Objective To determine the expression of glial fibrillary acidic protein(GFAP) and vascular endothelial growth factor(VEGF) in the hippocampus of rats with Alzheimer's disease(AD), and to determine the effect of butylphthalide on them and its significance. Methods Sixty male adult rats were randomly divided into a model group, a Butylphthalide group, and a control group. AD models were established by injecting β-amyloid protein 1-42 into the hippocampus of rats. Sixty days later,the rats were sacrificed and both sides of the hippocampus were sectioned for immunohistochemistry. Results Positive cells of GFAP in the hippocampus of the model group increased and the expression of VEGF decreased statistically, compared with the control group(P<0.01). The positive cells of GFAP in the hippocampus of the butylphthalide group decreased and the expression of VEGF increased significantly, compared with the model group(P<0.05). Conclusion Butylphthalide may protect the neuron-vascular unit of the hippocampus of Alzheimer model rats by inhibiting the expression of GFAP and increasing the expression of VEGF.

Objective This paper aims to make clear the post-disaster medical needs of residents in the disaster areas and changes among the poor population, for the purpose of policy recommendations on post-disaster medical assistance. Methods Such methods as in-home questionnaire survey and literature study were used to study the income, prevalence rate and mental health of 4 380 households in 10 counties (cities and districts) in the disaster areas. Results In the hardest hit areas, 80. 4% and 52. 8% of residents in rural and urban areas are dependent on government relief respectively;the proportion of poor population resulting from the disaster rose from 5% before the disaster to over 75% afterwards in the hard-hit areas, while such a population rose to 15% in the hardest-hit areas and about 10% in general disaster areas;It is estimated that the new medical aid funds in Sichuan Province will reach 350 million yuan, two-fold that of the budget for 2009;In the hardest hit areas, the two-week prevalence rate per thousand people is twice that found in the third survey of health services in 2003, characterized of acute respiratory illness and rheumatoid;In the hardest-hit areas, nearly 70% of the residents are exposed to high mental health risks. Conclusion Recommendations: Strengthening the raising and use of medical aid fund;dynamic management for the population in need of post-disaster medical aid;Developing appropriate medical aid packages to fit post-disaster health needs and postdisaster disease characteristics;and consolidating the connection between medical aid and primary medical insurance system.

Purpose Protein is the main influencing factors for diffusion weighted imaging (DWI) signals and apparent diffusion coefficient (ADC), it results in hyperintensity on DWI and low ADC, but not fully matched in clinic. This paper aims to investigate the effect of protein type and concentration on the signal intensity (SI) and ADC of DWI. Materials and Methods Different concentrations of albumin, globulin solution and the mixed solution were created in vitro. DWI was performed on GE 1.5T superconducting nuclear MRI system. Results ① There was a linear negative correlation between the ADC value and the concentrations of protein solution (at 37℃, ra= - 0.849, Pa<0.05; rg= - 0.843, Pg<0.05; at 40℃, ra= - 0.894, Pa<0.05; rg= - 0.819, Pg<0.05);there was a linear positive correlation between the SI of DWI and the concentrations of the albumin solution (at 37℃, r=0.753, P<0.05; at 40℃, r=0.845, P<0.05). There was no correlation between the SI of DWI and the concentrations of the globulin solution (at 37℃, r= - 0.222, P>0.05; at 40℃ , r= - 0.270, P>0.05). ② SI of the albumin solution was significantly higher than the globulin solution at the same concentration and temperature (t=3.96, P<0.001); the ADC values were not statistically different between the albumin and the globulin solution (t=0.61, P>0.05). Conclusion The nature of the cystic fluid can be understood preliminarily through quantitative analysis of the cystic fluid DWI and ADC values, so as to provide theoretical basis for the qualitative diagnosis of cystic lesions in vivo.

Objective To investigate the relationship between p62 expression,and occurrence and metastasis of nasopharyngeal carcinomas.Methods Immunohistochemical method was used to analyze p62 expression in 123 nasopharyngeal carcinoma (NPC) cases and 30 chronic nasopharyngitis cases.The clinical pathological characteristics were analyzed.Results The positive rate of p62 protein in chronic nasopharyngitis nasopharyngeal epithelium,non-metastatic NPC tissue,and metastatic NPC tissues was 13.3％,66.67％,and 84.72％,respectively,and the difference was statistically significant.The expression of p62 protein in nasopharyngeal carcinoma patients with lymph node metastasis or distant metastasis was significantly higher than non-metastatic NPC patients (P ＜ 0.01 or P ＜ 0.05).However,the expression of p62 was not related to age,gender,tumor size,and TNM stage (P ＞ 0.05).Conclusions High p62 protein expression in nasopharyngeal carcinoma tissue is closely related to the occurrence and metastasis of nasopharyngeal carcinomas.It provides good reference value to predict NPC malignancy and metastases.

