ObjectiveTo explore the content of isorhynchophylline in different medicinal parts of Ramulus Uncariae Cum Uncis.MethodsHPLC was adopted to determine 8 batches of different Ramulus Uncariae Cum Uncis of different origin and different medicinal parts. The Waters Symmetry C18 color(4.6 mm×250 mm, 5μm) was used with mobile phase of methanol -0.01 mol/L ammonium acetate buffer(pH 8.0)(60∶40), column temperature of 25℃ , 20μl sample volume, velocity of 1.0 ml/min, and detection wavelength of 246 nm. ResultsIsorhynchophylline can be detected in all 8 batchs of Ramulus Uncariae Cum Uncis in different regions, and different content were found among different origins. The content of isorhynchophylline in different parts of the same origin showed a decreasing sequence of the rhabd, stem with hook, stem without hook, and twig without hook and leaves.ConclusionMost of medicinal part of Ramulus Uncariae Cum Uncis contains isorhynchophylline, which provide a lab basis for exploring medicinal parts of this herbal medicine.

Objective To compare the effect of sevoflurane and propofol on cerebral metabolism in patients undergoing intracranial aneurysm clipping.Methods Sixty-eight ASA Ⅱ or Ⅲ patients aged 22-62 yr weighing 52-81 kg with Hunt-Hess Ⅱ or Ⅲ undergoing intracranial aneurysm clipping were randomly divided into 2 groups( n =34 each): group propofol(group P) and group sevoflurane (group S).Anesthesia was induced with target-controlled infusion(TCI) of propofol (target plasma concretration 2.0 μg/ml,group P) or inhalation of 8％sevoflurane (group S) and iv injection of remifentanil 0.8 mg/kg and atracurium 0.5 mg/kg.Anesthesia was maintained with TCI of propofol(target plasma concretration 1.5 μg/ml,group P) or inhalation of 2％ sevoflurane (group S) and TCI of remifentanil (target plasma concretration 2.0-3.5 ng/ml) and infusion of atracurium (4μg· kg- 1 · min- 1 ).Samples of dialysate in brain were collected at 5 min before temporary arterial occlusion (T0 ),5 min (T1),10 min (T2 ),15 min (T3) of temporary arterial occlusion,and 10 min (T4),20 min (T5),40 min (T6 ) after cerebral aneurysm clipping for determination of glucose,lactate and pyruvate concentrations.Lactate/pyruvate(L/P) ratio was calculated.Results Compared with group P,the concentrations of glucose,lactate and pyruvate were significantly increased at T1 -06,and L/P ratio was decreased at T2-T4 in group S( P ＜ 0.05).The glucose concentration was significantly lower,and lactate concentration higher at T1 -T6,pyruvate concentration was lower at T1 -T4,and higher at T5 and T6,and L/P ratio was higher at T1 -T5 in both groups than that at T0 ( P ＜0.05).The concentrations of glucose and pyruvate were higher and L/P ratio was lower at T4-T6,and lactate concentration was lower at T5,T6 in both groups than that at T3 ( P ＜ 0.05).Conclusion Compared with propofol,sevoflurane can better improve cerebral metabolites in patients undergoing intracranial aneurysm clipping.

Objective To compare the effects of sedation induced with propofol and midazolam on anterior pituitary hormone in mechanically ventilated patients with traumatic brain injury.Methods Eighty-four patients with acute traumatic brain injury,aged 20-60 yr,weighing 50-70 kg,undergoing mechanical ventilation during sedation induced with propofol or midazolam,were randomly divided into 2 groups ( n =42 each):propofol group (group P) and midasolam group (group M).Ramsay sedation score was maintained at 2-4.In group P,propofol was continuously infused at the initial infusion rate of 1.5-6.0 mg·kg-1 ·h-1 and propofol 50 mg was injected intravenously to increase the depth of sedation when needed.In group M,midazolam was continuously infused at the initial infusion rate of 0.10-0.35 mg· kg-1· h-1 and midazolam 7.5 mg was injected intravenously to increase the depth of sedation when needed.The patients were ventilated for 70-120 h.Glasgow Coma Scale scores were assessed before sedation and Glasgow Outcome Scale scores were assessed 4 weeks after admission to the intensive care unit.Venous blood samples were collected at 24 and 72 h of sedation and 4 weeks after admission to the intensive care unit for determination of the levels of serum cortisol,thyroid-stimulating hormone,prolactin,and growth hormone by ELLSA.Results Compared with group M,the levels of serum cortisol and growth hormone were significantly decreased and the level of thyroid-stimulating hormone was significantly increased at 24 and 72 h of sedation in group P ( P ＜ 0.05 or 0.01 ),and the parameters mentioned above were in the normal range.There was no significant difference in the serum prolactin level and outcome between the two groups (P ＞ 0.05).Conclusion The effects of sedation induced with propofol and midazolam on anterior pituitary hormone are comparable in mechanically ventilated patients with traumatic brain injury.

