Objective To achieve the software automatic updates and maintenance in the local area network which is developed based on the C/S structure. Methods Based on the existing software and hardware development platform,we use PowerBuilder to exploit and compile a program which can determine whether the software need to update automatically or not under the premise of unchanging the existing LAN software system. Results When the user terminal in the local area network runs this program,they can update it automatically whenever they need. Conclusion This method will greatly reduce the later maintenance software,upgrade works and also improve the work efficiency and accuracy.

Objective To investigate the in vivo effects of glutamine(Gln) on inflammatory cytokine release in murine peritoneal macrophages during sepsis. Methods Sixty Kunming mice were randomly divided into sham-operation group(Sham group,n=20),operation control group(Con group,n=20) and Gln-treatment group(Gln group,n=20).Sepsis was induced by cecal ligation and puncture in Gln group and Con group,and Gln(0.75 g/kg) or saline was immediately administered via single tail vein injection.Serum was collected and macrophages were harvested from peritoneal lavage at 6 h in these three groups.Intracellular and serum cytokines of tumor necrosis factor-?(TNF-?),interleukin(IL)-6 and IL-10 were detected by ELISA.The expression of TNF-? mRNA in macrophages was analyzed by RT-PCR,and the expression of heat shock protein(HSP) 72 in macrophages was evaluated by Western blotting. Results Gln group demonstrated significantly lower intracellular TNF-? and IL-6 levels than Con group(P0.05).The serum TNF-? level was significantly lower in Gln group than in Con group(P

Objective To explore the reason for remedy radical operation after endoscopic submucosal dissection (ESD) for early gastric cancer.Methods The clinical data of 26 early gastric cancer cases who received remedy radical gastrectomy after ESD between January 2012 to March 2015 in Nanjing Drum Tower Hospital were analyzed retrospectively.Results All cases were followed up and mid follow-up was 25 months.There was no death nor tumor reccurence cases during the follow-up.Three cases suffered from complications in radical surgery for gastric cancer including afferent jejunal loop obstruction,adhesive intestinal obstruction,stomach paralysis respectively,all were cured by conservative therapy.Postoperative pathology found lymph node metastasis in 3 cases.Conclusions En bloc resection and negative resection margin,as well as free lymphatic metastasis are two important factors determing the survival of early gastric cancer patients undergoing ESD treatment.

The clinical, neuroelectrophysiological, neuropathological characteristics and outcome of a case of acute sensory axonopathy are reported. The patient was a 32-year-old female. She presented with acute onset sensory abnormalities, sensory ataxia, pseudoathetosis and areflex. Lab testing showed cerebrospinal fluid albumin cytologic dissociation. Electromyography studies and sural nerve pathology were consistent with acute sensory axonopathy. Treatment including intravenous immunoglobulin and steroid therapy was provided. Her symptoms recovered slowly without relapse, so did tibial H-reflex amplitudes.

Objective To compare volume-controlled ventilation (VCV) versus pressure-controlled ventilation (PCV) improved by PEEP during one-lung ventilation (OLV).Methods Fifty ASA physical status Ⅰ-Ⅲ patients,aged 25-64 yr,weighing 40-80 kg,undergoing elective thoracotomy,were randomly divided into 2 groups (n =25 each) using a random number table:VCV + PEEP group (group Ⅴ) and PCV + PEEP group (group P).Those in group Ⅴ underwent OLV initially with VCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.Those in group P underwent OLV initially with PCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.At the beginning of two-lung ventilation before chest opening (T1),at 20 min of OLV before PEEP (T2),and at 20 min of ventilation with PEEP (T3),arterial blood samples were collected for blood gas analysis and the peak airway pressure (Ppeak) and development of SpO2 ＜ 95 ％ from beginning of OLV to T3 were recorded.Results Compared with group P,Ppeak at T2,3 and PaO2 at T3 were significantly increased in group Ⅴ (P ＜ 0.05).Compared with the baseline value at T1,PaO2 was significantly decreased and Ppeak was increased at T2.3 in Ⅴ and P groups (P ＜ 0.05).The incidence of SpO2 ＜ 95％ was significantly decreased and PaO2 was increased at T3 than at T2 in Ⅴ and P groups (P ＜ 0.05).Conclusion 4 cm H2O PEEP can improve VCV and PCV during OLV and the improved efficacy is better for VCV in patients undergoing thoracotomy.

