Out of 438 pupils aged 9-11 years from two primary schools,58 childrenwere identified with learning difficulty(as LD group),to be compared with 60 matchedchildren but with average academic acheivement(as AA group)and 60 with high academicacheivement(as HA group)from the same class of the same school.The three groups wereevaluated with child behavior checklist(CBCL)developed by Achenbach to see the possiblerelationship between academic achievement and behavior issues.The results showed that LDgroup was characterized with low IQ,low social competence,more behavioral and emotionalissues.A multi-step rgression analysis revealed that LD was closly correlated withheperactivity,attention deficiency and boy delinquency.Based on the above findings,authorsput forward some possible interventions.

Objective To investigate the value of deiminated recombinant rat filaggrin antibodies (ArFA)in predicting the activity of rheumatoid arthritis (RA).Methods ArFA was detected with enzyme linked immunosorbent assay(ELISA)in 61 patients with active RA and 48 patients with inactive RA.The ESR,CRP,RF were measured,while tender ioint count,swollen joint count and patient's general assessment were recorded.The level of ArFA in 20 RA patients was measured before and after treatment.Results The level of ArFA in patients with active RA was higher compared with patients with inactive RA [(130±35)U/L cs(66±25)U/L,P=0.004 ],the level of ArFA after treatment was reduced (79.8 U/ml vs 118.2 U/ml,P=0.000).Conclusion The level of ArFA can predict disease activity of RA.

Objective To establish a HPLC method for the determination of emodin in Niuhuang anti-inflammatory tablets. Method Thermo-Hypersil C18 (250 mm?4.6 mm, 5 ?m) was used, mobile phase was methanol-0.1% phosphoric acid (70∶30), with flow rate of 1.0 mL/min, detection wavelength of 254 nm, and column temperature was 40 ℃. Results There was a good linear relationship of emodin at the range of 0.020 11～0.402 2 ?g. Conclusion The method is simple, accurate, with better separation efficiency, wide linear range and high sensitivity. It can be used for quality control of the preparation.

Objective To investigate effect of double end-to-side neuroanastomosis for bilateral obsolete proper digital nerve injuries.Methods From November 2000 to October 2009,40 patients with bilateral obsolete proper digital nerve injuries were admitted to our center.Fifteen patients underwent double end-to-side neuroanastomosis.During operation,the injured digital nerve was excised,then bilateral distal ends and proximal ends were sutured,respectively; consequently,the distal and proximal nerve bows were formed.A cutaneous antebrachii lateralis nerve was freed and obtained from the homolateral forearm,then divided equally to 2 parts which were used to bridge the 2 nerve bows.Thirteen patients underwent single end-to-side neuroanastomosis,while other 12 patients underwent end-to-end neuroanastomosis.Results Thirty one patients were successfully followed up for 6 to 8 months.In double end-to-side neuroanastomosis group,12 patients were successfully followed up; anaesthesia and pain of the injured fingers disappeared completely; finger pulp was plump with good flexibility; the average result of sensation measurement was S(4.21 ±1.97),which was significantly higher than those of the other 2 groups; the average result of two point discrimination was 5.4±0.9 mm which was significantly lower than those of the other 2 groups.In single end-to-side neuroanastomosis group,10 patients were successfully followed up; anaesthesia relieved and spontaneous pain disappeared completely,but there was still tenderness; the average result of sensation measurement was S(1.57±0.72); the average result of two point discrimination was 7.2±1.2 mm.In end-to-end neuroanastomosis group,9 patients were successfully followed up; anaesthesia and pain relieved; the average result of sensation measurement was S(3.19± 1.04); the average result of two point discrimination was 7.68±0.8 mm; there were significant differences in results of sensation measurement and two point discrimination between the latter two groups.Conclusion The double end-to-side neuroanastomosis is a valuable method for repairing bilateral obsolete proper digital nerve injuries.

