Objective To explore the influencing factors of hypotension in hemodialysis patients with end stage of diabetic nephropathy.Methods 106 patients of advanced diabetic nephropathy who received maintenance hemodialysis were selected in the present study.According to the patients'condition needs, chose different dialysis modes,dialyzers, dialysis blood flow and ultrafiltration rate, compared the frequency of occurrence of hypotension during treatment.Results By multivariate regression analysis,gender,dialysis mode,dialysis and blood flow had no correlation with hypotension during dialysis.The age, hemoglobin, serum albumin, cardiac function and individual ultrafiltration rate were correlated with the incidence of hypotension in patients with diabetic nephropathy.Individual-ized ultrafiltration rate was less than or equal to 10 mL · kg-1 · min-1 and individual ultrafiltration rate was up to 10 mL· kg-1 · min-1 ,the incidence rates of hypotension were 18.9% and 25.9%,the difference was statistically significant (χ2 =7.102,P<0.05).Conclusion Diabetic nephropathy patients during dialysis,ultrafiltration rate control individuals can effectively reduce the frequency of occurrence of hypotension during dialysis, hemodialysis patients may improve tolerability.

Objective To establish renal calculus rat model induced by calcifying nanoparticles .Methods We extracted and cultivated calcifying nanoparticles from clinically diagnosed patients with nephrolithiasis .Forty adult male SD rats were divided into 4 groups (n=10 each):group A(given an intravenous injection of calcifying nanoparticles) ,group B(given an intravenous injection of calcifying nanoparticles and taken Shenshitong granules) ,group C(given an intravenous injection of calcifying nanoparticles and intraperitoneal injection of gallium nitrate) ,group D (as normal control) .Eight weeks later ,all rats were sacrificed .The kidneys were examined for pathology .Results Histopathological studies revealed calcifying nanoparticles induced renal tubular epithelial cells fatty degeneration and renal tubular crystallization ,and caused renal interstitial infiltration with inflammatory cells .The forma‐tion of renal crystals in group A was more obvious than those in group B and C(P<0 .05) .In group D ,no crystals were formed and no pathological changes occurred .The levels of urinary calcium and urinary creatinine(of All group) at one day before the observa‐tion period (T2 ) were higher than those at 4 weeks after injection(T1 )(P<0 .01) .The levels of urinary calcium and serum creati‐nine in group A and B and C were significantly higher than those in group D at T2 (P<0 .05) .The levels of urinary calcium in group B and C were lower than that in group A at T2 (P<0 .05) .However ,there were no apparent differences of the levels of serum calci‐um and urinary creatinine between groups at T2 (P>0 .05) .Conclusion Calcifying nanoparticles could cause renal tubular epithelial cells injury ,which leads to the formation of kidney stones .

Objective To investigate medical staff’s cognizance, response, and emotion changes when confronting a sudden public health accident. Methods The self-designed psychological questionnaire was used to investigate 138 medical staff’s psychological condition in a general hospital. Results When sudden public health accidents came, the medical staff’s positive cognizance, positive and negative response, and positive emotion exhibited significant difference according to which wards they worked in and what professional background they possessed(P

AIM: To study the effects of As_2O_3 on the growth of human cervical carcinoma cell line, HeLa cells, human pancreatic carcinoma cell line, AsPC-1 cells, and the generation of reactive oxygen species (ROS) in the cells. METHODS: HeLa cells and AsPC-1 cells were treated with various concentrations of As_2O_3. The effects of As_2O_3 on HeLa cells and AsPC-1 cells survival and apoptosis were determined by MTT assay and light microscope, and cellular ROS was also measured by fluorometer. RESULTS: After being treated with 2 ?mol/L As_2O_3 for 48 h, the survival of HeLa cells was decreased, a marked apoptosis characteristic was observed in time- and dose-dependent manner. However, the survival of AsPC-1 cells markedly decreased after being treated with even 1?mol/L As_2O_3 for 24 h. When we measured the cellular hydrogen peroxide (H_2O_2) level, we found that the H_2O_2 level in HeLa cells started to rise after being incubated with As_2O_3 for 2 h, and sustained increased, reached the peak of H_2O_2 level at 8 h, then it began to decrease. While the H_2O_2 level in AsPC-1 cells started to rise at 2 h, reached the highest point at 5 h, after which it began to descend. At 12 h, the H_2O_2 level in HeLa cells and AsPC-1 cells were similar to that of the control group. CONCLUSION: The molecular mechanisms underlying As_2O_3 -induced apoptosis in cells derived from the solid tumors may be related to the cellular ROS level.

Medicine education must pay attention to humanity education,which is determined by the nature of medicine.The present situation and problems of the medical humanity education in china were reviewed and new approaches to improve long-term mechanism of the medical humanity education in china were enhanced from the following four apects:constructing teaching staff,setting up curriculum,reforming teaching methods and building campus-culture.

