OBJECTIVE: According to the holism in traditional Chinese medicine (TCM) theory, this manuscript explores the relativity of pathogenesis among hypertension, diabetes and hyperlipemia.DATA SOURCES: We applied computer to search articles in English on pathogenesis ofhypertension, diabetes and hyperlipemia in Medline between January 1985 and December 2004 by words "hypertension, diabetes, hyperlipemia, pathogenesis" .Besides, we also used computer to search articles in Chinese on pathogenesis of hypertension, diabetes and hyperlipemia in Chinese magazine full text database between January 1990 and December 2004 by words "hypertension, diabetes, hyperlipemia, pathogenesis".STUDY SELECTION: Primarily, articles on pathogenesis of hypertension,diabetes and hyperlipemia were selected in TCM and modern medicine respectively. Accepted standard were: ① Random control clinic test with methods of single blind, double blind or no blind; ② Nonrandom control test;③ Fore-and-aft control test; ④ Chapter in monograph. Eliminated standard:repeated research.DATA EXTRACTION: Totally 28 articles on pathogenesis of hypertension,diabetes and hyperlipemia were found in TCM and modern medicine, however, 12 articles were selected according to accepted standard, and 16 articles were eliminated due to repeated content.DATA SYSTHESIS: Totally 12 selected articles were analyzed on pathogeneses of hypertension, diabetes and hyperlipemia in TCM and modern medicine, and hinted internal affiliation of these three diseases from view of molecular biology.CONCLUSION: These three diseases can be regarded as a whole entity for study. High blood pressure, high blood sugar and high lipemia could be treated as different forms of the entity or in different developing courses of the whole. In a certain course it might present as one of the forms specifically. It might manifest high blood pressure mainly in clinic, or high blood sugar, or high lipemia,also several forms at the same time. It will be beneficial to take the holism and visceral theory in TCM for reference in research of modern medicine.

Objective To investigate the pathogenesis of the syringomyelia in Chiari I malformation by measuring the posterior cranial fossa structures. Methods The posterior cranial fossa structures on mid sagittal MR image were measured in 50 normal subjects,and 24 Chiari I malformation patients associated with syringomyelia and 26 Chiari I malformation patients without syringomyelia. The t test was used for statistical analysis. Results In Chiari I malformation patients and normal subjects, the width of the CSF space anterior to the medulla oblongata was (4 2?1 8) mm and (6 6?1 4) mm respectively( t =7 30, P 0 05). In Chiari I malformation with syringomyelia group and without syringomyelia group, the width of the CSF space anterior to the medulla oblongata was (2 9?1 4) mm and (5 5?1 1) mm respectively( t =7 30, P

Objective To evaluate the STR profiling availability of formalin-fixed tissues and the detectable time limit of intact STR profile.Methods The different human tissues were fixed with 10-fold diluted commercial 40%formalin fixative for different duration under 15～20℃,and then DNA was extracted using the method of QIAamp~(R)DNA and IQ~(TM) DNA System.The extracted DNA was quantified with QuantifilerTM kit and amplified by both AmpFSTR identifiler kit and AmpFSTR MiniFiler kit.The STR profile was analyzed by GeneMapper ID v3.2 on 3100-Avant.Resuls The STR profiling availability of formalin-fixed tissues was relevant to the formalin fixing duration mainly.as well as the type of tissues and the template concentration and protocol of DNA extracting.The optimal ranges of template concentration is 1～3ng/μL and the QIAamp extracting method was preferable.There are differences in the degradation rate between various types of tissues in the unbuffered formalin fixative,and the lung tissue showed the slowest rate and liver and intestine tissues the fastest.Intact miniSTR profile of all the tissues detected could be obtained within 15 days duration of formalin fixing while intact STR profile could be obtained within 4 days.Conclusion The major factor that impact the availability of STR profiling of formalin-fixed tissues is the fixing duration in unbuffered formalin,as well as the type of tissues,method of extraction,concentration of PCR template and the kinds of STR loci.

Objective To investigate the characteristics and distribution of class teaching skill points in state high quality course pathology using Flanders interaction analysis system to analyze the teaching video of pathology course.Methods Teaching videos of state high quality course (pathology course) between 2006 and 2012 were analyzed by Flanders interaction analysis system.Frequencies of using teaching skill,presentation skill and interaction skill were statistically analyzed.Results The study found that frequencies of using teaching skill points in pathology course were decreased in the following order:presentation skill (53.94％),interaction skill (26.64％) and teaching skill (19.42％).Sensory focusing was most commonly used in presentation skill.Monitoring and expressing concern were most commonly used in interaction skill.Gestures and cases were most commonly used in teaching skill.Conclusions Teachers in pathology teaching should correctly handle the relationship among the presentation,interaction and teaching skills according to the teaching objectives and teaching content.

Objective To explore the effects of electroacupuncture on the expression of glucose transporter 4 (GLUT4) and protein kinase Bβ (Akt2) in the skeletal muscles of insulin-resistant (IR) rats. Methods Twentyfour male Wistar rats were randomly divided into a normal control group, a model group and an electroacupuncture (EA) group. The rats of the model group and the EA group were fed with high fat diets to establish a model of insulin resistance. The rats in the EA group were then treated with electroacupuncture for 2 weeks, while those in the model group were not. Blood samples were collected to evaluate fasting insulin (FINS) and fasting blood glucose (FBG) to calculate the insulin sensitivity index (ISI). GLUT4 and Akt2 mRNA in the skeletal muscles were determined with reverse transcription-polymerase chain reactions (RT-PCRs) after 2 weeks of EA treatment. Results Compared with the control group, the FINS in the model group increased significantly, and ISI decreased significantly. Compared with the model group, the FINS in the EA group decreased significantly and ISI increased significantly. The expression of GLUT4 and Akt2 mRNA in the model group was significantly lower than in the control group or the EA group. Conclusion Electroacupuncture might improve the condition of IR rats, probably by enhancing the transposition of GLUT4 in the phosphatidylinositol 3-kinase/protein kinase signaling pathway.

