Objective To investigate the risk factors of ischemic cerebral stroke after transient ischemic attacks (TIAs).Methods The clinical data of 184 TIA patients were collected.The risk factors of ischemic cerebral stroke after TIA were analyzed.Results Compared with no ischemic cerebral infarction group, the rate of elderly (≥60 years old), hypertension, diabetes, smoking and drinking history in ischemic cerebral infarction group (P<0.05-0.01).There was no statistical significance in gender and hyperlipidemia between the two groups (all P>0.05).Compared with no ischemic cerebral infarction group, the rate of attack time≥30 min, attack frequency≥3, course of disease≥24 h were significantly increased (P<0.05-0.01).There was no statistical significance in TIA types between the two groups (all P>0.05).Logistic regression analysis showed there were a positive correlations between elderly, hypertension, diabetes, smoking and drinking history and ischemic cerebral stroke after TIA (OR=29.799, 95%CI: 2.189-405.569, P=0.011;OR=0.649, 95%CI: 0.038-6.850, P=0.005;OR=8.569, 95%CI: 1.314-55.862, P=0.025;OR=0.158, 95%CI: 0.025-0.980, P=0.048).Conclusion Elderly, hypertension, diabetes, smoking and drinking history are independent risk factors for ischemic cerebral stroke after TIA.

Objective To develop models of epileptic discharge by activating group Ⅰ metabotropic glutamate receptors (mGluR) or by blocking gamma-aminobutyric acid (GABA) receptors on rat hippocampal slices. Methods Rat hippocampal slices were exposed to mGluR group Ⅰ specific agonist dihydroxyphenylglycine (DHPG) or to GABAA receptor antagonists bicuculline methiodide(BMI), and single pyramidal cell in the CA3 region of the slice was recorded by whole cell patch clamp technique. Results Exposure to DHPG or BMI resulted in the induction of spontaneously occurring epileptic discharge in the CA3 region of rat hippocampal slice, and there was no significant difference in the frequency of discharge between them(P>0.05). Conclusion Epileptic discharge can be generated in vitro in response to a loss of balance between excitatory and inhibitory influences.

In order to improve teaching lever and explore teaching approach, the feasibility study on the combination of the problembased learning method CPBL) and the lecture-based learning method (LBL) was conducted in the teaching of Acupuncture and Moxibustion. The 2010 undergraduates in the major of clinical integrated Chinese and western medicine of five years were randomized into a PBL and LBL group and a LEL group. In the first semester, according to the basic teaching requirement, LBL was used to accomplish the teaching of basic theory. In the internship teaching section, the different teaching method was applied. In the PBL and LEL group, PEL was used, and in the LBL group, LBL was given. At the end of semester, the examination results of the theory learning and medical cases learning were evaluated. The questionnaire was summarized in the teachers and students. The final examination result of theory learning was not different significantly between the two groups (P >0. 05), but the result of medical cases learning in the PEL and LEL group was better than that in LEL group (84. 47±10. 72 vs 76. 00±9. 97, P<0. 05). The questionnaire for the students and teachers indicated that the result of PEL and LEL combined method was higher than that of LEL method (86. 27±8. 36 vs 56. 00±14. 59, P< 0. 01; 45. 89±3. 68 vs 36. 61±6. 41, P<0. 0l), indicating that the combined method of PBL and LEL is feasible in teaching of Acupuncture and Moxibustion and the teaching outcome is superior to the simple LBL, which provides the new approach to the teaching reform.
Acupuncture ; education ; Acupuncture Therapy ; methods ; Adolescent ; Education, Medical ; Faculty ; Female ; Humans ; Male ; Moxibustion ; methods ; Problem-Based Learning ; Students, Medical ; psychology ; Surveys and Questionnaires ; Teaching ; methods ; Young Adult

Objective To investigate the gene expression pattern of metabotropic glutamate receptor- Ⅰ ( mGluR-Ⅰ ), D-p-hydroxyphenylglycine (DHPG) -induced rat hippocampal slice epileptic seizure model. Methods In vitro rat hippocampal sclice was continously perfused with artificial cerebrospinal fluid containing 50 μmol DHPG, and epileptic seizure model was established (DHPG group, n = 3). cDNA microarray chip was applied to explore the gene expression pattern in DHPG group, the differentially expressed genes were screened in comparison with control group ( n = 3), and functional classification analysis was conducted. Results There were 206 up-regulated genes and 489 down-regulated genes, among which 67 up-regulated genes and 86 down-regulated genes differentially expressed by 1.5 fold, 6 up-regulated genes differentially expressed by more than 2.0 folds, and 25 down-regulated genes differentially expressed by less than 0.5 fold. Functional classification analysis revealed that differentially expressed gene function involved in protein binding (19 genes), molecular function, calcium ion binding and nucleotide binding. Conclusion Epileptic seizure and roles of mGluR-Ⅰ agonist may be related to various genes, which is a complicated process. This experiment provides evidences for further researches.

Anterior cervical plating has been widely used to treat cervical spine trauma, degeneration, deformity and tumor due to the advantages such as augmentation of cervical stability and promotion of bone graft fusion. This paper introduced the classification and evolution of plate-screw internal fixation system, analyzed the biomechanics of anterior cervical plate, and discussed its clinical application. Although the therapeutic effect of anterior cervical plating is favorable, there are still various complications postoperatively. Therefore, it is necessary to improve the anterior cervical plate from different aspects to expand its clinical application.

