The afferant projections and their chemical nature from the midbrain raphe nuclei and periaqueductal gray to the thalamic ventral posterior nucleus were st- udied by HRP retrograde tracing combined with PAP immunocytochemical method Following injections of HRP into the thalamic ventral posterior nucleus, and reactions by HRP and PAP were performed subsequently. The double labelling cells containing HRP-positive granules and substance P-like immunoreactivity were found in various areas of brain, that is, the contralateral principal sensory nucleus of trigeminal nerve,nucleus gracilis,nucleus cuneatus, bilateral ventrola- teral divisions of the periaqueductal gray and midbrain raphe nuclei.A comparison of cell counts of double labeled cells with the total HRP-labeled cells indicated that the cells observed in the dorsal raphe nuclei were 21?7 in each rat, which constituted 48% of total HRP-labeling cells; The double labeling neurons in nuclei raphe centralis superior were found in two cases only, the cell bodies were very sparse and distributed mainly in the caudal area of these nuclei The double labeling cells were detected in bilateral ventrolateral divisions of periaqu- eductal gray, predominantly ipsilaterally. The double labeling cells observed in each rat were 26?9 ipsilaterally and 11?4 contralateraIly. The numbers of double labeling cells were 38% of the total counts of HRP-labeling cells in each side. These results above indicate that the thalamic ventral posterior nucleus receives afferent projections from midbrain raphe nuclei and ventrolateral division of periaqueductal gray and in the pathway, a part of substance P-positive neurons are exhibited. Therefore, this study provides evidence for existance ascending projection of substance P-like immunoreactivity.

Objective:To observe the clinical effect and adverse reaction of capecitabine as first-line monotherapy in elderly patients with stage Ⅱa breast cancer.Methods:From June 2002 to June 2005,71 elderly patients with stage Ⅱa breast cancer received chemotherapy(different scheme:capecitabine group and CEF group) after operation.The efficacies and adverse reactions were evaluated and compared between the two groups.Results:The 3-year and 5-year survival rates of patients in capecitabine group were 97.06% and 94.12%,respectively; the relapse rate was 5.88%; all were comparable to those of CEF group. One of the advantages of capecitabine was its oral administration. The adverse effect of capecitabine was mainly hand-foot syndrome,with an incidence of 82.35%,but was tolerable. The gastrointestinal reaction and bone marrow repression in capecitabine group were significantly lower than those in the CEF group(P

PEI Xue-yi has 60 years,experience in treating pediatric diseases with traditional Chinese medicine,especially obtains good effect in children's nephrapiathy.Based on the regulation and characteristics of children's zang-fu,yin-yang,blood-qi and children's nephrapiathy,he makes different therapeutic plans in different phases.In clinical treatment,he emphasizes the lung,the spleen and the kidney and combines syndrome differentiation with disease diagnosis.Eliminaing pathogens,excessive damp-heat is used in acute phase and strengthening healthy qi,securing the spleen and kidney is used in recovery phase.Children's nephrapiathy is treated by three phases as the edema,protein urine and rescovery stage.He adopts the methods of dispersing lung qi and invigorating spleen for diuresis,clearing heat-damp,nourishing spleen and kidney,nourishing yin for protecting lower jiao.

Background The visual system of animal have to optimally adjust in various environmental conditions in order to obtain stable and effective visual funetion.However,the color vision system of animals which encounter uncertainty of spectral signals should be plastic.Whether the densities of various cones and expression of opsins change with long-time spectral deprivation is unclear.Objective This study was to investigate the changes of cone density as well as the expression of corresponding opsin and mRNA following the long-term illumination of monochromatic light.Methods Thirty 3-day-old guinea pigs were randomized into 3 groups and exposed tO the 530 nm green light,400 nm purple light and white light for consecutive 8 weeks respectively.The flat-mounted retinal sample was prepared and divided into dorsal zone,ventral zone and mixed zone anatomically according to the distribution of difierent light-sensitive cone.The changes in density of cone cells sensitivited to different colored light were detected by single-1abel or double-label immunocytochemistry.The levels of opsin and its mRNA were determined using Western-blot and real-time PCR respectively.Results The density of green-sensitivity cones was significantly different in the dorsal zone of retina among green light group,purple light group and white light group (F=234.28,P<0.01).Compared with white light group,the density of green-sensitive cones in dorsal retina of green light group was obviously higher but that of purple light group wag evidently lower(q=389.68,P<0.01；q=67.11,P<0.01).No significant difference was found in the density of purple-sensitive cones in the ventral zone of retina among green light group,purple light group and white light group(F=3.14,P>0.05).The density of coexpression of the mixed cone cells was increased in green light group(q=157.55,P<0.01)but decreased in purple light roup (q=254.85,P<0.01)in comparison with white light group.The expression levels of green-opsin and green-opsin mRNA in green light group was significantly elevated(q=184.45,P<0.01；q=4.71,P<0.05),but those of purple light group were evidently declined(q=5.87,P<0.05；q=346.66,P<0.01)in comparison with white light group.There was no statistically significant differences were found in the expression of purple-opsin and its mRNA among all the groups(F=1.24,P>0.05；F=3.27,P>0.05).Conclusion After the exposure of long-time monochromatic light illumination,monochromatic cones density and its opsin in guinea pig occur the corresponding alteration to gain good spatial vision as a compensatory reaction.These outcomes imply that there is some plasticity during the development of color vision.The increase of green-sensitive cones might be from the differentiation of coexpression cones in transition region.

