Objective To study the apoptosis of PBLC in SLE patients and the roles of caspase in the pathogeneses of SLE.Methods PBLC apoptosis was evaluated by vitro cell culture in 25 patients with SLE(11 active stage,14 catabasis),and 18 controls.The expression of caspase of PBLC was also detected by Western blot.Results In SLE,compared with controls,the apoptosis of PBLC were reduced before cell culture while those were increased after culture 24 and 48hrs.Expressions of caspase-2,3 in active stage patients were lower than those of catabasis group and controls.Conclusions Abnormal PBLC apoptosis results in decreasing Caspase2,3 in SLE patients.

Objective To investigate the feasibility of induction of experimental chronic pancreatitis rat model with L-arginine.Methods Animals were randomly divided into control group,arginine 12 h group,arginine 24 h group and arginine 7 d group with 10 rats in each group.L-arginine solution was intraperitoneally injected twice with an interval of 1 h.Serum amylase and glucose levels at corresponding time points were detected and histopathological scores of pancreas were evaluated.Collagen in pancreas was stained with Van Gieson method.Results Serum amylase levels were (1 634±890 ) U/L,( 3 872±2 676 ) U/L,( 3 307±2 197)U/L and (1 561±304) U/L in control group,arginine 12 h group,arglnine 24 h group and arginine 7 d group,respectively.The serum amylase level in arginine 7 d group was significantly lower than those in arginine 12 h group and arginine 24 h group (P ＜ 0.05 ).There was no significant difference in serum glucose level among all the groups.Histopathological scores were 0.8±0.4,5.1±2.6,6.5±2.2 and 4.5±1.6,respectively.The histopathological score of arginine 7 d group was significantly lower than those in arginine 24 h group (P ＜ 0.05 ).Obvious collagen could be found in pancreatic parenchyma in arginine 7 d group,while little collagen was found in pancreatic tissue in control,arginine 12 h and arginine 24 h groups.Conclusions Injection of L-arglnine induced fibrosis in pancreatic parenchyma and proliferation of tubular complex 7 days later,and it could be used for chronic pancreatitis model induction.

Objective: The research is to study the present situation and influencing factors of inflammatory bowel disease (IBD) nursing competency in grade A of level Ⅲ hospital in Shandong province. and provided reference for further training and education of IBD nurses. Methods: From October, 2018 to May, 2019, the research is a cross-sectional study including 17 cities, 327 IBD nurses (qualified group n=197, unqualified group n=130) based on the IBD nursing competency questionnaire. The questionnaire is self-designed on the reference of registered nurse core competence scale and the reliability and validity have been tested very well. Results: The IBD nursing competence questionnaire has 8 categories and 68 entries. The content validity index (CVI) is 0.90, while the Cronbach index is 0.992. The median score of IBD nursing competency is 70.59 and each category vary from 55.00 to 84.38. Among them, the critical thinking skills or research ability (55.00) and continuing nursing (58.33) behave not very well. According to the single factor analysis, the hierarchy (P=0.031) and the follow-up numbers of IBD patients (P=0.001) are two significant factors for the IBD nursing competency. In the Logistic multiple factors analysis, the hierarchy (N₁ and N₂) and the follow-up numbers of IBD patients (21-50 patients) are also important factors. Conclusion The present situation of IBD nursing competency of Shandong province is acceptable. But there is still a long way to go in the aspect of critical thinking skills, research ability, and continuing nursing. Nurse hierarchy level and follow-up of IBD patients affect nursing competence and we should reinforce the training and education of IBD nurses.

Objective: To observe the effects of electroacupuncture (EA) pretreatment on motor function, cerebral blood flow, cerebral infarction volume, and vascular endothelial growth factor (VEGF) level in middle cerebral artery occlusion (MCAO) model rats. Methods: Twenty-four male Sprague-Dawley rats were randomly divided into a normal group, a model group, and an EA group, with eight rats in each group. The middle cerebral artery ischemia-reperfusion model was established by the suture-occluded method in the model group and the EA group, while not in the normal group. The EA group was pretreated with EA at bilateral Fengchi (GB20) before model preparation, once a day for 30 min each time for a total of 7 d. The changes in the CatWalk gait parameters, modified Bederson neurological deficit score, cerebral blood flow, cerebral infarction volume after ischemia, and VEGF level in the brain tissue of rats in each group were observed. Results: Compared with the normal group, the modified Bederson neurological deficit score in the model group and the EA group increased after modeling (P<0.05), and the CatWalk gait parameters (one-leg stance duration, gait cadence, and gait cycle) were all changed (P<0.05). Compared with the model group, the modified Bederson neurological deficit score in the EA group decreased (P<0.05), and the CatWalk gait parameters improved (P<0.05). Immediately after ischemia, the cerebral blood flow in the normal group was greater than that in the model group and the EA group (P<0.05); after reperfusion, the cerebral blood flow in the EA group was greater than that in the model group (P<0.05). Compared with the normal group, the cerebral infarction volume in the model group and the EA group increased (P<0.05). Compared with the model group, the cerebral infarction volume in the EA group decreased (P<0.05). The expression level of VEGF-positive cells in the rat brain tissue in the model group was higher than that in the normal group (P<0.05), and was higher in the EA group than in the model group (P<0.05). Conclusion: EA pretreatment improves the limb motor function in MCAO model rats, alleviates the symptoms of neurological deficits, promotes the recovery of cerebral blood flow, reduces the cerebral infarction area after MCAO modeling, and increases the VEGF expression in the brain tissue.

