ObjectiveTo compare the effect of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) on pulmonary function in post-thoracotomy patients.Methods33 ASA Ⅰ～Ⅱ patients undergoing selective esophagectomy were randomly divided into the PCEA group (n=16, treated with morphine plus bupivacaine) and PCIA group (n=17, treated with morphine plus droperidol) for 3 days postoperatively. Pulmonary function indices including respiratory rate (RR), tidal volume (Vt), vital capacity (Vc) and pulse oximetry (SpO2) were recorded before operation and on the first 2 days after operation. Pain scores with visual analogue scale (VAS) at rest, deep breathing and with cough, and adverse effects were also recorded.ResultsRR increased, Vt , Vc and SpO2 decreased markedly in both groups postoperatively compared with the base line (P<0.01), but there were no significant differences between two groups. VAS scores were much lower in PCEA group, especially, when the patient was at deep breathing or during coughing (P<0.001).ConclusionPCEA is superior to PCIA in pain relief, but contributes no more than PCIA in improving pulmonary function in post-thoracotomy patients.

ObjectiveTo compare the effects of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) on postoperative nausea and vomit (PONV) in gynecologic and obstetric patients. Methods56 gynecologic or obstetric patients (ASA Ⅰ～Ⅱ) scheduled for lower abdominal surgeries were randomly allocated to receive either 1 mg/ml morphine plus 0.1 mg/ml droperidol intravenously (group PCIA) or 0.1 mg/ml morphine plus 0.125% bupivacaine (group PCEA-Ⅰ) or 0.1 mg/ml morphine plus 0.1 mg/ml droperidol plus 0.125% bupivacaine (group PCEA-Ⅱ) epidurally. 4, 24, and 48 h after operation, pain scores with visual analogus scale (VAS), sedation scores with Ramesay and the incidences of nausea, vomiting, pruritus, respiratory depression were assessed. ResultsVAS scores in the two PCEA groups were much lower than that of PCIA (P<0.01). The incidences of nausea and vomiting in PCEA-Ⅱ group were significantly lower than those in PCIA group (P<0.05), incidences of other side-effects such as pruritus, respiratory depression etc. were similar between the three groups (P>0.05). ConclusionThe regimen morphine/droperidol/bupivacaine by PCEA shows superiorities in relieving pain and reducing postoperative nausea and vomiting in gynecologic and obstetric patients.

OBJECTIVETo establish social stress induced depression-like model in mice of C57BL/6 strain, and to assess its reliability using differenf behavioral methods.

METHODSTotally 20 male mice of C57BL/6 strain were divided into the normal group and the stress model group by random digit table,10 in each group. Another 10 CD1 mice were subjected to social stress. Mice in the normal control group received no stress, while those in the model group received social stress for 10 successive days. Behavioral assessment was performed using social interaction test (SIT), the elevated plus-maze (EPM) test, tail suspension test (TST), respectively. Serum cortisol level was detected by ELISA to assess the reliability of the model.

RESULTSIn the social interaction test when the social target (CDI mice) was inexistent, mice in the normal control group spent longer time in the social interaction zone and less time in the corner zone (P < 0.05); mice in the model group spent less time in the social interaction zone and more time in the corner zone (P < 0.05). Compared with the normal group when CDI mice existed, mice in the model group spent less time in the social interaction zone and more time in the corner zone (P < 0.05). Compared with the normal control group, the total times for entry into open arms, close arms, and the maze were obviously reduced (P < 0.05), and the proportion of entering open arms was significantly reduced (P < 0.05) in the model group. In TST, the motionless time within the last 4 mm was prolonged in the model group (P < 0.05). The serum cortisol level in the model group was obviously elevated (P < 0.01).

CONCLUSIONSocial stress induced depression-like animal model in mice of C57BL/6 straineasquite reliable and possibly suitable to be used in integrative medicine research of combination of disease and syndrome model.

