Objective:To study the expression of angiotensin-converting enzyme(ACE),extracellular signal-regulated kinase(ERK),and the changes of atrial fibrosis in patients with rheumatic heart disease(RHD) and atrial fibrillation(AF) treated with angiotensin-converting enzyme inhibitor(ACEI).Methods:Atrial tissues were obtained from the right appendage during open surgery in 35 patients with RHD.The mRNA of ACE and ERK2 were semi-qualified by reverse transcription-ploymerase chain reaction(RT-PCR) and normalized to the glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Western blotting analysis was employed to examine the expressions of ACE and phosphorylated ERK(pERK).Atrial collagen volume fraction(CVF) was detected by Masson's stain.Results:The mRNA of ACE and ERK2 or the protein of ACE and pERK were significantly increased,and CVF was significantly increased in patients with chronic atrial fibrillation(CAF) compared with sinus rhythm group(SR)( P 0.05).Conclusion:The expressions of ACE,ERK2 and pERK increase,and fibrosis is more severe in RHD patients with CAF as compared with those with SR.Compared with CAF patients treated without ACEI,the expressions of ERK2 and pERK significantly decrease( P 0.05)in CAF patients treated with ACEI.This suggests that the increasing expression of ERK2 and pERK resulting from local renal angiotensin-converting enzyme system activation mediates the development of atrial fibrosis,and ACEI may contribute to lesser atrial fibrosis in RHD patients with AF.

According to the sera aquaporin-4 antibody (AQP4), neuromyelitis optica (NMO) can be classified into two types as AQP4 antibody positive (AQP4+) and negative (AQP4-). However, the NMO patients with AQP4- are prone to delayed treatment, and may have a different pathogenesis compared to that in patients with AQP4+. Scientific researches and the clinical trials on NMO with AQP4- will deepen the understanding of NMO pathogenesis and help to make an early accurate diagnosis and rational therapy for NMO with AQP4-. This review aims to summarize the progress in clinic diagnosis for NMO patients with AQP4-.

Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. PH progresses rapidly to right ventricular (RV) failure and even death without treatment. Cardiac magnetic resonance (CMR) is an accurate and reproducible tool for the assessment of RV morphology and function, which plays an important role in the prognosis of patients with PH. The aim of this study is to review the clinical application and research progress of CMR in evaluation of PH.

Five flavors are basic nature of Chinese medicine. But the labeling of Chinese medicine flavors was in a chaos. Song Jin and Yuan dynasty is a transconformation stage of labeling Chinese medicine flavors. In this article the author put forward that the determination of Chinese medicine flavor shifted from tasting of early and middle age of Northern Song dynasty to categorical analogizing and functional analogizing in the late age of Northern Song dynasty. The latter method had a flourished development in Southern Song, Jin and Yuan dynasty. This regularity conclusion has provided a reference for the standardizing Chinese medicine flavors.
History, Medieval ; Medicine, Chinese Traditional ; history ; Taste

Periodontal ligament may have independent response to orthodontic stimulation and thus initiate alveolar bone osteogenesis and osteoclasts. Orthodontic-induced alveolar bone remodeling has no bone loss,while inflammation can lead to alveolar bone loss,suggesting that force signal and inflammatory factors may induce the differentiation of undifferentiated cells in the periodontal ligament via different pathways. The strength of the force and the nature of the force (basal tension and fluid shear force) may affect the differentiation of periodontal ligament cells,and may produce antagonistic or synergistic effect with the inflammatory factors through complex autocrine and paracrine regulation,resulting in local bone reconstruction,which is manifested as bone deposition and bone absorption. Studies have shown that Wnt signaling is an important regulatory pathway for osteoblast differentiation. Inflammatory factors can block the differentiation of stem cells into osteoblasts. The Wnt pathway is closely related to the effects of force and inflammatory factors on the differentiation of periodontal ligament cells.

