[Objective] The disease distribution of in-patients in different age groups from 1993 to 2002 in respiratory disease department of Guangdong Provincial Hospital of Traditional Chinese Medicine (TCM) was analyzed to provide evidence for clinical treatment. [ Methods ] A retrospective research was adopted. Fourteen categories of diseases and 3 age groups were classified according to the case history recorded from 1993 to 2002 in respiratory disease department of Guangdong Provincial Hospital of TCM. Reasons for hospitalization of the in-patients in different age groups during 10 years were analyzed by descriptive analysis and Vilfredo Pareto analysis. [Results] The principal and secondary reasons for hospitalization were respiratory tract infection, pulmonary tuberculosis and pneumothorax in the young age group while in the old age group, they were chronic bronchitis, pulmonary emphysema, chronic pulmonary heart disease and lung cancer. [Conclusion] The focus of daily medical treatment in the department of respiratory disease should vary with the age groups and disease categories, and the control of infectious diseases should be generally strengthened.

Objective To investigate the effects of hysteroscopic resection for mild-to-moderate uterine incision diverticulum after cesarean section.Methods From September 2010 to September 2014, hysteroscopic resection was performed under B-ultrasonography in 102 cases of mild-to-moderate uterine incision diverticulum after cesarean section.Results The operation was completed successfully in all the cases, without surgical complications.Outcome evaluation at 1 year after surgery showed cured in 89 cases (87.3%, complete disappearance of symptoms and recovery of normal menstruation), improved in 7 cases (6.9%, menstrual period shortened by 5-7 d, with or without lower abdominal dull pain and menstrual exacerbation), and ineffective in 6 cases (5.9%, no or slight symptom improvement).Conclusion Hysteroscopic resection is a safe, effective, and minimally invasive method for mild-to-moderate uterine incision diverticulum after cesarean section in patients demanding clinical symptom improvement without desire of fertility.

Objective To investigate Treg and Th17 cell numbers in the peripheral blood of patients with unexplained recurrent spontaneous abortion (URSA),with an aim to elevate their potential for predicting pregnancy outcomes.Methods Peripheral blood was collected from 60 URSA pregnant women and 56 healthy pregnant women during their first trimester in the Department of Reproductive Endocrinology of the Second Affiliated Hospital of Soochow University from January 2014 to June 2015.The counts of regulatory T cell (Treg),T helper cell 17 (Th17),CD4 positive T cell (CD4+ T cell) and total lymphocytes in the peripheral blood were determined by flow cytometry.Calculated the ratios of Treg/CD4+ T cells,Treg/total lymphocytes,Th17/CD4+ T cells,Th17/total lymphocytes and Treg/Th17,then the pregnancy outcomes were followed up.According to the different pregnancy outcomes,the patients were divided into three groups: URSA successful delivery group (23 cases),URSA re-miscarriage group (37 cases) and normal successful delivery group (44 cases).Non-parametric test were used to compare the differences between groups.Results There were no difference between the URSA re-miscarriage group and URSA successful delivery group in the CD4+ T cell counts[(1 570.16±519.56) vs (1 571.83±450.37),t=0.01,P=0.99]and total lymphocytes[(4 497.11±975.48) vs (4 558.52±1 032.54),t=0.23,P=0.82].However,the ratios of Treg/CD4+ T cells[(1.09±0.62) vs (3.32±2.30),t=4.55,P=0.000 1],Treg/total lymphocytes[(0.42±0.24) vs (1.31±1.14),t=3.67,P=0.001 3]and Treg/Th17[(0.56±0.41) vs (2.51±2.38),t=3.89,P=0.000 8]in the URSA miscarriage again group were significantly lower whereas the ratios of Th17/CD4+ T cells[(1.85±0.92) vs (0.93±0.36),t=5.40,P<0.001]and Th17/total lymphocytes[(0.64±0.31) vs (0.31±0.14),t=5.52,P<0.001]were significantly higher.Similarly,There were no difference between the URSA re-miscarriage group and normal successful delivery group in the CD4+ T cell counts[(1 570.16±519.56) vs (1 566.86±651.36),t=0.03,P=0.98]and total lymphocytes[(4 497.11±975.48) vs (4 720.91±1 572.92),t=0.78,P=0.44].However,the ratios of Treg/CD4+ T cells[(1.09±0.62) vs (3.17±1.81),t=7.16,P<0.001],Treg/total lymphocytes[(0.42±0.24) vs (1.03±0.51),t=7.08,P<0.001]and Treg/Th17[(0.56±0.41) vs (1.87±1.68),t=4.98,P<0.001]in the URSA re-miscarriage group were significantly lower whereas the ratios of Th17/CD4+ T cells[(1.85±0.92) vs (1.12±0.50),t=4.29,P<0.001]and Th17/total lymphocytes[(0.64±0.31) vs (0.36±0.15),t=5.01,P<0.001]were significantly higher.Conclusions Treg and Th17 cell counts in the peripheral blood of patients with URSA might be useful in predicting their pregnancy outcomes.The decrease of Treg cell counts and the increase of Th17 cell counts might imply another abortion.

