ObjectiveTo explore the effect of the cognition dysfunction on the stroke rehabilitation.MethodsThe loewenstein Occupational Therapy Cognitive Assessment Battery (LOTCA), Fugl Meyer motor scale, functional independence measure were carried out to evaluate the function of 66 stroke patients before and after rehabilitation.ResultsThe rehabilitation process of motor and independent function of patients who had suffered from cognition dysfunction was latered than that of patients who had not suffered from cognition dysfunction, and cognition dysfunction had a closed relationship with stroke rehabilitation.ConclusionCognition dysfunction directly has a influence to stroke rehabilitation, both special and comprehensive methods in rehabilitation process, improve cognition function, decrease its influence to the stroke rehabilitation.

Objective:To investigate the root canal anatomy of one-rooted mandibular second molars. Methods:The root canals of 18 one-rooted mandibular second molars were visualized on radiographs and clinical examination, some specimens were cut at the mid-root level and observations were made on the coronal root section. Teeth with C-shaped canal system were categorized by using a modification of Melton classification.Results:12 molars exhibited C-shaped canals.2 molars were classified as category Ⅰ,5 as Ⅱ and another 5 cases as Ⅲ.Conclusions:C-shaped canals in mandibular second molars vary in canal number and shape.

Objective: To investigate the roots and canals morphology o f extracted maxillary first premolars. Methods: The root morphol ogy and the root canals of 115 extracted maxillary first premolars were visualiz ed on radiographs taken in the mesio-distal direction, then the teeth were cut transversely and root sections were examined, the root canal systems was analyse d with Vertucci’s classification. Results: 74(64%) teeth were w ith one root, 41(36%) with two roots, all teeth with two roots had two canals a nd each canal with one apical foramen,〔TypeⅠ(1)〕.39% of the single-root teet h demonstrated one canal, whereas 61% of the single-root teeth had two canals, 〔TypeⅡ(2-1), TypeⅣ(2) and TypeⅤ(1-2)〕.Conclusions: The roots of maxillary first premolars possesses a variety of canal system types.

The blood-brain barrier (BBB) protects the brain against unwanted substances, while, at the same time, limits the transport of many drugs into the brain. Aromatic refreshing traditional Chinese medicine (TCM) can induce resuscitation and modify the permeability of BBB, promoting other drugs entering into the brain with brain protection effect. This paper mainly reviews the research progress in regulation effects and mechanism of usual aromatic refreshing TCM, such as borneol, moschus, styrax, benzoinum and Tatarinow Sweetflag Rhizome, on BBB permeability. To broaden the application of these drugs in modern pharmaceutics in the future, the relatively research should emphasis on combining aromatic refreshing TCM with new formulations and technologies in pharmaceutics, providing novel promising strategies for brain diseases therapy.
Animals ; Blood-Brain Barrier ; drug effects ; metabolism ; Humans ; Medicine, Chinese Traditional ; methods ; Permeability ; drug effects

Objective To investigate the EUS elastographic patterns of normal pancreas and focal pancreatic lesions, and its value for characterizing and differentiating between benign and malignant pancreatic tissues. Methods Between January and June 2009, 6 patients with normal pancreas and 9 patients with focal pancreatic lesions were enrolled. Real-time elastography was carried out during the conventional EUS examination. The elastographic images were scored with 1 to 5 based on the elastographic pattern. Results Nine focal pancreatic lesions were finally diagnosed as pancreatic cancer (n = 4), cyst-adenocarcinoma (n =1), cyst-adenoma (n = 2) and focal pancreatitis (n = 2), respectively. Pancreatic cancers were scored as 3(n = 1) and 4 (n = 3). Cyst-adenocarcinoma was scored as 5 and cyst-adenomas were scored both as 2,while focal pancreatitis were scored as 2 and 3, respectively. Elastographic pattern was scored as 1 (n = 5)and 2 (n = 1) in 6 normal pancreas. When scores 1 and 2 were assigned to benign lesion and 3 to 5 to malignancy, the overall diagnostic accuracy of EUS elastography for focal pancreatic lesions was 88. 9%(8/9). Conclusion There are apparent differences in elastographic patterns between benign and malignant pancreatic tissues. EUS elastography is a promising method that allows characterization and differentiation of benignancy and malignancy.

