Objective To explore the relationship between total bile acid(TBA)concentration and fetal pulmonary surfactant in intrahepatic cholestasis of pregnancy(ICP).Methods Fifry five patients with ICP(ICP group)who received cesarean section from April 2008 to February 2010 in Second Xiangya Hospital,Central South University,were recruited.The general conditions of the neonates within 7 days after birth in ICP group were recorded.Those with fetal distress,neonatal asphyxia,or neonatal respiratory distress syndrome were referred as pathological neonates, others were referred as normal neonates. Over the same period, 23 healthy gravidas were recruited as control group. Enzymatic method was used to detect the TBA concentrations in maternal blood, cord blood and amniotic fluid. ELISA was employed to measure the urfactant protein A (SP-A) concentration in cord blood. High performance liquid chromatography system was used to detect the concentrations of phesphatidylcholine (PC),phosphatidylinositol (PI),lysophosphatidylcholine ( LPC), and sphingomyelin(SM) in amniotic fluid. Results ( 1 ) The concentrations of TBA in maternal blood, cord blood and amniotic fluid were ( 30. 1 ± 7.9 ), (9. 3± 3. 3 ) and (4. 4 ± 1.5 ) mmol/L in ICP group, (4. 8 ± 2. 2), (4. 9 ± 0. 9) and ( 1.4 v 1.1 ) mmol/L in control group, respectively. The differences between the two groups were significant ( P ＜ 0. 05 ). ( 2 ) The SP-A concentration in cord blood in ICP group was ( 29. 5 ± 6. 4 ) μg/L, significantly higher than that in control group, which was ( 22. 6 ± 7. 4 )μg/L ( P＜ 0. 05 ). ( 3 ) There were 20 pathological neonates and 35 normal neonates in ICP group. In pathological neonates, the concentrations of TBA and SP-A in cord blood were (10.9 ± 2.2) mmol/L,(37.0 ± 5.9 ) μg/L, respectively; and were ( 8.0 ± 2. 8 ) mmol/L, ( 26. 7 ± 4. 8 ) μg/L in normal neonates. The differences were significant (P＜ 0. 05 ). (4) There was a positive correlation between TBA concentration in cord blood and in maternal blood ( r1 = 0. 706, P＜0. 05 ). The TBA concentration in cord blood was positively correlated with SP-A concentration as well ( r3 = 0. 494,P ＜ 0. 05 ). (5) The PC and PI concentrations in amniotic fluid were (65.4 ± 7.2) mg/L and ( 3. 8 ± 0. 6 ) mg/L in ICP group, ( 69. 7 ±3.7) mg/L and (4. 3 ± 0. 7 ) mg/L in control group, respectively. The differences were significant (P ＜0. 05 ). The concentration of LPC in amniotic fluid in ICP group was (4. 8 ±0. 9) mg/L, significantly higher than that in control group (P＜0. 05), which was (4. 2 ±0. 6) mg/L. The concentration of SM in amniotic fluid was (3.5±0. 8) mg/L in ICP group, (4. 0 ± 0. 5 ) mg/L in control group, with no significant difference ( P＞0. 05 ). (6) The ratio of PC/LPC in ICP group ( 14. 2± 3. 2 ) was significantly lower than that in control group ( 16. 9 ± 2. 5 ) ( P＜ 0. 05 ). ( 7 ) The TBA concentration in cord blood was negatively correlated with PC and PI concentrations (r1 = -0. 561, r2 = -0. 407, P ＜ 0. 05 ), and had no correlation with LPC concentration (r3 = 0. 260, P＞ 0. 05). Conclusions ( 1 ) The fetal TBA concentrations in both cord blood and amniotic fluid of patients with ICP was higher than those of healthy gravidas, they were also positively correlated with maternal TBA concentration. (2) ICP resulted in the change of fetal pulmonary surfactant and this change was associated with TBA concentrations in both cord blood and amniotic fluid.

