Objective To assess the efficacy of the mixtures of different concentrations of ropivacaine(R) and chloroprocaine(C)for epidural anesthesia in patients undergoing hysterectomy.Methods Sixty ASAⅠorⅡpatients aged 27-56 weighing 45-75 kg undergoing elective hysterectomy were randomly divided into 4 groups(n= 15 each);groupⅠ0.75% R alone;groupⅡ0.5% R-1% C;groupⅢ0.5% R-1.5% C and groupⅣ0.75% R+1% C.The epidural catheter was placed at L_(2,3)interspace and advanced 3.5 cm into the epidural space in cephalad direction.A total of 22 ml of epidural solution was injected in each group.The onset time,block height and duration of sensory block and the onset time,degree and duration of motor block(using Bromage scale)were assessed.The use of supplementary drugs(ketamine and ephedrine)and side effects were recorded.Results The onset time of sensory and motor block was significantly shorter in groupⅡ,ⅢandⅣthan in groupⅠ(0.75% R alone).The duration of sensory and motor block was significantly shorter in groupⅡandⅢthan in groupⅠandⅣ.The incidence of hypotension was significantly increased but the incidence of discomfort produced by traction on the viscera during operation was reduced in groupⅣas compared with groupⅠ.Conclusion The anesthetic efficacy of epidural 0.5% ropivacaine is significantly enhanced when mixed with 1.0% or 1.5% chloroprocaine.

Objective To investigate the effects of trimetazidine on the oxidative stress in maintenance he-modialysis (MHD) patients. Methods Eighty-six MHD patients and 30 healthy volunteers were recruited in the study. The activity of glutathione peroxidase (GSHPx) was measured by colorimetry and superoxide dismutase (SOD) in serum was measured by hydroxylamine method. The levels of serum malondialdehyde (MDA) were meas-ured by thiobarbituric acid reaction. Serum advanced oxidation protein products (AOPP) levels were measured by enzyme-linked immunosorbent assay (ELISA). All MHD patients were randomly divided into two groups, treatment group (n = 46) and control group (n = 40), who had undergone hemodialysis for at least three months before the study and were in a stable clinic status without signs of infection or disease activity. In the treatment group,20 mg of trimetazidine was taken orally three times each day for twenty-four weeks, when the parameters for oxidative stress were studied. The levels of GSHPx. SOD, MDA and AOPP in serum were measured before and after the treat-ment. Results At the initiation of the investigation, the serum levels of GSHPx [(584.37±215.70) μmol/L, (580.87±309.12) μmol/L vs (769.06±302.46) μmol/L] and SOD [(347.87±82.09) kU/L, (348.16±75.33) kU/L vs (428.34±15.23)kU/L] in the M HD patients were significantly lower than those in the normal eontrol group (P < 0.01), whereas the content of MDA [(4.94±1.32) nmol/L, (4.97±1.61) nmol/L vs (3.56±0.46)nmol/L] and AOPP [(120.95±59.24) μg/L,(121.76±69.12) μg/L vs (47.69±20.15) μg/L] in MHD patients was higher than those in the control group( P < 0.05 and P <0.01, respectively). After treatment for twelve weeks, the scores of GSHPx and SOD were significantly increased in the treatment group compared to that before treatment (P <0.01). However, the contents of the MDA and AOPP decreased. There were significant differences in the levels of GSHPx, SOD,MDA and AOPP between the two groups of MHD patients after the treatment with trim-etazidine. Conclusions Trimetazidine in maintenance hemodialysis patients appears to be associated with an im-provement of oxidative stress.

Child ; Congresses as Topic ; Humans ; Pediatrics

Child ; Congresses as Topic ; Humans ; Pediatrics

AIM:To investigate the effects of celecoxib,a selective cyclooxygenase-2 inhibitor,on antioxidative capability and apoptosis of cardiac myocytes after myocardial infarction.METHODS:24 New Zealand rabbits were divided into three groups randomly(8 in each group):sham-operated group(sham group),myocardial infarction group(MI group),celecoxib group(Cele group,10 mg kg-1?d-1,qd,with the drugs gastric gavage for six weeks).The NO concentration,total antioxidative capability(T-AOC),the activity of constitutive nitric oxide synthase(cNOS)and inducible NOS(iNOS)in cardiac tissue homogenate,adjacent to the infracted area,were detected.The pathological changes were observed by light microscope and electron microscopy.The expressions of Bcl-2 and Bax protein in myocytes were observed using immunohistochemistry,and the degree of apoptosis were examined by TUNEL.RESULTS:Cardiac tissue in MI group presented interstitial edema,fibroplastic proliferation,inflammatory cellular infiltration,and vacuolar degeneration in cardiac myocytes.The results of electron microscopy showed that myocytes presented more changes caused by ischemic injury:widened interspace of myofibril,disordered myofibrillae,focal lysis of myofilament,ectasia of sarcoplasmic reticulum.In Cele group,the pathological changes were light,the NO-_2/NO-_3 concentration,the activity of iNOS were lower(P

