Objective To investigate the role of plasma matrix metalloproteinase-9 (MMP-9) and nuclear factor kappa B (NF-κB) in the pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension.Methods The patients were selected in the respiratory medicine and neurology of our hospital from January 2014 to June 2014.Polysomnography(PSG) monitoring was employed to assess the patient.All patients were divided into 3 groups,including snoring group(23 cases),OSAHS group(32 cases),OSAHS with hypertension group(31 cases).And then according to the hypertension stage,OSAHS with hypertension group was divided into 3 groups,including OSAHS with stage 1 hypertension group(9 cases),OSAHS with stage 2 hypertension group(9 cases),OSAHS with stage 3 hypertension group(13 cases).The plasma MMP-9 was measured by ELISA.The mRNA expression levels of MMP-9 and NF-κB were detected by real-time quantitative PCR.Results The levels of MMP-9 and MMP-9 mRNA and NF-κB mRNA in OSAHS with hypertension group were significantly higher than those of snoring group and OSAHS group and the differences were statistically significant(P<0.05).The expression of MMP-9,the MMP-9 and NF-κB mRNA expression of monocytes in OSAHS with stage 3 hypertension group was significantly higher than those of OSAHS with stage 1 hypertension group and OSAHS with stage 2 hypertension group and the differences were statistically significant(P<0.05).The plasma MMP-9 was positively correlated with AHI and oxygen desaturation index and negatively correlated with LSaO2(P<0.05).The plasma MMP-9 was positively correlated with the MMP-9 mRNA expression(P<0.05).The MMP-9 mRNA expression was positively correlated with the NF-κB mRNA expression(P<0.05).Conclusion The plasma concentrations of MMP-9,the MMP-9 and NF-κB mRNA expression of monocytes in OSAHS with hypertension patients was significantly high,which is associated with disease severity and degree of hypoxia.The MMP-9 might play an important role in the pathogenesis of OSAHS with hypertension and be regulated by NF-κB pathway.

Objective To evaluate the protective effect of genistein on psoralens plus ultraviolet A (PUVA)-induced photoaging in human dermal fibroblasts (HDFs) in vitro.Methods Dermal fibroblasts were isolated from the foreskin of a healthy 5-year-old boy,and subjected to primary culture.After 5-8 passages of subculture,the fibroblasts were collected and used in the following experiment.To determine the optimal concentration of genistein,methyl thiazolyl tetrazolium (MTT) assay was conducted to detect the proliferation of fibroblasts pretreated with 8-methoxypsoralen (8-MOP) and various concentrations (0-20 μg/ml) of genistein for 24 hours followed by UVA irradiation.Then,the fibroblasts were divided into 3 groups:normal control group receiving no treatment,photoaging group incubated with 8-MOP for 24 hours followed by UVA irradiation,and genistein group incubated with both 8-MOP and genistein at the optimal concentration for 24 hours followed by UVA irradiation.After additional culture,invert microscopy was carried out to observe the morphology of fibroblasts,enzyme histochemistry to assess senescent cells by using SA-β-Gal kit,flow cytometry to determine the level of reactive oxygen species (ROS),real-time fluorescence-based quantitative PCR to detect the matrix metalloproteinase-1 (MMP-1) expression.One-way analysis of variance was conducted to assess the differences in these parameters among these groups.Results At 24 hours after UVA irradiation,the percentage of fibroblasts positive for SA-β-galactosidase was (0.67 ± 0.58)％,(96.67 ± 1.53)％ and (51.67 ± 2.08)％ in the normal control group,photoaging group and genistein group respectively,with significant differences among these groups (P ＜ 0.01).The level of ROS in the photoaging group and genistein group was (0.88 ± 0.24) and (0.62 ± 0.02) fold higher than that in the control group(both P ＜ 0.01).Moreover,the MMP-1 expression level in the photoaging group and genistein group was 10 times and 6 times that in the control group,respectively,with significant differences among the 3 groups (P ＜ 0.05).Conclusion In vitro,genistein can protect against PUVA-induced photoaging in human dermal fibroblasts to some extent.

Objective To understand the practice of experiential teaching in the core midwifery curriculum. Methods Phenomenology as a qualitative research method was utilized and fifteen students participated in the non-structured interviews. Results Four themes were found: comprehension of knowledge;professional thought; teacher- student relationship;gratitude. Conclusions Experiential teaching can increase the teaching effect of core midwifery curriculum, and develop good ideological and professional qualities.

