Dead-in-bed syndrome (DBS) is a rare but devastating sudden death condition that mainly affects young patients with type 1 diabetes.Its mechanism is quite complicated and may involve multiple factors.Acute onset of recurrent and severe nocturnal hypoglycemia,abnormal cardiac repolarization,genetic factors,and obstructive sleep apnea may all contribute to ventricular arrhythmias and even sudden death.The future research plans include elucidating and understanding the underlying mechanisms and triggers for DBS,developing a risk stratification system,using real-time continuous glucose monitoring system to detect severe nocturnal hypoglycemia,and initiating appropriate therapeutic interventions to uhimately prevent the tragedy.

According to the teaching practice in biochemistry laboratory course,we describe the characteristics of international students'teaching,teaching preparation,teaching course and so on.These experiences may provide an important source of information for teaching practice in the future.

Objective To evaluate the effect of sevoflurane preconditioning on brain injury induced by cardiopulmonary bypass (CPB) in rats.Methods Forty adult male Sprague-Dawley rats,aged 6-8 months,weighing 350-450 g,were randomly divided into 5 groups (n=8 each) using a random number table:sham operation group (S group),CPB group,and preconditioning with different concentrations of sevoflurane groups (SP1,SP2 and SP3 groups).In SP1,SP2 and SP3 groups,sevoflurane with the final concentrations of 1.2％,2.4％ and 3.6％,respectively,was inhaled for 1 h,and then CPB was started.After sevoflurane preconditioning and before CPB (T0),at 30 min of CPB (T1),at the end of CPB (T2),and at 1,2 and 3 h after termination of CPB (T3-5),venous blood samples were collected from the right internal jugular vein for determination of serum S100-β protein concentrations by enzyme-linked immunosorbent assay.Rats were sacrificcd at T5,and hippocampi were isolated for determination of neuronal apoptosis (by TUNEL) and NF-κB p65 expression (by immunohistochemistry).Results Compared with group S,the concentration of serum S100-β protein was significantly increased at T1-5,the number of apoptotic neurons was significantly increased,and the expression of NF-κB p65 was significantly up-regulated in CPB,SP1,SP2 and SP3 groups (P＜0.05).Compared with group CPB,the serum S100-β protein concentration was significantly decreased at T1-5,the number of apoptotic neurons was significantly decreased,and the expression of NF-κB p65 was significantly down-regulated in SP1,SP2 and SP3 groups (P＜ 0.05).Compared with group SP1,the serum S100-β protein concentration was significantly decreased at T1-5,the number of apoptotic neurons was significantly decreased,and the expression of NF-κB p65 was significantly down-regulated in SP2 and SP3 groups (P＜0.05).Compared with group SP2,the serum S100-β protein concentration was significantly decreased at T1-5,the number of apoptotic neurons was significantly decreased,and the expression of NF-κB p65 was significantly downregulated in group SP3 (P＜0.05).Conclusion Sevoflurane preconditioning can attenuate CPB-induced brain injury probably by inhibiting activation of NF-κB in hippocampal neurons of rats.

BACKGROUND: Surgeries on maxillary sinus carcinoma, soft palate carcinoma, tonsillar cancer and other malignant tumors and surgical trauma are known to cause mandibular defects. Patients with mandibular defects usually present with chewing, swallowing and speech dysfunction and imperfect facial appearance. It is difficult to repair mandibular defects in the maxillofacial surgery.OBJECTIVE: To investigate the efficacy of fixed bite plate combined with intermaxillary traction screw in the repair of mandibular defects with free fibular flap.METHODS: Seventy-five patients with mandibular defects reconstructed using free fibular flap in the Affiliated Stomatological Medical Hospital of Southwest University of Medical Sciences from June 2014 to December 2015 were enrolled, and were than randomized to two groups: 44 patients subjected to the bite plate combined with intermaxillary traction screw served as experimental group, and the others received intermaxillary traction using dental arch splint as control group. The operation time, wound healing at donor and accepting site, the survival rate of fibular flap, facial appearance, occlusion, functional speech and complications were compared between two groups.RESULTS AND CONCLUSION: The mean operation time showed significant difference between the experimental ((9.1±1.7) hours) and control ((10.2±2.1) hours) groups (P < 0.05). There were significant differences in the facial appearance (38 vs. 20), occlusion (41 vs. 22), and functional speech (39 vs. 21) between experimental and control groups (P < 0.05). The all-complication rate and the rate of maxillofacial wound dehiscence in the experimental group were significantly lower than those in the control group (P < 0.05). These results suggest that the bite plate combined with intermaxillary traction screw is simple and effective accompanied by less complications in the repair of mandibular defects.

