Objective To discuss the management and feasibility of sacral block anesthesia in pediatric interventional therapy. Methods A total of 80 pediatric patients were randomly and equally divided into two groups. Patients in group A received sacral block anesthesia together with basic anesthesia with propofol, while patients in group B received intravenous anesthesia with propofol. Small amount of ketamine as maintaining dose was used in both groups when needed. Results The interventional management was successfully completed in all patients. A marked decrease in blood pressure occurred in three patients of group A receiving sacral block anesthesia. In group B receiving intravenous anesthesia, a decrease, of SpO_2 to below 90 percent was seen in 8 cases, and obvious bradycardia developed in 12 cases. All these patients were treated with intravenous medication or by reducing the dose of propnfol. Additional small dose of ketamine was needed in 4 patients during the procedure. Conclusion Sacral block anesthesia combined with intravenous anesthesia is one of the effective anesthesia management schemes for pediatric interventional therapy.

Objective] To sum up the clinical experience of professor Zhang Qin in treating menostaxis caused by PCSD. [Methods] From the TCM theory , therapy and successful case,it analyses the professor Zhang Qin's unique feature of PCSD.[Results] Professor Zhang considers that the disease is induced by the blades,which leads to blood stagnation-heat and Qi-deficiency,and puts forward the two-step traditional Chinese medicine: step one is to expel blood stasis using modified Jiawei Shixiaosan in the menstrual cycle from the first day to the fifth day ,step two is to stanch bleeding using modified Guchongtang in the menstrual cycle from the sixth day to the twelfth day. A case in point proves that two-step traditional Chinese medicine can recover the menstrual period normally. [Conclusion] Professor Zhang Qin's clinical experience in treating menostaxis caused by PCSD obtains the good curative effect,having enlightenment meaning to clinical practice,with promotion value.

Objective To explore the correlation between nurses' work alienation and silence behavior.Methods 603 registered nurses were recruited from a tertiary hospital in Guangzhou.They were investigated with Alienation Scale and Work Silence Behavior Scale.Results The scores of work alienation and silence behavior were (34.35±6.53) points and (37.66±6.46) points respectively,and both of them were at the medial level.Work alienation was positively related to silence behavior (r=0.603).All dimensions of work alienation were positively related to all dimensions of silence behavior (P ＜ 0.01).The predictors of silence behavior were age,nursing working years,job title,department,frustration,helplessness and meaningless,explained 42.2％ of its variance.Conclusions Work alienation has positive effect to silence behavior.The administrators in hospitals should focus on nurse,work alienation and silence behavior,and reduce silence behavior by reducing work alienation.

Objective The purpose of this study was to investigate the early outcome of radiofrequency ablation for the treatment of atri-al fibrillation (AF) during concomitant mitral valve replace procedures. Methods From January 2013 to September 2014,43 patients with mitral valvular disease with atrial fibrillation were enrolled in this study. The cases were classified into underwent mitral valve replace surgery concomitant with atrial fibrillation radiofrequency ablation ( RFA group) or underwent only mitral valve replace surgery ( control group) . Re-sults There was no perioperative death and stroke. RFA group’ s time of Cardiopulmonary bypass was more longer than control group. The comparison between RFA and control groups revealed no differences in terms of bleeding,24 hours’ Pleural fluid volume,the mechanical ven-tilation time and time in intensive care unit. One week after the operation,20 cases (87%) in RAF group were sinus rhythm while it was 6 cases(30%) in control group. After a follow-up of one month,RAF group had 78% remaind sinus rhythm while it was 25% in control group. Conclusion Radiofrequency ablation for the treatment of atrial fibrillation ( AF) during concomitant mitral valve replace is safe and effective.

Objective To clone and identify neurotrophic factor NT3 gene from mouse liver so as to establish a cell strain expressing high level of NT3 gene. Methods The target genes amplified by RT PCR were cloned into the shuttle vector pExchange 1neo, and then the DNA sequence was analyzed by enzyme digestion and sequencing. The recombinant expression vector pExchange NT3 1neo was employed to transfect the embryonic stem cell strain MESPU35, and then the transfected cells were selected by G418. The NT3 level in the transfected cells was detected by RT PCR. Results A gene fragment of 777 bp was obtained by RT PCR, and the DNA sequence was identical to mice NT 3 gene sequence of GenBank. The recombinant vector was constructed successfully and the constructed cell strain could express high level of NT 3 gene. Conclusion The successful cloning of NT3 gene from mouse liver, construction of pExchange NT3 1neo expression vector, and establishment of cell strain stably expressing high level of NT3 gene have laid a foundation for the further studies.