Gata4 is an important transcription factor in heart development. Gata4 post-transcriptional protein modification regulates transcriptional activity and DNA binding, which in turn affects expression of downstream genes and transcription factors, differentiation of embryonic stem cells and cardiogenesis. This article summarizes the effect of post-transcriptional protein modification on transcriptional activity of Gata4 and the relationship between this effect and congenital heart disease. It was shown that acetylation, phosphorylation and SUMOylation upregulate transcriptional activity, DNA binding, downstream gene expression and embryonic stem cell differentiation. On the other hand, methylation and deacetylation downregulate Gata4 transcriptional activity. Post-transcriptional protein modification of Gata4 is very important in clinical research on congenital and other heart diseases.
Acetylation ; Animals ; GATA4 Transcription Factor ; chemistry ; genetics ; metabolism ; Humans ; Methylation ; Phosphorylation ; Protein Processing, Post-Translational ; Sumoylation

The internship is the transition period of a medico becoming a doctor,the cultivation of clinical work ability of interns is a comprehensive ability cultivation which includes the foundation theories' consolidation and use,the practical operative train- ing,the cultivation of clinical thought ability and communication between doctors and patients,etc.To educate pediatrics intern has its characteristics.

Objective To investigate the correlation of Bax and apoptosis in enterocytes of neonatal rats with necrotizing enterocolitis (NEC).Methods Forty-eight neonatal rats (1 day) were randomly divided into control group (n =24) and NEC model group (n =24) by use of odd and even.The rats in control group were maternal breast-fed.The rats in NEC model group were separated from their mothers.To be given formula feeding,cold exposure after hypoxic-reoxygenation treatment.The intestinal tissue located at the boundary of ileum and caecum of two groups were gained on the 24 h,48 h and 72 h with which that all rats were sacrificed by cutting neck.Section of intestinal tissue were stained with immunohistochemistry to detect the expression of Bax and were stained with TdT mediated dUTP nick end labeling(TUNEL) to evaluate the apoptosis in each group.Results The integrate optical density (IOD) value of expression of Bax in the NEC model group began to increase on the 24 h [(1 005.06-± 11.96) IOD] and reached the summit on the 72 h [(3 340.66 ±68.72)] compared with the control group[(666.55 ± 15.77)IOD].A few of TUNEL positive cells began to increase with time dependence.A lot of TUNEL positive cells could be found in NEC model group on the 24 h [(15.04 ± 0.24) ％],and the apoptotic index reached the peak on the 72 h [(35.65 ±0.61) ％] compared with the control group[(4.73 ±0.04) ％,P ＜0.01]-There was a significantly positive correlation between the cell apoptosis and the ratio change of Bax in NEC model group (r =0.94,P ＜ 0.01).Conclusion There is a significantly positive correlation between the cell apoptosis and the ratio change of Bax in enterocytes of neonatal rats with NEC.The cell apoptosis in enterocytes of neonatal rats with NEC maybe be induced by Bax.

Objective To explore the status,developing demands and directions of the education and training of military medical equipment.Methods The main problems of the PLA's medical equipment education and training were analyzed via being compared with those of foreign armies.According to the requirements on the campaign mode changing in the future war,the innovating mode under information-based military training,and the research and exploration of novel equipment and new technology,the developing directions in the future were ascertained.Results The interface was enhanced between new medical equipment development and educational training,and specifications were prepared for medical equipment application and maintenance.Conclutsion Exploring the pivot choke points and the developing directions will provide strategy guidance on the rapid and highly efficient elevation of military medical equipment supporting capacity.

·AlM: To investigate pathogeny and effects of surgery on paralytic strabismus.
· METHODS: A retrospective study was done in 46 patients with paralytic strabismus who underwent squint correction in our hospital from June 2010 to June 2013. Among 26 horizontal strabismus, the cases of extra rectus palsy was 16, internal rectus palsy was 10.Among all20 vertical strabismus, the cases of superior oblique palsy, superior rectus palsy, inferior rectus palsy, double elevator palsy counted for 7, 8, 2 and 3, respectively. Pathogenesis: trauma was 19 cases, followed by 10 cases that the causes could not be identified.Nine was congen ital paralytic strabismus, 8 o ccurred after nose or brain surgery. The surgery methods included rectus muscle recession, rectus muscle resection, partial rectus muscle transposition, Jensen procedure, inferior oblique myectomy and anterior transposition of inferior oblique. Statistical software SPSS10.0 was used in chi-square test between two groups, while the situation of paralysis eye movements improved by two methods in the horizontal strabismus group was compared with t test.
· RESULTS: Among all horizontal strabismus the rate of cure, improvement and inefficiency was 20 ( 77%) , 5 ( 19%) and 1 ( 4%) , respectively. Among vertical strabismus the ratio of cure, improvement and inefficiency was 15 (75%), 3 (15%) and 2 (10%).There was no significantly difference between the two groups ( P >0.05 ). The movements of paralytic eyes were improved. Two procedures used in horizontal strabismus, can improve paralysis eye movements were 3.76 ±0.91, 3.72 ±0.84mm, with no significant difference (P=0.93) statistically.
· CONCLUSlON: Paralytic strabismus in adults had complicated conditions. Choosing different operation methods in treating paralytic strabismus according to the degree of paralysis can result in satisfactory cosmetically alignment of the eyes and modify head position and diplopia.