Objective To estimate the effect of ginsenoside Rb1 on the production and clearance of cyclobutane pyrimidine dimer (CPD) as well as on the expression of two nucleotide excision repair-associated proteins,xeroderma pigmentosum group C (XPC) and excision repair cross-complementing group 1 (ERCC1),by ultraviolet B (UVB)-irradiated murine epidermal cells and human HaCaT keratinocytes.Methods Totally,42 BALB/c mice were shaved on the back and divided into four groups: untreated group (n =6),UVB group irradiated with UVB only (n =12),low-dose and high-dose Rb1 group (both n =12) treated with Rb1 of 0.5 g/L and 2g/L (100 μl/cm2) respectively two hours before UVB irradiation.The dose of UVB in the animal experiment was 180 mJ/cm2.Half of the mice in each group were killed at 0.5 and 16 hours respectively after the irradiation,then,the back skin was resected and subjected to the determination of CPD levels in the epidermis by immunohistochemical SP method.Some cultured HaCaT cells were divided into several groups to be treated with different concentrations (5,20,50 mg/L) of Rb1 before or after different doses (15 and 30 mnJ/cm2) of UVB irradiation,and cells were collected at 0.5 and 12 hours after the irradiation.Subsequently,genomic DNA was extracted and CPD was detected by dot blot hybridization.Some HaCaT cells were cultured with or without the presence of Rb1 (50 mg/L) and irradiated with UVB (30 mJ/cm2),then,the cells were collected immediately or at 0.5,2,4 and 12 hours after the irradiation,and total protein was extracted and subjected to immunoblot analysis for the quantification of XPC and ERCC1 proteins.Results There was a high level of CPD in the epidermis of mice at 0.5 hour after the irradiation,with no significant differences between these groups (P ＞ 0.05).The number of CPD-positive cells per high power field (× 400) in the murine epidermis at 16 hours was statistically lower in the low-and high-dose Rb1 group than in the UVB group (32.1 ± 8.5 and 14.6 ± 4.1 vs.67.3 ± 11.2,both P ＜0.01).The CPD level in HaCaT cells was similar between these groups at 0.5 hour after UVB irradiation,but was markedly decreased at 12 hours in Rb1-treated groups.After UVB irradiation,the protein expressions of XPC and ERCC1 decreased with time in untreated HaCaT cells but increased with time in Rb1 (50 mg/L)-treated HaCaT cells.In detail,the XPC/glyceraldehyde-3-phosphate dehydrogenase (GAPDH) protein ratio in untreated HaCaT cells was 0.68 ± 0.11 immediately after the irradiation,significantly higher than that at 0.5 hour (0.47 ± 0.09,P＜0.05),2 hours (0.45 ± 0.08,P＜0.05),4 hours (0.37 ± 0.06,P＜0.01),and 12 hours (0.18 ± 0.03,P ＜0.01),and that in Rb1-treated HaCaT cells was 0.56 ± 0.07 immediately after the irradiation,compared to 0.48 ± 0.14 at 0.5 hour (P＞ 0.05),0.68 ± 0.15 at 2 hours (P＞ 0.05),0.97 ± 0.20 at 4 hours (P＜0.01),and 0.79 ± 0.12 at 12 hours (P ＜0.05).The ERCC1/GAPDH protein ratio in untreated HaCaT cells was 0.28 ± 0.03 immediately after the irradiation,higher than that at 0.5 hour (0.25 ± 0.03,P ＞ 0.05),2 hours (0.21 ± 0.02,P＜0.05),4 hours (0.14 ± 0.02,P＜0.01) and 12 hours (0.11 ± 0.01,P＜0.01),and that in Rb1-treated HaCaT cells was 0.27 ± 0.04 immediately after the irradiation,compared to 0.24 ± 0.04 at 0.5 hour (P＞ 0.05),0.29 ± 0.05 at 2 hours (P＞ 0.05),0.35 ± 0.05 at 4 hours (P＜0.05),0.39 ± 0.05 at 12 hours (P ＜0.01).Conclusions Ginsenoside Rb1 shows no obvious effect on the UVB-induced production of CPD,but markedly accelerates the clearance of CPD,which may be partly associated with the upregulation of XPC and ERCC1 protein expression.

