Objective To investigate the effect of propofol pretreatment on the expression of phosphorylated c-Jun N-terminal kinase (p-JNK), matrix metalloproteinase-9 (MMP-9) and aquaporin-4 (AQP-4) during focal cerebral ischemia-reperfusion (I/R) in rats. Methods Seventy-two healthy male SD rats weighing 250-280 g were randomly divided into 4 groups (n = 18 each): sham operation group (group S), I/R group and propofol pretreatment group (P1 and P2). In group I/R, P1 and P2, focal cerebral I/R was induced by occlusion of middle cerebralartery for 2 h followed by 24 h of reperfusion. In group P1 and P2, intraperitioneal 0.5 % and 1% propofol 10 ml/kg were injected 30 rmin before ischemia respectively. In group I/R, normal saline 10 ml/kg was given instead of propofol 30 min before ischemia. Neurological deficit score (NDS) was assessed after consciousness was recovered. 2% Evans blue (EB) 3 ml/kg was injected intravenously 1 h before the animals were sacrificed at 24 h of reperfusion. The brain tissues were taken for determination of the brain water content, EB content and expression of p-JNK, MMP-9 and AQP-4. Results Compared with group S, the NDS and content of water and EB were significantly increased and the expression of p-JNK, MMP-9 and AQP-4 was up-regulated in group I/R, P1 and P2(P ＜ 0.05). Compared with group I/R, the NDS and content of water and EB were significantly decreased and the expression of p-JNK, MMP-9 and AQP-4 was down-regulated in group P1 and P2 (P ＜ 0.05). Compared with group P1 , the expression of p-JNK and MMP-9 was down-regulated (P ＜ 0.05), but no significant difference was found in the NDS, water and EB content and the expression of AQP-4 in group P2 (P ＞ 0.05). Conclusion Propofol pretreatment can reduce focal cerebral I/R injury by inhibiting the activation of JNK signal pathway and up-regulation of MMP-9 and AQP-4 expression.

Objective:To evaluate the effects of perioperatively administrated enteral immunonutrition in gastrointestinal cancer patients on immune and inflammatory responses,nutrition states and postoperative morbidity.Methods:Sixty patients with gastrointestinal cancer were divided randomly into two groups.Two groups perioperatively(from preoperative day 5 to postoperative day 7) received an supplemented diet with arginine,RNA,and ?-3fatty acids(immunonutrition group;n=30) or an isoenergetic and isonitrogenous standard diet (standard-nutrition group;n=30).All variables of immune and inflammatory responses,nutrition states and postoperative morbidity were measured on preoperative day 5 and postoperative day 1,4 and 8.Results:On postoperative day 4 and 8,most immune variables and prealbumin in the immuno-group were significantly higher than those in the standard-group(P0.05),and inflammatory variables as CRP in the immunonutrition group were significantly lower than those in the standard group.In the immunonutrition group,there were significantly fewer patients who experienced postoperative complications and shorter days of hospital stay compared with standard group(P0.05).Conclusion:The perioperative administration of enteral immunonutrition in gastrointestinal cancer patients can significantly modulate the postoperative immunosuppressive and inflammatory responses at the early postoperative day,can significantly decrease the occurrence of infectious and overall postoperative complications as well as the length of hospital stay.