BACKGROUND: Pathogenesy of immunoglobulin A nephropathy (IgAN) is not clear up to now. Present research has verified that the key pathogenetic pathway is abnormalities of IgA1 molecular O-glycosylation induced by decrease of ?1,3-galactosyltranferase activity in IgA1 hinge region of IgAN patients. Prophase study by the authors supposed that the key of IgAN O-glycosylation abnormality might be due to the decrease of ?1,3-galactosyltranferase specific molecular protein chaperone Cosmc in B lymphocyte of peripheral blood in IgAN patients. OBJECTIVE: To measure DNA sequence of ?1,3-galactosyltranferase specific molecular chaperone in coding region of Cosmc gene in IgAN patients,and compared with the sequence of Gene Bank. DESIGN: Case-controlled observation. SETTING: Department of Nephrology,West China Hospital,Sichuan University. PARTICIPANTS: Totally 27 IgAN patients and 10 non-IgAN patients were recruited in Department of Nephrology of West China Hospital of Sichuan University from November 2005 to August 2006,and five normal controls were included in this study. All the subjects knew the fact and agreed to participate in the experiment. METHODS: The experiment was performed at the State Key Laboratory of Biotherapy of Sichuan University. 2 mL peripheral venous blood of all the samples were taken into heparin sodium anticoagulated tubes,from which total genomic DNA were extracted by phenol/chloroform precipitation method. Concentration of DNA was determined by ultraviolet spectrophotometer. The polymerase chain reaction (PCR) was used to amplify the coding region of ?1,3-galactosyltranferase specific molecular chaperone Cosmc gene in all the subjects and direct sequencing was done in PCR products of each subjects. The results of all the sequencing were compared with Gene Bank one by one. MAIN OUTCOME MEASURES: Amplification findings and sequencing of coding region of ?1,3-galactosyltranferase specific molecular chaperone Cosmc gene by PCR. RESULTS: ①Coding region of Cosmc gene located at 257-1 213,and amplified Cosmc gene was 1 247 bp. ②The sequence of Cosmc gene coding region was similar in IgAN patients,non-IgAN patients and normal controls,and no difference of gene sequence was noticed in all the result sequences as compared with the Gene Bank registered sequence. CONCLUSION: No abnormal sequence is found in coding region of Cosmc gene in IgAN patients,suggesting that this coding region probably is not associated with the abnormalities of IgA1 O-glycosylation in IgAN.

AIM: To isolate peptides targeted binding and internalizing into glioblastoma cell line SWO-38. METHODS: Tumor cells were screened five rounds of whole cell screen through the Ph.D.-12 phage display library. The monoclone specific binding efficiency to the tumor cell was analyzed, and the DNA of phages were extracted, sequenced and translated to the sequences of amino acid. RESULTS: In the phage library after five rounds of screen , 10 of 13 monoclones had highly selective binding to SWO-38 cells. We found two repeated peptide sequences. CONCLUSION: Whole cell screening against tumor cells through random phage peptide library can obtain phage peptides with highly specific binding and internalizing ability. The peptides could be used as a therapy vector for tumor targeted delivery.

AIM: To study the protective effect of bone marrow stromal cells (MSCs) on ischemia /reperfusion hippocampal slices. METHODS: Ischemia/reperfusion models of hippocampal slices from newborn rats were established. MSCs obtained from adult bone marrow were cultured, isolated and purified. Cell death was assessed using propidium iodide fluorescence. And brain-derived neurotrophic factor (BDNF) expression in MSCs was determined by immunocytochemistry and Western blot. RESULTS: Maximal dead cells appeared in hippocampal slices 3 to 7 days after reperfusion. When the slices were co-cultured with MSCs, only a few cells were dead. The protective effect of MSCs on the slices was diminished significantly when anti-BDNF antibody was added to the medium. The protein of BDNF was faintly expressed in MSCs under normal conditions. When MSCs were co-cultured with ischemia /reperfusion hippocampal slices, the expression of BDNF in MSCs was increased gradually especially when co-cultured for 3 to 7 days. However, MSCs co-cultured with normal hippocampal slices expressed BDNF at a lower level at any times of co-culture. CONCLUSIONS: In an in vitro model of simulated ischemia, MSCs reduce cell death. Ischemia/reperfusion hippocampal slices co-cultured with MSCs promote the expression of BDNF in MSCs, which in turn protect the ischemic neurons.

Objective To compare the difference of serum heme oxygenase-1 (HO-1) and carbon monoxide(CO) levels between the patients with coronary heart disease(CHD) caused chronic heart failure(CHF) and CHD patients with normal cardiac function,and further to explore the protective mechanism of HO-1/CO system during the pathogenesis process of CHF.Methods Ninety-one patients with CHF were selected as the observation group and 72 CHD cases with normal cardiac function were taken as the control group.The concentration of HO-1 was determined by ELISA arid the Chalmer S method was used to detect serum CO concentration.The general clinical data of the two groups were recorded by the using the heart failure questionnaire.And the liver and kidney functions,blood lipids,NT-proBNP,BNP and cardiac echocardiography examination were performed.Results The serum HO-1 level in the observation group was (8.13±0.27)ng/mL,which was higher than (2.80±0.52)ng/mL in the control group;the CO level in the observation group was (0.35±0.06)mg/L,which was lower than(0.59±0.07)mg/L in the control group,the difference was statistically significant(P＜0.01);the HO-1 level in the observation group was gradually increased with the increase of cardiac function grade (P＜0.01);while the CO level was decreased with the increase of cardiac function grade (P＜0.01).Conclusion The serum HO-11evel in the patients with CHF is highly expressed with the heart failure aggravation;endogenous CO is gradually decreased due to consumption after cardiac failure aggravation.

PBL ( Problem-based learning) is a problem-based and student-centered learning pattern.PBL teaching method has been applied to evidence-based medicine ( EBM ) courses for international students.By this method,the students' learning enthusiasm was stimulated,the ability of ananlyzing and resolving problem was improved,and good teaching effect was achieved,which provided knowledge to improve further EBM teaching and evidence-based clinical practice.