This paper summarizes the kinds of long term care facilities, service delivery organization, service model, service role and experience of long-term service system in the United States. It provides referral implications for China to explore and establish its own long-term care service system. . There is a variety of long-term care services such as short and long-term stay, adult day care, and home care services, with a gradual change from institutional services to home and community ones. Long-term care services are provided by paid both formal and mostly unpaid informal caregivers. Informal family caregivers are most frequently daughters (29. 3%), followed by spouses with (21. 2%). With the increased availability of the family and community-based services, the family caregivers are more likely to share long term care services with the paid formal ones. The United States has a well-structured long-term care service system whose access mechanism is rigorous and systematic, emphasizing the evaluation of service quality and effectiveness. Moreover, the U. S. long term care service system pays more attention on elders' wishes, respecting their preferences and rights of choice on the services. Based on the experience of the United States, China should primarily focuses on establishing a family and community-based long term care service system with a variety of service delivery facilities, give a full play to the community health facilities, social partners, and families. The Chi-nese government should not only give a focus to the service institutions and content diversification, but should as well establish a sound and detailed assessment and evaluation standard system to access the services and assure the effec-tiveness of service quality with a humanized concern.

Objective To explore the diagnostic value of urine retinol binding protein (RBP) ,beta‐N‐acetyl amino glycosidase enzymes(NAG) combined with serum cystatin C (CysC) detection in early kidney damage of type 2 diabetes mellitus (T2DM ) . Methods Totally 58 cases of T2DM complicating in our hospital were selected as the group A ,54 cases of simple T2DM (group B) and 52 individuals undergoing the physical examination(group C) .The urine RBP ,NAG and serum CysC were detected in three groups ,their differences were compared .The positive rates for detecting early diabetic renal damage were compared between the single index detection and combined detection .Results The levels of urine RBP ,NAG and serum CysC level in the group A were significantly higher than those in the group B and C ,the differences were statistically significant (P< 0 .05);the levels of urine RBP ,NAG and serum CysC level in the group B were significantly higher than those in the group C ,the differences were statistical‐ly significant(P<0 .05);The positive rates of single detection of RBP ,NAG and CysC were 87 .93% ,86 .21% and 84 .48% respec‐tively ,the positive rate of 3‐index combined detection was 94 .83% ,which was significantly higher than that of single index detec‐tion ,the difference was statistically significant (P<0 .05) .Conclusion Urine RBP ,NAG and serum CysC are the sensitive indexes in early diabetic renal damage .The 3‐index combined detection has better comprehensive sensitivity and possesses higher clinical ap‐plication value .

Objective To investigate the relationship between blood pressure and electrocardiogram (ECG) findings in patients with differents ages and sex.Methods Blood pressure and clinical electrocardiogram findings were statistically analyzed in 1 268 patients ≥60 years old and 1 276

The effect of micronutrients on pressure ulcer was reviewed.Nutritional treatment is helpful to prevent and cure the pressure ulcer.Especially micronutrients should be paid more attention to.

