Objective:To investigate the influence of psychological intervention on depression and quality of life among perinatal women.Methods:60 perinatal women were selected under the condition of the study.30 cases were chosen randomly from the 60 women as the psychological invention group and another 30 cases as the control group.The interventon group received psychological intervention which included supportive therapy,health education,individual psychotherapy,and family and social supportive therapy;the control group received no invention measure.Psychometrics was used for 30-and 38-week gravida of both groups and continuous psychological intervention was enforced for more than seven weeks for the intervention group.Results:The depressive factor of the psychological group was lower than of the control group(P

To investigate the apoptotic effect of free fatty acids (FFAs) on human ovary granulosa cells, the granulosa cells were treated with FFAs in various concentrations for three days, and then the cell viability was determined by trypan blue exclusion method. DNA fragmentation was examined by DNA ladder formation and Annexin V GFP/PI staining of the cells. We also determined if the apoptotic effect of saturated FFAs was mediated by their acly CoA metabolites and measured the expression of apoptosis related genes, Bcl 2 and Bax by Western blot. The results indicated that saturated FFAs induced apoptosis of granulosa cell by their acly CoA metabolites in a dose dependent manner, and led to the down regulation of Bcl 2 and the up regulation of Bax. It is concluded that saturated FFAs can induce apoptosis of human ovary granulosa cells, suggesting that the sexual disorder of obese and insulin resistant women is related to it.

Objective To estimate the status of secondhand smoke (SHS) among restaurant customers in Shanghai and evaluate their support to smoke-free restaurants. Methods A random sample of 284 customers from 27 restaurants participated in the face to face interview. Results There were 55.8% smoking customers often smoke in the restaurants and 84.4% nonsmoking customers had suffered from secondhand smoke in restaurants. Among the customers, 73.9% supported the smoke-free law in restaurants and 49.6% of them expressed that they would more likely to go and eat in the restaurant after the smoke-free law implemented. Elder age, nonsmoking as well as college and above education background were the supporting factors for the smoke-free restaurants and the odds ratios were 1.03 (95%CI: 1.01~1.06), 6.40 (3.06~13.88) and 2.71 (1.44~5.11), respectively. Conclusion Customers have seriously suffered from SHS and most of them support the smoke-free policy. In general, the smoke-free restaurant policy will increase the intention of eating in the restaurants among customers.

Objective To study the influence of early dynamization of interlocking intramedullary nail on the treatment effect of the patients with lower limb fracture .Methods 62 patients with lower limb fracture treated with interlocking intramedullary nail in our hospital from June 2010 to March 2012 were selected as the research subjects and divided into the control group and the obser-vation group with 31 cases in each group according to random number table .The control group was treated with routine treatment method ,while the observation group was treated with early dynamization .Then the Johner-Wruch score ,healing time ,rate of ad-verse fracture healing ,incidence rate of complications and fracture healing related factors before and after the treatment were ana-lyzed and compared .Results The Johner-Wruch score excellent and good rate of the observation group was higher than that of the control group ,the healing time was shorter than that of the control group ,the rate of adverse fracture healing and the incidence rate of complications were lower than those of the control group ,the fracture healing related factors after treatment were all better than those of the control group ,the differences had statistical significance (all P<0 .05) .Conclusion The early dynamization of interloc-king intramedullary nail has the better effect for treating lower limb fracture and its influence on the fracture healing related factors is better too .

Objective To investigate the changes of phenotypes and function of CD56+T cells during primary HIV-1 infection and their relationship with disease progression.Methods Peripheral blood mononuclear cells (PBMCs) were collected from 53 subjects with primary HIV-1 infection and 31 HIV-1-negative healthy subjects.The percentages of CD56+T cells and the expression of several phenotypic markers on CD56+T cells including CD16, CD161, NKB1, NKG2A, NKp46, NKG2D, NKG2C and CD158a were analyzed by flow cytometry.IFN-γand TNF-αreleased by CD56+T cells with and without K562 stimulation and the levels of cytotoxic molecular CD107a were measured.Results The percentages of CD56+T cells in patients with primary HIV-1 infection were significantly lower than those of healthy subjects (P=0.025). The levels of CD56+T cells were negatively related to the viral loads in plasma samples ( P=0.021, r=-0.316).Compared with healthy subjects, the expression of CD16 (P=0.003), CD161 (P=0.023), NKB1 (P=0.023) and NKp46 (P=0.021) on CD56+T cells were decreased in patients with primary HIV-1 infection.The levels of NKB1 were positively related to the CD4+T cell counts ( P=0.007, r=0.364), but were negatively related to the viral loads in plasma samples (P=0.030, r=-0.299).Sponta-neous secretion of IFN-γand TNF-αby CD56+T cells and the expression of CD107a were dramatically in-hibited in patients with primary HIV-1 infection as compared with healthy subjects ( all P<0.001 ) . Moreover, the killing ability of CD56+T cells against K562 target cells was weakened in patients with prima-ry HIV-1 infection as the levels of IFN-γ-, TNF-α-and CD107a-producting CD56+T cells were significantly decreased (P<0.001 for IFN-γand TNF-α, P=0.016 for CD107a).Conclusion Inhibited expression and altered phenotypes of CD56+T cells were identified during primary HIV-1 infection.Lower levels of cy-tokines and cytotoxic molecular were also detected, indicating the dysfunction of CD56+T cells appeared dur-ing early stage of HIV-1 infection and was associated with disease progression.

