Objective To accurately understand multi-spot medical practice in China and evaluate its effect.Methods Operation data of 2008 and 2009 were gathered from all medical institutions in Kunming to analyze the effect of the practice trial using the fixed effect model.Results Under control of such factors as the scale and type of the hospitals,clinic visits of the second certified hospital benefited by the practice increased by 14％than before,whereas the medical revenue of the institution increased by 29％.The effect proves more significant in terms of total clinic visits and medical revenues at level-1 and level-2 medical institutions.Conclusion Multi-spot medical practice in Kunming proves successful as it increased medical service supply and medical revenue,especially for level-1 and level-2 medical institutions.This effect possibly results from releasing high-level physicians down to lower-level institutions,helping these institutions to attract patients.

BACKGROUND: Previous studies demonstrated that eucommia bark can promote bone marrow stern cells (BMSCs) differentiated into osteoblasts, but relative mechanism is poorly understood. OBJECTIVE: To investigate the effects of eucommia bark water/methanol extracts on expressions of osteopontin (OPN) and osteoprotegedn (OPG) in rat BMSCs. METHODS: Totally 2 g eucommia bark powder were added into water or methanol to 16 mL and oscillated for 1 hour at room temperature. After soaked overnight, both extracts were centrifuged at 15 000 r/min for 10 minutes. Water extract was obtained from supernatant in water soaked powder. In methanol soaked powder, methanol extracts was obtained by concentrated supernatant in vacuo and resolved using 16 mL water. Water and methanol extracts were then filtered by 0.22 μm membrane, and conserved at -20℃. Six SD rats, aged 2 months, were selected, and the 3~(rd)passage of BMSCs were induced by water or methanol extracts with dilution of 1 × 10~(-2), 1 × 10~(-3), 1 × 10~(-4) and 1 × 10~(-5), respectively. PBS was added in the negative control group. All cells were cultured for 6 days. Expressions of OPN and OPG was measured by immunocytochemistry at 6 days with induction. The expression of OPN and OPG induced by water and methanol at 1 ×10~(-3) and 1×10~(-4) dilution was detected by RT-PCR. RESULTS AND CONCLUSION: Immunocytochemistrical results indicated that both water and methanol extracts of eucommia bark simulated OPN and OPG expression, in particular with dilution of 1×10~(-4). The methanol extracts had a stronger effect than water extract, but the expression of OPG did not change obviously. RT-PCR demonstrated that at the 3rd day of inducement, the level of OPN expression induced by water extract was higher than that of methanol extract, and no OPG expression was detected. Osteogenic differentiation of rat MSCs induced by eucommia bark water/methanol extracts relates to stimulating expression of OPN, which has no correlation to OPG. OPN expression induced by water extract is early than that of methanol extract.

Objective To optimize the extraction conditions of volatile oil from Angelica Sinensis and Cassia Bark in Wenyang purgation granules.Methods The volatile oil was extracted from Angelica Sinensis and Cassia Bark by the method of steam distillation light oil device with diethyl ether extraction. The yield of the volatile oil was chosen as the evaluation index. The time of dip in water, the ratio of water to herbal medicine material and the time of distillation were used as the main factors. The optimum extraction conditions were investigated by the L9(34) orthogonal design. Results The optimal conditions for extraction process of volatile oil from Angelica Sinensis and Cassia Bark in Wenyang purgation granules were as follows:the time of dip in water was 3 h;the ratio of water to herbal medicine material was 10∶1;the time of distillation was 6 h. Conclusion The optimized conditions of extraction process are stable and feasible.

AIM: Test the character of Electrooculogram (EOG) in normal subjects so as to obtain reference values.METHODS: By using Vision Monitor visual evoked response imaging system, the EOG was recorded on 60 normal subjects (73 eyes).RESULTS: EOG under the condition of normal pupil was recorded in normal subjects according to ISCVE standard. The dark trough potential was (701.8±265.1)μV, the light peak potential was (1255.0±447.7)μV, the Arden ratio (light peak /dark trough ratio)was 180%±21%.CONCLUSION: Our study reflected the spatial characteristics of electrooculogram in normal subjects,provided reliable normal reference values for clinical research.