Objective To investigate dyslipidemia and the use of lipid-lowering drugs in patients with chronic kidney diseases(CKD)and analyze the related risk factors.Methods A total of 397 out-patients with CKD in our Renal Department from March 2006 to March 2007 were enrolled;258 healthy people with similar age and sex were taken as the control group.Lipid levels were compared between the two groups and related factors were analyzed.Results Among 397 CKD patients,there were 52.1% patients with high triglyceride(TG),41% with high total cholesterol(TC),18.8% with low high-density lipoprotein cholesterol(HDL-C),47.6% with high low-density lipoprotein cholesterol(LDL-C).Compared with controls,rates of hypertriglyceridemia and low high-density lipoprotein cholesterol in CKD group were higher(P

Studying classic cases is one of the applicable methods for student's self-learning,especially at clinical rotation period.Seven-year program pediatric students (2004 grade) from pediatric medical collage,Capital Medical University of China shared classic cases from New England Journal of Medicine (NEJM),reported clinical cases they took part in and summarized their writing of case report.Through these measures,students felt the significance of studying classic cases and noticed that case study played an important role in training of clinical reasoning,multidisciplinary approach,as well as self-learning ability for medical students.

Objective To detect the combining capacity of peripheral blood NF-E2-related factor 2 (Nrf2)of arsenic-exposed residents in the coal-contaminated arsenism area in Guizhou with the sequence of downstream antioxidant response element (ARE) as well as antioxidase gene expression,and to provide a basis for in-depth revelation of arsenic oxidative damage mechanism to human body.Methods Jiaole and Changqing villages in coal-burning-borne arsenism areas in Xingren County of Guizhou were selected as the survey spots,and 161 cases of arsenic-exposed residents were selected as the arsenic exposed group on the basis of physical examination.They were divided into non-patient group (21 cases) and patient group (140 cases) according to the Diagnostic Criteria of Endemic Arsenism (WS/T 211-2001),and the patient group was further divided into mild hepatosis group (52 cases),moderately severe hepatosis group (36 cases) and non-apparent hepatosis group (52 cases) according to the Diagnostic Criteria of Occupational Chronic (GBZ 59-2010).Moreover,45 residents from one village neighboring to non-epidemic area were selected as controls.The hemocyte nucleoprotein was extracted from peripheral blood in the sampling subjects.The combining capacity of peripheral blood Nrf2-ARE was tested by electrophoretic mobility shift assay (EMSA),and the relative expression quantity of Cu/Zn superoxide dismutase (Cu/Zn-SOD) and glutathione peroxidase 1 (GSH-Pxl) mRNA was tested with real-time fluorescence quantification PCR (qPCR).Results The testing results of Nrf2-ARE combining capacity showed that the difference of Nrf2-ARE combining capacity between groups was statistically significant (F =116.033,P ＜ 0.05).Compared with the control group (3.14 ± 1.34),the Nrf2-ARE combining capacity was higher in the non-apparent hepatosis group (5.17 ± 2.06),mild hepatosis group (13.13 ± 4.84) and moderately severe hepatosis group (32.35 ± 14.76,all P ＜ 0.05);compared with the non-patient group (5.15 ± 3.23) and non-apparent hepatosis group,the Nrf2-ARE combining capacity of mild hepatosis group and moderately severe hepatosis group was higher (all P ＜ 0.05);compared with mild hepatosis group,the Nrf2-ARE combining capacity of moderately severe hepatosis group was higher (P ＜ 0.05).The results of Cu/Zn-SOD and GSH-Pxl mRNA expression showed the relative expression quantities of Cu/Zn-SOD [Median (M):1.127 8,1.257 8,1.632 0] and GSH-Pxl (M:1.334 5,1.940 9,2.062 6) mRNA of non-apparent hepatosis,mild hepatosis,moderately severe hepatosis groups were higher than those of the control groups (M:0.961 8,0.884 3),respectively,and their differences were statistically significant (x2 =13.065,19.934,all P ＜ 0.05).The relative expression quantities of GSH-Pxl mRNA of mild hepatosis group and moderately severe hepatosis group were higher than that of the non-patient group (M:1.248 4),and their differences were statistically significant (all P ＜ 0.05).The correlation analysis indicated the Nrf2-ARE combining capacity was positively related to the Cu/Zn-SOD and GSH-Px1 mRNA expression (r =0.271,0.292,all P ＜ 0.01).Conclusion The increase of Nrtf2-ARE combining capacity by arsenic participates is involved in the regulation of Nrf2 downstream antioxidase gene expression,and this process possibly participates in occurrence and development of coal-burning-borne arsenism and hepatic injury.

