Research progress on cerebellar ataxia, neuropathy, vestibular areflexia syndrome / 中华神经科杂志

Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) is an autosomal recessive hereditary disorder characterized by cerebellar ataxia, sensory neuropathy and bilateral vestibulopathy. Recently a biallelic intronic AAGGG repeat expansion in the replication factor C1 (RFC1) gene was identified as the cause of this disorder. Clinical studies of genetically-confirmed CANVAS in the past 2 years have significantly expanded the clinical phenotype of the disease and the concept of RFC1-related disease was proposed. The clinical manifestations, characteristic auxiliary examination, genetic changes of CANVAS were reviewed and the new diagnostic criteria to improve clinicians′ awareness of the disease was discussed in this paper.

Progress and enlightenment on the construction of clinical teachers' teaching ability model / 中华医学教育探索杂志

This paper expounds that the construction of a clinical teacher's teaching ability model is an urgent problem to be solved in medical colleges and universities, and analyzes that the current clinical teaching concepts and methods are constantly improving, and the clinical teaching environment is more informatized and intelligent. This paper summarizes the clinical teachers' teaching ability models at home and abroad, such as the ability and quality iceberg model, teacher growth model, inquiry-based teaching model, Molenaar three-dimensional teaching ability model, etc., and discusses the practice research progress of current clinical teacher teaching ability models such as student-centered guided teaching, bedside teaching, micro-teaching and BOPPPS (bridge-in, objective, pre-assessment, participatory-learning, post-assessment, and summary) method, medical simulation teaching, etc., hoping to provide guidance for further constructing models of teacher's teaching ability suitable for Chinese medical colleges and universities.

Research progress on retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations / 中华神经科杂志

Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) is a rare hereditary cerebrovascular disease. The clinical presentations are characterized by early-onset visual impairment, liver and kidney dysfunction and neurological symptoms. Imaging examinations are often misdiagnosed as neoplasms or tumefactive multiple sclerosis for invasive examination. Early and correct identification is essential for optimizing treatment strategies and comprehensive management. This review is to improve the understanding of RVCL-S, which may help to reach more accurate diagnosis and better treatment, and improve further research.

Correlation of right ventricular wall fatty infiltration or fibrosis degree and function and volume of right ventricle in arrhythmogenic right ventricular cardiomyopathy / 中国医学影像技术

Objective To investigate the correlation of right ventricular wall fatty infiltration or fibrosis degree and function and volume of right ventricle in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).Methods Twenty ARVC patients were enrolled.Multi-sequences of MR scanning were performed,and the transverse diameter of outflow tract of right and left ventricle,end-diastolic dimension (EDD),ejection fraction (EF),end-diastolic volume index (EDVI),end-systolic volume index (ESVI),cardiac output index (CI),as well as right ventricular myocardial mass index (MASSI) and fat and fibrosis tissue characteristics were quantitatively evaluated.The correlation between right ventricular wall fatty infiltration or fibrosis and right ventricular function and volume were analyzed.Results The right ventricular outflow tract transverse diameter was (52.42±11.80)mm,and right ventricular EDD,EF,EDVI,ESVI,CI and MASSI was(50.13 ± 8.71) mm,(18.13± 6.71)％,(169.13 ± 72.11) ml/m2,(117.01 ± 67.31) ml/m2,(1.81±0.20) L/(min · m2) and (17.62 ±1.80)ml/m2,respectively.The right ventricular free wall/anterior wall involvement was observed in all 20 cases,while inferior wall involvement,apical involvement and right ventricular outflow tract involvement was noticed in 10,14 and 15 cases,respectively.The right ventricular wall fat infiltration or fibrosis index was (70.00±22.33) ％,correlated with right ventricular EF (r=-0.627,P =0.003),EDVI (r=0.695,P=0.001)) and ESVI (r=0.676,P=0.001).Conclusion The correlation of right ventricular wall fatty infiltration or fibrosis degree and function and volume of right ventricle may reflect changes of cardiac function in ARVC patients.

