Objective To find out an optimal anesthesia and the d osage used in painless gastroscopy, and to evaluate its efficiency. Meth ods 200 patients undergoing painless gastroscopy were divided into 4 gr oups randomly. 2?g/kg iv of propofol was used in group Ⅰ, fentani 1?g/kg + pr opofol 2?g/kg in group Ⅱ, rimifentani 0.5?g/kg + propofol 1.5?g/kg in grou p Ⅲ, and rimifentani 0.75?g/kg + propofol 0.75?g/kg in group Ⅳ. Observed o bjects induced starting time and depth of anaesthesia, HR, R and SpO2 during o peration, side effects such as cough reflex and larynx spasm, time of regaining consciousness, postoperative side effects such as nausea and vomiting. R esult Significant differences (P≤0.01) were found between group Ⅳand the other 3 groups in starting time and depth of anaesthesia, side effects , time of regaining consciousness and suppression of respiration during operatio n. Conclusion Combined rimifentani 0.75?g/kg + propofol 0.75 ?g/kg are optimal anestheties in painless gastroscopy if side effects are preve nted.

Objective To prepare the PLGA nanoparticles( NPs) loading tetrandrine, investigate in vitro drug release behavior. Methods Tetrandrine loaded PLGA NPs were prepared by the emulsion solvent diffusion method and the preparation process was optimized by changing the stabilizer concentration and emulsion energy. The drug loading and entrapment efficiency were studied to evaluate the drug-loading property.The influence of particles size and pH value of release media on drug release behavior was investigated. Results Nanoparticles in the mean size of(203.4±2.8)nm had spherical shape and showed negative surface charge.Drug loading and entrapment efficiency was(2.17±0.10)% and(67.88±4.27)%, respectively.Tet-PLGA NPs retarded drug release in vitro, the cumulative release percentage was increased with the particle size increasing and it in acidic release medium showed a higher drug release amount. Conclusion Tetrandrine loaded PLGA nanoparticles have good entrapment efficiency, uniform particle size and can retard drug release in vitro.

Aim To study the effect of novel AChE inhibitors, 2-phenoxy-indan-1-one derivatives (YKY-1~7), against glutamatic acid-induced neurotoxicity in PC12 cells and on learning & memory impairment in dementia model mice induced by A?25~35 icv Methods The PC12 cells were preincubated with different concentrations of YKY-1~7 for 24 h and subsequently treated by glutamatic acid, at the high concentration of 2 mmol?L-1 for 15 min to induce cytotoxicity. The cell viability was assessed with MTT method.. Dementia model mice were made by intracerebroventricular injection (icv) of aggregated A?25~35. From the next day, the model mice were administered YKY-7 (2.5, 5, 10 mg?kg-1, ig) for 10 consecutive days and sham control mice or A? model control mice received daily ig saline. After the final treatment, the passive avoidance learning was tested, regional cerebral blood flow at cerebral cortex was assessed, and the activity of AChE in the cerebral cortex, hippocampus and blood serum were determined. Results Six out of the seven YKY compounds appeared to be effective against glutamatic acid-induced neurotoxicity in PC12 cells, with YKY-7 demonstrating the most activity. YKY-7 significantly ameliorated the learning and memory ability in dementia model mice induced by A?25-35 icv, slightly and selectively inhibited the cortical and hippocampal AChE, and gently increased the blood flow at cerebral cortex. Conclusion Some of 2-phenoxy-indan-1-one derivatives reported here have protective effects against glutamatic acid induced neurotoxicity in PC12 cells, and improve the learning and memory impairment induced by A?25-35, which may be partly attributable to its selective inhibition of AChE activity in the cerebral cortex and hippocampus.

