Objective To detect the normal values of fetal cerebellar vermis using transabdominal ultrasonography and assess its clinical significance in the diagnosis of vermal hypoplasia(agenesis). Methods A total of 111 fetuses were evaluated by transabdominal sonography between 20 and 40 weeks of gestation.The mid-sagittal antero-posterior(AP) and cranio-caudal(CC) vermian diameters were measured. A second group of 15 fetuses with cisterns magna were assessed and compared with the value of normal fetuses.0.05) and correlated linearly with gestational age ( AP = - 5.406 + 0. 761 GA, r = 0.97 ; CC = - 5.795 +fissure, second fissure and fastigium may help identify developmental anomalies. Conclusions Transabdominal ultrasonography is a valuable tool in the study of fetal vermis during the second half of pregnancy.

Objective To investigate the intervention effects of Jiawei Ditan Decoction on oxidative stress and inflammatory reaction in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods A total of 60 OSAHS patients with deficiency of phlegm and blood stasis mutual junction were enrolled,and randomly divided into treatment group (n=30,receiving JiaweiDitan Decoction+ conventional treatment for 12 weeks) and control group (n=30,receiving conventional treatment for 12 weeks).The clinical symptoms integral,Epworth Sleepiness Scale (ESS),apnea hypopnea index (AHI),minimum oxygen saturation (SaO2),superoxide dismutase (SOD),malondialdehyde (MDA),tumor necrosis factor (TNF)-α interleukin (IL)-6,and C-reactive protein (CRP) were observed before and after treatment.Results The clinical symptoms integral,AHI value,minimum SaO2,ESS score,levels of SOD,MDA,TNF-α,IL-6 and CRP were significantly improved in treatment group after treatment as compared with pretreatment [(11.65 ± 3.82) points vs.(14.32±4.25) points,(21.18 ± 12.37) times/h vs.(29.16 ± 13.58) times/h,(83.24±7.42)％ vs.(76.92±11.91)％,(7.12±4.84)points vs.(10.01±4.16) points,(99.24± 13.15)×103 U/L vs.(87.511±14.82) ×103 U/L,(8.56 ± 3.23) μmol/L vs.(11.25±3.41) μmol/L,(50.63±10.57) ng/L vs.(58.92±11.65) ng/L,(78.12±15.92) ng/L vs.(89.13± 16.54) ng/L,(9.93±5.25) mg/L vs.(13.59±4.92) mg/L,t=2.559,2.379,2.467,2.480,3.243,3.137,2.887,2.651,2.786,respectively,all P＜0.05].All the above indicators after treatment had significant differences between the treatment group and the control group [(11.65 ± 3.82) points vs.(13.89±4.45) points,(21.18± 12.37) times/h vs.(28.03± 13.12) times/h,(83.24±7.42)％ vs.(78.26±10.15)％,(7.12±4.84) points vs.(9.56±7.12) points,(99.24± 13.15)×103 U/Lvs.(90.13±13.56)×103 U/L,(8.56±3.23) μmol/L vs.(10.86±3.65)μmol/ L,(50.63±10.57) ng/L vs.(56.52±11.04) ng/L,(78.12±15.92) ng/L vs.(87.81±15.61) ng/ L,(9.93±5.25) mg/L vs.(12.97±5.03) mg/L,t=2.092,2.018,2.169,2.009,2.642,2.585,2.111,2.380,2.290,respectively,all P＜0.05].Conclusions Jiawei Ditan Decoction could improve the clinical symptoms and has the intervention effect on oxidative stress and inflammatory reaction in elderly patients with OSAHS,which provides the experimental basis for the treatment of senile OSASH with Chinese herbal medicine.

Background:Functional dyspepsia(FD)is a commonly seen functional disease which has great impact on patient’s quality of life and mental health,and has got more and more concern by clinicians. Aims:To explore the role of mast cells (MC)and plasma motilin( MTL)in the pathogenesis of FD. Methods:Sixty FD patients including 32 postprandial distress syndrome(PDS)and 28 epigastric pain syndrome(EPS)patients from September 2013 to January 2014 at the Affiliated Hospital of Putian University were enrolled,and 28 healthy volunteers were served as controls(HS group). The number of gastric mucosal MC,plasma MTL level(fasting and 30 minutes after drinking warm water)and gastric emptying time(T1 / 2 )were compared. Results:Compared with HS group,number of gastric mucosal MC was significantly increased (P < 0. 001),plasma MTL level before and after drinking warm water in FD group were significantly decreased( P <0. 001),T1 / 2 was significantly prolonged(P < 0. 001). No significant difference in number of MC was found between PDS subgroup and EPS subgroup(P = 0. 094). Plasma MTL level before and after drinking warm water in PDS subgroup were significantly lower than those in EPS subgroup( P < 0. 001),and T1 / 2 was significantly prolonged( P < 0. 001). Conclusions:Number of gastric mucosal MC is significantly increased in FD patients compared with HS group,suggesting MC may play a role in the pathogenesis of FD. Plasma MTL level is decreased in FD patients,which may be one of the factors involved in the pathogenesis and occurrence of corresponding symptoms of FD.

