Objective: To evaluate the efficacy and safety of sibutramine,an anti obesity drug, in patients with overweight and simple obesity. Methods: Forty six patients with overweight and simple obesity were randomly assigned to sibutramine or placebo group according to the rule double blind. Results: After a 2 week wash out followed by a 24 week treatment periods, body weight, BMI, waistline and hip of sibutramine group decreased significantly compared with placebo group. The effect was significant at week 4 and advanced at week 8. In sibutramine and placebo group, the total effective rates were 81.82% and 16.67% respectively. The incidence of total adverse effects (thirsty, constipation, headache, agrypnin and so on) in sibutramine group was 27.27% and 11.11% in placebo group. Conclusion: The short term obeservation shows that sibutramine is an effective and safe anti obesity drug in overweight and simple obesity treatment, and the patients compliance is good.

To investigate the effect of high concentration glucose and AGEs on VCAM 1 expression of mouse cardiac microvascular endothelial cells, the VCAM 1 expression was measured by using FACS after the endothelial cells were incubated with high concentration glucose, AGEs alone or combined respectively, the TNF ? level of cultured medium was measured by using RIA. The results showed that the VCAM 1 expression and TNF ? level increased significantly in high concentration glucose and AGEs group and increased more over in combined group. It is suggested that High concentration glucose and AGEs could induce the VCAM 1 expression, and has synergistic action. The increased level of TNF ? coincident with the increased VCAM 1 expression,is probably one of the factors in the mechanism of increased VCAM 1 expression.

This paper explored factors influencing initiatives of clinical teachers in millitary medical university for training clinical undergraduates including work pressure after being transferring to civilian,work pressure,policy orientation,economic pressure,student factor and psychological factor,etc. Meanwhile,this paper explored the incentive mechanism of clinical teachers in millitary medical university for training clinical undergraduates including training and evaluating clinical teach-ing teachers, innovating evaluation criterion and creating sustainable teaching atmosphere (building examples and establishing various incentive systems). All measures taken above was mean to inspire the initiatives of clinical teaching teachers and to ensure the quality of clinical teaching.

Objective To evaluate the application effect of teaching-picture archiving and communication system (T-PACS) in training image reading ability of eight-year-program students. Methods Sixty students were divided into two groups: control group (applying traditional teaching method) and experimental group (applying traditional teaching method and T-PACS) when doing clinical medical image reading ability training. Making multimedia teaching movie, clinical image reading teaching and establishing image database by T-PACS were used in experiment group. Mean-while, reading room was set up and classroom teaching and problem-oriented assignments were in-creased. Finally objective evaluation of image recognition ability and questionnaire were used to compare the teaching effect. Measurement data were expressed as x±s. Total scores of image reading were am-alyzed by t test. Full score rates were analyzed by X2 test. Results The results showed that the score of medical image reading ability was higher in experimental group (90.08±4.52) than in control group (86.92±4.68) (P=0.010). There were differences in respiratory and orthopedic full score rate (P=0.006;P=0.035). Most students thought that application of T-PACS could effectively improve the teaching and learning quality. Conclusions Application of T-PACS can improve the medical image reading ability of eight-year-program medical students and is worth further promoting.

The relationship between 5-HT receptor and a-adrenoceptor was investigated in rat medullary slice preparations. In 57 nucleus tractus solitarii (NTS) neurons, 47 (82.5%) responded to both serotonin (5-HT) and norepinephrine (NE). After synapse transmission was blocked by perfusion of artificial cerebrospinal fluid (ACSF) with low calcium and high magnesium, 5 in 8 neurons were still sensitive to both 5-HT and NE. On the other hand, 3 in 5 neurons responding only to 5-HT or NA were sensitive to both 5-HT and NE after the synapse transmission blockage. In some neurons which exhibited excitatory or inhibitory responses to 5-HT or NE alone, the responses were inversed when perfused with 5-HT and NE in combination. These results suggest that there may exist an inhibitory interaction between 5-HT receptors and a-adrenoceptors in NTS and that most 5-NT and a-adrenoceptors coexist in the same NTS neurons.

