Objective To explore the relationship between cytogenetics with therapy and prognosis in myelodysplastic syndrome.Methods 124 cases of myelodysplastic syndrome from September 2005 to October 2009 were reviewed.124 cases contained 79 males and 45 females,aged 14 to 79 years,median age was 57 years old.26 cases were diagnosed as RA,13 cases as RAS,21 cases as RCMD,29 cases as RAEB-Ⅰ,35 cases as RAEB-Ⅱ.According to the karyotype,124 cases were divided into two groups,79 cases of normal karyotype and 45 cases of abnormal karyotype.Patients were followed up for three years in order to analyze the incidence of myelodysplastic syndrome changed into acute leukemia.Results In 39 patients diagnosed as RA and RAS,32 cases were with normal karyotype and 7 cases (17.9 ％) with abnormal karyotype.15 of 32 cases with normal karyotype achieved hematologic remission after treatment while only 1 of 7 cases with abnormal karyotype achieved remission.1 case with abnormal karyotype changed into acute leukemia after 2 years.In 85 patients diagnosed as RCMD,RAEB-Ⅰ and RAEB-Ⅱ.Difference of the lower incidences of RA and RAS changed into acute leukaemia during 3 years in normal karyotype and abnormal karyotype groups was statistically insignificant (P ＜ 0.05).The incidences of RCMD,RAEB-Ⅰ and RAEB-Ⅱ changed into acute leukemia were higher,especially in the abnormal karyotype group with 42.1 ％.Conclusion Myelodysplastic syndromea with abnormal karyotype is associated with poorer efficacy of therapy,higher incidence of changing into acute leukaemia.The patients can take early allogeneic hematopoietic stem cell transplantation to improve the prognosis.

Objective To explore ways for the supervision of department directors. Methods Job responsibility agreements with department directors were signed and a series of assessment standards were established. Results The methods adopted were standardized, individualized and easy to use. Conclusion Job responsibility agreements with department directors and a standard assessment system are currently effective measures for the supervision of department directors.

OBJECTIVE:To establish an analytical method for the determination of prednisolone and prednisolone-hemisuccinate in biological media METHODS:Using RP-HPLC,biological media were extracted with a mixture of n-pentane and methyl tert-butyl ether(2∶3) The mobile phase consisted of acetonitrile and trisodium citrate buffer (33∶67) The sample was eluted on C18 column and detected at 254nm RESULTS:The extraction recoveries of two drugs were over 80% and the RSDs of within-day and day-to-day were below 3% CONCLUSION:The method is simple,rapid,sensitive,accurate and good enough to be applied to the pharmacokinetic study of new preparation of prednisolone and can also be applied to other similar glucocorticoids

AIM: To explore the expression changes of bone morphogenetic protein-7 (BMP-7) and its receptors (BMPR-Ⅱ, ALK-2, ALK-3, ALK-6) in the renal tubulo-interstitial lesions induced by unilateral ureteral obstruction (UUO). METHODS: Rats were divided into normal control, sham operation and UUO groups, and sacrificed at postoperative day 1, 3, 7 and 14. The mRNA levels of BMP-7, BMPR-Ⅱ, ALK-2, ALK-3 and ALK-6 were examined by RT-PCR. The protein expression site and level of BMP-7 was detected by immunohistochemistry staining. RESULTS: Compared to sham operation group, the mRNA levels of BMP-7, BMPR-Ⅱ, ALK-2 and ALK-3 were significantly decreased, but the change of ALK-6 mRNA was not marked in UUO rats. The reduction of mRNA expression levels of BMP-7, BMPR-Ⅱ, ALK-2 and ALK-3 in the kidney tissue aggravated along with the delayed post-operated days. The results of immunohistochemistry staining indicated that BMP-7 mainly expressed in renal tubular and interstitial, rarely in glomeruli. In UUO rats, the protein expression of BMP-7 decreased in varying degrees according to the post-operated days. CONCLUSION: The loss of BMP-7 and its receptors (BMPR-Ⅱ, ALK-2, ALK-3) were observed in the early phase of fibrotic process and this may play a very important role in mediating the renal tubulointerstital fibrosis.

