Objective To study the interference effects of tetramethylpyrazine (TMP) on calcinuerin (CaN), c-fos and the nuclear antigen of proliferating cells in the proliferation of vascular smooth muscle cells (VSMCs) treated by angiotensinⅡ(Ang Ⅱ). Methods A cell proliferating model of VSMCs induced by Ang Ⅱ was established; the effects of TMP on CaN was detected by enzyme reaction phosphorus measurement; the effects of TMP on c-fos gene and PCNA expression were observed by immunocytochemical staining and image analysis technique (A value). Results The rats’ aortic smooth muscle cells were cultured in vitro successfully. CaN activities, cell proliferation activity and the expression levels of c-fos and PCNA increased significantly in VSMCs proliferation induced by Ang Ⅱ (P

Objective To investigate the difficulties in posterior approach lumbar microendoscopic discectomy (MED). Methods We retrospectively analyzed records of 42 cases of lumbar disc protrusion (totally 45 interspaces) treated by MED from February 2002 to October 2003. Results Conversion to open surgery was required in 3 cases.No intra- or post- operative complications were seen.Follow-up survey for 2 ～ 22 months (mean,8 months) found the "good" or "excellent" results in 95 2% of the patients (40/42).Surgical difficulties were mainly classified into two aspects: technical and etiological,including 8 cases of failure of collimation between the passage and the interspace,5 cases of excessive bleeding disturbing the operation,3 cases of incomplete surgical apparatus,2 cases of incorrect passage localization,2 cases of hyperplasia in tiny joints,1 case of ossification of the posterior longitudinal ligament,1 case of nerve root edema,1 case of accretion,and 1 case of laceration,respectively. Conclusions Treatment of lumbar disc protrusion with MED gives satisfactory efficacy.Proper selection of patients and careful performance during surgery are essential to a successful procedure.

Objective To observe the clinical efficacy of different kinds of insulin combined with Metformin in the treatment of T2DM.Methods 120 T2DM patients were selected and divided into three groups according to different therapies of reducing blood sugar with 40 cases in each group.Group A was treated with insulin glargine combined with Metformin;Group B with insulin detemir combined with Metformin and Group C with protamine zinc insulin combined with Metformin .The time for reaching the standards of blood sugar and the corresponding usage amount of insulin of three groups were observed;After 6 months, the three groups were com-pared in terms of FBG, PBG HbA1c, HOMA-IR, TC, TG and LDL-C.Meanwhile, the incidence rate of hypoglycemia after treat-ment was observed.Results Time for reaching the standards of blood sugar in Group A, Group B and Group C was (6.9 ±2.3)d, (4.1 ±3.0)d and (3.8 ±1.5)d, respectively;the corresponding dosages of insulin of the three groups was (19.0 ±7.8)U, (12.1 ±5.9)U and (11.9 ±5.3)U, respectively, with significant difference between Group A and Groups C, D (p<0.05) and insignifi-cant difference between Group B and Group C (p>0.05).After 6 months, FBG, PBG, HbA1c, HOMA-IR in Group B, Group C and Group A were significantly reduced (p<0.05);with insignificance between Group B and Group C (p>0.05).6 months follow-ing the treatment, TC, TG and LDL-C in Group B, Group C and Group A were significantly different (p<0.05), with insignificant difference between Group B and Group C (p<0.05).The incidence rate of hypoglycemia in Group A, Group B and Group C was 22.5%, 20.0% and 5.0%, respectively, with those in Group B and Group C significantly lower than Group A (p<0.05) and in-significant difference between Group B and Group C (p>0.05).Conclusion The insulin detemir and protamine zinc insulin com-bined with Metformin has a better clinical efficacy in the treatment of T2DM.It can promptly control the blood sugar level and lead to a lower incidence rate of hypoglycemia.Therefore it is worthy of promotion.

The clinical skills competitions for national medical students in China have been well organized for five times.Experience has been accumulated,and much has been emphasized on the low assessment efficacy throughout the competitions.However,few solutions has been brought about to conquer such problem.This article mainly focused on introducing a computerized clinical skill assessment system based on current clinical skills competition assessment.The system realizes functions such as team management,online marking,score calculation,data analysis,and real-time result presentation.Such appliance of computer,internet and information technology on conventional clinical skills evaluation could hopefully replace the traditional manual calculating procedures,improving the efficiency of the future competitions,to ensure their openness,impartiality,and equitability,as well as to deliver observatory appeal among audience.

0.05). The BHR distribution was slight 31.9%, mild 43.5%, moderate 24.6%, no severe BHR were found in this study, showing less correlation between the percentage of predicted FEV 1 and the PD 20FEV 1-His in the elderly (r=0.277, P

Objective To discuss the application of role reversal teaching in the clinical course of rehabilitation medicine. Methods 64 students of a vocational college under clinical practice were divided into traditional teaching group (n=30) and role reversal teaching group (n=34). The achievement of knowledge and practice tests were compared after course. Results There was no significant difference in the score of knowledge test between the groups before clinical practice (P>0.05), however, the scores of both knowledge and practice tests were higher in the role reversal teaching group than in the traditional teaching group (P<0.001). Conclusion The role reversal teaching may improve the achievement of students for clinical course of rehabilitation medicine.

