Objective To study the antitumor activity of steroid saponins,such as Rhizoma Paridis saponins,Rhizoma Paridis saponin Ⅰ,and diosgenin,extracted from Paris polyphylla var.yunnanensis against lung adenocarcinoma cells.Methods Taking mouse lung adenocarcinoma LA795 cell line and its T739-bearing mice as models,the antitumor activity of steroid saponins of P.polyphylla var.yunnanensis against lung adenocarcinoma cells was carried out in vitro and in vivo.The inhibitory activity of Rhizoma Paridis saponins,Rhizoma Paridis saponin Ⅰ,and diosgenin on the LA795 cell line was studied by means of MTT assay and their antitumor effects in vivo were carried on inbred strains of mice(T739) affected by LA795 metastatic lung cancer.Results The MTT assay of in vitro cytotoxicity of Rhizoma Paridis saponins,Rhizoma Paridis saponin Ⅰ,and diosgenin showed strong cytotoxicity against the growth of LA795 cells.IC50 Values were 24.33 ?g/mL,1.85,and 149.75 ?mol/L,respectively.The tumor weight in all treated groups was significantly lower than that in the control group and the inhibition of tumor growth were 41.82%,29.44%,and 33.94% in their high-dose groups.The metastasis of tumor cells was inhibited by different degrees in treated groups.Conclusion Steroid saponins of P.polyphylla var.yunnanensis have tumoricidal activity on lung adenocarcinoma cell line,both in vitro and in vivo.

Objective To investigate the statistical methods used in nursing papers for bachelor's degree. Method We collected 160 nursing theses for bachelor's degree in 2016 in our college and analyze the statistical methods. Results A total of 80 papers used statistical methods consisting of statistical table, statistical inference, single factor analysis, variance analysis and statistical description. Among them, the statistical methods in 66 papers (82.5%) were misused. About 139 misuses of statistical tables was found in papers, and about 23 misuses of statistical inference in papers, taking up 45.4%. Conclusions The nursing undergraduates are familiar with the application of statistical methods, but the methods tend to be simple and unitary. Therefore, it is a need to enhance their practice in using statistical methods.

Objective To identify the changes of outpatients/emergency visits at Nanjing Children′s Hospital since introduction of the general pricing reform at public hospitals.Methods Fluctuations of outpatients/emergency visits at Nanjing Children′s Hospital before and after the reform in 2015 were compared,and an empirical analysis was made in view of the overall structural changes,demand price elasticity and cross-price elasticity of various outpatients/emergency visits.Results The change of total outpatients/emergency visits was minimal,yet the composition registered significant changes.Monthly average of common outpatients totaled 7 072 visits,a growth of 12.6%;that of senior specialists totaled 3 035 visits,a growth of 48.4%.The price elasticity was<1,while the demand for various outpatients/emergency visits services and cross-price elasticity appeared inelastic.Conclusions The one year reform has witnessed the hospital in smooth operations as yet.Given the sizable rise of examination prices for both outpatients/emergency visits,patient volume remains stable instead of drastic decrease,evidencing the strong demand for children′s medical services.

Objective To establish a novel flow cytometric crossmatch assay allowing detection of complement-fixing donor specific anti-HLA IgG alloantibodies (Flow cytometry complement-dependent crossmatch,Flow-CDC). Methods One hundred pretransplant crossmatchings were performed using Flow-CDC and NIH-CDC between 62 patients awaiting renal transplantation and 33 donor cells.These crossmatchings were divided into two groups according to PRA.Group 1 consisted of 25 sera with negative PRA,and group 2 consisted of 75 sera with positive PRA.All of the sera were pretreated with DTT to inactivate IgM. Lymphocytes were isolated from peripheral blood (or,in a few instances,from the spleen) of the cadaveric donors. The correlation between different techniques for detection of donor specific anti-HLA antibodies was evaluated.The effect of both methods on clinical transplantation outcome was observed. Results In group 1,NIH-CDC and Flow-CDC were negative for all 25 sera.In group 2,24 (32.0%) had a positive NIH-CDC,31 (41.3%) had a positive Flow-CDC.There was a significant difference between two methods (?2=5.14, P= 0.016 ).Overall concordance between both tests was 93% with 69 concordant negatives and 24 concordant positives. The correlation coefficient (r) was 0.80.In group 2,5 patients received transplantation. One of them with negative NIH-CDC and positive Flow-CDC suffered from acute rejection after transplantation and lost the graft,and the other patients with negative NIH-CDC and Flow-CDC had good outcome. Conclusions Flow-CDC can detect specifically complement-fixing IgG alloantibodies against donor HLA and is more sensitive than NIH-CDC.Additionally,the computer printouts represent a permanent record of the crossmatch for retrospective review.Flow-CDC may become the standard crossmatch method as a possible alternative to conventional NIH-CDC testing.