Objective Onto investigate the significance of the pleth variability index (PVI) in predicting hypotension after epidural anesthesia for cesarean delivery. Methods Sixity seven pregnant women, with ASAⅠ~Ⅱ, aged 19 ~ 34 years, were enrolled for elective cesarean delivery. SBP, BDP, MAP, HR, PI and PVI were measured at 5 min after the parturients arrived in the operation room. SBP, BDP, MAP and HR were measured every 3 min after epidural anesthesia. According to the change rate of SDP or MAP was higher than 30% or not, the parturients were divided into two groups (the hypotension group and the non-hypotension group). Results No significant differences were found in parturients'age, body height, weight, BMI, gestational weeks, SDP, DBP, MAP and HR before anesthesia between two groups. The PVI in the hypotension group was significantly higher than that in the non-hypotension group (P<0.05). A receiver operator characteristic curve analysis showed the area under curve was 0.888 when PVI was used for boundary value. When PVI over 17.35 was used as the occurrence of hypotension, the sensitivity of PVI was 0.727, and specificity was 0.895. Conclusion PVI can be used to predict the occurrence of hypotension after epidural anesthesia for cesarean delivery.

The left lateral incisor with occlusal soreness of a 30-year old female was examined and treated.Radiographic examination re-vealed periradicular radiolucency around the apical and 3 canals.The 3 root canals were treated by root canal therapy,the tooth was restored by all-ceramic crown for the prevention of fracture.12 month follow-up showed that the treatment was effective.

Objective To explore the effect of self efficacy combined with mobile health information service applied in pulmonary rehabilitation in residence in elderly patients with chronic obstructive pulmonary disease. Methods Sixty-eight elderly patients in stable situation were divided into the control group and the intervention group with 34 cases in each group accoridng to the random digit table. In the control group, the nursing intervention included health education and telephone follow-up. The intervention group adopted self efficacy theory combined with mobile health information service. The items such as persistence in pulmonary rehabilitation, Exercise Self-Regulatory Efficacy Scale (Ex-SRES) and health condition were assessed. Results After intervention for 12 weeks, the scores of persistence in pulmonary rehabilitation in residence in the intervention group scored 5.35 ±1.42, which was higher than that in the control group (2.03±1.40), the difference was significant (t=160.43, P<0.01). Ex-SRES of the intervention group scored 62.06±13.10,91.21±11.12, which were higher than those of the control group, 50.38±18.03,42.56±18.23, the difference was significant (t=9.32,176.88, P<0.01) . The interaction between treatment effects and time effect was significant in COPD Assessment of Tool (CAT) and Ex-SRES respectively(F=489.95,P=0.00;F=134.80, P=0.00). Comparing value of CAT in baseline (24.97±4.74,24.62±5.39) and at the end of the twelfth week(24.94±4.74,24.65±5.35), the difference was not significant in two groups respectively(P>0.05). The improvement of CAT was significant at the end of the twenty-forth week (21.90±4.67) in the intervention group (t=-12.09, P<0.01). Conclusions Self efficacy theory and the application of mobile health information services can help patients persist in long-term rehabilitation exercise training.

