Objectives: To investigate the treatment effect of enteral nutrition rich in diet fiber in diarrhea because of bacteria disorder after severe brain injuries.Methods:20 cases with severe brain injuries were supported with enteral nutrition rich in diet fiber after the occurrance of diarrhea because of bacteria disorder as clinical treatment group.20 cases with the same conditions were treated with traditional methods as control.Results: Diarrhea of all patients in clinical treatment group had been controlled during 7-10 days,and the feeding quantities reached total calories.The nutrition state was improved,and the body internalenvironment was stable during the 20 days. Conclusion: Enteral nutrition rich in fiber can treat diarrhea caused by bacteria disorder after severe brain injuries.

HIV-1 fusion inhibitors are a new class of anti-HIV compounds, which block the entry of HIV into target cells through preventing the fusion between viral and cell plasma membrane and thus interrupt the initial steps of viral replication. T-20 (enfuvirtide), which has been clinically approved as the first fusion inhibitor of HIV-1 by U.S. FDA in 2003, can suppress replication of HIV variants with multi-drug resistance to reverse transcriptase and protease inhibitors. Peptides and small molecules display potent anti-HIV fusion activities by targeting gp41 thus inhibit its fusogenic function. In recent years, with the development of studies on the molecular mechanism of HIV membrane fusion process and the function of gp41, many new fusion inhibitors are found and some have been in advanced clinical trials. This review discusses recent progress in the development of HIV-1 fusion inhibitors targeting the gp41.

The levels of ?_2-m、IgG and Alb in CSF of 13 patients with cerebral haemorrhage and 20 patients with cerebral thrombosis and the levels of ?_2-m in CSF of control group consisting of 14 eases were measured. It Was showed that the levels of ?_2-m in CSF of the two groups of the patients with cecrebrovascular disease were obviously higher than that of the control group and the levcls of ?_2-m in CSF of the two groups of the patients with cerebrovascular discase also had rclation to the levels of ?_2-m in serum of the groups of the patients themselves, the valucs of ?_2-m did not corre- lated with the valucs of IgG or Alb in CSF of the paticnts with cerebral hacmorrhage, but there existed a strong correlation between IgG and Alb in CSF of these patients. The values of ?_2-m, IgG and Alb in CSF of patients with cerebral thrombosis were exactly inversdy correlated with that of patients with cerebral haemorrhage. Reviewing some other data about ?_2-m the authors suggest that the clevated ?_2-m in CSf may indicate an increased cell-mediated immune phenomenon of central nervous system in teh pathological process of cerebral haemorrhage, but this phenomenon in the pathological process of cerebral thrombosis is not obviuos.

Objective To develop a core competence evaluation index system for preventive medicine undergraduates.Methods Following the scientific,systematic and applicable principles,we proposed evaluation index system of core competence for professional medical prevention and selected 35 experts for three rounds expert consultation on the index system by using Delphi method.The basic situation,the positive and authority degree of experts and all levels of index weight coefficient were analyzed using SPSS 13.0 software.Results The core competence evaluation index system for preventive medicine undergraduates included six dimensionalities,fifteen secondary indicators and forty-nine tertiary indicators.The six dimensionalities included professional value behavior (0.25),professional knowledge and skills (0.28),basic specialized knowledge (0.20),communication (0.13),information management (0.06) and systems thinking (0.08).Conclusion The establishment of the evaluation system can provide a scientific and objective reference for the evaluation of the core competence of medical students.

BACKGROUND:During the process of acute brain injury after stroke, matrix metaloproteinase can undermine the integrity of vascular basement membrane, promote the migration of neutrophils and inflammatory factors, and cause secondary brain injury. OBJECTIVE:To investigate the activation of matrix metaloproteinase 2/9 and the degradation rule of claudin in rat models of middle cerebral artery ischemia at different ischemic durations. METHODS:Thirty-nine male SD rats were randomly divided into three groups according to different ischemic durations (3, 5 and 7 hours) . Middle cerebral artery occlusion (stroke) model was established using modified suture method,i.e., separation of the external carotid artery, inserting the suture into the internal carotid artery through the external carotid artery, and eventualy reaching the middle cerebral artery. The ischemic duration in these three groups was respectively 3 , 5 and 7 hours. After 2 hours of reperfusion, Zea-Longa score and Ludmila Belayev score, brain infarct area, matrix metaloproteinase 2/9 activities and claudin 5 degradation were determined in each group. RESULTS AND CONCLUSION:With the extension of ischemic duration, brain infarct area gradualy increased, central nervous system damage gradualy aggravated, matrix metaloproteinase 2/9 activities gradualy increased, and claudin-5 expression gradualy decreased. There were significant differences between any two ischemic durations in terms of each of above-mentioned indices. The results indicate that after long duration of ischemia, the progressive damage of brain tissue can cause the gradual increase of activation of matrix metaloproteinase 2/9 and the gradual degradation of claudin 5.