The application of continuous quality improvement program in standardized residency training examination in the central Hospital of Shanghai Jiading was introduced to inquire into the way to improve the quality of standardized training of resident doctors. Through the steps of FOCUS-PDCA, we continuously improved the examination content and quality compliance training personnel, and developed the examination process including test, training, supervision, learning and using. After the implementation of the project, the percentage of the departments that meet the residency training examination requirements has been increased from 33.3%to 100%in our hospital. The percentage of the students that passed the licensed medical skills examination was 96.6%in that year. 100%of the students passed the graduation comprehen-sive examination. Year-end evaluation showed that the students' satisfaction degree to the teachers increased from 94.5%to 98.2%. Thus, through the implementation of CQI project, we achieved the goal of promoting teaching and promoting learning.

OBJECTIVETo evaluate the effects of antiviral nucleotide/nucleoside analogues (NUCs) and interferon (IFN) on liver fibrosis and progression to cirrhosis in patients with hepatitis B virus (HBV) infection.

METHODSThe literature databases of PubMed (1966 to 2011), Embase (1966 to 2011), Wanfang database (1998 to 2011), Chinese National Knowledge Infrastructure (CNKI; 1997 to 2010), and Chinese Biomedical (CBMdisc; 1860 to 2011) were searched for studies that met the following criteria: (1) case-control phase III clinical trails that used only one kind of antiviral drug (NUCs or IFN), with the controls receiving placebo or no treatment; (2) analysis of biopsy specimens collected before and after treatment for both the cases and controls; (3) assessment of fibrosis as an outcome measure of the treatment's effect. The data from all 11 studies included in the meta-analysis were extracted and analyzed by the RevMan5.1 software.

RESULTSNUC treatment significantly regressed liver fibrosis, as compared with placebo treatment (33.7% vs. 19.2%, relative risk (RR): 1.82, 95% confidence interval (CI): [1.47, 2.25], P less than 0.01). NUC treatment significantly reduced the progression of fibrosis, as compared with placebo treatment (9.1% vs. 24.8%, RR: 0.33, 95% CI: [0.19, 0.58], P less than 0.01). IFN treatment significantly reduced progression of fibrosis, as compared with no treatment (23.8% vs. 30.7%, RR: 0.48, 95% CI: [0.34, 0.69], P less than 0.01). IFN significantly reduced progression to cirrhosis, as compared with no treatment (10.6% vs. 18.0%, RR: 0.62, 95% CI: [0.44, 0.88], P less than 0.01).

CONCLUSIONOne year of NUC treatment could partly regress liver fibrosis and partly reduce the progression of fibrosis, while one year of IFN treatment could reduce the progression of fibrosis and cirrhosis.

Antiviral Agents ; pharmacology ; therapeutic use ; Clinical Trials, Phase III as Topic ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; virology

Objective To apply 3C3R model in problem design of PBL for pediatrics teaching.Methods The 3C3R model comprises two classes of components:core components and processing components.Core components of the model are 3C,which are content,context and connection while processing components are 3R,which are researching,reasoning and reflecting.3C3R model was used in the problem design for the PBL case of ‘ Why the mouth of Baobao became purple when he was crying?' Totally 76 eight-year program medical students and 7 tutors were enrolled as teaching object.The anonymous questionnaires from the students were collected for assessment of PBL teaching.Results The percentage of students with scores ≥4 for content in PLB problem design was 90.8％,for context was 80.3％,for connection was 64.5％,for researching was 81.6％,for reasoning was 69.7％ and for reflecting was 40.8％.The percentage of tutors with scores ≥4 for content in PLB problem design was 100％,for context was 71.4％,for connection was 28.6％,for researching was 71.4％,for reasoning was100％,for reflecting was57.1％.Both students and tutors held a positive attitude towards the component of content,context,researching and reasoning in problem design model.But the components of connection and reflection needed to be improved.Conclusion The 3C3R model is helpful for problem design of PBL in pediatric teaching.

