Objective To explore the role of extracellular signal-regulated kinase(ERK)in the apoptosis of hepatic stellate cells(HSC) induced by Arg-Gly-Asp-Ser (RGDS) tetrapeptide. Methods The cultrued HSC cells were divided into six groups including untreated control, fibronertin (FN), FN+RGDS (25 mg/L), FN+RGDS (50 mg/L), FN+RGDS(100 mg/L) and FN+Arg-Gly-Glu-Ser(RGES, 100 mg/L) groups. 3H-thymidine incorporation, transmission electron microscopy and TUNEL were employed to estimate the influence of RGDS on proliferation and apoptosis of HSC. The HSC adhesion rates were observed by toluidine blue colorimetric assay. The expressions of ERK mRNA and ERK protein in HSC were detected by RT-PCR and Western blotting. Results Compared with control and fibronectin groups, RGDS tetrapeptide at concentrations of 25 mg/L, 50 mg/L and 100 mg/L inhibited the proliferation of HSC(P

Objective To investigate the effect of zinc oxide oil care on perianal skin ulceration in elderly patients.Methods A total of 90 elderly fecal incontinence patients with perianal skin ulceration were randomized into the observation group(n=48)and the control group(n=42):The former received zinc oxide oil treatment and the latter were treated with mupirocin ointment.Perianal skin injury was evaluated in all the patients and the treatment effect between two groups were statistically analyzed after one week.Result The total effective rate in the observation group(93.8%)was significantly higher than that in the control group(71.4%)(χ2=8.036,P<0.01).Conclusions Management of perianal skin ulceration in bedridden elderly patients with zinc oxide oil may produce better effect.

Objective To observe the health-related quality of life of children with recurrent respiratory tract infection (RRTI) simultaneously inoculated by pneumococcal vaccine combined with influenza vaccine.Methods A total of 454 cases with RRTI were randomly divided into four groups,the control group (n =135) was used with placebo only,and the combined inoculation group (n =143) was simultaneously inoculated with pneumococcal vaccine combined with influenza vaccine,the pneumococcus vaccine group (n =95),influenza vaccine group (n =81).The PedsQLTM 4.0 score and clinical indicators were observed in each group before the inoculation and 14 months after the inoculation.Results There were no significant differences in the number of cases,gender,age,duration and socioeconomic status score in the four groups (P ＞ 0.05).The incidence of upper and lower respiratory tract infection,respiratory diseases caused by the frequency of fever,the number of days of antibiotic use and total cost of treatment in the vaccine group were significantly less than those of the control group (P ＜ 0.05).And the combined inoculation group was significantly better than the pneumococcus vaccine group and influenza vaccine group(P ＜ 0.0l).The PedsQLTM 4.0 score showed no significant differences among four groups (P ＞ 0.05) before the inoculation.Each dimension of the quality of life of the vaccine group significantly increased (P ＜ 0.05) while those of control group showed no significant difference (P ＞ 0.05).Conclusion Combination of inoculation of pneumococcal vaccine and influenza vaccine can effectively improve the health-related quality of life of RRTI children as well as the PedsQLTM 4.0 score,and it should be highly recommended clinically.

Objective To compare the operation effect of esophageal foreign body removal with transparent cap-assisted endoscopic technique and traditional method. Methods Ninety-six patients with foreign body incarcerated in esophageal were randomly divided into two groups, and they were underwent transparent cap-assisted endoscopic esophageal foreign body removal or traditional endoscopic esophageal foreign body removal respectively. The clinical data of the two groups were collected, and the success rate, the operation time, the endoscopic vision clarity and the complication rate of the two groups were all recorded and analyzed. Results The success rate in transparent cap-assisted endoscopic technique group was 100% compared with 95.83% in traditional method group, and two cases of failure were transferred to transparent cap-assisted endoscopic technique and finally succeed. The mean operation time were (8.58±3.21) min in transparent cap-assisted endoscopic technique group, and (10.64 ± 5.45) min in traditional method group, and there was no significant difference in two groups (P > 0.05). Forty-five cases got A level and three got B in transparent cap-assisted endoscopic technique group in endoscopic vision clarity, in contrast to 35 A, 11 B and two C in traditional method group. The difference between the two groups was statistically significant (P = 0.020). There was no case with serious complications such as bleeding, perforation or death in two groups. Conclusions Transparent cap-assisted endoscopic technique for body removal is safety and efficacy, and this technique can provide better endoscopic operation field of vision and help improve the success rate of esophageal foreign body removal.

