Objective To explore the role of plasma level of homocysteine ( Hey ) in progressive ischemic stroke (PIS)of carotid artery system and to investigate the relationship between Hcy and carotid artery atherosclerosis(AS).Methods Plasma Hcy concentrations were measured in 68 patients with progressive ischemic stroke of carotid artery system (PIS group)and 72 patients with non-progressive ischemic stroke of carotid artery system ( non-PIS group ).Plasma Hcy level and carotid artery intima-media thickness ( IMT ) were compared among PIS group and non-PIS group as well as normal control group.The linear correlation between plasma Hcy level and IMT in PIS group was analyzed.Results Plasma Hcy concentrations was respectively (22.52 ± 5.26) μmol/L,( 16.38 ± 4.23) μmol/L and( 10.13 ± 2.16) μmol/L in PIS group,non-PIS group and normal control group( F =56.87,P ＜ 0.01 ).Compared PIS group and non-PIS group with normal control group,the differences were statistically significant ( P ＜ 0.01 ).And there was also significant difference on plasma Hcy levels between PIS group and non-PIS group( P ＜ 0.01 ).The thickness of carotid artery IMT was respectively(1.12 ± 0.34)mm,(0.96 ± 0.27)mm and(0.43 ± 0.21 )mm in PIS group,non-PIS group and normal control group( F =28.47,P ＜ 0.01 ).Compared PIS group and non-PIS group with normal control group,the differences were statistically significant( P ＜ 0.01 ).And there was also significant difference on IMT between PIS group and non-PIS group ( P ＜ 0.01 ).In PIS group plasma Hcy level was positively correlated with the carotid artery IMT ( r =0.687,P ＜ 0.01 ).Conclusion The plasma Hcy level is closely related to the occurrence and development of carotid artery atherosclerosis and PIS of carotid artery system,detection of plasma Hcy level helps to predict the occurrence of PIS of carotid artery system and provide an evidence for the therapy decision.

Objective: To observe the effect of acupuncture around the diseased region combined with point injection on post-herpetic neuralgia. Methods: Point injection on 30 cases in the related segments of spinal cord after needling around the diseased region. Results: Twenty-seven cases got effect and the total effect rate was 90%. Conclusion: Acupuncture combined with point injection has remarkable curative effect on post-herpetic neuralgia.

Objective To investigate the correlation of smokers in wnt/β-catenin signaling pathway activation as well as their correlation with lung squamous cell carcinoma incidence.Methods In the Department of Respiratory Medicine of the People's Hospital of Wuhan University,30 cases lung squamous cell carcinoma patients with a history of smoking,30 cases lung squamous cell carcinoma patients with no history of smoking,30 cases bronchiectasis patients with a history of smoking,30 cases bronchiectasis patients with no history of smoking were chose respectively as A group,B group,C group and D group.After the patients were treated by surgery,the removal of diseased tissue used immunohistochemical staining for CD68 + testing,TNF-α,wnt-2,β-catenin and the expression of TCF-4 were measured by using Western blot hybridization method,then wnt-2,β-catenin,TCF-4 transcription of mRNA concentrations were detected by using RT-PCR method.Results Immunohistochemical studies showed that cells in TNF-α,CD68 + expression of A group,B group,C group and D group were respectively 0.895±0.036 and 0.931±0.237,0.125±0.018 and 0.631±0.064,0.083±0.042 and 0.311±0.062,0.053±0.004 and 0.196±0.020,the differences were statistically significant(P＜0.05).Westblot test Results showed that wnt-2,β-catenin,TCF-4 expression level showed a gradually decreasing trend,the difference was statistically significant(P＜0.05),testing of RT-PCR showed that wnt-2,β-catenin,TCF-4 translation level showed a gradually decreasing trend,the difference was statistically significant(P＜0.05).Conclusion Smoking for body wnt/β-catenin pathway has a cell activation,after cigarette activate wnt/β-catenin signaling pathway in the incidence of lung squamous cell carcinoma of the body will greatly enhance the smoking crowd wnt/β-catenin signaling transduction circumstances.The detection of wnt/beta-catenin signal transduction in smokers can be used to indicate the occurrence of lung squamous cell carcinoma.

