BACKGROUND: It has been shown that Qiang Chang Heji (QCHJ) hadsome protective effects in rats with experimental brain injuries and couldimprove some hemorheological indices.OBJECTIVE: To observe effects of QCHJ on peripheral platelet in rats with experimental right brain insufficiency of blood supply.DESIGN: A randomized and controlled experiment.SETTING: Central Laboratory, General Hospital of Chengdu Military Area Command of Chinese PLA.MATERIALS: Totally 60 SD white rats (either sex, werghing from 150 g to 170 g) were used. They were divided randomly into 3 groups: sham-operation group (n=8), control group (n=18) and treatment group (n=34).QCHJ:Chinese herbal mixture, equal dosage of both Rhizoma seu Radix Notopterygii and Rhizoma Acori Graminei were decocted twice, each for 30minutes with mild fire after boiling. The two decoctions were mixed and concentrated to 1g raw herb per milliliter.METHODS: The experiment was carried out in Central Laboratory, General Hospital of Chengdu Military Area Command of Chinese PLA from July to September 2004. The right carotid artery (CA) of rats were separated,ligaturewas done in control and treatment groups ;but no ligature in sham operation group. Medication (po. by gastric perfusion) was given since the day of operation. In treatment group, 10 rats took QCHJ 10 g/kg per day for3 days; and others took 3.3, 6.7, 10 g/kg per day for 7 days respectively, (8 rats for each dose). In control group, equal volume physiological saline was given daily for 3 or 7 days. In sham operation group, equal volume physiological saline was given daily for 3 days. On the 3rd and 7th days after operation, platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW) and platelet-large cell ratio (P-LCR) of platelet were determined with a Bakeman Blood Cell Auto-analyzer. t test was used to compare the difference.MAIN OUTCOME MEASURES:Effects of QCHJ on peripheral platelet in rats with brain insufficiency of blood in brain.RESULTS: ①Day 3 after operation: PLt were similar between control group and sham-operation group (P ＞ 0.05); MPV, PDW and P-LCR were higher in control group than that in sham operation group (P ＜ 0.01); in QCHJ treated group (10 g/kg per day), MPV, PDW, and P-LCR were significantly lower than that in control group (P ＜ 0.01), and they were similar to that in sham operation group. ② Day 7 after operation: MPV, PDW, and P-LCR in control group were similar to that in sham operation group. In addition, P-LCR in control and QCHJ treatment group (3.3, 6.7, 10.0 g/kg per day) were lower than that in control group on the 3rd day of operation (P ＜ 0.01).CONCLUSION: Experimental brain injury induced by block blood supply may result in peripheral platelet abnormities. QCHJ has been shown to improve some of the abnormities.

Objective To investigate the application of OSCE evaluation system on the medical skills examination of clinical medical students and the significance of this system on the training of their medical skills.Methods 20 teachers examed 150 students by the OSCE evaluation system with 4 test stations,by comparing the score of the students of different test stations by one-way ANOVA and evaluating the system by questionnaire survey with Likert 5 on the degree of satisfaction and Likert 3 on effects and intrinsic influencing factors of the system.Results The score of the first and forth test stations was lower than that in the other stations(P＜0.05).8/5.48％ students and 1/5％ teachers were not satisfied with the system.The OSCE evaluation system could exam the psychological diathesis,ability of communication,cooperation,and clinical thinking,practical skill of the students and its effects are moderate (the score was more than 2.0).Evaluation on the intrinsic influencing factors:Students considered the questions were more difficulty in the 2nd,3rd,1st,4th test stations order.4/20％ teachers considered the questions of the second test station was easy.8/40％ teachers considered the duration of the second test station was too long.More than 70％ students and teachers considered the other indexes were rational.Conclusion The OSCE evaluation system can play an effective role in directing the teaching and learning.It can also help to culture the comprehensive capacity of the students.We should gradually improve the design of the system by considering the intrinsic influencing factors.

OBJECTIVE To analyze the clinical features of 8 patients with sigmoid sinus diverticulum and to improve the level of diagnosis and treatment. METHODS The tinnitus patients were asked in detail about the history, and performed a series of routine hearing tests (pure tone audiometry, acoustic impedance audiometry, otoacoustic emission inspection and brainstem auditory evoked potential (BAEP) etc.) and temporal bone HRCT scan. Eight cases were diagnosed with sigmoid sinus diverticulum, in which six cases undertook a surgery to reconstruct the sinus wall while the other 2 cases chose conservative treatment. RESULTS The diagnosis of 6 cases was proved to be correct by surgery, and the pulsatile tinnitus disappeared after reconstructing the sinus wall. No one recurred after following up from 2 to 12 months. Two cases of conservative treatment had no obvious improvement in symptoms. CONCLUSION Clinical manifestation, hearing examination, temporal bone CT/HRCT and Cranial CTA/CTV contributed to the diagnosis of sigmoid sinus diverticulum. Sinus wall reconstruction is a better approach.

