Objective To study the autonomic nervous regulation function,and to study relationship between heart rate variability and severity,organ dysfunction and prognosis in patients with systemic inflammatory response syndrome (SIRS).Methods All the patients were divided into two groups:SIRS and non-SIRS according to the criteria of SIRS. The SIRS group included 100 patients and the non-SIRS group 30 patients,and the control group included 30 heathy adults. SIRS group was further divided into two subgroups:survivor and succumbed.Heart rate variability(HRV)was analyzed with the two methods of time-domain and frequency-domain.Results The SIRS group had significantly higher APACHEll scores and MODS scores(P＜0.01)and lower HRV when compared with the non-SIRS group(P＜0.05).In the SIRS group,the succumbed groupallad statistically higher APACHEII and MODS scores and lower HRV than the survivor group( P＜0.01).There was a negative correlation between the prognosis of the patients and SDNN(r=-4.68,P＜0.01), SDNN＜55 ms was the most sensitive(76.2%),and specific(76.7%),with positive predictive value(90.4%)and negative predictive value(52.6%).Conlusion The SIRS patients had lower HRV,and there was a negative correlations with the severity of disease,organ dysfunction and prognosis.HRV(SDNN)were the useful index to evaluate the prognosis of critically ill patients.

Objective To investigate the treatment method of selective neck dissection(SND). Methods 68 cases patients with differentiated thyroid carcinoma were cured by selective neck dissection. Results The rate of lymph node diversion in 68 cases patients was 60.3%, among the diversion rate of lymph node in VI area was 51%. There were not patients who happend permanent damagement of laryngeal nerve and hypoparathyroidism. Conclusions It is available that selective neck dissection cures differentiated thyroid carcinoma.

Objective To investigate the effect of ketamine on the synaptic long-term potentiation(LTP) in the CA1 area of rat hippocampal slices,and to elucidate the mechanisms underlying the effect of ketamine on memory.Methods Hippocampal slices(400 ?m thick) were obtained from the brains of male Sprague-Dawley rats(2 months old) weighing 200-250 g that were decapitated.The slices were incubated in artificial cerebrospinal fluid(ACSF) at room temperature for at least 120 min before use.Forty-nine slices were randomly divided into 7 groups(n=7):control group,ketamine 1,5,10,30,50 and 100 ?mol?L-1 groups.All the slices in each group were perfused with ACSF,ketamine 1,5,10,30,50 or 100 ?mol?L-1,respectively.The slices in each group were performed to record evoked population spikes(PS) using extracellular microelectrode recording technique.Another forty-nine slices were randomly divided into 7 groups(n=7):LTP group,ketamine-LTP 1,5,10,30,50 and 100 ?mol?L-1 groups.All the slices in each group were perfused with ACSF,ketamine 1,5,10,30,50 or 100 ?mol?L-1,respectively.PSs were recorded for at least 30 min before LTP in each group.For LTP induction,high-frequency stimulation(HFS) conditioning pulses(100 Hz?s-1) were applied to the Schaffer collateral-commissural pathway of hippocampus using a bipolar stimulating electrode.The changes in PS amplitude after HFS were analyzed in each group.Results The PS amplitude of the rat hippocampal slices in ketamine 1,5,and 10 ?mol?L-1 groups had no significant difference compared with control group.The PS amplitude in ketamine 30,50 and 100 ?mol?L-1 groups decreased compared with control group(P

ObjectiveTo know the recent status of heart transplantation in Chinese multicenters.MethodsThe retrospectively data from 24 centers before 2010 (438 cases) and the data from China heart transplant Registry database between 2010 (149 cases from 15 centers)-2011(148 cases from 19 centers) were analyzed.Results In 2010,15 centers performed heart transplantation,including one large-scale center (60 transplants per year),3 moderate-scale centers (10 to 30 transplants per year),and 6 small-scale center (2-8 transplants per year).The rest 5 centers had one transplant per year each.In 2011,19 centers performed heart transplantation,including one large-scale center (52 transplants per year),3 moderate-scale centers (10 to 30 transplants per year),and 5 small-scale centers (2-8 transplants).The rest 8 centers had one transplant per year each.In 2010 and 2011,the median ages of heart transplant recipients were 44.6 and 42.9 years,respectively.Nonischemic cardiomyopathy was the leading indication for heart transplantation.The median donor age in 2010 and 2011was 30.2 and 30.8 years respectively.In 2010 and 2011,up to 99.3％ and 97.3％ of patients were treated with immune induction therapy,respectively.In 2010,the mortality at discharge was 10％,and that was 6％ in 2011.ConclusionAlthough total volume of heart transplants is still small in recent years,the discharge survival in China is similar to ISHLT report.

