Objective:To evaluate the relationship between long-term learning and memory impairment induced by sevoflurane anesthesia and postsynaptic density protein-95 (PSD-95)/Kalirin-7/Ras-related C3 botulinum toxin substrate 1 (Rac1) signaling pathway in neonatal rats.Methods:Sixty SPF male Wistar rats, aged 7 days, weighing 12-18 g, were divided into 5 groups ( n=12 each) using a random number table method: control group (group C), 1% sevoflurane anesthesia for 2 h group (group S 1), 1% sevoflurane anesthesia for 4 h group (group S 2), 2% sevoflurane anesthesia for 2 h group (group S 3) and 2% sevoflurane anesthesia for 4 h group (group S 4). Morris water maze test was performed at 4, 8 and 12 weeks after anesthesia.The rats were sacrificed after the last Morris water maze test, and the hippocampal tissues were obtained for microscopic examination of the pathological changes (using HE staining), neuron apoptosis (by TUNEL staining), and expression of PSD-95, Kalirin-7 and Rac1 protein and mRNA (by Western blot and quantitative real-time polymerase chain reaction). The apoptosis rate was calculated. Results:Compared with group C, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the time of stay in the target quadrant was shortened, and the apoptosis rate of hippocampal neurons was increased at 4th, 8th and 12th weeks after anesthesia, phosphorylated Rac1/Rac1 ratio was decreased, and the expression of PSD-95 and Kalirin-7 protein and mRNA was down-regulated in S 1, S 2, S 3 and S 4 groups ( P<0.05). Compared with group S 4, the escape latency was significantly shortened, the number of crossing the original platform was increased, the time of stay in the target quadrant was prolonged, and the apoptosis rate of hippocampal neurons was decreased, phosphorylated Rac1/Rac1 ratio was increased, the expression of PSD-95 and Kalirin-7 protein and mRNA was up-regulated, and the histopathological changes of hippocampal tissues were attenuated in S 1, S 2 and S 3 groups ( P<0.05). Conclusions:The mechanism by which sevoflurane anesthesia induces long-term learning and memory impairment may be related to inhibition of activity of PSD-95/Kalirin-7/Rac1 signaling pathway in hippocampi of neonatal rats.

To reflect specialty teaching characteristics and levels in clinical standardized training of medical professional degree postgraduates and highlight the thinking of evidence-based medicine culture,in urology rotation training practice,we conducted clinical pathway teaching according to picot principle (PICOT-CP teaching).According to the requirements of the teaching syllabus,the six kinds of major diseases were brought into PICOT-CP teaching.After the screening of pre teacher training,teaching tools and teaching cases,and based on the form of PICOT-CP,we standardized the implementation of clinical teaching of Urology,fully used subject website platform to discuss the interaction between teachers and students,and assessed the effect in combination with the departmental rotation examination and the teaching questionnaire survey of the students and the training teachers.Preliminary practice shows that PICOT-CP teaching helps to stimulate students' interest in learning,improve their overall quality,expand their clinical thinking,and establish their concept of evidence-based medicine.In addition,PICOT-CP teaching is beneficial to the teaching norms of teachers' teaching and can improve teaching level.

ObjectiveTo clarify the effect of medical students' non-intelligence factors on their academic records.MethodsTotally 104 medical students' non-intelligence factors and surgical academic records were collected and relationship between them was studied.Results① There were significant differences in academic records between students with different non-intelligence levels( F =4.21,P＜0.05 );better academic records were achieved in those with higher non-intelligence level than in those with good and poor non-intelligence level ( P ＜ 0.05 ).② There were significant differences in post clinical internship academic records between students with different non-intelligence levels ( F =8.65,P ＜0.01 ),better academic records were achieved in those with higher and good non-intelligence level( P ＜0.01,P ＜ 0.05 ).③ Medical students with higher and good non-intelligence level got obvious improvements in academic records after clinical internship,while students with medium non-intelligence level showed no difference ( P ＞ 0.05).ConclusionsMedical students' non-intelligence factors have obvious effect on their academic records.Keeping students' non-intelligence factors properly could improve their academic records.