Objective To investigate the possible existence of HBoV in children with acute respiratory infections in Nanjing area and explore its relationship with clinical characteristics.Methods A total of 397 nasopharyngeal secretion samples were collected from children with acute respiratory infection,admitted from July 2009 to June 2010 in Nanjing Children'S Hospital affiliated to Nanjing Medical University,and 50 cases of children without symptoms of respiratory infection were recruited as control group,whose nasopharyngeal secretion samples were also collected.HBoV was determined by real-time fluorescence quantitative PCR.MP and CT were detected by real-time fluorescence quantitative PCR in those HBoV-positive samples.RSV,ADV,IVA,IVB,PIV-1,PIV-2,PIV-3 and hMPV were detected by direct antigen-specific immunofluorescence assays.HBoV NP-1 fragments were amplified and sequenced in 5 HBoV positive samples randomly selected.The results were compared with the known GenBank sequence,and thereby the phylogenetic tree was established.The epidemiological characteristics,clinical presentation and the final clinical diagnosis of HBoV were analyzed according to the clinical data of the HBoV-positive patients.Results Thirty-three HBoV-positive cases were detected by real-time fluorescence quantitative PCR method with a positivity rate of 8. 3% ( 33/397 ). Among the 33 HBoV-positive cases, 19 cases (57.6%) were multiple infections with HBoV and other pathogens, the top three of which were MP (27.3% ,9/33 ),RSV (24.2% , 8/33 ) and PIV-3 ( 12. 1% ,4/33 ). Affected children aged from 7 to 36 months old accounted for 75.8% of the total ( 25/33 ). The measured HBoV NP-1 gene sequences of 5 specimens were consistent,indicating a high homology (99% to 100% ) with the stl, st2 and WHL-1. Conclusions HBoV is one of the pathogens of children's acute respiratory infections in Nanjing. HBoV NP-1 gene is highly conserved,with little variation in different seasons and in different regions and therefore can be used as a marker for real-time fluorescence quantitative PCR and other methods.

Objective To investigate a safe and effective method of lengthening the short nose.Methods Thirty-nine cases of short nose were corrected by the bilateral septal spreader graft and columellar strut using autologous cartilage,combined with expanded polytetrafluoroethylene (e-PTFE)to reconstruct the supporting structures to improve the forward and upward strength of the nasal tip in order to increase the nasal length and to correct the over rotation of nasal tip.The shield and cap grafts were also used for the patients whose nasal tip were too low with vertical dome division technique.Results All the patients showed preserved nasal length after surgery with well-proportioned nasal features and the nasal lip angles were normal.There was no evidence of postoperative nasal shortening.No operative or postoperative complications were observed by follow-up for 6 months to 1 year,except for 2 cases with graft cartilage being apparent on nasal tip.All the patients were satisfied with the surgical results achieved.Conclusions It is necessary to provide powerful forward and upward strength to lengthen nose and correct the over rotation of nasal tip effectively and safely.The application of bilateral septal spreader graft and columellar strut using autologous cartilage and combined with e-PTFE represents a valuable tool for the short nose and proper cartilage grafts of nasal tip can improve the height of the nasal tip and further correct the over rotation of the nasal tip.

Traditional Chinese medicine ( TCM ) is an important part of traditional Chinese culture . As the car-rier of TCM culture , TCM hospital should continuously strengthen its culture construction . This is conducive to develop TCM advantages , to consolidate the development direction of TCM , to embody basic features of TCM hospital , to improve the core competitive power , to meet needs of the masses of TCM services . Therefore , fur-ther promoting the cultural construction of TCM hospital is worth thinking and practicing deeply . This article discussed the connotation and function of hospital culture , elaborated measures and effects by demonstrating the process of hospital cultural construction , and put forward ideas for the reform and innovation of hospital cultur-al construction .

Objective To investigate the clinical characteristics and treatment of acute postrenal acute renal dysfunction associated with ceftriaxone.Methods Twenty-five cases of the ceftriaxione-associated acute postrenal renal insufficiency were reviewed.There were 16 males and 9 females,mean age 28years.The serum contents of BUN and Cr were ( 18.6 ± 7.0) mmol/L and (635.5 ± 248.7 ) μmol/L,respectively.All patients were divided into two groups depending on the therapy:11 patients accepted the drug therapy (alkalinization of the urine,antispasmodic,etc) and 14 patients accepted the intraureteral cannula.The clinical characteristics and the treatment effect were compared between the 2 groups.Results The patients of the intraureteral cannula group ( 1.4 ± O.7 d) went to hospital earlier than the drug therapy group (3.0 ± 1.4 d) ( P =0.045 ) after the symptom of oliguria or anuria appeared.There were no significant differences in serum creatinine,urea nitrogen,and the age between the 2 groups ( P ＞ 0.05 ).All the patients were cured after treatment.There were no significant differences in recovery time (2.9 ± 1.1 d and 3.2 ± 1.2 d,P =0.963) and hospitalization time (7.0 ±2.3 d and 5.9 +3.9 d,P =0.568) between the 2 groups.Conclusions The acute renal failure associated with ceftriaxone should have high attention.The prompt medical attention,including the intraureteral eannula and the drug therapy,can both achieve the satisfying curative effect.