Objective To study the association of the polymorphism of A9570G in ACE2 gene with the genetic predisposition of diabetic nephropathy (DN). Methods 312 patients with type2 diabetes(T2DM) were included in the study. All the patients were divided into DM group and DN group according to if onset of DN. PCRRFLP were used to observe the association of polymorphisms of A9570G in ACE2 gene with DN. Results G allele frequencies of male subjects were 57.9% in DM patients and 67.5% in DN patients (X2 = 1. 559 ,P =0.212) ,52. 4% and,52.1% in female DM and DN patients (X2 =0. 003 ,P =0.955). In female patients,genetype in DN patiants had no difference from that in DM patients (X2 = 0. 109, P = 0. 947). Conclusion The polymorphism of A9570G in ACE2 gane may not associated with the genetic predisposition of DN.

Objective To determine the effects of polymorphism of A9570G in angiotensin I converting enzyme 2 gene ( ACE2) gene on cardiac dysfunction and ventricular remodeling after myocardial infarction. Methods 252 patients with old myccardial infarction were included in this study. They were classified according to their polymorphisms of ACE 2 gene analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Echocardiograms were used to determine left ventricular end diastolic diameters (LVEDd) , Left ventricular mass index (LVMI) , mitral flow pattern early diastolic and late diastolic peak flow ratio (E/A) and left ventricular ejection fraction ( LVEF). Results In male, LVEDd, LVMI, and LVEF had significant difference among ACE2 genotypes ( t = 2. 609,3.527and 2.063, P =0.010,0.001 and 0.041), and no significant differences in E/A( t =0.689,P =0.492). In female,LVEDd, LVMI, E/A and LVEF had no significant difference among ACE2 genotypes( F =0. 848, 0.077,0. 985 and 1.611, P = 0. 432,0. 926,0. 377 and 0. 205 ). Conclusion The polymorphism of A9570G in ACE2 gene may be associated with cardiac dysfunction and ventricular remodeling after myocardial infarction in male. ACE 2 gene polymorphism may be a genetic factor on cardiac dysfunction and ventricular remodeling after myocardial infarction.

‘Service-learning’is fashionable and advanced teaching concept and mode in many countries currently.Applying‘service-learning’concept and methods in medical ethics curriculum can form a new ethics education mode.Three methods were adopted to evaluate the new model:conducting questionnaires for all students participating in‘service-learning’activities,selecting part of the students to do face to face interview and selecting the core project-medical poverty relief activities.The results showed that the effect of new model was obvious,which was embodied by innovating practical teaching path,improving medical ethics study effect,satisfying human needs and cultivating noble spirits.

The roots of Glycyrrhiza uralensis are widely used in Chinese medicine for their action of clearing heat, detoxicating, relieving cough, dispelling sputum and tonifying spleen and stomach. The reason why Glycyrrhiza uralensis has potent and significant actions is that it contains various active secondary metabolites, especially glycyrrhizic acid. In the present study, we cloned the cDNA coding 3-hydroxy-3-methylglutary CoA reductase (HMGR) involved in glycyrrhizic acid biosynthesis in Glycyrrhiza uralensis. The corresponding cDNA was expressed in Escherichia coli as fusion proteins. Recombinant HMGR exhibited catalysis activity in reduction of HMG-CoA to mevalonic acid (MVA) just as HMGR isolated from other species. Because HMGR gene is very important in the biosynthesis of glycyrrhizic acid in Glycyrrhiza uralensis, this work is significant for further studies concerned with strengthening the efficacy of Glycyrrhiza uralensis by means of increasing glycyrrhizic acid content and exploring the biosynthesis of glycyrrhizic acid in vitro.

OBJECTIVETo explore the cerebral function laterality of acupuncture at left and right Hegu (LI 4) by using functional magnetic resonance imaging (fMRI) and provide objective evidences for side selection of Hegu (LI 4) in the clinical application.

METHODSEighty healthy volunteers were randomly divided into a left-acupoint group and a right-acupoint group, and they were treated with acupuncture at left Hegu (LI 4) and right Hegu (LI 4) respectively. After the arrival of qi, the task-state fMRI data in both groups was collected, and analysis of functional neuroimages (AFNI) software was used to perform intra-group and between-group comparisons. After acupuncture, acupuncture feelings were recorded and MGH acupuncture sensation scale (MASS) was recorded.

RESULTSThe difference of MASS between the two groups was not significant (P>0. 05). The result of left-acupoint group showed an increased signal on right cerebral hemisphere, while the right-acupoint group showed extensive signal changes in both cerebral hemispheres. The analysis between left-acupoint group and retroflex right-acupoint group showed differences in brain areas.

CONCLUSIONSThe central effect of acupuncture at left and right Hegu (LI 4) is dissymmetry, indicating right hemisphere laterality. The right lobus insularis and cingulate gyrus may be the key regions in the acupuncture at Hegu (LI 4).

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Brain ; diagnostic imaging ; physiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Sensation ; Young Adult

Objective:Stephania tetrandra is widely used in traditional Chinese medication.In present study,we studied the resource status of it in Anhui and Jiangxi Province.Methods:We inspected relevant documents to confirm which counties we would investigate;and then,we interviewed many relative local people and carried out sample-plot survey.Results:The resource of wild Stephania tetrandra in the two provinces were both seriously damaged.Conclusion:Large-scale promotion of artificial cultivation was required to ensure the supply and to realize the reasonable and sustainable utility of this medicinal material.