Objective To observe the effect of PI3K/AKT signal passageway on renal tubulointerstitial fibrogenesis of UUO rats.Methods Thirty Sprague Dawley rats were divided into two groups,the sham-operated group and the uuo model group.The model group's left ureter was dissociated to be obstructed.The sham-operated group was dissociated left ureter only without obstruction.Five rats of each group were killed respectively at 5,10,15(days after) surgery.Histological changes of renal tubular interstitium was observed by HE and Masson staining.Immunohistochemistry was performed on left renal tubular interstitium for AKT1,phospho-AKT1,TGF-?1 in renal(tubulointerstitum) at each time point.Results AKT1,phospho-AKT1and TGF-?1 were faintly stained in the sham-operated kidneys.Immunostaining of AKT1,phospho-AKT1 and TGF-?1 in renal tubulointerstitium increased(progressively) starting from 5 to 15 days after UUO(vs sham-operated group,P

Objective To discuss the correlation between plasma homocysteine (Hcy) and diabetes and pre-diabetes.Methods Participants included 115 patients with diabetes,150 patients with abnormal glucose tolerance diagnosis for pre-diabetes and 131 cases without blood glucose abnormalities crowd as control.All the basic informations of the subjects were recorded detailedly.Multiple factors regression analysis was completed.Results Development of diabetes single factor correlation analysis result showed that history of hypertension,hyperlipidemia,body mass index (BMI) ≥ 24 kg/m2,high Hcy were positively correlated with development of diabetes,and life rules was negatively correlated with development of diabetes (P ＜ 0.05 or ＜ 0.01).Development of diabetes multiple factors correlation analysis result showed that history of hypertension,hyperlipidemia,BMI ≥ 24 kg/m2,high Hcy were the independent risk factor for development of diabetes (P ＜ 0.05).Development of pre-diabetes single factor correlation analysis result showed that hyperlipidemia,BMI ≥24 kg/m2,high Hcy were correlated with development of pre-diabetes (P ＜ 0.01).Development of pre-diabetes multiple factors correlation analysis result showed that hyperlipidemia,BMI ≥ 24kg/m2,high Hcy were the independent risk factor for development of pre-diabetes (P ＜ 0.05).Conclusions Plasma Hcy is intimate correlated with diabetes and pre-diabetes,and it is an independent risk factor for development of them.In clinical work,the patients with high Hcy need to give the necessary intervention.

Objective To observe the effect of salvia lignstrazine combined with methylcobalamin in treatment of type 2 diabetic peripheral neuropathy.Methods From May 2010 to May 2011,112 cases of type 2 diabetic peripheral neuropathy patients were classified into two groups by random digits table,control group of 56 cases were treated with methylcobalamin and observation group of 56 cases were treated with salvia lignstrazine combined with methylcobalamin.The clinical effects,motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of common peroneal nerve and tibial nerve between two groups were compared.Results The total effective rate in observation group was 87.5％(49/56),which was significantly higher than that in control group [ 57.1％( 32/56 ) ] (P ＜ 0.05 ).After treatment,the levels of MNCV and SNCV of common peroneal nerve and tibial nerve were (47.89 ± 6.93 ),(49.12 ± 5.54) m/s and (43.69 ± 4.97 ),(42.35 ± 5.14) m/s in observation group,which were significantly increased compared with those before treatment,while the levels of MNCV and SNCV of common peroneal nerve and tibial nerve were (41.15 ± 4.36),(39.89 ± 3.67 ) m/s and (37.57 ± 3.08),(36.56 ± 2.81 ) m/s in control group,which had no significant difference compared with those before treatment (P ＞ 0.05 ).Moreover,the levels of MNCV and SNCV of common peroneal nerve and tibial nerve in observation group were significantly higher than those in control group (P＜ 0.05).Conclusion Salvia ligustrazine combined with methylcobalamin in treatment of type 2 diabetic peripheral neuropathy can enhance the clinical effects,and improve neurological status,and can be applied in clinic.

Objective To explore the application of particle-gun technique in transfecting dendritic cells(DCs),and investigate the expression of DNA vaccine particle IgHV1-GM-CSF in DCs induced by particle-gun.Methods Monocytes were isolated from donor peripheral blood collected by Ficoll density gradient method and adherent culture,and then differentiated into immature DCs(imDCs) by rhGM-CSF and rhlL-4 induction.The plasmids for transfection were IgHV1-GM-CSF/pcDNA3.0 and pEGFP,which were prepared with endofree plasmid purification kit.The DCs were transfected with plasmid pEGFP by particle-gun at different transfection conditions,the green fluorescence positive cell and the total cell numbers were counted respectively under fluorescence microscope,and the transfection efficiency was calculated;the viable cell count was performed after trypan blue staining;the transfection efficiencies of particle-gun,liposome-mediated transfection and electroporation method were compared.The plasmids IgHV1-GM-CSF/pcDNA3.0 and pEGFP were cotransfected into imDCs by particle-gun under the optimum conditions,and then DNA was extracted,the expression of IgHV1-GM-CSF was determined by RT-PCR,and of GM-CSF by ELISA.Results The optimum conditions of particle-gun transfection in imDCs were: gas pressure at 120psi,PVP concentration in 0.02mg/ml,microcarrier loading in 0.5mg gold/shot,and DNA loading ratio in 1.5?g plasmid/mg gold.The transfection efficiencies of particle-gun and electroporation were 10.5%?2.4%(n=3) and 45.2%?5.6%(n=3) respectively,while that of liposome-mediated transfection was very low,and significant difference existed among the three methods(P