Objective To study the expression and enzyme activity of thioredoxin reductase 1 (TrxR1) in liver and peripheral blood of human and rats exposed to airborne arsenic through coal-burning as well as its role in liver injury of coal-burning-borne arsenic poisoning.Methods This study was divided into 2 parts.Part 1 was a population study:133 local residents exposed to airborne arsenic through coal-burning were selected as arsenic exposure groups including a non-patient group (25 cases),no obvious hepatopathy group (38 cases),mild (43 cases) and moderate to severe hepatopathy groups (27 cases) from areas affected by endemic arsenism in Guizhou Province.Thirty-four healthy residents from arsenic not affected areas were selected as controls.Peripheral blood samples were collected from all these people.The expression of TrxR1 mRNA was determined by real-time fluorescence quantitative PCR (qPCR),and enzyme activity of TrxR was tested by visible spectrophotometry.Part 2 was an animal experiment study:Thirty Wistar rats,weighing about 80-100 g,were divided into control group,drinking-waterborne arsenic poisoning group and coal-burning-borne arsenic poisoning group (including low,medium and high arsenic contaminated grain groups) by means of a table of random number according to body mass,6 rats in each group.The control group was fed with normal diet for 3 months; drinking-water-borne arsenic poisoning group and coal-burning-borne arsenic poisoning group were fed with 10 mg/kg As2O3 solution and different concentrations(25,50,100 mg/kg) of arsenic-containing feed,respectively,for 3 months.The expression of TrxR1 mRNA was determined by qPCR; protein expression level of TrxR1 in liver tissue was detected by immunohistochemistry,and enzyme activity of TrxR in serum and liver tissue was tested by visible spectrophotometry.Results The mRNA expressions of TrxR1 in peripheral blood were 1.599 8 (1.128 9-2.156 8),1.469 3 (1.146 1-1.976 3),1.203 6 (0.463 1-1.816 2) and 0.912 3(0.631 8-1.535 0),respectively,among non-patient group,no obvious hepatopathy group,mild and moderate to severe hepatopathy groups.Compared to the control group[1.649 7(1.161 1-2.380 2)],the differences were significant statistically in mild and moderate to severe hepatopathy groups (all P ＜ 0.05).The enzyme activity of TrxR in peripheral blood was (3.12 ± 0.76),(2.81 ± 0.84),(2.52 ± 0.73),(2.42 ± 0.76)U/ml,respectively,in those corresponding groups.Compared to the control group [(3.02 ± 0.70)U/ml],the differences were significant statistically in mild and moderate to severe hepatopathy groups (all P ＜ 0.05).The mRNA expressions of TrxR1 in peripheral blood were 1.05 ± 0.14,1.18 ± 0.18,1.04 ± 0.10 and 0.97 ± 0.13,respectively,among drinking-water-borne arsenic poisoning group,low,medium and high arsenic contaminated grain groups; all of which were lower than that in the control group (1.23 ± 0.15,all P ＜ 0.05) except that of the low arsenic contaminated grain group.The mRNA expressions of TrxR1 in liver tissue were 0.78± 0.10,0.83 ± 0.10,0.79 ± 0.09 and 0.77 ± 0.11,respectively; all of which were lower than that in the control group (0.94 ± 0.12,all P ＜ 0.05).The protein expression of TrxR1 in liver tissue was 310.33 ± 38.81,312.50 ± 23.36,305.67 ± 20.57 and 298.17 ± 23.52,respectively,among the arsenic poisoning groups; all of which were lower than that in the control group (348.50 ± 32.35,all P ＜ 0.05).The enzyme activity of TrxR in serum was (4.22 ± 0.73),(4.86 ± 0.63),(4.04 ± 0.57),(3.73 ± 0.64)U/ml,respectively; all of which were lower than that in the control group [(9.52 ± 1.08)U/ml,all P ＜ 0.05].The enzyme activity of TrxR in liver tissue was (14.82 ± 1.67),(18.76 ± 2.76),(14.90 ± 2.17),(11.55 ± 1.74) U/mg,respectively; all of which were lower than that in the control group [(23.71 ± 3.05)U/mg,all P ＜ 0.05].Conclusion Arsenic aggravates liver injury of coal-burning arsenic poisoning through down-regulating the expressions of TrxR1 mRNA and protein and reducing its enzyme activity as well.

