Objective To explore the characteristic and the rule of flash-visual evoked potentials (F-VEP) of SD rats after optic nerve injury in different grades. Methods By using APS-2000 multifunctional electric physiological instrument, changes in F-VEP were observed in normal optic nerve and injured optic nerve (crushed in 3 grades) in rats. The latency and amplitude of F-VEP wave, were recorded and statistically. Results The F-VEP wave was reliably displayed with characteristic curve. The L5b was(53.67?3.12)ms and A5 was(17.83?5.91)?v. The latency of F-VEP in rats with optic nerve injury in different grades showed a significant prolongation, and the amplitude showed a significant decrease compared with normal rats (P

Objective Through transmission electron microscopy we observe the ultrastructure of optic nerve to evaluate the curative effect of optic nerve incision decompression (ONID) for incomplete injury to optic nerve. Methods The optic nerve was crushed for 30s to produce incomplete injury to the optic nerve in rats, and then the rats were divided into two groups. ONID was performed 6 hours after the injury in one group, and in the other group decompression was omitted(non-ONLD). Ultrastructure of optic nerve was observed 1 month, 2 months, 3 months and 6 months later in both groups. Results After 1 month denaturalization of myelin sheaths and axons of the injured optic nerve was severe in non- ONID group, and after 3 months the optic nerve entirely lost its normal structure. On the other hand, denaturalization of myelin sheaths and axons was evidently less intense in ONID group, and the changes in structure of optic nerve were stabilized. Conclusions ONID reduced the speed of degeneration of the injured optic nerve and postpones the process of axon denaturalization, thus protects the optic nerve from secondary injuries.

Objective To investigate the image characteristics and clinical application of 18F-FDG PET/CT in autoimmune pancreatitis (ALP).Methods The PET/CT images from six male patients (age ranging from 51 to 78(average 69) years) with AIP from 2005 to 2012 were studied retrospectively.Of the six patients,two had follow-up PET/CT images after steroid therapy.The morphologic abnormality was visually analyzed and SUV was calculated.Scores were obtained according to the SUV of pancreas compared with that of the liver (3 =SUV higher than liver,2=SUV similar to liver,1 =SUV lower than liver).The difference between the regular and delayed SUV was compared by paired t test using SPSS 17.0.Results All of the 6 patients showed diffuse FDG uptake in the entire pancreas with SUVmax of 3.2-6.0(5.2± 1.1).Five patients had score 3 and one had score 2.Five patients had delayed scan,of which 4 had increased uptake (SUVmax5.3-7.2),but the SUVmax was not significantly different compared to that before delay scan (4.8-6.0,t =-2.424,P＞0.05).Five patients showed extrapancreatic uptake,especially in the salivary glands.After the steroid therapy,the enlarged pancreas reduced and the intense uptake of the pancreas disappeared.The extrapancreatic uptake showed coinstantaneous remission.Conclusions Increasing FDG uptake at entire pancreas was observed in patients with AIP.18F-FDG PET/CT may be useful for detecting AIP and the associated extrapancreatic uptake,and monitoring the change after therapy,yet it needs further evaluation.

Objective To explore the significance and correlation between MCP-1 and cardiovascular complication of diabetes. Methods 65 patients with diabetes and 64 patents with IGT and 60 healthy persons as control group are chosen from a population of 1231residents at Jiangnan community in Guangzhou city. Ultrasonic inspection of carotid artery was applied to the intimae media thickness (IMT),and the levels of-MCP-1 were detected by Elisa. Result There was significant difference in the levels of MCP-1 among the normal control group, IGT group and DM group (P=0.000).The levels of MCP-1 in IGT complicated with AS patients were significantly higher than that in IGT alone patients. The levels of MCP-1 in DM complicated with AS patients were significantly higher than that in DM alone patients. The levels of MCP-1 were positively correlated with IMT in these patients. A forward LR Logistic regression analysis showed that IMT was a dependent variable, gender, MCP-1 and age are independently correlated with IMT. Conclusion MCP-1 is correlated with diabetes and its cardiovascular complication and it may be served as the target of therapy.

Objective To explore methods of quickly identifying loopholes in medical quality management and to improve medical quality by means of analyzing low-risk death cases.Methods Two rounds of analysis of 1 14 low-risk death cases of hospitals in Beijing in 2012 in terms of data quality and medical procedures,in an effort to identify problems and to verify the feasibility and accuracy of the method through interaction with other data.Results Totally 585 760 inpatients were discharged in 2012 from 21 hospitals,of whom 1 5 1 1 93 being low-risk cases.Such cases included 1 14 low-risk death cases, accounting for 0.01 9% of the total discharged,and 0.075% of low-risk discharged cases.Analysis of these medical records found 50 cases of problematic diagnosis (43.86%),45 cases of possible defects in diagnosis and treatment (39.47%),39 cases of missing items of secondary diagnosis (34.21%),and 28 cases of missing items of surgery/operation (24.56%). Some of the abovementioned cases had overlapping mistakes.Conclusion Analysis of low-risk death cases can help focus among massive data of medical records,problems of diagnostic and therapeutic insufficiency,pinpointing common problems in medical service and improving medical quality and fine management of hospitals.

