Underlying both the angles of norm-referenced test and criterion-referenced test, the qualitative or(and)quantitative analysis and evaluation were made on the tests of 10 medical academic courses in recent 4 years in reliabil-ity and item quality. From the angle of norm-referenced test, 67.4 percent of the items had good quality, 60 percent ofthe tests could differentiate the classes and 12.5 percent of the papers could differentiate the individual person accord-ing to their reliability. However, from the angle of criterion-referenced test, approximately 90 percent of the items werequalified; 87.5% had high reliability to determine whether an examinee passes the test or not.[

Objective To examine the changes of red blood cell levels in the obese and non-obese patients with coronary heart disease (CHD) and its clinical significance. Methods 230 cases of coronary heart disease were selected and divided into the obese group and the nonobese group. Obesity and non-obesity were defined based on the body mass index (BMI I (Y) 28.0kg/m2), or waist-hip ratio (men> 0.9, women> 0.85). In addition, 130 healthy subjects were recruited as controls. The pathological status of coronary lesions was quantitatively analyzed according to the Coronary Vascular Image Segmentation Evaluation Criteria (American Heart Association 1984) and the Gensini scoring system. Results of the changes of both the hemoglobin levels and the red blood cell count in the obese group, the nonobese group with CHD and the control group were compared. Besides, Multivariant Logistic Regression Analysis was applied to assess the correlation between the red blood cells and the coronary artery disease. Results The red blood cell count and the level of hemoglobin in the obese group with CHD was higher than that in the non-obese group with CHD [(4.35 ± 0.55) and (4.13 ± 0.56) 109/L; (136.71 ± 15.87) and (129.96 ± 16.23) g/L, P < 0.05 in both]; the proportion of acute coronary syndrome in the obese group with CHD was higher in the obese group with CHD than that in the non-obese group with CHD (P<0.05); Multivariant logistic regression analysis also showed that the red blood cell count was positively correlated with obesity with CHD.Conclusion The red blood cell count and the level of hemoglobin in the obese group were higher than those in the non-obese group; the increase of red blood cell count and hemoglobin level is one of the independent risk factors for the obese patients with CHD.

OBJECTIVETo explore the analgesia of oxymatrine (OMT) affecting high voltage-dependent calcium channels (HVDCCs) and GABA release under neuropathic pain condition.

METHODSTotally 66 C57BL/6 mice were randomly divided into the sham-operation group, the model group, and the OMT group, 22 in each group. Neuropathic pain models were established by partial sciatic nerve ligation (PSNL). Hind paw plantar mechanical response threshold (MWT) was measured by up-and-down method with Von-Frey filament. mRNA expression of HVDCCs in brains and spinal cords was detected with Real-time PCR and concentration of GABA was determined using ELISA kit.

RESULTSCompared with day 0, the left hind paw MWTwas decreased on day 7, 10, and 14 in the model group (P < 0.05). Compared with the sham-operation group, the left hind paw MWT was significantly reduced in the model group on day 7 (P < 0.05). The MWT of PSNL ipsilateral hind paw was decreased on day 7 before OMT administration, when compared with day 0 (P < 0.05), and increased after OMT administration (P < 0.05). Compared with the sham-operation group, mRNA levels of Cav1.2, Cav1.3, Cav2.1, and Cav2.3 in brain tissues were increased and those of Cav2.2 were decreased significantly in the model group (P < 0.05). In spinal cord tissues, mRNA levels of Cav1.2 and Cav1.3 were increased, but those of Cav2.1, Cav2.2, and Cav2. 3 were decreased significantly in the model group, when compared with those of the sham-operation group (P < 0.05). Compared with the model group, mRNA levels of Cavl.2, Cavl.3, Cav2.1, and Cav2. 3 in brain tissues were decreased, and those of Cav2.2 were increased significantly in the OMT group (P < 0.05). In spinal cord tissues of the OMT group, mRNA levels of Cav1.3 decreased and those of Cav2.1, Cav2.2, and Cav2.3 increased significantly with statistical difference, when compared with those of the model group (P < 0.05). Compared with the sham-operation group, GABA levels in brain tissues decreased in the model group (P < 0.05). Compared with the model group, GABA levels in brain tissues increased in the OMT group (P < 0.05). There was no statistical difference in GABA levels of spinal cord tissues among these groups (P > 0.05).

