0.05).Conclusion:There was likely no association between the polymorphism at the serotonin transporter gene and autism. The serotonin transporter gene polymorphism might not play a causal role in the development of autism.

AIM: To study the effect of Qilong Capsule (QLC) on experimental thrombosis and its thrombolysis. METHODS: Rat's thromboses induced by the arteriovenous shunt and by stimulating the common carotid artery (CCA) and serum pharmacol ogy method was used to study the effect of QLC on thrombus. Turbidimetry was u sed to observe the effect of QLC on platelet aggregation of normal rats induced by A DP and collagen. RESULTS: QLC 0.6g?kg -1 and 0.3g?kg -1 could notably li ghten the wet-weight and dry-weight of thrombosis in the arteriovenous shunt m odel in rats(P

ObjectiveTo explore the significance and the scheme of OSCE ( Objective structural clinical examination ) applied in clinical resident training and examination. MethodsOSCE were adopted to train and evaluate residents clinical skills. 180 residents were trained through OSCE for two weeks.Then a test on clinical skills of the residents by OSCE was conducted after training. 172 questionnaires of evaluation on the training effect were collected and analyzed. ResultsWith regard to the training and examination of clinical skill, 96.51％ residents considered that it was helpful for clinical work, 98.26％ considered that it would make their operation more standandized. ConclusionThe training through OSCE is an important way to improve and evaluate clinical skills of residents and may be widely applied.

Objective To explore the features of clinicopathology,gastroscopy,endoscopic ultrasonography (EUS) and immunohistochemistry of esophageal mesenchymal tumors (EMT).Methods The clinical data of 98 cases of EMT patients who underwent endoscopic biopsy,endoscopic treatment or surgery and were diagnosed according to pathological and immunohistochemistry examination were collected.The clinicopathologic characteristics,endoscopy,EUS and immunohistochemistry of these cases were retrospectively analyzed,and differentiated from other submucosal tumor.Results Among the 98 cases of EMT,there were 77 leiomyomas (LM),15 gastrointestinal stromal tumors (GIST),four lipomas,one leiomyoblastoma and one schwannoma.The age of GIST group were older than that of LM group,and most were male patients predominated in these two groups.Dysphagia was the most common symptom of EMT.Gastrointestinal bleeding was rare,which was different from other gastrointestinal mesenchymal tumors.Under endoscopy,the appearances of EMT were similar,as submucosal protuberant lesions.One esophageal GIST was extraluminal lesion.Under EUS,LM,GIST and schwannoma showed low echo images originated from the muscularis propria or muscularis mucosa.Lipomas showed high echo images originated from submucosa.Pathological examination indicated that main cell type of LM and schwannoma was spindle cell,part of GIST was epitheloid cell type.The expressions of CD117 and CD34 were high in GIST,the expressions of SMA and Desmin were high in LM.S-100 was expressed in schwannoma.Other submucosal tumors,such as esophageal cyst,esophageal tuberculosis,esophageal carcinosarcoma,and some esophageal squamous carcinoma were easily misdiagnosed as EMT.Conclusions Esophageal LM is the most common EMT,followed by GIST.EUS is helpful in EMT diagnosis,however it can not accurately distinguish GIST,LM or schwannoma.

