Objective To explore the correlations of expression of Fas, FasL and C-erbB-2, its clinical significance and the correlation prognosis. Methods To protect the expression of mFas, mFasL and C-erbB-2 by immunohistochemistry SP method. To protect the sFas content by ELISA method. Results The expression of Fas showed lowest levels in breast carcinoma, showed lower levels in fibro-adenoma of breast and breast atypical hyperplasia, and showed highest levels in normal controls. The expression of FasL showed adversely, sFas showed highest levels in breast carcinoma, then in breast atypical hyperplasia, and showed lowest levels in normal control group. Fas and C-erbB-2 obviously presented negative correlation. Conclusion The expression of mFas showed inhibition in breast carcinoma, adversely the expression of mFasL showed enhancement, hint abnormality expression of mFas, mFasL may relevant tomammary glands cancer of occurrence and development. It can be used for estimating prognosis, but need a further research.

Objective:To explore clinical therapeutic effect and safety of diltiazem treating coronary artery spasm. Methods:A total of 100 patients with coronary artery spasm were selected in our hospital.According to number ta-ble method,they were randomly and equally divided into routine treatment group (n=50,received,lipid regulation and expanding coronory artery etc.)and diltiazem group (n=50,received diltiazem pumping based on routine treat-ment).Clinical and ECG therapeutic effect,changes of blood lipids,nitric oxide (NO)and endothelin-1 (ET-1) levels before and after treatment and safety were compared between two groups.Results:(1 )Compared with rou-tine treatment group,there were significant increase in total effective rates of clinical effect (60.00% vs.94.00%) and ECG (62.00% vs.92.00%)in diltiazem group,P<0.01 both;(2)Compared with before treatment,there were significant improvements in all ECG indexes,heart rate and blood pressure in two groups after treatment,and those of diltiazem group were significantly better than those of routine treatment group (P<0.05 all);(3)Com-pared with before treatment and routine treatment group,there were significant improvements in blood lipid levels in diltiazem group after treatment (P<0.05 all);(4)Compared with before treatment and routine treatment group,there was significant rise in NO level [(95.17±19.99)μmol/L,(95.17±21.22)μmol/L vs.(106.71± 22.38)μmol/L]and significant reduction in ET-1 level [(64.09±16.29)ng/L,(59.98±14.28)ng/L vs.(44.91± 6.38)ng/L]in diltiazem group after treatment (P<0.05 all);(6)During treatment,there were no adverse reac-tion in both groups.Conclusion:Diltiazem based on routine medication possess significant therapeutic effect and high safety for treating coronary artery spasm,which is worth extension in clinic.

Objective To explore the pathophysiological role of gastric leptin in helicobacter associated gastritis.Methods Patients undergoing gastroscopy were involved in the study.Helicobacter pylori infection was diagnosed by use of Hp-ureA-PCR,~(14)C urea breath test and rapid urease-nessler′s test. The level of leptin in local gastric mucosa and plasma were detected by ELISA. The level of IL-1? and IL-1ra in local gastric mucosa were detected by RIA.Results Total of 31 H pylori positive and 30 H pylori negative patients with chronic gastritis were founded. The level of Leptin and IL-1ra in the gastric mucosa in H pylori positive patients were significantly increased as compared with that in H pylori negative group (P 0.05).Gastric leptin closely related to IL-1? in H pylori positive group(r= -0.78,P

Objective To explore the influence of Helicobacter pylori (Hp) on the proliferation, apoptosis and expression of p27kipl protein of gastric epithelial cells in vitro. Methods SC, C-7901 cell pro-liferation was examined by flow cytometry after incubation with different concentration of NCTC11637. The effect of NCTC11637 on cell apoptosis was also evaluated by flow cytometryo And the expression of p27kipl of gastric epithelial cells was detected by immunohistochemical analysis and in situ hybridization, respectively. Results Cell proliferation was enhanced when co-incubated with the Hp in low concentration (3.4 x 104 to 1.9 x 105 CFU/ml) but inhibited in higher concentration (≥4.8×106CFU/ml). However, cell apoptosis was increase when co-incubated with the Hp in high concentration (≥9.6 ×105 CFU/ml) showing concen-tration dependent picture. In addition, the co-incubation of SGC-7901 with Hp led to decrease of the expres-sion of p27kipl protein but not mRNA in a Hp concentration dependent way. Conclusion Hp could effect the gastric epithelial cells apoptosis and proliferation directly and influence the expression of p27kips protein which might facilitate gastric carcinoma.

Objective To evaluate the diagnostic value of color Doppler ultrasonography(CDUS)and molybdenum mammography for breast tumor.Methods 86 breast diseases which were diagnosed by the surgery and pathology,were prospectively analysed,40 in mammary carcinoma,and 46 in mammary benign disease.All the patients were examined with CDUS,CDFI and molybdenum mammography.Diagnosis was made in every case compared using two methods(CDUS and molybdenum mammagraphy)with any using only one method.Results There is significant difference between mammary carcinoma and mammary benign disease in CDUS.The mammary carcinoma patients'blood stream signal is abundant. The diagnostic veracity of using both CDUS and molybdenum mammography for breast tumor is obvious higher than that of the any only one method.Conclusion Combined CDUS with molybdenum mammography which is the optimal methods of the mammary image examination,can improve the diagnostic veracity of breast tumor.