Animals ; Behavior, Animal ; Depression ; physiopathology ; Disease Models, Animal ; Hydrocortisone ; blood ; Male ; Mice ; Mice, Inbred C57BL ; Social Behavior ; Stress, Psychological

Objective To determine if propofol can protect cultured rat hippocampal neurons from anoxia-induced injury and elucidate the underlying mechanism.Methods Neonatal Wistar rats were decapitated. Hippocampus was isolated, minced and digested with 0.125 % trypsin at 371 for 25 min, then centrifuged at 1000 r/min for 5 min. The supernatant was discartled and the precipitate was resuspended in growth medium. The cell suspension was incubated at 37 ℃ for 10 days. The cultured hippocampal neurons were randomly divided into 3 groups: control group(group C) ,anoxia group(group A), propofol + anoxia group (group PA) . Group PA was further divided into 3 subgroups of different end-propofol concentrations:3, 12,48 mg?L-1 . The cultured neurons were transferred to low glucose medium and incubated at 37 ℃ in closed incubator filled with anoxic atmosphere (95% N2-5% CO2) for 24 h in group A and group PA (following addition of propofol) . The cell survival rate in each group was measured by MIT colorimetry. The real-time changes in [Ca2+ ]i in cultured hippocampal neurons induced by anoxia or glutamate or KCL were measured by fluorescence and laser scan confocal microscopy ( LSCM) after staining with fluo-3/AM.Results The hippocampal neurons developed acute swelling and widespread degeneration following anoxia. Propofol attenuated the neuronal injury at 12 and 48 mg?L-1 in a dose-dependent manner and significantly increased the cell survival rate following anoxia (P

OBJECTIVE To investigate the situation of prevalence for extended spectrum ?-lactamases(ESBLs)genes in multidrug-resistant Pseudomonas aeruginosa(PA). METHODS Antimicrobial susceptibility test was performed by agar dilution method and 7 kinds of ESBLs genes were detected by PCR methods in 35 strains of PA. RESULTS In 35 strains of PA, the positive rates of genes of TEM, OXA, PER and GES were 51.4%, 42.8%, 31.4%, and 22.9%, respectively, and genes of SHV, VEB, and CTX-M-1 were all negative. CONCLUSIONS This study shows that there are high positive rates of TEM, OXA, PER and GES genes in PA in our hospital. The GES genes in PA are first reported in China.

Objective To evaluate the cause of ischemia related to myocardial bridge (MB) by using SPECT/CT MPI and CTCA.Methods A total of 294 patients with chest pain,tightness or palpitation undergoing both CTCA and MPI were retrospectively enrolled in this study from March 2008 to March 2013.Among them,49 patients (26 males,23 females,age:32-85 (55.4± 16.6) years) had MB.Locations of MB and myocardial ischemia were recorded.Fused MPI/CTCA was analyzed.If there was no mural atherosclerotic plaque-related stenosis on CAG at the same location of coronary artery where ischemic myocardium was found,then MB was considered as the ischemic cause.Myocardial ischemia rates of different MB locations were compared by x2 test.Results Among 49 patients with MB,3 cases had MB in proximal segment of LAD,34 in mid LAD,4 in distal LAD,3 in septal branch,2 in distal LCX,1 in intermedius,and 2 in mid RCA.There were 41 cases with myocardial ischemia.Myocardial ischemia in 32 cases was caused by MB,including 23 caused by MB in mid LAD.The myocardial ischemia rates of the most common MB location (mid LAD,n =34) and other locations (n =15) were not significantly different (67.6％ (23/34) vs 60.0％ (9/15),x2 =0.27,P＞0.05).Conclusions MB is commonly found in the mid LAD.The myocardial ischemia rates caused by MB is not related the MB location.Hybrid MPI/CTCA could evaluate the sites of coronary MB and myocardial ischemia simultaneously and therefore may be useful to evaluate the relationship between MB and myocardial ischemia.

