Objective To investigate the optimum concentration and dose of ropivacaine for caudal block in the neonates undergoing laparotomy under general anesthesia.Methods One hundred pediatric patients of both sexes,aged 9-30 days,weighing 2.5-4.5 kg,scheduled for elective pyloromyotomy,were randomly divided into 5 groups (n =20 each) using a random number table:control group (group C),0.10％ ropivacaine 1.0 ml/kg group (group 0.1％ L1),0.15 ％ ropivacaine 1.0 ml/kg group (group 0.15 ％ L1),0.10 ％ ropivacaine 1.2 ml/kg group (group 0.10 ％ L2),and 0.15 ％ ropivacaine 1.2 ml/kg group (group 0.15 ％ L2).Anesthesia was induced with sevoflurane and cisatracurium.The pediatric patients were tracheally intubated and mechanically ventilated.Remifentanil was infused intravenously at 0.2-0.3 μg· kg-1 · min-1 in group C.In 0.10 ％ L1,0.15 ％ L1,0.10 ％ L2 and 0.15％L2 groups,the corresponding concentrations and doses of ropivacaine were injected into the sacral canal under the guidance of ultrasound.The operation was started at 15 min after administration and sevoflurane was inhaled and the end-tidal concentration of sevoflurane was maintained at 0.8-1.0 MAC.Before induction (T1),at pyloric muscle retraction (T2),and at 4,8,12 and 24 h after operation (T3-6),blood samples were collected from the central vein for determination of plasma concentrations of cortisol and interleukin-6 (IL-6).Pain was assessed using CRIES score at T3-6.When CRIES scores ＞ 3,10％ chloral hydrate 0.5 ml/kg was given by retention enema for analgesia,and the requirement for chloral hydrate was recorded.The emergence time,extubation time,duration of stay in post-anesthesia care unit (PACU) and hospital discharge time were recorded.Bradycardia and hypotension during operation,and development of motor block of lower extremities,infection and dehiscence of incision,vomiting,and urinary retention after operation were also recorded.Results Compared with group C,no significant changes were found in the emergence time,extubation time,duration of stay in PACU,hospital discharge time,plasma concentrations of cortisol and IL-6,the requirement for chloral hydrate,and the incidence of bradycardia,hypotension,motor block of lower extremities,and infection and dehiscence of incision in 0.10％ L1 and 0.15 ％ L1 groups,the emergence time,extubation time,duration of stay in PACU,hospital discharge time were significantly shortened,and the plasma concentrations of cortisol and IL-6,requirement for chloral hydrate,and the incidence of hypotension and infection of incision were decreased in 0.10％ L2 and 0.15％ L2 groups,and the incidence of vomiting and urinary retention was increased in 0.15％ L1 and 0.15％ L2 groups.Compared with group 0.10％ L2,the incidence of vomiting and urinary retention was significantly decreased,and no significant changes were found in the other parameters mentioned above in 0.15％ L2 group.Conclusion The optimum concentration and dose of ropivacaine are 0.10％ and 1.2 ml/kg,respectively,for caudal block in the neonates undergoing laparotomy under general anesthesia.

It is always an important academic and policy issue to understand the impact of hospital distance on Chinese inpatient service demand in rural areas. It employs household survey data collected from 97 villages in Shandong in 2006 and 2008, and investigates the influences of hospital distance on the demand of famars in rural areas. The discrete choice model is constructed to estimate the inpatient service demand function for patients in rural areas. The empirical analysis finds that the hospital distance is significantly affecting Chinese inpatient service demand in the rural areas. The longer the distance increases, the lower the visiting rate drops. In addition, the impact changes with the changes of hospital level; the lower the primary hospital is, the higher the impact would be. It paper provides new evidence for the understanding of the geographical characteristics of medical health care.

