Objective To explore the clinical efficacy and safety of ropivacaine for combined spinal-epidural anesthesia(CSE).Methods 40 patients,who intended to undergo elective lower limb or perineum surgery,were randomly divided into two groups,each with 20 cases,ropivacaine were used in treatment group,while bupivacaine in control group the differences of feeling,motor block and recovery time,as well as their side effect in the two groups were compared.Results The maximum of spread time of anesthesia and the recovery time,and side effect in treatment group were similar to those in control group.The onset time of motor block and the peak time of motor block were longer in treatment group than that in control group,the maximum modified Bromage scale in treatment group was lower than that in control group(P

Objective To observe the effect of diliazem on cerebral oxygen metabolism during the period of blood pressure lowering in hypertensive urgencies.Methods 30 patients of hypertensive urgencies were randomized into two groups with 15 cases each.Group Ⅰ was administered with nitroglycerin.Group Ⅱ was administered with diliazem.Nitroglycerin was injected from 2.5?g/(kg?min).Group Ⅱ were received intravenous injection of diltiazem 5~10 mg,and then were continuously infusion by 5~15?g/kg/min with mictosyringe.Blood gas analysis was carried out by taking blood samples from right internal jugular vein bulb and radial artery,and D(a-jv)O2 and CEO2 were calculated before,during and after induced blood pressure lowering 0.5,1,2,3 hours.Results Compared with those in group Ⅰ,SjvO2 increased significantly in group Ⅱ(P0.05).Conclusion Diltiazem can decrease cerebral metabolism,improve oxygenation and play a role in cerebral protection in hypertensive urgencies.

Objective To evaluate the clinical application value of susceptibility weighted imaging (SWI) in neonatal hy-poxic ischemic encephalopathy (HIE). Methods Thirty-six neonates with HIE were collected and scanned by GE 3.0 T supercon-ducting MR scanner. Routine axial T1WI, T2WI, FLAIR scan and axial SWI scan were conducted. SWI sequence was compared with conventional head MRI sequences in detection rate of distribution and quantity of intracranial hemorrhage. Meanwhile, the display condition of the dilated cerebral deep veins and cortical veins was observed on SWI image and the performance of HIE in different clinical classification on SWI was compared. Results A total of 97 intracranial hemorrhages were detected by SWI in 27 cases. Only 41, 27 and 51 hemorrhages were found by TIWI, T2WI and FLAIR sequences, respectively. SWI were significantly superior to T1WI, T2WI and FLAIR in displaying the size, scope and boundary definition of hemorrhage. A total of 50 dilated ce-rebral deep veins and cortical veins were detected by SWI in 22 cases which were not found by conventional head sequences. The detection rates of intracranial hemorrhage and intracranial hemorrhage in addition of dilated cerebral veins on SWI sequence were the lowest in mild HIE group, and highest in severe group. There was significant difference among the mild, medium and severe groups (P<0.05). Conclusions SWI sequence has higher sensitivity than conventional MRI sequence in detecting intracranial hemorrhage and dilated vein in HIE, and is useful for early diagnosis of HIE.

Objective To explore the behavioral patterns of middle school students and provide basis for unintentional injury prevention in these students.Methods 171 injury students and 171 normal students as controls were evaluated by Youth Self-Report(YSR),and mean scores were compared between the two groups by t Test.Logistic regressions were performed to analyze the relationship between injury students and behavioral problems.Results The rate was higher in injury group(15.79%) than in control group(8.19%).The score of injury group of boys was higher than thar of control group(t=2.942,P=0.004);the score of injury group of girls was higher than thar in control group(t=3.766,P=0.000).Multi-factor Logistic regression analysis showed that attention-deficit(OR=5.376),the problem of thinking(OR=3.672),social problems(OR=2.204) and friendly fellows' action was a risk factor.Conclusions There is a significant effect of the behavior of students and fellow students on the injury to students.

For obtaining new structural compounds with unique resistance profiles or novel mechanisms of action on HIV-1 from natural products, anti-HIV-1 drug screening models were used in vitro. Norcantharidin (NCTD), a derivative from cantharidin, was found to have inhibitory activities on HIV-1(IIIB) p24 antigen in lymphocyte lines MT-4, CEM and H9. It inhibited HIV-1 strain 018a (sensitive to zidovudine) from replicating with EC50 (50% effective concentration) of 14.9 micromol L(-1) and also inhibited HIV-1 strain 018c (resistant to zidovudine) from replicating with EC50 of 20.2 micromol L(-1) in primary lymphocytes peripheral blood mononuclear cells (PBMC). Norcantharidin showed synergistic activity with zidovudine on HIV-1(IIIB) in MT-4 cells, the combination index was less than 0.3. But, it was not active on HIV-1 integrase, reverse transcriptase or protease in vitro. As the structure of norcantharidin is unique and different from that of all clinic drugs approved, it would be possible to obtain new and effective compounds against HIV-1 with low toxicities after modification of norcantharidin.

Objective To determine the lumbar anatomical structure parameters of the lumbar spine posterior column and its sample data of three-dimensional conformation,and based on these data to design the lumber laminar screw dynamic fixation system.Methods 20 human L3 ～ S1 bone specimens,the thickness of the lumber laminar region were measured to obtain the normal anatomical parameters of the lumbar laminar.And 20 healthy lumbar vertebrae L3-S1 for three-dimensional reconstruction were detected by CT scan,which could obtain the structure data of the normal lumbar posterior three-dimensional conformation,and to obtain conformational sample data of three-dimensional space of the posterior structure.Results Lumbar lamina medial 1/3 could serve as a spine laminar screw setting area by anatomical observations and measurements.Lamina thickness of L3-4 on average (6.6 ±0.9) mm,L5 ～ S1average (6.0 ± 0.6) mm.Lumber laminar screw length 6.5 ～ 8.0mm could meet the requirements of bilateral cortical fixation.Conclusion Lower lumbar spinal lamina area can serve as the region to fix the bilateral cortical bone screw,and the optimal length of the laminar screw is 6.5 ～ 8.0rmm.

