resulted in difficult removal.[Conclusion]LISS is one of the reliable and effective methods in fixation of the fractures around the knee joint.However,its operation indications and operating instructions should be strictly followed.

In this article, the plasma half life of IL-2 and its bio-distribution were studied using radio-nucleus Technetium-99M labeled IL-2. The results showed the plasma half life of IL-2 was merely 10 minutes mainly due to IL-2 distribute to its target organ such as liver, kidney etc,rather than clear out of the body. Our results indicated that IL-2 is a high organ-specific drug. It's plasma half life is short under high concentration in its target organ. So it might have advantages of high effectiveness and low whole body toxicity in treatment of tumor of liver and kidney.

The clinical application of GlucoWatch used in 32 Chinese diabetic patients was evaluated to determine its value in following blood glucose trends and track patterns and to know the compliance of patient. The results confirmed the accuracy of GlucoWatch and showed that it could follow blood glucose trends and track patterns. The skin irritation was mild and most subjects thought that blood glucose monitoring by GlucoWatch could reduce the pain caused by traditional methods.

Objective To evaluate the safety and feasibility of LC in patients with acute cholecystitis. Methods The authors retrospectively analyzed 145 cases of acute cholecystitis treated by LC from 1992～2000. Results All cases were successfully treated by LC, durations of operations being 30 to 130min with a mean 68min. Postoperative complications were found in 5 cases: Two patients underwent cystic artery bleeding, which was stopped successfully via laparoscope; the other three patients had bile leakage, bleeding of the greater omentum and subhepatic abscess, respectively, the first two cases being dealt with by open operations and the later by anti-inflammatory therapy. The success rate of LC was 96 6% (140 of 145). Conclusions LC may be applied successfully to the patients with acute cholecystitis within the first three days of incidence, after the gallbladder wall is proved ≤ 5mm by B-ultrasonography.

Objective To evaluate the immune responses and its dynamic changes of the babies born to hepatitis B surface antigen (HBsAg) positive mothers after combined passive immunoprophylaxis and active immunoprophylaxis. Methods Two hundred and forty-nine infants born to HBsAg positive mothers were enrolled. All of these infants have received both passive immunoprophylaxis by injecting hepatitis B immunoglobuin (HBIG) and active immunoprophylaxis by vaccinated with hepatitis B vaccine simultaneously 12 hours after birth. After that, all infantscompleted the whole vaccination program. The titers of serum HBsAg and hepatitis B surface antibody (HBsAb) of the infants were checked at 7, 12, 24 and 36 months after birth. The data was analyzed by chi square test. Results Infants born to HBsAg positive mothers showed various immune response modes. The no response rate, low response rate and strong response rate were 8.0% (20/249),11.7% (29/249) and 80.3% (200/249) respectively in the 7-month infants, which were 10.8% (12/120), 26.7% (32/120) and 62.5% (75/120) respectively in 12-month infants. The results from further follow-up showed that no response rate, low response rate and strong response rate were 14.8% (4/27), 33.3% (9/27) and 51.9% (14/27) respectively in the 24-month babies and were 14.3 (1/7), 28. 6% (2/7) and 57.1% (4/7) respectively in the 36-month babies. There were statistically significant difference between the 7-month infants group and other groups (x2= 21.98,P＜0.01). The HBsAb titers of high-response infants group declined over time. The infants with higher antibody titers tended to not decline or decline more slowly. In infants who have even achieved HBsAb titers higher than 1000 mIU/mL, 57.6% (19/33) of them showed decreased titers in 36 months. The titer decrease peaked at 24 month after birth (57.9%, 11/19). In infants who have achieved HBsAb titers of 100 to 1000 mIU/mL, 73.8% (31/42) of them showed decreased titers in 36 months. The titer decrease peaked at 12 month after birth (54.8%, 17/31). HBsAg positive infants usually showed no response at 7 month, who accounted for 70% (14/20,x2 = 128.61, P＜0.01) of all no response infants. Ninety-nine percent (189/191) of HBsAg negative infants showed strong responses. The infants born to both HBsAg positive and hepatitis B e antigen (HBeAg)positive mothers tended to show no response. However, the difference between these infants and others was not statistically significant (9.1% vs 5.5%,x2 =0.24,P＞0.05). Conclusions The immune responses of infants born to HBsAg positive mothers after combined passive and active immunoprophylaxis change over time. The non-response status is usually found in HBsAg positive infants. HBsAg negative infants usually show strong response. Infants born to both HBsAg positive and HBeAg positive mothers tend to show low response. It is recommended to follow standard immunoprophylaxis procedure. The follow-up and active monitor are very important during 7 months to 2 years after birth.