ObjectiveTo detect the mechanism of the growth inhibition and apoptosis of human acute leukemia cell line U937 cells induced by honokiol.MethedsThe proliferation inhibition was detected by MTT method.Cell apoptosis was tested by Hoechst 33342 staining and flow cytometry with Annexin V/PI staining.RT-PCR was used to detect the mRNA expression of the apoptosis gene Bcl-2,Bax,Caspase 3,Caspase 8 and Caspase 9.ResultsThe inhibition effect of honokiol(5 μg/ml,48 h) on U937 cells proliferation could he observed,and the inhibition rate of 10 μg/ml honokiol on cell proliferation reached above 50％ (48 h).U937 cells proliferation could be completely inhibited for 120 h. U937 cells apoptosis rate reached 26.8％ (P ＜0.01)after being treated with 10 μg/ml honokiol.After being treated with 10 μg/ml honokiol for 48 h,the Bcl-2 gene expression in U937 cells was reduced (control group:0.33 ± 0.02,experimental group:0.14 ±0.01,P ＜ 0.01 ),and the Bax gene expression was elevated ( control group:0.1 ± 0.01,experimental group:0.87 ± 0.08,P ＜ 0.01 ).The gene expressions of Caspase 3 ( control group:0.48 ± 0.01,experimental group:0.87±0.06,P ＜0.01),Caspase 8(control group:0.23±0.02,experimental group:0.41 ±0.07,P ＜ 0.01 ) and Caspase 9 ( control group:0.44 ± 0.05,experimental group:0.76 ± 0.06,P ＜ 0.01 ) were all increased.The activity of Caspase-3 was 0.325 ±0.089,which was significantly higher than that of the control group ( P ＜0.01 ).ConclusionHonokiol can significantly inhibit the proliferation and induce cell apoptosis of human acute leukemia cell line U937 cells.The mechanism is related to the up-regulation of Bax and down-regulation of Bcl-2,and the endogenous and exogenous pathways are both inolved in the apoptosis process.

ObjectiveTo explore the effect of patients with acute cerebral infarction (ACI) at different ages receiving intravenous injection of alteplase for thrombolysis on their prognosis.Methods Ninety-eight ACI patients admitted to Jinghai Hospital of Tianjin from January 2014 to December 2015 were conducted in this study, and they were divided into elderly group (over 75 years old) and younger age group (under 50 years old). The patients in two groups of were given intravenous thrombolytic therapy with alteplase (0.9 mg/kg), 10% of the dose was intravenously injected, and continuously the remaining dose was pumped into the vein for 1 hour. Before the thrombolysis and 1 day and 21 days after thrombolysis, the score of United States National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological deficits, the incidence of bleeding adverse event and mortality were recorded.Results Compared to the before thrombolysis, the NIHSS scores after thrombolysis on the 1st day and 21st day were significantly decreased in the two groups (the younger age group 1 day: 6±4 vs. 10±5, 21 days 2±2 vs. 10±5, the elderly group 1 day: 7±5 vs. 10±7, 21 days: 6±4 vs. 10±7, allP < 0.05), and NIHSS score in the younger age group was significantly lower than that in the elderly group on the 21st day after thrombolysis (2±2 vs. 6±4,P < 0.05). After thrombolysis, the incidence of minor mucocutaneous bleeding in elderly group was obviously higher than that in younger age group, the difference being statistically significant [7.69% (4/52) vs. 2.17% (1/46),P < 0.05]; the elderly group had higher symptomatic intracerebral hemorrhage and death events than those in younger age group [1 (1.92%) vs. 0].Conclusion Different ages of patients with ACI can benefit from intravenous thrombolysis with alteplase, showing the younger the age of the patients, the better the benefit they can get and have relatively better prognosis.

Objective To identify the gene mutation of Chinese Charcot-Marie-Tooth (CMT) pedigrees and investigate the association of gene mutation to the clinical manifestations and electrophysiology,and the underlying mechanisms.Methods A total of 105 pedigrees with CMT in our hospital were enrolled from January,2007 to December 2013.The clinical features,CMT neuropathy score (CMTNS) and electrophysiological data were collected.Gene mutations were analyzed using multiplex ligation-dependent probe amplification (MLPA) and Sanger gene sequencing.Results We found 31 (29.5％) PMP22 duplication pedigrees,8 (7.6％) GJB1 mutation pedigrees,4 (3.8％) MFN2 mutation pedigrees,4 (3.8％) HSPB1 mutation pedigrees,3 (2.9％) MPZ mutation pedigrees and 1 (1.0％) PMP22 mutation pedigree.In Chinese Han population,the proportion of PMP22 duplication was relatively lower than that in western countries and manifested with classical clinical characteristics of CMT.Subjects with axonal CMT often presented with isolated lower extremity injury and with central nervous system involvement.Hereditary motor neuropathy might be underestimated in clinical setting and should be differentiated from motor neuron disease.Conclusions The gene frequency distribution in patients with CMT in Chinese Han population is different from that in patients from western countries.We should establish our own epidemiological data of CMT in Chinese Han population.

