Objective To investigate the information of outpatients with acute and chronic insomnia in the department of neurology in the general hospital.Methods In the case-control study and epidemiological investigation, the sleeping information of the outpatients in Department of Neurology of Peking University Third Hospital were collected according to classification and diagnostic criteria of mental disorder in American from October 2004 to December 2004. Multiple Logistic regression was performed to analyze the associated factors for insomnia.Results Total 925 cases were investigated and divided into acute insomnia group(149 cases), chronic insomnia group (361 cases) and control group (415 cases). After adjustment for major confounders including gender, smoking, coronary artery disease, hyperlipoidemia, education and occupation, it showed that:(1) Female (OR=2.02, P=0.001), hyperplasia of prostate (OR=1.94, P=0.036), anxiety (OR=3.29, P=0.000), depression (OR=2.48, P=0.000) and leg-moving (OR=1.78, P=0.019) increased the risk of acute insomnia significantly. (2) Female(OR=2.13, P=0.000), education (OR=2.05, P=0.005;OR=2.07, P=0.003), hyperplasia of prostate (OR=1.71, P=0.023), anxiety (OR=7.42, P=0.000) and depression (OR=4.73, P=0.000) increased the risk of chronic insomnia significantly.Conclusions Female, hyperplasia of prostate, anxiety and depression are associated with acute and chronic insomnia.

[Objective]Discussion on academic ideas and clinical experience of Professor XIE Jingri in treatment of ulcerative colitis(active phase). [Method] From the disease affiliation, etiology and pathogenesis,syndrome differentiation, clinical adding and subtracting, disease aftercare to expound the academic viewpoints and clinical experience of Prpfessor XIE Jingri in treating ulcerative colitis(active phase), summarize his prescription regularity and treatment characteristics,and put an example to exemplify that.[Results]Professor XIE Jingri thinks that spleen deficiency is its fundamental pathogenesis,dampness-heat is the key factor of attack, the liver is closely related to the lung, spleen and large intestine,it could adjust the emotions and circulation of Qi, blood and body fluid.Therefore,we shuold take the method of strengthening spleen and nourishing Qi and dampness-heat clearing simultaneously as basic therapy, and pay more attention to the treatment lying in regulating the liver, use the method of regulating qi activity and activating circulation to remove blood stasis, focus on disease aftercare at the same time,the clinical therapeutic effect is satisfied.[Conclusion]The clinical experience of Professor XIE Jingri in treatment of ulcerative colitis(active phase) could effectively alleviate symptoms and reduce relapse rate,it is worth to be summarized and popularized.

Objective To evaluate the clinical efficacy of coroflex (BRAUN, Germany) intracoronary stent. Methods To retrospectively analyze the immediate angiographic and clinical follow-up outcomes of 81 patients (pts) receiving coroflex intracoronary stenting. Results 88 coroflex intracoronary stents were implanted in 81 pts. According to ACC/AHA classification, 38 lesions were type A-B 1, 50 lesions were type B 2-C. 52 lesions were de novo, 22 were suboptimal results after PTCA and 14 lesions were bailout for dissections. Stent deployment was successful in 82/88 (93.2%). High-pressure (16-18 atm) balloon was used for stent deployment in 3 lesions with severe calcification. Dissection was occurred at distal of stent in 2 lesions but no inducing flow reduction. Angiography showed TIMI 2 grade after intracoronary stenting in 1 diffused lesion. There were no adverse events occurred during hospital stay. Clinical follow-up of in 75 pts were conducted for 7.5?3.0 (3-13) months, there were no cardiac death or myocardial infarction reported. Complain of angina (CCS class Ⅰ) occurred in 17 pts (22.7%). Repeat angiography was performed in 7 pts, there were 2 in-stent restenosis with successful revascularization. Conclusion Coroflex intracoronary stenting appears to be safe and effective in the treatment of coronary lesions with favorable outcomes.

