Objective To explore the effect and its clinical significance of different dose of glucocorticoids on inflammation mediators in patients with acute exacerbation of chronic obstructive pulmonary diseases.Methods 45 patients admitted to our hospitals from March 2007 to March 2011 were randomly divided into 3 groups:methylprednisolone 40 mg group (methylprednisolone 40mg,iv,qd),methylprednisolone 80 mg group (methylprednisolone 80mg,iv,bid),and control group (without any glucocorticoids).The changes of dyspnea scores,arterial blood gas analysis,clinical symptom scores and serum IL-6,IL-8 and tumor necrosis factor (TNF) levels were detected in patients of each group before and at the 7th day after treatment.The related adverse drug reactions were recorded.Results The improvements in clinical symptom scores,Borg scores,PaCO2,PaO2 after treatment were higher in methylprednisolone 40 mg group and methylprednisolone 80 mg group than in control group (F=3.6747.162 and 42.88,respectively,P＜0.01 or 0.001),and the above improvements was better in methylprednisolone 80 mg group than in methylprednisolone 40 mg group (all P＜0.05).The decreases in levels of serum IL-8,TNF-α,IL-6,C-RP after the treatment were more significant in methylprednisolone 40 mg group and methylprednisolone 80 mg group than in control group (F=12.65,16.17,30.99,respectively,all P＜0.001),and the decrements were more significant in methylprednisolone 80 mg group than in methylprednisolone 40 mg group(all P＜0.05).NO serious adverse drug reactions happened during the course of treatment in the three groups.Conelusions Short-term and moderate dose of glucocorticoid treatment is effective and safe in treating the patients with acute exacerbation of chronic obstructive pulmonary diseases.Methylprednisolone 80 mg injection daily can more obviously improve AECOPD symptoms,and reduce the levels of inflammatory factors better.

Objective:To approach the actions of survivin and COX-2 during the genesis and development in brain astrocytoma and whether they have dependablity each other.Methods:The expression of survivin and COX-2 was examined by immunohistochemistry SP and their interrelationship was analyzed.Results:The positive expressive rates of survivin in astrocytoma gradeⅠ,Ⅱ,Ⅲ and Ⅳsubgroups were shown in an increased tendency.The expression was weak positive in higher differentiation group,and the positive expressive rate of survivin was increased in the lower differentiation group.There was an significant difference between these two groups(?2=11.20,P

Objective To investigate the intervention of trans-theoretical model on the risk factors in the patients with prediabetes.Methods One hundred and twenty-two patients with pre-diabetes in a tertiary hospital of Zhengzhou City were selected and randomly assigned to control group and intervention group.The control group received the routine diabetic health education,while in addition to the routine health education,the intervention group was assisted by TTM interventional measures.The blood glucose,body mass index(BMI) and negative emotion were compared between the two groups.Results The blood glucose and BMI after intervention in the two groups were decreased,moreover the decrease level of fasting blood glucose and BMI in the intervention group was higher than that in the control group,and the difference was statistically significant(t=4.963、2.061,P＜0.05).The anxiety and depression emotion scores after intervention in the intervention group were [(3.47 ±1.07) and (0.30 ± 0.46)],before intervention were (7.74 ± 4.00) and(7.25 ± 4.50),The difference was statistically significant(P＜0.05),Moreover the anxiety and depression emotion scores after intervention in the intervention group were lower tghan those in the control group with statistical difference(t=3.300、2.054,P＜0.05).Conclusion The intervention measures based on TTM has significant advantage for controlling the risk factors of pre-diabetes and preventing diabetes than the conventional health education.

ObjectiveTo investigate the risk factors of nosocomial infection (NI) of patients with spinal cord injury (SCI).MethodsClinical data of SCI patients hospitalized in our hospital from Jan 1999 to Dec 2004 were analyzed retrospectively.ResultsThe NI rate of SCI patients was 27.78%, and the highest was in summer (33.09%), the lowest was in winter ( 22.41 %). The most common infection sites were urinary tract (71.07%), followed by respiratory tract (14.72%).ConclusionSCI patients are susceptible to NI; prevention and control measures should be taken to decrease the NI rate.

