Objective To investigate the activation of nuclear factor ?B (NF-?B) induced by lipopolysaccharides (LPS) in rat alveolar macrophages (AM) and its regulative role in tumor necrosis factor (TNF-?) expression. Methods The dynamic activity changes of NF-?B DNA induced by LPS (E.coli 026:B6) were determined with electrophoretic mobility shift assay (EMSA). The phosphorothioate oligodeoxynucleotides (S-ODN) decoy was transfected into AM 12 hours prior to LPS stimulation. The effect of NF-?B S-ODN decoy on expression of TNF-? in AM stimulated by LPS were measured with enzyme-linked immunosorbent assay (ELISA) kit. Results NF-?B could be activated remarkably after 0.5 hour of LPS stimulation at concentration of 100 ng/ml, reached the highest level 1 hour after LPS stimulation and gradually decreased. But the activation of NF-?B could last at least 8 hours. The dose for LPS stimulation was related to activation of NF-?B in a dose-dependent fashion, ie, the activation of NF-?B gradually strengthened with dose increase of LPS. Supershift assays proved that p50 and p65 were involved in the activation of NF-?B. NF-?B S-ODN decoy could markedly (not completely) inhibit LPS-induced TNF-? production. Conclusions NF-?B plays an important role in LPS induced inflammatory response. However, entire inhibition of the activity of NF-?B can not completely prevent TNF-? expression induced by LPS in rat AM, which implies that other nuclear factors may participate in TNF-? expression.

To investigate the kinetics of activation of the activator protein-1(AP-1) and elucidate its role in TNF-? expression induced by lipopolysaccharide(LPS) in rat alveolar macrophages(AM), dynamic changes of the activity of AP-1 were detected with electrophoretic mobility shift assay(EMSA). The phosphorothioate oligodeoxynucleotide (S-ODN) decoy was transfected into AM prior to LPS stimulation. The level of TNF-? in culture supernatants was measured with an ELISA kit. The results showed that after LPS stimulation for 0.5 hour, remarkable activation of AP-1 could be detected and reached the highest level. The activation of AP-1 rapidly decreased at 1 hour, then increased at 3 hours again and reduced at 5 and 8 hours after LPS stimulation. The activation of AP-1 could persist at least 8 hours and showed a dose-dependent manner to LPS within 1000ng/ml. AP-1 S-ODN decoys could markedly inhibit the LPS-induced TNF-? production by rat AM, but it could not completely inhibit the production of TNF-? induced by LPS in rat AM. It is suggested that LPS could induce activation of AP-1 in rat AM; AP-1 played an important role in LPS-induced inflammatory response. It is also suggested that AP-1 involved in the regulation on LPS-induced TNF-? production by rat AM, however, entirely inhibition of the activity of AP-1 could not completely prevent TNF-? production by rat AM. It is also implied that other nuclear factors might also play an important role in the regulation on LPS-induced TNF-? expression by rat AM.

Objective To investigate the efficacy of the hospital intensive treatment by auto-CPAP on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to analyse the possible factors related to the effectiveness.Methods Subjects were selected from elderly OSAHS patients over 60 years old.The eligible subjects were divided into intensive treatment group and non-intensive treatment group (non-ITG).Patients in intensive treatment group were intensively treated using auto-CPAP for 3 consecutive days,assisted with targeted health education and guidance,and making proper adjustments to parameters of the auto-CPAP according to treatment outcomes at the previous day.But those in non-intensive treatment group were just treated with auto-CPAP for only 1 day,supplemented by regular health education and guidance.The apnea-hypopnea index (AHI),minimum oxygen saturation (SaO2min),mean oxygen saturation (SaO2mean) and the time spent at SaO2 lower than 90％ (tSaO2＜90％),the occurrence of clinical symptoms and adverse effect,Epworth sleepiness scale(ESS) were compared between both groups.The correlation analyses were also conducted.Results ESS (3.58±3.76 vs.6.84 ± 3.22),AHI [(7.85±6.53) time/h vs.(10.42±7.27) time/h] and tSaO2＜90％[(5.65±15.43) min vs.(15.26±33.14) min] were lower(t=6.902,2.760,2.765,allP＜0.05),while SaO2mean [(96.57±1.53)％ vs.(94.63±1.38)％] and SaO2min [(88.24±4.43)％ vs.(83.28±5.06)％]were higher(t=-9.870,-7.740,both P＜0.05)in intensive treatment group than in non intensive treatment group.The occurrences of clinical symptoms and adverse effect (except for skin allergy) were decreased in intensive treatment group versus non-ITG (all P＜0.05).The AHI after intensive treatment was decreased in females versus males [(7.85±5.19) times /h vs.(11.27±7.78) times/h,t=2.133,P＜0.05].BMI,age,gender and the state of OSAHS were correlated to AHI,SaO2 mean,SaO2 min and tSao2＜90％ after intensive treatment (all P＜0.05).Conclusions The hospital intensive treatment can improve the clinical results and decrease the occurrences of clinical symptoms and adverse effect for elderly OSAHS patients,and is expected to improve therapy compliance,and its curative efficacy is correlated to BMI,age,gender and state of OSAHS before therapy.