Aim To investigate effects of indole-3-carbinol (I3C) on hepatic stellate cells (HSCs) activated by acetaldehyde in precision-cut liver slices (PCLS). Methods PCLS were incubated with 700 ?mol?L-1 acetaldehyde and 200 ~ 800 ?mol?L-1 I3C for 6 h. The expression of ?-smooth muscle actin(?-SMA) in liver slices was analyzed by immunohistochemistry. The leakages of glutathione S-transferase (GST), lactate dehydrogenase (LDH) and content of transforming growth factor-?1 (TGF-?1) in media were assayed. Contents of malondialdehyde (MDA) and hydroxyproline (Hyp) in tissue were also determined. Expressions of matrix metalloproteinases-1 (MMP-1) and tissue inhibitor of metalloproteinase (TIMP-1) in media were analyzed by the western blot. Results The increase of activated HSCs due to acetaldehyde was inhibited by I3C (200~800 ?mol?L-1). Meanwhile, I3C treatment (200~800 ?mol?L-1) showed significant and concentration-dependent antagonistic actions on the increment of GST, LDH leakages into the media and MDA, Hyp contents in tissues induced by acetaldehyde. The increase of TGF-?1 was also remarkable inversed by I3C (200~800 ?mol?L-1). As compared with acetaldehyde group, the ratio of MMP-1/TIMP-1 was increased significantly by I3C treatment (800 ?mol?L-1)(P

OBJECTIVE:To observe the effect of atorvastatin combined with methylprednisolone on the liver function of ne-phrotic syndrome patients. METHODS:The data of 93 patients with primary nephritic syndrome were retrospectively analyzed and divided into atorvastatin group,methylprednisolone group and combination group by different medication. Atorvastatin group was orally given atorvastatin 20 mg at bedtime,once a day+aspirin;methylprednisolone group was orally given methylprednisolone 0.8 mg/kg in the early morning,once a day+aspirin;combination group was given atorvastatin+methylprednisolone+aspirin(the same usage and dosage with the above-mentioned groups). The course was 4 weeks. The clinic data was observed,including ALT,AST, GGT,TB and DB before and after treatment,the incidence of patients with drug-induced liver disease and prognosis of patients with drug-induced liver disease. RESULTS:After treatment,the ALT,AST and GGT in atorvastatin group and combination group were significantly higher than before,with significant difference(P<0.05);compared with other parameters and all indexes in methylprednisolone group before and after treatment,there were no significant differences(P>0.05). There was no significant dif-ference in the elevated rate of ALT among groups(P>0.05);the incidence of drug-induced liver disease in combination group was significantly higher than atorvastatin group and methylprednisolone group,with significant difference(P<0.05). ALT in combina-tion group was significantly decreased and returned to pretreatment levels after atorvastatin withdrawal and 2 weeks of hepatoprotec-tants treatment for 7 patients with drug-induced liver disease. CONCLUSIONS:Atorvastatin combined with methylprednisolone has high risk on liver function in the treatment of nephrotic syndrome. Pretreatment levels can be recovered by both drug withdrawal and symptomatic treatment.

Objective To explore the value of applyingcomprehensive design experiment evalua-tionin the evaluation of nursing experimental teaching. Methods In the nursing profession, and after the acute and severe cases were collected, comprehensive design experiment evaluation was carried out by using the first-aid and severe training programs, according to the patients needs. Then the simulation effect of students was evaluated by multi-subjects Afterwards, a questionnaire survey was conducted among 143 participants on clinical competency and experimental assessment. The data were analyzed through ratio. Result 121 nursing students' (84.6%) clinical competence was improved. 143 nursing students (100%) thought that the test was of great significance to achieve education target. 138 nursing students (96.6%) thought that general design and arrangement of satisfaction were high. 141 nursing students (98.7%) were satisfied with the multi-subject evaluation. 106 nursing students (74.1%) were willing to conduct self evaluation and give evaluation of others. Conclusion Comprehensive designing experiments evaluationcan significantly improve the critical clinical competence of nursing students, and can help the professional education target implementation. The operation mode is recognized by the students. The evaluation of the multi-subject evaluation is highly respected, but it needs to develop the students' ability of objective evalua-tion.

Objective To study the role of three-dimensional conformal radiation therapy(3DCRT) in the treatment of elderly non-small cell lung cancer(NSCLC) patients.Methods From 2000 to 2004,39 elderly NSCLC patients(range 70-87 years) were treated by 3DCRT.Their Karnovsky performance score was 50-60 in 20 patients and those of the other 19 patients were not less than 70.Prescription dose were 40-60?Gy,with a median of 50?Gy.Results Thirty-six(92%) patients'symptoms were relieved at the end of treatment,with the other three patients' symptoms steady.Complete response and partial response was achieved in 19 and 17 patients respectively.The 1-year survival rate was 60%,with a median survival time of 10 months.Conclusions Three dimensional conformal radiotherapy is effective for elderly NSCLC patients in terms of symptom relief.For treatment choice of these senior NSCLC patients,the balance between tumor control and quality of life should be carefully considered.

