Objective To investigate the value of combined use of misoprostol and intravenous mixture of pethidine and droperidol during operative hysteroscopy. Methods A total of 168 cases scheduled for hysteroscopy were divided into 4 groups: Group Ⅰ (42 cases) was transvaginally given 0.4 mg misoprostol as monotherapy; Group Ⅱ (41 cases) was given 0.4 mg transvaginal misoprostol in combination with intravenous mixture of 50 mg pethidine and 2.5 mg droperidol; Group Ⅲ (43 cases) was given 0.4 mg transvaginal misoprostol combined with intravenous mixture of 100 mg pethidine and 5 mg droperidol; and Group Ⅳ (42 cases), intravenous mixture of 100 mg pethidine and 5 mg droperidol. The heart rate, breath rate, blood pressure, oxygen saturation, cervical responses, VAS scores and complications were assessed respectively. Results There were statistically significant differences regarding the degree of cervical dilatation, the operation time, and the used volume of cavity-distention media between the Group Ⅳ and the Group Ⅰ, Group Ⅱ, and Group Ⅲ, respectively (P0.05). Significant differences were observed in the analgetic effect in the 4 groups (?~2=86.325,P=0.000), among which the Group Ⅱ and Group Ⅲ were superior to the other two. All patients in the 4 groups represented a stable respiratory process and blood circulation, with no significant differences in the rate of adverse effects (?~2=1.649, P=0.648). Conclusions Transvaginal application of misoprostol offers a convincing effect for cervical dilatation. Combined use of misoprostol and mixture of 50 mg pethidine and 2.5 mg droperidol gives a satisfactory analgetic effect during operative hysteroscopy.

OBJECTIVE: Based on the overview of progress regarding seed cells and scaffolds for skin tissue engineering, to introduce the research of three dimensional nanofiber scaffolds prepared by electrospinning technique, and its application prospect in tissue engineered skin.DATA SOURCES: The databases of CNKI, Sciencedirect, and I.S.I were retrieved by the first author with key words of "tissue-engineering, skin, wound healing, seed cell, scaffold, electrospunning" in both Chinese and English from 1992 to 2009.DATA SELECTION: Major accomplishments of research on skin tissue engineering published in recent years.MAIN OUTCOME MEASURES: ①Papers related to treating skin destruction using tissue engineered materials. ②Articles correlative to seed cells and scaffold materials. ③Papers regarding electrospinning technique.RESULTS: The preparation of artificial skins is the research direction of tissue-engineered skin, in particular, studies regarding epidermal stem cells, bone marrow mesenchymal stem cells, hair follicle stem cells, and adipose-derived stem cells are attracted more attention. As tissue engineering, it is a key problems to prepare a scaffold to meet the needs of mechanical property,physical composition and biocompatibility. Scaffold materials comprise micrometer porous scaffold and nano-fiber scaffolds. The electrospinning technique is newly developed method for preparing nano-fiber scaffolds with the advantage of fast and convenience, and the scaffolds possess greater porosity, which not only benefit for the blood circulation and oxygen exchange,but also prevent the loss of water content and protein from wound surface.CONCLUSIONS: Tissue engineered skin is an important ingredient of regenerative medicine, seed cells and scaffold matrixes are two core problems that call for long term investigation. With the incessant development and integration among life sciences,nanotechnology and computer technology, marvelous progress has been achieved in the perspective of comprehending the interaction between seed cells, the mutual regulation mechanism and how the architecture and properties of scaffold materials affecting the regenerative procedures.

Objective To investigate the effects of interlukin-10 (IL-10) on lipopolysaccharide (LPS)-induced liver injury in rats.Methods One hundred male Wistar rats,aged 10-14 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =20 each):control group (C group),LPS group,IL-10 group,HO-1 inducer cobalt protoporphyrin-Ⅸ group (Co group) and HO-1 inhibitor zinc protoporphyrin-Ⅸ group (Zn group).The animals in LPS,IL-10,Co and Zn groups received intraperitoneal LPS 20 mg/kg.IL-10,Co and Zn groups received recombinant human IL-10 1 μg at 3 h before LPS injection.Co and Zn groups received cobalt protoporphyrin-Ⅸ and zinc protoporphyrin-Ⅸ 25 mg/kg at 2 h before administration of recombinant human IL-10.Ten rats in each group were chosen at 24 h after LPS injection and blood samples were collected from the heart for determination of the levels of serum alanine aminotransferase (ALT),aspartate transaminase (AST),tumor necrosis factor-α (TNF-α) and interlukin-1β (IL-1 β).The animals were then sacrificed and lungs removed for determination of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities,malonodialdehyde (MDA) content and expression of HO-1 mRNA in lung tissues.The left 10 rats in each group were chosen and the survival rates within 72 h after LPS administration were recorded.Results Compared with C group,the levels of serum ALT,AST,TNF-αand IL-1 β and MDA content in lung tissues were significantly increased,and GSH-Px and SOD activities in lung tissues and survival rates were decreased in LPS,IL-10,Co and Zn groups (P ＜ 0.05).Compared with LPS group,the levels of serum ALT,AST,TNF-α,IL-1β and MDA content in lung tissues were significantly decreased,GSH-Px and SOD activities in lung tissues and survival rates were increased,and the expression of HO-1 mRNA was up-regulated (P ＜ 0.05).Compared with IL-10 group,the levels of serum ALT,AST,TNF-α and IL-1β and MDA content in lung tissues were significantly increased,and GSH-Px and SOD activities in lung tissues and survival rates were decreased in group Zn (P ＜ 0.05),and no significant change in the parameters mentioned above was found in Co group (P ＞ 0.05).Conclusion IL-10 can attenuate LPS-induced liver injury in rats by inducing the expression of HO-1.

