Objective To evaluate the cardiac function changing before and after resection of pituitary tumor in patients with pituitary adenoma complicated with dilated cardiomyopathy with retrospective analysis method.Methods The clinical data of 14 cases of patients with pituitary adenoma complicated with dilated cardiomyopathy,treated with resection of pituitary tumor,in PLA General Hospital,from 2005 to 2011,were collected and analyzed.Comparative analysis of cardiac function were made in these patients before and after the surgery,also with the postoperative recovery status,using echocardiography and other noninvasive detection means to detect the growth hormone ( GH),left ventricular end-diastolic diameter (LVEDD),septal thickness (ST),left ventricular posterior wall thickness (LVPWT),left ventricular ejection fraction (LVEF) values.Results After the resection of pituitary tumor,the LVEDD,ST,LVPWT,LVEF levels were all significantly better than that before the surgery.Before the surgery the GH,ST,LVPWT,LVEF levels were 93.89 μg/L,11.13 mm,43.92％ and 10.53 mm,while those after the surgery were 5.16 μg/L,10.64 mm,49.28％ and 8.87 mm.The difference of the GH level before and after the surgery was correlated with the difference of ST,LVEDD and LVEF in a linear manner.Conclusions Recection of pituitary tumor can significantly improve the cardiac function in patients with pituitary adenoma complicated with dilated cardiomyopathy,and the cardiac function improving level is correlated with the difference of GH levels before and after the surgery.

Objective:Our purpose was to establish an ideal chronic pressure-afterload heart failure rat model which has the transition from cardiac hypertrophy to heart failure. Methods: Chronic pressure-afterload heart failure rat model was induced by gradually constricting the ascending aorta of young rats. Young rats were randomly divided into 2 groups: the constricted and sham-operated groups. Clinical manifestation, tail-cuff blood pressure, organ weight, and hemodynamic data were observed at various time after operation. Results: The overall survival rate was 87%. Tail-cuff pressure began to increase in 4 weeks after operation. Left ventricular hypertrophy appeared in 12 weeks and heart failure in 5 months. Conclusion:It's a practical and reproducible model of cardiac hypertrophy that progresses to chronic heart failure.

Objective To investigate the value of high-frequency ultrasound in diagnosis of thyroid carcinoma by comparative analysis of high-frequency ultrasound and spiral CT imaging results. Methods The imaging results of patients with thyroid carcinoma proved by postoperative pathology or biopsy results were reviewed.High-frequency ultrasound and spiral CT were used to examine the 35 patients in The Tumor Hospital of Harbin Medical University between 2007 and 2009. Results Diagnosis of thyroid carcinoma by application of Highfrequency ultrasound were 27 cases, diagnosis rate was 77.1%(27/35);by spiral CT were 25 cases, diagnosis rate was 71.4% (25/35);comparison of the two methods showed no significant difference (x2= 0.3, P ＞ 0.05). Combined application of high-frequency ultrasound and spiral CT diagnosed 33 patients with thyroid carcinoma, diagnosis rate was 94.3%(33/35), which was significantly higher than that of high-frequency ultrasound alone or that of spiral CT alone(compared with high-frequency ultrasound, x2 = 4.2, P ＜ 0.05;and spiral CT, x2 = 6.4, P ＜ 0.05). Conclusion Combined application of high-frequency ultrasound and spiral CT can improve the diagnosis rate of thyroid carcinoma.

The regulative role of extracellular signal-regulated kinase(ERK)signaling pathway on proliferation and apoptosis in rats' airway smooth muscle cells(ASMCs)was investigated.Primary cultures of ASMCs were established and cells between passages 4 and 7 were used for experiments.ASMCs were U-eated with ERK activator epidermal growth factor(EGF)and inhibitor PD98059.The expressions of ERK mRNA and protein were detected by RT-PCR and immunofluorescence staining.Proliferation of ASMCs were detected by MTT eolorimetric assay and [3H] thymidine incorporation.Apoptosis of ASMCs were detected by Hoechst staining and Annexin-V FITC PI donble staining.The levels of ERK1/2,phosphorylated forms of ERK1/2(p-ERK1/2) and proeaspase-3 protein were detected by Western blotting.The expressions of ERK mRNA and ERK protein were obviously observed in ASMCs. Compared with control,the absorbanee(A490) value and DNA synthesis index of PD-treated ASMCs were significantly decreased(P＜0.05).The apoptotic index and the percentage of the early apoptotic cells were significantly increased(P＜0.05).The expressions of ERK1/2 and pERK1/2 protein were significantly down-regulated.The expressions of procaspase-3 protein was significantly increased.Compared with c,ontrol,the A490 value and DNA synthesis index were significantly increased(P＜0.05)in EGF-treated cells.Apoptotic index and the percentage of the early apoptotic cells were significantly decreased(P＜0.05).The levels of ERK1/2 and pERK1/2 protein were significantly increased,and the levels of procaspase-3 protein were significantly decreased, There were no significant differences between control and P+E group(P＞0.05).ERK signaling pathway may play an important role in regulating ASMCs proliferation and apoptosis and ERK regulating the apoptosis of ASMCs possibly relates to the expressions of procaspase-3 protein. The finding will help to understand the mechanisms of asthmatic ASMCs involved in abnormal proliferation.

