Cognition ; Diagnostic Errors ; psychology ; Humans ; Physicians ; psychology ; Thinking

Objectives:To compare the effect of defferent routes of nutritional support on the 26 S proteasome. Methods:The means of immuno precipitation deduction,ELISA and fluore photomction were used to test the change of activities,contents of the 26 S proteasome and the rate of protein degradation in skeletal muscle of scalding rats with the animal model of enteral feeding and parenteral nutrition. Results:Compared with parenteral nutrition,enteral feeding could markedly reduce the activity and content of the 26 S proteasome,and the release of tyrosine was also lowered. Conclusions:The early enteral feeding can distinctly inhibit the system of 26 S proteasome,and reduce the protein degradation in skeletal muscle in bruned rats.

Objective To explore the mechanism of negative nitrogen balance in the treatment after burns. Methods The means of immuno precipitation deduction and ELISA were used to test the activities and contents of 26S proteasome and 19S regulator in skeletal muscle of rats inflicted with 30%TBSAⅢ burns. Results TNF? markedly raised the activities and contents of 26S proteasome and 19S regulator in skeletal muscle after scalding. Conclusion TNF? activates the 26S proteasome system in skeletal muscle, thus it enhances the degradation of protein, which is associated with the development of negative nitrogen balance following scalding.

Objective To investigate the usefulness of apparent diffusion coefficient (ADC)value and its coefficient variance (CV) in differentiating the cerebellopontine angle tumors.Methods 5 1 cases of cerebellopontine angle tumors comfirmed by surgery were enrolled ,in which cerebral enhanced MRI were obtained MRI data of different type of tumors were analyzed.ADC value and its CV of tumors were calculated.Results There were 24 cases of schwannoma,14 cases meningioma,7 cases metastases,4 cases epider-moid cyst and 2 cases dermoid cyst.There were obvious differences on ADC value’s CV among the schwannoma,meningioma and metastases (t=-1.31,P =0.03;t=-0.56,P =0.04;t =0.07,P =0.04).ADC value of schwannoma was only significant higher than that of meningioma (t=-2.5,P =0.04).Conclusion In combination with MRI,ADC value and its CV have a higher value in differential diagnosis of cerebellopontine angle tumors.

OBJECTIVE To investigate the effect of pranlukast(Pran) on learning and memory impairment and neuroinflammatory and apoptotic response in streptozocin(STZ)-induced type 1 diabetic mice. METHODS Male ICR mice were injected through the tail vein with STZ(150 mg·kg-1)to induce the type 1 diabetes model. Diabetic mice were administered orally with Pran. After 4 consecutive weeks of administration,the escape latency in hidden platform trials,number of platform crossings and time spent in the target quadrant of mice were assessed by the Morris water maze(MWM)test. Western blot was used to detect the proteins of cysteinyl-leukotrienes receptor-1(CysLT1R)and pro-inflammatory factors,nuclear factor-κB p65 subunit(NF-κB p65),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),and cleaved caspase 3,Bax and Bcl-2 in the hippocampus and prefrontal cortex of diabetic mice. We also determined fasting blood glucose,serum insulin and lipids such as triglyceride,total cholesterol,high density lipoprotein cholesterol,and low density lipoprotein cholesterol. RESULTS The data of the MWM test showed that untreated diabetic mice displayed a higher escape latency in hidden platform trials(P<0.05),and a smaller number of platform crossings(P<0.05)as well as shorter per?centage of time spent in the target quadrant(P<0.05). The data of Western blotting showed that treat?ment with Pran 0.6 and 1.2 mg·kg-1 significantly reduced the levels of CysLT1R,nuclear NF-κB p65, IL-1βand TNF-α,cleaved caspase 3,and the ratio of Bax and Bcl-2 in the hippocampus and prefrontal cortex of diabetic mice(P<0.05). However,Pran did not improve the fasting blood glucose,serum insulin or lipid metabolism disorder in diabetic mice. CONCLUSION Pran improves memory impairment and nerve injury in STZ-induced type 1 diabetic mice.

