OBJECTIVE:To evaluate the therapeutic effect of compound glycyrrhizin plus mizolastine for patients with generalized neurodermatitis(GND)and its influence on patietents' psychology.METHODS:60 patients with GND were randomly assigned to receive compound glycyrrhizin plus mizolastine(treatment group)or mizolasitine alone(control group)for 28 days.The psychological factors were examined before and after treatment using self-rating anxiety scale(SAS),and the curative effects and the psychological changes between two groups were compared.RESULTS:The SAS scores of treatment group and control group were 30.53? 1.50 and 33.20? 1.67,respectively(P

Cardiovascular Diseases ; Growth Differentiation Factor 15 ; Humans

Objective To design quality improvement checklist of catheter-related blood stream infection (CRBSI),in order to improve the nursing quality of ICU and ensure nursing safety.Methods A new ICU quality improvement checklist of CRBSI was designed and applied for the quality control of the patients with central venous catheter from April to June 2012.The using rate of central venous catheter and incidence of CRBSI were observed.Results After application of the checklists,the using rate of central venous catheter was decreased and the incidence of CRBSI was decreased.Conclusions The checklist may help improve the prevention and control of CRBSI in ICU.

BACKGROUND: The occurrence and severity of acute high-altitude disease(AHAD) are determined by the speed entering the highland, the altitude of highland and seasons. The association between obesity and AHAD has not been fully investigated.OBJECTIVE: To investigate the association between obesity and acute high-altitude in people exposed rapidly to the highland.DESIGN: Comparative observation.SETTING: Department of Cardiology, General Hospital of Chinese PLA and Department of Cardiology, Tibetan General Hospital of Chinese PLA.PARTICIPANTS: The experiment was conducted at the Department of Cardiology, General Hospital of Tibetan Military Area Command of Chinese PLA in August 2006. Totally 82 Henan subjects aged 28-45 years were selected from the male workers constructing the Qinghai-Tibet Railway and their managers with acute high-altitude exposure. They had never been to the highland before, and all agreed to the detection.METHODS: ①Every subject completed the AHAD self-report questionnaire at sea level and 12 hours and 24 hours after ascending high-altitude. The items in the questionnaire included symptoms of headache, gastrointestinal symptoms,fatigue or weakness, dizziness, and insomnia. Each symptom was graded from 0-3 with 0 as no symptoms, 1 as mild symptoms, 2 as moderate symptoms, and 3 as severe symptoms and a total score of 15. A score of 4 or more could by identified as AHAD. ②The height and body mass were measured to calculate the body mass (BMI). Those with BMI≥28 kg/m2 served as the obesity group [n =39, mean age (35±8) years], and those with BMI of 18.5-23.9 kg/m2 as the normal body mass group [n =43, mean age (35±8) years]. ③Arterial blood was taken to evaluate arterial oxygen saturation (SO2), arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) at baseline and 24 hours after ascending high-altitude. ④The measurement data was compared by t test.MAIN OUTCOME MEASURES: BMI, vital capacity of lungs, SO2, PaO2 and PaCO2 levels of obese and normal people.RESULTS: Totally 39 obese people and 43 normal people were involved in the result analysis. ①AHAD score: No symptom was reported at sea level in all participants (scored 0), but the AHAD scores in the obesity group were significantly higher than those in normal group 12-hour and 24-hour after ascending high-altitude. ②Blood gas analysis:At sea level, there were no statistical differences in the levels of SO2, PaO2, and PaCO2 between two groups (P ＞ 0.05).But 24 hours after ascending high-altitude, SO2 and PaO2 of the obesity group were much lower than in the normal group (P＜ 0.01), and PaCO2 was significantly higher than in the normal group (P＜ 0.01).CONCLUSION: Obese men are more vulnerable to high-altitude hypoxia than people with normal body mass. Obesity is an important risk factor for the development of acute high-altitude disease.