Objective To compare the analgesic effects of epidural Morphine versus lumbosacral plexus block in patients undergoing hip joint replacement.Methods A total of 94 ASA Ⅰ ～ Ⅱpatients undergoing hip surgery with combined spinal epidural anesthesia(CSEA) were selected and randomized into 4 groups:Group M received a single epidural injection of 2 mg Morphine for analgesia,Group MN1 received an epidural injection of 1 mg Morphine combined with lumbosacral plexus block,Group MN2 received an epidural injection of 2 mg morphine combined with lumbosacral plexus block,and Group N received lumbosacral plexus block.All patients were administered intramuscular parecoxib for 3 days after surgery and,if the visual analogue scale(VAS)≥4,additional intramuscular tramadol.Patient-controlled intravenous analgesia(PCIA) was applied if pain relief was insufficient after Tramadol treatment.Postoperative analgesic effects,the ability to ambulate and side effects were monitored.Results VAS scores gradually increased in the 4 groups after surgery and were higher between the morning of the 1st day and the evening of the next day than at 4 hours after surgery in all the 4 groups.There were no significant differences in VAS scores between rest and exercise conditions in any of the 4 groups.Ambulatory VAS scores were lower in Groups MN1 and MN2 than in Groups M and N 6 hours after surgery,while resting VAS scores had no significant differences between the 4 groups.Resting and ambulatory VAS scores were both lower in Groups MN1 and MN2 than in Groups M and N 6 hours after surgery,while they had no significant differences between either Groups MN1 and MN2 or Groups M and N 4-8 hours after surgery.Resting and ambulatory VAS scores were lower in Groups M,MN1 and MN2 than in Group M on the morning of the day after surgery,and more patients in Group N needed early tramadol and PCIA for rescue analgesia.Muscle strength was lower in Groups MN1 and MN2 than in Groups M and N 4 hours and on the morning of the day after surgery.No significant differences between the groups were found in standing ability 6 hours after surgery and in motor activity on the morning of the day after surgery.The incidence of urinary retention was higher in Groups M and MN2 than in Groups MN1 and N,and was higher in Group MN1 than in Group N.The incidence of pruritus was higher in Groups M and MN2 than in Group N.There was no significant difference in Ramsay sedation scores and postoperative nausea and vomiting (PONV) between the groups.Conclusions Epidural morphine combined with lumbosacral plexus nerve block can provide better analgesic effects than a single dose of epidural morphine or lumbosacral plexus nerve block in elderly patients undergoing hip joint replacement.Although the synergy of the combination has certain influence on early muscle strength recovery,it does not affect early postoperative rehabilitation training.With the combined use of parecoxib and lumbosacral plexus nerve block,epidural injection of 1 mg and 2 mg morphine provides similar analgesic effects,but epidural injection of 2 mg morphine results in a higher incidence of urinary retention.Thus,a small dose of epidural morphine combined with lumbosacral plexus nerve block is recommended for postoperative analgesia in elderly patients receiving hip joint replacement.

BACKGROUND:At present,the problems such as serious shortage of donor liver organs for transplantation,surgical injury,high incidence of surgical complications,as well as the high costs limit the development of liver transplantation,while the hepatic stem cell(HSC)transplantation provides a new pathway for the treatment of end-stage liver disease.OBJECTIVE:To introduce the source and classification of HSCs,research progress and problems of HSC transplantation for treatment of end-stage liver disease,and the clinical application prospects of HSC transplantation.METHODS:Articles were collected from CNKI and Medline database with the keywords of "hepatic stem cells,liver disease,transplantation" in both Chinese and English from 1999 to 2009.Among 87 articles,30 were included according to inclusion and exclusion criteria.Following reading titles and abstracts,original articles,and articles closely related to HSC transplantation with reliable argument and evidence and general analysis were included.Articles of repetitive studies and poor quality were excluded.RESULTS AND CONCLUSION:The HSC can be divided into liver-derived stem cells and non-liver-derived stem cells.Liver-derived stem cells include hepatic oval cells,mature liver cells and small hepatocyte-like progenitor cell.Non-liver-derived stem cells were mainly derived from embryonic stem cells,bone marrow hematopoietic stem cells and pancreatic stem cells.Currently,the research for the treatment of liver disease by HSC is still in its early stages.There are many difficult issues to be studied and solved in the discovery,separation,purification,comprehensive identification,cultivation,directed differentiation as well as clinical trials.However,as a new source of seed cells,HSC can not only replace the damaged tissue but can stimulate the receptor in tissue regeneration.Hence,compared with the clinical liver transplantation and bio-artificial liver,there are very bright future for the treatment of liver diseases by transplating HSC.

Objective To determine the effects of practicing a simplified 24 movement form of Tai chi on the level of inflammatory cytokines and the quality of life of type 2 diabetes patients. Methods A group of type 2 diabetes patients practiced a simplified 24 movement Tai chi routine 60 min/d, 3 d/week for 6 months. Plasma glu-cose and insulin concentration were monitored. The plasma level of IL-6, IL-18, sCD40L, hsCRP and HBAc1 were measured. Changes in the patients' quality of life were also measured by using the SF-36. Results Serum IL-6,IL-18, hsCRP and sCD40L levels were all significantly lower compared with a control group. Significant quality of life improvements were seen in the Tai chi group compared with the controls. Significant reductions were seen in blood pressure, glycated haemoglobin, glucose, insulin resistance and urinary albumin. Conclusions These results sug-gest that regular Tai chi practice can prevent complications and improve the quality of life of diabetes sufferers through glyeaemic control and down-regulating inflammatory cytokine levels.

