Objective To investigate the effects of penehyclidine hydrochloride (PHCD) pretreatment on hypoxia-inducible factor-1alpha (HIF-1α) expression in lung tissues in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods One hundred and twenty female Sprague-Dawley rats,weighing 180-220g,were randomly divided into 3 groups (n =40 each):control group (group C),ALI group and PHCD pretreatment group (group P).ALI was induced by intraperitoneal LPS 5 mg/kg in ALI and P groups.The equal volume of normal saline was given intraperitoneally in group C.Group P received intraperitoneal PHCD 2 mg/kg at 30 min before LPS administration.Eight rats in each group were chosen at 2,4,8 and 24 h after LPS administration,and the lung was removed for determination of HIF-1α mRNA expression in lung tissues by RT-PCR.Eight rats in each group were chosen at 6 h after LPS administration,and the lung was removed for determination of W/D lung weight ratio and IL-6 content (by ELISA) and for microscopic examination.Results The W/D lung weight ratio and IL-6 content at 6 h after LPS administration and HIF-1α mRNA expression at each time point after LPS administration were significantly higher in groups P and ALI than in group C (P ＜ 0.05),and lower in group P than in group ALI(P ＜ 0.05).The pathological damage was significantly ameliorated in group P as compared with group ALI.Conclusion PHCD can reduce LPS-induced ALI through down-regulation of HIF-1α expression in lung tissues and inhibition of the inflammatory response in rats.

Objective To investigate the efficacy of bend-assisted laparoseopie fight bemicolectomy for right colon carcinoma in elderly obesity patients. Methods 20 obesity eases undergoing hand-assisted laparoscopic right bemicolectomy were retrospectively reviewed, and compared with 25 obesity cases with transabdominal right hemicolectomy in the same period. The safety, recovery, eradication and stress reaction were compared. Results In hand-assisted laparoscopic group, there were less bleeding loss, rapid recovery to normal temperature and gastrointestinal function,ont of bed activity, short-time hospitalization compared with transabdominal group(P <0.01). There were no differences in operative time, numbers of lymph nodes removed, postoperative complications and length of specimen between two gronps(P > 0.05). CRP, IL-6, adrenocorticotrophic hormone (ACTH) and cortisol were more significantly increased in two groups after operation than before operation (P < 0. 05) , and this increase was moreprominent in transabdominal group than in hand-assisted laparoacopic group (P < 0.05). Conclusion Hand-assis-ted laparoscopic right hemicolectomy is a safe and effective way for elderly obesity patients,especially in postoperative recovery and physical stress reaction.

Objective To explore motivation alteration influencing factors of internet addiction disorder (IAD) undergraduates.Methods The study sampled randomly 793 undergraduates from China University.According to CIAS-R and Young's internet addiction diagnostic criteria,a total of 37 internet addicts were selected.Internet addiction survey was used to study the motivation alteration influencing factors of IAD undergraduates.Results (1) The negative effect of internet using on academy,personal relationship etc.(damage from internet using) had a significant positive correlation with motivation alteration (r =0.672,0.699,0.658,P ＜ 0.01 ; r =0.653,0.673,0.628,P ＜ 0.01 ; r =0.604,0.681,0.703,P ＜ 0.01).(2) Benefit from psychological satisfactory level of internet using had no significant difference with motivation alteration.(3) Self-efficiency of behavioral control on using internet had a significant negative correlation with motivation alteration (r =-0.397,-0.370,P ＜0.05).Conclusion The motivation alteration of IAD undergraduates is influenced by the factors of damage from internet using,sense of achievement,self-efficiency of behavioral control on using internet and so on.