Objective To determine whether the cross-sectional area (CSA)of the calf measured with MRI could stage lower ex-tremity lymphedema (LEL)secondary to gynecological cancer treatments.Methods 148 patients were enrolled in this research.116 females with unilateral LEL and 32 without LEL after gynecological cancer treatments underwent calf MRI and water displacement. Total soft tissue CSA (T),muscle CSA (M)and subcutaneous tissue CSA (S)of affected calf,and difference of T (DT),M (DM) and S (DS)between calves were obtained on MRI at mid-calf level.Volume of affected calf and difference of volume (DV)between calves were obtained by water displacement.Statistical analysis was performed to determine feasibility of MRI measurements for ac-cessing LEL.Results There were close correlations between volume and T or S of affected calf,and between DV and DT or DS of calves.The correlations of stages of LEL with T and S of affected calf as well as DT and DS were stronger than the volume of affect-ed calf and DV (P< 0.01).Multivariate analysis showed more significant differences in T and S than in volume of affected calf,and in DS than in DV between LEL stages (P< 0.05).No difference was found in volume of affected calf and in DV between stage 0 andⅠ. For staging LEL,DS showed the most profound discrimination ability among all measurable parameters.Conclusion DS of calves could be the most reliable parameter recommended for staging and early diagnosis of LEL.

21 8 patients with acute pulpitis were randomly divided into 2 groups.1 09 cases were treated by Depulpin inactivation agent (group DI)for emergency management,another 1 09 cases were treated by pulp drainage with phenol camphor cotton ball(group CP).The effective analgesia rate of DI and CP group was 95.4% and 69.7% respectively(P<0.001 ).

Objective To identify the susceptibile genes in a rat model for rheumatoid arthritis (RA),to determine whether sex affects disease onset and to define the mechanisms that impacts congenic genes on arthritis. Methods Arthritis-susceptible DA rats were compared with sex/age-matched congenic rats in which alleles were substituted with alleles from arthritis resistant PVG rats. Incomplete Freund's adjuvant (IFA) was injected from the base of the tail. Arthritis was visually scored, the messenger RNA (mRNA) levels of congenic genes and cytokine were determined by reverse transcription-polymerase chain reaction. The differences between two groups were analyzed using Mann-Whitney U test. Results In oil-induced arthritis (OIA), male congenic R16 rats deviated profoundly from DA rats by decreased arthritis severity (5.9±3.8 vs 9.3±2.3, P＜0.05 ), and markedly reduced lymph node mRNA levels for calsyntenin-3 (Clstn3) gene (0.7±0.4 vs 2.2±1.6, P＜0.01 ) and interleukin (IL)-17 (1.4±2.2 vs 2.7±2.9, P＜0.05) and IL-1β (1.5±2.1 vs 2.3±2.5,P＜0.05) levels. Conclusion Rat Clstn3 gene regulates the production of pro-inflammatory cytokines of OIA in male rats. The effect of arthritis-susceptible gene Clstn3 is gender-specific.

