In anesthetic clinical teaching,Dalian Medical University Department of Anesthesiology pays more attention to humanity education and keeps improving teaching methods.It also adopts the methods of “the combination of the virtual and reality”,multiple apprentices,PBL and other ways to enhance students' operational skills development and promote their clinical thinking.

Objective To explore the selection and clinical effects of internal or external drainage for upper urinary tract obstruction complicated with acute renal failure.Methods A total of 25 cases of upper urinary tract obstruction complicated with acute renal failure were treated with double J(DJ) tube internal drainage(12 cases,15 times) or percutaneous nephrectomy(PCN) external drainage(19 cases,23 times).15 cases of obstruction were induced by tumor and 10 cases of obstruction induced by benign disease.Results The drainage treatments were performed successfully in 23 cases,with the success rate of PCN and DJ drainage being 86.9%(20/23) and 60.0%(9/15),respectively.Postoperative bleeding occurred in 1 patient with PCN.Conclusions PCN is superior to DJ in the treatment of malignant obstruction,but DJ internal drainage may be the first choice for non-malignant obstruction.

Congenital Hyperinsulinism ; diagnosis ; Humans ; Infant, Newborn ; Male

0. 05). Conclusion Chronic fluorosis has no obvious effect on myocardial collagen metabolism of rats and myocardial collagen is not likely the main target of fluoride.

Objective To study the preventive effect of spironolactone on renal tubulointerstitial fibrosis of diabetic nephropathy (DN)in rats.Methods Sixty adult SD rats were random divided into sham operation group(C),diabetic nephropathy group(D)and spironolactone interventional group(A).After diabetes WaS induced by administrating strep tozotocin(STZ),spironolactone was perfused into the stomach of rats in group A.On the 7th,14th,21st,28th days after treatment,rats were put to death,their kidneys were removed to observe the expressions of TGF-β1 and MMP-9 by immunohistochemistry method.The blood potassium,natrium,glucose, serum creatinine,cholesterol,triglyceride and urinary albumin quantification were measured.Results Urine protein in group A wag lower than that in group D.The blood potassium,natrium,glucose,serum creatinine,cholesterol and triglyceride had no difference between group A and group D(P＞0.05).Compared with group D,the expressions of TGF-β1 in group A Was decreased(P＜0.01),the expressions of MMP-9 in group A was hisher than that in group D(P＜0.01).Conclusion Spironolactone could decrease the expression of TGF-β1 and increase the expression of MMP-9 in the tubulointerstitial of diabetic nephropathy,which may delay the progress of renal tubulointerstitial fibrosis.

Objective To investigate the demands and problems of the sharing and construc-tion of teaching resources in medical universities. Method A self-designed questionnaire named The questionnaire of the present situation and demand of teaching resources sharing platforms in medical universities in China was used to conducted in all the attainders during a national teaching resources meeting, and SPSS 17.0 was used to analyze the data. Results Among 125 valid questionnaires, 117 people (93.6%) think it's necessary to establish the resources sharing platform, what's more 108 people (86.4%) believe that education resources sharing platform is very helpful for teaching, and multimedia materials, online courses, course wares, teaching cases, website of subject resources and other educa-tion resources should be widely shared. Our investigation has involved 48 medical universities from all over the country, in which 33 medical universities have teaching resources sharing platform. However, 20 (60.6%) of the universities have still not updated the content on time. There are 10 main factors which influence the using of the education resource sharing platform, in which 105 (84%) of them have con-sidered the factor as backward concepts, 91 (72.8%) think that there exist problems in resource con-struction mechanism, 76 (60.8%) think to be the standardized and universal problems. Conclusion It is necessary to build the education resource sharing platform. In all, we should change the traditional education concept and consciousness, strengthen mechanism of management, and exploit high quality education resource to improve the sharing level of education resource in medical universities.

Objective To discuss the reason of pain on the shoulders and epigastrium after the reprotenal laparoscopic operations. Methods One hundred and eight patients had undergone the laparoscopic adrenalectomy or laparoscopie renal cyst unroofing. They were divided into two groups at random, group A and group B. In group A, discharged CO2 as soon as finished the operation, but did not in group B. At the same period, there were 49 patients who had received retroperitoneal laparoscopic radical nephrectomy, divided into two groups by the CO2-pheunopertomeum time, group C and group D. In the group D, the CO2-pheunopertomeum time was over 90 minutes, and the time was less than 90 minutes in the group C. Evaluated the pain degree through the vision analogue score (VAS) and recorded the pH,PaO2, PaCO2,BE in the arterial blood in group A and B before and after operation. Results The incidence rate of pain postoperation was significantly higher in group B than A (P < 0.05). In group A and group B, there was no difference in PaCO2, PaO2, pH, BE in the arterial blood(P > 0.05 ). The incidence rate of pain and the grade of VSA both were significantly higher in group D than group C (P < 0.05). Conclusions The stimuli of acid materials such as carbonate that derived from postoperative residual CO2 is probably the main cause of the pain on the shoulders and epigastrium after the laparoscopicsurgery.

OBJECTIVETo explore the effects of sacral canal injection on nerve root local inflammatory factors in rat model with lumbar disc herniation, in order to identify its mechanism of treatment.

