Objective The purpose of this study was to investigate the effects of cardiopulmonary bypass(CPB) on monocyte HLA DR expression and immune function Methods Sixteen ASA Ⅱ Ⅳ patients [mean age (38 5?5 1)yr,mean body weight (42 9?10 2kg)] of both sexes (male 7,female 9) with rheumatic value disease undergoing mitral value replacement (11 patients) and mitral value and aortic value replacement (5 patients) with moderate hypothermic CPB were enrolled in this study Another ten patients undergoing lung lobectomy were used as control group Patients suffering from infection, immuno deficiency or receiving corticosteroid or immunoregulatory drugs were excluded Premedication included intramusallar midazolam 0 1mg?kg -1 and morphine 0 1mg?kg -1 Anesthesia was induced with intravenous midazolam 0 15mg?kg -1 , fentanyl 8?g/kg and vecuronium 0 1mg?kg -1 and maintained with isoflurane inhalation (0 8%～1 2%) and intermittent boluses of fentanyl and vecuronium The total dose of fentanyl was (18 3?3 2)?g/kg in CPB group and (9 6?1 3)?g/kg in control group CPB time was (74 2?22 5) min and aortic clamping time (57 5?19 2) min Blood samples were taken from CVP line before and 5 min after induction of anesthesia, before and after CPB and on the 1st, 3rd and 5th postoperative day for determination monocyte count and percentage of HLA DR + monocytes Results The number of monocytes decreased at the end of surgery but greatly increased on the postoperative days The percentage of HLA DR + monocytes also decreased at the end of surgery and decreased further on the 1st postoperative day but started increasing on the 3rd postoperative day In two patients who developed infection the percentage of HLA DR + monoeytes was lower than the average percentage of HLA DR + monocytes of the other 14 CPB patients In control group the percentage of HLA DR + monocytes also decreased significantly after operation but there was no significant change in the number of monocytes However there was a significant difference in monoeyte HLA DR expression between the two groups Conclusions The changes in monocyte HLA DR expression and monocyte count may be induced by impaired immune response after CPB and dynamic monitoring of monocyte HLA DR expression may help to predict complication of infection after CPB

?AIM: To study the changes of choroidal thickness and hemodynamic parameters in patients with diabetic retinopathy and their influencing factors.?METHODS: From January 2013 to January 2015, 100 patients (100 eyes) with type 2 diabetes were divided into 3 groups:34 patients without diabetic retinopathy ( NDR) , 36 patients with non proliferative diabetic retinopathy ( NPDR) group, and 30 patients with proliferative diabetic retinopathy (PDR). According to the results of OCT, the patients with diabetic retinopathy were divided into 2 groups: diabetic macular edema ( DME ) group ( 28 cases) , and 38 cases without diabetic macular edema. During the same period in our hospital 35 subjects for physical examination were selected as the control group. The hemodynamic parameters of the posterior ciliary artery in different groups of patients at different distance from the center of the macular were compared, analyzing influencing factors.?RESULTS:With the aggravation of diabetic retinopathy, the choroidal thickness in different distance from the center of the macular decreased. The choroidal thickness of NPDR and PDR group were thinner than that of the control group (P<0. 05). The choroidal thickness of NDR group was not different from the control group (P>0. 05). There was no significant difference in the choroidal thickness between the DME patients and non DME patients (P>0. 05). Pearson correlation analysis showed that there was no significant correlation between choroidal thickness of patients with diabetic retinopathy and diabetic duration, fasting blood glucose, HbA1c, eye axis length, systolic blood pressure and diastolic blood pressure (P>0. 05), but there was a correlation with BCVA (logMAR) (P<0. 01). EDV and PSV in NDR group and NPDR group were significantly lower than those in control group, RI was higher than that in control group. PSV and EDV in PDR group were significantly lower than those in other three groups, RI was higher than the other three groups, and the difference was statistically significant ( P<0. 05).?CONCLUSION:With the severity of retinopathy in type 2 diabetic patients, the choroidal thickness decreased, and the thickness of the choroid is beneficial in the comprehensive analysis of 2 diabetic retinopathy.

Preeminent Doctors Education and Training Plan has put forward an urgent request to reform the five-year clinical undergraduate medical talent training mode and strengthen the professional spirit cultivation for medical students. As a pilot project, our college continuously explored the professional spirit cultivation mode for medical students in preeminent physician class and has almost established the three-dimensional mode of whole process, joint participation, multi approach and stressing practice.