Objective To observe the influence of hospital -community -family -individual 4 -level intervention model on schizophrenia patients in compliance,recurrence rate,psychotic symptom,social function,quali-ty of life and provide guidance for disease management.Methods 198 schizophrenia patients were divided into 4 -level intervention model group and conventional intervention group.After 6 moths follow -up,the effect was evaluated by compliance rate,recurrence rate,BPRS,WHO -DASII,SQLS.Results After the intervention for 6 months,the compliance,recurrence rate,the difference of severity of psychotic symptom,the difference of social function of the 4 -level intervention model group were 96.74%,13.04%,(7.57 ±2.83)points,[understanding and communication (6.32 ±3.64)points,physical exercise (5.16 ±3.28)points,self care (2.87 ±1.38)points,get on well with others (9.05 ±3.51)points,life activity (5.42 ±2.49)points,social participation (7.85 ±3.28)points],which of conven-tional intervention group were 74.74%,28.42%,(4.86 ±1.24)points,[understanding and communication (3.89 ± 1.86)points,physical exercise (2.80 ±1.238)points,self care (2.19 ±1.16)points,get on well with others (5.83 ± 3.04)points,life activity (3.41 ±1.96)points,social participation (4.27 ±2.17)points],the differences between the two groups were significant (χ2 =9.020,P =0.003;χ2 =6.932,P =0.009;t =8.527,P =0.000;t =5.775,P =0.000;t =6.554,P =0.000;t =3.652,P =0.000;t =6.712,P =0.000;t =6.144,P =0.000;t =8.829,P =0.000).The differences of before intervention and after intervention in the 4 -level intervention model group were psychological society (16.03 ±6.75)points,power and energy (15.79 ±6.41 )points,symptoms and side effects (19.37 ±7.28 )points,which in the conventional intervention group were psychological society (12.65 ± 5.46)points,power and energy (11.81 ±4.71 )points,symptoms and side effects (15.18 ±6.29 )points,the differences were statistically significant between the two groups (t =3.770,P =0.000;t =4.849,P =0.000;t =4.216,P =0.000).Conclusion Hospital -community -family -individual 4 -level intervention model has a positive effect on schizophrenia patients,which is worthy of clinical promotion.

Objective To find out present condition and differences in implementation of clinical pathways in hospitals of in China.Methods "Clinical pathway" was entered as a keyword to search in PubMed NCBI Chinese Science and Technology Periodical Database for related literatures in China from 1999 to 2009,analyzing the general implementations of clinical pathways in hospitals in different areas using the SPSS12.0 software.Results A total of 1051 relevant literatures were found.Through data analysis of these literature,differences of implementation of clinical pathways were found for 162 hospitals of different areas.It was found that the differences of total diseases among China's East,West and Central areas are significant statically.Diseases of implementation per hospital in the Central average 16.8,those in the East 8 types,while those for the West 4.4.Tertiary hospitals account for 70% as the main force of clinical pathway implementation,with diseases of implementation up to 13.7,while that under tertiary level down to 2.8.Conclusions Implementation of clinical pathways varies significantly among hospitals in different areas in China.In the process of implementing clinical pathway,appropriate management strategies should be developed according to actual situation in different hospitals in light of policies,hospital management and patient considerations.

Objective To assess the diagnostic capability of spiral CT for giant pure seminoma in intraabdominal undescended testis.Methods Spiral CT of 6 cases with pure seminoma of inabdominal testes as proved by surgery and pathology were analyzed.All patients were male,and the age ranged from 31 to 45 years old with the mean of 35.2 years old.Results All tumors were located along the path of testicular descent on CT images.The arterial-supply of tumors all came from the testicular artery ipsilaterally.The draining vein could be seen between the mass and inferior vena cava or left renal vein in 5 cases.Isolaterally spermatic cord was absent in the inguinal region.Isolateral kidney was shifted upward.CT scans typically demonstrated a unilateral,mixed solid and cystic mass,with areas of solid located at the lateral aspect and areas of necrosis at the medial aspect.Contrast-enhanced CT scan showed mild enhancement of solid areas and band-like septal enhancement in areas of necrosis.There is no evidence of calcification or fat within the mass.Conclusion Spiral CT proves to be a very useful preoperative imaging modality for the giant intraabdominal seminoma.

OBJECTIVE To explore the mechanism of methylamphetamine (MA) on heart toxicity. METHODS The effects of MA on delayed rectifier potassium current (IK) and action potential (AP) were analyzed in isolated decreased AP from 121.6 to 106.0 mV and delayed the action potential duration (APD), but had no effect on the resting potential. The 10%, 25%, 50%, 75% and 90% of APD (APD10, APD25, APD50, APD75 and APD90)inhibited the membrane potential of rapidly activating delayed rectifier potassium current (IKr) and slowly activating delayed rectifier potassium current (IKs), downward shifted the Ⅰ -Ⅴ curve, but had no effect on the curve shape and could be partly recovered after flushing. The tail current IKr was blocked concentration-dependently after simiarly inhibited by MA. CONCLUSION MA has inhibitory effects on Ik and AP in ventricular myocytes,which may be one of the possible electrophysiological mechanisms of the cardiac damage caused by MA.

