Migraine is a common neurovascular disease in clinical practice,its pathogenesis is both involved in the nervous system and vascular system.Many researchers believe that there are complex relationships between migraine and ischemic stroke.This article reviews the advances in this field in recent years.

Objective To explore the role of PI3K/AKT signaling pathway in total hepatic ischemia-reperfusion(I/R)-induced lung injury in rats.Methods This study was divided into 2 sub-projects.(1)36 rats were killed respectively at preischemia and after reperfusion,the lung tissue was then sampled.(2)12 rats were randomly divided into Wortmannin group and model control group. AKT,p-AKT protein expression,apoptotic cells and PCNA protein expression were tested respectively by Western blot,TUNEL and immunohistochemistry analysis.Results(1)Compared with that in preiscemia group,after I/R the apoptotic index (AI)was increased,the p-AKT/AKT ratio and PCNA-positive index showed bidirectional changes,and the histological changes were well identified.(2)p-AKT/AKT ratio showed a positive correlation with PCNA-positive index and a negative correlation with AI.(3)Compared with control group,the p-AKT/AKT ratio and PCNA-positive index were lower,histological changes was more significant and AI was higher in Wortmannin group. Conclusion PI3K/AKT signaling pathway had protective effect on lung injury induced by hepatic I/R,which was potentially mediated by anti-apoptosis and promoting proliferation.

Objective To establish a statistical model that can quantitatively analyze the dosimetric sparing of the bladder based on individual patient’ s anatomy in the static intensity-modulated radiotherapy (IMRT) plans for rectal cancer.Methods Static IMRT plans (7 AP fields) for 100 rectal cancer patients were used to train the model from 2012 to 2013.The anatomical features were quantitatively analyzed by the sizes of overlap regions of bladder-planning target volume (PTV) and bladder-PTV+0.5(0.5 cm margin around the PTV) .The mathematic relationship between anatomical features and dosimetric sparing of the bladder was evaluated after the bladder sparing dose was analyzed using dose-volume histogram.The established model was verified in the IMRT plans for additional 20 rectal cancer patients.Results Bladder V50 was linearly correlated with the ratio of bladder-PTV overlap size to bladder volume ( denoted as x%) , with an equation of V50=0.89x-0.99.Bladder V40 showed an approximately linear correlation with the ratio of bladder-PTV+0.5 overlap size to bladder volume (denoted as y%).The mean dose depended on both x%and y%.For the additional 20 plans, the absolute deviation between predicted and actual values for V50 and V40 were (-3.13%-3.78%) and (-5.30%-5.66%) , respectively, and the relative deviation for the mean dose was (-3.94%-3.76%) .Conclusions The model obtained in this work provides an effective method for quantitatively estimating the bladder sparing dose in IMRT plans for rectal cancer.

Objective:To explore the approaches and ideas for the pharmaceutical care performed by clinical pharmacists for the patients with bone tuberculosis and tubercular meningitis. Methods:Pharmacists participated in the clinical consultation for one patient with bone tuberculosis and tubercular meningitis. The methods and effect of clinical pharmacists were analyzed comprehensively in re-spect of the adjustment of anti-tuberculosis treatment scheme according to the disease condition, attention pald to the adverse reactions of anti-tuberculosis drugs, medical education for the patient and so on. Results: During the treatment, clinical pharmacists did have some actions to assist doctors in rational drug use, and the suggestions of clinical pharmacists in the consultation obtalned clinical rec-ognition, which significantly improved the effect of the medication. Conclusion:Clinical pharmacists can perform individual pharma-ceutical care for patients and help clinicians optimize drug therapy, which can improve the safety and efficacy of medication.

Through the system of medicine centralized bidding and purchasing, it intends to solve the problems of high medicine price and drug rebate; however, it failed which was against the willing. It requires exploding regardless hospital regulation system and the current drug production and circulation system to finally stop the high medicine price and drug debate.

Objective:To explore total hepatic ischemia-reperfusion(I/R)-induced lung injury in rats,its related mechanism and the protective effects of melatonin on lungs.Methods: This study was divided into 2 parts.In the first part,72 healthy male SD rats weighing 250-300 g were randomly divided into 2 groups: I/R group(ischemia-reperfusion,n=36) and sham-operation group(n=36).Total hepatic I/R was produced by occlusion of hepatic helium for 30 minutes,and the occlusion was then released for reperfusion.The animals were killed at 5 minutes prior to ischemia and 0 h,0.5 h,1 h,3 h and 6 h after reperfusion in sham-operation group and I/R group(n=6 at each time point),and the lung tissue was taken.Through comparisons of these two groups,we observed the dynamic changes of lung tissue after total hepatic I/R.In the second part,12 healthy male SD rats weighing 250-300 g were randomly divided into 2 groups: melatonin group(n=6) and vehicle group(n=6).Melatonin(0.5%,10 mg/kg)or vehicle of the same volume was injected via femoral vein 15 min before ischemia and 10 min before reperfusion,the animals were killed at 1 h after reperfusion,and the lung tissue was taken.Through comparisons of these two groups,we observed the effects of melatonin.Results:(1)Total hepatic I/R led to severe histological injury in lungs.Compared with those in sham-operation group,the MDA content and apoptotic index were increased,the SOD activity was decreased,the p-ERK/ERK ratio and PCNA-positive index were decreased respectively 0 h and 0.5 h after reperfusion,and then were increased gra-dually.Histological examination revealed that the alveolar architecture was destroyed with interstitial thickening and neutrophil infiltration in I/R group.Correlate analysis revealed that p-ERK/ERK ratio showed a positive correlation with PCNA-positive index(r=0.56,P

