Objective To systematically review the effects of air or liquid in a loss of resistance technique for identification of the epidural space. Methods We searched the Cochrane Library, PubMed, EMBASE, Chinese Biomedical Database (CBM), CNKI, VIP and ChinaInfo for studies on the effects of air versus liquid in a loss of resistance technique for identification of the epidural space. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.1 software. Results Seven prospective randomized controlled trials involving 5183 patients were included in our meta-analysis. The patients were randomly allocated into 2 groups according to the technique by which the epidural space was identified: loss of resistance with air group (group air, n = 2534) and loss of resistance with liquid group (group lidocaine, n = 2649). The results showed that the incidences of difficult catheterization, intravascular catheter insertion, incomplete block and post-operative headache were significantly lower in group liquid than in group air (P ＜ 0.05). There were no significant differences in the incidences of transient abnormal sense and accidental dural puncture between group liquid and air. Conclusion Loss of resistance with liquid can identify the epidural space more correctly than with air, with fewer complications and better analgesic efficacy.

Low-density lipoprotein receptor-related protein-1 (LRP-1) is a transmembrane receptor protein locatedon the plasma membrane of the cells and involved in receptor-mediated endocytosis.LRP-1 binds to distinct ligandsthat are structurally and functionally unrelated, which makes it not only mediates endocytosis, but also regulates cell surfaceproteolytic activity and specific intracellular signaling pathways related to multiple links in the process of developmentof atherosclerosis.Moreover, LRP-1 plays an important role in maintaining vascular stability.This review focuses on theprogress in LRP-1-regulated vascular integrity, and provides new insights to the target of the blood vessel diseases.

Filial piety and fraternal love ethics is the nucleus of tradition ethics and the base of a person's moral.Reinforcing filial piety and fraternal love education is beneficial to raising the medical students'morality and qualities,consummating their personality,raising their brotherhood life,easing up doctor-patient relationship and promoting the development of medical health.

Objective To know the pollution situation by microcystin MC in Tai Lake in Wuxi. Methods The MC content in 12 water samples and 28 fish samples in the Tai Lake were determined by ELISA. Results The positive rates of MC in water samples and fish samples were 100%. The mean content of MC in water samples was higher in July 9 874.8 pg/ml than in November 142.8 pg/ml. The mean content of MC in the livers was 27.84 ng/g, in the muscle it was 3.97 ng/g. Conclusion The Tai Lake has been contaminated by microcystin and it can be detected in the fish living in the lake.

Objective The aim of this study was to compare hypophosphatemia between the sepsis patients and the non-sepsis patients,and between within the subgroups of sepsis patients.Methods We collected 312 sepsis cases and 300 non-sepsis cases by stratified random sampling method yearly.In the sepsis cases,the number infected by gram-negative bacteria was 170,and by gram-positive bacteria was 142,containing 4 different bacteria infected cases in each one.Serum phosphorus of cases in each group were collected.The data were statistically processed to compare the incidence rates of hypophosphatemia,mean serum phosphorus levels and relative risk among groups.Results There was a statistical difference between the sepsis cases and the non-sepsis cases in incidence rate of hypophosphatemia (P ＜ 0.05,and RR ＞ 1.2).There were statistical differences between the cases infected by gram-negative bacteria and the cases infected by the gram-positive bacteria,also among cases infected by 4 different gram-positive bacteria in both incidence rate of hypophosphatemia and average serum phosphorus level (all P ＜ 0.05),and both RR ＞ 1.2.There were no statistical differences among cases infected by 4 different gram-negative bacteria in both incidence rate of hypophosphatemia and average serum phosphorus level (both P ＞ 0.05),and RR ＜ 1.2.Conclusions The sepsis patients were susceptible to hypophosphatemia,especially the ones infected by the 4 gram-negative bacteria,staphylococcus aureus and enterococcus in this study.We should pay attention to the serum phosphorus level seriously and prevent the occurrence of serious complications.

