ObjectiveTo study the ent-kaurane diterpenoids from Rabdosia rubescens.MethodsThe compounds were isolated by chromatographies and their structures were identified by spectral analyses.ResultsFour compounds were isolated,and they were identified as bisrubescensin E (1),2α,3α,24-trihydroxyurs-12-en-28-oic acid (2),2α,3α,24-trihydroxyurs-12,20-(30)-dien-28-oic acid (3),and 6,7-dihydroxycoumarin (4).ConclusionCompound 1 is a new asymmetric ent-kauranoid dimer.Compound 2 is isolated from the plant for the first time.Compounds 3 and 4 are isolated from the plants ofRabdosia (B1.) Hassk for the first time.

Objective Diagnosis of GDM during the early period and treatment in time can improve motherchild prognosis.Methods 805 pregnant women with gestational age of 24～28 weeks were screened by the 50g 1hour glucose challenge test(GET).75g oral glrcose tolerance test(OGTT)were further performed in the abnormal pregnant women,and the normal or abnormal pregnant outcomes were followed.Results The morbidity of pregnant women and neonates were higher in-group of gestational impaired glucose tolerence(GIGT)and geztational diabetes mellittts(GDM)(P＜0.05 or P＜0.01).Conclusion The research suggests that all pregnant women must be screened for detecting diabetes mettitus.The abnormality of glucose tolerance test need to be further treated and monitored.

Objective To investigate clinical significance of intermittent sinusoidal feial heart rate at third trimester.Methods From Jan 2002 to Dec 2010,48 pregnant women at 33 to 41 gestational weeks undergoing electronic fetal heart rate(FHR)monitoring presented with intermittent sinusoidal FHR in Department of Obstetrics and Gynecology,Second School of Clinical Medicine,Jinan University were enrolled in this retrospective study.Twenty-one cases were categorized into continuous group(i.e.with sinusoidal feature and a constant duration≥10 minutes).while the other 27 cases were categorized iuto intermittent group(i.e.with a duration＜10 minutes).In the mean time.76 normal cases were chosen randomly matched as control group.Blood gas and hemoglobin were measured in umbilical artery after fetal head delivery.General neurological system examination were performed in those fetus in hospitalization.The outcome of those fetuses was compared.Results (1)Neonatal complications:the rate of asphyxia,meconium-stained amniotic fluid and fetal anemia were 63%(17/27),33%(9/27)and 63%(17/27)in group of intermittent sinusoidal FHR,which were significantly higher than 1%(1/76),4%(3/76),3%(2/76)in control group(P＜0.05).When compared with 67%(14/21),52%(11/21),76%(16/21)in group of continuous sinusoidal,the statistical difierence were not observed(P＞0.05).(2)Blood gas in neonate:the rates of pH less than 7 were 18%(5/27)in intermittent group,52%(11/21)in continuous group and 0 in control group,which all reached statistical difference among those three groups(P＜0.05).(3)Brain damage and death:the rates of brain damage and death were 48%(13/27)and 11%(3/27)in intermittent group,81%(17/21)and 43%(9/21)in continuous group,and 0 in control group,which all showed significant difference between them(P＜0.05).Conclusion Intermittent and continuous sinusoidal FHR are typical graphics of severe fetal anemia at third trimester.Intermittent sinusoidal FHR is indicative of serious fetal hypoxia.

