Animals ; Apoptosis ; Cardiomegaly ; metabolism ; pathology ; Glycogen Synthase Kinase 3 ; metabolism ; Mice ; Mice, Transgenic ; Myocytes, Cardiac ; cytology

OBJECTIVETo research the distribution characteristics of Chinese medicine (CM) syndrome and syndrome elements of chronic fatigue syndrome (CFS) by analyzing literature in recent 20 years.

METHODSRelevant literature on treating CFS by syndrome differentiation of CM at home were retrieved by computer and manual ways. Database were established by using EpiData 3.1 to conduct frequency analysis of syndrome and syndrome elements.

RESULTSThe most common clinical syndromes were Xin-Pi deficiency syndrome, Gan stagnation Pi deficiency syndrome, Gan-Shen yin deficiency syndrome, Gan qi stagnation syndrome, and Pi-Wei qi deficiency syndrome. Disease locations were sequenced as Pi, Gan, Shen, and Xin. The clinical pathogenesis of CFS was characterized by deficiency of vital energy, complicated with intermingled excess and deficiency. Asthenia of healthy energy was mainly manifested as qi deficiency, blood deficiency, and yin deficiency, while excess of sthenia was mainly manifested as qi stagnation, phlegm dampness, and static blood.

CONCLUSIONSResearch of CM syndrome starting from syndrome elements can better unify and standardize clinical syndrome differentiation. Results of literature analysis can provide reference for further studies.

The active components from Centipeda minima were extracted by water or ethanol, and identified by FTIR spectroscopy and UV-visible spectrophotometer. The molluscicidal effect of aqueous extract and ethanol extract from Centipeda minima against Oncomelania hupensis was determined as referring to the WHO guidelines for laboratory molluscicidal test. Treated with over 2.0 g/L aqueous extract and ethanol extract for five days, the mortality of O. hupensis was up to 100%, and their LC50 for snails was 0.50 g/L and 0.62 g/L, respectively. The molluscicidal activity of aqueous extract was higher than that of ethanol extract. The main components of aqueous extract and ethanol extract were sesquiterpens lactones and sterols.

Objective; To investigate the cytotoxicity of monocytes/macrophages against Tca8113 cells in hypoxic microenvironment in vitro. Methods; Peripheral blood mononuclear cells were extracted from healthy person^ blood and cultivated to transform into monocytes/macrophages. The monocytes/macrophages were cultured with Tca8113 cells in hypoxic microenvironment (O_2 < 1%) and in normal microenvironment (20% O_2). The cytotoxicity of monocytes/macrophages against Tca8113 cell was examined by MTT assay. Results;The cytotoxicity of monocyles/macrophages against Tca8113 cells in hypoxic microenvironment was lower than that in normal environment(P<0.05). Conclusion; In hypoxic microenvironment, the cytotoxicity of monocytes/macrophages against Tca8113 cells is decreased. Bui the mechanism of monocytes/macrophages' function in tumors need further research.

Objective To summarize the effect of laparoscopic repair of acute gastric perforation. Methods Patients with acute gastric perforation underwent laparoscopic repair and abdominal drainage under intravenous- inhalation general anesthesia after a histological biopsy. Results Forty-six patients with acute gastric perforation were successfully operated.Of which, 6 patients with pylonic perforation, 37 patients with perforation in the front wall of gastric antrum, 3 patients with perforation in stomach body. Thirty-three cases were received frozen section biopsy, only 1 case showed a cancer in the lesser curve of stomach body. There was no complications occurred and no operative mortality in this series. Of the 45 benign ulcers patients,31 patients were discharged 7 days after the operation, 14 patients were discharged 2 weeks after medication treatment.Three months after operation the symptoms of the 45 patients disappeared totally,they had normal diet,and got body weight 1-3kg. Pathological examination showed that no malignant cell was found in 45 benign ulcer patients. The cancer patient was discharged 9 days after operation and refusing to further treatment. Conclusions Laparoscopic repair is a safe mini-invasive method, and it isn′t breach the surgical principles,it allows the patients recover quickly and with less complications. The intraoperative biopsy can prevent misdiagnosis of cancer. It is an effective treatment for acute gastric perforation and worthy to be widely used.

AIM: To analyze the effect factors of trabeculectomy combined with intraoperative application of mitomycin C in the treatment of neovascular glaucoma.
METHODS: Fifty patients (50 eyes) with neovascular glaucoma collected from January 2013 to August 2015 in our hospital were treated by trabeculectomy combined with intraoperative application of mitomycin C. Single factor and multi factor variables analysis were used for effect factors of trabeculectomy combined with intraoperative application of mitomycin C in the treatment of neovascular glaucoma.
RESULTS: By results of single factor variable analysis,< 50 years old, preoperative intraocular pressure ( IOP) was ≥45mmHg and postoperative occurrence of anterior chamber hemorrhage were risk factors for treatment failure ( P < 0. 05 ), and gender, proliferative diabetic retinopathy and previous cataract surgery and prior photocoagulation were not the risk factors for failure (P>0. 05 ). By multivariate analysis, < 50 years old and postoperative occurrence of anterior chamber hemorrhage were risk factors for treatment failure ( P < 0. 05 ), and preoperative IOP≥45mmHg was not a risk factor (P>0.05). CONCLUSION: For patients < 50 years old with neovascular glaucoma, should be careful on the selection of surgical treatment. For high- risk patients, we should strengthen the monitoring and give timely intervention, which are helpful to improve the prognosis.

