Objective To investigate the etiology and clinical features of transient global amnesia.Methods Seven patients diagnosed as transient global amnesia were analyzed by EEG,TCD,MRI or CT examination,five pa- tients analyzed by single photon emission computed tomography(SPECT).EEG and TCD examination were done within 24 hours during the attack.And SPECT,MRI or CT examination were done within 1 week during the at- tack.Results Six patients showed normal EEG,one patient showed a few slow waves;seven patients showed verte- brobasilar ischemia in TCD;six patients showed normal but one patient showed lacunar infarction in brain CT or MRI;five patients showed significant hypoperfusion in different encephalic region in brain SPECT.They were all fol- lowed up for three to tewty-four months respectively,six patients had no recurrence,but one patient recurred one time and the SPECT demonstrated a decreased cerebral blood flow in the left temporal lobe.Conclusion Transient global amnesia patients showed cerebral ischemia.Transient global amnesia may be related to the decrease of rCBF in the temporal lobe or the temporal hippocampus.

Objective To investigate the mechanisms of inhibitory effect of Erlotinib,an epidermal growth factor(VEGF) receptor inhibitor,on angiogenesis of pancreatic carncer.Methods①In a tube formation assay,Erlotinib(100?mol/L) was applied to the culture media and compared to the serum free media.The expression of vascular endothelial growth factor(VEGF) in BxPC-3 cells treated with Erlo- tinib at different concentrations(5,50,100,200?mol/L) was determined by RT-PCR.②The xeno grafts derived from BxPC 3 cancer cells were inoculated into the BALB/C nude mice.The mice were treated with either Erlotinib(100 mg/kg of Erlotinib oral lavage daily) or saline for four weeks.The vol- ume of the xenografts was measured and the tumor growth rate was calculated.The microvessel density (MVD) of tumor tissue was determined by immunohistochemistry with an antibody against factorⅧ. Results There were less endothelium cells and close hollow tubular structures in grlotinib treated group compared to the control group in the tube formation assay.The mean weight of xenografts in Erlotinib treated group[(0.397?0.550)g] was significantly lower than that in the control group[(1.570?1.060)g] with a inhibitary rate of 74.5%.The expression of VEGF mRNA in Ertotinib treated groups (=50?mol/L) were decreased comparing to the control group.The VEGF expression in xeno- grafts tumor tissues was also markedly down-regulated.The MVI) was significantly decreased in Erlotinib treated group( 1.86?0.43)than that in the control group (5.98?1.27,P

Objective To evaluate the value of volumetric brain MRI in multiple system atrophy.Methods Eleven patients diagnosed as multiple system atrophy were recruited,includin 5 parkinsonism dominant(MSA-P)and 6 cerebellar dominant(MSA-C).9 patients with parkinsonism of other types and 6 healthy persons were set as case control and healthy control,respectively.T1 weighted (T1W)sagittal and axial images and T2-weighted(T2W)axial images were obtained from all patients and controls at 3.0T scanner.Diameters of the brain structures were measured infratentorially(brainstem, middle cerebellar peduncles(MCP),dentate and red neelus)and supratentorially(globns pallidus and putamen).Results The transverse diameter of the pons was significantly smaller in MSA patients than in the case and healthy controls((27.6?2.0)mm and(30.5?0.6)mm and(29.9?1.1)mm).The significance could be seen when comparing MSA-C and MSA-P with healthy control.The anteroposterior diameter of the fourth ventricle was significantly dilated in MSA patients than in healthy control((11.9? 2.8)mm and(9.0?2.1)mm).The MRI of MSA-C showed narrower MCP((13.3?1.9)mm and (15.8?1.2)mm and larger fourth ventricle((17.3?2.1)mm and(12.6?2.7)mm)than that of MSA-P.The MRI of MSA-P showed smaller globus pallidus and red neclei.Conclusions The volumetric MRI is a useful means in evaluating the brain structure atrophy in multiple system atrophy.The transverse diameter of the pans,though objectively reflecting the atrophy of the pons,can' t be used to differentiate MSA-P from MSA-C.The atrophy of MCP and the dilated fourth ventricle are common in MSA-C,while the atrophy of red neclei is common in MSA-P.

