Objective To compare the therapeutic effect of endoscopic variceal ligation (EVL) and β-blockers plus isosorbide mononitrate (ISMN) in prevention of esophageal varieeal re-bleeding. Methods The randomized clinical trials (RCTs) on EVL and β-blockers plus ISMN for the prevention of esophageal varieeal re-bleeding were searched, and only the results from those with Jadad score higher than 3 were eval-uated with RevMan 4. 2 software for odds ratio (OR) with 95% confidence intervals (95%C1). Analysis of sensitivity was performed on the quality of the data and publication bias was investigated with funnel plots. Results Four trials matched the criteria were recruited including 504 cases with a follow-up from 8 to 25 months. There was no significant difference in rates of re-bleeding (OR =0. 93, 95% CI =0. 41 ～ 2. 11 ; P = 0. 87), re-bleeding due to esophageal varices (OR = 0. 68, 95% CI = 0. 19 ～ 2. 37 ; P = 0. 54), therapy-re-lated adverse effects (OR = 1.12, 95% CI =0. 75 ～ 1.67, P = 0. 57), severe adverse events (OR = 0. 89, 95% CI =0. 47 ～ 1.67, P = 0. 71), bleeding-related mortality (OR = 2. 11, 95% CI = 0. 88 ～ 5.08, P = 0. 10), or overall mortality (OR = 1.46, 95% CI = 0. 95 ～ 2. 24, P = 0. 09) between EVL and β-blockers plus ISMN groups. However, a trend towards lower bleeding-related mortality and overall mortality favored drug therapy. There was no heterogeneity found in the outcomes apart from re-bleeding (P = 0. 003) or re-bleeding from esophageal varices (P <0. 0001). The result of sensitivity analysis remained statistically sta-ble. Symmetric funnel plots showed there was no evidence of publication bias. Conclusion EVL and β-blockers plus ISMN show an equivalent efficacy and safety for the prevention of esophageal variceal re-bleed-ing. There is a trend towards lower bleeding-related mortality and overall mortality in drug therapy. But EVL is free from drug-related side effects, and its adverse events are similar to those of drug therapy. Thus, either of the two approaches can be used as the first choice for prophylaxis of re-bleeding of esophageal varices.

By exploring the fitting teaching methods and models oriented to these foreign students,the problems such as language,teaching materials,objectives existing in the basic medicine subjects teaching for South-Asian students are discussed,in order to further enhance the quality of teaching and reinforce the international cooperation of medicine education.

Frontotemporal lobar degeneration (FTLD) is a non-Alzheimer dementia syndrome characterized by focal atrophy of the frontal and/or temporal lobes. Recently, it has been found that FTLD is related to the degeneration of tau protein, and is closely associated with corticobasal ganglionic degeneration, progressive supranuclear palsy, and motor neuron disease. This article reviews the progress in etiology, genetics, pathology, clinical features, and diagnostic criteria of FTLD.

There are no anatomic or physiologic criteria for the diagnosis of irritable bowel syndrome (IBS) and the disease is defined mainly on exclusion of organic lesions. Therefore, quite a few patients with IBS are not promptly diagnosed and treated. It is important to apply RomeⅡCriteria, instead of its limitation, in those who have abdominal pain with relief by defecation, sensation of incomplete evacation after defacation, passage of rectal mucus and abdominal distention, and to employ endoscope and laboratory studies necessary for those with "red flags" to exclude organic diseases. Recent advances in the research of IBS demonstrated that predisposing factors such as intestinal inflammation may contribute to changes in the intestinal mucosal immune system, resulting in hypersensitivity of afferent nerves and abnormal intestinal motility. Severe life events or/and chronic depression are more likely to associate with the patterns of IBS and its severity, and to have relation with post infection IBS. Behind the above mentioned factors there may exist specific genetic abnormality.

