0.05). Conclusions Following retroperitoneal laparoscopy, the cerebral blood flow is increased and no cerebral anoxia is found.

Objective To evaluate the prophylactic effect of continuous epidural block combined with desflurane anesthesia on increase of sympathetic neural activity induced by desflurane Methods Thirty patients were randomly allocated to two groups: desflurane anesthesia (DA) group (n=15) and epidural block combined with desflurane anesthesia (ECDA) group (n=15) After rapid induction with fentanyl propofol scoline, in DA group 2% desflurane in oxygen was inhaled firstly, then imposed with successive 1% increase of desflurane until balance and in ECDA group epidural blockade at T 9 10 or T 10 11 was firstly performed with 2% lidocain and other procedures were same as DA group The central venous blood samples were taken before induction, 30 min following desflurane inhalation(T 1), 60 min after operation beginning(T 2) and at the end of operation(T 3), to measure the plasma conentrations of catecholamine with high performance liquid chromatography Results Compared with baseline, following desflurane inhalation, MAP increased in DA group, but decreased in ECDA group, with significant difference between both groups As compared with the baselines, plasma epinephrine (EPI) and norepinephrine (NE) concentrations increased significantly in DA group at T 1, T 2 and T 3, but in ECDA group remained unsignificant changes at T 1, rose markedly at T 2 and T 3 EPI and NE levels were evidently higher in DA group at T 1 and T 2 than those in ECDA group Conclusions Continuous epidural blockade can effectively prevent the increasing in sympathetic neural activity induced by desflurane

Objective To investigate the value ofsomatosensory evoked potentials (SEP) in early diagnosis of cervical spondylotic radiculopathy (CSR). Methods The median nerve SEP (SEPm) was examined in 65 cases of CSR (experimental group), and was compared with 30 controls(control group). All the patients were examined by MRI of the cervical spine which were compared with SEPm. All cases were followed up 12 months, at the same time MRI and SEPm were examined repeatedly. Results The experimental group with CSR had significantly prolonged peak latency (PL) of N11 and N13 wave and interpeak latency(IPL) of wave N9-NI3 within 3 months [( 12.92 ± 0.97), (14.81 ± 1.16), (4.45 ±0.65)ms] and at the 12th month [( 14.20 ± 1.06), ( 16.35 ± 1.75), (5.62 ± 0.88) ms] compared with those of control group[(11.65 ± 0.69), (13.26 ± 0.78), (3.56 ± 0.31 ) ms](P＜ 0.05). The PL of Nll and N13 wave and IPL of wave N9-N13 significantly prolonged at the 12th month compared with those within 3 months.SEPm provided more sensitive modality for the diagnosis[87.69%(57/65 )] of CSR within 3 months than that of MRI [70.77% (46/65)] ( X2 =4.35,P ＜0.05). While there was no significant difference in sensitive between SEPm [90.77%(59/65)] and MRI [81.54%(53/65)] at the 12th month (X2= 1.56,P＞0.05).Conclusion SEP is valuable for the early diagnosis of CSR and may be clinically utilized as a sensitive indicator of CSR.

The application status and disadvantages of lecture-based learning ( LBL ) and problem-based learning (PBL) have been compared and discussed, and the imagination of combina-tion of LBL with PBL in the application of biotechnological pharmaceutics teaching proposed. LBL teaching will be mainly applied in the fundamental principles of development and production of biotechnological pharmaceutics, while PBL teaching will be mainly applied in the specific production processes of typical biopharmaceutics. The three key points in the combination teaching process includ-ing the time allocation of LBL and PBL, the design and implementation of PBL cases and the founda-tion of reasonable teaching evaluation system have also been introduced. The combination of LBL with PBL will cultivate students' self-study, comprehensive analysis and teamwork capabilities to satisfy the demands of the development of current market for biopharmaceutical talents.

ObjectiveTo objectively evaluate the clinical efficacy of three-step acupuncture-cupping therapy for cervicogenic headache.MethodSixty patients were randomly allocated to treatment and control groups. The treatment group received three-step acupuncture-cupping therapy and the control group, conventional acupuncture based on “Acupuncture Therapeutics”. Both groups were treated for three courses (10 days as acourse with two days of rest between two courses) and then the clinical therapeutic effects were evaluated. The evaluation included the overall therapeutic effect on the symptoms, the VASscore and the follow-up recurrence rate at six months after treatment.ResultThe total efficacy rate was 96.7% in the treatment group and 83.3% in the control group; there was a statistically significant difference between the two groups (P<0.01). A follow-up of six months after treatment in the two groups showed that the recurrence rate was 16.7% in the treatment group and 46.7% in the control group;there was a statistically significant difference between the two groups (P<0.05).ConclusionThree-step acupuncture-cupping therapy has a definite effect on cervicogenic headache. Its immediate and long-term effects are superior to those of conventional acupuncture. The recurrence rate in six months is lower in this therapy than in conventionalacupuncture.

