[Summary] Adrenocortical carcinoma is a rare disease with poor prognosis, and its pathogenesis is mainly related to genetic mutations, abnormal expressions of steroidogenic factor-1, insulin-like growth factor 2,cell growth factors including vascular endothelial growth factor, dysfunction of Wnt pathway, as well as dysregulation of microRNA and DNA methylation. In recent years, the intensive molecular studies provide a brand-new methodology to distinguish adrenocortical carcinomas from benign tumors in early stage.

Objective To investigate the value of the senile degenerative aortic valve calcification (AVC) and to analyze the correlative risk factors by color Doppler echocardiograph.Methods Aortic valves of 110 cases with AVC (study group) and 110 cases without AVC (control group) were observed by color Doppler echocardiograph.All the patients with AVC have been excluded of congenital and other acquired valves' diseases.The aortic valve' s shape and the diameters of aortic root were measured.At the same time,the peak systolic and diastolic velocities of aorta were detected.The different features were compared between the two groups.Results Test results showed significant differences in study group:Anteroposterior diameter of aortic annulus and the area of aortic valve were decreased by calcification; The anteroposterior diameter of aortic sinus increased and aorta transvalvular pressure gradient augmented; Detection rate of atherosclerosis (AS) of aorta and the peripheral artery stenosis of the study group were higher than that of control group; The AS increased pulse pressure and aggravated AVC; Correlative risk factors,in addition to age,included hypertension,hypercholesterolemia,osteoporosis,and so on.The correct diagnosis of the correlated diseases were on the basis of clinical examines.The rate of AVC with multi-factor was higher than that with single-factor.In addition,gender difference and the diameters of ascending aortic showed no significant difference in two groups.Relationship between diabetes of correlative factors and the rate of AVC showed no significant difference in two groups.Conclusion Morphologic abnormality and malfunction of aortic valve and the large artery in elder patients were caused by senile degenerative AVC.The more correlative risk factors,the worse showed.

BACKGROUND: Clinical observation has been proved that acupuncture has effect on antiinflammation and immunoloregulation, which is the basis for preventing and curing immune disturbance and active chronic inflammation. OBJECTIVE: To observe the effect of electropumcture on antiinflammation, analgesia and subgroup of T cells of adjuvant-arthrosis rats at Jiaji acupoint.DESIGN: Completely randomized grouping and controlled study.SETTING: Basic Laboratory of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine. MATERIALS: A total of 30 Wistar rats were selected in this study. Five days after feeding, all rats were randomly divided into 3 groups: normal control group, model group and electropumcture group with 10 in each group. METHODS: ① The experiment was completed at Basic Laboratory of Acupuncture and Moxibustion of Shandong University of Traditional Chinese Medicine from January to May 2005. Freund's complete adjuvant (FCA) was used to establish adjuvant-arthrosis models in model group and electropumcture group. On the modeling day, the 3rd and the 5th Jiaji acupoints of bilateral lumbar vertebrae of rats in electropumcture group were acupunctured with 28-sized stainless-steel milli-needle of 0.5 inch.The needle was stimulated 0.3 cm from the 3rd and the 5th spinous process of lumbar vertebra which was counected to G6805-2A multiple functional electropumcture meter for sparse-tight waves (frequency of sparse wave: 4 Hz, frequency of tight wave: 60 Hz, intensity: t mA) 30 minutes each time,once a day for 7 days. Rats in normal group and model group were fixed with the same way for 7 days. (Rats were fixed with cloth-rope at fixing apparatus.) ② Pain threshold was measured before modelling, 1 and 7 days after modelling. Foot pad was exposured with strong light by hot-pain stimulation meter, and paw withdrawal latency was regarded as pain threshold. ③ Right hindfoot bulk of rats was assayed with foot bulk determinator (bulk draining method) before modelling, 1 and 7 days after modelling to calculate swelling rate (％) [(foot bulk after modelling-foot bulk before modelling)/ foot bulk before modelling × 100％ ]. ④ Expressional rates of serum CD4+ and CD8+ were assayed with FACSCalibur flow cytometer and the ratio between CD4+ and CD8+ was calculated 8 days after modelling. ⑤ Average value of multiple samples were compared with single-factor analysis of variance and t test.MAIN OUTCOME MEASURES: Effect of electropumcture at Jiaji acupoint on pain threshold, swelling rate and subgroup of serum T cells of adjuvant-arthrosis rats.RESULTS: A total of 30 rats were involved in the final analysis. ① One day after modeling, bulk of right hindfoot in model group and electropumcture group was bigger than that in normal control group and that before modeling (P ＜ 0.01), and swelling rate was higher than that in normal control group (P ＜ 0.01); 7 days after modeling, bulk and swelling of right hindfoot in model group were higher than those in normal control group (P ＜ 0.01), and bulk was bigger than that before modeling (P ＜ 0.01);bulk and swelling of right hindfoot in electropumcture group were lower than those in model group (P ＜ 0.05). ② Pain threshold of both rear feet of normal rats were not changed after modelling. One day after modelling,pain threshold at inflammatory side was decreased in model group and electropumcture group (P ＜ 0.01) and it was lower than that in normal control group (P ＜ 0.01); 7 days after modeling, pain threshold at inflammatory side was still lower than that before inflammation (P ＜ 0.05),and it in electropumcture group was higher than that in model group (P＜ 0.05). ③ Percentages of CD4+ T lymphocyte and CD8+ T lymphocyte in model group were lower than those in normal control group (P ＜ 0.01), and ratio of CD4+/CD8+ was also higher than that in normal control group (P＜ 0.05). Percentage of CD4+ in electropumcture group was higher than that in model group, but there was no significant difference. Percentage of CD8+ in electropumcture group was higher than that in model group (P ＜ 0.01),but ratio of CD4+/CD8+ was lower than that in model group (P ＜ 0.05).CONCLUSION: Electropumcture at Jiaji acupoint has obvious effect on anti-inflammation and analgesia, and can also regulate cellular immunity of adjuvant-arthrosis rats.