Objective To improve the corrected results of the nasal deformities of the hare lip nose. Methods Based on the reposition of the lower lateral cartilages and the caudal septum, the authors corrected the secondary hare lip nose with the L shaped silicon rubber graft to reinforce and model the nasal tip.Results From 1996～2000, the procedure was performed for 20 cases (15 male, 5 female ), aged from 16～21 years. Follow up was from 3 months to 4 years. All cases obtained satisfactory results. Conclusions The results of utilizing L shaped silicon rubber graft combined with reposition of the mislocated nasal cartilages are better than the latter method only, especialy for the nasal tip. The procedure is easy to learn .The material silicon rubber graft is cheap and can be trimmed very conveniently. And it can also correct the saddle nose at the same time.

Objective:To study the diagnosis value of Transcranial Doppler ultrasound for intracranial artery stenosis in patients with cerebral infarction.Methods:A total of 140 patients with acute cerebral infarction,transient ischemic attack and posterior circulation ischemic attack in Department of Neurology,Xinjiang cardiovascular and cerebrovascular disease hospital from October 2014 to October 2016 were selected as research object,CT angiography (CTA) and TCD detection were performed in all patients.Used CTA examination results as the gold standard,the detection results of intracranial artery stenosis in two groups were compared,the diagnostic value of TCD and the diagnostic results of TCD to the degree of bilateral middle cerebral artery (MCA) stenosis were analyzed.Results:CTA diagnosis showed that 140 patients had a total of 105 patients with intracranial artery stenosis,in the anterior and posterior circulation vessel of 1155 intracranial segments,CTA detection showed that 249 vessels were narrow,TCD detection showed that 236 vessels were narrow.Com-pared with CTA,TCD was better in the diagnosis of patients (Kappa value＞0.75).The diagnostic sensitivity and positive predictive value of TCD for MCA were the highest,which were 91.26％ and 93.07％,the consistency was the best (Kappa value =0.917).CTA detection showed that 210 MCA vessels had 103 stenoses,mild stenosis 17,moderate stenosis 41,severe stenosis 45,TCD detection showed that the stenosis was 101,mild stenosis 16,moderate stenosis 40,severe stenosis 45.The Kappa test showed that the diagnostic results of TCD to the degree ofMCA stenosis was better consistency compared with CTA (Kappa value=0.884.Conclusion:TCD has a high diagnostic value for cerebral artery stenosis in patients with cerebral infarction,and it is consistent with the diagnosis of CTA.

Objective To investigate the value of ultrasound guided autobiopsy technology in interventional diagnosis of pulmo-nary peripheral disease .Methods 117 cases of pulmonary peripheral disease proved by X-ray or CT ,confirmed by ultrasound ,but could not be identified the nature by the examination above ,were biopsied under the guidance of ultrasound .Results All the 117 ca-ses were biopsed successfully .115 cases of them had definite pathological results ,the pathological positivity rate was 98 .3% ,in which contained 20 cases of chronic inflammation ,14 cases of tuberculosis ,30 cases of squamous cell carcinoma ,45 cases of adeno-carcinoma ,6 cases small cell undifferentiated carcinoma .No complication ,such as pneumatothorax ,hemoptysis ,bleeding occurred during the operation .Conclusion The ultrasound guided autobiopsy technology in interventional diagnosis of pulmonary peripheral disease is a safe and effective technique ,the tissues obtained from ultrasound guided autobiopsy were adequate to pathological slide which can provide the basis of the clinical diagnosis .

Objective To evaluate the incidence and epidemiologic characteristics of Kawasaki disease (KD)in Nanjing.Methods We reviewed the medical records and reports of all patients admitted to Nanjing Chil-dren′Hospital with KD diagnosed during 3 -year periods from 2012 to 2014.Results We studied 1 446 inpatients diagnosed with KD from 2012 to 2014.There were 1 135 cases(78.5%)with complete KD.The ratio of male to female was 1.7241.The disease occurred in all of the seasons,but the peak was from spring to summer.Age at onset ranged from 1 month to 14 years old,and the peak age group was 1 year old.Fever(99.45%)was the most common clinical symptom,followed by conjunctive congestion(93.15%),rash(73.32%),oral changes(51.76%), extremities desquamate(75.08%)and lymphadenopathy(45.89%).There were 131(9.05%)patients with coronary aneurysm,the ratio of male to female was 3.02  1.14 patients (0.97%)developed recurrent KD.Conclusion Patients with KD has become more and more in Nanjing,and clinical doctors should improve the understanding of KD. Early diagnosis and treatment is very important to reduce the sequelae and reduce the mortality of KD.

