Objective To assess the incidence rate of postoperative nausea and vomiting (PONV) after total intravenous anesthesia (TIVA) with propofol versus sevoflurane-based anesthesia with or without ondansetron in patients undergone gynecological laparoscopy. Methods Totally 138 patients were randomly divided into three groups: sevoflurane group (Sev group) sevoflurane-ondansetron group (Sev-O group),and propofol TIVA group (TIVA group),with 46 cases in each. In the Sev and Sev-O groups,anesthesia was maintained by inhalation of 50% N2O and sevoflurane;in the Sev-O group,8 mg of prophylactic ondansetron was given intravenously 30 minutes prior to the end of the operation. In the TIVA group,target-controlled infusion of propofol and remifentanil were used. In each group,the incidence of nausea and vomiting and use of antiemetic drugs in 24 hours after the surgery were recorded. Results In 0 to 2 hours after the operation,the incidence rate of nausea and vomiting in the TIVA group was significantly lower than that in the Sev group [22% (10/46) vs 54% (25/46),?2=10.376,P=0.001] and Sev-O group [50% (23/46),?2=7.986,P=0.005]. In 2-6 hours,the rate in the Sev-O group was lower than that in the Sev group [22% (10/46) vs 46% (21/46),?2=5.887,P=0.015]. The total incidence rate of nausea and vomiting in 24 hours after the operation was 57% (26/46) in the TIVA group,which was significantly lower than that in the Sev group [80% (37/46),?2=6.093,P=0.014]. In the Sev,Sev-O,and TIVA groups,there were 13 (28%),6 (13%),and 6 (13%) cases respectively received antiemetic drugs after the surgery. Conclusions Compared with sevoflurane-based anesthesia,propofol TIVA results in a lower rate of PONV after gynecological laparoscopy.

OBJECTIVE:To observe the efficacy of Radix Astragali Injection in combination of Kallidinogenase for diabetic nephropathy.METHODS:A total of 78 patients with diabetic nephropathy were enrolled and randomly assigned to receive Kallidinogenase plus Radix Astragali Injection orally(trial group)or Kallidinogenase alone(control group)orally for 4wk.The main outcome measures were UPE,Alb,?2-MG,THP,Scr,BUN etc.RESULTS:After treatment,all the indexes were decreased significantly(P

Objective To investigate diabetes specialist nurse training mode and clinical practice conditions in Shandong Province,explore the main factors influencing clinical practice of diabetes specialist nurses,gradually improve diabetes specialist nurses training and application.Methods A total of 232 nurses with diabetes specialist nurses certificates in Shandong Province were carried out with the questionnaire about geneal information,training model,clinical practice conditions by convenient sampling method.Results Diabetes specialist nurse training mode in Shandong Province had achieved remarkable results.The total scores of practical skills were (54.64 ± 9.46),in which the scores of clinical nursing dimension were (12.99 ± 2.90),at top level.By using multivariate linear regression analysis,achiuement in scientific research,assessment form of clinical nursing and sources of training teachers were the ninfluential factors of clinical practice of diabetes specialist nurses.Conclusions It would play a positive stimulating effect in bringing diabetes nurse specialist into full play if we gave diabetes specialist nurse systematic and standardized training,a good learning and communication platform,and effective support system.

Objective:To investigate the role of monocyte chemoattractant protein-1 in the progress that isometric exercise training improves arteriogenesis.Method:Twenty-four male Sprague-Dawley rats were used,weighing (200±20)g.The rats were randomized into control group (CG),myocardial ischemia group (MI),exercise training group (ET),MCP-1 inhibitor group (LG).There were 6 rats in each group.Rats were continuously administered 10mg/kg subcutaneously isoproterenol for successive 2 weeks to establish the myocardial ischemia model.Successfully modeled rats were in groups MI,ET and LG.Isometric exercise training were performed in group ET and LG.The rats in group LG were given MCP-1 inhibitor leflunomide by gavage.After 8 weeks of training,the left ventricular myocardium was extracted and relative collateral blood flow (RCBF) was measured by microspheres.Artery density (AD) and monocytes were measured by immunohistochemistry analysis.Western blot analysis and real-time quantitative PCR were performed to assay protein and mRNA of MCP-1.Result:RCBF and AD increased significantly in group ET as compared to the rest groups.RCBF and AD in group LG showed higher than that in group MI but not significant.The number of monocytes,MCP-1 mRNA and MCP-1 expression were significantly elevated in ischemic myocardium of group ET.Interestingly,the number of monocytes,MCP-1 mRNA and MCP-1 expression showed lower than that in group MI but also not significant.Conclusion:Eight weeks of isometric exercise training can increase the expression of MCP-1 in ischemic myocardium and promote the arteriogenesis.

