Objective To investigate whether two polymorphism sites of the the exon 2 Lys65Lys(G/A) and exon 9 Va1365Met(G/A) in T ceils immunoglobulin domain and mucin domain protein-4(TIM-4) are associated with asthma in Chinese Han population of Hubei province. Methods The polymorphisms were de-tected with polymerase ehain reaction-restriction fragment length polymorphism(PCR-RFLP) in 185 cases of al-lergic asthma and 162 healthy controls. The genotype and allele frequencies were calculated and analyzed. Re-sults(1)The genotype frequencies of G/G, G/A and A/A in Lys65Lys(G/A)polymorphism were 0.840, 0.160 and 0 respectively in the healthy population, and were 0.859, 0.141 and 0 respectively in the allergic asthma population. No significant difference in genotype and allele frequencies was found between asthma pa-tients and the control subjects (P=0.603, P=0.618). (2) The polymorphism of the Val365 Met(G/A) was not detected in our study. Conclusion There is polymorphism site of the exon 2 Lys65Lys(G/A)in TIM-4, but this polymorphism site is not associated with asthma in Han nationality in Hubei Chinese population. There is no SNP of the exon 9 Val365Met(G/A) in TIM-4 in Chinese Han population of Hubei province.

Objective To investigate the value in distinguishing benign and malignant vertebral fractures with MR diffusion-weighted imaging(DWI).Methods 31 patients with 58 vertebral fractures were underwent routine MRI scanning and echo-planar DWI(EPI/DWI).The materials were divided into benign group(n=32,20 cases),malignant group(n=18,8cases),tuberculosis group(n=8,3cases) and normal vertebral body group(n=31). Signal intensities on DWI were compared and apparent diffusion coeffient(ADC) values of normal and abnormal vertebral bodies were calculated. ADC values among the benign,malignant,tuberculosis vertebral bodies and normal ones were quantitatively analyzed and compared.Results The ADC values of benign,malingnant,tuberculosis and normal vertebral bodies were (1.44?0.41)?10 -3 mm2/s,(0.94?0.17)?10 -3 mm2/s,(0.98?0.13)?10 -3 mm2/s and(0.42?0.16)?10 -3 mm2/s ,respectively. The ADC values of the three abnormal groups were higher than normal group ( all P0.05). The sensitivity and specificity of ADC for the diagnosis of malignant lesion were 72.2% and 90.6% if the upper bound of 95% confidence interval was set as a differential level.Conclusion DWI provides an important supplement to the routine MRI in the differentiation of benign with malignant vertebral fractures.

Objective To investigate the value of modified loop ileostomy in laparoscopic low and superlow radical resection of the rectal cancer with reservation of anus.Methods The clinical data of 108 patients who received laparoscopic low and super-low radical resection of rectal cancer with preservation of anus at the Subei Hospital of Jiangsu Province from January 2010 to June 2012 were retrospectively analyzed.Fifty-three patients who received preventive ileostomy were in the ileostomy group,and 55 patients who did not receive preventive ileostomy were in the non-ileostomy group.The operation,incidence of complication and follow-up of the 2 groups were analyzed.All data were analyzed using the t test,chi-square text or Fisher exact test.Results The operation time and blood loss were (185 ± 14)minutes and (31 ± 26)ml in the ileostomy group,and (154 ± 12)minutes and (28 ± 19)ml in the non-ileostomy group,with no significant difference between the 2 groups (t =2.34,1.82,P ＞ 0.05).The time to first flatus,time to liquid diet intake,time to pelvic drainage tube removal,duration of hospital stay,hospital costs were (1.1 ± 0.3) days,(1.1 ± 0.2) days,(5.2 ± 1.0) days,(7.2 ± 1.4) days,(3.0 ± 0.2) ×104 yuan in the ileostomy group,and (4.2 ± 0.6) days,(4.3 ± 0.6) days,(8.4 ± 3.9) days,(12.9 ±4.4)days,(3.8 ±0.7) × 104 yuan in the non-ileostomy group,with significant differences between the 2 groups (t =7.25,28.12,15.34,34.01,7.83,P ＜ 0.05).The incidences of postoperative complications and anastomotic fistula were 5.7％ (3/53) and 0 in the ileostomy group,and 21.8％ (12/55) and 12.7％ (7/55) in the non-ileostomy group,with significant differences between the 2 groups (P ＜ 0.05).Conclusion Modified loop ileostomy in laparoscopic low and super-low radical resection of rectal cancer can effectively reduce the incidence of anastomotic fistula,and helps the recovery of patients.

