Objective:To study the effect of Mg 2+ on glutamate and energy metabolites during focal cerebral ischemia and reperfusion in rats. Methods: Twelve male Wistar rats were divided into 2 groups(n=6):magnesium sulfate(100 mg/kg, i.p.) group and saline group.Cerebral ischemia was produced by occlusion of middle cerebral artery with a nylon thread for 60 min and followed by 60 min reperfusion.Microdialysis probes were stereotaxically implanted into the cortex; dialysates were collected every 15 min to determine the concentrations of glucose, lactic acid and glutamate. Results: There was a dynamic decrease of glucose and an increase of lactic acid and glutamate during ischemia and reperfusion in saline group.Glucose decreased slightly in magnesium sulfate group during ischemia and recovered to normal rapidly during reperfusion. The lactic acid levels in magnesium sulfate group were lower than that in saline group during early stage of ischemia(0-15 min) and reperfusion.There were significant attenuation in the elevation of glutamate during ischemia and reperfusion when magnesium sulfate was administered and recovered to normal after 30 min of reperfusion. Conclusion: The preservation of cellular energy metabolism,the decrease of lactacidosis and attenuation of glutamate level during ischemia and reperfusion may contribute to the neuroprotective effects of Mg 2+ .

Objective To investigate the effects of early core muscles and manual respiratory function training on stroke patients with dysphagia. Methods From June, 2015 to January, 2016, 60 stroke patients with dysphagia were divided equally into control group and obser-vation group randomly. Both groups accepted routine swallowing function training, electrical stimulation and respiratory function training, while the observation group accepted core muscles training and manual respiratory function training, for four weeks. They were evaluated with Standardized Swallowing Assessment (SSA), forced vital capacity (FVC), maximum ventilatory volume (MVV) and the maximum ex-piratory time before and after treatment. Results All the indices improved in both groups after treatment (P<0.001), and improved more in the observation group than in the control group (P<0.001). Conclusion Core muscles and manual respiratory function training at early stage can obviously improve swallowing and respiratory function of stroke patients with dysphagia.

Objective To evaluate the effect of injection duration on bruising and pain after the subcutaneous injection of heparin.Methods The relevant randomized controlled trials,quasi-randomized controlled trials about subcutaneous heparin injection duration of ≥30 s and ≤ 10 s were searched in the databases of CNKI,CBM,VIP Database for Chinese Technical Periodicals,PubMed,Highwire,ScienceDirect,Chinese Cochrane Library,Wanfang database and Google.The quality of RCTs was assessed and Metaanalysis was conducted by RevMan 5.0 Software.Results Twelve RCTs involving 1 986 injections were included.The results of Meta-analysis showed that:There was significant difference between the two groups in the occurrence of bruising.The injection duration of 30 s was much better to prevent bruising.Statistical differences existed in pain intensity between the two groups.Conclusions Prolonging the injection duration to 30 s may reduce the occurrence of subcutaneous bruising.There is no enough evidence to draw a conclusion on pain intensity.Adequately,the current study is limited to a small sample,powered and high quality randomized controlled trials are still needed to be conducted.

Objective To analyse the mutation of pathogenic gene TSC2 in tuberous sclerosis complex (TSC). Methods Using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), all the 41 exons of TSC2 gene were analyzed in 4 TSC cases(include 1 suspect case) from one family and 1 sporadic TSC case ,and compared with the kin familial controls and kinless normal controls. Results Missense mutation on exon33 1346S→P (4037T→C) of TSC2 was found in 4 familial cases, and no mutation of TSC2 gene was found in the sporadic case and all the health controls. Conclusion Missense mutation on exon33 (1346S→P,4037T→C)is a new discovery in TSC2 gene of patients with TSC.

Modern medical staff are facing the challenge to survive in competitions and develop through cooperation.Thus it is of great importance for the future medical staff,that is,medical students to cultivate and enhance their teamwork for future demand.Cultivating approaches mainly include creating a collaborative environment,carrying out cooperative scientific research,creating teamwork in the curriculum,and launching community service activities.

Objective To assess the efficacy of itopride on treatment of patients with functional dyspepsia (FD) overlapping constipation-predominant irritable bowel syndrome (C-IBS). Methods Patients who met criteria for FD and FD overlapping C-IBS were randomly assigned into FD treatment group (group A), FD control group (group B), FD overlapping C-IBS treatment group (group C) and FD overlapping C-IBS control group (group D). The patients in group A and group C received 100 mg of itopride 3 times daily for 8 weeks. Dyspeptic symptoms including abdominal pain, bloating, early satiety and constipation, were evaluated before and after treatment. Ultrasonic monitoring of gastric emptying function was performed in group A and group C before and two weeks after treatment.ResultsThe symptoms of FD were relieved in both group A and group C (P<0.05), while better results were shown in group C. The significant improvement of constipation was seen in group A and group C. Besides, after medication, gastric emptying was improved in group A and group C in comparison with group B and group D. Conclusion Itopride is an effective therapeutic option in the treatmentping of patients with overlapping of FD and C-IBS.