Objective To explore the relationship of neutrophil and interleukin-8(IL-8)with exercise-induced asthma(EIA).Methods From May 15,2001 to Dec 19.2005 the levels of peripheral neutrophil superoxide anion and IL-8 in the blood and the induced sputum from patients with EIA,non EIA and normal control subjects were measured respectively before and after exercises,meanwhile a comparison was made among them.Results Before exercise:the level of neutrophil superoxide anion was slightly higher in EIA group and non EIA group than that in control group;however,the differences were insignificant;the IL-8 and MDA levels in blood and induced sputum were higher in EIA group and non EIA group than those in control group,but there was no significant difference between EIA group and non EIA group;however,they were significantly different between EIA group and control group,non EIA group and control group respectively( P 0.05).Conclusion Oxyradical produced by neutrophil and IL-8 has significant effect on the production of EIA.

Objective To observe the effect of TanshinoneⅡA( TanⅡA) on endometriosis( EMS) rat model and study the possible mechanism. Methods EMS rat model was established by autologous endometrium transplantation. EMS rats were randomly divided into five groups: high-, medium-, low-dose TanⅡA group, mifepristone group and model control group( n=10), the other ten normal rats as normal control group.The rats in the model control group and normal control group were given 0.9% sodium chloride solution. The rats in the mifepristone group were given 25 mg . kg-1 . d-1 mifepristone. The rats in the high-, medium-, low-dose TanⅡA groups were given 30, 20 and 10 mg.kg-1.d-1 TanⅡA, respectively.Four weeks after the treatment, the volume of endometriotic implants in each rat was measured. Pathological changes of ectopic endometrium were observed under light microscope.Expression levels of Bcl-2, Bax and Caspase-9 in ectopic endomembrane of rats were determined by Western blotting. Results High and medium dose TanⅡA and mifepristone significantly reduced the volume of ectopic lesions(P<0.05).As compared with model control group, the inhibition rate of the ectopic lesions in low-, medium-, high-dose TanⅡA groups and mifepristone group was 17.81%, 57.78%, 58.88% and 64.12%, respectively.High and medium dose TanⅡA and mifepristone promoted atrophy of ectopic endometrium, inhibited the expression of Bcl-2 protein and promoted the expression of Bax and Caspase-9 in ectopic tissues( P<0.05) . Conclusion TanⅡA significantly decreases the size of ectopic lesions in rats, possibly through reducing the expression of Bcl-2 and increasing the expression of Bax and Caspase-9 to regulate cell apoptosis.

Objective To analyze the serum inflammation related factors of influenza A ( induced by sub-type H1N1 virus) patients with epidemic febrile damp-heat syndrome and warm-heat syndrome. Results Fifty-six patients confirmed as influenza A ( H1N1) were differentiated into epidemic febrile damp-heat syndrome ( 36 cases) and epidemic febrile warm-heat syndrome (20 cases) . And then we observed the serum immune globulins IgM and IgG, interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-ɑ), tumor growth factor beta 1 (TGF-β1), lipolysaccharide binding protein (LBP), Toll-like receptor 4 (TLR4) and soluble CD14 (sCD14) levels of the influenza A patients. Results Insignificant differences of serum IgM, IgG, IL-8, TNF-ɑand TGF-β1 levels were shown between epidemic febrile damp-heat syndrome patients and epidemic febrile warm-heat syndrome patients (P>0.05), but the differences of LBP, TLR4 and sCD14 were significant (P<0.05) .Conclusion Influenza A (H1N1) patients with epidemic febrile damp-heat syndrome have higher serum LBP, TLR4 and sCD14 levels than patients with epidemic febrile warm-heat syndrome, indicating that inflammatory reaction is severer in influenza A (H1N1) patients with epidemic febrile damp-heat syndrome.

Objective To explore the effect of transforamen lumbar interbody fusion in treatment of lumbar intervertebral disk herniation with unilateral pedicle screw fixation. Methods Retrospectivly studied the clinical data of 36 patients with lumbar intervertebral disk herniation who were treated through transforamen lumbar interbody fusion with unilateral pedicle screw from January 2011 to October 2012. There were 22 male and 14 female patients, aged form 44 to 68 years old with mean age of 56. The lesion positions included 8 patients in L3/4, 17 patients in L4/5, and 11 patients in L5/S1. The data of operation time, intraoperative bleeding volume, and postoperative drainage volume were collected. Therapeutic effect were evaluated by visual analogue score (VAS), lumbar vertebral score of Japanese Orthopedic Association (JOA) score, and Oswestry dysfunction index (ODI). Results Operation time was 65-100 min with mean time of 85 min. Intraoperative bleeding volume was 100-250 ml with mean volume of 135 ml. Postoperative drainage volume was 100-200 ml with mean volume of 150 ml. Followed up for 12-36 months with mean time of 20 months. No loosening, breakage of screws or displacement of interbody fusion cages were found in the follow up period. The rate of anastomosis was 100%(36/36). The VAS was (7.9 ± 1.2) scores before operation and (1.1±0.3) scores at the end of follow up period, there was significant difference( P<0.05). The JOA score was (10.2±2.6) scores before operation and (23.2±4.3) scores at the end of follow up period, there was significant difference (P<0.05). The ODI was (43.3±6.2) scores before operation and (15.2±4.3) scores at the end of follow up period, there was significant difference ( P<0.05). Conclusion The effect of transforamen lumbar interbody fusion with unilateral pedicle screw fixation is proper for the patients who are suffering from lumbar intervertebral disk herniation, which has advantages of less invasion, less bleeding, better stability, better effect, quicker recovery and less complication.