Objective:To observe the influence of the “Warming yang and Nourishing qi” acupuncture treatment in the serum interleukin-12 (IL-12) and interleukin-18 (IL-18) expression levels,in the rats with experimental autoimmune myasthenis gravis (EAMG) and to analyze the mechanism of acupuncture treatment to myasthenis gravis (MG).Methods: AchRα1 129-145 peptide fragments were used to immune the female Lewis rats to establish EAMG rat models.30 successful EAMG model rats were randomly selected and divided into acupuncture treatment group ,drug control group and model control group ( n=10 );the unmodelled 10 rats purchased at the same period were used as blank control group.The rats in acupuncture treatment group were treated by “Warming yang and Nourishing qi” acupuncture treatment,30 min/time,once a day,7 d for a period,1 d rest between two periods,two periods of continuous treatment.The rats in drug control group were treated by the pyridostigmine lavaged treatment , 18.5 mg/( kg · d ) , continuous treatment of 15 d.The rats in the other two groups had no any special treatment.After treatment,the blood samples from the vein of tail root of the rats in 4 groups were collected ,and the serum expression levels of IL-12 and IL-18 were detected with ELISA method.Results:After treatment,compared with model control group ,acupuncture treatment and drug control group the serum IL-12 and IL-18 expression level of the EAMG rats were significantly decreased ( P<0.05 or P<0.01 ).Compared between acupuncture treatment group and drug control group showed that ,the serum IL-12 and IL-18 expression level of the EAMG rats were no significant difference ( P>0.05 ).Conclusion:“Warming yang and Nourishing qi” acupuncture treatment can reduce the serum IL-12 and IL-18 expression levels of EAMG rats to treat MG ,and the effect of treatment was similar to pyridostigmine.

Objective To deepen and promote the development of nursing higher education internationalization through the analyzation of the status,existing problems and future trends of research about nursing higher education.Methods Searching literatures in China National Knowledge Infrastructure (CNKI),VIP and WANFANG databases from 1984 until 2014.Results 79 references were selected from 44 journals and the numbers increased each year.69.62％ (55/79) of them were accepted by statistical source core journals and 54.43％ (43/79) of them were funded.The authors came from 19 provinces.There were only 4 articles reported international education about graduates and most of them were about undergraduate students.The main reformation measures included curriculum and english teaching reform et al.Conclusions The educator paid more attention to nursing higher education internationalization than before,also the policy's support and the quality of literatures were optimistic.However,the breadth,depth and integrity of research should be strengthened in future.

Objective To discuss the optimal retrieval time of the indwelling Gunther Tulip and Cook Celcet inferior vena cava filters (VCF). Methods During the period from March 2013 to April 2015 at Shengli Oilfield Central Hospital, the implantation of retrievable inferior vena cava filter was performed in 58 patients. Among the 58 patients, Gunther Tulip VCF was used in 13 and Cook Celcet VCF was employed in 31. Twenty-one patients followed the doctor's advice to receive retrieval procedure of VCF within three months after the implantation. Results Among the 21 patients, successful retrieval of VCF was obtained in 19. The mean indwelling time of Gunther Tulip VCF was 54.4 days, the longest time being 79.0 days. Gunther Tulip VCF was successfully removed in 3 patients and retrieval of VCF failed in 2 patients, with a retrieval success rate of 60%. The mean indwelling time of Cook Celcet VCF was 37.6 days, the longest time being 67.0 days. Cook Celcet VCF was successfully removed in 16 patients, with the success rate of retrieval being 100%. Conclusion Despite many VCFs that have been indwelled for a long time can be safely retrieved, retrieval procedure should be performed as early as possible in order to improve the retrieval success rate of VCF. It seems that the use of Cook Celcet VCF is a better choice although it is more expensive.

Objective:To explore the relationship among cardioversion ,cerebral infarction (CI) and N terminal pro brain natriuretic peptide (NT‐proBNP) level in patients with heart failure (HF) complicated atrial fibrillation (AF) . Methods :A total of 150 HF + AF patients received intravenous drip of amiodarone for cardioversion therapy .Ac‐cording to cardioversion results ,they were divided into cardioversion group (n=100 ) and non‐cardioversion group (n=50) ,NT‐proBNP level change was observed in two groups before and after cardioversion .According to CI on‐set or not ,patients were divided into CI group (n=20) and non‐CI group (n= 130) ,NT‐proBNP level was com‐pared between two groups before and after onset .Results :Within 48h after administration ,a total of 100 patients (66.67% ) recovered to sinus rhythm .Compared with before cardioversion ,NT‐proBNP level significantly reduced [(967.04 ± 366.16) pg/ml vs .(496.21 ± 142.54) pg/ml] after cardioversion in cardioversion group ,and was signifi‐cantly lower than that of non‐cardioversion group (996.76 ± 351.28) pg/ml , P<0.01 all . In CI group ,compared with small size CI group ,there were significant rise in NT‐proBNP level [ (784.21 ± 231.26) pg/ml vs .(1983.24 ± 32.96) pg/ml ,(3562.19 ± 1468.32) pg/ml] in medium and large size CI group , P< 0.05 or <0.01 .Conclusion:NT‐proBNP level at hospitalization possesses predictive value for drug cardioversion effect in HF + AF patients . NT‐proBNP level is related with CI onset .After acute CI ,the higher NT‐proBNP level is ,the larger infarct size is , the poorer prognosis is .

