Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients.　Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied.　Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05)；and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05)；There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ；The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01）.⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r＝0.344, P<0.05).　Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis；The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells；The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.

Objective Epicardial fat volume ( EFV) was a risk factor for coronary heart disease ( CHD) , but there is little research regarding the relationship of EFV with insulin resistance ( IR) and CHD in patients with metabolic syndrome ( MS) .The aim of the article was to explore the effect of EFV in patients with MS on CHD and IR . Methods Patients with MS treated by percutane-ous coronary angiography ( CAG) in our hospital from February 2013 to August 2013 were recruited in this study .The data of height , weight, waist circumference(WC) and hip circumference(HP) were recorded.EFV were measured by MSCT.Fasting blood samples were collected for blood biochemical test . Results EFV in patients with MS was in positive relation with IR index (IRI)(r=0.335, P<0.001) and CHD (r=0.321, P<0.05), and the correlation still remained when the influences of WC and body mass index (BMI) were excluded.Logistic regression analysis showed that EFV was an independent risk factor for CHD (P<0.05), while linear regression analysis indicated EFV , BMI and LDL-C were the risk factors for IRI .ROC curves analysis proved EFV and BMI had diag-nosis value for IRI, and the areas under curve of EFV were 0.755 and 0.679 (P<0.05) respectively. Conclusion EFV is an in-dependent risk factor for CHD and IRI in patients with MS , and EFV has an advantage over BMI in the diagnosis value of IRI .

Objective Though paraquat (PQ) is highly toxic, there is still no effective treatment for PQ poisoning .The aim of the article was to study the protective effect and mechanism of the p 38 mitogen-activated protein kinase ( MAPK) inhibitor SB203580 on PQ-induced acute lung injury in rats . Methods 72 SD rats were randomly divided into three groups ( n=24 ): normal saline (NS) group, PQ poisoning group and p38 inhibitor SB203580 intervention (PQ+SB) group.The arterial blood gas analysis, lung wet and dry ratio (W/D),the expression of tumor necrosis factor-α(TNF-α), the superoxide dismutase (SOD) level and the pathological changes of lung tissues were recorded at different time points after drug intervention . Results On the 1st , 3rd, 5th days after drug intervention in PQ group, the alveolo-arterial oxygen partial pressure difference (PA-aO2) [(45.67 ±4.17), (68.78 ±6.63), (80.23 ±7.12 ) mmHg ], the lung tissue TNF-αexpression (14.63 ±3.10], [18.24 ±2.98], [16.22 ±2.79] pg/mg) and W/D ([4.931 ±0.034], [5.020 ±0.064], [5.079 ±0.016]) in-creased gradually to a peak on the 3rd day, while the SOD level de-creased respectively on the 1st , 3rd, 5th days after drug intervention ([175.26 ±7.98], [167.57 ±8.05], [160.24 ±6.78] U/ug) (P<0.05).Compared with PQ group, PQ+SB group got a decrease in the PA-aO2([80.23 ±7.12] vs [44.17 ±4.16]), the lung tissue TNF-αexpression ([16.22 ±2.79] vs [9.48 ±2.72]) and W/D ([4.805 ±0.070] vs [5.079 ±0.016]) (P<0.05), while the pulmonary SOD level increased in comparison with PQ group ([125.89 ±6.65] vs [160.24 ±6.78]) (P<0.05). Conclusion The p38MAPK inhibitor SB203580 plays a certain protective role in PQ-induced acute lung injury by reducing inflammation and improving antioxidant capacity .

