Objective To evaluate the clinical efficacy of shuxuening injection in the adjuvant treatment of cerebral infarction (CI) and its clinical nursing. Methods A total of 114 patients with CI were randomly divided into two groups: The control group (n=57) were received conventional treatment and nursing, the observation group (n=57) were received shuxuening injection on the basis of control group. The efficacy and incidence of complications were compared between the two groups, the NIHSS and MMSE scores were evaluated before and after treatment. Results The total effective rate in the observation group was significantly higher than that in the control group (96.49％ vs 82.46％)( P<0.05), while the complication rate in the observation group was significantly lower than that in the control group(7.02％ vs 21.05％)( P<0.05). After treatment, the NIHSS score in the observation group was significantly lower than that in the control group, while the MMSE score was significantly higher than that in the control group(P<0.05). Conclusion Shuxuening injection is effective in the treatment of CI, which can reduce the complications, promote the rehabilitation of neurological function and protect the cognitive function, proper nursing intervention can promote the rehabilitation.

Objective To investigate the influence of Zafirlukast on the inflammatory factors and immune function of patients with seasonal allergic asthma.Methods 182 patients with seasonal allergic asthma from the department of respiratory in our hospital were selected and divided into two groups, 91 cases in each group.The control group treated with budesonide and formoterol fumarate powder for inhalation, the experiment group received Zafirlukast on the basis of the control group,serum levels of inflammatory cytokines,peripheral blood T lymphocyte subsets,serum immunoglobulin levels, lung function,and the clinical effect were compared after the treatment.Results Compared with the control group, serum levels of TNF-,IL-4,IL-6 were lower, level of IL-10 was higher in the experiment group after treatment, CD8 +T lymphocyte levels was lower, CD3 +, CD4 +T lymphocyte and CD4 +/CD8 +ratio levels were higher after treatment, serum levels of IgE, IgG, IgA were lower after treatment, levels of PEF,FEV1 ,FEV1/FVC were higher after treatment, the difference was statistically significant (P<0.05).The effective rate in the experiment group 94.51% was higher than the control group 81.32% (P<0.05).Conclusion Zafirlukast can significantly reduce the levels of serum inflammatory factors in patients with seasonal allergic asthma, improve the cellular immune function, reduce the level of immunoglobulin, effectively improve lung function, shorten the length of hospital stay, has better clinical curative effect.

0.05), respectively; 10 cases out of 12 cases performed SAMT and 26 cases out of 33 cases per- formed VATS were operated bullaectomy; the number of recurrence after operation was 2 in VATS and none in SAMT; the average operative cost was ￥ 806 ? 78 in SAMT and ￥ l808 + 447 in VATS(t = 7 .6,P

Objective To explore the application of video-assisted thoracic surgery (VATS) in the diagnosis and treatment of mediastinal tumors. Methods Thirty-four patients with mediastinal tumors underwent VATS from June 1995 to December 2002. The patients comprised 9 men and 25 women, with a mean age 43 9 years (16～74 years). Entered into the study there were 14 cases of thymoma (9 benign thymomas and 5 malignant), 6 cases of neurogenic benign tumors, 5 bronchogenic cysts, 4 teratomas, 2 pericardial cysts and 3 other conditions (metastatic carcinoma, lymphoma and hemangioma racemosum, respectively). Maximum diameter of the tumors ranged 3 5 cm to 6 cm, mean 4 5 cm. Operations were performed under general anesthesia, double lumen endotracheal tube placement and single lung ventilation. The patients were maintained in the lateral decubitus position. Camera port was placed at the sixth or the seventh intercostals space on the midaxillary line. Sites of the other two ports depended upon the location of the tumors. Results Out of the 34 patients with mediastinal tumors, 25 patients underwent tumor removal by VATS alone and 6 patients received VATS combined with mini-thoracotomy, while the remaining 3 patients only underwent biopsy by VATS. Postoperatively, all patients recovered uneventfully, without severe complications or mortality. Conclusions VATS is the first choice for benign mediastinal tumors, typically those in the middle and posterior mediastinum.

