Objective To analyse the mutation of pathogenic gene TSC2 in tuberous sclerosis complex (TSC). Methods Using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), all the 41 exons of TSC2 gene were analyzed in 4 TSC cases(include 1 suspect case) from one family and 1 sporadic TSC case ,and compared with the kin familial controls and kinless normal controls. Results Missense mutation on exon33 1346S→P (4037T→C) of TSC2 was found in 4 familial cases, and no mutation of TSC2 gene was found in the sporadic case and all the health controls. Conclusion Missense mutation on exon33 (1346S→P,4037T→C)is a new discovery in TSC2 gene of patients with TSC.

Objective To evaluate the effect of injection duration on bruising and pain after the subcutaneous injection of heparin.Methods The relevant randomized controlled trials,quasi-randomized controlled trials about subcutaneous heparin injection duration of ≥30 s and ≤ 10 s were searched in the databases of CNKI,CBM,VIP Database for Chinese Technical Periodicals,PubMed,Highwire,ScienceDirect,Chinese Cochrane Library,Wanfang database and Google.The quality of RCTs was assessed and Metaanalysis was conducted by RevMan 5.0 Software.Results Twelve RCTs involving 1 986 injections were included.The results of Meta-analysis showed that:There was significant difference between the two groups in the occurrence of bruising.The injection duration of 30 s was much better to prevent bruising.Statistical differences existed in pain intensity between the two groups.Conclusions Prolonging the injection duration to 30 s may reduce the occurrence of subcutaneous bruising.There is no enough evidence to draw a conclusion on pain intensity.Adequately,the current study is limited to a small sample,powered and high quality randomized controlled trials are still needed to be conducted.

Objective To investigate the effects of early core muscles and manual respiratory function training on stroke patients with dysphagia. Methods From June, 2015 to January, 2016, 60 stroke patients with dysphagia were divided equally into control group and obser-vation group randomly. Both groups accepted routine swallowing function training, electrical stimulation and respiratory function training, while the observation group accepted core muscles training and manual respiratory function training, for four weeks. They were evaluated with Standardized Swallowing Assessment (SSA), forced vital capacity (FVC), maximum ventilatory volume (MVV) and the maximum ex-piratory time before and after treatment. Results All the indices improved in both groups after treatment (P<0.001), and improved more in the observation group than in the control group (P<0.001). Conclusion Core muscles and manual respiratory function training at early stage can obviously improve swallowing and respiratory function of stroke patients with dysphagia.

Objective:To study the effect of Mg 2+ on glutamate and energy metabolites during focal cerebral ischemia and reperfusion in rats. Methods: Twelve male Wistar rats were divided into 2 groups(n=6):magnesium sulfate(100 mg/kg, i.p.) group and saline group.Cerebral ischemia was produced by occlusion of middle cerebral artery with a nylon thread for 60 min and followed by 60 min reperfusion.Microdialysis probes were stereotaxically implanted into the cortex; dialysates were collected every 15 min to determine the concentrations of glucose, lactic acid and glutamate. Results: There was a dynamic decrease of glucose and an increase of lactic acid and glutamate during ischemia and reperfusion in saline group.Glucose decreased slightly in magnesium sulfate group during ischemia and recovered to normal rapidly during reperfusion. The lactic acid levels in magnesium sulfate group were lower than that in saline group during early stage of ischemia(0-15 min) and reperfusion.There were significant attenuation in the elevation of glutamate during ischemia and reperfusion when magnesium sulfate was administered and recovered to normal after 30 min of reperfusion. Conclusion: The preservation of cellular energy metabolism,the decrease of lactacidosis and attenuation of glutamate level during ischemia and reperfusion may contribute to the neuroprotective effects of Mg 2+ .

Modern medical staff are facing the challenge to survive in competitions and develop through cooperation.Thus it is of great importance for the future medical staff,that is,medical students to cultivate and enhance their teamwork for future demand.Cultivating approaches mainly include creating a collaborative environment,carrying out cooperative scientific research,creating teamwork in the curriculum,and launching community service activities.

The clinical thought is the core and the foundation of clinical ability.The logical teaching strengthens the students'clinical thought most directly and effectively.Through the thought training,the inference thought training and the basic thought rule training the medical students' clinical thought ability can be effectively strengthened.

Vascular smooth muscle cells (VSMCs) proliferation is the critical pathological process of in-stent restenosis (ISR). Recent researches indicate that the traditional Chinese medicine curcuma zedoary (E’zhu) can inhibit VSMCs proliferation, with a potential value in preventing and treating ISR. The major ac-tive components of curcuma zedoary are curcuma and β-elemene. The underlying mechanisms involve the inhibition of hemeoxygen-ase-1 expression, blockade of extracellular signal-regulated ki-nase – MAPK and Akt pathways, and subsequent cell cycle ar-rest. This article reviews the recent progress on curcuma zedoary extracts regulating VSMCs proliferation in ISR.

