BACKGROUND:Most end-stage renal failure patients must undergo hemodialysis before and after kidney transplantation.Noncompliance is common in patients who undergo hemodialysis,and it correlated with mortality.The improvement in self-management behavior is beneficial to the improvement of survival rate and quailty of life of hemodialysis patients.OBJECTIVE:To investigate and analyze the effect of nursing intervention on self-management behavior and health-related quality of life in hemodialysis patients before and after kidney transplantation.DESIGN:A randomized and controlled analysis.SETTING:Department of Nursing and Hemodialysis Center,First Affiliated Hospital of China Medical University.PARTICIPANTS:Forty-eight renal failure patients who underwent hemodialysis in the Hemodialysis Center,First Affiliated Hospital of China Medical University between February and April 2006 were recruited in this study.The involved patients.including 29 males and 19 females,aged 22-77 years,able to read and write the questionnaires,voluntarily participated in this study.Written informed consents of treatments and investigation items were obtained from each patient.The study was approved by the Ethics Committee of the hospital.The involved patients were randomly assigned into 2 groups with 24 patients in each:intervention group and control group.METHODS:Patients in the intervention group were given 6 months of nursing(i.e.according to actual conditions,each patient was given health education by handing out health promoting stuffs,giving individual or centralized guidance as well as other modalities).Patients in the control group were given routine health education.MAIN OUTCOME MEASURES:Self-management behavior and health-related quality of life were assessed before,3 and 6 months after nursing intervention using self-management behavior questionnaire and short-form 36 health survey.RESULTS:Forty-eight patients who underwent hemodialysis participated in the final analysis.There were no significant differences in the total scores of self-management behavior questionnaire and short-form 36 health survey between intervention group and control group before and 3 months after nursing intervention(P＞0.05).Significant difference in the total scores of self-management behavior questionnaire and short-form 36 health survey existed in each group 6 months after nursing intervention in comparison with baseline(P＜0.01,0.05).The total scores of self-management behavior questionnaire of intervention group were significantly increased 6 months after nursing intervention in comparison with the baseline (P＜0.01).CONCLUSION:Nursing intervention markedly improve the self-management behavior and quailty of life of patients who undergo hemodialysis before and after kidney transplantation.

Objective　To study the relationship of low density lipoprotein receptor gene polymorphism and hyperlipidemia in the population with essential hypertension. Methods　People with different lipid levels including 107 hyperlipidemia，104 at margin level and 108 normal were recruited in the study. Their polymorphisms of LDL-R gene were analyzed using PCR-RFLP. Results　There were three kinds of genotype: (+/+)、(+/-)、(-/-). In male, the frequencies of the(+/-)in three study groups were shown as follows: 41.18% in hyperlipidemia, 46.15% in margin level, 19.05% in normal lipid. The frequency of (+) allele was significantly higher in hyperlipidemia than that in normal lipid (24.51%,25.00% and 11.11%, respectively). In women, the differences were not statistically significant. The nonconditional univariate and multivariate logistic regression analysis demonstrated that (+) allele of AvaⅡ polymorphism of LDL-R was a genetic marker of male's hypercholesterolemia. Conclusions　The frequency of (+/-) hyperlipidemia in males was higher than that in normal lipid group and the (+) allele in male hyperlipidemia was significantly more frequant seen than that in normal lipid group. These results suggested that polymorphisms of LDL-Rgene might play an independent role of risk factor for hyperlipidemia.

Object To compare the HPLC fingerprints of Flos Chrysanthemi from different habitats Methods With Inertsil C 18 column, gradient elute was performed by mobil phase containing acetonitrile water (2% tetrahydrofuran, 0 1% trifluoracetic acid) The flow rate was 1 mL/min and column temperature 30 ℃ Different breeds of Flos Chrysanthemi from various producing areas and other species from the same genus were comparatively analyzed Results It is discovered that the HPLC fingerprints from different breeds of Flos Chrysanthemi have a strong comparability They have 16 mutual peaks and among them four are from the ten strongest peaks, two from the ten strongest peaks or stronger peaks The fingerprint data reflect the affiliation on producing area and genetic relationship of differnt breeds of Flos Chrysanthemi, and also characteristic features of each breed Conclusion This method can be used to establish the HPLC fingerprints of different breeds produced in different areas

