OBJECTIVE:To study the inhibitory effect of melatonin(MT)on the increased influx of Ca 2+ induced by L-glutamate in cultured rat neurons.METHODS:Fura-2/AM,a Ca 2+ sensitive fluorescent indicator was used to load the brain cells isolated from new-born rats,and the intracellular dissociative Ca 2+ concentration(〔Ca 2+ 〕i)was measured with fluores?cence-spectrophotometer.RESULTS:The L-glutamate of concentration500?mol/L could markedly promote the influx of Ca 2+ and intracellular free Ca 2+ concentration(P

AIM: To investigate the protective effects of ulinastatin on the rats with paraquat-induced acute lung injury and its mechanisms .METHODS:The Wistar rats ( n=108 ) were randomly divided into control group , pa-raquat group and ulinastatin group .The rats in paraquat group and ulinastatin group were given paraquat by gavage , while the rats in control group were given sterile saline by gavage .The rats in ulinastatin group were also given ulinastatin treat-ment.The serum levels of MDA, SOD, IL-6, IL-10 and TNF-αwere measured after 1 d, 3 d, 7 d, 14 d, 21 d and 28 d. The expression levels of p 38 MAPK, MMP-2 and TIMP-1 in the lung were also measured .RESULTS:The levels of SOD in 1 d, 3 d and 7 d in paraquat group and ulinastatin group were significantly lower than those in control group ( P<0.01).The level of SOD in ulinastatin group was significantly higher than that in paraquat group (P<0.05).The levels of MDA, IL-6, IL-10 and TNF-αin 1 d, 3 d and 7 d in paraquat group and ulinastatin group increased compared with con-trol group (P<0.01), and those in ulinastatin group were significantly lower than those in paraquat group (P<0.05). The levels of p38 MAPK and TIMP-1 in 1 d, 3 d, 7 d, 14 d, 21 d and 28 d in paraquat group and ulinastatin group were higher than those in control group (P<0.01), and those in ulinastatin group was significantly lower than those in paraquat group ( P<0.05) .The level of MMP-2 in 1 d, 3 d, 7 d, 14 d and 21 d in paraquat group and ulinastatin group increased compared with control group (P<0.01), and that in ulinastatin group was significantly lower than that in paraquat group (P<0.05).CONCLUSION:Ulinastatin protects the lung tissues of rats from paraquat-induced acute lung injury by in-hibiting p38 MAPK signaling pathway and ameliorating inflammatory and oxidative responses .

Objective To investigate the relationship between renin (REN) gene G10631A, angiotensinogen (AGT) gene T704C mononucleotide polymorphisms and cerebral infarction and to investigate the mechanisms and characteristics of cerebral infarction from molecular level. Methods REN gene G1063A and AGT gene T704C polymorphisms in 82 patients with cerebral infarction and 89 controls were detected with polymerase chain reactionrestriction fragment length polymorphism. The differences of the genotypes and allele frequencies were compared between the patient group and the control group. Results The frequency of REN 10631AA genotype (31. 7% vs. 10. 1%,χ2 =12. 816, P = 0. 002) and the frequency of A genotype (49. 4% vs. 30. 3% χ2 = 12. 969, P =0. 000), as well as the frequency of AGT 704 CC genotype (63. 4% vs. 34. 8% χ2 = 15. 029, P = 0. 001) and the frequency of A genotype (79. 9% vs. 61. 2% χ2 = 14. 173, P = 0. 000) in the cerebral infarction group were all significantly higher than those in the control group; the frequency of haplotype 704C 10631A was also significantly higher than that in the control group (P=0. 000). Conclusions REN 10631AA genetype and A allele as well as AGT 704 CC genetype and C allele may be the susceptible factors of cerebral infarction. Haplotype 704C-10631 A may be a genetic risk factor for the occurrence of cerebral infarction.

In order to carry out the training objectives ofexcellent doctor education training pro-gram implemented by the Ministry of Education and the Ministry of Health, an integrated organ-system oriented curriculum system of circulatory system was applied in five year clinical medicine education. The teaching contents of circulatory system from traditional Histology and Embryology, Physiology, Pathology, Pathophysiology, and Pharmacology were integrated and optimized to compile the integrated circulatory sys-tem textbook. problem-based learning (PBL) and comprehensive morphology experimental teaching were implemented into the integrated circulatory system curriculum. Diversified examination methods including continuous assessment of PBL were used to evaluate the learning effect of students. As a result, a new cur-riculum model of circulatory system teaching was constructed. And on the base of this curriculum model, an innovation course research experiment was performed, a digital network teaching platform with 4A (anybody, anything, anywhere, anytime) was set up, and diversified teaching methods were applied. This new developing curriculum system is helpful for students to relate what they have learned in the basic sci-ences to clinical medicine, gain clinical thinking competence, lifelong skills of self-directed learning, in-novative thinking, and ability of scientific research and practice.

