Objective It has been shown that ketamine attenuates cytokine production and release induced by endotoxin. The purpose of this study was to investigate the effects of diazepam and ketamine on inflammatory responses during early stage of burn. Methods BALB/C male mice weighing 20-25 g were randomly divided into 5 groups : (1) normal control group (n = 10); (2) burn control group received Ⅲ degree bums covering 15%-20% of the body surface (n = 10); (3) D-K group received intramuscular diazepam 0.4mg?kg-1 and ketamine 10 mg?kg-1 ( n = 10); (4) D + K pretreatment group received D + K 15 min before burn ( n = 10) and (5) D + K post-treatment group received D + K 15 min after burn ( n = 10) . Four hours after burn or anesthesia (D + K) the animals were sacrificed and blood was collected for determination of serum TNF-?, IL-1? and IL-10 concentrations (ELISA) and peritoneal macrophages were isolated for detection of glucocorticoid receptor (GR) by Western blotting. In addition peritoneal macrophages isolated from normal animals (group 1) and bum animals (group 2) were cultured with diazepam-ketamine for 1 h befor detection of GR.Results Serum TNF-?, IL-1? and IL-10 levels in group 2 were significantly higher than those in group 1. In group 4 and 5 serum TNF-?, IL-l? and IL-10 levels were significantly lower than those in group 2. In group 4 only serum IL-10 level whereas both serum IL-1? and IL-10 levels in group 5 were significantly higher than those in group 1. GR of peritoneal macrophage was significantly down regulated 4 h after bum (group 2) as compared with group 1. The level of GR in group 4 was significantly higher than that in group 2 but not significantly different from that in group 1; whereas the GR level in group 5 was significantly higher than that in group 2 but lower than that in group 1 and 4. There was no significant difference in GR expression after macrophages were cultured in vitro with diazepam and ketamine between normal or bum groups. Conclusion Diazepam-ketamine pretreatment can suppress cytokine release induced by severe bum. The expression of GR in peritoneal macrophages is significantly reduced by bum. Diazepam-ketamine given before or after bum can suppress the inflammatory response but have no direct effect on peritoneal macrophages.

The relationship between 5-HT receptor and a-adrenoceptor was investigated in rat medullary slice preparations. In 57 nucleus tractus solitarii (NTS) neurons, 47 (82.5%) responded to both serotonin (5-HT) and norepinephrine (NE). After synapse transmission was blocked by perfusion of artificial cerebrospinal fluid (ACSF) with low calcium and high magnesium, 5 in 8 neurons were still sensitive to both 5-HT and NE. On the other hand, 3 in 5 neurons responding only to 5-HT or NA were sensitive to both 5-HT and NE after the synapse transmission blockage. In some neurons which exhibited excitatory or inhibitory responses to 5-HT or NE alone, the responses were inversed when perfused with 5-HT and NE in combination. These results suggest that there may exist an inhibitory interaction between 5-HT receptors and a-adrenoceptors in NTS and that most 5-NT and a-adrenoceptors coexist in the same NTS neurons.

BACKGROUND: There is still no satisfactory therapy for thetreatment of cerebral infarction at present. Although sub-hypothermia is effective in the treatment of cerebral infarction, its side effect is relatively more. Local sub-hypothermia might have favorable effects in the treatment of cerebral infarction.OBJECTIVE: To observe the protective effects of local sub-hypothermia on the ischemic brain tissues in rats to further explore its mechanism.DESIGN: A randomized controlled basic study based on the experimental animals.SETTING: Institute of neurology of a university hospital.MATERIALS: The study was conducted in the Animal Laboratory of Neurology, the First College for Clinical Medicine, Harbin Medical University between April 2000 and January 2002. Fifty male Wistar rats(cleanness grade) with a bodyweight of(250 ± 25) g were selected.INTERVENTIONS: Ten rats were randomly selected from the 50 rats and divided into normal group and sham-operation group with 5 rats each. The rest 40 rats were randomly divided into normal temperature cerebral ischemia group and local hypothermia cerebral ischemia group with 20 rats each. Rat cerebral middle-sized arterial ischemia model was established for local sub-hypothermia disposal.MAIN OUTCOME MEASURES: Impacts on cerebral infarction volume,nerve function, and neuron-specific enolase(NSE) of rats in each group.RESULTS: The cerebral infarction volume at 48 hours after embolism in rats was ( 128.95 ± 13.42) or (84.90 ± 11.36) mm3 respectively, nerve function evaluation was( 1.60 ± 0. 24) or (0. 95 ± 0. 17), and serous NSE concentration was(13.55±4.07) or(9.19±3.42) μg/L in either sub-hypothermia group or normal temperature group, which were significantly different from each other.CONCLUSION: Local sub-hypothermia therapy has protective effects on ischemic cerebral neurons.

