OBJECTIVE:To investigate the effects of aerosol inhalation of budesonide combined with Compound ipratropium bromide on therapeutic efficacy and safety of patients with pneumoconiosis during perioperative period of massive whole-lung la-vage (WLL). METHODS:One hundred and fifty male patients with pneumoconiosis receiving WLL under general anesthesia se-lected from our hospital during Dec. 2014-May 2016 were divided into treatment group and control group in accordance with ran-dom number table,with 75 cases in each group. Both groups received WLL under general anesthesia as well as pure-oxygen manu-al positive pressure ventilation alternating with negative pressure drainage keeping interval and respiratory rate of ventilator synchro-nization. Treatment group was given Budesonide suspension 2 mL,bid+ Compound ipratropium bromide solution 2.5 mL,tid,by aerosol inhalation from 3 d before surgery to 3 d after surgery. The levels of arterial blood gas indexes(pH,PaO2,PaCO2,BE)at different lavage stages,lung function indexes (FVC,MVV,FEV1/FVC),blood gas indexes and clinical symptom score 3 d be-fore surgery and 7 d after surgery were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:After two-lung ventilation for 20 min following unilateral/bilateral lung lavage,PaO2 of 2 groups were all increased significantly compared to be-fore surgery,with statistical significance (P<0.05);but there was no statistical significance between 2 groups (P>0.05). three days after surgery,FVC,MVV,FEV1/FVC and PaO2 of 2 groups were all increased significantly,PaCO2 and clinical symptom score were all decreased significantly. FVC,FEV1/FVC,PaO2 and clinical symptom score of treatment group were significantly bet-ter than those of control group,with statistical significance(P<0.05). The incidence of airway spasm,hypoxemia and airway pres-sure increasing in treatment group were significantly lower than in control group,with statistical significance(P<0.05). CONCLU-SIONS:During perioperative period of WLL,the aerosol inhalation of budesonide combined with Compound ipratropium bromide for patients with pneumoconiosis can improve clinical efficacy of WLL and reduce the occurrence of ADR during surgery.

In the process of pathology teaching,the teacher can apply various methodologies and techniques to form student-oriented situation,to raise their interest in this discipline,to have the students actively involved in this learning process.In this way,the students become the subjects of the class so that the quality of pathology teaching can be improved.

Various teaching methods can be applied comprehensively to the teaching of oral histopathology. The authors make a probe into the function and significance of flexible introduction of such means as enlightened approach to teaching,metaphorical teaching method,multimedia teaching method. The paper insists that these methods will bring many benefits in that they will help to promote students’autonomous learning,stimulate their thinking,cultivate their competence for observation and analysis,broaden their vision,and consequently improve the teaching quality.

Objective:To investigate the serum level of C-C chemokine ligand 19 (CCL19)and its clinical significance in rheumatoid arthritis.Methods:The serum CCL19 levels in both rheumatoid ar-thritis (RA)patients and health controls were detected by ELISA.The proportion of peripheral blood B cells and memory B cell subsets were also detected in some patients.Then the clinical and laboratory data of the patients were collected.The CCL19 levels in patients with different clinical features were analyzed. And the correlation between the clinical data,laboratory parameters,B cell subsets proportion and serum CCL19 levels were also analyzed.Independent samples t test,paired t test,Pearson and Spearman corre-lation were used for statistical analysis.Results:The levels of CCL19 was higher in the RA patients than the health controls (P <0.05).The serum CCL19 levels were decreased in the RA patients who accep-ted disease-modifying anti-rheumatic drugs (DMARDs)treatment for 6 months (P <0.001 ).Serum CCL19 levels were correlated with the titers of both rheumatoid factor (RF)and anti-cyclic citrullinated peptide (CCP)antibody (r =0.42,P =0.002;r =0.33,P =0.013),but not with erythrocyte sedi-mentation rate (ESR),C-reactive protein (CRP)and disease activity score in 28 joints (DAS28)(P >0.05).The levels of CCL19 were higher in the serum positive (RF and anti-CCP antibody)patients,but there were no differences between low and high disease activity RA,as well as early and non-early RA. There was no correlation between the serum CCL19 levels and the proportion of B cells as well as memory B subsets.All the proportion of peripheral blood CD27 + memory B cell subsets in RA was lower than the healthy controls,including CD27 +IgD +,CD27 +IgD - and CD27 + B cells.Conclusion:The increased serum CCL19 levels in RA patients are associated with the activity of B cells,so CCL19 might predict whether the RA type is a B cell mediated RA,and specify the treatment directions for the rheumatologist.

