Objective　To study the relationship between smoking and oxygen free radicals (OFR) , activities of antioxidases.Methods Concentration of serum lipoperoxides(LPO) and activity of superoxide dismutase(SOD) ,glutathioneperoxides(GSH-PX) in 216 healthy smoker and 155 healthy non-smoker were performed.Results The smoker group: the averageLPO concentration was 5.87±1.23, the average SOD activity was 88.24±11.96, the average GSH-PX activity was 176.87±23.31;the non-smoker group:The average LPO concentration was 4.24±0.76, the average SOD activity was 106.18±16.04, the average GSH-PX activity was 206.32±50.25.The average LPO concentration of the smoker group was significantly higher than that in the non-smoker group (P<0.01) ; the average SOD GSH-PX activity of the smoker group were significantly lower than those of the non-smoker group (P<0.01) .The LPO concentration in 50 male smokers(39～45years of age)increased, while SOD and GSH-PX activity decreased as the duration and amount of smoking increased (P<0.01) , showing a linear correlationship.Conclusion The results suggest that smoking is one of the important factors causing, not only OFR and reaction of LPO obviously intensified,but also the imbalance between oxidation and antioxidation in the body.

Objective To comparatively investigate the effect of local cryotherapy pretreatment of tourniquet position on postoperative pain and short-term function recovery during total knee arthroplasty (TKA).Methods Thirty-one patients (38 knees) who received total knee arthroplasty for the first time from July 2012 to December 2012 were allocated to two groups according to the random number table:17 patients (22 knees) in experimental group received local cryotherapy pretreatment on the position of the tourniquet,while 14 patients (16 knees) in control group did not.Duration of tourniquet use in operation,postoperative swelling of limbs,visual analogue score (VAS) for tourniquet pain,postoperative function recovery,and perioperative complications were compared between the two groups.Results All patients were available to the follow-up.There were no significant differences between the two groups regarding the duration of tourniquet use,postoperative swelling of limbs,and perioperative complications.Lower VAS was observed in experimental group compared with control group at days 1 and 2 postoperatively.Time to meet the standard of short-term function recovery in experimental group was significantly shorter than that in control group[(5.3±1.5)daysvs(7.1±1.3)days,t=-3.77,P＜0.01].Conclusion During TKA,local cryotherapy pretreatment of the tourniquet position can improve local soft tissue' s tolerance to ischemia and anoxia,alleviate local inflammation and ischemia-reperfusion injury,ease tourniquet pain in early period after operation,accelerate short-term function recovery and improve patients' satisfaction.

Objective To explore the influence of nursing intervention on patients with schizophrenia receiving repetitive transcranial magnetic stimulation (rTMS) treatment.Methods A total of 80 patients with schizophrenia receiving (rTMS) treatment were randomly divided into intervention group 40 cases and control group 40 cases by random digits table method.The control group was given routine care, and the intervention group was given routine nursing and nursing intervention.Before and after treatment, the curative effect was evaluated by the Positive And Negative Symptoms Scale, and the completion of the treatment between two groups was compared.Results The Positive Scale score, Negative Scale score, General Psychopathology Scale, total score in intervention group after treatment were lower than those in control group:(13.1±2.3) points vs.(16.7±2.1) points,(11.5±2.6) points vs.(15.3±2.3) points, (28.3±2.3) points vs.(30.9±2.2) points,(56.9±1.8) points vs.(67.4±1.7) points, and there were significant differences, t=2.398,2.401,2.452,2.191 ,P＜0.05.There was no significant difference in the rTMS completion, x2=5.541, P＜0.05.Conclusions Nursing intervention can effectively improve the patients with schizophrenia completion of rTMS treatment to improve mental symptoms, so as to improve the clinical curative effect, promote patients recovery of disease.

Objective To investigate the correlation and characteristic of the functional polymorphism of the dopamine D4 receptor gene on the behavioral problems in school-age twins.Method The behavioral problems were assessed among a total of 147 twin pairs aged 6-12 years with the Achenbach Child Behavior Checklist (CBCL).The DRD4 gene polymorphism was applied for different types with polymerase chain reaction.The generalized estimating equations model was used to analyze the effect of DRD4 gene polymorphism and the interaction of DRD4 gene polymorphism with children age,gender,monozygotic/dizygotic on twins' behavioral problems.Results (1) School-age children's anxiety/depression,withdrawn,thought problems,attention problems,social problems,delinquent problems,aggressive behavior and total variance mainly were correlated with DRD4 gene polymorphism (P＜0.05),and physical discomfort might be related with DRD4 gene polymorphism (P=0.067).Except social problems,the detection rate of behavioral problems of the twins with 4/6 genotype (Gene type carrying 5 or more repeated sequences) of DRD4 gene (6.25％-21.25％) was higher than those with other genotypes (0-14.74％).(2) Withdrawal was related to children age (x2=4.348,P＜0.05),and twins aged 6-10 might lead to withdrawal.(3) The interaction of DRD4 gene polymorphism and children age had a significant effect on withdrawal (x2=4.348,P＜0.05) and physical discomfort(x2 =5.189,P＜0.05),and the elder age (11-12 years) children had a certainly protective effect on the withdrawal and physical discomfort with 4/6 genotype in twins.The detection rates were 3.54％ and 2.65％ in the younger-age (6-10 years) twins,while all 0 in the elder-age (11-12 years) for the withdrawal and the physical discomfort respectively.Conclusions The DRD4 gene polymorphism may be correlated with behavioral problems in school-age twins.The interaction of DRD4 polymorphism and children age had a significantly effect on withdrawal and physical discomfort.

