BACKGROUND: Insulin-like growth factor-1 (IGF-1) has important biological effects on the heart, it can promote cardiac and vascular smooth muscle growth and metabolism.OBJECTIVE: To summarize the biological effects of IGF-1, to clarify the mechanism of exercise-induced cardiac hypertrophy, and make better use of the exercise influence on IGF1 to achieve adaptive cardiac hypertrophy.METHODS: With exercise-induced cardiac hypertrophy, insulin-like growth factor, exercise in English for the search terms,Pubmed database from January 1990 to April 2009 was retrieved; With exercise-induced cardiac hypertrophy, insulin-like growth factor, exercise in Chinese for the search terms, CNKI database from January 1990 to April 2009 was searched. Literatures were limited to English and Chinese languages. Inclusive criteria: animal experimental study and clinical application research closely linked to IGF-1; exclusive criteria: the old literatures and Meta analysis.RESULTS AND CONCLUSION: Totally 41 literatures were screened out by computers, according to the inclusion and exclusion criteria; 31 documents of which were involved for analysis. The IGF coordinates with other growth factors to promote differentiations and maturity of a variety of cells. The current data indicate that the blood serum and the cardiac local IGF-1 play an important role on cardiac hypertrophy. This study used the method of literature to analyze the production and action mechanism of the circulatory and cardiac IGF, discuss the functions of cardiac local IGF and the effect of exercise on it, and bring forward that exercise can alter the IGF expressions, IGF is related to the formation of exercise-induced cardiac hypertrophy.

Objective To investigate the characteristics of the clinic manifestations and the electromyogram changes in patients with chronic N2hexane intoxication. Methods The clinic manifestations, the electromyography and nerve conduction velocities were analyzed in 9 patients with N2hexane intoxi2 cation. Results The main clinical manifestations of the disease were acroparesthesia and asthenia, especially in legs. The abnormality rate of electromyography in patients with N2hexane intoxication was 100%. The conduction velocity of the sensory nerve and the motor nerve decreased at a rate of 33.33% and 88.89% respectively. The distal latencies were prolonged( 100% ). The denervated electromyogram was 33.33%. Conclusion The main clinical manifestations of the disease were Peripheral neuropathy. The chronic N2hexane intoxication mainly led to the imparement, especially in the distal region of the motor nerve in legs,and the damages of the nerve could be related to the duration of exposure to N2hexane.

Objective For arising recognition to HIE of neonate.We made a summary and a retrospective studied to CT material of 130 cases for neonate suffering HIE,combined with clinical diagnosis and documents.Methods 130 cases for neonate suffering HIE diagnosed by CT and clinic,all underwent unenhanced CT scan.Results Appearance of HIE:Normal involved 1～4 brain′s lobe,often involved frontal lobe;can be accompanied by kinds of intracranial hemorrhage;can be accompanied by infarction.Conclusion Among HIE cases,hypoxia and ischiemia were cause and result each other;difference among clinical symptoms and CT apearances are possible;the neonate with moderate and sereve asphyxia can be accompanied by intracranial hemorrhage more easier;to the injury of parasagittal region,CT and USG can not make a diagnosis.

Objective To investigate the clinical efficacy and safety of low-dose rituximab (RTX) for patients in primary Sj(..o)gren's syndrome (pSS) with thrombocytopenia.Methods Four pSS patients,2 with refractory thrombocytopenia and 2 with glucocorticoid-dependent thrombocytopenia,were treated with rituximab at 100 mg,intravenous,weekly for a total of two cycles,together with prednisone 1-2 mg · kg-1 ·d-1,and the counts of platelets and B-cells were evaluated.Results Efficacy of treatment was observed in all patients.The counts of platelets,at (3-39) x 109/L baseline,incleased in 1-2 weeks,and went up to ( 107-241 ) × 109/L in 3-8 weeks.Sustained remission had been achieved for 27-52 weeks.The doses of prednisone were tappered to 3.75-7.50 mg/day in 12 weeks.One patient who relapsed at the 27th week (platelet count 47 x 109/L),was retreated with 100 mg of RTX and still had good efficacy.The counts of B-cells reduced to (0.007-0.010) × 109/L,but they did not achieved the depletion.There were no severe adverse events during RTX therapy.Conclusions Our study has shown good efficacy and tolerability of lowdose RTX for pSS with thrombocytopenia.Low-dose RTX allows for reduction in corticosteroid doses and B-cells,while large-scale randomized double-blind controlled trials are needed to confirm the results.

