Objective To compare and analyze differences in clinical characteristics, auxiliary examination and im?munotherapy between children with anti-N-methyl-D-aspartate(NMDA) receptor encephalitis and adults. Methods Clinical data was retrospectively collected from 34 cases anti-NMDA receptor encephalitis. All people were divided into the child group and the adult according to the age of onset and the inpatient department. Score of Modified Rankin Scale (mRS) before and after treatment and follow-up period (6 months~24 months) were compared to estimate the neurologi?cal outcomes. Results Data from 34 patients including 19 children and 15 adults was analyzed. Hypoventilation, epilep?sy and status epilepticus were more common in the adult group than in the child. The positive rate of EEG delta brush was higher in child group than in adult group. Two women were complicated by suspicious ovarian teratoma. Intravenous immune globulin was used commonly in the child group, while the plasma exchange or immunosuppressant used common?ly in the adult group. Time of onset to hospital admission and final diagnosis were shorter in the child group than in the adult. Patients requiring ICU were fewer in the child group than in the adult. The scores of mRS were significantly lower in the child group than in the adult at hospital discharge (P<0.05). Conclusion Clinical characteristics is more compli?cated in adults with anti-NMDA receptor encephalitis compared with children including a worse disease severity and a poorer short-term outcome.

Beginning from the tradition branch course obstacle analyzing on college student' practice ability,to define the effect and study domain and key problem about curriculum integration on practice ability cultivation can provide one kind of clear train of thought for the college curriculum adapting even surpassing the demand of this society.

Objective In order to summarize the common characters of medical education , this research Compared curricula and educational reformation of different counties .The common characters of international medical educa-tion are useful to China's current medical education reformation .Methods This research used method of compara-tive education study to compare the medical education of the U .S, the U.K and Japan.Results Although the medical education program length is different in the 3 countries, they all recognize medical education as professional education .So they all adopt muti-method to test candidates .The curriculum frameworks of medical education pro-gram of 3 countries are different , but the curriculum organization , teaching methodologies , assessment methods are similar.They all have complete quality control system .As the medical education reformation , about half of medical schools in the U .K and Japan have implemented graduate entered medical education program .Conclusions Al-though medical education program length is different in the U .S, the U.K and Japan, they do share some charac-ters.These common characters are useful to medical education reformation and quality control in China .

Objective To study the expression of toll-like receptor 4 (TLR4), nuclear factor κB (NF-кB) and Caspase-3 and the change of neuron apoptosis of the hippocampus in the status convulsion rat , and to explore the effect of resveratrol on them.Methods A total of 106 male Sprague-Dawley(SD)rats were randomly divided into the control (A), convulsion (B) and resveratrol treatment (C) groups.Group B was further randomly divided into four subset groups (B1-B4) which were executed at 4h, 24h, 48h, 72h after convulsion discontinued .Continuous epilepticus was induced by injecting lithium chloride and pilocarpine , and group C was daily injected with 30mg/kg resveratrol 30minutes after convulsion stopped for 3 days.TLR4 and NF-κB/p65 proteins were detected by immunohistochemistry ( IHC ); the expressions of TLR4 and Caspase-3 mRNA were detected by RT-PCR.The neuron apoptosis was observed by TUNEL . Results The IHC staining of TLR4 protein in group B was significantly higher than in group A (P<0.05), and that in group C was much lower than in B 4 group ( P<0.01 ) .The expression of NF-кB/p65 showed that hippocampal neurons had positive expression in cell nuclei in group B compared with group A (P<0.05), and the expression of NF-кB/p65 protein in group C was much lower than that in group B 4 (P<0.01).The mRNA expressions of TLR4 and Caspase-3 in the rat hippocampus of group B were significantly elevated than that in group A ( P <0.05 ) , and the tendency was increased gradually , reaching the peak at 72 hours after seizure , and that in group C was much lower than that in B 4 group (P<0.01).The TUNEL positive cells in hippocampus CAl of B group were more than that of group A after the SC 24hours (P<0.01),reached the highest level at the 72nd hour, and that in group C the TUNEL positive cells were lower than that in B4 group (P<0.01).Conclusion The expression of TLR4, NF-кB and Caspase-3 increased after SC.Resveratrol can down regulate the expression of TLR4, NF-кB and Caspase-3 in the hippocampus with pilocarpine-induced seizures, reduced the number of neuronal apoptosis .These results suggest that resveratrol may have a protective effect against the hippocampus damage caused by status convulsion .

