AIM: To investigate the changes of first order kernel ( FOK ) and second order kernel ( SOK ) of multifocal electroretinogram( mf-ERG) in detecting the early retinal abnormalities in sub-clinical stage of diabetic retinopathy. ·METHODS: Totally 32 patients ( 58 eyes ) with type 2 diabetes mellitus ( DM ) without apparent diabetic retinopathy( DR) were detected by mf-ERG, from June 2014 to May 2015. Thirty cases ( 60 eyes ) of normal control group had also been taken to compare the difference of the amplitude and latency between the two groups. ·RESULTS: Compared with the control group: there was no statistical difference in the FOK b-wave latency of the diabetic group, and the FOK b-wave amplitude was significantly decreased (t=3. 099, P=0. 012). The SOK b-wave latency in diabetes group was statistically delayed (t=2. 643, P=0. 025), and the SOK b-wave amplitude statistically decreased (t=4. 833, P<0. 01). There was no statistically difference in the a-wave latency and amplitude of FOK and SOK. The b-wave amplitude of FOK and SOK was negatively correlated with the course of the disease. However, the b-wave amplitude was not statistically correlated with the duration of diabetes mellitus. ·CONCLUSION: The function of the post-polar outer and inner retina detected by FOK and SOK had been damage even before retinopathy. The anomaly is mainly reflected by the decreasing amplitude of b-wave.

Objective To explore the teaching feasibility and practicability on team-based learning (TBL) and lecture-based learning (LBL) combined with PDCA circle teaching in clinical teaching of neurol-ogy, and evaluate its teaching effect. Method 100 cases clinical medical professional training students were chosen, divided into experiment group and control group, with 50 cases in each group. Control group used TBL and LBL teaching while experiment group used combined with PDCA circle teaching on the basis of control group. After the teaching, the teaching effects difference between two groups was evaluated and compared. Result The theoretical examination scores in experiment group (85.95 ±7.63) was higher than that in control group (77.31±5.38), and the difference was statistically significant (t=2.126, P=0.034). The practical operation scores in experiment group (82.37±5.15) was higher than that in control group (76.62± 4.35), and the difference was statistically significant (t=2.173, P=0.029). In anonymous satisfaction survey, the average coutent degree with teaching in experiment group is higher than control ( 92% vs . 82%) . Conclusion TBL and LBL combined with PDCA circle teaching improves the students' basic theory, prac-tical operation and doctor-patient communication ability, whose satisfaction has also significantly increased, which is worth popularizing in the clinical practice teaching of neurology.

Objective To evaluate the nutritional risk screening for younger patients with stroke and to explore risk factors of malnutrition. Methods Younger patients with stroke were enrolled in a prospective way. The patients were evaluated by nutritional risk screening 2002 (NRS 2002) at their admission for nutritional risk screening, and were divided into nutritional risk group and no nutritional risk group according to the evaluation results. Prealbumin less than 200 mg/L was defined as malnutrition. Demographic and baseline clinical characteristics of the patients were analyzed with multivariate logistic regression analysis to determine independent risk factors for malnutrition at the admission and the 14th day. Results (1) A total of 152 young stroke patients were enrolled, including 51 in nutritional risk group, 101 in no nutritional risk group, the rate of nutritional risk was 33.6%(51/152). (2) The rate of malnutrition at admission was 13.8%(21/152), the rate of malnutrition in nutritional risk group was 25.5%(13/51), and 7.9%(8/101)in no nutritional risk group on admission. While the rate of malnutrition was 32.2%(49/152), including the rate of malnutrition in nutritional risk group was 60.78%(31/51)and 17.8%(18/101)in no nutritional risk group was at the 14th day of admission. (3) Multivariate Logistic regression analysis showed that advanced age (from 36 to 45 years), sex, diabetes, hyperthyroidism were independent risk factors for malnutrition in younger patients with stroke. Recent history of surgery and smoking, stroke-associated pneumonia, post-stroke depression, swallowing disorder, sleep disorder, moderate and severe neurologic deficits were also risk factors for malnutrition. Conclusion The incidence of malnutrition in youngerpatients with stroke were higher, and earlier nutritional risk screening and nutritional support in these patients were urgent.