Objective To study the relationship between M3 receptor and prostastic tumor by analyzing the expressions of M3 and vascular endothelial growth factor(VEGF)in adult human normal and neoplastic prostatic gland tissue. Methods The specimens included 36 normal prostates(fresh),36 benign prostatic hyperplasia(BPH)tissue(fresh),and 36 cancer tissue(8 fresh).RT-PCR was used to detect M3 receptor,VEGPs genetic expression.At protein level,VEGF,Ms receptor,CD34 were detected by western-blot and immunohistochemical method. Results VEGF and M3 receptor's genetic expressions were higher in prostate cancer tissue(O.8354±0.1897,0.7824±0.2047)than in BPH tissue(0.6735±0.1603,0.6021±0.1637),while the expressions of these genes were lowest in normal prostate tissue(0.5425±0.1629,0.3436±0.1581)(P<0.001).There was a positive correlation between M3 and VEGFs gene expression(r=0.4999,P

Objective To observe different priming techniques with intubation dose when using cisatracurium in onset time and safety. Methods Eighty ASA physical status Ⅰ and Ⅱ patients undergoing elective surgery requiring general anesthesia were enrolled. Group Ⅰ with 20 cases received cisatracurium 0.010 mg/kg, group Ⅱ with 20 cases received cisatracurium 0.015 mg/kg,group Ⅲ with 20 cases received cisatracurium 0.010 mg/kg,and group Ⅳ with 20 cases received normal saline. Four minutes after priming,group Ⅰ received cisatracurium 0.140 mg/kg ,group Ⅱ received cisatracurium 0.135 mg/kg, group Ⅲ received cisatracurium 0.190 mg/kg,and group Ⅳ received cisatracurium 0.200 mg/kg. Mechanomyography assessed the neuromuscular function of the adductor pollicis with train-of-four (TOF) supramaximal impulses T1. The trachea was intubated when the amplitude of T1 decreased to 0. Recorded T1 and TOF in 4 minutes and onset time of muscle relaxation, then evaluated intubation condition. Results The onset time in group Ⅰ , Ⅱ, Ⅲ and Ⅳ were (151.30 ± 10.90), (138.90 ±8.37), (145.45 ± 17.12), (148.75 ± 18.70) s,respectively. The onset time in group Ⅱ was obviously shorter than that in group Ⅰ , Ⅲ and Ⅳ (P ＜ 0.01 ),thus there was no significant differences among the group Ⅰ , Ⅲ and Ⅳ. During the priming interval, the value of T1 and TOF were both showing downtrend, in group Ⅱ ,there was TOF ＜ 90%. Conclusions Priming dose 0.010 mg/kg and intubation dose 0.140 mg/kg is just the same like that in intubation dose of quadruple ED95 whether priming. There is no benefit in priming cisatracurium of intubation dose quadruple ED95. There is TOF ＜ 90% in 4 minutes priming interval when using priming dose 30% ED95 and it is proved unsafely.