Objective To evaluate the technique of finger palpation in thoracoscopic localization in patients with pulmonary nodules,and to summarize its technical details,especially with exploit of chest computed tomography (CT) facilitating it.Methods 95 patients with total amount of 109 pulmonary nodes 20 mm or smaller in size shown with lung window of CT,were reviewed.They were located subpleurally,with a median depth of 8.2 mm and a median size of 10.0 mm.The value of their depth over their size (D/d value) could be used as the extent of localizing difficulty.Each node had its own radiographic fealures for being localized,which was built preoperatively.Under thoracoscopic vision,nodules were finger-palpated by index finger via the 4th or 5th intercostal space on anterior axillary line,followed by wedgectomy or lobectomy for instant histopathological diagnosis to further decide the final surgical type.The distance between the nodule and the origin of segmental bronchus (L value) were also calculated out,as it might be relevant to the way the nodule could be biopsied.Results All nodules were successfully localized and resected for biopsy goal,105 by wedgectomy,4 by lobectomy.After intraoperative diagnosis was made by the pathologist,VATS lobectomy and lymph node dissection were further performed in 55 patients.L value of 4 cases being biopsied by lobectomy ranged from 18.3 to 30.3 mm,averaging 26.1 mm.Conclusion Finger palpation is viable in any cases of pulmonary nodules.Detailed reference of CT digital information,and enough detachment of mediastinal pleura,can greatly facilitate thoracoscopic localization by finger palpation.Lobectomy or segementectomy is preferable when L value is less than 30 mm.

Objective To investigate the effects of uric acid (UA) and UA under oxidative stress on cultured human umbillical vein endothelial cells (HUVEC).Methocds HUVECs were incubated with different concentration UA (0,4,8,16 mg/dL),H2O2 (500 mmol/l) and UA+H2O2 (500 mmol/l) for 24,48 and 72 hours.Then we observed the morphology of HUVECs and evaluated the proliferation of HUVECs by MTT assay.NO and ET-1 in supernatant medium was detected by ELISA.Results For the viability of HUVECs,there was no statistically significant difference between 4 mg/dL UA group and control group after incubation for 24,48 and 72 hours (P＞0.05) and between UA groups(8 mg/dL and 12 mg/dL) and control group after incubation for 24,48 and 72 hours (P＞0.05).After incubation with 12 mg/dL of UA for 48 hours or 8 mg/dL of UA for 72 hours,the viability of HUVECs decreased significantly (P ＜0.05) The viability of HUVECs in H2O2 group decreased significantly (P＜0.05).The viability of HUVECs in UA+H2O2 groups after incubation for 24 h was significantly better than H2O2 group.There was no signifiant difference in the cell viability between (8 mg/dL or 12 mg/dL) UA+H2O2 group and H2O2 group.Compared with the control group,the NO levels were decreased and the ET-1 levels were increased in the supernatants of HUVECs in 12 mg/dL UA group for 72 hours (P＜0.05).Compared with H2O2 group,the NO levels were increased and the ET-1 levels were decreased in the supematants of HUVECs in (8 mg/dL or 12 mg/dL) UA +H2O2 groups for 24 hours (P＜0.05),while for (12 mg/dL) UA +H2O2 group for 72 hours,the results were just the contary.Conclusion The effects of UA on HUVECs are related with both concentration and action rime.Acutely increased UA may protect HUVECs form injury,while long action of UA may injure HUVECs,especially under oxidative stress.

Clinical medicine is a comprehensive discipline integrating natural science and hu-manities and social science. Lemology is closely related with basic medicine and medical microbiology and medical immunology are the basis of lemology. Therefore, in the process of cultivating postgradu-ates of lemology, we should not only should attach importance to the cultivation of basic medical knowl-edge and clinical professional quality, but also pay more attention to the development of the intelligence factors and non-intelligence factors. Meanwhile education on humanity, social sciences and relevant laws and regulations should be enhanced to cultivate doctors' professional quality. Reverse thinking and lateral thinking in the clinical diagnosis should be strengthened to achieve the training objectives of cultivating international medical talents.