Objective To report a consanguineous family with lamellar ichthyosis and to detect the mutations in transglutaminase 1 (TGM1) gene in this family. Methods Genomic DNA was extracted from the blood samples of a 19-year-old male patient with lamellar ichthyosis, his family members and 100 normal human controls. PCR was carried out to amplify all the encoding sequences (15 exons) and adjacent flanking sequences of TGM1 gene followed by bidirectional sequencing. Results A C1666T mutation in the 11th exon in TGM1 gene, which resulted in the substitution of ACA (threonine) by ATA (isoleucine) at codon 529, was detected in the proband, while both his parents carried the C1666T mutation in heterozygous form, and his sister was a C/C homozygote. None of the 100 normal control individuals carried the mutation in TGMlgene. Conclusions The de novo mutation from ACA (threonine) to ATA (isoleucine) at codon 529, may contribute to the development of lamellar ichthyosis. Consanguineous marriage can increase the risk for lamellar ichthyosis by raising the probability of homozygosis of C 1666T mutation in TGM 1 gene.

Objective To investigate the changes of gamma-aminobutyric acid (GABA) in the anterior cingulate cortex of perimenopausal women with depression.Methods Forty perimenopausal women as the experimental group and ten healthy women as the control group were recruited and followed up for 18 to 24 months.The proton magnetic resonance spectroscopy (1H-MRS) was used to acquire the concentrations of GABA in the anterior cingulate cortex.The experimental group was examined before and after menopause.The control group was examined before into the group and after out of the group.The experimental group after menopause was further divided into the anxiety group and the depression group according to the Classification and Diagnostic Criteria of Mental Disorders in China-Third Edition (CCMD-3), 14-item Hamilton Anxiety Scale (HAMA-14) and 17-item Hamilton Depression Scale (HAMD-17).The data of three groups were compared respectively.Results The results showed that the concentrations of GABA after menopause in both of the anxiety group and depression group were significantly lower (P<0.05) than those before menopause, and were also significantly lower (P<0.05) than those in the control group.The concentrations of GABA after menopause in the depression group were significantly lower(P<0.05) than those in the anxiety group.Conclusion The changes of GABA in the anterior cingulate cortex are related with the pathophysiology mechanism of perimenopausal depression and the symptoms of perimenopausal depression.

The authors compared the purpose,and the main content of three international standards in medical education developed by the Institute for International Medical Education (IIME), World Health Organization Western Pacific Regional Office (WHO/WPRO), and World Federation for Medical Education (WFME) respectively. The IIME's standard is deferent from the others. The IIME's standard contains seven broad educational outcome domains and 60 items in the domains. The purpose of IIME's standard is to improve the common core competency of individual medical graduates of each medical school in the world, and the standard focuses the outcome of medical education and belongs to summative individual evaluation. The WHO/WPRO's and WFME's standards are quite similar. They define the standards across nine broad areas of medical schooling divided into 38 sub-areas. The ultimate goal of the WHO/WPRO's standard is to encourage national governments to adopt a quality assurance process in medical education. The aim of the two standards is to promote the quality assurance of medical schools. Both of the two standards focus the whole process of medical schooling and medical schools, and belong to formative evaluation.

Objective To evaluate special diagnosis and treatment of occult breast cancer. MethodsDiagnostic means used included breast roentgenography,selective mammary ductography, fine needle aspiration and excision biopsy in 28 cases. ResultsBreast roentgenography detected 4 cases ( 7/16), selective mammary ductography identified 4 cases(4/6). The definite diagnosis rate by lump biopsy and immunohistochemistry was 10 cases (10/13). Postoperative follow-up was abtained in 18 cases,with 5 dying of recurrence or distant metastases. Among them 4 patients underwent only axillary node excision. Conclusion Nipple discharge,localized thickening the gland are very important clue to the diagnosis of occult breast cancer.Lump biopsy and immunohistochemistry is a mainstay for the final establishment of the diagnosis of breast cancer. Radical or modified radical mastectomy with adjuvant radiotherapy and chemotherapy is a suitable treatment modality for occult breast cancer.

OBJECTIVE: To evaluate the protective effects of oral administration of D-methionine tablets on noise-induced hearing impairment. METHOD: Two hundred and three volunteers were recruited and randomly divided into two groups: experimental group (n= 113) and control group (n=90). The subjects received oral administration of D-methionine tablets in the experimental group and placebo in the control group before noise exposure. Routine audiometric evaluation and ABR testing were performed and recorded before and after noise exposure. The statistical analysis was carried out with SPSS 11.0. RESULT: There were no differences in auditory threshold and I-V interpeak latency pre-noise exposure (P>0.05), however, there were statistically significant differences between two groups 1 d, 7 d after noise exposure (P<0.01 and P<0.05). In-respective-group, there were statistically significant differences between before and 1 d after noise exposure (P<0.05 and P<0.01), however, no difference was noted between before and 7 d after noise exposure in the experimental group (P>0.05). CONCLUSION The protective effects of D-methionine tablets were prominent on the noise-induced hearing impairment. Further studies regarding the optimal time of D-methionine administration will be recommended in the future.
Administration, Oral ; Adult ; Hearing Loss, Noise-Induced ; drug therapy ; Humans ; Male ; Methionine ; therapeutic use ; Young Adult