Objective　To evaluate the correlation between vascular endothelial growth factor(VEGF) expression and microvessel density(MVD) in gastric carcinoma (GC) and the relationship of VEGF and MVD with clinicopathologic characteristics and prognosis of GC. Methods　The expression of VEGF and intratumoral microvessel density (MVD) in one hundred and sixteen resected specimens of the patients with GC were observed and counted, and the relationship of VEGF and MVD with clinicopathologic factors and prognosis of GC were analysed. Results　The expression of VEGF was found in 60.34% of the specimens. The MVD value was much higher in VEGF(+) group than that in VEGF(-) group (26.16±8.50 and 19.22±8.20, respectively, P<0.01). Expression of VEGF was significantly higher in patients with lymph node metastasis than that in patients without lymph node metastasis (p<0.05).Expression of VEGF was highly correlated with the stage of tumor (P<0.05). MVD correlated with lymph node metastasis (P<0.01) and abdomen metastasis (P<0.01) and increased with the TNM stage (P<0.01). The total five-year survival rate in VEGF(-) group and low MVD group were significantly higher than that in VEGF(+) group and high MVD group respectively(both P<0.01). Multivariate analysis indicated that the expression of VEGF and MVD were independent prognostic factors of GC. Conclusions　The expression of VEGF and MVD can reflect the malignant degree of GC. They may serve as the prognostic factors and guide the decisions on the therapy.

Objective To study the effects of CYP3A5 * 1 and CYP3A5 * 3 genotypes on tacrolimus dose requirement.Method We tested archival peripheral blood of 69 kidney recipients for CYP3A5 genotyping by polymerase chain reaction.The dose,blood concentrations and dose-normalized blood concentrations of tacrolimus were measured at 1st and 2nd month after the renal transplantation.Result There were 6 cases of CYP3A5 * 1/* 1 (8.7％),22 cases of CYP3A5 * 1/* 3 (31.9％),and 41 cases of CYP3A5 * 3/* 3 (59.4％).At 1st and 2nd month after the renal transplantation,the carriers of CYP3A5 * 1 genotype had a higher mean tacrolimus dose than CYP3A5 * 3/* 3 genotye (both P＜0.000 1),and those of CYP3A5 * 1 genotype had lower mean tacrolimus concentrations than CYP3A5 * 3/* 3 genotye (P=0.020 8,and P =0.019 1 respectively).Meanwhile,the carriers of CYP3A5 * 1 genotype had lower dose-normalized blood concentrations of tacrolimus than CYP3A5 * 3/* 3 genotye (P＜0.000 1) at 1st month after the renal transplantation,as well as at 2nd month after the renal transplantation (P =0.0191).Hepatic and renal function showed no significant effect on tacrolimus dose adjusted concentration at 1st and 2nd month after transplantation.Gender did not show a significant impact on tacrolimus dose.Conclusion CYP3A5 * 1 carriers needhigher tacrolimus dose than CYP3A5 * 3 homozygote to achieve the target blood concentration.CYP3A5 genotyping is a new approach for detecting tacrolimus dose requirement in kidney recipients.

Objective To compare the clinical effects of catheter-directed thrombolytic therapy for acute superior mesenteric vein thrombus (SMVT) between via superior mesenteric vein (SMV) route and via superior mesenteric artery (SMA) route. Methods The clinical data of 32 patients with acute SMVT, who were treated with catheter-directed thrombolytic therapy at the Central Hospital of Shengli Oil Field, were retrospectively analyzed. Among the 32 patients, percutaneous transhepatic catheter-directed thrombolytic therapy via SMV route was performed in 23 (SMV group), and percutaneous transhepatic catheter-directed thrombolytic therapy via SMA route was carried out in 9 (SMA group). Results After the treatment, the clinical symptoms were significantly improved in 28 patients, including 22 of SMV group (95.7%) and 6 of SMA group (66.7%). CT angiography showed that the blood flow became almost complete patency in 17 patients of SMV group (73.9%) and in only 3 patients of SMA group (33.3%). Both the thrombolysis procedure time and X-ray exposure time of SMV group were obviously longer than those of SMA group. Conclusion Both via SMV and via SMA catheter-directed thrombolytic therapies are effective treatment for acute SMV thrombosis. The former is more effective, while the manipulation of the latter is technically simpler.

