Objective To investigate the effects of different body temperatures on the neuromuscular block induced by different doses of cisatracurium in rabbits. Methods Seventy-two healthy New Zealand white rabbits of both sexes weighing 2.0-2.2 kg were randomly divided into 3 groups (n=24 each): hypothermia group (L), normothermia group (N) and hyperthermia group (H). The rectal temperature was set at 34.5℃, 38.5℃ and 41.8℃ in group L, N and H respectively. Each group was further divided into 4 subgroups (n=6 each) receiving intravenous cisatracurinm 0.33, 0.66, 0.99 and 1.32 mg/kg respectively after rectal temperature was stabilized for 20 min. The animals were anesthetized with iv 20% methane 1 g/kg, tracheostomized and mechanically ventilated (VT 12 ml/kg, RR 60 bpm, I:E = 1:2;FiO2 100% ). TOF was monitored. The onset time, the duration of action (from the end of cisatracurium injection to the recovery of T1 to 5%, 25% and 95% of control height) and recovery index (recovery of T1 from 25% to 75% of control height) were recorded. MAP, HR and rectal temperature were recorded at 5 min before alteration of the body temperature, at 2 min before and 5, 10, 30, 60 and 90 min after administration of cisatracurium. Results (1) With the same dose of cisatracurium the onset time and duration of action were significantly shorter in group H, longer in group L and recovery from N-M block faster in group H, slower in group L as compared with group N. (2) At the same body temperature the onset time was significantly shortened and the duration of action and recovery were significantly prolonged as the dose of cisatracurium increased. (3) There was significant difference in the effect of interaction between different doses of cisatracurium and different temperatures on the onset time. (4) With the same dose of cisatracurium MAP was significantly decreased in group H, increased in group L, while HR was significantly increased in group H, decreased in group L. Conclusion The neuromuscular blocking effect of cisatracurium is decreased when the body temperature is increased and vice versa. The neuromuscular blocking effect of cisatracurium (0.33-1.32 mg/kg) is dose-dependent at the same body temperature. There is interaction between the two factors.

In recent years, immune therapy for the treatment of cancer has made remarkable progress. The monoclonal antibodies of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) have shown considerable responses and good tolerance in the treatment of non-small cell lung cancer (NSCLC). In this review, we summarized the current clinical status and future direction of PD-1/PD-L1 in NSCLC.

No abstract available.
Uterus*

Objective To investigate the changes in the number of synapses and neurons in the spinal dorsal horn in a rat model of phantom limb pain. Methods Eleven healthy adult SD rats of both sexes weighing 209-300 g were randomly divided into 2 groups: sham operation group (group S, n = 5) and phantom limb pain group (group P, n = 6). Phantom limb pain was induced by resection of a 0.5 cm segment of unilateral sciatic nerve in group P. In group S unilateral sciatic nerve was exposed but not transected. The animals were observed for autotomy and scored (0 = no autotomy, 13 = the worst autotomy) after operation and were sacrificed on the 28th day after operation. The L3-6 segment of the spinal cord was removed for determination of the number of neurons (by Nissl's staining) and synapses (by synaptophysin immuno-histochemistry).Results In group S no animal developed autotomy. In group P autotomy started from the 2nd day after operation and the score reached 9-11. The number of the neurons in the spinal dorsal horn in all 4 segments and the number of synapses in L3 and 16 segments were comparable between the two sides and the 2 groups. The number of synapses in the spinal dorsal horn of L4and L5 segment was significantly larger in the operated side than in the contralateral side in group P. Conclusion The number of synapses in the spinal dorsal horn significantly increases in animals with plantom limb pain which induces no increase in the number of neurons in the spinal dorsal horn.