10.3969/j.issn.1000-8179.2013.12.011

Objective To propose a method based on deep belief network (DBN) to automatically identify pulmonary nodules so as to improve the detection accuracy of pulmonary nodules.Methods To meet the training sample requirements of DBN,a database of 4 000 lung nodule images identified by professional doctors was established,and the sample database was expanded using virtual sample technology.In this technology,new samples of the database were generated from the manually recognized region of interest (ROI) by rotation,scaling and panning,or by a series of combinations of two or more operations of panning,scaling,rotation,and compositing.Finally,some samples from the sample database were input into the convolutional neural network classifier,and the ROI of the suspected pulmonary nodule was output by optimizing the network parameters.Result The sample size of the training sample database was expanded to 40 000 using the virtual sample expansion.Based on the training database obtained by this method,the detection accuracy of DBN for identifying pulmonary nodules was 90％,and the false positive rate was 0.4％.Conclusion Virtual sample technology can effectively improve the efficiency of training database establishment.The accuracy of using DBN-based CAD technology to detect pulmonary nodules is high,allowing doctors to focus only on areas where lung nodules are detected,thus effectively improving the efficiency of diagnosis.

OBJECTIVE:To probe into the rational drug use condition in Shenzhen area and to promote the rational drug use level. METHODS: A multi-center randomized parallel test was conducted in 6 different levels of hospitals in Shenzhen area. In which the prescriptions in two months and the outpatients visiting the hospitals on that day were surveyed on the spot in respect of the international rational drug use (RDU) indicators then the data were analyzed statistically. RESULTS: Prescription indicators were as follows: the average number of drugs was 2.44; the percentage of antibiotics prescribed was 43.7%and that for injection was 22.3%. Patient care indicators were as follows: the average consultation time was 6.97 minutes; average dispensing time was 16.77 seconds; percentage of drugs actually dispensed was 100%; percentage of drugs actually labeled was 100%; percentage of patients’ knowledge of correct use of drugs was 96.5%. CONCLUSIONS: The rational drug use level in Shenzhen area is still low and problematic and the care given by doctors and pharmacists to the patients is insufficient, which remain to be improved and tackled.

Objective To investigate the correlation between cornexin37 (Cx37) CI019T polymorphism and ischemic stroke and its outcome.Methods Restriction fragment length polymorphism analysis was used to detect the distribution of Cx37 C1019T polymorphism in a ischemic stroke group and a control group.The modified Rankin scale (mRS) was used to evaluate the neurological outcome at 3 months after onset.Results A total of 235 patients in the control group,and 232 patients in the ischemic stroke goup were recruited.In the ischemic stroke group,210 had a good outcome (mRS ＜3) and 22 had a poor outcome (mRS≥ 3).The TT genotype (12.93％ vs.6.39％ ; x2 =10.087,P =0.006) and T allele (31.25％ vs.21.49％ ; x2 =11.466,P=0.001) frequency in the ischemic stroke group were significantly higher than those in the control group.Multivariatelogistic regression analysis showed that TT genotype (odds ratio [OR] 5.794; 95％ confidence interval [CI] 1.405-23.894; P =0.015) and T allele (OR 131.016,95％ CI 6.943 -2 472.477; P =0.001)signifkantly increased the risk of ischemic stroke.Univariate analysis showed that TT genotype (OR 0.650,95％ CI 0.144 - 2,934; P =0.575),CT genotype (OR 0.622,95％ CI 0.234 - 1.655; P =0.342),and CC genotype (OR 0.654,95％ CI 0.268 - 1.595; P =0.350) had no significant correlation with the outcome of ischemic stroke.Conclusions Cx37 1019TT genotype and T allele may increase the risk of ischemic stroke.T allele is one of genetic susceptibility factors for ischemic stroke; however,its gene polymorphism is not associated with the outcome of ischemic stroke at 3 months after onset.

