Objective To study the role of tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) in CTD-IDL. Methods mRNAs were extracted from lung tissues and perip-heral blood mononaclear cells (PBMCs) of CTD-ILD patients. RT-PCR was deployed to detect the percentages of TNF-α mRNA, TGF-β mRNAs; and the percentage of TNF-α, TGF-β and fibrosing parameters (hyaluronic acid, HA) was tested in serum by ELISA. The relationship between above laboratory data and image as well as pathological characteristics were analyzed. Results The percentage of TGF-β mRNA in lung tissue and PBMCs. As well as the serum TGF-β and HA increased significantly in those with interstitial lung diseases. On the other hand, the percentage of TNF-α mRNA of these patients did not increase in lung tissues and PBMCs. Conclusion TGF-β plays a role in lung interstitial fibrosis. It may be helpful to understand the degree of fibrosis in lung tissue by detecting lung tissue/PBMCs TGF-β mRNA, serum TGF-β and other fibrosis indicators.

Objective To compare the clinical effect of needle knife therapy and traction for treatment of cervical spondylosis .Methods 156 patients with nerve root type of cervical spondylosis patients definitely diag -nosed,randomly divided into two groups ,the treatment group of 78 cases,with small needle knife therapy;the control group of 78 cases,the cervical traction therapy ,combined with traditional Chinese medicine .The clinical efficacy was compared between the two groups .Results The treatment group 70 cases were cured(89.6%),the total efficiency of 96.9%;control group 44 cases were cured(56.7%),the total efficiency of 83.3%.The cure rate and total effective rate was significantly better than the control group (χ2 =22.02,11.57,all P<0.05).Conclusion The needle knife therapy to treat cervical vertebra disease is better than that of cervical traction ,has good clinical curative effect .

Objective To investigate employment of non medicine majors in medical universities and colleges and to provide recommendations.Methods Investigation on employment intention of 2010 grade non medicine majors in medical universities and colleges in Guangzhou was conducted.SPSS 13.0 was used to establish database and results were expressed as constituent ratio.Results Most non medicine majors wanted to find a job rather than taking postgraduate entrance exams and civil service test.Realizing their own values was the main purposes of employment.Preferred employment areas were mainly concentrated in large city(71.08％)and urban city(18.67％).Students expect a monthly salary between 3001 and 4000.Conclusions Employment intentions of non-medical students in medical universities and colleges are rational enough and career planning education should be strengthened.

Objective To investigate the clinical curative effect of dragon's blood combined with optothermal exposure in the treatment of cervical erosion. Methods 477 cases with cervical erosion were divided into two groups randomly which are 277 cases of the intervention group and 200 cases of the control group. The control group was treated with simplicity light-heat therapies and the intervention group was treated with dragon's blood oral,4 tablets each time ,3 times daily combined with optothermal exposure. The clinical outcome of two therapies were observed and compared. Results Control group :261 cases were cured(94. 3%), 11 cases were improved(3.9%) and 5 cases in vain (1.8%) The curative and total effective rate of the intervention and control group were 94. 3% and 75.0% ,98.2%and 92. 9%, respectively. The effective rate, and the vaginal secretion time and volume after operation have statistical significance (P ＜ 0.05). Conclusion The dragons invigorate blood and exhaust silt, convergent hemostatic, acetanilide detumescence, boils. Combined appicration of light-heat illuminate good curative effect, adverse reaction rate ,less in the treatment of cervical erosion.

Objective To study the anti-fibrotic function and mechanism of peroxisome proliferator activated receptorγ(PPARγ) in connective tissue disease-interstitial lung disease (CTD-ILD).Methods The expression of PPARγin lungs was analyzed in 37 cases with CTD-ILD and 20 control cases by immunohistochemistry.Changes in α-SMA levels were analyzed by Western blotting,and acetylation of Smad3 and Smad3 or PPARγ combined with P300 were analyzed by IP-WB.The data was analyzed by one-way ANOVA,t test or Mann-Whitney test.Results PPARγ' expression in the lung of CTD-ILD was lower than the controls [0.92％(1.44％),3.50％(1.94)％,respectively; Z=-8.924,P＜0.01].Different concentration of PPARγ (0,1,5,10,20,40 pmol/L) ligandinhibited the marked elevation of the protein α-SMA induced by TGF-β1 in a concentration-dependent manner (0.918 ±0.062,0.852±0.042,0.725 ±0.057,0.678 ±0.042,0.418 ±0.022,0.456±0.029; P＜0.05 or P＜0.01).However,this response was blocked by a selective antagonist PPARγ signaling GW9662 (0.946±0.087 vs 0.538±0.120,P＜0.01).Acetylation of Smad3 expression was increased when TGF-β1 was putted into lung fibroblasts after 60,90 and 180 min (0.565±0.047,1.127±0.101,0.873±0.022,0.614±0.407; all P＜0.05).The combination of Smad3 with P300 was also increased (1.46±0.12,0.98±0.09; P＜0.05),compared with the controls.But the ligand of PPARγ could block this effect (0.62±0.10,1.46±0.12; P＜0.05).Meanwhile,the combination of PPARγ and P300 was increased (0.94±0.05,0.76±0.22; P＜0.05).Conclusion PPARγ may play a physiologic role in the regulation of anti-fibrosis response.Its function may be realized by its competition with Smad3 combined with P300.

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.

