Adolescent ; Adult ; Cholestasis ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis, Viral, Human ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy

Objective:The aim of the present study was to determine the relation between coronary atherosclerosis and periarteries atherosclerosis by ultrasound measured as carotid and femoral artery structure and function and coronary angiograpgy. Methods: Subjects(75 cases) were divided into two groups according to coronary lesion and non-coronary lesion.Relation between coronary atherosclerosis lesion and multiple factors was found by analysis of clinical statues,laboratory test and sonograhpy. Results: Intima-media thickness in common carotid and femoral arteries,carotid plaques and invert peak and whole time on invert peak in femoral arteries were significantly higher in coronary lesion group than those in non-coronary lesion group(P

Objective To know the state of working satisfactory in appointment nurses, and then carry out certain countermeasures to promote their working satisfactory. Methods Investigated 137 ap-pointment nurses by serf-designed quesstionnair and JDI from five aspocts, to know their working satisfacto-ry and analyzed the resluts. Results The total points of working satisfactory in appointment nurses was 1882, which indicated that the level of working satisfactory was in a low state, the order of average points of working satisfactory in appointment nurses from low to more was promote, incomes, nursing cares, nursing management and yokemate. There were different working satisfactory in appointment nurses with different marital status, different working age, different operating post. Conclusions Effective nursing manage-ment, logical re, yard system and offer scope for nurses ability can promote their working satisfactory, and then ensure the stability of appointment nurses.

Objective: To determine the expressions of histidine triad nucleotide-binding protein 1 (HINT1) mRNA and protein in clear cell renal cell carcinoma (ccRCC) and their relationships with clinicopatholgical features. Methods: Real-time fluorescence quantitative reverse transcription PCR (RFQ-RT-PCR) was used to detect the expressions of HINT1 mRNA in 36 cases of fresh ccRCC and 37 cases of normal kidney tissues (29 paired cases), as well as their relationships with clinicopathological features were analyzed. Immunohistochemistry was used to detect the distribution and expression of HINT1 protein in 30 cases of paraffin embedded fresh ccRCC tissues and 12 cases of paraffin-embedded adjacent normal kidney tissues, as well as their relationships with clinicopathological features were analyzed. Results: The expression levels of HINT1 mRNA in 29 cases of paired ccRCC and normal kidney tissues were 0.209±0.033 and 0.733±0.136, respectively (P<0.001). The expression levels of HINT1 mRNA in 36 cases of ccRCC and 37 cases of normal kidney tissues were 0.245±0.035 and 0.694± 0.108, respectively (P<0.001). The positive expression rate of HINT1 protein in the adjacent normal kidney tissues was 100% (12/12), diffusely distributing in the nucleus and cytoplasm. HINT1 protein immunostaining in proximal convoluted tubule was stronger than that in distal convoluted tubule, while it was partially weaker in glomerular basement membrane and Bowman's capsule. The HINT1 protein expression was negative in renal interstitium. HINT1 protein expression distributing in nucleus and cytoplasm was 60% (18/30) positive in ccRCC, while it was negative in intercellular substance (P<0.01). The tendency of HINT1 mRNA expression in ccRCC and normal kidney tissues and their relationships with the clinicopathological features were the same as those of HINT1 protein. The expressions of HINT1 mRNA and protein in stages T1-2 of ccRCC were higher than those in stages T3-4 (P<0.05), and the same result was found in normal kidney tissues and ccRCC tissues. The expressions of HINT1 mRNA and protein were not correlated with Fuhrman grade, gender, age and tumor size (P>0.05). Conclusion: HINT1 may play a role as tumor suppressor gene in ccRCC. The abnormal expression of HINT1 may be associated with the abnormal regulation before translation. Abnormal expressions of HINT1 mRNA and protein may serve as a marker for the prognosis of ccRCC patients.

