Objective To observe the efficacy of biofeedback behavioral cognitive and vestibular re-habilitation treatment in patients with chronic subjective dizziness( CSD) . Methods 60 patients with chro-nic subjective dizziness were divided into two groups: study group ( 30 cases) treated with drug,vestibular rehabilitation and biofeedback behavioral cognitive therapy,and the control group (30 cases) was treated with drug treatment by random number table method,and all the 60 patients in the study were assessed by DHI,HADS and SF-36. Results After four and six weeks of treatment,the DHI and HADS scale scores of the study group were(4 weeks:DHI(9.07±3.18),HADS(3.17±1.56);6 weeks:DHI(4.67±3.08),HADS (2.03±1.10)),and the scores of the control group were(4 weeks:DHI(13.20±4.48),HADS(4.90±2.40);6 weeks:DHI(12.13±3.60),HADS(4.57±2.06)),and the differences were statistically significant(all P<0.05).After 6 weeks treatment,SF-36 scores in eight aspects about physiological function,role-physical,bodi-ly pain,general health,vitality,social-functioning,role-emotional,and mental health,in the study group were (96.17±5.20),(95.00±5.72),(96.67±4.79),(95.17±5.33),(95.50±5.14),(94.58±9.10),(88.90± 18.21),(96.67±4.59)and the control group were(85.33±11.29),(82.67±9.07),(88.53±8.63),(80.83± 7.44),(88.00±8.47),(80.00±14.90),(64.44±27.60),(81.73±14.04),the differences were statistically significant(P<0.05).Conclusion The study indicates that vestibular rehabilitation and biofeedback behav-ioral cognitive therapy can significantly improve symptoms of dizziness,anxiety,depression and quality of life.

To study changes in mRNA expression of induced nitric oxide synthase (iNOS) in the brain of rat repeatedly exposed to +Gz, and to explore the prevention and treatment effect of basis fibroblast growth factor (bFGF) and radix salviae miltiorrhizae (RSM) on the brain injury induced by repeated +Gz exposures. The mRNA expression levels of iNOS in brain were measured by semi quantitative reverse transcription polymerase chain reaction (RT PCR). The results showed the iNOS mRNA expression level in brain of rats repeatedly exposed to +Gz was significantly higher than that of control, but bFGF and RSM could alleviate the expression change of iNOS. It suggested that the iNOS mRNA expression in rat brain was induced by repeated +Gz exposures and it might play an important role in the pathologic course of brain damage induced by +Gz exposures.The bFGF and RSM possessed prevention and treatment on the brain injury induced by repeated +Gz exposures.

BACKGROUND: Brain injury can be induced by repeated high positive acceleration ( + Gz) exposure, but the mechanism was still unclear.OBJECTIVE: To investigate the role of apoptosis in higher + Gz exposures induced brain injury by observing the changes of mRNA expression of bcl-2,bax, p53, and interleukin-1β(IL-1β) hydroxylase in rat brain.DESIGN: Randomized control experimental study based on experimental SD rat model.SETTING: Aviation medicine research center of a hospital.MATERIALS: Twenty-six healthy male SD rats, weighed from 180 to 220 g,were randomly divided into control group(4 rats) and + Gz exposure group (22 rats).INTERVENTIONS: Rats were fixed on the rotating arm of animal centrifuger with their heads towards axis. Rats in + Gz exposure group were exposed to + 14 Gz for three times, each for 45 seconds with 30 minutes interval in between. Rats in control group were subject to the same experiment in + 1 Gz. The rat brains were taken 30 minutes, 6 hours, 24 hours and 48 hours after the last centrifuge run, and then fixed and embedded. Changes of bcl-2, bax, p53, and IL-1β hydroxylasein mRNA expressions in rat brain were measured with semi-quantitative reverse transcription polymerase chain reaction(RT-PCR) . Apoptotic cells were detected by terminal deoxynucleotide(correction of deoxynuleotide) transferase-mediated dUTP nick end labeling(TUNEL) technique.MAIN OUTCOME MEASURES: The changes of bcl-2, bax, p53, and IL-1 β hydroxyalse mRNA expressions at each time points.RESULTS: After repeated + Gz exposures for 6 hours, bcl-2 mRNA expression in rat brain tissue(0. 32 ± 0. 08) was found significantly lower than in control group(0. 69 ± 0. 15), while mRNA expressions of bax, p53, and interleukin-1β converting enzyme(ICE) 0.55 ±0. 09, 0. 48 ±0. 12, 0.79 ±0. 12were significantly higher than in control group 0.33 ±0. 09, 0. 31 ±0.05,0.51 ± 0.09 ( P ＜ 0. 01 ) . After 24 hours of exposure, mRNA expression of bcl-2 in rat brain tissue (0. 28 ± 0.05) was significantly lower than in control group, while the mRNA expressions of bax, p53, and ICE 0.61 ±0. 15,0.54 ± 0. 07, 0. 84 ± 0. 15 were significantly higher than in control group ( P ＜ 0.01); but the difference of brain bcl-2, bax, p53 and ICE mRNA expressions had no statistical significance when exposed for 0.5 hour and 48 hours( P ＞ 0.05). Partly apoptotic cells were observed at exposure for 6 hours and 24 hours.CONCLUSION: Changes of bcl-2, bax, p53 and ICE mRNA expressions, as well as apoptosis in rats brain can be induced by repeated + Gz exposures and may be involved in the molecular mechanisms of brain injury.