Objective To evaluate the outcome and safety of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) in the management of esophageal mucosal lesion.Methods The clinical data of 70 patients with esophageal mucosal lesion were analyzed.Twenty-five patients were treated by ESD (ESD group) and 45 patients were treated by EMR (EMR group).The enbloc resection rate,tissue healing resection rate,operation time,complication and recurrence rate were compared between two groups.Results The enbloc resection rate,tissue healing resection rate in ESD group were significantly higher than those in EMR group [60.0％(15/25) vs.48.9％(22/45),48.0％(12/25) vs.40.0％ (18/45)] (P ＜0.05).The local recurrence rate in ESD group was lower than that in EMR group [4.0％ (1/25) vs.20.0％ (9/45)] (P ＜ 0.05).The severe complication such as delayed hemorrhage,perforation,stenosis between two groups had no significant difference (P ＞ 0.05).The operation time in ESD group was (64.3 ±27.1) min,and significantly longer than that in EMR group [(27.6 ± 14.1) min] (P ＜0.05).Conclusions Compare with EMR,ESD has better enbloc resection rate,tissue healing resection rate,and lower recurrence rate.It is more safe and effective in the therapy of esophageal mucosal disease.

Objective To observe the effects of progesterone on the mRNA and protein expressions of nerve growth factor(NGF) and brain-derived neurotrophic factor(BDNF) in the focal cerebral ischemia-reperfused rats,and to explore its mechanism of brain protection. Methods Totally 96 healthy male SD rats were randomly divided into sham surgery group,ischemic reperfusion group,vehicle-treated group and progesterone-treated group (n=24 for each).The model of focal brain ischemia-reperfusion injury was induced by middle cerebral artery occlusion (MCAO).After 2 h temporary MCAO,rats were subjected to reperfusion for 3 h,6 h,12 h and 24 h,respectively.The mRNA and protein expressions of NGF and BDNF were analyzed by real time-PCR and Western blot,respectively. Results In the injured cortex,the mRNA and protein expressions of NGF and BDNF in ischemic reperfusion group came to the peak at 6 h after reperfusion,and then gradually declined to the level of sham operation group at 24 h after reperfusion.In progesterone treatment group,BDNF and NGF mRNA and protein expressions reach the peak at 12 h after reperfusion,and were still higher at 24 h after reperfusion than in ischemic reperfusion group(P＜0.05). Conclusions Progesterone plays a protective role in focal cerebral ischemia-reperfusion by increasing the expressions of BDNF and NGF in rats.

Background and purpose: Recent literature has high lighted an important role of inflammation in promoting cancer. CRP (C reactive protein) is a way of building the bridge between inflammation and cancer. We aimed to explore correlations between CRP levels and clinical stages of nasopharyngeal carcinoma(NPC). Methods: We analyzed 108 cases, among which 68 cases were NPC, 20 cases were benign inflammatory diseases of nasopharynx, and another 20 were healthy volunteers as control. We detected the level of CRP using immunoturbidimetry (ITM), q test was calculated by SPSS. Results: The mean concentrations of CRP in NPC[(19.8±4.7) mg/L] were significantly increased compared to those in the control group[(6.2±1.8) mg/L], while they were significantly lower than those in benign inflammatory group[(45.6±7.9) mg/L]. In NPC, The mean concentrations of CRP in T4[(25.6±3.9) mg/L] were higher than those in T1[(17.4±5.8) mg/L], T2[(18.6±8.5) mg/L] and T3[(15.6±1.8) mg/L] respectively. The mean concentrations of CRP in N3[(28.0±7.1) mg/L] were higher than those in N0[(17.6±6.8) mg/L], N1[(21.3±5.1) mg/L] and N2[(18.6±5.6) mg/L] respectively. The mean concentrations of CRP in 1V[(25.7±5.5) mg/L] were higher than those in Ⅰ[(14.2±1.9) mg/L], Ⅱ[(16.1±3.9) mg/L] and Ⅲ[(23.0±7.7) mg/L] respectively (P<0.05). There were no statistic differences between the other groups. Conclusion: The serum CRP level is associated with the occurrence of NPC and benign inflammatory disease of nasopharynx. In NPC, the higher the CRP level is, the more advanced the TNM stage will be.