BACKGROUND: Because of their size effect, nanometer particles (NPs) can combine molecular within cells, which can result in cell necrosis or apoptosis. But there are no systematic mechanisms of apoptosis induced by NPs about biological safety of NPs.OBJECTIVE: To investigate the effect of nano-hydroxyapatite particles on mononuclear macrophage in rat abdominal cavity at celluar and molecular level.DESIGN, TIME AND SETTING: A materials-cytology observation was performed at Shanghai Biomaterials Research & Testing Center from January 2001 to December 2008.MATERIALS: SD rats of clean grade were provided by SINO-BRITISH SIPPR/BK LAB. ANIMAL Co., Ltd.; NPs were provided by Shanghai Institute of Ceramics.METHODS: Peritoneal fluid was extracted under a sterility environment to in vitro separate and culture mononuclear macrophage using adherence method. The concentration of cell was adjusted at 2×10~9/L. At 300 W/40 kHz ultrasound, cell suspension containing 20,100 and 200 mg/L nano-hydroxyapatite particles was prepared to induce mononuclear macrophage for 24 hours, respectively. A normal control group was established.MAIN OUTCOME MEASURES: Ultrastructural phenotype was detected using transmission electron microscope; apoptotic rate was measured using AnnexinV-EGFP/PI staining; variation of apoptosis-related P53 gene expression was detected using Western Blot.RESULTS: Pseudopodia of mononuclear macrophage in the normal control group were intact, nuclear membrane was normal, and nucleoplasm was uniformed. After inducing by 20,100, 200 mg/L nano-hydroxyapatite particles for 24 hours, apoptotic morphological characteristics were typical in mononuclear macrophage. Compared with normal control group, apoptotic rate was significantly increased following the induction of 20 and 100 mg/L nano-hydroxyapatite (P< 0.01), and the increasing in the 100 mg/L nano-hydroxyapatite particle group was greater than 20 mg/L nano-hydroxyapatite particle group (P < 0.05). P53 protein was not observed in mononuclear macrophage in the normal control group. Following induction of varying concentrations of nano-hydroxyapatite particles, P53 protein expression was increased in the mononuclear macrophage, and the expression was positively related to concentration of nano-hydroxyapatite particles.CONCLUSION: Nano-hydroxyapatite particles can induce p53 expression through phosphorylation, which promotes downstream genes and finally results in cell apoptosis.

Background:Intrahepatic cholestasis is a commonly seen clinical manifestation, and often accompanied with jaundice.Study on clinical characteristics of patients with different degrees of jaundice is helpful for the acknowledge of intrahepatic cholestasis.Aims:To explore the clinical characteristics of intrahepatic cholestasis with jaundice.Methods:General data, biochemistry parameters, etiology and treatment of 703 patients with intrahepatic cholestasis were retrospectively analyzed.Results:Jaundice occurred in 168 patients (23.9%), including 149 mild jaundice, 15 moderate jaundice and 4 severe jaundice.Levels of ALT, AST, ALP, GGT, DBIL, TBIL, ratio of DBIL/TBIL, TBA were significantly increased in jaundice group than in non-jaundice group (P<0.05).Levels of ALT, AST, DBIL, TBIL, TBA were statistically different between groups with different degrees of jaundice (P<0.05), however, no significant differences in ALP, GGT, ratio of DBIL/TBIL were seen (P>0.05).The main etiology of intrahepatic cholestasis were digestive system tumors, cardiovascular diseases, shock, hematologic diseases and primary biliary cholangitis.Ursodeoxycholic acid and S-ademetionine were the main drugs for treatment of intrahepatic cholestasis.Conclusions:For patients with intrahepatic cholestasis, levels of ALT, AST, ALP, GGT are increased with the development of jaundice, and attention on damage of hepatocytes should be paid.The etiology of intrahepatic cholestasis with jaundice involves diseases of different organs and systems, most of them are malignant tumor, cardiovascular diseases, shock and primary biliary cholangitis.

OBJECTIVETo study the Cupric ion release characteristics of different copper raw materials in intrauterine device in vitro by ICP. Reveal the relationship between purity and shape of Cu-IUD copper and copper ion release.

METHODSAccording to a certain proportion, the copper raw materials were 100 times diluted into the simulated uterine solution at 37 +/- 0.5 degrees C. Replaced medium at certain time points and collected soaking liquid. Using ICP analyzed the concentration of copper ion released.

RESULTSThe largest daily release of copper ions was in the first 7 days. There was no statistically significant difference between the copper ion release amount of 99.99% and 99.95% purity copper wire (P > 0.05). The release of copper ion of the copper wire was far greater than that of the copper pipe in early stage (P < 0.01). The release amount decreased and stabilized at 56 day.

CONCLUSIONRelease characteristics of copper ion could effectively analysis by ICP. And in the same area, the release amount of copper ions of copper wire was greater than that of copper pipe.