Objective To investigate the effects of stromal cell-derived factor 1 (SDF-1) and an CXC chemokine receptor 4 (CXCR4) antagonist (AMD3100) on the invasion and migration capabilities of the huaman choriocarcinoma cell line JAR for further elucidating the role of SDF-1/CXCR4 axis in the pathogenesis of preeclampsia.Methods JAR cells were divided into four groups: SDF-1 group (treated with 50 ng/ml of SDF-1),SDF-1+AM3100 mixed group (first treated with 100 ng/ml of AMD3100 for 2 hours and then treated with 50 ng/ml of SDF-1),AMD3100 group (treated with 100 ng/ml of AMD3100) and blank control group (without any treatment).RT-PCR was performed to detect the expression of CXCR4 at mRNA level in JAR cells.Western blot assay was used to measure the expression of CXCR4 and p-AKT at protein level.MTT assay was used to analyze the effects of different concentrations of SDF-1 (10,30,50 and 100 ng/ml) on the proliferation of JAR cells at different time points (0,24,48,72 h).Transwell invasion assay and wound-healing assay were used to test the changes in invasion and migration capabilities of JAR cells after different treatments.Results (1) Results of the RT-PCR showed that the expression of CXCR4 at mRNA level in JAR cells was increased in the SDF-1 group (1.839±0.083) as compared with that in the blank control group (1.372±0.086),AMD3100 group (0.694±0.045) or SDF-1+AM3100 mixed group (0.703±0.093).Moreover,the differences between the SDF-1 group and the other three groups were statistically significant (F=30.67,P<0.05).Compared with the blank control group,the expression of CXCR4 at mRNA level in JAR cells was decreased in the AMD3100 group (P<0.01).(2) Results of the Western blot assay showed that the expression of CXCR4 and p-AKT at protein level in JAR cells were enhanced in the SDF-1 group as compared with that in the blank control group,AMD3100 group or SDF-1+AM3100 mixed group.Compared with the blank control group,the expression of CXCR4 and p-AKT at protein level in JAR cells were inhibited in the AMD3100 group.(3) Results of the MTT assay showed that SDF-1,especially at the concentration of 50 ng/ml,could enhance the proliferation of JAR cells (P<0.05) and its best effect on proliferation was seen at 48 h.(4) Results of the Transwell invasion assay showed that the number of transmembrane cells in the SDF-1 group (70.49±2.42) was more than that in the blank control group (54.36±2.26),AMD3100 group (21.68±8.31),or SDF-1+AMD3100 mixed group (28.18±4.61).The differences between the SDF-1 group and the other three groups were statistically significant (F=116.26,P<0.01).Compared with the blank control group,the number of transmembrane cells was reduced in the AMD3100 group (P<0.05).(5) Results of the wound-healing assay showed that the relative migration distance was increased in the SDF-1 group (1.162±0.034) as compared with that in the blank control group (0.823±0.101),AMD3100 group (0.160±0.047),or SDF-1+AMD3100 mixed group (0.183±0.064).The differences between the SDF-1 group and the other three groups were statistically significant (F=30.500,P<0.05).Compared with the blank control group,the relative migration distance was decreased in the AMD3100 group (P<0.01).Conclusion The invasion and migration of huaman choriocarcinoma JAR cells can be enhanced by SDF-1,but inhibited by AMD3100.This study indicates that the blocked biological axis of SDF-1/CXCR4 may play an important role in the pathogenesis of preeclampsia through inducing abnormal activation of PI3K/AKT pathway,which results in inhibited invasion and migration of trophoblast cells and placenta abnormality.

