Objective:To evaluate the effects of losartan、fosinopril and captopril on the excretion rate of urinary albumin (UAER) and the clearance of endogenous creatinine (Cr-C) in elderly patients. 　　Methods:In this study,162 elderly patients with stage of the 2—3 class hypertension were included,The patients were divided into 3 groups,that were losartan group and the fosinopril group and captopril group,the anti-hypertensive effects and UAER and Cr-C were determined before and after the treatment. 　　Results:The hypertensive effect rates were 94% in losartan group and 93%、93% in fosinopril group and captopril group respectively.Decrease of UAER was observed in 89% of patient in losartan group and 59%、50% in fosinopril group、captopril group.Cr-C were improved in 94%、78% of patient in losartan group and in fosinopril group and 63% in captopril group. 　　Conclusions:Losartan has better effects on UAER and Cr-C than captopril in elderly hypertensive patients.

Through the analysis on different development paths of western and Chinese medical ethics, this article proposed to construct the Chinese medical ethical review system. Although the medical ethical review system was originated in western countries, due to different origins of medical ethical thoughts, different cultures and beliefs among races, as well as different medical and science development models, the application of western medical eth-ical review system should not be mechanically used in China. The application should follow the idea of har-monization with differences. This article discussed on current status and significance of the construction of an ethical review platform which is suitable to the national conditions of China. It was also emphasized on the im-portance of ethics training among researchers.

Objective To study diagnosis significance of neutrophil surface adhesion molecules including CD11b,in type 2 diabetes mellitus patients with cytomegalovirus (CMV)infection.Methods Blood samples from 139 cases of type 2 diabetes mellitus patients were collected including 99 male and 40 female cases between Septem-ber 2011 and January 2015.Healthy male 20 cases and female 13 cases were collected as healthy control group from outpatients in the same period.Type 2 diabetes mellitus patients were divided into high active CMV infection group, CMV infection group and the negative control group,and healthy group as normal control group according to CMV -pp65 antigen detection.Neutrophil surface adhesion molecule CD11b was analyzed by flow cytometry and compared respectively.ROC curve of CD11b in 2 diabetes mellitus patients was made.Results The expression ratio of CD11b in high active CMV infection group and CMV infection group in type 2 diabetes mellitus patients was (41.25 ± 5.33)%.There was significant difference (P =0.019)compared with negative control group (61.13 ±5.28)% and there was significant difference (P =0.009)compared with negative control group (64.21 ±6.02)%;optimal cut -off value of CD11b in high active CMV infection group was 45.65%,the sensitivity was 100.00%,the specificity in high active CMV infection group was 60.12%,and the area under the receiver -operating curve(ROC)was 0.628;optimal cut -off value of CD11b in CMV infection group was 70.21%,the sensitivity of CD11b was 87.69%,the specificity of CD11b was 99.22%,and the area under of ROC of CD11b was 0.991.Conclusion The neutrophils CD11b expression in type 2 diabetes mellitus patients with CMV infection is down regulation.CD11b expression can be used as a laboratory diagnosis basis of CMV infection.

Objective To determine the power-time-ablation scope correlogram of a water-cooled single needle electrode radiofrequency (RF) ablation system and to establish a theoretical basis for its practical application.Methods RF ablations were performed using a water-cooled single needle electrode radiofrequency ablation system developed by the authors using fresh ox liver as well as liver and muscles of healthy adult New Zealand white rabbits.The temperature of the ablation area was monitored using a multichannel thermometric system.The maximum ablation scope was determined by detecting the rim at which the temperature was no less than 50 °C.The specific absorption rate (SAR) of the isolated liver tissue was calculated.Results In the treatment voltage range of 100-130V,the process was smooth and steady.No impedance variation was obvious.The maximum diameter of a single ablation was 51 cm.With the treatment voltage at 140-170 V,a larger ablation area could be reached in less time,but eventually the impedance began to increase while the ablation area was no longer expanded.When the treatment voltage reached the range of 180-200 V the impedance almost always increased rapidly out of limits,and the treatment system stopped automatically.The measured SAR value was consistent with the theoretical value.Pathology confirmed that both liver tissue and muscle tissue manifested typical coagulative necrosis.Conclusions The power amplifier,cooling,thermometric and control sections of the RF ablation system worked stably,and the practical ablation effect met the design and clinical treatment requirements.