BACKGROUND: Ginkgetin has been widely acknowledged as having multiple pharmaceutical values in domestic and abroad. In many western countries, ginaton is imported in large amount. Domestic production of ginkgetin is great, however, seldom applied and there is no ginaton agent for injection.OBJECTIVE: To observe the effects of the increased contents of total flavonoid glycoside and quercetin glycoside of ginkgetin injection on memory function of mice, superoxide dismutase (SOD) activity in myocardial tissues and hemorrheological indexes of rabbits with ischemia-reperfusion injury.DESIGN: Randomized control animal experiment.SETTING: Hebei Medical College of Employees.MATERIALS: Ninety Kunming mice (3-4 months old), weight (25±1) g and thirty-two Japanese rabbits (3-4 months old) were selected. Self-made high-purity ginkgetin injection [5 mL containing 17.5 mg ginaton, of which there were 8.7 mg ginkgo flavonoid glycoside (49.8%) and 4.61% lactone];Ginkgetin injection made in German (Jinnaduo): Manufactured by Schwabe Germany [5 mL containing 17.5 mg ginaton, of which there were 4.2 mg ginkgo flavonoid glycoside (24%)].METHODS: The experiment was conducted in the Central Department of Experimental Animal, Hebei Medical College of Employees from September to November 2002. ①Ninety mice were randomly divided into 6 groups:1, 2 mL/kg self-made ginkgetin injection group, 1, 2 mL/kg German ginkgetin injection group, model group and control group with 15 mice in each group. Mice in the model group and control group were intraperitoneally injected with normal saline, mice in each group were intraperitoneally injected respectively with testing medicine for 10 continuous days,One hour after the 10th day of administration, mice were intraperitoneally injected with 2 mL/kg scopolamine hydrobromide and dysmnesy models were duplicated. Ten minutes after that, mice were put in the step-down instrument for 36V-voltage-stimulus after accommodation. Measurements were re-performed respectively at 5 minutes and 24 hours after training.Latency and times of electric shock within 5 minutes were recorded.②Thirty-two Japanese rabbits were selected and randomly divided into normal control group, German ginkgetin injection group, 1 mL/kg, 0.5 mL/kg self-made ginkgetin injection group with 8 rabbits in each group. Medicineswere continuously injected into aural veins. Three days after administration, blood was collected to detect the hemorheological indexes. ③Thirtytwo rabbits were randomized into 4 groups: 1 mL/kg, 2 mL/kg self-made ginkgetin injection group, 2 mL/kg German ginkgetin injection group and normal saline group with 8 ones in each group. Rabbit models with ischemia-reperfusion injury in myocardial tissues were established, rabbits were ligated for 30 minutes and then unclamped to get ischemic reperfusion injury in myocardial tissues, testing drugs were injected via carotid artery at the moment of reperfusion according to different groups. Before reperfusion and 30, 60 minutes after reperfusion, blood was drawn from the arteria femoralis, activity of SOD in plasma was measured. Animals were executed to obtain myocardial tissues so as to measure SOD activity.MAIN OUTCOME MEASURES: ①Latency and times of shock within 5 minutes in the experiment were recorded. ②Hemorheological indexes and determination of SOD activity in myocardial tissues.RESULTS: All experimental animals were involved in the analysis of results and no one died. ①Test for memory: Latency and times of errors in step down test in the injection group were better than those in the control group, and differences were significant (P ＜ 0.01 or 0.05). Times of errors within 5 minutes in 1 mL/kg self-made ginkgetin irjection group was less than that in the German ginkgetin injection group and the differences were obvious.②Hemorheological indexes: Whole-blood viscosity low shear value,rigid index of red cells and gathering index of red cells etc. in injection groups decreased. ③SOD activity: Compared with control group, that was significantly increased in 1, 2 mL/kg self-made ginkgetin injection group and were in a dose-dependent manner. Those were obviously increased in the 1 mL/kg German ginkgetin injection group. Increase in SOD activity of ischemic myocardial tissues in the 1 mL/kg self-made ginkgetin injection group was more significant than that in the 2 mL/kg German ginkgetin injection group.CONCLUSION: Both self-made and German ginkgetin injections can enhance the ability of memory; While at the basis of same dose, self-made high-purity ginkgetin injection is superior to German ginkgetin injection.