Objective To evaluate the role of intravasc ular ultrasound (IVUS) in determining strategy for coronary artery stenosis of intermediate severity.Methods The study population consisted of 75 patients who had de novo coronary lesions of intermediate severity (40% to 70% diameter stenosis) in coronary angiography. IVUS examination was performed in all patients using standard methodology. Minimal lumen cross-sectional area (MLA) ≤ 4.0- mm 2 or percent area stenosis≥60% were identified as an IVUS index of functionally severe coronary stenosis, and used as an indication of coronary stenting. Major adverse cardiac events (cardiac death, acute myocardial infarction and recurrent angina) and the use of nitrates were recorded during follow-up. Results There were 44 patients (59%) with functional coronary artery stenosis, and all underwent successful coronary stenting. Acute coronary syndromes, soft plaque and positive coronary arterial remodeling were more common compared with the remaining 31 patients (41%) only treated medically. During a mean of (14?7) months of follow-up, there was no cardiac death and acute myocardial infarction. Readmission occurred in 5 patients (11%) due to in-stent restenosis in patients with interventional therapy and 4 patients (13%) due to exacerbation of coronary artery stenosis in patients with medical therapy. The use of nitrates was discontinued in 18(41%) and 14(45%) patients treated with interventional therapy and medical therapy, respectively. Conclusions It is valuable to perform IVUS examination in clinical decision making for intermediate coronary artery stenosis. IVUS criteria of MLA≤ 4.0- mm 2 or area stenosis≥60% may be a reliable index of functional coronary stenosis, determining the therapeutic strategy in patients with intermediate coronary artery stenosis.

Objective To explore the efficacy of case analysis and problem discussion in teaching the course of introduction to clinical medicine for law majors and to discuss their influence on cultivating students' ability and quality.Methods Totally 58 students were randomly divided into three groups:trial group A(n =20),trial group B (n =16) and control group (n =22).Trial group A was further randomly divided into six groups.Teaching contents included iron deficiency anemia and acute leukemia.Trial group A and trial group B adpoted case analysis and problem discussion while control group practiced traditional classroom teaching.Results of theoretical test were processed through one-way analysis of variance and the least significant difference,using SPSS 11.5 software.Self-evaluation of teaching effects on students'specialized learning,logic thinking and knowledge of diseases were analyzed by Chi-square test and Fisher's exact test.Influences of different teaching methods on self learning ability,summarizing ability,team cooperation consciousness and lateral thinking were evaluated after lecture.Results Exam results showed no difference between trial group A and control group (P =0.564),the students in trial group A had a significant higher score than those in trial group B (P =0.004).100％ and 75.0％ students in trial group A considered the course of introduction to clinical medicine helpful concerning knowledge of diseases and students' specialized learning,higher than those of 77.3％ and 40.9％ in control group,with statistical differences(P =0.049,P =0.026).Positive evaluation rates of self learning ability,summarizing ability,team cooperation consciousness and lateral thinking were 100％,70.0％,80.0％,60.0％ in trial group A ;75.0％,68.8％,62.5％,81.3％ in trial group B;22.7％,36.4％,4.5％,27.3％ in control group.Except for summarizing ability,students in trial group A and B were significantly better than those in control group(P＜0.05).Conclusions The teaching method of case analysis and problem discussion meets the needs of versatile legal personnel training and it can stimulate students' study interest as well as improve their professional quality and ability.

Objective To evaluate the effects of soybean protein and animal protein on renal function of patients with diabetic nephropathy.Methods In this Meta-analysis,literatures on the effects of soybean protein and animal protein on renal function of patients with diabetic nephropathy published during January 1980 and November 2011 were reviewed and analyzed quantitatively and synthetically by using Metaanalysis RevMan 5.0 software.Results Five case-control studies met the inclusive criteria and entered into random effect model.In comparison with animal protein,soybean protein significantly improved endogenous creatinine clearance rate (weight mean difference (WMD) =-11.51,95％ confidence interval (CI)-16.37 to 6.65),proteinuria (WMD =-0.96,95％ CI-1.36 to-0.58),urine creatinine (WMD =-1.11,95％ CI-1.91 to-0.30),glomerular filtration rate (WMD =0.28,95％ CI-0.12 to 0.68),serum urea nitrogen (WMD =-0.20,95％ CI-0.60 to 0.19) and serum creatinine (WMD =-0.22,95％ CI-0.54 to 0.10).Conclusions Soy protein seems to have potential to improve urine creatinine clearance,urine creatinine,proteinuria and serum urea nitrogen.However,animal protein may contribute to increased glomerular filtration rate.