Objective To investigate the effect of jejunal casein perfusion on pancreatic exocrine secretion in experimental acute necrotic pancreatitis (ANP) rats and analyze the neuromechanism that may be involved. Methods 30 SD rats were randomly divided into three groups (control group, ANP group and ANP jejunal nutrition group). Experimental ANP was induced by intra pancreatic duct injection of sodium taurocholate (STC). Animals in ANP jejunal nutrition group were given jejunal casein perfusion 24h after model induction, while control group and ANP group received jejunal saline perfusion. Pancreatic juice was collected every 15 min for six times and the volume of pancreatic juice and protein in pancreatic juice were detected. After jejunal nutrition c-Fos expression in nucleus tractus solitarii (NTS) was determined by immunohistochemistry method in three groups. Results There was no significant difference between the volume of pancreatic juice at different time points in ANP group and ANP jejunal nutrition group, however, these parameters were significantly lower than that of control group (P < 0. 05). There was no significant difference among the 3 groups in the protein level in the pancreatic juice during jejunal nutrition infusion, however, during the periods of 0 ～ 15 min, 15 ～30 min, 30 ～45 min and 75 ～90 min, the protein levels in the pancreatic juice in ANP and ANP jejunal nutrition group were lower than that of control group (P < 0.05). After jejunal perfusion, c-Fos expression was found in ANP jejunal nutrition group but not found in ANP and control groups. Conclusions Jejunal casein perfusion enhanced NTS c-Fos expression, but did not increase the volume of pancreatic juice and protein.

Objective:The purpose of this study is to investigate the expression of tumor stem cell marker aldehyde dehydrogE-nase 1 (ALDH1) in breast cancer and its clinical significance. Methods:The expression of ALDH1 protein was examined by immunohistochemical staining in 92 breast cancer tissues. The correlation analysis and diseasE-free survival analysis of patients was evaluated based on the clinical follow-up data. Results:Expression of ALDH1 protein had a significant correlation with progesterone receptor (PR) and cerb-B2 (P<0.05), but had no significant correlation with age, tumor size, clinical staging, and lymph node metastasis (P>0.05). The 2-year diseasE-free survival rate of AlDH1-positive patients was lower than that of ALDH1-negative patients (P<0.05). ALDH1-positive patients, who received CEF regimen chemotherapy and hormone therapy, had lower 2-year diseasE-free survival rate than that of ALDH1-negative patients (P<0.05). Conclusion:The decreased diseasE-free survival rate of ALDH1-positive patients is related with drug resistance. ALDH1 could be used as an independent factor for predicting the prognosis of breast cancer.

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS) treatment on the brain derived neurotrophic factor(BDNF) serum levels in depressive patients.Methods Sixty-eight unipolar depressions treated with venlafaxine were randomly assigned to the real rTMS group(n =34)and the sham rTMS group(n =34),which were accepted the real or the shame rTMS treatment on the left dorsolateral prefrontal lobes respectively.The Hamilton Rating Scale for Depression (HAMD) and BDNF serum was assayed before and after 4 weeks' treatment.Results 1) A significant increase of serum BDNF((12.2 ± 1.3) μg/L vs (5.6 ± 0.8) μg/L,t=-9.167,P=0.000;(11.4 ± 1.5)μg/L vs (6.0± 1.0)μg/L,t=-7.421,P=0.000)and a significant decline of HAMD((11.6 ± 1.7) score vs (32.6 ± 2.5) score,t =14.654,P =0.000 ; (4.2 ± 2.8) score vs (31.8 ± 3.2)score,t=12.089,P =0.000) were found after the treatment in the real and the shame group,and the real group changed more significantly than the shame group ((6.7 ± 0.8) μg/L vs (5.1 ± l.2) μg/L,t =2.690,P =0.009 ; (21.0 ± 2.1) score vs (17.6 ± 2.6) score,t =2.693,P =0.000).2) A negative correlation was found between the serum BDNF levels and the HAM D scores before the treatment(r =-0.530,P=0.003; r =-0.490,P =0.004),and a positive correlation between changes of BDNF levels and HAMD scores changes(r =0.439,P =0.006 ; r =0.454,P =0.005).Conclusion The rTMS treatment can increase serum BDNF levels in depressive patients.

