Objective To evaluate the training quality of anaesthesiology residents in different hospitals. Methods The scores of 125 residents,attending Shanghai resident clinic skill examination from 2005 to 2007,were analyzed. ResultsThe scores of examinees from municipal hospitals were higher than those from district hospitals,municipal specialized hospitals and traditional Chinese medicine hospitals.The scores of practice part were higher than those of theory part in all groups. Conclusion The training quality is related to the comprehensive strength of the hospital in which examinees work,but the training of theory knowledge still need to be strengthened.

Objective To investigate the curative effect of Quadrant channel transforaminal lumbar interbody fusion(TLIF) in the treatment of recurrent lumbar disc herniation(RLDH).Methods Seventy-six cases patients with RLDH were divided into traditional TLIF group(36 cases) and Quadrant group(40 cases) by the different operation modes.The operation,VAS scores and ODI scores were compared between the two groups.Results Operation time((98.2±18.1) min vs.(118.5±27.2) min,t=3.79,P<0.05),incision length((2.7±0.6) cm vs.(5.5±1.0) cm,t=14.97,P<0.05),intraoperative blood loss((90.7±20.1) ml vs.(170.3±33.5) ml,t=12.71,P<0.05) and intraoperative drainage((43.8±12.4) ml vs.(117.1±28.9) ml,t=14.62,P<0.05) in Quadrant group were less than that in traditional TLIF group.The ambulation time((2.8±0.6) d vs.(6.8±1.1) d,t=19.95.P<0.05) and hospitalization time((7.1±2.0) d vs.(14.2±2.7) d,t=13.11,P<0.05) of Quadrant group were shorter than those of TLIF group.VAS scores in both groups were significantly decreased.VAS in Quadrant group was significantly lower than that in traditional TLIF group from 3 d to 6 months after operation((4.4±1.0,3.9±1.2,3.4±0.8,1.9±0.6,1.3±0.4) points vs.(5.0±1.4,4.5±1.1,4.1±0.9,3.6±0.7,2.5±0.6) points,P<0.05).ODI scores in both groups were significantly decreased.ODI in Quadrant group was significantly lower than that in traditional TLIF group from 1 d to 6 months after operation((36.7±7.1,33.4±6.2,30.7±4.1,27.8±5.3,24.5±5.4,18.4±4.7) points vs.(39.8±6.0,36.8±5.8,33.5±6.6,31.3±5.1,28.9±6.6,22.3±5.2) points,P<0.05).Conclusion The treatment of RLDH by Quadrant channel TLIF has obvious curative effect,short operation time,less trauma,faster recovery and shorter hospital stay.

Animals ; Hypoxia ; metabolism ; physiopathology ; Insulin-Like Growth Factor I ; genetics ; metabolism ; Male ; Muscle, Skeletal ; metabolism ; Myostatin ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the methods of postoperative respiratory management and complications prevention of patients with myasthenia gravis who received thymectomy. Methods According to the accumulated scores of myasthenic crisis prediction, the patients with myasthenia gravis who underwent thymectomy in the past 5 years were divided into 2 groups: high risk group(12, n=11). The time of mechanical ventilation, restoration of muscle strength and spontaneously breathing during extubation, results of arterial blood gas analysis, body temperature, chest X-ray examination and sputum culture of each patient were analyzed. Results The time of mechanical ventilation in high risk group (18~30 h, 26 h in average) was longer than that in control group(4~28 h, 14 h in average)(P

