BACKGROUND: Ligustrazine possesses the effect to reduce ototoxicity of gentamicin, whether does it antagonize the ototoxicity of gentamicin through influencing the expression of heat shock protein (HSP) 70 in cochlea of guinea pigs with gentamicin induced ototoxicity? BJECTIVE: To investigate the effect of ligustrazine on the expression of HSP70 in cochlea of guinea pigs with gentamicin induced ototoxicity through immunohistochemistry and image analysis technique in combination with the measurement of auditory brainstem response (ABR).DESIGN: A randomized controlled study, and linear correlation analysis. ETTING: Physiological Department of Shenyang Medical College and Audiological Laboratory of China Medical University.MATERIALS: Totally 40 white and red-eye healthy guinea pigs of lean grade and with keen auricle reflect, weighing 200 - 250 g, of either gender, were at random divided as gentamicin group, ligustrazine + gentamicin group, ligustrazine group, and normal control group, with 10 in each group.METHODS: Ligustrazine injection 140 mg/kg was intraperitoneally at the left side given for animals in ligustrazine + gentamicin group, and at the same time gentamicin sulfate injection 100 mg/kg was given intraperitoneally at the right side. The same dosage of gentamicin sulfate injection was intraperitoneally given for animals in gentamicin group. The same dosage of ligustrazine was intraperitoneally give for animals in ligustrazine group. The normal saline 2.5 mL/kg was intraperitoneally given for animals in normal control group. Administration was consecutively given for 10 days for each group, once a day. The body mass was measured every day for regulating the dosage. Before starting and after finishing the administration, the thresholds of ABR of all animals in each group were measured respectively. After finishing administration, all animals in each group were put to death, and the conditions of expressions of HSP70 in cochlea of guinea pigs were investigated by SABC immunohistochemistry and image analysis technology.MAIN OUTCOME MEASURES: ① the thresholds of ABR of all animals in each group; ② expressions of HSP70 in cochlea of guinea pigs in each group.RESULTS: ① The thresholds of ABR of guinea pigs: The thresholds in ligustrazine + gentamicin group and gentamicin group were obviously higher than that in normal control group [(21.09±4.50) dBnHL, (36.55±6.13)dBnHL, (2.50±2.75) dBnHL, t=15.764-22.665, P ＜ 0.001]. The threshold in ligustrazine + gentamicin group was obviously lower than that in gentamicin group (t=9.092, P ＜ 0.001). ② The expressions of HSP70 in each part of cochlea of guinea pigs: The mean gray values of cellular HSP70 positive reaction products in Corti's organ, vascular stria and spiral ligament, spiral limbus and spiral ganglion in gentamicin group were lower than those in normal control group (88.24±4.34, 96.85±1.05; 121.24±0.92,128.76±1.59; 96.15±1.10, 98.78±0.54; 117.73±1.18, 120.51±0.80, t=6.097-18.307, P ＜ 0.001). The mean gray values of cellular HSP70 positive reaction products in ligustrazine + gentamicin group were lower than those in gentamicin group (92.53±2.25, 88.24±4.34; 125.20±1.43, 121.24±0.92;98.71±0.91, 96.15±1.10, 118.91±0.46, 117.73±1.18, t=3.925-10.415, P＜ 0.001).③ The mean gray value of cellular HSP70 positive reaction products in each part of cochlea of guinea pigs was highly correlated with the threshold of ABR (r=-0.814 1 to -0.984 1, P ＜ 0.001).CONCLUSION: Ligustrazine could reduce the threshold of ABR and the expression of HSP70 in cochlea with gentamicin toxicosis so as to relieve gentamicin ototoxic injury, hence improving auditory function.

Objective: To observe the inhibitory effect of scopolamine(Spm) and chlopromazine (Clo) on withdrawal syndromes in morphine dependent rats. Methods: The intensity of withdrawal syndromes on the model of morphine dependent rats was recorded after single or muiltiple subcutaneous administration(sc) of Spm and Clo at different doses. Results: Withdrawal syndromes were markedly decreased when single Spm 1 mg/kg and Clo 0.5 mg/kg combined with morphine were injected (P<0.05). Spm+Clo(sc) had much stronger effects on inhibiting withdrawal syndromes after intraperitoneal (ip) naloxone in morphine dependent rats (P<0.01). Conclusion: Spm can act on Ach-receptor and relieve morphine withdrawal syndromes. Clo may have a synergistic action with Spm via α2-receptor in the locus coeruleus of the rat brain stem.