Objective To investigate the expression changes and clinical significance of microRNA-155(miR-155) and chemokine receptor 4(CXCR4) in placental tissue from the patients with preeclampsia(PE).Methods Thirty pregnant women with severe PE(sPE) in the Third Affiliated Hospital of Zhengzhou University from December 2015 to February 2016 served as the sPE group,and contemporaneous 30 healthy pregnant women undergoing cesarean section due to the social factors served as the healthy control group(N).The real-time fluorescent quantitative PCR(RT-PCR) was used to detect the expression of miR-155 and CXCR4 mRNA in placental tissue and the relationship between miR-155 and CXCR4 levels was analyzed.The immunohistochemistry SABC methods were used to detect the expression of CXCR4 protein in villous cytotrophoblast(VCT) tissue microarray(TMA,42 cases in the normal control group 1,56 cases in the PE group) and extravillous cytotrophoblast(EVCT) TMA(29 cases in the normal control group 2,47 cases in the PE group) constructed by the same research group.Results (1) There was no statistically significant difference in the age,gestational age and pre-pregnancy body mass index(BMI) between the two groups(P>0.05).The differences of blood pressure between the two groups were statistically significant(P<0.05).The neonatal birthweight in the sPE group was significantly lower than that in the control group with statistically significant differences(P<0.05).The urine protein in the sPE group was significantly higher than that in the control group with statistically significant differences(P<0.05).(2)In the placental VCTand EVCT TMA,the age had no statistical difference between the two groups(P>0.05).The gestational weeks of the PE group were earlier than those in the N group 1,the systolic/diastolic blood pressure and urine protein were higher than those in the N group,the differences all were statistically significant(P<0.05),the neonatal birthweight was significantly lower than that in the N group with statistically significant differences(P<0.05).(3)The expression level of miR-155 mRNA in placental tissue in the sPE group was 1.53±0.92,which was significantly higher than 0.87±0.73 in the control group,the difference between the two groups was statistically significant(P<0.05).(4) The expression level of CXCR4 mRNA in the N group was 1.51±1.85,which in the sPE group was 0.54±0.38,the difference between the two groups was statistically significant(P<0.05).(5) In the sPE group,the miR-155 level and CXCR4 level in placntal tissue had a significant correlation(r=-0.773,P<0.05).(6) CXCR4 protein was expressed in VCT and EVCT TMA;the CXCR4 positive expression rate of the PE group in VCT TMA was 48.21%(27/56),which in the sPE group was 47.92%(23/48) and which in the early onset PE group was 53.66%(22/41),which all were significantly lower than 83.33%(35/42)in the normal control group,the differences all were statistically significant(P<0.05).(7)The positive expression rate of CXCR4 in the PE group in placent EVCT TMA was 48.94%(23/47),which in the sPE group was 50.00%(22/44) and which in the early PE onset group was 52.63%(20/38),which all significantly lower than 79.31%(23/29) in the normal control group,the differences all were statistically significant(P<0.05).Conclusion The level of placental tissue miR-155 is increased in the patients with sPE,while the level of CXCR4 is decreases obviously,both have a negative correlation,which may be associated with the pathogenesis of PE.

Objective:To investigate the effect on the CXCR4/PI3K/AKT pathway after the transfection of miR-155 mimics and miR-155 inhibitor combined with the research on the ability of invasion and migration of human chorionic JEG-3 trophoblast cells. Methods:Chemically synthesized miR-155 mimics and miR-155 inhibitor were transfected into JEG-3 cells. The effect on the ability of invasion and migration were analyzed by Transwell migration assay and Wound healing assay. The expression of CXCR4 mRNA was detected by Real-time PCR. The expression of CXCR4 and p-AKT protein were detected by Western blot. Results: Transfection with miR-155 mimics significantly down-regulated the expression of CXCR4 as compared with the control group(P<0. 05);JEG-3 cells transfected miR-155 mimics had lower levels of migration and invasion capacity than cells in the control group(P<0. 05). However, transfection with miR-155 inhibitor significantly up-regulated the expression of CXCR4 as compared with the control group(P<0. 05);JEG-3 cells transfected miR-155 inhibitor had higher levels of migration and invasion capacity than cells in the control group ( P<0.05).Addition,the expression of p-AKT protein of JEG-3 cells was down-regulated after transfected miR-155 mimics,and the expression of p-AKT protein of JEG-3 cells was up-regulated after transfected miR-155 inhibitor. Conclusion:miR-155 may inhibits the invasion and migration of trophoblast cells by regulating CXCR4/PI3K/AKT pathway contributing to the development of preeclampsia.

ObjectiveTo investigate the role of T helper (Th) 22 and Th17 cells in the pathogenesis of severe preeclampsia.MethodsThirty women with severe preeclampsia who delivered in the Third Affiliated Hospital of Zhengzhou University from October 2014 to February 2016 were enrolled in the study. Thirty healthy pregnant women matched for age and gestational weeks were recruited as the control group. The frequencies of Th22 and Th17 cells in peripheral whole blood were determined by flow cytometry. The concentrations of interleukin (IL)-22 and IL-17A in plasma were detected by enzyme-linked immunosorbent assay. Independent two samplest-test, non-parametric test and Spearman correlation analysis were used for statistical analysis.ResultsThe percentage of Th22 and Th17 cells in the severe preeclampsia group were significantly higher than those in the control group, respectively[Th22 cells: 0.59% (0.39%-1.13%) vs 0.40%(0.23%-0.57%),Z=2.530,P=0.010; Th17 cells: 3.24% (3.02%-3.97%) vs 1.87% (1.53%-2.64%),Z=5.046, P=0.000]. So were the plasma levels of IL-22 and IL-17A[IL-22: 285.72 (247.63-306.69) vs 233.85 (184.92-258.38) pg/ml,Z=4.341,P=0.001; IL-17A: 27.53 (23.84-32.78) vs 17.36 (15.58-19.13) pg/ml,Z=4.924, P=0.000]. There was a positive correlation between circulating Th22 and Th17 cells in the severe preeclampsia group (r=0.534,P=0.015), while no correlation was found in the control group (r=0.345,P=0.136). Positive correlation was found in plasma level of IL-22 with Th22 cells (r=0.600,P=0.005), but not with Th17 cells (r=0.398,P=0.082) in the severe preeclampsia group.ConclusionsIncreased Th22 cells and high IL-22 concentrations in the peripheral blood of severe preeclampsia patients may indicate a self-defense mechanism in the maternal body. Th22 cells and Th17 cells may interact with each other.