Objective To investigate the significance of antibody to Ro-52 in patients with autoim-mune liver disease(AILD). Methods One hundred and fifteen patients with abnormal liver functions, who had anti-Ro-52 detection by immunological blotting, were reviewed retrospectively. According to types of AILD, the clinical features were compared between patients with and without anti-Ro-52, respectively, κ test of concordance was used to provide a chance-corrected valve for immune-serological results. Results The rates of anti-Ro-52 in autoimmune hepatitis( AIH), primary sclerosing cholangitis(PBC) and AIH/PBC o-verlap syndrome groups were 32.43%, 24.56% and 33.33%, respectively, there were no significant differ-enees among three groups ( x2 = 0. 949, P >0. 05). The rate of anti-soluble hver antigen/liver-pancreas ( an-ti-SLA/LP) in AIH patients with anti-Ro-52 (58.33%) was higher than AIH patients without anti-Ro-52 ( 16.00% ,P < 0.05 ). The rate of anti-SLA/LP in AIH/PBC overlap syndrome patients with anti-Ro-52 (85.71%) was also higher than that of control group (28.57% ,P <0.05). Anti-Ro-52 and anti-SLA/LP had concordance according to κ test( κ >0.40, P <0.05). The average level of IgG in AIH/PBC overlap syndrome patients with anti-Ro-52 was higher than patients without anti-Ro-52 ( t = 2. 508, P < 0.05 ). Conclusion The rates of anti-Ro-52 in AIH, PBC and AIH/PBC overlap syndrome were of no significant differences. Anti-Ro-52 may have correlation with anti-SLA/LP. AIH/PBC overlap syndrome patients with anti-Ro-52 shewed higher IgG level than patients without anti-Ro-52.

AIM: To test the ability of multifocal visual evoked potential (mfVEP) in the detecting of glaucoma by comparing the mfVEP recorded from normal subjects and glaucoma patients.METHODS: The mfVEP of 32 normal eyes (n =21) and of 58 eyes (n =37) with primary glaucoma were recorded with the Vision Monitor electrophysical apparatus by the second kernel analysis and to determine the correlation of the topographic location between them.RESULTS: There were significant variability (the coefficient of variation was 43.05%) in mfVEP RMS amplitude in the normal subjects; The RMS amplitude of eyes with glaucoma were smaller than that of the normal eyes and significantly statistical difference were found in the relatively center (namely the 0° -10° ring zone) and in superior nasal quadrant (P＜0.05) while there were no significantly statistical differences of the latency time between them.CONCLUSION: The normal subjects have large individual variability of mfVEP responses. The RMS amplitude of the mfVEP of glaucomatous eyes descends, especially in center zone and superior nasal quadrant.

Objective To study the significance of antibody to double-stranded DNA (anti- dsDNA) in autoimmune hepatitis(AIH). Methods Anti-dsDNA were detected by immunological blotting. According to the anti-dsDNA, the patients were separated two groups: anti-dsDNA positive group and anti-dsDNA negative group. The clinical characteristics were compared between anti-dsDNA positive AIH group and negative group. Results Among the 43 serum samples, 13 (30.23%) eases with anti-dsDNA positive were found. The average level of AST(aspartate aminotransferase) and TBIL(total bilirubin) were (647.56 ±529.77) IU/L and (10.81± 8.08) rag/L, respectively, which was higher than that of the control group (P < 0.05). PTA (prothrombin activity) was 75.72%± 30.23 %, lower than that of the control group(P < 0.05). The liver cirrhosis rate in the anti-dsDNA positive AIH group was 61.5% (8/13), ,significantly higher than that of the control group. The time from the onset to liver cirrhosis was significantly shorter in an- ti-dsDNA positive AIH group than that of control group by the survival analysis and log rank test (P = 0. 0074). Conclusion AIH patients with anti-dsDNA positive generally associate with the serious liver damage, and prognosis is worse.