Objective To identify the effect of oral cod liver oil on serum 25-Hydroxyvitamin D [25 (OH)D] level in breast-fed infants during winter.Methods Healthy newborn infants were recruited at Children's Hospital Affiliated to Capital Institute of Pediatrics between December 2009 and February 2010 for the self-controlled study.Serum samples were obtained with 2 ml umbilical cord blood for each neonate.The neonates received vitamin D supplementation in the form of oral cod liver oil from 15 days to 4 months after birth.For each exclusively breastfed infant,2 ml fasting venous blood was collected at the end of postnatal 4 months to separate serum.Serum 25 (OH) D concentrations of the infants were determined with umbilical cord blood serum and venous blood serum.Results Altogether 43 exclusively breastfed infants were enrolled,including 26 boys and 17 girls.The mean serum 25 (OH)D concentration in umbilical cord blood was (20.9 ± 5.1) nmol/L (12.5-32.1 nmol/L).All the neonates were vitamin D deficient.The mean serum 25 (OH) D concentration in infants at 4 months was (106.3 ± 42.4) nmol/L (30.2-208.5 nmol/L).Among the infants,the serum 25 (OH) D level was ＜ 50 nmol/L in 4 infants (the rate of vitamin D deficiency being 9.3％),50-75 nmol/L in 7,75-150 nmol/L in 25,and ≥150 nmol/L in 7.A positive correlation was detected between serum 25(OH)D level and cod liver oil dose (r =0.530,P =0.001).The average percentage of the missed doses (missed doses/prescribed doses) was 36.1％,negatively correlated with serum 25 (OH)D level (r =-0.634,P =0.001).Conclusions Vitamin D deficiency is common among infants born during winter in northern China.Daily oral intake of cod liver oil in infants can significantly increase serum 25 (OH) D level; However,the prevention of vitamin D deficiency cannot be ensured if doses are missed.

ObjectiveTo explore the relative model for psychological resources and poverty attributions of migrant workers in adversities in the aim of understanding poverty problems in China Mainland and find out the factors for tolerance in systematic unjustness.MethodsChina Mainland Poverty Attribution Questionnaire (CMPAQ) ,Simple Coping Style Questionnaire(SCSQ),Resilience Scale (CD-RISC),Locus of Control subscale (I_E) and Thrift subscale (T_E) of CPAI-2 were used upon 398 rural migrant workers,in which 301 were valid.Results ①Deseription statistic: compared with national model,migrant workers score higher in positive coping style subsonic(1.92±0.45),and lower in negative coping style subscale (1.46±0.66),lower in CD-RISC (60.98±14.26) ,higher in I_E subscale (5.53±2.17) and lower in T_E subscale 7.48 + 1.77) ; Scores on the subscales of CMPAQ were separately overburden-fate (3.25±0.90),institution-unjustness (3.45±1.03),personal-competence(3.72±0.78),personal-quality (3.03±1.04),and geographical-environment (3.07±0.97).②Regress analysis:positive coping style can clearly positively predict personal-competence and personalquality attribution,while negative coping style can clearly positively predict all other factors.Resilience(CD-RISC)can clearly positively predict personal-competence attribution.The standard regression coefficient (β) of inner locus of control (I_E) to overburden-fate was negatively significant,while that of thrift (T_E) to all the poverty attribution factors was not significant.All variables other than negative coping style couldn' t clearly predict institution-unjustness attribution.ConclusionThe study discovered some positive psychological resources in rural migrant workers.These resources help them attribute poverty to personal competence but stand in tolerance for institutional unjustness.

Objective To explore the natural forgetters' episode memory and personality characteristics.Methods Situational Self-Awareness Scale(SSAS),Russell Loneliness Scale and Zimbardo Time Perspective Inventory(ZTPI)are used upon 127 natural forgetters and subjects of control group.in which 90 subjects participate tions,natural forgetters performance worse than subjects of control group(t=1.76 one-tail,P＜0.05),but subjects getters score lower in the SSAS and the future subscale of ZTPI(t1=1.73,P＜0.05 one-tail;t 2=2.70,P＜0.05),and tend to endorse in the present fatalistic subscale of ZTPI(t=2.19,P＜0.05),but don't feel more lonely.Conclusion Natural forgetters episodic memory is selectively micro-injured under the enactment conditions,which is different from the aging impairment mode of selective source memory,and they have some special personality characteristics.

