Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; Male ; Middle Aged ; Phytotherapy ; Tablets

Anemia, Aplastic ; therapy ; Cytomegalovirus Infections ; etiology ; Fatal Outcome ; Humans ; Immunotherapy ; adverse effects ; Male ; Pneumonia, Viral ; etiology ; Young Adult

There are problems in traditional medical education in China. It is important to cultivate medical talents who are adaptable to social changes and medical advancement. However, the scientific quality and innovative medical students have long been neglected. This paper discussed the essence of scientific quality and innovative talents, and introduced the experience of the program of "long term clinical medicine education" at Peking University Health Science Center. We here delineateded the key points of the scientific quality and innovation education that may provide new ideas for the training of the medical talents.

Objective To evaluate the CT findings of pancreatic carcinoid tumors.Methods The CT imaging data of five patients with pancreatic carcinoid tumors confirmed by pathology were retrospectively analyzed.Results The tumors ranged in maximum diameter from 2.0 to 11.0 cm with a mean of 6.4 cm. On unenhanced CT,the tumors were slightly hypodense relative to the pancreatic parenchyma,homogenous in 2 cases,and heterogenous in 3 cases.One tumor showed calcification.After contrast material injection, the solid component of the tumor showed marked heterogenous enhancement on the arterial phase scanning in 3 cases,and mild heterogenous enhancement in 2 cases.The degree of tumor enhancement was less intense than the surrounding pancreatic parenchyma due to necrosis of various degree,which led to the cystic appearance of the tumor in 1 ease.On the portal phase scanning,all tumors showed marked enhancement similar to that of the pancreatic parenchyma.On the delayed phase scanning,the degree of enhancement was more intense than the surrounding pancreatic parenchyma in 1 case.Liver metastases with retroperitoneal lymphadenopathy and peripancreatic vessels invasion were seen in 1 case.No dilatation of the biliary tract or pancreatic duct was present.Conclusion The CT features of pancreatic carcinoid tumors included infrequent dilatation of the biliary tract or pancreatic duct and unusual vascular involvement,calcification within the mass,marked enhancement similar to that of the surrounding pancreatic parenchyma during the portal phase scanning and more intense during the delayed phase scanning.

Objective To investigate if Rac1 GTPase activation plays an important role in hyperpermeability and tyresine phosphorylation of tight junction induced by vascular endothelial growth factor (VEGF) in glomertdar endothelial cells (GEnCs). Methods Primary cultured rat endothelial cells were used as experimental model. The effect of VEGF at different concentrations (5 or 50 μg/L) on endothelial permeability was investigated by transendothelial electrical resistance (TEER). The permeability of GEnCs transfected with wild type Rac1 (wtRacl) or dominant negative Racl (N17Rac1) was also detected. Immune precipitation and immune blotting were used to detect the tyrosine phosphor-occludin in GEnCs. Results VEGF at high concentration (50 μg/L) induced hyperpermeability in GEnCs (P<0.05). At the same time, GTP-binding and membrane-bound Racl GTPase significantly increased(P<0.01)in GEnCs. Tyrosine phosphor-occludin was also increased (P<0.05) under VEGF stimulation. However, transfection of GEnCs with N17Rac1 dramatically attenuated the effect of VEGF on tyrosine phospho-occludin and endothelial cell permeability. Conclusions Increased VEGF can induce hyperpermeability in glomerular endothelial cells, which is related to occludin tyrosine phosphorylation through Racl activation. It provides a framework for understanding the role of VEGF-induced Racl-phospho-occludin pathway in the integrity of barrier function in the diabetic milieu.

Objective To present the baseline characteristics of serum uric acid level in patients with chro-nic kidney disease(CKD). Methods A cross-sectional study on CKD patients was carried out in our hospital for 9 months. Results 713 patients were enrolled. The top three causes of CKD in these patients were primary glomerular disease(61.2%, 436/713), essential hypertensive kidney disease (7. 2%, 51/713 ) and diabetic nephropathy (5.8% ,41/713). Serum uric acid level and the incidence of hyperuricemia were associated with the stage of CKD (F = 73. 569, P = 0. 000;χ2= 138. 156, P = 0.000). A significantly negative correlation was discovered between ser-um uric acid level and the level of glomerular filtration rate(RR = - 1. 045 ,P =0. 000). A significantly positive cor-relation of serum uric acid level was found with diastohc blood pressure, proteinuia level, smoking and BMI ( RR = 1.400,15. 149,37. 696,and 3.421 ,P <0.05 ,respectively). Conclusions The cross-sectional study of serum uric acid level in patients with CKD will help to determine the dynamic changes of serum uric acid level in Chinese CKD patients and lay a solid basis for the prevention and treatment of CKD and its complications.