This study aimed to study the criteria of two-way referral between tertiary-care hospital and communityhealth-care service center for patients with cerebralhemorrhage and a protocol of implementation to promote its treatment and rehabilitation.The criteria of two-way referral between tertiarycare hospital and community health-care service center for patients with cerebral hemorrhage after surgical operation were formulated on a trial basis with mutual consultation by the department of neurosurgery,Shenzhou hospital affiliated to Shenyang Medical College and Hunhewan Community Health-Care Service Center,Heping district,Shenyang. Totally,91 patients of cerebral hemorrhage admitted to the hospital during October 2007 to September 2010 were recruited for the study,46 in the intervention group with two-way referral and 45 in the control group by self-referral determined by their family members.All the patients of the two groups were followed-up for three years.During the follow-up in the intervention group,40 of 46 (95％) patients could comply with taking medication ordered by physicians,ability of daily living remarkably improved by Barthel index in 21 (50％),physical function recovered well in 33 (79％),34 (81％) could insist in self-monitoring and 32 (76％) could visit physicians for regular consultation,all these being significantly better than those in the control group (64％,31％,28％,25％ and 25％,respectively) (P ＜0.01 ).Medical and rehabilitative cost for patients with cerebral hemorrhage accounted for 575 RMB yuan per month in intervention group,as compared to 2246 RMB yuan for those in control group.Two-way referral for patients with cerebral hemorrhage can reduce their medical cost and promote their better rehabilitation.

Objective To evaluate the operation of laparoscopic splenectomy(LS),its safety and clinical effects.Methods Literature of the advances of LS were reviewed and analyzed.Results With the development of technology and surgical technique,the indications for LS were widened,the size of spleen plays an important role in the clinical outcome of LS.Conclusion LS has all the advantages of minimally invasive surgery.The application of hand-assisted technique is safe and feasible for giant spleen.With the accumulation of surgical experiences and technique development,LS will be extensively used in clinic.

The traditional treatment of abdominal aortic aneurysm was open surgery.In the 1990s,endovascular abdominal aortic aneurysm repair (EVAR) began to emerge.In the early stage,this kind of minimally invasive method was applied in highly selected patient cohort due to the limitation of anatomic conditions of patients,age of patients and shortage of available endovascular devices.The indications for open surgery which were used in this new kind of therapeutic modality also influenced the outcomes.As the technique became mature and the properties of endogarft were developed,endovascular treatment can be used to treat more complex pathologies and the results were improved.However,several challenges were rising,including dealing with complex proximal aneurismal neck,intra-and post-operative endoleak,abdominal aortic aneurysm compromising branched arteries and ruptured abdominal aortic aneurysm.To solve these problems,chimney technique,fenestrated stent,branched stent and the sandwich technique had been invented and developed.It is believed that endovascular treatment for abdominal aortic aneurysm could be applied more widely under vascular surgeons' efforts.

Objective To study the correlation of posttraumatic growth with psychological resilience,social support and self-efficacy in breast cancer patients.Methods The questionnaires of Posttraumatic Growth Inventory (PTGI),Connor-Davidson Resilience Scale (CD-RISC),Perceived Social Support Scale (PSSS),General Self-Efficacy Scale (GSES) were used to measure 170 patients with breast cancer.Finally 159 questionnaires were returned.The investigation results were analyzed.Results Among 159 patients,the score of PTGI was (56.41±17.19) scores.The dimension score from high to low order were the relationships with others,personal strength,appreciation of life,new possibilities:(3.29±0.99),(3.19±1.00),(2.94±1.15),(2.36± 1.15) scores.The score of CD-RISC was (63.36± 14.43) scores,PSSS was (69.28±8.59) scores.The score of support from family was (24.45±3.67) scores,which was in the high level.The score of support out of family was (33.51±5.60) scores,which was in the medium level.The posttraumatic growth in breast cancer was positively correlated with the psychological resilience,perceived social support,support out of family,and general self-efficacy,P＜0.05.Conclusions The posttraumatic growth of patients with breast cancer is in the medium level,which still should be improved.The measures which can improve psychological resilience,social support,general self-efficacy of patients would also improve the posttraumatic growth in patients with breast cancer.

Objective:This study has two objectives. One is to detect the methylation status of reversion-inducing cysteine-rich protein with Kazal motifs (RECK, a new tumor suppressor gene) gene promoter in primary laryngeal squamous cell carcinoma and nor-mal laryngeal mucosa. The other is to analyze the correlation between RECK gene methylation status and radiosensitivity in laryngeal squamous cell carcinoma. Methods:Methylation-specific polymerase chain reaction was used to detect the RECK gene methylation of 70 specimens of laryngeal squamous cell carcinoma and 15 normal tissues of laryngeal mucosa. The patients underwent six cycles of ra-diotherapy and were followed-up for 5 years. The correlation between RECK gene methylation status and radiosensitivity in laryngeal squamous cell carcinoma was analyzed. Results: After six cycles of radiotherapy, 47 patients (67.14%) showed sensitivity and 23 (32.86%) showed tolerance to radiotherapy. The methylation level of the RECK gene was lower in the radiation-sensitive group than in the nonradiation-sensitive group (P<0.05). The methylation level of the RECK gene was lower in the remission group than in the non-remission group. RECK gene methylation could increase the risk of cancer by approximately 5.010 times (OR=5.010, 95%CI:1.616-15.533). Conclusion:RECK gene promoter methylation in human laryngeal squamous cell carcinoma is an early event that is correlated with the patient's sensitivity to radiotherapy. Thus, the patient's sensitivity to radiation can be predicted by detecting the meth-ylation status of the RECK gene promoter.