Objective To study the effect of Sarcandra Glabra on the expression of signal transduction molecules of TGF-β1/Smads signaling pathway in miniature pig of radiation-induced lung injury.Methods 75 miniature pigs were divided into control group,radiation group and radiation plus medication group randomly.At 1 week before exposure of right lung with 15 Gy γ-rays,the miniature pigs in radiation plus medication group were given Sarcandra glabra,while those in the other groups received an equal amount of saline.Right lung were taken at weeks 2,4,8,12 and 24 after irradiation,the pathological changes in the lung tissue were observed by HE staining,and the expression of mRNA and protein of TGF-β1,Smad2,Smad3,and Smad7 were detected by real-time PCR and western blotting,respectively.Results Sarcandra glabra reduced the inflammation and fibrosis of the lung tissue in miniature pig after irradiation.Compared with control group,the expressions of TGF-β1 and Smad3 were significantly increased at 2 weeks after irradiation(P ＜ 0.05),Smad2 and Smad7 were increased at 8 and 12 weeks after irradiation(P ＜ 0.05),respectively,in the radiation group.Compared with the radiation group,the expressions of TGF-β1 and Smad2 were significantly decreased(P ＜ 0.05) from the fourth and eighth week,respectively,Smad3 had no obvious change while Smad7 was significantly increased from the second week in the radiation plus medication group (P ＜ 0.05).Conclusions Sarcandra Glabra plays protective effect on radiation-induced lung injury in miniature pig by regulating TGF-β1,Smad2 and Smad7 expressions in the TGF-β1/Smads signaling pathway.

Objective To evaluate the quality of the examination paper of the theory of Clinical Diagnostics,to explore and reflect on the teaching methods,so as to improve the quality of teaching.Methods Finals results of Clinical Diagnostics including 40 clinical undergraduates of Capital Medical University were analyzed.SPSS 20.0 was used to make analysis of the frequency,means statistics and normality of the examination paper.Kuder Richardson/Cmnbacha formula,percentage unification methods and so on were used to calculate confidence,validity,difficulty and degrees of distinction.Acquisition of relevant knowledge was assessed according to score distribution,while test paper quality was evaluated based on indicators including confidence,validity,difficulty and degrees of distinction.Results Test scores of 40 students were between 61 to 96 (83.64 ± 8.07).The degree of confidence (γ) for choice questions and subjective questions was 0.65 and 0.59 respectively;The validity (V) was 0.27;The overall difficulty (P) of the examination was 0.84;The degrees of distinction (D) were between 0.16 to 0.30.And the total points losing rate was 16.36％.Conclusion The examination is of medium difficulty and good degree of distinction,but the teaching strategies still need further adjustment in order to improve the students' ability of flexible application of the basic knowledge.

AIM:The aim of this study was to examine the microstatellite instability(MSI)and loss of heterozygosity(LOH)of locus D17S396 on chromosome 17 and their influence on the expression of nm23H1 in hepatocellular carcinoma(HCC),which may provide experimental evidence for the mechanism of nm23H1 gene and tumor metastasis.METHODS:Techniques such as DNA extraction from formalin-fixed paraffin-embedded tissues,PCR-SSCP,ordinary silver stain were used to study MSI and LOH of locus D17S396.Envision immunohistochemistry and Leica-Qwin computer imaging techniques were used to assess the expression of nm23H1.RESULTS:① The frequency of heredity instability of HCCs was 35.42%.The frequency of LOH in the cases with lymph node or distant organs metastasis or not and with intrahepatic metastasis or embolus of portal vein or not was significantly different(P

Objective:To study the expression of matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2) in hilar cholangiocarcinoma.To discuss the relationship of MMP-2 and TIMP-2 expression with the metastasis and prognosis of hilar cholangiocarcinoma.Methods:Immunohistochemical S-P method was used in the examination of MMP-2 and TIMP-2 expression in 78 hilar cholangiocarcinoma.The relationships of MMP-2 and TIMP-2 expression with the pathological differentiation,metastasis and prognosis were analyzed.Results:The positive rate of MMP-2 expression was 72% ,and that of TIMP-2 was 76%.According to Ridit analysis,the degree of MMP-2 expression were correlated with the pathologic differentiation and lymph-node metastasis of hilar cholangiocarcinoma.The high expression of MMP-2 existed in the low pathologic differentiation and the high rate of lymph-node metastasis of hilar cholangiocarcinoma.The high expression of TIMP-2 existed in the high pathologic differentiation and the low rate of lymph node metastasis of hilar cholangiocarcinoma. MMP-2 and TIMP-2 expression had a significance correlation(r=0.708,P

Objective To explore the methods for training the abitity of critical thinking of ICU nurses.Methods ICU nurses were trained in terms of knowledge training, case study, care rounds, self-reflection, case discussion, simulation training and seminars. The Chinese version of the critical thinking disposition inventory(CTDI-CV)was used before and one year after the training.Result The scores on CTDI-CV as well as the items after training were all significantly higher than that before training(P<0.05).Conclusion The knowledge and ability in critical thinking can be improved by knowledge and skills training.

