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

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.

Objective To study the role of hydrogen sulfide (H2S) in the effect of SB203580 on proliferation and apoptosis of hepatic stellate cells and the effects of H2S on expressions of collagenⅠand collagenⅢmRNA in hepatic stel-late cells. Methods There were five groups of HSC-T6 cells in this study including control group (DMEM medium contain-ing10%fetal bovine serum), dimethyl sulfoxide (DMSO) group, sodium hydrosulfide (NaHS)group,SB203580 (SB)group and SB+NaHS group. MTT method was used to detect the cell proliferation and inhibition rate of HSC-T6 cells treated by SB203580 and H2S. The apoptotic rate of HSC-T6 cells was detected by flow cytometry with annexin V-FITC/PI double staining. RT-PCR was used to detect the expressions of collagenⅠand collagenⅢmRNA in HSC-T6. Results The apop-totic rate of HSC-T6 cells was significantly higher in SB group and SB+NaHS group than that of control group, and the rate was significantly higher in SB+NaHS group than that of SB group (P＜0.05). There was no significant difference in the apop-totic rate of HSC-T6 cells between DMSO and NaHS groups than that of control group. The expressions of collagenⅠand col-lagenⅢmRNA were found in five groups of cells. There was a higher expression of collagenⅠand collagenⅢmRNA in NaHS group than that of control group (P＜0.05). The expressions of collagenⅠand collagenⅢmRNA were significantly lower in SB group and SB+NaHS group than those of control group and NaHS group (P＜0.05). Conclusion H2S activated P38MAPK signal pathway. And P38MAPK was specifically blocked by SB203580 in HSC-T6 cells, which inhibited the cell proliferation stimulated by H2S and promoted the apoptosis.

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.

Objective To clarify the role of the virtual reality (VR)in the training of trans-femoral cerebral angiography for novices without any experience of intravascular manipulation. Methods Twenty-four novices without experiences of intravascular manipulation were divided into 2 groups (VR group or control group)with random pair method concerning the age,gender and subjects. The par-ticipants in control group were trained in routine manners while those in VR group practiced on a simulator and subsequently participated in real angiography once as assistants. Real angiography tests were performed for all participants after the training session and additional angiography tests were per-formed for VR group just after the stimulation session on the simulator. Real angiography tests were supervised and scored according to a modified rating scale by neuroradiological experts who were blinded to the novices' training procedures. Difference between the real test performance of the two groups were compared by pared-samples t test,while the correlation between the performance of the real tests and simulator tests of VR group was proved by Pearson correlation analysis. P<0.05 was con-sidered statistically significant. Results The mean scores of VR group were (27.6±3.6)and (26.4± 3.8)in the tests on simulator and real angiography tests respectively,while score of control group was (21.2±3.4)in the real angiography tests. A positive correlation was revealed in VR group between performance on the simulator and that on real patients (r=0.825,P=0.001). Real performance of the VR group was significantly better than that of control group (P=0.010). Conclusions Virtual reality could ensure transfer of acquired endovascular skills from simulators to patients so as to become a valid tool for novices to improve the interventional techniques in tranfemoral cerebral angiography.