To select appropriate descriptors for response of the patient-reported outcome (PRO) scale for the main symptoms of patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary heart disease.

Objective To develop a programmable neuromuscular electrical stimulation system as a potential countermeasure for muscle atrophy in long-term microgravity.Methods The system was mainly composed of a controllable constant current pulse generator,wires and skin electrodes.To meet the requirements of stimulating recipes selection,the stimulating parameters could be adjusted independently and the combinatorial output of different stimulating phases should also be achieved.Results The system worked well with high accuracy outputs.The sensation,contraction,tetany and pain thresholds of all the 5 waveforms stimulating signals were measured.For different stimulating waveforms,thresholds of each state were different and the subjective sensations induced by same stimulating amplitude were dissimilar.Conclusion The developed system providing powerful programmable and accurate stimulating signals,is convenient for the selection and verification of stimulating recipes and can be used as an instrument platform for study of electrical stimulation to prevent muscle atrophy in microgravity.Volunteer experiments have proved its validation for function of muscle contraction and provide primary basses for the optimization of stimulating recipes.

OBJECTIVES:To fathom situation and the cause about adverse drug reactions(ADR)from each drug manu?facturing enterprise and drug handling enterprise in our city.METHODS:501cases of ADR reports in our city collected by ADR monitoring center in2004were classified and analyzed statistically.RESULTS:Of the501ADR cases,226cases were resulted from antibiotic drugs which accounted for45.1%,80cases were resulted from by traditional Chinese drugs prepara?tions which accounted for16.0%;ADR most commonly manifested itself in the injury of skin and appendants,which accounted for48.9%(245cases),then the damage of digestive system and circulation system,there were21(4.2%)comparative serious ADR cases among which;most cases were resulted from iv which accounted for65.9%(330cases)of the total.CONCLU?SION:Cultivation of professional quality and service quality of the professional staff should be strengthened and the om?nibearing ADR monitoring work should be deployed so as to lessen and avoid the occurrence of ADR.

The article explores the significant role supervisor system plays in the credit system in medical college,the scientific selection of supervisors,their management,duty and directions in order to guide the supervisor system in correct and scientific orbit so as to train constantly new type of medical talents.