Objective To evaluate the effect of the transcranial magnetic stimulation on upper-extremity function rehabilitation and changes in the excitability of cerebral cortex,and to evaluate from the viewpoint of electro-physiology the prognosis so as to guide the rehabilitation treatment of patients after stroke.Methods Forty-six patients in the early stage after a stroke were given TMS examinations of the ipsilateral brain region.Those with the motor evoked potentials (MEPs) amplitudes lower than 50 μV were classified into a motion-induced experimental negative group (the negative group),whiie those whose MEP amplitude reached 50 μV or more were classified as movement-induced positive (the positive group).Both groups were given the same treatment.Before and after 2,4 and 8 weeks of treatment the Fugl-Meyer movement function rating scale was used to assess their bilateral upper limb movement function.TMS technology was used to detect any change in the resting motor threshold (RMT) and the amplitude (Amp) of MEPs in the motor cortex.The incubation period of the cortex (CL) and the central motor conduction time (CMCT) in the contralateral motor cerebral cortex were also observed.Results After 4 weeks of treatment,the average score of the positive group on Fugl-Meyer upper movement function rating scale reached (54.99±2.76),significantly higher than before treatment and significantly higher than the negative group's average (P＜0.05).After 8 weeks of treatment,the average score in the positive group had increased further to 73.11±2.98,still significantly higher than that of the negative group (P＜0.01).After treatment,RMT decreased progressively in both groups,but that of the negative group dropped from (98.35±10.12) to (30.35±7.31) (9＜0.01),with significantly greater decline in amplitude and rate than that of the positive group (P＜0.05).After treatment,the Amp of both groups showed a gradual increasing trend.Amp increased earlier in the positive group,but there was no significant difference in the extent of the increase between the two groups (P＞0.05).After the treatment the CL and CMCT had shortened significantly in the negative group compared to before the treatment (P＜0.05),while there was no significant change in CL and CMCT after the treatment (P＞0.05).Conclusions The excitability of the contralateral motor cortex changes after a stroke.TMS can be used to characterize the MEP to monitor and predict recovery.This should help clinicians prepare more scientific rehabilitation plans.

Objective To research the clinical rehabilitative effect of repeated transcranial magnetic stimulation (rTMS) for the non-motor symptoms of Parkinson's disease.Methods Fifty-five PD patients were randomly divided into an rTMS treatment group (n =29) and a sham stimulation group (n =26).The treatment group received a course of 0.5 Hz rTMS treatment,while the sham stimulation group had the same treatment but with no energy output.Both groups were evaluated using a non-motor symptoms questionnaire (NMSQuest),the Hamilton depression scale (HAMD),the Pediatric Daytime Sleepiness Scale (PDSS),the mini-mental state examination (MMSE) and the scale for outcomes in PD for autonomic symptoms (SCOPA-AUT) before treatment,immediately after,and a month after treatment.Results Compared with before treatment,the average NMSQuest score of the treatment group declined significantly,though 1 month after treatment the improvement was no longer significant.After treatment and 1 month later the average NMSQuest score of the sham stimulation group increased gradually.The effect in the treatment group was therefore significantly better than in the sham stimulation group.After treatment and 1 month later the average HAMD score of the treatment group was significantly lower than before treatment while the average HAMD score of the sham stimulation group had increased gradually.The improvement in depression in the treatment group was therefore significantly better than in the sham stimulation group.After treatment,sleep disorders in the treatment group had been significantly alleviated,but one month later the improvement was no longer significant compared with before treatment.PDSS scores in the sham stimulation group declined gradually,but the improvement in sleep disorders among the treatment group was significantly better than among the sham stimulation group.Cognition improved significantly among the treatment group right after treatment,but 1 month later it had worsened while the MMSE scores of the sham stimulation group decreased gradually.The difference between the two groups was statistically significant.The average SCOPA-AUT scores of the two groups were not significantly different from each other or from the scores before treatment.Conclusion Repeated TMS can improve most non-motor symptoms of PD.The improvement in depression is the most significant.A short course of rTMS has no obvious rehabilitative effect on the autonomic function disorders of PD patients.

