BACKGROUND: How to lessen neuronal necrosis to promote recovery of nerve function after ischemic cerebral injury? Cerebral ischemic preconditioning (IP) alleviates ischemic cerebral injury caused by re-ischemia to certain extent. It has been verified that sodium ferulate can lessen the incidence of neuron apoptosis after cerebral ischemia. Whether does sodium ferulate enhance the nerve protection of IP brain to not?OBJECTIVE: To explore the protection of sodium ferulate allied with IP in cerebral ischemic-reperfusion injury.DESIGN: Randomized controlled animal experiment was designed.SETTING: Neurological Surgery Department of 2nd Affiliated Hospital of Jiangxi Medical College, Department of Physiology of Jiangxi Medical College, Institute of Urinary Surgery of Jiangxi Medical College.MATERIALS: The experiment was perforned in Laboratory Room of Neurological Surgery Department of 2nd affiliated Hospital of Jiangxi Medical College from May 2001 to April 2002, in which, 85 Wistar male rats were employed, mass weighted varied from 250-300 g.METHODS: The rats were randomized into 4 groups: ① The control without ischemia (10 rats): Vertebral artery was ligatured bilaterally and common carotid artery was not clipped bilaterally. ② The control with ischemia (25 rats): Vertebral artery was ligatured bilaterally for 48 hours and common carotid artery was clipped for 10 minutes. ③ IP group (25rats): Vertebral artery was ligatured bilaterally for 48 hours and common carotid artery was clipped for 2 minutes, and 24 hours later, the common carotid artery was clipped again for another 10 minutes. ④ Sodium ferulate allied with IP group (Allied group) (24 rats): After IP, the common carotid artery was clipped again for 30 minutes and sodium ferulate (200 mg/kg)was injected intravenously from tail. The control without ischemia was subdivided into two groups of 2 days and 7 days after reperfusion respectively (5 rats for each one). The control with ischemia, IP group and allied group were subdivided into 5 groups of 6 bours, 12 hours, 24 hours,2 days and 7 days after reperfusion successively (5 rats for each one).The rats were sacrificed to collect brains at phase spots in each group.Coronary brain slice was collected 2.2 mm posterior to the optic chiasm and the effects of allied with was observed on neuron count and apoptotic cell count in cortex and hippocampal CA1 in cerebral ischemia reperfusion.MAIN OUTCOME MEASURES: Neuron count and apoptotic cell count in cortex and hippocampal CA1.RESULTS: Totally 85 experimental rats all entered result analysis. ①Neuron count in cerebral cortex and hippocampal CA1: On the 7th day after ischemia, the counts in IP group and allied group were higher than ischemia control (268±8.5, 244±12.5, 135±5.6, P ＜ 0.01). ② Count of TUNEL positive cell in cerebral cortex and hippocampal CA1: The count in allied group was lower than that in IP group and ischemia control (12 hours:1.2±0.8, 15.5±2.1, 39.8±3.9; 24 hours: 1.8±1.6, 39.3±11.8, 191.3±19.1;2 days: 2.8±1.2, 68.3±13.6, 328.4±24.0, P ＜ 0.01), and that in IP group was lower than ischemic control (P ＜ 0.01).CONCLUSION: IP lessens apoptotic neuron count in ischemic region.Sodium ferulate allied with IP further intensifies such effect and provides the protection of ischemic reperfusion injury of brain.

Objective:To study the effects of group counseling which based on interpersonal activities and aimed at the college students with computer gaming addiction in China.Methods:Seventeen college students with computer game addiction were chosen as the experimental group,and 10 college students from another college were chosen as the control group.The two groups had no difference in the scores of Computer Gaming Addiction Invention(CGAI)and several other scales before group counseling.There were a pre-test and a post-test separately set when the group counseling was started and finished,focused on CGAI and negative emotions and cognitions.Results:In post-test,the score of CGAI in experimental group was significantly lower than that in control group[(92.6±16.7)vs.(105.9±13.0)] and lower than that in pre-test(98.9±16.4)by analysis of covariance(Ps<0.01).The scores of Beck Depression Inventory(BDI),Self-Rating Anxiety Scale(SAS),and the negative cognition of oneself in socical settings in experimental group were also lower than those in control group [(6.4±7.9)vs.(13.5±5.6),(39.7±6.4)vs.(49.9±10.3),(15.1±4.3)vs.(19.9±3.0),Ps<0.01],while the score of Rosenberg Self-Esteem Scale(SES)was higher than that of the control group [(29.3±2.9)vs.(24.6±4.8),P<0.01].Conclusion:Group counseling based on interpersonal activities has obvious effects on the college students with computer gaming addiction.

