In this paper, we investigate the boundedness character, the global attractivity and the periodic nature of the svstem of ratiol difference equatious:xn+1=p+yn-k/xn,yn+1=q+xn-k/yn,n=0,1,2..., where p>0, q>0, k∈ of the system of rational difference equations:xn+1=P+yn-k/xn, yn=q+xn-k/yn,n=0,1,2 {1,2,…} and the initial values x1, y1∈(0,∞), i=- k, -k+1,… 0. Some new results are obtained.

ObjiectiveTo investigate the clinical efficacy of Chinese medicineShuxin-Huoxue decoction on coronary heart disease and angina pectoris.MethodsThis study was a randomized controlled trial. 86 patients with coronary heart disease and angina pectoris and conformed to the indusive criteria were randomly divided into a control group and a treatment group, with 43 cases in each group. The control group was treated with conventional western medicine, the treatment group was treated with traditional Chinese medicineShuxin-Huoxue decoction. Serum homocysteine (Hcy) was measured by enzymatic cycling assay, high sensitive C reactive protein (hs-CRP) was measured by immunotubidimetric assay and left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), cardiac index (CI) were measured by color doppler echocardiography before and after treatment. The clinical effect of the two groups was evaluated.ResultsThe total effective rate of the treatment group and the control group was 90.7% (39/43) and 74.4% (32/43) respectively,there was significant difference (χ2=3.957,P=0.047). Followed up for 4 weeks, LVEF(65.7% ± 8.7% vs. 61.5% ± 8.4%,t=2.277), SV(86.9 ± 16.8 ml vs.79.2 ± 16.5 ml,t=2.144), CO(49.3 ± 9.1 ml/m2 vs. 44.7 ± 8.8 ml/m2,t=2.383), CI (3.7 ± 0.9 L/min?m2 vs. 3.3 ± 0.7 L/min?m2,t=2.301) of the treatment group were significantly improved after treatment than those of the control group (P<0.05), and the decrease of serum Hcy  (8.7± 3.7mmol/L vs. 11.4± 3.5mmol/L,t=3.476), hs-CRP (2.7± 1.1 mg/L vs. 3.5± 1.3 mg/L,t=3.081) level of the treatment group were better than those of the control group(P<0.01).ConclusionTraditional Chinese medicineShuxin-Huoxue decoction has good therapeutic effect on coronary heart disease and angina pectoris.

Objective To study the internalization mediated by heat shock protein 70 (HSP70) receptors expressed on the surface of dendritic cells (DCs). Methods DCs from C57BL/6 mouse bone marrow were divided into HSP70 receptor-blocking group, non-receptor-blocking group and control group. The HSP70-FITC positive cells were detected by flow cytometry (FCM). Results FCM indicated that in HSP70 receptor-blocking group, the HSP70 receptors could be almost totally blocked by 50?g HSP70. With the increase of HSP70-FITC dosage, the number of HSP70-FITC positive cells increased. In non-receptor-blocking group, the rates of the HSP70-FITC positive cells were up to 90% either when 50?g HSP70-FITC or 100?g HSP70-FITC was used with no remarkable difference between them. Conclusions The internalization mediated by HSP70 receptors plays a major role in the stage of ingestion of HSP70 with the characteristics of saturation and priority. Once the receptors are blocked, non-receptor pathway participates in internalization in a dose-dependent manner.

Objective To study the effect of c-myc small interference RNA(siRNA) on c-mye protein in leukemic cells, and investigate a new method of gene therapy on leukemia. Methods siRNA against c-myc mRNA were designed and synthesized. The siRNA at 100 nmol/ml density was transfected into HL-60 cells. The cells cultured at 24 h, 48 h or 72 h were collected after being transfected, and the total protein of the cells was extracted according to the instruction booklet of TRIzol reagent. The expression level of c-myc protein was examined by Western blotting. Results After being treated with siRNA of c-myc, the quantity of c-myc protein was obviously reduced. It was remarkably lower than that of the control group. Furthermore after 72 h treatment with siRNA, the expression of c-myc protein reached its lowest. Conclusion The siRNA of c-myc can suppress the expression of c-myc protein in HL-60 cells. There are sequence targeted and time-dependence effect. The siRNA of c-myc may become a new tool of gene therapy on leukemia.