Objective To study the expression of CDK4 andβ-Catenin and their relevance in glioma. Methods We used immunohistochemistry to detect the expression of CDK4 andβ-Catenin in forty-five glio-ma tissues and eight normal tissues.According to the classification standard of WHO in 2000 classify and grade the tissues.Results There were significant differences of CDK4 andβ-Catenin expressions between normal tis-sues and glioma tissues(P<0.01).The expression of CDK4 and β-Catenin had positive correlation with the pathological grades of glioma and histological type and increased(P <0.05).Furthermore,the expression of CDK4 was positively correlated with the expression ofβ-Catenin in glioma(r=0.52,P<0.01).Conclusion The increased expression of CDK4 andβ-Catenin may have correlation with malignant change of glioma and oc-curance of glioblastoma,and their combination is expected to become an important indicator in assessing malignant glioma.

Introduction to the efforts made in Shanghai's clinical residency training.With joint efforts of both clinical training bases and community training bases, this approach integrates the instructional resources of medical schools, and hands-on training at community bases, in order to ease shortage of general practitioners, backup talents, and that of teachers.These efforts can effectively elevate competency of general practitioners.

Objective To investigate the association between chlamydia pneumoniae(Cpn)and atherosclerosis obliterans(ASO). Methods Sixty ASO patients and 40 healthy persons were selected,and their Cpn DNA expressions in venous blood determined by polymerase chain reaction(PCR). Results The ASO patients had significantly higher positive expression rate of Cpn DNA than that of healthy persons(78. 33% vs. 47.50% ,P ＜0.05). In all 60 cases the Cpn DNA expressions were positively correlated with the severity of ASO. Conclusions Cpn DNA expression closely relates with ASO severity,and it plays an important role in the ASO pathogenesis.

This study was aimed to discuss the influence of specific acupoint acupuncture therapy to the serum angiogenesis factor of high fat diet obese mouse models. Mice were randomly divided into the blank control group , acupuncture control group , model control group , and acupuncture treatment group . There were 6 mice in each group . Obese mouse models were induced after 15-week high fat diet . The specific acupoint acupunc-ture therapy was used as an intervention treatment method for 10 days . The enzyme-linked immunosorbent as-say (ELISA) was used in the detection of serum insulin, vascular endothelial growth factor (VEGF), soluble vascular endothelial growth factor receptor , leptin and the level of nitric oxide in mice . The results showed that the serum insulin , nitric oxide and leptin level in the obese mouse models were increased . However , there were no obvious changes on the vascular endothelial growth factor and soluble vascular endothelial growth fac-tor receptor level . The specific acupoint acupuncture therapy can obviously reduce the level of serum nitric ox-ide and leptin, and improve the content of vascular endothelial growth factor in obese mouse models. However, there were no influence on the level of blood glucose and soluble vascular endothelial growth factor receptor . It was concluded that the specific acupoint acupuncture therapy method had preferable antiobesity action . Its mechanism of action may be related to the regulation of angiogenesis .

Objective To study the feasibility of Video-assisted thoracoscopic thymectomy and the long term result of thoracoscopic thymectomy for myasthenia gravis. Methods 9 cases of thymus related disease were selected to undergo thymectomy though thoracoscopic approach from August 1996 to April 2001.Patients were followed up through outpatient service and telephone consultation. Results Of the 9 cases 2 cases were diagnosed as thymus cysts,1 cases thymoma,1 case malignant thymoma,1cases thymus carcinoma and 4 cases myasthenia gravis.Of the 4 cases of myasthenia gravis,3 cases were typeⅠ and 1 case was typeⅡb according to the modified Osserman classification.After thoracoscopic thymectomy 75% of patients had long-term good responses to surgery.The operation of one case of malignant thymoma was converted to lateral thoracotomy.One case of malignant thymoma with myasthenia gravis relapsed and reoperated through open thoracotomy . Conclusions video-assisted thoracoscopy can be usd to treat seleted thymic diseases .The results of video-assisted thoracoscopic thymectomy for mysthenia gravis is almost comparable with traditional open thoracotomy

