Human serum paraoxonase (PON1) is a high density lipoprotein (HDL)associated enzyme capable of hydrolyzing lipid peroxides in vitro .PON1 has recently attracted attetion as a key factor against oxidative modification of LDL by involving in degradation of oxidized phospholipid and may therefore play an important role on the prevention of the atherosclerotic process of HDL.The concentration and activity of PON1 have been shown to be associated with the risk of atherosclerosis.In addition,the genetic polymorphisms of PON1 have been proposed as a genetic marker of risk for coronary artery disease.The measurement of the genetic polymorphisms of PON1 may be helpful in the prevention of coronary artery disease.

Objective To investigate possible changes of lipoprotein(a) [Lp(a)] and oxidized Lp (a) [ox-Lp(a) ] levels after PCI and it mechanisms. Methods Bloods were selected from 75 patients with ACS undergoing PCI, and at 24 hours, 2 and 3 days, and 6 months pre-and post-PCI treatment, and from 29 control patients pre-and post-coronary angiography without undergoing PCI. The levels of Lp(a) , ox-Lp(a) , Lp(a) immune complexes (IC) and its autoantibody were determined by ELISA. The extents of CAD were determined by coronary angiography. The differences of variants pre-and post-operations were analyzed by paired samples t test. The differences of levels of Lp(a) and ox-Lp(a) among time points after PCI were analyzed by ANOVA. Correlations between Lp(a) and ox-Lp(a) , and between angiographic variables and Lp(a), ox-Lp(a) levels were calculated. Results Compared to pre-PCI, Lp(a) [233.10 (152.86-328.79) mg/L vs 202.05 (106.15-271.42) mg/L, t=6. 81, P<0.01], ox-Lp(a) [19.05 (10.98-31.80) mg/L vs 10. 51 (4.98-17.97) μg/ml, t = 13. 22,P <0. 01] and Lp(a)-IC [2.72 (1.604.91) AU vs 2. 11 (1.04-3. 97) AU, t = 3. 34, P < 0. 01 ] levels significantly increased immediately in post-PCI, while its antoantibody levels significantly decreased (A = 0. 81 ± 0. 33 vs A = 0. 72 ± 0. 28, t = 5.58, P < 0. 01). Strong correlations were noted between levels of ox-Lp( a) and Lp( a) both in pre-PCI (r =0. 66, P <0.01) and post-PCI (r = 0. 62, P <0. 01). PCI resulted in rapidrise of Lp(a) and ox-Lp(a) levels and then decreased quickly in 24 hours, returned to baseline in 2-3 days. The changes of Lp(a) and ox-Lp(a) levels in pre-and post-PCI were positively related with severity of ACS. In contrast, in the angiography-only control group, no significant changes were noted in Lp(a) , ox-Lp(a) , Lp(a)-IC and Lp(a) autoantibodies levels between the pre-and post-angiography samples. Conclusion PCI results in acute plasma acute increases of levels of Lp(a) and ox-Lp(a) ,and the changes are related with lesion severity of the coronary artery.

Objectives:To compare the susceptibility of serum lipoproteins to oxidation and the effects of high-density lipoprotein on oxidative stress in patients with lipid turbulence.　Methods:VLDL, LDL and HDL were isolated using sequential ultracentrifugation from serum of patients with chronic renal failure (CRF) (n=45), myocardial infarction survivor (MIS) (n=33) , cerebral infarction(CI)(n=33) ,type 2 diabetes mellitus(DM)(n=53) and normal individuals (n=44). The degree of lipid peroxidation was estimated using the thiobarbituric acid-reactive substances (TBARS) value and the susceptibilities of lipoproteins to oxidation were assessed by measuring the increased absorbance value at 234 nm due to the conjugated dinene formation. Lipid levels and lipoprotein fractions were measured using standard methods.　Results: VLDL obtained from the patient groups showed significant increase in TBARS values, especially from the patients with MIS (compared with control group, P<0.001). In addition, LDL from MIS and DM groups and HDL from CI and DM groups also showed markedly increase in TBARS content. Significant decrease in lag time was observed in both VLDL and LDL fractions from the four patient groups. However, no change was found in the lag time in HDL fraction from the patient group compared with control group. In addition, HDL from the four patients exhibited significantly decreased inhibitory effects on in vitro oxidation of LDL, with the most significant decrease in HDL from CRF and MIS groups.　 Conclusions:The oxidative modification of lipoproteins in vivo in patients with serum lipid turbulence might be involved in the development of atherosclerosis in these patients.