OBJECTIVE:To investigate the effects of Astragalus polysaccharides on heart function and myocardial fibrosis in spontaneously hypertensive rats (SHR) and corresponding mechanism. METHODS:50 SHR were randomly divided into a model group,a captopril tablets group (positive drug,30 mg/kg) and the groups of high,medium and low-dose (100,50,25 mg/kg) Astragalus polysaccharides,with 10 SHR in each group. Another 10 Wistar Kyoto rats were included into the normal group. The rats in the drug administration groups were given corresponding drugs ip,while those in the normal group and the model group were given isometric distilled water ip,once a day,for 12 consecutive weeks. The left ventricular systolic pressure (LVSP),left ventricular end diastolic pressure (LVEDP),left ventricular pressure rise rate (+dp/dtmax) and left ventricular pressure decline rate (-dp/dtmax) of the rats were recorded. The heart mass index (HMI) and left ventricular mass index (LVMI) thereof were deter-mined. The level of hydroxyproline and the mRNA and protein expression of transforming growth factor-β1(TGF-β1)and peroxi-some proliferator-activated receptor-γ(PPAR-γ)in the cardiac muscle tissue thereof were detected. RESULTS:Compared to the nor-mal group,the rats in the model group had lower LVSP,+dp/dtmax and-dp/dtmax,higher LVEDP,HMI and LVMI,as well as high-er levels of hydroxyproline and the mRNA and protein expression of TGF-β1 and lower level of the mRNA and protein expression of PPAR-γ in the cardiac muscle tissue (P<0.01). Compared to the model group,all the above-mentioned indexes of the rats in the group of high-dose Astragalus polysaccharides and the captopril tablets group were significantly improved (P<0.05 or P<0.01);except for LVEDP and the mRNA expression of PPAR-γ,all the above-mentioned indexes of the rats in the group of medi-um-dose Astragalus polysaccharides were significantly improved(P<0.05 or P<0.01);no statistically significant difference(P>0.05) in all the above-mentioned indexes was shown between the model group and the group of low-dose Astragalus polysaccha-rides,except that the-dp/dtmax of the latter was significantly higher and the level of the mRNA expression of TGF-β1 was obvious-ly lower (P<0.05). CONCLUSIONS:Astragalus polysaccharide can improve heart function and myocardial fibrosis in SHR by a mechanism which may be related to downregulating the expression of TGF-β1 and upregulating the expression of PPAR-γin the car-diac muscle tissue.

Objective To investigate the effects of sevoflurane delayed preconditioning on caspase recruitment domain (ARC) expression during myocardial ischemia-reperfusion (I/R) in rats. Methods Sixty-four adult male SD rats weighing 270-350 g were randomly divided into 4 groups ( n = 16 each): sham operation (group S); myocardial I/R group; sevoflurane + sham operation group (group S-S) and sevoflurane delayed preconditioning + myocardial I/R group (group S-I/R) . Myocardial I/R was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 2 h of reperfusion in groups I/R and S-I/R. Group S-S inhaled 33% oxygen for 2 h, and sham operation was performed 24 h later. Group S-I/R inhaled 2.5% sevoflurane for 2 h, and then myocardial I/R was induced 24 h later. Eight animals were sacrificed at the end of 2 h reperfusion in each group and the hearts removed for determination of myocardial infarct size (IS) as a percentage of area at risk (AAR) by triphenyl tetrazolium chloride staining (IS/AAR) . Myocardial apoptosis was detected using TUNEL and apoptosis index was calculated. Another 4 animals were sacrificed immediately before ischemia and at the end of 2 h reperfusion to determine the expression of ARC and Caspase-8 in myocardium by Western blot. Results Compared with group S, the infarct size and apoptosis index were significantly increased in groups I/R and S-I/R, and ARC expression was up-regulated immediately before ischemia in groups S-S and S-I/R, and Caspase-8 expression was up-regulated at 2 h of reperfusion in group I/R ( P ＜ 0.05) . Compared with group I/R, the infarct size and apoptosis index were significantly decreased in group S-I/R, and ARC expression was up-regulated, while Caspase-8 expression was down-regulated at 2 h of reperfusion in groups S-S and S-I/R ( P ＜ 0.05) . Conclusion Sevoflurane delayed preconditioning can attenuate myocardial I/R injury through up-regulating the ARC expression and decreasing the myocardial apoptosis.