A survey of the compensation for senior medical talents in four public tertiary hospitals in Jiangsu province was made,to probe into defects found with their compensation mechanism,and come up with a better compensation incentives practice, including both currency and non-current compensation.These aim at maximization of the incentives.

BACKGROUND: Choriocarcinoma is a kind of trophoblastic neoplasm with highly aggressive phenotypes. Forkhead box D3 (FoxD3) is an embryonic and trophoblastic stem cel transcription factor. It plays important roles in different physical and pathological situations such as embryogenesis, carcinogenesis and tumor progression.
OBJECTIVE:To investigate the role of FoxD3 in choriocarcinoma malignancy and the possible mechanism.
METHODS:The human choriocarcinoma JAR cel line was employed in this study. The mRNA and protein expressions of genes were measured by quantitative RT-PCR (qRT-PCR) and western blot, respectively. The FoxD3 specific short hair RNA was applied to down-regulate gene expression. The cel proliferation was evaluatedin vitro by cel counting assay andin vivo by tumor growth. The migration/invasion was determined by transwel assay. The profile of FoxD3 targeted genes was investigated with an Agilent microarray and verified by qRT-PCR.
RESULTS AND CONCLUSION: The FoxD3 mRNA and protein expressions in JAR cells were significantly higher than those in primarily cultured normal trophoblastic cells. Knockdown of FoxD3 by short hair RNA in JAR cells could inhibit cell proliferation and migration/invasionin vitro, and suppress thetumor growth with decreased β-human chorionic gonadotropin secretionin vivo. A profile of seven focal adhesion molecules (ITGA5, ITGB6, THBS4, COL6A3, VTN, NRXN3 and NLGN1) was verified to be targeted by FoxD3. Furthermore, knockdown of FoxD3 by short hair RNA could decrease the activation of focal adhesion kinase. All these findings suggest the overexpression of FoxD3 can contribute to the aggressive phenotype of choriocarcinoma JAR cells by regulating the profile of focal adhesion molecules and focal adhesion kinase.

Objective To compare the effects of propofol versus midazolam on serum hydrocortisone in the aged traumatic brain injury. Methods 64 patients (aged 65-72 years) with traumatic brain injury during mechanical ventilation were divided into propofol group (n=32) and midazolam group(n=32).The hemodynamics data,intracranial pressure(ICP) and the calculated cerebral perfusion pressure(CPP) were recorded.The serum hydrocortisone of patients was detectedby enzyme linked immunosorbent assay (ELISA) at 24 h,72 h and 4 weeks in intensive care unit(ICU). Results There was no differences in partial pressure of carbon dioxide,heart rate,meanartery pressure,pulse biood oxygen saturation (SpO2 ),armpit temperature,endexpiratory gas(PEr CO2),intraeranial pressure (ICP) and cerebral pertusion pressure (CPP) between the two groups (P＞0.05).The serum hydrocortisone in propofol group at 24 h and 72 h [(269.7±43.2) nmol/L and (235.0±67.0) nmol/L] were lower than in midazolam group [(278.0±75.5) nmol/L and (243.2±42.4) nmol/L] (t=5.312 and 5.919,both P=0.000).The serum hydrocortisone in propofol and midazolam group at 4 weeks were (209.1±73.9) nmol/L and (210.8±66.6) nmol/L,respectively,no significant difference was found(t=0.075,P =0.938). Conclusions There is a significant difference in the effects of propofol and midazolam on the early level of hydrocortisone in the aged patients with traumatic brain injury.