Objective:The clinicopathological features, diagnosis, and prognosis of follicular thyroid carcinoma (FTC) with distant me-tastasis as the first manifestation were evaluated in this study. Methods:A total of 129 FTC cases with clinical data were retrospective-ly analyzed in the Department of Pathology, Tianjin Medical University Cancer Institute and Hospital (January 2001 to January 2016). Survival analysis and conjoint analysis on FTC with clinical data, diagnosis, and morphological characteristics with distant metastasis as the first manifestation were performed. Results:Among the 129 FTC cases, 24 cases demonstrated distant metastasis as the first mani-festation (18.6%). Bone metastasis was the most common (13.2%). The presence of mass and pain at the metastatic sites were the usu-al clinical complaints. The morphological characteristics of FTC with distant metastasis can be classified into four subtypes:microfollicu-lar (10 cases), solid (4 cases), normofollicular (9 cases), and macrofollicular (1 case). Immunostaining tests on thyroglobulin and thyroid transcription factor-1 showed positive results in FTC with metastasis. Survival analysis showed that the five-year survival rates in the 24 cases were 87.1%. The prognosis of patients with solitary metastasis was better than that of patients with multiple metastasis (P=0.022). A higher survival rate was found in the normofollicular and macrofollicular subtypes than that detected in the microfollicular and solid subtypes (P=0.012). Conclusion:FTC is susceptible to distant metastasis. Some patients with FTC demonstrated distant me-tastasis as the first manifestation, and their diagnosis can be confirmed by pathological feature analysis and immunostaining. The prog-nostic significance is possibly related to the number of lesions of FTC with distant metastasis and histopathological subtypes.

Objective To discuss whether it is necessary to integrate metabolic indices into diagnosis of polycystic ovary syndrome (PCOS).Methods Taking ESHRE/ASRM diagnosis as the gold standard,51 women with PCOS and 47 women without PCOS were selected and divided into the intervention group and control group respectively from the Department of Gynecology in the Second Affiliated Hospital of Kunming Medical University between January 2013 and July 2014.Logistic regression based on principal component analysis and significant variables chosen through single factor analysis were used to establish the new diagnostic model which combined reproductive indices and metabolic indices.We evaluated the validity and reliability of the new diagnostic model by using ROC curve analysis.Finally,we analyzed the consistence and difference between the new diagnostic model and the gold standard.Results Thirteen significant variables were chosen using single factor analysis.ROC analysis showed that an area under the curve was 0.976 (P＜0.001) and the optimal cut-off point was 0.526 with a sensitivity of 96.08％,a specificity of 93.62％ and a consistency of93.88％.The new diagnostic model had superior validity and reliability.The two diagnostic methods had strong consistence (Kappa=0.877,P＜0.001) and no difference (x2=0.167,P=0.688).Conclusion Considering that the integration of metabolic indices does not change the diagnosis result,we come to a conclusion that it is unnecessary to integrate metabolic indices into diagnosis of PCOS.

Objective We sought to compare the ability of MEWS score,APACHE Ⅱ score and combination of the two scoring systems to predict the prognosis of patients in emergency medical department.Methods During January to March 2014,640 patients in emergency medical department who met the criteria were set as the research object.The patients admission was the starting point for clinic observation.The relevant data were collected for carrying on the MEWS and APACHE Ⅱ ratings,tracking the patients' prognosis.The corresponding predictors for prognosis of patients such as sensitivity,specificity,positive predictive value,negative predictive value and ROC curve by MEWS score,APACHE Ⅱ score and combination of the two scoring systems were compared.Results The area under the receiver operating characteristic curve was 0.93,0.79 and 0.93 with MEWS score,APACHE Ⅱ score and combination of the two scoring systems.The comparison of either of the two scoring systems showed significant difference.When death was named as the prediction factor,the sensitivity,specificity,positive predictive value and negative predictive value were 76.92％,91.70％,51.02％,97.23％ for MEWS score; 83.08％,62.80％,20.15％ and 97.04％ for APACHE Ⅱ score; 92.31％,86.43％,43.48％ and 97.58％ for combination of the two scoring systems.Conclusions Combination of the MEWS and APACHE Ⅱ scoring systems can be used to predict the prognosis of patients in emergency medical department.It posesses high sensitivity,specificity,positive predictive value and negative predictive value,which indicating a high predictive capability.

Objective To interpret the major characteristics of literatures cited by 2015 ATA management guidelines for adult patients with thyroid nodules and DTC (2015 version).Methods The titles,datelines of the references,the medical specialties and regional distribution of the journals,and the definition of the scientific evidence rating for relevant references were extracted and analyzed.The data were roughly compared with those of 2009 revised ATA management guidelines for patients with thyroid nodules and DTC (2009 version).Results A total of 1 078 literatures,from 172 journals and 8 books,were cited by 2015 version,with 63 years spacing from 1952 to 2015.Extensive medical specialties were involved.The journals were world-wide distributed but the regional bias was obvious.Compared to the 2009 version,2015version adopted more recent literatures,and used more evidence rating for the recommendations.However,references with high-quality evidence were both less than 50％ in the two versions.Conclusion Huge amount of references with multi-specialties have been cited in 2015 version,however the regional distribution bias is distinctive and references with high-quality evidence are still insufficient.

