Objective To investigate the correlation of alkal ine phosphatase(ALP) and isozymes with renal disease.Methods In 1997-03~2003-05 the activity of ALP was determined b y biochemical automatic analyzer in Heilongjiang Province Hospital.The activity of ALP isozymes were determined by polyacrylamide disc gel electrophoresis and s canning measurement.Results The samples from patients with renal disease were divid ed into glomerular injury group,renal tubular injury group and severe widespread damage group based on the pathological changes.The activity of ALPs in urine i n the glomerular injury group and renal tubular injury group were significantly different from those in the control group (P0.05).Conclusion Isozymes of ALP in urine can be a useful marker for different renal segments injury.

Objective To study the constituents from the berry of Panax ginseng. Methods Compounds were separated and purified by column chromatographic methods. Their structures were elucidated by physicochemical properties and spectral analyses. Results Twelve compounds were isolated from water extracts of the berry of P. ginseng. They were identified as benzoic acid (Ⅰ), isoginsenoside-Rh3 (Ⅱ), ginsenoside-Rh2 (Ⅲ), ginsenoside-Rh1 (Ⅳ), ginsenoside-Rg1 (Ⅴ), ginsenoside-Re (Ⅵ), ginsenoside-Rd (Ⅶ), ginsenoside-Rc (Ⅷ), ginsenoside-Rb2 (Ⅸ), ginsenoside-Rb1 (Ⅹ), ?-sitosterol (Ⅺ), and 20-O-?-D-glucopyranosyl-20 (S)-protopanaxadiol named as compound K (ⅩⅡ). Conclusion The compound K is a new natural product.

A new flavonoid glucoside was isolated from the aerial parts of Alhagi pseudoalhaki (M. B. )Desv.. Onthe basis of spectral data and chemical reaction,it was elucidated to be syringetin-3-O-?-D-glucoside- Moreover,fourteen known compounds have been isolated and identified as Psitosterol, stigmasterol,kaempferol,rhamnetin, ombuine, isorhamnetin, tamarixetin, kaempferol-3-O-?-D-(6″-O-p-coumaroyl )-glucoside, isoquercitrin, D-3-O-methylinositol, 1-O-?-D-methyl-glucoside, isoswertianolin, isorhamnetin-3-O-?-D-rutinoside,and tyramine. These compounds were isolated for the first time from the aerial parts of A. pseudoalhagl.

Objective struclured clinical examination (OSCE) is a kind of examination which could objectively evaluate the students′clinical skills.Nowadays,OSCE are wildly applied in medical educational field throughout the world.Timely discussion and analysis on the problems existed in the implementation process of OSCE is necessary.Measures should be taken to improve the OSCE examination and to meet the requirements of higher clinical practice training level such as increasing clinical skill simulation training hardware investment,optimizing settings and conlents of the examination and the test stations as well as introducing standardized patients (SP) and other measures.

In order to clarify the chemical composition of Tongmai Keli, a HPLC fingerprint was established, and the 22 peaks were characterized by LC-DAD-MS. The herbal sources of these peaks were assigned. The results implied that genistin 8-C-glucoside, puerarin, daidzein 8-C-apiosyl (1, 6)-O-glucoside, daidzin, and salvianolic acid B were the main constituents of in Tongmai Keli. Ten batches of Tongmai Keli produced by different pharmaceutical companies were analyzed. Although different batches contained similar compounds, the contents of major compounds were significantly different. The method established in this study could be used for the quality control of Tongmai Keli.

Objective To investigate the circadian and seasonal distribution of cardiovascular events (CVE) and the relationship between average monthly temperature and the incidence of CVE. Methods A total of 5837 emergency patients with CVE were enrolled from 1997 to 2007. The exact admission time of each patient was registered. The average monthly temperature data from a regional weather station for this time period was supplied by the meteorological office of the city. The relationship between the average monthly temperature and the incidence of CVE was explored and the corresponding curves were plotted. Results The occurrence of CVE has obvious seasonal variation, and its a higher tendency of episodes was found in spring and winter periods. High incidence of acute myocardial infarction, angina pectoris, acute left-sided heart failure, hypertensive crisis, and sudden death occurred in spring and winter as wee as the time for a change of season, that is, January, February, March, April, October, November, and December. There was a significant negative correlation between the incidence and the average monthly temperature (P<0.005-0.001). Circadian rhythm of CVE was present, with a peak in the early morning and forenoon. Conclusion There are circadian and circannian rhythms of the incidence of CVE. Cold weather condition is a risk factor for the occurrence of CVE, which usually peaks in the early morning and forenoon.

Tong-Mai(TM) granules were composed ofRadix Salviae Miltiorrhizae(Danshen),Rhizoma Chuanxiong(Chuanxiong) andRadix Puerariae(Gegen). It had the effect of activating blood circulation. It had been used to treat ischemic cardio-cerebrovascular diseases in the clinical practice. This research combined serum pharmacochemistry and serum pharmaocology to study the material basis of active components in TM granules. After single or multiple intragastric administrations of TM granules, serum blood samples of rats were collected at different time points. LC-MS/MS method was developed to analyze chemical components of TM in blood serum samples. The cardiomyocyte hypoxia / reoxygenation (H/R) model was used in the evaluation of cardiomyocyte protection by TM. The correlation analysis was also conducted between serum concentration of TM and cardiomyocyte activity. The results showed that 8 components of pueraria flavonoid, 5 components of salvianolic acids and 2 components fromGegen were promptly absorbed and reached their highest concentrations at 5 or 30 min after administration. After 3 times of medication, the serum concentration was obviously higher compared to single medication. The drug-serum of TM showed significant protective effect on the cardiomyocyte H/R injury with dose-effect relationship. Daidzein, lithospermic acid, salvianolic acid A, salvianic acid A and rosmarinic acid presented as the most correlated components linked to the effect of activating blood circulation by TM. The serum pharmacochemistry / serum pharmacology related studies provided references for the verification of material basis of active components in compound Chinese medicine.