OBJECTIVE: To observe the effects of Xinmailong (XML), Xiangdan (XD) and Shenmai (SM) Injection on early kidney damage induced by toxin of grass carp bile (GCB) and provide experimental evidence for Chinese medicine in treating toxication of GCB. METHODS: GCB (6ml/kg) was administered orally to adult SD rats to induce the model of GCB intoxication and a single intraperitoneal injection of XML, XD or SM was administered 10 min later. RESULTS: It was found that the levels of blood creatinine and blood urea nitrogen were decreased and the creatinine clearance rate was increased by XML, XD or SM. Degenerated epithelial cells of proximal convoluted tubules and glomeruli containing red blood cells in saccular cavities were decreased as compared with the normal group (P<0.01). CONCLUSION: The Chinese medicine XML, XD and SM Injection have therapeutic effects on early kidney damage induced by toxin of GCB.

AIM:To investigate the effect of tanshinone IIA on the apoptosis of human umbilical vein endothe -lial cells (HUVECs) after high glucose treatment.METHODS:The cell viability was determined by MTT assay.The cell apoptotic rate was examined by flow cytometry with Annexin V-FITC/PI double staining .The expression of Bcl-2 and Bax, and the release of mitochondrial cytochrome C ( Cyt C) were analyzed by Western blotting .RESULTS: Tanshinone IIA significantly inhibited high glucose-induced decrease in cell viability and increased the cell apoptosis .Additionally, after tanshinone IIA treatment , Bax expression and the release of mitochondrial Cyt C were significantly inhibited , while Bcl-2 expression was increased .CONCLUSION: Tanshinone IIA prevents high glucose-induced endothelial cell apoptosis via mitochondria-dependent pathway .

Objective To assess the relationship between mitochondrial DNA (mtDNA) ND2 gene C5178A polymorphism and complications of cardio-cerebral-vascular in patients with type 2 diabetes mellitus (T2DM).Methods This is a case-control study.448 unrelated patients with T2DM were collected from Zhejiang Provincial People's Hospital from 2010 to 2011,including 274 males and 174 females.Direct nucleotide sequencing analysis was used to screen mtDNA ND2 gene C5178A genotyping in ）patients.Meanwhile,detailed clinical and laboratory information for all of study subjects were collected.Body mass index (BMI),blood pressure,blood lipid,blood glucose and incidence rate of cerebral infarction were compared between 5178C patients and 5178A patients.Furthermore,according to the genotyping results,we 2analyzed whether these differences exist in patients with different gender by using t test or x2 test.Results 348 out of 448 patients with T2DM were C carriers and the remaining patients were A carriers.There're significant differences between T2DM patients with 5178A and T2DM patients with 5178C on systolic pressure (124.6 mm Hg ± 9.0 mm Hg vs 127.8 mm Hg ± 10.7 mm Hg,t =2.700,P =0.007)and HDL (1.3 mmol/L ± 0.2 mmol/L vs 1.2 mmol/L ± 0.3 mmol/L,t =2.968,P =0.003).Moreover,the incidence of cerebral infarction in T2DM patients with 5178A (8.0％,8/100) was much lower than that with 5178C (21.0％,73/348 ; x2 =8.832,P =0.003).No statistical gender difference was found in the distribution of C5178A (P ＞ 0.05).Our results also revealed that the female T2DM patients with 5178A had a lower serum triglyceride (1.5 mmol/L ±0.8 mmol/L; t =2.601,P =0.011) and lower systolic pressure (123.6 mm Hg±6.6 mm Hg; t =2.887,P =0.004) than that with 5178C (1.8 mmol/L ± 1.0 mmol/L and 128.0 mm Hg ± 9.0 mm Hg,respectively).Furthermore,cerebral infarction was more common in female T2DM patients with 5178C (21.3％,29/136; x2 =5.232,P =0.022) than that with 5178A (5.3％,2/38).Similarly,male T2DM patients with 5178A had a much lower incidence rate of cerebral infarction (9.7％,6/62; x2 =3.946,P =0.047) than that with 5178C (20.7％,44/212).In contrary,the serum concentration of HDL was higher in male T2DM patients with 5178A (1.4 mmol/L ±0.2 mmol/L;t=3.511,P =0.001) than that with 5178C (1.2 mmol/L±0.3 mmol/L).Conclusions The polymorphism site mtDNA C5178A correlates with cerebral-cardiovascular complications in patients with type 2 diabetes mellitus.mtDNA 5178A allele may protect T2DM patients from developing cerebral-cardiovascular diseases through regulation of blood pressure and lipid metabolism.