Objective To explore the comparative advantage of Team based learning (TBL) in common diseases teaching among pre-selected trainees for medical non-commissioned officer. Methods 200 trainees were randomly divided into two groups of equal size (each having 100 trainees), one TBL group and another lecture based learning (LBL) group as the control group. The teaching content was both Chapters of High Altitude Illness and Hypertension. In the LBL control group, the traditional lec-ture based teaching and learning manner was followed. In contrast, the trainees in the TBL group were assigned pre-lecture self-learning outline and questions to discuss in advance, team-based group dis-cussion was conducted, and scene simulation with typical disease case analysis were adopted in class. In both groups, the teaching effectiveness were evaluated by both exam test and questionnaire manner. Results It turned out the team based learning model resulted in significantly improved overall trainee assessment scores (88.90 ± 5.28 vs. 76.10 ± 5.12, P<0.05) and higher overall teacher satisfaction scores (8.63 ± 0.85 vs 7.18 ± 0.72, P<0.05), compared to the LBL group. Conclusion TBL model is more effective in improving trainees' capabilities of cultivating team work spirit, self-confidence, learn-ing enthusiasm, problem analysis and knowledge application. TBL model significantly brings more advantage in teaching pre-selected trainees for medical non-commissioned officer.

Objective To investigate the effects of gabapentin(GBP) on plasma β-endorphin(β-EP) level in the patients with painful diabetic neuropathy(PDN). Methods We detected the plasma β-EP level in 24 PDN patients in the treatment with GBP, 18 PDN patients without GBP treatment, 20 diabetic mellitus patients without PDN and 24 healthy control subjects. Results (1)The level of β-EP in diabetic mellitus patients was lower than in the healthy control(P<0.01). (2)The patients who received GBP had a significant change of β-EP level after treatment(P<0. 01).. Conclusions Gabapentin is effective for the treatment of PDN and its adverse effects are mild. It can lower the plasma β-EP level in the patients with PDN.

Case-based teaching (CBT) on the basis of treatment guidelines was carried out to develop standard medical behavior, improve learning efficiency and students' ability of solving clini-cal problems. In clinical internship teaching, guidelines for common and frequently-occurring respira-tory diseases and CBT were organically combined. Cases were carefully selected and questions were meticulously set. Guidelines were thoroughly analyzed and teaching was reasonably evaluated. There-fore, students' learning interests were initiated and learning efficiency was improved. It not only trained evidence-based medicine thinking of intern students, but also improved the teaching ability of clinical teachers.

Purpose To investigate the expression of VEGF, NRP1 and the cancer stem cell marker CD44 in gastric carcinoma and their correlations. Methods High throughput technology of tissue microarray and immunohistochemical SP method were employed to investigate the expression of VEGF, NRP1 and CD44 proteins in 72 gastric carcinoma specimens and 52 normal gastric tissues. Immu-nohistochemistry records were reviewed, their correlations and the clinicopathological characteristics were evaluated. Results ( 1 ) The positive rates of VEGF, NRP1 and CD44 proteins were 76. 4%, 66. 7%, and 83. 3% in gastric carcinoma, respectively, with sig-nificant differences from normal gastric tissues (P<0. 01). (2) The positive expression of VEGF and NRP1 were closely correlated with infiltration depth, lymph node metastasis and TNM stage (P<0. 05). The positive expression of CD44 was closely correlated with Lauren type, differentiation degree, lymph node metastasis and TNM stage (P<0. 05). (3) In addition, the expression of CD44 was significantly correlated with VEGF and NRP1 in gastric carcinoma (rs =0. 578, rs =0. 278, rs =0. 316, P<0. 05). Conclusions VEGF, NRP1 and the cancer stem cell marker CD44 are highly expressed in gastric cancer, which are closely related to the biological behaviors of gastric cancer. Synergistic effects are observed between VEGF and NRP1, and they are closely related to the expression of the cancer stem cell marker CD44, which remains to be further studied.

[ABSTRACT]OBJECTIVETo evaluate the short-term efficacy of Eustachian tube balloon dilation (ETBD) in the treatment of symptomatic Eustachian tube dysfunction (SETD) by subjective and objective analysis.METHODS Forty patients who underwent ETBD were included. Subjects’ inclusion criteria were as followed: symptoms of ETD (aural fullness predominantly, with or without otalgia, muffle hearing and tinnitus), normal tympanic membrane, type A or C tympanograms, and without a history of any middle ear diseases. Main outcomes including subjective improvement, otoscopy, pure-tone audiometry, impedance audiometry, R-value in tubomanometry (TMM) and Eustachian Tube Score (ETS) were assessed 1 week and 6 months postoperatively.RESULTSAll cases were dilated successfully. A significant effect of treatment was documented when measuring subjective improvement, impedance audiometry, R-value in TMM and ETS 1 week and 6 month postoperatively. Subjective symptoms were not relieved only in one patient. The overall success rate for all patients was 98%.CONCLUSIONETBD can provide short-term benefits to those who are diagnosed with SETD and refractory to medical management. SETD might be an optimal indication for ETBD in the treatment of ETD.