Objective To compare the noxious stimulations induced by insertion of Proseai laryngeal mask airway(PLMA)and classic laryngeal mask airway(CLMA)in children.Methods Forty-seven ASA Ⅰ or Ⅱ children,aged 3-12 yr and undergoing surgery under general anesthesia,were randomly divided into 2 groups:PLMA group(group P,n =23)and CLMA group(group C,n =24).General anesthesia was induced with target-controlled infusion(TCI)of propofol.When the effect-site concentration of propofol was equal to the plasma concentration predetermined.PLMA or CLMA insertion was attempted.The target plasma concentration of propofol was predetermined according to Dixon's up-down method,with 0.2 μg/ml as a step size.The initial target plasma concentration of propofol was 6 μg/ml and 4.4 μg/ml for groups P and C,respectively.The preedetermined target plasma concentration of propofol and the satisfaction of insertion conditions for each child were recorded.Results The 50％ effective concentration(EC50)of propofol to achieve satisfied condition of PLMA and CLMA insertion were 5.87(95％ CI,5.62-6.11)and 4.53(95％ C1,4.38-4.69)μg/nl,respectively,and the difference was significant(P ＜ 0.01).Conclusion The noxious stimulation induced by insertion of PLMA in children aged 3-12 years is stronger than that of CLMA.

BACKGROUND: There is still recrudescent risk in the convalescence stage of the acute myocardial infarction and the living condition is relatively poor. The study proved that it has relation to that the patients haven't mastered the scientific conformable life style for the myocardial infarction recovery.OBJECTIVE: Take the rehabilitation education to help the patients set up conformable life style so as to improve the quality of life.DESIGN: The patients in the convalescence stage of the acute myocardial infarction were chosen for the control study.SETTING: Nursing Institute of Beijing Medical University and two university hospitals.PARTICIPANTS: The cases were taken from the Cardiology Departm ents of the Second and Third Affiliated Hospital of Beijing Medical University from April 1999 to November 1999. Inclusive standard: the first onset of the acute myocardial infarction and voluntary for this study. Exclusive standard: not the first onset of the acute myocardial infarction. The control group contained 35 patients hospitalized from April 1999 to June 1999 conforming to the including standard. The experimental group contained 40 patients hospitalized from August 1999 to November 1999 conforming to the including standard. After eliminating the special unmatched cases and missed follow-up cases in the experimental group, the final 30 cases were respectively involved in the both groups. There were 23 male cases and 7 female cases in the control group with the mean age of(60 ± 14), and 22 male cases and 8 female cases in the experimental group with the mean age of(62 ± 10) . There was no significant difference in the age and sex in these two groups.METHODS: The Neuman health care system pattern was taken as the theoretical frame for the rehabilitation education of the patients in the convalescent stage of the acute myocardial infarction. That is the conver genceteaching and personal illustration accompanied the rehabilitation education hand books were adopted for the rehabilitation education in the experimental group before their leaving. Then the telephone education was taken for further direction and consultation during the first three months after being discharged. The evaluation information was obtained through the follow-up after the first three months.MAIN OUTCOME MEASURES: The quality of life and dimensions in the two groups.RESULTS: Compared with the control group, the scores of the quality of life, the dimensions of the body, the psychology, the duty role and the health consciousness in the experimental group were all significantly higher(t= 11.03,3.26,3.62,2.05,15.48, P < 0. 05), while there was no significant difference in the social degree( P > 0.05) .CONCLUSION: The rehabilitation education can significantly improve the quality of life of the patients in the convalescence stage of the acute myocardial infarction.

Objective To assess left ventricular(LV) longitudinal strain in patients with coronary heart disease by two-dimensional speckle tracking imaging (2DSTI),and to explore the clinical value of 2D longitudinal strain in detecting myocardial ischemia. Methods Forty-four patients with coronary heart disease (CHD group) and 28 age-matched subjects (control group) were enrolled into this study. The two-dimensional data were obtained in apical 4-chamble, 2-chamber and long axis view. And the longitudinal strains of every segments, the average longitudinal strain of LV 18 segments (SL18), the average longitudinal strain of 12 segments (SL12,excluded the 6 apical segments) were analyzed. Results In the patients with CHD, the longitudinal strain of ischemia segments and the global LV longitudinal strain were significantly decreased than that of the control subjects. Both in patients with CHD and in control subjects,the longitudinal strains in apical segments were higher than that of middle and basal segments. There was significant difference between SL18 and SL12 ( P=0.027 in CHD group and P =0.003 in control group).Receiver operating curve (ROC) analysis demonstrated that the cutoff point of SL18 to detect myocardial ischemia was - 18.8％ (sensitivity 80.2％ and specificity 74.1％ ) ,and the cutoff point of SL12 to detect myocardial ischemia was - 17.8％ ( sensitivity 81.7％ and specificity 85.6％ ). Conclusions 2D longitudinal strain was sensitive to detect myocardial ischemia, SL12 was better than SL18 in detecting myocardial ischemia. 2DSTI might be useful for identifying patients with severe CHD.