Objective To explore whether the pathophysiological mechanisms are same or not in different subtypes of functional dyspepsia (FD) patients. Methods Severity of symptoms and (44.2± 14. 6) years. Multi-gastrointestinal functions were also tested. Results No statistical difference was found among epigastric pain syndrome (EPS), postprandial distress syndrome (PDS) and mixed type in the data of gastric emptying function, gastric myoelectrical activity, autonomic nerve function,simultaneous introgastric pressure and water loading test, and psychological status assessment as well (P＞0.05). There was a positive linear correlation between postprandial fullness and half gastric emptying time (correlation coefficient=11.5, P= 0. 043). Early satiation was negatively related to maximal water intaking volume (correlation coefficient=-6. 8, P=0. 033). Conclusions In this study, it suggested that the FD patients with different pathophysiologic mechanisms cannot be distinguished efficiently according to Rome Ⅲ criteria, and then be treated in a well-targeted manner.

Objective To study the relationship between overlapping symptoms (OS) and psycho- mental factors in patients with functional dyspepsia (FD) in order to understand the possible mechanisms of OS.Methods One hundred and three FD patients diagnosed by Rome Ⅲ criteria were divided into with or without OS groups by Rome Modular Questionnaire.The emotional status,sleep status,anxiety and depression status were evaluated by Zung Anxiety and Depression Scale and quality of life was eveluated by SF-36 questionnaire.The results were compared between the two groups.Results The proportion of the patients with and without OS accounted for 62.5% and 37.5%,respectively.The patients with OS had a worse emotional status ("bad%" and "very bad%" being 39.1% and 20.2% vs.15.4% and 12.8%,P=0.018) and a worse sleep status (45.3% and 11.0% vs.19.1% and 7.7%,p=0.018)than those without OS.The proportion of the patients with anxiety (49 % ) and depression (68 % ) status in OS group was significantly higher than that in without OS group (19% and 44%,respectively,P＜0.05). The quality of life of the patients with OS was worse in the dimensions of psychological health (47.9), vitality (47.1) and mental component score (32.8)than those in without OS group (57.8,57.0,37.0, respectively,P＜0.05).Conclusions The psycho-mental factors are associated with overlapping symptoms in patients with FD,which suggests that abnormal psycho-mental factors may be involved in the mechanisms underlying overlapping gastrointestinal symptoms in FD.

Objective To evaluate the effect of integrative therapy and influencing factors in patients with intractable constipation (IC). Methods Eighty-four consecutive IC patients were divided into non overlap and overlap groups. All patients received individualized integrative therapeutic regimen for 4 weeks. The symptom scores of constipation and total effective rates were evaluated. Influencing factor of therapeutic effect in IC was analyzed.Results (1) IC of overlap group and non overlap group accounted for 40.5% (34/84) and 59.5% (50/84), respectively. (2)The total effective rates were 50.0% and 78.0% in overlap and non-overlap group, respectively(P

