Diabetic nephropathy is one of the most serious microvascular complications, which is related to many growth factors. Growth factors are a kind of cytokines that can stimulate cells to grow, which includes transforming growth factor-? (TGF-?), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF), connective tissue growth factor (CTGF), and so on. Different growth factors can cause glomerular hypertrophy or proliferation, perinephric angiogenesis, tubulointerstitial fibrosis and the like respectively. To know the relationship between the growth factors and diabetic nephropathy could provide a prospective mean to reduce the diabetic mortality rate. This paper reviews the recent researches about the growth factors and diabetic nephropathy to provide a scientific basis for clinical treatment.

The implantation of the foldable multifocal intraocular lens,a new pseudophakia intraocular substitute,needs only a small incision and the post-operative complications are rare.The incoming light can be refracted into several fo-cuses.Improved visual acuities both for far and near distance are obtained,which downregulated the glasses-wearing rate.This article summarizes the theories and designs,implantation,clinical application,theropeutic outcomes,and complications of this type of multifocal intraocular lens.

Objective To investigate and analyze the status quo of job satisfaction of nurses in a large 3-A-grade hospital in Tianjin. Methods Using stratified random sampling method, the general information questionnaire and the nurse job satisfaction scale were used to investigate the cross-sectional survey of 435 clinical nurses in large 3-A-grade hospital in Tianjin. Results The score of job satisfaction was (123.54±15.52) points, which was at the middle level. According to single factor analysis, there were significant differences in the influence of nurses′ job satisfaction on age, working life, department, monthly average night shift frequencies, monthly gross income (F=2.238-7.622, all P<0.05). There was a significant difference in job satisfaction among nurses with different income(F=2.642, P=0.049), among whichwork load,relationship with colleaguesandjob itselfhad the most significant impact on job satisfaction(F=2.667, 6.087, 4.023, all P<0.05). Conclusions Nursing managers should be rational allocation of human resources, reduce the workload of nurses, to build a harmonious atmosphere in the team, to create a good working environment, provide a better career development platform for nurses, implement flexible management, improve nurses′job satisfaction.

Objective To investigate the risk factors for heart failure in pregnant women with heart disease. Methods A retrospective analysis was made from 340 cases of pregnant women with heart disease in our hospital from January 2008 to December 2013. The pregnant women who presented heart failure were categorized in the observation group (n=65), and others were in the control group (n=275). Data was used to analyze by univariate and multivariate logistic regression for heart failure in pregnant women with heart disease. Results The total 340 cases of heart disease included 132(38.8%) of congenital heart disease, 86(25.3%) of rheumatic heart disease, 63(18.5%) of arrhythmia, 33(9.7%) of hypertensive heart disease and 26(7.6%) of peripartum cardiomyopathy. 65 cases (65/340, 19.1%) presented with heart failure, there were 4 cases resulted in death (1.2%). Multivariate logistic regression analysis showed that age≥35, the baseline parameters of New York Heart Academy (NYHA)≥Ⅱ, pulmonary artery pressure>50 mmHg (1 mmHg=0.133 kPa), baseline heart rate>100 bpm, cardiac events occurred before pregnancy were the independent risk factors for heart failure. Prenatal counseling and antenatal examination were the protective factors for heart failure. Conclusions There are a variety of influencing factors for the heart failure in pregnant women with heart disease. It is necessary to take targeted intervention measures in response to the influencing factors so as to reduce the development of heart failure.

Objective To investigate the relationship of change in hemodynamics of portal system and liver reserve of Chile-Pugh classification in patients with hepatocirrhosis.Methods Color Doppler ultrasound were applied to detect the inner diameter,average velocity of blood flow,quantity of blood flow of portal vein and splenic vein for 173 patients with post-hepatitis hepatocirrhosis(61 of Child grade A,53 of grade B,59 of grade C),which were sub- sequently compared with the healthy controls.Results In patients with hepatocirrhosis,the inner diameter of portal vein and splenic vein were widened,the average velocity of blood flow of portal vein and splenic vein were slowed down and the quantity of blood flow of splenic vein was increased,and the worse the damage of liver function was, the more obvious the change became.Conclusion The change in hemodynamics of portal system varies with the damage in liver function in patients with hepatocirrhosis.Measuring the hemodynamics of portal system is significant in determining the severity of the disease and the prognosis.

This study was designed to assess the immune protective effects of the vaccine strain of a precocious line of Eimeria necatrix with different doses and at different immunization times. The immunizations had a negative effect on weight gains of chickens to a certain degree but could be compensated during the “compensatory growth period” after immunity was established in the chickens. The number of oocysts excreted was positively correlated with the immunization dose. All the immunized chickens, whether they were immunized once or twice or immunized with different doses of sporulated oocysts, were able to resist attack from 1x105 virulent sporulated oocysts of E. necatrix. The lesion scoring showed that no significant difference existed in the chicken groups immunized with different doses (300 and 600) of sporulated oocysts. However, a difference existed in the immune homogeneity established in the different immunized groups, and two artificial immunizations were superior to one artificial immunization, indicating that two could extend the duration of oocyst excretion and allow more chances for the immunized chickens to become repeatedly infected.

Recent evidence has shown that neurogenesis occurs throughout adulthood, and neural stem cells reside in the adult central nervous system (CNS) in mammals. Experimental stroke in adult mammals increases neurogenesis from neural stem cells or progenitor cells located in the dentate subgranular zone and the subventricular zone lining the lateral ventricle. New neurons can migrate to the areas of damage regions and express morphological markers characteristic of died neurons. These findings bring hope for self-repair after brain injury. The author of this paper reviewed the adult neurogenesis and its regulation in vivo, and described evidence for stroke-induced neurogenesis and neuronal replacement in the adult, and discussed the future research directions about neurogenesis after stroke and other brain injuries.

Hepatitis B ; pathology ; therapy ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans

Objective To investigate the causes,diagnostic methods,prevention and cure of postmenopausal bleeding(PMB).Methods The clinical and pathological data of 210 PMB patients admitted in this hospital were retrospectively analyzed.Results The causes for PMB were benign diseases(69.5%),the most of which were infec- tious diseases(49.5%),non-organic disease(20.5%)and malignant tumor(10.0%).Compared with benign diseases and non-organic diseases,the attack age of malignant tumor was higher[(67.1?6.9)years old],menopausal dura- tion was longer(11.6?2.9)years,bleeding duration was longer[(157.6?26.4)days],and mucous membrane was obviously thickened[(14.6?3.2)mm](P0.05).Conclusion The main cause for PMB is benign diseases,followed by non-organic diseases.More attentions should be paid to the PMB patients with higher attack age,longer menopausal duration and bleeding dura- tion,and obviously thickened mucous membrane,so as to be precautions to the occurrence of malignant tumor.

The flip classroom,as a new teaching form,has innovated the traditional teaching model.Although the flip classroom has its superiority,it will encounterchallenges in practice.This paper firstly analyzed the feasibility and necessity of medical ethics education based on the flip classroom.Then,it introduced the teaching model of medical ethics flip classroom based on three aspects:the basic pattern design,learning resources design and teaching process design.Finally,it discussed the application and effects of the flip classroom on the teaching of medical ethics.