BACKGROUND: The choline acetyltransferase (CHAT) is the key synthetic enzyme for acetylcholine, and is the important symbol of the functional activity of the cholinergic system. There was a relationship of the cholinergic neurons damage with the pathogenesis of Alzheimer disease (AD) and the mild cognitive impairment (MCI). Whether or not the fimbria/fornix transection may affect the expressive variety of ChAT in different cerebral regions of rats (cortex, hippocammpi CA1, amygdala, Meynert nucleus) is very important for the recognition of the pathogenesis of AD and MCI and the establishment of experimental animal model of AD.OBJECTIVE: To observe the expressive variety of ChAT in different cerebral regions of rats with fimbria/fornix transection and discuss exploratorily the methods of simulative experimental AD.DESIGN: A randomized and control study.SETTING: Institute of Cerebrovascular Disease, Affiliated Hospital of the Qingdao University Medical College and the Department of Neurology, No. 1People' s Hospital of Jining.MATERIALS: The experiment was completed in the Institute of Cerebrovascular Disease, Affiliated Hospital of the Qingdao University Medical College from March to December 2003. Totally 14 adult healthy female Wistar rats aged 5 months were randomly divided into model group and control group with 7 in each group.METHODS: ① The bilateral fimbria-fornix of brain in model group were transected on the stereotaxic apparatus to set animal model. After opening the skull, at the coordinates, along the bregma posterior 2.2 mm-2.5 mm and lateral 1.0 mm according to the atlas of Paxinos and Watson, and the dorsal fornix, the anterior part of hippocampus and the fimbria were cut off with a double blade under visual inspection. Rats in the control group were not performed with fimbria/fornix transection, and the other procedures were completed as those in the model group. ② On the 28 day after the surgery, all rats were killed under anesthesia to take out the brain tissues and make coronary sections for histochemical observation in a immunohistochemical way. The expressions of the ChAT positive neurons were observed in the cortex, hippocammpi CA1, amygdala, Meynert nucleus, and the brown neurons under microscopy was the ChAT positive neurons.MAIN OUTCOME MEASURES: Expressions of ChAT positive neurons in the cortex, hippocammpi CA1, amygdala, Meynert of the basal forebrain in the model group and the control group.RESULTS: All the rats entered the final analysis without any loss. The expression of ChAT positive neurons in the cortex, hippocammpi CA1,amygdala, Meynert of the basal forebrain in the model group were distinctly decreased than that in the control group (2.97±1.45, 32.60±7.33, t=10.51,P ＜ 0.01); (6.83±2.41, 50.57±5.85, t=1 8.30, P＜ 0.01); (14.43±6.75, 35.43±10.49,t=4.47, P ＜ 0.01); (5.77±6.62, 48.77±7.10, t=1 1.72, P ＜ 0.01), and the differences were significant.CONCLUSION: Finbria/fomix transection can decrease the expression of ChAT positive neurons in many cerebral regions of rats, and can be used in a method of setting the experimental animal model of AD.

Objective To analyze the different doses of mifepristone in treatment of menopause induced by perimenopausal uterine leiomyoma , and to explore the clinical application of the effective dose of mifepristone.Methods 141 cases with perimenopausal uterine leiomyoma were divided into group A, group B and group C randomly, 47 cases in each group.Three group of patients were given mifepristone.Group A were treated with dose of 12.5 mg/d, group B was treated with 10.0 mg/d, group C was given with 5.0 mg/d.Three groups of patients continued treatment for three months. Uterine volume and leiomyoma volume were observed after treatment, and recorded status of induced menopausal after six months.Results Three groups with uterine volume and leiomyoma volume post-treatment were significantly less than pre-treatment (P<0.05);induction of menopause success rate of group A was 89.4%, menstruation incidence was 6.4%, vaginal bleeding was 2.1%, which was significantly better than the other two groups ( P<0.05) .Conclusion Different doses of mifepristone orally in treatment of perimenopausal uterine leiomyoma has a significant effect, but with 12.5mg/d induced menopause can effectively enhance the success rate , it could be used as the optimal dose of clinical treatment.

