Objective To investigate the causes,diagnosis and treatment of small intestinal bleeding.Methods The clinical datas of 34 cases of small intestinal bleeding confirmed by surgery and pathology were analyzed retrospectively.Results Tumor was the first cause of small intestinal bleeding(13/34),there was no significant difference between the number of benign and malignant tumor,other causes were inflammatory small intestinal diseases(9/34),small intestinal diverticulum(7/34),angiodysplasia(4/34) and heterotopic pancreas(1/34).There were 11,3 and 2 cases who were diagnosed by double contrast barium meal,angiography and radionucleide scanning respectively,18 cases were diagnosed by exploratory laparotomy.Most patients were treated by intestinal segmentectomy.Conclusion Neoplasia is the most common cause of small intestinal bleeding,other causes are inflammatory small intestinal diseases,small intestinal diverticulum andangiodysplasia.Acombination of double contrast barium meal,angiography,radionucleide scanning,exploratory laparotomy and/or enteroscopy are helpful to diagnose small intestinal bleeding.Medical or endoscopic thyrapy is the first choice for treating small intestinal bleeding,surgical procedure,mainly intestinal segmentectomy,is the second choice.

Anti-tyrosinase assay guided isolation of marine-derived fungus Botrytis sp.led to separation of three ?-pyrone compounds.The structures of these compounds were elucidated by various physicochemical analytical methods.The bioactivities of these ?-pyrone derivatives were evaluated in terms of anti-tyrosinase activity.By correlating the bioactivities of these compounds with their structures,it concluded that the ?-pyrone with pentyl group gives highest anti-tyrosinase activity.

AIM: The role of external-signal regulated kinaseⅠ/Ⅱ(ERKⅠ/Ⅱ) in the induction and maintenance of spinal long-term potentiation(LTP) is evaluated.METHODS: The C-fiber evoked field potentials were recorded at the superficial layers of spinal dorsal horn at the lumbar enlargement.RESULTS:(1) PD98059(100 ?mol/L) or SL327(200(?mol/L)),a selective MEK inhibitor,completely blocked LTP induction when applied at 30 min prior to tetanic stimulation.(2) PD98059 or SL327 reversed spinal LTP in a time-dependent manner.At 15 min after LTP induction,PD98059(100 ?mol/L) or SL327(200 ?mol/L) reversed LTP completely,and at 30 min after LTP induction,the inhibitory rate of spinal LTP inhibited by PD98059 or SL327 was 62.5% and 75.0%, respectively.At 1 h after LTP induction,however,the same concentration of PD98059 or SL327 did not affect the spinal LTP.CONCLUSION: Activation of ERKⅠ/Ⅱ in spinal dorsal horn may be crucial for the induction and the early-phase maintenance of LTP of C-fiber evoked field potentials.

In hippocampus, numerous studies have shown that N-methyl-D-aspartate (NMDA) receptors are essential for the initiation of long-term potentiation (LTP), whereas the expression of LTP is primarily mediated by the phosphorylation of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors and the increased insertion of postsynaptic AMPA receptors. However, in recent years there is also evidence that NMDA receptor channels contribute to the expression of LTP under physiological conditions. It was examined whether NMDA receptor channels contributed to the expression of LTP of C-fiber evoked field potentials in rat spinal dorsal horn by intravenous or spinal application of NMDA receptor antagonists after the establishment of LTP. It was found that MK 801 (a non-competitive NMDA receptor antagonist) at dose of 0.1 mg/kg (iv) had no effect on the spinal LTP and at the dose of 0.5 mg/kg depressed the LTP significantly. However, the inhibitory effect of MK 801 at higher dose (1.0 mg/kg)was not different from that produced by the dose of 0.5 mg/kg. The similar inhibitory effect on spinal LTP was also observed, when MK 801 was applied locally at the recording segments of spinal cord. To confirm the above results, a competitive NMDA receptor antagonist AP V was tested. Spinal application of AP V at a concentration of 100 μmol/L produced a stronger depression than at 50 μmol/L. When the concentration of AP V increased to 200 μmol/L, no further depression was observed. These results indicate that NMDA receptor channels are involved in the expression of LTP of C-fiber evoked field potentials in the rat spinal dorsal horn.

Objective To investigate the current prevalence of depressive disorder and the associated factors in pa?tients with essential hypertensive from cardiovascular divisions of tertiary general hospitals. Methods A Chinese version of Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) Axis I Disor?ders was conducted by five mental health professionals on 876 essential hypertensive outpatients at cardiovascular divi?sions of tertiary general hospital. Data on the socio-demographic and clinical characteristics of these hypertensive pa?tients were also collected. Results The current prevalence of depressive disorders among essential hypertensive outpa?tients of tertiary hospitals was 16.6%(145/876). Risk factors for depressive disorders in hypertensive patients included fe?male gender (OR=2.817, 95%CI:1.161~6.885), being 65-year-old and older (OR=1.747, 95%CI:1.118~2.688), non-marital status (OR=2.023, 95%CI:1.203~3.398), gradeⅢhypertension (OR=1.776, 95%CI:1.226~2.333) and car?diovascular diseases (OR=2.018, 95%CI:1.427~2.587). Conclusion Essential hypertensive outpatients, who receive med?ical services at cardiovascular divisions of tertiary general hospital, have high prevalence of depressive disorders. Clini?cians should pay more attention to the mental health of outpatients with essential hypertension.

