Objective To investigate the effect of parental presence on the anxiety of children during induction of anesthesia with sevoflurane. Methods One hundred and twenty children (ASA Ⅰ or Ⅱ ) aged 2-12 yr weighing 12-32 kg were assigned to one of 2 groups using a random number table ( n = 60 each): control group (group C) and parental presence group (group P). Preoperatiave visit was made the day before surgery in both groups. In group P a parent played with toys with the children for 15 min before induction of anesthesia, while in group C a nurse played with them. Anesthesia was induced with 8% sevoflurane in O2 delivered at 6 L/min through a scented face mask held by the parent or anesthesiologist talking with them in soft words. Modified Yale preoperative anxiety scale (mYPAS) was used to measure anxiety of the children during preoperative visit, before and during induction of anesthesia. Induction compliance checklist (ICC) was used to measure behavioral compliance during induction. ICC score ＞ 5 implied failure of induction of anesthesia with sevoflurane. Adverse events were recorded. Results The mYPAS scores were significantly lower before and during induction of anesthesia in group P than in group C (P ＜ 0.05), but there was no significant difference in ICC scores between the 2 groups ( P ＞0.05). There was no failure of induction in group P while in group C there were 3 failures. Cough occurred in 2 patients in group P but in 3 patients in group C. One patient vomited during induction of anesthesia in group C.Conclusion Parental presence is effective in reducing anxiety of children during induction of anesthesia.

Sustained release drug delivery from microparticles is an excellent alternative for daily protein/peptide drug administration protocol. Poly(lactic acid) (PLA) and poly(lactic-co-glycolic acid) (PLGA) are the most commonly used polymer carriers in the development of protein/peptide microspheres. Basically there are three preparation methods for PLA/PLGA microspheres: the solvent extraction/evaporation based multiple emulsion (W/O/W emulsion) method, the phase separation method and the spray drying method. The stability of the protein/pipetide loaded, encapsulation efficiency, and the burst effect of the microspheres are key problems usually met in the preparation of microspheres. In this review the preparation techniques and progress in the development of protein/pipetide microspheres which aimed to stabilize protein/peptide structural integrity, keep the bioactivity of drugs, increase the encapsulation efficiency and improve the release profile were summarized and evaluated.

Objective To study current situation of creativity among medical students and its influential factors, and to explore structural equation model about influential factors of creativity. Methods The sample was randomly chosen by using cluster-based sampling method, 413 students in medical university were tested by Williams creativity scale and the influential factors of creativity questionnaire. Results Among the medical student's creativity characters, the most extrusive character was challenge(2.35±0.26), the more important were curiosity(2.29±0.28) and risk-taking(2.21±0.27), and imagination(2.04±0.33) was less important. The structural equation model of influential factors of creativity implied that mental health was the most important factor about improving medical student creativity and by changing study style could promote creativity of medical students. Conclusion By establishing structural equation model, we not only study the influential factors of creativity in realistic view, but also master important extent of each influential factors theoretically.

Objective　To explore the mechanism of effects o f endotoxin (LPS) on apoptosis of pancreatic islet cells in rat.Metho ds　After the model of endotoxemia was established in rat with intrap eritoneal injection of LPS (2mg/kg),the changes of nitric oxide (NO) level in se rum and pancreas were dynamically determined.The expression of inducible nitric oxide synthase (iNOS) was also observed by situ hybridization in the islet,Moreo ver,DNA damage in islet cells by the external donor of NO (sodium nitroprussid e) and LPS in vitro with single cell gel electrophoresis and agarose gel electro phresis of DNA were also evaluated.Results　NO level in se rum was significantly increased at the 6th,and persisted to the 3rd day after in jection of LPS,the NO in pancreas was also elevated,but recovered to the normal at 24h. The expression of iNOS in pancreatic islet also began to enhance at the 6th and significantly enhanced at the 12th after endotoxemia.In vitro experiment sho wed that exogenous NO markedly caused the damage of DNA in islet cells,but LPS d i d not exert the same effects.Conclusion　The mechanism of the effcts of endotoxin on apoptosis of islet cells might stimulate the expressi on of iNOS in inflammatory or non-inflammatory cells that generates the NO indu cing the DNA damage of islet cells.