BACKGROUND: Thrombus formation and neointimal hyperplasia limit its use for revascularization of small-caliber vessels (<6mm diameter) in the coronary or peripheral circulation.OBJECTIVE: To improve hemocompatibility, the luminal surface of a small diameter expanded polytetrafluoroethylene (Eptfe) vascular prosthesis was modified with alginate and recombinant hirudin.DESIGN: Observational experiment.SETTING: This study was performed in Nanomedicine and Biosensor Laboratory, Bio-X Center, Harbin Institute of Technology from Marcy 2006 to June 2007.MATERIALS: The GORE-TEX Epife vascular grafts (W. L Gore & Associates, Inc., Flagstaff, AZ) used in this study were 4mm in internal diameter. rHir was obtained from Calbiochem, Germany. Sodium alginate (also called alginic acid sodium salt; medium viscosity) was purchased from Sigma.METHODS: A p-diazonium diphenyl amine polymer (PA) was used as an interlayer between alginate and recombinant hirudin (rHir). The diazonium moieties were capable of covalently coupling with electron-rich aromatic systems such as histidine and tyrosine residues of hirudin. No need for chemical pretreatment took all advantage by preserving the bulk properties with almost no effect on stability and elasticity of the Eptfe vascular graft. rHir amount on Epife surface Was determined by the Micro BCA (Bicinchoninic acid) Protein Assay kit.MAIN OUTCOME MEASURES: ① Determination rHir amount on Eptfe surface; ② Static water contact angles; ③ Attenuated total reflectance fourier transform infrared spectroscopy (ATR-FTIR) was employed to confirm the change taking place in the Eptfe graft surface modification process; ④ Characterization of the surface morphology and platelet adhesion by SEM; ⑤ APTT and PT; ⑥ Percent hemolysis.RESULTS: ① The amount of rHir adsorbed onto the Eptfe vascular was deduced to be 16.35 μg/cm2. ② Surface analysis ATR-FTTR revealed the presence of new functional groups on the modified graft surfaces. ③ The water contact angle of the modified graft surface decreased. ④ The longer APTT and PT value lower than 5% hemolysis level and dramatically decrease of platelet adhesion assay showed that rHir modified graft had great improved blood compatibility.CONCLUS10N: Cross-linked Alg/rHir onto Eptfe can improve luminal surface and hemocompatibility.

ObjectiveTo explore the risk factors for upper gastrointestinal bleeding after craniocerebral trauma.MethodsTo retrospectively summarize the clinical features of 80 cases with craniocerebral truma and to analyze the risk factors for upper gastrointestinal bleeding.Results Upper gastrointestinal bleeding was present in 39 of the 80 cases(48.8％) .Twenty-one of the 39 cases with gastrointestinal bleeding died(53.8％)In the patients without gastrointestinal bleeding, 5 cases died (19.2％) .Among the factors affecting the gastrointestinal bleeding after craniocerebral trauma, Glasgow Coma Scale(GCS) score, septicemia, decerebration,hypotention, metabolic acidosis and hyperglucose were closely related risk factors(x2 = 13.96;x2 = 27.43;x2 =46.28 ;x2 = 27.33 ;x2 = 11.88 ;x2 =5.71 ,P ＜0.05 or P ＜0.01).ConclusionProphylaxis against related risk factors could reduce the incidence of gastrointestinal bleeding, improve the prognosis and decrease the mortality of craniocerebral trauma.

Objective　To evaluate the therapeutic efficiency of reversed lamellar keratoplasty for bullous keratopathy, Terrien's marginal degeneration and ocular chemical burns.Methods　Twenty eyes of patients with bullous keratopathy, twelve eyes with Terrien's marginal degeneration, ten eyes with chemical burns were recruited in this study.Diseased tissues were removed by means of dissection.Reversed lamellae corneal tissues which had been prepared by cryopreservation were thawed and rinsed. Then the prepared posterior corneal lamellae was turned over, endothelium facing upwards. The diameter of the graft should be 0.5～1.0mm larger than that of the recipient bed. The reversed donor posterior lamellae was sutured into the host keratectomy bed with 10-0 nylon sutures continuously or interruptedly.Results　Allograft reaction episode occurred only one (chemical burn) of the total 42 eyes enrolled.The grafts of the rest 41 eyes maintained clear or semitransparent for 1～5 years. Graft edema could be observed within 2～4 weeks postoperatively. Postoperative interface separation was not found. For all 20 patients with bullous keratopathy, the symptoms of pain disappeared. The visual acuity improved 2～3 lines of Snellen among eleven of twelve patients with Terrien's marginal degeneration. The visual acuity improved 2～3 lines of Snellen with four patients with chemical burns.Conclusion　The technique of reversed lamellar keratoplasty can be applied successfully for tectonic reconstruction of corneal surface such as bullous keratopathy, Terrien' s marginal degeneration and also chemical burns.The effects of therapy was satisfactory.