Objective To quantitatively evaluate relative contribution of medical history,physical examination and laboratory investigation to diagnoses for medical outpatients.Methods In total,145 medical visitors to the outpatient department of Peking Union Medical College Hospital (PUMCH) during October 10 to 16,2008 were recruited and followed-up for 12 months.Results Nineteen of 145 visitors (13.1%) were lost during the period of follow-up and diagnoses were established for 86 of them (68.3%)finally with medical history and for 20 (15.9%) with physical examination or laboratory investigation,respectively.Confidence index of internists in their correct diagnosis increased to 7.3 with medical history and to 7.9 and 8.7 with physical examination and laboratory investigation in average,respectively.Conclusions Most visitors to internal medicine department could be diagnosed correctly with medical history only.On the basis of physical diagnosis,selection of adequate laboratory investigation for them is critical to improvement of clinical diagnosis.

Objective To study the effect and mechanism of taspine on wound healing and fibroblast proliferation. Methods The effect of taspine on skin wound was observed in vivo. The different concentration of taspine hydrochloride was added to L929 fibroblast cultivated in vitro, and lactate dehydrogenase was detected and MTT method was applied to observe effect of taspine on fibroblast proliferation. Results The local application of taspine 3 mg/Ml and 1.5 mg/mL accelerated the healing of skin wounded. In vitro, 0.01～0.5 μg/mL of taspine hydrochloride showed no effect on the change of lactate dehydrogenase activity and fibroblast proliferation. Conclusion Taspine is a kind of active alkaloid from leontice robustum which can enhance wound healing, its mechanism on wound healing is not by means of accelerating the proliferation of fibroblast, other mechanisms are necessary for being further studied.

Poly-?-hydroxybutyric acid (PHB) produ c ing strain NS-82# which was isolated from the soil was identified to be Bacillus sp.The purified sample from fermentation was similar to t he standard sample produced by Aldric Chemical Company Inc after determinated wi th ultraviolet absorption,IR-absorption,gas chromatographiyc and nuclea r magnetic resonance analysis of polyesters.

AIM: To investigate the effect of puerarin on diabetic myocardial damage and to explore its possible mechanisms in rats. METHODS: The male Sprague-Dawley rats were randomly divided into normal control group, diabetic group, high dose puerarin (160 mg/kg), middle dose puerarin (120 mg/kg), low dose puerarin (80 mg/kg) treatment groups and aminoguanidine (100 mg/kg) treatment group. Corresponding drugs were intraperitoneally injected once a day. The animals in normal control group and diabetic group were given equal propylene glycol. 12 weeks later, the rats were sacrificed and their cardiac muscles were collected. Myocardial structure was observed under transmission electron microscope (TEM). The blood glucose concentration and the activities of superoxide dismutase (SOD), Ca~(2+)-ATPase, Na~+-K~+-ATPase and the content of malondialdehyde (MDA) in myocardial homogenate were measured biochemically. In addition, the mRNA expressions of peroxisome proliferator activated receptor γ (PPAR-γ), glucose transporter-4 (GLUT-4) and aldose reductase (AR) in myocardial tissues were determined by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: It is observed that the myofibrils were diminished, broken or fused, some lipid droplets deposited in the cytoplasm of cardiocytes and part of cristae of mitochondria were broken or disappeared under TEM in diabetic group. The activities of SOD, Ca~(2+)-ATPase, Na~+-K~+-ATPase as well as the mRNA expressions of PPAR-γ and GLUT-4 decreased significantly (all P<0.01). The blood glucose concentration and the MDA level and the AR mRNA expression increased obviously (all P<0.01) in diabetic group as compared to those in normal control group. How-ever, in puerarin treatment groups, the above changes were reversed, a significant differences of those were found as compared to those in diabetic group (P<0.05 or P<0.01, respectively). The pathological change of cardiac muscles was relieved. It showed that myofibrils were well-arranged and only few lipid droplets deposited in the cytoplasm of cardiocytes and most mitochondria had clear and regular cristae under TEM in puerarin treatment groups. CONCLUSION: Puerarin exerts preventive and remedial effects on the diabetic myocardium, which may be related to up-regulating the mRNA expressions of PPAR-γ and GLUT-4, promoting glucose uptake and relieving oxidative stress damage.

Objective To study the treatment of neonate-infants after open-heart surgery during perioperafive period.Methods The clinical data of 1619 neonate-infants during perioperative period were analyzed.Results 68 cases died,mortality 4.2%.Postoperative complication 190 cases(11.7%).Conclusion The management of components and quantities of the infusion,admistration of cardiovascular drugs,the management of respiratory tracts and the protection of heart function,ale main points of perioperafive therapy of neonate-infants after open-heart surgery.

