Adolescent ; Child ; Child, Preschool ; Female ; Hepatocyte Growth Factor ; metabolism ; Humans ; Kidney ; metabolism ; pathology ; Male ; Nephrotic Syndrome ; metabolism ; pathology ; Proto-Oncogene Proteins c-met ; metabolism

Objective To evaluate the disease onset regions and spreading patterns in sporadic amyotrophic lateral sclerosis (ALS)patients and related influencing factors.Methods We performed a prospective analysis of 1 58 ALS patients.The disease-onset was confirmed according to the patients’self-reports,neurological examination results and electromyogram study.We followed up 1 5 1 patients with the second or other affected body regions during the disease progression.Data were analyzed according to the different groups of onset regions.Results 1.In 94.3% (149/1 58)of the patients,the early motor manifestations were focally in the bulbar,upper or lower limbs.2.The region of onset was associated with signs of lower motor neuron (LMN)and upper motor neuron (UMN)involvement (P = 0.000 ).The LMN involvement was more distinctive in patients with bulbar onset (65.4%,1 7/26 )group.Patients with cervical onset more frequently showed pure LMN (47.9%,45/94 )or concomitant UMN (52.1%,49/94)signs in the affected limbs.The highest proportion of UMN and LMN signs in the affected lower limb was found in the lumbar onset (83.8%,31/37 )group.3.Spreading patterns:Rostral to caudal spreading pattern was more frequent in bulbar onset patients.For patients with limb onset,there were significant differences between spreading patterns and disease-onset regions (P =0.04).Circular (31.5%,28/89),horizontal (30.3%,31/89)and vertical (21.3%,1 9/89)spreading patterns were more frequent in cervical onset patients whereas circular (47.2%,1 7/36)spreading patterns were more frequent in lumbar onset patients.4.There was a strong association between the rate of progression and age of disease onset (P =0.01 1).Patients aged over 60 had a faster progression.Conclusion ALS is a focal process at motor axis along the spinal cord and cerebral cortex.Different disease-onset can cause different distribution of UMN and LMN signs.Therefore,special attention should be paid to the signs of disease-onset clinically.ALS does start focally and spreads to adjacent regions.Elder patients have a faster disease progression.

Objiective To evaluate the histocompatibility of gelatin-bletilla/Salvia-miltiorrhiza i material and to discuss the appropriate concentration of salvia-miltiorrhiza in the material. Method Salvia-miltiorrhiza together with gelatin and bletilla was used to make a kind of porous membranes. A total of 175 rats were divided randomly (random number) into 5 groups ( n = 35 in each). The porous membranes containing salvia-miltiorrhiza material in different concentrations of 1, 2, 4, and 5 mL/100 g were implanted subcutaneously into the rats of the four experimental groups, respectively. The gelatin-bletilla material without salvia-miltiorrhiza was implanted into the rats of control group. In 1, 3, 7, 14, 21, 28 and 56 days after implant, the materials were taken out of the bodies of the rats, separately. The material implanted for 1, 3, 7 and 14 days were observed with immunohistoche-mistry. Results In the area of implant, no noticeable inflammation or other was found. The implanted materials were degraded and entirely absorbed in vivo in 8 weeks. The salvia-miltiorrhiza in concentration of 2 mL/100 g in vivo promoted the angiogenesis most significantly. Conclusions The gelatin-bletilla/salvia-miltiorrhiza material has excellent histocompatibility and the appropriate concentration of salvia-miltiorrhiza in material is 2 mL/100 g.

Objective To investigate the influence of high-voltage electrical burn on the throm-bomodulin (TM), protein C (PC), protein S (PS) and D-Dimer (D-D) in SD rats. Methods One hundred and twenty healthy SD rats were divided into the fake high-voltage electrical burn groups (FHEB), high-voltage electrical burn groups (HEB) according to the random number table, with 60 rats in each group. Ten rats were taken from each group at 15 minutes before injury. Plasma were collected from heart blood. Fifty SD rats of HEB group with voltage regulator and experimental transformer. The remaining fifty SD rats of FHEB group were sham injured with the same devices without electric current. At 5 minutes and 1, 2, 4, 8 hour (s) post injury, 10 rats of every group were randomly chosen at each time point for observation of the concentrations of TM, PC, PS and D-D. Plasma were collected from heart blood. Data were processed with analysis of variance of factorial design and LSD test. Results Compared with the FHEB group, the concentration of TM from 5 minutes to 8 hours post injury in HEB group was higher significantly (P < 0.05). Exception of the concentrations of PC and PS at 15 minutes before injury, the concentrations of PC and PS were lower than those of FHEB group (P < 0.05). The concentration of D-D in HEB group peaked at 8 hours post injury in (173.05 ± 4.08) ng/mL. Conclusion High-voltage electrical burn at early stage can increase the concentrations of TM, D-D, as well as decrease the concentrations of PC and PS, which are not only causing the vascular endothelium damage but also possessing serious effect on the thromboplastin function of SD rats.

