Objective: To detect the expression and distribution of activated cytotoxic cells in types of lymphoma with tissue microarray,and provide evidences for clinical treatment and prognosis. Methods: Immunohistochemical staining by S-P technique was used for detecting the expression and distribution of perforin and granzyme B in lymphoma tissue microarray,composed of 60 samples of lymphoma tissue.10 NK/T-cell lymphoma routine sections were used for relative research,and 10 reactive hyperplasia were used for comparison. Results: In the tissue microarray,samples originated from intranode and extranode were 48 and 12,respectively;consisting of 42 B-cell lymphoma,16 T-cell lymphoma(10 PTCLs,2 NK/T-cell lymphomas,2 lymphoblastic T-cell lymphomas,2 anaplastic large cell lymphomas),2 Hodgkin's disease.42 samples of B-cell lymphoma cells were negative in perforin and granzyme B.In 10 samples of peripheral T-cell lymphoma,perforin and granzyme B positive were 8 and 9,respectively,but the positive cells were no tumor cells.In 12 samples of NK/Tcell lymphoma(2 in the tissue microarray,10 routine sections),both perforin and granzyme B were strongly positive.B-cell lymphoma,T-cell lymphoma and NK/T-cell lymphoma differed significantly(P

Objective To explore the expressions of annexin and epidermal growth factor receptor(EGFR) in pediatric middle ear cholesteatoma.Methods Twenty-three children with middle ear cholesteatoma and 26 children with normal skin of external auditory canal(control group) were selected from the children enrolled in the First Affiliated Hospital of Zhengzhou University from August 2014 to March 2016.The expressions of annexin A1 (AnxA1),AnxA2 and EGFR mRNA in cholesteatoma and normal tissues were analyzed by quantitative real-time PCR (qPCR).Protein expressions of AnxA1,AnxA2 and EGFR were evaluated by using Western blot and immunohistochemistry methods.Results The expressions of AnxA1,AnxA2 and EGFR mRNA were significantly increased in cholesteatoma compared with the control group (AnxA1:4.68 ± 1.77 vs.2.65 ± 0.96,U =111.5,P ＜ 0.001;AnxA2:3.89 ± 1.00 vs.2.4 7 ± 0.81,U =84.5,P ＜ 0.001;EG FR:4.97 ± 1.85 vs.3.50 ± 0.95,U =15 3.5,P =0.004).AnxA1 and AnxA2 mRNA expressions were positively correlated with EGFR mRNA (AnxA1 and EGFR:r2 =0.283 2,P =0.009;AnxA2 and EGFR:r2 =0.213 5,P =0.027).Compared with the control group,protein expressions of AnxA1,AnxA2 and EGFR were markedly enhanced (AnxA1:0.450 ±0.031 vs.0.320 ±0.026,U =102.4,P ＜0.001;AnxA2:0.568 ±0.024 vs.0.365 ±0.028,U =94.6,P ＜0.001;EGFR:0.397 ±0.021 vs.0.228 ±0.017,U =128.4,P ＜0.001).The results of immunohistochemistry analysis showed that the ratio of AnxA1,AnxA2 and EGFR positive cells were higher than those in the control group(AnxA1:65.22％ vs.38.46％,x2 =9.296,P =0.026;AnxA2:69.57％ vs.46.15％,x2 =8.378,P =0.039;EGFR:69.57％ vs.50.00％,x2 =10.574,P =0.014).Conclusions The expressions of AnxAl,AnxA2 and EGFR are upregulated in pediatric cholesteatoma,with AnxA1 and AnxA2 expressions positively correlated with EGFR.

Objective To study the change and clinical value of SP‐D ,CCL18 and CC16 in serum and in exhaled breath con‐densate in acute exacerbation of chronic obstructive pulmonary disease .Methods Sixty two cases of COPD patients admitted in our hospital from 2010 January to 2013 December were selected as the research object .All the 62 patients were divided into group A(32 patients with COPD in acute exacerbation) and group B(30 patients with COPD in remission stage) in accordance with the severity of COPD .Thirty six cases of health people were selected as the control group .Statistical subjects SP‐D ,CCL18 ,CC16 content in se‐rum and in exhaled breath condensate ,and the relations between the various indexes and age ,smoking ,pulmonary function and BMI were analyzed .Results The exhaled breath condensate SP‐D ,CCL18 content in group A was significantly higher than that of B group and the control group (P<0 .05) ,and the SP‐D ,CCL18 in group B was higher than that in control group (P<0 .05) .The se‐rum SP‐D ,CCL18 ,CC16 content in group A was significantly higher than that of B group and the control group (P<0 .05) ,and the SP‐D ,CCL18 ,CC16 in group B was higher than that in control group (P< 0 .05) .Serum SP‐D ,CCL18 levels were significantly higher than those in the exhaled breath condensate (P< 0 .01) .Exhaled breath condensate SP‐D was positively associated with smoking age (r=0 .298 ,P<0 .05) ,and FEV1% pred ,FEV1/FVC (% ) showed a negative correlation (r= -0 .318 ,-0 .402 ,P<0 .05);the serum levels of SP‐D was positively associated with tobacco (r=0 .297 ,P<0 .05) ,and FEV1% pred ,FEV1/FVC (% ) were negative correlated (r= -0 .278 ,-0 .298 ,P<0 .05);serum CC16 and FEV1% pred ,FEV1/FVC (% ) were negatively corre‐lated (r= -0 .358 ,-0 .382 ,P<0 .05);Exhale breath condensate SP‐D ,condensate CCL18 ,SP‐D ,CCL18 serum ,serum CC16 were are positively correlated in each two (P<0 .05);and there was no significant correlation between other indexes and age ,smoking , pulmonary function and BMI etc .Conclusion Exhaled breath condensate ,serum SP‐D ,serum CCL18 ,exhaled breath condensate , exhaled breath condensate ,serum CC16 are closely related to acute exacerbation of COPD ,and monitoring the indicators can be judgment of the degree and prognosis of COPD .

