Objective To study the efficacy and safety of Taizhian in treatment of aged patients with primary hyperlipidemia.Methods Sixty patients with hyperlipidemia were divided into two groups.Taizhian and simvastatin of 10mg/d group have 30 patients (group A),simultaneously were given simvastatin 10mg before sleep and Taizhian three pills,po,tid for 8wk;30 patients (group B) were given simvastatim 20mg,before sleep for 8 wk.By using full-anutomatic biochemical analytic instrument to measure all lipidemia markers.Results In these two groups,the levels of TC,TG,LDL-C,AI decreased and HDL-C increased(P0 05).In the two groups the adverse reaction were mild.Conclustions Taizhian and simvastatin of 10mg/d are so effective in treatment hyperlipidemia as simvastatin of 20mg/d,while the former can decrease the adverse reaction.

Ashi point (tonsil) in combination of the pricking and bleeding technique on Shaoshang (LU 11 )and Shangyang (LI 1) were used to treat 58 outpatients of acute tonsillitis. The results showed cure in 38 cases,remarkable effect in 17 cases and failure in 3 cases by one treatment, and the total effective rate in 95%.

Objective To study the localization of specific allergen of Dermatophagoides pteronyssinus. \ Methods\ Through optical microscope,the specific allergens of D.pteronyssinus were observed in paraffin sections using D.pteronyssinus\|specific IgE antibodies from the patient sera. \ Results and Conclusion \ The digestive system was found occupying large parts of body cavity of D.pteronyssinus by HE staining, while the specific allergens of D.pteronyssinus were mostly occurred in the midgut tissue, gut contents, cuticle and reproductive system in the immunostained sections. The results also showed that many parts of D. pteronyssinus were recognized by the specific IgE antibodies obtained from allergic individuals to D.pteronyssinus, which provided a theoretic base for further study of isolation and purification of the specific allergen.

BACKGROUNDTo study the CT appearance of lung cancer combined with pleural dissemination and its anatomic characteristics.

METHODSCT findings of 32 cases of lung cancer with pleural dissemination proved by surgery and pathology were analyzed.

RESULTSThe main CT manifestations were pleural effusion (24 cases), visceral pleural dissemination with nodules (10 cases), parietal pleural dissemination with nodules (16 cases), and pleural thickening (31 cases). Out of the cases with visceral pleural disseminations, nodules distributed on the lung surface in 9 sites, while on the interlobular pleura in 10 sites. Parietal pleural dissemination with nodules were found in 45 sites which located on the diaphragmatic pleura, the costal pleura, the mediastinal pleura, and the pulmonary ligament. The diameters of the small nodules ranged from 2 to 5 mm, and the large nodules from 5 to 10 mm. There were direct invasion with tumor induced pleural thickening in 10 cases, while indirect invasion in 21 cases. In the later cases, 9 cases had parietal pleural thickening less than 10 mm, 4 circumferential pleural thickening, 5 mediastinal pleural involvement thickening, and 3 pulmonary ligament thickening.

CONCLUSIONSPleural effusion is the main manifestation of lung cancer combined with pleural dissemination. The CT features of lung cancer with pleural dissemination are the parietal and visceral pleural nodules, as well as the pleural thickening. The nodules are likely to distribute on parietal pleura of the diaphragmatic and the costal pleura, and they may transfer to the pulmonary ligament.The early small disseminating nodules are miliary in size, and only can be detected on the pulmonary window of chest CT scan.

Objective To evaluate the effect of short-term training of objective structured clinical examination (OSCE) examiner in general practice residency training final examination.Methods Sixty examiners from Xinjiang Uygur Autonomous Region participated in half-day workshop of OSCE.The participants were interviewed with questionnaire before and after the training program and the effect of training was evaluated.Results The study showed that 78.3％ (47/60) examiners knew OSCE and understood the concept and implementation steps before the training;21.7％ (13/60)had used it before;95.0％ (57/60) examiners intended to learn the performance of OSCE.After training most participants completely or basically understood the 6 test stands and implementation methods of OSCE;the participants were highly satisfied with the training duration,contents and methods,and the satisfaction rates were all over 70％.Conclusion The examiners recognize the advantages of OSCE in assessment of clinical skills and have strong intention of application.Short-term training has a certain effect and feasibility.

