Anemia, Aplastic ; genetics ; metabolism ; Bone Marrow Cells ; metabolism ; Case-Control Studies ; Cell Line ; Child ; Child, Preschool ; Female ; Fibroblast Growth Factor 2 ; metabolism ; Gene Expression Profiling ; Humans ; Male ; Mesenchymal Stromal Cells ; metabolism

Objective: To investigate the impact of stroke unit (SU) on the compliance of secondary prevention in patients with stroke at 12 months after stroke. Methods: Research subjects were stroke patients who were treated in SU (n = 500) and in general ward (GW) (n =445) using a design of retrospective study. The patients in the SU group were followed up by hospital, telephone and home interviews for 12 months, and the patients in the GW group were followed up by telephone interview for 12 months. The main outcome measures were the rate of using antithrombotics, the rate of smoking cessation, and the rates of awareness of early stroke symptom and stroke risk factors of patients. Results: he rate of using antithrombotics was 92.76% in the SU group, and it was significantly higher than 51.49% in the GW group (P ＜0.01); the rate of smoking cessation, and the rates of awareness of early stroke symptom and stroke risk factors of patients were 82.33%, 91.04%, and 94.03% respectively in the SU group, and they were significantly higher than 54.75%, 6.53%, and 70.37% in the GW group(P all ＜ 0.01 ). Conclusions: SU attaches importance to the secondary stroke prevention and emphasizes standardized treatment, and the compliance of the secondary stroke prevention in patient with stroke is improved significantly.

Objective To summary the experience of management for orthotopic homologous heart transplantation,heart-lung co-transplantation and to discuss the postoperative treatment of short-term complications.Methods Orthotopic homologous heart transplantation and heart-lung co- transplantation on 9 cases were performed from May 2004 to February 2006.The patients were traced closely and all complications were treated in time.Results During hospital stay,hypertension oc- curred in one case,right heart insufficiency in one case,infection of mycetes and cytomegalovirus in 2 cases after the heart transplantation,and in the patient undergoing heart-lung co-transplantation,renal inadequacy,bronchial anastomosis stenosis and fungus infection occurred.All patients obtained symp- tomatic relief before discharge.Conclusion Proper perioperative management,immunosuppressive therapy and management of postoperative complications could reduce mortality and obtain satisfactory therapeutic effect in the near future.

Objective:This study investigates the significance of human papilloma virus (HPV) subtype detection in opportunis-tic screening for cervical cancer in Uygur and Han women. Methods:Flow-through hybridization gene chip and thin-prep cytology test were used to detect HPV in cervical cell samples from 1140 females. A total of 428 patients had undergone cervical biopsies through colposcopy. The diagnostic results of the HPV subtype test for cervical lesions were evaluated on the basis of histology. Results:Total HPV infection rate for the 1140 cervical samples was 30.3%. The most common HPV subtypes were HPV16, HPV58, HPV52, HPV18, and HPV45. HPV52 infection rate was higher in Han women than in Uygur women, with statistically significant differences between the two (χ2=8.737, P=0.003). Among these cervical samples, the single HPV infection rate was 22.4%(255/1140), whereas the multiple HPV infection rate was 6.1% (69/1140). The sensitivity and specificity of the HPV subtype test for cervical lesions were 86.4% and 24.5%, respectively. The positive and negative predictive values were 58.5%and 59.3%. Conclusion:HPV infection subtypes in Ugyur and Han women have unique characteristics. Subtype detection is important in opportunistic screening for cervical cancer.

Objective:To investigate the effects of shikonin on osteoclastogenesis in vitro and amelioration of bone loss in ovariectomized-induced osteoporosis in mouse model.Methods:The optimal concentration of shikonin treating were evaluated in vitro depending on its effect on the viability of C57BL/6J mouse bone-marrow-derived macrophages by CCK-8 method.To establish the osteoclastogenesis cell model,macrophages were cultured with RANKL and M-CSF treatment,and TRAP staining was used to observe the generation of osteoclasts after treating with different concentration of shikonin solution.Expressions of osteoclast marker genes,including TRAP,c-Fos and NFATclwere detected with real-time PCR.Fifthteen mice were randomly allocated into sham operation group,ovariectomized model group and shikonin treatment group.After the modeling,mice in treatment group were received the intraperitoneal injection of shikonin,while the other two groups treated with normal saline.After thirty days treatments,all animals' tibias were dissected for micro-CT analysis.Results:①The macrophages viability was significantly inhibited when the concentration of shikonin was higher than 250 nmol/(P＜0.01).②The osteoclastogenesis was significantly suppressed by differemt dose of shikonin(P＜0.01).③ The expression of the osteoclastic marker genes (TRAP,c-Fos and NFATc 1) were suppressed by addition of shikonin comparing to control group (P＜0.01).④ Shikonin effectively prevented ovariectomy-induced bone loss (P＜0.05).Conclusion:Shikonin suppresses osteoclastogenesis in vitro and ameliorates ovariectomized-induced osteoporosis in mouse model.