OBJECTIVETo explore lupus nephritis (LN) patients' monocyte chemotactic protein 1 (MCP-1) and urinary IP-10 (ulP-10) levels, the correlation between each clinical activity index and rheumatism syndrome, thereby proving objective evidence for microscopic typing of rheumatism syndrome.

METHODSTotally 60 LN patients were assigned to the rheumatism group (31 cases) and the non-rheumatism group (29 cases). Besides, 20 healthy volunteers were recruited as the normal control group. Clinical data and renal pathology were collected, and urinary levels of MCP-1 and IP-10 detected by ELISA. The correlation between rheumatism syndrome and each activity index as well as manifestations of clinical activities was comprehensively analyzed. Results (1) Patients in the rheumatism group were more liable to occur fever, serositis, edema, and hypertension (P<0.05). (2) Compared with the non-rheumatism group, patients in the rheumatism group exhibited much higher levels of 24 h protein quantification and blood urea nitrogen, higher levels of uMCP-1 and ulP-10. Microscopic hematuria, anti-ds-DNA, anti-Sm, the positive rate of AnuA, scores of SLEDAI and BILAG were higher in the rheumatism group than in the non-rheumatism group (P<0.05). Levels of plasma albumin and complement C3 were lower in the rheumatism group than in the non-rheumatism group (P<0.05). (3) The average activity index (AI) of the renal pathology was higher in the rheumatism group than in the non-rheumatism group. The most frequent pathological type of rheumatism group was type IV of LN.

CONCLUSIONSMore severe renal damage and immune abnormality occurred in LN patients of rheumatism syndrome. Rheumatism syndrome is closely correlated to clinical activity indices.

Biomedical Research ; Chemokine CCL2 ; metabolism ; Complement C3 ; metabolism ; Hematuria ; Humans ; Kidney ; Lupus Nephritis ; epidemiology ; metabolism ; Rheumatic Diseases ; epidemiology ; metabolism

Objective:To explore the efficacy and safety of endoscopic esophageal varix ligation (EVL) combined with omeprazole and octreotide in the treatment of esophageal variceal bleeding.Methods:127 patients with cirrhosis complicated with esophageal variceal hemorrhage diagnosed and treated in our hospital from May 2014 to May 2016 were divided into the study group and the control group.The control group was treated with omeprazole and octreotide on the basis of conventional therapy,while the study group was treated with endoscopic esophageal variceal ligation (EVL) on the basis of control group.The clinical efficacy,hospitalization condition,incidence of adverse reactions and rebleeding rate after treatment of the two groups were analyzed.Results:All the patients in the study group were successfully operated.In the control group,10 patients showed hematemesis and melena,among which 1 patient wastreated with surgery.After treatment,the c lini cal effi cacy of the study group was superi or to the control group,and the di fference was stati sti cally significant (P＜0.05).During the treatment period,the hemostasis time,blood transfusion time,hospital stay and hospitalization expenses of the study gronp were significantly lower than those of the control group (P＜0.05).In the study group and the control group,10 cases and 7 cases respectively had nausea and vomiting,esophageal foreign body sensation,dizziness,palpitations,pain,bloating,increased facces frequency,fever and other adverse reactions,and the incidence of increased faeces frequency of control group was significantly higher than that of the study group (P＜0.05),but the incidence of other adverse reactions and the total incidence showed no significant difference between two groups (P＞0.05).The rate of rebl eeding was si gni fi cantly lower in the study group at 0.5,1,3,6 and 12 months after treatment than those in the control group(P＜0.05).Conclusion:Endoscopic ligation combined with omeprazole and octreotide was effective in the treatment of esophageal variceal bleeding,which could be effective,rapid hemostasis,reduce the hospital stay,hospitalization cost and rebleeding rate with high safety.