Objective To analysis the implementation of the objective structured clinical examination (OSCE) for completion of general practice residency training in Xinjiang Uygur autonomous region.Methods Ninety eight general practice residents took training-completion examination applying OSCE in Xinjiang Uygur Autonomous Region.The examiners (including SP examiners) and examinees were interviewed with questionnaire after the OSCE.Results All 60 examiners and 98 examinees were generally in favor of using OSCE in general practice residency training completion examination;100.0％ (60/60) examiners and 86.7％ (85/98) examinees thought that it was necessary;98.3％ (59/60) examiners and 89.8％ (88/98) examinees thought that the OSCE was able to evaluate the clinical competence of general practice;95.0％ (57/60) examiners and 78.6％ (77/98) examinees thought the OSCE examination stations reasonable;40.8 ％ (40/98) examinees thought that the difficulty degree of the exam was moderate,35.7％ (35/98) and 20.4％ (20/98) examinees thought that it was difficult or very difficult,particularly for history writing and case analysis.Conclusions The examiners and examinees recognize the advantages of OSCE in assessment of clinical competence.This study provides useful information for application of OSCE in general practice residency training completion assessment.

Objective:Through TTC staining, immunohistochemical analysis, RT-PCR and hind limb motor function evaluation and other experimental methods, to explore the regulatory mechanism of metformin on anti-apoptosis in rats with spinal cord injury (SCI).Methods:Establish a rat spinal cord injury model. Through Basso-Beattie -Bresnahan locomotor rating scale (BBB) and cant test to evaluate the recovery of hindlimb motor function in rats. The changes of necrotic area of spinal cord tissue were compared by TTC staining. Extraction of rat spinal cord tissue, by Dot blot analysis and immunohistochemical detection of the hydroxyl of DNA methylation level. By qPCR, Western Blot detection TET2mRNA and protein expression level, and the changes in the scope of spinal cord injury were detected by inhibiting the expression of TET2. The interaction between TET2 and Foxo3a was detected by immunoblotting and immunoprecipitation. Through RT-PCR assay Foxo3a downstream related changes in the level of gene expression.Results:Compared with the SCI+NS group, the necrotic area of the spinal cord tissue was reduced after metformin treatment, and the BBB score and the incline test score were higher ( P<0.05). At the same time, we found that the levels of TET2mRNA and protein increased significantly after SCI at 24 h, and the 5-hmC level of DNA increased. The levels of TET2mRNA and protein and 5-hmC increased further after the use of metformin. After using SC-1, compared with the SCI+MET group, the level of 5-hmC decreased and the area of infarction increased. After SCI, the mRNA levels of downstream genes Bim, P27kip, Bax increased significantly. After metformin treatment, the mRNA levels of Bim and Bax were lower than those in the SCI+NS group ( P<0.05). After SCI, the 5-hmC levels of downstream genes Bim, P27kip, Bax increased significantly. After metformin treatment, the 5-hmC levels of Bim and Bax were lower than those in the SCI+NS group ( P<0.05). Conclusion:Metformin can promote the interaction between TET2 and Foxo3a, increase the 5-hmC level of the overall DNA, and inhibit the activation of related apoptosis genes, thereby improving tissue damage and nerve function recovery after spinal cord injury.

