Objective The questionaires of the ONFH aegers who were hospitalized in Kanggu hospital,during 2005-2008 ,were collect-ed to evaluate the therapeutic effects of acupotomy by proper statistical methods. Methods Four indexes according to the criteria of Therapeutic effect of adult ONFH recovery and reconstruction (ZHAO Dewei, 1996) were measured to evaluate the effect of the treatment. Results Monofac-torial analysis showed that the treatrnent was effective,but some phenomena could not be correctly explined in specialized field. This problem was re-solved appropriately by structural equation model(SEM). Conclusion By the method of SEM, the confounding factors could be better controlled and the evaluation was more reliable.

Objective To investigate the expression of pro-inflammatory cytokines in lumbar dorsal root ganglions (DRG) of rats model of high-dose fentanyl induced hyperalgesia. Methods 64 male SD rats were divided into 2 groups (n = 32), fentanyl group and normal saline (NS) group. The rats were injected with fentanyl (60 μg/kg) or NS 4 times in total subcutaneously with a 15-minute interval. Mechanical and thermal nociception were measured via the tail pressure test (tail flick thresholds, TFT) and paw withdrawal test (paw withdrawal latency, PWL) at 1 day before, at 1, 2, 3 and 4 hour and on 1 ~ 7 day after administration. 4 rats were sacrificed and the lumbar DRG were harvested to analyze the expression of PGE2 , IL-1β, IL-6 and TNF-αvia ELISA. Results There were no significant changes of TFT, PWL and the expression of pro-inflammatory cytokines in DRG compared to baseline of rats in NS group. The value of TFT , PWL in fentanyl group were above the baseline at the 1 ~ 4 hour and below the baseline at 1~3 day after fentanyl injections. PGE2 , IL-1β, TNF-α and IL-6 increased on 1,3,5,7 day after fentanyl injections significantly. Conclusions High-dose fentanyl induced significant hyperalgesia and up-regulation of pro-inflammatory cytokines in DRG. The expression pro-inflammatory cytokines peaked later and were more protracted than the change of behavior test and show no direct relationship between the two.

ObjectiveTo investigate the effect of glucose and insulin on the synthesis and secretion of adrenomedullin (ADM) by rat aortas in vitro.MethodsThe rat aortas were cut into pieces and divided into several equal groups. All the groups were incubated in K-H buffers including different levels of glucose,insulin and insulin+glucose for 3 hours,the group incubated in K-H buffer without glucose was used as control. To determine ADM in K-H buffers and tissues using RIA method.ResultsADM levels in insulin groups (100.0 μIU/ml,200.0 μIU/ml) and insulin+glucose groups were higher than that in control (P<0.05),the ADM levels in glucose groups and low level insulin group (20.0 μIU/ml) were not significantly difference compared with the control. ConclusionHigh levels of insulin can stimulate the synthesis and secretion of ADM.

Group A,the differences among the three groups were statistically significant(P0.05). TCR,CCR,DAP,OD,BRC in Groups B and C showed trends of increasing,the differences in terms of the contents of BMP-RⅠamong the 3 phases were statistically significant(P0.05);the ER in Group B and C showed a trend of decreasing,thee difference between 4- and 8-week and 4- and 12-week were signifieantly dif- ferent(P0.05).Conclusion After application of glucocorticoid for a short term,pathological changes maintained and showed trends of inereasing in early stage.HBO can reverse these changes.The outcome of 3-course HBO therapy is better than that of 1-course therapy.