Objective:To investigate the effects of survivin inhibitor YM155{1-(2-methoxyethyl)-2-methyl-4,9-dioxo-3-(pyrazin-2-ylmethyl)-4,9-dihydro-1H-naphtho[2,3-d] imidazolium bromide} on cell viability,apoptosis and Cysteinyl aspartate specific proteinase-3,Cysteinyl aspartate specific proteinase-8,Cysteinyl aspartate specific proteinase-9 of the thyroid carcinoma cell line B-CPAP in order to discuss mitochondrial mechanisms of apoptosis.Methods: B-CPAP cells were cultured in vitro and treated with YM155 at various concentrations(0,0.5,1,2,4,8 nmol/L)for 24,48 and 72h.The cell viability of B-CPAP cells were measured by CCK-8 assay.B-CPAP cells were randomly divided into 4 groups:B-CPAP cells were treated with YM155 at various concentrations(0,1,2 nmol/L)and 5 μmol/L Cisplatin(the positive control group)for 24 h.The effects of YM155 on B-CPAP cells apoptosis were evaluated by TUNEL and flow cytometry Annexin V-FITC/PI method.The expression level of Survivin and Caspase-3,Caspase-8 ,Caspase-9 were detected by Western blot analysis.Results: Compared with the 0 nmol/L group,YM155 significantly inhibited the cell viability of B-CPAP cells and induced their apoptosis (P<0.05 or P<0.01).Compared with the 0 nmol/L group,YM155 significantly reduced the expression level of Survivin and upregulated Caspase-3,Caspase-8 ,Caspase-9(P<0.05 or P<0.01).Conclusion: YM155 can inhibit the cell viability of B-CPAP cells and induce apoptosis,its possible mechanisms maybe related to upregulated expression level of Caspase-3,Caspase-8 and Caspase-9.

Objective To explore the hierarchical chain management model of type 2 diabetes and determine its evaluation.Method Based on the hierarchical chain management of the three community health service institutions and Dahua hospital in Shanghai Xuhui district,215 cases of type 2 diabetes had been involved in the study.Results Compared with the baseline before management,lasting blood glucose (FBG),2 h postprandial glucose (2hPBG),glycosylated hemoglobin (HbA1c),low density lipoprotein cholesterol (LDL-C),systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the diabetes after 12 months' management declined [(8.50 ±2.81) mmol/L,(11.09 ±4.01) mmol/L,(8.56 ±2.41)% ,(3.31 ± 1.06) mmol/L,(139.06 ±20.68) mm Hg (1 mm Hg = 0.133 kPa),(78.20 ± 12.11) mm Hg vs.(7.41 ±2.04) mmol/L,(9.03 ±2.46) mmol/L,(7.34 ± 1.59)% ,(3.00 ± 1.06) mmol/L,(135.48 ± 17.82) mm Hg,(77.27 ±11.83) mm Hg],and the differences were statistically significant(P＜0.01 );control rate of FBG,2hPBG,HbA1c,LDLC,SBP,DBP had improved significantly [19.5% (42/215),20.9% (45/215),24.7%(53/215),20.0%(43/215),27.4%(59/215),30.2%(65/215) vs.50.7%(109/215),53.0% (114/215),54.0%(ll6/215),42.3%(91/215),47.0%(101/215),45.6%(98/215)](P＜0.01).Conclusion Primary and secondary-care hospital based hierarchical chain management model is valid and can be implemented for type 2 diabetes.