The article analyses the current situation of the unbalanced development of Chinese higher medical education and the reasons for it,and points out that to promote its development,gradation and diversify development of education must be realized.

Objective To investigate Toll-like receptor-4 (TLR4) protein expression in human pancreatic adenocarcinoma,and to evaluate the relationship between TLR4 protein expression and angiogenesis.Methods Sixty-two surgically resected human pancreatic adenocarcinoma specimens and 35 normal para-cancerous tissues were investigated for TLR4 protein expression by immunohistochemical SP methods,and CD31 antibody was used to mark microvascular endothelial cells and determine the microvessel density (MVD).The correlation among TLR4 protein expression and MVD and clinicopathologic features of pancreatic adenocarcinoma were analyzed.Results TLR4 protein positive expression rate and MVD in human pancreatic adenocarcinoma was 74.2％ (46/62) and 47.3 ± 13.5,respectively,which were significantly higher than those in the normal pancreatic tissue [17.1％ (6/35),12.6 ±4.8; P ＜0.01].TLR4 protein positive expression rate in the cases with lymph node metastasis was 83.8％,which was significantly higher than that in the cases without lymph node metastasis (60.0％,P =0.036).TLR4 protein positive expression rate in the patients with stage Ⅲ and Ⅳ of TNM classification was 85.3％,which was significantly higher than that in the patients with stage Ⅰ and Ⅱ (60.7％,P=0.028).MVD was closely related to tumor size,lymph node metastasis and TNM stage of pancreatic adenocarcinoma (P =0.008,0.036,0.010).There was a strong positive correlation between TLR4 protein expression and MVD (r =0.534,P ＜0.01 ).Conclusions TLR4 protein expression is closely related to the development and progression of human pancreatic adenocarcinoma and its potential mechanism is related to the promotion of tumor angiogenesis.

BACKGROUND: There has been increasing attention in the study of adolescent idiopathic scoliosis (ALS)and bone metabolism, which is accompanied by osteopenia and osteoporosis. Interleukin(IL) -6, a cytokine that strongly promotes bone resorption, participates in the regulation of bone metablism.OBJECTIVE: To explore the relationship between changes of bone mineral density(BMD) and serum IL-6 content in AIS.DESIGN: A controlled non-randomized concurrent study involving patients with AIS and and healthy volunteers.SETTING: The clinic and wards of the department of spinal surgery of a university-affiliated hospital.PARTICIPANTS: Thirty-six patients with AIS(6 males and 30 females aged 12 to 18 years) were treated in the Department of Spinal Surgery, Drum Tower Hospital, Medical College of Nanjing University from July to October 2003, who had a Cobb angle ranging from 34° - 109° and curvature of the thoracic spine. Thirty-six healthy adolescent volunteers(7 males and 29 females within the range of 13 - 18 years old) served as the control group.METHODS: The BMD was measured at L2- L4 and the proximal femur;(including the femoral neck, greater trochanter and Ward' s triangle) by dual-energy X-ray absorptiometry and serum IL-6 determined by enzyme-linked immunosorbent assay(ELISA).MAIN OUTCOME MEASURES: ① BMD of the lumbar spine and femur ② Comparison of serum IL-6 content of all the subjects.RESULTS: The BMD of AIS patients at L2- L4, femoral neck, greater trochanter and Ward' s triangle was 0.79±0. 12, 0.78±0. 12, 0.65± 0. 10, and 0. 69 ± 0. 13 g/cm2, respectively, all significantly lower than the corresponding measurements of the control group(1.09 ± 0. 11, 0.95 ± 0. 11,0. 78 ± 0. 10, and 0. 88 ± 0. 11 g/cm2, respectively, P ＜ 0. 001), whereas the serum IL-6 content in the patients was significantly higher than that in the control subjects ( P ＜ 0. 005). The changes of BMD at the lumbar spine and the three sites of femur were negatively correlated with serum IL-6 in AIS patients( P ＜ 0. 001 ), but not so in the control group( P ＞ 0.05).CONCLUSION: The BMD is decreased and serum IL-6 elevated in patients with AIS, and excessive secretion of IL-6 might be one of the important factors of osteopenia in AIS.

