Objective To analyze the expression of apoptosis-relared genes of retinal blood vessel in early diabetic rats by gene chip technology. Methods To make diabetic rat model by intraperitoneal injection of streptozotocin (STZ). On the 6th week after blood pressure increased, 10 rats were executed in Diabetic group and normal control group respectively. 20 retinal blood vessels were extracted and the RNA was isolated. The probe was made of α-32 P-deoxyadenosine triphosphate (dATP)-labeled sample which hybridized 1176 nylon chips, and then analyzed by software. Three different expression genes were selected to verify by reverse transcription polymerase chain reaction (RT-PCR). Results On the 6th week, 136 (11.5%)genes were differentially expressed [up-regulated genes were 90 (7.6%), down- regulated genes were 46(3.9%)] in diabetic group. These genes involved into different groups according to their function. Especially in 72 apoprosis-related genes, 15 genes were differentially expressed. The up- regulated genes were some TNF receptor family members such as TNFRSF12, TRAIL, TNFRSF9, FADD;Bcl-2 family members such as bcl-w, bax, bakl and AKT. The down-regulated genes were FAF1 which related to fas. Conclusions The expression of retinal vascular gene in early diabetic rats has been changed complicatedly. In particular, the multiple apoptosis-related genes have been changed in early diabetic, and most of them are at the upstream of apoptosis pathway. These findings indicate that the development of diabetic retinopathy is associated with multiple signaling pathways leading to apoptosis, while the alterations on the level of molecular biochemistry are still limited in apoptosis induction period.

Abstract: The principles, detection limits, advantages, shortcomings and precautions for procedure of spectrophotometry, atomic absorption spectrometry, potential stripping analysis and osillo-polarography for determination of lead in environmental samples and biological materials were introduced in this paper to provide some reference data for the selecting suitable method for determination of lead based on the various kinds of samples, the samples sizes and the various conditions of analytical instruments and equipments.

OBJECTIVE: To study the general pattern and characteristics of the ADR induced by lidocaine.METHODS: A total of 44 ADR cases caused by lidocaine reported in CHKD during 2002～ 2006 were collected and analyzed statistically. RESULTS: Lidocaine-induced ADR were mostly occurred in local anesthesia and block anesthesia,especially in the first time medication and within ten minutes.ADR could involve multiple organs and systems,and the clinical manifestations were complicated and diversified,which were mainly allergic reactions or even death in severe cases.CONCLUSION: Clinical physicians and pharmacists should be alert to the ADR induced by lidocaine and they should stick to the principle of rational drug use.

Objective To summariza the clinical and histological features of linear cutaneous lupus erythematosus (LCLE).Methods Six cases of LCLE were analyzed retrospectively.Results LCLE was often clinically characterized by unilateral.zonal or linear,dark-erythematous patches with telangiectasia,and some lesions were covered with adherent Scales.Histologically,there were patchy perivascular and periadnexal lymphoid inflammatory infiltrate occurring in the superficial and deep dermis.Some cases were pathologically manifested by parakeratosis of superficial dermis,follicular plugging and hydropic degeneration of the basal layer of the epidermis,which was characteristic of discoid lupus erythematosus.The preferred treatment was chloroquine for LCLE.Low dose of corticosteroids were recommended for widespread lesions,especially for those pathologically manifested by lymphocyte infiltrates in the lower dermis and fat tissue.Conclusion The diagnosis of LCLE should be based on clinical and histopathological manifestations.

Objective To investigate the role of malondialdehyde(MDA),superoxide dismutase(SOD),and interleukin-1β (IL-1β) played in the pathogenesis of acute gouty arthritis and the treatment efficacy of probucol.Methods Acute gouty arthritis model in rat was established with injection of monosodium urate monohydrate (MSU) into the ankle joint cavity,then the joint swelling index was observed periodically,and MDA,SOD,IL-1β,and white blood cell count in the synovial fluid were determined by 72 h.Results The joint swelling index gradually increased,reaching a peak by 11h,and this finding was most obvious in the model group.The joint swelling index in the group treated with high-dose of probucol was significantly lower than that in the model group by 48 h(P＜0.05).The joint swelling indices in the groups treated with moderate and high doses of probucol were lower than that in the model group by 72 h(P＜0.05).The values of MDA in the moderate and high-dose groups were (14.45±3.11) and (11.54 ±3.10) nmol/ml respectively,being significantly lower than that in the model group[(24.46±4.27) nmol/ml,P＜0.01].The amounts of SOD in the moderate and high-dose groups were (25.56±4.51) and (44.61±4.11)U/ml respectively,being higher than that in the model group[(13.32±2.02) U/ml,P＜0.01].The amount of IL-1β in the high-dose group was lower than that in the model group[(15.41 ± 3.12 vs 19.87±3.99)pg,P＜0.05].The white blood cell counts in the moderate and high-dose groups were (11.08±1.64)×l0~7/L and (7.43±1.52) x 10~7/L,being lower than that in the model group[(14.18±2.30)×10~7/L,P＜0.01].Conclusion The levels of MDA and IL-1β in the synovial fluid were raised,while SOD was significantly decreased in acute gouty arthritis.Moderate and high-doses of probucol can effectively control acute gouty arthritis attack.The efficacy of high-dose probucol was equal to that of colchicines.

