Objective To study the anti-aging effect of total saponins of Polygala tenuifolia (PTS). Methods The effects of total saponins of Polygala tenuifolia on oxygen free radicals were investigated by the methods of scavenging hydroxyl radical, superoxide radical and DPPH oxygen free radicals in vitro. The photoaging model of mice skin was established to observe the effect of total saponins of Polygala tenuifolia on mouse skin pathology. Results In the experiment of antioxidation in vitro, the total saponins of Polygala tenuiflora significantly scavenged hydroxyl free radicals (P<0.05, P<0.001) and superoxide radical (P<0.01) at 6.0 and 12.0mg/mL, DPPH free radicals (P<0.001). In the light aging experiment, the light aging model of mice skin was established successfully in group B (model + medium tea oil). Compared with group B, the density of the skin epidermis in D group (30 min before irradiation, 6mg/mL PTS) was thickened, the elastic fibers were arranged uniformly and tightly, the collagen fibers proliferated significantly and densely, and the inflammatory cells infiltration was not found. The treatment effect was most remarkable in group G (30min after irradiation, PTS 12mg/mL PTS), and the skin of the mice was thickened, the elastic fibers were evenly arranged, the collagen fibers had some hyperplasia, evenly distributed, and there was no infiltration of inflammatory cells, which had significant therapeutic effect. Conclusion The total saponins of Polygala tenuifoliahas significant antioxidant activity and anti - light aging effect.

Objective: To evaluate the efficacy and safety of high field MR-guided percutaneous precise puncture aspiration in treatment of multilocular brain abscess. Methods: Clinical data of 9 patients with multilocular brain abscess treated with high field 1.0T MR-guided percutaneous precise puncture aspiration were retrospectively analyzed. The operation time, complication and follow-up results were recorded. Results: Nine patients with multilocular brain abscess underwent 25 times of high field MR-guided puncture and aspiration therapy, among them 2 patients underwent 2 times and 7 cases underwent 3 times aspiration, and the technique success rate 100% (25/25). The operation time was 40-100 min, with an average of 75 min. All sucked pus was cultured with bacteria, and positive results were obtained in 8 patients. A small amount of subdural hemorrhage occurred in 1 patient, but no serious complication occurred. The symptoms were significantly improved in 9 patients during 6 months' postoperative follow-up, while imaging follow-up results showed subsided or granuloma formed in abscess cavities of all 9 cases, with an effective rate of 100% (25/25). Conclusion: High field open MR-guided percutaneous precise puncture aspiration is safe and effective for treatment of multilocular brain abscess.

Objective To evaluate the efficacy and safety of oral ginkgo biloba extract EGB761 in patients with mild cognitive impairment.Methods They searched PubMed,Embase,the Cochrane Library ,CNKI,Wanfang and VIP databases for randomly controlled trials of oral ginkgo biloba extract for mild cognitive impairment.After assessed the quality of studies included,RevMan5.2 software was used to analyze data.Results Seven studies which including 815 patients were involved by our inclusion criteria.The results of meta-analysis showed,compared with the control group,ginkgo biloba was superior in improving mild cognitive impairment patients' MMSE level[MD=1.81,95%CI(0.02,3.60),P=0.05;MD=1.96,95%CI(1.48,2.43),P<0.000 01;MD=1.79,95%CI(0.99,2.58),P<0.000 1] after treated three months、six months and twelve months.Ginkgo biloba was also superior in improving mild cognitive impaimant patients.CDT level[MD=0.43,95%CI(0.30,0.57),P<0.000 01;MD=0.57,95%CI(0.39,0.75),P<0.000 01] after treated six months and twelve months.The effect of preventing MCI patients into dementia was better than that of the control group[RR=0.27,95%CI(0.06,1.27),P=0.10;RR=0.32,95%CI(0.16,0.63),P=0.001]after treated six months and twelve months.Conclusion Oral preparation of ginkgo biloba extract in the treatment of MCI clinical efficacy and prevention of dementia occurrence rate was better than that of blank control group.