Objective Traumatic hemorrhagic shock ( THS) is frequently complicated by liver injury , and IL-1βis one of the important inflammatory factors involved in this process .We ob-served changes of liver injury-related indexes in the rat model of THS and investigated the effects of AS-1, the mimic of the TIR/BB loop of Myd88, an important molecule of the IL-1βsignal pathway, on liver injury triggered by ischemia/reperfusion following THS and resuscita-tion ( THSR) in rats. Methods Thirty-two healthy male SD rats
were randomly divided into groups A (THSR), B ( THSR+AS-1), C (THSR+dissolution medium), and D (control).For those of the first three groups , fracture was induced in the left tibia , the mean arterial pressure reduced to 30 mmHg by bloodletting from the femoral artery and maintained at 30-40 mmHg for an hour , and then the rats resuscitated by infusion of blood and Ringer′s solution in proportion at a uniform speed in 30 min.Before resuscitation, the rats in group B were treated with AS-1 (160 mg/kg), group C with dissolution medium, and group D left untreated .At 3 hours after resuscitation in groups A , B and C, and at 3 hours after 2.5h-our in-tubation in group D , we detected the activity of ALT , the levels of AST , IL-1βand TNF-α, and the activity of MPO in the left liver , and observed pathological changes in the liver by light microscopy . Results Compared with group D, groups A, B and C showed ev-ident liver injury and significant increases in the activity of ALT (87.55 ±6.8 vs 206.13 ±23.67, 110.45 ±18.20 and 210.73 ± 28.43), AST (327.03 ±36.23 vs 621.00 ±40.61, 409.13 ±63.53 and 600.25 ±44.05), the levels of IL-1β(327.03 ±36.23 vs 621.00 ±40.61, 409.13 ±63.53 and 600.25 ±44.05) and TNF-α(93.51 ±9.86 vs 214.13 ±21.24, 145.25 ±12.42 and 206.50 ± 36.97), and the activity of MPO (0.90 ±0.21 vs 1.72 ±0.12, 1.20 ±0.11 and 1.67 ±0.14) (all P<0.05).The above indexes were remarkably lower in group B than in A and C, (all P<0.05), but with no significant differences between the latter two groups (P>0.05).Conclusion TIR/BB-loop mimetic AS-1 can attenuate ischemia/reperfusion-induced liver injury after THSR in rats by decrea -sing the levels of IL1-βand TNF-αin the serum.

Objective High mobility group box 1 (HMGB1) mediates the inflammatory immune response as well as the prolif-eration, differentiation and migration of cells , neverthless, little study has been done on the changes of HMGB 1 expression in hepatoma tissues.The aim of the article was to investigate the changes of HMGB 1 mRNA and protein expression in hepatocellular carcinoma (HCC) tissues. Methods Real-time fluorescence quantitative PCR and Western blotting were applied to detect HMGB 1 mRNA and protein expression in HCC tissues and their paracancerous tissues of 13 cases.Immunofluorescence localization was used to analyze the changes of HMGB1 distribution in hepatic cells . Results The expression of HMGB1 mRNA and protein in HCC tissues (4.01 ±0.81) and (1.37 ±0.34) increased significantly in comparison with those in paracancerous tissues (5.76 ±1.28) and (0.52 ±0.12) ( P<0.01).Nucleo-cytoplasmic translocation of HMGB1 was observed in hepatocarcinoma cells . Conclusion There is increased expression of HMGB1 in HCC tissues, which shows HMGB1 mediates the carcinogenesis of HCC .

Objective There is a high occurrence rate of thalassaemia in Guangdong Province .Major and intermedia thalas-saemia bring severe burden for patients , families, and societies.This study aimed to reveal the economic burden of thalassaemia major and intermedia thalassaemia in Guangdong Province . Methods Eight areas of Guangdong Province were selected as the sampling ar-eas.Patients with major or intermedia thalassaemia were enrolled in the study .The patients′economic burden of this disease , inclu-ding direct economic burden , indirect economic burden and intangible economic burden was calcultated .The direct economic burden was estimated by outpatient fee , hospitalization expense , nutrition and transportation fees , indirect economic burden was evaluated u-sing disability adjusted life years ( DALY) combined with human capital , and intangible economic burden was calculated using method of willingness. Results Per average annual direct economic burden of 45 patients with major or intermedia thalassaemia was 43 058.66 yuan, per average annual indirect economic burden was 20 474.51 yuan, and per person intangible economic burden was 302 466.67 yuan. Conclusion Economic burden of major and intermedia thalassaemia is huge and most patients do not receive standardized treatment .More effective way should be taken to reduce the economic burden of thalassaemia and help the patients to re -ceive standardized treatment .

