Objective: To investigate whether antipsychotic agent-induced type 2 diabetes was associated with leptin gene -2548G/A functional polymorphism in schizophrenia patients who had treated by antipsychotics chronically. Methods: Fasting plasma glucose, 2-hour post meal plasma glucose, fasting plasma leptin and fasting plasma insulin were measured in 110 patients with chronic schizophrenia whose natural courses of the disorder were more than 5 years. According to the level of plasma glucose, these patients were divided into three groups, diabetes mellitus group, abnormal regulating glucose group and normal glucose group. The polymorphisms in the leptin promoter region (-2548 G/A) were determined with PCR-RFLP in the patients. Results: The patients in DM group were more likely to be homozygous for the -2548AA genotype. As compared with the patients with -2548AG/GG combined genotype, the patients with -2548AA genotype had significant increase in the level of plasma leptin(P=0.019). Conclusion: The -2548G/A polymorphism in promoter region of leptin gene may be associated with type 2 diabetes in schizophrenic patients treated by antipsychotics chronically. -2548A allele of leptin gene may be a genetic risk factor for the development of type 2 diabetes during antipsychotic treatment.

A child case of acute myocardial ischemia induced by symptomatic myocardial bridge (SMB)was reported and relevant literatures were reviewed in this article.The case and literatures indicate that myocardial bridge is a rare congenital coronary artery anomaly in children.The pathogenesis may be related to stenosis,spasm,arteriosclerosis of coronary artery because of myocardial bridge compression during systole.Clinical manifestations include chest pain,malignant arrhythmia,syncope,cardiac arrest and myocardial infarction.The diagnosis of myocardial bridge is based on cardiac imaging.SMB patients should be first treated with β-adrenergic; if ineffective,surgical treatment or implantable automated cardiac defibrillator shonld be chosen.The patients complicated with hypertrophic cardiomyopathy have worse conditions with high mortality.

BACKGROUND: Breast augmentation with polyacrylamide hydrogel injection has been used nearly for a decade in some Chinese medical therapy units. More patients need to be removing injections or a second augmentation due to complications. More attention should be paid for possibility of complications concomitant with breast malignant tumor. OBJECTIVE: Two cases of breast invasive duct carcinoma diagnosed after removing injection were analyzed retrospectively in order to increase the importance of detection rate of breast malignant tumor. METHODS: Two cases in all 41 assembled patients which were removed polyacrylamide hydrogel injections from 82 breasts were diagnosed with invasive carcinoma. The characteristics of medical history, physical diagnosis, image diagnosis and pathological examination were analyzed retrospectively. RESULTS AND CONCLUSION: The detection rate of breast malignant tumor should arise more attention in patients requiring removal of polyacrylamide hydrogel injection. The following aspects should be emphasized such as the comprehensive analysis for the results of physical diagnosis and image diagnosis, tumor-free operation with more samples from suspicious nodules and frozen pathological examination. The principles of cancer surgery should be followed in pathological diagnosed cases in case of iatrogenic metastasis and spread of breast malignant tumor.

Objective Glucose metabolism trend was dynamicly mornitored following liver transplantation, and its affecting factors were assessed. Methods The glucose metabolism status were assessed at four time points respectively after liver transplants, then they were divided into two groups:normal glucose metabolism (NGM) and abnormal glucose metabolism (AGM). The clinical data were univariate analyzed and multivariate analyzed to screen the risk factors. Results At 1 month, 3 months, 1 year and 3 years post-transplantation, the incidence of AGM were 74.0%, 43.9%, 29.4%, 24.1% respectively Between these two groups, age > 45 y had a significant difference at 1 month, 3 months, 1 year and 3years post-transplantation; the use of tacrolimus had a significant difference at 3 months, 1 year and 3years post-transplantation, but the dose of tacrolimus or tacrolimus blood concentration showed no significant difference; high dose of glucocorticoid had significant difference at 1 month , 3 months post-transplantation; high BMI and acute rejection had significant difference at 1 month post-transplantation. Conclusions There is a high incidence of abnormal glucose metabolism (AGM) in the early stage post-transplantation, and a considerable number of patients' glucose metabolism improved in the later period. Age>45 y and tacrolimus affect glucose metabolism for a longer period post-transplants. High BMI and acute rejection have an impact on glucose metabolism only in the early stage post-transplantation. Large dose of glucocorticoid affect glucose metabolism for at least 3 months post-transplantation , and there is no significant difference after 1 year.