Objective To investigate the effects of rhubarb on the expression of glucocorticoids receptor (GR)and peripheral blood lymphocytes in burning-induced septic rats. Methods Sixty-six male healthy Sprague-Dawley(SD)rats were randomly divided into sham operated control group(n=18),sepsis model group(n=24) and rhubarb treatment group(n=24),each group was further randomly divided into 12,24 and 72 hours subgroups according to different time points. The model of scald sepsis was replicated by scald injury induced by boiling water at the rat back accounting for 30% total body surface area(Ⅲ grade of scald),and administration of endotoxin (5 mg/kg)into the peritoneal cavity 12 hours after scald injury. After the successful establishment of septic models, the rats in the rhubarb treatment group were immediately infused with 50 mg/kg rhubarb powder dissolved in 1 mL saline through a gastric tube,while the rats in sham operated control group and sepsis model group received saline by the same way as a substitute for rhubarb. The the binding capacity of GR of peripheral blood leucocyte and binding activity of GR of hepatocyte were analyzed by radiation ligands binding assay. The CD4+,CD8+as well as CD4+/CD8+ ratio in peripheral blood lymphocytes were detected by flow cytometer. Results The binding capacity of GR of peripheral blood leucocyte and binding activity of GR of hepatocyte were significantly decreased in a time-dependent manner in sepsis model group compared to those of the sham operated control group,while in the rhubarb treatment group they were increased in a time-dependent manner after interference of rhubarb, and they were higher than those in the model group at the same time points〔leukocyte GR binding capacity (locus/cell)at 12,24,72 hours :1 515.38±300.44,1 859.63±258.26,1 890.50±307.88 vs. 1 122.63±225.39, 1 008.88±150.41,724.38±91.19;hepatocyte GR binding capacity(fmol/mg):210.19±26.26,258.01±20.98, 283.38±38.21 vs. 153.11±30.07, 129.83±26.89, 94.08±14.30, all P<0.01〕. Compared with the sham operated control group,the CD4+ and CD8+ were decreased in various degrees at 12 hours and 24 hours in the septic group, at 24 hours the differences being statistically significant (P<0.01 and P<0.05). CD4+/CD8+ratios were decreased significantly at all time points,the differences were statistically significant at 24 hours and 72 hours(both P<0.01). The CD4+ T cell and CD4+/CD8+ ratio at all the time points were increased at various degrees in the rhubarb treatment group,and the differences from those in the sepsis model group at 24 hours and 72 hours were statistically significant (1.58±0.69, 1.56±0.49 vs. 1.02±0.41, 1.01±1.68, both P<0.01). Conclusion Rhubarb can modulate the binding capacity of GR of peripheral blood leucocyte and the binding activity of GR of hepatocyte,and via its influence on the number of peripheral leucocytes,the immune dysfunction in the sepsis processes is improved.