Objective To compare the clinical results of surgical and conservative treatment of acute patellar dislocations.Methods Retrospective analyzed the clinical data of 35 patients with acute patellar dislocations from June 2004 to October 2009,and divided the patients into 2 groups.One group with 18 patients underwent surgical treatments,and the other group with 17 patients underwent conservative treatments,record the number of relapses cases of both the two groups.A radiographic examination was performed in the evaluation of the patients,and the Kujala questionnaire was applied with the intention of analyzing the improvement of pain and quality of life.Results All patients were followed up for more than 12 months.(1) The conservative treatment group exhibited a higher number of recurrent dislocations (7 patients) (41.2％) than the surgical treatment group,which did not have any relapses (x2 =9.265,P =0.002).(2) The patellar tilt returned to normal in the surgical group,while 8 patients returned to normal in the conservative group,with statistical difference between groups (x2 =10.980,P =0.001).And the lateral shift ratio returned to normal in the surgical group,while 6 patients returned to normal in the conservative group,with statistical difference between groups(x2 =7.667,P =0.006).(3)The surgical treatment group obtained a significantly better mean score on the Kujala test than preoperative ((90 ± 5) vs.(58 ± 6),t =16.465,P ＜ 0.01) ; The conservative treatment group,compared with the preoperative,is not improved obviously ((72 ± 6) vs.(62 ± 8),t =0.943,P ＞ 0.05) ;Postoperative group comparison,surgical group was higher than that in conservative group,there was significant difference between two groups (t =12.256,P ＜ 0.01).Conclusion For acute patellar dislocation,surgical treatment can significantly restore patellar stability,improve the function of knee joint.

Objective To investigate whether the genetic variant rs10830963 of melatonin receptor 1B(MTNR1B)gene is associated with increased risk for gestational diabetes mellitus (GDM).Methods Eighty-seven GDM subjects(GDM group)and 91 normal pregnant women (control group)were randomly recruited form Women and Children's Hospital of Quzhou,Zhejiang Province,China.The allele and genotype frequencies of the rsi0830963 in MTNR1B gene were determined in all participants with PCR amplification and DNA sequencing.The allele and genotype frequencies of rs10830963 were compared to determine their differences between GDM subjects and normal controls.In addition,multiple linear regression was conducted to investigate the association patterns of the risk allele with fasting glucose and HbAlc levels.Results Both GG genotype and G allele frequencies of the rs10830963 loci in the GDM group were significantly higher than those in the controls,and women with G allele and GG genotype were associated with increased GDM risk(OR=1.53,95％ CI:1.005-2.324,P=0.047 and OR=2.16,95％ CI:1.052-4.434,P=0.034 respectively).After adjusting for age,body mass index before pregnancy,and family history of diabetes mellitus,women carrying GG genotype still had a higher GDM risk(OR =2.07,95％ CI:1.048-4.372,P =0.022).Multiple linear regression showed that the rs10830963 G allele was positively correlated with higher levels of fasting glucose(0.068 mmol/L,P=0.015)and HbAlc(0.073％,P=0.028).Conclusions Genetic variant rs10830963 in MTNR1B gene may contribute to the susceptibility to GDM in Chinese population and the rs10830963 G allele is a risk factor for the GDM susceptibility.

Objective To evaluate the influence of long-term nucleotide reverse transcriptase inhibitors (NRTIs) on lipids metabolism in HIV/AIDS patients and correlating clinical factors.Methods A total of 118 HIV/AIDS patients were divided into 3 groups:untreated group (40 patients),highly active antiretroviral therapy(HAART) for 1-2 years group (37 patients) and HAART over 5 years group (41 patients),with 20 healthy individuals as the control group.Clinical lipodystrophy (LD) was defined as concordance between patient's report of change and physical examination.Fat mass (FM) was measured by dual-energy X-ray absorptiometry (DXA).Results There was no significant difference in the incidence of LD between HAART for 1-2 years group and HAART over 5 years group (51.2％ vs 40.5％,P =0.345).The prevalence of LD was 2.4 folds with strvudine (d4T) treatment compared with zidovudine (AZT)-containing regimens (61.6％ vs 23.5％,P =0.001).Based on DXA measurements,FM of total body and limbs were significantly lower in the HAART over 5 years group than that in the control group,the untreated group and the HAART for 1-2 years group (P ＜ 0.05).Trunk FM was significantly lower in the HAART over 5 years group than the untreated group and the HAART for 1-2 years group (P ＜ 0.05).FM of total body and trunk were significantly lower in patients without LD in the HAART over 5 years group than patients without LD in the HAART for 1-2 years group (P ＜ 0.05).FM was correlated positively with body weight and BMI.Limbs FM was correlated negatively with peripheral blood triglyceride concentration.Conclusions HIV/AIDS patients with NRTIs therapy have high prevalence of LD,which mainly occurs 1-2 years after therapy,and increases with d4T treatment compared with AZT-containing regimens.There was no significant difference in the incidence of LD between the HAART for 1-2 years group and the HAART over 5 years group.FM was significantly decreased after long-term HAART in the patients with or without LD.DXA can evaluate LD objectively and guide further clinical treatment.