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Objective To synthesize antimicrobial bioceramic using chitosan and calcium phosphate cements mixed with ceftriaxone sodium. Methods The bioceramic was synthesized through the hardening of chitosan liquid combined with calcium phosphate cements and cefiriaxone sodium.The released ceftriaxone sodium was studied according to the linear equation between UV-VIS absorbance to concentration.The in vitro bactefiostatic effect of the chosen bioceramic was investigated via the microbiological method.The model of rats'contaminated bone defect were deployed to study the antimicrobial performance of the bioceramic. Results The best synthesis condition was chosen at:0.1g calcium phosphate cements and 10.4 mg ceftriaxone sodium combined with 2.4 ml hardening liquid C.then keeping the mixture at 60℃ and 100%humidity for 24 h.In vitro release of the resulting antimicrobial bioceramic remained stable,while that of ceftriaxone sodium lasted for a week,higher than the minimal inhibitory concentration(MIC) of Staphylococcus aureus.As proved by the WBC number and tissue sectioning,a lighter inflammatory response of treatment group was observed as compared with the control group. Conclusion The antimicrobial bioceramic combined with chitosan and ceftriaxone sodium shows promising antimicrobial performance.

OBJECTIVETo evaluate the protective effects of punicosides on alcohol induced acute liver injury in mice and its possible mechanisms as well.

METHODThe 60 mice were randomly divided into normal control, model group, three dose groups of punicosides with low, medium and high, then there is silibinin group. Three dose groups of punicosides and silibinin were given in advance by gavage for 4 weeks, then the mouse model of alcoholic acute liver injury was established. The serum levels of ALT, AST and TG were determined, and the mice were killed to calculate somatic index of liver, thymus as well as spleen. MDA, SOD, GSH-Px and GSH-ST were detected in the liver homogenate. Histopathological changes of the liver were observed by HE staining. The expression of MCP-1 and NF-kappaB in the liver tissues were detected by immunohistochemistry.

RESULTMid and high dose of punicosides reduced the liver index in mice significantly, improved liver steatosis, decreased the level of ALT, AST and TG in serum and the content of MDA in liver homogenate, furthermore the two dose groups increased the activity of SOD, GSH-Px and GSH-ST, inhibited the expression of MCP-1 and NF-kappaB in liver tissue.

CONCLUSIONPunicosides can protect the acute liver damage induced by alcohol.

Alcohols ; adverse effects ; Animals ; Chemical and Drug Induced Liver Injury ; blood ; drug therapy ; metabolism ; pathology ; Chemokine CCL2 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Gene Expression Regulation ; drug effects ; Liver ; drug effects ; enzymology ; pathology ; Male ; Malondialdehyde ; metabolism ; Mice ; NF-kappa B ; metabolism

