Objective To observe the effect of cyanin on the expression of L-glutamate/ L-aspartate transporter (GLAST) in high glucose cultured retina Müller cells. Methods The retinal tissue of SpragueDawley (SD) rats was collected at postnatal 10 day, and Müller cells were isolated and cultured according to literature. The Müller ceils (2nd-4th generations) were treated with five different medium as normal group (group A), high glucose control group (group B), high glucose+30 μmol/L cyanin group (group C), high glucose+60 μmol/L cyanin group (group D) and high glucose+100 μmol/L cyanin group (group E). Cell relative survival rates (A value) were measured by MTT assay at 570 nm. The GLAST protein expression in M011er cells was observed by Western blot. Results MTT assay showed that the A value of the five group were 0. 450 8±0. 020 4, 0. 270 1±0. 031 4, 0. 332 0±0. 023 2, 0. 428 3±0. 017 2, 0. 361 9±0. 027 0,the cell relative survival rate were 100. 0%, 59. 9%, 73.6%, 95%, 80.3% respectively. The A value of group C, D, E were significantly higher than that of group B (F=32.25, P<0.05), the A value of group D were significantly higher than that of group C and E (F=21.07, P<0. 05). Western blot showed that the GLAST protein expression of group B was lower than that of group A (t=5.25, P<0. 05) ; there was no obvious changes of GLAST protein expression in group A, C, D and E (F= 2. 979, P>0.05).Conclusion Cyanin can rescue high glucose-induced GLAST reduction.

Objective To establish the determination of Dehydroandrographolide in Ganmaoqing Capsule. MethodsThe determination was carried out by HPLC with a KromasilC-18 column(250 mm ×4.6 mm,5μm),methanol-water(65:35)severed as the mobile phase,the speed was 1mL/min and the detection wavelength was at 254 nm. ResultsDehydroandrographolide showed a good linear relationship at the range of 0.04872 μg ～0.38976 μg(r2 =0.9995,n= 8);The average recovery of Dehydroandrographolide was 100.1%(RSD= 2.92%). ConclusionHPLC method was sensitive,accurate,reproducible,specific and could be used for quality control of Ganmaoqing Capsule efficiently.

Objective To study the risk factors of pulmonary embolism and comparison of the effect of different therapy.Methods Risk factors of 182 patients with pulmonary embolism were analyzed retrospectively.The patients were randomly divided into simple drug group and drug joint intervention group.Simple drug group was given heparin and warfarin,or jiont urokinase fibrinolytic therapy.The drug joint intervention group was given the same drug therapy joint vena cava filter implantation and/or catheter broken bolt therapy.After different treatment,the clinical prognosis was compared between the two groups.Results Of 182 patients with pulmonary embolism,the elderly and smoking prevalence rate increased significantly,deep vein thrombosis,cardiovascular disease,cancer,blood system diseases,trauma and surgery,chronic lung disease,fracture and orthopaedic surgery were the main risk factors.The effective rate and mortality between the pure drug therapy group and drug joint intervention group had no significant differences(x2 =0.145,P ＞ 0.05).Conclusion The incidence of pulmonary embolism is closely related to the risk factors.Cancer is one of the important diseases caused by pulmonary embolism.In a timely manner to give the antithrombotic drug treatment has great significance to the prognosis of pulmonary thromboembolism,there was no significant difference compared with the antithrombotic joint intervention.

The community rotation is an important stage of standardized residency training for general practitioners (GPs).However, the community rotation is also considered as a most difficult part of the GP residency training because of the problems in training management and evaluation .Based on our experiences of 7-months community training , we expanded the duration of community training to 1 year, and implemented a new segmentation and multipoint practice plan in Zhongshan hospital .This is a new attempt for GP residency training , which would hopefully meet the international standards of GP residency training .

Objective To explore the relationship between learning and memory ability and antioxidant enzyme (SOD, CAT, GSH-Px)activities in specific brain areas of D-galactose model rats. Methods The aging models were induced by D-galactose in 3-month old rats, and the learning and memory ability of aging model was detected in model MG-2 maze. The activity of SOD, CAT and GSH-Px in brain cortex, cerebellum,hippocampus, striatum and hypothalamus were detected immediately after rats were executed. Results The learning and memory ability of D-ga-lactose aging model was lower than that of control group. The difference of antioxidant enzyme activity among different rat brain areas was significant. The correct response rate of D-galactose aging model was( 58.9 ± 5.4 ) %, which is significantly lower than that of the control group (66.8 ±8.9) %, P ＜ 0.05. The times of response required reaching the standard after 24h of aging model rats was significantly higher than that of the control( Aging group :29.5 ± 12.8, Control group 16.6 ± 6.2; P＜ 0.01 ). Correct response rate after 24h was significantly lower than that of the control ( Aging group :67.3 ± 10.3 , Control group: 79.1 ± 6.9; P＜ 0.01 ). The SOD activity in cortex, hippocampus and striatum( Aging group :66.12 ±5.89,80.46 ± 6.57,87.82 ± 6.87; Control group :57.63 ± 4.21,67.46 ± 6.80,68.37 ± 6.52) significantly reduced ( P ＜ 0.05 and P ＜ 0.01 ).The CAT activity in cortex, hippocampus, striatum and hypothalamus( Aging group :6.45 ± 0.55,5.86 ±0.35,6.93 ± 0.63,8.89 ± 0.38; Control group :5.32 ± 0.56,4.76 ± 0.38,4.37 ± 043,6.11 ± 0.37) significantly reduced ( P ＜ 0.05 and P ＜ 0.01 ). GSH-Px activity was similar in each brain area without significance ( P ＞ 0.05 ). Conclusions The learning and memory ability of aging mode rats decreased. The change of antioxidant enzyme activities in hippocampus, cortex, striatum and hypothalamus is closely related to learning and memory ability.

