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.

Objective To explore the serological variations for syphilis in infants delivered by treated syphilitic mothers and its influencing factors. Methods Totally, 146 singleton gravidas, who had been treated for syphilis during pregrancy from January 2006 to January 2008 in our hospital, were chosen. Rapid plasma reagin(RPR) and treponema pallidum particle agglutination assay (TPPA) of these mothers before delivery and of the newborns within 3 d after delivery were tested and 92 of the 146 babies were followed up until the age of 24 months. Results (1) Among the 146 neonates, 104 (71.2%) were positive for both RPR and TPPA and 140 (95.9%) TPPA positive only. The RPR positive rate in neonates born to RPR+ + TPPA+ mothers were higher than those born to TPPA+ (only) mothers (81.4% vs 36.4%,χ2 = 25. 3, P<0. 01). 90.4% of the RPR+ neonates (94/104) showed lower or equivalent RPR titers compared to their mothers. (2) Among the 92 babies bein g followed up, the seroreversion of RPR were found in 98. 2%(n = 56) of the 57 babies, who were RPR+ +TPPA+ at delivery, at the 6 months and 100% (n=57) within 8 months, with the peak time within 2 months after birth (78. 9%, n = 45). While, 100% of the babies were found to be TPPA-within 24 mo with the peak time at 10～18 mo (64. 9%, n = 37). For those babies with TPPA+ at delivery, all turned to be TPPA- at 18 mo, with the peak time at 6 ～ 12 mo (57. 1%, n = 20). (3) The seroreversion time of babies with maternal RPR between 1:1～1:4 was later than those with maternal RPR (P<0.05). The seroreversion time of babies with maternal RPR titer of 1:4 was longer than those with maternal RPR titer of 1 > 1 [(2.5±0.8) mo vs (1. 2±0. 4) mo,P<0. 01]. However, the maternal RPR titer did not affect the TPPA reversion time (P > 0.05). The seroreversion time of RPR in infants with neonatal RPR titer of 1 : 4 was later than those with neonatal RPR titer of 1:1 [(3.7±0. 9) mo vs (2. 3±0. 6) mo,P<0. 01], and babies with RPR titer at 1 : 1 - 1 :4 showed longer duration than those with neonatal RPR- in TPPA seroreversion [(11. 2±2. 8) mo, (12.2±2.9) mo, and (11.0±2.2) mo vs ( 6. 9±2. 1) mo, P< 0.01, respectively]. Conclusions Most infants born to syphilitic mothers are serological positive for syphilis despite of standard maternal treatment during pregnancy. Infants, with higher maternal RPR titer during the pregnancy or at delivery, may persist to be serological positive for syphilis for a longer perieod, but all will turn to negative finally. Long term follow up is recommended for serological positive infants, and the diagnosis of congenital syphilis should be cautious.

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.

Objective To explore the anti-inflammatory mechanisms of purslane by evaluating its effects on the expression of tumor necrosis factor-α (TNF-α) and intercellular adhesion molecule 1 (ICAM-1).Methods A model of inflammation was developed in 45 mice by painting xylene to the auricle of the right ears,which were then divided into 3 groups to receive no treatment (negative control group),be topically treated with the extraction of purslane from South Korea (positive control group) or Yunnan province (experimental group).Fifteen mice receiving no sensitization nor treatment served as the blank control group.Two hours after the single topical treatment,skin tissue samples were obtained from the site of experimental inflammation and subjected to pathological examination by using hematoxylin and eosin (HE) staining.Immunohistochemistry was performed to quantify the expression of TNF-α and ICAM-1 in the tissue samples.Results Pathological examination showed blood vessels and a small quantity of lymphocytes in murine dermis of the blank control group as well as loose and edematous dermis infiltrated with massive lymphocytes in the negative control group.However,there was only mild edema and perivascular infiltration with some inflammatory cells in the dermis of the positive control group and experimental group.Neither TNF-α nor ICAM-1 was expressed in the skin tissue of the blank control group,but an intense expression was observed for TNF-α in the vascular endothelial cell membrane and for ICAM-1 in the vascular endothelial cell membrane and lymphocyte membrane in the negative control group,which was significantly downregulated by the purslane from South Korea in the positive control group and by the purslane from Yunnan province in the experimental group (all P ＜ 0.01).Rank sum test showed a statistical difference in the expression level of TNF-α and ICAM-1 between the blank control group and experimental group (both P ＜0.01).Conclusion The purslane from Yunnan province may counteract inflammation by affecting the expression of TNF-α and ICAM-1.

[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.

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 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.

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 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.

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.