ObjectiveTo explore the effect of TLR4,PI3K and NF-κB on the migration of asthmatic airway smooth muscle cell(ASMCs) induced by airway epithelial cells.MethodsPrimary ASMCs were cultured by the method of cell digestion.Cell culture supernatant of RTE cells were collected by TNF-α stimulation of epithelial cells.Detected the IL-8 and RANTES levels in the supernatant.The effect of TLR4/PI3K-related signaling molecules on the migration of asthmatic ASMCs induced by epithelial cells were detected by Modified Boyden chemotaxis chamber with anti-TLR4 antibody,Wortmannin and PDTC drugs as a tool.ResultsThe levels of IL-8 and RANTES in the supernatant of TNF-αgroups were significantly increased,and that in the 20 ng/ml group was significantly higher than other groups ( P＜0.01 ).Compared with control group,the transmembrane migration of asthmatic ASMCs from other groups was significantly increased (P＜0.01 ).The transmembrane migration of asthmatic ASMCs from treated groups was significantly increased than asthma group (P＜0.01).The migration of asthmatic ASMCs from TNF-α+anti-TLR4 antibody group,TNF-α+Wortmannin group and TNF-α+Wortmannin+PDTC were significantly decreased than that of TNF-αgroup( P＜0.01 ).The migration of asthmatic ASMCs from TNF-α+Wortmannin+PDTC were significantly decreased than that of TNF-α+Wortmannin group (P＜0.05).ConclusionTLR4/PI3K-related signaling molecules involved in the transmembrane migration of asthmatic ASMCs induced by airway epithelial cells and may be one of the mechanisms of airway remodeling of asthma.

Objective To explore the time of application of hemoperfusion (HP) for the treatment of acute serious organophosphorus pesticide (ASOPP). Methods One hundred and four patients with ASOPP were randomly divided into two groups, 46 patients accepted traditional treatment(control group), 58 patients were treated with traditional treatment and HP (HP group). The patients in HP group were again divided into three groups according the different time of treatment (time of beginning HP after poisoning), the 4-8 hours group (HP-1 group, 27 patients), the 9-16 hours group (HP-2 group, 19 patients), the 17-32 hours group (HP-3 group, 12 pafients).Tbe coma period, the dosage of atropine, the time of regaining the vitality of cholinesterase, the time of hospitalization and the rate of fatality and curing among groups were observed. Results The coma period, the dosage of atropine, the time of regaining the vitality of cholinesterase, the time of hospitalization and the rate of fatality of the HP group were less than those of the control group (P<0.05). Compared with HP-1 group, the eoma period, the dosage of atropine, the time of regaining the vitality of eholinesterase and the time of hospitalization of the HP-2 group and the HP-3 group were higher (P<0.05), but the difference of the rate of fatality and curing between the HP-1 group and the other HP groups was not statistically significant (P>0.05). The difference of all of the above indicators between HP-2 group and HP-3 group was not statistically significant (P>0.05). Conclusion Application of hemoperfusion among 4-32 hours after poisoning for the treatment of ASOPP can improve the efficacy of therapy, and the efficacy of application of hemoperfusion among 4-8 hours is the best.