Objective To observe the regulative effect of high dose of glucocorticoid (GC) on protein synthesis and mRNA transcription of corticotropin-releasing hormone (CRH) in paraventricular hypothalamic nucleus (PVN) so to ascertain whether there exists difference upon effect of GC either at high dose or at normal dose. Methods A total of 60 Wistar rats were divided into five groups, ie, blank control group, 10 -6 mol/L dexamethasone (DEX) group, 10 -9 mol/L DEX group, 9 g/L saline group and group that was treated with 10 -4 mol/L RU486 first and then with 10 -6 mol/L DEX. The drugs were given through femoral vein. CRH protein expression was measured by means of immunohistochemistry and laser confocal scanning microscophy (LCSM); CRH mRNA transcription level was investigated by in situ hybridization. Results There appeared positive CRH mRNA granules in cytoplasm of PVN after administration with 10 -6 mol/L DEX for 20 minutes but could be seen positive fluorescent granules of CRH protein 30 minutes later, which was reversed at an in advance blockage of GR, as was free in 10 -9 mol/L DEX group, 9 g/L saline group and blank control group. Conclusions High dose of GC can up regulate CRH gene expression in PVN and differs much from the traditional effect of GC at normal dose, as may be due to that high dose of GC exerts effects depending on membrane glucocorticoid receptor but normal dose of GC dose via iGR.

Objective:To investigate the effects and underlying mechanisms of phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/NF-κB signaling pathway in human kidney-2(HK-2) cells of hyperuricemic nephropathy.Methods:HK-2 cells were cultured in vitro and randomly divided into control group and experimental group. The experimental group was induced by high uric acid (720 μmol/L) immersion for 48 h to establish a cell model of hyperuricemic nephropathy in vitro and subsequently divided into hyperuricemic group, overexpressed protease activated receptor 2 (PAR2) and knockdown PAR2 group. The expressions of PAR2, PI3K, AKT, NF-κB mRNA were measured by real-time PCR. The expressions of PAR2, PI3K, AKT and NF-κB protein were measured by Western blotting. The expressions of tumor necrosis factor-α (TNF-α), monocyte chemotactic protein-1 (MCP-1), interleukin-6 (IL-6), pro-interleukin-1β (pro-IL-1β), interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) were detected by enzyme linked immunosorbent assay (ELISA). Results:(1) Compared with the control group, the expressions of PAR2, PI3K, AKT and NF-κB mRNA and protein in hyperuricemic group were significantly increased (all P<0.05), the expressions of TNF-α, MCP-1, IL-6, pro-IL-1β, IL-1β and TGF-β1 in the supernatant in hyperuricemic group were significantly increased (all P<0.01). (2) Compared with the hyperuricemic group, the expressions of PAR2, PI3K, AKT and NF-κB mRNA and protein in overexpressed PAR2 group were significantly increased (all P<0.05), the expressions of TNF-α, MCP-1, IL-6, IL-1β and TGF-β1 in the supernatant were significantly increased (all P<0.05). (3) Compared with the hyperuricemic group, the expression of PAR2, PI3K, AKT and NF-κB mRNA and protein in knockdown PAR2 group were significantly decreased (all P<0.05), the expressions of IL-6, pro-IL-1β, IL-1β and TGF-β1 in the supernatant were significantly decreased (all P<0.05). Conclusions:In the process of uric acid-induced HK-2 cell damage, uric acid significantly up-regulates the expression of PI3K/AKT/NF-κB signaling pathway by activating PAR2, leading to a marked increase in inflammatory damage. Knocking down PAR2 inhibits the expression of PI3K/AKT/NF-κB signaling pathway, which can effectively reduce the inflammatory damage of HK-2 cells.