Partial hepatectomy (PH) is widely used and the preferred method for the surgical treatment of hepatocellular carcinoma,and liver regeneration is directly related to the prognosis of the patients after the operation.Therefore,the specific mechanism and cytokines related to liver regeneration have become a hot topic in recent years.Currently,there is a wide variation of reported gene expressions and signal transduction pathways in the literature,but the mechanism and interactions are still unclear,especially for postoperative liver regeneration with hepatitis or cirrhosis.This review summarizes current research on the liver regeneration process,the mechanism of liver regeneration after partial hepatectomy,and the different mechanisms of hepatocirrhosis.

Objective To evaluate the clinical efficacy of cutting balloon angioplasty (CBA) for treating lesions in small coronary arteries. Methods The diameter for reference of coronary artery is less than 2.7mm which is considered as “small vessel”. CBA procedures were performed on 25 lesions in 22 patients. Results The procedure was successfully obtained in 21 lesions(84%). Seven severe stenotic lesions (diameter of stenosis≥90%) underwent dilatation with small conventional balloon(1.5 mm diameter). Bail out stenting was performed in 2 lesions because of severe dissections. Failure of cutting balloon to pass through the stenosis in one lesion. During follow up, 5 patients had recurrence of coronary angina and 3 of them underwent coronary angiography for check up, In stent restenosis (ISR) occurred in one patient, which was successfully redilated using CBA. One patient had total occlusion of the diagonal branch with ISR of LAD. One patient developed new lesion in other coronary artery.Conclusions CBA is safe and effective, and provides a new therapeutic strategy for lesions in the small coronary arteries.

Objective To investigate the efficacy of relaparoscopic common bile duct exploration in choledocholithiasis.Methods 50 patients who underwent LC/OC/LCBDE/OCBDE for biliary surgery with choledocholithiasis were randomized into two groups:Group A (n ＝25) laparoscopic approach and Group B (n =25) open approach.The operation time,hospital stay,cost of hospitalization and postoperative complications were compared.Results There was no significant difference in the operation time,liver functional index,postoperative bile leakage rate and cost of hospitalization between the two groups.The postoperative hospital stay in group A was shorter than that in group B (7.1 ± 1.5 vs 12.4 ±4.3 days,P ＜0.05),as was the volume of intraoperative blood loss (58.3 ± 24.2 ml vs 108.6 ± 35.7 ml,P ＜ 0.05),recovery of gastrointestinal function (26.3 ±3.6 vs 58.2 ±6.3 hours,P ＜0.05),postoperative analgesia (7/25 vs 17/25,P＜0.05) and wound infection rate (1/25 vs 6/25,P＜0.05).Conclusions Relaparoscopic commonbile duct exploration for recurrent choledocholithiasis appeared to be a safe,feasible,and efficacious procedure when carried out by expert laparoscopic surgeons.The procedure is worth promoting.

Objective To investigate the influence of pullulan molecular weight and spacer length on the properties of modified pullulan carriers including morphologies,sizes and in vitro release behaviours of drug-loading carriers.Methods Using cholesterol as hydrophobic ligand,succinic anhydride and 1,6-hexyldiisocyanate as spacers,hydrophobic modified pullulans with different molecular weights were prepared.Self-assembled nanoparticles were then formed in the aqueous solution,and drug-loaded nanoparticles were prepared by dialysis method.The influence of pullulan molecular weight and spacer length on the loading-content,morphologies and in vitro release behaviours of drug-loading nanoparticles were then investigated in detail.Results Self-assembled nanoparticles could be formed by the cholesterol-modified pullulan,and doxorubicin and mitoxantrone could be loaded into cholesterol-modified pullulan to form nanoparticles.Pullulan molecular weight and spacer length show influences on sizes,morphologies and stabilities of pullulan nanoparticles and drug-loaded nanocarriers.Conclusions Before drug loading,nanoparticles with larger moleculare weight and shorter spacer length are more stable in solution,while after drug loading,the influences of these two factors on the nanoparticles are drug-type depended.