Objective To explore the antagonistic effect of Schistosoma japonicum soluble adult worm antigen (SWA)and solu-ble egg antigen (SEA)in the mice with type 1 diabetes.Methods The 24 successful modeling type 1 diabetes mice were randomly divided into three groups (A,B,C group,n=8).SWA and SEA of Schistosoma japonicum were prepared.Mice in A group were immunized by abdominal subcutaneous multi-point injection SWA.Mice in B group were immunized by abdominal subcutaneous multi-point injection SEA.And mice models of C group were immunized by PBS instead of antigen through abdominal subcutaneous injection.The mice got immunization once a week,a total of four times.4 weeks later,the mice were sacrificed,and serum speci-mens were collected for the determination of serum levels of IL-4 and IFN-γby double-antibody sandwich ELISA,while pancreas tissues were collected and the pathological changes were observed.Results The serum IL-4 level of B group [(23.87 ±4.85)pg/mL]was higher than C group [(4.39 ± 0.56 )pg/mL],with significant differences (P < 0.01 ),while the serum IFN-γ level [(271.85±26.04)pg/mL]was lower than C group [(362.79 ±32.50)pg/mL],also with significant differences (P <0.01).The serum IL-4 and IFN-γof A group were (5.09±0.37)pg/mL and (379.56±34.47)pg/mL,which had no difference with C group (P >0.05).The islet structure of mice in B group was not intact,however,the lymphocytic infiltration in B group was less than C group,and there was no lymphocytic infiltration in pancreatic islets in B group.Compared with C group,the pancreas of mice in A group did not have significant changes,lymphocytes infiltration was still visible in islets.The number of residual islet cells de-creased,and visible minority islet structure was destroyed.Conclusion SEA of Schistosoma japonicum has certain antagonism effect on type 1 diabetes in experimental mice.Its mechanism may be the reduction of Th1 response and the enhancement of Th2 response through increasing IL-4 level and decreasing IFN-γlevel.

This paper reports various cases of cerebral concussion which strongly supportthat cerebral concussion may be regarded as a graded phenomenon with practicalvalue for clinic forensic medicine.The diagnosis,neuropathological changes of the central nevous system,typing ofconcussion are discussed in this paper.The pathological changes of the brain hase been analysed.

Objective:To study the relationship between smoking and P53 protein expression in oral tumor tissue.Methods:The expression of P53 protein in oral tumor tissue was detected in 22 smoking cases and 32 nonsmoking cases by immunohistochemical SP method. SAS software was used for statistic analysis.Results:The positive expression rate of P53 protein in smokers (90.91%) was higher than that in nonsmokers (46.88%,P0.05). Conclusion:Smoking may stimulate the mutation of p53 gene and play an important role in the carcinogenesis of oral tissues.

Objective:To study the genetic toxic effect of smoking on human oral mucosa,and the DNA damage of exfoliated oral mucosa cells.Methods:The DNA damage of exfoliated oral mucosa cells was investigated by single cell gel electrophoresis(SCGE)in 12 cases of malignant tumor,19 cases of benign tumor and 10 health controls.There were 24 smokers and 17 non-smokers among them.The tail length and frequency of comet cells were used to measure DNA damage.SPSS and SAS software were used for statistical analysis.Results:Malignant tumors had a longer tail length and higher frequency of comet cells than benign tumors and health controls,and the difference was statistically significant(P0.05).The DNA damage of exfoliated oral mucosa cells in smokers was more serious than that of non-smokers(P

Objective To investigate the applicative value of enhanced 3D multi-echo GRE T2*-weighted angiography(ESWAN) sequence phase values in evaluating brain gray nuclei iron content in idiopathic restless legs syndrome(RLS) patients, providing imaging basis in diagnosis and treatment of idiopathic RLS. Methods In our institute from June 2012 to September 2016,forty-five RLS patients were selected as the RLS group, and 45 healthy volunteers as the control group. ESWAN sequence was performed and serum ferritin values were obtained in all patients and volunteers. The raw data of ESWAN was postprocessed , where the phase maps were obtained. Phase analysis was performed on localized brain gray nuclei regions of interest (substantia nigra, red nucleus, dentate nucleus, thalamus, pallidum, putamen and caudate nucleus ) selected on phase maps. Differences between the 2 subject groups were evaluated using ANCOVA including age as a covariate. Results The phase values of the substantia nigra, thalamus, pallidum and putamen in the RLS group were (-0.087 ± 0.021), (-0.053 ± 0.012), (-0.161 ± 0.008), (-0.125 ± 0.019) radians , respectively. The phase values of the substantia nigra, thalamus, pallidum and putamen in the control group were (-0.127 ± 0.007), (-0.066 ± 0.007), (-0.166 ± 0.007), (-0.150 ± 0.010) radians, respectively. There were significant differences between the two groups (F=142.492, 37.988, 10.558, 60.725;P<0.05). Indicating reduced iron content in several regions of brain gray nuclei of the patients with RLS. Serum ferritin concentration between the RLS patients (157.02±95.78)μg/L and healthy controls (175.49 ± 38.65)μg/L was not significant (F=1.353,P>0.05). Conclusions Phase values can make a quantitative assessment of brain gray nuclei iron content in RLS patients, our results supported the hypothesis of reduced brain iron content in RLS patents , which may have an important role in the pathogenesis of the disorder. However, iron content change in some brain regions was not correlated with serum ferritin concentration changes.

