Objective To investigate the protective effects of G CSF on lungs of rats with acute cholangitis and changes in blood TNF and TXA 2/PGI 2 by treating the rats with G CSF. Methods Seventy two Wistar rats were randomized into the control, infected and treated groups. We established the model of cholangitis in the rats with injection of E. coli 25922 into the bile duct. The animals in the treated group were pretreated with G CSF 500 ng/day bid) for 5 days before the E. coli injection. The levels of blood TNF and TXA 2/PGI 2 were measured at the 3rd, 6th and 12th h after the injection. Meanwhile, the morphological changes in lungs of the rats were observed. Results The morphological changes in lungs were milder and levels of blood TNF and TXA 2/PGI 2 were significantly lower in the treated group than in the infected one (P

Objective To evaluate the clinical value of pulmonary embolism severity index (PESI) in non high-risk acute pulmonary thromboembolism (APTE) patients treated with sequential anticoagulation.Methods Non high-risk APTE patients treated with sequential anticoagulation were divided into two groups according to PESI:high-value group and low-value group.Prognosis and treatment response was compared between two groups.Results There were 82 cases in high-value group,and 76 cases in low-value group.The rate of adverse events in high-value group was significantly higher than that in low-value group [23.2％(19/82) vs.7.9％ (6/76)] (x2 =5.0698,P =0.009),and 30 days cumulative hazard was also significantly higher than that in low-value group (P ＜ 0.05).The sensitivity of predicting adverse events by PESI was 76.0％,specificity was 52.6％,positive predicting value was 64.6％,and negative predicting value was 65.9％.The mortality in high-value group was significantly higher than that in low-value group [9.8％(8/82) vs.1.3％ (1/76)] (P =0.022).After 30 days of anticoagulation,the pulmonary artery systolic pressure,internal diameter of right ventricle in high-value group was significantly higher than that in low-value group [(39.4 ± 8.1) mm Hg (1 mm Hg =0.133 kPa) vs.(27.2 ± 5.5) mm Hg,(33.0 ± 7.8) mm vs.(21.7 ± 4.6) mm] (P =0.034,0.021),and arterial oxygen partial pressure was significantly lower than that in low-value group[(75.15 ± 12.41) mm Hg vs.(86.36 ± 9.22) mm Hg](P=0.016).Conclusions PESI can effectively predict short-term prognosis of non high-risk APTE patients treated with sequential anticoagulation.At least some of these patients might need treatment other than sequential anticoagulation.

Objective To observe the recent clinical efficacy of the sequential therapy hormone in the treatment of active rheumatoid arthritis.Methods In accordance with the principle of digital sheet,160 patients with active rheumatoid arthritis were randomly divided into the observation group and the control group,80 cases in each group.On the basis of methotrexate and leflunomide in both groups,the hormone sequential therapy was given in the observation group,but prednisone was given in the control group.The clinical efficacy of treatment after 1 week and 3 months were compared in two groups.Results In the observation group,the indicators in 7 d after treatment were significantly reduced,compared with untreated(t =19.90,7.63,14.73,7.58,6.84,14.09,all P ＜0.01),In the control group,three indicators of the duration of morning stiffness,joint tenderness index and joint swelling index in 7d after treatment were significantly reduced,compared with untreated (t =13.42,3.34,7.24,all P ＜ 0.01),Compared the indicators in the two groups in 7 d after treatment,there were statistically significant differences (t =13.07,4.92,10.51,5.23,5.74,15.03,all P ＜ 0.01).The indicators in the 3 months after treatment in both groups were signifi cantly decreased,buttherewasnosignificantdifferencebetweenthetwogroups (t =1.80,1.73,1.59,1.22,1.21,1.35,all P ＞ 0.05).The total effective rate was 80% in the observation group; but the rate was 75 % in the control group;there was no statistically significant difference in the two groups(x2 =0.57,P ＞ 0.05).Conclusion The sequential hormone therapy is an effective means for the treatment of active rheumatoid arthritis,by controlled the symptoms of rheumatoid arthritis effectively and alleviated the patient's condition.

Objective struclured clinical examination (OSCE) is a kind of examination which could objectively evaluate the students′clinical skills.Nowadays,OSCE are wildly applied in medical educational field throughout the world.Timely discussion and analysis on the problems existed in the implementation process of OSCE is necessary.Measures should be taken to improve the OSCE examination and to meet the requirements of higher clinical practice training level such as increasing clinical skill simulation training hardware investment,optimizing settings and conlents of the examination and the test stations as well as introducing standardized patients (SP) and other measures.