BACKGROUND: Bone marrow cell transplantation is a simple and effective treatment to promote angiogenesis. The neovascularization and reestablishment of blood circulation is crucial to the repair of injured but still living neurons as well as to the survival and differentiation of the implanted tissues and cells. However,it is not clearly known whether autologous bone marrow cells implantation could promote neovascularization and facilitate reestablishment of circulation in ischemic regions of the brain.OBJECTIVE: To investigate the effect of autologous bone marrow cell transplantation via the carotid artery on angiogenesis in the ischemic regions of the brain.DESIGN: A randomized controlled experiment based on experimental animals.SETTING: Department of neurosurgery and institute of urinary surgery in a university hospital.MATERIALS: The experiment was conducted in the Laboratory of the Department of Neurosurgery,Second Affiliated Hospital,and the Institute of Urinary Surgery,Jiangxi Medical College during the period from September 2002 to April 2003,using 10 specific pathogen-free male SD rats weighing 250 - 300 g.INTERVENTIONS: Rat models of focal cerebral ischemia model were established and randomized equally into two groups. The rats in the transplantation group were injected with autologous bone marrow cells via the carotid artery and those in the control group normal saline injection. The angiogenesis in the ischemic regions of the brain was observed with immunohistochemical staining for microvessel counting.MAIN OUTCOME MEASURES: The density of microvessels. Immunohistochemical staining for F8.RESULTS: Greater density of the microvessels was found in the ischemic regions after bone marrow cell transplantation than in the control group[(159. 15 ±40.4)/mm2 vs(81.70 ± 32. 18)/mm2,P ＜ 0. 05] . Numerous endothelial cells were found scattered in the ischemic cortex of the transplantation group,but scarcely in the control group.CONCLUSION: Autologous bone marrow cell transplantation via the carotid artery can promote angiogenesis in the ischemic regions of the brain.

Objective: Epithelial dysplasia of the esophagus and gastric cardia is precancerous lesion, including mild, moderate and severe levels. In 2000 year, WHO recommended to replace dysplasia with intraepithelial neoplasia. Mild and moderate dysplasia were classified as low-grade intraepithelial neoplasia (LIN). Cardia adenocarcinoma was suggested to be called esophageal-gastric junction adenocarcinoma. The risk of cancer development and the rule of time evolution were detected in esophagus and esophageal-gastdc junction LIN in high incidence area of esophageal cancer in Northern China, in an effort to provide scientific data for the prevention of esophageal cancer. Methods: Between October 2001 and October 2002, two townships of Cixian were chosen to carry out endoscopic iodine staining screening cohort study. The total population aged 0-85 was 22,016, of which 6,596 aged 40-69 (3257 males and 3339 females). Except for thoese with contraindications and those who refused to join the study, 3,506 cases were finally recruited in the study, and the screening rate was 53.2%. According to WHO criteria of the pathological diagnosis, the esophageal squamous epithelium with mild and moderate dysplasia and esophageal-gastric junction with mild dysplasia were classified into LIN groups (including 616 cases). The control group contained a total of 2,478 cases without precancerous lesions and free of cancer in endoscopic screening. Results: From June to September in 2008, the cohort was followed up and 174 cases were lost, with a follow-up rate of 95.0%. Follow-up was 3,970.7 person- years in the LIN group and 16,120.0 person-years in the control group.Carcinomous conversion rates were 251.7 and 68.2/per 100,000 person- years respectively in the LIN group and the control group. The median time in the two groups was 38 and 47 months, respectively. Compared with that of the normal population, the relative risk (RR) of LIN was 3.69 (95% CI=1.57-8.69, P=0.001). Conclusion: Population with LIN are at high-risk for esophageal cancer and endoscopic examination every year is absolutely necessary.