BACKGROUND: There are many drawbacks with hormone replacement therapy for menopausal syndrome. The blood levels of 5-HT and norepinephrine are lower. Fluoxetine hydrochlorde(ProzacR) is a selective serotonin reuptake inhibitor which is widely used in treating anxiety and depression,OBJECTIVE: To evaluate the effect of combined antidepressant and estrogen therapy compared to estrogen alone in the treatment of perimenopausal syndrome in this prospective open study.DESIGN: Randomized comparative study.SETTING: Department of Obstetrics and Gynecology of the First Affiliated Hospital of Chongqing Medical University PARTICIPANTS: From November 2003 to December 2004, 60 female patients with diagnosed menopausal syndrome of 3-12 month duration, aged (46±3) years, from Department of Obstetrics and Gynecology of the First Affiliated Hospital of Chongqing Medical University were enrolled into the study after giving their informed consents. The patients were randomly divided into two equal groups with Group 1 (n=30) receiving a combination of antidepressant + estrogen and Group 2 (n=30) receiving estrogen only.METHODS: Patients in Grgup 1 received fluoxetine hydrochloride (ProzacR) 20 mg orally every morning plus oral estradiol 1 mg once every two weeks for 2 months. Patients in Group 2 received only oral estradiol 1 mg once every two weeks for two months. Patients were not taking any other drug during the treatment period. At the end of two month treatment all patients were evaluated with the following 3 assessment tools: ①female menopausal symptom evaluation with the following 4 categories: Complete symptom relief, markedly improved, improved and no effect. Overall efficacy was defined as 50% symptom improvement. ② Hamilton Depression Scale which reflects energy level and psychosomatic factor of sleep and anxiety. ③Menopause index: Which are description of clinical evaluation and adverse effects; this would help to assess the safety of using both drugs in treating the menopausal syndrome.MAIN OUTCOME MEASURES: female menopausal symptom assessment, hamilton depression scale, and menopause index.RESULTS: ① In female menopausal symptom assessment group 1 showed better results in the complete relief and markedly improved scores. ②Hamilton Depression Scale group 1 also showed better scores than Group2(In Groupl, the scores at week 1 to 8 were 25,18,15,10,8,5,5,4 respectively ,in Group 2, the scores at week 1 to 8 were 25,17,15,14,13,12,13,13 respectively). ③ Group 3 showed a significant better score in the menopausal index with improvement in sleep disorder, anxiety and depression than Group 2 (In Group 1 the scores at week 1-8 were 32,22.5,15,15,14,15,15,14 respectively,In group 2, the scores at week 1 to 8were 33,21,16,14,13,12,13,13 respectively) ,there was no significant difference of incidence of adverse events as compared with Group 3 .CONCLUSION: Combined therapy of fluoxetire hydrochlarde(PROZAC)plus estrogen showed better efficacy in the treatment of menopausal syndrome than estrogen alone.

Objective To observe the protection effect of ischemic preconditioning to small intestines injury after limbs ischemia reperfusion ,and investigate the role of nitrogen monoxidum in the process .Methods 52 male Wistar rats were randomly divided in-to Sham group ,limbs ischemia-reperfusion (IR) group ,IPC + IR group and Nω-nitro-L-arginine methylester (L-NAME) group . The value of diamine oxidase (DAO) and nitrogen monoxidum (NO) in plasma and gut tissue ,the content of fluorescein isothiocya-nate lipopolysaccharide (FITC-LPS) in plasma ,and the value of cyclic guanosine monophosphate (cGMP) and malondialehyde (MDA) in gut tissue were measured ,respectively .The expression of P-selection and Caspase-3 were measured by immunohisto-chemistry .The apoptosis of intestinal cells was detected by terminal deoxynucleotidyl transferase -mediated dUTP nick end labe-ling (TUNEL) and the results were analysed quantitatively by automatic image analytical system .Results Compared with the LIR group ,the values of DAO and FITC-LPS in plasma decreased obviously in the IPC group ,and the level of NO in plasma increased obviously (P<0 .01) .The values of DAO ,NO and cGMP in gut tissue increased obviously ,the level of MDA and the expression of Caspase-3 and the apoptosis index (AI) were significantly decreased in IPC group (P<0 .01) .Compared with the IPC group ,the value of DAO and FITC-LPS were higher and the level of NO was lower in plasma of the L-NAME group (P<0 .01) .The values of DAO ,NO and cGM P in gut tissue obviously decreased ,the level of MDA significantly increased ,and the expression of Caspase-3 and the AI significantly upregulated in L-NAME group than those in IPC group (P<0 .01) .Conclusion IPC can improve the small intestine injury and the apoptosis following hind limbs ischemia reperfusion which may correlated with the increase in the level of NO .

