0.05). The marks of the group of CBL in case analysis test and clinical skills test are significantly higher than that of the group of stepwise learning (P

Objective To explore the cell metabolism of the bilateral hippocampus effected by the inflammatory factor of blood serum in the development of the depression.Methods Using Proton magnetic resonance spectroscopy 1 H-MRS technology to detect multiple metabolic indices of the bilateral hippocampus of 20 first episode depression patients and 20 healthy persons,and detecting the levels of IL-6,IL-2,IL-10 in blood serum were detected.Finally the correlation between them was analyzed.Results Compared with the healthy group,the values of Glx/Cr and NAA/ Cr were reduced in left hippocampus (Glx/Cr: (0.82±0.48),t=2.69,P＜0.05 ; NAA/Cr: (1.12 ±0.44),t =2.81,P＜ 0.05) and the value of Cho/ Cr was increased in left hippocampus ((2.49± 0.78),t =2.36,P＜0.05),but only the value of Glx/ Cr were reduced in right hippocampus ((0.84 ± 0.47),t =2.43,P＜ 0.05),and the other metabolic indices changed unobvious.The depressive group had the significantly higher levels of IL-6,IL-2 in blood serum(IL-6: (12.47±3.19) ng/L,t=4.53,P＜0.05 ; IL-2: (29.44±5.72) ng/L,t=2.44,P＜0.05),but no significant difference was found in the IL-10 level in blood serum.The Glx/ Cr of bilateral hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(left:(IL-6: r=-0.555,P＜0.05;IL-2: r=-0.624,P＜0.05) ;right:(IL-6: r=-0.575,P＜0.05; IL-2: r=-0.523,P＜0.05)).The NAA/ Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(IL-6: r=-0.582,P＜0.05;IL-2: r=-0.607,P＜0.05).The Cho/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(IL-6: r=0.601,P＜0.05; IL-2: r=0.552,P＜0.05).Conclusion The abnormal of glutamic acid system in bilateral hippocampus maybe the important performance and the potential originating link,the changes of the inflammatory cytokines level maybe the factor of these abnormal changes.

Objective To evaluate the clinic efficacy of sufentanil and remifentanil by target- controlled infusion (TCI) combined with propofol in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixty patients,ASA Ⅰ ～ Ⅱ,undergoing elective EBUS-TBNA were randomly divided into group S ( sufentanil group),group R (remifentanil group) and group SR (sufentanil + remifentanil group),each group were twenty patients.The anesthesia of all groups is propofol intravenous anesthesia with 2％ lidocaine topical anesthesia,to controll BIS between 50 and 60 during surgery.Heart rate(HR),mean arterial pressure(MAP) pulse oxygen saturation( SpO2 ) and respiratory rate (RR) were recorded and compared 5mins after entering room(T0),30mins after the beginning of surgery(T1 ) and after surgery(T3).Arterial blood gas and the times of cough during surgery were also recorded and compared in all groups.The use of propofol and lidocaine,the wake-up time,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were also obtained.Results ( 1 ) RR decreased distinctly in group R and PaCO2 increased distinctly in group S and group R compared with that of group SR (P ＜0.05) during surgery.(2)The times of cough and the wake-up time lessened distinctly in group R and group SR compared with that of group S ( P ＜0.05 ).(3) The use of propofol and lidocaine,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were similar in all groups ( P ＞ 0.05 ).Conclusion Sufentanil compounded remifentanil by TCI combined with propofol is a safe and feasible anesthesia option for EBUS-TBNA,which provides better efficacy,high satisfaction and less side effects compared with using alone of sufentanil and remifentanil respectively.

Standardized training program for residents in Shanghai is one of the important measures in the health care reform.In accordance with Implementary methods of standardized training for residents in shanghai (for trial implementation),the department of stomatology in the affiliated Changzheng Hospital quickly initialized the standardized training program by defining the training objectives,establishing the training mechanisms,formulating the training contents and building the system of the assessment.Special attention was paid to improve the professional skill of the residents including ① clinical diagnostic ability; ② medical theoretical level and the medical thinking ability; ③ interpersonal communicational skill; ④ professionalism; ⑤ scientific research ability.Useful exploration was made to test the feasibility of the training program based on the practices and the effect was encouraging.

Objective To investigate the intervention of Chinese herb Shengjiang San(SJS)for the imbal-ances of serum Th1/Th2 cells and related regulatory factors in sepsis patients. Methods Fifty-five sepsis patients were randomly divided into two groups:conventional treatment group of 27 cases and SJS group of 28 cases. Nine cases of healthy volunteers were enrolled as control group in the study. Cases of conventional group were treated with western medicine only and cases of SJS group were treated with both western medicine and Chinese herb SJS (100 mL twice one day). The therapy course of both groups was 3 days. Score of Chinese medical syndromes ,se-rum level of leukocyte count,C reactive protein(CRP)and procalcitonin(PCT),serum T-bet,GATA-3,Th1&Th2 cells in the proportion of whole CD4+Th cells and Th1/Th2 ratio were compared respectively in each group be-fore and after treatment. Results There were significant differences between SJS group and conventional group in score of Chinese medical syndromes,serum level of leukocyte count,T-bet,GATA-3,Th1&Th2 cells in the pro-portion of whole CD4+Th cells and Th1/Th2 ratio(P<0.05 or P<0.01). There were no significant differences be-tween the two groups in serum level of CRP,PCT and GATA3. Compared with control group,there were signifi-cant differences in all indicators except GATA3 of the two groups(P<0.01). Conclusion Chinese herb Shengji-ang San has an effective benefits to Chinese medical syndromes,inflammatory reaction,the imbalance of serum Th1/T2 and related regulatory factors(T-bet&GATA-3)in sepsis patients.