The original strain was treated with UV combining LiCl. The total carotenoid yield of the strain UL-61 was 7.62mg/L, the maximal yield of astaxanthin had reached 616.8?g/g under 25℃. 8 variables including fermentation temperature, initial pH were optimized by Plackett-Burman design and Response Surface Analysis of SAS software. The temperature, initial pH and corn steep liquor were the major factors. The optimal conditions were predictted to be 16.78℃, pH4.73 and 7.06 mg/L, respectively. Under these conditions, the theroretical maximal yield of carotenoid was 3.9407 mg/L and the practical maximal yield was about 3.9261mg/L. The carotenoid production was increased by 20.4% when Phaffia rhodozyma was cultivated under the optimal conditions as compared with the control.

OBJECTIVETo investigate the mid-term outcome of operation for thoracolumbar tuberculosis. METHODS : Twenty-eight patiens with thoracolumbar tuberculosis underwent one stage anterior debridement,interbody fusion with bone graft and posterior pedicle screw internal fixation treatment from July 2006 to July 2011. There were 17 males and 11 females. Total 17 patients had nerve injuries ,including 6 cases of grade B, 5 cases of grade C, 6 cases of grade D according to Frankel classification. The poisoning symptoms of tuberculosis and recovery of spinal function were observed. The bone fusion and recovery of [umbar function were evaluated.

RESULTSAll the patients were followed up ,and the duration ranged from 39 to 85 months (mean 57 months). The clinical symptoms were controlled gradually, and the thoracolumbar back pain was alleviated after operation. Among the 17 patients with complications of nerve injuries, 3 patients were improved from preoperative grade B to postoperative grade D, 3 patients were improved from preoperative grade B to postopertive E, 5 patients with preoperative grade C and 6 patients with preoperative D were almostly recovered to normal after operation. According to JOA scoring system for curative effect evaluation, the excellent and good rate at the 3rd month, the 1st year, the 3rd year and the 5th year after operation were 67.86% ,82.14% ,85.71% ,89.29% and 91.30% respectively. The results at the 6th month and the 1st year had no statistical differences compared to the results at the 3rd month (P > 0.05); but the results at the 3rd year and the 5th year were better than that at 3 months after operation (P < 0.05); and the results between 3 yesrs and 5 years after operation had no statistical differences (P < O.05). The degeneration of adjacent segments were evaluated according to the California University (Universith of California at Los Angeles , UCLA) score. The degeneration rate was 53.57% (15/28) at the 3rd year after surgery, which was better than that before surgery. Twenty-three patients were followed up for 5 years ,and the degeneration rate was 86.96% (20/23) ,which was better than those of before surgery and 3 years after surgery.

CONCLUSIONThe surgical treatment for thoracolumbar spinal tuberculosis can achieve the thorough debridement, reconstruction of spinal stability, recovery of lumbar function and promote the functional recovery of the spinal cord, which is an effective method of treatment. However, the mid term follow-up showed that more severe degenerative changes were found in the postoperative adjacent segment.

Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; physiopathology ; surgery

Adding the qualification examination of rural general practicing assistant doctors conforms to the needs of the rural doctors practicing medicine according to law.It benefits to the progress of practicing physician and improves the rural doctors'quality.Meanwhile, it has great significance in standardized management and stabilize the rural doctors.The villages and towns examination of practicing assistant doctors'qualification examination as an exam-ple, current relevant laws and policies provided legal basis.Meanwhile, the object of policy implementation that rural doctors desire the policy.This three aspects make adding the qualification examination of rural general practicing as-sistant doctors is feasible.In order to guarantee the practicing physicians process of rural doctors, we should complete the current laws, regulations and policies.Enhancing general practitioners'training and medical professional training that aims at the examination of practicing doctors'qualifications.Establishing a reasonable compensation, old-age se-curity and other social security mechanism for rural general practicing assistant doctors.