Objective: To observe the liver function changes and to analyze the risk factors in patients at peri-operative period of cardiopulmonary bypass surgery.
Methods: A total of 108 patients with cardiopulmonary bypass surgery were observed for their liver function at prior and 1, 2, 3, 6 days post-operation, the related risk factors for lever damage were studied by uni- and multivariate regression analysis.
Results: Compared with pre-operative indexes,① at 1, 2, 3 and 6 days post-operation, aspartate aminotransferase (AST), direct bilirubin (DBIL) were increased, serum albumin (ALB), cholinesterase (CHE) were decreased, and at 1, 2, 3 days post-operation, total bilirubin (TBIL) was increased, at 1, 2, 3 days post-operation, alkaline phosphatase (ALP) was decreased, while it increased at 6 days post-operation, allP<0.05;② glutamyl endopeptidase (GGT) was decreased at 1, 2 days post-operation, while it increased at 6 days post-operation,P<0.05;③glutamate pyruvate transaminase (GPT) was increased at 6 days after operation,P<0.05. Univariate regression analysis indicated that cardiothoracic ratio ≥ 0.56 (P<0.05, OR=2.900, 95% CI: 1.206~6.976), cardiopulmonary bypass time (P<0.05, OR=1.042, 95%CI: 1.017~1.068), aortic clamping time (P<0.05, OR=1.041, 95% CI: 1.012~1.070) and lactic acid level at 1 day after operation (P<0.05, OR=1.518, 95% CI: 1.182-1.948) were related to post-operative damage of liver function. Multivariate regression analysis presented that cardiopulmonary bypass time (P<0.05, OR=1.033, 95% CI: 1.007-1.059) and lactic acid level at 1 day after operation (P<0.05, OR=1.340, 95% CI: 1.028-1.745) were the independent risk factors for post-operative damage of liver function.
Conclusion: Multiterm of liver function could be damaged at the early stage after cardiopulmonary bypass surgery; cardiopulmonary bypass time and lactic acid level at 1 day after operation were the independent risk factors for peri-operative damage of liver function in relevant patients.

Objective To observe the clinical effect of nitroprusside,dopamine and dobutamine for treatment of refractory heart failure. Methods 60 patients with refractory heart failure were randomly divided into control group and treatment group. Clinical symptoms, signs, echocardiography and other changes were observed. Results The total effective rate was 86.67% ,control group was 66.67% ,the total effective between the two groups was statistically significant(P ＜ 0.05). After treatment, left ventricular ejection fraction (LVEF) improved significantly compared with the control group, the difference was statistically significant(P ＜ 0.05). Conclusion The Sodium nitroprusside, dopamine and dobutamine for treatment of refractory heart failure was safe and effective method.

Objective To analyze the actions of transforming growth factor ? 1 (TGF-? 1) and tumor necrosis factor ?(TNF-?) in the liver fibrosis formation in chronic viral hepatitis patients and liver cirrhosis patients.Methods Serum levels of TGF-? 1 and TNF-? were measured by ELISA in 107 patients with chronic liver diseases,liver biopsy was performed in 23 patients in order to identify pathological stages under optic microscope.Results The serum levels of TGF-? 1(?g/L) in mild,middle and severe groups of chronic viral hepatitis and liver cirrhosis group were 14 2?5 9,20 1?7 0,30 2?6 7 and 32 6?7 5 respectively.The serum levels of TNF-? (pg/L) were 6 1?3 2,29 8?18 6,57 3?22 5 and 96 7?38 2 respectively.The serum levels of above two markers increased with hepatitis progression.The results of liver biopsy revealed that the changes in these two markers were related to liver cirrhosis degree.Conclusions TGF-? 1 and TNF-? are related to liver cirrhosis formation.

Acupuncture Therapy ; Adult ; Aged ; Fasciitis ; therapy ; Female ; Humans ; Male ; Middle Aged

Objective To investigate the effects of Zafirlukast on emotions and Th1/Th2 cytokines in asthmatic children.Methods One hundred and eight asthmatic children were randomly allocated to 3 groups.The children in group A inhaled Pulmicort aerosol 200 ?g twice every day.On the basis of inhaled Pulmicort aerosol,the children in group B took orally Zafirlukast orally 10 mg once every day.The children in group C only took orally Zafirlukast 10 mg once every day.The course of treatment of all children were 4 weeks.Anxiety,depression status and the levels of IFN-? and IL-4 in blood serum were respectively detected before and after treatment.Results Scores of anxiety and depression after treatment in 3 groups were significantly lower than those before treatment(Pa0.05).Conclusions Zafirlukast or Glucocorticoid inhalation has the same effect on improving emotional status and accommodating disequilibrium of Th1/Th2 for asthmatic children,but effect of Zafirlukast combined with Glucocorticoid inhalation are better.