ObjectiveTo assess the value of transvalvular pressure gradient (TPG) by use of realtime color Doppler echocardiography in percutaneous balloon pulmonary valvuloplasty (PBPV).Methods Patients with pulmonic stenosis (80 cases) were performed by PBPV,in which the pilmonic annular diameter and TPG were measured by using of 2-D and color Doppler echocardiography in the different periods of this operation.Results The pilmonic annular diameter was not significantly difference by intraoperative echocardiography and radiography measurement (t =2.013,P ＞ 0.05).And pressure measurement by catheterization pre- and post-dilatation was not markedly significant ( t =1.258,P ＞0.05).However,TPG in patients with the different degree of pulmonic stenosis were decreased significantly ( P ＜0.01).PBPV treatments in the mild pulmonic stenosis for twice got an excellent effect according to operation criteria,but PBPV treatment in patients with the moderate and severe pulmonic stenosis need to be done for three times.ConclusionsReal-time color Doppler echocardiography is an effective way and plays a guiding role in PBPV.

Objective To determine the expression of Caspase 8 and phospho-Akt(p-Akt)in condyloma acuminatum(CA)lesions, and to evaluate their significance. Methods Skin lesion samples were collected from 30 patients with CA, cancer tissue samples from 20 with cervical cancer, and normal skin samples from 20 healthy controls. All the samples were subjected to paraffin embedding. An immunohistochemical study was conducted to determine the expression and distribution of Caspase 8 and p-Akt in the above samples. Results The expression rate of Caspase 8 was significantly lower in CA lesions (23.33%)than in normal skin samples(90%, P < 0.01)and cervical cancer lesions(80%, P < 0.001). Moreover, the expression rate of p-Akt in CA lesions(93.33%)was significantly higher than that in the normal skin samples(90%, P<0.001), but lower than that in the cervical cancer lesions(95%, P<0.001). No significant correlations were observed between the expression of Caspase 8 and p-Akt in either CA lesions or normal skin samples. However, the expression of Caspase 8 was positively correlated with the expression of p-Akt in cervical cancer lesions(r=0.369, P<0.05). Conclusion Both suppressed apoptosis initiation of Caspase 8 and anti-apoptotic effect of p-Akt may be involved in the occurrence and development of CA.

Objective To investigate the correlation of the expressions of P170,topoisomerase Ⅱ(TOPⅡ)and the proliferation in gliomas.Methods Ki-67 was used as the marker of the proliferation in gliomas.The expressions of P170,TOPⅡ and Ki-67 were tested by S-P immunohistochemical technique using monoclonal antibody to their protein in 54 cases of low-grade gliomas(WHO Ⅰ～Ⅱ grade)and 54 cases of high-grade gliomas(WHO Ⅲ～Ⅳ grade),analysis of the clinical and follow-up were performed.Results The expressions of P170,TOPⅡ and Ki-67 had significant differences between low-grade and high-grade gliomas(P<0.01).Correlation analysis showed that the expression of P170 was negatively related with Ki-67(r=-0.276,P=0.019);the expression of TOPⅡ was positively related with Ki-67(r= 0.637,P<0.001);there was no correlation between the expressions of P170 and TOPⅡ.Conclusion The expressions of P170 and TOPⅡ are associated with the malignant prognosis in gliomas.

Objective Pathophysiology has high comprehensiveness and practical characteristics. Developing analytical capacity is a major teaching aim of Pathophysiology. This study was aimed to build up the basic knowledge of pathophysiology and develop a critical approach through comparative case learning in medical students. Methods A pair of related cases were chosen in this study. Comparative case learning was performed in our lecture. Case analysis was tested before and after comparative case learning,and a self-evaluation was accessed after comparative case learning. The scores of case-analyzing test and self-evaluation assessment were statistically analyzed. Results Using“comparative case learning”in pathophysiology could improve medical students' case-analyzing score,especially in clinical syndrome analyzing examination questions(difficult examination questions). There was a significant correlation between high score of clinical syndrome analyzing examination and students' self-evaluation. ConclusionComparative case learning could improve the analytical,data searching and comprehensive abilities,thereby enhancing a case-analyzing ability in medical students.