Objective To investigate clinical curative effect of partial foraminotomy after C4.5 ossification of posterior longitudinal ligament (OPLL) on preventing C5 nerve root palsy.Methods A total of 155 patients with OPLL were treated with expansion open-door laminoplasty (EOLP) between January 2008 and October 2012,including 75 male patients and 80 female patients,with average age of 54.5 (ranging from 38 to 75).Among them,90 cases took EOLP (open team),and 65 cases took EOLP and C4.5 partial foraminotomy (incision team).Clinical curative effect and imaging evaluation were used in 8 weeks and 12 months after operation.JOA scores,JOA scores improvement rate,C5 nerve root palsy occurrence rate,neurological function of patients with C5 nerve root palsy and the prognosis,cervical curvature index,opening angular variation,backward drift distance of anterior margin and posterior margin of the spinal cord were evaluated after 8 weeks and 1 year after the surgery.Results The operation time was 90-140 min,with the average time of 110±14 min;mean bleeding volume was 160±45 ml (ranging from 100 to 250 ml);follow-up visit time was 15.4 months on average (ranging from 12 to 18 months).JOA score and improvement rate after 8 weeks and 1 year of the operation have no statistical significance.The C5 nerve root palsy occurrence rate in open team was 8.89％ (8/90),while that in incision team was 4.62％ (3/65).The difference of two groups has statistical significance.C5 nerve root palsy all happened in laminar opening side.Comparison of cervical curvature index of two groups before the operation and after 8 weeks of the operation and inter-group comparison have no statistical significance.The difference between laminar opening angle after 1 year of the operation and laminar opening angle after 8 weeks has no statistical significance.The difference of backward drift distance of anterior margin of the spinal cord at different time after the operation and inter-group difference have no statistical significance.The difference in backward drift distance of posterior margin of the spinal cord between 1 year after the operation and 8 weeks after the operation has no statistical significance.Conclusion Treating OPLL with EOLP and C4.5 partial foraminotomy can reduce occurrence rate of C5 nerve root palsy,but has no significant influence on JOA score improvement rate.

·AIM:To present a case of late onset bilateral keratectasis after laser in situ keratomileusis (LASIK) for myopia with rigid gas-permeable contact lenses with a brief review of literature on this subject.·METHODS:A 27-year-old woman underwent bilateral uneventful LASIK for moderate myopia. Preoperative cycloplegic refractions were -5.50/-0.50×50° right eye (OD) and - 4.50/-1.00×15° left eye (OS).Corneal pachymetry was 526μm OD and 541μm OS, Preoperative corneal topography was normal and did not reveal any keratoconus or forme fruste keratoconus.Following the creation of flaps with 160μm plates,ablations of 102μm OD and 86μm OS were performed,estimated to leave residual stromal beds of 264μm OD and 295μm OS.·RESULTS:Twenty-nine months postoperatively,the patient developed bilateral inferior keratectasia of -12.50/-4.00×160° OD and -6.00/- 4.25×125° OS.Visual acuity was reduced in both eyes;the central cornea had steepened; and pachymetry showed central corneal thinning.Keratectasia was diagnosed,and rigid contact lenses were fitted.Three years later,the patient achieved satisfactory visual acuity and all-day lens wear with minimal complications.·CONCLUSION:Late keratectasia may follow LASIK for low to moderate myopia despite a thorough preoperative work-up.Rigid contact lenses can offer a safe,reversible option for improving visual acuity in such patients by delaying or avoiding the need for intracorneal ring segments implanting or penetrating keratoplasty.

Objective To explore the value of 18F-FDG PET/CT on the assessment of chemotherapy response in patients with diffuse large B-cell lymphoma (DLBCL). Methods 18F-FDG PET/CT was performed before and after 4 cycles of chemotherapy( R-CHOP or CHOP protocol) in 53 patients with DLBCL. The patients were divided into 3 groups: complete response group, partial response group and no response group. The therapeutic response was assessed by comparing post-treatment 18F-FDG PET/CT with pre-treatment PET/CT. Complete remission (CR) rate at the end of chemotherapy was calculated. χ2 test was performed with software SPSS 13.0. Results CR rates of complete response group, partially response group and no response group were 88.5% (23/26), 73.3% (11/15) and 8.3% (1/12), respectively (χ2=23.548, P=0.000). CR rates of the complete and partially response groups were significantly higher than those of no response group (χ2=22.656, P=0.000; χ2=11.407, P=0.001). Conclusion 18F-FDG PET/CT may be useful for the assessment of chemotherapy response in DLBCL.