PBL (Problem-based learning) is a kind of teaching method, which is helpful for guiding students to solve practical and complex problems. The compiling of PBL teaching plans is the key to the implementation of PBL teaching. According to the teaching outline of internal medicine, we set the PBL teaching plan, formulated the teaching goal, collected the clinical real cases, finished the compiling of PBL cases of student version and teacher version, and preceded teaching practice accord-ing to the PBL cases. Improving and constructing the compiling framework of internal medicine PBL teaching plan laid the theoretical foundation for carrying out internal medicine PBL teaching.

Objective To evaluate the role of hypoxia inducible factor?1α ( HIF?1α) in reduction of apoptosis in cortical neurons of rats by sevoflurane preconditioning and the relationship with Slit2∕Robo signaling pathway. Methods Primary cortical neurons obtained from neonatal Sprague?Dawley rats were seeded in 6?well (2 ml∕well) or 96?well plates (100 μl∕well) at a density of 1×106∕ml, and randomly divided into 4 groups ( n=24 each ) using a random number table: control group ( C group ) , anoxia?reoxygenation ( A∕R ) group, sevoflurane preconditioning group ( SP group ) and HIF?1α inhibitor 2?methoxyestradiol group ( H group ) . The neurons were subjected to O2?glucose deprivation for 90 min followed by restoration of O2?glucose supply for 24 h. In group SP, the neurons were exposed to 2%sevoflurane for 2 h followed by 5 min washout with phosphate buffered saline for 3 times, and then sevoflurane preconditioning was performed immediately. In group H, sevoflurane preconditioning was performed with 5μmol∕L 2?methoxyestradiol at 72 h of incubation. The apoptosis in neurons was assessed using AnnexinⅤ?FITC∕PI assay, and apoptosis rate ( AR) was calculated. The amount of lactic dehydrogenase ( LDH) released was measured using colorimetric method. The expression of Slit2, Robo1 and Robo4 mRNA and protein was detected by fluorescent quantitative real?time polymerase chain reaction or Western blot. Results Compared with group C, the amount of LDH released and AR were significantly increased, Silt2 and Robo1 mRNA and protein expression was up?regulated, and no significant change was found in Robo4 mRNA and protein expression in A∕R group. Compared with group A∕R, the amount of LDH released and AR were significantly decreased in SP and H groups, and Silt2 and Robo1 mRNA and protein expression was up?regulated, and no significant change was found in Robo4 mRNA and protein expression in SP group. Compared with group SP, the amount of LDH released and AR were significantly increased, and Silt2 and Robo1 mRNA and protein expression was down?regulated in H group. Conclusion HIF?1α mediates reduction of apoptosis in cortical neurons of rats by sevoflurane preconditioning, and the mechanism is associated with Slit2∕Robo1 signaling pathway, but not with Slit2∕Robo4 signaling pathway.

Objective To investigate the clinical application effects of gabapentin in the treatment of recurrent trigeminal neuralgia.Methods 68 patients with recurrent trigeminal neuralgia were chosen as study subjects,and they were divided into control group and research group according to the digital table.The research group was treated with gabapentin,the control group was treated with carbamazepine.After treatment for 4 weeks,the clinical effects,life satisfactory index,pain,drug dosage and adverse reaction between the two group were compared.Results Each group had 32 patients completed the study.The total effective rate of the research group was higher than that of the control group(68.75％ vs.59.37％),the difference was not statistically significant(x2 =0.611,P ＜0.05).The average gabapentin dosage in the research group was higher than the average carbamazepine dosage in the control group,the difference was statistically significant (t =11.278,P ＜ 0.05).Before treatment,the VAS scores between the two groups had no statistically significant difference (t =0.153,P ＞ 0.05).At 7 d after treatment,the VAS scores in the research group was lower than that in the control group [(4.09 ± 0.83) points vs.(4.63 ± 0.79) points],the difference was statistically significant (t =2.666,P ＜ 0.05).At 14 d and 28 d after treatment,the VAS scores between the two groups had no statistically significant difference (t =1.527,0.352,all P ＞ 0.05).Before treatment and 7 d after treatment,the life satisfaction index B (LSI-B) scores between the two groups had no statistically significant difference(t =0.049,0.224,all P ＞ 0.05).At 14 d and 28 d after treatment,LSI-B scores in the two groups were both increased,which in the research group was higher than taht in the control group[14 d:(15.09 ± 3.68) points vs.(12.91 ± 3.45) points,28 d:(16.48 ± 3.43) points vs.(13.35 ± 3.14) points],the differences were statistically different(t =2.445,3.808,all P ＜ 0.05).The incidence rate of adverse reaction of the research group was lower than that of the control group(15.63％ vs.37.50％),the difference was statistically significant (x2 =3.925,P ＜ 0.05).Conclusion Gabapentin has similar treatment effects in recurrent trigeminal neuralgia as carbamazepin,and gabapentin has better improvement in patients'life quality,and with better safety.