Objective To explore the relative factors of aggressive behaviors in inpatients with schizophrenic.Methods 178 cases of continuously admitted schizophrenic patients were divided into attack group and non aggressive group according to the aggressive behavior of preadmission.Single factor analysis and multi factor regression analysis was applied to two groups in situation(such as age,gender,education level,course of disease,past aggressive behaviors and so on),Brief Psychiatric Rating Scale (BPRS) and Eysenck Personality Questionnaire (EPQ).Results By single factor analysis,attack group had significantly longer course of disease(7.73±6.67) than non aggressive group (5.22 ± 5.47,t =2.631,P＜ 0.01).The score of hostile suspicious factor in BPRS (13.73 ± 3.098) in attack group was significantly higher than that in nonaggressive group(11.47±3.93) (t=4.063,P＜ 0.01),but anxiety factor (7.18± 3.583) was significantly lower than that in nonaggressive group (8.70 ± 3.89) (t=2.679,P＜0.01).The score of E scale of EPQ(11.99±4.340) in attack group was significantly higher than that in nonaggressive group(10.67±4.293) (t=1.990,P＜0.01).Attack group's proportion of patients of previous attacks (71.1％) was significantly higher than that in non aggressive group (16.0％),(x2 =39.082,P＜ 0.01).(2) Logistic analysis showed that hostile suspicious factor in BPRS and past aggressive behaviors entered the regression equation.Condusions Aggressive behavior in schizophrenic patients occurs mainly with psychiatric symptoms and the past history of aggressive behavior.The patients should be treated actively to control the symptoms and prevent the disease recurrence.

Objective To investigate the changes in the number of microglias and astrocytes in the spinal dorsal born in a rat model of phantom limb pain.Methods Eleven healthy adult SD rats of both sexes weighing 290-300 g were randomly divided into 2 groups:sham operation group (group S,n =5 ) and unilateral sciatic nerve transection group (group SNT,n =6).Phantom limb pain model was induced by resection of a 0.5 cm segment of unilateral sciatic nerve in group SNT.In group S unilateral sciatic nerve was exposed but not transected.The animals were observed for autotomy and scored (0 =no autotomy,13 =the worst autotomy) after operation and were sacrificed on the 28th day after operation.The L5 segment of the spinal cord was removed for determination of the number of microglials (by iba-1 immuno-histochemistry) and astrocytes (by GFAP immuno-histochemistry).Results In group S no animal developed autotomy.In group SNT autotomy started from the 2nd day after operation and the score reached 9-11.Compared with group S,the number of the microglias and astrocytes in the spinal dorsal horn was significantly decreased in the operated side in group SNT ( P ＜ 0.05 ).Conclusion The number of microglias and astrocytes in the spinal dorsal horn is decreased in animals with phantom limb pain.

Objective To investigate the clinical effect of the blood transfusion with equal ratio component in severe multiple in‐juries with acute traumatic coagulopathy(ATC) .Methods Thirty‐eight patients who had severe multiple injuries with ATC were divided randomly into control group and treatment group .Control group was treated with the different ratio packed red blood cells (PRBC)and fresh frozen plasma(FFP) ,while treatment group received the equal ratio PRBC and FFP .Hemoglobin(HB) ,pro‐thrombin time(PT) ,international normalized ratio(INR) ,fibrinogen(FIB)were measured on the 1st ,2nd ,3rd day after admission . The total amount of PRBC during these 3 days ,the days of hospitalization in ICU ,the corrected rate of shock ,the 28‐day mortality were compared between groups .Results Compared with the control group ,the levels of PT ,INR and FIB of treatment group on the 2nd ,3rd day after admission were better(P<0 .05) .The total amount of PRBC[(18 .5 ± 6 .3)U]during these 3 days ,the days of hospitalization in ICU [(5 .9 ± 4 .3)d] in treatment group were less than those in the control group [(25 .9 ± 7 .8)U ,(10 .5 ± 7 .6)d] (P<0 .05) ,while the corrected rate of shock(85 .0% )in treatment group was higher than that of the control group(44 .4% ) .The 28‐day mortality(10 .0% )in treatment group was lower than that of the control group(27 .8% )(P<0 .05) .Conclusion The blood transfusion with equal ratio component in severe multiple injuries with ATC could not only improve blood clotting index ,reduce the total amount of PRBC and the time in ICU ,but also increase the corrected rate of shock and decrease the 28‐day mortality .

Objective:to culture excellent bachelor majoring in anesthesiology.Methods:to make teaching plan for practice in anesthesiological department with emphasis on following aspects:culture of emotional intelligence;development of the sense of responsibility for work;training of clinical thought to combine theory and practice and training of basic techniques;formation of good relationship and communication with the others and culture of scientific research ability.Results:All faculties execute the plan carefully,and all the interns graduate with clinical and research ability as expected.Conclusion:It is very important for ability improvement of interns to make and execute available plan,keep strict and careful attitude,train their clinical thought and basic techniques,and emphasis the sense of responsibility for work.