ObjectiveTo observe the expressions of PPAR-γ protein during the course of pancreatic fibrosis of chronic pancreatitis (CP) in Wistar rats and its significance.Methods Bibutyltin dichloride ( DBTC,8 mg/kg body weight) in a volume of 200 ml solvent was injected into the tail vein to establish the CP rat's model.Wistar rats were randomly divided into control group and 1,3,5,7,14,42 d group according to weights.Pancreatic tissue underwent routine pathological examination,and collagen accumulation in pancreatic sections was determined by staining for Sirius Red.Pancreatic myeloperoxidase (MPO)activity was determined.Expressions of α-SMA and PPAR-γ proteins were assessed by immunohistochemical method.Results Light microscopy showed signs of acute pancreatitis with interstitial edema and infiltration of neutrophilic granulocytes 7 d after DBTC injection.Acinar cells necrosis,atrophy,lymphocytes and monocytes infiltration,fibrosis within lobule and peri-lobule as well as pancreatic duct changes were found,which was in accord with the course from AP to CP.One days after induction,the activity of MPO,expressions of α-SMA was significantly increased[ (0.78 ±0.71) vs (0.15 ±0.05)U/g,6.67 ±3.14 vs 0,P＜0.05],then it did not increase with time of induction.Seven days after induction,collagen level reached the peak [ (45.42 ±15.99)％ ],which was significantly higher than that in control group [ (10.87 ± 2.28 )％,P ＜ 0.05 ].Collagen fibers accumulated from periductal to intra-acinar and/or inter-acinar areas.In control rats,the expression of PPAR-γ protein was positive only in vessel walls,and the expression level was 0.17±0.41 and increased with time of induction,then reached the peak of 4.83 ± 2.71 at 42 d.ConclusionsDuring the course of pancreatic fibrosis in rats,the expression of PPAR-γ protein is gradually increased,and plays a limited anti-inflammation and anti-fibrosis role.

Objective To evaluate hepatitis B virus large surfsce protein(LHBs) in monitoring of antiviral treatment.Methods LHBs.HBV serum markers and HBV DNA loads in 46 patients with adefovir dipivoxil(ADV) therapy were monitored for the whole course(60 weeks).Enzyme linked immunosorbent assay(ELISA),time differentiate immunofluoresence assay and real.time polymerase chain reaction(RT-PCR)were performed to detect LHBs,HBV serum markers and HBV DNA loads,respectively.And correlation analysis was also performed.Results Both LHBs and HBV DNA declined during the ADV treatment.and the correlation coefficient was 0.97.but LHBs declined after HBV DNA.There were 20 patients with HBV DNA<5×102/mL at 60th week.in which 8 were LHBs negative;in 14 recurrent patients,the HBV DNA turned to negative and became positive again,3 with negative LHBs;while in 12 patients resistant to the ADV therapy.2 were LHBs negative.Conclusion Dynamic monitoring of LHBs is useful in the evaluation of antiviral treatment.

Objective To investigate the survival of patients with painful chronic panereatitis and evaluate the risk factors for mortality in these patients.Methods This was a historical cohort study,subjects ≥18 yr with painful chronic pancreatitis who were treated in our center from Feb.1997 to July 2007 were enrolled.A life-table method was used to estimate the probability of the cumulative survival rate.COX proportional-hazards model was used for multivariate analysis.Results Follow-up data were obtained from 346 patients (87.2%) with the ratio of male/female was 2.4:1.The age of first admission and first symptom onset was (47±14)years and (43±15 ) years.The mean follow-up period was ( 34.3±27.1 ) months.Alcoholic origin accounted for 22.2% of all the patients,while biliary origin was 26.0%.The overall mortality rate was 9.8% (34/346),which happened (62.5±61.1 ) months after abdominal pain was present.The causes of mortality included pancreatic cancer and cancers of other sites.The cumulative survival rate estimated at 2 years was 96.3%,at 5 years 93.6% and at 10 years 86.4%.COX proportional-hazards model suggested age at onset (≥51 years),no improvement of abdominal pain or increased frequency of pain,active smoking,and no diarrhea were associated with increased mortality,and the corresponding hazard rates (HR) were 3.4,3.5,4.2,2.8 and 17.7,respectively.Conclusions The mortality rate of painful chronic panereatitis in China was lower than those reported outside China.The main cause of mortality was pancreatic cancer.Great caution shall be placed on patients with age at onset ≥51 yr,no improvement of abdominal pain,increased frequency of pain,active smoking and no diarrhea.