Objective A retrospective study was carried out for the analysis of correlation of traditional Chinese medical syndrome patterns of asthma patients at period of onset with five-element motions and six climatic factors. Methods All of the subjects were the inpatients of the First Affiliated Hospital of Guangzhou University of Chinese Medicine admitted from January 20, 2011 to January 19, 2014, matching the year of Xinmao, Renchen, Guisi correspondingly in ancient Chinese calendar. The patients were confirmed as asthma at period of onset and were differentiated into various traditional Chinese medical syndrome patterns. The time of onset was classified into various Yunqi periods according to the theory of five-element motions and six climatic factors, and then the correlation of syndrome patterns with the Yunqi periods was analyzed. Results A total of 308 inpatient case files were collected. In the year of Xinmao (2011) , 31 cases were differentiated as cold pattern asthma, 48 as heat pattern asthma, 6 as turbidity pattern asthma, 5 as wind pattern asthma. In the year of Renchen (2012) , 37 cases were differentiated as cold pattern asthma, 58 as heat pattern asthma, 13 as turbidity pattern asthma, 7 as wind pattern asthma. In the year of Guisi (2013) , 32 cases were differentiated as cold pattern asthma, 47 as heat pattern asthma, 14 as turbidity pattern asthma, 10 as wind pattern asthma. The results of statistical analysis showed that the differences of the distribution of syndrome patterns were insignificant among the year of Xinmao, Renchen, Guisi (P>0.05) . During the 3 years, heat pattern asthma had the highest incidence, cold pattern asthma came next, and turbidity pattern asthma and wind pattern asthma came last. Distribution of syndrome patterns of asthma in the year of Xinmao was consistent with the law of five-element motions and six climatic factors of the year of Xinmao. On the aspects of the theory of six Jianqi ( climatic periods) , the distribution of patterns of asthma in the climatic periods of Chuzhiqi, Erzhiqi, Sizhiqi was consistent with the law of climatic periods, while that in the climatic periods of Sanzhiqi, Wuzhiqi, Liuzhiqi was not consistent with the law of climatic periods. In the year of Renchen, syndrome pattern distribution was not consistent with the law of five-element motions and six climatic factors of the year of Renchen. In the climatic periods of Chuzhiqi, Erzhiqi, Sanzhiqi, the distribution of patterns of asthma was not consistent with the law of climatic periods, while that in the climatic periods of Sizhiqi, Wuzhiqi, Liuzhiqi was consistent with the law of climatic periods. In Guisi year, the distribution of syndrome pattern was not consistent with the law of five-element motions and six climatic factors of Guisi year either. On the aspects of the theory of six Jianqi, except for Erzhiqi, the distribution of patterns of asthma in the other five climatic periods was consistent with the law of climatic periods. Conclusion The theory of five-element motions and six climatic factors has some significance in predicting the pathogenic characteristics of asthma and in guiding the prevention and diag nosis of asthma, but convinced conclusion needs more proof from large-sample clinical trial.

ObjectiveTo observe the effect of long-term fluoride excess on rat thyroid morphology,thyroid peroxidase(TPO) activity and the expression of TPO protein,and to explore its possible mechanism of action.MethodsForty male SD rats were randomly divided into four groups by weight:control group,low-fluoride group,moderate-fluoride group and high-fluoride group(n =10),and they were fed with ordinary tap water containing fluorine 0.40,15.00,30.00,60.00 mg/L,respectively,and ate ordinary food prepared feed.After fed for 180 days,rats were anesthetized,and thyroid was taken.The morphology of thyroid was observed under light microscope.TPO activity was measured with improved guaiacol method.The expression of TPO protein was evaluated by Western blotting.ResultsThe thyroid histopathology results show:in control group,the thyroid follicular epithelial cells were columnar or cuboidal,with the follicular cavity filled with pink gum; in low-fluoride group,the thyroid follicular epithelial cell presented active hyperplasia; in moderate-fluoride group,the size of follicular increased,and follicular cavity was filled with dark,sticky colloid follicular; follicular increases,follicular cavity filled with dark,sticky colloid follicular; in high-fluoride group,the follicular epithelial cells showed apparent flat shape and excessive concentration of follicular colloid,a small amount of follicular lumen even showed the phenomenon of fusion,forming a giant follicular or cystic cavity.Among the four groups of control group,low-fluoride group,moderate-fluoride group and high-fluoride group,with increased fluoride,TPO activity [ ( 1.572 ± 0.046), ( 1.414 ± 0.086), (1.322 ± 0.049), (0.960 ± 0.083)U/L] decreased,and the differences were statistically significant between the two groups(all P ＜ 0.05).With increased fluoride,the expression of TPO protein (0.335 ± 0.011,0.156 ± 0.027,0.084 ± 0.020,0.045 ± 0.002) decreased,and the differences were statistically significant between the two groups(all P ＜ 0.05).Conclusioons Long-term intake of excessive fluoride can inhibit the thyroid TPO activity and the expressions of TPO as well as thyroid hormone synthesis,and leads to histological changes in rat thyroid.

