There were a lot of differences between the American and Chinese medical education.Students in American should obtain bachelor's degree of humanities or science before reciveing medical doctor's degree at graduation.High altitude militray medicine is a characteristic discipline of the third military medical university,aming at training general doctors for the plateau.During the designing of high altitude militray medicine curriculum and its teaching process,we actively learned from the advanced experiences of American based on the reality,optimizd currulum,improved teaching methods,greatly cultivated the students' protential in order to increase the qualify of high altitude militray medicine personnel.

From October 1978 through 1983, 225 rectal cancer patients were randomized into R+S group (115 patients) and S only group (110 patients). The radiation dose of pre-operative radiotherapy was 30～45Gy/3～4.5 wks. Radical or palliative resection was done after a rest of 2～4 weeks. The lymphatic metastasis and local recurrence rates of the R+S group (20.6% and 27.8%) were lower than those of the S only group(32.7% and 41.8%)(P

Objective To investigate prognosis of acute ischemic patients with internal carotid artery or middle cerebral artery occlusion and define predictors of clinical outcome.MethodsThe clinical and radiological data of 48 stroke patients who underwent magnetic resonance angiography (MRA) within 6 hours of symptom onset and visualized internal carotid artery or middle cerebral artery occlusion on early MRA were analyzed. 90 days after onset, modified Ranking Scale (mRS) scores were obtained and factors related with prognosis were defined by logistic regression analysis.ResultsOf 48 patients, 17 cases (35.4%) got good clinical outcome (mRS 0～2), 31 cases (64.6%) got poor clinical outcome (mRS 3～6) with 7 cases (14.6%) died. In multivariate logistic regression analysis, only large infarction ( OR=21.1, 95%CI 1.4～314.2, P=0.027) and hyperglycaemia ( OR=5.1, 95%CI 1.3～19.8, P=0.019) were independent predictors of poor outcome.ConclusionClinical outcomes of most acute stroke patients with internal carotid artery or middle cerebral artery occlusion are poor. Large infarction and hyperglycaemia are independent predictors of clinical outcome.

Objective To investigate the clinical features and prognosis of acute ischemic stroke patients with different infarction patterns.Methods87 patients who underwent diffusion weighted imaging (DWI) within 6 h after symptom onset and visualized acute cerebral infarcts within the middle cerebral artery territory were prospectively studied.According to DWI lesion patterns,the patients were divided into 6 groups.Before MR was performed and 24 h after onset,scores of National Institutes of Health Stroke Scale (NIHSS) were recorded.3 months after onset,scores of modified Ranking scale(mRS) were obtained.ResultsThe baseline NIHSS,infarction volume,occlusion of relevant internal carotid artery or middle cerebral artery and clinical outcome were significantly different among 6 groups(P<0.05).ConclusionDifferent infarction patterns of acute ischemic stroke were associated with clinical symptoms,vascular status,and clinical outcome,that may help to guide treatment and judge prognosis.

AIM: To study the protective effects of HIF-1α gene transfection on hypoxic injury in human HepG2 cells. METHODS: After gene transfection, HepG2 cells were randomly divided into 4 groups: normoxia with Ad-GFP transfected group, normoxia with Ad-HIF-1 transfected group, hypoxia with Ad-GFP transfected group and hypoxia with Ad-HIF-1 transfected group. LDH leaking rate, cell viability, contents of NO and ROS, the iNOS activity were measured. RESULTS: High levels of HIF-1α mRNA and protein were detected in Ad-HIF transfected HepG2 cells. Cell viability was significantly lower in Ad-GFP transfected-hypoxia group than that in Ad-GFP transfected-normoxia group (P<0.05). No marked difference of cell viability was found between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group. ROS was significantly higher in Ad-GFP transfected-hypoxia group than that in Ad-GFP transfected-normoxia group (P<0.05), while no marked difference was found either between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group or between Ad-HIF transfected-hypoxia group and Ad-GFP transfected-hypoxia group. The content of NO and iNOS activity were significantly higher in Ad-HIF transfected-normoxia group and Ad-GFP transfected-hypoxia group than those in Ad-GFP transfected-normoxia group (P<0.05), no marked difference was found either between Ad-HIF transfected-hypoxia group and Ad-GFP transfected-hypoxia group or between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group. CONCLUSION: Higher HIF-1α expression is contributed to protective effects against hypoxic injury in HepG2 cells, the mechanisms of which may be correlated with promoting expression of gene regulated by HIF-1 and restraining over-expression of injure factors.