Objective To study the prevention and treatment of complications occurring in anterior cervical spinal surgery.Methods3163cases with cervical spondylotic meylopathy,spinal injury,spinal tu-mor and spinal tuberculosis treated by anterior cervical surgery,were included in this study.Trephination,corpectomy,disectomy and debridement were used for decompression,iliac bone autograft,BAK cage,cubic shaped cages and titanium mesh cages were used for bone grafting,while anterior cervical spine locking plates were performed in some of the cases.1848cases were followed-up from6months to8years with an aver-age of 2years and3months.646cases suffered from operative complications,372cases were immediate due to anterior cervical surgery,and the incidence of morbidity was11.76%.Results26cases of transient laryn-geal nerve or superior laryngeal nerve injury recovered in4to12weeks without special treatment.Most of 16cases with cervical hemotoma were caused by bleeding of smaller blood vessels and obstruction of drainage.13cases of spinal cord or nerve root irritation or injury were treated with medicine for dehydration,12of them had good result.11cases of CSF leakage were cured with cervical spinal immobilization and moderate local compression.8cases of local infection were cured with antibiotics or combined with debride-ment and suturing.2cases of esophagus perforation were repaired and healed.8cases of grafted bone dis-placement were re-operated on the day or second day of occurring.17cases of pseudoarthritis had revision surgery.6of 35cases of adjacent segments degeneration with new symptoms of spinal cord compression were treated with anterior cervical decompression again,and had good results.Most of 342cases of iliac donor side com plications were local pain or lateral femoral cutaneous nerve injury,infection occurred in some cases.Compli cations related to instruments included10cases of BAK subsidence,1case of plate breakage,1case of screws and plate back-out and7cases of titanium mesh cage subsidence.216cases of cervical axial pain were cured3to6months later with medicine.There was1case of sudden death in this group.Conclusion Many kinds of operative complications could occur in anterior cervical surgery.A standardized procedure in diagnosis and surgery methods are the key points to decrease and prevent operative related complications.

Objective To explore the effects of cobalt chloride (CoCl2)-induced hypoxia on migration of melanoma cells, and to detect the transcription, expression and secretion of Follistatin-like 1(FSTL1) in this process. Methods B16F10 melanoma cell line was treated with CoCl2 in order to mimic hypoxia. Experimental cells were divided into three groups: 0μmol/L, 50μmol/L and 100μmol/L CoCl2 treatment groups. MTT assay was used to assure cell viability, and to determine the treatment concentration of CoCl2. Transwell assay was used to determine the migration ability of B16F10 melanoma cell line. Real-time PCR was used to measure the mRNA expression of Fstl1. Western blot assay was used to detect the intracel?lular and extracellular protein expression of FSTL1. Results The cell viability of B16F10 melanoma cell line was signifi?cantly reduced by CoCl2 treatment, with a time and concentration-dependent manner. The migration ability of B16F10 cell line was significantly increased in CoCl2 treated group compared with that of control group (P<0.05). The mRNA level of Fstl1 was obviously higher in CoCl2 treated group than that of control group (P<0.05). The intracellular expression of FSTL1 protein was consistent with the expression trend of Fstl1 mRNA. Simultaneously, the extracellular protein level of FSTL1 was significantly decreased compared with that of control group. There was no expression of FSTL1 in 100μmol/L CoCl2 treat?ment group. Conclusion The migration ability of melanoma cell line is enhanced by CoCl2 treatment, which may be associ?ated with expression and secretion of FSTL1, however, the relevant mechanism still needs further investigation.

Objective To evaluate the profile of proliferating T cells and dendritic cells ( DCs ) in the skin infiltrates of patients with mycosis fungoides ( MF) in different stages. Method Paraffin section and immunohistochemisty with monoclonal antibody were used to detect the expression of special antigen per section. Results The numbers of Ki-67+ cells and cutaneous lymphocyte-associated antigen ( CLA+) cells both increased significantly in the skin infiltrates of MF. Most Ki-67+ cells expressed both CLA and CD4 antigen. The number of Ki-67+ cells was significantly higher ( P