This article summarized TCM education development history of Sino-US,with emphasis on Sino-US TCM education development of horizontal comparison in terms of admission requirements,faculty,teaching materials,forms of education,a comprehensive understanding of the characteristics and differences of the two countries education which beneficial to both countries education to learn from each other.

Objective Through the practice of new practice teaching methods, to observe whether it can help students to strengthen their self-identity as ‘trainee doctors’. Methods By sim-ulating interrogation, building simulation medical environment and increasing operation project, the practice operation abilities and sense of identity were improved,The questionnaire were required to fill in at the beginning and at the end of the term, and the differences between two teaching methods in advantages, characteristics and the identity of ‘trainee doctors’by their own pairing were compared. Data were analyzed by software SPSS 18.0. Results The new teaching model, to a certain extent, alleviated the present situation of having relatively more students and insufficient source, which was superior to traditional teaching mode in improving students' initiative, enthusiasm, learning ability, practical ability, analysis of the problems, comprehensive ability and so on. It also enabled students to master some of doctor-patient communication skills(P<0.001), to realize the identity of‘trainee doctors’ (Z=-7.671, P<0.001). Conclusion The new practice teaching mode has solved the problems such as insufficient source in clinical teaching. It has also increased the initiative and enthusiasm of students' clinical learning, so that students can think, analyze and deal with the problems from the point of view of doctors, and implement the identity of a‘trainee doctor’.

Objective:To explore the use of internet-based continuous visual recognition task (MemTrax test, MTX) as a rapid screening tool for amnestic mild cognitive impairment (aMCI).Methods:Sixty-four patients with aMCI and 64 individuals with normal cognition as healthy controls were enrolled respectively from Department of Neurology and Health Examination Center of the First Affiliated Hospital of Kunming Medical University from August 2018 to December 2019. Montreal Cognitive Assessment (MoCA) scale and MTX were adopted to assess the cognitive function of all subjects. The total adjusted MoCA scale score, correct rate of MTX, reaction time of MTX and MTX score were obtained and statistically analyzed.Results:The adjusted MoCA scale scores of aMCI patients and healthy controls were 19 (14, 24) and 26 (24, 27; Z=6.795), the correct rate of MTX of aMCI patients and healthy controls were 74% (60%, 80%) and 88% (84%, 94%; Z=8.359), and the MTX score of aMCI patients and healthy controls were 51.11±14.07 and 70.56±14.91 ( t=7.590), respectively, all with statistically significant difference ( P<0.001). Reaction time of MTX of aMCI patients and healthy controls was 1.401 (1.253, 1.590) s and 1.277 (1.163, 1.410) s, respectively ( Z=3.083, P<0.01). After adjustment for age, physical or mental occupation, exercise, hypertension, hyperlipidemia, stroke, sleep time, as well as smoke, the linear regression showed that the aMCI patients had a significant decrease of adjusted MoCA score, correct rate of MTX and MTX score ( P<0.001), and an extension of reaction time of MTX ( P=0.071), compared with the controls. By MTX and MoCA scale assessment, the best cutoff value was 81% for correct rate of MTX and 23 for adjusted MoCA scale score respectively for the prediction of aMCI (with sensitivity of 79.7%, 93.8% respectively, and specificity of 68.8%, 82.8% respectively). The area under the curve (AUC) of correct rate of MTX was 0.93 (95% CI 0.89-0.97, P<0.001), and the AUC of adjusted MoCA score was 0.85 (95% CI 0.78-0.91, P<0.001). There was a statistically significant difference in paired comparison of the two AUCs (χ2=4.620, P<0.05). Conclusion:MTX acts better for the detection of aMCI than MoCA scale, and correct rate of MTX<81% can be considered as the existence of MCI.

During the teaching activities, to stimulate students' subject awareness and encour-age them to play the main role in class activities are inevitable trends in the reform of college educa-tion. Students’ subjective activity is a key to the teaching effect of regional anatomy, a course mainly based on experimental program. Department of Human Anatomy in Chongqing Medical University lay-outs regional anatomy teaching program to develop the students' subjective activities in learning from the course specialty: in preview and review, to train students' image-thinking by drawing; in anatomi-cal operation link, to cultivate students' interest in learning and innovation by discussing the relation-ship of anatomical structure and clinical disease and identifying the variation of structure; in the eval-uation process, taking the formative evaluation system to promote the students' initiatives and ensure the objectiveness and fairness. The implementation of these measures promotes the regional anatomy teaching quality.