Objective: To evaluate the potential dose influence to organs at risk (OARs) and targets of adaptive radiotherapy (ART) for non-small cell lung cancer (NSCLC). Methods:Twice positional CT images of 12 patients with locally advanced NSCLC were captured during radio-(n=3) or radio-chemotherapy (n=9) for ART simulation. The twice positional scanningplan was fused using MIM software. The variation of irradiation doses for the lung, heart, and spinal cord was evaluated, and the prescription doses for the targets were escalated. Results:Adaptive radiation enabled dose reduction by an average of 3.53%for lung V20 and by 2.55%for V30. The mean dose for the lung decreased by 2.11 Gy. The dose was reduced by an average of 4.17%for heart V30 and by 3.37%for V40. Meanwhile, the maximum dose for the spinal cord was reduced by 3.52 Gy on average. Lung sparing with ART enabled an iso-mean lung dose escalation of the Planning gross tumor target volume dose, which improved by an average of 1.25 Gy. Conclusion:The adap-tation of radiotherapy for continuous tumor shrinkage during the treatment course for NSCLC reduces doses to OARs, enables signifi-cant dose escalation, and has the potential to increase local control.

Objective To investigate the activation of apoptotic genes of the brain with hypoxia- ischemia (HI) in newborn SD rats, and MRI changes and memory and learning ability in adulthood. Methods HI was induced by right carotid artery ligation followed by 2.5 h of hypoxia (6% O2) on 3-day-old SD rats (n=36). Control pups were sham-operated (n = 27). Right brain hemisphere was collected at 12 h and 7 d after HI and subjected to an apoptosis Oligo GEArrayR. MRI and Morris water maze test were performed on both groups at 42 and 44 days old, respectively. Results Comparing to 12 h after HI, up-regulated apoptotic genes included TNF, Caspase and pro-apoptotit genes of Bcl2 families, whereas the anti-apoptotic genes of Bcl2 family were down-regulated at 7 d after HI. The MRI assessment of the rats in HI group demonstrated that the area of the right cerebra l cortex was significantly smaller than the left side and control [periventricular layer: (23.5±3.6) mm2 vs (33.0±4.3) mm2, (34.5±3.9) mm2; hippocampus layer: (18.9±4.4) mm2 vs (29.1±5.0) mm2,(30.8±4.5) mm2, both P<0.01]. During the navigation trial, the HI rats demonstrated longer escape latency (4th day: (52.7±35.9) vs (17.8±8. 9) s, P<0.01). HI rats passed the platform less times than the control ones (T= 292.5, P<0.05) in space probe trial. Conclusions The activation of apoptotic genes induced by HI brain injury remains until 7 days later, involving intrinsic and extrinsic apoptotic pathway. The apoptosis of neural cells may lead to poor development of the cortex and impair the memory and learning ability in the adult rats after neonatal hypoxia- ischemia injury.

Objective To analyze the prognostic factors and evaluate the effect of stereotactic radiosurgery for patients with multiple brain metastases. Methods Comparison was made in 53 such patients treated by stereotactic radiosurgery plus radiotherapy and 53 treated by radiotherapy alone. Patients were matched paired according to the following criteria: age, Karnofsky performance scale(KPS) before treatment, extent of systemic cancer and number of brain metastasis.Fourty patients had stereotactic radiosurgery, 13 patients stereotactic fractionated radiosurgery. In the stereotactic radiosurgery group, the patients were given a mean marginal dose of 20?Gy. Methods of stereotactic fractionated radiosurgery was 4 12?Gy per fraction, twice a week to a total dose of 15 30?Gy. Whole brain radiotherapy was given immediately after stereotactic radiosurgery. For patients treated by radiotherapy alone, the entire brain was treated by 30 40?Gy in 3 4 weeks. Results The median survival was 11.6 months in stereotactic radiosurgery plus radiotherapy and 6.7 months in radiotherapy alone. The one year survival rate and one year local control rate were 44.3%,17.1% and 50.9%,13.2%. Those with KPS increased after treatment gave 1 year survivals of 69.8% and 30.2%, respectively. The validity rates in CT or MRI three months after treatment were 82.0% and 55.0%.The difference in the two groups was found to be statistically significant (P

Objective To investigate the relationships between occupational coping self-efficacy, job stress and core competence of nurses. Methods A total of 493 registered nurses were recruited in the survey with the Chinese nurse job stressors scale, occupational coping self-efficacy scale for nurses and competency inventory for registered nurse (CIRN). The correlations were analyzed using Pearson correlation analysis. Results The total scores on occupational coping self-efficacy, job stress of nurses and core competence of nurses were (31.94 ± 6.39), (90.29 ± 17.41) and (159.93 ± 34.31), respectively. Nurses′occupational coping self-efficacy negatively correlated with (r=-0.267, P<0.01) and positively correlated with the core competence of nurses (r=0.355, P<0.01). Conclusions The occupational coping self-efficacy of the nurses can be improved by successful experiencing, verbal persuasion and positive feedback. In this way, nurses core competence can be enhanced and their job stress can be relieved and consequently the quality of nursing can be enhanced.