ObjectiveTo study the effects of small-dose glucocorticoid (GC) on glucocorticoid receptor (GR) and cellular immune function in critical patients.MethodsForty ICU critical patients admitted in Shanghai Changzheng Hospital from March 2007 to March 2009 were enrolled in the study and were divided into GC group and non-GC group according to the use or absence of GC.Blood samples were collected at days 1,7 and 10 after GC treatment to detect GR binding affinity of mononuclear leukocytes (MNLs) and polymorphonuclear leukocytes (PMLs) in the peripheral blood and the CD4/CD8 ratio in the T lymphocytes.The method of GC use was that the hydrocortisone was given intravenously at a dose of 100 mg every eight hours.ResultsGR binding capacity of MNLs at day 1 and 7 showed no statistical difference between the GC and non-GC groups.GR binding capacity of MNLs in the GC group was lower at day 1 and was much lower at day 7 (P ＜ 0.05 ).However,in the non-GC group,it was lower at day 1,but showed significant improvement at day 7 ( P ＜ 0.05 ).The change of GR binding capacity of PMLs was similar to that of MNLs.There was no significant difference of CD4/CD8 ratio between the GC and non-GC group at day 1.The ratio of CD4/CD8 in the non-GC group was significantly higher than that in the GC group at day 10 (P ＜0.05).CD4/CD8 ratio in the GC group showed a slight reduction at day 10,with no significant difference from that at day 1.While,the non-GC group showed a significant increase of CD4/CD8 ratio at day 10 as compared with that at day 1 (P ＜ 0.05 ).ConclusionLow-dose GC plays some role in the negative feedback regulation of GR binding capacity of peripheral blood leukocytes and in the inhibition of cellular immune function.

Objective To study the changes of mRNA expression of heat shock protein 70 (HSP70) in the rat brain exposed to repeated +Gz. Method The mRNA expression levels of HSP70 in rat brain were measured by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Result The HSP70 mRNA expression levels in rat brains taken 30 min and 6 h after repeated +Gz exposures were significantly higher than those in control group, while the difference between the levels of control group and those of experimental rat brains taken 24 h after +Gz exposure was not significant. Conclusion It is suggested that HSP70 mRNA expression in rat brain can be induced by repeated +Gz exposures and the increased HSP70 mRNA expression may play an important role in self-protection against brain damage induced by+Gz exposures.

The purpose of this study is to observe the changes in gene expressions of bcl 2, bax, p53 and interleukin 1? converting enzyme (ICE) in the cerebral tissue of rat exposed to repeated +Gz, and to explore the pathogenetic role of apoptosis in brain damage induced by repeated +Gz exposures. The expression levels of bcl 2, bax, p53 and ICE in cerebral tissue of rats exposed to repeated +Gz were measured by semi quantitative reverse transcription polymerase chain reaction (RT PCR), and the apoptotic cells in brain tissue were detected by terminal deoxynuleotidyl transferase mediated dUTP nick end labeling technique. The results showed that the bcl 2 expression levels in the brain 6h and 24h after repeated +Gz exposures were significantly lower than those of control group, whereas the bax, p53 and ICE expression levels in the brains tissue 6h and 24h after repeated +Gz exposures were significantly higher than those of control group. Apoptotic cells could be observed in cerebral cortex, CA1 subregion of hippocampus and striatum at 6h and 24h after repeated +Gz exposures. It is suggested that the changes in bcl 2, bax, p53 and ICE expressions in rat brain can be induced by repeated +Gz exposures and apoptosis might be one of the molecular mechanisms of brain damage induced by repeated +Gz exposures