Objective To explore the cognitive function of the theory of mind(TOM) in early-onset schizophrenia from faux pas recognition and belief understanding dimensions.Methods 41 early-onset schizophrenias (EOS) and 40 normal adolescents were interviewed by the Chinese version of faux pas recognition task and theory of mind picture-sequencing task(ToM-PST),then early-onset schizophrenias cognitive features were analyzed.Results ①In faux pas recognition task,compared with healthy subjects,EOS showed significantly less total scores (16.11±6.34 vs 20.86±7.79,P＜0.05)and subscores of understanding faux pas questions (9.88±4.11 vs 13.27± 6.07,P＜0.05).In faux pas recognition scores(6.72±2.60vs 7.58±2.20) and control questions(9.83±0.44vs 9.97± 0.16) had no statistically significant difference (P＞0.05).②In ToM-PST task,early-onset schizophrenic patients also had significantly less total score(17.29±3.38 vs 21.48± 1.73,P＜0.01),subscores of understanding first order belief,first order error belief,second order belief,second order error belief,third order error belief,sense of reality,reciprocity,fraud,detecting fraud compared to normal controls had significant difference (all P＜ 0.05 or 0.01).③ The correlation between clinical course time and PANSS score and its subscores of the theory of mind picture-sequencing and faux pas task was non-significant(P＞0.05)except the subscores of understanding the first order belief (P＜0.01).Conclusion The theory of mind is apparent damage in early onset schizophrenia and non-significant correlation is found with psychiatric symptoms.

Objective To quantify the incidental irradiation dose (ⅡD) to lymph node stations of esophagus when treating patients with T1-4N0 M0 thoracic esophageal squamous cell carcinoma (ESCC) with a dose of 60 Gy/30f.Methods Twenty-nine patients with medically inoperable T1-4N0M0 thoracic ESCC were treated with three-dimensional radiotherapy on involved-field.The conformal CTV was re-created using a 3 cm margin in the proximal and distal direction (following the course of the esophagus) beyond the barium esophagogram,endoscopic examination and CT defined GTV and a 0.5 cm margin in the lateral and anteroposterior directions of the CT defined GTV.The PTV encompassed 1 cm proximal and distal margins,0.5 cm radiaI margin on the basis of CTV.Cervical,mediastinal and abdominal lymph nodes were delineated respectively.Equivalent uniform dose (EUD) and other dosimetric paraneters were calculated for each nodal station.Nodal region whose metastasis rate is greater than 5％ was considered a high risk lymph node subgroups.Results Under a 60 Gy dose prescription,the median Dmean and EUD,V40 and V50 were ≥40 Gy,≥85％ and ≥75％ in most of the high risk nodal regions.For the subgroups whose EUD were less than 40 Gy,most of the ⅡD of these regions was significantly associated with the length and location of esophageal tumor (r =0.892,P =0.000).Conclusions Lymph node stations nearby of ESCC received considerable ⅡD with involved-field irradiation which could control subclinical lesions.But more clinical studies should be needed.

Objective To evaluate the clinical efficacy and toxicities of radical intensity-modulated radiotherapy (IMRT) combined with reduction in dose of prophylactic irradiation in the treatment of stage Ⅲ small cell lung cancer (SCLC).Methods A retrospective analysis was performed on the clinical data of 40 patients with stage Ⅲ SCLC who were admitted from January 2010 to August 2012.The prescribed dose was 60 Gy in 30 fractions to the primary gross tumor volume and was 54 Gy in 30 fractions to the planning target volume.All patients received induction chemotherapy,31 patients received adjuvant chemotherapy,and 22 patients received concurrent chemoradiotherapy;the platinum-based chemotherapy combined with etoposide or teniposide was adopted.Prophylactic cranial irradiation (25 Gy in 10 fractions) was administered to 17 patients.The short-term tumor response was evaluated by RECIST 1.0,and radiation-related toxicities were assessed by CTCAE 4.0.Overall survival (OS),local recurrence-free survival (LRFS),and progression-free survival (PFS) were calculated by Kaplan-Meier method.Results The short-term tumor response rate was 98％.The follow-up rate was 100％.Twenty-two patients were followed up for at least 2 years.The 1-and 2-year OS rates were 84％ and 48％,respectively; the LRFS rates were 89％ and 85％,respectively; the PFS rates were 61％ and 41％,respectively.Grade 0-1 radiation-related pneumonia was observed in 65％(26/40) of all patients,grade 2 in 25％ (10/40),grade 3 in 5％ (2/40),and grade 5 in 5％ (2/40).Grade 0-1 radiation-related esophagitis was observed in 53％ (21/40) of all patients,grade 2 in 43％ (17/40),and grade 3 in 5 ％ (2/40).Conclusions Preliminary results from this study suggested that IMRT combined with reduction in dose of prophylactic irradiation is safe and effective in patients with stage Ⅲ SCLC and is worth further evaluation in a large,prospective,randomized study.