Objective To compare the clinical effects of dydrogesterone and gestrinone on postoperative endometriosis and the rate of pregnancy in patients with infertility. Methods One hundred and fifty patients with postoperative endometriosis were enrolled in the current study who were hospitalized in fuzhou General Hospital of Nanjing Command from Jan. 2009 to Aug. 2013. They were randomly divided into dydrogesternne group(76 cases)and gestrenone groups(54 cases)based on progestogent treatment. The situation of pain symptoms improvement,the recurrence rate of 1 year,side effects and postoperative pregnancy rate were observed in order to evaluate the drug efficacy. Results There were a high rate of postoperative pain remission rate and a low recurrence rate of the two groups,and the difference was not significant( P ﹥0. 05 ). The main adverse reaction of patients in dydrogesterone group was breast pain and the incidence rate was 3. 9%( 3/76 ),while there was no breast pain in gestrinone group,and the difference was not significant( P =0. 140 ). The main adverse reaction of patients in gestrinone group was liver function damage and the incidence rate was 25. 9%(7/54),while the dydrogesterone group hadn't liver function damage,and the difference between two groups was significant( P =0. 000 ). The abnormal uterus bleeding incidence rate in dydrogesterone group was 15. 8%(12/76),higher than that of gestrinone group(13. 0%(7/54)),and the difference was significant(P=0. 038) . The serum carbohydrate antigen-125(CA-125)level in two groups were down to normal after operation,and still declined after drug treatment for 3 months. But there was no obvious change after 6 months. One year pregnancy rate of dydrogesterone pregnancy was 80%(24/30),higher than that of gestrinone group(48%,12/25),and the difference was significant( P =0. 038 ). Conclusion There is no significant difference in therapeutic effect between two groups. However,dydrogesterone therapy have no significant liver damage,and a higher postoperation pregnancy rate.

Objective To investigate the expression of FHIT,WWOX and MDR1 gene in nasopharyngeal carcinoma and FHIT and WWOX mechanism of inactivation.Methods Real-time PCR was used to test FHIT,WWOX and MDR1 gene′s mRNA expression in 89 nasopharyngeal carcinoma patients (experimental group) and 61 inflammatory patients (control group).Q-MSP was used to test the FHIT and WWOX promoter methylation status.Denatured polyacrylamide gel electrophoresis was used to test the LOH of FHIT and WWOX gene.Results (1)The three genes′ mRNA expression were different between experimental group and control group (P<0.05).After grouped according to the histological type and clinical stages,the expression of FHIT and WWOX mRNA between the patients with serious illness or poorly differentiated squamous cell carcinoma and mild cases or highly differentiated squamous cell carcinoma were significantly different in the experimental group,the difference is statistically significant (P<0.05)Meanwhile,the FHIT and WWOX mRNA expression had statistical association with the clinical stage and histological type(r=-0.731,P=0.000;r=-0.816,P=0.000;r=-0.626,P=0.000;r=-0.536,P=0.001).The MDR1 mRNA expression was different between poorly and highly differentiated squamous cell carcinoma (P=0.021),which was statistical associated with the histological type (r=-0.697,P<0.001).(2)The degrees of FHIT and WWOX promoter methylation in the experimental group was higher than those in the control group,the difference was statistically significant (P<0.05);Also,the expression of FHIT and WWOX mRNA were closely related to the degree of promoter methylation(r=-0.689,P=0.000;r=-0.594,P=0.000).(3) In the experimental group,there were 39 cases (43.8%) of LOH in the FHIT gene,and 42 cases (47.2%)of the WWOX genes were significantly higher than those in the control group (4.9% and 3.3%),the difference was statistically significant (P<0.05).The FHIT and WWOX gene mRNA were negatively correlated with the loss of heterozygosity(r=-0.239,P=0.049;r=-0.364,P=0.013).Conclusion Promoter methylation is the main reason for the down-regulation of FHIT gene and WWOX gene expression in nasopharyngeal carcinoma patients,which may be the main reason for the occurrence and development of nasopharyngeal carcinoma.The higher expression of MDR 1 mRNA is statistical association with the histological type.

