Retrospective analyses were conducted for the clinical data of two cases with pseudoMeigs' syndrome at our hospital.Both had respiratory symptoms,such as cough and dyspnea.Radiological examinations revealed ascites,pleural effusion and pelvic mass.The definite pathological diagnosis was pelvic malignant tumor.After surgical tumor removal,ascites and pleural effusion disappeared without recurrence.Along with reviewed cases from PubMed in the last decade,a total of 49 cases had pseudoMeigs' syndrome.The age range was 11-73 years.Their clinical manifestations include dyspnea (78％),abdominal distension (69％),cough (14％),abdominal pain (12％),fatigue (10％),weight loss (6％) chest pain (4％),fever (4％),abdominal mass (4％),and oliguria (2％).CA125 was commonly elevated.The primary tumors in pelvic cavity accounted for 78％.And ovarian metastasis from colon cancer was one of the most common in metastatic tumor.

Objective To study the effect of glucagon-like peptide-1 agonist(exendin-4)on insulin signaling pathway in skeletal muscle of mice with insulin resistance(IR). Methods Thirty male KM mice were divided into normal control group(NC group, n=10)and IR group(n=20). The mice in NC group and IR group were fed with routine diet and high-fat diet for 16 weeks, respectively. After IR models were successfully established, 10 mice in IR group were treated with exendin-4(Ex group, 3μg·kg-1·d-1)for 4 weeks. NC group and IR group were given the same dose of normal saline. Body weight, fasting blood glucose(FBG), and fasting insulin(FINS)were measured before and after the intervention, and homeostasis model assessment for insulin resistance ( HOMA-IR ) was calculated . The muscle glycogen content were measured by Periodic Acid-Schiff Stain ( PAS ) . The expressions of insulinreceptor(IRC), insulin receptor substrate-1(IRS-1), and phosphatidylinositol 3-kinase(PI3K)in the skeletal muscle were measured by Western blot and immunohistochemistry. Results Before intervention, the body weight, FBG, and HOMA-IR of IR group and Ex group were higher compared with NC group(all P<0. 05), but FINS did not rise significantly(P>0. 05). Compared with before intervention, the body weight of three groups after intervention were all increased, but increased more significantly in the IR group. After intervention, the FBG and HOMA-IR in Ex group decreased, compared with IR group and Ex group of non-intervention (all P<0. 05), but FINS did not decrease significantly(P>0. 05). The skeletal muscle cells in NC control were colored extensively and more colored granules, while IR group were less colored, and Ex group were between NC group and IR group. Compared with NC group, the expressions of IRC, IRS-1, and PI3K in the skeletal muscle of IR group were significantly decreased(P<0. 05), not in Ex group(P>0. 05). Compared with IR group, the expressions of IRC, IRS-1 and PI3K in Ex group were higher(P<0. 05). Conclusions Exendin-4 improves insulin resistance by up-regulating the expressions of IRC, IRS-1, and PI3K in the skeletal muscle and promoting the synthesis of muscle glycogen.

Objective To retrospectively analyze the data of patients with T3N0-1M0 nasopharyngeal carcinoma (NPC) who underwent radiotherapy (RT) alone or concurrent chemoradiotherapy (CCRT), and to investigate the relationship between therapeutic modality and prognosis. Methods From January 2004 to December 2004, 781 patients with biopsy-proven newly diagnosed non-metastatic NPC were analyzed in Sun Yat-Sen University Cancer Center, who had MRI data of nasopharynx and neck. With restaged based on the Chinese 2008 staging system, 82 cases of T3N0-1M0 patients who were treated by RT alone or CCRT were enrolled. They were divided into group A (46 cases, RT) and group B (36 cases, CCRT). Results The clinical data was comparable between the two groups. The 5-year overall survival rate (OS) was 93.5 % (group A) and 100 % (group B)(P =0.046), while the 5-year disease-free survival rate (DFS) was 85.2 % (group A) and 91.7 % (group B) (P =0.498). N-Staging was the factor affecting the DFS. Stratified analysis showed that the 5-year OS of T3N0M0 patients was 94.7 % (group A) and 100 % (group B) (P =0.432), those of T3N1M0 patients were 92.6 %(group A) and 100 %(group B) (P =0.066), while the 5-year DFS was 73.7 % (group A) and 89.3 % (group B) (P =0.244). Multifactor analysis showed that CCRT was not the independent factor affecting the OS(HR =0.019; 95 % CI, 0 to 21.793), and N-stage was not the independent factor affecting the DFS (HR = 0.203; 95 % CI, 0.135 to 1.231×104). Conclusion For T3N0M0, NPC patients, CCRT is not superior to RT alone. Whether CCRT can improve survival of T3N1M0 NPC patients needs further study.

Objective To investigate the effects of simvastatin pretreatment on ischemia-reperfusion (I/R)injury to the spinal cord in rats. Methods Ninety-six healthy male SD rats weighing 220-280 g were randomly divided into 3 groups (n=32 each): Ⅰ group sham operation (group S); Ⅱ group I/R and Ⅲ group simvastatin pretreatment (group Si). The animals were anesthetized with 10% chloral hydrate 0.4 ml/100g. I/R to the spinal cord was induced by cross-clamping the aorta below renal artery for 45 min followed by reperfusion according to Zivin in group Ⅱ and Ⅲ. In group Ⅲ simvastatin 20 mg/kg was administered via gastric tube in the morning for 3 days before operation. Neurological function was assessed and scored (0 = no spontaneous movement of the hindlimbs, 7 = normal gait) at 2, 6, 12 and 24 h (n = 8 at each time point). The animals were then sacrificed and the lumbar segment (L2-5) of the spinal cord was removed for microscopic examination and determination of expression of TLR4 mRNA, NF-κB protein activity and TNF-α and ICAM-1 contents in the spinal cord. Results I/R to the spinal cord significantly increased TLR4 mRNA expression, NF-κB protein activity and TNF-α and ICAM-1 content in the spinal cord and decreased neurological scores in group Ⅱ compared with group C. Simvastatin pretreatment significantly attenuated the I/R-induced increase in the above-mentioned variables and ameliorated I/R-induced neurological dificit and histopathological damage. Conclusion Simvastatin pretreatment has neuroprotective effects on the spinal cord against I/R injury by attenuating inflammatory response.

