The virtual reality teaching system of human skeletal anatomy developed in this paper is based on the advanced personal computer and uses the stereo glasses of ELSA 3D REVELATOR, mouse and keyboard to make up the human-computer interface. Using this system, students can take apart and assemble the skeleton, grasp single bone to rotate and zoom, learn the human skeletal anatomy in a vivid environment, and thus know more about motion physiology.

Objective To study the relationship between the renal cortical thickness and age,and to establish the range of the normal renal cortex thickness by using CT measurement in different age groups so as to obtain a best age-related and practicable method for clinical measurement. Methods (1) the accuracy of measuring renal cortical thickness by CT was evaluated; 18 kidneys resected due to renal neoplasm were studied and the cortical thickness of the normal part of these specimens was assessed. The difference between the renal cortical thickness of specimens and preoperative measurements of renal cortex of the same patient by contrast enhanced CT was analyzed statistically. (2) 120 patients without history of renal disease or long term usage of potentially renal toxic drugs or history of hypertention were examined by CT with indication(s) other than renal disease. All the patients were divided into 20-40, 41-60, and 61-80 year-old groups. The renal cortical and parenchymal thickness and renal size were measured in three CT sections. The difference of the measurements among the three groups and their relationship to age was analyzed statistically. Results There was no significant difference between the renal cortical thickness measured by enhanced spiral CT and measured in renal specimens(t =0. 80,P =0. 43). The renal cortical thickness in three groups was 0. 73 cm, 0. 65 cm, and 0. 53 cm, respectively, and the differences among the three groups were significant ( F = 93.430, P 0. 05). Conclusion The measurement of the renal cortical thickness with enhanced spiral CT was reliable and was a sensitive method in investigating the morphologic changes of the kidney. The renal cortical thickness of normal kidney diminishes with age, but the change of the ratio of thickness of renal cortex to renal parenchyma with age was not significant.

Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery.Methods Fifty ASAⅠorⅡ patients undergoing elective cesarean delivery were randomly divided into the two groups,Ephedrine group (n=5 1 ):intrave-nous injection of 10mg ephedrine before anesthesia;Dopamine group(n=52):continuous intravenous infusion at the speed of 5μg·kg-1 ·min-1 .During the whole process,we investigated the incidence rate of adverse effects,com-pared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein.Results Compare to the dopa-mine group,the incidence rate of hypotension was lower in the ephedrine group (43.1% vs 69.2%,χ2 =7.06,P=0.00).The pH value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22 ±0.03)vs (7.27 ±0.06),t=0.62,P=0.02],there are no significant difference of 5 min Apgar score in the two groups.Conclusion Compared with dopamine,ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine.Ephedrine has transient effect on the neonate,while the effect of dopamine is minor.

Virtual Reality is just emerging as an accepted scientific discipline. It has been widely used in medicine. The major applications of virtual reality for medicine are introduced from three areas :virtual humans,the fusion of virtual humans with real humans and virtual telemedicine. The advanced graphics behind medical virtual reality,such as computational demands,hardware and software environments is briefly discussed. This article also gives a summary of existing distributed VR systems.

