Objective To explore the relevant factors of macrosomia in order to own better antepartum prevention and obsterical measure.Methods Retrospective analysis was conducted in the total of 349 complete macrosomia cases in this hospital,the relevant factors of macrosornia( except diabetes melitus) were compare and analyzeed.Results There was significant correlation between macrosomia and age of pregnant woman,gestional weeks,body mass index.Conclusion In order to reduce the incidence rate of macmsomia,decrease the rate of uterine-recision delivery and save the life for the mother and the infant,some effective measures should be carried out for pregnant ladies who are foreseen to have a macrosomia.

Cognitive dysfunction is associated with common symptoms of people with epilepsy, mainly declining in attention, memoryand planning ability to judge. With the change of medical model, cognitive rehabilitation should be comprised in epileptic therapeuticschemes by doctors. The relationship between epilepsy and cognition has attracted more and more attention. This article summarized thecognitive influencing factors in epilepsy itself, treatments and social psychological factors in order to explain the mechanism of the effect ofcognitive function.

Objective To investigate the role of extracellular signal-regulated kinase(ERK)signal pathway in the spinal cord in the development of chronic morphine tolerance.Methods Thirty healthy male SD rats weighing 300-350 g in which intrathecal(IT)catheters were successfully implanted without complication were randomly divided into 3 groups(n = 10 each): group Ⅰ control(group C);group Ⅱ morphine tolerance(group M)and group Ⅲ morphine tolerance + PD98059(ERK upstream kinase MEK inhibitor)(group P).Morphine tolerance was induced with IT morphine 10 μg twice a day for 7 consecutive days.In group P PD98059 10 μg was injected IT at 30 min before each morphine administration.Tail flick latency(TFL)(the time between the onset of heat stimulus and voluntary tail withdrawal)was measured once a day at 30 min after first IT morphine administration and at 1 day after last IT morphine.Maximum analgesic effect(MPE)was calculated.MPE =(TFL after IT morphine - baseline TFL)/(12 - baseline TFL)× 100%.The animals were sacrificed after last TFL measurement.The L3-5 segment of the spinal cord was isolated for determination of the expression of μ-receptor and phosphorylated ERK 1/2(p-ERK1/2)by Western blot analysis and fluoroimmunoassay.Results Morphine tolerance was induced in group M and M + P.MPE was higher in group P than in group M.The expression of μ-receptor in spinal dorsal horn was significantly lower while the p-ERK1/2 expression was higher in group M than in group C.IT PD98059 significantly up-regulated μ-receptor expression and down-regulated p-ERK expression in group P as compared with group M.Conclusion ERK signal pathway is involved in the development of chronic morphine tolerance in rats.

It is crucial for the medical staff to build up mutual trust with patients by their credible attitude and behavior.As core competitiveness of the hospital,the fame of credibility is important to the development of building a harmonious hospital.Only by constructing the hospital's credibility system,integrating the principle of commitment to credibility into the hospital culture,making medical staff work according to this principle,and guiding the harmonious development of a hospital by the credibility culture,can make the hospital management achieve the ultimate goal and reach a satisfying state.

Objective To investigate the role of glucocorticoid receptor (GR) in the induction of neuronal apoptosis in spinal dorsal horn in chronic morphine tolerant rats. Methods Twenty healthy male SD rats weighing 300-350 g in which intrathecal (IT) catheter was successfully implanted without complication were randomized into 4 groups ( n = 5 each): group Ⅰ control ( group C);group Ⅱ morphine ( group M );group Ⅲ morphine +RU38486 (GR antagonist) (group MR) and group Ⅳ morphine + dexamethasone (GR agonist) (group MD).Normal saline 10 μl, morphine 10 μg, morphine 10 μg + RU38486 2 μg and morphine 10μg + dexamethasone 4 μg were injected IT twice a day at 8:00 and 20:00 for6 consecutive days in group C, M, MR and MD respectively. Tail flick latency (TFL) to a thermal nociceptive stimulus was measured every day at 30 min after IT administration in the morning (8:00). Hyperalgesia was considered to be a sign of morphine tolerance. The animals were killed at 7 days after IT drug administration. The L3-5 segment of the spinal cord was isolated for determination of neuronal apoptosis in spinal dorsal horn by TUNEL staining. Apoptotic index was calculated ( the number of apoptotic neurons/the total number of neurons × 100% ). Results TFL was significantly prolonged at day 1 and 3 of IT morphine 10 μg twice a day and returned to baseline at day 5 and 7 indicating morphine tolerance. RU38486 inhibited while dexamethasone enhanced morphine tolerance. IT morphine significantly increased the number of apoptotic neurons in spinal dorsal horn. Morphine-induced neuronal apoptosis was decreased by IT RU38486 and increased by IT dexamethasone. Conclusion Glucocorticoid receptors may be involved in morphine tolerance by inducing neuronal apoptosis in spinal dorsal horn.

Purpose To assess the expression of DLL4 in non-small cell lung cancer ( NSCLC) patients and to determine its associa-tion with clinicopathological parameters and prognosis. Methods DLL4 expression was evaluated in NSCLC tissues and adjacent non-cancerous normal lung tissues from 89 patients undergoing surgical treatment by immunohistochemistry. Results DLL4 had high ex-pression in 52 of 89 cases of NSCLC (58. 4%), which was significantly higher than that in adjacent non-cancerous lung tissues (P<0. 05). Moreover, DLL4 overexpression was significantly correlated with TNM stage (P=0. 010 78). Kaplan-Meier survival analysis showed that the overall survival times in patients expressing DLL4 in NSCLC were shorter. Conclusion High level of DLL4 expression is significantly correlated with NSCLC progression and unfavorable prognosis. Thus, DLL4 expression may be used as a clinical param-eter for predictive prognostication of NSCLC patients.

