Objective To study the relationship between the serum homocysteine ( Hcy ) levels in patients with first-episode depression and event related potentials ( ERP ) P300.Methods 117 first-episode depressive patients were selected as the case group,and 110 healthy volunteers were selected as the health control group,the de-termination of serum Hcy levels in the two groups were detected by enzyme linked immunosorbent assay,measured by the Shenzhen Brain Master brain evoked potential system to complete the visual P300.Results The serum Hcy levels of the case group was (14.0 ±9.8)μmol/L,which was higher than (10.5 ±7.5)μmol/L of the health control group (t=-3.087,P <0.05).The N1,N2 incubation period of the case group were (91.4 ±18.6) ms,(235.4 ± 30.5)ms,respectively,which were longer than (88.6 ±13.0)ms,(204.3 ±20.3)ms of the health control group(t=1.305,8.990,all P<0.01);The P3 incubation period of the case group were (359.5 ±30.0)ms,which was longer than (327.2 ±41.8)ms of the health control group(t=6.685,P<0.05).The target P3,non-target P2 amplitude of the case group were (4.1 ±2.0)μV,(4.2 ±1.9)μV,respectively,which were singnificantly lower than (6.8 ± 3.8)μV,(6.6 ±3.6) μV of the health control group( t=-6.694,-6.485,all P<0.01).The P2 incubation period of Hcy case group was (194.4 ±13.6) ms,which was longer than (163.1 ±21.8) ms of the non Hcy case group(t=8.486,P<0.01).The P3 incubation period of Hcy case group was (357.0 ±24.5)ms,which was longer than (337.1 ±45.5)ms of the non Hcy case group(t=2.645,P<0.05).The target P3,non-target P2 amplitude of the Hcy case group were (5.4 ±1.5)μV,(5.2 ±1.2) μV,which were significantly lower than (5.8 ±3.8)μV, (5.4 ±3.2)μV of the Hcy case group(t=-0.745,-0.208,all P<0.01).Conclusion The serum Hcy levels in patients with first-episode depression increased, and P300 latency, amplitude decreased, the cognitive function is related to Hcy metabolism disorder and depression damage.

Objective: ANGPTL2 is a newly found angiogenesis-associated protein.In the previous studies,we found that the renal expression of ANGPTL2 is involved in the development of diabetic nephropathy,but failed to reveal the exact distribution and synthesis of renal ANGPTL2.This study aimed to analyze the expression of the ANGPTL2 gene in the glomerulus and tubules in the kidney of db/db mice with diabetic nephropathy and to determine the cells responsible for the synthesis of renal ANGPTL2.Methods: Glomerulus and tubules were microdissected from the renal tissue of diabetic db/db mice and the expression of ANGPTL2 mRNA was analyzed by RT-PCR.The distribution and synthesis of ANGPTL2 in the kidney of the db/db mice were determined by immunohistochemistry,dual-labeling immunofluorescence and immunoelectron microscopy.Results: Significantly increased expression of ANGPTL2 mRNA was found in the glomeruli but not in the tubules of the diabetic db/db mice,as compared with the controls.Immunohistochemistry revealed that the ANGPTL2 protein was distributed in a podocyte-like pattern;dual-labeling immunofluorescence analysis showed colocalization of ANGPTL2 with WT1(Wilms' tumor 1,a marker of podocyte) staining,suggesting that renal ANGPTL2 was expressed specifically by podocytes,which was confirmed by immunoelectron microscopy.Conclusion: ANGPTL2 is specifically expressed by podocytes in diabetic nephropathy mice.

It is significant to carry out standardization of Prescription Technology on Chinese clinical pharmacy,which will not only improve the regulation of traditional Chinese medicine techniques,but also promote the standardization of the pharmaceutical industry an important part of the building. The discussion of seven areas of clinical medicine about Prescription audit, prescription pricing, prescription cope, deployment dose, footnote implementation, regulating review, dispensing explain for standardization will be improving and perfecting the pharmacy service system.

OBJECTIVE To establish an in vitro blood-cerebrospinal fluid barrier (BCB) model to investigate the underlying mechanism of lead-induced BCB injuries.METHODS The in vitro BCB model was established by Z310 cells.Different concentrations of Pb(AC)2 (2.5,5.0 and 10.0 mmol·L-1) were used for 24,48 and 72 h.Transendothelial electrical resistance (TEER) and flux of FITC-dextran were performed to determine the permeability of the in vitro BCB model.Western blotting and immunofluorescence methods were used to observe the expression of tight junction protein ZO-1 and occludin.RESULTS Compared with control group,Pb(AC)2 2.5,5.0 and 10.0 mmol· L-1 exposure for 48 h to Z310 cells had no significant effect on survival rate and density.TEER in different groups was gradually increasing.At the 12th day after Pb(AC)2 exposure,the values of TEER and flux of FITC-dextran in Pb(AC)2 5 and 10 mmol· L-1 groups were significantly decreased (P＜0.05).Western blotting and immunofluorescence images showed that the expression of ZO-1 and occludin were significantly decreased (P＜0.05) after Pb(AC)2 exposure for 48 h.CONCLUSION Lead exposure can cause the breakdown of BCB barriers,and this effect may be mediated by reducing the expression of ZO-1 and occludin proteins.