Objective To analyze the difference of the venous port access (VPA) and peripherally inserted central catheter (PICC) in cancer chemotherapy.Methods All eligible studies on VPA and PICC were searched in the databases of PubMed,China National Knowledge Internet (CNKI),Chinese Biomedical Database (CBM),WANFANG Database and VIP Database.Literatures screening,quality evaluation and data extraction were conducted according to Cochrane Handbook;Meta-analysis was calculated by using RevMan 5.2.Results Twenty-nine studies with a total of 4 449 cases of patients were included in this Meta-analysis,with 1 912 cases in experimental group which adopted VPA and 2 537 cases in controlled group which adopted PICC.Experimental group had advantages in the average catheter retention time (SMD=3.36,95％CI 2.51-4.21) and quality of life (RR=1.61,95％CI 1.15-2.24) compared with controlled group.The overall complication rate (RR=0.26,95％CI 0.20-0.34,P＜0.01),phlebitis incidence (RR=0.08,95％CI 0.04-0.16,P＜0.01),catheter infection incidence (RR=0.32,95％CI 0.23-0.44,P＜0.01),catheter obstruction incidence (RR=0.32,95％CI 0.22-0.48,P＜0.01),catheter dystopy incidence (RR=0.18,95％CI 0.09-0.37,P＜0.01) in experimental group were remarkably lower than that in controlled group.However,no significant difference was found between the two groups in the incidence of the puncture success rate for the first time,errhysis or hematoncus,thrombus and catheter leakage (P ＞0.05).Conclusions Compared with PICC,VPA had advantages in a long retention time,fewer complications and few influence on quality of life.Therefore,VPA should be widely used in cancer chemotherapy.

BACKGROUND: Ions doping is an important method for the modification of bioceramic.OBJECTIVE: To evaluate a novel co-substituted bioceramic scaffolds as bone repair material.METHODS: The microstructure and crystallization of the scaffolds were detected by scanning electron microscope and X-ray diffraction. Compression strength test,degradation test and cell culture experiment were assumed to evaluate the properties of KSCPP in vitro. After a short period of muscle pouches implantation,the performance of KSCPP in vivo was evaluated.RESULTS AND CONCLUSION: The results show that KSCPP scaffold has a higher compressive strength and degradation rate. Moreover,the MTT assay and implantation test reveal that the KSCPP scaffold exhibits lower cytotoxicity and better tissue biocompatibility than CPP and HA. The study proved the great potential of KSCPP in bone repair applications.

Objective To analysis the influence factors of standardization in the hierarchical chain management of type 2 diabetes and to enhance the hierarchical chain management of type 2 diabetes.Methods ( 1 ) Six hundred and ninty patients with type 2 diabetes completed 1 years management were divided into well-controlled glycosylated hemoglobin ( HbAlc ) group (＜7.0％ ) and bad-controlled glycosylated hemoglobin (HbAlc) group ( ≥ 7.0％ ).The conditions of diet,physical activity,medication,self-blood sugar monitoring and participation in health seminars were investigated and analyzed.(2) The patients were divided into standardized management group and not standardized management group.Their age,sex,educational background,occupation,monthly income per person,medical security,the course,cognition for glycuresis,two-way transfer,and chronic complications were investigated and statistically analyzed.Results ( 1 ) The proportions of physical activity (70.1％ vs 54.2％,x2=6.163,P=0.018),self-blood sugar monitoring(60.4％ vs 43.8％,x2=6.268,P=0.016) and participation in health seminars (56.0％ vs 41.7％,x2=4.577,P=0.045) in the well-controlled HbAlc group were significantly higher than those in the bad-controlled HbAlc group.(2) Their age [(61.08 ±10.04) years old vs ( 57.75 ± 9.89 ) years old,t=2.539,P=0.012],educational background ( ratio of low educational attainment:8.3 ％ vs 17.2％,x2=6.426,P=0.041 ),medical security (own expense ratios:4.6％ vs 11.5％,x2=3.543,P=0.048 ),awareness of diabetes ( ratio of poor awareness of diabetes:19.4％ vs 41.0％,x2=17.518,P=0.000 ),two-way transfer ( ratio of not transfer treatment:4.6％ vs 14.8％,x2=7.662,P=0.022) and chronic complications ( ratio of chronic complication:41.7 ％ vs 26.2％,x2=6.130,P=0.017) were significantly different between the standardized management group and not standardized management group.(3) Logistic regression analyses indicated that the age ( OR=0.954,P=0.006),monthly income per person ( OR=4.101,P=0.018 ),medical security ( OR=7.617,P=0.003 ),cognition for glycuresis ( OR=0.030,P=0.000),two-way transfer ( OR=9.079,P=0.000) and chronic complications ( OR=0.456,P=0.031 ) were the risk factors of standardized management.Conclusion We should focus on the impact factors affecting the standardized management of patients including age,monthly income per person,medical security,awareness of diabetes,ratio of not transfer treatment,positive strategies for chronic complications,improve the hierarchical chain management of type 2 diabetes,and then make the diabetic patients to early participate in standardization management of diabetes mellitus and delay the appearance of complications.