Objective To investigate iodine nutritional status of pregnant women of Taizhou City,in order to provide a basis for assessment whether normal consumption of iodized salt is needed,to take complement iodine measure and to carry out monitoring of urinary iodine and thyroid function in pregnant women.Methods Early pregnancy (gestation ＜ 4 months),medium (4 to 7 months gestation) and late (pregnancy≥8 months) of each of more than 300 pregnant women were chosen from maternal and child health (hospital) and part of the township hospitals of Taizhou City (district) from September 2012 to December 2013.Based on the principle of informed consent,disposable urine and blood samples were collected,urine iodine and thyroid hormone [serum thyroid stimulating hormone (TSH),three free triiodothyronine (FT3) and free thyroid hormone (FT4)] were measured.Urinary iodine was measured using a urinary iodine rapid quantitative detection kit,thyroid function was measured by an electrochemical method.Use 95％ of the reference value range of thyroid function in pregnant women as the basis for evaluation of thyroid function in pregnant women.Results A total of 997 pregnant women were investigated,early stage,medium-term and late pregnancy women were 302,357 and 338,respectively.The median urinary iodine was 124,129,119 μg/L,pregnant women in late pregnancy had the lowest iodine urine.The median TSH of early stage,medium-term and late pregnancy women were 2.03,2.18,2.22 mU/L;the mean FT3 and FT4 of the three groups were (4.39 ± 0.66),(4.06 ± 0.61),(3.92 ± 0.61)pmol/L and (14.56 ± 2.56),(13.08 ± 2.03),(12.70 ± 2.38)pmol/L,respectively.The rate of abnormal thyroid function was 4.91％ (49/977),mainly in subhypothyroidism [48.98％ (24/49)].Conclusions Poor iodine-nutritional status exists in some pregnant women in Taizhou City.It is necessary to strengthen the propaganda and education of pregnant women on iodine supplement knowledge in the future,and carry out routine monitoring of urinary iodine and thyroid function in early pregnancy.

OBJECTIVE: To study the effects of Naomaitong Recipe, a compound Chinese herbal medicine, on the expressions of nuclear factor-kappaB (NF-kappaB) and nitric-oxide synthases (NOSs) in brain tissue after focal cerebral ischemia reperfusion in aged rats and the dosage-effect relationship. METHODS: We adopted the middle cerebral artery occlusion (MCAO) in aged rats as the focal cerebral ischemia model, with 3-hour ischemia and 12-day reperfusion, and observed the changes of the nerve dysfunction score, the water content of cerebral constitution and the expressions of NF-kappaB, heat-shock protein 70 (HSP70) and NOSs in cerebral cortex. RESULTS: The nerve dysfunction score, the water content of cerebral constitution, the expressions of NF-kappaB, HSP70, neuronal nitric-oxide synthase (nNOS), endothelial nitric-oxide synthase (eNOS) and inducible nitric-oxide synthase (iNOS) in the untreated group were higher than those of the sham-operated group. The nerve dysfunction score, the water content of cerebral constitution, the expressions of NF-kappaB, iNOS and nNOS were lower, while the expressions of HSP70 and eNOS were higher in the high-, medium- and low-dose Naomaitong-treated groups and nimodipine-treated group than those of the untreated-group. The nerve dysfunction score and the expression of nNOS were lower, while the expression of eNOS was higher in the medium-dose Naomaitong-treated group than those of the nimodipine-treated group. The expressions of HSP70 and eNOS were higher, while the other indices were lower in the medium-dose Naomaitong-treated group than those of the low-dose Naomaitong-treated group. CONCLUSION: Naomaitong Recipe can protect the brain cells from damage after focal cerebral ischemia reperfusion injury by adjusting the expressions of NF-kappaB, HSP70 and NOSs, and the medium-dose Naomaitong Recipe is more effective.

OBJECTIVE:To determine the content of ?-schizandrin,one of the effective ingredients,in Shuangjia Wuling capsules METHODS:The RP-HPLC method was performed with YWG C18 column(4 6mm?250mm) The mobile phase consisted of methanol-water(72∶28) The detecting wavelength was 254nm RESULTS:The calibration curve for ?-schizandrin was linear in the range of 0 0 207～0 4 130mg/ml(r=0 9 999) The average recovery was 97 68% with RSD=1 85% CONCLUSION:The method is simple,rapid and reliable for quality control of the capsules