Objective To observe the effects of Yougui Pills (YP) intervention on SREBP pathway related factors of sterol regulatory element binding protein-1c ( SREBP-1c) , cholesteryl ester transfer protein ( CETP) and fatty acid synthase ( FAS) protein and gene expression in kidney yang deficiency hyperlipidemia rat model. Methods Sixty SD rats were divided into normal control group, model group (in the dosage of 2.43 g/kg), and YP group. Rat model of kidney yang deficiency hyperlipidemia was induced with intramuscular injection of hydrocortisone. Normal control group and model group were given normal saline, and YP group was given YP suspension intragastrically. After treatment, the hepatic pathomorphology of rats in the three groups was examined, and the contents of serum lipids were examined. Hepatic SREBP-1c, CETP and FAS protein expression was detected by Western-blotting method, and their mRNA expression was detected by real-time polymerase chain reaction ( RT-PCR) . Results Compared with the normal control group, serum triglyceride ( TG ) , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) contents were significantly increased (P<0.01), high-density lipoprotein cholesterol (HDL-C) was significantly decreased (P<0.01), and hepatic pathomorphological changes of hyperlipoidemia were obvious in the model group. Compared with the model group, TG, TC, LDL-C contents were significantly decreased ( P<0.01) , and HDL-C was significantly increased (P<0.01) in YP group. Model group had higher SREBP-1c, CETP and FAS mRNA and protein expression than the normal control group ( P<0.05) , while YP group had lower SREBP-1c, CETP and FAS mRNA and protein expression than the model group ( P<0.05) . Conclusion YP can decrease the blood lipid levels probably by down-regulating the expression levels of SREBP-1c, CETP and FAS gene and protein related to the the SREBP pathway in rats of kidney yang deficiency hyperlipidemia induced by intramuscular injection of hydrocortisone.

Objective To investigate the correlation of serum ferritin (SF) and hypersensitive C-reactive protein (hs-CRP) with carotid intima-medium thickness (CIMT) in aged type 2 diabetes mellitus ( T2DM) patients.Methods sixty patients with T2DM, 60 with impaired glucose regulation (IGR) and 60 normal control subjects were recruited .SF, hs-CRP, fasting blood glucose (FBG), 2h postprandial blood glucose(2h PBG) along with glycosylated hemoglobin (HbA1c), fasting insulin (FINS), triglyceride (TG) and total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were assayed, while CIMT of the participants were measured using B mode colorful Doppler ultrasonography .Results FBG, 2hPBG, HbA1c, FINS, homeostasis model assessment insulin resistance (HOMA-IR), TG, TC and LDL-C showed significant difference be -tween patients with T2DM and normal controls ( P <0.05).FBG, 2hPBG, HbA1c, FINS, HOMA-IR showed significant difference between patients with IGR and normal controls ( P <0.05).FBG, 2hPBG, HbA1c, FINS, HOMA-IR, TG and LDL-C showed sig-nificant difference between patients with T 2DM and IGR (P <0.05).Compared with patients with IGR and controls , SF、hs -CRP and bilateral CIMT were found significantly increased in the T 2DM group (P <0.05), the similar differences which was also found comparing IGR group and normal control group .Besides, SF had positive correlation with hs -CRP and bilateral CIMT in both T2DM group ( r =0.89, P <0.05; r =0.82, P <0.05) and IGR group ( r =0.79, P <0.05; r =0.75, P <0.05).Conclusions SF and hs -CRP might contribute to the pathogenesis of diabetic macroangiopathy ,which means they could be useful clinically as vascular risk factors.

Background Corneal confocal microscopy can denamically offer the morphological image of corneal cells at cellular level.To find out the dynamic change of corneal thickness and morphology of corneal cells with aging is very important for the design of corneal refractive surgery.ObjectivePresent study is to find out the important relevance of dynamic change of corneal thickness and morphology of corneal cells with aging and the design of corneal refractive surgery and investigate the influence of age on central corneal tissue and characterize precisely the anatomy of cornea by in vivo confocal microscopy.Methods122 eyes of 122 normal subjects were enrolled in this study with the age from 18 through 80 years old.The subjects were diagnosed as emmetropia in the Center of Tianjin Medical University from August 2003 to December 2007.All eyes were examined in vivo by confocal microscopy.The cell morphology,cell density and corneal thickness were measured by confocal microscopy.The relationship of central corneal tissue change and age was evaluated.ResultsThe density of corneal superficial basement epithelial cells showed a significantly negative correlation with age (r=-0.355,P=0.017).The keratocyte density in the anterior and posterior stroma indicated a significantly negative correlation with age (r_1=-0.462,P=0.001;r_2=-0.403,P=0.016).The thickness of corneal epithelium cells had a significantly negative correlation with age (P=0.02).The mean value of total corneal thickness and stromal thickness in high myopic eyes was (523.2±26.20)μm and (468.4±20.72)μm respectively,presenting a significantly negative correlation with age (r_1=-0.552,P=0.014;r_2=-0.545,P=0.035).A significantly negative correlation was also found in endothelial cell areas and density with age (r_1=0.417,P=0.004;r_2=-0.598,P=0.002).The percentage of polymorphological corneal endothelial cells was considerably increased(r=0.417,P=0.004)but that of pleomorphism cells was significantly decreased in >60-year-old population compared with younger subjects (r=-0.598,P=0.002).The morphology of corneal basement cell,anterior stroma cytocyte and endothelial cell were normal in younger subjects,and enlargement of the cells in size,decreases of number and density of the cells were found in >60-year-old subject.ConclusionThe anatomy and histology of the central cornea in young subjects exist discrepancy from older ones.The corneal hisological changes with aging include thinner thickness of epithelium,thinner thickness of cornea,decreased density of keratocyte and endothelial cells and increased size of endothelial cells.Corneal thickness is asymmetric and seems to undergo age-related anatomic changes.