AIM: The present study was designed to ex amin e the changes in glial fibrillary acidic protein (GFAP) expression during cerebr al ischemia and the effects of ginkgolide B on GFAP expression. METHODS: The focal thrombotic cerebral ischemia was formed by ph otochemistry-induced in tree shrews. GFAP stained by ABC immunohistochemistry an d absorbance were measured with image analyze system. RESULTS: GFAP expression in astrocytes increased significantly ( P

AIM: To observe the effect of platelet-activating factor (PAF) on cultured neuronal viability and glial fibrillary acidic protein (GFAP) expression in cultured astrocytes. METHODS: Neurons and astrocytes obtained from the brain cortex of the embryo and newborn mice respectively were cultured and purified, and they were divided into the control and experimental groups. PAF was added into the experimental groups at concentrations of 4, 8 and 16 ?mol/L. Each group was cultured for 4 h, 24 h and 72 h, respectively. MTT method and immunohistochemistry were used to observe the neuronal viability and GFAP expression in astrocytes, respectively. RESULTS: During different time after adding PAF at different concentrations into cultured neurons and astrocytes, respectively, neuronal viability declined, and the number of astrocytes decreased, but GFAP expression in survival astrocytes increased. The effects were shown to be in a concentration-dependent manner. CONCLUSION: PAF decreases the neuronal viability directly and influences the neuronal survival indirectly by astrocytes.

OBJECTIVE:To investigate the effect of α-interferon on long-term survival rate and tumor recurrence after radical hepatic resection. METHODS:104 patients with primary hepatocellular carcinoma underwent radical hepatic resection were divided into observation group(62 cases)and control group(42 cases). Observation group was treated with IFN-α for 18 months 4-6 weeks after surgery;control group received rountine treatment. Total survival rate and disease-free survival rate after surgery were com-pared between 2 groups. RESULTS:In observation group after surgery,1-year survival rate was 82.26%(51/62),3-year survival rate 61.29%(38/62),and 5-year survival rate 24.19%(15/62);in control group after surgery,1-year survival rate was 41.94%(26/62),3-year survival rate 28.57%(12/42)and 5-year survival rate 9.52%(4/42);there was statistically significant difference in postoperative survival rate between 2 groups (P<0.05). In observation group after surgery,1-year disease-free survival rate was 61.29%(38/62),3-year disease-free survival rate 40.32%(25/62),and 5-year disease-free surial rate 17.74%(11/62);in control group after surgery,1 year disease-free survival rate was 43.55%(27/62),3 year disease-free survival rate 22.58%(14/62),and 5-year disease-free surial rate was 0(0/62);there was statistically significant difference in postoperative disease-free survival rate be-tween 2 groups (P<0.05). CONCLUSIONS:The application of α-interferon after radical hepatic resection can significantly inhibit the recurrence of postoperative tumor,improve the long-term survival rate,and is worthy of clinical research.

Objective To summarize the therapeutic experience of 23 patients of traumatic head injuries with a score of 3 on GCS,Methods 23 most severe head injuried patients with a score of 3 on GCS who admitted were analyzed retrospectively.Results 8 cases(34%)survived in which 5 cases(21%)had a good recovery or moderate disability,and other 3 cases(13%)with severe deficits.The other 15 cases(66%)dead after therapy.Conclusion The prognosis of most severe head injured patients with a score of 3 on GCS could be improved by early evacuation of intracranial hematoma with large decompressive cranietomies,early moderate hypothermia therapy,early assistant ventilation and effective prevention and treatment of complications.

To discuss the situation of country doctors' training in Honghe State of Yunnan Province and to search the more useful training methods, the 171 trainees were surveyed by self-designed questionnaire. It appeared that most students improved knowledge and clinical skills obviously and they wanted more knowledge and case analysis and training of clinic skills.