BACKGROUND: It is difficult to culture human dental pulp cells in vitro. Studies regarding effects of growth factors on proliferation and differentiation of dental pulp cells cultured in vitro have been reported. However, little is known about the Chinese herb rhizoma drynariae decoction on dental pulp cells cultured in vitro.OBJECTIVE: To observe the effects of different concentrations of rhizoma drynariae decoction on the proliferation and differentiation of human dental pulp cells cultured in vitro.DESIGN, TIME AND SETTING: A controlled observation was performed at the Scientific Resaarch Center, Fourth Hospital, Hebei Medical University between March 2006 and May 2007.MATERIALS: Human dental pulp cells were sourced from the patients who acquired orthotherapy through pulling out impacted wisdom tooth at the Department of Stomatology, Fourth Hospital, Hebei Medical University. Written informed content of sample collection was obtained from all patients. Rhizoma drynariae (place of production: Yunnan Province in China) was provided by the Dispensary of Traditional Chinese Medicine, Fourth Hospital, Hebei Medical University.METHODS: Human dental pulp cells were cultured in vitro using method of tissue piece. The effective ingredients of rhizoma drynariae were extracted by alcohol deposition. 1 mL of physic liquor contained 1 g crude drug and diluted into 10, 50, 100, 500, and 1000 mg/L culture medium utilizing fetal bovine serum. Subsequently, the prepared culture medium was used to culture human dental pulp cells in vitro. Cells that were cultured using culture medium without rhizoma drynariae decoction were used as controls.MAIN OUTCOME MEASURES: ①Primary culture and source identification of human dental pulp cells. ②Effects of different concentrations of rhizoma drynariae decoction on proliferation of human dental pulp cells by methyl thiazolyl tetrazolium (MTT) assay. ③ Effects of different concentrations of rhizoma drynariae decoction on fibronectin expression in human dental pulp cells by immunohistochemistry. ④ Effects of rhizoma drynariae decoction on ultrastructure of human dental pulp cells utilizing scanning electron microscope and transmission electron microscope.RESULTS: Primarily cultured human dental pulp cells displayed polygon- and shuttle-shaped appearance. Different concentrations of rhizoma drynariae decoctions, in particular 100 mg/L, exhibited proliferation-promoting effects on proliferation of human dental pulp cells, and could induce dental pulp cell synthesis and secrete fibronectin. Electron microscopy results revealed that following treatment of rhizoma drynariae decoctions, human dental pulp cells were found with abundant ridges on their surface, surround by extracellular matrix, cytoplasm full of abundant rough endoplasmic reticulum and dissociative ribosome, as well as evenly dispersed nuclear euchromatin, and occasionally seen heterochromatin.CONCLUSION: 100 mg/L rhizoma drynadae decoction apparently promotes the proliferation of human dental pulp cells cultured in vitro.

AIM: To investigate whether three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) can be used as a reliable screening tool for evaluation of intracranial vascular stenosis and occlusive disease before stent implantation. METHODS: Thirty-three patients with suspected intracranial arterial stenosis received 3D TOF MRA and digital subtraction angiography (DSA) examinations in Chaoyang Hospital Affiliated to Capital Medical University between March 2007 and April 2008,and were included for this study. Two physicians blindly estimated stenosis,patient history,and clinical information of 363 vascular segments from 33 patients,including bilateral internal carotid artery (ICA),anterior cerebral artery (ACA),middle cerebral artery (MCA),posterior cerebral artery (PCA),vertebral artery,and basilar artery (BA). Stenosis was categorized as 30%-49%,50%-69%,70%-99%,and 100%. For each kind of stenosis,sensitivity,specificity,positive predictive value,negative predictive value,K and P values of MRA were calculated,respectively,as compared to DSA. RESULTS: A total of 42 diseased vascular segments were identified. Compared to DSA,for intracranial stenosis 50%-69%,3D TOF MRA showed sensitivity 100%,specificity 96.8%,positive predictive value 62.1%,negative predictive value 100%,K value 0.751,and P value 0.000; For intracranial stenosis 70%-99%,the corresponding value was 100%,98.6%,70.6%,100%,0.821,and 0.000,respectively; For intracranial stenosis 30%-49%,it was 25.0%,99.7%,66.7%,98.3%,0.356,and 0.000,respectively.CONCLUSION: For high sensitivity and specificity to intracranial stenosis 100%,70%-99%,or 50%-69%,compared to DSA,3D TOF MRA is a reliable screening tool for preoperational evaluation of intracranial vascular stenosis and occlusive disease.