Objective: To optimize and establish the best hydrolysis method of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate through the optimization of simple compound of diethyl N-(4-aminobenzoyl)-L-glutamate.Methods: To increase the low yield of hydrolysis reaction of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate due to the by-products and difficult purification, we studied the effect of NaOH and KOH, two kinds of alkalis, three concentrations between 0.175-1 mol/L and five types of reaction time involved in 20, 30, 60, 120 and 180 min on the common side chain diethyl N-(4-aminobenzoyl)-L-glutamate.A high performance liquid chromatography was established for measuring the target product and the by-products in reaction liquid in different reaction conditions.Finally, on the basis of the best hydrolysis method of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate, we completed the optimization of the hydrolysis reaction conditions of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate.Results: We developed the best reaction condition for the hydrolysis of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate, which could be carried out easily and efficiently.The results indicated that treated with the optimized condition of 0.3 mol/L KOH in 60 min at the room temperature, diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate was converted into its diacid derivative in 95.6 % yield, which turned to be a better reaction condition compared with the previous reaction condition.The structures of those compounds were identified to be correct by 1H nuclear magnetic resonance(1H NMR), 13C nuclear magnetic resonance(13C NMR) and electrospray ionization time of flight mass spectrometry (ESI-MS).The purity of the diacid derivative of the compound was determined to be 96% by high performance liquid chromatography(HPLC).The new hydrolysis reaction condition could not only avoid the formation of single ester hydrolysis product and amide bond hydrolysis product, but also improve the yield of the hydrolysis reaction.Conclusion: We have developed an efficient reaction for the hydrolysis of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydro.Since the final step of the synthesis of classical folic acid antagonists is always the catalyzed hydrolysis of the side chain glutamate, the reaction also has great significance for anti-folic acid anti-tumor inhibitors synthesis.

Objective To investigate the pharmacokinetics ( PK ) and pharmacodynamics ( PD ) processes of rabeprazole in inhibiting gastric acid secretion with the combined PK-PD model. Methods A total of 10 healthy volunteers were given a intravenous infusion of 20 mg rabeprazole over a 30-min period. The concentration of rabeprazole in the plasma at different time points was detected by HPLC,and the PK parameters were calculated by DAS 2. 0 software. At the same time the intragastric pH was monitored over 24 hours to fit the PD parameters with indirect inhibition model. Results The main PK parameters,t1/2,Cmax,and AUC were(60. 5±17. 3)min,(1 299. 1±201. 0)ng·mL-1,and(106. 4±26. 0)mg·min·L-1, respectively.The corresponding PD parameters,Kin,Ke,IC50 and Imax were(8.200±3.362)h-1,(1.080±0.378)h-1,(0.286± 0. 129)mg·L-1 and(6. 93± 2. 15)pH,respectively. Conclusion The PK of rabeprazole in healthy volunteers conforms to one compartment model,and the PD fits the indirect response inhibition model. The equation can effectively establish the relationship between the blood drug concentration and the effect.

OBJECTIVE:To observe the effects of alprostadil combined with papaverine on blood coagulation indexes and complications in uremic hemodialysis patients after initial arteriovenous fistula.METHODS:One hundred and eighteen uremic hemodialysis patients undergoing initial arteriovenous fistula in our hospital during Feb.-Jun.2015 were divided into control group and observation group according to random number table,with 59 cases in each group.Both groups received local irradiation with hemodialysis internal fistula repair instrument 30 min,tid,from 3 days before surgery to 10 days after surgery.Control group was treated with Alprostadil injection 10 μg,iv,qd,immediately after surgery.Observation group was additionally treated with Papaverine in jection 30 mg,iv,qd,on the basis of control group.Both groups received treatment for 10 d.The orificium fistulae blood flow,hemodialysis blood flow and the time of initial hemodialysis were compared between 2 group.The plasma prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fib),platelet count (PLT) and C-reactive protein (CRP) levels were observed in 2 groups before and after surgery.The occarrence of postoperative complications was observed.RESULTS:The orificium fistulae blood flow and hemodialysis blood flow of observation group were significantly higher than those of control group,and ini tial hemodialysis time was significantly shorter than control group,with statistical significance (P＜0.05).Before surgery,there was no statistical significance in PT,APTT,Fib,PLT and CRP between 2 groups (P＞0.05).After surgery,APTT and CRP of 2 groups were increased significantly,Fib was decreased significantly;the above indexes of observation group was significantly better than that of control group,with statistical significance (P＜0.05).There was no statistical significance in PT,PLT between 2 groups (P＞0.05).There was no statistical significance in the incidence of internal fistula infection and postoperative wound bleeding volume＞ 10 mL between 2 groups (P＞0.05).The incidence of internal fistula occlusion and orificium fistulae thrombus in observation group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:The application of alprostadil combined papaverine on uremic hemodialysis patients after initial arteriovenous fistula can effectively prevent inflammation reaction,fistula thrombus formation and fistula occlusion,and improve the maturation of fistula.