OBJECTIVEThis study aimed to investigate the effects of different tooth preparations on the fracture strength and pattern of failure of teeth with severe wedge-shaped defect restored with post and core crowns.

METHODSAccording to whether the teeth above the wedge-shaped defect was removed (represented by B) or not (represented by A), the ferrule next to the wedge-shaped defect was prepared (represented by D) or not (represented by C), the cast post-and-core was chosen (represented by E) or glass-fiber post and resin core was chosen (represented by F). A total of 64 human mandibular premolar teeth were randomly divided into 8 groups: A1-1 (A + C + E), A1-2 (A + C + F), A2-1 (A + D + E), A2-2 (A + D + F), B1-1 (B + C + E), B1-2 (B + C + F), B2-1 (B + D + E), B2-2 (B + D + F), each group 8 teeth. All the teeth were prepared and restored accordingly and then mounted on an electronic pressure universal testing machine. The maximum fracture strength and the patterns of failure were recorded.

RESULTS1) The fracture strength of Group A1-1 > that of Group B1-1, Group A1-2 > Group B1-2, Group B2-1 > Group B1-1, and Group B2-1 > Group B2-2 with significant differences (P < 0.05). 2) The patterns of repairable fracture in Group A1-2 and B1-2 were both 37.5%, and that of the other groups were 0. Furthermore, the difference was significant, and Group A1-2 and B1-2 were higher than other groups.

CONCLUSIONThe maintenance of the overhang above the severe wedge-shaped defect aid in the improvement of the fracture strength of the tooth restored with post and core crown. The ferrule of the wedge-shaped defect is not recommended to be prepared. Furthermore, the glass-fiber post and resin core is favorable for the re-repair of the teeth than the cast post and core.

Objective To evaluate the effect of Ji Tang Zhi on glucose metabolism in insulin resistance (IR) HepG 2 cell line,and to explore the related mechanism.Methods The HepG2 cells were incubated in culture medium addition of 10-7 mol/L insulin for 24 h to establish the IR cell model.Effect of Ji Tang Zhi on rate of glucose absorption in HepG2 cell was detected by the method of glucose oxidase-peroxidase (GOD-POD).We performed an MTT assay to determine cytotoxicity effects of Ji Tang Zhi on HepG2 cell line.The expression of p-IRS-1 Ser307,PI3K and GLUT-4 were detected by Western blotting.Results Incubated with 10-7 mol/L insulin for 24 h,the insulin resistance cell model had been built.Compared with model group,the rate of glucose absorption of cell treated with JTZ (30 ～ 120 μg/mL) was significantly improved.According to model cells,the expression of GLUT-4 and PI3K decreased significantly compared to control cells.While the expression of p-IRS-1 Ser 307 was inhibited and GLUT-4 and PI3K expression were increased in IR cells after treated with JTZ (30 ～ 120 μtg/mL).Conclusion JTZ exert beneficial effects on hyperglycosemia in IR cell line possibly through regulating the levels of GLUT-4,p-IRS-1 Ser307 and PI3K in HepG2 cell.

Objective To investigate the clinical significance of N-terminal pro-B-type natriuretic peptide(NT-proBNP) detection in evaluation of acute type A aortic dissection (AAAD) prognosis .Methods Medical records of patients with confirmed diagnosis of AAAD were retrospectively analyzed .64 patients were enrolled in accordance with the inclusion and exclusion criteria ,and were di-vided into survival group(n=56) and death group(n=8) according to prognosis .Multivariate Logistic regression analysis was em-ployed to screen the independent risk factors which would affected the prognosis .Receiver operator characteristic ,ROC) curve was used to evaluate the predictive value of NT-proBNP for AAAD prognosis .Results Differences of history of smoking ,incidence sea-son ,disturbance of consciousness ,misdiagnosis ,low density lipid-cholesterol(LDL-C) ,fasting C-peptide(FCP) ,hypersensitive C-re-active protein(hs-CRP) ,cardiac troponin I(cTnI) ,NT-proBNP ,mean arterial pressure(MAP) and prothrombin time(PT) of pa-tients between the survival group and the death group showed statistical significance (P<0 .05) .Multivariate Logistic regression a-nalysis demonstrated that smoking history ,disturbance of consciousness ,high LDL-C ,high cTnI ,high NT-proBNP and low MAP were independent risk factors for patients with poor prognosis .ROC area under the curve(AUC) of NT-proBNP prediction for peri-operative mortality risk of patients with AAAD was 0 .697(P< 0 .05 ,95% CI:0 .643~0 .733) ,and its specificity and sensitivity were 75 .85% and 70 .07% ,respectively .When NT-proBNP was 909 .69 pg/mL ,its predictive value for AAAD was the best .Set the critical value as the threshold ,the patients above were divided into the threshold above group and the threshold below group . The survival rate of patients in the threshold below group [98 .18% (54/55)] was significantly higher than that in the threshold a-bove group[22 .22% (2/9)](χ2 = 7 .211 ,P< 0 .05) .Conclusion NT-proBNP level is closely related to the prognosis of patients with AAAD and NT-proBNP detection may be conducive to predicting high risk of AAAD .