Roles of long noncoding RNA in cerebral ischemia / 国际脑血管病杂志

Long noncoding RNA (lncRNA) is a kind of RNA whose length exceeds 200 nt,but lacks a complete open reading frame.It participates in many biological processes through a variety of regulation mechanisms of gene expression and is also related to the occurrence and development of many diseases.Studies have shown that the expression of lncRNA in brain tissue changes significantly during cerebral ischemia,and participates in the pathophysiological process of cerebral ischemia.This article reviews the roles of lncRNA in cerebral ischemia in recent years,hoping to provide new ideas and strategies for the prevention,diagnosis,and treatment of ischemic stroke in the future.

Preparation of span-poly(ethylene glycol) ultrasound contrast agent microbubbles combined with folate-carbon nano tube-paclitaxel / 中国组织工程研究

BACKGROUND:As the sensitivity, clarity and accuracy of traditional ultrasound contrast agents are easy to be affected by objective factors, it is difficult to achieve diagnose and therapy simultaneously. Carbon nano tubes (CNTs) possess a specific reticular, hol ow and tubular structure and the potential to enhance the ultrasound imaging. The functional CNTs obtained through non-covalent adsorption, covalent bonding and internal embedding hold a good biocompatibility and high drug loading efficiency. So the drug loaded CNTs are added into the microbubble to synthesize a multi-functional ultrasound contrast agent. OBJECTIVE:To prepare the span-poly(ethylene glycol) (span-PEG) ultrasound contrast agent microbubble combined with folate-CNTs-paclitaxel (FA-CNTs-PTX) and to investigate its appearance, particle size as wel as loading efficiency of CNTs and PTX. METHODS:Firstly, the span-PEG microbubble was prepared using the acoustic cavitation method and its preparation process was optimized through the orthogonal experiment. Then the FA-CNTs-PTX compound was synthesized by the electrostatic self-assembly andπ-πadsorption principle. In the end, the span-PEG ultrasound contrast agent microbubble combined with FA-CNTs-PTX was obtained by loading the FA-CNTs-PTX into the span-PEG microbubble. The appearance of the composite microbubble were observed using scanning and transmission electron microscopes, the distribution and average particle size were detected by laser particle size analyzer, and the loading efficiency of CNTs and PTX was measured through ultraviolet spectroscopy. RESULTS AND CONCLUSION:The composite microbubble had a smooth surface and the average particle size was 442 nm. The loading efficiency of CNTs and PTX in the composite microbubble was 1.69%and 47.9%, respectively. To conclude, the FA-CNTs-PTX targeting drug delivery system is successful y loaded into the span-PEG microbubble. The composite microbubble is a hol ow sphere that has uniform nanoscaled particle size distributions, which is expected to become an ideal ultrasound contrast agent involved in angiography and targeting therapy.

Arrhythmogenic cardiomyopathy with left ventricle involvement/arrhythmogenic left ventricular cardiomyopathy:a clinical and MRI study / 中华放射学杂志