Objective To compare the clinical eficiency of gemcitabine plus oxliplatin and gemeitabine alone for advanced pancreatic cancer.Methods The histologic or cytologic confirmed 60 cases of pancreatic cancer were randomly divided into control Gemcitabine plus oxaliplatin group(GEMOX)with gemcitabine alone group(GEM)treatment,each 30 Cases.Results 54 patients were enrolled.The general remission rates(CR+PR)were 68.0 % in GEMOX group and 37.9 %in GEM group respectively.There was significant statistical diference between two group(P

Objective To explore status quo of Shanghai community health services based on the investigation of rural community doctors in Shanghai suburb,and to propose measures on training rural doctors. Methods Retrospective investigation was carried out in 114 rural community health service centers and 1 563 clinics.Primary investigation included the registration,distribution,age,academic titles and education background. Results The results showed insufficient number of human resources and inadequate investment in human capitals in the primary medical services of Shanghai suburbs,and there was a serious shortage of general practitioners.The other problems included older age,insufficient academic qualifications,and without professional titles. Conclusion We should improve the status and treatment of rural doctors.Job training and well-trained professional students should be encouraged for the primary health services.More and more doctors should be attracted to work in community health service centers.General practitioners' personnal information network and general medical training network should be established,and the general medical education system gets improvement.

Objective To develop the Occupational Embeddedness Scale for Nurses and test its re liability and validity.Methods The original scale was designed according to document analysis,openlabel questionnaire and interview results.After 3 sampling tests,the first predicted sample (n=368) was conducted with item analysis and exploratory factor analysis (EFA),the second predicted sample (n=306) was conducted with EFA,and then the formal tested sample (n=372) was conducted with confirmatory factor analysis (CFA).Another sample of 55 nurses was tested and retested two weeks later.The intestine emendatory Turnover Intention Scale was used to test its criterion validity.Results The final scale had 18 items and 3 dimensions,including fit,link and Sacrifice.Occupational Embeddedness Scale revealed good model fit indices (x2/df =2.563,RMR=0.048,TLI=0.914,CFI=0.925).The total scores was negatively correlated with the Turnover Intention Scale scores.The Cronbach's α coefficients of the whole scale was 0.917,and range 0.800～0.834 for each dimension.The test-retest reliability was 0.890,and ranged 0.732～0.873 for each dimension.Conclusions It suggests that the Occupational Embeddedness Scale for Nursing has good reliability and validity,and can be used to assess the occupational embeddedness status of nursing in China.

Health management plays an important role in the control of medical costs and in maintaining people' s health.Since the beginning of health management performance in our country,the major problems were:inadequacy of govement's support;imperfect laws;irregular marketing operation;lack of feasible health management model;controversy over long-term economic benefits;lack of awareness on health in common people and so on.To solve these problems,it is necessary to strengthen government support,and enhance people's health awareness,and explore the health management model consistent with the actual situation in China.

Objective To analyze the operative effect of fracture of ulna coronoid process and evalu- ate the repairing effect of reconstruction of combined injury of ligamental structure or radius head.Methods During 2001 to 2004,16 cases(14 males and 2 females)of fractures of ulna coronoid process,aged 18-54 years(mean 36.6 years),were treated operatively in our department.Routine medial approach on the elbow or anterior trance-joint approach was used.Once reduction was achieved,screws or Kirschner wires were used to fix the fracture and the capsule was repaired at the same time.If there was combined fracture of the radius head or rupture of the collateral ligament,simultaneous repair or resection was applied.Functional exercise was requested in all patients.Results The follow-up was 8 to 24 months.Fracture union needed 4 to 6 weeks. Average Mayo elbow score was 80.Conclusion Ulna coronoid process fractures need active therapy. The radius head should be reserved as complete as possible during treatment.It is necessary to work out a standard management plan,and a notice should be taken to ligamental structure examination.