Objective To study the effect of long-term fluoride excess on the activity of thyroid peroxidase (TPO) and the expression of TPO mRNA in rat thyroid,and explore the underlying mechanism.Methods Forty male SD rats were randomly divided into four groups based on their body mass(n =10 in each group):control group,low-fluoride group,moderate-fluoride group and high-fluoride group,and rats were fed on water containing 0.40(tap water),15.00,30.00 and 60.00 mg/L NaF,respectively,eating ordinary food formulated feed.All rats were sacrificed 180 days afterwards.Serum FT3 and FT4,TPO activity and mRNA expression level were determined by radio-immunoassay,modificd guaiacol method and semi-quantitative RT-PCR,respectively.Results Although serum FT3 levels in low-fluoride [(3.62 ± 0.47)pmol/L],moderate-fluoride [(3.57 ± 0.55)pmoi/L]and high-fluoride [(3.30 ± 0.68)pmol/L]treated groups were decreased compared with the control[(3.64 ± 0.45)pmol/L],the difference was not statistically significant (P ＞ 0.05).Serum T4 levels of the high-fluoride group [(8.64 ± 1.72)pmol/L]were significantly lower compared with other groups[(13.08 ± 1.69),(12.68 ± 1.32),(12.05 ± 1.43)pmol/L,all P ＜ 0.05].TPO activity in control,low-fluoride,moderate-fluoride and high-fluoride-treated groups[(1.572 ± 0.064),(1.414 ± 0.086),(1.322 ± 0.049),(0.960 ± 0.083)U/L]was decreased with the dose of fluoride increasing,the difference was statistically significant between any two groups(all P ＜ 0.05).The TPO activity was negatively correlated with the dose of fluoride(r =-0.955,P ＜ 0.05).With increased fluoride,the expression of TPO mRNA (0.936 ± 0.160,0.368 ± 0.095,0.115 ± 0.018,0.016 ± 0.008) decreased,the difference was statistically significant between any two groups (all P ＜ 0.05).Conclusion Chronic fluoride excess inhibits the activity and the expression of TPO as well as thyroid hormone synthesis.

Objective To research the clinical manifestations of renal tuberculosis and improve the diagnosis and treatment of renal tuberculosis. Methods From 1993 to 2007,223 cases of renal tuberculosis were hospitalized. Retrospective analysis was complied for all the cases about age, clinical manifestations, imaging and treatment. Results The incidence rates of the renal tuberculosis were obviously higher in the 20-40 years old(41.7%) and in the 41-54 years old (36.3%). The course of this disease was from 1 day to 30 years(mean 38. 5 months). Only 36 patients (16.1%) were made a definite diagnosis when they went to see a doctor primary. The miediagnosis of urinary tract infec-tions( 50.3%) was most frequent. The clinical manifestations of most patients included frequency(54.7%), urgency(50.2%), odynuria(42.2%)and hematuria(58.7%). About 58. 3% patients pres-ented with over 3 kinds of above manifestations. The positive yield of the tuberculin test in urine was only 41.9%. The positive diagnostic rate of renal tuberculosis was only 35.7% in KUB+IVU,72.2%in Type-B Ultrasonic, 76.0% in CT test. One hundred and seventy-three cases were performed with nephrectomy(78.6%) and partial nephrectomy(21.4%). Two cases were treated with dialysis due to uremia. Standard medication was taken for the other 48 patiernts, and effective for 41 cases. Conclu-sions The incidence of atypical renal tuberculosis is increasing. More attention must be paid especially to those patients with urinary infection.