OBJECTIVE:To provide basis and thinking for the development of medicines for treating depression. METHODS:Rats with adaptive feeding for 7 d were randomly divided into normal group,depression group and treatment group(citalopram hy-drobromide 1 mg/kg),8 in each group. Rats in depression group and treatment groups randomly received once low-density stimula-tion in a day [catching tail stimulation(1 min),frequent flashing stimulation(120 times/min,12 h),noise stimulation(4 h),ice water swimming stimulation(1 h),hot water stimulation(45 ℃,1 h),electric shocking foot(10 Hz,1 mA,each time interval of 100 ms,100 times),no food and no water(24 h)] for 21 d to reduce stress depression model. Body mass of rats in 0,7 d of adaptive feeding and 7,14,21 d of stress were respectively weighed,and horizontal activity and vertical activity frequencies in open field test were detected. After stress,rats were intragastrically administrated related medicines for 30 d,then 5-hydroxytrypta-mine (5-HT) and tryptophan hydroxylase (TPH) expressions in brain,liver,kidney tissues were determined. RESULTS:Com-pared with normal group,the increasing trend of body mass in depression group and treatment group slowed down from the 14 d of stress(P<0.05). The horizontal activity frequencies in depression group and treatment group in 14,21 d of stress slowed more ob-viously than the previous time point (P<0.05 or P<0.01);vertical activity frequencies in 21 d of stress slowed more obviously than the previous time point (P<0.05 or P<0.01). After 30 d of administration,horizontal activity and vertical activity frequen-cies in treatment group were increased more obviously than the previous time point (P<0.01). Compared with depression group,brain tissue of rats,indicating that TPH can be used as a target for depression treatment.

Objective To design a new Chinese mandarin version of speech sample text for perceptual assessment .Meth-ods The speech sample text included all phonemes and limit number of words .The correlation analysis of the constituent rati-os of all phonemes was performed between the speech text and the ones in Chinese language reported by the institute of Acous-tics Chinese Academy of Sciences using Pearson's correlation coefficient and Spearman correlation coefficient .And their differ-ences were tested by paired sample t test and Wilcoxon signed rank test .Legibility was alsotested .Results Our speech sarrple text contained 21 vowel ,38 consonant and 4 tones .The proportions of vowel ,consonant and tone in the speech text had high correlation with those in Chinese language (for proportions of vowel ,the Pearson's correlation coefficient was 0 .908 and Spearman correlation coefficient was 0 .775 ,P<0 .01 ,respectively ;for proportions of consonant ,the Pearson's correlation co-efficient was 0 .802 and Spearman correlation coefficient was 0 .808 ,respectively ,P<0 .01 ;for proportions of tone ,the Pear-son's correlation coefficient was 0 .967 and Spearman correlation coefficient was more than 0 .999 ,respectively , P< 0 .01) . There was no difference in the proportions of vowel ,consonant and tone between them(P>0 .2) .The value of legibility was 2 , indicating legibility of the speech sample text was good .Conclusion The new Chinese mandarin version of speech sample text can be used in perceptual assessment .The value for perceptual assessment still needs further clinical research .

BACKGROUND: The affected liver can be completely removed by liver transplantation,long-term efficacy is superior to liver resection,the 5-year survival rate reaches 70% H1.In addition,liver transplantation can avoid a serious risk for incomplete liver function caused by hepatic resection in the case of liver dysfunction.OBJECTIVE: To retrospectively analyze the treatment effects and importance of orthotoplc liver transplantation for primary hepatic cancer patients.METHODS: A total of 75 patients with primary hepatic cancer treated by orthotopic liver transplantation in Department of Hepatobiliary Surgery,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from March 1980 to December 2008 were involved in the analysis for the postoperative survival rates and recurrence of tumors.RESULTS AND CONCLUSION: For all the patients,the total postoperative survival rate in the 1st,2nd and 3rd year was 86.6%,66.7% and 53.3% respectively,the disease free survival rate was 65.2%,53.9%,34.1%.Their mean survival time is 25 months.For the patients in line with Milan standard,the postoperative survival rate in the 1st,2nd and 3rd year was 88.4%,72.5% and57.9% respectively,the disease free survival rate was 77.6%,62.3%,51.8%.Their mean survival time is 39 months.Tumor recurrence occurred within one year in all six patients who were beyond Milan standard.Two patients died in one year after operation,the survival rate at postoperative one year was 66.7% and the remanent four patients all died in the 2nd year after operation.Orthotopic liver transplantation was one of the effective treatments for pdmary hepatic cancer patients.The patients which were measured up to Milan standard would have the best curative effects.