Objective To analyze the performance of a rapid immunofluorescence assay for plasma NT-proBNP. Methods Human plasma NT-proBNP was measured by RAMP in 264 healthy cases and 78 patients with heart failure. The precision, stability, linearity and interference factors of RAMP were evaluated according to the protocold from America CLSI. Meanwhile, the results were compared with those obtained by Elecsys. Results Functional sensitivity of RAMP in 20% CV and 10% CV were 48 ng/L and 57 ng/L respectively. The linear range was 18-8 000 ng/L. NT-proBNP in plasma samples detected by RAMP were stable at room temperature for 24 hours, 4 ℃ for 3 days and - 20 ℃ for 20 days. No influences on results were observed throughout three freeze-thaw cycles. The results measured by RAMP were compared between EDTA-K2 anticoagulant plasma and heparin anticoagulant plasma, which showed that YEDTA-K2 =0. 953 9 Xheparin + 0. 365 2 ( R2 = 0. 982, P < 0. 01, n = 40 ). The results of EDTA-K2 and heparin anticoagulant plasma using RAMP and Elecsys showed no significant difference( P ＞0. 05). Slight hemolysis( Hb 2 g/L)had small effect on the results of PAMP and Elecsys assays and deviations of them were below 5%. However median and heavy hemolysis( Hb 3-4 g/L )obviously influenced the results with deviation were more than 15%. The values measured by RMAP fell from 390 ng/L to 82 ng/L, and those measured by Elecsys method fell from 390 ng/L to 178 ng/L when 3 different concentrations of triacylglycerol were added, the values measured by two methods fell from 7 777 ng/L to 7 741 ng/L when bilirubin ( 16-330 μmol/L) was added. The anti-interference ability of RAMP method was similar to Elecsys. Results detected with two methods in 45 EDTA-K2 anticoagulant plasma samples were analyzed with Passing and Bablok regression.The regression equation was YRAMP = 0. 972 8XElecsys - 0. 035 2 (R2 = 0. 994, P ＞ 0. 05, n = 45 ). When heparin anticoagulant plasma samples increased to 78 samples, Passing and Bablok regression equation showed:YRAMP= 0. 983 2XElecsys - 0. 037 6 ( R2 = 0. 991, P ＞ 0. 05, n = 78 ). NT-proBNP levels in healthy adults were elevated along with age and related to the gender. The median value of female[105(60-120) ng/L] was higher than that of male [59 ( 44-91 ) ng/L, Z = 3. 264, P < 0. 01] significantly. Conclusions RAMP method has good repeatability, outstanding stability, and broad linear range. The results detected by RAMP is consistent with results detected by Elecsys.

12 gestational-week uterus) were treated in our hospital by LAVH. The operation time,intraoperative blood loss,and postoperative recovery of the patients were compared to another 110 cases that underwent TAH. Results The operation time in the TAH group was significantly shorter than that in the LAVH group [(109?27) min vs (130?22) min,t=-6.441,P=0.000]. During the operation,the LAVH group had a mean of (121?70) ml blood loss,which was significantly lower than that in the TAH group [(141?73) ml,t=-0.903,P=0.368]. After the operation,the patients in the TAH group had longer recovery time for gastrointestinal function and longer hospital stay than those in the LAVH group [(45?13) h vs (24?6) h,t=15.778,P=0.000;and (7?2) d vs (5?2) d,t=7.530,P=0.000]. Conclusions Compared to TAH,LAVH results in shorter hospital stay and fewer postoperative complications. It is a feasible and safe treatment for large uterus.

AIM:The homologous recombination takes place in E.coli BJ5183 between shuttle vector and adenoviral backbone vector.Recombinants are selected for kanamycin resistance,and the linearized recombinant plasmid is transfected into 293 cells.In this study,AdEasy system was used to generate recombinant adenovirus vector carrying rat interleukin-10(IL-10) gene.METHODS:The experiment was conducted in Department of Microbiology,Qingdao University Medical College from August 2006 to May 2007.①The materials included five clean-grade SD rat,a shuttle vector pAdTrack-CMV,an adenoviral backbone plasmid pAdEasy-1,E.coli.BJ5183 and DH10B,and human embryo kidney 293 cells,which were given as a present by professor Luo.All animal treatment was accorded with the ethical standards.②Total RNA was extracted from spleen cells of rat stimulating by lipopolysaccharide.IL-10 cDNA was amplified by using RT-PCR.The gene of interest was firstly cloned into a shuttle vector pAdTrack-CMV.The resultant plasmid was linearized by digesting with restriction endonuclease Pme Ⅰ,and subsequently transformed into E.coli.BJ5183 cells with an adenoviral backbone plasmid pAdEasy-1.Finally,the linearized recombinant plasmid was transfected into adenovirus packaging cell lines 293 cells.Recombinant adenovirus vAd-IL-10 was obtained.The expression of green fluorescent protein(GFP) was observed under fluorescent microscope.293 cells were cultured in 96-well culture plate with 1 ?104 cells per well.Condensed virus stock solution was added into the plate at different ratios.Recombinant adenoviruses titer was determined.Three days later,total RNA was extracted from 293 cells by TRIzol one-step method,and contaminant DNA was digested by DNaseⅠ.Electrophoresis detected the expression of IL-10 mRNA.RESULTS:①GFP expression was observed 16 hours after packing of the linearized recombinant adenoviruses in 293 cells.The amplification product of replicationdeficient Ad-IL-10 virus was transfected into adenovirus packaging cell lines 293 cells.When the fourth and fifth generations were seeded in virus for 24-48 hours,fluorescence was found in almost cells,and 5.5?108 pfu/mL titer of Ad-IL-10 was obtained.Titer of vAd-GFP was 9.0?108 pfu/mL.②Total RNA was extracted from transfected 293 cells.Electrophoresis showed that 580bp amplification product was expressed obviously and recombinant adenovirus was duplicated in 293 cells.CONCLUSION:The recombinant adenoviral vector carrying IL-10 gene is successfully constructed using AdEasy system.Moreover,vAd-IL-10 recombinant adenovirus with high titer is prepared and transcribed in 293 cells.