AIM:To investigate the effect of genistein on the proliferation of human oral cancer TCA 8113 cells and to explore the underlying mechanisms .METHODS:The cell proliferation was examined by MTT assay , cell counting and colony formation assay .Western blotting was employed to examine the protein levels of vascular endothelial growth fac -tor (VEGF), extracellular signal-regulated kinase (ERK) and p-ERK.RESULTS: Genistein significantly inhibited the proliferation of TCA8113 cells in a concentration-dependent fashion .Moreover , genistein dose-dependently decreased the protein levels of VEGF, ERK and p-ERK.The expression of VEGF was also blunted by U 0126, a specific inhibitor of ERK.U0126 and axitinib, a VEGF receptor antagonist , both significantly inhibited the proliferation of TCA 8113 cells. CONCLUSION:Genistein inhibits the proliferation of TCA8113 cells, which may be related to its inhibitory effect on ERK expression and activation , thus subsequently decreasing the expression of VEGF .

BACKGROUND:Glucosamine hydrochloride is considered to have the role in the treatment of knee osteoarthritis. Whether it is effective for varying degrees of osteoarthritis and whether there are efficacy differences between the combinations nonsteroidal anti-inflammatory drugs and simple glucosamine hydrochloride need further clinical research. OBJECTIVE:To compare the clinical effects between glucosamine hydrochloride capsules and combined with celecoxib for the treatment of knee osteoarthritis through prospective study. METHODS:According to Lequesne score, 152 patients with knee osteoarthritis were divided into mild, moderate and severe groups, then each group was divided into groups treated just by glucosamine hydrochloride and groups treated by glucosamine hydrochloride combined with celecoxib randomly. The Lequesne score was recorded at 2, 4 and 6 weeks after drug administration and 8 and 12 weeks after drug withdrawal, and then the adverse reactions of glucosamine hydrochloride were compared between groups and before and after treatment. RESULTS AND CONCLUSION:In the mild group, there was significant difference in Lequesne score of glucosamine hydrochloride group at 4 weeks after treatment and 12 weeks after drug withdrawal when compared with that before treatment;the Lequesne score was improved in the combined group at 2 weeks after treatment, and there was significant difference between two groups at 2 and 4 weeks after treatment, it showed that the combined group improved the score, which was more significant than the glucosamine hydrochloride group. In the moderate group, the Lequesne score in the glucosamine hydrochloride group was lower than that in the combined group at 2, 4 and 6 weeks after treatment and 8 weeks after drug withdrawal (P<0.05). It showed that the effect of glucosamine hydrochloride combined with celecoxib for the treatment of medium knee osteoarthritis was better than that of glucosamine hydrochloride. In the serious group, there was no significant difference in Lequesne score between two groups before and after treatment. The results indicate that the clinical symptoms of mild knee osteoarthritis patients can be significantly improved by a single use of glucosamine hydrochloride. To moderate osteoarthritis, combination therapy with nonsteroidal anti-inflammatory drugs is recommended to improve clinical symptoms, and both of the two methods are invalid on severe knee osteoarthritis patients.