Objective To investigate the regulatory effects of miR-145 on the proliferation,cell cycle and apoptosis of a human keratinocyte cell line HaCaT.Methods miR-145 mimics and negative control (NC) mimics were chemically synthesized and then transiently transfected into HaCaT cells respectively.After additional culture for different durations,real-time PCR was performed to determine the expression level of miR-145,MTS assay to estimate cell proliferation,and flow cytometry to detect cell apoptosis and cycle.Luciferase assay,real-time PCR and Western blot were conducted to determine whether NRAS was the target gene of miR-145.Results The miR-145 expression level in miR-145 mimic-transfected cells increased by 85.00 ± 1.21 folds compared with NC mimic-transfected cells (t =115.90,P ＜ 0.0001).The transfection with miR-145 mimics significantly inhibited the proliferation of HaCaT cells (F =8.76,P =0.008),and the inhibitory effect significantly varied with the duration (24-96 hours) of culture after transfection,with no interaction effect between the transfection with miR-145 mimics and culture duation (F =1.21,P =0.18).Compared with NC mimic-transfected cells,those transfected with miR-145 mimics showed a significant increase in the proportion of early apoptotic cells (18.9％ ± 4.1％ vs.4.3％ ± 1.2％,t =7.126,P ＜ 0.01),late apoptotic cells (9.3％ ± 2.3％ vs.3.6％ ± 1.6％,t =12.38,P ＜ 0.01),G1-phase cells (85.83％ ± 5.2％ vs.62.08％ ± 6.23％,t =11.78,P =0.007),but a significant decrease in the percentage of G2-phase cells (6.26％ ± 1.2％ vs.19.36％ ± 3.45％,t =7.610,P =0.017) and S-phase cells (7.91％ ± 1.3％ vs.18.56％ ± 5.23％,t =7.230,P=0.019).As luciferase assay showed,luciferase activity was significantly lower in HaCaT cells cotransfected with miR-145 mimics and a recombinant luciferase reporter vector psi-CHECK2-NRAS-wild carrying the wild-type 3'UTR of NRAS than in those cotransfected with NC mimics and the vector psi-CHECK2-NRAS-wild (t =11.09,P =0.008),but similar between cells cotransfected with miR-145 mimics and a recombinant luciferase reporter vector psi-CHECK2-NRAS-mut carrying the mutant-type 3'UTR of NRAS and those cotransfected with NC mimics and the vector psi-CHECK2-NRAS-mut (P ＞ 0.05).Real-time PCR and Western blot revealed that the overexpression of miR-145 mimics had no significant effect on NRAS mRNA expression (P ＞ 0.05),but significantly inhibited NRAS protein expression (1.52 ± 0.07 vs.0.20 ± 0.02,t =28.43,P＜ 0.01).Conclusion miR-145 might inhibit proliferation and promote apoptosis of HaCaT cells by influencing cell cycle via NRAS.

ObjectiveTo analysis the clinical features of thoracic spine and spinal cord injury (SCI) and summarize the inclusive standard of cellular transplant clinical trial for SCI.MethodsThe data of 72 cases with thoracic spine and spinal cord injury from 1990 to 2005 were analyzed retrospectively.ResultsMean follow-up period was 20 months (6～48 months). There was no recovery in 12 spinal cord injury without radiographic abnormality (SCIWORA) patients, but improvement of urine function in 4 cases. 5 cases of 52 fracture-dislocation complete injury were improved to grade B (sense recovery), rate of recovery was 9.6%; recovery rate was 62.5% in incomplete injury. Sense recovery of all cases was better than motor recovery. Partial cases appeared spasm paralysis relief.ConclusionIncidence rate of complete injury is high and recovery is bad in thoracic spine and spinal cord injury. The inclusive standard of cellular transplant clinical trial for SCI is old complete thoracic spinal cord injury without residual compression.