BACKGROUND: In treatment of traditional acute myocardial infarction,patients were required to lie on the bed resting for 1-4 weeks. Recently research showed that early rehabilitation exercise in myocardial infarction patients could ameliorate the reservation of cardio function, increase exercise tolerance, augment myocardial hemoperfusion, decrease myocardial ischemia and reduce the anxious and depressive emotion.OBJECTIVE: To observe the influence of early rehabilitation movement on activity of daily living, duration of hospital stay, mean hospitalized cost,incidence rate of arrhythmia and recurrence rate of myocardial infarction in two years.DESIGN: Non-randomized concurrent control analysis.SETTING: Beijing Tiantan Hospital.PARTICIPANTS: Totally 80 patients with acute myocardial infarction,who were hospitalized at Department of Circulation, Beijing Tiantan Hospital from August 2002 to October 2003, were enrolled. They were all at most 70 years old with stable pathogenetic condition. Left ventricular ejection fraction (LVEF) was over 35%. They were not combined with severe hypertension, severe pulmonary disease, nerve and disease of locomotor system.METHODS: The selected cases based on patients' will were assigned into two groups (n=40), ①early rehabilitation group: They were treated with routine drugs, absolute bed rest for 24 hours. At day 2 the head stock was rose about 30°to do passive exercise of extremity joint. At days 3-5, the patients sat on the bed, 3 times per day. At days 6-7,the patients stood at bedside, 3 times per day. At days 8-9, the patients moved joints of extremities at bedside and walked slowly in room. At days 10-14, the patients exercised walking. If there were angina pectoris attacks, serious cardiac arrhythmias or dyspneic respiration, etc., the movement should be suspended or the exercise intensity came back to that in the former stage. ②Absolute bed rest group: The patients were absolute bed rest, and only treated with routine drug without any rehabilitation training.MAIN OUTCOME MEASURES: Barthel index (full mark was 100 points, and ＜ 60 points represented unable self-care) was used to assess activity of daily living of patients. Mean duration of hospital stay, mean hospitalized cost, incidence rate of arrhythmia and recurrence rate of my ocardial infarction in two years were compared between the two groups.RESULTS: A total of 80 patients that conducted the therapy and follow up were involved in the result analysis. ①Mean duration of hospital stay and mean hospitalized cost in the early rehabilitation group were less than those in the absolute bed rest group (17.1 days vs 24.5 days; 9 021.23 yuan vs 12 383.45 yuan; P ＜ 0.05). ②Barthel index: There was insignificant difference before treatment between the two groups. It was significantly higher in the early rehabilitation group than that in the absolute bed rest group before discharge (81.43±13.57,70.68±11.48,P ＜ 0.05). ③Six and seven patients had the onset of arrhythmia in the early rehabilitation group and the absolute bed rest group, respectively. ④Follow-up observation was performed for two years. The recurrence rate of myocardial infarction in the early rehabilitation group (5% ,2/40) was obviously lower than that in the absolute bed rest group (22 %,9/40).CONCLUSION: The early rehabilitation training is of benefit to elevate activity of daily living of myocardial infarction patients, reduce mean duration of hospital stay and mean hospitalized cost and decrease recurrence rate.

In this study,the relationship between the advanced glycation end products(AGEs) and the expressions of receptor for AGEs(RAGE),intercellular cell adhesion molecule-1(ICAM-1) was investigated.The diabetic rat model was reconstructed and the fluorescence method,RT-PCR and in-situ hybridization techniques were used to detect AGEs content and the expressions of RAGE and ICAM-1 gene in the aorta and cardiac tissues.The results showed that AGEs content in aortic and cardiac tissues increased(P＜0.01) in diabetic rats; The expressions of RAGE and ICAM-1 enhanced (P＜0.05～0.01) and were positively correlated with the quantity of AGEs accumulation(P＜0.01) in the aorta and cardiac tissue.These parameters change in the diabetic rats can be improved with aminoglumine(AG) treatment.Suggesting that AGEs might induce RAGE and ICAM-1 expression.It's postulated that AGEs binding to RAGE play an important role to result in diabetic endothelial cells dysfunction and lesion.

Objective To evaluate the effect of embelin combined with paclitaxel on the inhibition of A 549 lung cancer cell proliferation and tumor growing in tumor bearing nude mice. Methods The anti-proliferation efficiency of embelin combined with paclitaxel were evaluated by MTT assay, and A 549 cell apoptosis were evaluated by lfow cytometry. A 549 cells were xenografted in mice to establish the animal model, which were used to evaluate the effect of anti-tumor. Results compared to saline group、embelin group and paclitaxel group, the (paclitaxel+embelin) group could inhibit the growth of A 549 cells effectively(P<0.05). The embelin combined with paclitaxel induced the apoptosis of A 549 cells more effective than paclitaxel alone. The (paclitaxel+embelin) group significantly inhibited the growth of tumor tissue. Conclusion the paclitaxel can inhibit the growth of A 549 cells, the embelin can induce the apoptosis of A 549 cells, and the combination of paclitaxel and embelin may be a potentially effective treatment for lung cancer.