OBJECTIVE:To optimize the ethanol mixed-extraction technology of Red ginseng and Salvia miltiorrhiza in Xin-likang granules. METHODS:L9(34)orthogonal test was adopted to optimize ethanol mixed-extraction technology with ethanol vol-ume fraction,amount of ethanol and extraction times as factors using weighting coefficient comprehensive score of the contents of ginsenoside Rg1,Re and Rb1 in R. ginseng and the contents of tanshinone ⅡA and salvianolic acid B in S. miltiorrhiza as index;and the verification test was detected. RESULTS:Optimal mixed-ethanol extraction technology was as follows as 6-fold 70% etha-nol,reflux extracting for 3 times,2 h each time. In verification test,average contents of ginsenosides Rg1,Re,Rb1 in R. ginseng and those of tanshinone ⅡA and salvianolic acid B in S. miltiorrhiza were 3.963 8,0.757 3,4.986 2,0.964 7,27.662 5 mg/g,re-spectively,and comprehensive score was 0.96 (RSD=1.26%,n=3). CONCLUSIONS:Ethanol extraction technology of R. gin-seng and S. miltiorrhiza in Xinlikang granules optimized by multiple indexes comprehensive score combined with orthogonal test is stable,reasonable and feasible.

BACKGROUND: +Gz-induced acute dysencephalia and its protection is one of the significant topics in Aero-medical researches. Its pathological mechanism, however, is still unclear and protective measures should be developed further. OBJECTIVE: To observe the expression of inducible nitricoxide synthase (iNOS) in brain tissue after +Gz exposure and to analyze the protective effects of danshen and basic fibroblast growth factor (bFGF) on repeated +Gz exposure-induced brain injury. DESIGN: Randomized controlled animal study. SETTING: Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA.MATERIALS: The experiment was carried out at the Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA from April to August 2000. A total of 20 healthy SD rats of clean grade were divided into 5 groups according to randomly digital table, including control group, +Gz exposure group, bFGF group, danshen group and saline group with 4 in each group.METHODS: All rats were fixed on rotatory arm of centrifugal apparatus,and their heads were towards core of the apparatus. Except the rats in control group, the value of +Gz exposure was +14 Gz, and the growth rate was 1.5 G/s. The exposure at peak value lasted for 45 s. +Gz exposure was done for three times, and the interval was 30 minutes. Rats in the control group were also treated with the same +Gz exposing procedure, but the G value was +1 Gz. Rats in bFGF group and danshen group were intraperitoneally injected with 100 μg/kg of bFGF and/or 15 g/kg of danshen solution, respectively, at 30 minutes before centrifugation and immediateness after centrifugation; moreover, rats in saline group were injected with the same volume of saline. Six hours after exposure, rats were cut off their heads to obtain the brains which were maintained in liquid nitrogen for RNA extraction. The expression of iNOS mRNA in brain tissues of the rats in each group was detected with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and calculated on the basis of ratio between iNOS and glyceraldehyde-3-phosphate dehydrognase.MAIN OUTCOME MEASURES:Expressed level of iNOS mRNA in brain tissue of rats.RESULTS: Expression of iNOS mRNA in brain tissue was higher in repeated +Gz exposure group than that in control group (0.452 ±0.014,0.065±0.008, P ＜ 0.01); however, that was lower in bFGF group and dan-shen group than that in +Gz exposure group (0.196±0.010, 0.183±0.011,0.452±0.014, P ＜ 0.01).CONCLUSION: Repeated +Gz exposure can increase the expression of iNOS mRNA, this plays an important role in cerebral injury induced by repeated +Gz exposure. Moreover, bFGF and danshen have protective effects on cerebral injury induced by +Gz exposure.

The improvement of comprehensive therapy of breast cancer, not only improve the prognosis of patients, but also affect the strategy of surgical treatment, especially the widespread development of preoperative neoadjuvant chemotherapy. The timing of sentinel lymph node biopsy and the incision margin of breast-conserving surgery in patients treated with neoadjuvant chemotherapy are hot topics for surgeons. And for patients who cannot accept total breast resection, stage I reconstruction after mastectomy is the best surgical method to preserve the cosmetic breast shape. Methods and materials of reconstruction are another hot topic of surgical treatment. This article reviews the hot issues of surgical treatment of breast cancer in 2019, with a view to arousing the thinking of surgical colleagues on standardized treatment of breast cancer and strengthening multidisciplinary collaboration.