Objective To explore the mechanism of notch signaling pathway in the treatment of cervical cancer with notch receptor blocker(DAPT).Methods After treatment of Me180 cells with different concentrations of DAPT combined with curcumin-photodynamic therapy (PDT),3-(4,5 Dimethylthiazlo-yl)-2,5 Dimethylthiazol-2-yl)-2,5 dipheny tetrazo lium bromide(MTT)assay was used to detect the effect on the proliferation of Me180 cells,annexin V-FITC/PI combined with flow cytometry was used to detect the effect on apoptosis,and real-time fluorescence quantitative PCR and Western blot were used to detect the mRNA and protein expressions of Notch1 gene respectively.Results Both DAPT(1.0 μmol/L)and curcumin-PDT groups could inhibit the proliferation and induce apoptosis of cervical cancer cell line Me180,and the synergistic effect of the two groups was significant (P＜0.05 or＜0.01).DAPT and curcumin-PDT group reduced the mRNA expression level of Notch1 in cervical cancer Me180 cells with inhibition ratio of 40.0％ and 32.3％ respectively.DAPT and curcumin-PDT group inhibited the protein expressions of Notch1,nuclear factor-kappa B(NF-kB),vascular endothelial growth factor (VEGF),and the synergistic effect of the two groups was statistically significant.Conclusions Both DAPT and curcumin-PDT may effectively block the conduction of Notch signaling pathway,which is associated with down-regulation of the expression of Notch1 and NF-kappa B.Notch signaling pathway may be one of the targets of curcumin photodynamic therapy.

Objective　To evaluate the therapeutic effect of phacoemulsification for complicated cataract secondary to uveitis. Metho ds　Twenty-one eyes of 19 patients with complicated cataract secondary to uveitis were emulsified in situ frature technique after blunt separation of iris posterior synechiae, excision of organized membrane with scissors and st retching pupil. Results　The visual acuities with correction on e week after operation was≥ 0.5 in 16 eyes (76.2%), and ≥0.2 in 18 eyes (85.7% ). The major complications were iris damage and corneal edema. No rupture of pos terior capsule and corneal decompensation were found. After operation, a round p upil was obtained in 19 eyes (90.5%) and an irregular pupil in 2 eyes (9.5%).Conclusion　This operation is suitable for complicated cataract se condary to uveitis, and worth to popularize due to the minimization of iris dam age and postoperative inflammation in the anterior chamber, good visual acuity r ehabilitation earlier.

Objective To investigate the correlation between G753A and C1040T polymorphisms in the gene encoding region of thrombin-activatable fibrinolysis inhibitor (TAFI )and cerebral infarction in patients with cerebral infarction in Chinese Han population. Methods C1040T and G753A poly-morphisms in the TAFI gene encoding region in 130 patients with cerebral infarction and 118 healthy subjects (control group)were analyzed retrospectively and they were detected by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP ). Results The GG genotyping of the TAFI gene G753A polymorphism in the cerebral group was 41. 5%(n=54)and the A allele carriers were 58. 5%(n=76),while those in the control group were 44. 9%(n=53)and 55. 1%(n=65)respectively. There were no significant differences in the GG genotyping of TAFI gene G753A polymorphism and the A allele carriers between the cerebral infarction group and the control group (χ2 =0. 288,P=0. 592). In the cerebral infarction group,the CC genotyping of C1040T polymorphism was 50. 0%(n=65)and T allele carriers were 50. 0%(n=65),while those in the control group were 51. 7%(n=61)and 48. 3%(n=57)respectively. There were no significant differences in the GG genotyping of C1040T polymorphism and the T allele carriers between the two groups (χ2 =0.071,P =0.790 ). Multivariate logistic regression analysis showed that G753A and C1040T single nucleotide polymorphisms (GA or AA genotype)in the TAFI gene encoding region were not the independent risk factors for cerebral infarction. Conclusion There are no significant differences in the correlation between the G753A and C1040T polymorphisms in the TAFI gene encoding region and cerebral infarction. They are not the independent risk factors for the onset of cerebral infarction.