Objective To investigate the clinical value of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and red blood cell distribution width in discriminating disease activity of rheumatoid athritis.Methods Eighty-nine rheumatoid arthritis out-patients of the Affiliated Hospital of Jiangsu University from Jan.2012 to Mar.2013 were recruited into this study.The disease activity index,such as swollen joint count and tender joint count were made by rheumatologists,and laboratory parameters（blood cell analysis,erythrocyte sedimentation rate and C-reactive protein) were measured as well.The enrolled patients were divided into the active RA group and remission RA group based on the DAS28 definition.Differences of NLR,PLR and RDW among groups were analyzed by t test and relations between variables were assessed by Spearman correlation analysis.The t test,non-parametric test and Spearman analysis were used for statistical analysis.Results The levels of NLR (3.2±2.0,2.4±0.9,respectively) and PLR (167±70,133±43,respectively) in active RA group were higher than that of the RA remission group (t=2.28 and 2.50,P=0.02 and 0.01).The level of RDW [(13.9±2.5)％,(13.9±2.4)％,respectively] was not significantly different between the active RA group and the RA remission group (t=0.14,P=0.89).However,compared with healthy controls,the level of RDW [(13.9±2.5)％,(13.2±0.2)％,respectively] was significantly increased in RA patients (t=2.74,P=0.006 9).NLR and PLR were positively correlated with DAS28 (r=0.23,P=0.03;r=0.26,P=0.04,respectively),ESR (r=0.28,P=0.03;r=0.43,P＜0.01,respectively) and CRP (r=0.33,P=0.006;r=0.41,P＜0.01,respectively).However,there was no association between RDW and DAS28 (r=0.01,P=0.93),ESR (r=0.20,P=0.15) and CRP (r=0.05,P=0.71).Areas under curve of receiver operating characteristic (ROC) for assessing disease activity of rheumatoid athritis by NLR and PLR were 0.802 and 0.753 respectively.The cut-off values for discriminating active/remission RA were 2.86 and 143.05,with the sensitivity as 0.66 and 0.63,specificity as 0.72 and 0.65.Conclusion NLR and PLR are significantly associated with the disease activity of RA and can be useful to understand the activity state of the illness.

Objective To investigate the association of vitamin D receptor gene (Apa1,Bsm1,Taq1) polymorphisms with autoimmune liver diseases risk.Metiods Case control test documents were retrieved through Pubmed,Ovid,Medline,and Web of science databases,according to the inclusion and exclusion criteria included in this study.The design of experiments,the characteristics of the object of study,research results was excerpted,STATA version 12.0 software were used.The correlation intensity was demonstrated with odds ratio (OR) and 95％ confidence interval (CI).Results A total of 6 publications containing 9 studies (7 studies about primary biliary cirrhosis,2 studies about autoimmune hepatitis) published from January 2000 to February 2012 were identified and 844 cases and 1 522 controls were included.The combined results based on all studies showed that there was a statistically significant link between Apa 1 and autoimmune liver diseases (OR =0.85,95％ CI 0.74-0.96,P =0.058,for a vs.A; OR =0.75,95％ CI 0.58-0.97,P =0.212,for aa vs.AA;OR =0.78,95％ CI 0.63-0.98,P =0.235,for Aa vs.AA; OR =0.77,95％ CI 0.63-0.94,P =0.231,for Aa/aa vs.AA),while the Bsm 1 and Taq 1 didn' t show the association with autoimmune liver diseases.Conclusion The current meta-analysis shows that Apal may be a low-penetrant risk factor for autoimmune liver diseases.Bsm1 and Taq1 don't show the association with autoimmune liver diseases.

Objective To analyze the X -ray, CT, and MR imaging findings in osteoid osteoma. Methods Forty-eight cases of osteoid osteoma proved by surgical pathology were collected, including 33 males and 15 females. Among the 48 cases, all patients had plane films, 32 were imaged with CT scanning, 10 with MR imaging, and 8 with all three techniques. The imaging findings of osteoid osteoma and the ability of X-ray, CT, and MRI in demonstrating the nidus and the surrounding reaction were analyzed. Results The imaging manifestations of osteoid osteoma revealed a circular or oval nidus with different bone sclerosis around the nidus. The diameters ranged from 0.4 cm to 1.7 cm, with the average of 9.7 cm. There were also soft tissue and bone morrow edema around the nidus or distinct effusion of joint on MR imaging in all 10 cases. Among 48 cases, only 37 cases showed nidus on plane film. All 32 cases with CT scanning showed nidus. The display ratios of nidus were 77% for X-ray and 100% for CT, respectively. 10 cases with MR imaging could be diagnosed correctly. But the nidus could be affirmed in only 8 cases, and the nidus was affirmed by comparing with plane film or CT in the other 2 cases. Conclusion Nidus is the key in diagnosing the osteoid osteoma correctly. Plane film is still an important checking method for osteoid osteoma. CT scan is the best method to demonstrate the nidus. MRI can demonstrate the soft tissue and bone morrow edema around the nidus sensitively, but probably lead to an incorrect diagnosis. Combining with X-ray or CT, MRI can make an accurate diagnosis.