Objective To observe the clinical curative effect of zhidanhuayu decoction on patients with carotid atherosclerotic plaque.Methods 80 patients with carotid atherosclerosis were randomly divided into two groups, each group of 40 cases, the control group was treated with rosuvastatin calcium 20 mg, once every night.The treatment group in the control group on the basis of a scheme based on the use of night zhidanhuayu decoction water 500 mL temperature and heat to 200 mL, then add water and cook until 200 mL to 100 mL, on the afternoon of two phase decoction against half amount of clothes, a daily agent;the two groups were 3 months for 1 courses.Before and after treatment, the mean medial thickness(IMT), plaque score, blood lipid and adverse reactions were observed.Results There was significant difference between the two groups before and after treatment, the difference was significant between the medial and middle thickness(IMT), plaque score and blood lipid(P< 0.05).After treatment, compared with the control group, the treatment group and the control group, IMT, plaque score, blood lipids were statistically significant(P< 0.05).Conclusion Zhidanhuayu decoction can adjust the blood lipids, but also has the effect of anti atherosclerosis.

Objective To investigate the effect of three blood purification techniques on minerals disorder in maintenance hemodialysis patients,and provide clinical guidance for patients to choice the blood purification techniques.Methods Eighty-eight maintenance hemodialysis patients were divided into three groups according to the blood purification techniques:hemodialysis (HD) group (30 cases),hemodiafiltration (HDF) group (30 cases),and hemoperfusion (HP) group (28 cases).Serum urea nitrogen,creatinine,calcium,phosphorus,intact parathyroid hormone (iPTH),ftbroblast growth factor (FGF)-23 and so on before and after treatment were measured and compared among the groups.Results The serum phosphorus in HD group,HDF group and HP group before treatment were (1.93 ±0.44),(2.11 ±0.54) and (2.17 ±0.59)mmol/L,and after treatment were (1.01 ±0.23),(0.84 ±0.19),(0.99 ±0.27) mmol/L.There were significant differences in serum phosphorus level after treatment compared with that before treatment in the three groups (P ＜0.05).There were no significant differences in the descend rate of serum phosphorus among the three groups (P ＞0.05).There were no significant differences in clearance index of serum phosphorus among the three groups (P ＞ 0.05).The serum iPTH in HD group before treatment was (48.8 ± 42.9) pmol/L,and after treatment was (49.9 ± 42.9) pmol/L.The serum iPTH in HDF group and HP group before treatment were (64.7 ± 45.4) and (50.4 ± 45.9) pmol/L,after treatment was (46.2 ± 37.8) and (35.8 ± 36.5) pmol/L.There were significant differences in serum iPTH level after treatment compared with that before treatment (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum iPTH in HDF group and HP group (P ＞ 0.05).There was no significant difference in serum FGF-23 in HD group before and after treatment (P＞ 0.05).The serum FGF-23 in HDF group and HP group before treatment were (782.5 ± 105.8) and (879.5 ±97.2) ng/L,after treatment were (712.0 ±98.1),(823.5 ± 89.1) ng/L.There were significant differences in serum iPTH level after treatment compared with that before treatment in HDF group and HP group (P ＜ 0.05).The descend rate of serum FGF-23 in HD group,HDF group and HP group were (5.7 ±2.8)％,(12.3 ±6.2)％ and (9.1 ±4.6)％,and there was significant difference among the three groups (P ＜0.05).The clearance index of serum FGF-23 in HD group,HD F group and HP group were 0.06 ± 0.05,0.19 ± 0.11 and 0.12 ± 0.08,and there were significant differences among the three groups (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum urea among the three groups (P ＞ 0.05).Conclusions HD can only clear serum phosphorus.HDF and HP can clear serum phosphorus,iPTH and FGF-23 effectively,while HDF has better clearance effect on FGF-23.The HDF and HP blood purification can reduce minerals disorder in maintenance hemodialysis patients and has important clinical significance in improving the long-term prognosis of the patients.