Objective To evaluate the effect of dexmedetomidine on noise-induced hearing loss in guinea pigs.Methods Twenty-four adult male guinea pigs,aged 3 months,weighing 400-500 g,were randomly divided into 3 groups (n =8 each) using a random number table:dexmedetomdine group (group D),noise-induced hearing loss group (group N) and dexmedetomidine + noise-induced hearing loss group (group DN).A loading dose of dexmedetomidine 5 μg/kg was infused over 5 min,followed by 135 min of infusion at a rate of 10 μg· kg-1 · h-1.The equal volume of normal saline was infused in group N.Groups N and DN were exposed to noise of 4 kHz center frequency and 118-122 dB SPL for 120 min starting from 20 min of administration.Mean arterial pressure (MAP) and cochlear blood flow (COBF) were recorded before administration and every 5 min during drug administration.The changing rate of COBF was calculated.Arterial blood samples were collected for determination of plasma concentration of noradrenaline (NE) by high performance liquid chromatography at 20 and 140 min of administration.Auditory brainstem response (ABR) threshold was recorded before administration and at 1 and 72 h and 10 days after the end of administration.Results Compared with group N,MAP was significantly decreased,the changing rate of COBF was increased at 5-10 min and 30-140 min of administration,ABR threshold was decreased at 1 and 72 h and 10 days after the end of administration,and the plasma concentration of NE was decreased at 140 min of administration in D + N group (P ＜ 0.05).Conclusion Dexmedetomidine can attenuate noise-induced hearing loss in guinea pigs possibly through inhibiting activation of sympathetic nerves and increasing COBF.

The vital force of Chinese medicine is rooted in the excellent clinical efficacy,however,the good efficacy,is inseparable from a profound theoretical basis,noble medical ethics,and superb medical skills;Based on these aspects,the characteristics of clinical thinking of the medical master Professor WANG Mian-zhi was analyzed preliminary.The master developed a unique clinical thinking style by integrating the ethics,principles of Chinese medicine and clinical skills,which was based on deep morality and rigorous scholarship.Professor Wang's unique style can be summed up as emphasis on syndrome differentiation,elaborate discussion on treating,fine adjusting formula and herbs according to the evidence based syndrome change;thinking carefully and harmoniously;Thought of integration and innovation,overcoming difficulties.Master Wang's thought is very valuable for the cultivation of Chinese medicine scholars and is beneficial for clinical and research personnel of Chinese Medicine,it is worth being further developed.

Objective Magnetic resonance diffusion tensor imaging (DTI) was applied to study the cantral auditong pathway in patients with .Methods A total of 30 cases of acquired hearing loss patients were divided into 2 groups ,group 1 (15 ,sudden deafness) and group 2 (15 ,with duration up to 2 years SNHL group from the time of onset) .A total of 15 cases of normal-hearing patients on MRI examination were selected as the control group for the same period .All subjects received DTI of whole brain .The values of the whole brain DTI were obtained from the inferior colliculus and lateral lemniscus ,consisting of the fractional anisotropy (FA) ,radial diffusion (RD) ,axi‐al dispersion (AD) and mean diffusivity .Results There were significant differences(P<0 .05) in FA of bilateral in‐ferior colliculus among sudden deafness group ,SNHL of 2 -year -history group and the control group by ANO‐VA .FA of inferior colliculus in the control group was higher than that of in the SNHL group ,but lower than that of in the sudden deafness group .RD of lateral lemniscus in the SNHL group was higher than that of in the sudden deafness group(P<0 .05) ,MD of lateral lemniscus in the sudden deafness group was higher among the other 2 groups ,and there were signigicant(P<0 .05) .For AD of the inferior colliculug and lateral lemniscus ,there were no differ‐ences among the 3 groups (P>0 .05) .Conclusion There was no obviously abnormal change on the central auditory processing in sudden deafness group ,but significant destruction was found on 2 years SNHL group .It indicated that central auditory processing of the history of sensorineural deafness affected the structural changes of the central au‐ditory pathway .