[Objective]To study the best time for infusing antibiotics as prophylaxis against infection in hip arthroplasty.[Method]Ninty cases of hip arthroplasty were divided into 6 groups randomly with 15 cases each.Ampicillin(UNASYN,1.5g) and cefuroxime axetil(Zinacef, 2.0g) was administered by intravenous infusion respectively one day or one hour before operation or 30 minutes after the operation began.Blood samples from peripheral vein,cancellous bone of acetabulum when reaming,medullary canal of femur when rasping and catheter right after the operation were harvested.Serum Bactericidal Activities(SBAs) were determined by minim dilution technique and were compared between the groups.[Result]SBAs of UNASYN and Zinacef are similar to the bacteria most commonly causing infection after prosthesis implantation such as staphylococcus.Percentage at SBA≥1:8 of UNASYN and Zinacef is significantly more at the beginning of operation and when reaming acetabulum than the other groups(P

Aged ; Female ; Foreign Bodies ; pathology ; Humans ; Laryngeal Diseases ; Larynx ; pathology ; Vestibule, Labyrinth

Community psychiatry is an important branch of psychiatry. This article introduced the concept of community psychiatry, the importance and necessity of setting up community psychiatry course in psychiatry , and the modern teaching methods in teaching community psychiatry course . Combined with the research results about knowledge and attitude of college students on mental illness and the teaching activity, the author further explalned the necessity of setting up community psychiatry in the teaching of undergraduate medical students, and put forward the problem-based learning and case teaching method to make it more easy for students to grasp and understand the knowledge points.

The paper discusses the application of the informatization teaching mode in the surgical nursing teaching and the impact on the information literacy of five-year higher vocational nursing students by taking 213 five-year higher vocational nursing students of the Wuxi Higher Health Vocational Technology School as research objects.The result shows that the application of the informatization teaching mode in the surgical nursing teaching can help improve the comprehensive quality of nursing students.

Object To compare the contents of alkaloids of callus at different period with tissue culture of fresh bulbs of Fritillaria mellea S. Y. Tang et S. C. Yueh.Methods To study the best condition of induction frequency of callus about some phytohormones, temperature and light, and then to determine the contents of alkaloids of callus in F. mellea. Results The best condition of induction frequency of callus above was NAA 1 mg/L+ 6BA 3 mg/L; temperature at (22?1) ℃ and scattered light; the contents of alkaloids were kept highest in about 20th day ofter the callus appeared.Conclusion The contents of alkaloids of callus are kept higher level than fresh bulbs of F. mellea.

Objective Define the association of the catechol-O-methyltransferase(COMT) gene single nucleotide polymorphism(SNP) Ala22/72Ser with schizophrenia(SCZ) in Northern Han population.Methods In 506 SCZ patients,the genotype of Ala22/72Ser of COMT gene was sequenced and typing by polymerase chain reaction(PCR)-sequencing;the severity of psychiatric symptoms of SCZ patients was scaled by positive and negative syndrome scale(PANSS);the expression of COMT gene was determined by Real-Time PCR.Results In SCZ patients,the overall score of positive scale and general psychopathology scale were significantly increased in Ser and Ser/Ala carriers(P

Objective To investigate the protective effect of methylene blue (MB) on blood-brain barrier (BBB) injury after focal cere-bral ischemia-reperfusion in rats. Methods 18 male Sprague-Dawley rats were randomly divided into sham-operated group (n=6), model group (n=6) and MB treatment group (n=6). The left middle cerebral arteries were occluded for 1 hour and reperfused. MB was infused intra-venously immediately after reperfusion (3 mg/kg) and again 2 hours post-reperfusion (1.5 mg/kg), while normal saline was administered in the model group. The sham-operated group was treated as same as the model group without occlusion and infusion. HE staining was used to observe the histological injury in the cortex around the infarcted region 47 hours after reperfusion, while albumin immunohistochemistry was used to evaluate the permeability of the BBB, and immunohistochemistry and double immunofluorescence staining were used to exam-ine the expressions of glial fibrillary acidic protein (GFAP) and aquaporin-4 (AQP-4). Results HE staining showed that cells and blood ves-sels were not intact in the cortex around the infarcted region in the model group and they were better in the MB treatment group. The expres-sions of the albumin, GFAP and AQP-4 were higher in the model group than in the sham-operated group (P<0.01), and were lower in MB treatment group than in the model group (P<0.05). The double immunofluorescence staining showed the colocalization of GFAP and AQP-4 in the astrocytes. Conclusion MB may ameliorate the BBB disruption induced by focal cerebral ischemia-reperfusion through reducing glio-cyte proliferation and down-regulation of AQP-4 expression in rats.