Objective To improve the understanding of pelvic lipomatosis.Methods The clinical features of eight patients(males,aged 26-64years) with pelvic lipomatosis who were admitted to Peking Union Medical College Hospital from 1983 to November 2006 were reviewed.The clinical and pathologic features,treatment and prognosis were analyzed.The course of disease before admission was(95?82)months,The period of follow-up was(15?32)months,five cases under went upper tract urinary diversion,one case had urinary tract diversion and received steroids,one case received steroids treatment only.Results Four cases had cystitis glandularis,frequency and urgency of micturition were observed in three cases.Dysuria in three cases,hematuria in three cases,and hypertension in five cases were recorded during the course of disease.Renal insufficiency was observed in all of eight cases(Mean Ccr was 76?18mL/min).All cases had abnormal features in their image investigation,which indicated excessive pelvic fat directly or indirectly.Six cases had upper tract distention.Four cases underwent pelvic tissue biopsy.The result of biopsy was fat-vessel tissue.Their symptoms,not renal function,were relieved after treatment.Conclusion The symptoms of pelvic lipomatosis are atypical,they had renal insufficiency,and their diagnosis mainly depends on image investigation and pathologic examination.

To identify the key elements and available tools of regional health information resources plamling,the study introduced an innovative I-beam map,aiming to solve the two key questions of what and how to plan The paper covered such issues of planning as what is the present situation of regional health information,how to divide functional categories of regional health information resources,what are included in the business subclasses,which core data are used in the business process,which data to share and exchange,how to regulate such data,how to manage the regulations and make continuous improvement,and how to evolve towards planning standardization discriminatively.The study also drew a midfield line with such seven fields as medical service,maternity and child care,disease control and Drevention,health administration,emergency management,blood management and primary healtheare.This midfield line is used,along with stakeholders,planning process,information flow and planning output make the four quadrants,describing the whole process in the I-beam form.This practice can provide the methodology ofhow to plan,in the hope of guiding regional health information resource planning from theory to practice.

Regional health planning is a leading and scientific management philosophy for healthcare development in the international community.Information resources planning paves the way for scientific development.In the ongoing health reform in China,planning of regional health resources will play a key role by leveraging information technology.From the viewpoints of health information resources and information resources planning,the paper defines the concept of regional health information resources planning in microcosmic perspective.It summarized the five features of public welfare,specificity,imbalance,small channel and low noise,and non-symmetry.Authors compared the five planning modes,namely the community medical information resources mode,the general hospitals as the center of information resource mode,the regional PACS mode,the regional health data resource mode,and the regional medical coordination resources mode.In the paper,the planning is rounded up as four key points,that is,the basic steps of situation assessment and analysis,routine work of health information standardization,the planning should both comply with general rules of information resource planning and characteristics of the health sector,in addition to guidelines of forward-looking concepts.

Objective:To eveluate and study the anatomic basis of the posterior contour sign of lumbar intervertebral disc.Methods:The most protruding length of the soft tissue mass behind intervertebral spase on lumbar plain film were measured in 100 cases and compared with CT or MR findings.Results:41 posterior contour sign of the interlumbar disc were fined in 39 cases,of which there were 25 in L4/5(61.0%),15 in L3/4(15.6%)and 1 in L2/3(2.4%).The protruding was less than 0.2 cm in 26 and larger than 0.2 cm in 15,there were 10 lumbar disc protruding confirmed by CT or MR ,7 of which the pesterior contour ≥0.2 cm,and 3＞0.3 cm,none was ≤0.2 cm.Conclusion:The adipose tissue in the posterior border of lumbar body and disc was the anatomic basis of the sign,and it was an importent sign for diagnosing of lumbar disc hernia on plain film.