OBJECTIVE:To investigate the occurrence of ADR induced by over-the-counter(OTC)drug in order to guide the rational use of drugs. METHODS:45 cases of ADR induced by OTC drug were analyzed retrospectively in terms of patient's gen-eral information,allergic history,allergenic drugs,reason for drug use,route of administration,incubation period,days of hospi-talization,clinical manifestation,treatment,outcome,etc. RESULTS:Among 45 patients,there were 14 male and 31 female. The patients were mainly 20-30 year-old(31.1%). Three patients had previous history of allergy(6.7%). Most ADR were induced by oral drugs(82.2%). Reasons for drug use were mainly disease of respiratory system(23 cases,51.1%). The results of causality as-sessment were positive in 3 patients(6.7%),probable in 35(n=77.8%),and possible in 7 patients(15.6%). ADR were mainly induced by non-steroidal anti-inflammatory drugs (NSAIDs,57.8%),Chinese patent medicine (20.0%),drugs for external use (17.8%). The clinical manifestations mainly included exanthematous drug eruption (33.3%),erythama multiforme drug eruption (24.4%),urticarial drug eruption(13.3%). CONCLUSIONS:NSAIDs are the main allergenic drugs,and ADR induced by OTC traditional Chinese medicine can not be ignored. To improve medical knowledge and skills of the public and the scientific use of OTC drug are beneficial to improve the clinical treatment level.

AIM:ToinvestigatetheprotectiveeffectofquercetinonangiotensinⅡ(AngⅡ)-inducedcardio-myocyte hypertrophy and its possible mechanism .METHODS: Cardiomyocyte hypertrophy was induced by AngⅡ ( 100 nmol/L) in primary neonatal cardiomyocytes and H 9c2 cells.The cells were treated with different concentration of querce-tin (10 μmol/L, 20 μmol/L and 40 μmol/L) for 48 h and then the cardiomyocyte surface areas were measured by immu-nofluorescence .Proteasome activity was detected by fluorescent peptide substrate .The phosphorylated levels of GSK-3α/βand Akt in H9c2 cells were determined by Western blot .RESULTS:Compared with control group , the cardiomyocyte sur-face areas were both increased in primary cultured neonatal cardiomyocytes and H 9c2 cells, while the surface areas were significantly decreased by quercetin , especially at concentration of 20 μmol/L compared with Ang Ⅱgroup (P<0.05). Compared with control group , the chymotrypsin-like, trypsin-like and caspase-like activities of proteasome were all in-creased in H9c2 cells (P<0.05).The trypsin-like and caspase-like activities of proteasome were inhibited by 20 μmol/L and 40 μmol/L quercetin , while chymotrypsin-like activity was inhibited only at 20 μmol/L of quercetin compared with AngⅡgroup (P<0.05).In addition, phosphorylated levels of GSK-3α-Ser21, GSK-3β-Ser9 and Akt-Ser473 in AngⅡgroup were all increased compared with control group , which were obviously inhibited by in 20 μmol/L and 40 μmol/L quercetin ( P<0.05 ) .CONCLUSION: Quercetin decreases cardiomyocyte hypertrophy through proteasome inhibition , which may be related to the inhibition of Akt and therefore increasing activation of GSK -3α/βin H9c2 cells.

OBJECTIVE To investigate the value of screening hospital urinary tract infection with UF-100 automated urine analyzer. METHODS It was to count the bacteria and white blood cells in 422 urine specimens with UF-100 as well as to culture the specimens quantitatively.Then the sensitivity and specificity of UF-100 counts and the correspondence of the two methods were evaluated with Yerushalmy mode. RESULTS Compared with the culture results,UF-100 showed a sensitivity of 81.5%,specificity of 63.9%,positive predictive value of 29.1%,negative predictive value of 95.0%,false positive rate of 30.5%,false negative rate of 2.8% and an accuracy of 67.2%. CONCLUSIONS The UF-100 is excellent in analyzing urine specimens,and its bacteria counts can be a valuable indicator in screening hospital urinary tract infection.

Aim To investigate the role of physiological concentration of glucocorticoids on the inflammation mediator IL-6 expression in response to LPS in rat alveolar epithelial cells(CCL149).Methods The CCL149 were treated with LPS,H2O2 and glucocorticoid respectively.Flammtory mediator IL-6 protein expression was measured with ELISA,and the activity of histone deacetylase(HDAC) was measured using colorimetric HDAC activity assay kit.Results IL-6 protein levels were increased in cells exposed to 10 mg?L-1 LPS.Hydrocortisone decreased IL-6 protein expression induced by LPS.Such effect of hydrocortisone was blunt by HDAC inhibitor trichostatinA treatment(10 ?g?L-1).LPS decreased HDAC activity.Hydrocortisone increased HDAC activity.The expression of IL-6 protein induced by LPS was further enhanced by H2O2 treatment.Pretreatment with H2O2 resulted in the inhibition of antiflammtion effect of glucocorticoids.Conclusion Physiological concentration of glucocorticoids could suppress inflammatory response,and this effects requires recruitment of HDAC.Oxidants such as H2O2 may cause the failure of glucocorticoids to function effectively,and the reason may be related to the reduction of HDAC activity.This mechanism may contribute to the pathogenesis of pulmonary disorder.