Closely related to health and life of patients,doctors share a bigger ratio of responsibility compared with other careers.Doctors' responsibilities include responsibilities for medical skills,responsibilities for patients,and responsibilities for one's nation.It is doctors' necessary mission,and also a lifelong commitment to accomplish the above three responsibilities.

Objective:To determine whether mild hypothermia,isoflurane and propofol reduce gultamate release in rat hippocampus brain slices after hypoxia. Method: Brain slices preparations were separated and incubated from rat hippocampus. Glutamate released from rat brain slices during chemical anoxia(100?M KCN)were measured with a fluorescence assay,at 28℃,31℃ and 37℃ after anoxia and after administration of 1 MAC of isoflurane and 200 ?m propofol respectively. Result: Glutamate release was significantly reduced at 28℃ or 31℃ compare with that at 37℃ (P

Objective To evaluate the significance of combined determination of glutamic acid decarboxylase antibodies(GADA),islet cell antibodies(ICA) and insulin autoantibodies (IAA) in predictive of type 1 diabetes mellitus Methods GADA, ICA and IAA were determined by enzyme linked immunosorbent assay and C peptide by radioimmunoassay Diagnose efficiency were calculated by matrix decision method Results The positive rate of GADA,ICA and IAA(68 8%,43 0% and 39 8%) were significantly elevated in the patients with type 1 diabetes mellitus compared with type 2 diabetes mellitus or normal subjects ( P

Objective To evaluate the efficiency of microsurgical methods for treatment of hypothalamic gliomas in children and the management of postoperative complications Methods Twenty-one tumors were classified into two types according to their location, size and extensive direction The tumors were removed with microsurgical technique by various approaches, such as transcallosal-interforniceal or translongitudinal fissure, transubfrontal methods Results Twenty-one cases of hypothalamic gliomas were verified by surgery and pathology The total and subtotal removal was 18 cases Partial removal was 3 cases There was no mortality in this series Major neurological complications included diabetes insipidus, electrolyte disorder and hyperthermia Surgical complications included subdural fluid collections, hydrocephalus, epilepsy Seventeen cases were followed up, and showed satisfying results Conclusion Microsurgical operations through appropriate approaches and reasonable management of complications are important methods for improving the outcome of hypothalamic gliomas in children

Purpose:To study the methods of treatment of spinalcord implanation medulloblatoma with combined chemotherapy. Methods:Teniposide (VM 26) 100 mg/day (dissolving in 250 ml physiological saline(N.S.)) was injected intravenously in 3 consecutive days. And it was repeated after a 7 day interval, and bleomycin A 5(PYM) 4 mg (in 250 ml N.S.) was intravenously injected twice a week. Methotrexate (MTX) 10 mg (in 5 ml N.S.) and dexamethsone 3 mg were injected intrathically once a week. The whole treatment included 5 courses and lasted about one and half month.Results:The study involved 6 cases. MRI, whick were performed 2 weeks after the treatment, showed tumors disappeared in 2 cases and 80% shrunk in 4 cases. The tumors completely disappeared after repeated treatments in the 4 cases. Conclusions:Combined chemotherapy is an efficient alternative treatment for spinalcord implanation medulloblatoma.

Nervous system develops from multipotential stem cells of the embryonic neural tube.The discovery of cells of stem-like properties in the adult central nervous system(CNS)has provoked an intense search for ways to utilize their potential for treatments of multiple neurological disorders.Expansion and recruitment of endogenous progenitors may be limited in treating widespread cell loss in the adult CNS.Transplantation of neural stem cells(NSCs)or more restricted progenitors to replace cells lost to injury or disease may facilitate functional recovery in a spectrum of neurological disorders.A major challenge to the development of effective NSCs therapies is to direct the fate of the newly generated cells to specifically replace those lost to disease.The key to the effective treatment of NSCs is molecular regulation of the differentiation of NSCs and their progeny in areas of injury to the adult CNS,the fate of transplanted stem cells is also important.

Objective To study the effect of catgut implantation at acupoint on insulin resistance of simple obesity.Methods All patients were separated into the treatment group(catgut implantation group)and the control group(acupuncture group)with 30 cases in each group.Acupoints of zhongwan,tianshu,qihai,shangjuxu,were selected and needled for 3 months.Such indexes as body weight,waistline,hip circumference,body mass index(BMI),fasting blood glucose(FBG),insulin and insulin resistance(IR) before and after treatment were observed.Results Both groups showed obvious anti-obesity effect to simple obesity,manifested by significant differences(P＜0.05)at the indexes of body weight,waistline BMI and appetite before and after treatment.Self-comparison in each group showed such indexes as BFS,insulin and IR were significantly decreased after treatment than those before treatment (P＜0.05)There was no significant difference at the above-mentioned indexes between the two groups(P＞0.05).Conclusions Catgut implantation at acupoint can reduce fat for simple obesity patients by controlling the level of fasting blood sugar,fasting blood insulin and IR in patients.