Objectives To investigate the dynamic change of galectin-1 in myocardium of mice with viral myocarditis (VMC). Methods A total of 58 male BALB/c mice were selected and randomly divided into CVB3 group (n=50) and control group (n=8). Mice in CVB3 group were infected with 0.10 ml 10-5/L CVB3 through intraperitoneal inoculation, and 8 mice were killed on day 7, 10, 14 and 28 respectively after inoculation. Mice in control group inoculated with 0.10 ml eagle reagent was killed on day 28. The myocardial pathological changes were observed using light microscope. In addition, expressions of serum galectin-1 were detected by ELISA and expressions of myocardial galectin-1 were detected by real-time quantitative-polymerase chain reaction (RQ-PCR). Results Compared with control group, the myocardial expression of galectin-1 mRNA in CVB3 group was obviously increased on day 7 and day 10 (all P<0.05);the serum concentration of galectin-1 in CVB3 group was obviously increased on day 7, day 10 and day 14 (all P<0.05). Conclusion The expressions of galectin-1 in myocardium of mice with viral myocarditis were in dynamic changes. Galectin-1 may play a role in the pathogenesis and development of viral myocarditis.

Objective To investigate the effects of apolipoproteinA1 (apoA1) on levels of cholesterol, cholesteryl ester (CE), and expression of ATP-bindiag cassette transporter A1 (ABCA1) in human acute monocytie leukemia cell line (THP-1) macrophage-derived foam cells.Methods The cultured THP-1 cells were induced into foam cells by exposing first to phorbol myristate acetate (PMA, 50 ng/ml) for 48 h, and then to oxidized-low density lipoprotein (ox-LDL, 50μg/ml) for 48 h.Under treatment of apoA1 in different doses (5, 10, 15 and 20 μg/ml) and one simple dose (10 μg/ml) for different time (6, 12 and 24 h), THP-1 macrophage-derived foam cells were incubated to observe the expression of cholesterol and ABCA1.The concentrations of cellular total cholesterol (TC), free cholesterol (FC) and CE were determined by oxidization enzymatic methods.Oil red O dyeing experiment was used to show the cellular lipid droplets in the cells.The expression of ABCA1 was tested by immunofluorescence method.Reverse transcription-polymerase chain reaction was applied to investigate mRNA expression of ABCA1.Results The THP-1 cells turned into typical foam cells after treated with PMA (50 ng/ml) for 48 h, and ox-LDL (50 μg/ml) for 48 h.apoA1 could lower the levels of TC, FC and CE in THP-1 macrophage-derived foam cells in a dose-dependent and a time-dependant manner, apoA1 could increase the expression of ABCA1 protein in THP-1maerophage-derived foam cells without up-regulation of mRNA.Antibody of ABCA1 could up- regulate the expression of ABCA1.Conclusions apoA1 may decrease the levels of cholesterols in THP-1 macrophage-derived foam cells, by promoting the expression of ABCA1 and the reverse cholesterol transport of high density lipoprotein.

Objective To investigate the fall efficacy of elderly people in nursing homes and its influencing factors. Methods A total of 174 elderly people in 8 nursing homes in Fujian province were recruited by convenience sampling method. They were investigated with a self-designed questionnaire about the demographic data, the Modified Falls Efficacy Scale (MFES) and the Kessler Psychological Distress Scale (K10). Results The mean score of fall efficacy was 7.81±1.15, which revealed a middle level. The score of get dressed and undressed scored 9.04 ±1.42, which was the highest, while the score of using public transport scored 5.80 ±3.21, which was the lowest. Multiple regression analysis showed that the mental health status, degree of self care, age were influencing factors of fall efficacy of elderly people. Conclusions The fall efficacy level of 174 elderly people is at medium level, which is different among fall efficacy with mental health status, degree of self care, age. Individualized interventions should be designed and provided for them.

Objective To study the clinical characterics of 139 patients with wide QRS complex tachycardia.Methods Retrospective analysis was performed on 139 patients with QRS wave tachycardia treated by radiofrequency ablation at TEDA International Cardiovascular Hospital.The patients were divided into supra-ventricular tachycardia with intra-ventricular aberrany group (group A,n =84) and ventricular tachycardia (group B,n =55).The clinical data,electrocardiogram (ECG) and echocardiographic features between the two groups were compared.Results There was no statistical significance between the two groups in terms of gender,height,weight and ventricular rate (P ＞ 0.05).The difference in the course of disease,blood pressure,age,QRS duration,left ventricular diameter by echocardiography and ejection fraction was statistically significant (P ＜ 0.05).Radiofrequency ablation result showed that 81 (96.4％) cases were successful in group A,and 37 (67.3％) cases were successful in group B.The difference in the success rate was statistically significant (P ＜0.05).After 1 year of follow-up,4 (2.9％) cases in group A were recurred,13 (23.6％) cases in group B were recurred.The difference in the recurrence rate was statistically significant.Conclusion The wide QRS wave tachycardia is often accompanied with left ventricular diameter enlargement and left ventricular ejection fraction reduction,The success rate of radiofrequency ablation is low,and the recurrence rate is high when diagnosis is ventricular tachycardia.