Background Macular hole in high myopia has been paid tremendous attention in clinical research due to its high recurrence rate and unpredictable prognosis.Spectral domain optical coherence tomography (SD-OCT) is considered to be of a good evaluating value for macular hole,yet its application is compromised in patient with high myopia.High myopia might lead to retinal detachment which consequently prevents an accurate OCT.Therefore,it is important to assess the effectiveness of OCT on prognosis in these patients after surgical restoration of the detached retina.Objective The aim of this study was to evaluate the risk of reopening of a macular hole in highly myopic patient after removing silicone oil by SD-OCT.Methods A case-observational study was designed.Twenty-five highly myopic patients with monocular macular holes who underwent vitrectomy combined with internal limiting membrane peeling and silicone oil tamponade were included in this study.Four patients were male and 21 patients were female,with the average age (61.4±9.0) years old and diopter (-14.14 ±6.86)D.Regular ocular examination,axial length measurement,fundus photography and OCT were performed at the day before removing silicone oil and every month till the 6 months after operation.Retinal thickness,macular height index (MHI) and choroidal thickness were measured by OCT.Written informed consent was obtained from each patient.Results All 25 patients finished the follow-up of 6 months.Macular holes remained closure 6 months after operation in 19 patients (76％) and reopened in 6 patients macular holes were in 1-5 months (24％),with a mean time at (3.3± 1.4) months.The average foveal retinal thickness,MHI and the choroidal thickness at the middle of the macular hole were (216.5±95.6) μm,0.30 ± 0.09 and (122.9 ± 20.5) μm in the closed group,respectively,and those in the unclosed group were (113.5±28.7) μm,0.58±0.27 and (96.8±22.9) μm,with significant differences between the two groups (t=2.577,-4.143,2.669,P ＜ 0.05).The percentage of macular hole closure was 85.7％ in the MHI＜0.5 group and 25.0％ in the MHI ≥ 0.5 group,showing a significant difference (P =0.031).The base diameter in the unclosed hole group was significantly larger than that in the closed hole group (1070.2±393.6 μm versus 533.3±277.7 μm) (t =-3.700,P =0.001).Conclusions The measurements of the retinal thickness,MHI and the choroidal thickness at the central area of the macular hole are helpful for the evaluation of reopening risk of macular hole after removing silicone oil.

Objective To investigate the changes of lead,zinc,copper,iron and calcium in blood of chronic poisoned infantal mice.(Methods) Forty-eight 21 day-old kunzea mice were randomly divided into 4 groups,each having 12 mice.Distilled water group was as control group and other three lead acetate poisoning groups had a dose of 10,20,40 mg/kg,respectively.The poisoning was carried out by lavage once a day,and consecutively for 46 days.Eyeballs of mice were picked then for blood sampling,and BS trace element analysis grapher was used to determine level of lead,zinc,copper and iron.Level of calcium was measured by Dimentional-RXL auto-biochemistry analysis meter.Results The lead and zinc levels in poisoned mice blood were increased with increasing lead acetate level administration,while zinc level changed inversely with lead acetate level.Significant differences were shown among control group and poisoning groups in terms of lead(P0.05).Conclusion Lead posioning can lead to zinc decreasing and copper(increa)-sing,which suggests that zinc works as a poential antidote of lead poisoning.

Objective·To prepare chitosan-gelatin porous microspheres by high voltage electrostatic method combined with freeze-drying and ionic cross-linking method and investigate the factors that influence the formation of porous medium.Methods·Porous chitosan microspheres and chitosangelatin porous microspheres were prepared using high voltage electrostatic method combined with freeze-drying and ionic cross-linking method,with sodium tripolyphosphate (STPP) as crosslinking agent.Factors that affect the porous structure and pore size of porous microspheres were compared,such as different chitosan-gelatin ratio,freezing temperature,curing time with saturated STPP in 85％ ethanol solution.The morphology,surface and internal structure,particle size of the porous chitosan microspheres and chitosan-gelatin porous microspheres were observe by using light microscope,scanning electron microscope and hematoxylin-eosin staining.Results·Microspheres prepared by freeze-drying with an electrostatic and ionic cross-linking method have open,interconnected and highly macroporous,with good spherical surface.Saturated STPP ethanol solution (85％ ethanol) was chosen as the crosslinking agent to prevent destruction of the porous structure.The order of freeze and crosslinking,cross-linking time and the second freezing temperature,can influence the pore size of porous microspheres.Gelatin and chitosan can form polyelectrolyte complexes,and can also be used as porogen in porous structure.Conclusion·The preparation of porous chitosan-gelatin microspheres via this method has a large pore size (diameter 100-200 μm),suitable for cell growth and the migration.

The holding of the national college students' clinical skills competition reflects the importance of medical education for clinical practice training . Although through intensive itemized skills drills, the competitors can complete each individual operation with satisfaction, due to the lack of clinical experience, in the integrated circuit training, they will easily stray into question stemtrap. The concrete analysis of the national college students' clinical skills contest competition reflects the medical students' insufficient recognition of clinical skills, lack of the overall concept of the intensive medical treatment, not flexible and insufficient mastery of the connotation of the clinical skills, which seriously restricts the improvement of clinical education. Therefore this article raises special sugges-tions, referring to training focusing on “Airway and Circulation”, developing the critical care thinking based on the relationship of multi-organ and improving the first-aid capability of the team work, so as to provide reference for the improvement of training effect.