Objective To investigate the possible contribution of PPAR-? coupled signaling pathways to rat liver regeneration (LR) at transcription level.Methods The above signaling pathways-related genes were obtained by collecting database data and retrieving pertinent literatures. The gene expression during LR was checked by Rat Genome 230 2.0 array, and LR-associated genes were identified by comparing difference between partial hepatectomy (PH) and operation control (OC) groups.Results Sixty four genes were found to be LR-associated. The number of initially and totally expressed genes occurring in initiation phase of LR, G0/G1 transition, cell proliferation, cell differentiation and structure-function reconstruction was 28, 4, 34, 2 and 72, 41, 247, 90 respectively. Classification of their expression patterns into 11 groups reflected diversity and complexity of gene expression alteration in LR. Conclusion PPAR-? coupled signaling pathways may promote glycogen synthesis in forepart, prophase and anaphase of LR, cell proliferation and migration in the whole LR, while inhibits inflammation during LR.

OBJECTIVE:To discuss the solution of therapeutic contradictions of bleeding and hemostasis in pulmonary embo-lism patients receiving warfarin anticoagulation. METHODS:The risk evaluation and dissolution of bleeding and embolism induced by warfarin anticoagulation were summarized by analyzing therapeutic duration of INR abnormal elevation in a pulmonary embo-lism patient receiving warfarin anticoagulation. Case analysis was based on foreign and domestic guideline and information. RE-SULTS:Referring to INR value,based on HAS-BLE,Caprini scale,China Expert Consensus on Anticoagulant Therapy of Warfa-rin,China Expert Suggestions on Prevention of Venous Thrombosis in Internal Inpatients and Guidelines of Prevention of VTE in Nonsurgical Patients of American College of Chest Physicians,clinical pharmacists and physicians adjusted the dose of Warfarin tablet timely. The patient was recovered after symptomatic treatment of anticoagulation,relieving cough and asthma,reducing phlegm,etc.,and then disagreed from hospital with drugs. CONCLUSIONS:The risk of bleeding and embolism for this type pa-tients can be evaluated and resolved on the basis of HAS-BLED,Caprini scale and relevant guidelines. At present,there still are some problems as deficient evaluation method,lack of large-scale high-level evidence and quantitative study. It is needed to carry out multiple center clinical study and drug interaction quantitative study actively,and develop suitable risk evaluation method so as to provide high-quality and valuable decision-making evidence.

The study explores the current situation of the burden of chronic poor patients and the core essence of the accurate health poverty alleviation policy.More specifically, it aims to analyze the existing problems and practical dilemmas in the implementation of the accurate health poverty alleviation policy, and conveying recommendations for the policy formulation.The analysis shows that the problems in the implementation of the accurate health poverty alleviation policy in China are: the empowerment of the poor population is not accurate;the dynamic management and assessment mechanism is not accurate;and the allocation of poverty alleviation resources is not rational.In view of these problems, the following suggestions were put forward: the establishment of a multi-dimensional poverty identification system, the improvement of poor households through building up their card information;improve the accurate poverty alleviation dynamic supervision and assessment system;rational allocation of poverty alleviation resources, promote the supporting policies and institutional innovation.