The clinical skills competitions for national medical students in China have been well organized for five times.Experience has been accumulated,and much has been emphasized on the low assessment efficacy throughout the competitions.However,few solutions has been brought about to conquer such problem.This article mainly focused on introducing a computerized clinical skill assessment system based on current clinical skills competition assessment.The system realizes functions such as team management,online marking,score calculation,data analysis,and real-time result presentation.Such appliance of computer,internet and information technology on conventional clinical skills evaluation could hopefully replace the traditional manual calculating procedures,improving the efficiency of the future competitions,to ensure their openness,impartiality,and equitability,as well as to deliver observatory appeal among audience.

Computed tomography (CT) has become a very important method for preoperative examination for hilar cholangiocarcinoma.In this article,the multidetector helical CT findings of 20 patients with hilar cholangiocarcinoma who were confirmed by surgical pathological examination or biopsy in the Ruijin Hospital of Shanghai Jiaotong University from September 2010 to September 2012 were retrospectively analyzed to investigate the value of muhidetector helical CT in the diagnosis and resectability evaluation of hilar cholangiocarcinoma.All the 20 patients received dynamic contrast enhanced CT scanning after abdominal plain scanning,including arterial phase and portal venous phase scanning.Six patients received additional delayed phase scanning for 3-4 minutes.Muhi-phase reconstruction (MPR) and CT angiography were performed after the scanning.The location and sizes of lesious,the range of invasion of adjacent vessels,swelling of lymph nodes of hilar and retroperitoneum,and hepatic metastasis were recorded.The results showed that only 8 lesions were found on CT plain scanning,and they were presented as hypodense nodules.All lesions were showed on contrast enhanced images.Five cases with infiltrating type were showed as focal wall thickness of hilar bile duct,ringlike enhancement appeared on arterial phase scanning,and the enhancement was more apparent in portal venous and delayed phasc scanning.Eight cases with intraductal growing type demonstrated as intraductal nodules,obvious enhancement was detected on delayed phase scanning,and the dilation of intrahepatic bile duct was also found.Seven cases of tumoral type showed as mass located in hilar region and involved adjacent vessels and partial hepatic parenchyma.Diffused or local dilation of bile duct could be seen on CT images.Combination of 2and 3-dimensional reconstruction images can show more clearly of hilar cholangiocarcinoma lesions,invasion of hepatic arery or portal vein,segmental atrophy and metastasis of lymph nodes and liver.One-stop CT examination combined with axial multiphase dynamic contrast enhanced scanning with MPR and CT angiography of multidetector helical CT can clearly show the lesions of hilar cholangiocarcinoma,improve the preoperative tumor staging and help to design the surgical treatment.

Although talus fractures are not common among foot and ankle injuries, their treatment is difficult because of their complications and poor prognosis. They can be treated conservatively or surgically, with a variety of treatment protocols. At present, the main strategy of surgical treatment is to use strong and effective fixation to restore anatomic structure of the talus and preserve blood supply to the talus as much as possible so that deformity can be avoided and early healing be facilitated. This paper reviews the difficulties and current situation, and summarizes principles and the latest progress in clinical treatment of talus fractures, hoping to provide useful references for the treatment.

Posterior capsular opacification (PCO) is the most common complication that leads to loss of vision after cataract surgery.Neodymium doped:Yttrium-Aluminum-Garnet (Nd:Yag) laser capsulotomy is a common treatment for PCO, but still associated with several complications.In the past decades, the prevention and treatment of PCO have always been a hot spot of research in ophthalmology.This review will address the advances in the prevention and treatment of PCO in the aspects of surgical techniques and types of intraocular lens (IOL).

Maple syrup urine disease (MSUD) is an autosomally recessively inherited disorder of branched-chain amino acid (BCAA) metabolism caused by the defective activity of branched-chainα-ketoacid dehydrogenase complex (BCKD). The disease is characterized by severe ketoacidosis, mental retardation, and neurological impairments. So far, application of tandem mass spectrom-etry and HPLC has allowed newborn screening and early detection, but some patients with variant forms of the disorder will escape detection. Liver transplantation is an effective treatment. However, the rareness of liver donation limits the liver transplantation. In this review, the screening, diagnosis and therapy of MSUD will be discussed.