Objective To observe the effect of tongue-drawing at lateral position in nasogastric intubation for senile patients with conscious disorders. Methods One hundred senile patients with conscious disorders were randomly divided into observation group and control group with 50 cases in each group. The patients in the control group were given routine nasogastric intubation while those in the observation group were given nasogastric intubation by tongue drawing at the lateral position. The two groups were compared in terms of success rate of intubation, the rate of adverse reactions and intubation effects. Result Compared with the control group, the observation group showed significantly higher in one-time intubation success rate , comfort rate and lower rate of adverse reaction (all P<0.01). Conclusions The nasogastric intubation by tongue-drawing at lateral position is superior to the routine intubation. It can improve the success rate of one-time intubation, decrease the rate of adverse reactions and relieve the pains of patients.

ObjectiveTo explore the efficacy of 131 Ⅰ treatment in Graves' disease,and to analyze the related factors.MethodIn 87 patients with Graves' disease,thyroid uptake ratio( TUR ) and its effective half-life(EHL) were compared before and after 131 Ⅰ treatment.The weight of thyroid gland was evaluated with radio-imaging and type B ultrasonography.ResultThe dose of 131 Ⅰ was ( 185.2 ± 148.0 ) MBq.The TUR of tracer dose and therapeutic 131 Ⅰ dose were 76.5 ％ ±8.2％ and 73.3 ％ ±9.0％ ( t =2.451,P =0.008 ).The EHL were ( 5.2±0.7 ) and ( 5.0 ±0.8 )days,respectively ( t =1.998,P =0.023 ).After followe-up of ( 57.0 ±26.3 ) months,49 patients ( 56.3 ％ ) became euthyroid,14 ( 16.1％ )manifested delayed hypothyroidism,and 24 (27.6％)remained in hyperthyroidism.Thyroid autoantibodies were found in 34.5％ patients,of whom,the incidence of hypothyroidism was higher in patients with positive autoantibodies than those with negative ones (30.0％ vs 8.8％,x2 =6.560,P =0.009 ).ConclusionBoth TUR and EHL of therapeutic doses of 131 Ⅰ are lower than the tracer doses.Positive thyroid autoantibodies may affect the outcome of the 131 Ⅰ treatment.

Objective To investigate the correlation between bone mineral density(BMD)and the PXh haplotype combining estrogen receptor (ER) gene Xba Ⅰ , Pvu Ⅱ polymorphisms and osteocalcin gene Hind Ⅲ polymorphism in postmenopausal women.Methods In 307 subjects,the BMD of lumbar vertebrae and proximal femur were measured by dual energy X-ray absorptiometry and the Xba Ⅰ and Pvu Ⅱ polymorphisms of ER gene and the Hind Ⅲ potymorphism of osteocalcin gene were detected by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP).Results (1)The BMD of greater trochanter was significantly lower in XX genotype group than in xx genotype group ( P<0.05).The BMD of femoral neck, greater trochanter and Ward's triangle were lower in Xx genotype group[(0.695±0.087)g/cm2 , (0.592±0.106)g/cm2, (0.500±0.115) g/cm2] and X allele group[(0.697±0.088)g/cm2 , (0.594±0.105)g/cm2, (0.505±0.123)g/cm2] than in xx genotype group[(0.737±0.108) g/cm2,(0.653±0.119)g/cm2 ,(0.554±0.130)g/cM2] and non-X allele group[(0.737 ± 0.108) g/CM2, (0.653 ± 0.119) g/cm2 , (0.554 ± 0.130) g/cm2] ,respectively (all P<0.05 ).(2)The BMD of Ward's triangle was lower in PP genotype group and P allele group than in pp genotype group and non-P allele group (P<0.05).(3)The BMD of femoral neck, greater trochanter and Ward's triangle were lower in hh genotype group and h allele group than in I-IH genotype group, and were lower in non-h allele group than in HH genotype group(all P<0.05).(4)Women carrying PX, PXh haplotypes combining ER gene and osteocalcin gene had lower BMD at femoral neck than those not carrying PX,not carrying PXh haplotypes, respectively (all P<0.05).ConclusionsER gene(Xba Ⅰ) polymorphism and osteocalein gene(Hind Ⅲ) polymorphism are associated with BMD in postmenopausal women.The presence of X allele or h allele　shows negative influence on the BMD of postmenopausal women.The PXh haplotype is a suitable　genetic marker of postmenopausal women osteoporosis in Fuzhou area.