CONCLUSIONSOMT had analgesic effect on neuropathic pain, which might be probably related to HVDDCs. Cav2.2 might directly affect GABA release.

Alkaloids ; pharmacology ; therapeutic use ; Analgesia ; methods ; Animals ; Calcium ; Calcium Channels ; drug effects ; metabolism ; Disease Models, Animal ; Mice ; Mice, Inbred C57BL ; Neuralgia ; drug therapy ; Pain Management ; Quinolizines ; pharmacology ; therapeutic use ; Spinal Cord ; metabolism ; gamma-Aminobutyric Acid

OBJECTIVE: To investigate the guiding function of three-dimensional CT scan in the operation of eagle syndrome. METHOD: There were 48 cases of eagle syndrome hospitalized during July 2006 to June 2010 who underwent both three-dimensional reconstruction of CT scan and adem position and lateral X ray film. The images were measured by specialist of radiology department. RESULT: The detail of styloid process is showed more precisely by three-dimensional CT scan, which is able to determine the existence of interrupt, decline, ossification in styloid process. There was significant difference in the measured value (20.83%) between X ray and CT scan (4.16 ± 1.27)cm vs (3.11 ± 0.62)cm, P < 0.05, in 10 cases. We could not touch styloid process in oral approach in 6 cases (12. 5%), which also had diagnostic confliction between X ray and three-dimensional CT scan. Five patients whose styloid process could not be touched during surgery had longer operation time than the other 41 patients. CONCLUSION Three-dimensional CT has good repeatability, high detailed distinguishability, which is an important basis to diagnose eagle syndrome. When X ray shows prolonged styloid process which can not be palpable in oral, we suggest further three-dimensional CT to avoid unnecessary surgery.
Female ; Humans ; Imaging, Three-Dimensional ; Male ; Ossification, Heterotopic ; diagnostic imaging ; surgery ; Temporal Bone ; abnormalities ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

Objective To investigate the prostecdtive efficacy of one-stage bone grafting in man-aging chronic osteomyelitis after debridement.Methods From March 1999 to May 2003, 79 patients with chronic osteomyelitis including 28 patients with nonunion underwent one-stage autogenous bone graft-ing, allografts or mixed bone grafting after debridement in Nanjing General Hospital of Nanjing Military Command.All patients were followed up for a mean period of 77 months (60-111 months).Results Six patients (8%) , including two with autogenous bone grafting, three with allografts and one with mixed bone grafting, were confirmed with recurrence of infection, with no statistical difference among three methods of bone grafting.Of 28 patients with nonunion, 23 patients with autogenous bone grafting and two with allografting obtained union, the other three patients with mixed bone grafting obtained union in two patients but resulted in recurrence of infection with nonunion in one, with cure rate of 96% (27/28).Conclusions One-stage bone grafting after debridement for infection and bone union can reach cure rate of over 90%.The recurrence of infection mostly occurs within the first year after operation, with stable long-term curative effect.

Objective To investigate the curative effect of granulated cancellous bone autograft in treatment of refractory bone nonunion after limited contouring of bone ends. Methods Between 2003 and 2006, 13 patients with refractory bone nonunion were treated with external fixation and granulated cancellous bone autograft after limited contouring of bone ends. Results The mean follow-up period was 22.6 months (19-30 months), which showed that all patients gained bone union and resumed com-plete weight loading or previous job at final follow-up. The mean fixation time of external fixators was 10.6 months (7-18 months). The intermittent or persistent pin-track infection occurred in eight patients and relieved by pin-track care and oral or parenteral antibiotics, with no infection after removing external fixator. Conclusion The granulated cancellous bone autograft after limited contouring of bone ends is an effective method for treatment of refractory bone nonunion.

OBJECTIVETo assess the feasibility of interstitial magnetic resonance lymphangiography (IMRL) with intracutaneous injection of gadobenate dimeglumine--a commercially available, non-ionic, extracellular paramagnetic contrast agent.

