OBJECTIVE:To investigate the expression difference and its mechanism of miR-497 and miR-34a in platinum-sen-sitive and platinum-resistant epithelial ovarian carcinoma(EOC)patients. METHODS:A total of 72 EOC patients underwent ovari-an cancer staging surgery or cytoreductive surgery were selected from department of gynaecology and obstetriscs of our hospital dur-ing Jan. 2008-Jan. 2012. They received standardized platinum chemotherapy after surgery and were followed up (during Jul.2008-Jul.2016). According to the sensitivity to platinum,those patients were divided into platinum-sensitive group (42 cases) and platinum-resistant group (30 cases) . Real-time fluorescent quantitative PCR was adopted to detect the expression of miR-497 and miR-34a in tumor tissue,and the relationship of it with total survival period was investigated. The levels of DNA methylation of miR-497 and miR-34a promoter region were determined by nest type land type methylation specific PCR. Western blot assay was used to detect the H3K9 dimethylation(H3K9me2)levels. The H3K9me2 levels of miR-497 and miR-34a promoter region were de-termined by chromatin immunoprecipitation method. RESULTS:The expression levels of miR-497 and miR-34a in platinum-sensi-tive group were significantly higher than platinum-resistant group,with statistical significance (P<0.05). Total survival period of 72 patients was(45.7±17.5)months,which was positively correlated with the expression levels of miR-497 and miR-34a(r2 were 0.2714,0.3782,P<0.01). The DNA methylation of miR-497 and miR-34a promoter region in platinum-resistant group was signif-icantly higher than platinum-sensitive group,and H3K9me2 level of promoter region was significantly higher than platinum-sensi-tive group,with statistical significance (P<0.05 or P<0.01). H3K9me2 levels of platinum-resistant group were slightly higher than that of platinum-sensitive group,but there was no statistical significance (P>0.05). CONCLUSIONS:The expression of miR-497 and miR-34a in tumor tissue of EOC patients are related to the sensitivity of platinum chemotherapy and the survival time of patients. DNA methylation and histone methylation of promoter region may be one of the mechanisms of their expression changes.

Objective To evaluate the clinical significance of detecting serum anti-Saccharomyces cerevisiae antibody (ASCA)IgG and IgA in the diagnosis of Crohn′s disease(CD).Methods A total of 51 patients with CD were enrolled as CD group and 22 healthy volunteers as healthy control group.The serum samples of both groups were collected.ASCA-IgG and ASCA-IgA were determined with enzyme linked immunosorbent assay (ELISA).According to Montreal standard,patients with CD were divided into subgroup according to the age of onset (A),lesion (L),clinical behavior (B).The sensitivity, specificity and positive predictive value of both groups were calculated.Chi-square test was performed for count data analysis.Results The sensitivities of ASCA-IgG and ASCA-IgA in CD group were 45 .1 % and 35 .3%,respectively,while in the healthy control group which were 0 and 9.1 %,respectively.There were significant differences between two groups (χ2 =14.49 and 5 .31 ,both P <0.05 ).The specificities and positive predictive values of ASCA-IgG in CD group were both 100.0%,and those of ASCA-IgA were 91 .0% and 90.0%.The sensitivities of ASCA-IgG in A1 ,A2 and A3 groups were 75 .0%,36.4% and 57.1 %,respectively,and those of ASCA-IgA,were 25 .0%,30.3% and 50.0%,respectively.The sensitivities of ASCA-IgG in L1 ,L2 and L3 groups were 38.5 %,37.5 % and 57.1 %,respectively,and those of ASCA-IgA were 30.8%,31 .3% and 42.9%,respectively.The sensitivities of ASCA-IgG in B1 , B2 and B3 groups were 45 .2%,50.0% and 25 .0%,respectively,and those of ASCA-IgA were 29.0%, 50.0% and 25 .0%,respectively.There was no significant difference in the sensitivities of ASCA-IgG and IgA between the subtgroups of CD group (all P >0.05 ).The sensitivities of ASCA-IgG in CD patients with complications and without complications were 56.3% and 26.3%,respectively,and there was significant difference (χ2 =4.31 ,P <0.05).Conclusions Serum ASCA-IgG is not suitable for population screening,however it has certain value for the differential diagnosis of CD.The clinical value of detecting ASCA-IgG is higher than that of detecting ASCA-IgA.