Objective To evaluate diagnostic accuracy based on patient history and physical examinations in medical outpatients.Methods Totally, 145 consecutive patients visiting general internal medicine clinic at a university-affiliated teaching hospital during October 10 to 17, 2008 were recruited into the study and followed-up for 12 months.Results Eighteen of 145 patients ( 12.4% ) were lost to followup.Diagnosis was confirmed by follow-up for 45 ( 35.4% ) of those with medically unexplained symptoms (MUS).Sensitivity of physical diagnosis for those with MUS was 82.2 percent, with specificity of 95.1 percent, likelihood ratios of positive and negative results of 16.9 percent and 0.19 percent, its positive and negative prediction values of 90.2 percent and 90.7 percent, and overall accuracy of 90.6 percent,respectively.Conclusions MUS was common in medical clinical practice.Preliminary diagnosis for MUS based on patient history and physical examinations has been proved remarkably reliable.Carefully selected auxiliary laboratory evaluation combined with physical diagnosis is important for management of MUS.

Adolescent ; Child, Preschool ; Female ; Humans ; Lymphangiectasis, Intestinal ; Male

BACKGROUND: Total flavone of ginkgo biloba(TFG) can affect on free radical, but the effect on apoptosis induced by cerebral ischemia is unclear.OBJECTIVE: To study the inhibitory effect of TFG on apoptosis induced by cerebral ischemia.DESIGN: Completely randomized controlled experimental study based on experimental animals.SETTING: Department of pharmacology in a university.MATERIALS: Totally 24 SD rats in half genders with clean grade and body mass of(250 ± 50) g, were divided into 4 groups at random: sham-operation group, model group, TFG 40 rmg/kg group and TFG 80 mg/kg group (Certificate No. 01).METHODS: This study was completed in the Department of Pharmacology,Anhui Medical University during October 2001 and January 2002. Incomplete cerebral ischemia was made by ligating bilateral common carotid arteries(CCA) in rats. The cerebral injury was evaluated by brain edema. The apoptosis was determined by terminal deoxy-nucleotidyl transforase-mediated dUTP-digoxigenin nick end-labeling(TUNEL) and transmission electron microscopy (TEM) method. The DNA fragmentation analysis was measured with the diphenylamine reagent method.MAIN OUTCOME MEASURES: Major factor: Effect of TFG on ultrastructral alteration of apoptotic cerebral cortex cells; Secondary factor: Effect of TFG on DNA fragmentation induced by cerebral ischemia.RESULTS: Ligating of bilateral CCA markedly induced apoptotic cell in cerebral cortex. TFG 80 mg/kg significantly inhibited brain edema( P ＜ 0.05 )and decreased the numbers of apoptotic cells in cortex( P ＜ 0.01 ) and improved ultrastructral alteration of apoptotic cells; TFG 40, 80 rmg/kg also inhibited the increase of DNA fragmentation induced by cerebral ischemia (P ＜0.05, P ＜0.01).CONCLUSION: TFG has inhibitory effect on ischemia-induced apoptosis of cerebral cortex and improve the ultrastructual changes of apoptosis. Moreover,TFG can relieve the occurrence of edema of ischemic brain tissue and inhibit the increase of DNA section induced by cerebral ischemia.

Objective To observe the effects of Danqi Granules combined with Xianling Gubao Capsules on bone metabolism and bone mineral density (BMD) in patients with postmenopausal osteoporotic vertebral compression fractures (OVCF) after surgery. Methods 90 cases of postmenopausal women with OVCF were randomly divided into the control group and the observation group, 45 cases in each group. The two groups were treated by vertebroplasty (PVP), and after the surgery, the control group was treated with Xianling Gubao Capsules while the observation group was additionally given Danqi Granules. The serum markers of bone metabolism [(25 (OH) D, PINP, β-CTX] and BMD of L2-4 and left femoral neck were detected before and after treatment. Results The level of serum 25 (OH) D in the observation group after treatment was significantly higher while the levels of PINP and β-CTX were significantly lower than those in the control group (P<0.05), and the BMD of L2-4 and left femoral neck of the observation group were significantly higher than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Danqi Granules combined with Xianling Gubao Capsules can significantly accelerate fracture recovery, and improve bone mineral density in the treatment of postmenopausal women with OVCF.