Argininemia(OMIM 207 800) is an autosomal recessive inherited metabolic disease of urea cycle disorders caused by deficiency of arginase I.Arginase I(AI) is the enzyme involved in the final step of the urea cycle which catalyzes the hydrolysis of arginine to ornithine and urea.The patients untreated will undergo the slowly progressive course and spastic tetraplegia,seizures and mental retardation.Unlike other urea cycle disorders,Argininemia is not generally associated with severe hyperammonemia.It is unlikely that elevated plasma ammonia is the main neurotoxic compound in argininemia because hyperammonemia rarely occurs in this condition.These neurological complications could result from the accumulation of arginine and its metabolites.argininemia can be diagnosed by ARG gene analysis or arginase acivity assay.Early diagnosis of argininemia through newborn screening program by tandem mass spectrometry may lead to a better outcome.

Cause-effect deduction is the basis of both natural and social sciences. Both wealthy knowledge and logical design are essential in obtaining the true causality among medical studies. Though association analysis provides important information for cause-effect deduction, it does not mean causality itself. Before the existence of the causality between two variables being identified, rigorous criteria must be followed. A number of indexes, such as the significance and the degree of the association, the dose-response relationship, the biology-based possibility, as well as the consistency and specificity, all should be examined very carefully. Clear verifiable hypotheses, rational selection of subjects, reliable experimental methods, appropriate statistical analysis and correct logical deductions, all are the integral parts that finally constitute a faithful deduction.

Objective To summarize the experience of operation on gastric carcinoma combined with severe pulmonary dysfunction and reduce the incidence of postoperative fatality and complications.Methods According to FVC,MVV,FEV1 from high to low grouping,and interfere with ambroxol hydrochloride,doxofylline,budesonide,terbutaline,ipratropium bromide,tiotropium bromide to 20 patients who suffered gastric carcinoma combined with severe pulmonary dysfunction before and after operation,and interfere with different anesthesia methods.Results Postoperative complications occurred in 20 patients within one month,Hydrothorax in 2 cases,pulmonary infection in 2 cases,respiratory failure in 2 cases,acute pulmonary edema in 1 cases,acute pulmonary embolism in 1 case.After active treatment,19 patients cured,1 case died due to acute pulmonary edema.Conclusion The complications rate and risks are high in the gastric carcinoma patients combined with severe pulmonary dysfunction,and strict preoperative and postoperative managements are key to the operation.

OBJECTIVE:To study the effects of ulinastatin on pathological state of lung tissue and aquaporin 1(AQP-1)and matrix metalloproteinases (MMP-2),MMP-9 expressions in silicosis rats. METHODS:Wistar rats were divided into normal con-trol group,model group,ulinastatin high-dose,medium-dose,low-dose groups(50×104,10×104,2×104 u/kg),20 in each group. Except for normal control group,rats in other groups were given 40 mg/mL SiO2 suspension 1 mL by non-exposed endotracheal per-fusion to induce silicosis model;1 h before modeling administration,corresponding doses of ulinastatin were intraperitoneally in-jected,for 3 d. Hematoxylin-eosin staining was used to observe silicon nodules in lung tissue of rats in each group;immunofluores-cence method was used to detect AQP-1 expression in lung tissue;real-time fluorescence quantitative polymerase chain reaction method was used to detect MMP-2,MMP-9 mRNA expressions in lung tissue;Western blot method was used to detect MMP-2, MMP-9 protein expressions in lung tissue. RESULTS:There were obvious silicon nodules and serious structural damage in lung tis-sue in model group,ulinastatin groups showed macrophage foci visible dust,but pulmonary fibrosis was obviously reduced. Com-pared with normal control group,AQP-1 expression in lung tissue in other groups were reduced,MMP-2,MMP-9 mRNA and pro-tein expressions were enhanced (P<0.05). Compared with model group,AQP-1 expression in lung tissue in ulinastatin groups were increased,MMP-2,MMP-9 mRNA and protein expressions were decreased (P<0.05),in which improvement effects in high-dose,medium-dose groups were superior to low-dose group(P<0.05). CONCLUSIONS:Ulinastatin can reduce the patholog-ical state of silicosis rats,increase AQP-1 expression and decrease MMP-2,MMP-9 expressions.