Objective To investigate the therapeutic effect of post-traumatic complex posterior urethral stricture in the male patients.Methods Clinical data of 479 male patients with post-traumatic complex posterior urethral stricture were reviewed.One-stage resection of the stenosis and end-to-end anastomosis was performed in 422 patients and scrotal flap with blood pedicle posterior urethroplasty in 57.Results The mean operation time was 115 minutes(range,90-140 minutes).The mean blood loss was 225 ml(range,100-300 ml).No intraoperative blood transfusion was needed.The mean follow-up time was 15 months(range,12-24 months).Among the 422 patients performed end-to-end anastomosis,386 patients had good voiding and 36 had dysuria because of the formation of anastomotic stoma valve(21 patients)or stricture ring(15 patients).The problem was resolved by transurethral valve/stricture ring resection.Among 57 patients undergone posterior urethroplasty,45 patients had good voiding nine patients were found with anterior urethra-skin tube anastomotic stoma stricture,of which four patients were treated by urethral dilatation and five by endourethrotomy; three patients were found with posterior urethra-skin tube anastomotic stoma stricture,of which one patient was treated by urethral dilation and two by endourethrotomy.Conclusions One-stage resection of the stenosis and end-to-end anastomosis is the main treatment for post-traumatic complex posterior urethral stricture.If the condition of the patients does not allow the end-to-end anastomosis,posterior urethroplasty can be an alternative.

Objective To investigate the effect of general anesthesia with sevoflurane or intravenous propofol on anesthesia recovery period in obstructive jaundice patients. Methods Thirty ASA Ⅰ or Ⅱ and Child A obstructive jaundice patients were randomly divided into two equal groups (n=15 each). The patients in group S received inhalation anesthesia with sevoflurane and those in group P intravenous anesthesia with propofol during operation for obstructive jaundice. The patients were premedicated with intramuscular phenobarbital 100mg and atropine 0.5mg, anesthesia was induced with midazolam 0.05mg/kg, atracurium 0.5mg/kg, propofol 1.5-2.5mg/kg and fentanyl 4μg/kg. Maintained with TCI of propofol (target plasmaconcentration was set at 3.5mg/L) or sevoflurane inhalation (end-tidal sevoflurane concentration was 2%-3%) and intermittent i. v. boluses of fentanyl. EGG, HR, MAP, SpO<,2> and end-tidal sevoflurane concentration were continuously monitored during operation. Duration of anesthesia, the volume of infusion and fentanyl were recorded, awaking time, extubation and regained consciousness after operation were recorded. Results There were no significant differences between the two groups in average age, sex, body-weight, duration of anesthesia, the parameters of MAP and HR (P>0.05). The awaking time was (7.9±1.5) minutes in group S and (26.1±8.8) minutes in group P. The extubation time was (8.5±2.5) minutes in group S and (27.8±11.2) minutes in group P. The regained consciousness time was (13.1±4.4) minutes in group S and (33.7±12.5) minutes in group P. The incidence of lethargy, fidget were higher in group P than those in group S. Conclusion Both sevoflurane and propofol can provide satisfactory anesthesia for the operation of obstructive jaundice, but the recovery of influence caused by sevoflurane is faster and more steady than that caused by propofol.