OBJECTIVE:To systematically review the efficacy and safety of Moxifloxacin(MFX)in the treatment of acute ex-acerbation of chronic bronchitis (AECB),and provide evidence-based reference for Tational use of MFX. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,Medline,CBM,CJFD,VIP and Wanfang Database,the relevant conference proceed-ings and grey literature were also hand-searched,randomized controlled trials(RCT)about MFX(test group)versus other antibiot-ics (control group) in the treatment of AECB were collected. Meta-analysis was performed by using Rev Man 5.2 software with ITT analysis and PP analysis after literature selection,data extraction and quality evaluation. RESULTS:Totally 14 RCTs were in-cluded,involving 6 058 patients. Results of PP analysis showed,the clinical effective rate in test group was similar to that of con-trol group [RR=1.02,95%CI(1.00,1.04),P=0.06],while bacteria clearance rate was significantly higher than control group [RR=1.07,95%CI(1.04,1.11),P<0.001]. Results of ITT analysis showed,the clinical effective rate in test group was significantly high-er than control group [RR=1.03,95%CI(1.00,1.06),P=0.03],while there was no significant difference in the bacteria clearance rate [RR=1.02,95%CI(0.92,1.12),P=0.73] and the incidence of adverse reactions [RR=0.97,95%CI(0.87,1.08),P=0.52] be-tween 2 groups. CONCLUSIONS:The efficacy of MFX is not inferior to other antibiotics in the treatment of AECB,safety is simi-lar to other antibiotics.

ObjectiveTo define the difference of urine analysis result,α1-microglobulin (α1-MG) and β2-microglobulin ( β2-MG) between those patients suffering from calcium oxalate stone,non-calcium oxalate stone and non-urolithiasis controls at the same time period.MethodsData from 100 patients admitted to the Department of Urology,First Affiliated Hospital of Anhui Medical University from July,2010 to September,2010 were reviewed.66 patients (45 men,21 women) suffered from urolithiasis,and 34 patients (22 men,12 women) were non-urolithiasis.Patients' ages in urolithiasis group varied from 13 to 78 years and the male to female ratio was 2.1∶1.0.The patients in non-urolithiasis controlgroup aged from 12 to 80 years and the male to female ratio was 1.8∶1.0.Blood and urine were taken from the patient the next morning after admission.The biochemistry from blood and 24 h urine were measured by automatic biochemistry analyzer.The α 1-MG and β2-MG content were measured by radioimmunoassay.The stone compositions were analyzed by infrared spectroscopy.ResultsThere was difference in the levels of serum creatinine and blood urea nitrogen among three groups ( P ＜ 0.05).In controls,those with calcium oxalate stone had higher level of urinary α1-MG and β2-MG,but there were no differences in the urinary electrolyte levels.Group of non-calcium oxalate stones urinary uric acid levels were higher than calcium oxalate and control groups,the difference was statistically significant.ConclusionsIn the formation of uric acid stones,uric acid increased as independent risk factors.α1-MG,β2-MG may promote the formation of calcium oxalate stones.

Objective To investigate the effect of combination of cervical manipulation with cervical conditioning exercise for the treatment of cervical spondylosis of neck type or nerve root type. Methods Seventy-two patients were randomly divided into a treatment group (37 patients) or a control group (35 patients) by using a random number table. Patients in the treatment group and in the control group were treated with combination of cervical manipulation or cervical manipulation only, respectively. At the end of treatment and 3 months, treatment effects were assessed by Neck Disability Index (NDI) and Visual Analog Scale (VAS). Results NDI scores in both of the treatment group and the control group after treatment were significantly lower han those before treatment (t=4.471 in the treatment group, t=3.599 in the control group, all P<0.05), and NDI score in the treatment group were significantly lower than that in the control group after treatment (t=-2.085,P<0.05). Follow-up at 3 months, NDI score in the treatment group was significantly lower than that in the control group (t=-4.549, P<0.05). Proportions of improved patients, as assessed by NDI items, including pain intensity, personal care, lifting, reading, headaches, concentration, work, sleeping, driving and recreation in the treatment group were significantly higher than those in the control groups (Z=-3.521,-3.331,-3.003,-3.001,-3.265,-3.198,-3.016,-3.000,-2.102,-2.971, respectively, all P<0.05). VAS scores in both of the treatment group and the control group after treatment were significantly lower than those before treatment (t=7.986 in the treatment group, t=6.507 in the control group, all P<0.05), and VAS score in the treatment group were significantly lower than that in the control group after treatment (t=-2.426,P<0.05). Follow-up at 3 months, the VAS score in the treatment group was significantly lower than that in the control group (t=-7.065, P<0.05). Proportions of improved patients in the treatment group was significantly higher than that in the control group (91.89% vs 74.29%; χ2=4.014, P=0.045). Conclusion Combination of cervical manipulation with cervical conditioning exercise may be superior to cervical manipulation only for the treatment of cervical spondylosis of neck type or nerve root type.