Objective To investigate the therapeutic effect of Tiaozhi Decoction for the treatment of coronary heart disease induced stable angina complicated with hyperlipemia, and to observe its effect on serum inflammatory factors. Results One hundred qualified patients were evenly randomized into treatment group and control group. Both groups were given conventional western medical treatment with reference to Guide for Diagnosis and Treatment of Chronic Stable Angina, and additionally, the control group was given oral use of Simvastatin and the treatment group was given Tiaozhi Decoction orally. The treatment of the two groups covered 8 weeks. Before and after treatment, blood lipid levels of total cholesterol ( TC) , triglyceride ( TG) , low-density lipoprotein cholesterol ( LDL-C) , high- density lipoprotein cholesterol ( HDL-C) , apolipoprotein A (ApoA) and apolipoprotein B (ApoB) were observed. The frequency of angina pectoris attack and the dosage of Nitroglycerin Tablets per week in both groups were recorded during the treatment. Therapeutic effect on lowering blood lipid and on improving electrocardiogram was evaluated after treatment. Serum levels of hypersensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), homocysteic acid (Hcy), adiponectin (APN), and oxidized low-density lipoprotein (ox-LDL) were detected before and after treatment. Results(1) The results of Ridit analysis showed that the treatment group had better therapeutic effect on lowering blood lipid and on improving electrocardiogram than the control group ( P<0.05) . ( 2) After treatment, TG, HDL-C, ApoB and ApoA levels were much improved in the treatment group compared with those in the control group (P<0.01) . ( 3) The frequency of angina pectoris attack and the dosage of Nitroglycerin Tablets per week were reduced in the treatment group compared with those in the control group (P<0.01) . (4) After treatment, the treatment group had lower hs-CRP, IL-6, Hcy and ox-LDL levels, and higher APN level than the control group (P<0.01) . Conclusion Tiaozhi Decoction is effective for the treatment of coronary heart disease induced stable angina complicated with hyperlipemia through improving lipid metabolism and reducing angina pectoris attack, and the mechanism may be related with the regulation of inflammatory factors.

Objective To evaluate the effect of dexmedetomidine on inflammatory response and the changes of serum inflamma-tory mediator caused by cardiopulmonary bypass(CPB)in cardiac valve replacement surgery.Methods 30 patients scheduled for cardiac valve replacement were randomly divided into two groups:experimental group(n=15)and control group(n=15).For the experimental group,dexmedetomidine was infused intravenously with the dose of 2.0μg·kg-1 ·h-1 after induction of anesthesia. In control group,normal saline was given instead of dexmedetomidine.Blood samples were taken from radial artery in each of the following five time points:after induction of anesthesia(T1 ),the beginning of CPB(T2 ),after beginning of CPB 40 min(T3 ),after the termination of CPB 2 h(T4 )and 24 h(T5 )for determination of TNF-α、IL-6、IL-10.Results The concentration of TNF-α、IL-6、IL-10 levels showed no significantly difference between the two groups before CPB(P>0.05).But serum TNF-α、IL-6 levels of ex-perimental group were significantly lower and IL-10 were significantly higher than control group(P<0.05 or P<0.01)at the time points of T3~T5 .All biomakers rose significantly at the time of T3 and T4 in both groups(P<0.05 or P<0.01).At the time of T5 IL-6、IL-10 returned to preoperative levels(P>0.05)while TNF-αremained heigh level(P<0.05 or P<0.01)in both groups. Conclusion dexmedetomidine can regulate the release of the serum inflammatory mediator which suggest that dexmedetomidine may alleviate the systemic inflammatory reaction resulting from cardiopulmonary bypass in cardiac valve replacement surgery.

Objective To study the value of transfer constant(Ktrans)derived from dynamic contrast-enhanced MRI (DCE-MRI) for quantitative evaluation of Ki-67 labeling index (Ki-67 LI) in glioma. Methods Twenty patients with glioma who underwent DCE-MRI and operation were retrospectively reviewed. The Ktrans value and Ki-67 LI were acquired and correlated using the Spearman correlation test. Also, the Ktrans values were compared between high(larger than 10%)and low(no more than 10%)Ki-67 LI group with Mann-Whitney U test, receiver operating characteristic curves was performed to evaluate the diagnostic value. Results The Ktrans value(0.0165 to 0.8048, median 0.1252)was significantly associated with Ki-67 LI(5%to 50%, median 20%) (r=0.721,P<0.001), and the Ktrans value was significantly higher in high Ki-67 group(0.0810 to 0.8048, median 0.1810)than that in low Ki-67 LI group(0.0165 to 0.1456, median 0.0697)(Z=-3.209, P=0.001). The most predictive Ktrans value differentiated high Ki-67 LI and low Ki-67 LI with an area under the curve(AUC) of 0.945 at a sensitivity of 92.3% and specificity of 85.7%. Conclusion Ktrans value could be used for quantitative evaluation of Ki-67 LI in glioma.