Aim To study the effect and molecular mechanism of pretreatment with COPP on hypoxia/reoxygenation injury of H9c2 myocytes.Methods H9c2 myocytes model of hypoxia/reoxygenation injury was established and H9c2 myocytes were given COPP pretreatment before hypoxia/reoxygenation.Treatment with Znpp and all-trans retinoic acid(ATRA)inhibited HO-1 and Nrf2-ARE respectively.The level of LDH and CK in cell supernatants were measured.HO-1mRNA expression was analyzed by RT-PCR.HO-1 and Nrf2 protein expressions were analyzed by Western blot.Results Compared with hypoxia/reoxygenation group,the level of LDH and CK in COPP pretreatment groups decreased significantly and the level of HO-1mRNA,HO-1 protein expression and Nrf2 protein expression in the nucleus significantly increased.Znpp abolished protective effect of COPP pretreatment.ATRA blocked the nuclear accumulation of Nrf2 and decreased HO-1 protein expression that COPP pretreatment induced.Conclusions COPP can induce HO-1 overexpression which has protective effect on hypoxia/reoxygenation injury of H9c2 myocytes.Its mechanism is related to Nrf2-ARE signaling pathway.

Objective To evaluate the diagnostic values of diffusion tensor imaging(DTI)in early radiation-induced brain injury of the temporal lobes.Methods Conventional and MR diffusion tensor imaging examinations were performed in 23 patients following radiotherapy for nasopharyngeal carcinoma(NPC)and in 28 age-matched healthy controls.Isotropic apparent diffusion coefficient(ADCiso)and anisotropic index were measured in the white matter on both of the temporal lobes.Results The value of ADCiso,fractional anisotropy(FA),relative anisotropy(RA)and 1 minus volume ratio(1-VR)were(644.08?56.80)?10-6 mm2/s,0.394?0.074,0.344?0.075 and 0.182?0.072 respectively.In comparison with control group,these values were significant decreased(P

Objective:To investigate the efficacy of three different methods of digestive tract reconstruction after total gastrectomy.Methods:A total of 106 cases underwent the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch(group A,n=38) ,Roux-en-Y esophagojejunostomy with the J-type jejunal pouch(group B,n=31) ,and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch(group C,n=37) respectively.The clinical data were retrospectively studied.The digestive tract reconstruction time,the post-operative complication incidence rate,postprandial symptoms,food-intake quantity,weight,serum nutritional parameters and emptying time of the gastricsubstitute were compared respectively.Results:The reconstruction time was the shortest in group A,which was significantly shorter than that in group B(P0.05) ,Group A was significantly lower than group B and C in the incidence of roux stasis syndrome.The Visick score of group A were superior to those of group B and C in 6 and 12 months after operation.The food intake gain of group A and B were superior to that of group C 6 and 12 months after operation.There were no significant differences among 3 groups in the term of weight,Hb and ALB loss and prognosis nutritional index(PNI) 6 months postoperatively.Weight and ALB loss in group A and B were lower than those in group C 12 months postoperatively,but PNI was higher in group A and B than those in group C.Emptying time of the gastric substitute was prolonged both in group A and B 12 months postoperatively.Conclusion:The uncutted Roux-en-Y esophagojejunostomy may act as an adoptable method of digestive tract reconstruction after total gastrectomy for gastric cancer.

Objective KIF18A is a protein that has close relation with mitotic regulation and tumor development.This study aimed to establish KIF18A protein expression system in baculovirus,which may help to realize high efficient synthesis of KIF1 8A protein in vitro.Methods Transfer vector was constructed with molecular cloning method,and recombinant baculovirus were obtained through gene transposition.KIF18A protein was expressed by transforming recombinant baculovirus into infected insect Sf-9 cells to realize the synthesis efficiency.Results It was confirmed by DNA sequencing,microscopic observation and Western Blot that the KIF18A protein expression system in baculovirus was successfully established.Conclusions Conditions for transfer vector and recombinant virus transfection are defined,and high efficient KIF18A protein baculovirus expression system are successfully constructed.

This study is to screen the Chinese herbal compounds which could inhibit the production of Abeta and investigate the underlying mechanism. Ten types of compounds which have potential value in the treatment of AD were selected as initial screening trial. The cell models which used could overexpress Abeta and beta-secretases or Abeta and gamma-secretases. Extracellular Abeta was determined by ELISA after the cell models treated with different concentrations of compounds (0.5-100 micromol x L(-1)), separately. Then the compounds were selected which could inhibit extracellular Abeta and their best concentration ranges were decided, too. Furthermore, the cell viability and apoptosis rate, the level of intracellular Abeta, beta and gamma-secretases were determined after the cell models treated with different concentrations of selected compounds. The results showed that 4 of the 10 compounds could reduce the level of extracellular Abeta; they were cryptotanshinone, astragalosides, gastrodin and paeoniflorin, and their best concentration ranges were 0.5-5.0, 0.5-5.0, 5.0-50, 1.0-25 micromol x L(-1), respectively. Further study indicated that the 4 selected compounds were nontoxic to the cellular models and lowering intracellular Abeta were more effective compared with extracellular; of which astragalosides and gastrodin showed dose-dependent inhibition to the activities of beta and gamma-secretases, with the maximum inhibiting rates of 78.2% and 80.3%, respectively. In conclusion, cryptotanshinone, astragalosides, gastrodin and paeoniflorin could inhibit the expression and secretion of Abeta, and the underlying inhibiting mechanism of astragalosides and gastrodin were related with the reduction of the beta and gamma-secretase activities, respectively.