Aim To study the effects of HSP70 on hepatic ischemia-reperfusion injury after heat preconditioning in rats.Method To establish the models of the hepatic ischemia-reperfusion injury. 42 Wistar rats were randomly divided into 6 groups, (each group had 7 rats): normal group(N); quercetin injection group(Q); ischemia-reperfusion group(I); heat preconditioning 16 hours before ischemia-reperfusion group(H+I); quercetin injection before heat preconditioning group(Q+H+I); quercetin injection before ischemia-reperfusion group(Q+I).We detected the activity of serum enzyme of ALT,AST and the pathological changes of the liver;The expressions of HSP70 of the rats were observed by Western blotting. Results The expressions of HSP70 from high to low were:group H+I,group I,group Q+H+I,group Q+I,group Q,group N; The serum levels of ALT and AST from high to low were: group Q+I,group I,group Q+H+I,group H+I,group Q,group N;All groups had visibly hepatic histological changes respectively.Conclusion The protection of heat stress pretreatment from ischemia reperfusion injury was possibly performed by inducing the expression of HSP70.

Objective To investigate the features of vascular damage in metabolic syndrome (MS) by a comparison of changes in vascular structure and function between spontaneous hypertension (SH) and MS in rats. Methods Pathological study of changes in arteries was carried out. The contractile response of aorta ring and the expression of RhoA, ROCK, eNOS and iNOS were also determined. Results Besides the thickening of arterial wall and proliferation of both intima and smooth muscle layer, marked infiltration of inflammatory cell appeared in large and medium arteries of MS rats, and obvious hyaline degeneration was found in mesenteric arterioles. Moreover, the relaxant response of aorta ring was weakened markedly in MS rats, while the contractile response increased in SH rats dramatically. The expression of RhoA, ROCK increased and that of NOS decreased in MS rats, but the up-regulation of the RhoA, ROCK expression was not as much as in SH rats. Conclusion The damage to both arterial structure and function was much more serious in MS rats than that in SH rats. Activation of RhoA/ROCK system and reduction of NOS expression might be involved in the mechanism.

The teaching of clinical probation is the main link in the course of training medical talents. In the past fewyears the teaching of clinical probation bears much heavier pressure with the health care reform, some new unveiledpolicies and laws, and the growth of student intake scale of clinical medicine. To better carry out the clinical teaching,this article systematically analyzes many relevant factors that influence the clinical teaching. At the same time thearticle also makes research and discussion in relation to the following aspects:the clinical teaching reform,establishingthe teaching system on standardized patients,setting up simulation center for clinical skill training and implementing thesystem of Bachelor-to-Master program and Master-to-Doctorate program.[

Objective To evaluate the accuracy of point-of-care testing (POCT) for blood glucose monitoring in critically ill patients.Methods Two hundred and forty critically ill patients,of both sexes,aged 20-88 yr,with Acute Physiology and Chronic Health Evaluation Ⅱ score of 1-45,were enrolled.The venous,arterial and capillary blood samples were collected to determine the real-time blood glucose level using glucose oxidase (GOD) and glucose dehydrogenase (GDH) methods.The blood glucose level measured by central laboratory hexokinase method simultaneously was served as standard level.Error Grid analysis (EGA) and Bland-Altman analysis were used to determine accuracy and consistency,respectively.The accuracy of real-time blood glucose levels within the consistent limits was evaluated.Results 1.The results of EGA showed that 98.7 ％,98.3 ％,98.3 ％(GDH method) and 96.2％,96.6％,96.7％ (GOD method) of the difference between venous,arterial and capillary blood glucose levels measured and the standard level were located in the A and B zones,respectively,and 1.2％,1.7％,1.7％ (GDH method) and 2.9％,3.3％,3.3％ (GOD method) in the D zone.0.8％ (GOD method) of the difference between venous blood glucose levels and the standard level were located in the C zone.2.Bland-Altman analysis showed that the difference between the standard level and glucose level measured in blood samples from the vein,artery and capillary.was-0.1,-0.3,-0.2 mmol/L (GDH method) and-0.9,-1.0,-0.9 mmol/L (GOD method),respectively,and the incidence beyond the upper and lower limits of consistency zone was 4.5 ％,6.7 ％,6.6 ％ (GDH method) and 4.6 ％,5.0 ％,7.1％ (GOD method),respectively.The accuracy of venous,arterial and capillary blood glucose levels within the consistent limits was 94.3 ％,92.1％,93.7％ (GOD method) and 96.6％,95.1％,95.5％ (GDH method),respetively.Conclusion The accuracy of POCT for blood glucose monitored by GOD and GDH methods is good in critically ill patients,but it is possible to overestimate the patient's real glucose level.