AIM: To study the subtype of metabotropic glutamate receptors (mGluRs) which induce contralateral rotations of rats after mGluRs activation. METHODS: Turning movement was measured at 6 h after agonist or antagonist of mGluRs was microinjected into rat striatum. RESULTS: tACPD, an agonist of mGluRs, at 500 nmol and 1 000 nmol induced contralateral rotations of rats. L-AP 3, MCPG and dantrolene attenuated the turning effect of tACPD. DHPG, a selective agonist of group I mGluRs, mimicked the effect of tACPD. The effect of DHPG was blocked by MCPG, LY367385 (antagonist of mGluR 1) and MPEP (antagonist of mGluR 5), and abolished by pretreatment with reserpine (5 mg/kg). CONCLUSION: These results indicated the activation of group I mGluRs in rat striatum induced turning effect, which may be associated with the mobilization of intracellular Ca 2+ stores and dependant on the existence of dopamine.

BACKGROUND:Finding of neural stem cells(NSCs)brings new hope for repairing central nervous system(CNS)injury.However,the influence of internal environment after brain injury on the survival and differentiation of NSCs is a complexand variable process.OBJECTIVE:To observe the survival and differentiation of human embryonic NSCs following implantation into rats with fluid percussion brain injury.DESIGN:Open experiment.SETTING:Department of Neurosurgery,Guangdong Provincial Hospital of Traditional Chinese Medicine;Beijing Institute of Neurosurgery.MATERIALS:This experiment was carried out In the Laboratory of Neural Stem Cells,Beijing Institute of Neurosurgery from September 2002 to March 2003.Twenty-four female SD rats,aged 7 weeks,with body mass of(250±10)g,were provided by the Experimental Animal lnstitute, Chinese Academy of Medical Sciences[License Nd. SCXK(Jing)2002-2003]. Cerebrum of 8-week aborted fetus was obtained (Informed consents were obtained from parturients and their relatives). Fetal survival was monitored by B ultrasonic wave during abortion. BrdU monoclonal antibody(Sigma Company),rabbit anti-nidogen polyclonal antibody(Chemicon Company),mouse anti-microtubule-associated protein 2 (MAP-2)monoclonal antibody(Neomarkers Company),rabbit anti-gliaI fibrillary acidic protein(GFAP)polyclonal antibody (Biogenex Company).METHODS:① CerebraI cortex cells of 8-week aborted human fetus was harvested and cultured in vitro for obtaining human embryronic NSCs.②Rat models of hydraulic impact injury were developed.Bone window of motor sensory area of cerebral cortex was set at 2.5mm posterior to bregma which was zero point and 3.0 mm lateral to midline.Hydraulic impact injury parameters were set as impact pressure 0.3 MPa. impact time 25 ms and impact time once. ③BrdU-labeled human embryronic NSCs were implanted into injured area al 24 hours after injury.After 1 and 4 weeks.rats were sacrificed.Adjacent sections were doubly stained bv BrdU/MAP-2 and BrdU/GFAP.MAIN OUTCOME MEASURES:①Survival and immigration of implanted human embryonic NSCs.②Differentiation of implanted human embryonic NSCs.RESULTS:①BrdU-positive cells were oval and brown.At 1 and 4 weeks after implantation,BrdU-positive cells survived and migrated,and they migrated more widely at 4 weeks after implantation. ②At 1 week after implantation,more BrdU-positive cells were found in the subcortical granular layer and subcortex,and BrdU/MAP-2-positive cells were more than BrdU/GFAP-positive cells;At 4 weeks after implantation,BrdU-positive cells were significantly reduced,and found in choroid plexus and blood capillary,and BrdU/GFAP-positive cells were more than BrdU/MAP-2-positive cells.CONCLUSION:Implanted human embryonic NSCs can survive in the region of brain injury.gradually differentiate into astrocytes during rehabilitation and are easily digested by endothelial phagocytes.It indicates that immunological rejaction possibly influences the survival of human embryonic NSCs.

Objective To understand laboratory diagnosis and clinical characteristics of human immunodeficiency virus (HIV ) infection and AIDS patients in three comprehensive hospitals .Methods Laboratory diagnosis and clinical characteristics dates of people living with HIV/AIDS patients consulted in Chongqing Emergency Medical Center between 2007 to 2013 were retrospective‐ly analyzed .Results Totally 47 355 cases were carried HIV antibody screening during 7 years ,179 cases of HIV antibody were positive in preliminary screening ,171 cases were confirmed as positive .Among 5 cases of HIV antibodies result unconfirmed ,2 ca‐ses were followed up ,1 case was ruled out HIV infection ,1 case was converted to HIV antibody positive .People living with HIV al‐ways merging double or multiple infection with hepatitis b virus (HBV) ,hepatitis c virus (HCV) and treponema pallidum (TP) and so on .People living with HIV aged from 18 to 86 years old ,9 .36% was over 60 years old .Most patient has two or more clinical manifestations when consulted a doctor .Conclusion There were false‐positive of HIV antibody preliminary screening ,HIV anti‐body positive results must be confirmed by Western blot confirmatory test .Uncertainty of HIV antibody results should be judged by regularly follow‐up or combining with other detection methods ,epidemiological data .Routine HIV antibody screening should be adopt for HBV ,HCV and TP infection .Elder patients should not be ignored .Clinical specificity of HIV/AIDS is not strong ,it is need to be valued and identified from other cause similar symptoms of diseases caused by phase identification ,in order to reduce missed diagnosis and misdiagnosis .