Objective:To analyze and evaluate the teaching effect of the Problem-Based Learning and intelligent simulation training in emergency medicine.Methods:Based on Problem-Based Learning,129 residents of our hospital accepted the cardiopulmonary resuscitation training and test by intelligent simulation training.And their feedback questionnaires were analyzed.Results:After training,their abilities to deal with the cardiac arrest have made a great progress(P

Objective To investigate the clinical efficacy and value of percutaneous transluminal angioplasty (PTA) in treating arteriosclerosis obliterans (ASO) of lower extremity that shows no visualization of its vascular outflow tract. Methods A total of 19 patients with ASO of lower extremities showing no outflow tract visualization were included in this study. The patients included 11 males and 8 females with a median age of 66 years (48-79 years. The main clinical symptom was rest pain of the leg in all patients; 10 cases had different degrees of foot ulcer and gangrene. Preoperative multi-slice CT angiography and DSA examination were performed in all patents. After PTA, the patients were followed up for 12 months, the changes of the clinical symptoms and signs were recorded. The claudication distance, toe skin temperature, ankle-brachial index (ABI), toe-brachial index (TBI), and CT angiography or color Doppler examination were separately performed before and one, 3, 6 and 12 months after PTA. Results In the 19 patients (38 diseased limbs in total), ASO with no visualization of vascular outflow tract was detected in 54 arteries, 3%), posterior tibial artery (n=18, 33.3%), peroneal artery (n=9, 16.7%) and popliteal artery (n=2, 3.7%). The technical success rate of limb PTA was 89.5%, while the technical success rate of single artery PTA was 85.2%. After PTA, the skin temperature of all the diseased limbs that had been successfully treated was obviously improved, the pain was significantly relieved or disappeared. One, 3, 6 and 12 months after PTA, the claudication distance, toe skin temperature, ABI and TBI were strikingly improved when compared with those determined before PTA (P<0.05). Twelve months after PTA the vascular restenosis rate was 39.5% (15/38), the limb vascular patency rate was 55.3% (21/38), and the limb salvage rate was 81.6%(31/38). Conclusion For the treatment of lower extremities arterial obliterans with obstructed outflow tract, PTA is safe and effective in short-term period. Although its long-term restenosis rate is higher, this technique can effectively control the progress of the disease, relieve the clinical symptoms, and help improve the limb salvage rate of ischemic limbs.

BACKGROUND:Edaravone as an antioxidant protective effect on nerve cells injured by hydrogen peroxide has been confirmed, but its protective effect on oxidative damage to bone marrow stromal cells has not been reported in-depth. OBJECTIVE:To investigate the regulatory effects of edaravone on oxidative injury to bone marrow stromal cells. METHODS:Bone marrow samples were extracted from the long bone of New Zealand rabbits by the method of washing the pulp cavity, then subjected to the density gradient centrifugation and adherent screening to obtain bone marrow stromal stem cells in vitro. The bone marrow stromal cells at 3 passage were divided into five groups:blank group, treated with low-glucose Dulbecco’s modified Eagle’s medium containing 10%fetal bovine serum and 1%double antibody;dexamethasone group, treated with cellculture medium containing 1×10-7 mol/L dexamethasone;50, 100, 300 mg/L edaravone groups, cultured in cellculture medium containing 1×10-7 mol/L dexamethasone and 50, 100, 300 mg/L edaravone, respectively. After culture, MTT method and flow cytometry were used to detect the proliferative level and cellcycle of cells. RESULTS AND CONCLUSION:Compared with the control and dexamethasone groups, edaravone significantly enhanced the cellproliferation. Edaravone played a protective role in bone marrow stromal cells. When the concentration was 50 mg/L, edaravone began to play a regulatory role (P<0.05), and this effect was certainly associated with the concentration of edaravone. When the concentration was up to 100 mg/L, edaravone showed a better protective role (P<0.01). However, with increasing concentration, this protective effect was not further increased, but decreased slightly. Results indicated that high-concentration dexamethasone can induce oxidative injury to bone marrow stromal cells, and edaravone can protect the cells against this oxidative damage by antioxidant role.