Objective To explore how to establish and safeguard the peripherally inserted central catheters(PICC) maintenance network for the management and practical activity of PICC,so as to provide continuous high-quality PICC maintenance for discharged patients with PICC. Methods 40 nurses each year from 10 cities and 100 country hospitals affiliated with Shanxi Quality Control Center to train in the 1st and 2nd affiliated hospital of Xi`an Jiaotong University were choosen as 214 PICC maintainers. These maintainers were taken into the inner-net of 1st affiliated hospital of Xi`an Jiaotong University management system complete the PICC maintenance net of Shanxi province. Results After the establishment of maintenance network, the number of patients with PICC increased (from 610 cases in 2008 to 1 434 cases in 2014);A large number of PICC management had been down by the qualified nurses in primary hospitals; Duration of PICC in patients days was prolonged; The PICC related complications including thrombophlebitis, catheter infection,occlusion or dislodgment and unplanned extubate were significantly decreased (P < 0.05 respectively). Conclusions Establishment of PICC maintenance network can provide patients with standardized and convenient PICC maintenance service,decrease the incidence of catheter which related complications and ensure patient safety. The application of PICC maintenance network should be used more and more.

BACKGROUND:Medical stuff have significant impacts on the development of organ donation and transplantation, however, medical students present insufficient knowledge and ambivalent attitude towards organ donation and transplantation. OBJECTIVE:To perform a systemic review on the effectiveness of educational program intervention on medical students’ knowledge and attitudes toward organ donation and transplantation. METHODS:PubMed, WILEY ONLINE LIBRARY, ProQuest Health, Medline, EMbase, CNKI, Wanfang and VIP databases were ful y searched for the published literature of medical students receiving an educational program intervention on organ donation and transplantation. According to the inclusion criteria, randomized control ed trials and quasi-experimental study were evaluated with the standard of Joanna Briggs Institute. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework was used to guide the assessment of the methodological quality of the studies. The outcomes were mainly medical students’ knowledge and attitudes toward organ donation and transplantation.
RESULTS AND CONCLUSION:Eight studies from three countries were summarized. The methods were employed in two studies of randomized control ed trials and quasi-experiment received a high quality rating, five studies received middle quality rating and one study received low quality rating. Educational program increased the knowledge in six studies, and changed the attitudes in six studies. Educational program intervention is a significant strategy to increase medical student’s knowledge about organ donation and transplantation. The majority of involved study are
quasi-experiment study, so more high-quality randomized control ed studies are needed.

Objective To validate the therapeutic effect of acupuncture stage treatment on facial spasm and seek a better method for treating this disease. Method One hundred and forty patients were randomly allocated to stage treatment (50 cases), acupuncture (50 cases) and Western medicine (40 cases) groups. In the stage treatment group, treatment was divided into early, middle and late stages according to the patients’ duration of disease. Each stage provided acupuncture point injection of different medicine plus warm needling. The acupuncture group received conventional acupuncture with 1 hour retention of needles and the Western medicine group, oral administration of carbamazepine tablets, 0.2 g 3 times a day. After the completion of treatment course, a six-month follow-up was performed to determine no relapse or aggravation in the three groups and the therapeutic effects were evaluated using Cohen and Albert spasm grading criteria.Result The complete resolution rate was 56% (28/50) in the stage treatment group, 14.0% (7/50) in the acupuncture group and 20.0% (8/40) in Western medicine group. The complete resolution rate was significantly higher in the stage treatment group than in the acupuncture and Western medicine groups (P<0.05). The total efficacy rate was 100.0% (50/50) in the stage treatment group, 70.0% (35/50) in the acupuncture group and 60.0% (24/40) in the Western medicine group. The total efficacy rate was significantly higher in the stage treatment group than in the acupuncture and Western medicine groups (P<0.05).Conclusion Stage treatment has a marked effect on facial spasm.

Objective To explore the risk factors of schistosomiasis cirrhosis esophageal varices hemorrhage. Methods A total of 113 cases of schistosomiasis cirrhosis esophageal varices hemorrhage and 128 schistosomiasis cirrhosis esophageal varices patients without hemorrhage were selected and their relevant factors were analyzed statistically. Results There were significant differences between the two groups in the prothrombin time,portal vein diameter,degree of esophageal varices,and varicose vein tumor-like lesions(P<0.01). Conclusion The risk factors of schistosomiasis cirrhosis esophageal varices hemorrhage are the prothrombin time,portal vein diameter,degree of esophageal varices,and varicose vein tumor-like lesions.