Objective To investigate the effects of intrathecal (IT) gabapentin on the analgesic efficacy of morphine in a rat model of incisional pain. Methods Forty-eight male SD rats in which IT catheters were successly inserted according to the method described by Yaksh were randomly divided into 6 groups ( n = 8 each): Ⅰ sham operation group, Ⅱ incisional pain group, Ⅲ GBP 50 μg group, Ⅳ morphine 2.5 μg group, Ⅴ morphine 5 μg group, and Ⅵ morphine 2.5 μg + gabapentin 50 μg group. In group Ⅰ , IT artificial cerebrospinal fluid (ACSF)10 μl was injected and then 1.4% isoflurane was inhaled for 5 min. IT ACSF 10 μl, gabapentin 50μg and morphine 2.5 and 5 μg were injected 30 min before the establishement of the model in group Ⅱ -Ⅴ respectively. Paw withdrawl threshold (PWT) to mechanical stimulation and paw withdrawal latency (PWL) to a thermal nociceptive stimulus were measured at 2 h after the establishement of the model. Results Compared with group Ⅰ , MWT was significantly decreased and TWL was significantly shortened in group Ⅱ , Ⅲ and Ⅳ ( P ＜ 0.05), but no significant change in MWT and TWL was found in group Ⅴ and Ⅵ (P＞0.05). Compared with group Ⅱ , MWT was significantly increased and TWL was significantly prolonged in group Ⅴ and Ⅵ (P ＜ 0.05), but no significant change in MWT and TWL was found in group Ⅲ and Ⅳ/ ( P ＞ 0.05). MWT was significantly decreased and TWL was significantly shortened in group Ⅲ and Ⅳ compared with group Ⅵ ( P ＜ 0.05). Conclusion IT gabapentin enhances the analgesic efficacy of morphine in a rat model of incisional pain.

The enrollment scale of clinical medicine postgraduates with professional degree was expanded each year in order to meet the needs of the society.How to train high quality medical talents in line with modem medical education and people's health needs was the problem we were confronted with.The affiliated hospital of Inner Mongolia medical university lunched reform on training mode of clinical medicine postgraduates with professional degree; the concrete measures included increasing postgraduate pre-service training,implementing tutor responsible system,applying PBL teaching and focusing on the overall quality training.Students' clinical competence was improved after the reform.

This paper aimed to review the recent literature on the TCM treatment for stroke sequelae. The content summarized and discussed the definition of stroke sequelae, herbalmedicine, TCM patents, acupuncture and so on. Sequelae of stroke’s pathogenesis was mainly caused by deficiency generating stasis, so the treatment principles were to tonifying Qi and blood and promote circulation and remove stasis with the common prescriptions, such asBuyang-Huanwudecoction,Xuefu-Zhuyu decoction andDihuang-Yinzi. Meanwhile, Chinese medicine patents and acupuncture treatment canimprove the brain function and ADL.

Objective To investigate the predictive value of heart rate variability to,and its correlation with ventricular arrhythmias in patients with structural heart disease.Methods 24 hours ambulatory electrocardiogram monitoring was administered during March 2012 and October 2013,and standard deviation of the NN interval (SDNN) in the time-domain analysis and sympathetic/vagal ratio in the frequency domain analysis were collected and retrospectively analyzed in 300 patients.Results The incidence rate of ventricular arrhythmias was higher in patients with structural heart disease in SDNN ＜100 ms group than in control group [4.1％ (3/74) vs.39.5％ (45/114),P＜0.01].The sympathetic/vagal ratio was significantly higher in group with structural heart disease and ventricular arrhythmia than in control group(19.9 ±2.3 vs.10.1 ±1.7,P＜0.01)The time-domain index SDNN was negatively correlated with the frequency domain index (sympathetic/vagal ratio) (r=-0.819,P ＜0.01).Conclusions SDNN ＜100ms and the increased sympathetic/vagal ratio can be considered as the predictors of ventricular arrhythmias in patients with structural heart disease.

Objective To design and develop a cardiovascular automatic feedback control instrument for rescuing the critical patients.Methods Ten dogs used this kind instrument and the effects were obserred.Resuts The experiment of the dogs showed:the computer collected samples promptly,accurately and rapidly,and the instrument could help us to reach the expected goal.Conclusion In animal experiments,it showed that the whole cycle,from obtaining blood pressure to adjusting the amounts of medicine through feedback,was shortened.The calculating was accuratel and curative effect was reliable.This instrument is wait to be apprnsed by clinic.

