Objective To investigate the effect of exogenous calcitonin gene related peptide(CGRP) and nerve growth factor(NGF) on the expression of cyclic AMP response element binding protein(CREB) and phosphorylated CREB(p-CREB) in rat hippocampus during focal cerebral ischemia/reperfusion(I/R). Methods Focal cerebral ischemia/reperfusion model was set up by occlusion of the right middle cerebral artery using the intraluminal suture method.The expression of CREB and p-CREB in the right hippocampus were detected with immunohistochemistrical SABC method and Western blotting.The immunoreactive positive products were analyzed by image analysis system. Results The expression of CREB decreased in I/R group as compared with sham group in right hippocampus,but the expression of p-CREB was higher in I/R group than that in sham group(P

Children systemic rheumatic diseases are characterized by multisystem involvement,the underlying pathogenesis for gastrointestinal manifestations is deposition of immune complexes in blood vessel walls resulting in ischemia or thrombosis.Gastrointestinal manifestations of these diseases often can't be diagnosed early and correctly,because children can't demonstrate the clinical features accurately,the clinical manifestation varies and often nonspecific,and often confused with the side effect of medicine.Gastrointestinal manifestations are considered rare,comparing with other system involvement,but the consequence can be life-threatening.This makes early and immediate diagnosis and management very important.This paper reviews the various children systemic rheumatic diseases that affect the gastrointestinal tract,including systemic lupus erythematosus,Henoeh Schonlein Purpura,Bechet's disease,mixed connective tissue disease,scleroderma,polyarteritis nodosa,Wegener's granulomatosis,Sjogm's syndrome,dermatomyositis.

Systemic lupus erythematosus(SLE) is an autoimmune inflammatory disease,virtually every system and organ can be affected.Gastrointestinal manifestations of SLE attract far less attention than the other major organ involvements.Gastrointestinal manifestations of these diseases often can't be diagnosed early and correctly,because the clinical manifestation varies and often nonspecific,and often confused with the side effect of medicine.But SLE related gastrointestinal involvement is clinically important because some cases can be life-threatening if not treated promptly.This paper reviews the common SLE gastrointestinal involvements,including the diagnosis and treatment of esophageal and gastric involvement,lupus mesenteric vasculitis,lupus pancreatitis,lupus peritonitis,pseudo-obstruction,proteinlosing gastroenteropathy,and hepatic involvement,to improve the recognition of gastrointestinal manifestations,and make an early and accurate diagnosis so that appropriate treatment along with prognosis can be made.

The etiology of inflammatory bowel disease(IBD) is complex and multifactorial.Recent genetic association studies within large IBD cohorts have identified 163 genetic loci.But these 163 loci in total explain 13.6％ of Crohn's disease and 7.5％ of ulcerative colitis total disease variance.The classification defines very early-onset IBD as diagnosis before the age of 5 years old,and also before the age of 6 years old in some research.It is likely that genetic factors contribute more to the etiology of very early-onset IBD.Recently some cases have been reported,which have linked to very early-onset IBD,such as IL-10 and IL-10 receptor gene mutation,immune dysregulation,polyendocrinopathy,enteropathy,X-linked syndrome,X-linked lymphoproliferative syndrome,IL-21 deficiency,mevalonate kinase deficiency,and so on.And many of these diseases are classified as primary immunodeficiencies.This paper introduces these series of very early-onset IBD in brief.

AIM: To establish a method of determining the content of total saponin of Radix et Rhizoma Notoginseng in buccal tablets by HPLC. METHODS: Chromatographic conditions are as follows:Hypersil NH_2 column(4.6 mm?200 mm,5 ?m) as the stationary phase,acetonitrile-1% phosphate buffer solution(0-10 min,20:80;10-20 min,25:75;20-25 min,45:55;25-30 min,50:50) as the mobile phase,the velocity of flow is 1.0 mL/min,the temperature of coloum is 35(?C) and the detection wavelength is 203 nm. RESULTS: The HPLC method has good linearity in determining the total saponin of Radix et Rhizoma Notoginseng content,and we can detect four saponins at the same time,linear range,ginsenoside Rg1 0.093 75-6 ?g,ginsenoside Re 0.011 72-0.75 ?g,notoginsenoside R1 0.023 44-1.5 ?g and ginsenoside Rb1 0.140 6-9 ?g,the correlation coefficient r=0.999 9. CONCLUSION: The established method in this article is simple and convenient,with good reproductivity.We can detect four saponins in the total saponin of Radix et Rhizoma Notoginseng Buccal Tablets at the same time by this method.It can be used for quality control of the total saponin of Radix et Rhizoma Notoginseng Buccal Tablets.