Objective To investigate the clinical effect of QianlieShutong capsule in combination with tamsulosin in the treatment of benign prostatic hyperplasia ( BPH) and its effects on serum testosterone and estrogen.Methods 114 cases of BPH were randomly divided into control group (n=54) and observation group (n=60).The control group were treated with tamsulosin, while the observation group were treated with QianlieShutong capsule in combination with tamsulosin.Then, the curative efficacy, improvement of related indexes, level of serum testosterone, estrogen and adverse reactions were compared.Results The observation group had a total therapeutic efficacy ratio of 95.0%, which was statistically higher than that of 83.3% in control group (P<0.05).In comparison with control group after the treatment, international prostate symptom score (IPSS), residual urine (Ru), prostate volume (PV) in observation group statistically decreased, and maximum flow rate (Qmax), level of estrogen increased (all P<0.05), while level of testosterone in two groups was statistically same.During the treatment, there’ s no case of severe adverse reaction.And the incidence of adverse reactions in the observation group was 13.3%, which was statistically same with that of 11.1% in control group.Conclusion Combined treatment of QianlieShutong capsule and tamsulosin is effective for BPH, which can significantly increase curative efficacy, improve related indexes and regulate level of sexual hormone with minor adverse reactions.

Objective To investigate curative efficacy of RevoLix 2 μm laser in combined with pirarubicine in the treatment of non-muscular invasive bladder cancer and its effects on level of serum vascular endothelial growth factor (VEGF).Methods 115 cases with non-muscular invasive bladder cancer who received therapy in our hospital from January 2012 to April 2013 were selected as research objects to retrospectively analyze their materials.According to therapeutic schemes,patients were divided into group A ( n=52 ) and group B ( n =63 ).Group A was given electrocision of bladder tumor and perfusion of pirarubicine 30 mg in 5% glucose injection 30 mL,one times per week,for eight weeks,and then one times per month,a total of one year; while group B was given RevoLix 2μm laser resection of bladder tumor and perfusion of pirarubicine 30 mg in 5% glucose injection 30 mL,one times per week, for eight week, and then one times per month, a total of one year.Then, operation status, incidence of complications after operation,level of VEGF and recurrence rate between the two groups were observed and compared.Results Compared with group A, group B had statistically less bleeding volume,shorter retention time of urinary tube and hospitalization time (P<0.05),while operation time in the two groups was statistically same.After operation,incidence of complications in group B was 3.2%,which was statistically lower than that of 15.4% in group A ( P<0.05).On admission and 1 week after operation,levels of VEGF of two groups had no significant differences.8 weeks and 6 months after operation,level of VEGF in group B was statistically lower than that in group A respectively (P<0.05).After the two-year follow-up,recurrence rate in group B was 4.8%,which was statistically lower than that of 17.3% in group A (P<0.05).Conclusion RevoLix 2μm laser combined with pirarubicine is effective for patients with non-muscular invasive bladder cancer with less bleeding volume,quicker postoperative recovery,lower incidence of complications and recurrence rate after operation.This may be related to the decrease of serum VEGF level in patients,it is necessary to further study.

Objective To investigate effect of sodium cyanide(NaCN)at different concentrations on the mitochondrial respiratory oxygen consumption,the mitochondrial membrane potential(MMP)and activity of the complex Ⅳ of mitochondrial breath train in in vitro liver mitochondria from the rats exposed to simulated high altitude hypoxia,and to explore the characteristics of energy metabolism in the mitochondria from the rats subjected to cyanide poisoning during acute hypoxia exposure.Methods Adult Sprague-Dawley(SD)rats were set randomly into control and acute hypoxia groups(n=8 in each group).The acute hypoxic rats were exposed to simulate 5 000 m high altitude in a hypobaric chamber 23 h/d for 3 d.Rats in the control group were bred in the normoxia condition at the same time.The liver mitochondria were isolated by centrifugation.Mitochondrial oxidative respiratory consumption and activity of the complex Ⅳ was measured by Clark electrode after the treatment of NaCN at 0,0.01,0.1 and 0.25 mmol/L respectively,so as to calculate mitochondrial state 3 respiration(ST3),state 4 respiration(ST4),respiratory control rate(RCR),the rate of oxidative phosphorylation(OPR),and oxygen consumption rate of the complex Ⅳ.MMP was detected by Rhodamine 123 method at the above-mentioned concentrations of NaCN.Results NaCNat0.01,0.1and0.25mmol/Linhibited the mito-chondrial oxidative respiratory function,and decreased MMP significantly.The inhibitory effects of NaCN onenergy metabolism in mitochondria was in a dose-dependent manner.Compared with the treatment of NaCN atthe corresponding concentration in the control group,mitochondrial function in the acute hypoxia group was in-hibited more seriously.Conclusion Acute hypoxia exacerbates the inhibitory effects of sodium cyanide on en-ergy metabolism in rat liver mitochondria.Its mechanism might be relevant to the decoupling of oxidative phos-phorylation,functional down-regulation of complexⅣin respiratory chain and changes of the mitochondrialmembrane potential in liver mitochondria from rats exposed to acute hypoxia.