OBJECTIVE: To study the association of the vitamin D receptor gene BSM Ⅰ, TAQ Ⅰ and APA Ⅰ genetic polymorphisms with bone mineral density and biochemical markers of bone turnover in postmenopausal women.METHODS: ①total of 576 postmenopausal Han ethnic women of 48-84 (62.17±6.37) years old in Fuzhou city were investigated, on the basis of their informed consent, through random sampling method from January 2007 to December 2008. ②The subjects were recorded regarding to their age, menopause duration, body mineral index and postmenopausal fracture incidence. ③Dual energy X-ray absorptiometry was used for measuring the bone mineral density of vertebrae L<,2-4>, left femoral neck, trochanter and Ward's triangle. ④The genetic polymorphisms of vitamin D receptor gene BSM Ⅰ, TAQ Ⅰ and APA Ⅰ were detected using polymerase chain reaction-rastriction and fragment length polymorphism (PCR-RFLP) technique. ⑤The biochemical markers of bone turnover (serum bone gla protein, serum bone alkaline phosphatase, urinary pyddinoline and urinary deoxypyridinoline) were detected with enzyme linked immunosorbent assay.RESULTS: A total of 561 subjects up to standard were involved in the result analysis. ①There was no significant difference in bone mineral density among genotypes of vitamin D receptor gene BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms (P > 0.05). ②There was no significant difference in the biochemical markers of bone tumover among genotypes of BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms (P > 0.05). ③There was no significant difference in the incidence of osteoporosis among genotypes of BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms (P > 0.05). ④There was no significant difference in the incidence of postmenopausal fracture among genotypes of BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms (P > 0,05).CONCLUSION: BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms of the vitamin D receptor gene are not obviously associated with osteoporesis in postmenopausal women, and accordingly can not be taken as genetic markers of osteoporosis in postmenopausal women in Fuzhou.

BACKGROUND:Studies have shown the bone mineral density of postmenopausal women is closely related to parathyroid hormone. But there are differences in different areas.
OBJECTIVE:To investigate the association between BstBⅠ polymorphism of parathyroid hormone gene with bone mineral density in postmenopausal women from Fuzhou area.
METHODS:The bone mineral densities of the lumbar spine, femoral neck, trochanter and Ward’s triangle were measured in 150 postmenopausal women by dual energy X-ray absorptiometry. The genotype of parathyroid hormone gene was determined by polymerase chain reaction-restriction fragment length polymorphism.
RESULTS AND CONCLUSION:(1) The distribution of parathyroid hormone genotypes were BB genotype 68.8%, Bb 24.1%, and bb 7.1%. The B al elic gene frequencies reached 81%, while b was 19%. The distribution fol owed the Hardy-Weinberg equilibrium. (2) Analysis of the relationship between the genotypes and bone mineral density:There was no significant difference in the bone mineral densities of the lumbar spine, femur, neck, trochanter and Ward’s triangle among the three genotypes (P>0.05). BstBⅠ gene polymorphism of parathyroid hormone gene is not correlated to bone mineral density, and there is no enough evidence to support genotype of parathyroid hormone gene as a genetic marker in predicting the risk of developing osteoperosis in Fuzhou postmenopausal women.

OBJECTIVE To develop a rapid system for bacteria identification and susceptibility test in 24 hours,and provide bacteriological evidence for the control of nosocomial infection and the timely diagnosis and treatment.METHODS The simple constant temperature box was replaced by revolving constant temperature box;2,3,5-triphenyltetrazolium chloride(TTC) and succinate were added to the culture bottle and the culture medium of drug susceptibility;the concentration of the reactive substrate in the bacterial biochemical tube and the number of the inoculated bacteria were increased at the same time.RESULTS The time of positive blood culture in the revolving constant temperature box was significantly shorter than that in the simple one(?2=74.92,P

AIM:To investigate the expression and potential role of complement 5a receptor (C5aR) in chro-nic graft-versus-host disease (cGVHD).METHODS:The expression of C5aR on lymphocytes and the frequency of CD4+CD25+ Foxp3+ regulatory T cells (Tregs) in 20 cGVHD patients and 9 healthy donors was detected by flow cytometry.The correlation between the expression of C5aR and the percentage of Tregs in the cGVHD patients was analyzed.In addition, the splenocytes from the mice were cultured in vitro, and stimulated these splenocytes with recombinant mouse C5a protein (rmC5a).The peripheral blood mononuclear cells (PBMCs) from cGVHD patients were cultured in vitro, which was inhibited by C5aR antagonist (C5aRA).The frequency of Tregs in these splenocytes and the PBMCs were evaluated by flow cytometry.RESULTS:The expression of C5aR on the lymphocytes was significantly increased in the cGVHD patients compared with the healthy donors, while the percentage of Tregs was markedly lower in the cGVHD patients.The expression of C5aR was negatively correlated with the percentage of Tregs.Furthermore, the development of Tregs was suppressed by rmC5a stimulation, but was promoted by C5aRA in vitro.CONCLUSION:C5aR elevation is associated with Treg reduction in cGVHD, indicating that C5aR may play a potential role in suppressing Tregs, resulting in the incidence of cGVHD.

