Objective To investigate the expression of interleukin-18(IL-18) and signal transducers and activators of transcription 5(STAT5)in retina of 4-24-week-old diabetic rats, and explore the potential molecular mechanisms involved in diabetic retinopathy (DR). Methods Retinal gene expression profile of healthy and 8-week-old diabetic rats was established with restriction fragment differential display-polymerase chained reaction (RFDD-PCR), and the differences was analyzed by bioinformatics. IL-18 and STAT5 were filtrated as the candidate genes of DR. The expression of IL-18 and STAT5 in retina of diabetic rats with the age of 4, 8, and 24 weeks was observed by semi-quantitative reverse transcriptase-polymerase chain reaction(RT-PCR). Results The result of RFDD-PCR showed:expression of IL-18 was higher in healthy retina than that in diabetic one; expression of STAT5 was not found in healthy rats but in diabetic ones. The result of RT-PCR showed:compared with the normal, high expression of IL-18 was found in 4-week diabetic retina, reduced in 8-week one, and decreased to the lowest in 24-week one. The expression of STAT5 was not observed in healthy or 4-week diabetic retina, but occurred in 8-week one, and increased in 24-week one. Conclusion The expression of IL-18 and the activation of STAT5 may relate to the occurrance of DR. The expression of IL-18 doesn′t depend on the activation of STAT5.

Objective:To establish an HPLC method for the determination of calcium disodium edetate in fosaprepitant dimeglu-mine for injection. Methods:The chromatographic column was Agilent Zorbax Eclipse XDB C18(250 mm ×4.6 mm,5μm). The mo-bile phase consisted of 0. 2% tetrabutylammonium hydroxide(adjusting pH to 4. 0 with phosphoric acid)-acetonitrile(85∶15). The flow rate was 1. 0 ml·min-1 . The detection wavelength was 254 nm. The chromatographic column temperature was 35℃. The injection volume was 20μl. Results:The calibration curve was linear within the range of 26. 06-104. 24μg·ml-1(r=0. 999 8) for calcium di-sodium edetate. The average recovery was 99. 51% (RSD=0. 25%, n=9). Conclusion: The method is simple, rapid, accurate, specific and reproducible, and can be used in the determination of calcium disodium edetate in fosaprepitant dimeglumine for injection.

Objective:To compare the characteristics of Dean's index(DI) and tooth surface index of fluorosis(TSIF). Methods:416 inhabitants of 12, 15 and 35~44 years old were sampled randomly to receive epidemiological survey assessed by DI in fluorosis endemic areas of Xingtai City, Hebei Province. Then TSIF was used to investigate the 178 samples selected randomly from the 416 subjects. Two examiners(S/C) were trained by an experienced specialist of epidemiology(W) before investigation. SPSS 10.0 software and Excel database were used to analyze the data.Results:Weighted Kappa of theoretic calibration of DI and TSIF was ranging from 0.86 to 0.96. The results of TSIF were lower than DI in clinical calibration test. With the increase of the number of tooth surfaces concerned, strength of agreement declined, ranging from “very good” to “moderate”. Prevalence of fluorosis according to DI was lower than that accoding to TSIF.In 35-44 years old people difference of fluorosis prevalence calculating between DI and TSIF was almost 40%. The most probably reason for this phenomenon was that a person with “questionable” fluorosis wouldn't be calculated as a fluorosis patient. The proportion of “questionable” in 35-44 age group was the highest (40.3%). Conclusion:DI is suitable for large-scale epidemiology survey, and should be combined with community fluorosis index (CFI), while TSIF is suitable for esthetic study, especially for severe fluorosis patients.

