It showed that the distribution of examination score was Gaussian distribution,the average score was 74.4,the paper reliability was 0.81,the difficult coefficient was 0.74 by analyzing and evaluating the quality of the examination paper of pharmacology from 2002 seven-year medical students in Central South University.Some objective questions are too difficult,while some subjective questions are too easy.According to the results of analysis,we think it better to culture the student's multi-ability in analyzing and solving questions by increasing the proportion of subjective question with some difficult coefficient and improving the teaching methods in future teaching.

The article introduces characteristics of problem-based learning teaching method and traditionary medical teaching method,analyzes the current status and practical importance of pharmacology teaching with PBL,and suggests promoting the development of the teaching of pharmacology with PBL by reforming teaching approach and altering teaching thought.

Objective To establish a HPLC method for determination of the content of catechin in Songling- Xuemaikang capsules. Methods The analysis was performed on Alltima C18 column (250 mm × 4.6 mm, 5 μm) with mobile phase consisting of methanol (A) -l% Acetic Acid (B) for gradient elution. The flow rate was 1 ml/min and the column temperature was 25 ℃. Results The results showed that catechin was well separated with the good linearity in 0.00756-0.05040 μg/μl. The average recovery of catechin was 100.147%. Conclusions The method could be applied to determine catechin in Songling-Xuemaikang capsules, which would make sure the quality control of capsules.

Objective To elevate the efficacy and safety of descending neurogenic evoked potentials (DNEP) monitoring during severe rigid spinal deformity surgery.Methods All of 108 patients (43 males,65 females) who underwent surgical treatment for spinal deformity in our spinal center from July 2010 to August 2013 were retrospectively reviewed.The average age (17.5±5.8) ys(range 12-50 ys),the average following period is 38.6 months(range 24-52 months).Combined monitoring of SEP,MEP and DNEP model were used during surgery.All subjects with no neurological deficits preoperatively and got satisfied outcomes.Respectively evaluate the results of neurophysiological intraoperative monitoring (IOM).Data were collected to elevate the efficacy and safety of DNEP monitoring.Results All of 108 patients,15 patients (13.9％,15/108) showed significant changes of neurophysiological parameters,of which 9 cases (60％,9/15) were identified as true positive and 6 cases (40％,6/15) were identified as false positive.During the following-up period,2 patients developed permanent neurological deficit,and 3 patients showed transient neurological deficit who got fully recovered within 6 months after operation.DNEP showed alert in all 5 patients with truepositive alarm,of which 2 patients developed permanent neurological dysfunction and 3 cases showed postoperative short nerve dysfunction that got fully recovery within 6 months after operation.The sensitivity and specificity of SEP+MEP and DNEP were 100％ and 97.98％,100％ and 98.99％,respectively.Conclusion Combining use of MEP+SEP+DNEP monitoring during surgical treatment of spinal deformities presented to be a highly reliable method for the detection and prevention of iatrogenic injury.The results confirmed a high efficacy and safety of DNEP monitoring during spinal surgery.

Objective To understand the research status and development trend of TCM in the treatment of lower limb arteriosclerosis obliterans(LLASO);To provide reference for related research.Methods The literature on the treatment of LLASO by TCM was retrieved from CNKI,Wanfang Data and VIP from September 18,1992 to September 18,2022.NoteExpress 3.6.0 was used to manage and remove repetition.Excel 2019 was used to analyze the trend of the number of articles published.VOSviewer 1.6.18.0 and CiteSpace 6.1.R6 were used to analyze the co-occurrence,clustering,timeline and emergence of the included authors,institutions and keywords,and knowledge graph was drawn.Results A total of 1 095 articles were included,and the number of articles published showed an overall upward trend;1 915 authors were involved,and the author with the most articles was Chen Bainan,forming research teams with Xi Jiuyi,Cao Yemin and Ge Jianli as the cores respectively;the main research institutions were Shandong University of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Heilongjiang University of Chinese Medicine and so on,but there was little cooperation among them.High-frequency keywords included arteriosclerosis,diabetes,clinical efficacy,gangrene,hemorheology,etc.,forming 13 clusters such as qi deficiency and blood stasis,Simiao Yong'an Decoction,angiogenesis and so on.The focus of research was external treatment of TCM,clinical efficacy,blood stasis syndrome,medication law,Buyang Huanwu Decoction.Conclusion The research heat of TCM in the treatment of LLASO has gradually increased,and the modern research in this field from 1992 to 2022,such as gene detection and molecular biology based on big data platform,is the research hotspot in this field.The development trend is the combination of internal treatment and external treatment of TCM,as well as the interdisciplinary research of integrated traditional Chinese and Western medicine combined with interventional therapy and other techniques.

Objective To analyze the efficacy and safety of hypofractionated stereotactic radiotherapy ( FSRT ) combined with temozolomide ( TMZ ) for large brain metastases ( BMs ) in a prospective phaseⅡclinical trial.Methods From 2010 to 2015, a total of 33 patients were enrolled as subjects.The median Karnofsky Performance Status scores before and after treatment were 70 and 80, respectively.The major primary tumor was non-small cell lung cancer (57.6%).The brain metastasis had a diameter of≥3 cm or a volume of ≥6 cm3 .The radiation dose was 52 Gy in 13 fractions or 52.2 Gy in 15 fractions.Patients received TMZ at a dose of 75 mg/m2 per day concurrently.The radiotherapy was followed by 6 cycles of adjuvant treatment with TMZ (150 mg/m2, days 1-5, 28 days per cycle).Patients were reexamined by magnetic resonance imaging ( MRI) during the treatment.The radiation field would be shrunk if the gross target volume ( GTV) was reduced by≥20%.The treatment outcomes were evaluated by MRI at 2-3 months after treatment.Results The total numbers of tumors and GTVs were 95 and 38, respectively. Twenty-four (63%) out of the 38 GTVs had a volume larger than 10 cm3 and the median GTV was 15.3 cm3 (5.7-142.8 cm3).Twenty-two (67%) out of the 33 patients achieved field shrinking during the treatment, and the median reduction rate of GTV was 44%( 21%-88%) .The median total dose was 59.5 Gy, and 100%and 21.2%of patients completed the concurrent and adjuvant treatment with TMZ, respectively.In all patients, the overall response rate was 97.0%;the 1-year local control, intracranial progression-free
survival, and overall survival rates were 97%, 70%, and 62%, respectively;the median survival time was 15.3 months.The main adverse reactions were grade 1-2 nausea and vomiting.One patient got grade 3 liver function impairment.Conclusions FSRT combined with TMZ is a safe and effective approach for treating large BMs.More than 50%of patients can achieve field shrinking to shorten treatment duration and reduce toxicity.Clinical Trial Registry ClinicalTrials.gov,registration number:NCT02654106.

