Objective Research of chromosome’s influence and curative effect on first and second generation tyrosine kinase inhibitor therapy to CML patients.Methods Giving conventional genetic analysis to 80 Ph+ CML patients,and contrast CML patients’chromosome changing situation with first and second generation tyrosine kinase inhibitor therapy.Results There were 1 1 cases with other abnormalities of chromosome number and structure in 80 cases of Ph+ CML patients,and 10 cases were resistant or intolerant to imatinib.35 patients (87.5%)achieve sustained complete cytogenetic remission (CCyR)who treated with imatinib (TKI-Ⅰ)in the total 40 cases,in these 35 patients,7 cases (17.5%)got CCyR in 3 months;10 cases (25%)got CCyR in 6 months,13 cases (32.5%)got CCyR in 12 months,and 5 cases (12.5%)got CCyR in 18 months.33 patients (82.5%)achieve sustained completecytogenetic remission (CCyR)who treated with dasatinib/nilotinib (TKI-Ⅱ)in the total 40 cases,in these 33 cases,16 cases (40%)got CCyR in 3 months;9 cases (22.5%)got CCyR in 6 months,5 cases (1 2.5%)got CCyR in 1 2 months,and 3 cases (7.5%)got CCyR in 1 8 months.Conclusion Ph+ CML patients combined with other chromosome abnormity were more easily to be resistant or intolerant to imatinib,espe-cially in acceleratd phase and blastic phase.First and second generation tyrosine kinase inhibitor have little difference to treat with CML patients in long time efficacy,but the second generation effect is better than first generation in short time effica-cy.

Objective To discuss the application of cervical lateral mass plate for the treatment of fractures and dislocations of the cervical spine. Methods From January 1998 to January 2001, internal fixation with cervical lateral mass plate and bony fusion were performed in 21 patients during posterior decompression for the treatment of fractures and dislocations of the lower cervical spine . A posterior median approach was used to expose the lateral edge of the articular process. All patients received spinal decompression and reduction according to the types of fracture and dislocation. A cervical lateral mass plate was applied in each lateral mass, a suitable bicortical screw was inserted using Magerl technique (the inserting point of the screw was 2 mm medial and superior to the center of lateral mass, the direction was 20?-25? laterally and 30?-40? cranially). Results The follow-up of all 21 cases ranged from 9 months to 3 years and 9 months (with the mean of 27 months). There were 20 cases with complete reduction of antero-posterior and rotational dislocation, and 1 case with incomplete reduction according to post-operative X-ray film. Patients could sit up with the protection by wearing soft collar 4 days (2-7 days) after the surgery. The mean off-bed time of those without spinal cord injuries or with spinal cord injuries less than Frankel C grade were 9 days (3-14 days) after operation. All cases obtained solid bony fusion 6 months postoperatively. Eighteen cases with spinal cord injury improved one ASIA grade, 2 cases without root injury obtained complete recovery eventually. No severe complications such as injuries of vertebral artery, nerve root and spinal cord or aggravation of spinal cord injury occurred. Conclusion Cervical lateral mass plate fixation has the advantages of wide indications, strong stability, short segment fixation and easily reduction. The results suggested that this technique is an efficient, reliable segmental posterior fixation.

Objective To explore the current situation of nursing students' leadership,in order to improve the clinical leadership of nursing students and provide reference for nursing teaching.Methods In July 2016,a questionnaire survey of nursing students including undergraduate and junior college students in our hospital was conducted by using the Self Assessment Leadership Instrument.SPSS 17.0 was used to conduct the t test to investigate the nursing leadership differences between the two groups.Results The total score of nursing students was (114.68 ± 18.25),and the score of undergraduate students was higher than junior college students (t=8.13,P=0.000);In the dimensions of critical thinking,decision-making skill,interpersonal relationship,team spirit and working relationship,there were significant differences in the scores of undergraduate and junior college students with different levels of education (P＜0.05).Conclusion The level of leadership of nursing students is low.In the process of nursing students' education,we should carry out the leadership courses in the school and practice leadership in clinical clerkship,so that we can promote the improvement of nurses' leadership and promote the development of nursing science.