【Objective】To observe the effect of Ma Xing Shi Gan Decoction(MXSGD)on metabolism of oxygen free radicals in mice with bronchial asthma.【Methods】Forty BALB/c mice were randomized into 4 groups:normal group,model group,low-dose MXSGD group(20?g?kg~(-1)?d~(-1))and high-dose MXSGD group (80?g?kg~(-1)?d~(-1)).Except the normal group,the mice in other 3 groups received sensitization by intraperitoneal injection of ovalbumin(OVA)and challenge by inhalation of OVA to induce bronchial asthma.Meanwhile,MXSGD groups were given the corresponding doses according to the experimental design by gastric gavage,and normal group and model group received the same volume of normal saline for 27 days.Twelve-four hours after last challenge,blood sample was taken and homogenate of lung tissue was prepared for the detection of superoxide dismutase(SOD),malondialdehyde(MDA)and glutathione peroxidase(GSH-Px)contents in the plasma and the lung tissue.【Results】High-and low-dose MXSGD increased SOD and GSH-Px contents and decrease MDA content in the lung tissue and plasma(P

AIM:To study the human brain hemodynamics responses induced by acupuncturing foot shaoyang gallbladder meridian point GB37 and visual stimulation,and to analyze the effect of acupuncture to activate the cerebral functional area in visual stimulus. METHODS:Twenty five normal subjects were divided into two groups:15 subjects for electro -acupuncture GB37 in visual stimulus group and 10 subjects for electro-acupuncture GB37 groups. The blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) was carried out under the condition of two dif-ferent stimulation patterns (including a vision stimulation task and point GB37 acupuncture under the vision stimulation condition). A scintillating chessboard grid was applied as the vision stimulation task and the frequency was 8 Hz. The activation of cerebral functional areas of tested people under the conditions of the vision stimulation task and acupuncture were analyzed,respectively. RESULTS:Out of 15 subjects of electro -acupuncture GB37 in visual stimulus groups,twelve health volunteers were enrolled. When the vision stimulation task was carried out,the alarge area of brainstem and posterior lobe of cerebellum was seen to be activated. The areas of limbic lobe,hippocampus,middle temporal gyrus and inferior temporal gyrus were also activated. Under the condition of acupuncture only,the areas of posterior central gyrus,inferior parietal lobule,parietal lobe precuneus and the middle frontal gyrus were activated. When doublesided points of gallbladder meridian of foot-shao-yang were electroacupunctured under the visual stimulus status,the areas of superior frontal gyrus,inferior frontal gyrus,parietal precuneus and occipital gyrus lingualis were activated. CONCLUSION:The functional MRI shows the activation of cerebral functional area after acupuncture. Visual stimulus causes significant changes of brain conduction path connection. Under the visual stimulus status,the acupuncture to the points of gallbladder meridian of foot -shao -yang,GB37 has an extent of influence to conduction path conformity of the vision system and with the treat-ment of ophthalmocace. Furthermore,the external stimulation has prominent influence to the acupuncture therapy possibly.

The recombinant adenovirus Toll like receptor 4 (TLR4) shRNA vector (pGSadeno-TLR4) was constructed and transfected into human aortic vascular smooth muscle cells (HA-VSMC).After HA-VSMC were treated with palmitate or different signaling pathway inhibitors,the mRNA and protein levels of interleukin-6 (IL-6)and NF-κB activity were tested with real-time PCR and ELISA,respectively.The results showed that palmitate increased mRNA and protein levels of IL-6 in HA-VSMC in a dose-dependent manner.The expression of IL-6 mRNA reached peak after treatment with 400 μmol/L of palmitate for 6 h,being 10.43 fold of control (P＜0.01).Treatment with 400 pmol/L of palmitate for 24 h maximally upregulated the protein level of IL-6,which was 2.18 fold of control (P＜0.01).NF-κB inhibitor parthenolide markedly inhibited palmitate-stimulated increased in IL-6 mRNA level by 65％ and protein level by 59％ (both P＜0.01).Protein kinase C (PKC) inhibitor chlerythrine suppressed palmitateinduced IL-6 mRNA expression by 24％ and IL-6 protein level by 28％.By contrast,extracellular signal-regulated protein kinase inhibitor PD98059 and phosphatidylinositol 3-kinase inhibitor wortmannin had no effect on the induction of IL-6 by palmitate.Blockade of TLR4 with pGSadeno-TLR4 significantly suppressed palmitate-induced IL-6 mRNA expression by 72％ and IL-6 protein expression by 75％ (both P＜0.01),along with decrease of NF-κB p65 activity decreased by 62％.These results suggest that TLR4/NF-κB and PKC pathways mediate palmitate-induced IL-6 expression in HA-VSMC.