Objective To investigate the mastery of clinical students' doctor-patient communi-cation skills and to assess the teaching effectiveness about the doctor-patient communication, and then propose some improvement ideas. Methods We conducted a study in students of clinical medicine of Nanjing Medical University in Grade 2009, using Objective Structured Clinical Examination (OSCE) after internship, which included graduation assessment of doctor-patient communication skills. Then we analyzed the doctor-patient communication skills and related scores of students trained in different clinical medical programs. Results The average score of doctor-patient communication skills of 549 students was (82.72±4.23), of which, the average score of 329 five-year students of clinical medicine was (81.88±4.23) and the average score of seven-year students was (83.96±3.91) in. The average score of seven-year students of clinical medicine was significantly higher than five-year students (P=0.000). Moreover, there was a significant positive correlation between the total score of OSCE and the score of doctor-patient communication skills in both five-year and seven-year students of clinical medicine (five year program students' score correlation coefficient was 0.520, P=0.000;seven year pro-gram students' score correlation coefficient 0.416, P=0.000). Conclusion The teaching effectiveness of doctor-patient communication has proved to be quite effective, and it is definitely of great significance in improving clinical students' doctor-patient communication skills. The score of the assessment of the doctor-patient communication reflects not only the training effectiveness of the communication skills, but also the comprehensive capacity.

Objective: To observe the clinical efficacy of needling nape acupoints in the treatment of pseudobulbar palsy. Methods: One hundred and twenty cases of pseudobulbar palsy were randomized into two groups, a treatment group in which 60 cases were treated by needling nape acupoints and a control group in which 60 cases were treated by needling tongue acupoints; after one-month treatment, the clinical symptoms and signs were observed. Results:The cure rate and total effective rate were respectively 41.7% and 90.0% in the treatment group,and respectively 26.7% and 81.7% in the control group, with differences in the cure rate and total effective rate between the two groups (P＜0.01). Conclusion: Needling nape acupoints is quite effective to treat pseudobulbar palsy in the relief of clinical symptoms and signs.

Objective To observe the effects and safety of rapamycin (Rap) in combination with cyclosporine A (CsA) and steroid (Pred) as triple regimen for prevention of acute rejection after renal transplantation.Methods Fifty patients with de novo cadaveric kidney allograft were randomized into two groups. In the study group there were 30 patients treated with Rap, CsA, and Pred, while in the control group there were 20 patients with conventional triple therapy of azathioprine (Aza), CsA, and Pred. Same dosages of CsA and Pred were used in both groups. Any adverse event after treatment was observed and recorded in detail. The laboratory investigations were checked and analyzed periodically.Results The pre-protocol population included 26 patients in study group and 18 patients in control group. The 2-year patient and graft survival rates in both groups were 100 %. The incidence of acute rejection was 3.7 % (1/27) in study group, 25 % (5/20) in control group, respectively. All episodes of acute rejection were reversed by methylprednisolone. The trough levels of CsA kept same in both groups, but CsA dose in study group was lower than that in control group. Blood concentrations of total cholesterol and triglyceride in study group were higher than those in control group. Conclusion Rap is an effective and safe immunosuppressive drug for prevention of acute rejection after renal transplantation. Rap combined with CsA allows reducing the dose of CsA. But its main side effect is hyperlipidemia.

Objective To explore risk factors of type 2 diabetes mellitus in suburban of Tianjin.Methods A frequently matched community-based case-control study was conducted in Tianjin suburb.The multi-phasic stratified cluster sampling method was adopted.Finally 9 961 people were selected as study subjects.All of 585 patients with type 2 diabetes mellitus were recruited as cases,and 620 persons without type 2 diabetes mellitus were chosen as controls.The two groups were frequently matched by age and sex.Results Family history of diabetes mellitus(OR=2.671),depression(OR=3.759),higher level of BMI(OR=1.502) and WHR(OR=1.740),history of hypertension(OR=2.016),history of hyperlipoidemia(OR=1.867),were risk factors for type 2 diabetes mellitus while increased the risk of type 2 diabetes.And increasing intake of fruits(OR=0.736) was shown to be reversely associated with diabetes mellitus.Conclusions Family history of diabetes mellitus,depression,overweight,central obesity,history of hypertension,history of hyperlipoidemia were risk factors of type 2 diabetes mellitus in suburban of Tianjin,while increasing intake of fruits was shown to be a protective factor of diabetes mellitus.

Objective To understand the feedback of seven-year students of clinical medicine about the application of PBL teaching method and investigate its related factors.Methods Four classes of seven-year students of clinical medicine of Nanjing Medical University which had received PBL teaching method were randomly selected in grade 2009 and 2010 (243 students)and 233 valid questionnaires were analyzed statistically.The questionnaire has four main parts and they are about basic situation,factors that may affect the PBL Teaching,students' subjective attitude,their effect evaluation and suggestion for improvements.SPSS 11.0 was used to analyze the first part of the resuhs withx2 analysis(P＜0.05).Results 233valid questionnaires were recovered and 79.0％(184/233) of students held a favorable position toward PBL application in their course.It is irrelevant to no other related factors but the accessibility of information(P=0.000).More than half of the students think it is suitable for PBL on the clinical medical students(57.5％,134/233),PBL teaching is more free and easy(51.9％,121/233)and can improve their awareness of participation(72.5％,169/233).However more students (193) are in favor of more traditional teaching combined with PBL,with the former dominated.Conclusion PBL teaching method in seven-year clinical medical program has been proved to be quite effective.Though with certain drawbacks,it is a good supplement to the traditional teaching methods in many aspects,and it is definitely of great significance in improving the quality of teaching.