Objective To analyze the coverage of iodized salt and the focus population iodine nutrition after implementing new standard of iodized salt in Hainan Province.Methods Eighteen cities (counties,districts) were divided into eastern coastal,western coastal and inland areas according to coastline and terrain of Hainan Province in 2013.One township (town,street) was sampled from each city (county,district) in the east,the west,the south,the north and the center of these areas.Four villages (committees) and 15 households in each village (committee),and 40 children aged 8-10 in one primary school,20 pregnant women and lactating women were sampled from each township (town,street).Iodized salt samples collected from household were monitored by the method of direct titration;random urine samples of children aged 8-10,pregnant woman and lactating woman were tested by arsenic cerium catalytic spectrophotometry.Results Totally 6 310 edible salt samples were tested,and the median of salt iodine was 25.9 mg/kg.The coverage of iodized salt was 97.92％ (6 179/6 310).Residents consumption rate of qualified iodized salt reached 95.47％ (6 024/6 310),and the rate of non-iodized salt was 2.08％ (131/6 310).About 4 444 urine samples of children aged 8-10 were examined,and the median of urinary iodine was 165.4 μg/L,in which suitable urinary iodine (100-199 μg/L) accounted 49.3％ (2 194/4 444);about 1 286 urine samples of lactating woman were examined,the median of urinary iodine was 122.3 μg/L,≥ 100 μg/L was 60.6％ (779/1 286);about 813 urine samples of pregnant woman were examined,the median of urinary iodine was 126.6 μg/L,59.6％ (485/ 813) of this group were urinary iodine deficiency (＜ 150 μg/L).There were significant differences between the three groups in the east,the middle and the west areas of Hainan Province (children:176.7,147.7,158.0 μg/L,lactating women:148.7,108.7,106.7 μg/L,pregnant women:146.7,108.0,147.1 μg/L,H =34.70,26.76,35.95,all P ＜ 0.01).Conclusion The results have showed that pregnant woman are iodine deficiency,they should be given more iodine.

Objective To analyze the genetic mutation patterns and the constituent ratio of α-thalassemia in Luzhou area and to investigate the clinical application value of the gene diagnosis .Methods The PCR method combined with DNA chip hybridization technique was adopted to conduct the gene detection and analysis on 116 cases of suspectedα-thalassemia .Results Among 116 sus-picious cases of α-thalassemia ,39 cases were found with genotypes of α-thalassemia ,the detection rate was 33 .62% .7 kinds of mu-tation genotypes were detected ,in which the deletion type of - -αSEA/ααaccounted for 41 .03% and the deletion type of -α3 .7/ααaccounted for 25 .64% .Conclusion The main gene mutation of α-thalassemia in Luzhou area is the deletion type of - -αSEA/αα. The gene diagnosis is an important criterion for definitely diagnosing α-thalassemia .

Objective To study the expression of cIAP and Caspase‐7 in endometrial adenocarcinoma tissue and its relation with prognosis .Methods Fifty‐five cases tissues of endometrial adenocarcinoma patients were detected by immunohistochemistry assay from the First Affiliated Hospital of Henan University of Science and Technology from 2009 to 2010 .Histological classifica‐tion ,pathological stage ,lymph node metastasis ,age and other parameters were collected ,the survival and overall survival of the tumor were followed up ,immunohistochemistry was used to observe the expression of cIAP and Caspase‐7 in paraffin sections of pathological specimens ,and the relationship between them and the parameters were analyzed .Results The expression level of cIAP and Caspase‐7 was related to the histological classification ,pathological stage and lymph node metastasis of endometrial carcinoma (P<0 .05) ,but it was not related with the age ,muscular layer infiltration(P>0 .05) .There was significant difference between the positive expression and the negative expression of cIAP and Caspase‐7(P<0 .05) .Conclusion The expression level of cIAP and Caspase‐7 in patients with endometrial carcinoma is correlated with tumor grade and overall survival ,or can be used as a prognostic indicator for endometrial cancer .