Objective To investigate the protein expression and genetic alterations of c-myc in primary systemic anaplastic large cell lymphoma (ALCL) and discuss its relationship with clinicopathologic features and immunophenotypes.Methods 87 cases of ALCL were selected.Immunohistochemical method was used to detect the protein expression of c-myc,ALK,CD3,CD10,CD20,CD30 and EMA.c-myc and ALK genetic alterations were detected by using fluorescence in situ hybridization (FlSH).The interrelationships between protein expression,genetic alterations and clinicopathological parameters were analysed statistically.Results Immunohistochemical results:of 87 cases,ALK protein was expressed in 54 cases (62.1％).c-myc protein was expressed in 27 cases (31.0 ％).ALK and c-myc were co-expressed in 20 cases (23.0 ％).c-myc protein expression,ALK and c-myc co-expression increased with the upgrade of ALCL clinical stages,and the expression was higher in International Prognostic Index (IPI) high-risk groups than in low-risk groups (P ＜ 0.05).FISH test results:of 87 ALCL cases,there were 50 cases (57.5 ％) of ALK rearrangements and 19 cases (21.8 ％) of ALK aneuploidy.c-myc rearrangement was detected in none of 87 ALCL cases,but there was aneuploidy in 19 cases (21.8 ％).The differences of c-myc aneuploidy in ALK positive and negative groups were statistically insignificant (P ＞ 0.05),while they were statistically significant in c-myc groups (P ＜ 0.05) and in different IPI groups (P ＜ 0.05).Conclusion c-myc protein expression and aneuploidy were related with ALCL clinical stages and IPI,which could be used as an indicator of estimating ALCL malignant degree and predicting prognosis.

Objective:To explore the effect of prostaglandin E2 (PGE2) on the expression of high mobility group box-1 protein (HMGB1) in peritoneal macrophages of septic mice and its possible mechanisms.Methods:Ihe mouse peritoneal macrophages were isolated and cultured by conventional methods.The model of inflammation was established by using lipopolysaccharide (LPS) to incubate with mouse peritoneal macrophages.The PGE2,prostaglandin E receptor (EP) 4 agonist,EP4 RNAi,and DN.CREB inhibitory plasmid were used to interfere with the LPS-treated mouse peritoneal macrophage.The levels of HMGB 1 was determined by Western blot.Results:Compared with LPS alone treatment,the expression of HMGB 1 in peritoneal macrophages was increased obviously after 24 h by treatment with PGE2 and LPS,and it was also increased after the combined treatment of EP4 receptor agonist with LPS for 24 h (both P<0.05);compared with the PGE2+LPS treatment,the level of HMGB1 was decreased after knockdown of EP4 receptor expression (P<0.05);compared with EP4 receptor agonist +LPS treatment,there was no difference in HMGB1 levels in mice after the treatment with DN.CREB plasmid to suppress CREB function (P>0.05);compared with LPS alone treatment,the combined treatment of EP4 receptor agonist with LPS for 24 h could up-regulate the phosphorylation of epidermal growth factor receptor (EGFR) and protein kinase B (Akt) thr308 (P<0.05),which were blocked by EGFR inhibitor.Once Akt specific inhibitor was used before EP4 and LPS treatment,the expression of HMGB1 was declined (P<0.05).Conclusion:PGE2 can up-regulate the expression of HMGB1 in sepsis of peritoneal macrophages through EP4 receptor,which may be related to the activation of EGFR/PI3K/Akt signaling pathway.

Objective To construct the teaching model of medical statistics in universities of TCM through the questionnaire of knowledge,attitude and practice structure.Methods Medical statistics KAP questionnaire survey was conducted among postgraduates using proportional stratified sampling according to the grade.It describes the present situation and calculates the knowledge loss coefficient,knowledge demand index and behavioral application intensity of medical statistics.The Chi-square test was used to analyze the differences among different grades.Results 109 questionnaires were withdrawn.The recovery was 83.84％.45 cases (41.3％) were first year postgraduate,33 cases (30.3％) were 2nd year postgraduate,and 31 cases (28.4％) were 3rd year postgraduate.At the knowledge level,the knowledge loss coefficient of the second year postgraduates was 0.635,and there was no statistical difference (P=-0.651) vs the first year postgraduate (0.638).At the attitude level,Knowledge demand index had no statistical significance difference (P=0.213)between postgraduates in grade two (96.87％) and grade three (75.00％).Most medical postgraduates held positive attitudes toward medical statistics,hoping to strengthen the training of their application ability such as medical statistics in design and research thinking (29.18％),the statistical methods selection and the interpretation of the results (31.53％) and the statistical software operation (36.07％).At the practice level,the percentage of application intensity with statistical methods of third-year postgraduates (100.00％) was higher than the second-year postgraduates (37.50％),and the second-year postgraduates higher than the first-year postgraduates (20.45％).And with the growth of year,the percentage of application intensity was gradually increasing (P=O.O03).Among them,published scientific papers accounted for 16.5％,and 58.6％ paper grade concentrated in the core journals.Conclusion Application development should be enhanced by modularization teaching with practical issues.