Adolescent ; Child ; Electromyography ; Female ; Humans ; Male ; Stomach ; physiology

Based on the formation and developing course of the system of diagnosis and treatment of Traditional Chinese Medicine(TCM),to explain three modes of diagnosis and treatment,including differential diagnosis of diseases therapy,determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs,illness-syndrome coalescent.The latter one consist of the mode of illness-syndrome coalescent of TCM,which is based on diagnosing disease in TCM,to carry out determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs and that based on diagnosing disease in modern medicine,to carry out determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs of TCM.Meanwhile,to approach the advantages and flaws among different modes of diagnosis and treatment,accordingly we could offer theory evidences for elevating the level of curing disease of TCM.

BackgroundProliferative vitreo-retinal disease (PVD)is one group of ocular complications marked by the enhanced proliferation of various cells included retinal pigment epithelial (RPE) cells.Insulin-like growth factor-1 (IGF-1)and vascular endothelial growth factor(VEGF) are implicated in the aberrant cell proliferation and pathological neovascularization that characterizes PVD,but the signaling mechanism is unclear now. Objective This study was to explore the effect of IGF-1 on VEGF in cultured human RPE cells under the small hairpin loop RNA (shRNA) keeping hypoxia-inducible factor-1 α ( HIF-1 α) silencing. Methods Human retinas were isolated from 4 healthy male donors,and the RPE cells were harvested and cultured.The ceils were identified using anti-human keratin antibody.The third to fifth generation of human RPE cells were used in the experiment.One target site of HIF-1α mRNA was chosen by certain design principle,and shRNA was designed and synthesized by the target site and transferred into the cells in vitro,and then the cells were cultivated with 50 μg/L IGF-1 for 24 hours.The mRNA and protein expressions of HIF-1α and VEGF were detected by RT-PCR and Western blot respectively. Results Cultured human RPE cells showed the flat irregularly multangular shape,and 97％cells appeared the positive response for keratin.HIF-1α mRNA expression in human RPE cells was significantly lower in 50 μg/L IGF-1 group than the 0 pg/L IGF-1 group ( 1.49±0.18 vs 1.46±0.17 ) ( t =0.335,P =0.743 ),however,the expressing levels of HIF-1α protein( 1049.86±172.54 vs 0.00±0.00) and VEGF mRNA(0.95±0.15 vs 0.35±0.07) and VEGF protein (391.98±56.77 vs 214.36±37.15)were raised in the 50 μg/L IGF-I group compared with 0 μg/L IGF-1 group (t=16.098,9.935,6.928,P＜0.05).After the HIF-1α-specific shRNA was transferred into cultured RPE cells,the expressions of both HIF-1α mRNA and its protein significantly decreased in RPE cells under 50 μg/L IGF-1 concentration condition( F=68.679,89.904,P=0.000),moreover,the expression of VEGF mRNA and its protein were significantly lowed(F=21.770,6.205,P＜0.05). ConclusionsIGF-1 promotes the accumulation of HIF-1α protein and induce the expression of VEGF in human RPE cells,which probably play a pivotal role in the development of PVD.

Objective To evaluate the level of specific anti human leukocyte antigen IgG antibodies and its effect on renal transplantation Methods Specific anti HLA IgG antibodies of 685 serum samples were measured by the micro enzyme linked immunosorbent assay with Lambda Antigen Tray and Lambda Antigen Tray Mixed Results There were 12% positive recipients of anti HLA IgG antibodies among 685 renal transplantation patients The rates of allografts rejection after transplantation were 50% and obviously higher in the sensitized recipients than in non sensitized ones ( P

Objective To investigate the clinical teaching situation by using developmental inspection of School of Medicine,Shanghai Jiaotong University(SJTU-SM),and to put forward some suggestions. Methods By checking questionnaires and informal discussions,the relevant information was collected and analyzed by using SPSS statistics sofware. Results The clinical teaching quality of SJTU-SM was basically satisfied.The satisfaction from internship of grade 2004 was better than that of grade 2003.However,some problems in clinical teaching must be improved.Conclusion The investigation showed that the clinical teaching quality of SJTU-SM is being improving.However,in order to achieve the international accreditation standards,the quality guarantee system of clinical teaching need to be further perfected.

Acute Kidney Injury ; blood ; physiopathology ; therapy ; Blood Pressure ; Critical Illness ; therapy ; Electrolytes ; blood ; Female ; Hemofiltration ; methods ; Humans ; Infant ; Male ; Prognosis