Objective To explore the prognostic role of nutritional benefit assessment (NUTRIC score), nutritional risk screening 2002 (NRS 2002), traditional nutritional laboratory indicators albumin (ALB) and prealbumin (PA) in critically ill patients. Methods A historical-prospective cohort study was conducted. The data of 427 patients admitted to Department of Critical Care Medicine of the Affiliated Hospital of Guizhou Medical University from February 2014 to October 2014 were retrospectively analyzed, and thereafter a follow-up of 275 critically ill patients from November 2014 to April 2015 prospectively enrolled was performed. 261 patients were enrolled finally. Patients were divided into death group and survival group according to 28-day and 90-day outcome, the baseline data, acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, NRS 2002, NUTRIC score, ALB and PA were compared between the two groups. Logistic regression analysis was used to find risk factors for 28-day and 90-day prognosis. Results ① NRS 2002 score of all the 261 patients were greater than or equal to 3 with 100% nutritional risk. The patients in NUTRIC score 5-9 group had lower ALB and PA, higher NRS 2002 score, longer mechanical ventilation time and length of intensive care unit (ICU) stay, which indicated they were more serious. ② Twenty eight-day mortality was 20.7% (54 died from 261). Compared with survival group, the patients in death group had higher APACHE Ⅱ, SOFA, and NUTRIC scores [29.00 (22.75, 34.25) vs. 24.00 (20.00, 28.00), 10.0 (8.0, 13.0) vs. 9.0 (7.0, 11.0), 6.37±1.84 vs. 5.59±1.64, all P < 0.01], and longer days from hospital to ICU admission and mechanical ventilation time in ICU [1.5 (0, 9.2) days vs. 0 (0, 4.0) days, 6.0 (4.0, 11.0) days vs. 4.2 (2.5, 7.8) days, both P < 0.05]. It was revealed by logistic regression analysis that APACHE Ⅱ score [odds ratio (OR) = 1.089, 95% confidence interval (95%CI) = 1.039-1.141, P = 0.000] and days from hospital to ICU admission (OR = 1.042, 95%CI = 1.014-1.071, P = 0.003) were the independent risk factors for 28-day death in critically ill patients. ③ Ninety-day mortality was 42.5% (111 died from 261). Compared with the survival group, the death group patients were older with higher APACHE Ⅱ, SOFA, NRS 2002, and NUTRIC scores [age (years): 64.44±18.11 vs. 54.25±19.66, APACHE Ⅱ: 27.00 (23.00, 31.00) vs. 23.00 (20.00, 27.00), SOFA: 10.0 (8.0, 12.0) vs. 9.0 (7.0, 11.0), NRS 2002: 5.08±1.47 vs. 4.67±1.41, NUTRIC: 6.32±1.58 vs. 5.33±1.68], ALB was significantly reduced [g/L: 27.70 (23.05, 32.00) vs. 30.73 (26.90, 34.20)], and mechanical ventilation time in ICU was extended obviously [days: 5.7 (3.6, 11.0) vs. 3.9 (2.4, 7.0), all P < 0.05]. It was revealed by logistic regression analysis that old age (OR = 1.019, 95%CI = 1.002-1.037, P = 0.029) and NUTRIC score (OR = 1.211, 95%CI = 0.983-1.491, P = 0.072) were the independent risk factors for 90-day death probability, and ALB probability was the protect factor for 90-day death (OR = 0.954, 95%CI = 0.916-0.994, P = 0.024). Conclusion It was NUTRIC score but not NRS 2002, ALB and PA predicted 90-day mortality in critically ill patients.

This paper analyzed the system,methods,content,scope and standards of last two competition in order to further improve the clinical skills competition for national medical students in China.According to the characteristics of medical education,the paper proposed several opinions and suggestions as follows:repechage should be cancelled in competition system and objective structured clinical examination should be used in competition; the content,scope and criteria of the competition should take the actual ability of the medical students at graduation into consideration.

