The research of epilepsy drug-resistant mechanism has been paid more and more attention. Pglycoprotein(Pgp) ,being one of the hot points of recent research,plays the transporting role in the body,and its coding genetic polymorphism also affects its expression. The relationship between Pgp and drug-resistant epilepsy is reviewed based on the coding genetic polymorphisms, multidrug transporters hypothesis, concentration equilibrium transport assay, and Pgp inhibition effect.

Objective To diagnose the patients with coronary heart disease and arrhythmia by the ECG and dynamic ECG,in order to compare the clinical application value of two kinds of examination methods.Methods 120 patients with coronary heart disease were studied,and the dynamic electrocardiogram and routine electrocardiogram were given.The positive detection rate of two kinds of ECG examination method and the effect of clinical detection were observed and compared,.Results The positive detection rate of the dynamic electrocardiogram was 63.33%(76 /120),which was higher than 50.00% (60 /120)of conventional ECG,but the difference was not statistically significant (P >0.05).Pairs and atrial,ventricular contractility in front of the room,room sex period before contraction trigeminy and nonsustained ventricular rate dynamic electrocardiogram (ECG)the number of detected cases were 24 cases,42,54,52 cases,32 cases,which were significantly higher than those in routine ECG examination of the 12 cases,4 cases,20 cases,14 cases,4 cases of(χ2 =6.317,825.7,6.112,5.368,6.414,all P <0.05).Dynamic electrocardiogram (DCG)conduction block and ventricular early,real early early detection.There were 18 cases, 76 cases,66 cases,and routine electrocardiogram in 8 cases,73 cases,64 cases of comparison did not exist significant difference.(χ2 =1.237,1.035,127.6,all P >0.05).Conclusion In the implementation of routine ECG in patients with coronary heart disease,The dynamic ECG can obtain a higher positive rate than ECG diagnosis,and has certain advantages in the detection effect,and has a certain clinical application value.

TCM believes renal deficiency is a major cause to climacteric syndrome,thus invigorating the kidney is considered to be the most basic treatment of this disease.This article makes an overview on the treatments of climacteric syndrome with kidney-invigorating Chinese medicine

Objective To explore the CT,clinical,and pathological features of eosinophilic lymphogranuloma(ELG)in head and neck region. Methods CT,clinical,and pathological data of 9 cases of ELG in head and neck region,confirmed by biopsy were retrospectively an-alyzed.Results Parotid gland was lonely involved in 3 cases,and cervical lymph nodes were lonely involved in 2 cases,and they were both involved in 4 cases.All of the patients suffered from painless nodule or mass in head and neck region with peripheral blood eosinophilia.On CT examination,nodular lesions of parotid gland were clear or slightly blurred defined with moderately or obviously homogeneous enhancement,and diffuse mass lesions in parotid gland were ill defined with involvement of surrounding tissue,and heterogenous progressive enhancement.The involved cervical lymph nodes were enlarged with clear boundaries,and moderately or obviously homogeneous enhancement.The pathological findings of ELG included the marked infiltration of eosinophilia,lymphocytic proliferation,lymphatic follicles,variable degrees of fibrosis and vascular proliferation.Conclusion ELG in head and neck region has some CT features,and diagnosis could be suggested combining with the clinical manifestations and peripheral blood eosinophilia. The final diagnosis depends on histopathological examination.