Phosphoinositide 3-kinase/serine-threonine kinase (PI3K/AKT)has been found playing an important role in the pathogenesis of severe acute pancreatitis (SAP)in recent years,but the underlying mechanism has not been clarified.Aims:To investigate the role of PI3K/AKT in regulating the inflammatory response in SAP by evaluating the effect of insulin-like growth factor-Ⅰ (IGF-Ⅰ)and wortmannin,the agonist and inhibitor of PI3K/AKT on Toll-like receptor 4 (TLR4)signaling pathway in macrophage cell line RAW264.7.Methods:RAW264.7 cells were treated with different concentrations of lipopolysaccharide (LPS ), IGF-Ⅰ and wortmannin, respectively, and cell viability was determined by CCK-8 assay.RAW264.7 cells were divided into blank control group (no treatment),LPS group (LPS 1 μg/mL),IGF-Ⅰ group (IGF-Ⅰ 100 ng/mL +LPS 1 μg/mL),wortmannin group (wortmannin 100 nmol/L +LPS 1 μg/mL)and IGF-Ⅰ +wortmannin group (wortmannin 100 nmol/L +IGF-Ⅰ 100 ng/mL +LPS 1 μg/mL).Protein expressions of tumor necrosis factor-α(TNF-α)and interleukin-6 (IL-6)were detected by ELISA;mRNA expressions of TLR4,myeloid differentiation factor 88 (MyD88),AKT,PI3K,p38 mitogen-activated protein kinase (p38MAPK)and nuclear factor-κB (NF-κB)were determined by real-time PCR.Results:After treated with LPS,IGF-Ⅰand wortmannin, respectively,no differences in cell viability of RAW264.7 cells were found between different concentrations groups (P>0.05).Protein expressions of TNF-αand IL-6 in LPS,IGF-Ⅰ,wortmannin and IGF-Ⅰ +wortmannin groups were significantly higher than those in blank control group (P<0.05 ).Protein expressions of TNF-αand IL-6 in wortmannin group were significantly lower than those in LPS and IGF-Ⅰ groups (P<0.05),and those in IGF-Ⅰ+wortmannin group were significantly lower than those in IGF-Ⅰ group (P<0.05).In LPS group,mRNA expressions of AKT and PI3K as well as TLR4 and its downstream molecules MyD88,p38MAPK and NF-κB were significantly higher than those in blank control group (P <0.05 ).Expressions of all above-mentioned mRNAs in IGF-Ⅰ group were further increased and significantly higher than those in LPS group (P<0.05).Expressions of all above-mentioned mRNAs in wortmannin group were significantly lower than those in LPS and IGF-Ⅰ groups (P<0.05 ),and those in IGF-Ⅰ+wortmannin group were significantly higher than those in wortmannin group (P<0.05),but significantly lower than those in IGF-Ⅰ group (P<0.05).Conclusions:PI3K/AKT might regulate TLR4 signaling pathway and its downstream molecules in macrophages, thereby affects the expressions of inflammatory cytokines and being involved in the pathogenesis of inflammatory response in SAP.

To promote practical(experimental) teaching reform of non-preventive medicine in our college,we implemented a survey among non-preventive medical students by means of a self-designed questionnaire.It showed students of different genders and specialties had different practice demands and suggested special schedules should be made for different situations in our future work.