Objective To investigate the effect and mechanism of necrostatin-1 (Hec-1) on the level of HMGB-1 protein in liver of rats with hemorrhagic-traumatic shock.Methods A number of 96 male SD rats were divided into sham-operated group,dimethyl sulfoxide (DMSO) group and Nec-1 group (n=32in each) by randomized number method.Rat model of hemorrhagic-traumatic shock was made by fracture of femoral bone and tibia bone and exsanguination from femoral vein until 30 mmHg and maintained at 30-40 mmHg for 90 min,then the shed blood was transfused back with Ringer's solution.The rats in shamoperated group were only under anesthesia for separating and ligating blood vessels,without exsanguination to induce hemorrhagic shock and without replenishment with blood.Rats in Nec-1 group were given 1 mg/kg Nec-1 through femoral vein 5 min before replenishment with blood and Ringer' s solution,while the rats in DMSO group were given equal volume of DMSO solution instead.Eight rats in each group were sacrificed separately at 2 h,8 h,16 h and 24 h after replenishment.The serum and liver tissues of rats in each group were collected to detect serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST),and to observe the pathological changes in liver with hematoxylin-eosin (HE) staining.The level of HMGB-1 in serum was detected by using ELISA.The cytoplasm protein and total protein expressions of HMGB-1 were assessed by using western blot analysis.Results Compared with DMSO group,levels of serum ALT at 8 h (P ＜0.05),16 h (P ＜ 0.01) and 24 h (P ＜ 0.01) in Nec-1 group were significantly lower.Level of serum AST in Nec-1 group were lower compared with DMSO group at 8 h (P ＜ 0.01),16 h (P ＜ 0.01) and 24 h (P ＜0.01).Compared with DMSO group,levels of serum HMGB-1 at 8 h (P ＜ 0.05),16 h (P ＜0.01) and 24 h (P ＜ 0.01) in Nec-1 group were significantly lower.Under light microscopy and transmission electron microscope,hepatic lobule destroyed,the blood extravasated,the immunocyte infiltrated and cellular organelle destroyed were found.Compared with DMSO group,the level of HMGB-1 protein in cytoplasm protein in Nec-1 group were significantly decreased at 8 h (P ＜ 0.01),16 h (P ＜0.01) and 24 h (P ＜0.01).The level of HMGB-1 protein in total protein in Nec-1 group were significantly decreased 8 h (P ＜ 0.05) and 24 h (P ＜ 0.05).Conclusions Nec-1 can remarkably protect the liver of rats with hemorrhagic-traumatic shock,decrease the level of HMGB-1,and protect the hepatocyte effectively.

Objective: To study the synergistic and additive effects of commonly used antibiotics on multi-drug resistant Gram-negative bacilli and to establish a database of combined pharmacodynamics in vitro. Methods: Seven antibiotics including fosfomycin (PHOS), levofloxacin (LEV), ceftazidime (CAZ), compound sulfamethoxazole (SMZ), piperacillin/tazobactam (TZP), cefoperazone/sulbactam (SCF) and imipenem (IMP) were selected and grouped into 21 drug pairs. Based on the results of extended spectrum β-lactamases (ESBLs) test and modified carbapenem inactivation method (mCIM), a total of 172 strains of multidrug-resistant Gram-negative bacilli were divided into four groups: 20 strains of carbapenem-resistant Klebsiella pneumoniae (group A), 50 strains of pan-resistant Acinetobacter baumannii (group B), 62 strains of ESBLs-producing Enterobacter (group C) and 40 strains of carbapenem-resistant Pseudomonas aeruginosa (group D). Chessboard dilution method was used to detect the in vitro combined efficacy of 21 drug pairs on drug-resistant bacteria from the four groups. Whonet 5.6 was used for statistical analysis. Results: All 172 strains were single drug resistant to the seven antibiotics. Results of the combined drug efficacy test showed that no antagonism was found in the four groups. In group A, ten drug pairs, especially the combination of PHOS+ LEV (30%, 6/20), had synergistic effects and 14 showed partial synergistic effects, but no additive effect was detected. Synergistic effects, partial synergistic effects and additive effects were respectively achieved by 12, ten and three drug pairs in group B. The LEV+ SMZ combination had synergistic effects against 56% (28/50) of the strains, which was the highest among all combinations. There were 14, 17 and 16 drug pairs showing synergistic effects, partial synergistic effects and additive effects in group C, respectively, and the strongest synergistic effects were achieved by the IMP+ LEV combination (30.6%, 19/62). There were 12, 14 and 13 drug pairs having synergistic effects, partial synergistic effects and additive effects in group D, respectively, and the strongest synergistic effects were achieved by the IMP+ LEV combination (20%, 8/40). Conclusions The combined use of quinolones, carbapenems, sulfonamides and PHOS could have good synergistic effects against multi-drug-resistant gram-negative bacilli. Monitoring the in vitro combined efficacy before treatment would improve the accuracy of antibiotic use and is of great clinical value.