Objective:To study the effect of trigonelline on the change of indicators of serum transaminase, lipoprotein and liver lipid of model rats with non-alcoholic fatty liver diseases and on the expression level of Bcl-2 and Bax proteins.Methods:A total of 45 SD rats were randomly divided into Fthe control group, model group and trigonelline intervention group. Rats in the control group were fed with the common diet, while rats in the model group and intervention group were fed with the high fat diet. 8 weeks later, the intervention group received the intragastric administration of trigonellin e (with the dosage of 40 mg/kg/d) for 8 weeks; while control group and model group received the intragastric administration of saline with the equal dosage. Blood was taken from the abdominal aorta of rats 8 weeks later, detecting the level of a series of indicators of ALT, AST, TG, TC, HDL-C and LDL-C in the serum. After the rats were sacrificed, detect the indicators of TG, TC, SOD and MDA in the liver tissue of rats, as well as the expression of Bcl-2 and Bax in the liver tissue.Results: Results of histopathologic examination showed that the damage degree of liver for rats in the trigonellineintervention group was smaller than the one in the model group, with significantly reduced hepatic steatosis and the partially visible hepatic lobule. The levels of ALT, AST, TC and LDL-C in the serum of rats in the trigonelline group were significantly reduced, while the change in the levels of TG and HDL-C was not significantly different. The levels of TG, TC and MDA in the liver tissues were significantly decreased, while the level of SOD significantly increased; the expression of Bcl-2 protein in the liver tissues of rats in the trigonelline intervention group was significantly increased, while the expression of Bax protein significantly decreased.Conclusions: The trigonelline contributes to the therapeutic effect of non-alcoholic fatty liver diseases. It can also increase the expression of Bcl-2 protein and decrease the expression of Bax protein in the liver tissues, which can protect the liver.

Objective To investigate the clinical value of 125I particle implantation brachytherapy combined with intermittent hormonal therapy for treating clinical moderate and high risk non-metastatic prostate cancer.Methods A prospective study was proceeded and 100 cases with moderate and high risk (cT≥T2b,Gleason score ≥ 7,pre-biopsy PSA ≥ 10 ng/ml)non-metastatic prostate cancer were included.The selected patients were divided into two group.In the study group,patients were treated with 125I particle implantation combined with intermittent hormonal therapy.In the control group,patients were treated with only intermittent hormonal therapy.Hormonal therapy was maximal androgen blockage for two groups,including bicalutamide 50 mg oral every day and Leuprorelin 3.75 mg subcutaneous injection every 28 days.There were 50 cases in each group and clinical trial agreements were signed.During follow-up,PSA were tested every month.Chest X-ray and whole-body hone scanning were checked every 6 months.Hormonal therapy was stopped when patient's PSA level fell to 0.2 ng/ml,and keep stabilized for 3 months.When PSA level elevated for 3 times continuously and over 1 ng/ml,hormonal therapy was initiated again.The IPSS scores were documented before treatment and every 3 months after treatment.Adverse reactions of urinary tract and rectum were assessed every 3 months after 125I particle implantation in study group.The ratio of the first time to stop hormonal therapy,the time duration of first hormonal therapy and stable phase,re-hormonal therapy free survival rate,bone metastasis free survival rate,castration resistance prostate cancer(CRPC) free survival rate,cancer-specific free survival rate and overall survival rate were compared.Results The 100 cases in this study were followed up for 24-40 months,with an average time of 31.6 months.In study group,the PSA level in all cases descended to the level of stopping hormonal therapy.The time duration of hormone therapy ranged from 4 to 12 months,with an average time of 6.3 months.21 (42％) cases had a PSA elevation again to restart hormonal therapy.In control group,the PSA level in 47 cases descended to the level of stopping hormonal therapy.The time duration of hormone therapy ranged from 5 to 15 months,with an average time of 7.2 months.34 (68％) cases had a PSA elevation again to restart hormonal therapy.There was no significant difference in percentage of cases of stopping hormone therapy and in time duration of hormonal therapy for the first cycle.Instead,there were significant differences in stable phase after first cycle hormonal therapy between two groups (27.2 months vs.17.7 months;P ＜ 0.001).When analyzed by Kaplan-Meier survival curve,there was no significant difference in cancer-specific survival rate and overall survival rate.There were significant differences in Re-hormonal therapy free survival (P =0.002),bone metastasis free survival (P =0.04) and CRPC free survival(P =0.005).Conclusions Compared with intermittent hormonal therapy alone,125I particle implantation brachytherapy combined with intermittent hormonal therapy could prolong the hormonal sensitive time in moderate and high risk nonmetastatic prostate cancer patients and control the progress of the prostate cancer.

The stability of the intraocular lens ( IOL ) after cataract surgery is composed of decentration, tilt, rotation, and the change of anterior chamber depth. Its stability is an important factor affecting postoperative visual quality. By analyzing the related factors which influence the stability of intraocular lens, improvements can be identified for future cataract operations. The stability of intraocular lens is influenced by many factors: intraocular structure, the size and the symmetry of intraoperative capsulorhexis, the position of the intraocular lens, the material and design of the intraocular lens, etc. In order to improve the patient's vision, cataract surgeries have been experiencing an evolution. IOL material have also been contributing to such innovations.