Objective To observe the efficacy and safety of rosuvastatin in the treatment of hyperlipidemia and carotid atherosclerotic plaque in young ischemic stroke patients.Methods In prospective study,264 young ischemic stroke patients with hyperlipidemia and carotid atherosclerotic plaque were randomly divided into low dose group,middle dose group,high dose group,88 cases in each group.All patients were given rosuvastatin immediately after dinner,in doses of 5mg,10mg,20mg,respectively,for eight months.Then,the changes of hyperlipidemia and carotid atherosclerotic plaque in the three groups were surveyed,and its safety by the observation of clinical symptoms and monitoring of adverse reactions after eight months were assessed.Results Before treatment,the blood fat and carotid atherosclerosis plaque index in the three groups had no statistically significant differences (all P >0.05). After treatment,the total cholesterol,triglycerides,low -density lipoprotein cholesterol of the high dose group were (1.67 ±0.68)mmol/L,(3.23 ±0.53)mmol/L,(1.83 ±0.62)mmol/L,which of the middle dose group were (1.93 ±0.74)mmol/L,(3.73 ±0.23)mmol/L,(2.24 ±0.73)mmol/L,which of the low dose group were (2.16 ± 0.77)mmol/L,(4.06 ±0.93)mmol/L,(2.93 ±0.35)mmol/L.These indicators were decreased than before treat-ment [(2.79 ±0.72)mmol/L,(5.40 ±0.67)mmol/L,(3.64 ±1.03)mmol/L,(2.75 ±0.81)mmol/L,(5.59 ± 0.95)mmol/L,(3.43 ±0.92)mmol/L and (2.83 ±0.53)mmol/L,(5.84 ±0.79)mmol/L,(3.83 ±0.88)mmol/L].The decrease of the high dose group was higher than the middle and low dose group,the difference was statistically significant(F =6.61,P <0.05).The effective rate of the high dose group was 85.23%.which of the middle dose group was 76.14%.The effective rate of the low dose group was 62.50%.The efficacy of the high dose group was better than the middle dose group and low dose group,the difference was statistically significant(χ2 =5.79,P <0.05).After treatment,the intima -media thickness,plaque area and Crouse score of the high dose group were (0.92 ±0.41)mm,(0.52 ±0.56 )mm,(3.07 ±0.58 )mm,which of the middle dose group were (1.11 ± 0.52)mm,(0.60 ±0.36)mm,(3.39 ±0.83)mm,which of the low dose group were (1.42 ±0.87)mm,(0.81 ± 0.91)mm,(4.09 ±0.77)mm,which were decreased than before treatment[(1.71 ±0.89)mm,(0.86 ±0.55)mm, (4.39 ±0.19)mm,(1.74 ±1.03)mm,(0.89 ±0.48)mm,(4.42 ±0.53)mm and (1.68 ±0.96)mm,(0.87 ± 0.61)mm,(4.38 ±0.22)mm].The decrease of the high dose group was higher than the middle and low dose group, the difference was statistically significant (F =5.83,P <0.05 ).The effective rate of the high dose group was 78.41%.The effective rate of the middle dose group was 52.27%.The effective rate of the low dose group was 30.68%.The efficacy of the high dose group was better than the middle dose group and low dose group,the difference was statistically significant(χ2 =5.37,P <0.05).There were 10 cases (11.36%)had adverse reaction in the low dose group,12 cases (13.64%)in the middle dose group,14 cases (15.91%)in the high dose group.There was no statistically significant difference in incidence of adverse reactions among the three groups (P >0.05),and no serious adverse reaction was found.Conclusion The high dose rosuvastatin treatment can reverse the nature of plaque, decrease the thickness of the plaques and lower blood lipid of young ischemic stroke with hyperlipidemia and carotid atherosclerotic plaque,which is better than middle and low dose,and has better security.There is no serious adverse reaction.It is worth for clinical promotion.

The esophageal cancer mouse models have three categories:chemical carcinogenesis model,xenograft tumor model and genetic engineering model.Chemical carcinogenesis model can simulate well the pathological processes of human esophageal cancer and is prepared simply.Xenograft tumor model is currently the most commonly used esophageal cancer animal model,which has advantages of rapid tumor formation,higher tumor formation rate and lower cost.Genetic engineering model involves mainly p53,Cyclin D1,Brca1 and p120ctn,and it helps to understand the biological characteristics of tumors,but it is expensive and the preparation time is long.

Radiotherapy is one of the most important treatment method for esophageal cancer. Cene expression profile of cancer cells may be one of key factors in determining the effectiveness of radiation therapy To provide guidance for individual therapy, research advances in gene expression involved in radiosensitivity of esophageal cancer are discussed from three aspects: radiation damage repair, cell cycle distribution and signal traneduetion.

Hemispatial neglect often occurs after brain injury, especially the higher incidence after stroke. The studies on cognition, attention, and perception have greater significance. However, the related domestic studies at present are rare. Being themed by line bisection, this article reviews the influencing factors and relevant mechanisms, brain location, and extensional study in the assessment of hemispatial neglect.

[Objective]To discuss the diagnosis and surgical management of lumbar degenerative juxtafacet joint cysts. [Methods]From June 2004 to June 2007,seven patients were diagnosed as degenerative juxtafacet joint cysts and were treated by surgery. The authors made a retrospective analysis on the clinical data of these 7 patients. Among these 7 patients,there were one as ligamentum flavum cyst and six as facet joint cysts. Five lesions were located at the L4、5 level and two were located at the L5S1 level. According to the preoperative lateral films and CT scan,segment instability were found in two patients. Fenestration decompression,resection of cyst and 1/3 medial articular process were performed on five patient without preoperative segment instability,while additional posterior fixation and posterolateral fusion were done to two patients with preoperative segment instability.The mean length of follow up were 14 months (range: 9~24 months ). The VAS score and ODI score were used for clinical outcome assessment.[Results]The pathological results confirmed the preoperative radiological diagnosis in all patients. Improvement were found in all patients,including completely recovery in five patients and significant relief of pain in other two patients.[Conclusion]Lumbar degenerative juxtafacet joint cysts has been proved to be a cause of low back pain. Preoperative CT scan and MRI are helpful in the diagnosis and the clinical outcome of surgery is satisfactory.

Objective To explore the relationship between brain development and early behavior development of infant rats. Methods Infant Spraque - Dawley(SD) rats were used respectively for testing their spontaneous behaviors, inhibitory escaping response and behavior development, and also determine their brain weight and content of Zinc in different part of the brain at age of 1 day, 11 days and 21 days. Results There was a positive correlation between brain development and early behavior development of SD rat, and the high content of zinc in hippocampus and cerebellum. Conclusion It is suggested that the high content of Zinc guarantee furnish security for the late behavior development of infant rat.

To understand the continuing medical education status of Beijing Shijitan Hospital,so as to continue to reform and improve the teaching management of continuing medical education.,literature and information retrieval methods were used and relevant personnel was interviewed about the content,form,time and suggestions of continuing medical education.The results indicate the presence of training content is too wide,training methods are too simple,and there is lack of medical humanities quality training and other issues in continuing medical education.Variety of training methods should be increased,the quality of medical humanities education and training should be enhanced,featured training should be developed to make the continuing medical education more scientific,standardized and highly efficient.