Objective Xiangqingzhitong spray ( XQ spray) is a kind of class V new Chinese drugs .This paper studied the anti-inflammatory and analgesic effects of XQ spray to provide experiment evidence for clinical application . Methods Mice were divided into blank control A group , yunnan baiyao aerosol A group , voltaren A group and low , middle and high dose A group of XQ spray.Analgesic effects were studied by observing effect of XQ spray for pain threshold in electrical stimulation test .Mice were divided into blank control B group , yunnan baiyao aerosol B group , voltaren B group and low , middle and high dose B group of XQ spray .Analgesic effects were studied by observing the effects of XQ spray for pain threshold in tail pain tenderness test .Mice were divided into blank control C group , yunnan baiyao aerosol C group , voltaren C group and low,middle and high dose C group of XQ spray .Anti-inflammatory effects were observed by the models of ear swelling induced by xylene in mice.Rats were divided into blank control D group , yunnan baiyao aerosol D group , voltaren D group and low, middle and high dose D group of XQ spray .Anti-inflammatory effects were observed by the models of paw edema induced by carrageenin in rats . Results Electrical stimulation test showed that middle and high dose A group of XQ spray could enhance the pain threshold and the analgesia percentage reached 90%after the administration of 15 min and 30 min.Compared with control group , significant difference was found in medium and high dose A group (P<0.05).High dose B group of XQ spray could enhance pain threshold in tail pain tenderness test markedly after the administration of 15 min and 30 min and the difference was significant compared with control group ( P<0.01).Middle dose C group could inhibit the ear swelling induced by xylene in mice and the difference was significant compared with control group ([4.41 ±4.55]mg vs [9.15 ±3.94]mg,P<0.05).High dose C group could inhibit the ear swelling induced by xylene in mice and significant difference was found compared with control group ([3.62 ±3.56]mg vs [9.15 ±3.94] mg,P<0.01). High dose D group could inhibit the paw edema induced by carrageenin in rats after the administration of 30 min and there was signifi-cant difference compared with control group ([1.19 ±0.94]mg vs [2.54 ±1.28]mg,P<0.01). Conclusion XQ spray has sig-nificant anti-inflammatory and analgesic effects .

[Abstract ] Objective The tension-free vaginal tape is the main method for treatment of stress urinary incontinence (SUI). The aim of the present study was to analyze the effect and safety of tension-free vaginal tape ( TVT) and tension-free vaginal tape-obtu-rater ( TVT-O) for female stress urinary incontinence and to sum up the experiences . Methods Clinical data of 142 patients who re-ceived anti-incontinence surgery ( TVT/TVT-O ) between January 2011 and May 2014 were retrospectively analyzed , 111 cases re-ceived TVT and 31 cases received TVT-O.The effect and the complication were analyzed at least 6 months post surgery .Incontinence quality of life ( I-QOL) and organ prolapse/urinary incontinence sexual function questionnaire ( P-ISQ) were used to observe the sub-jective symptoms .One hour pad test value was used to assesse the objective response . Results The effective rate post-TVT/TVT-O was 88.03%, and the cure rate was 95.07%6 months post surgery.In the group of TVT, I-QOL and P-ISQ score were 52.1 ±16.8 and 60.1 ±36.5 at time of pre-operation, and they were 92.1 ±17.1 and 62.2 ±37.8 at time of post-operation, respectively.In the group of TVT-O, they were 61.2 ±15.8 and 57.1 ±36.8 at time of pre-operation, and they were 91.3 ±20.1 and 62.1 ±35.9 at time of post-operation, respectively.Compared with pre-operation, I-QOL and P-ISQ score were obviously rised at time of post-operation ( P<0.05 ). The total incidence rate of surgery complication was 21.83%.And,in proper was urinary tract infection (16.9%),OAB (14.08%), bladder injury(11.26%), retention of urine(7.74%), nerve pain(2.81%), retropubic hematoma(1.41%), urethral injury(1.41%).All patients′surgeries were successful except three cases.One patient was cured after reoperation .The other two was improved with dislodge sling urinary incontinence . Conclusion TVT/TVT-O was a highly effective and safe method in the treatment of SUI .But we should not ignore the complications;the timely and effective treatment measures could improve the operation rate of success .

How to cultivate and evaluate the nursing students′clinical competency is an important part of the process of higher nursing education .Objective structured clinical examination is regarded as an effective assessment method to evaluate the clinical com -petency of medical students .However , it is still at the initial stage in the nursing education in China .This article presents an overview on the design of nursing objective structured clinical examination , the present application of objective structured clinical examination in cultivating and evaluating the nursing clinical competency and the effectiveness of objective structured clinical examination .

DNaseⅠhypersensitive sites (DHSs) are regions of extreme chromatin which is highly sensitive to DNaseⅠ.Ge-nome-wide mapping DHSs is a powerful method for identifying many different types of regulatory elements within nuclear chromatin .It can help systematically resolve gene and genomic information , and the dynamic molecular mechanism of transcriptional regulation .This paper reviews the distribution of DHSs , the technology of DNase-seq and the research progress in transcriptional regulation functions of DHSs.