BACKGROUND: Arterial injury surrounding the mandibular angle is very common during mandibular angle ostectomy. The retromandibular vein is susceptible to injury owing to thin vascular wall and deep location. Anatomical studies regarding the retromandibular vein are rarely reported.OBJECTIVE: To observe the construction, branches, backstreaming of the retromandibular vein and its relation to the facial nerve and mandibular angle.METHODS: Twenty formalin-fixed adult cadavers (40 samples) were randomly selected. Bilateral retromandibular veins and their branches were cleaned. The construction, branches, backstreaming of the retromandibular vein and its relation to the facial nerve and mandibular angle were anatomically observed.RESULTS AND CONCLUSION: The retromandibular vein originated constantly and provided an average length of (4.51±2.01) cm, with an average outer diameter of (0.52±0.28) cm at the origination part. A total of 34 samples showed that the retromandibular vein was formed by the union of the superficial temporal and maxillary veins, and six samples showed that the retromandibular vein originated from the superficial temporal vein. The retromandibular vein divided into two types according to the backstreaming and course: one type consisted of the anterior and posterior branches: the anterior branch mostly drained into the internal jugular vein and minorly drained into the external jugular vein; the posterior branch was joined by the posterior auricular vein and became the external jugular vein. Another type of retromandibular vein without the anterior and posterior branches directly connected with the posterior auricular vein and entered the external jugular vein. The retromandibular vein had the following branches (appearance frequency): facial transverse vein (88%), mandibular articular vein (98%), parotid veins (95%),anterior auricular veins (58%), styloid process vein (43%). 88% of the retromandibular vein was located in the superior and inferior trunks of the facial nerve and in the medial branches. The retromandibular vein connected with facial nerve trunk or major branches in a decussated fashion. 75% of the arc-shaped structures formed by the retromandibular vein and its branches coursed close to the inferior and posterior border of the mandibular angle, and 25% of the arc-shaped structures were not close to the lowest point of the mandibular angle. The thin periosteum between the venous wall and cortical bone was just the position of ostectomy line of mandibular angle. The retromandibular vein was easily injured no matter in vein dissection or ostectomy.

Neoadjuvant chemotherapy evaluation methods are becoming the focus of osteosarcoma chemotherapy research in recent years.This paper updates the evaluation methods of osteosarcoma neoadjuvant chemotherapy in such aspects as pathological histology,imaging studies,and the examination of molecular levels.

OBJECTIVE:To provide reference for the promotion of rational use of essential medicines and further implementa-tion of essential medicines system. METHODS:Depended on the data (including the number of species,the amount of prescrip-tion and prescription departments,etc)of essential medicines(chemical drugs and biological drugs)use in outpatient and emergen-cy departments and wards of 20 sample medical and health institutions fromThe Hospital Prescriptions Cooperation Project,statis-tical analysis was performed by using Excel and Access software. RESULTS:The proportion of the amount of essential medicines included in National Essential Medicines List(2012 edition)or Beijing Essential Medicines(Supplementary list)(2012 edition)to the amount of total medicines(hereinafter referred to as the essential medicines use ratio)in medical and health institutions of Bei-jing from 2013 to the first half year of 2014 was small and showed a slight downward trend. The essential medicines use ratio of grade 2 and grade 3 general hospitals did not reached the required ratio by former Health Department. The essential medicines use ratio in different departments showed great differences,the essential medicines use ratio in imaging department was 100%,while chemotherapy departnent was 4.04%. The essential medicines use ratio in different medicines also showed great differences,5 kinds of drugs(including sulfani lamides)was 100%,while there were 16 kinds of drugs that was less than 0.1%. CONCLUSIONS:The essential medicines use ratio is relatively low in medical and health institutions of Beijing from 2013 to the first half year of 2014 and shows great differences in different departments and different medicines. It is suggested to further improve the essential medi-cines use ratio to better benefit the majority of patients by changing the prescribing habits of physicians,strengthening the advocacy of essential medicines policy and optimizing the use of essential medicines in different departments.