Objective To study the roles of advanced glycation end products and its receptor on fetal brain injury of gestational diabetes mellitus (GDM) rats.Methods Twenty one adult pregnant Wistar rats were administered streptozotocin (STZ) intraperitoneally to induce GDM rats model.The fourteen pregnant rats were divided into two groups according to the fasting glucose on the 3rd day of pregnancy:severe GDM group with the fasting glucose ＞ 16.7 mmol/L and mild GDM group with the fasting glucose between 6.7 - 16.7 mmol/L Another seven pregnant rats were chosen as the severe GDM and intervention with micronutrient group,receiving gavage with micronutrient during the whole pregnancy.Five control rats received the same volume of citric acid buffer.All the pregnant rats were tested fasting glucose from the tailvein and their weight on the pregnant day 3,13 and 19.Maternal serum levels of AGE were measured by ELISA and RAGE levels in the embryonic brain tissues were tested by immunohistochemistry.Results ( 1 ) There was no statistically significant difference of pre-pregnancy fasting glucose level among all groups (P ＞ 0.05 ).The fasting glucose levels on the 3rd day and the mean fasting glucouse level of pregnancy in the severe GDM group and the severe GDM and intervention with micronutrient group were higher than those of the control group ( P ＜0.05 ).And there was no significant difference between the severe GDM group and the severe GDM and intervention with micronutrient group (P ＞0.05 ).(2)The serum AGE levels in the severe GDM group and the mild GDM group were( 1037 + 38) ng/L and( 880 ± 34) ng/L respectively,with no significant difference ( P ＞ 0.05 ).The serum AGE levels in the control group and the severe GDM and intervention with micronutrient group were (857 ± 32 ) ng/L and (988 ± 37 ) ng/L,and the difference was statistically significant ( P ＜ 0.05 ).The serum AGE levels in the severe GDM and intervention with micronutrient group and in the mild GDM group had no significant difference ( P ＞ 0.05 ).( 3 ) The serum AGE levels in the severe GDM group,mild GDM group and the control group were positively associated with the mean glucose level of pregnancy ( r =0.603,P ＜ 0.05 ) and the grlucose on the 3rd day of pregnancy (r =0.704,P ＜ 0.05 ).(4)The fetal brain nerve cell number and morphology in the control group were normal.While in the mild GDM group fetal brain nerve cells decreased,the proliferation and swelling of glial cells were seen.In the severe GDM group and the severe GDM and intervention with micronutrient group,the fetal brain cells furtherly reduced,and large vacuole around the cells,deformation and debris of the cells were seen. Glial scar formation was visible in some fetal brain tissues.There was a few RAGE expression in the control fetal brain tissues.In the mild GDM group and the severe GDM group,RAGE expression increased significantly.And the RAGE expression intensity in the severe GDM and intervention with micronutrient group was between the severe and the mild GDM groups.Conclusions( 1 ) Abnormal fetal brain development of GDM rats was associated with the increase of maternal serum AGE and the enhancement of RAGE expression in fetal brain tissues,which suggested that AGE/RAGE pathway may play an important role in the fetal brain injury of GDM rats.(2) Micronutrients can reduce the brain damage of GDM fetuses.

Objective To investigate the clinical efficacy and mechanism of electrical pudendal nerve stimulation (EPNS) in treating female stress urinary incontinence.Methods Thirty-five female patients with stress urinary incontinence were enrolled from May 2006 to April 2008.The average age was (54.9±9.7) years,the duration of incontinence was (74.1 ±45.6) months,the maximum urethral closure pressure was (63.7± 15.9) cm H2O,functional urethral length was (2.34±0.72) cm and bladder neck mobility was (1.23±0.76) cm.Long acupuncture needles were deeply inserted into four sacral points,which were located by the two edges of the sacrum on a level with the fourth sacral foramina and bilaterally to the tip of the coccyx.The needles were electrified (continuous waves,a frequency of 2.5 Hz,an intensity of 45-55 mA and 60 min once) to stimulate the pudendal nerves.When EPNS was performed,perineal ultrasonographic B-mode movements of the pelvic floor muscles (PFM),M-mode curves indicating the PFM contractions,vaginal pressure (VP) and PFM electromyogram were recorded simultaneously.Results When EPNS was performed correctly,the patient felt strong PFM contractions.Simultaneous records showed:1)B-mode cranio-caudal PFM movements; 2) M-mode PFM movement curves (amplitude:about 1 mm,n=31 ; in the other four patients,the M-mode curves were not obvious) ; 3) a sawtooth curve of VP changes (2.61±1.29 cm H2O,n=34); 4) PFM myoelectric waves (amplitude:23.9±25.3 μV).If during the EPNS process the electric current was stopped or its intensity was reduced or the two lower needles were drawn back 1-2 cm,then the above ultrasonographic PFM movements and VP changes disappeared.In the 35 patients,the ICI-Q-SF score was 12.9±2.9 before treatment and decreased to 3.5±3.3 after 27.5± 11.9 sessions of treatment (P＜0.01).Twenty-five patients with ≥50％ symptom improvement at the end of treatment were followed up for 24-72 months (mean 50),and 19 cases had ≥ 50％ symptom improvement during the period of follow-up,including complete symptoms resolution in 10 cases.Conclusion EPNS can contract the PFMs and simulate PFM training to treat female stress incontinence.