Objective To study the pulmonary functions of pediatric ALI/ARDS(acute lung injury/acute respiratory distress syndrome) survivors. Method A prospective cohort study of all survivors of ALI/ARDS in the PICU of Beijing Children's Hospital was performed. Patients were divided into three groups(0-3 years of age,3 ～ 7 years of age, and over 7 years of age) and followed up three months after diagnosis. Results There were 36 survivors in total of 44 ALl patients, three patients lost follow-up, 12 died and 21 survived. Five survivors refused to participate in the study because of asymptomatic, and one was unable to participate because of lymphoma com-bined with sepsis. A total of 15 children completed the whole survey (11 patients were less than 3 years old, andfour were over 7 years of age). Twelve patients had no discomfort in their respiratory tracts. Three months after be-ing enrolled, the pulmonary functions of all children improved, especially in terms of tidal volume and respiratory compliance (P<0.05). Conclusions The abnormal respiratory symptoms and signs in most children disap-peared three months after discharge. Most survivors still have pulmonary dysfunction at 3 monthes after discharge, but better than discharge.

OBJECTIVETo observe the relation between Pi deficiency syndrome (PDS) and the configuration and functions of extensor digitorum longus (EDL)and soleus (SOL).

METHODSTotally 36 ICR mice were randomly divided into 3 groups according to weight matching principle, the control group, the exhausted group, and the rhubarb group, 12 in each group. Two PDS models were established by either purgation with rhubarb diarrhea (as Group A) or exhausted swimming plus sleep deprivation (as Group B).The cross sectional area (CSA) of type I and II fibers of extensor digitorum longus (EDL) and soleus (SOL), relative proportions of type I and II fibers were measured by m-ATPase histochemical method. The isotonic contraction and the maximum tetanus contraction of EDL and SOL were detected by PowerLab system.

RESULTSCompared with the control group, the body weight, body temperature, and the general health condition of PDS model rats obviously decreased; the spleen index and the thymus index were also lower; the maximal isotonic contraction and the maximum tetanus contraction obviously decreased; the cross section areas of EDL and SOL were reduced with loosely arranged cells. In EDL, the proportion of type I fibers was added and the proportion of type II fibers was lowered. In SOL, there was no change in the proportion of type I and type II fibers.

CONCLUSIONSEDL and SOL were obviously atrophied in the two PDS model mice. The type I fibers of SOL was more significantly atrophied in Group B.

AIM: To investigate the effect of problem - based learning ( PBL) used in the teaching of medical students'evidence-based medicine ( EBM) .
METHODS: Five classes ( total 147 students ) were randomly selected as experimental ( PBL ) group, at the same time, another 5 classes ( total 149 students ) were also randomly selected as control group, using traditional teaching method ( lecture-based learning, LBL ) in 2010 grade. The final examination scores of the experimental group were compared with control at the end of term. In addition, all students were interviewed using self -administered questionnaire to obtain their evaluation for PBL practice. SPSS13. 0 software was used for statistical analysis.
RESULTS: The homogeneity test in baseline survey showed that the basic characteristics between the two groups of students were no significant differences, and were comparable (P>0. 05). Final exam results showed that in addition to the scores of the EBM basic knowledge indicated no significant difference between two groups of students (P>0. 05), for the 5 steps of EBM procedure, namely, asking questions, finding the best evidence, evaluating the evidence, using and practicing the evidence, re - evaluating the evidence, and the total scores between the two groups, there were significant statistically differences (P<0. 05). The results to student learning evaluation showed that there was no significant difference between the two groups (P>0. 05) in aspects of better understanding classroom knowledge, improving language expression ability, and writing skill exercises. And other residual items had a significant difference ( P<0. 05), especially in aspects of improving enthusiasm for learning, self - study ability, improving learning efficiency, information analysis and utilization ability, team collaboration, and communication between teachers and students, however, there was a very significant difference (P<0. 001) between the two groups.
CONCLUSION: PBL teaching mode can effectively improve teaching effectiveness and the quality of EBM teaching, so the this teaching mode is worth further popularizing.