Objective To investigate the association between matrix metalloproteinase (MMP) -2 C735T and MMP-9 C1562T polymorphisms and TOAST subtypes, the outcome in patients with stroke. Methods A total of 232 patients with ischemic stroke were divided into large artery atherosclerosis (LAA, n =37), cardioembolism (CE, n =31), small artery occlusion (SAO, n =65) stroke, stroke of other demonstrated etiology (SOE, n =2), and stroke of undemonstrated etiology (SUE, n =97) according to TOAST criteria. A total of 235 healthy subjects in the outpatient served as control. Genetic polymorphisms of MMP-2 C735T and MMP-9 C1562T were identified by polymerase chain reaction-restriction fragment length polymorphism.The outcome of patients was evaluated with Barthel Index (BI) at day 21 and 90 after stroke.Results The frequencies of MMp-2 735CC genotype and C allele in the ischemic stroke group (CC genotype: 63.36％ vs. 54.04％,x2 =4. 182, P=0.014; C allele: 79.31％vs. 74.04％,x2 =3. 936, P =0. 047 ) and its LAA subtype ( CC genotype: 78. 37％ vs. 54. 04％, x2 =7. 740, P =0. 005; C allele: 87. 83％ vs. 74. 04％, x2 =6. 655, P =0. 01 ) were significantly higher than those in the control group. The frequencies of MMP-9 1562CT +TT genotype and T allele in the ischemic stroke group (CT +TT genotypes: 21.98％ vs. 13. 19％,x2 =6. 233, P=0.013; T allele: 11.64％ vs. 7. 02％ ,x2 =5. 891, P =0. 015)and its LAA subtype(CT +TT genotypes: 32. 43％ vs. 13. 19％ ,x2 =8. 892, P =0. 003; T allele: 20. 27％ vs. 13.19％ ,x2 =13. 950, P =0. 000). Multivariate logistic regression analysis indicated that risk of ischemic stroke and its LAA subtype with MMP-2 735CC genotype (ischemic stroke: odds ratio [OR]1.099, 95％ confidence interval [CI] 1.038-1.260, P =0.028; LAA: OR 1.360, 95％ CI 1. 167-5. 774, P =0. 009) and with MMP-9 1562TT genotype (ischemic stroke: OR 9. 409,95％ CI 1. 154-76. 722, P =0. 036; LAA: OR 8. 962, 95％ CI 1. 380-58. 218, P =0. 022)increased significantly. There were no significant correlation between the different genotypes of MMP-2 and MMP-9 and the outcome of ischemic stroke. Conclusions Polymorphisms of MMP-2 C735T and -9 C1562Tare associated with ischemic stroke and its subtype large artery atherosclerotic stroke, but not associated with the outcome in patients with ischemic stroke

OBJECTIVE:To provide reference for rational drug use in elderly patients with depression. METHODS:A total of 96 elderly outpatients and inpatients with depression were selected from 39 mental health institutions of Hebei province during Jul. 2nd to 9th,2012. The drug use were surveyed by using self-made questionnaires on the basis of prescriptions/medical orders. The results of investigation were analyzed statistically. RESULTS:In this study,96 questionnaires were distributed and all were collect-ed with effective recovery rate of 100%. Among 96 respondents,95 elderly patients used a new type of antidepressants,mainly by selective serotonin reuptake inhibitors(SSRIs),accounting for 75.0% of the total. The top 5 drugs in the list of use frequency were sertraline(23 cases,24.0%,daily dose:25-200 mg),paroxetine(22 cases,22.9%,daily dose:20-60 mg),escitalopram(20 cas-es,20.8%,daily dose:5-40 mg),venlafaxine (13 cases,13.5%,daily dose:75-300 mg),mirtazapine (12 cases,12.5%,daily dose:8-30 mg). Among all respondents,22 patients (22.9%) were treated with mono-antidepressant and the other 74 patients (77.1%) were treated with drug combination therapy among which 47 cases were treated with two antidepressant drugs,22 were treated with three drugs,4 were treated with four drugs and 1 was treated with five drugs. 6 cases combined with mood stabilizers, 21 cases with antipsychotic,50 cases with benzodiazepine(6 of them combined with two benzodiazepine),2 cases with other hyp-notic drugs,14 cases with anxiolytic drugs and 2 cases with anticholinergic drugs. CONCLUSIONS:The drug use of elderly pa-tients with depression in mental health institutions of Hebei province basically in line with current trends. However,there are still the phenomenon of irrational drug use as drug dose meets or exceeds the prescribed maximum dose;many varieties are used in combination therapy;route of administration is improper.