Objective To explore the practical method and teaching effect of problem-based learning (PBL) pattern in teaching of gastrointestinal disease for seven-year-program students during their internal medical probation.Methods The traditional pattern (gastrointestinal diseases) and PBL pattern (hepatobiliary diseases) were applied in these students to assess the teaching effects by exam scores and questionnaire.Results ① There was no significant difference between traditional training and PBL by exam scores (P＞0.05).② The PBL approach was widely accepted by students,which could contribute to the improvement of their learning motivation.It developed skills,including self-directed learning,summarizing,and clinical thinking capability and so on.Conclusion The PBL approach is a practical learning strategy that can improve the teaching effect; therefore it should be wildly practiced in future works.

Objective To investigate the serum levels of soluble human leukocyte antigen (sHLA)-G in patients with polymyositis (PM) or dermatomyositis (DM),and to analyze its association with clinical features and possible role in the pathogenesis of PM/DM.Methods Serum sHLA-G levels of 26 patients with PM,70 patients with DM and 35 matched healthy controls were measured by ELISA.The relationship between the sHLA-G levels and clinical features or seroimmunological data in the patients with PM/DM was analyzed.Results Serum levels of sHLA-G in PM/DM patients were significantly higher compared to healthy controls [(44±70) U/ml vs (4±5) U/ml,P＜0.01].There was statistically significant difference between DM patients and PM patients [(54±81) U/ml vs (27±41) U/ml,P=0.004].The incidence of dysphagia was significantly higher in sHLA-G elevated group than those in sHLA-G normal group (P=0.001).Additionally,Spearman rank correlation analysis showed that the serum sHLA-G levels were positively correlated with serum C3 (r=0.284,P=0.021),but negatively correlated with CD3+ T cells (r=-0.233,P=0.047) and CD4+ T cells (r=-0.287,P=0.015) in the peripheral blood in patients with PM/DM.Serum levels of sHLA-G in non-treated PM/DM patients were significantly higher compared to treated patients [(77±99) U/ml vs (34±52) U/ml,P=0.021].No relationship between serum sHLA-G levels and PM/DM disease activity,or different drug therapy was found.Conclusion Serum levels of sHLA-G are increased in PM/DM patients.The increased production of sHLA-G,paralleled with higher incidence of dysphagia and lower level of CD3+ T cells and CD4+ T cells,indicates that sHLA-G may play an important role in the pathogenesis of PM/DM.

Objective This study aims to test the hypothesis that low density granulocytes (LDGs) is involved in the pathogenesis of DM associated-Interstitial lung disease (ILD).Methods Forty eight DM patients (28 with ILD) and 19 age-and sex-matched healthy Chinese volunteers were recruited to this study.LDGs percentage in peripheral blood mononuclear cells (PBMCs) was tested by flow cytometry.Neutrophilrelated genes (LL-37,MPO and MMP-8) expressions in PBMCs were tested by quantitative RT-PCR.Myositis disease activity assessment visual analogue scales (MYOACT) was used to assess the disease activity.Percentages of LDGs were compared in patients with ILD and without by using unpaired t test with Welch's correction,the correlations between LDGs and clinical parameters were further analyzed by linear correlation analysis.The expressions of neutrophil-related mRNA and proteins in PBMCs were compared by using MannWhitney U test.Results LDGs percentage in PBMCs was 7.1-fold higher in DM patients than healthy controls [(9.1±11.5)％ vs (1.3±0.7)％,t=4.664,P＜0.01].LDGs percentage in PBMCs was 2.7-fold higher in DM patients with ILD than DM patients without ILD [(12.3±14.1)％ vs (4.5±2.6)％,t=2.835,P=0.008 3].The mRNA expression level of LL-37,MPO and MMP-8 and LL-37 protein levels in the DM group were significantly higher than those in the control group.LDGs percentage positively correlated with MYOACT lung disease activity scores (r=0.439,P=0.010).Conclusion Percentage of LDGs in PBMCs is significantly increased in DM patients with ILD and positively correlated with MYOACT lung disease activity scores,suggesting that abnormall increasing of LDGs is a potential contributor to the pathogenesis of DM-associated ILD.