Objective To investigate the characteristics of clinical and cardiovascular magnetic resonance imaging(CMR) of arrhythmogenic cardiomyopathy with left ventricular(ALVC) involvement. Methods Ten cases of arrhythmogenic cardiomyopathy with left ventricular involvement and sixteen randomly chosen cases of arrhythmogenic cardiomyopathy with right ventricular (ARVC) involvement were enrolled in this study. Clinical symptoms, cardiac electrophysiological changes as well as the cardiac morpharage, ventricular functions and delayed enhancement of myocardium assessed by CMR were compared between the two groups. The size of heart chambers, global ventricular functions and the fat/fibrosis infiltration were evaluated by turbo fast spin echo, ture FISP cine and delayed enhancement. These were statistically analyzed by independent samples t test, respectively.Results There was no significant difference in age and gender between two groups. All the patients in two groups presented non-specific clinical manifestations with no significant differences (P>0.05) except for short of breath(P=0.034). The end-diastolic diameter of left ventricular, left ventricular end-diastolic volume index, left and right ejection fraction in ALVC and ARVC group were (64.2±7.7), (49.2±5.9) mm(t=5.551,P<0.001), (113.9±24.0), (69.2± 30.0) ml/m2(t=3.962, P<0.001), (38.5±3.1)%, (56.0±8.4)%(t=-6.733,P<0.001), (42.0±5.5)%, (18.0±7.3)%(t=8.817, P<0.001) respectively. An medium of 11 and 14 segments of fat or fat/fibrosis were found in intramural wall of the LV myocardiumin patients with ALVC,while only 0 segment(all P<0.001)was found in patients with ARVC.Conclusions The clinical manifestations of arrhythmogenic cardiomyopathy with left ventricular involvement was similar to ARVC, however, with regarding to cardiac morphological, functional and myocardial lesions, these two diseases have different characteristics in CMR features.“one-stop-shop”MRI examination has high value in the diagnosis of arrhythmogenic cardiomyopathy with Left ventricular involvement.

Analysis of mortality and cause of death in inpatients with single-center cerebral infarction / 中国脑血管病杂志

Objective To investigate the mortality and cause of death in inpatients with cerebral infarction. Methods The clinical data of 515 patients with cerebral infarction as the underlying cause of death from January 2005 to December 2009 were analyzed retrospectively. The hospital mortality, direct cause of death,and constituent ratio of the cause of death were calculated. The clinical features,such as classification of the Trial of Org 10 172 in acute stroke treatment( TOAST),age and duration of hospital-ization were analyzed. Results ( 1 )The hospital mortalities in patients with cerebral infarction from 2005 to 2009 were 2. 0%(91/4 659),2. 1%(110/5 264),1. 9%(95/5 035),1. 2%(100/8 656),and 1. 0%(119/11 640),respectively. The overall mortality rate was 1. 5%(515/35 254),basically had a declining trend year by year(χ2 =42. 39;P74 years)groups were 1. 1%( 22/2 009 ),1. 0%( 112/11 158 ),1. 5%( 221/14 311 ),and 2. 1%(160/7 776),respectively. They increased with increasing age(P<0. 01).(3)The TOAST classification in 515 died patients were as follows:57. 3%(n=295)for large-artery atherosclerosis,19. 4%(n=100) for cardioembolism,14. 4%(n=74)for cryptogenic stroke,7. 0%(n=36)for small-artery occlusion and 1. 9%(n=10)for other reasons. The five leading direct cause of death were cerebral hernia 49. 3%(n=254),primary central respiratory and circulatory failure 25.0%(n=129),pneumonia 8. 9%(n =46), cerebral-cardiac syndrome 5. 8%( n =30 ),and multiple organ failure 5. 6%( n =29 ).( 4 ) The mean age of death was 67 ± 12 years old. The patients who died of cerebral hernia and primary central respiratory and circulatory failure were younger than those who died of pneumonia(65 ± 13,68 ± 11,and 75 ± 10,respectively;all P<0. 01). The median length of hospital stay was 3 days. The length of hospital stay in patients who died of hernia,primary central respiratory and circulatory failure,and cerebral-cardiac syndrome were significantly shorter than those who died of pneumonia and multiple organ failure( the median length of hospital stay was 3. 0,3. 0,3. 0,12. 5,and 9. 0 days,respectively;all P <0. 05). Conclusions The mortality of hospitalized patients with cerebral infarction have a declining trend year by year. Brain disease itself is the most important reason of early death for patients with cerebral infarction, indicating that it is the important point of prevention and treatment in clinical work.