Objective To investigate the expression level and its significance of KLF13 in patients with diffuse large B-cell lymphoma (DLBCL).Methods Fifty-six DLBCL patients treated with CHOP chemotherapy regimen were followed up in 4-6 years.Tissue samples of the 56 DLBCL patients were collected.Then the expression level of KLF13 in tissue samples was detected by immunohistochemistry,the relationship between the expression level of KLF13 and the survival rate,clinical features of the patients were analyzed,respectively.Western blot was used to detect the expression level of KLF13 in DLBCL cell trains Pfeiffer and LY8.Subsequently,the expression of KLF13 in DLBCL cell strains was blocked by siRNA method.The proliferation rates of DLBCL cell strains were assayed by CCK-8.Results The expression of KLF13 was significantly over-increased in 32 patients with DLBCL (57.1％) and slightly increased in 24 patients with DLBCL (42.9 ％).The 5-year survival rate in the significant overexpression group (46.5 ％) was lower than that of slight overexpression group (75.0 ％) (P =0.01).Multivariate analysis demonstrated that KLF13 expression,serum LDH levels and clinical pathological stage were independent prognostic indicators for patients with DLBCL (all P ＜ 0.05).There was statistically significant association between the expression level of KLF13 and the clinical stage,the diameter of lymphoma,respectively.After the expression of KLF13 in DLBCL cells was blocked,the proliferation rate of cells decreased.Conclusion KLF13 might be regarded as a prognostic factor and used as a treatment target.

ObjectiveTo explore the clinical features,etiological factors,diagnosis and treatments in children with hemophagocytic syndromes (HPS).MethodsA retrospective study was carried out to analyze etiological factors,clinical symptoms and sighs,laboratory findings and outcomes of 32 children with HPS in our hospital.Results( 1 ) Etiological factors:virus infection cases accounted for 75.0％ (24/32),in which Epstein-Barr virus infection cases were predominant,making up to 68.8％ (22/32) ; (2) Main clinical features:included persistent fever,hepatosplenomegaly,lymphadenopathy; ( 3 ) Characteristic laboratory findings:included decrease of three lines or two lines of peripheral blood cells,hyperferrttinemia,abnormal liver function and coagulation function,hypertriglycerdema and decreased fibrinogen,hemophagocytosis in bone marrow,high soluble interleukin-2 receptor level,decreased natural killer cell activity.(4) Treatments and outcomes:twenty-four(24/32) virus infection cases received antivirus and high dose of immunoglobulin treatment.Twenty-two cases were treated with glucocorticoid and cyclophosphamide,resulting in 11 cases improvement,5 cases with complete remission,2 cases giving up and 4 death.The other 10 cases were treated under the guide of HLH-2004 protocol treatmemt with 4 cases improved and 6 cases with complete remission.Conclusion HPS is mainly triggered by infections,especially Epstein-Barr virus infection.Serum ferrifin,interleukin-2 receptor level and natural killer cell activity are biomarkers of the disease,so that they should be monitored during the progress of chemotherapy.HLH-2004 protocol is a good guide for the treatment of this disease.