Myostatin (Mstn) is a member of the transforming growth factor-beta superfamily that functions as a negative regulator of skeletal muscle growth and differentiation in mammals. The transcriptional regulation of Mstn is controlled by multiple genes including MEF2, which raise the importance of identifying the binding sites of MEF2 on myostatin promoter region and mechanisms underlying. In this study, we investigated the transcriptional regulation of MEF2 on porcine Mstn promoter activity in C2C12 cells. Sequence analysis of the 1 969 bp porcine Mstn promoter region revealed that it contained three potential MEF2 motifs. Using a serial deletion strategy, we tested the activity of several promoter fragments by luciferase assay. Overexpression of MEF2C, but not MEF2A increased Mstn promoter activity in all the promoter fragments with MEF2 motifs by two to six folds, in both C2C12 myoblasts and myotubes. When we transfected exogenous MEF2C, Mstn mRNA level was also upregulated in C2C12 cells, but the protein level was only significantly increased in myotubes. Thus, we propose that MEF2C could modulate and restrain myogenesis by Mstn activation and Mstn-dependent gene processing in porcine. Our research also provided potential targets and an effective molecule to regulate Mstn expression and gave a new way to explore the functional performance of Mstn.
Animals ; Cells, Cultured ; Gene Expression Regulation ; MEF2 Transcription Factors ; Mice ; Muscle, Skeletal ; metabolism ; Myoblasts ; cytology ; Myogenic Regulatory Factors ; genetics ; physiology ; Myostatin ; genetics ; physiology ; Promoter Regions, Genetic ; Swine

Objective: To compare the clinical outcomes of transoral anterior Jefferson-fracture reduction plate (JeRP) and posterior screw rod (PSR) surgery for unstable atlas fractures via C1-ring osteosynthesis. Methods: From June 2009 to June 2022, 49 consecutive patients with unstable atlas fractures were treated by transoral anterior JeRP fixation (JeRP group) or PSR fixation (PSR group) and followed up at General Hospital of Southern Theatre Command of PLA; 30 males and 19 females were included. The visual analogue scale (VAS) score, Neck Disability Index (NDI), distance to anterior arch fracture (DAAF), distance to posterior arch fracture (DPAF), lateral mass displacement (LMD), Redlund-Johnell value, postoperative complications, and fracture healing rate were retrospectively collected and statistically analyzed. Results: Compared with that in the PSR group, the bleeding volume in the JeRP group was lower, and the length of hospital stay was longer. The VAS scores and NDIs of both groups were significantly improved after surgery. The postoperative DAAF and DPAF were significantly smaller after surgery in both groups. Compared with the significantly shorter DPAF in the PSR group, the JeRP group had a smaller DAAF, shorter LMDs and larger Redlund-Johnell value postoperatively and at the final follow-up. The fracture healing rate at 3 months after surgery was significantly greater in the JeRP group (p < 0.05). Conclusion Both C1-ring osteosynthesis procedures for treating unstable atlas fractures yield satisfactory clinical outcomes. Transoral anterior JeRP fixation is more effective than PSR fixation for holistic fracture reduction and short-term fracture healing, but the hospital stay is longer.

Objective: To compare the clinical outcomes of transoral anterior Jefferson-fracture reduction plate (JeRP) and posterior screw rod (PSR) surgery for unstable atlas fractures via C1-ring osteosynthesis. Methods: From June 2009 to June 2022, 49 consecutive patients with unstable atlas fractures were treated by transoral anterior JeRP fixation (JeRP group) or PSR fixation (PSR group) and followed up at General Hospital of Southern Theatre Command of PLA; 30 males and 19 females were included. The visual analogue scale (VAS) score, Neck Disability Index (NDI), distance to anterior arch fracture (DAAF), distance to posterior arch fracture (DPAF), lateral mass displacement (LMD), Redlund-Johnell value, postoperative complications, and fracture healing rate were retrospectively collected and statistically analyzed. Results: Compared with that in the PSR group, the bleeding volume in the JeRP group was lower, and the length of hospital stay was longer. The VAS scores and NDIs of both groups were significantly improved after surgery. The postoperative DAAF and DPAF were significantly smaller after surgery in both groups. Compared with the significantly shorter DPAF in the PSR group, the JeRP group had a smaller DAAF, shorter LMDs and larger Redlund-Johnell value postoperatively and at the final follow-up. The fracture healing rate at 3 months after surgery was significantly greater in the JeRP group (p < 0.05). Conclusion Both C1-ring osteosynthesis procedures for treating unstable atlas fractures yield satisfactory clinical outcomes. Transoral anterior JeRP fixation is more effective than PSR fixation for holistic fracture reduction and short-term fracture healing, but the hospital stay is longer.