Application and new progress of probiotics in enteral nutrition / 肠外与肠内营养

It is critical to preventing gut-originaltel infection to attenuate bacterial and/or endotoxin translocation, maintain bacterial balance, improve gut mucosal barrier function and elevate local immunity. Probiotics beneficially affect the host by improving its intestinal microbial balance, by preventing gut mucosal barrier breakdown and bacterial translocation, by modulating immunity,and by promoting gut movements and absorption. The role and new progress of probiotics in enteral nutrition are reviewed .

Short-term therapeutic effect of neoadjuvant chemotherapy with herceptin and docetaxel in patients with localized advanced breast cancer / 中国综合临床

Objective To investigate the efficacy and adverse effect of herceptin combined with docetaxel in patients with localized advanced breast cancer. Methods 16 patients with localized advanced breast cancer were treated with herceptin (8 mg/kg in the first cycle and 6 mg/kg from 2 to 4 cycles,d1) and docetaxel (75 mg/m2 ,d2) for 4 cycles. Three weeks were taken as a cycle. Following chemotherapy, the patients underwent improved radical operation of breast cancer or radical operation of preserving breast. Results The overall response rate (oRR) was 87.5%. The complete clinical remission rate (cCR) was 56. 3%. The complete pathologic remission rate (pCR) was 25.0%. The mainly adverse effects were bone marrow depression and gastrointestinal toxicity. Conclusion The regimen of herceptin combined with docetaxel is effective and can be well-tolerated by patients with localized advanced breast cancer. It shows promising prospect in clinical application.

Magnetic Resonance Imaging of Intracranial Hemorrhage / 国际脑血管病杂志

Traditional sequences of magnetic resonance imaging (MRI) such as T1-weighed imaging, T2-weighed imaging, and fluid-attenuated inversion recovery (FLAIR) imaging can sensitively detect the subacute and chronic intracranial hemorrhage; gradient echo sequence can detect various stages of intracranial hemorrhage, but there is no correlation between the signal intensity of the hematoma and the time of the presence of hematoma. Diffusion-weighted imaging and apparent diffusion coefficient may provide more information about the center and surrounding areas of hematoma, as well as the hemorrhagic tendency after infarction.

Post stroke depression:multiple-factor analysis of 125 cases / 中国组织工程研究

BACKGROUND: The frequency of body ailments combined with depression is relatively higher, and hence post stoke depression(PSD) has gained more and more concentration.OBJECTIVE: To investigate the morbidity, related factors and pathophysiological mechanism of PSD.DESIGN: Case analysis and observation study.SETTING: Department of eurology in a hospital of a university; Third department of internal medicine in a hospital of Chinese People' s Armed Police Force; Department of neurology in a province hospital.PARTICIPANTS: This study was carried out at the Neurological Department of First Clinical Hospital Affiliated to Harbin Medical University and the General Hospital of Armed Police Army in Heilongjiang Province from January 2001 to May 2004. A cohort of 312 stroke patients was followed up in this study.METHODS: All 312 patients scored for Hamilton rating scale for depression (HAMD) and European stroke scale(ESS) within 48 hours of hospitalization. Meanwhile their clinical presentations and social-psychological factors were also collected.MAIN OUTCOME MEASURES: The stroke morbidity in patients with different sex, age, personality, educational degree, as well as stroke type, lesion location and extent of neurological functional deficit.RESULTS: The morbidity of PSD was 40. 1%, predominated by mild and medium stroke; amongst which PSD was found more frequent in women than men( P ＜ 0.01), as well as in elders than youngers( P ＜ 0.01); Patients who has diffidence personality are liable to suffer from PSD; and it was found more common in patients with over middle school education than those received only elementary school education ( P ＜ 0.01 ); depression was more frequent in left-sided stroke than right-sided stroke( P ＜ 0.01 ), especially in frontal lobal stroke; PSD was found negatively correlated with the scores for ESS(r= -0.846, P ＜0.05).CONCLUSION: As the result of the interaction of multiple factors, the development of PSD is found accorded with biology-psychology-society mode.