Objective To present the baseline characteristics of serum uric acid level in patients with chronic kidney disease(CKD)in single.centre nephrology clinic and judge the risk factor for decreased renal function of CKD Datients.Methods A cross-sectional study on CKD patients in clinic was carried out for 9 months.Results 780 CKD cases were enrolled in the study.The top four causes of CKD in these patients were primary glomerular disease(59.0%),essential hypertension(7.6%),lupus nephritis(6.4%)and diabetic nephropathy(6.3%).The average age was 41.9.The distribution of CKD stage was 47.8%of CKD1,18.7%of CKD2,14.0%of CKD3,8.1% of CKD4 and 11.4%of CKD5.Multivariate Logistic regression regression analysis indicated that age,proteinuria,hypertension were independently correlated with decreased renal function.Conclusion This is the largest cross-sectional study of CKD in China,which will help to determine the basic status of Chinese CKD patients,laying a basis for further followup.

Anticonvulsants ; therapeutic use ; Child ; Child, Preschool ; Diagnosis, Differential ; Electroencephalography ; Epilepsies, Myoclonic ; complications ; diagnosis ; drug therapy ; physiopathology ; Female ; Fever ; complications ; physiopathology ; Humans ; Infant ; Male ; Prognosis ; Seizures ; drug therapy ; etiology ; physiopathology ; Severity of Illness Index

OBJECTIVETo compare the clinical effects between hip anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery and posterior K-L approach combined with quadratus femoris bone flap transplantation for the treatment of femoral neck fracture of Garden III-IV in young and middle-aged patients.

METHODSFrom January 2004 to January 2011,46 patients with femoral neck fractures were treated by two kinds of operation. Among them, 20 cases were treated with anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery, included 12 males and 8 females with an average age of (32.1 ± 7.3) years old, involved 12 cases of Garden III and 8 cases of Garden IV. The other 26 cases were treated with posterior K-L approach combined with quadratus femoris bone flap transplantation, included 20 males and 6 females with an average age of (37.8 ± 6.9) years old, involved 16 cases of Garden III and 10 cases of Garden IV. The index of hospitalization (hospitalization time, total cost, operative time, intraoperative blood loss, postoperative complications), the quality index of operation (fracture reduction, position of internal fixation, fracture healing time, nonunion and femoral head necrosis) of two groups were observed and compared. Hip joint function were evaluated by Harris score.

RESULTSAll patients were followed up from 28 to 41 months with an average of 36 months. The intraoperative blood loss of group S-P (92.3 ± 10.4) ml was less than that of group K-L (132.4 ± 11.2) ml, there was significant difference between two groups (P < 0.05). The operation time of group S-P (81.4 ± 9.2) min was more than that of group K-L (67.1 ± 4.5) min, the difference was statistically significant (P < 0.05). One case in group S-P and 9 cases in group K-L appeared postoperative complications, there was significant difference between two groups (P < 0.05). The fracture healing time of S-P group (83.5 ± 7.3) d was shorter than that of group K-L (103.2 ± 12.6) d, there was significant difference between two groups (P < 0.05). At 30 months after operation, there were significant difference in Harris scoring between two groups (P < 0.05).

CONCLUSIONAnterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery for treatment of femoral neck fracture of Garden III-IV of young and middle-aged patients, it has characteristics in clear anatomic and easy to operate. As compared with K-L approach, S-P approach can better reserve residual blood supply of femoral neck. While combining with the iliac bone flap transplantation with deep circumflex iliac artery, it could better reconstruct the blood supply of femoral neck to promote fracture healing.

Adult ; Case-Control Studies ; Female ; Femoral Neck Fractures ; physiopathology ; surgery ; Fracture Healing ; Humans ; Iliac Artery ; Male ; Middle Aged ; Surgical Flaps ; transplantation

Chronic Disease ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Humans ; Male ; Prostatitis ; drug therapy ; Randomized Controlled Trials as Topic ; Suppositories