Objective To explore the influence of different dose of Helicobacter pylori on the expression of transforming growth factorβ(TGF-β1) and B7-H1 in the infected gastric mucosal epithelial cell and the bacterial factors which influence the expression of TGF-β1.To confirm that H.pylorican induce the expression of TGF-β1 and B7-H1 to inhibit the host immune function in gastric mucosal epithelial cell.Methods (1) We investigated the expression of TGF-β1 of human gastric mucosal epithelial cells infected with different concentration(1.0 × 109 CFU/ml,4.0 × 109 CFU/ml,8.0 × 109 C FU/ml) of H.pylori(NCTC 11637) in different time-point(0 h,0.5 h,1 h,1.5 h,2 h,4 h,8 h,12 h),and compared with the expression of TGF-β1 between the deactivated H.pylori group and activated H.pylori group.The blank group is the gastric mucosa epithelial cells which does not infect H.pylori.To detect expression of TGF-β1 in infected cell culture supernatant by enzyme-linked immunosorbent assay(ELISA) and the expression of B7-H1 mRNA by in situ hybridization.(2)At the same time,the middle concentration of deactivated H.pyloriand in vitro gastric mucosal cells were incubated for 2 h and 12 h,to detect expression of TGF-β1 in the cells and cell culture supernatant.(3)In vitro gastric mucosal cells were incubated with H.pylori bacterial supernatant and sedimentation by ultrasonic crushing and centrifugation and with H.pyloribacterial supernatant and sedimentation after boiling respectively,to detect expression of TGF-β1 in the cells and cell culture supernatant after 2 h,12 h.Results (1)Compared to the control group,the expression of TGF-β1 was significantly increased after stimulation with different concentration of activated H.pylori in different time-point(P ＜0.05).The expression of TGF-β1 secretion group has a similar dynamic trend,and the highest expression is the middle concentration group(P ＜0.05).(2)There was no difference between the middle concentration of deactivated H.pylori group and the same concentration of activated H.pylorigroup(P ＞ 0.05).(3) The expression of TGF-β1 in the H.pylori bacterial supernatant group was significantly increased higher than the blank group and the H.pylori bacterial sedimentation group(P ＜0.05),and the H.pylori bacterial supernatant group after boiling was significantly lower than the H.pylori bacterial supernatant group(P ＜ 0.05),but there was no difference between H.pylori sedimentation group after boiling and not boiling(P ＞ 0.05).The B7-H1 expression of different concentration groups which the H.pylori and gastric mucosal epithelial cells cocultured 12 h are higher than the blank group(P ＜ 0.05) by in situ hybridization,and the middle concentration group is the highest expression.TGF-β1 and B7-H1 mRNA are positively correlated(r,=0.628,P ＜0.01).Conclusion H.pylori can induce the gastric mucosal epithelial cells to express the TGF-β1,the factor was the soluble protein in the H.pylori thalline.At the same time,H.pylorican induce the B7-H1 expression increased.In gastric mucosal epithelial cells,TGF-β1 and B7-H1 mRNA are positively correlated.So H.pylori can inhibit the host immune response and participate the process of immune escape by increased the expressions of TGF-β1 and B7-H1.

To investigate the the possibility to utilize the cellular fatty acid (CFA) information as a method in Brucella typing, 90 Brucella strains were subjected to the study on CFAs, and all the experimental strains were inoculated on Brucella Agar plates for 48 hours. After that, cells were harvested, saponificated, methylated and extracted to provide fatty acids methylesters for gas chromatography analysis. Based on the CFAs data matrix, dendrogram of 90 experimental strains was generated by SPSS11.5 software package. As shown in the dendrogram, 90 Brucella strains could be divided into 5 clusters. The first cluster included some species of Brucella abortus,Brucella melitensis,Brucella suis, Brucella ovis; and some of the variant strains of Brucella abortus and Brucella melitensis and the typical strain of Brucella neotomae. The second cluster included typical strains of Brucella suis (1,2,3 and 5 types); vaccine strains of Brucella suis S2; vaccine strains of Brucella melitensis M28、Rev.1 and typical strain of Brucella ovis. The third cluster included some of Brucella melitensis; some of the variant strains of Brucella melitensis; some of Brucella abortus(3,6 types); Brucella canis and Brucella ovis. The fourth cluster was the typical strain of Brucella canis.and the fifth cluster included some of Brucella melitensis(1 type); some of Brucella abortus (1 type); some of the variant strains of Brucella melitensis and Brucella suis(1,3 type). It is apparent that CFAs information can be used in brucella typing. and Brucella suis and Brucella canis can be distinguished by the difference in the CFA contents of 3 fatty acids 19:0CYCLOω8c, 18:1ω7c and 16:0. The results of CFAs typing in Brucella species show that Brucella canis includes 2 biovars at least and the high homologization of Brucella abortus (3 type) and Brucella abortus(6 type) can be found.