Study on the Extractive Process of Qiangliyanhou Mixture / 中国药房

OBJECTIVE:To optimize the technics for the extraction of Qiangliyanhou mixture.METHODS:The physico-chemical properties of the compositions in the formula medicinal substances were analyzed,the obtained quantity of aqua aromatica was used as an investigation index of distillation technics;The preparation technics was optimized by orthogonal experiment in which the extraction ratio of the water extractives and the content of chlorogenic acid were used as the indexes to investigate the influence of the amount of water added,the soaking time before decoction,decoction time and times of decoc?tion on the extraction result.RESULTS:The optimized amount of aqua aromatica in the distillation procedures was collecting distillate that is3times the amount of the medicinal substances;The optimum water extraction condition was:the medicinal substances was soaked for2hours by adding15times amount of water before decocting for total3hours(3times?1hour/time).CONCLUSION:The preparation procedure is reasonable and reliable.

Analysis of factors affecting on adverse drug reactions in 122 cases / 中国临床药理学与治疗学

AIM: To analyze factors affecting on adverse drug reactions (ADRs) in 122 cases, in order to avoid and reduce occurrence of ADRs. METHODS: The cases of ADRs by the pharmacist and the clinical reports were collected, and then counted up and analyzed. RESULTS: In 122 cases of ADRs, there were 11 severe cases, the others are ordinary. The most common clinical displays of ADRs were the lesion of skin and the append ants ( 50.82 %), followed by the lesion of digestive system ( 20.49 %) and nervous system responses ( 18.03 %). Anti-infective drugs showed the highest proportion of ADRs, accounting for 61.48% of the total. The affected patients ranged in age over 50 years ( 34.42 %) and low age ( 21.32 %). The most of ADRs were induced by IV drop ( 91.96 %). CONLUSION: For the child and the old man crowd clinical doctors must be prudent with the medicine, avoiding the unreasonable combination of the medications, use the anti-infective drugs reasonably and strengthen monitoring of its use, in order to reduce occurrence of ADRs.

Beta-fibrinogen promoter -455 G/A (HaeIII) polymorphism prediction of plasma fibrinogen but not of ischemic cerebrovascular disease / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>The -455 G/A (HaeIII) polymorphism of beta-fibrinogen gene influences levels of plasma fibrinogen. We further investigated whether it influences the risk of ischemic cerebrovascular disease.</p><p><b>METHODS</b>We accumulated 134 acute ischemic cerebrovascular disease (ICVD) cases and compared their -455 G/A status with a control group (n = 166). The beta-fibrinogen gene -455 G/A polymorphism was analyzed for all subjects by PCR-RFLP with the restrictive enzyme HaeIII.</p><p><b>RESULTS</b>Plasma fibrinogen was higher in AA homozygous participants (341 mg/dL) than in participants carrying the G allele: GA (290 mg/dL), GG (298 mg/dL) in the control group. Plasma fibrinogen was also higher in AA homozygous patients (353 mg/dL) than in cases carrying the G allele: GA (287 mg/dL), GG (302 mg/dL) in the ICVD group. However, there was no significant association between beta-fibrinogen gene -455 G/A polymorphism and ICVD group.</p><p><b>CONCLUSIONS</b>Although a small effect cannot be excluded, beta-fibrinogen gene -455 G/A polymorphism is an independent predictor of plasma fibrinogen, but not of ischemic cerebrovascular disease.</p>

Impact of Drug Price Limits Policy on the Consumption of Anti-infectives in Our Hospital / 中国药房

OBJECTIVE:To investigate the impact of the drug price limits policy on the consumption of anti-infectives in our hospital.METHODS:The consumption sum and DDDs of the chief categories of anti-infectives in our hospital before and after the adoption of drug price limits policy(between Oct.,2004 and Sept.,2005 and between Oct.,2005 and Sept.,2006)were analyzed statistically.RESULTS & CONCLUSION:Both DDDs and consumption sum of the chief categories of anti-infectives in our hospital decreased markedly since the adoption of drug price limits policy.