Objective To investigate the optimal treatment planning of intensity modulated radiotherapy (IMRT) for non-small cell lung cancer (NSCLC) .Methods Two types of treatment plans were designed for 11 patients with inoperable NSCLC disease.In the first plan(PTV60 plan) ,60 Gy was prescribed to the planning target volume(PTV) which was created using CTV(GTV +6-8 mm) plus the margin for organ motion and setup uncertainties.In the second plan(PTV70 plan) ,70 Gy was prescribed to the PTV which was created using GTV plus the margin for organ motion and setup uncertainties.The dose-volume histogram,the planning target volume coverage,and other dosimetric parameters of normal structures were compared between the two plans.Results These two plans were not significantly different in the dose heterogeneity,but commpared with the PTV60 plan,the PTV70 plan significantly improved 60 Gy volume with regard to PTV coverage.The values of V_(20) and V_5 of lung were reduced in average by (1.69 ±0.42) % ,and (1.29 ±1.09) % (t ＝ 0.047,0.264,P ＝ 0.002) ,respectively.Conclusions The planning of 70 Gy to the PTV using GTV plus the margin for organ motion and setup uncertainties might be better than that of 60 Gy to the PTV using CTV(GTV +6-8 mm) plus the margin for organ motion and setup uncertainties.

ObjectiveTo summarize and review the clinical characteristics of congenital pulmonary lymphangiectasia with fetal bilateral pleural effusions.MethodsThe clinical data of a newborn diagnosed as congenital pulmonary lymphangiec-tasia with bilateral pleural effusions in Obstetrics and Gynecology Hospital, was summarized. The clinical, radiographic features, treatment and prognosis of this case are discussed in the context of the literature review.ResultsThe premature infants present-ed with rapid progression bilateral pleural effusions, respiratory distress, chylothorax, hypoalbuminemia and persistent pulmo-nary hypertension at birth. The pulmonary surfactant was given and mechanical ventilation was used for respiratory support. NO was inhaled, high-frequency mechanical ventilation was applied and albumin was repeatedly administered. After treatment for 3 months in the NICU, the patient was discharged. After 10 days, the patient was administered to the PICU with severe pneumo-nia, chronic lung disease, mechanical ventilation and anti-infection treatments were applied for 2 months. After living for six months, the baby died.ConclusionsCongenital pulmonary lymphangiectasia is extremely rare and prenatal diagnosis was dif-ifcult. The disease should be considered in patients presented with progressive dyspnea, interstitial emphysema after birth. Lung tissue biopsy and radioisotope scanning should be performed in time to get diagnosis.

Objective To evaluate the role of phosphodiesterase 4B (PDE4B) in lipopolysaccharide (LPS)-induced release of inflammatory factors in rat microglias.Methods The pri mary cultured microglial cells were randomly divided into 5 groups (n =24 each) using a random number table:control group (group C),LPS group,vehicle group,mismatch small interfering RNA (siRNA) group and PDE4B-siRNA group.The cells were incubated for 48 h in C and LPS groups.The cells were transfected with lipofectaminTM RNAiMAX 1 μl for 48 h in vehicle group.In mismatch siRNA and PDE4B-siRNA groups,mismatch siRNA 2 μl and PDE4B-siRNA 2 μl were added to 100μl serum-free culture medium (final concentration of siRNA 20 nmol/L),respectively,lipofectaminTM RNAiMAX 1 μl was added simultaneously and the cells were then transfected for 48 h.The expression of PDE4B protein and mRNA was determined by Western blot and real-time PCR,respectively.The cells were cultured for 24 h in serum-free culture medium containing LPS 100 ng/ml in LPS,vehicle,mismatch siRNA and PDF4B-siRNA groups.Then the release of TNF-α and IL-1β was measured by ELISA and the expression of extracellular signalregulated protein kinase (ERK) and phosphorylated ERK (p-ERK) was detected by Western blot.Results Compared with C group,the expression of PDE4B protein and mRNA was significantly down-regulated in group PDE4BsiRNA (P ＜ 0.05),no significant changes were found in LPS,vehicle and mismatch siRNA groups (P ＞ 0.05),and the release of TNF-α and IU1β was increased and the expression of p-ERK was up-regulated in the other four groups (P ＜ 0.05).Compared with LPS group,the release of TNF-α and IL-1β was decreased and the expression of p-ERK was down-regulated in PDE4B-siRNA group,and no significant changes were found in vehicle and mismatch siRNA groups (P ＞ 0.05).There was no significant difference in ERK expression between the five groups (P ＞ 0.05).Conclusion PDF4B can promote LPS-induced release of inflammatory factors in rat microglias and activation of ERK is involved in the mechanism.

