The emotional stressors, societal challenges and unique physician specific stressors such as greater risks of contagion, a rapidly evolving practice environment and ever-changing protocols and regulations brought on by the COVID-19 pandemic have placed family physicians at greater risks of physician isolation and loneliness. Establishing and strengthening connections with oneself, peers and patients, and an inclusive and decisive leadership in the Family Medicine fraternity can prevent isolation and loneliness.

BACKGROUND: Diabetic glycometabolism disorder and lipoid metabolism disorder are often reciprocal causation, which cause the reduction of hepatic glycogen and the changes of many plasma factors. Hence, the occurrence of vascular complications in heart, kidney and brain is common. It becomes a hot topic in latest researches to find an effective medicine for the secondary prevention of diabetes.OBJECTIVE: To study the interventional effects of leizhusun' s juice on hepatic glycogen, plasma glucose and blood fat.DESIGN: A randomized and controlled observatory study by employing experimental animals as subjects.SETTING: Laboratory of Pharmacy College of Xianning College.MATERIALS: Totally 40 male Wistar rats with a bodymass of (230 ± 20) g were obtained from the Experimental Animal Center of Wuhan General Hospital of Guangzhou Military Area.METHODS: The diabetic rat model was established by the injection of Alloxan(200 mg/kg) into abdominal cavity in the laboratory of Pharmacy College of Xianning University between September 2002 and June 2003. Leizhusun' s juice(LZS) of different doses(205.70 mg/kg and 436. 40 mg/kg) was respectively perfused into the stomach for 28 days, and healthy rats were used as normal control. Levels of hepatic glycogen(HG) in liver and the factors in plasma were detected.MAIN OUTCOME MEASURES: HG, glucose(Glu), triacylglycerol (TG), non-esterified fatty acid(NEFA), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-c), high-density lipoprotein cholesterol (HDL-c), and malondialdehyde(MDA) contents, and superoxide dismutase (SOD) activitiesRESULTS: The level of Glu in LZS-Ⅱ group(436.40 mg/kg) was (9.65± 1.14) mmol/L, TG was(1. 31 ±0. 18) mmol/L, NEFA was(0. 51 ±0. 04)mmol/L, LDL-c was(0.79 ±0. 19) mmol/L, and MDA was(6.31 ±0. 83)nmol/L, which were significantly lower than Glu of (16. 14 ± 1.59) mmol/L,TG of(1.94 ±0. 31) mmol/L, NEFA of(0.59 ±0. 05) mmol/L, LDL-c of (1.34 ±0.28) mmol/L and MDA of(10.95 ±2.90) nmol/L in experimental control(Model) group( t= 3. 478 - 9. 379, P ＜ 0.01), while the HDL-c was (1.09±0.13) mmol/L, SOD was(39.76±6.23) NU/mL and HG was (6.70 ±0.62) mg/g in LZS-Ⅱ group, which were significantly higher than HDL-c of(0.55 ± 0. 11) mmol/L, SOD of (23.24 ± 3.35) NU/mL and HG of (4.06±1.24) mg/gin Model group( t = 5. 388 - 9. 000, P ＜0.01). Furthermore, the decreasing effect on LDL-c and increasing effect on SOD in both LZS groups had dose-dependence relationship( P ＜ 0.05 -0.01 ).CONCLUSION: LZS significantly decreases plasma Glu, TG, NEFA, LDL-c and MDA levels, but increases HDL-c, SOD and HG levels, which displays obvious antidibetic effects.

Chronic Disease ; therapy ; Constipation ; diagnosis ; therapy ; Gastrointestinal Transit ; Humans

AlM:To explore the clinical outcome of trabeculectomy with mitomycin C ( MMC) on glaucoma.
METHODS: A total of 57 patients (95 eyes) of primary glaucoma were randomly divided into two groups, 31 patients ( 54 eyes ) in trabeculectomy with MMC ( T+MMC ) group, which received trabeculectomy with 0. 2mg/mL MMC in surgical sites, and 26 patients ( 41 eyes ) in trabeculectomy ( T ) group. The anterior chamber, bleb, intraocular pressure ( lOP ) and complications were observed. The post-operative follow-up periods ranged between 4 and 6mo.
RESULTS:The mean lOP was 11. 24 ± 3. 73mmHg on 1d in group T+MMC. There was the significant difference compared with preoperative lOP ( P<0. 01 ), while no difference with the group T (P>0. 05). At final follow-up, the lOP was significantly different between group T+MMC and group T (16. 15±3. 62mmHg vs 18. 79±5. 27mmHg, P<0. 05). The rate of bleb formation was 94. 44% and 80. 48%in group T+MMC and T, respectively (P<0. 01). The postoperative complications were seldom, hyphema and corneal edema, and were cured finally.
CONCLUSlON:Trabeculectomy with MMC for glaucoma can effectively reduce postoperative scar formation of the filtration passage and lower the lOP to a target level with fewer complications.