Objective To explore the clinical regularity of drugs on epidemic encephalitis B with text mining technique. Methods The data set on epidemic encephalitis B was downloaded from CBM database. The regularities of Chinese herbal medicine, Chinese patent medicine (CPM), western medicine and the combination of CPM and western medicine on epidemic encephalitis B were mined by data slicing algorithm. The results are showed visually with Cytoscape 2.8 software. Results The main function of herbal pieces was focused on clearing heat and removing toxicity. The herbal pieces such as Rehmanniae Radix Isatidis Raxis, Isatids Folium, Paeoniae Radis rubra and Scutellariae Radix were most often used. Angong Niuhuang Wan and Qingkailing Injection were usually used as CPM. For western medicine, antiviral drugs such as interferon and ribavirin were often used, and they were often used together with brain cells nutrition medicine, hormone, immunopotentiator and so on, and they were also frequently used together with CPM such as Angong Niuhuang Wan and Qingkailing Injection. Conclusion Text mining approach provides an important method in exploring the medication regularity for diseas, and provide refenrence for clinical use.

Objective:To provide clinicians with insights about the patients with breast cancer complicated with thyroid cancer and dermatomyositis,and to improve early detection of the diseases by observing the clinical characteristics of 1 case of breast cancer complicated with thyroid cancer and dermatomyositis and reviewing the literatures about the relationships between these three kinds of diseases.Methods:The medical information of this patient,including gender,age,clinical manifestations,glucocorticoid treatment dose,type of concurrent tumor and the time point it occured and therapeutic regimen were collected and recorded.These clinical data were retrospectively analyzed.Results:The patient with dermatomyositis was diagnosed with breast cancer and thyroid cancer in succession.Oral administration of 50 mg dexamethasone per day was continued in the treatment of dermatomyositis.Then the patient received 4 cycles of pirarubicin/cyclophosphamide (AC) followed by 4 cycles of paclitaxel/Hessaitin (TH) as neoadjuvant chemotherapy for breast cancer.During the 24 weeks of chemotherapy,the breast tumor size was gradually decreased while there was no significant change in thyroid tumor size.The clinical symptoms of dermatomyositis were also improved.The blood lactic acid dehydrogenase and alpha hydroxybutyrate dehydrogenase levels were decreased,but not obviously.After 8 courses of AC-TH neoadjuvant chemotherapy followed by radical resection of thyroid cancer,there was no significant improvement in the symptoms of dermatomyositis 1 week after operation and the myocardial enzyme levels remained unchanged.Then modified radical mastectomy was performed.The myocardial enzymes were examined again 1 week after the second operation all of them were decreased to the normal levels.The clinical symptoms of dermatomyositis were also improved.Conclusion:Although the relationships between the three diseases is still controversial,the clinical data of the patient and relevant literatures collected in this paper support that breast cancer is associated with thyroid cancer and dermatomyositis is associated with breast cancer,but not thyroid cancer.

The aims of tooth restoration of endodontically treated teeth are to protect the remaining dental tissue; restore coronal morphology, functions and aesthetics; prevent bacterial microleakage and ensure periodontal healthy; prevent fracture of the restorations and reduce the wear from antagonist teeth. This article reviews the preservation and minimally invasive restoration of endodontically treated teeth. The results of the literature review show that tooth fracture resistance decreases after root canal treatment, the amount of remaining tooth tissue is an important factor affecting the success of root canal treatment, and the neck is the stress concentration area of tooth tissue, the traditional full crown and postcore crown have a certain amount of abrasion on the healthy neck teeth tissue, which will further reduce the bending resistance of the teeth and may cause the teeth to fracture. With the development of bonding technology, composite resin materials and ceramic materials, there are fewer molar tissues removed when resin, inlay, onlay, overlay and inlay crown are used to repair tooth defects, which can better preserve the remaining tooth tissues, especially the neck tooth tissues. After root canal treatment, only the pulp cavity of the tooth can be directly repaired by resin. When the marginal ridge is absent, minimally invasive restoration methods, such as inlay, onlay, and inlay crown, can be selected according to the number of marginal ridges removed and the thickness of the remaining dental tissue.