Objective To compare the effects of dezocine and fentanyl on analgesia and cognitive state for elderly patients after neurosurgery.Methods A total of 42 elderly patients with brain tumors and American Society of Anesthesiologists (ASA) Ⅱ-Ⅲ were randomly divided into two groups:Dezocine group and fentanyl group (n=21,each).The time of recovery and extubation,pain intensity descriptive scale (PIDS),Ramsay score and mini-mental state examination (MMSE) before operation,and 1 h,2 h and 3 h after extubation were recorded.Results The time of recovery [(15.9±2.8) min vs.(16.2 ± 4.3)] min and extubation [(22.4 ± 5.1) min vs.(23.8 3.7) min] between the two groups had no differences (both P＞0.05).And there were no statistical differences between the two groups in Ramsay and MMSE score at 1 h,2 h,3 h after extubation and on PIDS at 1 h after extubation (all P＞ 0.05).The PIDS were lower in Dezocine group than in fentanyl group at 2 h[(2.01±0.79)scores vs.(2.55±0.51)scores,(t =-2.24,P=0.04))] and 3 h after extubation [(2.30±0.66)scores vs.(2.75±0.64)scores,(t =-2.44,P=0.03)].Conclusions The using of dezocine and fentanyl before the end of operation could have a good sedative and analgesia effect on neurosurgery without influence on the duration of recovery and extubation,and dezocine may maintain a longer time of analgesia than fentanyl in elderly patients.

Objective To investigate the effects of different anesthesia methods on oxidative stress in elderly patients undergoing neurosurgery.Methods Totally 60 patients undergoing neurosurgery were randomly divided into 3 groups:propofol group,isoflurane group and sevoflurane group (n-20 each group),heart rate(HR) and mean artery pressure(MAP) in all patients were recorded at the time points of pre anesthesia (T0),incision of skin (T1),incision of dura (T2),end of operation (T3).The activity of superoxide dismuase (SOD),catalase (CAT),and glutathione peroxidase (GSH-Px) were measured at the time of T0,6 h (T4),24 h (T5),48 h (T6),72 h (T7)after operation.The efficacy of anesthesia was evaluated by Glasgow Outcome Score (GOS) at 3 months after operation.Results The activity of SOD,CAT and GSH Px in 3 groups were lower at T5and T6 than at T0 (P＜0.05).The SOD activity at T4,T5,T5and TTwere higher in propofol group [(87.2±11.8) U/ml,(75.1±12.4) U/ml,(84.6±9.3) U/ml,(92.5±12.5) U/ml,respectively]than in isoflurane group [(75.0±12.2) U/ml,(63.8±8.9) U/ml,(70.3±9.0) U/ml,(82.5±13.5) U/ml,respectively] and in sevoflurane group [(79.4±10.4) U/ml,(68.7±10.5) U/ml,(72.0±10.9) U/ml,(85.17±8.41) U/ml,respectively] (all P＜0.05).The CAT activity at T5 was higher in propofol group [(66.59±7.21) U/ml] than in isaflurane group [(51.58±8.19) U/ml] and in sevoflurane group [(58.49±7.27) U/ml] (both P＜0.05).The GSH-Px activity was higher at T4,T5and T6 in group propofol[(159.2 ± 20.8) U,(140.7 ± 16.2) U,(152.3 ± 19.1) U,respectively] than in isoflurane group [(129.4±17.9) U,(108.3±15.9) U,(118.4±14.1) U,respectively] and in sevoflurane group [(140.1±15.8) U,(125.2± 17.1) U,(137.9±10.7) U,respectively] (all P＜0.05).The outcome of neurosurgery had no significant differences among the 3 groups (P＞0.05).Conclusions Propofol has a better effect on oxidative stress than isoflurane and sevoflurane in elderly patients undergoing neurosurgery.

To adapt to the new training program and requirement of MOE , a reform in Chinese curricula, textbook selection and editing, and teaching evaluation method was carried out to strengthen medical Chinese teaching and improve the students' overall Chinese proficiency. Detailed measures in-cluded adjusting the class hour, formulating Chinese reading and writing syllabus, Chinese listening and speaking syllabus and graded vocabulary, evaluating the effect through Chinese proficiency test, learning evaluation and file cover evaluation. After the reform, attendance rate was improved obviously, plagiarism rate was declined obviously and students were highly praised by teacher during the internship and practice.

TakingY Generationundergraduates of medical colleges and universities in China as the study objects, the paper ana-lyzes characteristics and deficiencies of their information behaviors.It proposes the strategies to enhance the information quality education and the service level including improving services based on characteristics ofY Generation, penetrating medical information quality ed-ucation from all dimensions and angles, valuing continuing education for librarians.