Objective:To investigate the effect of levosimendan on myocardial injury in patients with sepsis.Methods:Eighty-two patients with sepsis complicated by myocardial injury who received treatment in Yinzhou Second Hospital from June 2015 to September 2017 were included in this study. They were randomly assigned to receive either dobutamine treatment (control group, n = 41) or levosimendan treatment (study group, n = 41) based on conventional basic treatment. Before and after treatment, serum levels of heart-type fatty acid-binding protein (H-FABP), cardiac troponin I (cTnI), N-terminal pro brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LEVF), Acute Physiology, Age, and Chronic Health Evaluation II (APACHE II) score, intensive care unit (ICU) stay, and 28-day mortality were compared between the control and study groups. Results:Before treatment, there were no significant differences in serum levels of H-FABP, cTnI, and NT-proBNP as well as LVEF and APACHE II score between the control and study groups (all P > 0.05). At 6 hours after treatment, serum levels of H-FABP, cTnI, and NT-proBNP in the control and study groups [(26.22 ± 7.22) μg/L vs. (39.93 ± 9.85) μg/L, (25.97 ± 6.93) μg/L vs. (34.86 ± 8.55) μg/L, (0.004 ± 0.002) μg/L vs. (1.580 ± 0.360) μg/L, (0.003 ± 0.003) μg/L vs. (0.760 ± 0.210) μg/L, (1 561.73 ± 633.70) ng/L vs. (2 570.06 ± 747.95) ng/L, (1 602.28 ± 681.45) ng/L vs. (2 225.53 ± 585.14) ng/L] were significantly increased compared with before treatment ( t = 7.188, 5.172, 28.031, 23.079, 6.586, 4.443, all P < 0.05). After treatment, serum levels of H-FABP, cTnI, and NT-proBNP in the study group were significantly lower than those in the control group ( t = 2.489, 12.598, 2.323, all P < 0.05). In each group, serum level of H-FABP at 72 hours after treatment was significantly lower than that at 6 hours after treatment [(39.93 ± 9.85) μg/L vs. (6.28 ± 1.07) μg/L, (34.86 ± 8.55) μg/L vs. (5.82 ± 1.88) μg/L], serum levels of cTnI and NT-proBNP at 72 hours after treatment were significantly increased compared with those at 6 hours after treatment [(1.58 ± 0.36) μg/L vs. (2.72 ± 0.55) μg/L, (0.76 ± 0.21) μg/L vs. (1.78 ± 0.49) μg/L, (2 570.06 ± 747.95 ) ng/L vs. (3 623.27 ± 1 105.28) ng/L, (2 225.53 ± 585.14) ng/L vs. (3 128.08 ± 1 098.07) ng/L, t = 11.105, 12.251, 5.053, 4.645, all P < 0.05). At 72 hours after treatment, serum levels of cTnI and NT-proBNP levels in the control group were significantly higher than those in the study group ( t = 8.171, 2.035, both P < 0.05). At 72 hours after treatment, there was no significant difference in serum H-FABP level between the control and study groups ( P > 0.05). At 72 hours after treatment, APACHE II score in each group was significantly decreased and LVEF in each group was significantly increased compared with before treatment ( t = 7.718, 11.380, 9.049, 9.501, all P < 0.05). The change in APACHE II score at 72 hours after treatment relative to before treatment in the study group was more obvious than that in the control group ( t = 2.583, P < 0.05). At 72 hours after treatment, there were no significant differences in LVEF, ICU stay and 28-day mortality between the control and study groups (all P > 0.05). Conclusion:Levosimendan can reduce the serum levels of H-FABP, cTnI and NT-proBNP as well as APACHE II score in patients with sepsis, increase serum level of LVEF, and alleviate myocardial injury.

The short stature homeobox-containing(SHOX) gene,located in the short-arm pseudoautosomal region (PAR1) of the sex chromosomes,is one of the recently discovered genes,which is related to short stature.Its encoded protein,as a transcription activator,plays an important role in the regulation of growth.It has now been confirmed that the human SHOX gene mutation can cause L?ri-Weill syndrome,Turner syndrome,idiopathic short stature growth and its related characteristic skeletal deformities.This review makes a summary about SHOX gene defects,its clinical phenotype and treatment.