Objective To detect the incidence of inherited metabolic diseases(IMD)and disorders of metabo-lism in 4 710 high - risk infants,as well as providing basis of clinical diagnosis and treatment by using urease pretreat-ment - gas chromatography - mass spectrometry(UP - GC - MS). Methods Samples were collected from high - risk infants with IMD,after removing urea,putting in internal standard,removing protein,vacuum drying and bis (trimethyl - silyl)trifluoroacetamide / trimethyl - chlorosilane derivativing,UP - GC - MS was used to analyze compo-sitions such as organic acids,amino acids,carbohydrates,pyridoxines,purines and pyrimidines,then metabolic analysis was proceeded to refer to the normal detection value of the healthy children,finally a metabolic diagnosis was made ba-sing on the clinical data such as the high - risk clinical manifestations and general biochemical tests and other special examinations. Results In the 4 710 cases,there were 98 cases of IMD(2. 1% ),326 cases of suspected IMD(6. 9% ), 2 610 cases of metabolic disorders(55. 4% ). There were 98 cases of IMD,including 57 cases of methylmalonic aciduria,12 cases of propionic acidemia,7 cases of glutaric aciduria,5 cases of hyperphenylalaninemia,maple syrup u-rine disease and multiple carboxylase defects each,4 cases of isovaleric acidemia and 3 cases of 4 - hydroxy butyric acid urine disease. Conclusions UP - GC - MS is a effective way to diagnose IMD and metabolic disorders of infants. Common IMD in Guangdong Province include methylmalonic aciduria,propionic academia,glutaric aciduria,hyperphe-nylalaninemia,maple syrup urine disease and multiple carboxylase defects. The results of the tests can provide effective guidance for diagnosis and treatment of suspected infants.

Objective To explore the application and effect of SBAR communication model in clinical nursing teaching. Methods Delphi Method was used to determine SBAR clinical nursing teaching points and the clinical teaching program. A total of 80 baccalaureate and associated students were selected as the research subjects by the method of stratified sampling in the 2015-2016 academic year of Affiliated Hospital of Weifang Medical University.They were divided into experimental group and control group by random digits method.The control group was taught regularly,and the experimental group was given SBAR communication model. Both teachers and nursing students′ satisfaction, patient satisfaction, nursing students and patient communication ability questionnaires were used to observe the effectiveness of SBAR communication model in clinical nursing students teaching. Results Five key points of SBAR communication model in the application of clinical nursing teaching was established,and the corresponding teaching plan was formed.The data of two-way satisfaction survey,patient satisfaction survey, and evaluation of nurse patient communication ability of nursing students of experimental group and control group were analyzed, with statistical significant difference. Data showed that the relevant statistical indicators of the experimental group were better than those of the control group(t = 2.079 5-18.267 6, P<0.05). Conclusions The application of SBAR communication model in clinical nursing teaching can significantly elevate student nurses′communication ability.

Objective:To analyze the risk factors of acute kidney injury (AKI) in patients with septic shock in intensive care unit (ICU), construct a predictive model, and explore the predictive value of the predictive model.Methods:The clinical data of patients with septic shock who were hospitalized in the ICU of the Affiliated Hospital of Jining Medical College from April 2015 to June 2019 were retrospectively analyzed. According to whether the patients had AKI within 7 days of admission to the ICU, they were divided into AKI group and non-AKI group. 70% of the cases were randomly selected as the training set for building the model, and the remaining 30% of the cases were used as the validation set. XGBoost model was used to integrate relevant parameters to predict the risk of AKI in patients with septic shock. The predictive ability was assessed through receiver operator characteristic curve (ROC curve), and was correlated with acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), procalcitonin (PCT) and other comparative verification models to verify the predictive value.Results:A total of 303 patients with septic shock were enrolled, including 153 patients with AKI and 150 patients without AKI. The incidence of AKI was 50.50%. Compared with the non-AKI group, the AKI group had higher APACHEⅡscore, SOFA score and blood lactate (Lac), higher dose of norepinephrine (NE), higher proportion of mechanical ventilation, and tachycardiac. In the XGBoost prediction model of AKI risk in septic shock patients, the top 10 features were serum creatinine (SCr) level at ICU admission, NE use, drinking history, albumin, serum sodium, C-reactive protein (CRP), Lac, body mass index (BMI), platelet count (PLT), and blood urea nitrogen (BUN) levels. Area under the ROC curve (AUC) of the XGBoost model for predicting the risk of AKI in patients with septic shock was 0.816, with a sensitivity of 73.3%, a specificity of 71.7%, and an accuracy of 72.5%. Compared with the APACHEⅡscore, SOFA score and PCT, the performance of the model improved significantly. The calibration curve of the model showed that the goodness of fit of the XGBoost model was higher than the other scores (the calibration curve had the lowest score, with a score of 0.205).Conclusion:Compared with the commonly used clinical scores, the XGBoost model can more accurately predict the risk of AKI in patients with septic shock, which helps to make appropriate diagnosis, treatment and follow-up strategies while predicting the prognosis of patients.