Objective To quantify the concentration of peripheral blood plasma neutrophil gelatinase-associated lipocalin (NGAL) in patients with acute pancreatitis (AP) and to explore its value in assessment of the severity of AP.Methods From June 2011 to March 2012,83 patients with AP were selected,among those 43 cases were mild acute pancreatitis (MAP) and 40 were severe acute pancreatitis (SAP).The control group included 30 healthy individuals.The peripheral blood of patients with AP and healthy controls was collected,and plasma was isolated after centrifuged.The concentration of NGAL in plasma was detected by enzyme-linked immunosorbent assay (ELISA).The t-test was performed for comparison between groups.The correlation between the concentration of NGAL in plasma and clinical parameters of AP was analyzed by Spearman rank order correlation analysis.The diagnosis value of the concentration of NGAL in SAP was evaluated by receiver operating characteristic (ROC) curve and area under the curve (AUC).Results The concentration of plasma NGAL in AP group ((10.30± 5.97)nmol/L) was higher than that in healthy control group ((1.94±1.35) nmol/L) and the difference was statistically significant (t=11.924,P＜0.01).The concentration of plasma NGAL in SAP group ((14.61 ±5.28) nmol/L) was higher than that in MAP group ((6.27±-3.09) nmol/L) and healthy control group,the differences was statistically significant (t=8.677 and 14.539,both P＜0.01).The concentration of plasma NGAL of AP patients was positively correlated with acute physiology and chronic health evaluation-Ⅱ score,Ranson score,bedside index for severity in acute pancreatitis score,computed tomography (CT) severity index,C-reactive protein,white blood cells and the days of hospitalization (r=0.651,0.556,0.514,0.620,0.320,0.458 and 0.346,all P＜0.05).The area under the ROC curve of plasma NGAL concentration in diagnosis of SAP was 0.926 (95％CI:0,870-0.983).The cutoff value of plasma NGAL level in diagnosis of SAP was 8.44 nmol/L.The sensitivity and specificity was 87.5 ％ and 88.9％,respectively.Conclusions Plasma NGAL level is correlated with the severity of patients with AP.NGAL may be one of the markers for the early diagnosis of SAP.

Based on our long-time teaching practice,we tried to explore some measures of the teaching innovation about maternal and child health care,in terms of the innovation of course system,the compiling of teaching materials and the updating of teaching methods and skills.Through the discussion,we aimed to enhance our students' integrated qualities,cultivate and bring up more and more capable medical students of new-pattern fit for the social demands.

0.05).However,there were significant differences in retinal sensitivity among the other abnormalities(P

Objective To investigate prognostic factors for bloodstream infection in adult patients. Methods Clinical data of 131 adult patients with positive blood cultures during January 2002 to December 2003 in the Hospital were collected and 91 cases of them were retrospectively analyzed to understand their pathogen species and prognostic factors for it.Results Blood samples from 91 patients were cultured positive,53 cases(58.2%)with gram-negative bacteria mainly including Escherichia coli,Salmonella spp. and Klebsiella pneumoniae,28(30.8%)with gram-positive bacteria,mainly including Staphylococcus aureus and coagnlase-negative Staphylococci,eight(8.8%)with fungi and two(2.2%)with multiple infections.Case fatality ratio in this group of patients with septicemia was 30.8% during their hospitalization,and that in those with Pseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia and E.coli with extended-spectrum beta-lactamase was over 50%.Case fatality ratio was associated with severity of sepsis(OR=1.15)and inappropriately initial empirical treatment with antibiotics (OR=6.77).Conclusions Pathogen causing bloodstream infection in adults were mainly gram-negative bacteria and severity of infection and inappropriate initial antibiotics treatment could increase their fatality.