Objective:To analyze the therapeutic effect and safety of finasteride on aged patients with isolated systolic hypertension (ISH)complicated benign prostatic hyperplasia (BPH).Methods:A total of 84 aged ISH + BPH pa-tients admitted from Jun 2011 to May 2013 were selected.According to medication plan,they were divided into fin-asteride group (n=44)and routine treatment group (n=40,only received routine treatment because they cannot use finasteride).Course of treatment was all six months.International prostate symptom score (IPSS),quality of life (QOL) questionnaire score,prostate-specific antigen (PSA),incidence rate of acute urinary retention,maximum u-rinary flow rate (Qmax),postvoid residual urine (PRV),prostate volume (PV)and incidence rate of adverse reac-tions were compared between two groups.Results:Compared with routine treatment group,there were significant reductions in IPSS [(13.2±2.4)scores vs.(9.4±1.1)scores],PRV [(21.4±4.6)ml vs.(9.0±2.3)ml],PV [(36.8±3.8)ml vs.(29.5±3.0)ml],PSA [(2.45±0.74)μg/L vs.(1.26±0.48)μg/L]and incidence rate of acute urinary retention (17.50% vs.9.09%),P<0.05 or <0.01,and significant increase in Qmax [(10.2±2.4) ml vs.(13.7±3.8)ml]and QOL score [(3.1±1.0)scores vs.(4.7±1.5)scores]in finasteride group (P<0.05). There were no significant difference in incidence rates of adverse reactions between two groups,P>0.05 all.Con-clusion:Therapeutic effect of finasteride is significant and adverse reactions don’ t increase significantly in aged pa-tients with isolated systolic hypertension complicated benign prostatic hyperplasia.

OBJECTIVE:To discuss how to carry out clinical pharmacy in second-class medical institution.METHODS:The contents,methods and experience of implementing clinical pharmacy in our hospital in recent 6 years were summarized.RESULTS:The practice such as reorganizing departments,training professionals,pharmacists' ward round,providing information services and supervising of ADR etc facilitated the combination of medicine and pharmacy,enhanced the quality of medical treatment and shed insights into the exploring of a suitable clinical pharmacy mode.CONCLUSION:The support of policy and the training of clinical pharmacists are essential factors for the successful clinical pharmacy.

Objective To investigate the cardioprotective effects of 3-nitropropionic acid (3-NPA) pretreatment against ischemia-reperfusion (I/R) injury. Methods Sixteen male Wistar rats weighing 200-250 g were randomly divided into 2 groups ( n = 8 each):(1) 3-NPA group received intraperitoneal 3-NPA 4 mg?kg-1 24 h before the animals were sacrificed and (2) control group received normal saline instead of 3-NPA. The animals were sacrificed and the hearts were immediately removed and mounted on Langendorff apparatus and perfused with K-H solution saturated with 95% O2 and 5% CO2 at 37℃ . After being perfused for 30 min the hearts were subjected to 30 min global ischemia by suspension of perfusion followed by 60 min reperfusion. The HR, left ventricular developed pressure (LVDP) and ? dp/dtmaxd were recorded before ischemia and at 30 and 60 min of reperfusion. Coronary effluent was collected at 15 min of reperfusion for determination of CK and LDH activity. At the end of 60 min reperfusion the hearts were removed for determination of myocardial MDA content and SOD activity.Results LVDP and ? dp/dtmax recovered significantly better in 3-NPA group than in control group. The myocardial MDA content, CK and LDH release were significantly lower in 3-NPA group than in control group. The myocardial SOD activity was significantly higher in 3-NPA group than in control group. Conclusion Chemical preconditioning with 3-NPA protects the heart from I/R injury.

Objective To improve the traditional percutaneous cholecystolithotripsy in order to elevate the success rate and to discuss its indications. Methods With selfmade apparatus, we modified the open procedure which is otherwise impossible in removing the stones. We have followed 120 patients for 3 to 36 months to look into the recurrence of cholelithiasis. Results We have succeeded in 287 operations in a total of 291 (98 6%) cases. Among which 99 cases (34 5%) received modified open procedures, and the postoperative course was all uneventful. 120 patients were followed up postoperatively from 3 to 36 months and the stone recurrence rate was 13 3% (16 cases). Statistical analysis showed that the stone recurrence rate in patients with 3 stones and up, or poor gallbladder function was significantly higher than those with less than 3 stones and or good gallbladder function.Conclusions The percutaneous cholecystolithotripsy with improved procedures can effectively increase the success rate of operation. According to our result the indications should be restricted to those with less than 3 stones and or with good gallbladder functions.