Objective To analyze the epidemiology,clinical and imageological characteristics,diagnosis,misdiagnosis,treatment and prognosis of pulmonary alveolar proteinosis (PAP) reported in China in recent 20 years,in an attempt to provide important clues for prompt and accurate diagnosis of PAP.Methods Clinical data of PAP from 1988 to 2008 in China were retrospectively analyzed and the clinical data of 126 patients with PAP which were misdiagnozed were summarized.Results There were 19 cases misdiagnozed with pneumonia,24 cases with pulmonary cancer,18 cases with bronchitis,19 cases with idiopathic pulmonary fibrosis,15 cases with pulmonary tuberculosis,10 cases with eosinophilic pneumonia,9 cases with sarcoidosis,5 cases with fungus pneumonia.The clinical manifestations of PAP had no specificity and the imageology manifestation was various.Its final diagnosis mainly depended on the examination of brochoalveolar lavage fluid and/or lung biopsy,and pathologic examination.Conclusions The diversity of clinical manifestations of PAP has resulted in higher clinical misdiagnosis rate.WhoLe lung irrigation is the safest and the most effective way to treat PAP.

Objective To evaluate the effect of high-level spinal cord injury (SCI) on the myocardial energy metabolism in rats.Methods Sixty healthy male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 2 groups (n=30 each) using a random number table:sham operation (group S) and SCI group.SCI was induced in anesthetized rats by dropping a 10 g weight onto C7 spinal cord from 5 cm height falling freely inside a vertical hollow glass tube.At 6,12,24,48 and 72 h after SCI,6 rats in each group were chosen and arterial blood samples were taken for measurement of serum creatine kinase (CK) and creatine kinase isoenzyme-MB (CK-MB) activities.The rats were then sacrificed and myocardial specimens were obtained for examination of myocardial ultrastructure and for determination of ATP weight ratio,levels of Na+-K+-ATPase,Ca2+-Mg2+-ATPase,non-esterified fatty acids (NEFA) and lactic acid (LD),and expression of peroxisome proliferator-activated receptor alpha (PPARα) mRNA and protein (using fluorescent quantitative PCR and Western blot).Results Compared with group S,the serum CK and CK-MB activities were significantly increased,the ATP weight ratio,activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase and levels of NEFA and LD were decreased,and the expression of PPAR-α mRNA and protein was down-regulated in SCI group.No pathological changes of myocardium were found in group S,and the pathological changes of myocardium were obvious in SCI group.Conclusion High-level SCI can lead to decrease in the myocardial energy metabolism in rats,and down-regulated expression of PPARα is involved in the mechanism.

Objective To analyze and compare efficacy and safety of different chemotherapy regimens in the treatment of elderly patients with advanced gastric cancer. Methods 60 elderly patients admitted to our hospital with advanced gastric cancer were selected as research subjects , and divided into experimental group and control group depending on the treatment of chemotherapy. The experimental group were treated with Gio oxaliplatin (SOX), and patients in the control group accepted Olivier Elizabeth, leucovorin and fluorouracil (FOLFOX6) treatment. Compare and analyze the efficacy of the two groups after two cycles of therapy. Results By chemotherapy, recent efficiency and disease control rate were not significantly different (P>0.05) between the two groups;and there was also no significant difference in the incidence of adverse reactions,such as adverse reactions, fatigue weakness, gastrointestinal reactions, hand-foot syndrome, oral mucositis (P > 0.05). Conclusion The efficacy was equivalent between FOLFOX6 chemotherapy SOX test group and the control group in the treatment of elderly patients with advanced gastric , and there was no significant difference in the incidence of adverse reactions.

AIM: To study the effects of propofol on plasma membrane fluidity in PC12 cells and liposome,and its relevant mechanism. METHODS: Fluorescence depolarization method was used to measure values of fluorescence anisotropy, fluorescence polarization as well as microviscosity in PC12 cells and microviscosity in liposome continuously for 30 min. RESULTS: Propofol induced a significant decrease of fluorescence anisotropy, fluorescence polarization as well as microviscosity in PC12 cells, particularly in the first 5 min. After 5 min, the values of anisotropy were remained lower levels. Although propofol at concentration of 1 mg?L -1 had no effects on microviscosity in liposome, porpofol at concentration of 10 mg?L -1 and 100 mg?L -1 significantly decreased microviscosity in liposome. CONCLUTION: Propofol can significantly increase membrane fluidity in PC12 cells and liposome in a concertration dependent manner, and the anesthetic effect of propofol may be resulted from changes of membrane fluidity and structure of neurocyte.

This article unfolds from the current application of problem-based learning (PBL) in medical education in China, analyzing the limitations of it and briefly elucidates the necessity of open-ended question from the perspective of constructivism theory. Furthermore, with the implementation of open-ended questions listed from obstetrics and gynecology for three different grades of students, post-survey result shows that open-ended question serves as an effective approach not only to improve students' ability of finding questions and independent learning , but also to realize the sense of construction.