Objective To observe the regularities of distribution of TCM syndrome types and correlation between TCM syndrome types and cardiovascular prognosis risk factors of elderly hypertensive patients in three different urban and rural communities.Methods Totally 299 elderly hypertensive patients who conformed to the hypertensive diagnostic criteria from 896 respondents which participated in the health monitoring questionnaire drafted by health management team of China Academy of Chinese Medical Sciences were screened. The syndrome types were differentiated according to Guiding Principle of Clinical Research on New Drugs of Traditional Chinese Medicine (for Trial Implementation). The levels of some risk indicators, such as blood glucose, blood lipid, CREA, ET, Hcy and mALB were measured by radioimmunoassay, enzymatic cycling assay and other methods. Age, gender, BMI and pulse pressure were recorded.Results The TCM syndrome types of 299 elderly hypertensive patients were deficiency of yin and yang type (74 cases), hyperactivity of yang due to yin deficiency type (65 cases), blood stasis syndrome type (62 cases), stagnation of phlegm-dampness type (61 cases), hyperactivity of liver-fire type (37 cases). Single factor analysis showed that there existed statistical significance among BMI, FBG, GHbA1c, CREA, TC, LDL-C, ET, Hcy and mALB in the 5 TCM syndromes (P<0.05,P<0.01), and the statistical significance was more apparent in the stagnation of phlegm-dampness type, blood stasis syndrome type and hyperactivity of yang due to yin deficiency type. Discriminant analysis showed BMI and Hcy have certain reference value for the diagnosis of TCM syndrome types in elderly hypertensive patients. Binary-Logistic regression analysis showed that the course of disease had a positive correlation with syndrome of deficiency of yin and yang.Conclusion Compared with other types of elderly hepertensive patients, stagnation of phlegm-dampness type and blood stasis syndrome type are more closely related to hypertension cardiovascular prognosis risk factors.

Objective To analyze the compatibility laws of homologous Chinese medicine of medicine and food in prevention and treatment of Alzheimer disease (AD). Methods We screened the clinical literature for the treatment of AD during 1988-2012 in TCM Clinical Diagnosis and Treatment Database, CNKI, VIP and Wanfang database. The nature, flavor, channel tropism, high frequency drug pair and compatibility laws of Chinese medicine and homologous Chinese medicine of medicine and food in prevention and treatment of AD were analyzed by frequency statistics and association rules. Results Two hundred and twenty-two clinical literatures were included. The top five frequently-used homologous Chinese medicines of medicine and food were Poria, Fructus Lycii, Fructus Alpiniae Oxyphyllae, Semen Persicae, and Rhizoma Dioscoreae. The top five frequently-used medicine were Rhizoma Acori Tatarinowii, Radix Polygalae, Rhizoma Ligustici Chuanxiong, Radix Salviae Miltiorrhizae, and Radix Angelicae Sinensis. The top five frequently-used drug pairs of homologous Chinese medicine of medicine and food were Rhizoma Dioscoreae→Poria, Poria→Pericarpium Citri Reticulatae, Rhizoma Dioscoreae→Fructus Lycii, Fructus Lycii→Fructus Alpiniae Oxyphyllae, and Fructus Lycii→Poria. The top five frequently-used drug pairs were Rhizoma Acori Tatarinowii→Radix Polygalae, Radix Salviae Miltiorrhizae→Rhizoma Acori Tatarinowii, Rhizoma Ligustici Chuanxiong→Rhizoma Acori Tatarinowii, Radix Salviae Miltiorrhizae→Rhizoma Ligustici Chuanxiong, and Rhizoma Acori Tatarinowii→Radix Astragali Seu Hedysari. Conclusion The commonly used homologous Chinese medicine of medicine and food in preventing and treating AD are tonic herbs with mild nature.