Objective To investigate the protective effect of flos puerariae flavonoid on adriamycin (ADR)-induced toxic myocarditis and its mechanisms from morphological,biochemical and molecular levels.Methods 96 healthy Kunming male mice were randomly divided into 6 groups:normal control group,ADR model control group,ADR+low dose of flos puerariae flavonoid group(50 mg/kg),ADR +middle dose of flos puerariae flavonoid group(100 mg/kg),ADR +high dose of flos puerariae flavonoid group(200 mg/kg),and Vit E positive control group(40 mg/kg),16 in each group.The drugs were orally administered for consecutive 15 d and the model of toxic myocarditis was induced by intraperitoneal injection of ADR(3 mg/kg)in mice from day 2,one time every other day,for 7 times Colorimetry was used to measure the changes of marker enzymes about myocardial injury and inducible nitric oxide synthase(iNOS)activity in serum and tissue;immunohistochemical method was adopted to detecte the expression of myocardial apoptosis related proteins Bax and bcl-2;HE staining was conducted to observe the pathological changes of cardiac structure.Results Compared with normal control group,ADR(3 mg/kg,ip,7 times)induced the elevation of serum creatine kinase (CK),lactate dehydrogenase (LDH),aspartate transaminase(GOT)and iNOS activity increased significantly in mice(P<0.01).Meanwhile myocardial superoxide dismutase(SOD)activity decreased, and the malondialdehyde(MDA)content increased(P<0.01).Myocardial cell apoptosis in mice increased significantly,and the apoptosis rate was(40.5 ± 5.2)%;the expressions of Bax and Bcl-2 were significantly increased(P<0.01),However,the Bcl-2/Bax ratio decreased.The flos puerariae flavonoid (50,100,200 mg/kg,ig,15 d)and Vit E positive control group could reverse the changes induced by ADR,decrease serum CK,LDH,GOT and iNOS activities,increased myocardial SOD activity,lower MDA content and the expression of bax protein,and elevated Bcl-2/Bax ratio,in a dose-dependent manner.Light microscopy confirmed that flos puerariae flavonoid significantly alleviated the changes of myocardial microstructure.Conclusion ADR could induce myocardial cell apoptosis and lead toxic myocarditis in experimental mice.The flos puerariae flavonoid has protective effect on ADR-induced myocardial injury and the mechanism may be related to elevating myocardial SOD activity and anti-lipid peroxidation,inhibiting the expression of Bax protein and adriamycin-induced cardiomyocyte apoptosis.

Objective To compare the clinical value of hepatitis C virus (HCV)antibody(HCV-Ab),hepatitis C virus core anti-gen (HCV-cAg),hepatitis C virus ribonucleic acid (HCV-RNA)in diagnosis for hepatitis C.Methods A total of 258 patients with hepatitis C were recruited in this study,HCV-RNA was detected by fluorescence quantitative PCR detection,HCV-Ab and HCV-cAg were detected by the double antigen sandwich ELISA statutory,and the test data was analyze.Results The result of HCV-Ab detection was significant difference with those of HCV-cAg and HCV-RNA detection respectively(P <0.05),HCV-cAg and HCV-RNA detection had no significant difference (P >0.05).Conclusion The coincidence rate of HCV-cAg detection and HCV-RNA detection was high,and complement with HCV-Ab,the early detection could be done to prevent the omission of HCV infection and to improve the detection rate.

Expression of cytokeratin19(CK19)mRNA was detected by reverse transcription-PCR in bone marrow and integrin α_vβ_3 was detected by immunohistochemistry(IHC streptavidin-biotinperoxidase SP)in breast tissue from 62 breast cancer patients with negative axillary lymph nodes.Out of 62 patients 15cases(24%)presented positive CK19,in which all had positive integrin α_vβ_3;36 cases(58%)presented positive integrinα_vβ_3.Two markers were positively correlated with each other(kappa=0.6839,P＜0.05),and correlated with the size of tumor(P＜0.01).The results indicate that combined detection of CK19 in bone marrow and integrin α_vβ_3 in cancer tissues may be helpful for guiding therapy and estimating prognosis in breast cancer patients with negative axillary lymph nodes.