Objective: Carnitine,the only carrier for the fatty acid crossing into mitochondria for oxidization,has a significant effect on the metabolism serum lipids.The purpose of this study is to investigate the effects of different doses of carnitine supplement on serum lipids in hyperlipemia rabbits. Methods: Twenty-eight rabbits were equally randomized into a control and three experimental groups,the former fed on high-fat diet,and the latter on carnitine at the dose of 100,200 and 400 mg/kg respectively every day in addition to high-fat diet.Blood samples were collected from the central artery of the rabbits for the measurement of the total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein B(ApoB) and free carnitine in the serum,their body weight obtained at 0,1,2,3,4 and 5 weeks,and the effects of different doses of carnitine supplement were observed on serum lipids.Results: All the 28 rabbits were included in the result analysis.The hyperlipemia model was successfully established after 4 weeks of high-fat diet.Compared with the control group,the experimental groups showed a remarkable decrease in the levels of TC,TG,LDL-C and AapoB and an increase in that of HDL-C in the serum,positively correlated with the dose and time of carnitine supplement.With the lengthening of time,the effects of different doses of carnitine supplement on the serum lipids was gradually decreased.Conclusion: Carnitine supplement can inhibit the increase of the levels of TC,TG,LDL-C and AapoB in the serum of the rabbits with hyperlipemia induced by high-fat diet and the effect is positively correlated with the dose and time of carnitine supplement.

Objective To understand the current situation of satisfaction and self-efficacy of nursing students in clinical practice and to explore the correlation between the two. Method A total of 120 nursing students in clinical practice were investigated using the general nursing student satisfaction scale and the general self-efficacy scale (GSES). Results The satisfaction score of nursing students was(151.89 ± 22.36)points and the score of nursing students self-efficacy was(29.06 ± 6.70)points.Nursing students self-efficacy was positively correlated with their job satisfaction (r=0.390,P＜0.01).Regression analysis showed that nursing students self-efficacy had a significant impact on job satisfaction (t=3.363,P＜0.01). Conclusion According to the characteristics of nursing students,clinical nursing education administrators should formulate and implement targeted interventions to deepen their love of nurses and improve their sense of self-efficacy,so as to enhance job satisfaction of nursing students.

Objective: Oxidative modification of low density lipoprotein(LDL) plays an important role in the development of premature atherosclerosis in autoimmune disorders.Oxidized LDL(ox-LDL) reportedly forms stable complexes with ?2-glycoprotein I(?2-GPI),a major autoantigen for anticardiolipin antibodies,in circulation and the intima of atherosclerotic lesions. This study aims to investigate the serum ?2-GPI/ox-LDL concentration in Chinese patients with systemic lupus erythematosus(SLE),and clinical diagnostic value.Methods: The concentrations of ?2-GPI/ox-LDL complexes were analyzed in 47 SLE patients and 42 healthy controls by ELISA.Results: The serum ?2-GPI/ox-LDL concentrations were significantly higher in the SLE patients than in the controls(\U/ml vs\U/ml,P