Objective To explore the role and their relationship of Ki-67, VEGF and p27 expressed in adult patients with acute leukemia. Methods The expression of Ki-67, VEGF and p27 in bone marrow mononuclear cells (BMMNC) were analyzed by immunocytochemical staining, and their correlations of Ki-67, VEGF and p27 were statistically analyzed. Results The expression of Ki-67(42.48±25.78)% or VEGF (44.89±24.01)% on BMMNC from acute leukemia cells was significantly higher than that in the control (11.40±9.94)% or (16.90±12.54)% (P<0.01). But the expression of p27 (23.65±13.30)% was significantly lower than that in the control (50.23±22.68)% (P<0.01). The expressions of Ki-67 were positively correlated with and VEGF in patients with acute leukemia were positively correlated(r=-0.666, P<0.01), and the expressions of Ki-67 and p27 were negatively correlated with p27 in patients with acute leukemia (r=-0.316, P<0.05).Conclusion The evaluation of expression of Ki-67, VEGF and p27 on acute leukemic cells provides new insights to the pathogenesis is helpful in mechanism and is helpful in the diagnosis of acute leukemia.

Objective To investigate the therapeutic effects and side effects of FLAG and MEA regimen in the treatment of relapsed and refractory adult acute myeloid leukemia.Methods Use retrospective analysis to Observe the therapeutic effects and side effects of the 51 cases of relapsed and refractory adult acute myeloid leukemia (M3 except) from January 2009 to June 2012 in our hospital,which are divided into FLAG group (23 cases) and MEA group (28 cases) according to chemotherapy.Results In FLAG group,the rate of complete remission was 30.4 ％ (7/23),the rate of partial remission was 17.4 ％ (4/23),the effective rate was 47.8 ％ (11/23).In MEA group,the rate of complete remission was 35.7 ％ (10/28),the rate of partial remission was 21.4 ％ (6/28),the effective rate was 57.1％ (16/28),difference between two groups was not statistically significant. Both groups appeared Ⅳ degrees myelosupression,and there were no significant differences between them on incidences of secondary infection [95.7 ％ (22/23) vs 89.3 ％ (25/28)] and haemorrhagia [82.6 ％ (19/23) vs 85.7 ％ (24/28)].Difference on cardiac toxicity was statistically significant.Conclusions Compared with MEA regimen, FLAG regimen are similar effective and can be well tolerated,which has lower cardiac toxicity. Thus, FLAG regimen can be used as first-line treatment for relapsed and refractory adult acute myeloid leukemia.

Objective To understand information on cognitive and demand of chronic kidney disease(CKD) patient to contin‐uing nursing .Methods Adopting stratified random sampling method took samples 200 CKD patiens who were treated at kidney disease of internal of general hospital form March to June 2014 .Self‐made questionnaire was used to survey cognitive and demand of chronic kidney disease patient to continuing nursing .Results Totally 200 questionnaires were gave out and 184 of them were taken back ,efficient rate is 92% .First ,cognition :10 .32% CKD patiens knew the meaning of continuing nursing ,9 .24% CKD patiens knew the content of continuing nursing ,12 .50% CKD patiens knew the role of continuing nursing .Second ,demand :65 .76% -95 .11% CKD patiens had demand on disease treatment knowledge ,individual diet guidance ,regular telephone follow‐up ,and regular follow‐up nurse ;38 .04% - 53 .26% CKD patiens had urgent demand on individual diet guidance ,free health consultation ,and regu‐lar follow‐up nurse ;28 .89% CKD patiens had demand on electronic health record .Conclusion The cognitive of CKD patiens to continuing nursing is low and the demand is high .Hospital should to actively develop the continuation of local nursing service .