Objective To search for the changes of T cells subpopulations and immunoglobulin and their relation-ship in children patients with simple nephrotic syndrome. Design Case-control research. Patients aud Participants 39 patients with simple nephrotic syndrome were divided into two groups:the incipient group and relapse group (6 cases were determined at the incipient and relapse time) .Thereare 28 patients in incipient group, 19 males and 9 females, at the age of 2 to 10 years old. There are20 patients in relapse group, 12 males and 8 females, at the age of 3 to 13 years old. There are 35health children in control group, 21 males and 14 females, 2～13 years old. Interventions T cells subpopulations were determined by indirect immunofluorescence of OKT linesmonoclonal antibodies. The serum IgG was determined by routine simple agar immunodiffusion tests. Results and Conclusions The CD_3~+ and CD_4~+ cells are of no change in the children patients withsimple nephrotic syndrome, and the CD_8~+ and CD_(10)~+ cells are obviously increased, the Values of CD_4~+/CD_8~+ are obviously lower than those in the control qroup, there are no difference between the incipientand relapse groups. The levels of serum IgG were decreased in the 85.3% children patients, IgM were inc-reased in 29.4% of that. The values of CD_4~+/CD_8~+ have positive correlation and negative correlationwith the levels of serum IgG and IgM respectively.

Objective To evaluate the effects of unilastatin on brain injury in children undergoing aortic arch surgery under cardiopulmonary bypass (CPB).Methods Twenty ASA physical status Ⅲ or Ⅳ children of both sexes,aged 1-24 months,weighing 3-12 kg,undergoing repair of coarctation of aorta or interrupted aortic arch complicated with intracardiac malformations under CPB,were randomly divided into 2 groups (n =10 each):control group (group C) and ulinastatin group (group U).Ulinastatin 20 000 U/kg was diluted into 10 000 U/ml with normal saline and it was then injected intravenously in 3 parts (1/3 was injected via the internal jugular vein after induction of anesthesia; 1/3 at the beginning of CPB and 1/3 at 5 min before aortic unclamping).In group C the equal volume of normal saline was given instead of ulinastatin.Blood samples were taken from the radial artery after induction of anesthesia (T1),at 10 min after aortic clamping (T2),at 10 min after aortic unclamping (T3),at the end of CPB (T4),and at 6 and 24 h after termination of CPB (T5,T6) for determination of plasma S100B protein and neuron-specific enolase (NSE) concentrations.Results There was no significant difference in plasma levels of S100B protein and NSE at T1 between the two groups (P ＞ 0.05).Plasma S100B protein and NSE levels were significantly increased at T2-5 as compared to the baseline values at T1 in both groups (P ＜ 0.05).Plasma S100B protein and NSE levels were significantly lower at T2-5 in group U than in group C (P ＜ 0.05).Conclusion Ulinastatin can attenuate brain injury in children undergoing aortic arch surgery under CPB.

Objective To study the prognostic value of circumferential resection margin(CRM)status. Methods Specimens of 62 patients with rectal cancer,who underwent total mesorectal excision from December,2001 to June,2002,were examined using whole-mount sections.All patients were followed up for 4～60 months. Results Circumferential resection margin involvement(CRMI)was identified in 12 specimens.while only 4 of them were cancer positive in the resection margin.Analyzed by logistic regression test,the occurrence of CRMI was related to tumor differentiation [ P=0.015,Exp(B)=0.131]and lymph node metastases[P=0.013,Exp(B)=7.488 ],but not tumor distance to anal verge(P=0.246).The difference in local recurrence rate,overall recurrence rate,disease-free survival rate and overall survival rate between CRMI and that of CRM negative,were significant(P=0.002,0.000,0.000 and 0.003,respectively). Conclusions CRMI is an accurate prognostic factor of recurrence and postoperative survival,and its occurrence is mainly determined by biologic characteristics of the tumor.TME could decrease the incidence of CRMI.

