Objective To observe the effects of marzulene(L-glutamine and sodium gualenate)on cellular immune function in patients with severe acute pancreatitis(SAP). Methods A prospective study method was conducted in which 80 patients with SAP were divided into trial group and control group(each 40 cases)according to the table of random number methods,and in the mean time 20 healthy volunteers were enrolled in the healthy control group. Both SAP groups received standard total parenteral nutrition(TPN)with same quantities of heat and nitrogen, and the trial group additionally accepted intravenous drip of marzulene 0.4 g?kg-1?d-1(once a day)for 7 days,while the control group received the same amount of normal saline intravenous drip for 7 days. One day before treatment and on the 7th day after treatment,the peripheral venous blood samples were collected. The T-lymphocyte proliferation activity was tested by methyl thiazolyl tetrazolium(MTT)assay,and the interleukin-2(IL-2)and interleukin-6(IL-6) secretion levels were detected by enzyme-linked immunosorbent assay(ELISA). Results Compared to the healthy control group,the levels of T lymphocyte proliferation activity〔absorbance(A)value〕and IL-2(ng/L)were markedly decreased and IL-6(ng/L)secretion level was obviously increased before treatment in the two SAP groups(P<0.05 or P<0.01). Compared to prior treatment,the levels of T lymphocyte proliferation activity and IL-2 were significantly increased after 7 days of treatment in the trial group(both P<0.05),and basically restored to normal levels,while in the control group they were progressively decreased(both P<0.05),the levels in trial group being significantly higher than those of the control group(T lymphocyte proliferation activity:1.08±0.27 vs. 0.43±0.25,IL-2:16.5±1.4 vs. 9.4±2.9,both P<0.05),but compared to prior treatment,the level of IL-6 was significantly decreased in the two SAP groups(both P<0.05),the level of IL-6 in control group was recovered to the level of healthy control group,and the level in trial group being significantly lower than that of the control group(18.8±4.5 vs. 22.3±3.1, P<0.05). Conclusions The patients with SAP have cellular immune dysfunction,the manifestations being the suppression of T lymphocyte proliferation and IL-2 and increase of IL-6 release. Early application of marzulene can help to improve the immune function of lymphocytes in patients with SAP.

Objective: To investigate the Ventral Pallidrm′s function of cardiovascular adjustment by observing the changes of the rats′blood pressure. Methods:Ten SD rats′blood pressure were respectively observed through a catheter in one of the common carotid arteries after unilateral Ventral Pallidum stimulation by certain concertration,certain volume glutamate solution under stereotaxic guidance. Results:Glutamate stimulation on Ventral Pallidum caused elevation of the rats′blood pressure,thechanges were significant. Conclusion:Ventral Pallidum has a role in regulating blood pressure. It belongs to behavior related pattern and sympathetic regulated.

Satisfactory communication skill is the essential requirement for medical students to become future qualified medical doctors.Clinical clerkship is the key process to absorb medical knowledge and professional skill,cultivate the ability to solve practical problems in medical practice,and develop medical students into qualified doctors by guiding them to reasonably handle physician-patient relationship,better solve medical disputes,and gradually improve their legal awareness.Therefore,medical students should strengthen to cultivate their communication ability,and set up reasonable sense of physician-patient communication.

With the Meta-analysis method, the clinical efficacy of acupuncture and other regular methods for aphasia was evaluated, and the acupoints selection for aphasia was explored. The acupuncture literature of clinical randomized control trials for aphasia published in CNKI, WANFANG, VIP and CBM database was searched; the statistical analysis of clinical efficacy of acupuncture and other regular methods for aphasia was performed by using software Revman 5. 2 provided by Cochrane library. A file of Microsoft Excel was established to perform the analysis of acupoints selection based on frequency analysis method, so as to summarize the characteristics and rules. Totally 385 articles were searched, and 37 articles those met the inclusive criteria was included, involving 1,260 patients in the acupuncture group and 1 238 patients in the control group. The Meta-analysis results showed OR = 3.82, 95% Cl [3.01, 4.85]; rhombus was located on the right side and the funnel plot was nearly symmetry, indicating the treatment effect of the acupuncture group for aphasia was superior to the control group (Z = 11.04, P < 0.000 01). The frequency-analysis results showed that the frequency of acupoints from top to bottom was Lian-quan (CV 23), Tongli (HT 5), Yamen (GV 15), Jinjin (EX-HN 12), Yuye (EX-HN 13), Baihui (GV 20), Yuyan II, Yuyan I and Yuyan III. The frequency of meridians from top to bottom was the governor vessel, extra channels, conception vessel, heart meridian and large intestine meridian. It is concluded that the clinical efficacy of acupuncture combined with speech rehabilitation training and medication treatment for aphasia is superior to that of speech rehabilitation training and medication treatment alone. The clinical treatment for aphasia focuses on its local effect; the main acupoints are in the head and face, and the meridians are governor vessel, extra channels and conception vessel.
Acupuncture Therapy ; Aphasia ; therapy ; Databases, Bibliographic ; Humans ; Retrospective Studies