Objective To explore the application and effectiveness of simulated patient role play in the inquiry and the medical record writing teaching.Methods Carrying out the teaching model of simulated patient role play in the Second Clinical Medical College of Southern Medical University to the undergraduate students of grade 2009 snd 2010 in diagnose inquiry and medical record writing training class.A self-designed student questionnaire mainly about atmosphere of class,study enthusiasm,Self-evaluation of learning efficiency,the effect of the medical record writing in-class training and so on was used to do the survey.On the other hand,questionnaire for teachers included students' performance,students' writing ability,etc.100 students and 50 teachers were investigated with the survey.The percentage of the options of each question on the questionnaire was calculated in order to analyze the new teaching mode.Results The random questionnaire survey showed that 85％ (85/100) of the students believe that the new teaching mode can activate classroom atmosphere and improve learning motivation.About 62％(62/100) of the students said medical record writing errors can be obtained and corrected timely in-class training.Most students in grade 2009 have better capacity in medical record writing than those students who did not contact with new teaching mode.Conclusion The teaching model of simulated patient role play in the analogue inquiry and medical record writing is efficient and feasible in medical education,which can improve students' practical ability and is expected to be applied in undergraduate medical education.

Objective To evaluate the efficacy and safety of acarbose tablets combined with protamine zinc recombinant lai pulp mixing insulin injection in the treatment of elderly patients with type 2 diabetes.Methods 170 elderly patients with type 2 diabetes were randomly divided into the observation group and the control group.85 cases in the observation group were given acarbose tablets combined with protamine zinc recombinant lai pulp mixing insulin injection,85 cases in the control group received aspart 30.The patients were followed up for 12 weeks,the blood glu cose levels,blood glucose fluctuation,glycosylated hemoglobin (HbAlc),the incidence of hypoglycemia and insulin dosage were observed.Results' The level of fasting plasma glucose (FPG) (t =9.92,P ＜ 0.05),2h postprandial blood glucose(2hPG) (t =18.18,P ＜0.05),the mean blood glucose within 4h(t =13.62,P ＜0.05),days of average blood glucose fluctuations (t =14.56,P ＜ 0.05) of observation group dropped significantly compared with that before treatment;HbAlc achieved rate(6.5％)of the observation group and control group were 35.29％,28.23％,re spectively,HbAlc achieved rate (7.0％) of observation group and control group were 57.64％,52.94％,the differences were not statistically significant(all P ＞ 0.05).The dose of insulin was significantly lower in the observation group(20.11 ±3.36) u/d than(35.78 ±4.68) u/d in the control group(t =25.08,P ＜0.01).There were 2 cases of hypoglycemic events and 3 cases in the control group.Conclusion Protamine zinc recombinant insulin lispro injection combined with acarbose has reliable clinical efficacy and safety.

The mechanism of central nervous system injury is complex.Microglia cells participate in a variety of central nervous system diseases and damage processes.Toll-like receptor 4 (TLR4) mediates the microglial activation and the expression of inflammatory cytokines.It is one of the important receptor proteins for microglia cells performing their functions.This article briefly introduces the role of TLR4 signal pathway in the central nervous system injury.

Abdominal increment is applied to patients with abdominal compartment syndrome (ACS) after severe trauma,while for some patients,intra-abdominal volume increment could not close the fascia within the primary stage.For theses patients,abdominal wound skin grafting was conducted,and the planned hernia was formed.Planned abdominal hernia developed over time,and finally huge incisional hernia was formed.This article described a modified sliding myofascial flap of the rectus abdominus muscles for definitive abdominal wall reconstruction for a patient with huge planned abdominal hernia,and a good curative effect was obtained.

Objective To observe the value of myocardial performance index (Tei index) in evaluating the left ventricular function in diabetic patients with normal left ventricular ejection fraction (LVEF),and to investigate its correlation with plasma N-terminal pro-brain natriuretic peptide (NT-proBNP).Methods 96 diabetic patients with normal LVEF were selected as the observation group,50 healthy persons were selected as control group.Left ventricular Tei index was measured by color Doppler ultrasound.The plasma NT-proBNP was detected.Results The Tei index,plasma level of NT-proBNP of the observation group were (0.49 ± 0.11),(397.6 ± 39.4) ng/L,those of the control group were (0.32 ± 0.07),(101.2 ± 18.4) ng/L,the differences between the two groups were statistically significant(t =11.357,1.992,all P ＜ 0.05).There was significant positive correlation between Tei index and plasma NT-proBNP in the observation group(r =0.661,P ＜ 0.05).Conclusion Combined determination of Tei index and plasma NT-proBNP can detect early myocardial damage in patients with diabetes mellitus.

With the progress of the genetics and the molecular biology and biotechnology,the development of genetic markers of Oncomelania hupensis also has gone through the course from indirect methods to direct methods and from sketchy results to precise results.The paper reviews the progress of research on genetic markers of O.hupensis.

The establishment of animal model is fundamental to the experimental studies. It involves the selection of animals and cell lines, the determination of the number of cells and the option of the ways of transplant. Only when each production step is operated by following the occurrence and the development mechanism of the gastric cancer, can we simulate the process of growth of the gastric cancer in human body.Due to their congenital immune deficiency, the nude mice serve a better choice for the establishment of gastric cancer animal model. Beyond that, the cell lines selection and transplant way option also play important roles.