Objective To investigate the lateralizing value of head deviation(HD) during complex partial seizures (CPS) in patients with refractory mesial temporal lobe epilepsy (mTLE).Methods Presurgical videotypes of 43 patients who were seizure-free for at least one year after temporal lobectomy were retrospectively reviewed.Attention was paid to the relationship between time and type of HD and the side of epileptogenic zone.Results HD was seen in 88 CPS from 43 patients who had total 206 CPS with or without secondary generalization.Both versive and non-versive HD displayed high positive predictive value (83％ (33/40) and 88％ (22/25)) for localization of an ipsilateral and contralateral seizure onset,respectively.Conclusion Both non-versive HD and versive HID during CPS in patients with mTLE are reliable lateralizing signs that can complement other diagnostic modalities in presurgical evaluation.

OBJECTIVE: To prepare Polylactic-co-glycolic acid)(PLGA) microspheres loaded with Chinese herbal extract cucurbitacin B.METHODS: Cucurbitacin B loaded by PLGA microspheres were prepared by modified emulsification-solvent evaporation method.Central composite design-response surface method was applied to optimize the formulation with PVA concentration and ratio of drug to polymer as independent variables,and with yield of microspheres(Y1),drug loading amount(Y2),encapsulation efficiency(Y3),mean particle diameter(Y4),and the cumulative percentage of the drug release in 24 hr(Y5) as indexes to conduct multiple linear regression and second-order polynomial equation fitting.In vitro release test was performed by modified immediate release method.RESULTS: The results showed that all response variables were greatly fitted by a second-order polynomial equation.The optimal formulation was proved to be as follows: PVA concentration was 0.014 and ratio of drug to polymer was 0.066 5.The microspheres prepared in the optimal formulation were spherical and had smooth surface.Y1,Y2,Y3,Y4,and Y5 were 79.9%,7.83%,80.5%,56.18 ?m and 6.98%,respectively.The cumulative release from microspheres within 35 days reached 86.73%.CONCLUSION: Cucurbitacin B-PLGA microspheres are characterized by prolonged action and sustained-release.Furthermore,the established model has satisfactory predictability.

ObjectiveTo discuss the effects of adsorption(AP) combined with continuous venovenous hemofiltration(CVVH) on the serum inflammatory mediators levels in systemic inflammatory response syndrome (SIRS) patients.Methods Sixty-three SIRS patients were divided into treatment group (31 cases,AP combined with CVVH ) and control group (32 cases,CVVH ) by random digits table method.The changes of the serum tumor necrosis factor-alpha (TNF-α ),C-reactive protein (CRP),interleukin (IL)-1,IL-6 and IL-10 before and after treatment were compared in two groups.ResultsThere was no significant difference in the serum TNF-α,CRP,IL-1,IL-6,IL-10 before treatment between two groups (P ＞ 0.05 ).The serum TNF- α,CRP,IL- 1,IL-6,IL- 10 decreased after 2,26 and 50 h treatment compared with those before treatment in treatment group[after 2 h treatment:(226.4 ± 27.6) ng/L,(70.4 ± 22.1 ) mg/L,(30.1 ±2.9) ng/L,(227.5 ± 13.2) ng/L,(40.0 ±5.2) ng/L; after 26 h treatment:(165.3 ±24.5) ng/L,(58.2 ±25.1) mg/L,(18.2 ±2.7) ng/L,(82.4 ±7.2) ng/L,(26.2 ±4.3) ng/L; after 50 h treatment:( 120.6 ± 19.2) ng/L,(46.2 ± 24.6) mg/L,( 12.4 ± 2.3 ) ng/L,(38.1 ± 4.4 ) ng/L,( 15.2 ± 2.1 ) ng/L; before treatment:(350.8 ± 40.2) ng/L,( 126.4 ± 34.6) mg/L,(38.2 ± 3.6) ng/L,(307.7 ± 15.1 ) ng/L,(60.2 ± 9.3)ng/L,P ＜0.05].The serum TNF-α,CRP,IL-1,IL-6,IL-10 decreased after 26 and 50 h treatment compared with those before treatment in control group [after 26 h treatment:(262.7 ± 29.4) ng/L,(86.4 ±23.7) mg/L,(29.6 ± 3.1) ng/L,( 175.0 ± 10.6) ng/L,(42.7 ± 5.4) ng/L; after 50 h treatment:(219.3 ±25.6 ) ng/L,(75.6 ± 24.0) mg/L,(23.5 ± 2.8 ) ng/L,(99.0 ± 8.2 ) ng/L,(29.3 ± 4.8 ) ng/L; before treatment:(352.5 ± 40.4) ng/L,( 123.2 ± 35.2) mg/L,(37.5 ± 3.8) ng/L,(308.2 ± 15.3) ng/L,(58.4 ± 8.8) ng/L,P ＜0.05].There were significant differences in the serum TNF- α,CRP,IL-1,IL-6,IL-10 after 2,26 and 50 h treatment between two groups (P ＜ 0.05).ConclusionAP combined with CVVH can effectively decrease the serum inflammatory mediators in SIRS patients and it's therapeutic effect is superior to mere CVVH.

