Objective To observe the expression of vascular endothelial growth factor (VEGF) in synovial tissue during treatment of rabbit arthritis model with corticosteroids and explore its mechanism.Methods The expression and alteration of VEGF in different periods of treatment process of rabbit arthritis model with corticosteroids (after 1 h ,24 h,3,7,14,21 and 28 d treatment with lipopolysaccharide),were investigated by reverse transcript polymerase chain reaction (RT PCR).Results There were different expressive degrees of VEGF in synovial tissue during each period of the process of rabbit arthritis model by corticosteroid treatment and the expressive degree of VEGF had been strongly inhibited by corticosteroids.Conclusion It is indicated that corticosteroids decrease inflammatory reaction of arthritis by inhibiting the expression of VEGF.

Objective To investigate the effects of the platelet activation and the endothelial cell impairment on the osteonecrosis. Methods The contents of TXB2,6-keto-PGF1a, GMP-140 and TM in different periods of animal models of adrenoglucocortisone-induced osteonerosis were measured by the radio-immunity method. ResultsThe contents in group B increased dramatically from 24h after the injection of adrenoglucocortisone, and the contents of GMP-140 and TM from 3d after injection increased with significant difference from group A. Conclusion The results suggest that the early emergence of the platelet activation and endothelial cell impairment models induced by horse serum and adrenoglucocortisone plays a role in the formation of the osteonecrosis.

Objective To explore the mechanism of the femoral head necrosis induced with long term glucocorticoid treatment by means of microvascular density and cellular ultrastructure. Methods 40 Japanese rabbits were used to establish an animal model of the femoral head necrosis induced by long term glucocorticoid treatment using injection with methylprednisolone 8 mg/kg weekly. In studying cellular ultrastructure and microvascular density of the femoral head necrosis models, the slides were made after vascular infusion with Chinese ink on 4th, 8th, and 12th week of the experiment. The network of microvasculature of the rabbit ear was photographied as a reference data before and after methylprednisolone treatment. Results Microvascular density in bilateral cancellous and compact bone of the femoral head became decreased statistically after 12 weeks of glucocorticoid treatment(P

The needle-recording electrodes deviced by the author and the improved recording method were applied in this article. Firstly, the lumbar spinal evoked potentials (LPs) and cortial somatosensory evoked potentials (CPs)to the stimulation of tiable nerves and segmental (radcular) cutaneous nerves (superficial peroneal and sural nerves )were recorded in 50 normal volunteers. Then similiar thacings were recorded and observed in 48 patients with unilateral L_5 or S_1 root compression. We found that the LP to the segmental cutaneous nerve stimulation was abnormal in 85%, and its CP in 48%. The LP to the tiable nerve stimulation was abnormal in 33%,and its CP only in 8%.

Objective An investigation of the effectiveness of treatment of spinal cord injuries(SCI) from the point of view of the transforming factor. Methods Animal model of SCI was made by modified Allens method. Mixed grafts of Schwann cells(SCs) modified with nerve growth factor(NGF) and brain derived neurotrophic factor(BDNF) genes along with fetal spinal cord cell suspension(FSCS) were transplanted into SCI site after 1 month and 3 months. Immunocytochemical staining was conducted for neurofilament(NF), glial fibrillary acidic protein(GFAP), myelin basic protein(MBP), 5 hydroxytryptamine/serotonin(5 HT), NGF, BDNF and the results analyzed with image pattern analysis. Pathological changes of spinal cord tissues were observed with light and electronic microscopy. Results These findings demonstrate the advantages of using mixed grafts of NGF and BDNF genetically modified SCs with FSCS in SCI in the rat: 1) They can be well integrated with the host and survive, 2) FSCS plays the role of bridging and mesomerism, 3) SCs can act as canal tubes and guides for the axons, 4)NGF and BDNF may stimulate the growth of axons and salvage the injuried neruron. Conclusion Mixed grafts of SCs genetically modified with NGF and BDNF genes along with FSCS may be effective measures for the treatment of SCI.

