As a molecular switch,Rho can be transformed between the inactive GDP-bound form and the active GTP-bound form,transfering signals to downstream effector Rho kinase (ROCK),mediating specific biological effects,and participating in various neurological diseases, such as the pathological processes of ischemic stroke,cerebral vasospasm,and axonal regeneration after spinal cord injury.The application of ROCK inhibitor in the treatment of neurological diseases has achieved satisfactory effect.Rho/ROCK is expected to become a novel therapeutic target.

Objective To find out about community residents' demands and intentions for health service and explore new ways of delivering life-long health service. Methods An investigation was made via sending questionnaires to each household into the health conditions and demands and intentions for health service of 700 residents in 5 neighborhood committees and 1000 discharged patients as well as sub-healthy groups of people in a certain area in Nanchang. Results Of those surveyed, the two-week morbidity was 438 per thousand; the chronic morbidity was 574 per thousand; only 31.1% of the residents went to eommanity hospitals for medical service; and 63.4% of the residents never took any health care service while 59.6% of the residents thought it necessary to take health care service. Conclusion The masses of people are in dire need of low-price life-long medical service. Second-grade third-tier and second-tier hospitals in big and medium-sized cities may explore viable new ways of medical service that will meet the needs of society.

China ; Gastroesophageal Reflux ; therapy ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; methods

Objective To probe into the social support, coping styles, and mental health status of medical staff in a tertiary hospital in Beijing, for identifying potential mental problems. Methods Such means as the Social Support Rating Sheet (SSRS), Simple Coping Style Questionnaire (SCSQ), Symptom Checklist (SCL-90), and demographic characteristics questionnaire were called into play, to study 2460 medical staff in five tertiary hospitals in Beijing. Results Differences were identified among medical staff of different demographic characteristics, in terms of positive coping style and support dimensions. Analysis of the survey data indicates that the total SCL scores, total symptom problem index, positive symptom pain level, total average score of the factors, are positively related to passive coping style, as P<0. 01; and are negatively related to subjective/objective support, support utilization, and total support scores, as P<0. 01. Conclusions Hospital administration is expected to implement focused intervention to such medical staff as those under 40 years old, women, widows or divorcees, those with education lower than university degree, those with junior academic title or lower, those without titles, those in emergency departments and emergency intensive care units, doctors and nurses, frequent night-shift workers, those of excessively low self evaluation, and medical staff with chronic diseases. The purpose of this practice is to alleviate their mental stress.

Objective To evaluate the MR lymphangiography (MRL)in diagnosis of limb lymphedema.Methods A total of 582 patients with lymphedemtous limbs were enrolled in the study,MRL was performed at 3.0T MR.The morphology and enhancement of the lymph nodes,the number of lymphatic vessels and the lymph flow were evaluated.Results No matter in primary or secondary lymphedema,there were patients showed only lymph nodes affected,or only lymph vessels affected,and some patients showed both affected.Lymphatic aplasia,hypoplasia or hyperplasia were showed in primary lymphedema.Obstruction lymphatic vessels,and lym-phangiectasia were showed in secondary lymphedema.The velocity of lymph flow was (1.0±0.62)cm/min in affected limb of pa-tients with primary lymphedema,which was significantly slower than that of affected limb of patients with secondary lymphedema (2.22±1.64)cm/min(P<0.01)in dynamic contrast-enhanced MRL.In both type of lymphedema,the contrast enhanced lymph nodes showed less nodes with delayed enhancement and lower signal intensity,compared to that of lymph nodes in the contralateral normal side.Conclusion Dynamic contrast-enhanced MRL is helpful for assessing the anatomical and functional status of lymphatic system in lymphedematous limb.This new imaging techniques provides a powerful tool for the diagnosis of lymphedema.

Objective To evaluate the surgical modalities and prognosis in elderly patients with gastric cancer.Methods Sixty three gastric cancer patients aged ≥≥ 75 years underwent radical surgery,with D0 + D1 resection in 32 cases and D2 resection in 31 cases,in Beijing Hospital from January 2005 to December 2009.Results More lymph nodes were dissected in D2 group than those in D0 + D1 group (27.42 ± 12.75 vs.14.59 ± 12.11,t =-4.095,P ＜ 0.05).There was no significant difference in postoperative complication rate [25.81％ (8/31) vs.31.25％ (10/32),x2 =0.095,P ＞ 0.05] and perioperative death rate [3.23％ (1/31) vs.6.25％ (2/32),x2 =0.324,P ＞ 0.05] between two groups.The 5-year survival rate was higher in D2 group than that in D0 ± D1 group (47.3％ vs.21.4％,x2 =6.346,P ＜ 0.05).The 5-year survival rate was higher in POSSUM score (PS) ＜ 20 group than that in PS≥20 group (46.3％ vs.11.1％,x2 =5.492,P ＜0.05).In PS≥20 group,postoperative complication rate did not increase after D2 radical resection(1/8 vs.3/10,x2 =0.824,P ＞ 0.05).Univariate analysis showed that PS ＜ 20 was associated with the prognosis of patients (x2 =5.492,P ＜ 0.05).Cox proportional hazards model showed that lymph node metastasis (OR=4.103,95％ CI:1.790-9.405,P ＜ 0.05) and D2 radical gastrectomy(OR =0.313,95％ CI:0.158-0.620,P ＜ 0.05) were the independent factors associated with the prognosis of patients aged ≥ 75 years with gastric cancer (all P ＜ 0.05).Conclusion Standardized D2 lymph node dissection is beneficial for gastric cancer patients aged ≥75 years.PS ＜ 20,lymph node metastasis and D2 radical gastrectomy are associated with the prognosis of patients.