AIM:To assess whether the expression of tight junction (TJ) proteins, occludin/zonula occludins (ZO)-1, and regional cerebral blood flow (rCBF) link to brain edema in tree shrews during thrombotic cerebral ischemia and ischemic postconditioning (PC), and to explore how TJ affects brain edema and cerebral infarction .METHODS:Tree shrews were randomly grouped into control , ischemia and cerebral ischemia +PC (n=23), and the remaining 3 ani-mals were used for magnetic resonance imaging ( MRI) .The local cerebral thrombosis were induced by photochemical reac-tion in the tree shrews , and ischemic PC was established at 4 h after induction of cerebral ischemia followed by clipped ipsi-lateral common carotid artery (5 min ×3).The changes of the neural ultrastructure were observed under electron micro-scope.The neuronal apoptosis was analyzed by the method of TUNEL .Laser Doppler brain flowmetry was used to monitor the rCBF.The protein levels of occludin/ZO-1 were determined by immunochemistry and Western blot .The cerebral in-farction volume was detected by MRI .The brain water content was measured by dry-wet weight method .RESULTS: In-duction of cerebral ischemia led to a significant reduction of the normal neuron numbers in the hippocampal CA 1 area, and conversely, the number of neurons with abnormal ultrastructure was increased .The TUNEL positive cells were increased significantly (P<0.01) in ischemia group.Moreover, the rCBF decreased significantly (P<0.01), and occludin/ZO-1 protein expression decreased ( P<0.01 ) .The brain water content and cerebral infarction volume were significantly in-creased (P<0.01).Ischemic PC increased the rCBF and the occludin/ZO-1 expression, but reduced the brain water con-tent, the TUNEL positive cells, and the infarction volume (P<0.01).CONCLUSION:Ischemic PC increases the rCBF but not the local water content , suggesting that reduced cerebral infarction volume after ischemia PC is associated with the attenuation of cerebral edema by the enhancement of occludin /ZO-1 protein expression .

Objective Pathophysiology has high comprehensiveness and practical characteristics. Developing analytical capacity is a major teaching aim of Pathophysiology. This study was aimed to build up the basic knowledge of pathophysiology and develop a critical approach through comparative case learning in medical students. Methods A pair of related cases were chosen in this study. Comparative case learning was performed in our lecture. Case analysis was tested before and after comparative case learning,and a self-evaluation was accessed after comparative case learning. The scores of case-analyzing test and self-evaluation assessment were statistically analyzed. Results Using“comparative case learning”in pathophysiology could improve medical students' case-analyzing score,especially in clinical syndrome analyzing examination questions(difficult examination questions). There was a significant correlation between high score of clinical syndrome analyzing examination and students' self-evaluation. ConclusionComparative case learning could improve the analytical,data searching and comprehensive abilities,thereby enhancing a case-analyzing ability in medical students.

目的探讨应用湿性愈合疗法治疗压疮的疗效。方法将54例压疮患者分为湿性愈合治疗组和传统治疗组,并对两组患者的创面愈合时间、护理工作量、治疗费用进行比较。结果与传统疗法相比,湿性愈合疗法可使压疮的平均愈合时间缩短,换药次数与时间明显减少,而治疗费用接近。结论在有效处理伤口的基础上,湿性愈合疗法更有助于伤口愈合,无需每日换药,不增加患者负担,可替代传统换药方法。

Network Meta-analysis was used to compare the efficacy and safety of Chinese patent medicines in the treatment of unstable angina pectoris. PubMed, Cochrane Library, CNKI, Wanfang, VIP and other databases were retrieved by computers from the establishment of the databases to June 2020. Randomized controlled trials(RCTs) of Chinese patent medicines for the treatment of unstable angina pectoris were collected. Two investigators independently screened out the literatures, and extracted data according to the inclusion and exclusion criteria. The quality of the included RCTs was evaluated according to the bias risk assessment tool recommended by the Cochrane System Reviewer Manual, and the Stata 13.0 software was used for data analysis and mapping. Through screening, 28 eligible studies were finally included, with the sample size of 2 885 cases, involving 8 Chinese patent medicines. The results of the network Meta-analysis showed that in terms of total effective rate for angina symptom improvement, the order was as follows: Shenshao Capsules > Naoxintong Capsules > Ginkgo Ketone Ester Dripping Pills > Compound Danshen Dripping Pills > Ginkgo Leaf Tablets > Shexiang Baoxin Pills > Tongxinluo Capsules > Yindan Xinnaotong Soft Capsules; in terms of total effective rate for ECG curative effect, the order was as follows: Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills > Tongxinluo Capsules > Shenshao Capsules > Shexiang Baoxin Pills > Yindan Xinnaotong Soft Capsules; in terms of hypersensitivity-C-reactive protein curative effect, the order was as follows: Tongxinluo Capsules > Shenshao Capsules > Ginkgo Leaf Tablets>Compound Danshen Dropping Pills> Shexiang Baoxin Pills > Naoxintong Capsules > Yindan Xinnaotong Soft Capsules > Ginkgo Ketone Ester Dropping Pills. Chinese patent medicine combined with conventional therapy can improve the clinical efficacy of unstable angina pectoris. Due to the differences in the quantity and quality of the included studies, the order results of Chinese patent medicines need to be further verified.
Angina, Unstable/drug therapy* ; China ; Drugs, Chinese Herbal ; Humans ; Medicine, East Asian Traditional ; Network Meta-Analysis ; Nonprescription Drugs