Re-evaluation of the diagnostic criteria in mild Wilson Disease / 中国医师杂志

Objective With the development of children 's health care policy, mild Wilson Disease as the first symptom of pa-tients is increasing.In this study, we assessed the reliability of the 2001 international general standards of the Wilson Disease diagnos -tic score.Methods Twenty -one cases of Wilson Disease in children (11 cases were boys, 10 cases were girls, average age was 3 ~10.8 years) included in the study, other 21 cases with liver disease were age-matched and gender-matched.There were no clinical symptoms, only with abnormal liver function in laboratory tests .All the patients with Wilson Disease were all confirmed through genetic diagnosis.Results Receiver operating characteristic (ROC) curve analysis showed that at 20 mg /L threshold, the sensitivity of cer-uloplasmin was 93.4% (95% CI : 81.2% ~98.8%), the specificity was 81.8 (95% CI : 71.6% ~93.6%); urinary copper diag-nostic threshold was 40μg/L/24h, the sensitivity was 75.9% (95% CI :61.7% ~92.4%); the specificity was 89.9% (95% CI :73.7% ~96.6%).WD scoring diagnostic system of the positive and negative predictive values as high as 93% and 91.6%.Penicil-lamine load test in Wilson Disease and control groups , no significant difference between the ROC curve showed a sensitivity of only 10%.Conclusions WD scoring diagnostic system in the mild Wilson Disease patients still has a high diagnostic specificity , but peni-cillamine load test does not have diagnostic significance in some patients .

Research on problem design of problem-based learning in pediatric teaching / 中华医学教育探索杂志

Objective To apply 3C3R model in problem design of PBL for pediatrics teaching.Methods The 3C3R model comprises two classes of components:core components and processing components.Core components of the model are 3C,which are content,context and connection while processing components are 3R,which are researching,reasoning and reflecting.3C3R model was used in the problem design for the PBL case of ‘ Why the mouth of Baobao became purple when he was crying?' Totally 76 eight-year program medical students and 7 tutors were enrolled as teaching object.The anonymous questionnaires from the students were collected for assessment of PBL teaching.Results The percentage of students with scores ≥4 for content in PLB problem design was 90.8％,for context was 80.3％,for connection was 64.5％,for researching was 81.6％,for reasoning was 69.7％ and for reflecting was 40.8％.The percentage of tutors with scores ≥4 for content in PLB problem design was 100％,for context was 71.4％,for connection was 28.6％,for researching was 71.4％,for reasoning was100％,for reflecting was57.1％.Both students and tutors held a positive attitude towards the component of content,context,researching and reasoning in problem design model.But the components of connection and reflection needed to be improved.Conclusion The 3C3R model is helpful for problem design of PBL in pediatric teaching.

The application of multi-modal MRI in venous thrombolysis therapy for hyperacute cerebral arterial thrombosis / 中华放射学杂志

Objective To investigate the value of MRI in thmmbolytic thempy of hyperacute cerebral arterial thrombosis.Methods One hundred and sixteen patients with acute cerebral arterial thrombosis were recruited.plain CT and multi.modal MRI were performed in all patients.Thirty-three patients with hyperacute cerebral infarction were treated bv recombinant tissue plasminogen activator(rt-PA) and followed-up periodically using MRI.Results The 33 patients with thrombolysis selected by MRI demonstrated clinical improvement.90 d moclified Rankin scale scores(mRs)were less than 2 and life quality Barthal indexes(BI)were from 80 to 100.The complication included one asymptomatic parenchymal hematoma(PH1)one weeks after thrombolytic therapy and 4(12.2%)hemorrhagic infarction(HI)6 to 24 hours after thrombolytic therapy.Condusions MRI has significant clinical value for the screening and follow-up of intravenous thrombolytic therapy of hyperacute ischemic stroke.MRI-based thrombolysis is a safe and effective method for hyperacute ischemic stroke.