Adolescent ; Anticonvulsants ; therapeutic use ; Body Mass Index ; Child ; Child, Preschool ; Epilepsy ; blood ; drug therapy ; Female ; Galanin ; blood ; Humans ; Infant ; Male ; Valproic Acid ; blood ; therapeutic use

Aim To investigate the protective effect of pituitary adenylate cyclase activating polypeptide(PACAP)on focal cerebral ischemia reperfusion injury in rats.Methods The models of focal cerebral ischemia reperfusion in rats were established with suture-occluded method to simulate the middle cerebral artery ischemia reperfusion injury in clinic.The treatment groups were given three different dose PACAP(PACAP 10-11 mol,PACAP 10-10 mol and PACAP 10-9 mol) in 15 minutes before cerebral ischemia.PACAPs were infused into lateral cerebral ventricle by microinjector.The water content of brain,the activity of superoxide dismutase(SOD),the content of malondialdehyde(MDA) and the content of nitrogen monoxidum(NO) of the brain tissue were determined.Results Compared with NS group,the water content of brain and the concentration of MDA and NO were obviously lower in each PACAP treatment group,while the activity of SOD was elevated to different degrees.Conclusion PACAP has an obvious protective effect on ischemia-reperfusion injury of focal brain tissue in rats,in which edema-alleviating,free radicals-scavenging and lipid peroxidation-attenuating could be involved.The protective effect seems to be more clear in middle-and high-dose group than in low-dose group.

Insomnia is one of the most common sleep disorders among children and adolescents.Poor sleep affects cognitive performance and is associated with poor emotional and physical health in children and adolescents.Early identification and treatment can have positive short-and long-term effects on the children,the parents,and the family as a whole.Pediatric sleep medicine had sustained development in recent years,however,in China,the researches on the epidemiology,diagnosis and treatment of insomnia in children and adolescents are in lack.In order to capture the majority of pediatric medical workers and parents attention,and to improve the clinical diagnosis and treatment level,the focuses on current diagnosis,therapy and related study progress of insomnia in children and adolescents were reviewed.

Objective:To explore the clinical measurements for preventing and curing epistaxis in patients irradiated for nasopharyngeal carcinoma by analyzing the related factors. Methods:Thirty patients irradiated for nasopharyngeal carcinoma and consequently presented epistaxis were retrospectively reviewed by analyzing the clinical characteristics and measurements. Literature review was also performed. Results:Twenty-two cases were successfully rescued, and eight cases died (mortality rate:26.6%). Twenty-five cases underwent inflation sponge packing hemostasis, whereas three cases underwent endoscopic hemostasis with cauterization. Five patients underwent digital subtraction angiography (DSA) and selective arterial embolization. For patients who underwent one irradiation course, the epistaxis latent period ranged from 3 to 12 years, and the amount of bleeding ranged from 200 mL to 1 200 mL. For patients who underwent more than one irradiation course, the epistaxis latent period ranged from 6 months to 3 years, and the amount of bleeding ranged from 300 mL to 8 000 mL. Conclusion:Packing through choanal atresia by using inflation sponge, cautery under endoscopy, DSA, and selective arterial embolization are useful and effective measurements for hemostasis. The epistaxis latent period and volume are related to the age, tumor stage, and ir-radiation course of the patients. Patients with advanced age, tumor stage, and more than one irradiation course have short latent period and high amount of bleeding.

Objective To investigate clinical characteristics of relapsing polychondritis(RP)and to improve early recognition for it.Methods Clinical and laboratory data of 56 patients with RP were analyzed retrospectively.Results Ratio of number of male patients to female ones was 1.2.Age at onset was(46?11)years(ranging from 27 to 71)and average interval between onset and diagnosis was(21? 35)months,(8?6),(16?31)and(29?37)months for patients initial onset with auricle,respiratory tract and joints involved,respectively.Site involved included airway in 40 patients(71.4%),auricle in 32 (57.1%),joints in 32(57.1%),eyes in 27(48.2%),nasal chondritis in 25(44.6%)and inner ear in 13(23.2%).At initial stage of the course,17 patients were misdiagnosed as respiratory infection (30.4%),nine as perichondritis(16.1%),six as pulmonary tuberculosis(10.7%),five as rheumatoid arthritis(8.9%).Seven of 40 patients with airway involvement received metallic stents for their tracheobronchial stenosis.Four patients whose condition never improved after regular therapy all had respiratory involvement.Conclusions Patients of RP with initial onset at non-auricle,non-nasal sites tended to be misdiagnosed.Prevalence of airway involvement was not so low with a poor prognosis in patients of RP.