Objective Toobservetheeffectofperioperativeuseoflowmolecularheparin(LMH)forpreventinglowerlimbdeep vein thrombosis(DVT ) in elderly hip peripheral fracture .Methods 105 cases of elderly hip peripheral fracture from July 2007 to July 2011 were divided into the LMH group(65 cases) and the conventional treatment group(40 cases) .The two groups were per-formed the physical therapy for preventing lower limb DVT .The LM H group was added with LM H for preventing DVT .The sta-tuses of DVT occurrence and the coagulation related indicators were compared between the two groups .Results In the LM H group ,the thrombus events happened in 4 cases ,accounting for 6 .15% .In the conventional treatment group ,thrombosis occurred in 13 cases ,accounting for 32 .5% .The difference between the two groups had statistical significance (P<0 .05) .Hemoglobin on post-operative 1 ,10 d was obviously improved ,the difference had statistical significance(P<0 .05) .Conclusion Using LMH has rela-tively ideal effect for preventing lower limb DVT in elderly hip peripheral fracture .

Objective To understand the status quo of stressors and mental health of undergradu-ates of local medical colleges in internship and provide relevant countermeasures so as to provide scientific reference for psychological health counseling for them. Methods The stress source scale and mental health symptom self-rating scale for medical students in internship (SCL-90) coded by Chang Lirong et al was adopted to investigate. The questionnaire survey was conducted on the stress and mental health status of 390 interns in Binzhou Medical College, and 384 valid questionnaires were collected, with the effective rate of recovery as 98.46%. The questionnaire results were analyzed by sample t test, variance analysis and Pearson correlation analysis. Results A total of 24.1% of students in local medical schools were under moderate pressure (1.17±0.63). The highest pressure source was examination and employment (1.58±0.74), and the other followed were knowledge and skills (1.43 ±0.68), interpersonal relationships (1.11 ±0.54), patients (1.06±0.53), medical conditions (1.00±0.53) and work load (0.95±0.52) respectively. The scores of various stressors were significantly and positively correlated with most of the mental health factors. Conclusion The undergraduates of local medical colleges and universities are generally under stress in internship, which would affect their mental health. It is suggested that the interns should be guided from the aspects of employment, study and psychology so as to help them relieve their stress and develop good psychological qualities.

Objective To explore the clinical application and value of percutaneous treatment of pancreatic pseudocysts guided by CT.Methods The percutaneous external draining of pancreatic pseudocyst caused by various causes was performed under CT guidance in 29 cases, including 21 males and 8 females, age from 22 to 71 years, average (48.2?13.6) years. After the point, the angle,and the depth of puncture were measured on CT images, pseudocyst puncture and catheterization of external draining were made and followed up. Results 30 procedures of puncture in 29 lesions were done, the successful rate was 100%. Puncture path included frontal in 17 cases(18 times of puncture), lateral in 8 cases ; back in 4 cases, and 30 drainage catheters were placed. All cases were followed up except one case, follow up time ranged from 1 to 20 months [average (8 07?4 04) months]. Following disappearance of pseudocyst, catheters were extracted in 19 cases except 2 cases with pseudocyst recurrance. Follow up time from 4 to 14 months[average (8.29?4.03) months]. 5 cases had surgerical operations again after draining 1-4 months, 4 cases were still being followed up. The effective rate of therapy was 65.52%(19/29). Conclusion The technique of percutaneous catheter external draining of pancreatic pseudocyst guided by CT is mildly invasive and simple, and has high successful rate.

OBJECTIVETo investigate the epileptic seizure-like effect of Sophora alkaloid sophoridine on electroencepholography (EEG) and its possible characteristic and the mechanism of the seizure-like effect.

METHODChronic electron implantation was employed for the intracranial electroencepholography (IEEG) recording in rat, and the traditional anti-seizure drugs were for the mechanism study in mice.

RESULTCompared with the medial perforant path (PP) area and the temporal cortex (TC), the granule cells in hippocampus dentate gyrus (DG) area is more sensitive in the kindling effect by sc sophoridine. Under-threshold hypnotic dosage of diazepam and the hypnotic dosage of pentobarbital sodium can block the sophoridine kinded seizure in mice, but the phenytoin sodium can not block the seizure, also the dosage of it can block the maximal electroconvulsive shock (MES) seizure.