ObjectiveTo observe the effect of early bilateral limbs rehabilitation on nerve function of stroke patients.Methods60 cases of acute stroke were divided into unilateral group and bilateral group with 30 cases in each group. Cases in bilateral group were treated by training healthy side and sick side limbs alternatively and electric stimulating bilateral limbs at same time. Cases in unilateral group were treated only on sick limbs (both training and electric stimulating). After 4 weeks treatment, neurological deficit evaluation (NDE), motor function and activities of daily living of all cases in two groups were assessed.ResultsAfter treatment, scores of NDE, Fugl-Meyer Motor Assessment Scale and Barthel index of patients of bilateral group were 9.9±4.52, 71.21±22.43 and 78.6 ± 20.17 respectively. Those of patients of unilateral group were 13.46±9.2, 52.21±17.68 and 54.2±16.34 respectively. There was a significant difference between two groups (P<0.01) after 4 weeks treatment.ConclusionEarly rehabilitation can improve nerve function of stroke patients and the effect of bilateral limbs rehabilitation is better than that of unilateral limbs rehabilitation.

Cell Proliferation ; Cell Transformation, Neoplastic ; Epigenesis, Genetic ; Hodgkin Disease ; genetics ; immunology ; metabolism ; pathology ; Humans ; Immunophenotyping ; NF-kappa B ; metabolism ; Receptor, Notch1 ; metabolism ; Reed-Sternberg Cells ; immunology ; metabolism ; pathology ; Transcription Factor AP-1 ; metabolism

Ginseng is a typical adaptogen which has resistance to various stresses. This effect is related to the hypothalamic-pituitary-adrenal (HPA) axis. As the main active ingredients, saponin has the similar structure to steroids. The regulation characteristics of ginseng saponin on the HPA axis are narrated from the aspects of total saponin and saponin monomers in this paper after the introduction of adaptation definition and HPA axis regulation mechanisms. Pharmacological effects of ginseng saponin and the regulation effect of HPA axis are summarized finally.
Adaptation, Physiological ; Adrenocorticotropic Hormone ; secretion ; Animals ; Corticosterone ; secretion ; Ginsenosides ; isolation & purification ; pharmacology ; Humans ; Hypothalamo-Hypophyseal System ; drug effects ; secretion ; Panax ; chemistry ; Pituitary-Adrenal System ; drug effects ; secretion

Acute Disease ; Bone Marrow Neoplasms ; pathology ; Hematologic Neoplasms ; pathology ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Leukemia ; pathology ; Lymphoma ; pathology ; Myelodysplastic Syndromes ; pathology ; Neoplasm Invasiveness ; Plastic Embedding ; Purpura, Thrombocytopenic, Idiopathic ; pathology

Adaptor Proteins, Signal Transducing ; metabolism ; Adenocarcinoma, Clear Cell ; genetics ; metabolism ; pathology ; surgery ; Adenosine Triphosphatases ; metabolism ; Age Factors ; Carcinoma, Endometrioid ; genetics ; metabolism ; pathology ; surgery ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; metabolism ; pathology ; surgery ; Cystadenocarcinoma, Serous ; genetics ; metabolism ; pathology ; surgery ; DNA Mismatch Repair ; DNA Repair Enzymes ; metabolism ; DNA-Binding Proteins ; metabolism ; Endometrial Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Female ; Humans ; Mismatch Repair Endonuclease PMS2 ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; metabolism ; Neoplasms, Multiple Primary ; genetics ; metabolism ; pathology ; surgery ; Nuclear Proteins ; metabolism

Objective To study the effect of purified water on the neurobehavioral development of the offspring and the synergistic effect of the magnesium deficiency in food. Methods SD rats were divided into four groups,control food plus control water (control group),control food plus purified water,magnesium deficiency food plus control water,magnesium deficiency plus purified water,from five weeks of age of the F0 generation to five weeks of the F1 generation respectively. Morris water maze (MWM) was used to test the spatial learning and memory ability of offspring of rats. Results In the early training days of the place navigation,control group offspring of rats showed a shorter swimming time than the other groups. There were no significant differences among all experimental groups in the later training days of the place navigation,spatial probe test and visible platform trial,however the tendency was still to remain. Conclusion Purified water can damage the learning ability of offspring of rats and the learning ability delay will be more obviously when magnesium is deficient in food.