Objective: To observe the clinical effect of sodium nitroprusside and dopamine injected by micro pump for the treatment of refractory heart failure. Methods:One hundred and six cases of patients with refractory heart failure were chosen as the research object, which were cardiac functionⅢ~Ⅳlevel. All patients were treated with sodium nitroprusside and dopamine injected by micro pump. Starting dose of sodium nitroprusside was 6.25 μg/min. At same time pumping dopamine, starting dose of 2 g/kg·min, the dose was increased gradually until blood pressure dropped to 90~100 mm Hg, continuous 7~10 d, the signs and symptoms after treatment and parameters of cardiac function and adverse reactions were observed. Results: 1)In 106 cases of patients with refractory heart failure after treatment, the total effective rate 85.85%(91/106). 2)The heart rate, blood pressure, cardiothoracic ratio, left ventricular short axis reduced rate,cardiac output, each index of cardiac,indexes of left ventricular ejection fraction were improved significantly after treatment. Conclusion:The clinical effect for the treatment of refractory heart failure by using the micro pump injection of small doses of sodium nitroprusside combined dopamine would be obvious, have less adverse reactions, worthy of clinical popularization and application.

Objective: To explore the coping strategies of students of military medical university, and the relationship between coping strategies and mental health. Methods: 4786 students of military medical university were assessed with the Simplified Coping Style and SCL-90. Results: 30～40% of the student chose active strategies when facing stresses. Fewer students adopt negative strategies (2～38%). The SCL-90 score of the students of military medical university were lower than students of other military schools. Positive coping strategies were associated with less SCL-90 score (fewer somatic and mental discomfort).Conclusion:Coping strategies are associated with mental health in student of military medical university.

Objective: To investigate the status of the quality of life (QOL) and its related factors of graduate students in military medical universities. Methods: 189 graduate students of a military medical university were assessed with WHO Quality of Life-BREF, Eysenck Personality Questionnaire (EPQ), Life Event Scale, Perceived Social Support Scale, and Simplified Coping Style Questionnaire. Results: The scores of QOL of graduate students in the military medical university were higher than average; The four domains of QOL were significantly correlated with introversion- extroversion, neuroticism, life event, social support, and coping style. The result from multiple regression showed that introversion- extroversion, neuroticism, social support, life event, and negative coping style were main factors influencing QOL. Conclusion: The status of the QOL of graduate students in military medical universities was pretty good; Their QOL could be improved by these factors, such as keeping stable emotion, developing extroversion, seeking social support, relieving the influence of bad life event, reducing negative coping behavior.

Objective To investigate the MR features of uterine leiomyomas and evaluate its diagnostic value. Methods Twenty six patients with probable uterine leiomyomas underwent preoperative ultrasound, T 1 weighted spin echo and T 2 weighted fast spin echo MR examinations. Among them, 11 cases were performed with dynamic contrast enhancement. Comparative analysis between MRI findings and pathologic results was done. Results MRI diagnosis in all cases was consistent with the results given by surgery and pathology, except 2 being pathologically proven as endometrial polyp or inflammatory pseudoplasma. The diagnostic accuracy of MRI was 92%, while the accuracy of ultrasound was 85%. The difference between the number of lesions detected by two modalities had statistical significance (89% for MRI vs 69% for ultrasound, ? 2=17.86, P