Objective To study the role of calcium homeostatic and kinetics in the epileptogenesis activity. Methods Hippocampal neurons were acutely isolated from controls and status epilepticus (SE) models induced by lithium-pilocarpine at different time point. The [Ca2+]i levels were detected by laser scanning confocal microscope. And the ability to restore resting [Ca2+]i levels after a brief exposure to 5 μmol/L glutamate in control and epileptic neurons were evaluated. Results The [Ca2+]i level of acute separated hippocampal neurons in the control rats was (95.4±22. 1) nmol/L After injection of lithium pilocarpine, the [Ca2+]i level in hippecampal neurons increased dramatically to (867.6±35.2) nmol/L, and decreased to (292.8 ± 18.3) nmol/L on the 7th day, lasting for about 30 days ((220. 8± 17.6) nmol/L), it is higher than that in the control group (t = 12. 55, P < 0.01). The distribution of neuronal [Ca22+]i showed that 92% of control neurons were in the normal range of [Ca2+]i level (25-150 nmol/L) ; After 6 hours, however [Ca2+]i levels of all SE neurons increased, and 85% of which were higher than 500 nmol/L; After 7, 14 and 30 days, there were 75%, 60% and 52% of SE neurons still manifested an elevated [Ca22+]i level, but less than 500 nmol/L. After the exposure to 5 μmol/L glutamate treatment for 2 minutes, [Ca2+]i of the control neurons restored to baseline values in (9. 5±3.4) minutes, whereas the SE rats of acute, latent and chronic phases did not (t = 5.08, 4. 56, 4. 21, all P < 0. 01). Conclusion Lithium-pilocarpine induced epilepsy causes a long-term alteration of calcium homeostatic mechanisms of hippocampus neurons, which may play an important role in the development and maintenance of spontaneous recurrent seizures.

To observe the facial spectrum and color of different points, the positions of heart, liver, spleen, lung and kidney of traditional Chinese medicine reflecting on the face, in healthy participants and those with a sub-health status, so as to provide an objective basis for health evaluation.

Objective To explore a new mode of prenatal diagnosis and counseling for congenital heart disease (CHD) by interdisciplinary cooperation and the value of Grading scale of fetal echocardiography in disease management.Methods The Grading scale of fetal echocardiography and a new integrative service mode of prenatal diagnosis and counseling for CHD with multidisciplinary team,including obstetric sonographers,obstetricians,pediatric cardiologists and geneticists,was established.For pregnant women referred to prenatal clinic in Shanghai First Maternity and Infant Hospital from January 1,2011 to December 31,2012,counseling about the diagnosis,severity,treatment options and long-term prognosis would be provided based on detailed fetal echocardiography and the grading scales.The significance of such mode in the prenatal management of CHD was analyzed and the rate of pregnancy termination was compared by Fisher exact test.Result According to the Grading scale of fetal echocardiography,there were four categories:Class Ⅰ,minor anomalies probably without treatment requried; Class Ⅱ,simple defects with normal life quality following after-born therapy; Class Ⅲ,complex anomalies with reasonable life quality after treatment; Class Ⅳ,severe malformation requiring multiple stage surgical repair or with very poor prognosis.There were a total of 54 pregnancies confirmed to have fetal cardiac anomalies by echocardiography,among which 27 were terminated.The average age of pregnant women was (29±3) years old,the average gestational week was 28.0±3.8.The abortion rate in women with the fetuses diagnosed as Class Ⅳ CHD was 17/19,higher than that in Class Ⅰ,Ⅱ and Ⅲ (3/15,3/10 and 4/10,Fisher exact test,all P＜0.01).In 19 Class Ⅳ cases,only two twin pregnant women continued their pregnancies because the other fetuses were healthy.Abortion was conducted in all 7 fetuses associated with extra-cardiac,chromosome anomaly or genetic syndrome.Conclusion The establishment of new integrated mode of prenatal diagnosis and counseling for CHD and Grading scale of fetal echocardiography in a multidisciplinary manner could provide comprehensive and authentic information and ethical advices for the families.