CONCLUSIONSophoridine-induced synchronous oscillations in the hippocampus could elicit the generation and development of seizure. And the hippocampus might play the crucial role and be the original part of the seizure. Sophoridine kinded seizure might belong to clonic seizures, and the diazepam is the ideal agent for the treatment.

Alkaloids ; chemistry ; pharmacology ; Animals ; Epilepsy ; chemically induced ; metabolism ; Hippocampus ; drug effects ; metabolism ; Male ; Mice ; Quinolizines ; chemistry ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sophora ; chemistry

Objective Using middle cerebral artery occlusion (MCAO) model to observe protective effect of effective components of bezoar on brain damage.To discuss the anti-cerebral ischemia mechanism and compare the efficacy of effective components of bezoar from the endoplasmic reticulum stress intervention angle.Methods Rats were stratified randomly divided into sham group,model group,Qingkailing group (positive drug,3 mL/kg),taurine group,ursodeoxycholic acid (UDCA,78 mg/kg) group,taurine-conjugated ursodeoxycholic acid (TUDCA,100 mg/kg) group.Through establish MCAO model in rats,observed the scores of the neurologic impairment,measured infarct volume by TTC.Immunohistochemistry and Western blotting were Used to detect the content of P-PERK,P-EIF2α,and ATF4.Results Compared with sham group,neurologic impairment scores of model group significantly reduced (P ＜ 0.01).Compared with model group,Qingkailing group,UDCA group,and TUDCA group significantly improved neurological function in rats (P ＜ 0.05,0.01).Compared model group,all the treatment groups could significantly reduce the volume of cerebral infarction (P ＜ 0.01).Compared with sham group,expression of P-PERK,P-EIF2α,and ATF4 was significantly increased (P ＜ 0.01).Compared with model group,all the treatment groups reduced the expression of P-PERK,P-EIF2α,and ATF4 in varying degrees,effect of Qingkailing and TUDCA were more obvious.Conclusion The effective components ofbezoar alleviate cerebral ischemia reperfusion injury in rats by inhibiting endoplasmic reticulum stress,the effect of TUDCA is better than that of taurine and UDCA.

Objective To analyze the relationships of high mobility group box 1 protein (HMGB1) with regulatory T cells (Treg), T helper 17 cells (Th17) and cytokine secrtion in peripheral blood of gravidas with preeclampsia(PE),and to investigate the mechanism of HMGB1 in regulating Th17/Treg ratio via receptor for advanced glycation end products (RAGE)-IL-6 pathway. Methods Forty gravi-das with mild(20 cases) and severe(20 cases) PE were recruited as experimental groups,20 heathy gravi-das in the third trimester of pregnancy were enrolled as control group. Concentrations of HMGB1,IL-6,IL-17 and TGF-β in peripheral blood of all subjects were determined by enzyme-linked immunosorbent assay (ELISA). Real-time quantitative PCR(RT-PCR) was used to detect the expression of RAGE at mRNA lev-el in peripheral blood mononuclear cells(PBMCs). The percentages of Treg and Th17 cells were determined by flow cytometry. RT-PCR was performed to analyze changes in the expression of RAGE,IL-6,Foxp3 and RORγt at mRNA level after the PBMCs isolated from 20 garvidas with PE were cultured in vitro and stimula-ted with recombinant human HMGB1 (rhHMGB1). Results The levels of HMGB1,IL-6,Th17 and IL-17 in peripheral blood of gravidas with PE were significantly higher than those in the normal pregnancy group. Moreover,HMGB1 level was positively correlated with IL-6 level and ratios of Th17/Treg and IL-17/TGF-β in preeclamptic pregancies. In vitro stimulation of PBMCs with rhHMGB1 significantly enhanced the expres-sion of RAGE,IL-6 and RORγt at mRNA level, but suppressed the expression of Foxp3 at mRNA level. Conclusion Enriched HMGB1 in plasma shifts the Th17/Treg balance towards Th17 dominance via the RAGE-IL-6 pathway, which exacerbates inflammation and participates in the onset of preeclampsia during pregnancy.