To explore target blood pressure (BP) for lower incidence rate of stroke and better prognosis in patients with H‐type hypertension .Methods :A total of 600 patients with H‐type hypertension according to BP were divided into low level group (＜ 120／90mmHg or DBP ＜ 90mmHg , n ＝ 200 ) , medium level group (120 ～ 130／90mmHg or DBP＜90mmHg ,n＝ 200 ) and high level group (130～140／90mmHg or DBP＜ 90mmHg ,n＝ 200 ) , three groups were treated for two years .Levels of BP ,serum homocysteine (Hcy) ,carotid intima‐media thickness (CIMT) were measured and compared among three groups before and after treatment ,and incidence rates of ad‐verse events were recorded in three groups during follow‐up .Results :During follow‐up ,there were gradual signifi‐cant reductions in serum Hcy level and CIMT in three groups ,P＜0.05 or ＜0. 01. After four‐week follow‐up ,com‐pared with low level group ,there were significant rise in levels of BP and Hcy in medium and high level group ,and SBP of high level group was significantly higher than that of medium level group ,CIMT was significantly higher than the other two groups , P＝0.001 all ;after eight‐week and two‐year follow‐up ,compared with low level group , there were significant rise in levels of BP ,Hcy and CIMT in medium and high level group ,SBP and CIMT of high level group were significantly higher than those of medium level group ;and Hcy level of medium level group was sig‐nificantly higher than that of high level group after two‐year follow‐up , P＜0.05 or ＜0.01. After two‐year follow‐up ,recurrence rate of stroke ,incidence rates of cardiovascular diseases and adverse reactions in high level group were significantly higher than those of low and medium level group ,and recurrence rate of stroke in medium level group was significantly lower than that of low level group , P＜0.05 or ＜0.01. Conclusion :Total therapeutic effect of low level group is significantly better than those of medium and high level group .It can more significantly reduce Hcy level ,further reduce recurrence rate of stroke and mortality and more comprehensively control risk factors of cardiovascular diseases .

Objective To assess the efficacy and safety of oral fosfomycin trometamal in patients with lower urinary tract infections ( UTIs) caused by multi drug resistant ( MDR) bacteria in the clinical setting in China.Methods Multicenter study was conducted from January 2011 to December 2011 in 12 hospitals in China.Three hundred and fifty-six patients with non-fever lower UTls were treated by fosfomycin trometamal 3 g once daily.Three hundred and fifty cases with complete data were further evaluated .One hundred and twenty ( 34.3%) were male and 230 ( 65.7%) were female.The average age was ( 49.9 ± 16.6) years.Depending of the results of urine culture at the first visit ,142 patients with E.coli, Klebsiella pneumonia, proteus, Staphylococcus aureus, Staphylococcus epidermidis and entercocous were analyzed.The susceptibility of MDR bacteria to fosfomycin trometamol were calculated . The clinical efficacy , bacteriological efficacy of fosfomycin trometamol to these patients was evaluated .Results For the gram-negative bacteria detected by culture , among the E.coli, Klebsiella pneumonia and proteus, 50%(52/104) were Extended-Spectrum β-lactamases producing organisms . For the gram-positive bacteria ( n =38 ) detected by culture, methicillin-resistant staphylococcus accounts for 55%(11/20) of all the Staphylococcus and the other gram-positive bacteria were Enterococcus ( n=18 ) .Higher susceptibility rates to fosfomycin trometamol were observed among MDR bacteria (85.7%) and the clinical effective rate and bacteriological effective rate of fosfomycin trometamol were 96.4%( 53/55 ) and 87.5%( 42/48 ) , respectively .The incidence of drug-related adverse events (AEs) was 5.6%(20/356).The most common AE was diarrhea. No drug-related serious adverse events were found .Conclusions The distributions of uropathogens in China are complicated. The detection rate of MDR uropathogens is high . The dosing regimen of fosfomycin trometamal 3 g once daily is effective and tolerable for the patients with lower UTIs caused by MDR bacteria . It may represent good options for the empiric therapy for the patients with lower UTIs .

OBJECTIVE: To explore the clinical features and genetic basis for a Chinese pedigree diagnosed with congenital glycosylation disease (CGD). METHODS: Clinical manifestations of two brothers were analyzed. Whole exome sequencing was carried out for the sib pair. Suspected variants were verified by Sanger sequencing. RESULTS: Both the proband and her younger brother were found to carry compound heterozygous variants of the PMM2 gene, which included a known pathogenic mutation of c.395T>C (p.I132T) and a previously unreported c.448-1(delAG) in the 5' end of exon 6 of the gene. CONCLUSION The compound heterozygous variants of the PMM2 gene probably underlay the CGD in the sib pair.
Asians/genetics* ; China ; Female ; Glycosylation ; Humans ; Male ; Mutation ; Pedigree ; Whole Exome Sequencing