Objective To observe the dynamic level of platelet activation and to analyze the correlation between platelet activation and systemic inflammatory response syndrome(SIRS)in patients with acute ischemie stroke. Methods　Mean platelet component concentration(MPC)and white blood count(WBC)were serially determined in patients with acute isehemic stroke,and other parameters including initial plasma fibrinogen(FIB)and adenosine diphosphate(ADP)aggregative rate were also determined.All parameters were compared between the SIRS group and the non-SIRS group.Correlation was analyzed between initial MPC and SIRS score,WBC,FIB and ADP aggregative rate. Results MPC level was declined slightly on the first day,and was followed by a relatively low MPC level from the second day to the forty-fifth day.The average level was fluctuated between 229 g/L and 242 g/L.There was no significant difference in initial FIB(t=1.835,P=0.07)between the SIRS group and the non-SIRS group,but the differences of other parameters had statistical significance(all P＜0.01).In the first three days,MPC level was negatively correlated with SIRS score(r=-0.392,-0.376,-0.341,t=3.484,3.405,3.125 respectively,all P＜0.01),but not correlated with WBC,FIB and ADP aggregative rate(P＞0.05). Conclusions　Platelets maintain an activated state during the entire course of ischemic stroke.The initial level of platelet activation.WBC count and ADP aggregative rate are higher in SIRS patients than in non-SIRS patients.The initial level of platelet activation suggests the severity of SIRS,and may be one of the independent risk factors for SIRS.

Objective To evaluate the role of autophagy in inflammatory response in the lungs of silicosis rats. Methods The specific pathogen-free healthy male Wistar rats were randomly divided into four groups with 10 rats in each group. The rats in the control group were given an equal volume of 0.9% sodium chloride solution; all rats in the silicon dioxide (SiO2 ) group, the SiO2 + 3-methyladenine (3-MA) group, and the SiO2 +rapamycin (RAPA) group were given a mass concentration of 0.05 mg/L of SiO2 suspension (1.0 mL/rat) to establish a rat model of silicosis using non-exposed tracheal instillation method. Two days before SiO2 exposure, the rats in SiO2 +3-MA group were intraperitoneally injected with 3-MA at a dose of 2.5 mg/kg body weight. The rats in the SiO2 +RAPA group were intraperitoneally injected with a dose of RAPA 1.0 mg/kg body weight, once a day, and once every other day after modeling, for a total of 10 injections. The pathological changes in the lung tissue of the rats in each group were evaluated using hematoxylin-eosin and Masson staining. The relative expression levels of transforming growth factor-β (TGF-β) , interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the lung tissue of the rats in each group were detected using enzyme-linked immunosorbent assay. The relative expression levels of microtubule-associated protein 1 light chain 3 (LC3) and yeast autophagy-related gene 6 (Beclin1) in lung tissue of rats in each group were detected by Western blotting. Results The pathological observation of rat lung tissue showed that scattered inflammatory nodules and interstitial inflammatory cells were found in the lung tissue of the rats in the SiO2 group. In the SiO2 +3-MA group, the inflammation in the lung tissue was more severe and the alveolar cavity had viscous secretions. The rats in the SiO2 +RAPA group had less inflammation and smaller inflammatory nodules than the SiO2 group. Compared with the control group, the TNF-α, IL-1β, TGF-β, Beclin1 protein relative expression levels and LC3 Ⅱ/Ⅰ ratio in the lung tissue were increased in the SiO2 group (all P<0.05). Compared with the SiO2 group, the relative expression levels of TGF-β and TNF-α in the lung tissue of the rats increased (all P<0.05), and the ratio of LC3 Ⅱ/Ⅰ and Beclin1 protein relative expression decreased in the SiO2+3-MA group (all P<0.05). Compared with the SiO2+ 3-MA group, the relative expression levels of TNF- α, IL-1β and TGF- β in the lung tissue of the SiO2 +RAPA group were decreased (all P<0.05), and the LC3Ⅱ/Ⅰ ratio and the relative expression level of Beclin1 protein were increased (all P<0.05). Conclusion Autophagy occurs when inflammatory reaction occurs in the lungs of silicosis model rats; autophagy has inhibitory effect on pulmonary inflammation.

Accidents, Occupational ; prevention & control ; Occupational Diseases ; prevention & control ; Occupational Health Services ; organization & administration ; Risk Assessment ; methods ; organization & administration

Translational medicine emerging as a new concept in medical field, concentrates on the integration of theory and practice , and the conjunction of basic medical science and clinical medicine. Barriers between the basic medicine and clinical medicine existing in medical education in China make students possess limited intelligence, narrow perspectives and low creativity etc., causing the medical teaching unable to conform to the demand of translational medicine. The article introduces the basic conception of translational medicine and the necessity of medical teaching reform, the meth-ods of promoting teaching reform by integrating the curriculum systems, bettering experimental teach-ing systems, strengthening humanities education, improving faculty construction and optimizing eval-uation system for students.

Objective To investigate the surgical strategy of recurrent rectuvaginal fistula. Methods Retrospectivly analyzed the clinical data of 13 patients with recurrent rectovaginal fistula from December 2001 to December 2008. The etiopathogenisis and the ways of treatment were analyzed. Results All the 13 patients with a transverse colostomy surgical repaired with Mason operation in the secondary intention,and recepted closure of colostomy in the third intention for treatment, all patients were cured. No recurrent fistula was identified with postoperative follow-up 4 - 84 months. Conclusions After recurrent rectovaginal fistula with multiple surgical treatment,the blood supply of local tissue is poor,the scar is serious. Selecting the appropriate timing of operation, adequate preoperative preparation, the application of transverse colostomy and Mason operation in different period could significantly enhance the successful operation rate.

MicroRNAs (miRNAs) are small non-coding RNAs that regulate both mRNA and protein expression of target genes and play important roles in proliferation,differentiation,development and metabolism of cells.This paper reviews the research progress on miRNAs involvement in liver diseases,including viral hepatitis,fatty liver,drug induced liver disease,primary biliary cirrhosis and primary hepatocellular carcinoma.