Objective: To investigate the effects of artesunate treatment on chronic graft-versus-host disease (cGVHD). Methods: Recipient BALB/c mice received 8 × 10⁶ bone marrow cells with 8×10⁶ spleen cells from B10D2 mice. Artesunate solubilized in acetone was injected intraperitoneally every day at the dose of 1 mg/kg at Day 28 after BMT. The clinical scores, survival and histopathological damage were analyzed. The frequency of Th17 and Tregs in PB and spleens from the mice were evaluated by flow cytometry. In addition, CD4⁺ T cells from the spleens of mice were cultured in vitro, then stimulated with artesunate, the frequency of Th17 and Tregs in these splenocytes were evaluated by flow cytometry. Results: Artesunate administration diminished clinical and histopathological damage, and improved the survival of cGVHD mice[(46.57±7.83)% vs (55.71±6.99)%, χ²=5.457, P=0.020]; Artesunate contributed to Tregs development [(4.45±0.04)% vs (8.40±0.23)%, t=15.679, P<0.001; (6.62±0.24)% vs (10.48±0.48)%, t=6.587, P=0.003] while decreased Th17 cells [(1.51±0.18)% vs (0.58±0.19)%, t=7.233, P<0.001; (1.48±0.38)% vs (0.71±0.18)%, t=3.653, P=0.011] expressions in both PB and spleens, and decreased the Th17/Treg ratio (0.34±0.05 vs 0.09±0.03, t=7.621, P=0.002; 0.19±0.03 vs 0.06±0.02, t=6.993, P=0.002). Moreover, artesunate suppressed the Th17 cells expressions [(0.82±0.37) % vs (3.39±1.22) %, t=4.044, P=0.007] and contributed to Tregs development [(34.63±1.29) % vs (14.28±1.69) %, t=19.119, P<0.001], and also decreased the Th17/Treg ratio (0.24±0.09 vs 0.02±0.01, t=4.780, P=0.003) in vitro. Conclusions Artesunate suppressed the Th17 cells expressions and contributed to Tregs development, which provided new sights into the development of a novel drug for cGVHD, e.g., artemisinin.

Objective: To monitor the WT1 mRNA level and its dynamic changes in patients with myelodysplastic syndromes (MDS) after hypomethylating agents (HMA) , as well as to assess the significance of WT1 mRNA levels and its dynamic changes in evaluating the efficacy of HMA and distinguishing the disease status of heterogeneous patients with stable disease (SD) . Methods: Bone marrow or peripheral blood samples of 56 patients with MDS who underwent hypomethylating agents (≥4 cycles) from November 2009 to March 2018 were tested by real-time quantitative polymerase chain reaction (PCR) to detect the expression of WT1 mRNA, and to observe the correlation between the dynamic changes of WT1 mRNA expression and clinical efficacy and prognosis of patients. Results: WT1 mRNA expression levels of MDS patients decreased significantly after 3 cycles of hypomethylating agent treatment. Besides, the WT1 mRNA expression levels of patients increased significantly after diseases progression. According to the dynamic changes of WT1 mRNA expression levels during SD, 45 cases could be further divided into increased group and non-increased group. In those SD patients with increased WT1 mRNA expression level, the ratio of suffering disease progression or transformation to AML was 95.65% (22/23) , whereas the ratio turned to be 9.09% (2/22) for the non-increased group (χ²=33.852, P<0.001) . Compared with those SD patients reporting no increase in WT1 mRNA expression level, the overall survival[17 (95%CI 11-23) months vs not reached, P<0.001] and progression-free survival [13 (95%CI 8-18) months vs not reached, P<0.001] of those SD patients reporting increase in WT1 mRNA expression level were significantly shorter. Conclusion WT1 mRNA expression level is a useful indicator to assess the efficacy of hypomethylating agents in MDS patients. Especially in patients with SD, detection of the changes in WT1 mRNA expression level is able to predict disease progression and help to make clinical decision.