Objective To evaluate the clinical efficacy and safety of orlistat in Chinese overweight and obese patients. Methods In six research centers, 444 overweight and obese patients (body mass index 25～40 kg/m 2) were divided into orlistat group (296 patients) and placebo group (148 patients) with a low-energy diet for 24 weeks by a randomized, double-blinded, placebo-controlled study. Results For intent-to-treat analysis, 286 orlistat-treated and 142 placebo-treated subjects were evaluated. After 24 weeks, orlistat-treated patients lost more weight 〔(6.1?3.6)kg,( x ?s)〕 than placebo-treated patients did (3.0?3.5)kg (P

BACKGROUND:Studies have shown that tanshinone II can improve microcirculation, dilate cerebral blood vessels, increase cerebral blood flow, reduce infarct size, and improve brain function after cerebral metabolic disorder.
OBJECTIVE:To investigate the effect of tanshinone II combined with bone marrow mesenchymal stem cel transplantation on nerve regeneration folowing cerebral infarction in rats.
METHODS:Rat models of acute cerebral infarction were prepared using the thread occlusion method and then given tanshinone II combined with bone marrow mesenchymal stem cel transplantation (combined group), bone marrow mesenchymal stem cel transplantation (cel transplantation group), and no treatment (model group), respectively. Neuromotor function was assessed using Longa scores. Expression of brain-derived neurotrophic factor gene around the infarction region was detected using RT-PCR. Cel apoptosis was detected using TUNEL. Immunohistochemistry staining was used to determine peri-cortex Nogo-A and NgR protein expression at the infarction region.
RESULTS AND CONCLUSION:Longa scores, apoptotic index, and expression of Nogo-A and NgR proteins exhibited significant differences among three groups (P< 0.05) as folows: combined group < cel transplantation group < model group. Conversely, the expression of brain-derived neurotrophic factor gene was highest in the combined group successively folowed by the cel transplantation group and model group (P< 0.05). These data show that tanshinone II combined with bone marrow mesenchymal stem cel transplantation accelerate the recovery of neurologic function and promote nerve regeneration after cerebral infarction by incresing mRNA expression of brain-derived neurotrophic factor.