Objective To evaluate the prognosis capacity of the Primary Angioplasty in Myocardial Infarction (PAMI) risk score for 6 months mortality in the clinical patients with ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PCI), in addition to asses the incremental value of EF and multivessel disease for risk stratification. Methods Six clinical variables and their relative value of score derived from PAMI risk scoring system were used to determine individual's risk score. The patients with STEMI were evaluated during the in-hospital period and followed-up for a mean of (10.34?3.24) months for mortality. The p values were calculated using a Kruskal-Wallis H test for categorical variables when appropriate; otherwise Independent-samples test was used. Logistic regression examined the discriminant accuracy of the PAMI risk score to predict death and assessed the incremental value of the EF and multivessel disease. Results A 88.8% of patients (183 patients) finished the follow up of 6 months. The overall in-hospital mortality rate was 4.4%, 30-day mortality rate was 6% and 6 months mortality rate was 9.3%. Eighty-eight patients scored 0-2 points, 54 patients scored 3-5 points, 17 patients scored 6-8 points and 24 patients scored ≥9 points. The 6 months mortality were 1.1%,3.7%, 17.6% and 41.7% respectively. Logistic regression analysis indicated that multivessel disease is a risk factor (OR 10.189) and EF is a protected factor (OR 0.849) for 6 months mortality after PCI. Multivessel disease and EF provided incremental information over that provided by the PAMI risk score. Conclusion The PAMI risk score can be applied in early stage after PCI for mortality risk assessment for patients with STEMI. EF and multivessel disease also convey important prognostic information and should be included in risk stratification after STEMI.

Objective: To improve the language teaching ability of teachers.Method: The teachers younger than 35-year-old youth from the Premedical courses were selected for observation of teaching,and they were divided into control and experimental classes in teaching language classes for quantitative evaluation skills.Result: The distribution of scores of the classes focused on the 80 to 95 between classes and the scores were mostly concentrated in between 65 to 80.P

Assurance system of Medical Quality is the core of teaching quality assurance work from colleges itself.This paper analysed the major factors affecting the teaching quality such as teachers,students,the teaching environment,teaching management based on quality management theory,making use of information technology to support the implementation of quality assurance system,constructing a system composed of five quality security system framework and forming protection of the quality of teaching based on information.

Most of the clinical teachers in medical colleges have not received training in the teaching profession.This article explores the post-job education system of the clinical teachers in our hospital,aiming at improving the quality of medical education.

Diabetic retinopathy (DR) is one of the signs of complications related to diabetes in eye In clinic,there has not perfect measurement and method to prevent and treat DR.Proteomics as an emerging subject focuses on studying the organizational structure and related functions as a whole level.The application of proteomics research method can fully reveal the protein expression in tissues and cells with comparison of the difference between the normal and diabetes.The differentially expressed proteins can reveal the various factors in the pathological process of DR to address the accurate regulatory mechanism,and can find some new regulatory proteins associated with DR.This approach provides further theory and methodology to study DR,which has its unique advantages in drug-targeted treatment of DRs.

Objective To explore the nurses'self-efficacy for palliative care and its related factors.Methods Data were collected via a self-constructed questionnaire,using the purposive sampling method.Subjects were nurses from two “grade-A” general hospitals in Henan province.Results The nurses' self-efficacy for palliative care stayed at a disequilibrium state,mean score of self-efficacy for physical care was 4.00,followed by family care self-efficacy 3.85,then psychological and spiritual care self-efficacy 3.70.Significant difference existed in self-efficacy for palliative care in nurses having different attitudes toward death.The cognitive level for palliative care,past experience of caring for end-stage patients were positively correlated with self-efficacy.Conclusions The main factors of the nurses' self-efficacy for palliative care related to attitudes toward death,past experience of caring for end-stage patients and the cognition level of nurses to palliative care.

Objective To understand and explore the lived study feeling and experience of nursing undergraduate students during high- fidelity simulation training so as to provide the evidence of reforming teaching methods and performing the teaching practice of nursing educators. Methods Phenomenological study of qualitative research was used. In- depth interviews were conducted among 4 focus groups. 28 nursing undergraduate students were interviewed to understand their lived study feeling. Results 5 themes were emerged using Colaizzi's phenomenologic method, including cooperating explicitly, integrating theory with practice closely, promoting disease observation ability and nursing decision making, enhancing self-confidence. Conclusions High- fidelity simulation training was beneficial to integrate theory with practice, cultivate students' comprehensive ability and increase clinical practical opportunities.