Effects of rosuvastatin on endothdial function during myocardial ischemia-reperfusion injury in rabbits / 中华急诊医学杂志

Objective To study the change of endothelial function during myocardial ischemia-reperfusion injury in rabbits and the effect of Rasuvastatin. Method Sixteen New Zealand rabbits were randomLy divided into two groups: ischemia/reporfusian injury group (control group) and Resuvastatin group(drug group). The myocar-dial ischemia-reperfusion model was established by occlusion of left anterior descending coronary artery for 40 min-utes evidenced by the elevation of the ST segment≥0.2 my on ECG waveform, and after release of ooclusion, the ST segment of ECG retttmed to 1/2 or more of the normal wavefonn, which was the evidence of successful reperfu-sion. The rabbit serum nitric oxide (NO) and plasma endothelia-1 (ET-1) content were assayed before occlusion, 40 minutes, 60 minutes and 180 minutes after reperfusion. SPSS11.5 software was used for ANOVA(Repested Measurement designs). P<0.05 was considered as statistically significant. Results There were no significant differences in serum NO and plasma ET-1 between two groups bsfore isehemia, but 40 minutes, 60 minutes and 180 minutes after reperfusion, the levels of serum NO in drug group were higher than those in control group [(82.000±13.825), (63.375±17.541), (50.250±18.987)μmol/L vs. (63.125±18.962), (43.500± 16.518), (29.625±14.162) μmol/L, P<0.05], and the levels of plasma ET-1 content in drug group were lower than those in the control group [(282.541±38.928), (315.152±55.263), (377.795±60.427) pg/mL vs. (331.785±35.341),(375.914±5.204),(459.829±70.110) pg/mL, P<0.05]. Conclusions By the means of increasing serum NO and decreasing plasma ET-1, rosuvastatin can improve the endothelial function in rabbits with isehemia-reperfusion injury.

Intervention of compound danshen drop on serum cyclic adenosine monophosphate and cyclic guanosine monophosphate on transient cerebral ischemic attack / 中国组织工程研究

BACKGROUND: Blood platelet is active commonly appeared in both acute and recovery stages in ischemic cerebral apoplexy. Cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) are closely correlated with the blood platelet function.OBJECTIVE: To observe the therapeutic effects of compound danshen drop on clinical prevention and treatment of transient cerebral ischemic attack (TIA) and the influence on serum cAMP and cGMP.DESIGN: Randomized control experiment.SETTING: Department of Neurology of Binzhou Medical College affiliatedHospitalPARTICIPANTS: Totally 180 TIA patients participated in the experiment in volunteer in the clinic of Neurological Department of Affiliated Hospital of Binzhou Medical College from September 2000 to April 2001. Based on randomized number scale, 3 groups were divided according to dosages of compound danshen drop. In 10 drops/d group, there were 60 cases, of which 35 cases were male and 25 cases female, aged varied from 50 to 70 years, averagely (54.3±7.2) years old. In 20 drops/d group, there were 60 cases, of which, 32 cases were male and 28 cases female, aged varied from 49 to 62 years, averagely (55.7±5.1) years old. In 30 drops/d group, there were 60 cases, of which, 33 cases were male and 27 cases female, aged varied from 52 to 69 years, averagely (54.9±5.5) years old.METHODS: In 10 drops/d group, the drug was given once per day, 10drops each time. In 20 drops/d group, the drug was given twice per day,10 drops each time. In 30 drops/d group, the drug was given three times per day, 10 drops each time. Four weeks after medication, 3 mL blood was collected from each patient in the morning. With radioimmunoassay, the contents of cAMP and cGMP in serum were determined. Each case was tions, gem bleeding, epistaxis, subcutaneous bleeding, mouth numbness,headache, dizziness, etc.tack: In 10 drops/d group, there were 1 case in internal carotid arterial system, 2 cases in vertebral arterial system, 1 case of cerebral infarction and 2 cases of myocardial infarction. In 20 drops/d group, it was 2, 2 and 1 cases successively and in 30 drops/d group, it was 1, 2, 1 cases succesgroup: There were 1, 2 and 4 cases of harmful accident and side effects in three groups successively, of which, peripheral numbness of mouth 1 case in 10 drops/d group, 1 case of either peripheral numbness of mouth or headache in 20 drops/d group, gastrointestinal reaction 1 case, peripheral numbness of mouth 2 cases and dizziness 1 case in 30 drops/d group.There was no gem bleeding, epistaxis and subcutaneous bleeding, and no patient was withdrawn the treatment due to above-mentioned side effects.With comparison among groups, significant difference was not indicated The contents of cAMP were (21.22±3.94), (22.5±3.67), (23.1±7.7) ng/Land cGMP were (3.67±1.18), (4.74±2.12), (4.6±0.7) ng/L successively in three groups (P ＞ 0.05).CONCLUSION: During second-grade prevention of TIA, compound danshen drop presents definite therapeutic effects, which is basically same in comparison of dosages. Simultaneously, no remarkable side effects appear.