OBJECTIVE:Analyze drug use of pediatrics in China,and to provide reference for promoting research,develop-ment and supply of pediatric drugs. METHODS:Analyze the data of drug use in 2 632 514 pediatric patients aged from 0 to 14 of 78 sample hospitals from Beijing,Shanghai,Tianjin,Hangzhou,Zhengzhou,Guangzhou and Chengdu in“The Hospital Prescriptions Cooperation Project”of Hospital Pharmacy Professional Committee of Chinese Pharmaceutical Association,statistical analysis was performed by using Excel and Access software. RESULTS:Pediatric patients in 78 sample hospitals of 7 regions had used 1 572 kinds of drugs from 2013 to 2014,but only 31.04%of drugs were pediatric drugs;both the ratio of pediatric drug types and the ra-tio of pediatric drugs use frequency had a great gap in different drug classifications. The ratio of drug use frequency in injection ad-ministration was 57.97%,and it was greatly higher than that of oral administration(31.04%). Among oral solid preparations,the ratio of drug use frequency for drugs with unreasonable specification was 29.57%,and ratio of drug types was 40.99%. CONCLU-SIONS:The pediatric patients had a great drug shortage in kinds,dosage forms and specifications in 78 sample hospitals of 7 re-gions during 2013-2014. Off-label drug use,high frequence of injection use,tablets used after breaking and other irrational phenom-ena were found in pediatric patients during clinical drug therapy,which reduced high risk of drug use. It is recommended that gov-ernment should strengthen and improve incentives mechanism of research,development and supply of pediatric drugs,so as to solve pediatric drug shortage in China,promote rational clinical drug therapy for children and guarantee the safety of drug use in pe-diatrics.

Based on the theory and approach of International Classification of Functioning, Disability and Health (ICF), the literatures on the improvement of physical function by physical exercise were reviewed. People with disabilities can improve their body functions, in-cluding mental function, cardiovascular, blood, immune and respiratory function and neuromuscular skeletal and motor related functions via sport and exercise rehabilitation. Some advice was suggested about sports rehabilitation for the disabled.

Objective To evaluate the efficacy and safety of repeated endoscopic sclerotherapy injection(ESI) and endoscopic variceal ligation(EVL) in eradication of esophageal varices among patients who survive an episode of first variceal hemorrhage with a high risk of rehaemorrhagia and death. Methods The correlated literatures were identified from Medline,Embsae,the Library Cochrance,PubMed and CNKI.RevMan 4.2 Software provided by the Library Cochrance was used for data analysis. Results A total of 4 randomized controlled trials were included.It was demonstrated that there was no significant difference in the esophageal varices eradication rate between repeated ESI and EVL(OR=0.75,95%CI: 0.48-1.15;P=0.19).However,the rehaemorrhagia rate of EVL after emergency hemostasis was significantly lower than that of ESI(OR=2.19,95%CI:1.44-3.31;P=0.000 2).Meanwhile,there was no significant difference in mortality between ESI and EVL(OR=1.34,95%CI:0.82-2.17;P=0.24).Little publication bias was found with funnel plot analysis. Conclusion EVL outperforms ESL in prevention of rehaemorrhagia in treatment of esophageal varices,while does no better than ESL in eradication of esophageal varices and mortality.