Coma is one of the most serious type of consciousness disturbances.The causes of coma are complicated and the mortality rate is high.In this review,we discuss the definition,diagnosis and emergency treatment of coma,which is helpful for pediatricians to have a deeper understanding of coma,make correct diagnosis and administer appropriate treatment more quickly.

The binding of the nuclear factor erythroid 2 related factor 2(Nrf2)to the antioxidant response elements(ARE)can start the expression of batches of antioxidant proteins,anti-inflammatory factors and detoxification enzymes. Nrf2/ARE signalling plays a pivotal role in anti-inflammation and in preventing xenobiotics induced lesions. Besides involvenment in physiological processes,such as regulating nutrient metabolism,Nrf2/ARE signalling also functions in the pathogenesis of various dieases. This review outlines the strcuture,functions,and regulation of Nrf2/ARE signal pathways.

OBJECTIVE: To introduce the summarization of ginkgo leaf extract in treating senile disease so as to provide references for clinical application and scientific design.DATA SOURCES: A computer-based online search of Tsinghua Full-text Database was undertaken to retrieve articles about ginkgo leaf extract, senile disease and cardio-cerebral vascular disease in Chinese between January 1994 and October 2005, and the key words were ginkgo leaf extract,senium and cardio-cerebral vessels.STUDY SELECTION: All articles were selected firstly in treatment group and control group, those were relevant to nonrandom researches were excluded, and full text of the rest articles was looked up further. Inclusion criteria: ① randomized controlled study; ② experimental or clinical researches including those in parallel control group; ③ studies by using ginkgo leaf extract in treatment group. Exclusion criteria: repetitive investigations.DATA EXTRACTION: The 221 random and nonrandom articles about therapeutical effect of ginkgo leaf extract on senile disease were collected,and 25 animal experiments or clinical investigations were also included.However, among 196 papers, 175 were excluded because of nonrandom or repetitive trials, and 21 because of review papers.DATA SYNTHESIS: There were 1 099 patients and 355 animals in 25 experiments. The research results showed that ginkgo leaf extract could regulate level of lipid and improve resistance of insulin on the aspect of treating diabetes mellitus (DM); effectively improve hypercoagulable state and hemorheological property on the aspect of treating hypertension; increase contents of levarterenol and 5-serotonin, protect cerebral ischemiareperfusion injury through up-regulating expression of Bcl-2 protein and down-regulating expression of Bax protein, and improve hemorheological indexes of patients with cerebral infarction and diabetes mellitus on the aspect of treating cardio-cerebral vascular disease; protect activity of adenosine triphosphate (ATP) enzyme in cerebral tissue, inhibit injured effect of oxygen-derived free radicals on mitochondrial RNA, delay cerebral senility, and improve learning and memory ability of senile rats on the aspect of treating anti-senility and senile dementia. Ginkgo leaf extract has been widely used in treating hypertension, diabetes mellitus, cerebral senility, senile dementia, cardio-cerebral vascular disease, etc., but there are no reports on side events.CONCLUSION: Ginkgo leaf extract is a valuable drug and also has a wonderful prospect in treating senile disease.

Objective To compare the efficacy between the brucea javanica oil emulsion combined with the whole radiotherapy group (treatment group) and only radiotherapy group (control group) in non-small cell lung cancer patients with brain metastases.Methods The clinical data of 53 non-small cell lung cancer patients with brain metastasis were retrospectively reviewed,including 27 cases in treatment group and 26 cases in control group.Results The remission rates were 77.8 ％ (21/27) and 69.2 ％ (18/26) respectively in treatment group and control group.The improvement rates of Kamofsky in the treatment group and control group were 66.7 ％ (18/27) and 30.8 ％ (8/26),the stable rates were 22.2 ％ (6/27) and 30.8 ％ (8/26),the decrease rates were 11.1％ (3/27) and 38.5 ％ (10/26).The remission rates of clinical sympotoms were 92.6 ％ (25/27) and 69.2 ％ (18/26) respectively in treatment group and control group.The difference of remission rate between two groups has no statistic significance (P ＞ 0.05),while the difference of the quality of life and clinical sympotoms between two groups were significant respectively (P ＜ 0.05).Conclusion The brucea javanica oil emulsion combined with the whole radiotherapy can relieve clinical sympotoms and improve the quality of life of patients,and may play a role on improving the effect of radiotherapy.