Objective To evaluate the diagnostic and therapeutic significance of serum free light chain (sFLC) in primary systemic(AL) amyloidosis. Methods Twenty-five patients with AL amyloidosis,including 18 men and 7 women with a mean age of 54(47-77) years old, were enrolled from October, 2005to May, 2010. sFLC was measured by immunoturbidimetric assay. The type of monoclonal light chain was judged upon sFLC κ/λ and its sensibility was compared with serum immunofixation and immunohistochemical analysis. Four patients were treated with M (T)D (melphalan/thalidomideand, dexamethasone), one with VD (velcade and dexamethasone) and four with high-dose melphalan followed by autologous stem cell support. The changes of sFLC were serially determined before and after treatment. Results Among the 25 patients with AL amyloidosis, two were κ light chains of precursor protein and 23 were λ light chains. Mean plasma cell in bone marrow was 3.5% (0-15%). Nineteen (76%) patients had abnormal elevated sFLC and abnormal κ/λ ratios, and 17(68% ) patients with immunofixation positive. The sFLC test had similar sensitivity as serum immunofixation (P = 0. 727 ). Twenty-one (84%) patients were shown to have either κor λ immunoreactive amyloid deposits on biopsied tissues. The sFLC test combined with serum immunofixation allowed the M protein to be detected in 22 (88%) patients. The positive rates of immunohistochemical analysis combined with sFLC test and/or serum immunofixation were 96%. Four patients with hematologic response showed obvious improvement in visceral organ involvement, but illness of 5 patients without hematologic response kept stable or progressed. Conclusions sFLC test is a sensitive qualitative and quantitative method to detect M protein. Preliminary data show the patients with obvious sFLC level decrease and/or κ/λ recovery to normal may have a high percentage of improved organs function. sFLC is critical index in diagnosing AL amyloidosis, which might help efficacy assessment.

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL). Methods: A total of 12 specimens were collected, which were surgically resected and verified as MEITL by postoperative pathology, immumohistochemical staining and gene rearrangement at the First Affiliated Hospital of Nanjing Medical University from 2012 to 2018, and all of these had complete clinical and pathological data. The MEITL cases were reviewed to compare the clinicopathological characteristics, including morphologic and immunophenotypic features and followed up by telephone and clinic visit. Results: All the cases were diagnosed with MEITL. There were 8 males and 4 females. Male to female ratio was 2∶1, at a median age of 54 years. The sites of involvement included jejunum (4 cases), ileum (5 cases), duodenum (1 case), ileocecal junction (1 case) and rectum (1 case). The neoplastic cells were monotonous of small to intermediate cells in size with round to slightly irregular nuclei in 11 cases. The immunophenotyping showed that CD3 (12/12), CD8 (11/12), CD43 (11/12), CD56 (11/12), TIA-1 (12/12) were positive; CD5 (12/12), Gran B (9/12), and perforin (7/12) were negative. Two cases aberrantly expressed the B-cell marker CD20. A high proliferation index was demonstrated by Ki-67 immunostaining. In situ hybridization for EBER was all negative(12/12). The whole exome sequencing(WES) mutational landscape of MEITL was remarkably homogeneous, showing significantly enriched clusters among histone modifier genes, JAK-STAT and MAPK-signal pathways. Histonelysine N-methytransferase SETD2 gene was mutated in 2/4 tumors. All the patients analyzed harbored at least one mutation in the JAK-STAT signal pathway, including STAT5B (2/4), JAK3 (3/4) and STAT5A (2/4). Furthermore, frequent alterations (TP53) were observed in the MAPK pathway in 3/4 of MEITL cases. The CNV analysis derived from WES data identified multiple regions of frequent gains and losses. In particular, gains in 1q, 7q and 9q, and recurrent losses involving 7p and 8p were observed. Conclusions MEITL is a rare and aggressive type of extranodal T-cell lymphoma. The differential diagnosis of MEITL includes EATL, extranodal NT/T-cell lymphoma and other types of PTCL. Diagnosis should be correlated to clinical symptoms while the final diagnosis is mainly based on the pathological features, immunophenotypes and genetic testing.