Objective The aim of the study was to investigate the application effect of de-escalation thinking in first aid nursing of craniocerebral injury complicated with cervical spine injury.Methods 23 cases of craniocerebral injury and cervical spine injury patients received first aid rescue in emergency department of our hospital during the period from September 2012 to August 2014 were set as the observation group,and the de-escalation thinking way was used during rescue process.19 cases of craniocerebral injury and cervical spine injury patients during the period from September 2010 to August 2012 were set as the control group,traditional way of clinical experience thinking way was used.The early warning time,emergency treatment time and missed diagnosis cases were compared between the two groups.Results The early warning time of diagnosed as traumatic brain injury complicated with cervical spine injury (t=18.035) and emergency treatment time (t=7.650) in the observation group were shorter than those of the control group,the difference was significant.The missed diagnosis rate of the observation group [4.35％(1/23)] was significantly lower than that of the control group (9/19),the difference was significant (x2=8.38).Conclusions Application of de-escalation thinking mode in rescue by emergency nurses can shorten the early warning and emergency treatment time,decrease the missed diagnosis rate and improve the timeliness of the rescue for craniocerebral injury complicated with cervical spine injury.

Objective To investigate the change of cyclin-dependent kinase 5(CDK5)during 1 week after conditioned fear extinction.Methods Forty-two male adult SD rats were randomly divided into native group,extinction control group and 24h extinction group.Extinction retention test and immunohistochemistry of CDK5 of hippocampus were done at 1st,3rd,7th day after fear extinction.The numbers of CDK5 positive cell in hippocam-pus CAI was measured by computer analytic system.Results (1)Extinction retention scores were increasedgradually in extinction group compared with native group(75.60±2.51)%,the scores of extinction control group was decreased at 1st day(15.62±10.28)% and 3th day(20.58±7.79)% after extinction(P＜0.01);24h extinction group(71.04±11.65)% were better than extinction control group(35.48±12.37)at 7th day after extinction(P＜0.01).(2)The number of CDK5 positive cell was increased significantly in 24h extinction group (24.94±5.20;32.25±6.14;33.28±6.56)compared with native group(75.60±2.51;P＜0.01).In 24h extinction group the number was increased significantly at 3rd day(P＜0.01)and 7th day(P＜0.05)compared with extinction control group(25.09±4.83;26.70±4.57),and decreased at 1st day compared to 3rd day(P＜0.05)and 7th day(P＜0.01).Conclusion From 1st to 7th day after extinction,CDK5 may contribute to the retention of fear extinction in hippocampal CA1.

Objective:To analyze the influences of azithromycinantibiotic combined glucocorticoids on the levels of erythrocyte sedimentation rate (ESR),serum lactate dehydrogenase (LDH) and inflammatory cytokines levels as well as the clinical effect of severe pneumonia mycoplasma.Methods:112 children with severe pneumonia mycoplasma who were treated in our hospital were selected and randomly divided into the control group and the observation group with 56 cases in each group.The patients in the control group were treated with azithromycinantibiotic,while the patients in the observation group were treated with glucocorticoid on the basis of the control group.Then the levels of ESR,LDH,isoenzyme MB (CK-MB),creatine kinase (CK),aspertate aminotransferase (AST),c-reactive protein (CRP),interleukin 6 (IL-6),tumor necrosis factor-o (TNF-α),CD4+ and CD8+,the clinical efficacy and adverse reactions between two groups were observed and compared before and after the treatment.Results:The effective rate in the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).After treatment,the levels of ESR,LDH,CK-MB,CK,AST,CRP,IL-6,TNF-α and CD8+ in the two groups decreased,which were lower in the observation group than those of the control group (P＜0.05).After treatment,the levels of CD4+ in both groups increased,which was higher in the observation group than that of the control group (P＜0.05).The disappearance time of fever,cough relief,lung rale of observation group were shorter than those of the control group(P＜0.05).There was no statistically significant difference in the adverse reactions between the two groups (P＞0.05).Conclusion:Azithromycin combined with glucocorticoids was more effective than azithromycin alone in the treatment of severe mycoplasma pneumonia with high safety,which could obviously relieve the myocardial injury and inflammatory response,enhance the immune function.

Extracurricular activities are necessary to curricular study and significant in quality and practical ability education for medical students.Research and practice on how to improve the interest in extracurricular activities for medical students were carried out,and good results were achieved in the aspect of the development of teaching efficiency.