Objective To study the clinical characteristics, treatment and prognosis of infective endocarditis in children. Methords Clinical data from 83 patients of infective endocarditis admitted from 1998 to 2012 were retrospectively analyzed. Results In a total of 83 patients, there were 53 males and 30 females, and the average age was 6.8±4.6 years. The main clinical characteristics were fever (77.1%) and mild to moderate anemia (71.1%). The C-reaction protein (67.5%), erythrocyte sedimen-tation rate (60.2%), and white blood cell (47.0%) were elevated. Twenty (24.1%) patients had embolism. Blood culture was pos-itive in 56 (67.5%) cases with bacteria mainly being Gram-positive and Streptococcus and Staphylococcus accounted for 89.3%. Vancomycin and other sensitive antibiotics were effective. Neoplasm was detected in 68 cases (82%) by transthoracic echocar-diograerphy. Fifty-ifve (66.2%) patients underwent cardio surgery. Seven patients (8.4%) died. Conclusion In recent years, the distribution of pathogenic bacteria in infective endocarditis had changed. Streptococcus mitis and Staphylococcus aureus has become a major pathogens and need to be treated by vancomycin and other sensitive antibiotics. The detection rate of neoplasm is higher by echocardiography.

Objective To explore the value of hysteroscopy in diagnostic curettage, the incidence of complications and preventive measures in senile women. Methods One hundred and thirteen senile patients who underwent hysteroscopy from January 2002 to December 2007 were recruited in the study, and one hundred and fifty-seven non senile patients were selected as control group. All the patients were operated with diagnostic curettage and hysteroseopy. The success rate of hysteroscopy operation, the incidence of complications and control effect were recorded and compared between two groups. Results The success rate of hysteroscopy operation was 88. 5% (100/113) in the senile group and 100% (157/157) in the non senile group, and there was significant differenee(P <0. 01). The incidence of complications was higher in the senile women group than that in the non senile women group (P< 0. 01). In senile group, the accuracy of diagnostic curettage and hysteroscopy was higher than diagnostic curettage alone, and the success rate was 95.5% (64/67)in estrogen group and 69.6%(32/46) in blank control group (P<0. 01) ,which indicated that estrogen was positively related with the success rate of operation. Compared with misoprostol, estradiol-pretreatment operation was safer and had higher success rate. Conclusions It is safe and feasible to perform hysteroscopy and diagnostic curettage for older women, though it has higher incidence of complications and lower success rate compared with non senile women. Hysteroscopy and diagnostic curettage are more accurate than diagnostic curettage alone, and it is a good choice to apply estradiol before operation.

Objective Previous study found TGF-βpathway might be the molecular pathway influencing the prognosis of colo-rectal cancer, while it was uncertain whether Chinese population is associated with the disease.The article was to evaluate the genetic factors associated with prognosis in colorectal cancer. Methods 52 cases patients with colorectal cancer were followed-up for 36 months in our hospitals from January 2013 to August 2014.Their DNAs were extracted and stored and gene typing were carried out in 5 candidate genes to detect the association between SNPs and the prognosis in colorectal cancer. Results The results showed that within the TGF-βsignaling pathway, after adjusting for Bonferroni multiple testing, allele A of SNP rs10749971 located in gene POU2AF1 was associated with the recurrence of patients with stage III disease under additive and recessive genetic models ( HR =1.968, P=0.004;HR=2.174, P=0.010).Allele C of SNP rs961253 in the gene BMP2 could increase the recurrence risk (HR=1.992, P=0.005) and the death risk (HR=3.161, P=0.007) of patients with stage III disease under recessive genetic models.Allele A of SNP rs4464148 in SMAD7 gene could significantly decrease the death risk of patients with stage II and III colorectal cancer under dominant genetic model (HR=0.382, P=0.017;HR=0.230, P=0.006).In addition, accumulated effects of several adverse genes showed gene high risk group could increase the risk of death for patients with stage III colorectal cancer significantly ( HR=15.512, P=0.036;95%CI:1.611-149.360). Conclusion In different genetic models, SNP locus mutation within gene POU2AF1, BMP2 and SMAD7 on TGF-βpathway was associated with the prognosis of patients with colorectal cancer.With the increase of the number of unfavorable genes, the death risk increases accordingly.

Objective To analyze the characteristics in the incarcerated inm ate’s death, investigate the m ain cause of death of the incarcerated inm ate and provide som e inform ation for forensic investigation. Methods The cases from the forensic m edical center of Shanxi Medical U niversity from 2005 to 2013 were selected. The statistical analysis w as perform ed by using the incarcerated inm ate’s gender, age, cause of death, m anner of death, and disease as the m arkers. Results There were 100 men, 5 w omen in the 105 incarcerated inm ates;the age range w as from 16 to 65 years;Inm ates were mostly died of nat-ural diseases, m ainly in the respiratory and cardiovascular diseases;the m ain unnatural death w as suicide w ith a rate of 54.5%. Conclusion Atpresent, most incarcerated inm ate’s death are due to natural dis-eases. The prison should im prove incarcerated inm ate’s lives, w ork and health care conditions, and strengthen supervision of law enforcement.