The teaching and management of our eight-year program students is relatively new,so we should gradually study and explore the adapted cultivation pattern,learn and accumulate the successful experiences of the high starting point teaching in order to cultivate the qualified medical talents.

Objective The increased use of high-resolution ultrasound (US) for thyroid disease has markedly increased the detection rate of nonpalpable thyroid nodules .The objective of this study was to investigate the diagnostic value of conventional ultrasonography, ultrasonic elastography(UE) and combined application of both in the differential diagnosis of thyroid nodules. Methods A retrospective analysis was made on 105 patients with 160 histologically proved thyroid nodules from September 2014 and August 2015 in our hospital.The receiver operating characteristic ( ROC) curve analysis was made on Thyroid Imaging Repor-ting and Data System ( TI-RADS) score, elastography score and the score of combined application.The area under curve ( AUC) was calculated and compared to select the best cut-off value in order to work out the respective diagnostic efficacy of 3 methods and Kappa consistence check with pathologic results . Results In ROC curve analysis, AUC of combination score(0.930, 95%CI:0.890-0.969) was higher than those of TI-RADS score(0.855, 95%CI:0.794-0.915) and elasticity score(0.845, 95%CI:0.780-0.909), and the difference was statistically significant (Z=2.20, 2.03, P<0.05) .Taking TI-RADS score≥4, elastography score≥3, and combination score≥7 as the limitation to diagnose ma-lignant thyroid nodules, the specificity and PPV of combination score(94.3%, 95%CI:0.867-0.979;91.7%, 95%CI:0.809-0.969) were higher than those of TI-RADS score(78.4%, 95%CI:0.681-0.862;84.7%, 95%CI:0.692-0.886) and e-lasticity score(81.8%, 95%CI:0.719-0.889;78.7%,95%CI:0.674-0.870).Kappa value of combination score(0.718, 95%CI:0.610-0.826) was higher than that of TI-RADS score(0.586, 95%CI:0.461-0.711) and elasticity score(0.635, 95%CI:0.515-0.755). Conclusion Conventional ultrasonography and UE are mutual complementation, and the application of conventional ultrasonography combined with UE has higher value than single examination in the differential diagnosis of thyroid nodules.

Objective To investigate the diagnostic value of Lugol solution staining combined with nar-row band imaging (NBI)for esophageal cancer and precancerous lesions.Methods From December 201 3 to December 2014,1 87 patients who were with suspicious esophageal lesions and stained with Lugol solution under endoscopy were selected as control group,while from January 2015 to June 2015,124 patients who were with sus-picious esophageal lesions and examined with Lugol solution staining and NBI under endoscopy were selected as observation group.The sensitivity,specificity and accuracy between the two groups were compared and analyzed. Results One hundred and four cases (75.0%)were found among observation group,which was higher than 93 cases (55.6%)among control group (χ2 =12.07,P <0.01 ).The total detection rates of esophageal cancer and high grade intraepithelial neoplasia (HGN)were 29.0% and 17.7% in observation group respectively,which were higher than 1 8.2% and 6.4% in control group (χ2 =4.15,P =0.04;χ2 =8.54,P <0.01 ).The Kappa value in observation group was 0.55,which was higher than 0.36 in control group.The sensitivity and accuracy in observation group were 89.9% and 82.3% respectively,which were significantly higher than 71 .8% and 68.4% in control group (χ2 =9.79,P <0.01 ;χ2 =7.38,P <0.01 ).Conclusion The sensitivity and accuracy of endoscopic Lugol solution staining combined with NBI for esophageal cancer and precancerous lesions are higher than Lugol solution staining,and it is worthy to popularize the application of Lugol solution staining com-bined with NBI in diagnosing esophageal cancer and precancerous lesions.

Mitochondrial calcium homeostasis plays a key role in maintaining various cellular characteristics and mediating cellular physiological function and pathological processes .Although it has long been known that mitochondria takes up Ca2+, the molecular identities of the channels and transporters involved in this process are revealed only recently . Here, we review the structure and function of the channel-forming subunit, mitochondrial calcium uniporter (MCU) and its regulators, which include MICU1, MICU2, and MCUR1.