Objective To explore the current sources of stress for medical graduates, their personality characteris-tics and social support. Methods 208 postgraduates of Peking Union Medical College were surveyed by question-naire with the Graduate Student Stressor Scale, Symptom Checking List ( SCL-90) , NEO Five-Factor Inventory and Perceived Social Support Scale ( PSSS) . Results According to the five common stressors such as academic, economic, employment, physical and mental health, and tutor relationship, single-factor analysis of variance ( ANOVA) showed that there were significant differences in the composition of pressure sources between different sexes and grades. Univariate correlation analysis showed that all five dimensions of stressors had a significant posi-tive correlation with anxiety and depression symptom. There was a positive correlation between stressor and neurotic personality, and significant negative correlation with extroversion and rigorous personality. Furthermore, the stressors were significant negative correlation with perceived social support. Conclusions Medical graduate students are under various pressures at present. It is necessary to pay more attention to the education and training in the fu-ture and adopt diversified measures to rationalize them.

In order to affirm the cardioactive components in Fuzi, we identified a group of aminoalcohol- diterpenoid alkaloids in Fuzi using ultra high-performance liquid chromatography coupled with electrospray ionization mass spectrometer (UPLC-ESI-MS) method. Among a total of forty-one isolated ingredients, thirteen major aminoalcohol-diterpenoid alkaloids were identified by comparing their retention times and MS spectra with those of the reference substances. Moreover, Fuzi samples from different places of origin and with different processing methods were examined and their components displayed a pattern of high similarity, though the relative abundance varies probably due to their different processing methods. Furthermore, the cardiac effect of each identified alkaloid was individually evaluated using the isolated bullfrog heart perfusion experiment. Among the thirteen aminoalcohol diterpenoid alkaloids tested, six of them significantly enhanced the amplitude rates. Taken together, we affirm that the cardioactive components in Fuzi are aminoalcohol-diterpenoid alkaloids, shedding light on future studies of the mechanisms and development of these cardioactive compounds.
Aconitum ; chemistry ; Alkaloids ; chemistry ; Amino Alcohols ; chemistry ; Animals ; Cardiotonic Agents ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Heart ; drug effects ; In Vitro Techniques ; Plant Extracts ; chemistry ; Rana catesbeiana ; Spectrometry, Mass, Electrospray Ionization

Objective To detect the neuronal network activity of specific brain areas in heroin addicts under craving state induced by heroin related cues with independent component analysis (ICA) of functional MRI (fMRI) data. Methods Fifteen heroin addicts,admitted to our hospital from February 2010 to December 2010, and 15 healthy controls were recruited in the case-control study; they were performed whole brain scan with 3.0Tesla MR scanner when being presented with heroin related cues.ICA was performed on these data and their neuronal network activities were compared. Results As compared with those in the controls,the bilateral prefrontal cortex,the left anterior cingulated cortex,the bilateral posterior cingulated cortex, the left inferior temporal gyrus and the left parietal lobe enjoyed obviously decreased activity, while bilateral nucleus accumbens, the right hippocampus, part of the temporal lobe and the occipital lobe enjoyed significantly increased activity (P＜0.05). Conclusion ICA is an advanced approach to identify fMRI data induced by related cues; the specific neuroanatomy mediated to cue-elicited heroin craving mostly locates in the learn-memory system and reward system,which involves the frontal cortex,the parietal lobe,the anterior eingulate,the posterior cingulate,the hippocampus and the nucleus accumbens.

Objective To explore the changes of functional connectivity of anterior cingulate cortex (ACC) in online game addicts during the resting state,and to analyze the function of ACC in the pathogenesis of online game addiction from a perspective of resting-state functional connectivity.Methods Seventeen online game addicts treated in our hospital from March 2011 to October 2011 were recruited as addiction group and 17 healthy controls at the same period were recruited as HC group.The baseline characteristics of all 34 subjects were investigated and compared between the addiction group and the HC group.All fMRI data were preprocessed after a resting-state fMRI scan,and then,the left and right anterior cingulate cortexes were selected as regions of interest (ROIs) to calculate the linear correlation between the ACC and the entire brain to compare the differences between the online game addicts and normal controls.Results Obvious differences between the addiction group and HC group were noted in hours and days of online game using and degree of thirst to play online games (P＜0.05);within the functional connectivity of ACC during the resting state,in contrast to the controls,the online game addicts showed increased connectivity with posterior cingulate,medium cingulate,midbrain,nucleus accumbens and supplementary motor area,but reduced connectivity with prefrontal cortex,temporal lobe and occipital lobe (P＜0.05).Conclusion Altered functional connectivity of the ACC reflects the dysfunction in ACC of online game addicts,which may be linked to the forming and maintaining of the online game addiction.

BACKGROUNDHypoxemic respiratory failure (HRF) is one of the most common causes for neonatal infants requiring aggressive respiratory support. Inhaled nitric oxide (iNO) has been established routinely as an adjunct to conventional respiratory support in developed countries. The aim of this study was to investigate effects of iNO in neonates with HRF in resource limited condition with no or limited use of surfactant, high frequency oscillatory ventilation (HFOV) and extracorporeal membrane oxygenation.

METHODSA non-randomized, open, controlled study of efficacy of iNO was conducted over 18 months. Eligible term and near-term neonates from 28 hospitals with HRF (oxygenation index > 15) were enrolled prospectively into two groups as either iNO or control. Oxygenation improvement and mortality as primary endpoint were determined in relation with dosing and timing of iNO, severity of underlying diseases, complications and burden. Intention-to-treat principle was adopted for outcome assessment. Response to iNO at 10 or 20 parts per million (ppm) was determined by oxygenation in reference to the control (between-group) and the baseline (within-group).