Objective By means of control test,to compare the surgical trauma and perioperative recovery between video-assisted thoracoscopic surgery(VATS) and conventional thoracotony for lobectomy.Methods Eightysix non-small cell lung cancer patients who had undergone operations from April 2010 to April 2011 were chosen.According to operative mcthods,the patients were divided into two groups:video-assisted thoracoscopic surgery group(VATS) and open chest group(OT).The protein and hormone level of serum Cortisol(Cor),growth hormone (GH),triiodothyronine (T3),tetraiodothyronine (T4),C-reactive protein (CRP) were selected as indexes to investigate the surgical trauma on non-small cell lung cancer patients.The duration of operation,quantity of lymph node dissection,chest tube duration,postoperative hospital stay,postoperative complications were chosen as indexes to measure operation result and perioperative recovery.Results Under the condition that patients undergone the same operation level(lobectomy + Systemic lymph node dissection),there was no ststistical significance in preoperative level of serum Cor,GH,T3,T4,CRP.The postoperative concentrations of serum Cor,GH,T3,T4,CRP on the 1 d,2 d,3 d and 7 d were lower in VATS group,and there were obvious statistical significance(P ＜0.01).And there were obvious statistical significance in duration of operation (P ＜ 0.01),postoperative hospital stay(P ＜ 0.01),quantity of lymph node dissection (P =0.477).There were no obvious statistical significance in chest tube duration (P =0.508),postoperative complications (P =0.787).Conclusions VATS lobectomy is able to achieve a same result for radical treatment outcone and safety to routine open chest lobectomy in patients.Compared witt routine open chest lobectomy,VATS lobectomy has less surgical trauma,much rapid recovery,it should be recommended for patients with non-small cell lung cancer.

Since the implementation of the Trial Measures of Degrees in Clinical Medicine in 1998,the application for clinical M.D.degree for in-service doctors has been considered as way of continued education for medical practitioners.To guarantee the quality of this education mode,Peking University Health Science Center adopted measures and achieved outcomes that are parallel to that of full-time M.D.programs.-service doctors at,This paper introduces the experience of PUHSC and proposes measures for MD program of in-service doctors in terms of quality control,informatization,etc..

Objective To investigate the regulatory effect of glutamate signaling pathway on filopodia formation in epidermal cells and on melanosome transfer.Methods Epidermal melanocytes and keratinocytes were isolated from human foreskin and subjected to subculture.After two to three passages of subculture,the melanocytes and keratinocytes were cultured alone or in combination with or without the presence of MK801 (an antagonist of N-methyl-D-aspartic acid (NMDA) receptor) of 100 μmol/L,or NMDA (the activator of NMDA receptor) of 100 μmol/L,for 24 hours.The melanocytes irradiated with UVB at 311 nm served as the control.Scanning electron microscopy was used to observe the appearance of filopodia and dendrites of melanocytes and keratinocytes.Melanosome transfer was visualized under confocal laser scanning microscopy after double immunofluorescent staining.Results Although no obvious changes were observed in the number of dendrites in monocultured melanocytes after treatment with MK801 or NMDA for 24 hours,dendrites became thinner at the terminus and longer with a decrease in the number and length of filopodia after MK801 treatment,but thicker and shorter with an increase in the number and length of filopodia after NMDA treatment compared with untreated monocultured melanocytes.In the coculture system,filopodia were observed between the untreated melanocytes and keratinocytes,and the number of filopodia in melanocytes was larger in the side adjacent to keratinocytes than in the opposite side.Compared with the untreated coculture system,the number of both filopodia connecting melanocytes and keratinocytes and filopodia extending from melanocytes to keratinocytes decreased in the coculture system after treatment with MK801 of 100 μmol/L,but increased after treatment with NMDA of 100 μmol/L,for 24 hours.Melanosomes were found in keratinocytes cocultured with melanocytes without treatment,which were decreased in number after 24-hour treatment with MK801 of 100 μmol/L,but increased in number and even present in keratinocytes nonadiacent to melanocytes after 24-hour treatment with NMDA of 100 μmol/L.Conclusion Glutamate signaling pathway may modulate the transfer of melanosomes from melanocytes to keratinocytes via modulating the appearance of melanocyte dendrites and formation of filopodia.