Objective: To observe relation among sICAM-1 level in the sera of patients with chronic viral hepatic disease, viral replication and the clinical significance. Methods: The level changes of sICAM-1, IL-1,IL-8 and TNFa in the sera of patients with chronic hepatitis B(CH),chronic severe hepatitis B(CSH) and hepatocirrhosis (HC) were detected by ELISA. Results: The levels of sICAM-1,IL-1,IL-8 and TNFa in sera of the patients with chronic viral hepatic disease were significantly higher than those of healthy control group(P<0.01). The bilirubin level in the sera of patients with chronic viral hepatic disease of different clinical types positively correlated with sICAM-1 and cytokine activities. The sICAM-1 level in the sera of HBV-DNA or HBeAg positive patients was significantly higher than those of negative patients(P<0.05,P<0.01). Conclusion: The sICAM-1 level and activities of cytokine IL-1,IL-8 and TNFa as well as the bilirubin level in the sera of the patients can reflect the necrosis degree of hepatocytes, and the sICAM-1 level and activities of IL-1,IL-8 and TNFa were related to state of HBV carrier or the active degree of HBV in patients with hepatic disease.

To explore the impact of Salmonella on Enterococcusfaecalis isolate N41 under the coexisting,the growth traits and the transcription of 26 virulence genes of N41 at various growth phases were detected.Salmonella and/or N41 were inoculated and done plate counting,then growth curves were drawn and bacterial total RNA were extracted at given time points,quantitive realtime PCR was used to analyze the RNA transcription levels of 26 virulence genes of N41.The result showed that comparison with single incubation,the bacteria concentration of N41 dropped about 3.9 times,and Salmonella dropped about 110-times.Among 26 virulence genes of N41,the RNA transcription levels of 12 virulence genes such as ebpA,ebpC,rnjB,ace,ebpR,psr and so on were promoted at the four growth phases,but the RNA transcription levels of SlyA and sprE were dropped.Except that the RNA transcription levels of CylL-S,CylL-L,efaA and AS had no significant changes at the four growth phases,the mostly rest genes increased dramatically at post-log phase.This indicated that when incubated together,N41 inhibited the growth of Salmonella significantly,and Salmonella promoted the transcription levels of virulence genes of N41 as a whole.The results lay a foundation for further research on the interaction between bacteria species and the pathogenicity mechanism of Enterococci.

A brief introduction to the development milestones of postgraduate medical education in the world, highlighting the present details of such systems in the United States, United Kingdom, France, Germany and some Asian countries.It is held that common patterns can be identified despite the gaps found in such systems of these countries.In view of the training management system cornmonalities of thecountries,the authors proposed the development directions of residency training in China to enhance thehands-on capability and competence of clinical doctors in a standardized manner.