Case discussion is an effective approach,which combines basic theory with clinical medicine.It can evoke students' interest and cultivate their creative thinking capacity.Moreover,it can improve teachers' general ability in teaching pathophysiolo- gy.In this article,we discuss the application of case discussion in pathophysiology teaching.

Objective To examine the caregivers' burden and quality of life (QOL) of main caregivers of patients with Parkinson's disease by analyzing caregiver and patient-related factors. Methods A total of 53 cases with Parkinson's disease seen from October 2012 to December 2013 in Yantaishan hospital of Yantai City were selected. Assessments: (a) EuroQol-5 questionnaires, including: EQ-5 dimensions (EQ -5d) and visual analogue scale (VAS). (b) Unified Parkinson's Disease Rating Scale. (c) Hoehn-Yahr(H-Y) stage; (d) Parkinson's disease sleep scale (PDSS), 15 items; (e) Hamilton Anxiety Rating Scale (HAMD-14), Hamilton Depression Rating Scale (HAMA-24); (f) Chinese version of Zarit caregiver burden interview. Results Spearman correlation analysis showed that the EQ-5D index and EQ-VAS negatively correlated with HAMD-14 of caregivers of Parkinson diseasepatients (r=- 0.318, - 0.046) (P<0.05), and negatively correlated with H-Y staging (r=-0.592, -0.531), UPDRSI (r=-0.434, -0.316) , UPDRS Ⅱ (r=0.521, 0.513) , UPDRS Ⅲ (r=0.520, 0.534), UPDRS Ⅳ (r=0.564, 0.509), PDSS in patients with Parkinson's disease (r=0.547, 0.490), HAMD-14 (r=0.315, 0.350), HAMA-24 (r=0.413, 0.401) of Parkinson's disease patients (P<0.05). Caregiver burden was related with HAMD-14 (r=0.496), HAMA-24 (r=0.551),H-Y stage (r=0.697), PDSS (r=0.659), UPDRS Ⅰ-Ⅳ (r=0.538, 0.668, 0.696, 0.600), EQ-5D index of Parkinson disease patients (r=0.682), EQ-VAS of Parkinson disease patients (r=0.670) (P<0.05); and positively related with anxiety of caregivers (r=0.275) , and a negative correlation with the caregivers' quality of lives (r=0.665) (P<0.05). Bivariate analyses showed significant correlations between caregiver burden and patients' sleep, scores of Parkinson's motor symptoms, and caregivers' depression. Based on multiple regression analysis, Zarit score proved to be the main predictor of caregivers' QOL. Caregivers' age, total numbers of caregivers and H-Y stage also proved to be a relevant factor. Conclusion Improvement of patient's sleep, motor symptoms anddepression might alleviate caregivers' strain. There is a correlation between caregivers' burden and QOL. QOL of caregivers can be improved through reducing their care-burden.

OBJECTIVETo evaluate the effectiveness of manual therapy and traction for lumbar disc herniation and analyze the current status of this kind of randomized clinical trial (RCT).

METHODSDatabase of CNKI, VIP, WANFANG, PubMed and OVID were searched. Some relevant journals were manually retrieved. A total of 2 874 literatures on manual therapy and traction for lumbar disc herniation were collected, of which 17 articles met the inclusion criteria. The Jadad score scale was used to evaluate the quality,and RevMan5.0 was used for meta-analysis of literatures.

RESULTSThe results of the meta-analysis of all trials involved were as followed:the combined effect of the effective rate was RR = 1.10, 95% CI [1.06, 1.14], the combined effect of the cure rate was RR = 1.36, 95% CI [1.21,1.52], the combined effect of the VAS was RR = 1.37, 95% CI [1.28, 1.45], the combined effect of the JOA was RR = 4.75, 95% CI [4.40, 5.09].

CONCLUSIONThe overall quality of the current RCT researches about manual therapy for lumbar disc herniation was lower,and did not support the conclusion that manual therapy was more effective than traction for lumbar disc herniation.