Dyslipidemia is one of the most important pathogenic factors of atherosclerotic cardiovascular disease.Detection of lipid and lipid metabolism related indicators is important in diagnosis and treatment for dyslipidemia,as well as risk assessment and prevention of cardiovascular disease.In recent years,with advances in technology and research,focuses on lipoproteins gradually extended from quantity changes toqualitative changes.The emphasis also turns to some lipid metabolism related proteins,susceptibility genes,DNA methylation,miRNA and lipidomics.Relevant researches have become a hot topic in this field.

Objective　To study the role of the structural gene variation of hepatitis C virus(HCV) in the chronicity of HCV infection. Methods　Serum samples from four HCV infection acquired during six-month follow up and four patients with chronic hepatitis C type were obtained. A 1-kb fragment containing the 3' half of core ，completed E1 and 5' half of E2/NS1 was amplified by nested reverse transcription polymerase chain reaction (RT-PCR). For each，30 cloned cDNAs were examined by a method that combined heteroduplex analysis (HAD) and a single-stranded conformational polymorphisim (SSCP)assay to optimize selection of clones with unique gel shift patterns (clonotypes )as a measure of the quasispecies complexity. Results　There was obvious difference between the SSCP bands of cloned cDNAs representing core-E1 and E2 region，but more distinct difference between heteroduplex and the homoduplex of clones spanning E2 region which accurately reflected the degree of heterogeneity. Quasispecies complexity was higher in those with persistent viremia than those with acute viremia. Conclusion　HCV persistence is associated with complex quasispecies in viral structural region.

Objective To compare the effects of piracetam and oxiracetam on elderly cognitive dysfunction after cerebral hemorrhage.Methods Elderly patients (82 cases) with cerebral hemorrhage treated in Tongchuan People's Hospital from January 2012 to December 2015 were selected and divided into two groups according to the different treatment drugs.Two groups were treated by oxiracetam and piracetam respectively.The Montreal cognitive assessment scale (MoCA),simple mental state examination (MMSE),and daily life ability scale (ADL) score of the two groups before and after treatment were compared.The neuron-specific enolase levels and cognitive function after treatment of 1,3,and 6 months were also compared.Results After treatment,MoCA,MMSE,and ADL scores of two groups were significantly improved (P ＜ 0.05),and oxiracetam group were significantly better than piracetam group (P ＜0.05).After treatment 6 months,MoCA,MMSE,ADL effective and total effective rate of the two groups were significantly higher (P ＜0.05),and oxiracetam group were significantly better than those ofpiracetam group (P ＜ 0.05).After treatment for 1,3,and 6 months,the neuron-specific enolase levels were significantly lower than those before treatment (P ＜ 0.05),and in the treatment of 3 and 6 months,oxiracetam group were significantly lower than piracetam group (P ＜ 0.05).The incidence of adverse reactions had no significant difference.Conclusion Oxiracetam can improve the elderly cognitive dysfunction after cerebral hemorrhage,the curative effect was increased with the prolonging of the time,and can reduce the neuron-specific enolase levels,which has high clinical value.

0.05)and the total costs of the 3 groups were 1 111.82 yuan,1 132.82 yuan and 1 219.62 yuan,respectively.CONCLUSION:Group A(Ceftriaxone Sodium)has been proved to be preferable for children's bronchopneumonia.