Objective: To observe the different effects between Mahuang (Herba Ephedra Sinicae) and Wuweizi (Fructus Schisandrae Chinensis) on the pathological changes of rats with bleomycin A(5)-induced pulmonary fibrosis. Methods: Ninety Wistar rats were randomly divided into sham operation group, model group, hydrocortisone group, Herba Ephedra Sinicae group, Fructus Schisandrae Chinensis group and Herba Ephedra Sinicae plus Fructus Schisandrae Chinensis group. There were 16 rats in each group except the sham operation group (10 rats). Pulmonary fibrosis was induced by a single intratracheal injection of bleomycin A5. Hematoxylin and eosin straining and immunohistochecical method were used after 7- and 28-day treatment to observe the pathology of lung injury, measure the inner diameter of pulmonary arterioles and the density of nuclear membrane. Results: Compared with the sham operation group at 7 and 28 d, alveolar inflammation level was significantly increased in the model group (P<0.01). Alveolar inflammation level was decreased obviously in the hydrocortisone group (P<0.05) after 7- and 28-day treatment as compared with the model group, and that in Herba Ephedra Sinicae plus Fructus Schisandrae Chinensis group was also decreased obviously (P<0.05) at 28 d. Compared with the sham operation group, nuclear density of the model group was increased, while its inner diameter was decreased (P<0.05). In the Fructus Schisandrae Chinensis group, Herba Ephedra Sinicae plus Fructus Schisandrae Chinensis group and hydrocortisone group, the nuclear density was decreased (P<0.05) as compared with the model group. Inner diameter in the Herba Ephedra Sinicae group, Herba Ephedra Sinicae plus Fructus Schisandrae Chinensis group and hydrocortisone group was higher than that in the model group (P<0.05). Microvessel density of the model group was obviously higher than that of the sham operation group (P<0.05). Compared with the model group, Herba Ephedra Sinicae plus Fructus Schisandrae Chinensis group and hydrocortisone group had lower microvessel density (P<0.05). Conclusion: Herba Ephedra Sinicae combined with Fructus Schisandrae Chinensis can restrain pulmonary artery injury. The nuclear density and microvessel density can be reduced by Fructus Schisandrae Chinensis, while Herba Ephedra Sinicae can increase the inner diameter.

Objective To screen the clinical factors affecting the malignant probability of solitary pulmonary nodule (SPN) with univariate and multivariate Logistic regression analysis,and to establish a clinical prediction model,evaluate its test effectiveness in the differential diagnosis in SPN.Methods A retrospective cohort study included 182 patients with diagnosis of SPN (group A).Clinical data included gender,age,smoking history,quitting smoking,history of tumor,serum carcinoembryonic antigen (CEA),location,diameter,density,vacuole sign,cavity,airbronchogram,calcifcation,lobulation,spiculate sign,spiculation,pleural indentation sign,vascular convergence sign,enhanced CT value,the maximum standard uptake value (SUV~x) of positron-emission tomography (PET),pathological diagnosis were collected.The independent predictors of malignancy were estimated with univariate and multivariate analysis,then the clinical prediction model to identify malignant was established.Other 45 SPN patients (group B) were used to tested value of the model.Results Univariate analysis showed that gender,age,no lower lobe location,diameter,density,airbronchogram,calcification,lobulation,spiculation,pleural indentation sign,enhanced CT value ≥ 15 HU,SUVm,≥ 2.5 of PET significantly affected judgment of SPN of benign or maligant (P ＜ 0.05).Multivariate analysis revealed that female,age,lobulation,short spiculation,pleural indentation sign was the independent predictors of malignancy in patient with SPN,solid nodule suggested benign.The clinical prediction model to identify malignant was established:P =ex/ (1 + ex),x =-3.399 +1.382 × gender + 0.056 × age + 1.377 × lobulation + 1.498 × spiculation-2.096 × solid + 1.005 × pleural indentation sign,e was natural logarithm.P =0.663 was as cut-off point,group B was used to test value of the model:the sensitivity was 86.5％,the specificity was 62.5％,the positive predictive value was 91.4％,the negative predictive value was 50.0％,the accuracy was 82.2％.Conclusions As for SPN,female,age,lobulation,short spiculation and pleural indentation sign is the independent predictor of malignancy in patient with SPN,solid nodule suggests benign.The prediction model is sufficient to estimate the malignancy of patient with SPN.

BACKGROUND: Neural stem cells are always derived from animals, and unsuitable for human transplantation treatment. OBJECTIVE: To explore the in vitro culture methods of human embryonic striatum-derived neural stem cells, and to observe the biological characteristics. METHODS: The human embryonic striatum were separated from the embryo at a gestational age of 8-16 weeks that received induction of labor with water bag, and then the embryonic striatum was in vitro cultured in the serum-free Dulbecco’s modified Eagle’s medium. The cells were passaged after neurospheres formation, and then the cells were induced to differentiation with the Dulbecco’s modified Eagle’s medium/F12 containing 10% fetal bovine serum. RESULTS AND CONCLUSION: The in vitro cultured human embryonic striatum-derived neural stem cells grew rapidly and could express nestin. Colony formation assay showed the cel clone formation rate was 6.0%-7.0%. 5-Bromodeoxyuridine incorporation assay showed the cel proliferation rate was 37.9%. Immunofluorescence staining showed that the cells after induction and differentiation could express Tuj-1, glial fibril ary acidic protein and nestin, but not express myelin basic protein. The results indicate that human embryonic striatum-derived neural stem cells cultured in the serum-free medium can maintain their biological characteristics and have self-renewal capacity, and the cells can differentiate into the neurons and astrocytes induced by the fetal bovine serum.