AIM To evaluate whether l glutamine monofluorophosphate(MFP) together with Alendronate sodium may further increase bone mass in ovariectomized rats. METHODS Forty two 3 month old Sprague Dawley female rats were randomized into six groups:group 1 rats were sham operated(Sham),group 2 rats were ovariectomized controls(Ovx),and groups 3～6 were ovariectomized and received either 1 mg?kg -1 ?d -1 of alendronate sodium ,270 mg?kg -1 ?d -1 of calcium gluconate,5 6 mg?kg -1 ?d -1 of MFP or combination of 5 6 mg?kg -1 ?d -1 of MFP and 1 mg?kg -1 ?d -1 of alendronate sodium for 3 months. All animals received double bone fluorochrome labeling prior to sacrifice. At the end of experiment,the left tibiae were havested for histomorphometrical evaluations. RESULTS Alendronate sodium increased trabecular bone volume significantly with suppressed bone resorption and bone formation. Administrated calcium gluconate had no influence on the bone mass. MFP also could not restore cancellous bone of ovariectomized rats. Administration of both MFP and alendronate sodium increased bone mass significantly but did not increase bone mass compared with alendronate sodium. CONCLUSIONS The results indicated administration of both alendronate sodium and MFP could not further increase bone mass of ovariectomized rats.

AIM: To study the relationship between prostaglandins and acute pulpitis. METHODS: Rat traumatic pulpitis model was established by pulp exposure. The kinetic pathological changes in dental pulpal tissues and changes of PGE 2?6-Keto-PGF 1? and TXB 2 concentration in dental pulp were observed. RESULTS: After pulpal trauma, the dental pulp showed inflammatory changes and the concentrations of PGE 2?6-Keto-PGF 1? and TXB 2 were increased, which peaked at 6 hour post-trauma. CONCLUSION: Prostaglandins play a significant role in the pathogenesis of pulpitis.

Objective:To investigate the effect of a low calcium diet on the distal and proximal tibial metaphysis in male rats using bone histomorphometrical techniques. Methods:Forty 3-month-old male Sprague-Dawley(SD) rats, with a mean weight of 280?22g, were randomized into five groups. Group one and group two were fed a normal diet (Ca 1.0%) and a very low calcium diet (VLCD ,Ca 0.1%) respectively for one month,and the rest three groups were fed a normal diet (Ca 1.0%), a very low calcium diet (VLCD, Ca 0.1%) and a low calcium diet (LCD , Ca 0.3%) respectively for three months. All animals received double bone fluorochrome labeling prior to sacrifice. At the end of experiment, the left tibiae were harvested for bone histomorphometrical evaluations. Results:After one month, compared to control group, distal tibial metaphysis(DTM) of VLCD did not change significantly but proximal tibial metaphysis(PTM) was decreased significantly whose percent trabecular area (%Tb.Ar) was decreased to 38% (P

Objective To compare the clinical diagnoses with autopsy findings and evaluate the frequency of misdiagnosis.Methods The findings of 356 cases who were autopsied in our department due to medical treatment dispute during the period of 1988 to 2007 were retrospectively analyzed.The clinical diagnosis and autopsy findings,sex and age of the death,length of hospitalization,the hospital department,distribution of death disease and the rank of hospital were analyzed.The concordance between diagnosis before death and at autopsy was calculated.Results In 162 cases(45.5%),the autopsy findings confirmed the clinical diagnosis.In 101 cases(28.4%),the clinical diagnosis suggested by clinicians were discordant with the autopsy findings.In 63 cases(17.7%),some diagnoses made by clinicians were proved by autopsy,and in 30 cases(8.4%),the clinical and postmortem diagnosis were beyond comparison.The most frequently misdiagnosed diseases were from cardiovascular and respiratory diseases,and among them,cardiomyopathy,aortic atherosclerosis and pneumonia were most common.Conclusion Autopsy is not only helpful for the management of medical dispute,but also beneficial to reduce the misdiagnosis in clinical practice.

Objective To compare the efficacy of rcmifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.Methods We searched the Coehrane library,PubMed,EMBASE,OVID and Chinese Biomedical Database for prospective randomized controlled trials involving the comparison of the efficacy of remifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the mechanical ventilation time after operation,duration of stay in hospital,and level of cardiac troponin,mortality,requirement for positive inotropic drugs and incidence of hyperalgesia and myocardial infarction during perioperative period.Meta-analysis was conducted using the RevMan 5.0 software.Results Sixteen prospective randomized controlled trials involving 1473 patients were included in our Meta-analysis.The patients were divided into 2 groups:fentanyl or sufentanil group ( n =644) and remifentanil group ( n =573).Compared with fentanyl or sufentanil group,the mechanical ventilation time after operation and duration of stay in hospital were significantly shortened,the level of cardiac troponin during the perioperative period was significantly decreased and the requirement for positive inotropic drugs during the perioperative period was significantly reduced ( P ＜ 0.05),and no significant change was found in the incidence of hyperalgesia or mortality of myocardial infarction during the perioperative period in remifentanil group ( P ＞ 0.05 ).Conclusion The efficacy of remifentanil combined anesthesia is better than that of fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.