Objective To explore the effect of ginseng combined with transplantation of bone marrow mesenchymal stem cells(BMSCs)on functional recovery of rats with spinal cord injury(SCI). Methods Forty-eight female Wistar rats were randomly assigned to following four groups(n=12 per group):the sham operation group was treated by opening the vertebral lamina and exposing spinal cord without SCI;the SCI model group was reproduced by using improved Allen bump method and afterwards no treatment was given;methyl prednisolone(MP)group was treated by MP pulse treatment after SCI,including intravenous injection of MP 30 mg/kg immediately after SCI and 4 hours later the same injection was repeated,and then the same intravenous injection 2 times daily,3 days in total;The ginseng+BMSCs group was treated by orally taking ginseng ultra-microgranules 300 mg/kg after SCI,twice a day for 20 days and BMSCs 5μL(concentration 1×107 cell/μL)transplantation was carried out in SCI region on the 7th day after SCI. In the above 4 groups,the ethological observation(BBB scores)was done regularly and on the 30th day after operation,silver staining was applied to investigate the changes of spinal cord,and neuro-electrophysiological tests including somatosensory evoked potential(SEP)and motor evoked potential(MEP)were performed. Results In sham operation group,after surgery the movement of both hind limbs became temporarily sluggish and on the 7th day their functions recovered to approximately normal. In SCI model group,after injury paralysis of both hind limbs occurred,while in the MP group and ginseng+BMSCs group,different degrees of functional recovery of the injured limbs developed,and the recovery in ginseng + BMSCs group was more significant. Compared with sham operation group,after surgery the BBB score was reduced markedly at various time points in SCI model group;compared to the SCI model group,the BBB scores in MP and ginseng+BMSCs groups were increased significantly,especially more remarkable in ginseng+BMSCs group(all P<0.05),and beginning from the 12th day after operation,the difference became obvious (5.23±1.22 vs. 3.61±1.03, P<0.05). Histological detection showed that in sham operation group,the structure of spinal cord was complete,neurons distributed evenly in the gray matter and a large number of silver staining positive nerve fibers paralleled to each other and arranged regularly;in SCI model group,fragmented construction was present and the defects of gray and white matters were prominent. Compared with the SCI model group, the extents of tissue necrosis in MP and ginseng + BMSCs groups were ameliorated. The neuro-electrophysiological tests demonstrated that in SCI model group,the loss of normal wave form occurred. Compared with SCI model group,in MP and ginseng+BMSCs groups,after treatment latent periods(ms)were shortened prominently in different degrees of SEP and MEP,and their peak-to-peak values(mV)were increased obviously;the improvement in potential in ginseng+BMSCs group was greater than that in MP group〔SEP:latent period(ms):3.31±0.36 vs. 4.66±0.33, peak-to-peak value(mV):0.10±0.01 vs. 0.05±0.01,MEP:latent period(ms):3.40±0.13 vs. 4.24±0.31, peak-to-peak value(mV):41.12±0.56 vs. 16.46±2.83,all P<0.05〕. Conclusion A combined treatment of ginseng and BMSCs transplantation can effectively promote the recovery of neural function for rats with SCI.

BACKGROUND:Cel transplantation becomes a new approach for treatment of cerebral infarction. In recent years, bone marrow mesenchymal stem cels (BMSCs) have become an important kind of seed cels in cel transplantation.
OBJECTIVE: To investigate the effect of fleabane injection combined with BMSC transplantation on S100B protein and superoxide dismutase expression in acute cerebral infarction rats.
METHODS:Animal models of acute cerebral infarction were made in Sprague-Dawley rats using suture method. After successful modeling, 80 model rats were randomly divided into control group, fleabane group, BMSC group and combined group (fleabane combined with BMSC transplantation). Changes of serum S100B protein and serum superoxide dismutase levels were detected using enzyme-linked immunosorbent assay and xanthine oxidase method, respectively, before and after treatment. NIHSS neurological function scores were measured to observe neurological behavior changes in model rats. The infarct volume was measured by TTC staining.
RESULTS AND CONCLUSION:At 36, 7, 14 days after treatment, S100B protein levels in the fleabane group and BMSC group were significantly lower than that in the control group, but higher than that in the combined group (P <0.05); serum superoxide dismutase levels in the fleabane group and BMSC group were significantly higher than that in the control group, but lower than that in the combined group (P < 0.05). At 1, 2, 3 weeks after treatment, NIHSS neurological function scores were ranked as folows: combined group < fleabane group and BMSC group < control group, and there was a significant difference between groups (P < 0.05). At 2 weeks after treatment, the infarct volume in the fleabane group and BMSC group was higher than that in the combined group but lower than that in the control group (P < 0.05). These findings indicate that fleabane combined with BMSC transplantation can inhibit the expression of S100B protein in rats with acute cerebral infarction, and promote the activity of superoxide dismutase, thereby playing a neuroprotective role.

Objective To explore the professional identity of medical students with long education periods and its influencing factors.Methods Survey on professional identity was conducted through self-designed questionnaire among 665 medical students with long education periods of every grade.Single factor analysis of variance and t test were applied to do statistical analysis.Results There were significantly statistical differences in influencing factors of professional identity among every grade of long periodical medical students (P ＜ 0.05).There were significant statistical differences among influencing factors of sex,educational background of parents and residing(P ＜ 0.05).Conclusions Because of characteristics of medical education and psychological changes of students,professional identity of students shows a first decline and then an increase.Personal and environmental factors exert influences on professional identity at varying degrees.