Objective To summarize the experience of surgical treatment of chronic pancreatitis (CP) and improve the operative efficiency Methods The clinical data of 138 CP patients under going surgical treatment in this hospital from March 1992 to May 2002 were analyzed retrospectively Results Relapsing upper abdominal pain was the major symptom of CP All patients were treated surgically, in which pancreatic fistula developed in three patients and anastomotic hemorrhage in two postoperatively The morbidity rate was 3 6% Pain was relieved in 97 8% patients One hundred and twenty four patients (89 9%) were followed up for 1～9 years (mean 4 9 years) Recurrence was seen in 13 patients (9 4%) Seven patients developed diabetes mellitus and five occurred fat diarrhea during the follow up Five patients died with two dying of CP complications Conclusion Timing of operation and selection of operation modality are of critical importance in modifying the course of the disease and improving life quality of patients

0.05).The 2 -year and 3-year survival rates were 91.7 %,89.2 % and 85.8%,86.1% in all patients for either gr oup. The 2 -year and 3-year survival rates were 84.2%,81.8% and 72.9%,77.1% in p atients with positive axillary lymph nodes for the two groups, with the differen ces insignificant (Logrank test P=0.663, P=0.9 19).There were no differences in the 2-year and 3-year survivals for patients with stage Ⅲ and over receiving ch est wall irradiation or not and patients who received different doses of chest w all irradiation (Logrank test P=0.449, P=0.764 ). Conclusions Locoregional recu rrence is not reduced and survival rate is not improved by chest wall irradiatio n in this study. The prognostic impact of chest wall irradiation and the optimal target of radiotherapy remains to be substantiated by more randomized trials.

Objective To evaluate the effectiveness of applying simulation based medical education (SBME) in critical care medicine PBL teaching. Methods Totally 46 undergraduates in medical college of Shanghai JiaoTong University , who participated in critical care medicine PBL teaching in our Hospital from 2012 to 2013 were chosen as research objects. These students were divided into two groups: PBL group (2009 grade, n=24) and SBME-PBL group (2010 grade, n=22). The teaching effectiveness was evaluated by questionnaire survey, theoretical exam, direct observation of procedural skills (DOPS) and mini-clinical evaluation exercise (Mini-CEX). Data were analyzed by SPSS 17.0 software. The data of questionnaire survey were expressed as percentage and the assessment results were expressed as x±s. Chi-square and t test were used to do statistical analysis. P<0.05 signi-fies for statistically significant differences . Results ①The results of questionnaire survey showed that:there was no significant difference between two groups in study interests(P=0.665, 0.937, 0.746) and study ability(P=0.937, 0.665). But regarding collaboration ability, SBME-PBL group performed better than PBL group (P=0.019, 0.038, 0.024). ②These was no significant difference in the theo-retical knowledge exam between PBL and SBME-PBL group(P=0.743). But the DOPS scores of car-diopulmonary resuscitation (P=0.000), endotracheal intubation (P=0.023), defibrillation (P=0.002) and central venous catheterization(P=0.047) were all significantly higher in SBME-PBL group than in PBL group. ③In Mini-CEX, there was no statistical difference in physical examination skills (P=0.790) and clinic judgment(P=0.426) between the two groups. However, SBME-PBL group performed better in medical interviewing capacity(P=0.002), humanistic care (P=0.001), counseling skills(P=0.017), organization efficiency(P=0.029) and overall clinical competence(P=0.024) than PBL group. Conclusions SBME can promote the students' team work spirit, basic clinical skills and comprehen-sive clinical capacity in critical care medicine PBL teaching and can improve the teaching quality of critical care medicine.

Objective To investigate clinicopathological features、diagnosis and surgical treatment of duodenal stromal tumors. Methods A retrospective clinical analysis was made in 23 cases of duodenal stromal tumors admitted from 1995 to 2004. Results Melena and abdominal pain was the most common presenting symptom. Complete resection was achieved in all cases, including pancreatoduodenectomy in 13 cases, by pylorus-preserving pancreatoduodenectomy in 3 cases, and tumor enucleation in 7 cases. The mean size of the tumor was 6. 6 cm (2 - 21 cm) , among them 10 cm in 6. Pathologically tumors less than 5 cm were all of potential malignancy, whereas those larger than 5 cm were malignant. Follow-up of 2 months to 9 years found all cases alive and healthy except for one who died of liver metastasis one year postoperatively. Conclusion Duodenal stromal tumors were low malignancy tumors. Aggressive surgery is the choice of treatment. Favorable prognosis is expected after complete surgical excision.