Humans ; Intervertebral Disc Displacement ; surgery ; therapy ; Lumbar Vertebrae ; surgery ; Musculoskeletal Manipulations ; methods ; Randomized Controlled Trials as Topic ; Traction ; methods

Objective:To investigate the effects of different processing products of Cortex Phellodendri on scavenging oxygen free radicals and anti-lipidperoxidation. Method:The oxygen free radicals generation system and mouse liver homogenate lipid peroxidation in vitro were used. Result:The aqueous and 80% alcohol extracts of raw,stir-fried,stir-fried with salt,stir-fried with yellow alcohol products of Cortex Phellodendri could scavenge superoxide radical(O2*)generated through hypoxanthine-oxidase system and(*OH)generated through Fenton action,and inhibit lipid peroxidation induced by hydroxyl radical generation system,respectively.But the carbonized product has no effect.There are differences among these processed products.Conclusion:80% alcohol extract of stir-fried with yellow alcohol products of Cortex Phellodendri was more intense.

Animals ; Arsenites ; therapeutic use ; Catheter Ablation ; Liver Neoplasms ; therapy ; Male ; Rabbits

Objective To understand the role of NOD-like receptor pyrin domain containing 3 (NLRP3)-dependent activation of cysteinyl aspartate specific proteinase 1 (caspase-1) in mediating the neuroinflammatory response in mice with MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine)-induced Parkinson's disease(PD) and to investigate the underlying mechanism. Methods Male C57BL/6 mice were randomly divided into two groups:experimental and control groups. MPTP solution (30 mg·kg-1·d-1) was given to mice through intraperitoneal injection to prepare the PD model and equal amount of saline was used to set up the control group. Changes in mouse behavior were observed through pole climbing and suspension experiment. Expression of inflammasome in the midbrain of mice was detected by Western blot. SH-SY5Y cells,a human neuroblastoma cell line,were cultured in vitro and randomly divided into five groups including control,nonsense,siRNA-NLRP3,MPP+(1-methyl-4-phenylpyridinium) and siRNA+MPP+groups. siRNA-NLRP3 was transfected into SH-SY5Y cells using Lipofectamine 2000 to silence the expression of NLRP3 gene. Then the transfected cells were incubated with MPP+for 48 h to observe the protective effect of NLRP3 on nerve cells. MTT assay and flow cytometry were performed to measure the viability and the apoptosis rate of SH-SY5Y cells,respectively. Western blot was used to detect the levels of NLRP3,B-cell lymphoma 2 (Bcl-2),Bcl-2-associated X protein (Bax) and cleaved caspase-3. Results Compared with the control group,the mice in the experimental group spent more time climbing from the top to the bottom of the pole (P<0. 05),got a lower score on suspension experiment (P<0. 05) and showed enhanced expression of NLRP3, IL-1β,Pro-IL-1β and caspase-1 in the substantia nigra (P<0. 05). Compared with the MPP+group,the siR-NA+MPP+group showed significantly inhibited expression of NLRP3, cleaved caspase-3 and Bax ( P<0. 05),enhanced cell viability (P<0. 05),suppressed cell apoptosis (P<0. 05) and promoted expression of Bcl-2 ( P<0. 05). Conclusion NLRP3-dependent activation of caspase-1 plays an important role in the nerve injury in PD. Inhibition of NLRP3 expression in vitro can significantly enhance the vitality and inhibit the apoptosis of SH-SY5Y cells,which may have a protective effect on nerve cells through regulating mito-chondrial apoptosis signaling pathway and provide a new drug target for the treatment of PD.

Objective To explore the expression of HCK gene during the cardiomyocyte differentiation of mouse embryonic stem cells and analyze the role of HCK gene in maintenance of pluripotency of embryonic stem cells.Methods Mouse embryonic stem cells were cultured,then induced to differentiate into cardiomyocytes.Total RNAs were isolated from mouse embryonic stem cells in the differentiation days:0 day(D0),the second day(D2),the fourth day(D4),the sixth day(D6),the eighth day(D8),respectively.The levels of HCK mRNAs were assessed by the method of semi-quantitive reverse transcriptase-polymerase chain reaction(RT-PCR).In the meanwhile,Total proteins were also isolated from mouse embryonic stem cells in the differentiation D0,D2,D4,D6,D8,and the levels of HCK proteins were evaluated by Western-blot.Results HCK mRNAs could be detected in the mouse embryonic stem cells in D0 and D2,however,they were undetectable from D4 to D8.The expression of HCK mRNAs was rapidly down-regulated during cardiomyocyte differentiation of mouse embryonic stem cells.Expression of HCK proteins,which coincided with HCK mRNAs,down-regulated during differentiation and couldn't be detected in D4.Conclusions With the cardiomyocyte differentiation of mouse embryonic stem cells,the expression of HCK in the levels of mRNA and proteins are sharply down-regulated;HCK may play an important role in maintaining the pluripotency of embryonic stem cell.