Objective To explore the value of applying flipped classroom in human parasitology. Methods Totally 430 students of 5-year program were divided into experimental group and control group. The experimental class received human parasitology teaching through flipped classroom teaching mode, while the control class received traditional teaching. The effect of teaching was evaluated by questionnaire and examination. The data were analyzed through t-test. Result Meanwhile, statistical difference was found in aver age score of total between experiment group and control group [(68.2 ±8.6) vs. (66.6 ±11.0), P=0.032]. There was also statistical difference in average score of comprehensive analysis [(16.4±3.2) vs. (16.1 ±3.9), P=0.038]. Questionnaire survey of satisfaction showed that 191 students of experimental class (90.95%) felt new teaching mode could improve autonomous learning ability, 199 students (94.76%) in-creased interest in learning;185 students (88.10%) had more interactive with teachers, 178 students (84.76%) enhanced cooperation between st udents, 186 students (88.57%) approved of small group discussion learning and 165 students (78.57%) had no extra burden. Conclusion Flipped classroom teaching mode can improve students' autonomous learning ability and cultivate their abilities of independent thinking, cooperation, criti-cism, innovation, analyzing and solving problems. Thus this new teaching mode is worthy of reference and popularization.

Objective: To investigate the clinical treatment results of combined Tretinoin-chemotherapy protocol and kinetics of PML-RAR ? fusion gene in childhood acute promyelocytic leukemia(APL). Methods: Ten children with APL were involved in this study. Induction therapy was Tretinoin alone(6 cases),Tretinoin plus chemotherapy(3 cases) and arsenic trixode(1 case). Postremission therapy consisted of three consolidation courses with DA,MA or HA and a monthly maintenance therapy over 4-5 years. Monitoring of minimal residual disease was performed regularly by RT-PCR assay for PML-RAR ? at differential clinical stages. Results: Clinical complete remission(CR) was obtained in 9 cases (90%).After a median follow-up of 42 months(14-156 months), the estimated 5-year event-free survival was (56? 16.5)%.Four cases relapsed at 14-42 months after achieving CR and 5 cases remained continuing CR. PML-RAR ? fusion gene was positive in all cases at CR and turned negative gradually during consolidation and maintenance treatment. The duration of conversion to RT-PCR negative status varied from 6 to 42 months.Four patients who were persistent positive(2 cases) or converted to positive(2 cases) for PML-RAR ? relapsed. Conclusion: Continuous negative RT-PCR results are associated with long-term disease-free survival and may be considered as potentially curative. RT-PCR assay for detection of PML-RAR ?should be performed regularly during post-remission period. The hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RAR ?.

Objective To analyze the diagnostic procedures and treatment strategies in the mycotic aneurysm caused by Salmonella enterica serotype choleraesuis infection in a single medical center. Methods From January 2000 to December 2008, clinical data of 8 cases with infected aneurysm caused by Salmonella enterica serotype choleraesuis were analyzed. Results All cases were treated with endovascular stent-graft treatment, including abdominal aortic aneurysm in six cases, thoracic aortic aneurysm in one, and popliteal artery aneurysm in one case. Six bifurcated stent-graft and two tube stent-graft were used. The surgical success rate was 100% with no perioperative or 30-day mortality nor major morbidity. All of the patients recovered uneventfully and were discharged with oral antibacterial agents. During mid-term follow up (range 15-36 months), four patients are alive and well with no signs of persistent or recurrent infection, three cases with recurrent infection were cured by drainage of local abscess and debridement, one case died of rupture of the abdominal aortic aneurysm. Conclusion Endovascular grafting combined with antibiotic therapy and careful surveillance program represent an alternative to conventional surgery in mycotic aneurysms caused by Salmonella enterica serotype choleraesuis.