Objective:To explore epidemiologic features of primary aldosteronism (PA) in northern Jiangsu and using plasma aldosterone/renin activity ratio (ARR) combined plasma aldosterone level to screen PA patients among pa-tients with hypertension .Methods:A total of 2014 inpatients and outpatients with hypertension were collected from our hospital .Radioimmunoassay was used to measure plasma levels of renin and aldosterone and blood biochemical indexes ,then ARR was calculated .PA was diagnosed when ARR>240 and aldosterone>150 pg/ml .Results:A to-tal of 239 patients (11. 87% ) were complicated with PA among the 2014 patients with hypertension ,and it occupied 23.69% (145/612) among patients with refractory hypertension .Compared with pure hypertension group ,there were significant reductions in renin activity [ (2.18 ± 2.54) ng?ml-1 ?h-1 vs .(0.68 ± 0.49) ng?ml-1 ?h-1 ] and serum potassium level [ (3.96 ± 0.45) mmol/L vs .(3.54 ± 0.45) mmol/L] ,significant rise in aldosterone level [ (132.99 ± 104.25) pg/ml vs .(272.55 ± 154.68) pg/ml] and ARR [ (118.40 ± 109.4) vs .(463.19 ± 251.85)] ,P<0.05 or <0.01 ,and significant reduction in onset age of hypertension [ (49.37 ± 9.31) years vs .(39.69 ± 7.59) years] ,P<0.01. Patients complicated with hypokalemia occupied 33.47% among PA patients ,linear correlation a-nalysis indicated that serum potassium level was correlated with aldosterone level (r= -0.706 , P=0.001) .Conclu-sion:In northern Jiangsu ,PA occupies 11.87% among patients with hypertension and it occupies 23.69% among pa-tients with refractory hypertension .Therefore ,plasma ARR should be regularly detected to screen PA patients in patients with hypertension ,especially those with refractory hypertension .

Objective To explore the risk factors of liver metastasis from colorectal cancer. Methods The clinic data of 1341 patients with colorectal cancer who had been admitted to our department from January 1989 to December 2004 were analyzed retrospectively. Results The incidence of the liver metastasis from colorectal cancer was 11.56% (155/1341). Univariate analysis showed that sex, location and size of the primary tumor site, regional lymph node metastasis, infiltration depth of the bowel wall, involvement of the adjacent viscera, complications and peritoneal implantation were relevant to liver metastasis (X2=6.517, 10.208, 11.173, 42.160, 80.731,6.593, 3.887, 14.352, P < 0.05). Logistic regression analysis showed that sex, regional lymph node metastasis, infiltration depth of the bowel wall, complications and primary tumor site were correlated with liver metastasis ( b = 0.655, -0.488, 1.355, -0.752, 0.273, P <0.05). Conclusions Male patients, patients with regional lymph node metastasis or with involvement of tissues out of the serosa have higher chance of liver metastasis from coloreetal cancer. Patients with colon cancer are apt to develop liver metastasis than those with rectal cancer. The incidence of liver metastasis in colorectal cancer patients complicated with other diseases is low.

Objective To study the correlation between single nucleotide polymorphisms of -238,-308 G/A in promoter region of tumor necrosis factor -?(TNF-?) gene and the type of juvenile idiopathic arthritis (JIA).Methods Clinical data and blood preparation of 127 children with JIA and 106 healthy children were evaluated.Subgroups of JIA were defined according to the Edmonton criteria.The -238 G/A and -308 G/A polymorphisms in DNA analysis in this study were extracted from the whole blood.The restricted fragment length polymorphisms were determined in the cases of all JIA children and control group.Results 1.The TNF-?-238 G/A allele frequencies of JIA group and control group:allele frequency of JIA group was 92.9% and 7.1%,and the control group was 95.3% and 4.7%.The distribution of allele frequencies was no significantly different between JIA group and control group(?2=1.149 P=0.284).But there were significant difference between polyarticular JIA (RF negative) and control group(?2=7.621 P=0.006).2.The TNF-?-308 G/A allele frequencies of JIA group and control group:allele frequency of JIA group was 94.1% and 5.9%,the control group was 95.3% and 4.7%.The distributions of allele frequencies was no significantly different between JIA group and control group(?2=0.322 P=0.571).There were significantly difference between polyarticular JIA (RF negative) and control group (?2=7.621 P=0.006).Conclusions The TNF-?-238,-308 polymorphisms of A in the-238 and-308 TNF-? gene are important to the joint destruction of JIA.The study will be beneficial to provide indirect support to the application of anti-TNF drugs to the treatment of JIA.