The PBL teaching and the case teaching have begun to be applied to the course of health economics, which has strong adaptability to the two teaching methods. Two teaching methods not only have the same characteristics, such as diversified teaching, outstanding students as the main body, paying atten-tion to the theory and practice, emphasizing on the comprehensive use of knowledge, but also have different characteristics, such as teaching idea, applied range and points of focus. These similar characteristics and differences are reflected in the development of health economics course. Based on the differences and simi-larities of the two teaching methods and further integration of the characteristics of health economics, this paper puts forward the countermeasures to optimize the application of the two teaching methods in health economics course.

Objective To study the molecular pathway of osteoblastic differentiation induced by substance P (SP), a neurotransmitter. Methods Mesenchymal stem cells were isolated and cultured, and treated with SP or its receptor (NK1) antagonist to induce osteoblastic cell differentiation, respectively. Alkaline phosphatase activity was determined; Osterix gene expression was detected by RT-PCR after 1-2 weeks for three times. The data of each culture condition were analyzed using SPSS12.0 statistical software to determine whether the differences between conditions were significant. Results After 4-5 days' culture, bone marrow stromal cells became spindle-shaped, triangular or polygonic. They covered the plate surface, formed extensive cell sheets in each group after 11-12 days of culture, and then induced differentiation to osteoblast. SP up-regulated the important transcription factor Osterix gene expression significantly (P<0.05). Conclusion The up-regulation of Osterix gene expression by SP may stimulate osteoblastic cell differentiation. SP's regulation depends on its receptor NK1.

Objective:This paper aims to investigate the awareness and demand for medical liability insurance of doctors, and to provide policy recommendations for the further development of medical liability insurance in China. Method:A stratified random sampling survey is conducted on doctors from a Top3 general hospital in Guangzhou, and the relevant departments and individual doctors were interviewed. Results:The higher the risk in a department, the higher their awareness of medical liability insurance becomes;the longer the length of service for a doctor, the more understanding of medical liability insurance the doctor has. Medical liability insurance is generally supported by doc-tors with a strong willingness of demand, but they opinions on bearing and sharing the insurance premium are quite different. Discussion:Doctors still lack sufficient knowledge of medical liability insurance due to the lack of effective publicity. The structural mode of medical liability insurance is still relatively vague, and the government leadership and market operation ability have a serious shortage. Suggestion:This paper suggest to improve the relevant laws and regulations of medical liability insurance, to strengthen government supervision and publicity, to build a reasonable development model of medical liability insurance in line with the national circumstances, and to strengthen an effec-tive combination of government leadership and market operation.

Objective To confirm the role played by apoptosis in spinal cord injury. Methods 36 rats models of spinal cord injury were made by Allen method. Histological examinations using HE staining and in situ end-labeling were used to observe apoptosis in spinal cord tissues from 1h to 21d after injury. Results HE staining sections showed hemorrhage and necrosis, neuronal degeneration and gliai cell proliferation. In situ end-labeling sections showed the appearance of apoptosis in both gray and white matter as well as in both central and surrounding region. The number of apoptotic cells increased from 12h after injury, increased to the peak at 4d and declined to normal at 21d. Conclu sion The results suggest that apoptosis, especially glial apoptosis, plays a role in the pathogenesis of spinal cord in jury.

To investigate the role of nitric oxide (NO) in steroid-induced femoral head necrosis, NO production was measured indirectly as nitrite in serum and synovial fluid samples from patients with steroid-induced femoral head necrosis together with serum samples from healthy volunteers matched for age and sex. The results showed that:① serum nitrite concentration in patients with femoral head necrosis were significantly lower than that in controls (P＜0.001); ② nitrite level of synovial fluid was markedly higher than that of serum. In addition, there was a positive correlation between them (r＝0.378,P＜0.05). We reach the conclusion:① NO is synthesized by synovium and chondrocytes; ② the decreased NO concentration in serum suggests a protective role in steroid-induced femoral head necrosis.