OBJECTIVE To observe the protective effect and underlying mechanism of total ginsenosides (TG) on bleomycin-induced pulmonary fibrosis. METHODS Intratracheal instillation of bleomycin 5 mg · kg-1 was conducted to establish a pulmonary fibrosis mouse model. Kunming mice(1/2 males and 1/2 females)were randomly divided into sham-operation(Sham),model,total ginsen?osides 40,80 and 160 mg·kg-1 and prednisone acetate(5 mg·kg-1) groups. After 28 d administration,the histopathological changes in the lung were analyzed by hematoxylin eosin(HE)and Masson staining. The exprssion of alpha smooth muscle actin(α-SMA)in the lung was detected by real-time PCR. The content of hydroxyproline(HYP)and glutathione(GSH),level of total antioxidant capacity(T-AOC)and hydroxy radical(·OH),activity of myeloperoxidase(MPO)and nitric oxide synthase(NOS)in the lung were detected by corresponding kits. RESULTS Compared with the sham group,the pulmonary indexes in model group were significantly increased(P<0.01),alveolitis and pulmonary fibrosis were obvious. The mRNA expression ofα-SMA,content of HYP and · OH,activity of MPO and NOS were increased(P<0.05),but the content of GSH and T-AOC in model group was decreased(P<0.05). Compared with model group,the pulmonary indexes in TG 80 and 160 mg · kg-1 and prednisone acetate 5 mg · kg-1 groups were reduced(P<0.05),and the degree of alveolitis and pulmonary fibrosis was mitigated. The mRNA expression ofα-SMA,content of HYP and · OH, the activity of MPO and NO were decreased (P<0.05),while the content of GSH and T-AOC was increased(P<0.05). CONCLUSION TG can improve the degree of mice pulmonary fibrosis induced by bleomycin. The mechanism may be related to the increased antioxidant capacity of organisms.

Objective To investigate the method to isolate and culture hepatic stellate cells ( HSCs) for studying the cellular mechanisms of hepatic frbrosis.Methods HSCs were isolated by nycodenz density gradient centrifugation after the hepatocytes obtained from adult male gebils were digested with pronase, collagenase and DNase, infused via portal vein.The cell viability was determined by trypan blue exclusion test.The purity of HSCs was identified by detectingα-SMA, desmin immunohistochemical staining.Results The yield rate of HSCs was 0.5~1 ×107 per gerbil liver, and the cell viability was more than 90%.The percentage ofα-SMA-positive cells was more than 75%after 3 days primary culture and almost 100% cells were α-SMA and desmin positive in passage culture.Conclusion The successful protocol of primary culture of Mongolian gerbil HSC provide a technical support for research of relevant liver diseases and drug development in the future.

Objective This study is designed to determine whether an association exists between single nucleotide polymorphism (SNP) variant rs2252673 of insulin receptor(INSR) gene and polycystic ovarian syndrome (PCOS) in Han Chinese in order to identify INSR as a genetic susceptibility factor for PCOS.Methods A total of 224 women with PCOS,192 controls and 672 participants consisting of 224 trios (mother,father and offspring with PCOS) were recruited from the Hospital for Reproductive Medicine Affiliated to Shandong University,from July 2007 to April 2013.Genomic DNA was extracted according to the manufacturer' s protocol.SNP rs2252673 of INSR gene was amplified by PCR and then sequenced on an automated sequencer.Moreover,clinical and metabolic features of the patients with PCOS were compared according to the genotypes.The subjects were divided into twot groups according to body mass index (BMI),and then the results were compared between two groups.And the transmitted disequilibrium test (TDT) was applied for data analysis.Results (1) There were three kinds of genotype of CC,CG and GG.Genotype frequencies of rs2252673 were 8.0％,38.8％,53.1％ and 14.6％,42.2％,43.2％ in the PCOS group and the control group,respectively.The allele frequencies of C and G were 27.5％,72.5％ and 35.7％,64.3％ in the PCOS group and the control group,respectively.There were statistical differences in genotype frequencies and allele frequencies between two groups (all P＜0.05).(2)No significant differences were observed in the different genotype according to clinical and metabolic characteristics of women with PCOS (P＞0.05).But when merging the genotype CG and GG,carriers of the CG and GG genotypes in women with PCOS were slightly associated with total cholesterol (TC) levels (t=2.072,P=0.048) and lower high-density lipoprotein (HDL) levels (t=2.274,P=0.026).Although statistical significance was not achieved,there was an increased tendency in fasting blood glucose (FBG) and fasting insulin (FINS) levels in CG and GG genotypes in PCOS cases.(3)Between the obesity and the non-obesity with PCOS,there was no statistical significance in the genotype and allele frequencies (x2=0.054,P=0.974; x2=0.022,P=0.883).(4)The results of families based analysis shown that genotype distribution of the SNP rs2252673 was in Hardy-Weinberg equilibrium (P＞0.05).After the TDT,the G allele in SNP rs2252673 was over transmitted in families (transmitted∶ non-transmitted=120∶ 88; x2=4.923,P=0.027).There was a transmitted disequilibrium in rs2252673,which implies the association of INSR and PCOS were independent of population stratification.Conclusions There were a association between the SNP variant rs2252673 of INSR gene and the susceptibility to PCOS in Han Chinese women,which was independently of body mass index.The carrier of G allele frequency of rs2252673 may have higher risk of PCOS.