Objective To clone and express the extracellular portion of mouse Fcγreceptor Ⅱ-b ( FcγRⅡb) and to analyze the functions of the expressed proteins in a mouse model of systemic lupus ery-thematosus ( SLE) .Methods The gene fragment encoding FcγRⅡb was amplified by PCR, and then in-serted into the prokaryotic expression vector pET-32a(+) to construct the recombinant expression plasmid pET-FcγRⅡb.The expression plasmid was identified with restriction enzymes and then sent to the Shanghai Bio-Engineering Co.LTD for further sequencing analysis.The transformed Escherichia coli ( E.coli) BL21 ( DE3) strains carrying the recombinant expression plasmid pET-FcγRⅡb were induced by isopropylβ-D-1-thiogalactoside ( IPTG) .The expressed fusion proteins were analyzed by Western blot assay and purified with purification kits.The immune complex ( IC)-binding ability of FcγRⅡb was measured by ELISA.MRL/lpr mice with SLE in both the prevention (12 weeks old, n=40) and the treatment groups (19 weeks old, n=40) were randomly divided into four groups including 60 μl (4.8 μg) treatment group, 120 μl (9.6 μg) treatment group, 180μl (14.4μg) treatment group and PBS treatment group with 10 mouse in each group. The MRL/lpr mice with SLE were injected with the fusion protein through tail vein once a week for four con-secutive weeks.Serum samples were collected from each mouse after one week of observation.The levels of FcγRⅡb in soluble form in mice form both the prevention and treatment groups as well as the levels of anti-double stranded DNA antibodies were detected by ELISA.Results The gene encoding FcγRⅡb was ampli-fied and the recombinant expression plasmid pET-FcγRⅡb was successfully constructed.The recombinant proteins were expressed in the prokaryotic expression system, and then successfully purified.The recombi-nant proteins could bind to IC.Compared with the corresponding PBS control group, the levels of FcγRⅡb in soluble form were increased in mice from both prevention and treatment groups after treating with various concentrations of the recombinant protein (P<0.05).Significant differences in the levels of FcγRⅡb were found among mice of the same age after treating with different concentrations of the recombinant protein ( P<0.05).Compared with the corresponding PBS control group, the levels of anti-double stranded DNA anti-bodies were decreased in mice from both prevention and treatment groups after treating with various concen-trations of the recombinant protein (P<0.05).The levels of anti-double stranded DNA antibodies were grad-ually decreased along with the increasing dosage of protein (P<0.05).Conclusion The extracellular por-tion of murine FcγRⅡb in soluble form was successfully expressed.The recombinant proteins played a cer-tain role in the prevention and treatment of SLE in a mouse model.

Objective To compare the impact of conventional vs. zero-balanced ultrafiltration on serum pro-inflammatory factors,acute kidney injury and clinical prognosis after cardio-pulmonary bypass procedure. Methods Forty patients receiving cardiac surgery under cardio-pulmonary bypass procedures in Xiangyang Central Hospital during January 2013 to June 2013 were randomly divided into conventional ultrafiltration group(group A,n=20)and zero-balanced ultrafiltration group(group B,n=20). Blood and urine samples were collected on different time points( pre-operation,T0;pre-ultrafiltration,T1;immediately after ultrafiltration,T2;24 hours post-operation,T3;48 hours post-operation,T4;7 days post-operation, T5). TNF-α,IL-6,KIM-1,CysC,serum creatinine and urea nitrogen were detected and compared. Pre-and post-operative clinical data were also collected. Results There was no difference in baseline data or intra-operative data(p>0. 05). TNF-αand IL-6 started to increase when the operation began. Compared with conventional ultrafiltration,zero-balanced ultrafiltration alleviated the increase of TNF-α and IL-6,espe-cially on T2,T3,and T4(p<0. 05). Zero-balanced ultrafiltration also decreased CysC,Rbp,serum creati-nine and urea nitrogen on T2,T3,and T4 compared with conventional ultrafiltration(p<0. 05). A total of 11 patients experienced AKI( >grade I)in group A and 2 patients experienced in group B(p<0. 01). There were significant differences of ventilation time,total complication incidence and ICU stay time be-tween two groups. There was no difference in other complications,post-operative days in hospital or death rate within 30 days. Conclusion Though there is a trend of more patients receving renal replacement therapy,no statistical difference has been achieved. In conclusion,zero-balanced ultrafiltration can effec-tively decrease the concentration of serum pro-inflammatory factors,alleviate acute kidney injury and improve the clinical prognosis after cardio-pulmonary bypass procedures. It is a safe and reliable method valuable for promotion.