AIM:To investigate the efftct of Gypenosides on contraction of isolated duodenum smooth mustle of rabbits.METHODS:The routine experimental method of isolated duodenal smooth muscle of rabbits were used.The contraction curves of isolated duodenum smooth mustle before and after administration of different concentrations of Gypenosides(0.01%-1.00%)were recorded by Medlab biological information collecting system.RESULTS:Different concentrations of Gypenosides significantly reduced the contraction amplitude of isolated duodenum smooth mustle of rabbits,and showed a dose-dependent relationship.CONCLUSION:Gypenosides can inhibit the contraction of isolated duodenum smooth muscle of rabbits.

Objective To discuss the treatment effect of locking-proximal-humerus-plate (LPHP) for three- or four-part proximal humeral fractures. Methods A retrospective study was done on 13 cases of proximal humeral fractures treated with LPHP from July 2003 to January 2005. There were six males and seven females, with age of 24-73 years (mean 49.8 years). According to Neer classification, five cases were with three-part fractures and eight with four-part fractures including six cases with osteoporosis. Reduction and fixation was done via deltopectoral-groove approach, without cutting the capsule or peeling the soft tissues of the greater and lesser tuberosity. Of all, three cases with bone defects was treated with allografts. Shoulder exercise could be performed passively three days after operation. One week after operation, passive and active shoulder exercise was done, which was gradually intensified two weeks after operation. Results A follow up for 3-20 months (average 11 months) on 12 cases showed that all fractures were healed. According the Neer shoulder score, the results was excellent in six cases, good in four and fair in two, with excellence rate of 83.3%. Conclusions The screw of LPHP can lock the plate so that the plate can firmly fixate the fractures without tightly contacting the bone, as simultaneously reaches fracture healing and function exercise and enhances the treatment effect. LPHP is a specially suitable procedure for osteoporosis and three-or four-part proximal humeral fractures.

BACKGROUND:Human memory is significantly correlated with recognition. When recognition begins to decrease, a decrease in memory appears first. How about the memory of rural population?OBJECTIVE:To investigate the picture memory related factors of the rural households who are over 50 years old.SETTING:Department of Geriatrics,Huaian First Hospital,Nanjing Medical University;Department of Neurology, Huashan Hospital,Fudan University.PARTICIPANTS:Totally 50 rural inpatients at the Department of Geriatrics,Huaian First Hospital Nanjing Medical University,who would be recovered and out of charge,were selected from March 2003 to February2004. Meanwhile, 11 relatives of the patients and 55 healthy elderly people from Dingji Town,Huaiyin District, were also included.All the participants were over 50 years old.METHODS:Employing questionnaire,mini-mental state examination,auditory-verbal learning test (AVLT), pictorial learning test and many nonmemory tests were performed. According to the levels of education,participants were divided into illiterate group,primary school group,junior middle school group and higher than junior middle school group.The correlation of picture memory ability with sex,age,educational level and simple intelligence test was compared. And the interactions among variables of picture memory were also investigated.MAIN OUTCOME MEASURES:The relationships between the variablesof picture memory and age, sex, educational level and simple intelligence of rural households in Huaian city were calculated. And the interactions among these variables were all investigated.RESULTS:Practically, 103 participants entered the statistical analysis proage,sex,educational level and simple intelligence:Except for recurring figures, all the other variables of picture memory had positive correlations with simple intelligence and educational level (r=0.197-0.533, P ＜ 0.05-0.01).Among them, immediate memory showed the closest correlation with simple intelligence (r=0.533).Delayed recall memory of pictures, recurring figures,and serial memory 4 (the number of recalled pictures in the last 4 pictures in delayed recall test) had negative correlation with age (r=-0.194 to -0.324,P ＜ 0.05-0.01),among them, serial memory of 4 pictures had the closest correlation with age (r=-0.324),while, all the other variables were not related to age. All the variables of picture memory were not linked to sex. Recurring pictures was not linked to educational level 1 (period of education:0-11 years),2 (education level: illiterate, primary school, junior middle interactions among these variables:Recurring figures was not linked to serial memory 2 (the number of recalled pictures in the last 4 pictures in immediate memory test),serial memory 1 (the number of recalled pictures in the first4 pictures in immediate memory test) was not related to serial memory 2 and serial memory 4.Except for these cases, variables of picture memory had significant correlations with each other (r =0.206-0.855 ,P ＜ 0.05-0.01),and delayed recall memory of pictures had the closest relationship with conceptual memory 2 (r=0.855).CONCLUSION:Picture memory capacity of middle aged and elderly rural households is not linked to sex, while it is correlated with age,educational level and intelligence.