ObjectiveTo analyzing the psychological status of hospitalized patients of internal medicine and its impact factors.Methods Hospitalized patients of internal medicine underwent a survey by using Chinese Health Questionnaire (CHQ-12),Social Support Scale and Disease-Cognition Scale.Those with a score of ＞4 received further investigation of Symptom Check-List 90 (SCL-90).Correlation analysis was performed between all factors of SCL-90 and social support or disease-cognition scale score.Results There was no significant difference of psychological status between males and females ( P ＞0.05 ).All SCL90 factors were negatively correlated with social support,of which obsessive,paranoid,and phobic presented stronger negative correlations with social support and objective support (P ＜ 0.05 ).Furthermore,all factors were negatively correlated with disease-cognition scale score.A significantly negative correlation between phobic factor and disease-cognition scale score was identified ( P ＜ 0.05 ).Improvement was found in 26.2％ patients after intervention.Conclusion Patients tend to show unhealthy emotion when they are under the stress of hospitalization.Hospitalization support system may need to be improved and patients' cognition of disease should be increased.

Objective To evaluate the role of mitochondria-mediated apoptosis in hippocampal neurons in sevoflurane anesthesia-induced cognitive dysfunction in aged rats.Methods Sixty healthy male Sprague-Dawley rats,aged 20 months,weighing 550-600 g,were randomly divided into 2 groups (n =30 each) using a random number table:control group (group C) and sevoflurane anesthesia group (group S).Animals inhaled pure oxygen and 3 ％ sevoflurane for 4 h in C and S groups,respectively.Ten rats were chosen at 1 and 6 days after anesthesia and hippocampal tissues were obtained for detection of cell apoptosis and mitochondrial membrane potential (MMP) (using flow cytometry) and expression of cytochrome c (Cyt c) in cytoplasm and activated caspase-3 in hippocampal neurons (by Western blot).The apoptotic rate was calculated.Results Compared with group C,the escape latency was significantly prolonged,the frequency of crossing the original platform,the percentage of time of staying at the original platform quadrant and MMP were decreased,the apoptotic rate was increased,and the expression of activated caspase-3 and Cyt c in cytoplasm was up-regulated in.group S.Conclusion The mechanism by which sevoflurane anesthesia induces cognitive dysfunction is related to the activation of mitochondria-mediated apoptosis in hippocampal neurons of aged rats.

Objective To evaluate the effect of preconditioning with nimodipine on postoperative cognitive dys function of aged rats.Methods Ninety healthy male Sprague-Dawley rats,aged 18 months,weighing 400-500 g,were randomly divided into 3 groups (n =30 each) using a random number table:nimodipine control group (group N),surgery group (group S),and nimodipine + surgery group (N+ S group).In N and N + S groups,nimodipine 1 mg/kg was intraperitoneally injected,while the equal volume of normal saline was given instead in S group.30 min later,group N inhaled pure oxygen for 2 h,and S and N + S groups inhaled 1.8 ％ isoflourane for 2 h when splenectomy was performed.Morris water maze test was performed on 1 day before operation and 1st,3rd and 7th days after operation.After the end of Morris water maze test at 1 day before operation and 1st and 7th days after operation,10 rats were sacrificed and brains were removed and hippocampi were isolated for determination of apoptosis in hippocampal neurons,intracellular [Ca2+] i in cytoplasm,and hippocampal Bcl-2 and Bax mRNA expression and for examination of ultrastructure of hippocampal neurons.Results Compared with the value before administration,the escape latency was significantly prolonged,the frequency of crossing the original platform was decreased,apoptotic rate and [Ca2+]i were increased,Bcl-2 mRNA expression was down-regulated,and Bax mRNA expression and Bax/Bcl-2 mRNA ratio were up-regulated at each time point after operation in S and N + S groups,and no significant changes were found in the parameters mentioned above in N group.Compared with group S,the escape latency was significantly shortened,the frequency of crossing the original platform was inecreased,apoptotic rate and [Ca2+]i were decreased,Bcl-2 mRNA expression was up-regulated,and Bax mRNA expression was down-regulated at each time point after operation in group N + S.Pathological changes were found in S and N + S groups and the damage was severer in S group than in N + S group.Conclusion Nimodepine preconditioning can prevent postoperative cognitive dysfunction of aged rats,and inhibition of calcium overloadinduced apoptosis in hippocampal neurons may be involved in the mechanism.