Objective To evaluate the current situation of two-way referral system by qualitative study.Methods The qualitative study was carried out in Department of General Internal Medicine of Peking Union Hospital and 4 clinics under Beijing Gaobeidian Community Health Center from June to December 2009.In-depth interview was conducted on 6 patients,who were referring from community health center to tertiary hospital and 16 general practitioners in the community.The method of thematic framework was used for data analysis.Results Only 1 of the 6 patients,who made the appointment,completed the two-way referral.From the view of the patients,the interrupt of the two-way referral was due to long-time waiting,inconvenient transportation to the hospital,availability of specialists,unsmooth process of referral and unsatisfied doctors.However,the community health service staff thought that difficulties of the two-way referral originated from the system,doctors,patients,and doctor-patient relationship.Sometimes patients distrusted doctors both in hospital and in community; communications between doctors or between doctors and patients were less efficient; patients had multiple choice for their primary care and they may go to any hospital freely bypass community-based referral system; patients had excessive expectation for medicine and doctors; some patients paid less attention to their own health,and so on.For improvement of the two-way referral system,the community health service staff proposed concrete measures in terms of relevant policy,the hospital,community health service,the doctors and patients; they emphasized the importance of upgrading their own communication ability and professional skills for primary care.Conclusions Many factors may influence successful implement of two-way referral,so it is necessary to improve the relevant policy and procedures and to upgrade medical staff in community.

To explore the population composition and the morbidities and treatment of hypertension and diabetes mellitus among the patients at 4 community healthy service stations at Gaobeidian,Chaoyang District of Beijing during the period of February 2009 to October 2010.A cross-sectional survey was conducted by self-reporting questionnaires.Most patients were above 40 years old,had a lower income level and education status and their treatment costs were mainly covered by social health insurance.Their incidences of hypertension and diabetes mellitus were high.Though most of them could recognize and treat their illnesses,the control rate remained non-satisfactory.Targeting incoming patients,community health service stations should take its advantages of managing chronic diseases and enroll more patients from local communities.

BACKGROUND:Dendritic cel s can regulate the immunological reaction in the intestinal tract, this functional deficit may induce inflammatory bowel disease. Tol-like receptor-4/nuclear factor-κB pathway is highly involved in this reaction. OBJECTIVE:To establish experimental colitis model in rats, to observe effects of resina draconis on dendritic cel s and Tol-like receptor-4/nuclear factor-κB expression in rats with experimental colitis, and to explore its action mechanism. METHODS:A total of 44 male Sprague-Dawley rats were randomly assigned to four groups (n=11):blank control group, model group, resina draconis group, 5-aminosalicylic acid treatment group. With the exception of blank control group, 2,4,6-trinitrobenzenesulfonic acid-induced ulcerative colitis models were established in the model group, resina draconis group and 5-aminosalicylic acid treatment group. After the models were successful y established, the rats in the resina draconis and 5-aminosalicylic acid treatment groups were intragastrical y treated with resina draconis [(0.75 g(kg·d)] and 5-aminosalicylic acid [100 mg(kg·d)] respectively for 10 days. RESULTS AND CONCLUSION:Disease activity index, macroscopic colonic damage score and histopathological score were significantly decreased in the resina draconis group compared with the model group (P<0.05). Symptoms and tissue damages were obviously lessened in the 5-aminosalicylic acid treatment and resina draconis groups compared with the model group. Expression rates of CD80 and CD86, as wel as expression levels of Tol-like receptor-4 and nuclear factor-κB were significantly higher in the model group compared with the blank control group, resina draconis group and 5-aminosalicylic acid treatment group (P<0.05, P<0.01). Tol-like receptor-4 and nuclear factor-κB expression was significantly lower in the resina draconis group than that in the 5-aminosalicylic acid treatment group. Experimental findings indicate that, resina draconis can partial y relieve experimental colitis symptoms in rats and effectively inhibit the activation of dendritic cel s in the mesenteric lymph node. Resina draconis can relieve enteric inflammatory reaction by suppressing the expression of Tol-like receptor-4 and nuclear factor-κB in rats.