Objective To evaluate the value of the clinical application of piezosurgery-assisted sliding genioplasty.Methods A total of 9 patients (7 women,2 man,aged 19-40 years) with microgenia were performed operation by intraoral V incision with subperiosteal exposure of the mandibular mentum area.Note relaxtion and preservation of the mental nerves.A horizontal osteotomy of cortical bone on anterior mandible was underwent by the conventional electric bone saw and internal plate bone was sectioned with the piezoelectric device.The segment was divided with preservation of the lingual soft tissue attachment and was advanced in the mandibular mentum area.These was fixed in the reposition by titanium plate and screw for preventing displacement.Results The piezoelectric device produced selective sectioning of the mineralized bone structures,bone was cut precisely without damage to vital anatomic structures and dental pulp,and was much easier to control and less aggressive,creating only minimal damage to soft tissues.The operative effects were satisfactory during 3- 6 months of follow-up.Stable chin contours were created and became nature.Iatrogenic problems with bleeding,in fection,mental nerve injury had been avoided.Conclusions Piezosurgery is a safe and precise technique to reduce the complication rate and to improve the treatment outcomes of genioplasties.

Objective To measure the levels of caspase-1 and its downstream factor interleukin (IL)-18 and IL-33 in rheumatoid arthritis (RA) and explore their possible mechanisms.Methods Blood samples were drown from 56 patients with RA and 22 healthy subjects.Serum levels of caspase-1,IL-18 and IL-33were tested by the method of enzyme linked immunosorbent assay (ELISA).Kruskal-Walls and Mann-Whitney test were used to compare the levels of caspase-1,[L-18 and IL-33 and Spearman's correlation test was used for correlation analysis.Results The level of caspase-1 was significantly increased in RA group compared to healthy group [(32±26) ng/ml vs (15±6) ng/ml,P＜0.01].Meanwhile,the active disease groups showed a higher level than the remission group,and level in the untreated group was higher than the treated group [(47±27) ng/ml vs (25±22) ng/ml,P＜0.01].The levels of IL-18 and IL-33 were significantly increased in RA group compared to healthy group [(121±121) ng/L vs (58±33) ng/L,(1032±1011) ng/L vs (510±231)ng/L,respectively,P＜0.05].Meanwhile,the active disease groups had a higher level than the remission group and the untreated group had higher levels than the treated group [IL-18 and IL-33 were (172±139) ng/L vs (97±106) ng/L,(1469±1039) ng/L vs (825±941) ng/L,respectively,P＜0.05].Caspase-1 was correlated withIL-18 and IL-33 (r=0.824,0.854,P＜0.01) and IL-18 was correlated with IL-33 (r=0.800,P＜0.01).But neither of the three factors was related with clinical indexes including disease duration,RF,anti-CCP antibody,tender joints count and swollen joints count.Conclusion Caspase-1 and its downstream factor IL-18,IL-33 increase in RA,and they may play important roles in RA.

Objective To investigate the characteristics of click -auditory brainstem response (ABR) in nor-mal infants of 1 to 6 months old ,and to establish the normative values for latencies of Wave I ,III ,V and interpeak latencies of I- Ⅲ ,III-V and I-V for younger infants .Methods Click auditory brainstem responses were recorded from infants within 6 months :166 infants of 1 -months old(269 ears) ,141 2 -month old (226 ears) ,111 3 -months old(177 ears) ,58 4-months old(96 ears) ,78 5-months old(121 ears) and 45 6-months old(76 ears) .We compared the latencies of wave I ,III ,V and interpeak latencies of I - Ⅲ ,III-V ,I-V obtained from infants of differ-ent ages at different stimulus intensities .Results The average threshold of 1 to 6 months infants was 16 .18 ± 5 .35 dB nHL ,the average latency of Wave V was 9 .03 ± 0 .49 ms .The differences among the thresholds were statistical-ly insignificant(P>0 .05) .Wave I ,III and V were noticeable in all ears tested at 80 dB nHL .Wave I disappeared first as the stimulus intensity decreased ,and the latencies of Wave I ,III and V prolonged;on the contrary ,interpeak latencies of I -III ,III-V ,I-V shortened significantly .At the same stimulus intensity ,the latencies of Wave III , V and the interpeak latencies of I - Ⅲ ,III-V ,I-V shortened significantly except for Wave I .When comparing the differences among the testing parameters as a function of each month ,we found that there were statistically signifi-cant differences for the latencies of wave III ,V and the interpeak latencies of I -III ,III-V ,I-V before the 4 months old(P<0 .05) ,and there were no significant differences after 4 months old(P>0 .05) .Conclusion It is recommen-ded that 16 .18 ± 5 .35 dB nHL be used as the normative references for the evoked threshold of click auditory brain-stem responses for 1~6 month old infants .The development of central nervous system below the inferior calicles is fast before the 4 months old .