Background Small incision lenticule extraction (SMILE) was a new procedure which is miniinvasion and flapless,but few attentions were paid to the visual quality after SMILE.To understand the changes of intraocular straylight after SMILE is of important significance for the assession of the visual quality after the procedure.Objective This study was to compare the characteristic of straylight between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LAISK) after surgery.Methods A retrospective study was designed.Written informed consent was obtained from each patient prior to accepting the surgery.One hundred and twenty-seven eyes of 68 patients with myopia and myopic astigmatism were included in Tianjin Eye Hospital from January 2011 to July 2013.SMILE was performed on 64 eyes of 35 patients and FS-LASIK was carried out in 63 eyes of 33 patients at the same period.Stray light was detected with C-Quant stray light meter before and 1 week,1 month and 6 months after surgery.The changes of stray light values following the surgery were compared between the two groups,and the correlations between postoperative stray light values with operative parameters were analyzed.Results The mean stray light values were (1.03 ±0.19)D and (0.95±0.16)D at 1 week and 1 month after surgery,which were higher than (0.88 ±0.18)D at preoperation in the FS-LASIK group (P =0.000,0.012).The stray light values were (0.98±0.16),(0.95±0.14) and (0.94±0.16)D at 1 week,1 month or 6 months after surgery,and no statistically significant differences were found in comparison with (0.91 ±0.15)D in preoperation in the SMILE group (all at P＞0.05).No significant intergroup difference was seen in the stray light values (Fgroup =0.077,P=0.781).The stray light differences of various time points after surgery and before surgery were increased in the FS-LASIK group compared with SMILE group (Fgroup =14.798,P＜0.001),with the significant difference in postoperative 1 week between the two groups (P＜0.01).The negative correlations were found between stray light values at 1 week,1 month and 6 months after SMILE with the lenticule thickness/central corneal thickness (CCT) (R2=0.123,0.145,0.098,all at P＜0.05) or between stray light change.Conclusions Intraocular stray light appears less change in operative eyes after SMILE.However,intraocular stray light increases in the eyes received FS-LASIK,especially at early stage after operation.The stray light shifts return to normal with the lapse of postoperative time.

Anti-glutamic acid decarboxylase antibody-associated encephalitis is a kind of autoimmune encephalitis mediated by anti-glutamic acid decarboxylase antibody, which belongs to anti-neuronal intracellular synaptic protein antibody-associated encephalitis. Clinical manifestations include stiff-person syndrome, cerebellar ataxia, limbic encephalitis, seizures, etc., often associated with a variety of autoimmune diseases, rarely associated with tumors. Detection of anti-glutamic acid decarboxylase antibody is crucial for clinical diagnosis. Immunotherapy helps to relieve symptoms and improve prognosis. The incidence of this disease is low, and there are few reports at home and abroad. This paper intends to review the research on this encephalitis, hoping to improve the clinicians′ understanding and the level of diagnosis and treatment of the disease.