Obejective: To investigate the islet functions and free radical metabolism of different Se-deficient rat models induced by diet control and chemical drugs and improve the animal model research of roles of oxidative stress in islet ? cell lesions in nutritional field. Methods: The Se-deficient rat models and DM model on the basis of Se-deficient rats were made respectively with natural, artificial semisythetic diets, and the injection of streptozotocin into the Se-deficient rats. Both the free radical metabolism of pancreas and ? cell functions in all rat mode ls were observed by biochemistry and radioimmunoassay. Results: T he decrease of GSH-Px, SOD activities and increase of LPO,MDA contents followed the decreased insulin level not only in serum but also in pancreas in almost all Se-deficient rat models. The supplementation of either Se or VE significantly decreased the contents of LPO, MDA and increased the insulin contents as well as the activities of antioxidant enzymes in serum and pancreas of the rats. Comclusion: The diabetes mellitus animal model induced on the basis of Se-deficient and by multiply and low doses injection of STZ is more useful for investigation of DM in nutritional fields.

Objective To investigate the effect of penehyclidine hydrochloride on endotoxemiainduced intestinal injury in neonatal rats.Methods Ninety healthy neonatal Sprague-Dawley rats,aged 7days,weighing 16-20 g,were randomly divided into 3 groups (n =30 each) using a random number table:control group (group C),lipopolysaccharide (LPS) group,and penehyclidine hydrochloride group (group P).Endotoxemia was induced by intraperitoneal LPS 5 mg/kg in LPS and P groups.In group P,penehyclidine 2 mg/kg was injected intraperitoneally at 30 min before and after LPS injection.The equal volume of normal saline was given in group C.At 2,6 and 12 h after LPS or normal saline administration,10 rats in each group were randomly chosen and sacrificed.The ileum was removed to detect wet/dry lung weight ratio (W/D ratio) and contents of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),hypoxia-inducible factor 1 alpha (HIF-1α) and glutamine (Gln),and for examination of the pathologic changes of the ileum with light microscope.Results Compared with group C,the W/D ratio and contents of TNF-α,IL-6 and HIF-1α were significantly increased,and the content of Gln was decreased at each time point in LPS and P groups.Compared with group LPS,the W/D ratio and contents of TNF-α,IL-6 and HIF-1α were significantly decreased,the content of Gin was increased at each time point,and the pathologic changes of the ileum were mitigated in group P.Conclusion Penehyclidine hydrochloride can reduce endotoxemia-induced intestinal injury in the neonatal rats,and down-regulated expression of HIF-1α,up-regulated expression of Gln and attenuated inflammatory responses may be involved in the mechanism.

Objective To explore the relationship between case mix index ( CMI ) and the bed allocation in clinical departments, and to evaluate the performance of bed scale of departments at tertiary hospitals based on CMI. Methods Based on the HIS system of a tertiary hospital, the authors collected the disease treatment information and bed allocation information of each clinical department in 2015. The CMI value was calculated by means of diagnosis-related group( DRG) , while the proportion of cases and average daily beds occupancy corresponding to the quartile of the CMI value of each department was also counted. Then the bed occupancy and distribution of various patients were analyzed. Results The hospital′s overall CMI value, DRG groups, DRG cases at the departments, days of stay, DRGs, CMI values and its quartiles were calculated. It was found that the medical and surgical CMIs had a linear relationship with the critical proportion (r=0. 998, 0. 996, P<0. 001). The main influencing factors of average daily bed occupancy were ranged from high to low as followed: the number of cases that were allocated in the group, employee numbers and CMI (F=87. 656, P<0. 001). Conclusions CMI is an ideal indicator for the difficulty of medical services at different departments and for evaluating the bed scale performance. Hence it can be used as an important reference for bed number adjustment in hospitals.

The formative assessment system has been applied to the internship education for the clinical anesthesia with the aim to improve students' initiative and to evaluate their outcomes more compre-hensively. The students' performance in the shift exchange, case discussion, raising question, solving question at the time points of after the preclinical train, one month and 3 months into the anesthesia internship, and after the completion of internship, and their capability in preoperative patient assessment, condition report, clinical practice, review writing have been evaluated to determine the educational quality and to instruct the improvement of educational approach. Assess process takes into account both the individuality and the gen-eral character of the students and feedbacks the evaluation result to improve the practice teaching The im-plementation of the evaluation can promote students' autonomous learning and comprehensively evaluate students' practice process.