Objective To investigate the related factors of early angina after acute myocardial infarction,and to provide basis for the disease prevention and control.Methods 1 32 cases with acute myocardial infarction were selected.The clinical data were collected.The occurrence rate of early angina pectoris after acute myocardial infarc-tion,and clinical characteristics were analyzed.The related factors of acute myocardial infarction angina were explored.Results The incidence rate of early angina pectoris after acute myocardial infarction was 29.55%.Within 7 days after acute myocardial infarction occurred angina,the highest rate for 64.1 0%,followed by 7 -1 4 days in the occurrence of angina pectoris,28.21 %.34 cases were the original location of myocardial infarction ischemia and 5 cases were the far part of ischemia,21 cases showed ST segment elevation,1 8 cases showed ST lack blood group downward.Anterior wall,inferior wall infarction composite,successful thrombolytic therapy recanalization,myocardial infarction before episodes of angina pectoris,history of hypertension,heart function classification more than or equal to grade III in patients with acute myocardial infarction occurred after the proportion of early angina pectoris were signifi-cantly higher (all P <0.05).Conclusion Anterior wall,inferior wall infarction composite,successful thrombolytic therapy recanalization,myocardial infarction before episodes of angina pectoris,history of hypertension and cardiac functional grading more than or equal to grade III are related to early angina pectoris after acute myocardial infarction. We should actively take measures aimed at early prevention and treatment of early angina pectoris after acute myocar-dial infarction to avoid illness aggravating,improve the patients'prognosis.

se—Met. In the experimental range of concentration, the activities of GSH—px were higher than that of control.

Objective To investigate the construction of compound membrane with corneal stromal cells and collagen-chitosan by tissue engineering technique and its biocompatibility.Methods Rabbit and human corneal stromal cells were separated and seeded into collagen-chitosan membrane.The compound membrane was transplanted into rabbit corneal stroma.Then the growth condition of keratocytes,the effect on normal keratocytes and degradation of compound membrane were detected by corneal confocal microscope,anterior OCT and histological and immunohistochemical methods ex vivo 1,2,4 weeks after grafting.Results The rabbit and human corneal stromal cells grown well in collagen-chitosan scaffold.The compound membrane degradated gradually after grafting.There was no necrosis and dissolvation.Corneal epithelium,stroma and endothelial cells were all normal.Conclusion Collagen-chitosan can be used as a biological scaffold for construction of corneal stroma.Corneal confocal microscopy and anterior OCT are new methods to observe the biological activity of constructed corneal stroma.

Objective To investigate the effects of GGNBP2 on proliferation,migration and invasion of human gli-oma U251 cells and the potential mechanism. Methods U251 glioma cells were transfected with lentiviral vector carrying GGNBP2 to establish a stable overexperssion of GGNBP2 in U251 cell line. After verification of the efficiency of transfec-tion by real-time PCR, Western Blot, PCR and CCK-8 were applied to detect the proliferation of U251 cells. The Tran-swell chamber assay was applied to measure the migration and invasion of human U251 glioma cells. Western blot was applied to measure protein levels of AKT, p-AKT, PCNA and MMP9. Result The stable U251 glioma cell line overex-pressing GGNBP2 was successfully established. Compared with the control group, overexpression of GGNBP2 significant-ly inhibited the proliferation(P<0.05),invasion(57±6 vs. 203±6,205±7,F=512.4,P < 0.05)and migration (74±7 vs. 254±14,248±13,F=242.5,P<0.05) of U251 cells. The protein expression levels of p-AKT (F=45.4, P<0.05), PCNA (F=348.5, P<0.05) and MMP-9 (F=88.7, P<0.05) in GGNBP2 group were markedly decreased compared with the control group. Conclusion GGNBP2 may suppress the proliferation, invasion and migration of glioma though down-regulation of p-AKT, which in turn inhibits PCNA and MMP-9 expression.

Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.

Objective To optimize the processing technology of sliced Myristicae Semen. Methods Roasting temperature, roasting time and the amount of bran were set as factors, and the content of total lignans, volatile oil, fatty oil were set as evaluation indicators. The processing technology of sliced Myristicae Semen was optimized by L9(34) orthogonal test. Results The optimal processing technology was as following: 40 g bran plus 100 g sliced Myristicae Semen, roasting for 20 minutes at 110-120 ℃. Conclusion The process is reasonable and reliable, which can provide references for new processing technology of Myristicae Semen.