BACKGROUND: Muscarine receptor plays a key role in adjusting contraction of detrusor muscle cell, and M3R, isoforms of its receptor, can mediate contraction of detrusor muscle cell directly. Ca2+ is the direct factor in stimulating contraction of detrusor muscle cell. Of several 10 kinds of Ca2+conjugable receptors protein, Ca2+ conjugated with different receptor proteins can adjust various reactions.OBJECTIVE: To investigate the effect of Ca2+-calmodulin (Ca2+-CaM) on contraction of M3R-mediated detrusor muscle cell.DESIGN: Compared observation .on the basis of detrusor muscle cell.SETTING: Ourological Center of Southwest Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was completed at Central Laboratory of Southwest Hospital of the Third Military Medical University of Chinese PLA. Healthy Wistar rats were selected in this study.METHODS: The primary cultured detrusor muscle cells were divided into experimental group and control group. Cells were inoculated in 6-well plate, and 10-4 mmol/L carbachol and M2R antagonist were added to cells of the experimental group during 70% confluence to block M3R and M2R respectively. Ca2+ concentration and CaM activity were detected by Ca2+ test kit and CaM test kit respectively.MAIN OUTCOME MEASURES: Changes of [Ca2+]I concentration and CaM activity of cells in both groups.RESULTS: The mean channel fluorescence values (log) of [Ca2+]I and CaM were higher in the experimental group than those in the control group(3.26±0.38, 2.06±0.12; 2.87±0.34, 2.14±0.24, P ＜ 0.05).CONCLUSION: Results in this study suggest that Ca2+-CaM participates in adjusting contraction of M3R-mediated detrusor muscle cells through signal transduction.

Objectives To observe the changes of the detrusor excitability and contractility and to study the mechanism of the unstable bladder. Methods Detrusor strips were obtained from prostectomy patients with benign prostatic hyperplasia. According to the results of urodynamic examination, patients were divided into detrusor instability (DI) and detrusor stability group(DS). Test of mechanical tension and stimulations with electricity and carbachol were performed on the excitability and contractility of the detrusor strips from 8 patients selected from each of the groups in vitro . Results The minimum tension of the detrusor strips when contraction occurred in DI and DS was (0 324?0 132)g and (0 822?0 216)g, respectively. There was significant difference between DI and DS ( P

Objective To study the mRNA expression of Toll-like receptor (TLR) 2 and 4 in human urinary tract epithelium. Methods The epithelial cells of nephric tubule, pelvis, ureter and bladder were cultured in vitro, and their mRNA expressions of TLR2 and TLR4 were measured by RT-PCR. Results The mRNA expression of TLR2 in nephric tubule, pelvis, ureter and bladder was 0.326, 0.589, 0.602 and 0.735, and that of TLR4 was 0.223, 0.327, 0.379, 0.365, respectively. The mean TLR2 mRNA copy was significantly higher than TLR4 in each tissue (P

Objective To explore the expression of connexin 43 in the interstitial cells of Cajal (ICCs) from guinea pig bladder in vitro. Methods Bladder ICCs were primarily cultured from guinea pigs by collagenase digestion method. Primarily cultured bladder smooth muscle cells (SMCs) from guinea pig were taken as control. The expressions of c-kit and smooth muscle actin (SMA) were detected by immunofluorescent method. Immumofluorescent method and Western blotting were used to detect the expression of Connexin 43 in 2 groups of cells. Results The expression of c-kit was positive in ICCs but negative in the control group. On the contrary, the expression of SMA was negative in ICCs but positive in the control group. Connexin 43 expression was significantly higher in ICCs than that in the control group (P

Objective To explore the expression of neuron specific enolase(NSE)and neuronal nitric oxide synthase(nNOS)in the interstitial cells of Cajal(ICCs)in vitro from guinea pigs.Methods The ICCs of bladder were primary cultured from guinea pigs by collagenase digestion.The control group was smooth muscle cell(SMC)of bladder primary cultured from guinea pigs.The expression of c-kit and smooth muscle actin(SMA)were detected by immumofluorescence.RT-PCR and Western blotting were used to detect the mRNA level and protein content of NSE and nNOS at 1,3 and 5 d after primary culture.Results The expression of c-kit was positive in the ICCs of bladder but negative in the control group,while the expression of SMA was negative in the ICCs of bladder but positive in the control group.Both NSE and nNOS of the ICCs of bladder were high in the mRNA and protein content,but were negative in the control group.Conclusion NSE and nNOS were expressed stably in the ICCs of bladder in vitro,indicating that the ICCs of bladder may be involved in the regulation of bladder function.