Objective To investigate the maturation status of monocytes and their responses to the stimulation of toll like receptor (TLR) ligands during primary HIV-1 infection, and to further understand the correlation between functional status of monocytes and disease progression during primary HIV -1 infection. Methods Peripheral blood mononuclear cells ( PBMCs) were collected from 35 subjects with primary HIV-1 infection and 13 HIV-negative healthy subjects to isolate monocytes .Monocytes were stimulated with LPS and Pam3CSK4, respectively, and cultured for 20 hours.The expression of activaion/inhibitory markers on monocytes were analyzed by flow cytometry before and after stimulation .The secretion of proinflammatory cy-tokines ( IL-1β, TNF-αand IL-6) by stimulated monocytes were detected by ELISA .Results The expres-sion of activation markers CD80, CD86, CD40 and inhibitory marker PD-L1 on monocytes were increased in subjects with primary HIV-1 infection (P<0.001 except for CD86 P=0.01).The level of CD40 was posi-tively correlated with viral load in plasma (P<0.001, R=0.553).Compared with control group, primary HIV-1 infection group showed a less increase in the expression of HLA-DR, CD80, CD86 and PD-L1 on monocytes after stimulation with LPS and Pam3CSK4 (P<0.001), but the secretion of proinflammatory cyto-kines TNF-α(LPS:P=0.004, Pam3CSK4:P=0.012) and IL-6 (LPS:P=0.006) were enhanced in mono-cytes from patients with primary HIV-1 infection.Conclusion Monocytes were activated during primary HIV-1 infection.They secreted higher level of proinflammatory cytokines after stimulation with TLR ligands , indicating monocytes might play a role in microbial translocation and immune activation during HIV -1 infection .

Objective To establish a flow cytometry-based assay for the detection of monocyte-me-diated antibody-dependent cell-mediated cytotoxicity ( ADCC ) .Methods P815 cells double stained with PKH26 and carboxyfluorescein succinimidyl ester ( CFSE ) were used as target cells and coated with P 815 specific antibodies to form antigen-antibody complexes .The peripheral blood mononuclear cells were isolated as effector cells and co-cultured with the antigen-antibody complexes .The CD3-CD14+PKH26+CFSE-cell population were gated by flow cytometry .Optimized effector/target cell ratio and incubation time for killing assay were identified .Monocyte-mediated ADCC in 23 patients with chronic HCV infection and 22 healthy subjects were analyzed .Results The monocyte-mediated ADCC could be evaluated through analyzing the CD3-CD14+PKH26+CFSE-cells with flow cytometry .The optimized effector/target cell ratio was 10 ∶1 and the optimized time for incubation was 4 h.Monocyte-mediated ADCC was inhibited in patients with chronic HCV infection as compared with healthy subjects (P=0.009).Conclusion A flow cytometry-based assay for the detection of monocyte-mediated ADCC was established , which could be used as a fast , sensitive and safety method for the evaluation of monocyte-mediated ADCC during viral infections and the research and de-velopment of drugs .

Objective To isolate HIV-specific T cell clone and to expand them in vitro through the activation-induced expression of CD137 molecule.Methods The peripheral blood mononuclear cells were isolated from HIV-infected patients and HIV Gag specific CD3+CD8+CD137+T cell subset were sorted to 96-well plate in 1 cell/well by multicolor flowcytometry and single cell sorting.After 14 days in vitro culture with feeder cells and cytokines, the numbers and phenotypes of the cultured HIV-specific T cells were calcu-lated and identified.Results The CD137 expression was low on rested T cells but up regulated by the stim-ulation with Gag peptide pool.The CD8+CD137+T cells could secret IFN-γ.The number of CD8 T cells reached to 106 after 14 days in culture and expanded to 107-108 cells after 28 days of culture in vitro 100%of the cells remained activated upon Gag stimulation.Conclusion In stead of using IFN-γ, CD137 could be utilized as a novel molecule to isolate and expand HIV specific T cells in vitro.The expanded antigen spe-cific T cell clones could maintain good activation status.

Prominent problems of clinical teaching in Tibet University school of medicine were analyzed and countermeasures were proposed from aspects of management system construction, facul-ty construction, curriculum construction, base construction and quality evaluation system construction. The aim was to increase students' opportunity, enhance students' learning interest and improve stu-dents' ability of analysis and problem solving so as to improve the practical effects of clinical teaching. All countermeasures taken above laid the foundation for future clinical work and provided help for clinical medical personnel in Tibetan border areas.

Objective To investigate the changes of serum apolipoprotein M (ApoM) level in cord blood and pregnant women during different gestational periods and to explore the relationship with the occurance and development of gestational diabetes mellitus (GDM).Methods Three hundred and eight pregnant women performing regular prenatal examination were registered in Changzhou Women and Children Health Hospital from June,2011 to April,2013,including 99 normal pregnant women during the second trimester,122 during the third trimester,and 87 pregnant women with GDM.At the same time,100 samples of cord blood of normal neonates were collected.The levels of serum ApoM and other lipids were measured.Results (1) Serum ApoM levels in pregnant women during the second trimester,during the third trimester,and in the cord blood of normal neonate were (0.036-± 0.013) g/L,(0.023 ± 0.008) g/L,and (0.010 ± 0.004) g/L,respectively.(2) The serum ApoM level of GDM group was lower than that of control [(0.029 ± 0.010 vs 0.036 ± 0.013) g/L,P＜0.05].Multivariate non-conditional logistic regression analysis showed that there was statistically significant difference in ApoM levels between GDM and control groups after adjusting for potential confounders (Z =-3.62,P＜0.05).Conclusions The level of serum ApoM in pregnant women was increased at first and then decreased.The serum ApoM level in the neonatal cord blood was significantly lower than that in pregnant women.The level of serum ApoM was lowered with raised blood glucose level in women with GDM,suggesting that ApoM might play a role in the pathological processes of GDM.