[Objects]To isolate and identify the pathogen of the large outbreak of dengue in Guangdong province in 2014. To understand the origin and the phylogenetic characteristics of the isolates ,and provide scientific foundation for the surveillance and prevention of dengue fever.[Methods]Collected the patient serum samples over all the Guangdong province during the 2014 outbreakperiod,isolated and identified the virus from these samples. Amplified complete E gene and complete genome with certain primers and sequenced all the products. Then the Phylogenetic ,Bayesian phylogeography and mutations analysis were carried.[Results]40 DENV-1 strains were isolated and identified. 40 complete E gene sequences and 6 complete genome sequences of DENV-1 were obtained. Phylogenetic analysis with E gene sequences revealed that the 40 isolates were classified into two genotypes including 16 genotypeⅠ(Asia)and 24 genotypeⅤ(America/Africa). 14 genotypeⅠisolates were clustered closest with isolates from Guangdong province(2013)and Sigapore(2013)which share the nucletide identities of 99.6% ~ 99.9%,other two genotypeⅠisolates were clustered with strains from Malaysia (2013) and both share the nucletide identities of 99.7%;24 genotypeⅤisolates were all classified in one clade with striains from Bangladesh(2009),China(2009)and Bhutan(2013)which share nucletide identities of 99.0%-99.9%. Further analysis with six complete genome sequences showed that five isolates were clustered closest with strains isolated from Guangdong province(2013)share the nucletide identities of 99.6%-99.8% while the sixth stains closest with strains isolated from Myanmar(2002)share the nucletide identities of 98.8%. The isolates have five amino acid mutations compared with strains epidemic in Guangdong province in 2013,three mutations(S88V,E203G,T275R)are in the EⅡdomain and one mutation (S305P)is in the EⅢdomain which associated with virulence.[Conclusions]During the outbreak in Guangdong province in 2014, DENV-1 is the predominant causative serotype,and there are at least two different kinds of genotypes of DENV-1 largely epidemiced in the whole province. Evolution analysis reveals the multiple origins of the isolates which may origin from Guangdong province , Sigapore,Malaysia,Myanmar so that we should enhance the study and surveillance of autochthonous and vectors in order to understand the epidemic way of dengue in Guangdong province. The isolates have had four mutations in the domain associated with virulence which remain further study to know their biological effects.

Objective To investigate MRI localization the accuracy and correct the deviation for gamma knife treatment.Methods With 25-point-matrix tank,the deviation of MRI localization and its regularities could be identified after the comparison between the coordinates of MRI localization and the ones which have already been verified by CT within the deviation of 0.5 mm.Then the original MRI coordinates will be corrected by the acquired mean deviation and the geometric distortion of images.Afterwards the corrected coordinates will be compared with the standard ones and finally validated by exposure film.Results There are no significant deviations on x-and z-axis after measurement in three hospitals,y-axis,however,bears deviation of (1.94 ±0.45) mm for hospital A,(-2.22 ±0.29) mm for hospital B,(-1.25 ±0.21) mm for hospital C,respectively.Furthermore there also exists geometric distortion of 1％ on y-axis in hospital A.The corrected coordinates on y-axis (Yc) will be calculated from the formula:Yc =(Y-M) + GD (Y0-Y) (Y:the original coordinates on y-axis,M:the mean of deviation on y-axis,GD:the geometric distortion,Y0:the coordinate on y-axis of the central point among the 25-point matrix).Once completed,the corrected coordinates of MRI localization is of no significant difference with the standard coordinates verified by CT.Even the deviation of focal spot on validation film is within 0.5 mm.Conclusions The 25-point-matrix tank in the multi-point measurement of the accuracy and the correction of deviation for gamma knife treatment is feasible to determine whether MRI can be utilized in the localization for head gamma knife treatment.