Objective:To observe the clinical efficacy of intermittent feeding through an oral to esophageal (IOE) tube for persons with a late-onset swallowing disorder after radiotherapy for nasopharyngeal carcinoma.Methods:Fifty-six patients with late-onset swallowing difficulties after radiotherapy for nasopharyngeal carcinoma were divided at random into an observation group and a control group, each of 28. In addition to conventional therapy, the controls were fed through an indwelling nasogastric tube (NGT) while an IOE tube was used in the observation group. The nutritional status of the two groups was compared after 20 hours and after 15 days of treatment. Depression, oral feeding ability, leakage and aspiration, and life quality were evaluated using patient health questionnaire-9 (PHQ-9), a functional oral feeding scale (FOIS), a leakage-aspiration scale (PAS), and a swallowing-quality of life (SWAL-QOL) evaluation. From the 3rd day after admission the daily amount fed was recorded.Results:At admission there were no significant differences between the two groups. After 15 days, however, there was significantly greater improvement observed in the average serum albumin, hemoglobin, serum total protein, serum prealbumin level, body mass index(BMI) and SWAL-QOL score of the experimental group compared to the control group, with significantly fewer members suffering from depression. From the 4th day after admission the observation group′s members ate a significantly larger proportion of the target feeding amount.Conclusion:IOE feeding can improve the nutritional status, psychological status, and life quality of persons with a late-onset swallowing disorder more effectively than NGT feeding, with a lower incidence of adverse events.

Metabolism reprogramming plays an important role in the process of tumor occurrence and development, and provides the necessary material basis for tumor cells. It can change the metabolic patterns of amino acids, glucose and fatty acids in tumor cells, which is one of the hallmark features of tumors. At present, it is shown that most tumors tend to take advantage of glycolysis for energy resource. In contrast, studies have shown that prostate cancer cells dependent more on the fatty acid oxidation pathway for metabolic reprogramming to obtain energy substances. Therefore, it is of great significance to understand the relation between key enzymes of lipid metabolism and regulatory genes for early diagnosis, targeted treatment and better prognosis of prostate cancer.

Myopia in China shows a trend of high incidence,younger age of onset and severe de-gree.Childhood is the golden age of myopia management,and the prevention and control of myopia in children has gradually become the focus of public health issues.Orthokeratology has become the ma-instream treatment regimen for controlling the development of myopia.This paper summarized the re-search progress of orthokeratology lens in the prevention and control of myopia in children from three aspects:the principle,function and safety of orthokeratology lens in the correction of myopia in chil-dren,and the influencing factors of application effect so as to provide scientific basis for clinical diag-nosis and treatment and myopia prevention and control.

Myopia in China shows a trend of high incidence,younger age of onset and severe de-gree.Childhood is the golden age of myopia management,and the prevention and control of myopia in children has gradually become the focus of public health issues.Orthokeratology has become the ma-instream treatment regimen for controlling the development of myopia.This paper summarized the re-search progress of orthokeratology lens in the prevention and control of myopia in children from three aspects:the principle,function and safety of orthokeratology lens in the correction of myopia in chil-dren,and the influencing factors of application effect so as to provide scientific basis for clinical diag-nosis and treatment and myopia prevention and control.

OBJECTIVETo evaluate the efficacy and safety of celecoxib in treating inflammatory(Type IIIA) chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS-IIIA type).

METHODSSixty-four patients with diagnosed CP/CPPS-IIIA were randomized equally into two groups, Group A treated with celecoxib 200 mg daily(qd), while Group B with 200 mg twice a day(bid), both for 6 weeks. The white blood cell (WBC) count in expressed prostate secretion(EPS) and National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI) were assessed and compared at baseline(0 week) and at 2, 4, 6 weeks or the endpoint.

RESULTSThe mean number of WBC in EPS and the mean NIH-CPSI total scores were decreased gradually after treatment from baseline in both groups. The mean number of WBC of in EPS of either group at the endpoint was decreased by 46.2% and 69.4% respectively(Group A vs Group B) compared with the baseline level. The mean NIH-CPSI total scores of the two groups were decreased respectively by 5.6 and 8.3 points (Group A vs Group B). In terms of the above two parameters, Group B, responded better than Group A to the treatment. The differences observed above were statistically significant(all P < 0.05). No serious adverse event presented.

CONCLUSIONCelecoxib is effective and safe for patients with CP/CPPS(IIIA). The dosage of 200 mg twice a day is more efficacious than that of 200 mg daily.

Adult ; Celecoxib ; Chronic Disease ; Cyclooxygenase Inhibitors ; therapeutic use ; Humans ; Male ; Middle Aged ; Prostatitis ; drug therapy ; Pyrazoles ; Sulfonamides ; therapeutic use