Objective To investigate the effect of angelica polysaccharide (APS) on bioactivity of bone marrow macrophage (BMM?) and its relationship to hematopoietic regulation, for clarifying the hematonic mechanism of Angelica sinensis. Methods The techniques of hematopoietic progenitor cell culture and BMM? culture in vitro, biological assay of hematopoietic growth factor (HGF) in culture media of BMM?, immunocytochemistry, and nucleic acid in situ hybridization were used. Results The culture supernatant of BMM? induced by APS can enhance the CFU-Mix, CFU-E, CFU-GM; the expression of erythropoietin (EPO), GM-CSF, IL-3, IL-6 protein in BMM? induced by APS was much stronger than that in the control group at different levels; the expression of EPO mRNA and GM-CSF mRNA in BMM? induced by APS were intensified. Conclusion APS may directly and/or indirectly stimulate the BMM? in hematopoietic inductive microenvironment to accelerate the synthesis and secretion of hematopoietic regulation factors on the basis of gene and protein level, such as EPO, GM-CSF, IL-3, IL-6, which in turn to promote the proliferation and differentiation of CFU-Mix, CFU-E, and CFU-GM.

Objective: To observe the clinical curative effect of narrow band ultraviolet combined infrared with 8-Methoxypsoralen for the treatment of vitiligo,to seek a new method for the treatment of vitiligo. Methods: Sixty cases of vitiligo patients were randomly divided into experimental group and control group. The experimental group adopted 365-nm narrow band ultraviolet LED combined 850-nm infrared LED with 8-Methoxypsoralen for the treatment of vitiligo, the control group adopted 365-nm narrow band ultraviolet LED irradiation combined with 8-Methoxypsoralen for the treatment of vitiligo, the clinical curative effect of two group were observed when treated with 1 months,2 months. Results:After 2 months of treatment, the efficiency rate of the experimental group was 66.67%, higher than that of the control group with an efficiency of 40%, the difference was statistically significant(x2=4.653, P<0.05). Conclusion: The clinical efficacy of narrow band ultraviolet combined infrared with 8-Methoxypsoralen for the treatment of vitiligo is better than that of narrow band ultraviolet combined with 8-Methoxypsoralen in the treatment of vitiligo.

Diabetic foot is one of the most common and serious complications of diabetes. Early detection and prompt treatment is of great significance to the prevention of diabetic foot. Imaging is the most convenient and effective method for making an early diagnosis of diabetic foot, and imaging examination can directly and accurately reveal the peripheral vascular disorders, peripheral neuropathy, soft tissue complications, muscle and tendon lesions, bone complications, etc. thus the lesion’s extent can be exactly evaluated, which provides reliable basis for the selection and evaluation of the clinical therapeutic scheme. This paper aims to make a general review about the recent imaging research progress in diabetic foot.

Textbooks are the base of teaching.The physiology textbooks used in medical education was compared between China and the United States.Guyton and Hall Textbook of Medical Physiology was chosen as the major representative of the United States.The overall framework, the selection and arrangement of the contents, the application of tables and pictures, and the relationship between basic medicine and clinical medicine were discussed.This paper may provide some information for remodeling of specialized course system and teaching contents of physiology, especially for improving the constructive quality of textbooks in the future.

Objective:To explore the effect and mechanism of CXCL10 on immune-mediated liver injury.Methods:The CXCL10 expression vector was injected into mice by hydrodynamic injection.The levels of CXCL10 in the liver were measured 72 hours after injection.Concanavalin A (ConA) was injected into mice to induce immune-mediated liver injury.The levels of alanine a minotransferase (ALT),tissue damage,IFN-γ,TNF-α and percentages and numbers of regulatory T cells were tested and compared between CXCL10 expression group and control group.Results:The levels of CXCL10 in the liver were significantly increased at 72 hours after CXCL10 expression vector was injected.The pretreatment of CXCL10 expression vector markedly reduced ConA-induced ALT levels,IFN-γlevels and TNF-α levels.Additionally,the pretreatment of CXCL10 expression vector increased the percentages and numbers of regulatory T ceils in the liver.Conclusion:The pretreatment of CXCL10 expression vector decreases the levels of inflammatory cytokines and attenuates ConA-induced liver injury,which might be beneficial for the treatment for immune-mediated liver injury.

Objective To evaluate the recent effects of IMRT plus gemcitabine for locally advanced non-small-cell lung cancer.Methods The data of forty-five patients were retrospectively reviewed.The treatment group consisted of 23 cases,treated with sequential same chemotherapy regimens and IMRT,the control group consisted of 22 cases,receiving same chemotherapy regimens after two cycles of gemcitabine and cisplatin induction chemotherapy.Resuls The remission rates were 65.2 ％ (15/23) and 31.8 ％ (7/22) respectively in treatment and control group.The 1 year survival rates were 66.4 ％ and 45.0 ％ respectively in treatment and control group.The remission rates and 1 year survival rates were significant different between two groups (both P ＜ 0.05).Conclusion The short-term effect of sequential chemotherapy and IMRT is better than chemotherapy and the adverse events can be better tolerated.