Objective: To study the effect of cytochrome P-450 4F2 (CYP4F2, rs2108622) gene polymorphisms in patients with warfarin for initial doses in 7 days.
Methods: A total of 271 patients treated by warfarin were studied. The CYP4F2 gene polymorphisms were assessed by real-time PCR, the average initial warfarin doses in 7 days and the time of international normalized ratio (INR) ifrst arrived to therapeutic range were recorded. The differences of initial warfarin doses and the time of INR ifrst arrived to therapeutic range among CYP4F2 gene polymorphisms of CC, CT and TT genotypes were analyzed by statistical method.
Results: The average initial warfarin doses among CYP4F2 polymorphisms of TT and CT/TT were higher than CC, P<0.05. The times of INR first arrived to therapeutic range in TT genotype was higher than CC genotype, P<0.05. With adjusted gender, age, body height and weight, CYP2C9 and VKORC1 polymorphisms, conditions of disease and medication, the effect of CYP4F2 gene polymorphisms on initial warfarin doses in 7 days were still with the statistic meaning (regression coefifcient=0.21, P=0.003).
Conclusion: CYP4F2 polymorphisms inlfuenced the initial warfarin doses in 7 days in relevant patients.

Objective To investigate the effects of lentivirus-mediated heat shock protein 70 (HSP70) gene on calcium homeostasis and calcium channels of PC12 cells induced by ischemic and hypoxia and its mechanisms. Methods PC12 cells at logarithmic phase were collected, and they were divided into recombined lentiviral infection group [infected by lentivirus containing HSP70 and green fluorescent protein (GFP) fluorescin gene], lentivirus control group (infected by lentivirus containing GFP without HSP70 gene) and non-infection group. PC12 cells were subjected ischemia/hypoxia for 4, 8, 12, 24 hours, and the cell activity was determined by methylthiazolyl tetrazolium (MTT) assay test inorder to determine the best time for ischemia/hypoxia. The mRNA expressions of HSP70, muscle/endoplasmic reticulum Ca2+-ATP isoforms (SERCA2a, SERCA2b), ryanodine receptor 2 (RyR2), and inositol 1,4,5-triphosphate receptor 1 (IP3R1) were determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR), and the protein expressions of HSP70, SERCA, and IP3R were determined by Western Blot at 8 hours after ischemic/hypoxia. Flow cytometry was used to determine the levels of intracellular reactive oxygen (ROS) and intracellular Ca2+ ([Ca2+]i). Results With the prolongation of time of ischemia/hypoxia, the cell viability in all groups showed an increase followed by a weakening, and peaked at 8 hours. The cell viability at 8 hours in lentiviral infection group was significantly higher than that of the non-infection group and lentivirus control group [A value (×10-2): 20.3±2.2 vs. 14.1±2.1, 15.0±1.6, both P < 0.01], the mRNA and protein expressions of HSP70 and SERCA in lentiviral infection group were significantly increased [HSP70 mRNA (2-ΔΔCt ): 0.785±0.018 vs. 0.428±0.019, 0.423±0.023; HSP70 protein (gray value): 2.72±0.20 vs. 1.56±0.36, 1.63±0.41; SERCA2a mRNA (2-ΔΔCt ): 0.971±0.037 vs. 0.367±0.014, 0.347±0.012; SERCA2b mRNA (2-ΔΔCt ): 8.869±0.162 vs. 3.015±0.091, 2.941±0.091; SERCA protein (gray value): 2.84±0.18 vs. 1.48±0.26, 1.52±0.29], and IP3R2 mRNA and protein expressions were significantly declined [IP3R2 mRNA (2-ΔΔCt ): 0.183±0.020 vs. 0.439±0.020, 0.433±0.040; IP3R2 protein (gray value): 1.15±0.12 vs. 1.91±0.20, 1.83±0.19], with statistically significant differences (all P < 0.01); no significant difference in RyR mRNA was found [2-ΔΔCt (×10-3): 1.97±0.63 vs. 2.02±0.22, 2.01±0.09, both P > 0.05]; the relative fluorescence intensity of ROS and [Ca2+]i in lentiviral infection group was significantly reduced (ROS: 30.54±1.23 vs. 58.03±1.97, 57.72±2.35; [Ca2+]i: 34.50±2.05 vs. 48.20±3.02, 46.80±2.75, all P < 0.01]. Conclusion Exogenous HSP70 can maintain calcium homeostasis in the endoplasmic reticulum of PC12 cells, affect the Ca2+ channel protein regulated by calcium channel IP3R and calcium pump SERCA, which may cause hypoxia/ischemia intracellular injury.