Objective To explore the application of PBL teaching method and brainstorming method in the training of medical students' medical record writing ability,in order to strengthen the cultivation of medical students' medical record writing ability.Methods 122 medical undergraduate interns of Grade 2010 majoring in clinical medicine in our hospital were taken as the research object,of which 60 were in the experimental group,62 were in the control group.PBL teaching combined with brainstorming method was used in the experimental group,while the control group used the traditional teaching method of teaching.After the end of the training course,data were analyzed using SPSS 19.0 software,count data and measurement data were analyzed using chi square test and t test to carry out the significant test between the two groups of data,the training effect was compared between the two groups.Results The results of questionnaire in the experimental group were significantly higher than those in the control group,and the difference was statistically significant,The experimental group theory test scores were higher than the control group[(84.28 ± 6.65) vs.(74.52 ± 6.75)],and the difference was statistically significant;The experimental group outstanding achievement ratio was higher than the control group,and the difference was statistically significant;The proportion of operation and non operative medical records in the experimental group were higher than that in the control group (P=0.005,P=0.004).Conclusion Combined application of PBL teaching method and brainstorming method plays a positive role in superposition and complementation.It gives full play to and mobilizes the students' enthusiasm and initiative,and the training effect is obviously superior to the traditional teaching method,therefore it is worth popularization and application in the training of students' medical record writing ability.

Objective To investigate the effect of neonatal overfeeding on the expression of lipid metabolic associated enzymes and molecular mechanisms in the livers of rats. Methods Male Sprague-Dawley rats were randomly assigned to litter sizes of three group ( small litters,SL group) or ten ( normal litters,NL group) on postnatal day 3. Body weight,milk intake,liver and fat pad (epididymal and retroperitonea) weight,and hepatic histological anal-ysis were recorded in week 2 and week 3,respectively. The levels of lipids were detected by the automatic biochemical analyzer. The mRNA expressions of acetyl-CoA carboxylase ( ACC) ,lipoprotein lipase ( LPL) ,liver-type fatty acid-binding protein (L-FABP), carnitine palmitoyltransferase 1(CPT1),microsomal triglyceride transfer protein (MTP), sterol regulatory element-binding protein-1c (SREBP-1c) and peroxisome proliferator activated receptorα(PPARα) in liver were determined by real time PCR;the protein expressions of SREBP-1c and PPARα were determined by Western lot. Results As early as week 2,the body weight of rats in SL group began to elevate (t=-5. 997,P<0. 001) and food intake (t=-3. 462,P=0. 002) compared with the rats in NL group,and persistent to weaning (body weight:t=-17. 019,P<0. 001;food intake:t=-2. 276,P=0. 031). By the time of 3 weeks old,SL rats increased visceral fat pad [ret-roperitonea (t=-7. 643,P<0. 001),epididymal (t=5. 997,P=0. 001)],liver weight (t=-7. 812,P<0. 001),hepatosomatic index (t=-3.829,P=0. 003) and serum triglyceride (TG) level (t=-2. 703,P=0. 022) compared with those of NL rats,as well as the level of hepatic ACC mRNA (t=-3. 751,P=0. 007),LPL (t=-2. 721,P=0. 017) and L-FABP mRNA (t=-2. 521,P=0. 026) . While CPT1 mRNA (t=-1. 531,P=0. 155) and MTP mRNA (t=-1. 741,P=0. 098) levels remained unchanged in both groups. Hepatic SREBP-1c mRNA expression increased in SL rats after 2 to 3 weeks (t=-2. 836,P=0. 016),paralleled with ACC and LPL mRNA expression;while the mRNA and protein expression of PPARα re-mained unchanged (t=-0. 854,P=0. 411). Conclusions Postnatal overfeeding can promote higher liver pad and dyslip-idemia at the time of weaning. The process may be regulated by up-regulated expression of ACC, LPL and L-FABP. SREBP-1c may be participated in the regulation of ACC,a rate-limiting enzyme involved in lipogenesis.