Objective To investigate the effect and underlying mechanisms of ghrelin in a rat model of renal fibrosis. Methods Male Sprague-Dawley rats were divided into 4 groups , including sham operation +saline or brain gut peptide treatment group , model + saline or brain gut peptide treatment group. Unilateral ureteral obstruction (UUO) was established by left ureteral ligation. 7 days and 14 days after operation, the rats were sacrificed , while the kidney tissue of obstruction side was harvested for pathlogical changes through Masson coloration. Expression of α-smooth muscle actin (α-SMA), transforming growth factor beta1 (TGF-β1) and phosphorylated Smad3 (p-Smad3) in renal tissues were analyzed through immunohistochemistry. Expression of α-SMA and TGF-β1 mRNA was detected by real-time-PCR. Apoptosis kidneys cells were marked with TUNEL. Results Ghrelin inhibited renal fibrosis by reducing the production of collagen , restraining extracellular matrix (ECM) deposition and decreasing the expression of α-SMA. Meanwhile, ghrelin inhibited the accumulation of myofibroblasts by blocking the transforming growth factor-β1/Smad3 (TGF-β1/Smad3) signaling pathway. Moreover, ghrelin could attenuate renal tubular cell apoptosis induced by UUO injury. Conclusion Ghrelin can reduce renal fibrosis and renal cell apoptosis induced by UUO , demonstrating that ghrelin is a potent antifibrotic agent that may have therapeutic potential for patients with obstructive nephropathy.

Posterior pedicle fixation-based dynamic stabilization is now densely studied in the non-fusion spine surgery.The method is characterized by the motion preservation of segmental lumbar,avoidance of the stress change after fusion surgery,and adjacent disc degeneration.Posterior pedicle fixation-based dynamic stabilization systems have undergone fast development and are now used for the treatment of degenerative lumbar spine disease.As an innovation of traditional fusion surgery,the clinical evaluation of its efficacy has become a focus of study among spine surgeons.In this paper,we review the recent progress in the clinical efficacy of posterior pedicle fixation-based dynamic stabilization.

OBJECTIVE To understand the distribution of common pathogens and their drug resistance trend and to provide the basis of the correct selection of antibiotics for clinic.METHODS Retrospective analysis was taken for blood culture specimens during 2 years in our hospital.And statistical analysis was done.All of 4028 cases of blood culture specimens were detected on automatic BacT/Alert3D rapid blood culture system,strains isolated were taken to VITEK-2 automatic microbiological analysis/sensitivity system for identification and drug susceptibility testing.Drug susceptibility results were analyzed using WHONET 5.3 software.RESULTS Totally 435 pathogen were isolated from 4028 cases of blood culture sample and the positive rate was 10.8%.195 Gram-negative bacteria strains accounted for 44.8%,mainly Escherichia coli,Klebsiella pneumoniae,Burkholderia cepacia,Acinetobacter baumannii,and Pseudomonas aeruginosa.Gram-positive bacteria accounted for 49.9%;mainly Staphylococcus epidermidis,S.haemolyticus and S.aureus dominated.Fungi were 23 strains(5.3%),mainly Candida albicans.Among them,extended-spectrum ?-lactamases(ESBLs) produced by E.coli and K.pneumoniae strains were 43.9% and 48.8%,respectively.Meticillin-resistant S.aureus and coagulase-negative staphylococci were 35.3% and 72.9%,respectively.But vancomycin-resistant S.aureus was not found.CONCLUSIONS The bacteria identification detected in blood culture class is quite complicated,and the drug resistance is high.Laboratories should increase the detection rate of bacterial culture and provide drug monitoring results for the clinics on time based on CLSI norms.Clinicians should use the antibiotics reasonably based on the drug susceptibility results in order to reduce nosocomial infections and the emergency of multiple drug-resistant strains.

Objective We evaluated the molecular epidemiology ofStenotrophomonas maltophilia strains in adult patients in Renji Hospital to Shanghai Jiao Tong University School of Medicine for better control ofS.maltophilia infections.Methods Nonduplicate clinical isolates of S.maltophilia were collected from Renji Hospital from January 2014 to September 2014.We examined the clonality among the S.maltophilia isolates by multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE).Antimicrobial resistance pattern was investigated by Kirby-Bauer method and prevalence of toxin genes (Stmpr1,Stmpr2,stmr-1,Smlt3773locus) by PCR.We also studied the biofilm formation of S.maltophilia by semiquantitative biofilm formation test.Results A total of 78 nonduplicate S.maltophilia isolates were analyzed,of which 26 were isolated from surgical intensive care unit,and 53 strains were from male patients.All patients infected by S.maltophilia had received antibiotic therapy before the strains were isolated.At least three kinds of antibiotics were used in 62.8％ of the patients.MLST analysis indicated that 49 isolates were assigned novel STs(STnewl-STnew38),with new combinations of allelic profiles.The largest cluster of isolates was ST23 (6 strains).PFGE showed that there was weak genetic linkage between S.maltophilia strains.The 78 isolates were divided into 58 groups.About 2.6％ (2/78) and 10.3％ (8/78) of these strains were resistant to levofloxacin and trimethoprim-sulfamethoxazole,respectively.All the strains were susceptible to minocycline.The prevalence of virulence genes Stmprl,Stmpr2,snf-1 and Smlt3773 locus was 79.5％ (62/78),93.6％ (73/78),94.9％ (74/78) and 48.7％ (38/78),respectively.Biofilm formation test indicated that the mean ability of biofilm formation was 0.51±0.44 in terms of D492.There was no significant difference between males and females.Conclusions All patients with Stenotrophomonas maltophilia infection had a history of antibiotic use and male patients were susceptible population.Stenotrophomonas maltophilia isolates showed high prevalence of virulence genes.No clonal dissemination was found in the same department of hospital.