Objective: To study the role of estrogen receptor (ER) and progesterone receptor (PR) in the formation of cholesterol calculus and investigate the effects of Shengqing CapsuObjective: To observe the effects of Huzhang Gout Granule (HZGG), a compound traditional Chinese herbal medicine, on cyclooxygenase (COX) and 5-lipoxygenase (5-LOX) activities, the two important oxidases in the course of inflammation, so as to investigate the possible anti-inflammatory mechanism of HZGG. Methods: After stimulating the blood sample of healthy volunteer with calcium ionophore A23187, concentration of thromboxane B(2) (TXB(2)) in the healthy volunteer's blood was detected by enzyme-linked immunosorbent assay (ELISA) to observe the effects of HZGG at low- and high-dose on the activity of COX-1, with aspirin as control drug. The concentration of prostaglandin I(2) (PGI(2)) in the healthy volunteer's blood sample, in which aspirin was added to destroy activity of COX-1 beforehand and which was stimulated with lipopolysaccharide, was detected by ELISA method to observe the effects of HZGG on the activity of COX-2, with celecoxib as control drug. In the animal experiment, 40 rats were implanted with sponges soaking in 0.5% arachidonic acid solution in the back to induce inflammatory effusion. Content of leukotriene B4 (LTB4) in the polymorphonuclear leukocytes (PMNs) from the inflammatory effusions was detected with reversed-phase high-performance liquid chromatography (RP-HPLC) to observe the impacts of different doses of HZGG on the activity of 5-LOX, with dexamethasone as control drug. Results: The concentration of TXB(2) in the low-dose HZGG group was higher than those in the high-dose HZGG group and the aspirin group (P<0.05). The concentrations of PGI2 in the low- and high-dose HZGG groups were higher than that in the celecoxib group (P<0.05), but there was no significant difference between the low-dose HZGG group and the high-dose HZGG group (P>0.05). The content of LTB4 in the blank control group was higher than those in the low-dose HZGG group, the high-dose HZGG group or the dexamethasone group (P<0.05) Conclusion:HZGG can reduce the releasing of inflammatory mediators, such as TXB2, PGI2 and LTB4, by inhibiting the activities of COX and 5-LOX.

Objective To investigate the clinical efficacy of electroacupuncture incorporate with acupuncture point injection in treating cervical spondylotic radiculopathy.Methods 103 cases from Chen Jia Qiao Community Health Service Centre and other community centers during February 2011 to November 2012 were collected and randomly allocated into three group:a electroacupuncture group of 34 cases; an acupuncture point injection of another 34 cases and an observation group of 35 cases treated with electroacupuncture which incorporated with traction therapy.After the treatment,the therapeutic effects among three groups were compared.Results ① clinical efficacy comparing:total efficacy rate of observation group was 91.4％ (32/35),the electroacupuncture group was 73.5％ (24/34),the group treated with acupuncture point injection was 70.6％ (25/34).There were statistically significant differences between the observation group and the other two groups (Z=1.721,P＜0.05),while there's no statistically significant of comparison between the group treated with electroacupuncture and the group treated with acupuncture point injection (Z=2.473,P＞0.05).② NDI score comparing:NDI score of these three groups before and after treatment.Before treatment,the score of observation group was (12.32 ± 5.03) ; the electroacupuncture group was (12.96± 6.10) ; the acupuncture point injection group was (12.79±5.07),after treatment,the separate sore was (7.40±4.12),(6.08±3.60) and (6.08 ± 3.60) sequentially.There were statistically significant differences of NDI score of the three groups before and after treatment (P＜0.05).After treatment,the efficacy of observation group was better than the group treated with electroacupuncture and the group treated with acupuncture point injection(P＜0.05).③ signs or symptoms comparing:After treatment,there were statistically significant differences between the observation group and the other two groups on the aspect of relieving pain of neck and arm,numbness of arm and hand,and alleviating soreness when doing spurling test on cervical intervertebral foramen (Z-score is 2.603,2.862,2.307,P＜0.05).There's no statistically significant of comparison among three groups on the aspects of neck functional activities and segmental tenderness of cervical spondylosis (Z-score is 1.414,1.572,P＞0.05).Conclusion In treating cervical spondylotic radiculopathy,the total efficacy rate of electroacupuncture incorporate with acupuncture point injection was higher than only treat with electroacupuncture or acupuncture point injection.

Fetal atrioventricular block (AVB) is a type of fetal bradyarrhythmias. The reported incidence of fetal complete atrioventricular block (CAVB) and mortality of perinatal fetuses and neonates are signiifcantly higher in pregnancies of anti-SSA/Ro-positive mothers than that of anti-SSA/Ro-negative mothers. The auto-antibodies in maternal serum that can be transported into fetal circulation through placenta may damage fetal cardiac conductive system and eventually result in fetal AVB. There are evidences that early diagnosis and proper treatment can improve the prognosis and survival rate of affected fetuses. In this article, the pathogenesis, risk factors, prenatal diagnosis, treatment and prognosis of fetal immune mediated AVB is reviewed.