Objective To investigate the relationship of vitamin D with the intestinal development and study the expression of vitamin D receptor (VDR) in the duodenum of C57BL/6 mice at different developmental stages.Methods Quantitative PCR (qPCR),histology using H&E staining and immunofluorescence staining,and Western blotting (WB) were performed to elucidate the expression of VDR in mice intestine at different growth and developmental stages.Results The peak of VDR mRNA expression reached on 21 d.The pathological result showed that VDR mainly distributed in the cytoplasm of epithelial cells and smooth muscle cells in the mouse duodenum.WB result indicated that there was no nuclear translocation of VDR protein in the mouse duodenum.Conclusions This study demonstrates the regularity of expression of VDR in the mouse duodenum during its development,and contributes to understanding the function of VDR in the intestines.

We investigate the different expression of toxin gene mazF3,6,9 and antitoxin gene mazE3,6,9 in the drug-resistance Mycobacterium tuberculosis,we used quantitative real-time polymerase chin reaction method to detect the expression level of toxin gene mazF3,6,9 and antitoxin gene mazE3,6,9 in M.tuberculosis (20 mono-resistance strains,20 multidrug resistance strains and standard strain H37Rv).The differences of gene expression levels between groups were analyzed by oneway ANOVA.Contrasting with control group,toxin genes mazF6,9 were up-regulated expression levels both in mono-resistance (11.1519±22.31721;8.4306±17.97897) and multidrug resistance (4.6016±1.29018;6.9627±6.92948),had statistical significance (P＜0.01),mazF3 expression levels had statistical significance neither in mono-resistance nor in multidrug resistance (P＞0.05);antitoxin genes mazE3 was in down-expression level,and had statistical significance both in mono-resistance (0.3606±0.12527) and multidrug resistance (0.2016±0.16542) (P＜0.01),mazE6 had no statistical significance (P＞0.05)either in mono-resistance or multi drug resistance,mazE9 only in multidrug resistance(0.3989±0.37679) was in downexpression level,and has statistical significance (P＜0.001).The toxin gene mazF6,9 and antitoxin gene mazE3,9 may participate in the drug-resistance formation of M.tuberculosis.

Objective To determine the value of 18F-FDG PET/CT in the detection of subsolid pulmonary nodules.Methods The 18F-FDG PET/CT imaging data of 44 patients (35 males,9 females,mean age (68.05±9.89) years) with 49 subsolid pulmonary nodules were retrospectively analyzed.There were 28 pure ground-glass nodules (pGGN) and 21 part-solid nodules (PSN),which were all confirmed by postsurgical pathology or imaging results during follow-up.The lesion size (dmax),ground-glass opacity (GGO) percentage,SUV retention index (RI),and the positive rates on PET images were accessed.The correlation between SUVmax and lesion size and GGO percentage was analyzed by Pearson correlation analysis.The SUVmax between benign and malignant pGGN,and that between malignant pGGN and PSN,were compared using two-sample t test.The diagnostic accuracy was compared using x2 test.Results (1) Six pGGN were benign while 43 nodules (including 22 pGGN and 21 PSN) were malignant among the 49 nodules.(2) SUVmax was positively correlated with lesion size (r=0.500,P＜0.05) and was negatively correlated with GGO percentage (r=-0.605,P＜0.05) for PSN,while SUVmax was positively correlated with lesion size (r=0.375,P＜0.05) for pGGN.(3) SUVmax was not significantly different (t =-0.813,P＞0.05) between 6 benign pGGN (0.78±0.25,range:0.50-1.20) and 22 malignant pGGN (0.91±0.34,range:0.40-1.70);SUVmax of 21 malignant PSN (2.10±1.16,range:0.60-5.60) was higher than that of 22 malignant pGGN (t=-4.645,P＜0.05).(4) When a nodule's activity being equal to or greater than that of mediastinal blood-pool was defined as malignancy,the accuracy rate of PSN (66.7％,14/21) was significantly higher than that of pGGN (9.1％,2/22; x2 =15.244,P ＜0.05).Based on the criteria for malignancy of RI＞10％,the accuracy rates for PSN and pGGN were 65.0％ (13/20) and 45.8％ (11/24),respectively (x2 =1.616,P＞0.05).Conclusion 18F-FDG PET/CT shows no clear advantage for diagnosis of pGGN,but is helpful for PSN.

Objective To study the causes of emergency department (ED) overcrowding and access block in Beijing.Methods This was a multi-center cross sectional study.The studied cohort of patients included all ED visiting patients from 18 municipal teaching hospital EDs in Beijing from 2012 to 2013.Patient' s characteristics and medical care settings were analyzed.Results The urgent care cases accounted for only 4.6 ％ (71 224/1 554 387) of the emergency annual visits in 2012 and 5.5 ％ (88 190/1 615 571) in 2013.The total number of observation patients in EDs was 185 277 and 211 900 in 2012 and 2013 respectively,with an increase of 14.4 ％ (P ＜ 0.01).The total ED-admission inpatients only accounted for 2.97％ and 2.89 ％ of total annual visits in 2012 and 2013 respectively.The average time of ED-admission took 37.1 hours and 36.2 hours in 2012 and 2013 respectively.The average time of ED stay for observation was 4.9 days and 5.4 days in 2012 and 2013 respectively.Upper respiratory tract infection was the leading illness in annual visits.The leading cause of ED stay for observation was bedridden with pneumonia.Conclusions The ED settings in Beijing are different from other countries.The EDs actually assume the task of the clinic and ED service for 24 hours thereby made EDs terribly overcrowded.The main causes are large number of non-emergency patients visiting the ED and patients in the ED are difficulty to be hospitalized.Patients with end-stage disease and multiple organ failure stayed in the ED due to nursing home shortage.