Objective To evaluate the value of ultrasound elastography in the diagnosis of breast tumor ,and compared with imaging analysis .Methods To collect the image data of 160 patients ,confirmed by pathology ,a total of 182 ,preoperative ultra-sound elasticity imaging and DWI ,ultra sonic elastography diagnosis by five points method ,DWI on the basis of the measured ADC value in the diagnosis of lesions ,respectively compared with pathology .Results Ultrasound elastography diagnosis of 89 malignant tumors ,of which the correct diagnosis of 78 malignant tumors ,7 misdiagnosis ,11 benign misdiagnosed as malignant diagnosis;93 benign tumors ,86 of correct diagnosis ,11 misdiagnosis ,7 malignant misdiagnosed as benign ,sensitivity was 87 .6% ,specificity of 92 .5% ,the Accuracy was 93 .9% ;ultrasound elastography and DWI combined imaging diagnosis of 86 malignant tumors ,81 correct diagnosis of malignant tumors ,4 misdiagnosis ,5 from the benign misdiagnosed as malignant diagnosis ,96 benign tumors ,92 correct diagnosis ,5 misdiagnosis ,the sensitivity was 94 .1% ,specificity of 95 .8% ,the accuracy was 97 .2% .Conclusion Ultrasound elas-tography in breast benign and malignant tumor diagnosis with higher sensitivity and specificity ,accuracy ,joint DWI can significantly improve the sensitivity and specificity of breast benign and malignant tumor diagnosis ,accuracy .

Objective To provide reference and ideas for information service in hospital library by analyzing the influencing factors for its service satisfaction.Methods The satisfaction of hospitalized patients for information service was investigated.The characteristics of patients,their requirements for information service and the influencing factors for their satisfaction were analyzed by logistic regression analysis.Their satisfaction for information service was assessed according to the IPA method and analyzed using the SPSS19.0.P<0.05 was considered statistically significant.Results Health information was provided for 221 patients.No significant difference was found in sex,age,education level between the importance of information service and the influence of satisfaction for information service (P>0.05).The importance of information service and the satisfaction of patients for information service were rather high.IPA analysis showed that the patients considered high the importance of library-provided personal bibliography and departments-provided health pamphlets with a low satisfaction,which should thus be solved.Conclusion The satisfaction of patients for information service is good.However,the importance of library-provided personal bibliography and departments-provided health pamphlets is high and the satisfaction for them is low.It is thus necessary for librarians to improve their service and encourage more medical staff to participate in information service for patients.

Objective To detect levels of IL - 4 and INF - ? in induced sputum dynamically in children with mycnplasma pneamo-niae pneumonia( MPP), and to analyze the function of Th1 /Th2 cell factor immune response in the genesis and development of MPP, so as to evaluate the clinical value of induced sputum method in MPP research. Methods There were 38 cases who were diagnoses as MPP using 3% high osmotic pressure of saline water to ultrasonic atomizing inhalation for inducing sputum. ELISA was used to detect IL-4 and INF-?. Results The content of IL-4 in acute stage was higher than that in convalescence stage in induced sputum of MPP children. Severe stage was higher than mild stage. However, the comparison between acute and convalescence stage didn't have statistics difference in the content of INF-?, neither did the comparison between severe and mild stage. IL- 4/INF- ? in acute stage was higher than that in convalescence stage. Severe stage was higher than mild stage. In convalescence stage, the comparison of INF - ?, IL - 4, IL - 4/INF - ? between the severe and the mild didn' t have statistic significance. Conclusions IL-4 and INF - ? have participated in the monogenesis of MPP. The disequilibria of Th1 /Fh2 is existed in MPP and Th2 reaction predominates. So induced sputum analysis can be a better way to judge the light or heavy press degree of MPP practically, conveniently and sensitively.