Objective To assess the value of C-reactive protein(CRP) for the prognosis of acute pulmonary embolism (PE). Methods 56 acute pulmonary embolism patients, confirmed by spiral computed tomography (sCT), magnetic resonance imaging(MRI), or pulmonary angiography (CTPA). CRP as well as electrocardiogram (ECG), echocardiography(UCG), blood gas analysis, were taken after admission. Results Among these patients,24 cases with higher CRP(≥10 mg/L),were diagnosed as massive (50.0%), sub-massive PE(45.8%), mini-massive (4.2%) or died(25.0%). 24 cases (100.0%) showed right heart dysfunction and 24 cases showed pulmonary hy-pertension on UCG, right ventricular 20 (83.8%) on ECG, 22 cases (91.7%) showed hypoxemia. 8 cases (33.3%) had syncope,and 9 cases (37.5%) had cardiogenic shock. CRP was lower than 10 mg/L in 32 patients, among whom,3 cases (9.4%) were with massive PE,6 cases (18.8%) were with sub-massive PE,23(71.8%) were with small PE,1 cases(6.3%) died. 13 (40.6%) had right heart dysfunction and 16(50.6%) had pulmona-ry hypertension on UCG, right ventricular on ECG in 15 cases (46.9%), hypoxemia in 11 cases (34.4%), syncope in 2 cases (6.3%), cardiogenic shock in 4 cases (12.5%). The occurrence of massive PE, mortality (P<0.01) and sub-massive PE (P<0.05)were statistically different between the groups with higher CRP and the groups with lower CRP. The ratio of right heart dysfunction, pulmonary hypertension, right ventricular overloading, hypoxemia had statistical significance (P<0.01). There was statistical significance in the occurrence of syncope, cardiogenic shock (P<0.05). Conclusions CRP can be used as a parameter for PE, and can be used to stratify risk levels for severi-ty and assess the effectiveness of treatment.

Objective To study on the changes of the DNT cells and T lymphocyte subtype in children with infectious mononucleosis (IM) and its clinical significance.Methods The flow cytometry (FCM) was used to detected the DNT cells and other T lymphocyte subtype in 48 cases of IM.Results The study showed that DNT cells( 9.39 ± 4.89 )% were greatly increased in comparison with normal controls (NC) (4.26 ± 1.68)% ( P ＜0.01 ).CD4 cells(21.45 ±9.87)% were decreased ( P ＜0.01 ) and CD8 cells increased in comparison with NC (32.43 ± 5.07) % ( P ＜ 0.01 ).Conclusion DNT cells and T lymphocyte subtype can be used to evaluate the immune function of children with infectious mononucleosis (IM) and provide guidance for adoptive immunotherapy.

Objective To detect mutations in the OSMR gene in 2 Chinese families with familial primary cutaneous amyloidosis (FPCA),and to analyze their relationship with clinical manifestations.Methods Clinical data were collected from 2 families with FPCA,and genomic DNA was extracted from peripheral blood samples.PCR was performed to amplify 18 exons and their flanking sequences of the OSMR gene followed by DNA sequencing in 2 probands and their family members.One hundred healthy individuals served as controls.Results In the first family,a heterozygous mutation (c.2081C ＞ T) in exon 15 of the OSMR gene,which leads to a codon change at amino acid position 694 (p.P694L),was identified in the proband,as well as in the other 4 patients.In the second family,a heterozygous mutation (c.1538G ＞A) in exon 11 of the OSMR gene,which causes a codon change at amino acid position 513 (p.G513D),was identified in the other proband and her mother,suggesting the cosegregation of the gene mutation with the disease.None of the above mutations were detected in the healthy family members or controls.Conclusion The heterozygous mutations p.P694L and p.G513D in the OSMR gene may be associated with primary cutaneous amyloidosis.

AIM: To study the difference in glucose and lactate levels between brain extracellular fluid (ECF) and plasma in rabbits in the different blood glucose levels. METHODS: Using intracerebral microdialysis technology, brain ECF levels of glucose and lactate were measured in every 10 min under basal conditions and during a hyperglycemia-hypoglycemia clamp study. RESULTS: Under basal condition, brain ECF glucose levels were markedly lower than ambient plasma levels (30% of plasma), whereas ECF lactate levels were substantially higher (165% of plasma). During the hyperglycemia-hypoglycemia clamps, the relationship between plasma and ECF levels of glucose remained similar, but changes in ECF glucose lagged about 30 min. There were no substantially changes in ECF levels of lactate during dynamical study. CONCLUSION: There are striking differences in glucose and lactate levels between brain ECF and plasma. Lactate may involve in the metabolic process of central nervous system.