Objective To investigate the relationship between chronic gastropathy with intestinal metaplasia (IM) and caudal type homeobox genes 2 (Cdx2),tumor necrosis factor-α (TNF-α),Helicobacter pylori (Hp) infection.Methods Onehundred and thirty patients underwent gastroscopy were divided into 2 groups by typical pathological type:gastritis group (30 cases) and IM group [100 cases,including mild IM group (30 cases),moderate IM group (35 cases),severe IM group (35 cases)].Hp infection was confirmed.The expressions of Cdx2 and TNF-α protein was evaluated by immunohistochemistry.Results The positive expression rates of Cdx2 and TNF-α protein in IM group were significantly higher than those in gastritis group [78.0％(78/100) vs.6.7％(2/30),60.0％(60/100) vs.16.7％(5/30)],and there were statistical differences (P ＜ 0.01).The positive expression rates of Cdx2 and TNF-α protein in positive and negative Hp infection in IM group were significantly higher than those in gastritis group [Cdx2 protein:79.4％(50/63) vs.1/10,75.7％(28/37) vs.5.0％(1/20);TNF-α:74.6％(47/63) vs.4/10,35.1％(13/37)vs.5.0％ (1/20)],and there were statistical differences (P ＜ 0.01).The positive expression rate of Cdx2 protein in moderate IM group and severe IM group were significantly higher than those in mild IM group [80.0％ (28/35) and 97.1％ (34/35) vs.53.3％ (16/30)],in severe IM group were significantly higher th.an those in moderate IM group,and there were statistical differences (P ＜0.05).There were no statistical differences in the positive expression rate of Cdx2 protein of difference Hp infection among the 4 groups (P＞0.05).There were no statistical differences in the positive expression rate of TNF-α protein between mile IM group and moderate IM group (P ＞ 0.05).The positive expression rate of TNF-α protein in severe IM group was significantly higher than that in mild IM group and moderate IM group [80.0％(28/35) vs.40.0％(12/30) and 57.1％(20/35)],and there were statistical differences (P ＜ 0.05).The positive expression rate of TNF-α protein of positive Hp infection patients in gastritis group,mild IM group,moderate IM group and severe IM group were significantly higher than those of negative Hp infection patients (4/10 vs.1/20,47/63vs.13/37,10/18 vs.2/12,15/21 vs.5/14,22/24 vs.6/11),and there were statistical differences (P ＜ 0.05).Conclusions The expressions of Cdx2 and TNF-α protein and Hp infection are closely related with IM.Therefore,testing the level of Cdx2 and TNF-α protein expressions can help to judge the degree of IM,which provides a basis for reversing IM.

Objective To explore the effects of different courses of antenatal dexamethasone on brain development of premature SD rats. Methods The pregnant rats were randomly assigned to 3 groups: 3-dose dexamethasone (group 1), 1-dose dexamethasone group (group 2) and control group. The treated were sacrificed on 19 days of gestation, body and whole brain weight of the offspring rats were measured. Meanwhile the expression o{ neuron specific enolase (NSE) in brains of offspring rats was detected by immunohistochemical staining. The histological structures of baby rat brain were observed under transmission electron microscope. The differences among the three groups were analyzed by ANOVA. Results (1) The body and whole brain weight, the brain and body weight ratio were (1.543±0.052) g, (88.80±7.12) mg, and (5.75±0.38)% in group 1 and (1.584±0.035) g,(98.21±3.71) mg, and (6.20±0.26)% in group 2, both were lower than the control group [(1.696±0.076) g, (111.53±6.29) mg, (6.59±0.48)%], (P<0.01 or P<0.05, respectively). (2) The expression of NSE in cortex in group 1 and 2 were lower than that in control group (0.223±0.054, 0.381±0.041 vs 0.590±0.064) (P<0.01). The expression of NSE in hippocampi in group 1 and 2 were also lower than that in the control group (0.192±0.054, 0.359 ±0.046 vs 0.529±0.068) (P<0.01). (3) Disconnection of nuclei membrane, vacuolization in mitochondria, loss of nueleolus, and disconnection of neurofilaments were observed in the ultrastructure of baby rat brain tissue in both group 1 and 2. Conclusions Antenantal administration of dexamethasone can cause impairment of brain development in premature offspring rats and this might be related to the times of dexamethasone administered.