Objective To summarise the clinical data of neonatal early onset sepsis (EOS) and investigate the correlation factors, clinical manifestation, diagnosis, therapy and prognosis of EOS. Methods Data of 32 neonatal EOS patients admitted into the neonatal intensive care unit, Peking Union Medical College Hospital from January 2000 to June 2009 were collected and retrospectively analyzed. Results Among 32 EOS infants, there were 23 preterm infants (71.9%), nine term infants (28.1%); 21 low birth weight infants (65.6%), six very low birth weight infants (18.8%) and one macrosomia (3.1%). Among 32 mothers, 27 (84.4%) were accompanied with various kinds of complications during perinatal period, such as 15 perinatal infection (46.9%), six preeclampsia (18.8%), five gestational diabetes mellitus (15.6%) and one hypothyroidism (3.1%). EOS infants had various clinical manifestations, including 25 low response (78.1%), 20 respiration or temperature abnormity (62.5%), 18 pallor and clammy skin (56.3%), 18 feeding intolerance (56.3%), 18 fever (56.3%), 15 metabolic acidosis (46.9%), 8 infectious shock (25.0%), 20(62.5%) high white blood cell count (>25×109/L), 22 (68.8%) low blood platelets (<100×109/L) and 28 (87.5%) high C-reaction protein (>8 mg/L). Blood culture of 24 infants were positive (75.0%), among which nine infections were caused by gram-positive bacteria (9/24, 37.5%), including Listeria monocytogenes, group B Streptococcus, Staphylococcus, et al; 15 infections were caused by gram-negative bacteria (15/24, 62.5%), including Klebsiella Pneumoniae, Enterobacteria, Bacillus Smaragdinus, et al. Antibiotics were used in all infants when EOS was supposed to be or infectious symptoms were presented, and were adjusted under the results of culture. Twenty-two infants (68.8%) were cured, eight(25.0%) were given up from the therapy, two(6.3%) died. Conclusions The neonatal EOS correlates to various kinds of perinatal factors, its clinical manifestations are complicated and usually involves many systems. Multiple factors in perinatal period, clinical manifestation and laboratory examinations should be considered to make early diagnosis, assist management to improve the prognosis.

BACKGROUND: Bone joint immobilization is often used to prevent the injured tissue from secondary injury.OBJECTIVE: To investigate the effects of knee immobilization on biomechanical changes in rabbit patellar tendon and ultrastructure morphology. METHODS: Twenty adult rabbits were assigned into two groups. The left hindlimbs of rabbits in the immobilized group (n = 10) were immobilized by plaster of paris and two adjustable aluminium splints for 6 weeks, while those left hindlimbs in the control group (n = 10) served as controls. Rabbit knees were immobilized in extension and the ankle was immobilized at 90°flexion for 6 weeks. Then the patellar tendon-bone complex was harvested to observe the biomechanical properties and ultrastructure changes of patellar tendon. RESULTS AND CONCLUSION: After 6-week immobilization, the tensile strength and tangent modulus of patellar tendon-bone complex were decreased to 64.44% and 53.08% of the control values (P < 0.01). However, there was no significant difference in the elongation at failure and the maximum load between the immobilized and control groups. The curves of stress and strain of patellar tendon based on the average material constant were greatly different. The cross-sectional area of patellar tendon was significantly larger in the immobilized group than in the control group (P < 0.01). Smaller collagen fibrils took the predominance in the immobilized group. These results showed that immobilization of knee joint could result in biomechanical changes of patellar tendon and produce influence on patellar tendon.