Objective To explore the rate of incidence of cerebral venous sinus thrombosis(CVST)in patients with idiopathic in- tracranial hypertension(IIH).Design Restrospective case series.Participants 92 cases with idiopathic intracranial hypertension.Meth- otis All patients diagnosed with papilledema from January 1,2000 through May 1,2007 at our ophthalmology center.Consecutive pa- tients with a diagnosis of papilledema were identified.Patients with space-occupying lesions,hydrocepbalus,or meningitis were excluded. The remaining patients were evaluated with lumbar puncture,magnetic resonance imaging(MRI)and magnetic resonance venography (MRV).Main Outcome Measures The rate of incidence of cerebral venous sinus thrombosis(CVST)in patients with idiopathic in- tracranial hypertension(IIH).Results Excluding patients with mass lesions,meningitis,or hydrocephalus,the occurrence of CVST was 7 (7.6%)of 92 patients with presumed IIH.One additional patients had a diagnosis of suspected CVST.Cerebral venous sinus thrombosis was diagnosed in 1 of the 7 patients with MRI alone,whereas it was evident in all 7 patients with MRV.Conclusions Cerebral venous si- nus thrombosis accounts for 7.6% of patients with presumed IIH in our ophthalmology services.Magnetic resonance venography in com- bination with MRI is recommended to identify this subgroup of patients.(Ophthalmol CHN,2007,16:410-413)

Objective To study the effects of nitroglycerin on leak point pressure of chronic complete spinal cord injury female rats. Methods Models of chronic complete spinal cord injury in female rats were established. Changes of leak point pressure were investigated following nitroglycerin 3 mg intraperitoneal injection. Results Leak point pressure decreased from (32.27±15.00) cmH2O to (23.29±9.46) cmH2O. Conclusion There was obvious descent of leak point pressure of chronic complete spinal cord injury female rats following nitroglycerin intraperitoneal injection.

Objective To study the effects of nitroglycerin on urethral sphincter of chronic complete spinal cord injury female rats in vitro. Methods 30 SD female rats with 3 months old were transected at T10 spinal cord. After 8 weeks, the 10 rats with BBB scores ≤5 were selected as experimental group, and other 10 normal rats as control group. The difference of tension in both proximal segment (urethral smooth muscle strips) and distal segment (external urethral sphincter muscle strips) were surveyed before and after nitroglycerin 0.5 mg administration in bath. Results The tension of distal segment in control group reduced from (640.50±91.79) mg to (597.50±92.61) mg, and from (485.50±68.94) mg to (459.90±69.51) mg in experimental group. The difference between proximal segment and distal segment were (222.30±12.14) mg and (42.00±7.86) mg before and after administration in control group, and were (223.00±15.78) mg and (25.60±5.17) mg in experimental group. Conclusion The administration of nitroglycerin 0.5 mg in bath can reduce the tension of both urethral smooth muscle and external urethral sphincter in both normal and spinal cord injured rats. The relaxative effect on external urethral sphincter muscle of normal rats exceed that of injured ones, but approximate on urethral smooth muscle.

OBJECTIVETo discriminate Descurainiae Semen and Pantagirus Semen.

METHODA high-performance liquid chromatographic method was developed to establish the fingerprint of Descurainiae Semen, and hierarchical cluster analysis (HCA) and partial least squares discriminant analysis (PLS-DA) were applied to study HPLC fingerprinting and chemical recognition.

RESULTThere exists large difference of chromatographic peaks and its relative peak area of HPLC fingerprints between Descurainiae Semen and Pantagirus Semen, and after conducting statistical analysis, the result demonstrated that all samples were classified into three categories: Descurainiae Semen, Pantagirus Semen and their mixtures.

CONCLUSIONThe developed HPLC fingerprint combined with chemometrics can be utilized to discriminate between Descurainiae Semen and Pantagirus Semen, which was quick, simple, accurate and reliable an can provide the basis for the characterization and quality assess of Descurainiae Semen and Pantagirus Semen.