RESULTSCompared to 93 controls, initial dose of iNO at 10 ppm in 107 treated infants significantly improved oxygenation from first hour (P = 0.046), with more partial- and non-responders improved oxygenation with subsequent 20 ppm NO (P = 0.018). This effect persisted on days 1 and 3, and resulted in relatively lower mortalities (11.2% vs. 15%) whereas fewer were treated with surfactant (10% vs. 27%), HFOV (< 5%) or postnatal corticosteroids (< 10%) in both groups. The overall outcomes at 28 days of postnatal life in the iNO-treated was not related to perinatal asphyxia, underlying diseases, severity of hypoxemia, or complications, but to the early use of iNO. The cost of hospital stay was not significantly different in both groups.

CONCLUSIONSWith relatively limited use of surfactant and/or HFOV in neonatal HRF, significantly more responders were found in the iNO-treated patients as reflected by improved oxygenation in the first three days over the baseline level. It warrants a randomized, controlled trial for assessment of appropriate timing and long-term outcome of iNO.

Administration, Inhalation ; Female ; Humans ; Hypoxia ; drug therapy ; physiopathology ; Infant, Newborn ; Male ; Nitric Oxide ; administration & dosage ; therapeutic use ; Pregnancy ; Respiratory Insufficiency ; drug therapy ; physiopathology

Objective To explore the changes of functional connectivity of the prefrontal cortex in chronic heroin addicts under resting-state functional MRI (fMRI). Methods Resting fMRI examination was performed on 13 chronic heroin addicts and 14 healthy volunteers. After pre-processing the resting-state fMRI data, the prefrontal cortex was selected as the seed region, with which a whole-brain voxel temporal correlation in Iow frequency fMRI fluctuations was analyzed and the changes of functional connectivity of the prefrontal lobe in both chronic heroin addicts and healthy volunteers were calculated with SPM5 software. Results Compared with that in the control group, the functional connectivity between the left prefrontal cortex and the left hippocampus, right anterior cingulate, left middle frontal gyrus, right middle frontal gyrus, right precuneus in the heroin addiction group was significantly decreased. The functional connectivity between the right prefrontal cortex and the left orbital frontal cortex, left middle frontal gyrus in thc heroin addiction group was also significantly decreased as compared with that in the control group. Conclusion Functional connectivity of prefrontal cortex in chronic heroin addicts decreases, indicating that the prefrontal cortex may be involved in the maintenance of heroin addiction and relapse after withdrawal.

To identify the structure of three related substances in potassium sodium dehydroandrographolide succinate (PSDS), an HPLC preparation method was used to separate the impurities. These main impurities were identified using LC-ESI/TOFMS, LC-ESI/MSn, NMR, UV and IR. One of the main impurities was a hydrolyzed and oxidized product of PSDS, which has not been reported previouely. The other two impurities were hydrolyzed products of PSDS after losing different succinic acids. The results indicate that PSDS can be easily hydrolyzed and oxidized. It should be stored at cool and dry places.
Andrographis ; chemistry ; Antiviral Agents ; chemistry ; isolation & purification ; Chromatography, High Pressure Liquid ; Diterpenes ; chemistry ; isolation & purification ; Drug Contamination ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Plants, Medicinal ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective To explore the functional location of brain regions related to internet game addiction using clue-reaction model and functional magnetic resonance imaging (fMRI). Methods Twenty participants with internet game addiction and 20 control subjects without addiction were tested. They were presented with different internet game videos and the paired common life videos while undergoing fMRI. Questionnaire survey was employed to investigate their emotion changes after watching the game video; the activation data produced by the stimulations were collected through the measurement of blood-oxygen-level dependent signals in the brain. Subtraction algorithm was adopted to analyze the corresponding regions of interest. The activated brain areas stimulated by the internet game videos were determined. Results Compared with the common life video watching, the interact game video watching showed significantly different results of psychological assessments, including emotional states, degree of thirst, degree of liking and wishing to re-watch in the addiction group (P<0.05); while the interact game video watching only had a strong degree of re-watching as compared with the common life video watching in the control group. As compared with the common life videos, internet game videos could induce significantly high activation in the parietal lobe and visual cortex of the temporal lobe of the left brain region in the control group (P<0.05);while significantly activation of all the brain regions, except the nucleus accumbens and the caudate nucleus of the left brain region, was found in the internet game video watching as compared with those in the common life video watching in the addiction group (P<0.05). Conclusion The regions of brain activation of the internet game addiction can be determined by fMRI and these areas may be involved in the generation and maintenance of the internet game addiction.

Objective To investigate the brain areas having functional connectivity with nucleus accumbens in heroin addicts with resting-state functional magnetic resonance imaging (fMRI), and explore the reward system of heroin addiction. Methods Fifteen participants with heroin addiction,voluntarily admitted to our drug rehabilitation center from June 2009 to March 2010, and 15 healthy controls at the same period were chosen in our study. Resting-state fMRI was performed on these patients; and then, the resting-state brain functional connectivity was also concluded by analyzing the left and right nucleus accumbens selected as regions of interests (ROIs). The corresponding brain areas having functional connections with ROIs were defined in the resting-state and the changes of functional connectivity were observed in heroin addicts. Results In the addiction group, the areas having functional connectivity with double nucleus accumbens included bilateral thalamus, the basal ganglia, the hippocampus, the midbrain and contralateral nucleus accumbens; and anterior cingulate cortex was also significantly correlated with left nucleus accumbens. However, in the control group, only the hippocampus and contralateral nucleus accumbens had these connection and their activity was much weaker than that in the addiction group. Conclusion In the resting-state, reward system of heroin addiction is constituted by the brain areas having functional connectivity with nucleus accumbens. And fMRI can be used to study the functional connections between the brain areas related to the heroin addiction from neuroimaging perspectives.