Objective To investigate whether the splenic metastasis of B16 melanoma cells in C57BL/6 mice occur through the blood.Methods Cultured B16 melanoma cells were collected,adjusted into 1?10~7/ml and inoculated into the left armpit of C57BL/6 mice,200 ?l each.After 15 days,the mice were sac- rificed and metastasis was examined in various tissues and organs by HE stain.1.5 % Evan Blue(EB),2 ml/kg, was administered to normal C57BL/6 mice through the tail vein,and the region stained blue was compared with that of metastasis.Results All of 12 mice inoculated were burdened with melanoma.Splenic metastasis occurred in 9 of them,among which 3 were accompanied by lung metastasis,and all of 9 mice showed differ- ent degree of local lymph node metastasis.The dorsal 1/4 part of the positive spleen was stained black by the metastatic tumor cells.Under the microscope,distribution of the metastatic tumor cells in the spleen was scat- tered,their growth inhibited,and maturation accelerated.The region stained blue by EB also located at the dorsal 1/4 part of the spleen,which was almost the same as the positive part of metastasis.Conclusions Metastasis of B16 melanoma cells in C57BL/6 miee occurs earlier in the spleen than in other organs,and this metastasis is achieved most possibly through the blood.

One-hundred and eighty-eight cases of metabolic syndrome conforming to the criteria of International Diabetes Federation(IDF) were enrolled,and 166 healthy subjects served as control.Phalangeal bone mineral densities in both groups were measured.Osteocacin,bone alkaline phosphatase,and parathyroid hormone were determined with Enzyme-linked immunosorbent assay.Results:Body mass index,waist circumference,waist-tohip ratio,fasting blood glucose,blood pressure,triglycerides,total cholesterol,and low-density lipoproteincholesterol in the group with metabolic syndrome were higher than those in normal control group(all P＜0.01),while high-dcnsity lipoprotein-cholesterol was lower (P ＜ 0.01).T values,Z values,and osteocacin in the metabolic syndrome group were lower than those in control group (all P＜0.05),while parathyroid hormone was higher (P＜0.05).There was no significant difference in levels of bone alkaline phosphatase between the two groups.Metabolic syndrome as an aggregate of multiple metabolic disorders was prone to be accompanied with osteoporosis.Body mass index was an important protective factor of osteoporosis,triglycerides and waist-hip ratio were independent risk factors.

Objective To assess compliance in liver transplant recipients,ascertain related factors,and help clinical nunrses take measures to improve compliance. Methods Questionnaires including social demo-graphic variables and questionnaire about compliance after liver transplant,were used to investigate 54 liver transplant recipients whose post transplant time>6 months.Results Liver transplant recipients had good compliance to immunosuppressive medication,scored(3.67±0.51),and health lifestyle,scored(3.30±0.44),but relatively poor compliance to follow-up.scored(3.05±0.89)and self-monitoring,scored(2.00±0.89).The main factors influencing the compliance were average monthly per capita family income(P<0.01)and post trans-plant time(P<0.01).Conclusions The importance of compliance to follow-up and self-monitoring should be emphasized in health education to the recipients and more attention should be paid to those re-cipients with lower income or longer post transplant time.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Neural Conduction ; physiology ; Paraplegia ; diagnosis ; physiopathology ; Sural Nerve ; physiopathology

Objective The diabetic foot ulcer has high incidence rate,many complications,and is difficult to heal.Methods We summary the treatment expericncc of 156 cases of diabetic foot wounds.On the basis of comprehensive standard medical treatment,according to the wound characteristics,blood supply,and the degree of tissue necrosis,we performed staging gnawing-away debridement for all tbe wounds,combining with pressure suction,new dressing,skin grafts and skin flaps.Results Of all the 156 cases,2 cases died,4 cases were lost to follow-up,the remaining 150 cases healed,with an average time of 56 days.Conclusions The treatment of diabetic foot ulcer must take into account both the systemic therapy and local processing,the wound should be debrided with different stage and progressively.When the wound microenvironment is gradually improved,it can be covered appropriately with skin grafts.The skin flap should be chosen cautiously.

BACKGROUND:More than 10 kinds of lipid metabolism-related genes have been found, and endocrine dysfunction mediated by these genes is an important pathological basis for the occurrence and development of insulin resistance. OBJECTIVE:To investigate the effects of metformin on serum lipid profiles and the expression levels of various genes associated with insulin resistance, as well as the histopathological changes of the liver and pancreas in rats with type 2 diabetes melitus. METHODS:A type 2 diabetes mellitus rat model was established by feeding a high-fat diet to the rats for 4 weeks, combined with the intraperitoneal injection of streptozotocin (35 mg/kg). In the meanwhile, metformin was administered orally (400 mg/kg?d) (model group) or nothing (control group). Semi-quantitative RT-PCR, histopathological and biochemical examinations were then performed. RESULTS AND CONCLUSION:Metformin improved the symptoms of insulin resistance by normalizing the serum lipid profiles in the diabetic rats. Furthermore, metformin upregulated the expression levels of insulin receptors and genes associated with lipid metabolism, including acyl-CoA oxidase, carnitine palmitoyl transferase-1 and peroxisome proliferator activated receptor-α. In addition, metformin downregulated the expression levels of fetuin-A and retinol binding protein-4, and improved the expression of perilipin that had been reduced in the type 2 diabetes mellitus rats. Metformin was shown to induce positive signaling for insulin and the regeneration of pancreaticβcells in the pancreas. These results suggest that metformin ameliorates the insulin resistance induced by type 2 diabetes mellitus via regulating the expression levels of fetuin-A, retinol binding protein-4, perilipin and various genes associated with lipid metabolism.