Objective To assess the diagnostic value of capsule endoscopy (CE) and CT virtual endoscopy (CTVE) for small intestinal diseases.Methods The data of 31 patients with suspected small bowel diseases who were examined by both CTVE and CE were collected.The diagnostic rates of CE and CTVE was compared by paired data McNemar test,using the diagnosis confirmed by surgery or follow-up as the golden standard.Results The confirmed diagnosis of 31 patients were small intestinal tumor in 16,nontumorous lesion in 10 and no abnormal lesion in 5.CE identified positive findings in 24 patients,including 14 cases of tumorous lesion (with mis-location in 2 and failure in definite diagnosis in 7) and 10 cases of non-tumorous lesion.CTVE identified positive findings in 17 patients,including 14 cases of tumorous lesion (with mis-location in 1 and failure in definite diagnosis in 4) and 3 cases of non-tumorous lesion.The combination of CE and CTVE could identified positive findings in 26 patients,including 16 tumorous and 10 nontumorous lesions.The diagnostic rates of CE and CTVE for tumorous lesions were both 87.5％ (14/16).The overall diagnostic rate of combined CE and CTVE was 83.9％ (26/31),which was significantly higher than that of CTVE alone (54.8％,17/31) but similar to that of CE alone (77.4％,24/31).Conclusion Both CE and CTVE are effective in diagnosis of small intestinal lesions and the combined use of 2 methods can increase diagnosis yield.

Objective To investigate the difference of apparent diffusion coefficients (ADCs) changes in three major salivary glands after gustatory stimulation using two different stimuli. Methods Thirty healthy volunteers were examined with a 1.5 T MR unit. A diffusion-weighted MR imaging (MR DWI) sequence was performed once at rest and continuously repeated 13 times after gustatory stimulation using a commercially available lemon juice and vitamin C tablets in the same volunteer by using self-controlled method. The subsequence of two stimuli was random. In addition, the salivary flow rates at rest and after stimulation were measured. Characteristics and differences in ADCs curves of three salivary glands before and after stimulation between two stimuli were analyzed. Comparison of maximum ADCs, maximum ADCs increase rates (IRs) and times to maximum ADCs(Tmax) between two stimuli was performed by using independent-samples t test. Correlation analysis between rest salivary flow rates and rest ADCs, the maximum salivary flow rates and ADCs after stimulation, the maximum salivary flow IRs and ADC IRs after stimulation were performed by using Pearson correlation test. Results In lemon juice stimulation group, the mean ADCs mostly showed a steady increase to peak values during the first DW MRI scan after stimulation in all glands, followed by a gradually decrease fluctuating slightly around the baseline values. In vitamin C stimulation group, the mean ADCs were significantly increased in all glands during the first DW MRI scan after stimulation, followed by a gradual upward trend till peak values. In lemon juice stimulation group, the mean Tmax of submandibular and sublingual glands[(184±122)s, (345±232)s, respectively] were significantly earlier than those[(454 ± 301)s, (528 ± 297)s, respectively] in vitamin C stimulation group (t=-3.517 and-2.548 respectively, P<0.01 for all). The mean maximum ADCs of three glands in lemon juice stimulation group[(1.05 ± 0.12) × 10-3 mm2/s, (1.22 ± 0.10) × 10-3 mm2/s and (1.26 ± 0.21) × 10-3 mm2/s, respectively] were all lower than those in vitamin C stimulation group[(1.13±0.13) ×10-3 mm2/s, (1.32±0.25) × 10-3 mm2/s and (1.57 ± 0.36) × 10-3 mm2/s, respectively], and the differences in parotid and sublingual glands between two groups were significant(t=-2.894 and-3.681 respectively, P<0.01 for all). The mean maximum ADC IRs of three glands in lemon juice stimulation group[(11.35±4.07)%, (8.81±5.40)%, (34.08±21.66)%, respectively] were significantly lower than those[(17.80 ± 12.72)%, (18.16 ± 18.93)%, (67.49 ± 46.04)% , respectively] in vitamin C stimulation group (t=-2.252,-2.330 and-3.432 respectively, P<0.05 for all) . In two groups, the mean maximum ADC IRs of parotid and submandibular gland were all significantly lower than sublingual gland (t=-5.994 and-6.443 respectively, P<0.01 for all). No correlation was observed between ADCs and salivary flow rates, ADC IRs and salivary flow rate IRs in two groups (P>0.05). Conclusion MR DWI with transient stimulation using lemon juice is more stable for evaluating the physiologic changes of salivary glands in vivo.