Objective To evaluate the role of expression of phosphodiesterase 4B (PDE4B) in the spinal cord in inflammatory responses in a rat model of neuropathic pain and the relationship with extracellular signal-regulated kinase (ERK).Methods Sixty healthy male Sprague-Dawley rats,weighing 180-220 g,in which intrathecal catheters were implanted at L5,6 interspace,were used.The location of catheters was confirmed 6 days later.The rats were randomly divided into 5 groups (n =12 each):sham operation group (group Sham),normal saline (NS) group,vehicle group (group Ⅴ),mismatch siRNA group (group siR-M),and PDE4B-siRNA group (group siR-B).Neuropathic pain was induced by ligation of L5 spinal nerve (SNL).In Sham group,the L5 spinal nerve was only exposed,but not ligated.Immediately after ligation and on 1,3,5,and 7 days after ligation,10 μl NS,10 μl NS,LipofectaminTM RNAiMAX,PDE4B-siRNA (2 μg/10 μl) encapsulated in mismatch siRNA and PDE4B-siRNA (2 μg/10 μl) encapsulated in LipofectaminTM RNAiMAX were injected intrathecally in Sham,NS,V,siR-M,and siR-B groups,respectively.The mechanical pain threshold was measured at 1 day before and 2,4,6 and 8 days after operation.After behavioral testing on 8th day after operation,the rats were sacrificed and the lumbar segment of the spinal cord was removed for determination of PDE4B protein,ERK and phosphor-ERK (p-ERK)expression,and TNF-α,IL-1β and IL-6 levels.Results Compared with Sham group,the mechanical pain threshold was significantly decreased at 2,4,6 and 8 days after operation in NS,V,siR-M and siR-B groups (P ＜0.05),and no significant change was found in the mechanical pain threshold at 2,4,6 and 8 days after operation (P ＞ 0.05) and the expression of p-ERK and PDE4B protein,and levels of TNF-α,IL-1β and IL-6 were increased at 2,4,6 and 8 days after operation in V and siR-M groups (P ＜ 0.05).Compared with NS group,the mechanical pain threshold was significantly increased,and the expression of p-ERK and PDE4B protein and levels of TNF-α,IL-1β and IL-6 were decreased at 2,4,6 and 8 days after operation (P ＜ 0.05),and no significant change was found in the parameters mentioned above in V and siR-M groups (P ＞ 0.05).Conclusion Up-regulation of the expression of PDE4B protein in the spinal cord is involved in the development of neuropathic pain in rats,which may be related to promoted phosphorylation of ERK in the spinal cord and enhanced inflammatory responses.

Objective To investigate the percentages of T follicuLar helper cells (Tfh)and interleukin-21(IL-21)in the plasma of patients with rheumatoid arthritis,and the immunological mechanism of Tfh cells in the development of rheumatoid arthritis. Methods According to ACR and DAS28,patients with rheumatoid arthritis were divided into low,moderate and high activity group.The percentages of CD3 + CD4 + CXCR+ 、CD3 + CD4 + ICOS+ and CD3 + CD4 + CXCR+ ICOS+ Tfh cells were detected by Flow Cytometry.While the levels of IL-21 、RF-IgM and anti-CCP in plasma were measured by ELlSA test.The analysis was performed by t-test and Spearman′s correlation analysis.Results The expression of CD3 + CD4 + CXCR+ ICOS+ Tfh cells in PBMCs of rheu-matoid arthritis was significantly higher than that in the normal controls(P <0.05).Meanwhile the results of the three rheumatoid arthritis groups(low,moderate and high activity groups)showed that the expression of Tfh increased accordingly(P <0.05).The expression of Tfh in rheumatoid arthritis was positively related with the levels of IL-21 ,ESR,CRP,RF and anti-CCP respectively. Conclusion The expression of Tfh and IL-21 increases significantly and is closely related to the disease activity in rheumatoid ar-thritis.The results indicate that the abnormality of Tfh may play an important role in the pathogenesis of rheumatoid arthritis.

Objective:To investigate the expression of aromatase of renal tissue in systemic lupus erythematosus(SLE)model mice.Methods:BALB/c mice were induced SLE with homologuous splenic cell activated with ConA after being ovariectomized,and in the same time administered different doses of benzestrofol.E2 in peripheral blood and renal tissue was detected by ELISA and the expression of mRNA of aromatase in renal tissue was detected by RT-PCR in the 4th,6th,8th and 10th weeks.Results:The level of E2 of peripheral blood and renal tissue of SLE model mice became higher as benzestrofol exogenously administered heightened.Compared with control mice,the level of E2 in SLE model mice increased,and the expression of mRNA of aromatase of renal tissue increased with E2 increment.Conclusion:E2 promotes development of SLE through regulating expression of aromatase mRNA.