· AIM:To investigate the prevalence of juvenile myopia and factors affecting its occurrence in Linxia Prefecture.· METHODS:Totally 8 683 juvenile students who were 6-18 years old were extracted as respondent with stratified cluster sampling method.The eyesight,diopter and axial length were detected,and the gender,age,ethnicity,eye behavior were collected by self-made questionnaire.· RESULTS:The prevalence of myopia was 42.80％.The myopic rates of all ethnic groups were as follows:Tibetan Nationality:59.05％,Han Nationality:46.71％,Dongxiang Nationality:46.36％,Tu Nationality:45.24％,Sala Nationality:41.30％,Baoan nationality:40.61％,Hui Nationality:31.97％.Myopia rate between each ethnic groups had statistical difference (x2 =44.08,P=0.007).Multivariate analyses revealed that outdoor activities during the break was the protect factor for myopia;age,using electronic products on weekends and holidays,using the same lighting in room while studying were risk factors for myopia.· CONCLUSION:The prevalence of myopia increase with age in Linxia.The prevalence in different ethnic groups is different.Education department and family should make joint efforts to increase the outdoor time,improve the environment for teenagers to reduce the occurrence and development of myopia.

Objective To analyze the behavioral and psychological symptoms in patients with vascular dementia (VaD),investigate the relationship between behavioral and psychological symptoms and such correlative factors as cognitive disturbance,age,education level of the patients,and explore the internal relations among Neuropsychiatric Inventory (NPI) items. Methods NPI and Mini-Mental State Examination (MMSE) were introduced to assess the behavioral and psychological symptoms in 120patients with VaD and 61 healthy elders (control group). Results The VaD patient group had significantly higher scores in 8 items,including delusion,hallucination,agitation,dysphoria,apathy,irritability,aberrant motor and appetite/eating changes in the NPI list,as compared with the control group (P＜0.05),with the points ranked from the highest by dysphoria,apathy and irritability.Among the 8 items in the NPI list, delusion, apathy and aberrant motor were significantly correlated with cognitive disturbance; and aberrant motor was correlated with age and education level.Besides that,NPI factor analysis showed that 3 behavioral sub-syndromes,psychosis,mood disorder and behavioral disturbance,exited. Conclusion Behavioral and psychological symptoms were common in VaD patients,and the frequency and severity of appearing of behavioral and psychological symptoms were correlated with cognitive disturbance,age,and education level of different degrees; in addition,each sub-syndrome may have common pathophysiologic mechanism.

Objective To clarify the genetic characteristics of N protein coding region of HRSV isolates from Beijing and GenBank downloaded sequences.Methods Reverse transciption polymerage chain reaction(RT- PCR)was performed to amplify the N protein gene of 2 A and 2 B subgroups HRSV isolates from Beijing in the year 2004.The RT-PCR products were sequenced for N protein coding region.The sequences of N protein coding region of 4 Beijing isolates and those downloaded from GenBank were compared and analyzed.Results The differences in number of nucleotide and deduced amino acid between 2 A Beijing 2004 isolates and prototype strain Long were 36.40(3.1%-3.4%)and 4(1.0%).The difierences in number of nucleotide and deduced amino acid between 2 B Beijing 2004 isolates and prototype strain CH18537 were 17(1.4%)and 1(0.3%).The differences in number of nucleotide and deduced amino acid were 3-172(0.25%-14.63%)and 0-18(0-4.6%)respectively between 4 Beijing 2004 isolates and GenBank sequences.Conclusion N gene is the hishly conservative gene in the HRSV genome.The variation between A and B subgroups were widely distributed in the entire gene of N protein,while the variation within the A or B subgroups HRSV wag considerably lower.