Objective To compare the clinical outcomes and safety of synchronous vs staged bilateral total hip arthroplasty (THA).Methods Fifty-eight cases (116 hip joints) undergone bilateral THA from January 2008 to January 2010 were reviewed retrospectively.Follow-up period was postoperative 2 years,including synchronous bilateral THA in 29 cases (synchronous group) and staged bilateral THA in 29 cases (staged group).The two patient groups were compared in aspects of total operation time,total amount of blood loss,total amount of blood transfusion,duration and cost of hospitalization,postoperative discrepancy in bilateral leg length,preoperative and postoperative function score and perioperative complications.Results During the follow-up,no complications of incision infection,deep vein thrombosis and prothesis dislocation or loosening were noted.And postoperative delirium symptoms occurred only in four cases (three in synchronous group and one in staged group).There were no statistical differences between synchronous group and staged group in aspects of total operating time [(117.9 ± 23.8) minutes vs (124.1 ± 18.8) minutes],total amount of blood loss [338.1 ml (180-720 ml) vs 303.9 ml (200-600 rnl)],total amount of blood transfusion [227.6 ml (0-800 ml) vs 189.7 ml (0-400 ml)],postoperative function score.However,differences of the following data were considered statistical significance between synchronous group and staged group:expense of hospitalization [9.5 ten thousand yuan (7.0-11.3 ten thousand yuan) vs 10.5 ten thousand yuan (8.8-11.0 ten thousand yuan)],length of hospitalization [(12.1 ±3.2) days vs (20.1 ±3.5) days],postoperative discrepancy in bilateral leg length [(0.11 ± 0.22) cm vs (0.42 ± 0.44) cm].Conclusions Synchronous bilateral THA is safe and feasible as far as the patients' physical condition is allowed,perioperative management is rational and physicians have mature surgical techniques.Moreover,it gains advantage over staged bilateral THA considering cost of hospitalization,length of hospitalization and postoperative discrepancy in bilateral leg.

Objective To analyze the correlation between 5-hydroxytryptamine transporter gene linked polymorphic region(5-HTTLPR) and twin children's behavioral problems and its interaction with environmental factors.Methods A total of 147 pairs of school-age twins aged 6-12 years were enrolled.The behavioral problems were assessed with the Child Behavior Checklist (CBCL).The genotype of 5-HTTLPR was detected by the method of PCR.The correlation of 5-HTTLPR and children's behavioral problems was performed using generalized estimating equation.Results (1) The overall incidence rate of behavioral problems in school-age twins was 24.15％ (27.94％ in the boys;20.89％ in the girls),in which the rate of thinking problems (15.31％) was the highest,and the rates of other problems were lower (3.40％-8.16％).(2) The results of correlation analysis showed that 5-HTTLPR was only related to the social problems (P＜ 0.05).The S allele of 5-HTTLPR maybe associated with the social problems.(3) The results of interaction of 5-HTTLPR with twin factors of themselves and family environmental factors showed that 5-HTTLPR was the main effect of the anxious/depressed problems,and S allele carriers were easier to occur anxious/depressed problems.Gender was the main effect of the social problems,and boys were easier to occur social problems.There was no significant interaction between 5-HTTLPR and twin factors of themselves and family environmental factors.Conclusion 5-HTTLPR genetype may have some relevance to the social and anxious/depressed problems,and S allele may be a susceptibility gene of social and anxious/depressed problems.

Objective To make clear the knowledge level of emergency treatment during the disasters among emergency nurses,and then make out the countermeasures.Methods Using the self-designed questionary to investigate the knowledge level of emergency treatment during the disasters among emergency nurses.The contents of survey included: general condition,related experiences about emergency treatment,the anxiety and the pattern of how to obtain the related knowledge.Results The level of knowledge of emergency treatment was different in the different nurses according to their different working time.Most of the emergency nurses had not accepted the normal training about the emergency treatment of disasters.Conclusion The nursing administers should put out certain measures to strengthen the training about emergency treatment,and then improve the nurses ability to deal with disaster.

Objective To understand the efficiency of defluoridation facilities used in drinking water defluoridation in the rural high fluoride areas in Tianjin and the sanitary characteristics of treated drinking water. Methods The raw water samples and treated water samples were collected from 4 water stations where the electrodialysis technics was applied and 6 water stations where the reverse osmosis technics was applied and the facilities had been operated for 2-3 years in a county, as well as 3 water stations applied activated aluminium oxide adsorption technics and 2 water stations applied nanofiltration membrane technics in the other counties in Tianjin in 2002-2004. The pH value,turbidity, total dissolved solids, total hardness, fluoride, sulfate, aluminium, in all water samples were determined and evaluated according to the Sanitary Standard for Drinking Water(2001). Results The treated water samples from electrodialysis and reverse osmosis defluoridation facilities showed lower fluoride level(below 1.0 mg/L with fluoride removal rates of 90.01% and 75.32%),and lower total dissolved solids and total hardness levels with removal rates of 75.83%-93.48%. The treated water samples from nanofiltration membrane defluoridation facilities also showed lower fluoride level(below 1.0 mg/L with fluoride removal rates of 75.16%,and lower total dissolved solids and total hardness levels with removal rates of 64.90% and 77.22% respectively. Conclusion The investigated electrodialysis, reverse osmosis and nanofiltration membrane defluoridation facilities show a reliable efficiency and are suitable for application of removal of fluoride in drinking water with different levels of total dissolved solids in the rural high fluoride areas. The effects of defluoridated water produced by reverse osmosis defluoridation facilities on human health need to be studied further more.