BACKGROUND: Studies are very few regarding the specific reaction of bone marrow mesenchymal stem cells (BMSCs) to activated microglia. Moreover, it remains unclear how MSCs maintain dopaminergic neuronal survival under specific microenvironment.OBJECTIVE: To explore the effect of BMSCs stimulated by activated microglia on dopaminergic neuron survival.METHODS: BMSCs were isolated from Wistar rats by attachment method, and in vitro cultured; microglia was activated, and dopaminergic neurons were cultured by enzyme digestion method. The experiment included 5 groups: BMSCs, microglia, lipopolysaccharide (LPS)+microglia; BMSCs+LPS+microglia groups, in which the dopaminergic neurons were cultured with corresponding culture medium; the dopaminergic neurons alone group was cultured with 10% fetal bovine serum+ DMEM/F12. The effect of different microenvironment on dopaminergic neuron survival and gliocyte-derived neurotrophic factor released from BMSCs were detected by immunofluorescence technique.RESULTS AND CONCLUSION: The release of gliocyte-derived neurotrophic factor in groups involving BMSCs was greater than corresponding control group. Tyrosine hydroxylase immunofluorescence showed that neuronal survival of dopaminergic neurons alone group was 15%, microglia group was 10%, LPS+microglia was 5%, but BMSCs+LPS+microglia group was 28%, significantly greater than the other groups (P < 0.05). In addition, survival of in vitro cultured dopaminergic neurons was decreased with increasing culture duration, but the survival of dopaminergic neurons in group involving BMSCs was significantly greater than corresponding control group. This indicates that microglia activation stimulated BMSCs to upregulate gliocyte-derived neurotrophic factor to prevent dopaminergic neurons from toxic injury, and inhibit delayed death of dopaminergic neurons.

Objective To investigate the development of rat heart and the expressions of TGF-?1,SMAD4 and Bax protein to detect the location and mechanism of action in different developmental periods of rat heart. Methods Histology and immunohistochemistry of rat embryonic hearts from day11 to day19(E11～E19) in paraffin-embedded were used to analyze the heart development and TGF-?1,SMAD4 and Bax protein expressions. Results The muscular part of interventricular septum appeared on E12.5,and the partition of the ventricle finished on E16.The positive expression of TGF-?1 can be seen in the rat embryonic heart during E11～E19.The positive staining was increased to E15 and then declined significantly.The expression of SMAD4 was enhanced gradually and the positive signals were strong on E17,and a spatial difference was found in the expression on E13.The expression peaks of the Bax protein appeared on E15 then subsided to a stable.Conclusion The critical period of cardiac muscle cell differentiation and heart moulding was E15.TGF-?1,Smad4 and Bax protein play important roles during the development of rat embryonic heart.

BACKGROUND:It has been reported that mesenchymal stromal cells(MSCs)are capable of differentiating into cells of multilineage.Different methods and reagents have been used to induce the differentiation of MSCs,but most inducing systems contain serum and cytokines.OBJECTIVE:To investigate the gene expression of mash-1 and ngn-1 in differentiation of SD rat bone marrow-derived mesenchymal stem cells induced by salvia mitiorrhiza. DESIGN:Controlled experiment in vitro with repeated observation and measurement based on cells.SETTING:Department of Anatomy,School of Preclinical and Forensic Medicine,Sichuan University. MATERIALS:This study was performed in the Department of Anatomy,School of Preclinical and Forensic Medicine,Sichuan University from October 2004 to December 2005.SD male rats weighing 160-200 g were purchased from the Animal Center of Sichuan University.The experimental animals were disposed according to ethical criteria.Parenteral solution of salvia mitiorrhiza purchased from Tianyang Medicine Company Limited of Anhui(batch number:20050411).METHODS:The nucleated cells were separated from rat bone marrow through gradient centrifugation and cell adherent method,and then MSCs differentiated into neurcyte-like cells induced by salvia mitiorrhiza.Cells in the control group were cultured with salvia mitiorrhiza-free serum-free culture media.The expression of neuron specific enolase(NSE)and glial fibrillary acidic protein(GFAP)were detected by immunohistochemistry.RT-PCR was used to detect the mRNA of mash-1 and ngn-1. MAIN OUTCOME MEASURES:①mash-1 and ngn-1 expressions were detect by the RT-PCR method.②NSE and GFAP expressions were detected by immunohistochemistry.RESULTS:①The MSCs were well adherent to walls.Most of the cells transformed in dipolar-like or multipolar-like.Axon-like or dentrite-like process was developed and these processes synapse with each other.② RT-PCR showed that ngn-1 and mash-1 mRNA were negative before induction,but positive after induction.③Immunohistochemistry indicated that NSE and GFAP expressions were positive after induction but negative in the control group. CONCLUSION:MSCs can be induced to differentiate into neurocyte-like cells by salvia mitiorrhiza.