Objective To investigate the effect of Toutongning capsule for treatment of headache with stroke-associated risk fac-tors .Methods 60 cases of headache patients with stroke-associated risk factors were selected and divided into the treatment group and the control group ,30 cases in each group .The treatment group were given conventional therapy plus Toutongning capsule while the control group were given conventional therapy only .Results After 4 weeks ,the remission rate of treatment group was 93% and that of the control group was 63% .The attack frequency ,duration and degree between the two groups showed statistically signifi-cant difference(P<0 .05) .Conclusion Additional Toutongning capsule has a better effect for treatment of headache with stroke-as-sociated risk factors.

To elucidate the mechanism of negative nitrogen balance after burns, immuno precipitation deduction was used to observe the changes in the activity of 26S proteasome and 19S regulator in skeletal muscle of rats inflicted with 30%TBSAⅢ o burns. The protease activity, ATPase activity of 26S proteasome,as well as 19S regulator in skeletal muscle of rats were markedly enhanced on the second day after scald. It is suggested that burn injury could activate the 26S proteasome in skeletal muscle, in turn enhance the degradation of protein , which is associated with negative nitrogen balance following scald

Objective To study the effectrve approach of the nutrition support in burn patients. Methods The means of immuno-precipitation-deduction,ELISA and fluore-photometion were used to test the change of activities,protein expression of the 19S regulator and the rate of protein degradation in skeletal muscle in scard rats with enteral feeding or parenteral nutrition. Results Compared with parenteral nutrition , enteral feeding could markedly reduce the activity and protein expression of the 19S regulator ,and the digeneration of skeletal muscle was also lower. Conclusions The early enteral feeding can distinctly inhibit the system of 26S proteasome , thereby reduce the protein degradation of skeletal muscle in scald rats,which may be benefical to the metabolic modulation of the burned patients.

Diagnostic errors can result in tangible harm to patients. Despite our advances in medicine, the mental processes required to make a diagnosis exhibits shortcomings, causing diagnostic errors. Cognitive factors are found to be an important cause of diagnostic errors. With new understanding from psychology and social sciences, clinical medicine is now beginning to appreciate that our clinical reasoning can take the form of analytical reasoning or heuristics. Different factors like cognitive biases and affective influences can also impel unwary clinicians to make diagnostic errors. Various strategies have been proposed to reduce the effect of cognitive biases and affective influences when clinicians make diagnoses; however evidence for the efficacy of these methods is still sparse. This paper aims to introduce the reader to the cognitive aspect of diagnostic errors, in the hope that clinicians can use this knowledge to improve diagnostic accuracy and patient outcomes.
Affect ; Attitude of Health Personnel ; Cognition ; Diagnosis, Differential ; Diagnostic Errors ; psychology ; Humans ; Physicians ; psychology ; Prejudice ; Thinking

The present study was to develop and design a new sonography rigid bronchoscopy and corollary vacuum-assisted biopsy device system with less injury and complication. The system combined ultrasonic-probe with ultrasound catheter, a new medical ultrasound technique, and rigid bronchoscopy (RB) which is improved with an auxiliary vacuum-assisted biopsy device. The principle of the device is vacuum suction and rotary knife. The reduced outer diameter of the RB led to less pain and lower complications for the patient. With the help of ultrasonic-probe (30 MHz), lesions and blood vessels can be identified clearly and unintentional puncture and damage to blood vessels can be avoided. Plenty of lesions can be obtained quickly through the vacuum-assisted biopsy device without getting puncture needle in and out repeatedly. The novel endobronchial sonography rigid bronchoscopy and matched vacuum-assisted biopsy device has many remarkable advantages. It can enlarge the applied range of the RB from endobronchial to mediastinal lesions, avoiding unintentional puncture of vessels. Obtaining multiple samples with a higher accuracy rate than that by other sampling techniques, minimizing operation time, alleviating pain and decreasing the complication rate, the system makes up the technical deficiency for the diagnosis and treatment of the mediastinal lesions, to a certain degree.
Biopsy, Needle ; instrumentation ; Bronchoscopy ; instrumentation ; Equipment Design ; Humans ; Mediastinum ; pathology ; Ultrasonography ; instrumentation ; Vacuum