Objective To explore the clinical and genetic features of Rubinstein-Taybi syndrome (RSTS). Methods The clinical data of 2 children with RSTS were reviewed and analyzed. Results Two male children (3 years old and 4 months old) were admitted to hospital because of growth retardation. Both of them were characterized by short stature, language and motor retardation, excessive hairiness and cryptorchidism. Case 1 had slightly broad thumbs and toes, and case 2 had distinctive facial features of high arched palate, broad nasal bridge, ptosis, and obviously broad thumbs and toes. Cardiac dysplasia was found in both of them by echocardiography. The c.152T>G (L51X) heterozygous mutation was found in case 1 by high throughput sequencing and genomic chip technology, and this mutation has not been reported. Deletion of 2.5 Mb in chromosome 16p13.3 region was found in case 2. Conclusions The main clinical manifestations of RSTS are excess hair, deformity of thumbs and toes, deformity of the heart development, and growth retardation. Molecular detection can help the clinical diagnosis.

Adolescent idiopathic scoliosis (AIS) is a highly heterogeneous condition,with some patients showing marked progressive exacerbation and others relatively stable.Accurate identification of patients at high risk of progression can help to intervene early in treatment to control scoliosis progression and avoid over medication of patients at low risk of progression.Epigenetic factors dynamically regulate gene expression without altering the gene sequence,fully reflecting genetic and environmental interactions,and hold great po-tential in predicting AIS progression.Recent studies have reported numerous epigenetic factors associated with AIS progression and have shown positive results in the prediction of AIS progression.This article provides an overview of research progress on epigenetic factors at risk for AIS progression,with the expectation that it will provide ideas for subsequent AIS treatment and research.

China ; Hepatitis B ; epidemiology ; Humans ; Seroepidemiologic Studies

Objective:To explore the application effect of modified direct observation of procedural skills (DOPS) as a formative assessment tool in clinical skills training of professional graduate students.Methods:A total of 130 professional graduate students of Batch 2019 were selected as the experimental group, and 127 graduate students of Batch 2018 were selected as the control group. Two groups of students received clinical general skills training after enrollment, the control group adopted the traditional skills teaching method, and the experimental group added DOPS as formative assessment on the basis of traditional teaching. The teaching effect of DOPS was evaluated by means of scores analysis and student self-assessment. SPSS 23.0 was used for t-test. Results:The score of the experimental group (84.35±3.41) was higher than that of the control group (77.58±2.68), which showed a statistically significant difference ( t=2.63, P<0.05). The scores of "skill operation ability" and "communication ability" were the lowest single indexes in the assessment of DOPS. The results of self-assessment showed that the scores of autonomous learning ability, clinical thinking ability, clinical practice ability and professional accomplishment of students in the experimental group were all higher than those in the control group ( P<0.05). Conclusion:Modified DOPS is helpful to improve clinical core ability, which is worth promoting for application.

Objective To evaluate the application value of polarized light dermoscopy in the diagnosis of vitiligo and differential diagnosis between vitiligo and other common hypopigmented diseases.Methods Dermoscopic images of lesions of 235 patients with confirmed vitiligo (130 with active vitiligo and 105 with stable vitiligo) were collected from the database in the Department of Dermatology,Xijing Hospital from January 2018 to July 2018,and retrospectively analyzed.Meanwhile,dermoscopic images of amelanotic nevus (151 cases),pityriasis alba (113 cases) and idiopathic guttate hypomelanosis (54 cases) were compared with the dermoscopic images of vitiligo.Chi-square test was used for comparison of rates among groups.Results The prevalence of perifollicular pigmentation,reticular pigmentation,starburst,Tapioca sago and micro-Koebner phenomenon was significantly higher in the patients with active vitiligo than in those with stable vitiligo (x2 =36.5,151.2,13.0,14.9,8.4 respectively,all P ＜ 0.05).The prevalence of perifollicular pigmentation,perilesional hyperpigmentation,perifollicular telangiectasia,leukotrichia was significantly higher in patients with stable vitiligo than in those with active vitiligo (x2 =91.2,166.0,54.3,41.1 respectively,all P ＜ 0.05).The prevalence of residual perifollicular pigmentation was significantly higher in patients with active (89.2％,116/130) or stable vitiligo (54.3％,57/105) than in those with amelanotic nevus (20.5％,31/151,P ＜ 0.05),pityriasis alba (12.4％,15/113,P ＜ 0.05)or idiopathic guttate hypomelanosis (9.3％,5/54,P ＜ 0.05).Conclusion Residual perifollicular pigmentation could serve as an important feature for distinguishing vitiligo from achromic nevus,pityriasis alba and idiopathic guttate hypomelanosis,and polarized light dermoscopy shows good value in the differential diagnosis between vitiligo and some hypopigmented diseases.