METHODSForty-eight male SD rats were randomly divided into sham operation group(group A), model group (group B), Chinese medicine group(group C) and western medicine group(group D). There were 12 rats in each group. The model of lumbar disc herniation was established using compression and inflammatory stimulation in group B, C, D. All rats were given epidural catheterization and group A and B with physiological saline (1 ml/kg), group C with mixed liquor of 2% lidocaine and compound Danshen injections and physiological saline (2:2: 16) and group D with mixed liquor of 2% lidocaine and triamcinolone acetonide injection and physiological saline (2:2:16), once a week for a total of three treatments. Four rats were killed every 1 week after injection for once, and the inflammatory factors of tumor necrosis factor (TNF-alpha), prostaglandin E2 (PGE2), interleukin-l (IL-1) and interleukin-6 (IL-6) were detected by ELISA method.

RESULTSThe levels of TNF-alpha, PGE2, IL-1 and IL-6 in compressed nerve tissues in group B were increased than those of group A (P < 0.01). The levels of PGE2, IL-1 and IL-6 in group C and D were decreased than those of group B, and group D was much less(P<0.05). There was no significant difference in level of TNF-alpha among group B, C, D (P > 0.05).

CONCLUSIONCompound compression with inflammatory stimulation can lead to massive release of inflammatory mediators, such as TNF-alpha, PGE2, IL-1 and IL-6. Both injection with compound Danshen injections and triamcinolone acetonide injections by sacral canal can reduce the levels of part inflammatory mediators (PGE2, IL-1 and IL-6), and the effect of Glucocorticoid is better than Danshen (P < 0.05).

Animals ; Dinoprostone ; analysis ; Disease Models, Animal ; Injections ; Interleukin-1 ; analysis ; Interleukin-6 ; analysis ; Intervertebral Disc Displacement ; drug therapy ; immunology ; Lumbar Vertebrae ; Male ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; Spinal Nerve Roots ; immunology ; Triamcinolone Acetonide ; administration & dosage ; Tumor Necrosis Factor-alpha ; analysis

Small molecule covalent inhibitors, or called as irreversible inhibitors, are a type of inhibitors that exert their biological functions by irreversibly binding to target through covalent bonds. Compared with non-covalent inhibitors, covalent inhibitors have obvious advantages in bioactivity. Nevertheless, these agents may also exhibit larger toxicity once off-target effects arise. This "double-edged swords" property often leads drug researchers to avoid attaching them. In recent years, some problems such as drug resistance are difficult to be solved with reversible inhibitors leading researchers to pay more attention on the covalent inhibitors. In this review, we shall make a short summary to the recent research progress of covalent inhibitors and the interaction modes between covalent inhibitors and their target protein residues.
Amino Acids ; chemistry ; Antineoplastic Agents ; chemical synthesis ; chemistry ; therapeutic use ; Antiviral Agents ; chemical synthesis ; chemistry ; therapeutic use ; Drug Discovery ; Drug Resistance ; Enzyme Inhibitors ; chemical synthesis ; chemistry ; therapeutic use ; Hepatitis C ; drug therapy ; Humans ; Molecular Structure ; Neoplasms ; drug therapy ; Protein Binding ; Protein Kinase Inhibitors ; chemical synthesis ; chemistry ; therapeutic use ; Receptor, Epidermal Growth Factor ; antagonists & inhibitors ; Serine Proteinase Inhibitors ; chemical synthesis ; chemistry ; therapeutic use

Background Posterior capsular opacification (PCO) following the extracapsular extract of cataract is associated with the proliferation and migration of residual lens epithelial cells (LECs).Study showed that the incidence of PCO is higher in diabetic patients than those of non-diabetes.So if insulin-like growth factor-1 (IGF-1) participates in the pathogenesis of PCO deserve research.Objective This study was to explore the active mechanism of IGF-1/IGF-1 receptor (IGF-1 R) system in the migration of LECs and offer theoretical basis for clinical prevention and treatment of PCO.Methods Human lens epithelial cell lines (HLEC-B3) were cultured and passaged in DMEM.The cells were identified using fluorescence immunocytometry.IGF-1 with the concentrations of 0,30,90 μg/L were added into the medium separately for 48 hours.The numbers of migrated cells were calculated by Transwell test.The cells were cultured in DMEM containing 0,1.5,30,60,90 μg/L IGF-1,and the expressions of IGF-1 Rα and IGF-1Rβ in the cells were assayed and compared by Western bolt.Results The cultured showed the positive response for α-crystallin anibody with red fluorescence in the cellular membrane.Twelve hours after Transwell incubation,the number of migrated cells (Median) was 0(0,1),10(10,11) and 29(27,31) in the 0 μg/L IGF-1 group,30 μg/L IGF-1 group and 90 μg/L IGF-1 group,respectively,showing a significant difference among the 3 groups (Z=12.610,P=0.002).The number of migrated cells in the 30 μg/L IGF-1 group and 90 μg/L IGF-1 group was significantly more than that of the 0 μg/L IGF-1 group (both at P =0.008),and the number of migrated cells in the 90 μg/L IGF-1 group was significantly more than that of the 30 μg/L IGF-1group (P =0.009).Western blot assay showed that the expressions of IGF-1Rα and IGF-1Rβ in the cells were significantly different among the 0,1.5,30,60,90 μg/L IGF-1 groups (F=63.700,130.530,both P =0.000).The expressions of IGF-1 Rα and IGF-1Rβ were gradually elevated as increase of IGF-1 doses when then concentration of IGF-1 was ＞ 30 μg/L,with significant differences among the different concentrations groups (all at P＜0.05).Conclusions IGF-1 can upregulate the expressions of IGF-1R in HLEC-B3 cells in vitro in a dose-dependent manner.Also,IGF-1 enhances the migration ability of HLEC-B3 cells.These results suggest that activation of IGF-1/IGF-1R system may be associated with the pathogenesis of PCO.