Objective To compare the effects of Valsartan on blood ressure(BP)of patients with mild to moderate essential hypertension(EH).Method 64 patients with EH were randomly divided into 2 groups:Valsartan group(Enalapril 10 mg bid n=32).Treatment lasted for 8 weeks.Result Valsartan and Enalapril significantly reduce BP compared with that bdfore treatment(P< 0.05),effective rate and magnitude of decreasing BP were no significantly different between two groups(effective rate of Valsartan group was 78.1％ vs 70.0％ in Enalapril group(P>0.05).Conclusion Valsartan and enalapril have effect for decreasing the BP in EH patients.

Prostate cancer (PCa) incidence is increasing in China.Because of the limited clinical symptoms,early detection of PCa is critical and difficult.Current clinical diagnostic methods for localizing PCa including both the conventional anatomic imaging and histological techniques have many problems.Enormous novel PCa specific molecular probes have been evaluated.Those probes have substantially improved the diagnostic accuracy and specificity of PCa.This review briefly introduces the conventional noninvasive imaging techniques for PCa diagnosis.Nuclear medicine probes that have great clinical value for PCa molecular imaging are also discussed.

Objective To evaluate toxicopathological changes of central nervous system in rats at different morphine-dependent time. Methods Animal model of morphine-dependence in rats was established by subcutaneous injection of morphine. Histopathologic changes of coeruleus, periaqueductal gray, substantia nigra, lenticula, corpus amygdaloideun and hippocampus in morphine-dependent rats were observed by microscopy and electron microscopy, and synaptic numbers were counted and compared with those in control animals. Results Six morphine dependence-related regions in morphine-dependent groups were observed. Pyknosis or swelling of the nerve cells, swollen nerve fibers, swollen and deformed mitochondria were detected. Dilated endoplasmic reticulum and disaggregated polyribosomes were observed with increased number in synapsis. Gliocytosis and subpial infiltration of lymphocytes and monocytes became more obvious with extension of dependent time, and glial nodules were formed. Synaptic numbers were significantly increased in morphine-dependent groups at 4 or 8 weeks as compared with those in control group(P

A total of 135 patients diagnosed with Budd-Chiari syndrome(BCS)during August 2004 and February 2007 were reviewed and analyzed retrospectively.The results showed that 105 subiects (77.8%)caused by malignances,while 29 participants(21.5%)had no definite pathogens.The most commonly seen symptom included jaundiee(69.6%),followed by ascites(48.2%),abdominal distention (40.7%)and lower extremity edema(37.0%).Hisher levels of STB,PT and γ-GT were determined.Color Dopple ultrasound,CT and MRI could be helpful in diagnosing BCS;angiography remained the most accurate measurement.Main treatment strategies were stent implantation and/or balloon dilation.BCS is a clinical syndrome with no typical symptoms.which makes its management very difficult.A complete understanding of the condition will help reduce misdiagnosis.Angiography and stent implantation are primary ways to diagnose or treat BCS.

Objective To investigate current status of general practice service teams in urban Shanghai to provide practical evidence and lay theoretical basis for sustainable development of general practice service teams in the future. Methods A cross-sectional study was carried out for 40 staff members of eight general practice service teams in eight urban districts of Shanghai, as well as 110 local residents, by observation, interview and questionnaire methods during March to April 2008. Results Among 21 general practitioners, 86 percent of them ( 18/21 ) were graduated from medical colleges or universities with three-year curriculum or at levels above it and 52 percent ( 11/21 ) had intermediate professional titles or above.Among the eight general practice service teams, five had full coverage of supervision and management for tuberculosis therapy, six had full coverage of management for tumor patients, four had full coverage of management for cardiovascular and cerebrovascular diseases and four had full coverage of management for patients with mental disorders. In all staff members of eight general practice service teams, 38 percent of them (15/40) were satisfactory with their working environment, 40 percent (16/40) with their work activities, five percent (2/40) with their incomes, and 28 percent (11/40) with their professional future.In 110 local residents, 77 percent (85/110) were satisfactory with service environment, 85 percent (93/110) with quality of health-care service and 89 percent (98/110) with the attitude of service teams.Conclusions Implementation of management for chronic diseases and two-way referral, as well as satisfaction of staff members in general practice service teams should be improved further.

Chimeric antigen receptor T-cell (CAR-T) therapy is an emerging cancer immunotherapy strategy in recent years. CAR-T therapy has shown significant efficacy in the treatment of relapsed or refractory diffuse large B cell lymphoma and refractory pediatric acute lymphoblastic leukemia. However, restricted by the complexity of solid tumor microenvironment, the application of CAR-T therapy in solid tumors is still underway. Molecular imaging can trace the in vivo status of T cells in real time and in depth, which is of great significance to investigate the biological behavior of CAR-T cells in vivo and to evaluate their activation status. Meanwhile, molecular imaging strategy can also act as an early predictor of CAR-T treatment efficacy and related side effects, which can provide effective information for clinical intervention and play an important role in guiding the development of CAR-T therapy.