Objective To evaluate the expression of macrophage migration inhibitor factor (MiF) and cyclinD1 in pancreatic carcinoma and their relationships with clinical pathology characteristics. Methods The expression of MIF and eyclinD1 in 89 carcinoma and 5 normal pancreatic tissues was detected with immunohis-tochemistry methods, and the relationships among MIF and cyclinD1 expression and clinicopathological factors were studied. Results The overexpression of MIF and cyclinD1 was found in 88.8%, and 50. 6% of pancre-atic carcinoma tissues respectively. The overexpression of MIF had a significant correlation with Ⅰ,Ⅱ,Ⅲ,Ⅳ tumor stage (69. 2%, 94. 7%, 96. 4%, 100%, P <0.05), while the positive expression rate of cyclinD1 only had a significant correlation with tumor stages Ⅲ,Ⅳ (33. 3%, 68. 8%, P <0. 05). Both of the two proteins had a correlative tendency with pathological grade and lymph node metastasis. The different expression of MIF between pancreatic carcinoma with and without liver metastasis had no statistical significance, (100% ,85.9%, P >0. 05)while there was a statistically significant difference about cyclinD1 (66. 7% ,46. 5% ,P <0. 05). A significant positive correlation was also found between MIF and cyclinD1 (P < 0. 05). Conclusion The ex-pression of MIF and CyclinD1 was higher in pancreatic cancer tissues than in normal tissue, and they may be associated with the malignant stage, tumor differentiation, local lymph node and liver metastasis of this tumor.

Objective To analyze the feature of SLA specific T cell response in AIH. Methods Thirtyone cases of AIH were enrolled by investigating T-cell reactivity against chemically synthesized peptides spanning the full SLA protein using ELISpot. The 31 cases of AIH included 10 anti-SLA/LP positive cases and 21 negative cases. The control groups included 30 PBC patients, 29 chronic viral hepatitis patients and 30 healthy cases. The secretion of IFN-γ after PBMC stimulated by SLA peptides was observed. Results Eighteen of 31 cases with AIH [56. 08 % ( 18/31 ) ] showed the positive response to SLA peptide pools, and only 1 of 30 patients with primary biliary cirrhosis (3.34%) and 1 of 29 patients with virus hepatitis ( 3.44% ), could be elicited responses by SLA peptide pools. There wasn't positive response in healthy eases. The response frequency to SLA peptides in AIH group was significantly higher than those in PBC cases, chronic viral hepatitis cases and healthy cases (X2 = 21. 295, 20. 655, 15.988, P < 0. 01 ). Amongst 18 AIH patients with positive responds to SLA pool, 8 antigen clusters including aa 1-44, aa 57-132, an 129-180,aa 177-196, aa 193-244, aa 241-268, aa 281-308 and aa 321-428 were highlighted. The mean number of recognized peptides was 6 (2-17), indicating the polyclonal feature. Fourteen of 18 AIH patients with positive response to SLA peptides were subjected to live function test simultaneously when PBMC were collected. There was significant correlation between the breadth of recognized poptides and AST ( logarithm, r = 0. 539, P = 0. 045). Conclusions SLA peptides can induce PBMC in peripheral blood of AIH patients to secrete IFN-γ and it is polyclonal response. The breadth of recognized peptides may reflect the degree of liver inflammation.

Objective　To investigate what effects BmKAS-1 (a polypeptide purified from the Chinese scorpion Buthus martensi Karsch ［BmK］ and named as BmK activator of skeletal-muscle ryanodine receptor) and its upstream mixture BmK1-3-2 have on Na+ channels in dorsal root ganglion (DRG) small diameter neurons. Methods　The whole-cell patch-clamp technique was used to investigate the effects of BmKAS-1 and BmK1-3-2 on Na+ current in rat small diameter DRG neurons. Results　About 50% peak Na+ current was suppressed by 10*!μg/ml of BmK1-3-2. 1.62*!μg/ml of BmKAS-1 also blocked 50% peak Na+ current, and there was an obvious dose-dependent relationship. Conclusion　Both BmK1-3-2 and BmKAS-1 have a blocking effect on Na+ channels, and this may one of the mechanisms for the analgetic effect of BmK1-3-2 and BmKAS-1.