BACKGROUND: Puerarin functions to relieve the injury caused by ischemia reperfusion, improve the microcirculation, and inhibit the agglutination of platelet. But it is not clear yet that whether its protection on neurons relates to the apoptosis of cells.OBJECTIVE: To observe the protection of puerarin on neurons injured by mimic ischemia reperfusion in vitro.DESIGN: A random control study. SETTING: Laboratory of Biochemistry and Moleculobiology Department of Preclinical Medicine College of Tongji Medical College of Huazhong University of Science and Technology.PARTICIPANTS: The experiment was done on March 11, 2002. The cultured N2a cells of rat neuromablast were observed.METHODS: Ninety minutes after the cultured N2a cells were put into the 37 ℃ incubator with 0.05 CO2 and 0.95 N2(v/v), puerarin 0.5 mmol/L was added for cuiture for 24 hours. The methyl thiazolyl tetrazolium (MTT)method was used to observe the surviving ability of cells. The Annexin-V staining was adopted to exam the severity of apoptosis in the early stage and the supernate was collected to analyze the activity of lactate dehydrogenase (LDH) to reflect the permeability of cytomembrane. The immunoblotting method was applied to analyze the expression of caspase-3, at the same time, its activity was measured.MAIN OUTCOME MEASURES: The severity of cell apoptosis, the activity of LDH, the expression and activity of caspase-3.RESULTS: Puerarin could improve significantly the surviving rate of N2a cells 24 hours after reperfusion, decrease remarkably the activity of LDH in the culture fluid, lessen obviously the N2a apoptosis (P ＜ 0.01), at the same time, reduce tremendously the activity and expression of caspase-3 induced by ischemia reperfusion (P ＜ 0.01).CONCLUSION: Puerarin can protect nerves, inhibit obviously the N2a apoptosis induced by ischemia reperfusion. The mechanism is that it inhibits greatly the expression and activity of caspase-3.

Objective:To investigate the effects of monotherapy of SSRI and SSRI with psychotherapy on patients of somatoform disorders.Methods:96 patients who met the criteria of CCMD-3 for somatoform disorders were divided into three groups:group one taking Fluoxetine only;group two taking Fluoxetine and a small dose of Olanzapine;group three combining the above two medicines with Gestalt psychotherapy.Before treatment and after three months' treatment,the effects of each group were evaluated by scores of HAMD.Results:According to the effective rate within each group(53.1%、61.8% and 96.7%),there was significantly differences in three groups after three months treatment(?2=15.5,P

[ Objective ] To assess the quality of clinical randomised controlled trials (RCT) of traditional Chinese medicine (TCM) for acute myocardial infarction (AMI). [Methods] Eighty - three journals of TCM from the first issues of 1977 to the latest issues of 2002 were manually searched and reviewed under the following inclusion criteria: clinical trials of TCM for AMI with 'randomized controlled or randomised being mentioned. And a questionnaire was designed according to the criteria of RCT with the items of diagnostic standard, consistent of baseline, method of randomization, concealment in allocation, blind method, intention - to - treat analysis, statistic methods and conclusion. Percentages of each item were figured out to assess the quality. [Results] Two thousand five hundred and one trials were associated with heart diseases, among which 102 were associated with AMI and 42 accorded with the inclusion criteria. Calculation method of sample size, concealment in allocation and intention - to - treat analysis after drop - out were mentioned in none of the 42 articles, single - blind method adopted in 4 (9.52%) , diagnostic standard described in 40 (95.24%), baseline consistent illuminated in 27 (64.29%), method of randomization presented in 8 (19.05%) , statistic methods used mistakenly in 6 (14.28%) and statistic methods not described in 18 (42.86%). [Conclusion] There still exist some problems in the design of RCT of TCM for AMI: (1) mistaken use of randomization method; (2) less adoption of calculation method of sample size, concealment in allocation and intention - to - treat analysis after drop - out; (3) improper application of statistic methods; (4) lower rate of utilization for blind study.

The carboxyl-terminal amino acids 272-299-truncated apoE4 (delta272-299) is the main fragments of apoE4 hydrolysate in neurons. The effects of truncated-ApoE4 (delta272-299) overexpression on tau phosphorylation in cultured N2a cells were investigated. The truncated-apoE4 (delta272-299) cDNA was subcloned into pEGFP-c3 to form recombinant pEGFP-T-apoE4. pEGFP-c3, pEGFP-T-apoE4 and pEGFP-apoE4 were transfected into N2a cells respectively by lipofectamine 2000 method. After 24--48 h, tau phosphorylation was detected by Western blot assay and glycogen synthase kinase-3 (GSK-3) activity by using GSK-3 activity assay. The results showed that the overexpression of both full length-apoE4 and truncated apoE4 fragments in N2a cells induced a dramatic increase in phosphorylation of tau at Ser202 sites and the activation of GSK-3 as compared with untransfected cells, most significantly in the cells transfected with pEGFP-T-apoE4 (P < 0.05). It was concluded that in vitro overexpression of truncated-ApoE4 (delta272-299) can result in tau hyperphosphorylation in N2a cells by activating GSK-3, suggesting truncated-ApoE4 (delta272-299) might contribute the pathogenesis of Alzheimer disease.

Objective To study the value of fiberoptic bronchoscopy in treatment of ventilator associated pneumonia. Methods The 168 cases of ventilator associated pneumonia in ICU were randomly divided into treatment group and control group, each group of 84 cases, were given oxygen, anti-inflammatory, expectorant treatment. Treatment group was given fiber bronchoscope sputum suction and irrigation, control group was given sputum suction tube, then we observed the oxygenation changes after sputum suction of two groups of patients, compared clinical efficacy, sputum culture positive rate, antibiotic using time and staying time in the ICU between two groups of patients. Results Compared with control group, in treatment group SaO2, PaO2 and oxygen index were significantly improved (P< 0.05) ; in treatment group CRP, PCT and IL-6 were significantly improved (P <0.05) . In the treatment group, the total effectiveness is significantly higher than the control group;antibiotic using time and staying time of ICU were obviously shorter than the control group (P< 0.05) . Conclusion Fiberoptic bronchoscopy irrigation treatment can improve oxygenation, antibiotic using time and staying time in ICU of ventilator associated pneumonia patients, and is worthy of clinical application.