First aid skills are very important in the process of disaster medical rescue methods. Some first aid skills is rarely applied in clinical work at ordinary times, resulting in relevant medical personnel grasp of these skills being not enough skilled. This training method combined with the sim-ulator, has the characteristics and advantages of being close to the real, operational and repeatable. The main training program consists of 6 basic skills such as ventilation, hemostasis, bandaging, fixing, handling, basic life support. By simulating the real disaster scenario and simulation cases, we have targeted a single first aid skills training and multiple comprehensive ability training of first aid skills to trainees. To evaluate the training effect we have examined the individual skills of our trainees, with excellent performance as the goal, and in the comprehensive skills ability assessment we have paid attention to the emergency team's team cooperation ability. By the application of comprehensive simu-lation training and evaluation, the trainees can master all kinds of first aid skills in a short period of time.

Objective To study the effects of constant and intermittent high glucose on the apoptosis of cultured bovine retinal capillary pericytes (BRPs), and to investigate the role of mitochondrial apoptotic pathway in the apoptosis of BRPs. Methods After being cultured under glucose with different concentrations tot 6 days, the change of uhrastructure of BRPs was observed under electronmieroscope, the apoptosis of pericytes was detected by TUNEL method, the mitochondrial inner transmembrane potential (△Ψm) was detected by laser scanning confocal microscopy, the change of cytochrome c (cyt-c) was assayed by spectrophotometer and the expression of apoptotic genes was detected by immunohistochemical method and RT-PCR. Results (1) BRPs showed typical changes of apoptosis in constant and intermittent high glucose concentrations. The apoptosis induced by constant high glucose concentration was more obvious than that by intermittent high glucose. (2) Constant and intermittent high glucose concentrations obviously decreased △Ψm compared with control group. The △Ψm of BRPs was correlated negatively with the apoptotie rate of BRPs (r = - 0.89, P < 0.01) ; (3) Constant and intermittent high glucose concentrations increased the release of cyt-c from mitochondria to cytoplasm, and the concentration of cyt-c in the cytoplasm was correlated positively with the apoptotic rate of BRPs (P < 0.01) ; (4) Constant and intermittent high glucose concentrations increased the expression of proapoptotie gene Bax and decreased the expression of prosurvival gene Bcl-2, resulting in increased Bax/Bcl-2 ratio. Bax/Bcl-2 ratio was negative correlatied with the △Ψm of BRPs, and positively eorrclaticd with the concentration of cyt-c in cytoplasm and apoptotic rate (both P < 0.01).Conclusion Constant and intermittent high glucose concentrations could decrease △Ψm, increase the release of cyt-c and induce the apoptosis of BRPs, the effects being stronger with constant high glucose concentration. The mitochondrial apoptotic pathway plays an important role in the apoptosis of BRPs, in which Bax and Bcl-2 are involved.

From the current situations and problems on communication between doctors and patients,the paper discusses the necessity of strengthening the training of interns' communication ability between doctors and patients and explores its ways and development trend in the future.

Objectives To investigate the application modes of indocyanine green (ICG) angiography,digital subtraction angiography (DSA) and methylene blue angiography in the hybrid surgery of cerebral and spinal arteriovenous malformations (AVMs) and to compare the application value of different intraoperative angiographic methods.Methods From July 2013 to December 2015,55 patients treated with hybrid surgery of cerebral and spinal AVMs in Xuanwu Hospital,Capital Medical University were analyzed retrospectively,including 8 patients with cerebral AVM(Spetzler-Martin grade ≥Ⅲ) and 47 with spinal AVM.Their mean age was 33.8±15.6 years.Intraoperative DSA was performed in a hybrid operation room and methylene blue angiography was performed via the feeding artery.ICG angiography was performed in 4 cases in the initial stage as a comparison.Anatomic cure was confirmed by DSA at 3 months after surgery and the results were assessed.Results All 55 patients performed intraoperative DSA,32 underwent methylene blue angiography and 4 performed intraoperative ICG angiography.The frequency of intraoperative DSA was 3.6±1.3 times for each case.After the resection of the first lesion,the residual lesions revealed by DSA accounted for 27.3% (15/55).85.5% (47/55) patients achieved anatomic cure,in which the patients with midbrain AVM (8/8) and spinal AVM 83.0% (39/47) achieved anatomic cure.Three patients were lost to follow up at 1 year after procedure.The median modified Rankin scale (mRS) score of the cerebral AVMs was 2.0 (0.0-3.8).Compared with 3.5 (2.0-4.0) before procedure,there was significant difference (Z=-2.264,P<0.05).The Aminoff score in patients with spinal AVM after procedure was 3.5 (1.0-6.0).Compared with 4.0 (1.0-6.0) before procedure,there was no significant difference (Z=-0.262,P>0.05).The patients with function preservation (function score equal or better than pre-operation) accounted for 88.5% (46/52).Conclusions Intraoperative DSA could precisely localize the nidi and verify the complete resection.Intraoperative methylene blue angiography could selectively reveal the feeding artery supplied nidi in the operative field and identify the angioarchitecture.ICG angiography could reveal the structures of nidi on the surface of the operation area.The intraoperative methylene blue angiography could replace ICG angiography and achieve the treatment target of anatomical cure of the hybrid surgery of the cerebral and spinal cord vascular malformations.