Objective To establish a assessment system for comprehensive clinical competency of general practice residents.Methods An assessment system for comprehensive clinical competency of general practice residents was developed with modified Delphi expert consultation during November 2010 to October 2011.Thirty three experts in clinical practice,education and administration of general practice were invited for two-round Delphi questionnaire consultation.Results In two-round consultation,the expert activity coefficient was 100％,the authority coefficient was 0.852 and 0.855,and the coordination coefficient for the importance of the indicators was 0.228 and 0.245 respectively (P =0.000).The opinions among the experts became consistent from round 1 to round 2.An assessment system was established,which consisted of 5 first-level (professionalism,communicate skills,clinical competency and professional development ability) and 36 second-level indicators.Conclusion The index system established in this study may be used as references for evaluating comprehensive clinical abilities of general practitioners systematically and objectively.

Objective To evaluate the role of AMP-activated protein kinase (AMPK)-dependent autophagic signaling pathway in ketamine-induced reduction of diabetic neuropathic pain (DNP) in rats.Methods Sixty male Wistar rats,aged 3 months,weighing 200-250 g,were equally randomized into 5 groups using a random number table:control group (C group),normal saline group (NS group),ketamine group (K group),ketamine + Compound C group (KC group),and ketamine + 3-methyladenine (3-MA) group (KM group).DNP model was established by intraperitoneal injection of streptozocin (STZ)65 mg/kg in anesthetized rats.Four weeks later,the equal volume of normal saline,ketamine 10 mg/kg,ketamine 10 mg/kg + Compound C1 mg/kg,and ketamine + 3-MA 2 μl were injected intraperitoneally once a day for 7 consecutive days in NS,K,KC and KM groups,respectively.The mechanical paw withdrawal threshold (MWT) was measured on 8th day.The rats were then sacrificed,and the lunbar segment (L1-5) of the spinal cord was removed for determination of the expression of AMPKαt,Beclin-1,microtubule-associated protein 1 light chain (LC) 3B (by Western blot) and dendritic spine density in the dorsal root ganglia.Results Compared with group C,the MWT,expression of AMPKα,Beclin-1,and LC3B,and dendritic spine density were significantly decreased in group NS (P＜0.05).Compared with group NS,the MWT,expression of AMPKαt,Beclin-1,and LC3B,and dendritic spine density were significantly increased in group K (P＜0.05).Compared with group K,the MWT,expression of AMPKα,Beclin-1,and LC3B,and dendritic spine density were significantly decreased in KC and KM groups (P＜0.05).Conclusion Activation of AMPK-dependent autophagic pathway is involved in ketamine-induced reduction of DNP in rats.

Hypoxiaisoneofthemostimportantfactorsinfluencingcancertherapyandclinicalprogno-sis.With positron emission tomography (PET)widely adopted in clinical practice,the development and appli-cation of PET hypoxia imaging agents has been much popular in the field currently.PET hypoxia imaging can detect tumor hypoxia region noninvasively,which has important significance for optimizing cancer treatment decisions and improving the prognosis of cancer.

Objective To evaluate the validity of GP proceptors in mini-CEX workshop.Methods Three mini-cex workshops for GP proceptors of standardized training of general practitioners in Shanghai were held during November 2009 to September 2012.In the workshops 82 GP proceptors gave the complete rating scores for the training videotapes and the assessment accuracy was analyzed.Results The accurate rates of all items including history taking,physical examination,communication,clinical judgement,consulting skills,organisation and overall clinical perfomance were lower than 50％ in 9-point scale and the completely accurate rate and completely error rate were 1.2％ and 30.5％,respectively.The accurate rates of 5 items were more than 50％ in 3-rank system and the completely accurate rate and completely error rate were 3.7％ and 9.8％,respectively.The accurate rates of 4 items were more than 50％ in standard score ± 1 system and the completely accurate rate and completely error rate were 8.5％ and 2.4％,respectively.Comparing with 9-point scale,3-rank system had higher accurate rate in 5 items (P ＜ 0.05) and standard score ± 1 system had higher accurate rate in all 7 items(P ＜ 0.05).Abnomal rating scores were found more common in medical interview (41,50.0％),clinical judgement (32,39.0％) and physical examination (13,20.7％).GP proceptors with more than five years teaching experience were more likely to give error scores than those with five or less years teaching experience in 9-point scale(OR =6.993) and 3-rank system (OR =4.902).Leniency and halo effects occurred in 11 (13.4％) and 8 (9.8％) GP proceptors,respectively; and 14 (17.1％) GP proceptors gave written feedback.Conclusions The rater accuracy of GP proceptors in mini-CEX workshop should be improved further.