METHODSWe studied 10 patients with lower extremity lymphedema. A mixture of 7.5 ml gadobenate dimeglumine and 0.5 ml 2% lidocaine were evenly subdivided into 8 portions and injected intracutaneously into each web space of both feet. For IMRL, a 3D fast spoiled gradient-recalled echo T1-weighted images with a fat saturation technique (T1 high resolution isotropic volume excitation, THRIVE) was performed.

RESULTSThe beaded appearance of lymphatic vessels extending from the injection site were detected in 11 of 12 lower legs and the best delineation of lymphatic vessels was present at 15-30 minutes after injection. In 6 of 12 affected thighs, lymphatic vessels could be also visualized with the strongest enhancement at 45 minutes.

CONCLUSIONIMRL is a safe and technically feasible new method which can effectively visualize the pathological lymphatic vessels in lower extremity lymphedema.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Lower Extremity ; Lymphedema ; diagnostic imaging ; Lymphography ; methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult

The high performance liquid chromatography-fluorescence micelle assay (HPLC-FMA) method for the content determination of polysorbate 80 in monoclonal antibody drugs was validated to study its applicability and transferability between various laboratories, and the feasibility to be included in the Chinese Pharmacopoeia. Both J.T. Baker and Nanjing Well-sourced polysorbate 80 was used in the collaborative validation of polysorbate 80 content analysis in seven different laboratories. The results show that when the protein concentration was no more than 20 mg·mL^-1 and the concentration of polysorbate 80 ranged from 0.05 to 0.5 mg·mL^-1, the method had good specificity. The recovery rates of the spiked samples ranged from 92.20% to 117.70% for J.T.Baker and from 93.90% to 117.20% for Nanjing Well. The intra-laboratory precision (%RSD) was less than 4.30% for J.T. Baker, and less than 2.60% for Nanjing Well, while the overall precision was less than 5.45% for J.T. Baker, and less than 6.70% for Nanjing Well. The linear correlation coefficient was more than 0.98 for J.T. Baker and more than 0.99 for Nanjing Well. The results of the collaborative validation prove that the HPLC-FMA method has good accuracy, precision, linearity, and specificity, and could be used for release control analysis of polysorbate 80 content in monoclonal antibodies across different laboratories.

Aim To investigate the effects of perindopril, an angiotensin converting enzyme inhibitor, on mean pulmonary arterial pressure(mPAP) and pulmonary vascular remodeling.Methods Using the normobaric hypoxia-hypercapnia rat model,the changes of plasma angiotensin Ⅱ (Ang Ⅱ), mPAP and ultrastructure of pulmonary arteriolar wall were observed after administration of perindopril.Results The mPAP and AngⅡ were significantly greater and the ultrastructure of the small lung vessels had a more obvious change in the 4 weeks hypoxia-hypercapnia group than those in the control group.It was also found that perindopril decreased AngⅡ, declined mPAP and ameliorated vascular ultrastructure change.But the change of ultrastructure was similar in the 8 weeks hypoxia-hypercapnia group and perindopril treatment group.Conclusion It is suggested that chronic hypoxia-hypercapnia should induce the remodeling of pulmonary arteriolar structure via AngⅡ and that perindopril could ease pulmonary vascular remodeling in early stage.

Objective To investigate the relationship between paraoxonase (PON) concentration and the risk of acute coronary syndrome (ACS).Methods The levels of serum PON were detected by enzyme-linked immunosorbent assay in 229 patients with confirmed ACS and 129 control subjects without CHD.Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were applied to analyze the association between PON and ACS.Results PON was significantly lower in ACS group than in control group [ lgPON:( 5.72 ± 0.73 ) ng/L vs.( 5.07 ± 0.57 ) ng/L,P ＜ 0.05].Logistic regression analysis showed that the level of PON was an independent risk factor of ACS (regression coeffient was - 1.793 in univariate logistic regression,OR =0.166,95％ CI:0.088 - 0.316; - 0.779 in multivariate logistic regression,OR =0.459,95％ CI:0.222 -0.949).ROC analysis showed that the optimal diagnostic cut-off point of PON for ACS was 180 mg/L ( sensitivity:83.3％,specificity:71.2％ ).Multiple stepwise regression analysis revealed that there was no significant correlation between lgPON and Gensini score in ACS patients.Conclusion Lower PON is linked with increased risk of ACS,but does not relate with the severity of coronary stenosis.