AIM: To observe effect of Diyu Shengbai Tablet on preventive treatment for interferon-induced leu-kopenia. METHODS: One hundred and twelve patients with chronic hepatitis B treated by IFN were randomly as-signed into two groups, and they were respectively treated with Diyu Shengbai Tablet and Leucogen for 7 days before treatment by IFN. The leukocyte count of each group was done in 3 days,7 days, 10 days, 14 days,28 days after treatment by IFN. Comparison was made on the value of leukocytes between two preventive treatment groups. RE-SULTS: In the third day after treatment by IFN the value of ANC were(1.91±0.56)×10~9/L, (1.48±0.55)× 10~9/L respectively. The value of leukocytes were (3.91±0.33)×10~9/L, (3.16±0.49)×10~9/L respectively. They had the statistical difference (P<0.05). CONCLUSION: Diyu Shengbai Tablet has an effect on preventing lekopenia induced by IFN, and it is a safe, cheap and convenient drug to treat leucopenia by IFN.

Objective To assess the applicative effect of the flipped classroom in nutrition and food hygiene. Methods 48 students of Class One from Grade 2011 majoring in preventive medicine were taken as the TBL group, with 49 students of Class Two as the flipped classroom group. The TBL group used TBL and the formative assessment, while the flipped classroom group used the flipped classroom and the forma-tive assessment. The teaching effect was evaluated through the unified examination and teaching satisfaction questionnaire survey. SPSS 17.0 statistical software was used for the data t test between the groups, and Wilcoxon test, chi square test were used for the linear correlation analysis of the usual grade and final grade of the flipped classroom group. Results The experimental scores (9.21 ±1.14) and the final scores (66.76±4.53) of the flipped classroom group students were significantly higher than the experimental scores (8.31±1.01) and final scores (61.31±4.37) of the TBL group and the difference was statistically significant (t=4.50, P=0.004; t=5.45, P=0.003). The excellent distribution of the flipped classroom group's overall results were higher than that of the TBL group (u=21.36, P=0.002). The usual scores and the final scores were positively correlated (r=0.960, P=0.000) in the flipped classroom group. The results of the question-naire showed that the flipped classroom group students' satisfaction with the positive impact the teaching methods had on all aspects of their own was higher than that of TBL group (P<0.05). Conclusion The flipped classroom teaching can help improve the students' learning enthusiasm, thinking activity and com-municative competence.

Objective:To analyze the result of smooth pursuit test(SPT) in unilateral vestibular peripheral vertigo and investigate its influencing factors.Method:Smooth pursuit test (SPT) and spontaneous nystagmus (SN)were examined in one hundred and eighty-five patients with unilateral peripheral vertigo(case group) and 51 normal persons(control group) by Video-Nystagmography (Synapsys, France), and the gain of SPT and SN were selected as the observation parameters in order to analyze the waveform and gain of SPT and the relativity between SN and the gain of SPT.Result:Of the 185 patients, 105(56.8%),72(38.9%) and 8(4.3%) cases producedⅠ,Ⅱ and Ⅲ waveforms respectively. Of these patients, 58(31.4%) demonstrated SN and none had Ⅳ waveform. While of 51 normal persons, 38(74.5%), 13(25.5%) persons producedⅠand Ⅱwaveforms repectively and there were no Ⅲ, Ⅳ waveforms or SN. There was statistical significance between the stong and weak gain of SPT in these two groups. Weak gain was significantly different between two groups. The stong and weak gain of SPT in case group were 0.86±0.06,0.80±0.06; 0.78±0.09, 0.65±0.1; 0.68±0.13, 0.45±0.12. The relativity between SN and the gain of SPT was positive when they had same direction(r_s=-0.63,P＜0.05)and negative when opposite (r_s=0.34,P＜0.05).Conclusion:Ⅰ,Ⅱ,Ⅲ three waveforms of SPT could appear in unilateral vestibular peripheral vertigo and the corresponding gains are gradually decreasing.SN is the influencing factor of SPT.