Objective To discuss the clinical value of CT combined electronic level guided percutaneous transthoracic needle biopsy in diagnosis of small pulmonary nodules.Methods 44 cases of lung mini-nodule underwent CT combined electronic level guided percutaneous transthoracic needle biopsy.After operation the tissue was sent for pathologic examination.The nodules were divided into two groups,including Group A (diameter 0.5-1.0 cm,N=10) and Group B (diameter 1.1-2.0 cm,N=34),according to the different sizes of diameter.The excision of postoperative pathological and diagnosis result of clinical diagnosis and treatment of more than 12 months follow up were taken as the final result.The sensitivity,specificity,veracity and complications were compared and analyzed using paired x2 test,taking P＜0.05 as significant difference.Results (1)The arrival rate of target puncture were 100 ％ in 44 cases,with the sensitivity rate of 90.9％,specificity rate of 100 ％,veracity rate of 88.6 ％,positive predictive value of 97.5 ％,and negative predictive value of 100 ％.The sensitivity,specificity and veracity of Group A were 77.8％,100％ and 70.0％ respectively.And the sensitivity,specificity and veracity of Group B were 94.1％,100％ and 94.1％ respectively.The sensitivity,veracity of Group A was higher than Group B (P＜0.05),while there was no difference in specificity.(2)Complication:the incidence rate of pneumothorax,pulmonary bleeding symptoms and hemothorax were 9.1％,11.4％,2.3％,respectively.The incidence rate of total complication was 22.7％,and all be cured after the treatment.The lesions with emphysema around is a risk factor for pneumothorax and pulmonary bleeding symptoms (x2 =11.2,10.2,P＜0.05).However,the position,size and deepness was not correlated with the complications mentioned above (P ＞0.05).Conclusion CT combined electronic level guided percutaneous transthoracic needle biopsy is a safe,effective and accurate diagnostic method for lung mini-nodule lesion.

Diabetes is a kind of metabolic disease characterized by hyperglycemia The oral hypoglycemic agents used currently are required to take every day,which brings inconvenience to patients.Omarigliptin is a small molecule DPP-4 (depeptidyl peptidase-4) inhibitor.The drug is developed by the Merck Co,mainly for the treatment of type two diabetes.The drug only need to be taken once a week,so as to improve the patient's compliance and adherence,thereby improving the therapeutic effect.This article introduces the information of omarigliptin from the aspects of synthesis,pharmacology,pharmacokinetics,and clinical research,which provides valuable information for pharmaceutical workers.

Objective To evaluate the reliability of PainVision method for assessment of postoperative pain in patients undergoing gynaecological laparoscopy.Methods Twenty ASA physical status Ⅰ-Ⅱ patients,aged 30-45 yr,undergoing gynaecological laparoscopy under fentanyl-propofol-cisatracurium anesthesia,were studied.Pain intensity was simultaneously assessed using PainVision method and visual analog scale (VAS) at 12,24 and 48 h after surgery.PainVision was a new method for quantitative measurement of pain intensity using a painless electrical stimulation (PainVision PS-2100 device).Pain degree was calculated from two parameters,current perception threshold and pain compatible electrical current by using PainVision.The former parameter was defined by the lowest electrical current detected ; the latter parameter defined by the electrical current judged as being compatible with the intensity of ongoing pain.Results There was a significant positive correlation between pain degree calculated by PainVision method and VAS scores,and the correlation coefficient was 0.902 (P ＜ 0.01).Conclusion PainVision method can be applied for assessment of postoperative pain in patients undergoing gynaecological laparoscopy.

Objective To analyze the characteristics of extra-pulmonary tuberculosis in renal transplant recipients,and discuss its diagnosis and management. Methods From Jan.1991 to Apr.2007,37 cases of post-operational tuberculosis were identified out of the 2333 renal transplantations done in our center.Among them there were 19 cases with extra-pulmonary foci(51%),which involved allograft kidney in 5 cases,meninges in 4 cases,pleura in 4 cases,lymph node in 3 cases,soft issue in 2 cases,larynx,liver,vertebra and intestine in 1 case each.In 3 cases,there were 2 extrapulmonary sites involved at the same time.Most of the cases happened within one year post-transplant (53%).The most common clinical manifestation was fever. Results After anti-tuberculosis therapy,14 cases were cured and 5 were irresponsible and died.Eight cases (42%) experienced acute rejection and 4 cases(21%)had abnormal liver function during the treatment. Conclusions Extra-pulmonary tuberculosis had a high incidence and high mortality in post-renal-transplant population.Therefore,attention should be given to its differential diagnosis in clinical practice.Balancing anti-tuberculosis and anti-rejection therapy is important for this specific population.