Objective To explore the forensic identification points of deaths caused by secondary dam-ages of road traffic accidents. Methods Seventeen deaths caused by secondary dam ages of road traffic accidents were collected. Through scene investigation and necropsy, the basic inform ation of the acci-dents, distribution and property of the injuries, and other inform ation were collected. A ccording to the collected data, the scene was reconstructed in order to confirm the injury process, analyze the way, mechanism and severity of injury, distinguish antem ortem injury from postm ortem injury, and determ ine the cause of deaths. Results C ertain features such as serious injuries, multiple traum as, com bined in-juries, co-existence of antem ortem and postm ortem injuries, multiple causes of wounds, com plex injury mechanism , as well as the mutual dam aging and overlapping injuries were quite characteristically noted in these secondary traffic accident cases. Conclusion Forensic assessment of deaths caused by secondary dam ages of road traffic accidents should be synthetically analyzed and judged through scene investigation and necropsy.

AIM: The role of cyclic adenosine monophosphate (cAMP)-dependent protein kinase (PKA) in the induction and maintenance of spinal long-term potentiation (LTP) was evaluated. METHODS: The C-fiber evoked field potentials were recorded at the superficial layers of spinal dorsal horn at the lumbar enlargement. RESULTS: (1) 8-Br-cAMP induced LTP of C-fiber evoked field potentials and 8-Br-cAMP-induced LTP occludes tetanus-induced LTP. (2) Rp-CPT-cAMPS, an inhibitor of PKA, blocked the induction of spinal LTP and reversed established LTP of C-fiber evoked field potentials in a time-dependent manner. (3) In the presence of anisomycin, a protein synthesis inhibitor, the potentiation induced by 8-Br-cAMP was completely blocked. (4) PD98059, a selective inhibitor of mitogen-activated protein kinase (MAPK),completely blocked the 8-Br-cAMP-induced LTP.CONCLUSION: Activation of PKA signal pathway in spinal dorsal horn may be crucial for the induction and the early-phase maintenance of LTP of C-fiber evoked field potentials.

Objective To investigate the prevalence and risk factors of needle-sharing behavior among intravenous drug users (IDUs).Methods Data regarding socio-demographics,drug abuse characteristics and HIV related health literacy of 474 heroin IDUs were collected.Antisocial personality disorder of IDUs was diagnosed through Mini international neuropsychiatric interview.Results The prevalence of needle sharing among IDUs was 53.8％.Needle-sharing behavior of IDUs was significantly associated with male gender,marital status of being single and separated/divorced,local dwelling,an early age of first drug abuse and antisocial personality disorder (OR =1.11 ～ 6.69,P＜0.05).Conclusion Heroin IDUs have high prevalence of needle sharing.A comprehensive social,behavior and psychology based intervention is needed to effectively prevent HIV infection in IDUs.

AIM: The role of protein kinase C (PKC) in th e induction and maintenance of spinal long-term potentiation (LTP) was evaluated . METHODS: The C-fiber evoked field potentials were recorded at t he superficial layers of spinal dorsal horn at the lumbar enlargement. RESULTS: (i) Chelerythrine (200 ?mol/L) or G 6983 (100 ? mol/L), a selective PKC inhibitor, completely blocked LTP induction. (ii) Chel eryt hrine or G 6983 reversed spinal LTP in a time-dependent manner. 15 min after L TP induction, chelerythrine (200 ?mol/L) and G 6983 (100 ?mol/L) depre ssed LTP to baseline in all tested rats. The same concentration of chelerythrine and G 6983, applied at 3 h after LTP induction, did not affect LTP. CONCLUSION: PKC in spinal dorsal horn may be crucial for the ind uction and the early-phase maintenance of LTP of C-fiber evoked field potentials .

Objective Mizoribine ( MZR) is a new immunosuppressant , however , little domestic research has been done on MZR for treatment of nephrotic syndrome in children .This study was to investigate curative effect and adverse reaction of MZR in the treatment of children with frequently relapsing nephrotic syndrome , using prospective controlled trials . Methods A total of 59 pa-tients with frequency relapsing nephrotic syndrome were randomly divided into two groups .29 patients of treatment group were treated with MZR +glucocorticoid , while 30 patients of control group were given Tripterygium wilfordii ( TW)+glucocorticoid treatment , and the course of treatment lasted for 12 months.24-hour urine protein, urinary N-acetyl β-glucosidase (NAG), serum albumin, serum cholesterol, serum creatinine, recurrence frequency, and average prednisone dosage were observed . Results At the end of treat-ment, Serum albumin in treatment group was higher than that in control group [(40.95 ±6.12)g/L vs (30.25 ±9.02)g/L], and Se-rum cholesterol ([5.45 ±0.82]mmol/L vs [7.53 ±2.74]mmol/L), urinary protein ([0.89 ±0.52]g/24 h vs [1.63 ±2.02]g/24 h), urinary NAG enzyme ([21.43 ±14.16]U/g· Cr vs [41.67 ±12.35]U/g· Cr) levels were lower compared with control group . There was significant difference between the two groups .In terms of mean recurrence times , no significant difference was found at 6th months of follow-up between the two groups, however, treatment group had lower recurrence rate than control group at 3rd month, 9th month, 12th month of follow-up, which was of significant difference .The average amounts of hormone of treatment group were lower than those of control group ([0.56 ±0.16] mg/kg· d vs [0.72 ± 0.34]mg/kg· d)、([0.64 ±0.35]mg/kg· d vs [0.67 ±0.52]mg/kg· d)、([0.53 ±0.41] mg/kg· d vs [0.83 ±0.37] mg/kg· d)、([0.34 ±0.15] mg/kg· d vs [0.54 ±0.26] mg/kg· d) at 3rd month, 6th month, 9th month, 12th month of follow-up, which was of significant difference . Conclusion Compared to Tripterygium wil-fordii combined with hormone therapy , MZR combined with prednisone therapy in children with recurrent NS frequency can reduce the relapse rate and dosage of corticosteroid to improve the clinical remission rate .