BACKGROUND:Hydroxyapatite (HA) is a good scaffold material, and recombinant human bone morphogenetic protein-2 (rhBMP-2) possesses a strong osteogenic ability, therefore, by which preparing a novel composite material wil be helpful for bone repair. OBJECTIVE:To explore the effects of the hol ow HA/rhBMP-2 microspheres on the osteogenesis and biomechanics of rabbit bone defects. METHODS:Forty-eight male healthy adult New Zealand white rabbits were randomly divided into three groups (n=16 per group), including composite, single and control groups. Radical defect models were prepared, and the hol ow HA/rhBMP-2 and hol ow HA scaffolds were implanted into the composite and single groups, respectively. The control group received no treatment. At the 1st day of 4, 8, 12, and 16 weeks after implantation, the level of serum alkaline phosphatase was detected, and the bone healing was assessed through X-ray, three-dimensional CT, radionuclide bone scan and biomechanics testing, respectively. RESULTS AND CONCLUSION:The level of serum alkaline phosphatase, X-ray scale scores, osteogetic effect, region of interest volume, three-dimensional CT and biomechanical strength in the composite group were superior to those in the single group. In the meanwhile, the bone healing was unsatisfactory in the control group. Our findings indicate that the hol ow HA/rhBMP-2 artificial bone exhibits a good osteogenic ability and mechanical strength, contributing to bone healing.

Objective To investigate the adhesion molecule expression and functional status of platelets in lung cancer patients, and their relations with disease progression. Methods Using flow cytometry to measure the expression of surface antigens and functional status of platelets in 60 healthy control group, and 164 lung caneer patients. Results Comparing with control group, the expression in early group and mid term group(A group) of CD31, CD36, CD62, CD63 increased, and there is no significant meaning in the differences of surgery group (B group) of CD31, TSP, CD36, CD62, CD63. The expression in advanced group (C group) of CD31, TSP, CD36, CD62, CD63 increased. Comparing with A Group, the expression in B Group of CD36, CD62, CD63 decreased. The expression in C group of CD31, TSP, CD36, CD62, CD63 increased. Comparing with the small cell lung cancer, the expression of adenocareinorna of TSP, CD36,, CD62, CD63, squamous cell carcinoma of CD31, CD62, CD63, and alveolus cancer of CD31, TSP, CD63, all decreased. Conclusion The high level expression of platelet activation exists in patients with lung cancer of different stage, and decreased after operation. Platelet activation expressed significantly in the advanced stage of small cell lung cancer.

Objective To study the effects of platelet activation on the metastasis and prognoies of lung cancer. Methods Radio-immunity and ELISA were employed to detect the TXB_2,DH-TXB_2,TSP, β-TG, GMP-140,CGMP and FN of 168 cases of lung cancer patients (lung cancer group) and 80 cases of healthy persons control group. The lung cancer group included two subgroups: earlier and metaphase group (n=51) and advanced group (n=17), 39 cases in the former group underwent operation (after operation group). Results (1)Compared with control group, the levels of DH-TXB2,TSP,β-TG,GMP-140,CGMP in group of earlier and metaphase lung cancer increased and FN decreased. TXB2,DH-TXB2,TSP,β-TG,GMP-140,CGMP in advanced group increased and FN decreased;DH-TXB2 and GMP-140 increased in group of after operation. (2)Compared with group of earlier and metaphase lung cancer,the levels of DH-TXB2,TSP,β-TG,GMP-140,CGMP in group of after operation increased and FN decreased; In advanced group, levels of TXB2, DH-TXB2,TSP,β-TG,GMP-140,CGMP increased and FN decreased. (3)In the lung cancer group, CGMP was positively correlated with DH-TXB2,TSP,β-TG and GMP-140. (4)Compared with control group,TXB2, DH-TXB2, TSP,β-TG,GMP-140 and CGMP in group glandular cancer and small cell carcinoma cases increased,FN decreased;In squamous cancer, the levels of TXB2, DH-TXB2,GMP-140 and CGMP increased and FN decreased. (5)Compared with small cell carcinoma cases, DH-TXB2 decreased in cases of glandular cancer; GMP-140 decreased in squamous cancer. Conclusions Activations of platelet generally emerged with lung cancer patients, platelet activation was severe in advanced cancer patients. Activations of platelet, after operation, is obviously eased. The level of platelet activation marker is possibly related with histological classification of lung cancer.