Objective To observe the variation of phosphatidylinositol-3 kinase (PI3K),protein kinase B (AKT),sodium iodide symporter (NIS) mRNA and protein expression in rat mammary tissues and serum insulin growth factor Ⅰ (IGF-1) under different iodine nutrition levels,and to study the role of PI3K-AKT signaling pathway in the process of mammary gland intaking iodine during lactation period.Methods Totally 130 Wistar rats (100 female rats,30 male rats) were randomly divided into five groups with 20 female rats in each group:①control group (NI):was feed with normal diet and iodine content 50 μg/L in deionized water;②low iodine group 1 (LI1 group):was feed with low iodine diet and deionized water;③low iodine group 2 (LI2):was feed with low iodine diet and iodine content 5 μg/L in deionized water;④high iodine group 1 (HI1 group):was feed with normal diet and iodine content 3 000 μg/L in deionized water;⑤high iodine group 2 (HI2):was feed with normal diet and iodine content 10 000 μg/L in deionized water.After feeding for 3 months,females were mated with male rats,then male rats were taken out and every female rat was feed individually.Urinary iodine level of rats in lactation period 10 days after giving birth was tested.Blood and mammary tissue samples of rats in lactation period were taken after killing them.Enzyme linked immunosorbent assay (ELISA) was used to detect serum IGF-1 level,real-time fluorescence quantification PCR to detect the mRNA expression of mammary gland PI3K,AKT and NIS,Western blotting to detect mammary gland PI3K,total AKT,phosphorylation AKT (p-AKT) and NIS protein expression.Results The medians urinary iodine of lactation period rats in LI1 and LI2 (3.16,6.36 μg/L) were significantly lower than that in NI group (162.59 μg/L),and were significantly higher in HI1 and HI2 (2 356.27,11 507.29 μg/L) than that in NI group.The differences were statistically significant (all P ＜ 0.01).Compared with control group [(8.84 ± 2.12) μg/L],the content of serum IGF-1 increased significantly in lactation period rats in LI1 and LI2 groups [(13.30 ± 2.37) and (10.90 ± 1.92) μg/L,all P＜ 0.01].The real-time fluorescence quantification PCR detection results indicated that the differences were statistically significant by comparing NIS,AKT,PI3K mRNA expression of the mammary tissues of lactation period rats in the five groups (F=14.916,36.477,14.994,all P＜ 0.01).Among them,NIS mRNA expression quantities in LI1 and LI2 groups (0.75 ± 0.40,0.89 ± 0.51) were significantly higher than that in NI group (0.53 ± 0.31),and significantly lower in HI2 group (0.30 ± 0.24) than that in NI group (P ＜ 0.05 or ＜ 0.01).AKT mRNA expression quantities in LI1 and LI2 groups (0.90 ± 0.19,0.64 ± 0.22) were significantly higher than that in NI group (0.43 ± 0.22),and significantly lower in HI2 group (0.29 ± 0.15) than that in NI group (P ＜ 0.05 or ＜ 0.01).PI3K mRNA expression quantity in LI1 group (0.85 ± 0.42) was significantly higher than that in NI group (0.50 ± 0.24),and significantly lower in HI2 group (0.28 ± 0.10) than that in NI group (all P ＜ 0.01).Western blot detection results indicated that the differences were statistically significant by comparing mammary gland NIS protein expression of lactation period rats in the five groups (F=4.510,P＜ 0.01).Among them,LI1 group (1.67 ± 0.97) was significantly higher than NI group (0.87 ± 0.43,P ＜ 0.05).The differences were statistically significant by comparing the p-AKT protein expression among groups (F =3.528,P ＜ 0.05).Among them,HI2 group (1.10 ± 0.30) was significantly higher than NI group (0.75 ± 0.23,P ＜0.05).The differences were not statistically significant by comparing total AKT and PI3K protein expression among groups (F =0.558,1.319,all P ＞ 0.05).Conclusion The inhibitory effect of PI3K-AKT signaling pathways on NIS in the mammary gland was weaker than the effect of iodine intake.But the expression of functional p-AKT was gradually increased with the increment of iodine intake,which had been presented inhibit effect on NIS expression in lactating mammary gland.