Objective To investigate the methylation status in the promoter region of Dickkopf-3 (Dkk3) gene in patients with myelodysplastic syndromes (MDS),and to initially explore the relationship between the methylation of this gene and survival time.Methods Methylation-specific PCR (MSP) was applied to measure the promoter methylation of Dkk3 gene in 43 bone marrow or peripheral blood samples of MDS patients.As controls,70 normal peripheral blood samples from general outpatients were examined.Results In 43 patients with MDS,7 patients (16.3 ％) showed Dkk3 gene methylation.And 5 of them were semi-methylation status,2 of them were exhaustive methylation status.In 70 controls,1 showed Dkk3 gene semi-methylation.The frequency of methylation in MDS patients was significantly higher than that of controls (x2 =8.93,P =0.005).In the Dkk3 methylation group,2/7 were from bone marrow and 5/7 were from peripheral blood.Meanwhile,2 patients were RA,1 patient was RCMD,4 patients were RAEB.There was no significant difference between the different sample source (bone marrow or peripheral blood) for the results of the methylation status (x2 =0.051,P =0.821).Either between the different sex,age,type,chromosome and WPSS score (P ＞ 0.05).The progress of disease didn't influence the methylation frequency (P ＞ 0.05).The smvival analysis showed no relationship between the methylation of this gene and smvival time.Conclusions In this MDS group,there is high level of methyl-modification in Dkk3 gene.The methylation of Dkk3 might be one of the molecular mechanisms that contribute to the progress of patients with MDS.The peripheral blood sample maybe a better substitute in detective of Dkk3 with MDS.

OBJECTIVE To investigate whether it is essential to utilize prophylactic antibiotics in patients with gynecologic surgery type Ⅰincision.METHODS Antibiotics were applied prophylactically to 112 patients in the study group,while 101 cases in the control group were treated without antibiotics.The postoperative infection rate,the hemogram,the incision healing rate,the duration in hospital,hospital fees and so on were analyzed.RESULTS The postoperative infection rate,the incision healing rate and other items were compared in the two groups.No significant difference was found ststistically.CONCLUSIONS Prophylactic antibiotics are not necessery in patients with gynecologic operation type Ⅰ incision during perioperative periods.

Objective To compare the difference in risks of obstetric complications of singleton pregnancy between women with hyperandrogenic polycystic ovary syndrome (PCOS) and women with normoandrogenic PCOS. Methods Prospective cohort study. This study was a secondary analysis of data collected during a multicenter randomized controlled clinical trial. Women who got clinical singleton pregnancy were grouped according to whether they were diagnosed with hyperandrogenism at baseline. There were 118 women with hyperandrogenism and 366 women without hyperandrogenism. The incidences of obstetric complications and birth weight were compared between the two groups. Results Women with hyperandrogenic PCOS had a significantly higher risk of preterm delivery than women with normoandrogenic PCOS [12.7％ (15/118) versus 3.6％ (13/366); OR=3.94, 95％CI: 1.82-8.56]. After adjustment of age, duration of infertility, body mass index, and fresh or frozen embryo transfer group, hyperandrogenism was still associated with an increased risk of preterm delivery (OR=3.67, 95％CI: 1.67-8.07). Compared with women with normoandrogenic PCOS, women with hyperandrogenic PCOS had similar risks of pregnancy loss, gestational diabetes mellitus, pre-eclampsia, placenta previa, and postpartum hemorrhage (all P>0.05). Birth weight as well as the risks of being small for gestational age and large for gestational age were also comparable between the two groups (all P>0.05). Conclusion In women with PCOS and singleton pregnancy, those with preconceptional hyperandrogenism have a higher risk of preterm delivery than those without hyperandrogenism.