Objective To investigate the effect of leflunomide on the superficial costimulatory molecules expression of T lymphocytes in patients with lupus nephritis ( LN ). Methods The peripheral blood mononuclear cells (PBMCs) of female active LN patients and healthy female were separated by density gradient centrifugation, and cultured by phytohemagglutinin (PHA) or leflunomide active metabolites(A771726).The CD28, CD40L, CTLA-4 and LFA-1a expressions on the peripheral blood T lymphocytes were detected by double-colored flow cytometry. The differences of the means were tested by analysis of variance( ANOVA ) and SNK q test. Results Comparing with healthy controls, there were significantly higher expressions of CD28,CD40L, LFA-1a and CTLA-4 on the peripheral blood T cells in active LN patients (CD28:33.4±6.5 vs14.4±3.2; CD40L: 13.2±3.2 vs 5.4±2.3; LFA-1a: 8.5±2.3 vs2.2±1.1; CTLA-4:4.6±1.5 all P＜0.01) as well as CD28 and CD40L expression on the peripheral blood T cells from healthy controls induced by PHA (CD28:26.8±6.7 vs14.4±3.2; CD40L: 13.9±4.9 vs 5.4±2.3 all P＜0.01 ), but not CTLA-4 and LFA-1a expression.However, CD28, CD40L, LFA-1a and CTLA-4 expressions on T cells stimulated by PHA increased in active LN patients(all P＜0.05 ). A771726 could significantly inhibit over-expression of LFA-1a and CD40L on the T cells from active LN patients (CD40L:8.2±2.0 vs13.3±3.2;LFA-1a:5.1±1.3 vs8.5±2.3 all P＜0.01 ), but not CD28 and CTLA-4 expression. A771726 did not inhibit CD28, CD40L, LFA-1a and CTLA-4 expression on the T cells in healthy controls. Furthermore, A771726 could markedly inhibit the over-expression of all of the above molecules induced by PHA on the T cells of active LN patients (all P＜0.05). Conclusion One of the major mechanisms for LEF treatment of LN is that LEF can down-regulate CD40L and LFA-1a expression but not CD28 and CTLA-4 expression on the peripheral blood T cells in active LN patients.

Objective To summarize microskin grafting in recent 15 years.Methods Microskin grafting was performed in 162 patients with extensive burn. The indications and forms of the grafting, mechanization in making microskin and outcome of wound recovered by micrografts were discussed.Results Extremely extensive third degree burns, common extensive third degree burns and extensive granulation wound were healed by different ways of microskin grafting. A new machine was used to mince micrografts with good clinical results. The homografts as covertures were exfoliated in either necrosis or desquamation. Scar formation was related to wound repair. Conclusions Microskin grafting has made progress in recent years. The orientation and even spread of micrografts are very important for good wound repair. The technique should be further improved.

Objective To investigate the effect of optimized radiological examination strategy on iatrogenic radiation exposure in severe trauma patients so as to provide scientific basis for standardized application of radiological examination.Methods A controlled, three-stage intervention study from April 2010 to November 2011 was carried out.From April 2010 to July 2010, a pre-intervention study was conducted and enrolled 60 patients [43 males, 17 females;age (50 ± 14)years, age range 23-78 years].From August 2010 to March 2011, optimized strategies of radiological examination were implemented, including improving clinicians' knowledge to the standardization of radiological examination and iatrogenic radiation injury and limiting frequency of CT scans through the electronic medical record.From April 2011 to November 2011, post-intervention study was conducted and enrolled 100 patients (81 males, 19 females;age (47 ± 14) years, age range 18-79 years].During this period, major trauma patients were analyzed with respect to the clinical information, radiation examination frequency, ionizing radiation dose and influencing factors.Radiation examination frequency and radiation dose were compared before and after the intervention.Results Radiological examinations were mainly X-ray and CT before the implication of optimized strategies.Of the 60 patients, median frequency of X-rays and CT scan was 6.0(3.0-11.0) and 10.0(8.0-13.8).Median frequency of CT scan was positively correlated with the injury severity score (ISS) and ICU length of stay (r =0.369 and 0.523, P ＜ 0.05).Of the 100 patients, median frequency of CT scan was significantly reduced after the optimization of radiological examination (8.0 vs.10.0, P ＜ 0.05).Total frequency of radiological examination was significantly reduced as well (13.6 vs.17.8, P ＜0.01).There was no significant difference in the treatment success rate before and after the optimization of radiological examination (85.0％ vs.88.3％, P ＞ 0.05).When the frequency of head and chest CT scan was limited, the frequency of radiological examination, radiation exposure and radiological examination expenses were greatly reduced.Conclusions Too much X-ray,CT or other radiological examinations are noted in major trauma patients during the treatment period.Improved understanding of radiation-induced injury, optimizing radiological examination and controlling the repeated radiological examinations of the same site contribute to reducing iatrogenic radiology exposure without affecting the outcome.

Objective To evaluate the efficacy and safety of lamivudine combined with thymosin α1 therapy for patients with chronic hepatitis B.Methods Sixty-eight eligible patients with chronic hepatitis B were enrolled in this multi-center randomized controlled rlinical trial.Patients were randomized into the trial group and the control group(n=34 for each).Patients in trial group received thymosin α1 for 6 months and lamivudine for 12 menths:patients in control group received lamivudine for 12 months only.The rates of serum HBV DNA clearance.HBeAg loss,HBeAg seroconversion,ALT normalization and the safety of thymosin α1 were observed at 3rd.6th,12th and 18th month during and after the treatment.Results At 12th month of the treatment,there were significant differences in the rates of serum HBV DNA clearance,HBeAg loss and ALT normalization between two groups(χ2=31.17,7.17 and 5.92,P＜0.05);at 6th month after the treatment.there were significant differences in the rates of sernm HBV DNA clearance and HBeAg loss between two groups(χ2=4.53 and 7.17,P＜0.05).HBV DNA was not detected in 2 patients during 6-month follow-up study and no sever side effect was observed throughout the study.Conclusion The conlbination of lamivudine and thymosin α1 is safe and has better effect than the monotherapy of lamivudine in patients with chronic hepatitis B.