Chlorine ; Computer Simulation ; Computers, Analog ; Diffusion ; Software

Acetamides ; metabolism ; toxicity

Objective To explore the contents,routes and ways of the training of clinical teachers in teaching hospitals.Methods According to the requirement of teachers' professional development,the characteristic of clinical teachers in teaching hospitals,setting from the cultivating of fundamental ability and occupation quality,to reinforce the training of clinical teachers,especially young teachers' basic teaching skills,job skills and professional ethics in order to improve the teaching team's overall quality unceasingly. Results According to the results of the classroom teaching mass and practice teaching mass' test from the year 2005 to 2007,the teaching ability and consciousness of clinical teachers were reinforced after the training. Conclusion With the dual role of doctor and teacher,the clinic teachers should be trained to reinforce their basic teaching skills and professional competence,so that they can have the ability to cultivate the high-qualified medical talent.

Objective To investigate the clinical value of cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase MB(CK-MB) in early diagnosis of myocardial injury(MCI) in neonatal asphyxia.Methods The serum cTnⅠ and CK-MB in neonates [34 with asphyxia and MCI,38 with asphyxia but no MCI(NMCI)],and 30 cases of normal control(NC) were measured with direct immunoassay chemiluminometric technology and immunoinhibition enzymes-activated assay.Results The cTnⅠ level in NC group had no changes within 10 days after birth,MCI group were significantly higher than those in NMCI and NC groups(all P0.05).The diagnostic sensitivity,specificity and accuracy of cTnⅠ for neonates with MCI were 91%,88% and 89%,respectively;and of CK-MB were 85%,68% and 74%,respectively.Conclusions cTnⅠ and CK-MB can be taken as early diagnostic markers of MCI in neonates with asphyxia,(cTnⅠ) is better than CK-MB.

Objective To investigate the risk factors for prognosis of severe acute pancreatitis (SAP).Methods The clinical data of 563 patients with acute pancreatitis (AP) treated from January 2008 to December 2014 were analyzed retrospectively.There were 334 patients with mild acute pancreatitis (MAP),and 198 patients with moderately severe acute pancreatitis (MSAP),and 31 patients with severe acute pancreatitis (SAP).Risk factors associated with MAP and MSAP + SAP group,MSAP and SAP group were determined by univariate logistic regression,and multivariate analysis was used to determine the risk factors for severity of AP.Results Univariate logistic regression analysis showed that age,WBC,serum glucose,calcium,urea nitrogen arterial partial pressure of oxygen (PaO2),SIRS,pleural effusion,peripancreatic fluid collection were associated with severity of AP in MAP and MSAP + SAP patients;age,serum calcium,PaO2,SIRS,pleural effusion,peripancreatic fluid collection were associated with severity of AP in MSAP and SAP patients.Multivariate logistic regression analysis showed that age,serum calcium,PaO2 and peripancreatic fluid collection were risk factor of MSAP and SAP;age,serum calcimm and SIRS were risk factors of SAP patients for persistent organ failure and pancreatic necrosis.Conclusions For elderly AP patients,measurement of arterial partial pressure of oxygen and serum calcium,peripancreatic fluid collection can help evaluate the severity of AP and early recognition.For SAP patients,the presence of SIRS,high serum urea nitrogen,and low serum calcium and peripancreatic fluid collection raise the concerns of persistent organ failure and pancreatic necrosis.

Objective To observe the therapeutic effect of methylphenidate hydrochloride controlled-release tablets (OROS-MPH) on attention-deficit hyperactivity disorder (ADHD). Methods Seventy-two cases of children with ADHD were randomly divided into treatment group (40) and control group (32). Cases of treatment group were given 0.8-1.0 mg??kg-1 of OROS-MPH for three months. Cases of control group were given 1.2-1.4 mg??kg-1 of atomoxetine hydrochloride for three months. After 12 weeks treatment, children were evaluated by Wechsler intelligence test, Integrated visual and auditory continuous performance test (IVA-CPT), the SNAP-Ⅳ effect assessment scale and TESS scale. Results The treatment efficiency was similar in both groups. Attention deficit and hyperactivity in both groups were improved obviously. Wechsler intelligence score was significantly elevated ( P<0. 05), SNAP-Ⅳ score was significantly decreased ( P<0. 05), and IVA-CPT score was increased significantly after treatment ( P<0.05) . The changes of scores on hyperactivity, auditory attention and visual attention were more in OROS-MPH group than those in atomoxetine group(P<0.05). There was loss of appetite in 10 children of OROS-MPH group and in 14 children of atomoxetine group. There was drowsiness in 1 child of OROS-MPH group and in 5 children of atomoxetine group, as well as difficulty to fall asleep in 6 children of OROS-MPH group and 1 child of atomoxetine group (P<0.05). One child developed a transient spasm after 4-month treatment. Conclusion Both of OROS-MPH and atomoxetine hydrochloride can improve learning ability and the symptom of attention deficit and hyperactivity, and they are similarly effective and safe in children with ADHD, but OROS-MPH can work faster.