Objective To investigate the distribution of human papillomavirus(HPV)in different age groups and its correlation with the degree of cervical lesions.Methods 2 031 patients with HPV screening specimens in our hospital from May 2012 to May 2015 were chosen as study subjects.To acquire patient cervical squamous columnar epithelial cells at the junction to detect HPV DNA types.HPV -positive patients used ultra -thin liquid -based cervical cytology technology (TCT)to detect.Patients with abnormal TCT detection were performed with electronic biopsy,and the diagnosis was made by pathology biopsy,and analyzed the distribution of HPV in different age groups and different degree of cervical lesions.Results In different age groups,≤20 years of age groups of patients with high -risk HPV positive rate was 19.7%,which was significantly higher than that of >20 -30 years,>30 -40 years and >40 -50 years three groups (14.4%,13.9%,15.0%)(χ2 =4.259,5.724,3.988,all P <0.05).There was no significant difference with the 50 years old group (17.1% )(χ2 =1.724,P >0.05).There was no significant difference in HPV positive rate among the ≤20 years,>20 -30 years,>30 -40 years,>40 -50 years,>50 years ages patients with high risk HPV infection group and low risk HPV infection group(χ2 =0.679,1.021,0.968,0.736, 0.668,all P >0.05).In the high -risk HPV infected group,the risk of single type infection in >20 -30 years,>30 -40 years,>40 -50 years,>50 years ages patients were significant higher than the mixed types infection(χ2 =4.213,3.894,4.256,5.330,5.666,all P <0.05).Infected patients of all ages with high -risk HPV were HPV16, HPV52,HPV58 type -based,low -risk type HPV43 type places mainly.More than 31 to 40 years age group of patients infected with high -risk HPV types in cervical lesions mainly cervicitis and 40 years and older group of patients with high -risk HPV infection incidence of invasive cervical cancer were significantly higher.Conclusion Different age groups of women for HPV genotyping is important for diagnosis of cervical lesions.

Objective To investigate the distribution of pathogens and positive alarming time of blood culture,and provide basis for laboratory diagnosis and clinical treatment. Methods Blood specimens from clinical departments in a hospital in May-November 2015 were collected,positive alarming time of blood culture was recorded,species of pathogens were identified. Results A total of 157 pathogenic strains were isolated from blood culture specimens, gram-positive cocci,gram-negative bacilli,and fungi accounted for 31 .85% ,57.32% ,and 10.83% respectively. The median positive alarming time were as follows:Enterobacteriaceae 0.50 day,non-fermenting bacteria 0.63 day, Enterococcusspp. 0.60 day,Streptococcusspp. 0.80 day,Staphylococcusspp. 1.01 days,and fungi 1.44 days, respectively. Conclusion Positive alarming time of blood culture specimens from early to late are as follows:Enter-obacteriaceae,Enterococcus,non-fermentative bacteria,Streptococcus spp.,Staphylococcus spp.,and fungus. Positive alarming time of pathogens causing bloodstream infection are all within 4 days,and most of them are within 1 day.

Background Constipation is a common complication after stroke, and the results investigated overseas showed the incidence was about 30% ～60%. The difference of results is so significant because the time investigated and the diagnosis criterion used are different. There are less relative report about risk factors of constipation and no report about the impact of constipation on pragnosis. The study is to investigate the incidence and risk factors of new-onset constipation after stroke in the patients with acute stroke and to evaluate the impact of new-onset constipation occurrence on the prognosis in the patients.Methods A prospective cohort study of new-onset constipation was performed to investigate 154 cases of acute stroke patients who were hospitalized from December 2003 to October 2004 in the department of neurology, the first Affiliated Hospital of Sun Yat-sen University. We recorded the demographics, medical history,stroke severity and medication used. National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI)and Modified Rankin Scale (MRS) were evaluated in the 1st week and 4th week after stroke to evaluate the neurological function and ability of an independent life. BI and MRS were recorded at the 12th week after stroke.Patients were then followed for the development of stroke, the event such as recurrence or death. Constipation was defined by Rome Ⅱ criteria.Results The incidence of new-onset constipation after stroke within 4 weeks was 55. 31%, and the highest risk was within seven days after onset of stroke. Cox regression showed that the incidence of constipation occurrence was strongly related to neurological functional status of patients in the 1st week assessed by BI and the transform of surrounding for defecation. In the 4th week and 12th week after stroke, the rates of poor prognosis in patients with constipation in middling state were both higher than patients without constipation, and the difference was statistically significant respectively(P ＜ 0. 01 ;P = 0. 012).Conclusions The new-onset constipation occurrence in acute stroke is very common and its main risk factor is functional status assessed by Barthel Index at the 1st week after onset and the transform of surrounding for defecation. The results indicate that the new-onset constipation occurrence after stroke has negative effects on the outcome of partial stroke patients.