Objective To evaluate the diagnostic value of 99Tcm-MDP SPECT/CT in the diagnosis of lumbar spondylolysis.Methods A total of 58 patients (28 males,30 females,average age 61.3 years) who underwent bone scan and SPECT/CT because of low back pain from January 2012 to May 2014 were retrospectively evaluated.The final diagnosis was based on comprehensive results of SPECT/CT and followup.The diagnostic sensitivity and accuracy of SPECT,CT and SPECT/CT images were calculated and x2 test was performed to analyze the data.Results Twenty-eight patients were diagnosed as lumbar spondylolysis.The diagnostic sensitivities of SPECT,CT and SPECT/CT were 53.6％ (15/28),78.6％ (22/28) and 100％(28/28).The diagnostic accuracies of SPECT,CT and SPECT/CT were 48.3％ (28/58),89.7％ (52/58) and 93.1％(54/58).SPECT/CT was proved to be more accurate than SPECT(x2=28.13,P＜ 0.05).Conclusion SPECT/CT bone scan may detect lumbar spondylolysis in early stage.

AIM:To investigate the potential effect of all-trans retinoic acid (ATRA) on the proliferation of human breast cancer MCF-7 cells and its underlying mechanism.METHODS:Human breast cancer MCF-7 cells were in-cubated in DMEM supplemented with 10%fetal bovine serum and 1%penicillin/streptomycin.Western blot was performed to detect the protein expression and its phosphorylation.MTT assay and bromodeoxyuridine ( BrdU) incorporation, and TUNEL staining were carried out to determine the cell proliferation and apoptosis, respectively.Lentivirus carrying shRNA sequences targeting the gene of docking protein 1 ( DOK1 ) was used to silence DOK1 expression.The activity of peroxi-some proliferator-activated receptor gamma ( PPARγ) was measured using a PPARγtranscription factor assay kit.RE-SULTS:ATRA treatment suppressed the proliferation and promoted the apoptosis of MCF-7 cells.ATRA was also found to induce DOK1 expression in a time-dependent manner.Silence of DOK1 mitigated anti-cancer effect of ATRA evidenced by recovered the cell proliferation and reduced the cell apoptosis.In addition, DOK1 knockdown inhibited PPARγexpression and activity.Furthermore, inhibition of PPARγwith its specific inhibitor GW9662 attenuated impacts of ATRA on the cell proliferation and apoptosis.CONCLUSION: ATRA suppresses MCF-7 cell survival through inhibiting cell proliferation and promoting cell apoptosis, which is mediated by DOK1-activated PPARγ.

Objective To analyze the impact factors for early renal damage in type 2 diabetic patients by the classification tree model.Methods A total of 601 patients with type 2 diabetes were enrolled.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 2 diabetes group (418 cases) and early diabetic renal damage group (183 cases).The clinical data of the patients were recorded to analyze the main influential factors for the microalbuminuria of type 2 diabetic patients using the Exhaustive CHAID classification tree algorithm.Results Six important explanatory variables were screened out by the classification tree model from the 34 candidate variables related to early renal damage,including fibrinogen,history of hypertension,retinopathy,Cys C levels,SBP and peripheral neuropathy.Elevated fibrinogen was the main factor.Conclusion The classification tree model can analyze the major influential factors of early renal damage in type 2 diabetic patients effectively,and it can help develop the prevention and treatment methods.

Objective To evaluate the effects of mild hypothermia therapy on cerebral function and edema as assessed by magnetic resonance imaging (MRI ) during the first 72 hours after restoration of spontaneous circulation (ROSC)in a porcine model.Methods Ventricular fibrillation was induced in 33 Inbred Wuzhishan miniature swine.After ventricular fibrillation untreated for 8 min,standard CPR was initiated and 30 animals got ROSC.The ROSC animals were randomly (random number)assigned to normothermia group (n=15 ) and hypothermia group (n =15 ).The hypothermia group immediately received endovascular cooling to regulate temperature to 33 ℃,which was maintained for 12 h,followed by passive rewarming at 0.5 ℃/h to 37 ℃.The two groups were scanned to get Diffusion-weighted imaging (DWI)at baseline (before experiment),6 h,12 h,24 h,and 72 h after ROSC.The statistical analysis was carried out with Student t test,One-way repeated-measures and Kaplan-Meier survival analysis.Results Compared with the normothermia group,the hypothermia group exhibited a higher 72-h survival rate (73.3% vs.40%,P<0.05),lower neurological deficit scores (43.81 vs.119.50;P<0.01),a lesser decrease in the apparent diffusion coefficient during DWI and milder cerebral edema on DWI image. Conclusions Cerebral edema occurred at early stage after ROSC.Cerebral edema was worst at 6 hours after ROSC and then subsided gradually.Hypothermia therapy could reduce cerebral edema and produce a protective effect on neurological function.MRI could effectively reflect the underlying trend of cerebral injury of swine within the first 72 h after ROSC,and demonstrated that hypothermia could reduce brain edema, increase cerebral blood flow,and reduce the production of toxic metabolites.DWI could monitor brain injury after resuscitation and could be used to evaluate the efficacy of hypothermia intervention dynamically.