Objective To explore the clinical effect of dopamine,phentolamine,recombinant interferon α combined with nasal continuous positive airway pressure(CPAP) ventilation in treating severe infantile bronchiolitis.Methods Ninety-five cases of infantile severe bronchiolitis were divided into the observation group(55 cases) and control group (40 cases).The control group was given the combined treatment scheme of dopamine,phentolamine and recombinant interferon α,while on this basis the observation group was added with NCPAP.The curative effects were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group(P<0.05);the temperature recovery time,wheezing disappearance time,cough stopping time,lung wheezing sound disappearance time and hospitalization time in the observation group were significantly lower than those in the control group(P<0.05);the breathing rate,heart rate and PaCO2 level after treatment in the two groups were significantly lower than those before treatment,the levels of PaO2,PaO2/FiO2 and pH were significantly higher than those before treatment in the same group,the differences were statistically significant(P<0.05);the breathing rate,heart rate and PaCO2 level after treatment in the observation group were significantly lower than those in the control group(P<0.05);the levels of PaO2,PaO2/FiO2 and PH after treatment in the observation group were significantly higher than those in the control group(P<0.05);the levels of IL-8,sVCAM-1and LTE4 after treatment in the two groups were significantly lower than those before treatment(P<0.05);there was no statistically significant difference in the levels of serum IL-8,sVCAM-1 and urine LTE4 between the two groups(P>0.05);the recurrence rate and death rate in the observation group were significantly lower than those in the control group with statistical difference(P<0.05);the occurrence rate of adverse situation during treatment period had no statistical difference between the two groups(P>0.05).Conclusion Dopamine,phentolamine,recombinant interferon α combined with NCPAP has obviously clinical effect for treating infantile severe bronchiolitis,can effectively improve the blood gas analytical indexes,reduces the signs and symptoms relief time,reduces the rates of relapse and death,and has higher clinical application value.

Objective To investigate the recheck rule by investigating the coincidence rate of the results detected by the LabU‐Mat urine dry chemistry analyzer and the Urised tangible composition analyzer with the results detected by the microscope examina‐tion .Methods 1 040 urine specimens from children outpatients and children inpatients were collected .Firstly ,the specimens were analyzed by the LabUMat urine dry chemistry analyzer and the Urised tangible composition analyzer ,and then detected by using the microscopic examination for investigating the recheck rule of the routine analysis by the urine automatic analyzer ;the regulation was evaluated by the missed detection rate ,and then the recheck rule avoiding the missed diagnosis of abnormal renal function was also evaluated .Finally ,clinically verify the rules adopting 200 specimens to perform the clinical verification on this recheck rule .Results Among the specimens used for researching the recheck rule ,the specimens of positive microscope examination results accounted for 58 .65% ,the specimens of negative results accounted for 41 .35% .In the positive detection specimens ,the specimens of RBC positive were the majority ,accounting for 50% ,the specimens of WBC positive accounted for 23 .08% and the specimens of CAST positive accounted for 7 .69% .The coincidence rate of the set rule was 87 .5% and the missed detection rate was 2 .9% .In conduc‐ting the verification on the recheck rule by 200 urine specimens ,the coincidence rate was 89 .52% and the missed detection rate was 2 .4% .Conclusion When the detection results of occult blood(BLD) ,WBC(LEU) and protein(PRO) by the dry chemistry analyzer and the detection results of RBC ,WBC ,CAST by the tangible composition analyzer are inconsistent or the differences among them are beyond 2 grades of differential ,the recheck by the microscopic examination should be performed .