SUMMARY We analyzed the clinicopathological characteristics of one patient with Rhupus syndrome as-sociated nephropathy in Peking University People ’s Hospital, and reviewed the related literature .The pa-tient was a middle aged female .She developed rheumatoid arthritis first , and then manifested mild sys-temic lupus erythematosus together with positive anti-neutrophil cytoplasmic antibodies ( ANCA ) and cryoglobulinemia several years later .The renal biopsy was performed and manifested as lupus nephritis . The transmission electron microscopy revealed cryoglobulinemia associated renal damage .This report shows that the clinicopathological characteristics in patients with Rhupus syndrome associated nephropathy are complicated .The renal pathology can be used as a diagnostic tool .

Objective To investigate the effects of hydrogen rich water on the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and oxidative stress in rats with traumatic brain injury (TBI).Methods Ninety healthy male Sprague-Dawley (SD) rats were randomly divided into sham operation group, TBI group and hydrogen rich water treatment group (HW group), with 30 rats in each group.TBI model was reproduced by the modified Feeney weight dropping method.The skulls of rats in sham operation group underwent only craniotomy without direct hit.The rats in HW group received brain injury by hitting after craniotomy, followed by injection of hydrogen rich water (5 mL/kg) intraperitoneally once a day for 5 days after successful reproduction of the model.The rats in sham operation group and TBI group were given an equal amount of normal saline in same manner.Six rats from each group were sacrificed at 6, 12, 24, 48 hours and 5 days after evaluating neurological severity scores (NSS).The brain tissue in injured ipsilateral cortex was harvested.The activity of catalase (CAT), glutathione peroxidase (GSH-Px), and content of malondialdehyde (MDA) were determined by spectrophotometry.The expressions of mRNA and nucleoprotein of Nrf2 were determined by quantitative real-time polymerase chain reaction (RT-qPCR) and Western Blot.The pathological changes were observed with microscopy after hematoxylin and eosin (HE) staining.Results ① NSS score:compared with TBI group, NSS in HW group at 12, 24, 48 hours and 5 days were significantly decreased (12 hours: 9.83±2.32 vs.13.17±2.71, 24 hours: 9.83±2.79 vs.13.50±2.43, 48 hours: 7.50±2.07 vs.11.83±2.14, 5 days:5.50 ± 1.87 vs.10.50 ± 2.43, all P ＜ 0.05).② Compared with sham operation group, the activity of GSH-Px and CAT in TBI group were markedly declined after operation, while the MDA content was elevated significantly, especially at 24 hours [CAT (kU/g): 1.080±0.312 vs.3.571 ±0.758, GSH-Px (kU/g): 9.195±3.173 vs.32.385± 10.619, MDA (μmol/g): 12.282±2.896 vs.4.349± 1.511, all P ＜ 0.01].Compared with TBI group, the parameters in HW group were improved, and they were similar as sham operation group.③ RT-qPCR: no significant difference was found in the expression of Nrf2 mRNA at each time point in three groups.④ Western Blot: the expression of Nrf2 nucleoprotein (gray value) in TBI group was apparently higher than that in sham operation group, and peaked at 24 hours (0.703 ± 0.262 vs.0.238 ± 0.120, P ＜ 0.05), and the expression in HW group was obviously higher than that in TBI group, especially at 24 hours (1.110 ± 0.372 vs.0.703 ± 0.262, P ＜ 0.05).⑤ HE staining: the brain structure in sham operation group was found to be intact.However, there were different degrees of pathological changes at each time in TBI group, especially at 24 hours.The pathological damage of brain tissue in HW group was significantly milder.Conclusions Hydrogen rich water can up-regulate the expression of Nrf2, and reduce oxidative damage of traumatic brain injury in rats.Nrf2 can up-regulate the expression of its downstream antioxidant enzymes, which may be the mechanism of the upregulation expression of Nrf2 in the study.