Objectives To investigate the influence of cytomegalovirus infection after kidney transplantation on the recipients and the associated risk factors of cytomegalovirus infection .Methods Data of 892 kidney transplantation recipients from January 2000 to December 2004 in our department were analyzed retrospectively . All the recipients were divided into case group (with cytomegalovirus infection) and control group (without cytomegalovirus infection) . Log-Rank test was used to compare the 1-, 3-, 5-year survival of patients and grafts between two groups . The incidence of complications, the difference of regiment of immunosuppressant and anti-CMV drugs were compared as well . The independent risk factors of cytomegalovirus infection were assessed by Logistic regression analysis . Results One-, 3-, 5-year survival rates of patients in case group were 81 .3%, 72 .8% and 54 .8% respectively, while the patients in control group were 96 .4%,91 .4% and 79 .9% respectively, the prior was significantly lower than the latter (Log-Rank value=49 .62, P＜0 .01) . One-, 3-, 5-year survival rates of grafts in case group were 71 .0%, 66 .2% and 46 .1%, while the grafts in control group were 91 .5%, 86 .6% and 74 .5% respectively, the prior was significantly lower than the latter as well (Log-Rank value=44 .87, P＜0 .01) . The incidence of acute rejection in case group was 24 .9%, while it was 13 .9% in control group, with significant difference between two groups (x2=14 .49, P＜0 .01 ) . Logistic regression showed that acute rejection,mycophenolate mofetil dose more than 2 g, and usage of ATG/ALG or OKT3 were the independent risk factors of cytomegalovirus infection (OR=1 .464, 3 .097 and 2 .837, P＜0 .05 ) . Ganciclovir was the protective factor of cytomegalovirus infection (OR =0 .234, P ＜0 .01) . Conclusions Cytomegalovirus infection decreases the long-term survival of recipients and grafts in kidney transplantation . Acute rejection, high dose of mycophenolate mofetil, and ATG/ALG or OKT3 are the independent risk factors of cytomegalovirus infection . Prophylactic usage of ganciclovir after kidney transplantation can effectively reduce cytomegalovirus infection .

Objective To investigate the combined effect and mechanism of metformin (Met) and 2-deoxy-D-glucose (2DG) on cell proliferation and apoptosis in liver cancer cells HepG2 and Hep3B.Methods Wst-1 reagent was used to determine the anti-proliferation effects after treatments with Met and 2DG alone or combined in HepG2 and Hep3B cells.Microscopy was used to observe cell morphological changes after treatments with Met and 2DG alone or combined in HepG2 and Hep3B cells.Cell apoptosis was observed by flow cytometry after treatment of different kinds of drugs.Western blotting was used to analyze the protein expressions of Caspase-3,PARP,Mcl-1 of HepG2.Results The survival rate of HepG2 cells in the combination group was (22.48 ± 0.51)％,and compared with the control group (100.00 ± 5.05)％,Met group (80.68 ±5.10)％ and 2DG group (72.56 ±4.34)％,the differences were statistically significant (P ＜ 0.001;P ＜ 0.001;P =0.001).The survival rate of Hep3B cells in the combination group was (29.16 ± 1.34) ％,and compared with the control group (100.00 ± 1.23) ％,Met group (59.58 ± 1.92) ％ and 2DG group (33.87 ± 1.95) ％,the differences were statistically significant (P ＜ 0.001;P ＜ 0.001;P =0.001).Microscopy observation showed that combined treatment of Met and 2DG caused less viable adherent cells of HepG2,but more floating dead cells.While the combination group also caused a decrease in the density of Hep3B cells,but did not significantly increase the shedding of cells.The apoptosis of HepG2 cells in the combination group was (39.63 ± 0.21) ％,and compared with the control group (7.12 ± 0.14) ％,Met group (12.56 ± 0.35) ％ and 2DG group (15.16 ± 1.93) ％,the differences were statistically significant (P ＜0.001;P ＜ 0.001;P =0.001).The apoptosis of Hep3B cells in the combination group was (12.58 ± 1.03) ％,and compared with the control group (2.82 ± 0.51) ％ and Met group (8.98 ± 0.86) ％,the differences were statistically significant (P ＜ 0.001;P =0.007),but compared with the 2DG group (12.40 ± 1.78) ％,the difference was not statistically significant (P =1.000).Furthermore,Western blotting demonstrated that the combined treatment induced evident Caspase-3 activation and poly ADP-ribose polymerase (PARP) cleavages,and decreased expression of Mcl-1.Conclusion The combination of Met and 2DG can effectively inhibit cell proliferation of HepG2 and Hep3B,and induce apoptosis of HepG2 cells.The mechanism may be involved with Caspase-3 activation,cutting PARP substrate and decreasing Mcl-1 protein.