Objective To investigate the effect of diammonium glycyrrhizinate(DG)on pulmonary injury of rats with pulmonary tuberculosis.Methods The rat models of pulmonary tuberculosis were constructed and then the an-imals were randomly divided into model group,diammonium glycyrrhizinate treatment groups(low-dose,medium-dose and high-dose)groups,high dose of diammonium glycyrrhizinate plus peroxisome proliferator-activated receptor γ(PPARγ)inhibitor group(H-DG+GW9662 group),and another 18 rats were selected as control group.The colony count of Mycobacterium tuberculosis(Mtb)in lung tissue was detected.HE staining microscopy was ap-plied to detect lung histopathology.TUNEL was applied to detect apoptosis of lung tissue cells.ELISA was applied to detect serum level of inflammatory factors.Western blot was applied to measure PPARγ,phosphorylated p38 mi-togen-activated protein kinase(p-p38MAPK)and p38 mitogen-activated protein kinase(p38MAPK)in lung tissue.Results Compared with the control group,the lung tissue structure in model group was severely damaged with a large number of proliferative tuberculosis nodules,changes of alveolar morphology,inflammatory cell infiltration and even caseous necrosis were found,and the number of tuberculosis colonies,apoptosis rate,TNF-α,IL-6,IFN-γ,COX-2 levels,and p-p38MAPK/p38MAPK expression were all increased,while PPARγ expression was decreased(P＜0.05).In L-DG,M-DG,H-DG groups improvement of lung tissue structure,alveolar morphology,inflammatory cell infiltration,and caseous necrosis were found as compared to the model group,while the counting number of tuberculosis colonies decreased and rate of cell apoptosis decreased.The level of TNF-α,IL-6,IFN-γ,COX-2 and expression of p-p38MAPK/p38MAPK reduced,the expression of PPARγ all increased.The H-DG group showed the most significant changes(P＜0.05).GW9662 treatment significantly reversed the improvement of DG on pulmonary injury in rats with pulmonary tuberculosis.Conclusions DG improves lung injury in rats with pul-monary tuberculosis and its mechanism is potentially related to the activation of PPARγ pathway and inhibition of p38MAPK pathway.

Objective:To investigate the clinical and gene variant characteristics of PCDH19 gene related epilepsy, and improve the ability of clinicians in early disease identification. Methods:The clinical data of 3 PCDH19 gene related epilepsy patients admitted to Children′s Hospital Affiliated to Zhengzhou University from October 2018 to August 2023 diagnosed by gene detection were reviewed and analyzed. Results:All the patients are female, and the onset age of seizure ranged in their infancy. Seizures in clusters and fever sensitivity were observed in all patients, and were very hard to control by single-drug treatment. Proband 1 was seizure-free after 2 kinds of anti-epileptic drug treatment, but with mild degree of intellectual disability. Proband 2 had refractory epilepsy with severe degree of intellectual disability. Proband 3 was seizure-free after 2 kinds of anti-epileptic drug treatment and without intellectual disability. In the first family, the proband carried heterozygous c.369C>G variant in the PCDH19 gene which was identified as de novo after parental validation. In the second family, the proband carried c.1652T>A variant inherited from her mother. In the third family, the proband carried c.278G>A variant inherited from her father. The 3 mutations had not been reported in the Human Gene Mutation Database. Conclusions:PCDH19 gene related epilepsy is one special kind of X-linked inherited epilepsy syndrome characterized by seizures in clusters and sensitivity to fever. And gene detection can help with early diagnosis and make rational clinical strategies in time. The variants c.369C>G, c.1652T>A and c.278G>A have enriched the gene variant spectrum of PCDH19.

Objective To determine the most cost-effective modality for breast cancer screening in women living in Shanghai.Methods A Markov model for breast cancer was redeveloped based on true effect which was derived from a project for detection of women at high risk of breast cancer and an organized breast cancer screening program conducted simultaneously in Minhang district,Shanghai,during 2008 to 2012.Parameters of the model were derived from literatures.General principles related to cost-effectiveness analysis were used to compare the costs and effects of 12 different screening modalities in a simulated cohort involving 100 000 women aged 45 years.Incremental cost-effectiveness ratio (ICER) was used to determine the most cost-effective modality.Sensitivity analysis was conducted to evaluate how these factors affected the estimated cost-effectiveness.Results The modality of biennial CBE followed by ultrasonic and mammography among those with positive CBE was observed as the most cost-effective one.The costs appeared as 182 526 Yuan RMB per life year gained and 144 386 Yuan RMB per quality adjusted life-year (QALY) saved,which were within the threshold of 2-3 times of local per capita Gross Domestic Product.Results from sensitivity analysis showed that,due to higher incidence rate of breast cancer in Shanghai,the cost per QALY would be 64 836 Yuan RMB lower in Shanghai than the average level in China.Conclusion Our research findings showed that the biennial CBE program followed by ultrasonic and mammography for those with positive CBE results might serve as the optimal breast cancer screening modality for Chinese women living in Shanghai,and thus be widely promoted in this population elsewhere.