Objective]To investigate the change of spinal pro?inflammatory cytokines in a rat model of fentanyl induced acute hyperalgesia.[Methods]64 male SD rats were divided into 2 groups(n=32),fentanyl group and NS group. The rats were subcutaneously injected with fentanyl (60 μg/kg) or normal saline (1.2 mL/kg) 4 times with 15?minute intervals. Mechanical nociceptive thresholds and thermal nociceptive latency were measured via the tail pressure test(Tail flick thresholds,TFT) and paw withdrawal test(Paw withdrawal latency,PWL)on the day before,at 1,2,3,and 4 hour and on 1~5 day after injection. 4 rats were killed concomitantly and the lumber spinal cord were harvested to analysis the expression of NF-κB,PGE2,TNF-α,IL-1β,and IL-6.[Results]There were no significant changes of TFT,PWL and the expression of spinal inflammatory cytokines such as NF-κB, PGE2,IL-1β,and TNF-αcompared to baseline of rats treated with normal saline. The value of TFT ,PWL in fentanyl group raised to the highest(above the baseline)at the 1st hour after fentanyl injections and decreased thereafter,reached the lowest at the 1st day, raised increasinglyand up to baseline on the 3 day after injection. NF-κB,PGE2,IL-1β,and TNF-αincreased at the 4th hour,on 1 and 2 day and IL-6 increased at the 4 hour and onthe 1 day after fentanyl injections.[Conclusion]Subcutaneously injection of fentanyl induced significant mechanical and thermal hyperalgesia and increased spinal pro?inflammatory cytokines parallelly , indicated that fentanyl induced acute hyperalgesia is associated with spinal inflammatory reaction in rats.

Objective To explore the attitudes towards the Smoking Ban policy and the bias in different levels of related society sanctions so as to provide evidence for implementing anti-smoking measures in the public places.Methods A multi-univariate-multilevel logistic model was developed to find the relation between penalty attitudes and the covariates' effects.Results 74.6％ (3647/4892) and 61.2％ (2994/4892) of the residents agreed to punish either the managers of public places or to the smokers.The two kinds of attitude were associated (x2 =1253.45,P＜0.0001 ).Residents being female,aged between thirty and fifty-nine years old,having had higher than college education,being non-current smokers,with high scores on knowledge of tobacco control,tended to have the attitude of punishing the public place managers and smokers.However,those persons exposed to everyday secondhand smoke or being non-current smokers,tended to punish the smokers in the generalized Wald test.Conclusion There was strong evidence noticed that most of the residents in Guangzhou had supported the ‘tobacco control penalty'.Factors as age,sex,level of education received,knowledge on hazards of smoking,being current smokers and under secondhand smoke exposure were the influencing factors.Non-current smokers and those who exposed to secondhand smoke everyday,would prefer to take different penalties policies.

Objective To investigate the changing pattern of antimicrobial resistance among gram-negative bacilli isolated from respiratory intensive care unit (RICU) for rational use of antimicrobial agents.Methods Antimicrobial susceptibility of 1 047 isolates of gram-negative bacilli from 2000 to 2004 was tested by disk diffusion method.WHONET 5.3 software was used to analyze the data.Results The most common pathogens were Pseudomonas aeruginosa (42.9%),Stenotrophomonas malto- philia (17.1%),Acinetobacter baurnannii (10.0%) and Klebsiella pneumoniae (6.5%).The susceptibility rate of P.aerug- inosa was relatively higher to ceftazidime (50%-74%),amikacin (33.3%-81.0%),piperacillin-tazobactam (30.4%-64.6%) and cefoperazone-sulbactam (33.5%-47.5%),while the susceptibility to imipenem decreased.The susceptibility rate of S. maltophilia was relatively higher to cefoperazone-sulbactam (47.2%-78.6%) and ticarcillin-clavulanic acid(28.3%-86.6%). More than 90% of Acinetobacter baumannii isolates were susceptible to imipenem.The susceptibility rates of K.pneumoniae to imipenem and cefepime were 92.9%-100% and 55.6%-80.0%,respectively.The susceptibility rate to piperacillin-tazobac- tam decreased from 58.3% to 21.7%.The prevalence of extended-spectrum?-lactamases (ESBLs) in K.pneumoniae increased from 11.1% in 2002 to 47.8% in 2004.Conclusions Most pathogens show significant resistance to the most commonly used an- tibiotics.It is very important to select antibiotics for the treatment of infections in ICU based on the results of susceptibility.