Objective To evaluate the early clinic effects and anterior knee pain after total knee arthroplasty with or without patellar resurfacing.Methods From June 2010 to June 2011,100 patients who underwent TKA in our department were covered in this study,they were randomly divided two groups:resurfacing of the patellar (42 patients,50 knee) and nonresurfacing of the patellar (57 patients,66 knee).They were followed up at 6th month and 12th month.Comparison was performed with the West Ontario and McMaster Universities score (WOMAC) and Knee Surgery Society (KSS) score system,anterior knee pain visual analogue scale (VAS) score between two groups.Results Anterior knee pain VAS score had significant improvement postoperation in resurfacing groups and nonresurfacing group.But there was no statistical difference between two groups.In two groups,WOMAC scores at 6th month were 28.8±11.2 and 18.6±7.2,20.7±6.2 and 16.0±5.5 at 12th month.KSS scores at 6th month were 87.0±8.3 and 90.9±7.2,84.2±10.6 and 88.8±9.2 at 12th month.And the KSS function scores at 6th month were 86.6±21.6 and 84.9±16.5,85.2±16.4 and 91.0±10.0 at 12th month and had no statistical difference between two groups.In sunrise views (Bending 30 degrees),the curvature tolerance between patella and femoral trochlea was well at two timestamp postoperation without instability and dislocation.No revision of TKA and no re-resurfacing of patella one year after TKA.Conclusion TKA is very effective for relief of knee pain and improvement of joint function for OA and RA.Patella resurfacing and nonresurfacing have not significant difference during one year and two ways,and have the same good result in function and anterior knee pain improvement.

Objective To evaluate the corneal astigmatism changes after phacoemulsification performed using clear corneal incision with different locations.Methods Seventy-two eyes of 72 patients having phacoemulsification and implantation of foldable intraocular lens through a clear corneal incision were chosen.Patients were divided into two groups by table of random digit:group A (incision at 11:00),group B (incision at the steepest corneal meridian).The change of corneal astigmatism was compared between group A and B postoperatively.Surgically-induced astigmatism (SIA) was calculated by vector analyses using the HoHaday-Cravy-Koch method.Results Preoperative corneal astigmatism between group A and group B had no significant difference [(0.96 ± 0.52) D vs.(0.94 ± 0.56) D,P ＞ 0.05].One and three months after operation,the corneal astigmatism in group A were significantly higher than those in group B [(1.15 ± 0.32)D vs.(0.82 ± 0.43) D,(0.85 ± 0.38) D vs.(0.63 ± 0.40) D,P＜ 0.05].The SIA in group A was significantly higher than that in group B 1 month after operation [(0.85 ± 0.37) D vs.(0.75 ± 0.54) D,P ＜ 0.05],there was no significant difference between group A and group B 3 months after operation [(0.60 ±0.35) D vs.(0.58 ±0.30) D,P ＞0.05].Conclusions Corneal astigmatism is prｅsent in most cataract surgery candidates.Cataract surgery using steepest corneal meridian incision induces significantly less SIA,and correct corneal astigmatism already present preoperatively.

Three different arrangements of neurology curriculum were compared including the traditional neurology teaching in Wuhan University School of Medicine,neurology teaching modules in clinical pathophysiology and therapeutics (CPPT) in University of Chicago Pritzker School of Medicine and the clinical pathophysiology and therapeutics (CPPT) as well as the current reform of neurology teaching in Wuhan University School of Medicine.This article discussed the issues related to the neurology curriculum integration in medical school.Results showed that curriculum integration in ‘ teaching reform class' was praised by teachers and students.Integrating basic medical courses into clinical courses of neurology is of great importances in improving the quality of medical education in China and cultivating high-quality medical personnel to meet the requirements of the times.

Pediatric knowledge was not fully learned by seven-year program medical students of pediatrics major in first five years,so two years of postgraduate was the key period for culturing their pediatric specialty.Students of seven-year program were characterized by strong theoretical knowledge but poor pediatric clinic knowledge,therefore,pediatric clinic teaching should emphasize on basic knowledge and skills,avoid dwelling on specific details at early stage,pay attention to their communicative ability with children and their relatives,combine theory with clinic practice and teach from surface to point.Meanwhile,we aimed at changing them into pediatric doctor through cultivating their clinic skills and scientific research ability.

Clinical research progress of Traditional Chinese Medicine(TCM) on treatment of diabetic nephropathy in recent ten years was explained from aspects of pathogen and pathogenesis, patterns classification of TCM, Chinese herbal Compound, single drug and the extractive. And the result showed a good therapeutic effect on early stage of TCM treatment for diabetes mellitus which was worthy to be popularized.