AIM:To determine the effects of glutamine ( Gln) pretreatment on occludin protein in the rats with intestinal ischemia-reperfusion ( I/R ) injury.METHODS: Male Wistar rats ( n =30 ) were randomly divided into 3 groups (n=10):sham group, I/R group and Gln pretreatment group.The rats in Gln pretreatment group were pretreated with Gln at dose of 1 g? kg-1? d-1 by orogastric route for 7 d, and those in the other 2 groups were pretreated with the same volume of normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion.After the operation, the levels of IL-10, IL-2, TNF-α, SOD and MDA were measured.The occludin protein was determined by the methods of immunohistochemistry and Western blotting .RESULTS: The occludin protein level in I/R group was significantly lower than that in sham group and Gln group (P<0.05).The levels of MDA and TNF-αin I/R group were significantly higher than those in sham group and Gln group ( P<0.05 ) .The levels of SOD , IL-10 and IL-2 in I/R group were significantly lower than those in sham group and Gln group ( P<0.05 ) .CONCLUSION:Glutamine has a protective effect on occludin protein in intestinal ischemia-reperfusion injury .The mechanism may be rela-ted to oxidative stress response and inflammatory inhibition .

Objective To evaluate the value of the short-segment nerve conduction studies (SSCSs, inching test) in the diagnosis and localization of cubital tunnel syndrome (CubTS).Methods The clinical and electrophysiologic data of 46 patients (92 limbs from 32 men and 14 women, aged from 19 to 59 years, with average age of 41.2 years) with CubTS were collected.The symptoms occurred in unilateral arm in 41 patients and bilateral arms in 5 patients, involving 35 left arms and 16 right arms.SSCSs were performed in both arms in all the 46 patients.Sixty ulnar nerves were studied in 30 healthy control subjects using SSCSs.Results The 51 symptomatic arms with CubTS were abnormal in long segment motor nerve conduction studies.There were 68 abnormal arms ( 51 symptomatic arms, 17 asymptomatic arms ) in SSCSs.The lesions were located 2 cm proximal to the elbow-the elbow segment ( AE2-E ) in 41 arms (44.6%),the elbow-2 cm distal to the elbow segment (E-BE2) in 23 arms (25%), 4 cm proximal to the elbow-2 cm proximal to the elbow segment (AE4-AE2) in 18 arms (19.6%), 6 cm proximal to the elbow-4 cm proximal to the elbow segment (AE6-AE4) in 9 arms (9.8%), 2 cm distal to the elbow-4 cm distal to the elbow segment (BE2-BE4) in 8 arms(8.6%) and 4 cm distal to the elbow-6 cm distal to the elbow segment (BE4-BE6) in 6 arms(6.5%),respectively.Conclusions SSCSs are more sensitive in detecting CubTS than the conventional long segment motor conduction studies.SSCSs could precisely localize the entrapment lesions in patients with CubTS ,might be a useful tool for the detection of ulnar mononeuropathy at the elbow, especially for diagnosing the patients with CubTS who have no clinical features or have a normal long segmental nerve conduction findings.

Objective: To investigate the treatment effect of rational enteral nutrition in stress ulcer bleeding after severe brain injuries.Methods: 30 cases with severe brain injuries accompanied with stress ulcer bleeding were supported by enteral nutrition as clinical treatment group.50 cases with the same conditions were managed with traditional treatment methods as control.Results: All patients in clinical treatment group had no stress ulcer bleeding any more. The nutritional state was improved. On the other hand,the stress ulcer bleeding occurred again and again and the nutritional state was poor.Conclusion: Rational enteral nutrition can treat upper gastrointestinal stress ulcer bleeding in severe brain injuries effectively.

Objective To assess the efficacy and safety of argon plasma coagulation(APC) in treating patients with Barrett's esophagus.Methods Two reviewers independently searched the Cochrane Library(Issue 2,2008),MEDLINE(January 1948 to November 2008),and CNKI(January 1999 to November 2008),respectively.The quality of the included studies was assessed according to the guidance in the Cochrane Handbook of systematic reviews of interventions.Results Six randomized controlled trials involving 253 patients with Barrett's esophagus met the inclusion criteria and were included.One trial reported that the ablation rate of patients in the APC group was significantly higher than that in the endoscopic surveillance group.Followed up one year,the ablation rate in APC group was 63% compared with 15% in the control group(P

Hepatitis C virus (HCV) infection is the leading cause of chronic liver diseases worldwide.There is no vaccine to prevent HCV infection.Current standard of care (SOC) for hepatitis C is pegylated interferon-α (pegIFN-α) in combination with ribavirin (RBV).However,the efficacy of pegIFN-α and RBV combination therapy is less than 50％ for genotype 1 HCV,which is the dominant virus in human.Additionally,IFN and RBV are highly toxic,causing severe side effects.Therefore,it is urgent to develop safer and more efficacious anti-HCV drugs.Over the last decade,a number of HCV-specific inhibitors have been discovered with many of them reached to late stages of clinical trials.Recently,2 HCV NS3 protease inhibitors,telaprevir and boceprevir,have been approved by the Unite States Food and Drug Administration (FDA).This opens up a new era for anti-HCV therapy.Several new classes of antiviral drugs targeting HCV NS3 protease,NS5A and NSSB RNA-dependence RNA polymerase (RdRp) are currently at various stages of preclinical and clinical studies.Upon approval of more NS3 protease,NS5A and NS5B polymerase inhibitors,future clinical studies will lead to optimal combination therapies which will have desirable parameters such as IFN-free,higher efficacy,safe,one daily dose and short duration.