This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED (1966 to 2009), Embase (1980 to 2009) and CMB-disk (1979 to 2009) for the randomized clinical trials (RCT) concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration's RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure (IOP) between non-penetrating trabecular surgery and trabeculectomy (Z=6.05 P<0.00001). There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures (Z=4.92, P<0.00001). Difference in the success rate was also found between the two surgeries (Z=3.82, P=0.0001). It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.

Objective To study the curative effect of continuous positive airway pressure (CPAP) on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with diabetes mellitus. Methods Eighty patients with OSAHS and diabetes mellitus were included and randomly divided into treatment group (n=40) and control group (n=40). The control group was given conventional treatment including diabetes diet and hypoglycemic drugs. The treatment group was given Futong ST-25 continuous positive airway pressure (CPAP) ventilation besides the conventional treatment. The serum levels of fasting blood glucose (FBG), two-hour postprandial blood glucose (2 hPG), insulin, sleep apnea hypop-nea index (AHI), low oxygen saturation (LSpO2) and the longest apnea time were monitored before and after treatment in two groups. Results After four-week treatment, values of FPG, 2 hPG, AHI and the longest apnea time were significantly lower in treatment group than those in control group (P < 0.01), but values of insulin, two-hour postprandial insulin and LSpO2 were significantly higher in treatment group than those in control group (P<0.01). Conclusion CPAP therapy can effec-tively decrease blood sugar level and improve AHI, LSpO2 and the longest apnea time in elderly patients with OSAHS compli-cated with type 2 diabetes.

Objective To apply 360 degree evaluation in competence assessment of community general practice trainers.Methods The 360 degree evaluation questionnaire was designed by authors and the evaluation was applied to assess the personal comprehensive quality,competence in general practice and teaching of 16 general practice trainers in Fenglin Community Health Service Center of Shanghai Xuhui District.Results The scores of personal comprehensive quality,competency in general practice and teaching were 7.73 ± 0.73,6.91 ± 0.91 and 6.44 ± 1.38,respectively.The total scores from different evaluators were 6.93 ± 0.12 for peers,6.68 ± 0.74 for hospital executives,8.17 ± 0.12 for nurses and 6.43 ± 0.89 from self evaluation (F =27.91,P =0.000).Conclusion The variance between different evaluators in 360 degree evaluation can avoid bias of single one.The results of 360 degree evaluation show that the teaching ability of community general practice trainer is relatively low,suggesting the training of teaching ability should be strengthened for these trainers.

Objective To survey the double-preceptor system in standardized residency training of general practitioners (GPs).Methods A questionnaire survey was conducted among 48 residents,53 clinical and community preceptors during May and June 2013.Results The preceptors mostly agree with the necessity to carry out double-preceptor system.82.8％ (24/29) clinical preceptors,95.8％ (23/24) community preceptors and 89.6％ (43/48) residents considered that it was very effective.Less than half of the clinical(13/29) and community (11/24) preceptors knew very clearly about their responsibilities and obligations ; 93.1％ (27/29) clinical preceptors and 95.8 ％ (23/24) community preceptors hoped to receive corresponding training courses.72.4％ (21/29) clinical preceptors and 75.0％ (18/24) community preceptors communicated with residents frequently,75.9％ (22/29) clinical preceptors thought residents were not actively involved was the main obstacle in the implementation of double-preceptor system.The guide contents were focused on clinical skills,scientific research and how to pass assessments.The main approaches were interviews,checking the quality of medical instruments and small lecture.Only 6.9％ (2/29) clinical preceptors conducted outpatient teaching,83.3％ (40/48)residents thought tutors did not knew clearly about their responsibilities and obligations was the main obstacle in the practice of doublepreceptor system.Regarding how to evaluate the double-preceptor system,clinical and community preceptors tended to use examination results and feedback of residents.Clinical preceptors,community preceptors and residents all gave low comments about the preceptor-resident contact handbook.87.5％ (21/24) community preceptors thought lack of corresponding incentive mechanisms was the main obstacle in the practice of double-preceptor system.Conclusions Double-preceptor system has been widely recognized by both preceptors and students.In order to improve the system,we should conduct tutor training courses regularly and establish an effective mechanism to assess and evaluate tutors.

Objective To evaluate the efficacy of short-term training of direct observation procedural skills (DOPS) for community general practitioner (GP) trainers.Methods Thirty six GP trainers participated in one-day workshop of DOPS.The participants were interviewed with questionnaire before and after the training program and the training video was scored.Results 47.2％ (17/36) of GP trainers knew and briefly understood DOPS before the training.41.7％ (15/36)of them had a rough idea of how to use it and only 2.8％ (1/36) had used it before.All of these trainers wanted to learn how to perform DOPS.The vast majority of GP trainers completely or basically understood the standards for evaluation of 11 items of DOPS after the training.The accuracy rates of 4 items were close to or more than 50.0％ in 9-point scale and 7 items exceeded 50.0％ in 3-rank system.There was significant difference in accuracy rates of 6 items between the two scoring system(all P ＜ 0.01).Conclusions Community GP trainers recognize the advantages of DOPS in assessment of clinical skills and have strong intention of application.The efficacy of short-term workshop is satisfactory,but the evaluators need more training and practice.