Background and purpose:The epidermal growth factor receptor (EGFR) is commonly overexpressed in a variety of solid tumors, and has important roles in cancer pathogenesis and progression. EGFR thus provides a rational target for cancer therapy. We studied siRNA-mediated inhibition of epidermal growth factor receptor expression and its biologic effects in different human cancer cell lines (A431, HeLa and SPC-A-1). Methods:Cells were transfected with chemically synthesized siRNA-EGFR. EGFR mRNA was quantified by real-time PCR and was detected by immunofluorescence staining and flow cytometry. The biologic effects on cell growth were assessed by colony-formation assay.Results:siRNA-EGFR significantly decreased mRNA level of EGFR by 73.9 %, 44.6 % and 57.7 %, protein expression of EGFR by 77.0 %, 61.3 % and 65.2 %, and reduced colony number by 27.2 %, 53.9 % and 59.1 % in A431, HeLa and SPC-A-1, respectively.Conclusions:Our data suggested that RNA interference could downregulate EGFR and inhibit colony forming ability and EGFR expression at mRNA/protein levels in human cancer cell lines with different pathological types. siRNA could be one of the promising strategies in future targeted cancer therapy.

Objective To investigate the clinical value of tumor's longest diameter and volume in assessing pathologic response in locally advanced breast cancer treated with neoadjuvant chemotherapy(NAC).Methods A prospective study was undertaken in women undergoing NAC for locally advanced breast cancer in order to determine the ability of quantitative MRI to assess the final pathologic response. 36 cases with pathologically confirmed locally advanced breast cancer who had been undergone four courses of NAC underwent preoperative breast MRI three times during the NAC. Pathologic response was assessed according Miller & Payne grading system, of which grade 4 and 5 defined as major histological response (MHR), and grade 1 to 3 as non-major histological response (NMHR). The tumor's longest diameters and volumes in MHR were compared with those in NMHR by Mann-Whitney U test before, after the second and fourth cycle of NAC. Concordance correlation coefficient (CCC) were assessed to evaluate the agreement between the two method. Receiver operating characteristic curve (ROC) analysis was carried out to assess the clinical value of tumor size and the change rate.Results Before,after the second and the fourth cycle of NAC, the difference of tumor's longest diameters and their first change rate between MHR [(2.75±1.16) cm,(2.19±1.07) cm ,(1.58±0.75) cm and (21.70±15.09)%]respectively,and NMHR [(2.71±1.10) cm,(2.33±0.90) cm,(2.01±0.94) cm and (11.68±10.27)%] respectively were not significant(P>0.05). The second change rate of tumor's longest diameter in MHR [(39.00±15.38)% ] was significantly higher than that in NMHR[ (25.83±21.77)% ](P=0.04). Before, after the second and the fourth cycly of NAC, the differences of tumor volumes and their first change rate between MHR [ median 14.00 cm~3 ( range 2.96～83.41 cm~3 ) , median 7.31 cm~3 (range 0.05～55.35 cm~3), median 2.69 cm~3 (range 0～33.40 cm~3 ) , median 48.65% (range 33.64%～98.48%) ] and NMHR [median 4.25 cm~3 (range 4.78～106.55 cm~3), median 10.53 cm~3 (range 1.72～42.85 cm~3), median 7.56 cm~3 (range 0.68～156.58 cm~3), median 52.04% (range-35.79%～78.31%) ] were not significant. The second changing rate of tumor's volume in MHR [median 85.37% (ranged 27.52%～100%)] was significantly higher than that in NMHR [median 68.80% (ranged -289.60%～94.24%)](P=0.01). CCC was computed before and (0.82), after the second cycle (0.67) and after the fourth cycle (0.55), in all examinations pooled together (0.78).The second change rates of tumor's longest diameter and volume were equal to predict the final pathologic response, and the area under curve were 0.75 and 0.80, respectively (P=0.61). Conclusion The agreement between the tumor's longest diameters and tumor's volumes is good in all in breast carcinoma. The assessment efficacy of the change rate of tumor's longest diameter and that of volume were low.

Objective To study the relationship between stress rise of blood glucose and the PEEL prognostic index of the patients with acute myocardial infarction, and provide the basis for a quick judgement and evaluation of prognosis to nurses. Methods Taking the 6.8,7.8 and 8.8 mmol/L as demarcation point to study the PEEL prognostic index in 59 patients with acute myocardial infarction, and compare the PEEL score value on two sides of each demarcation point. Results No significant difference in PEEL evaluation score when taking 6.8 mmol/L as the demarcation point, there was significant difference when taking 7.8 mmol/L as the demarcation point, PEEL score in blood glucose > 7.8 mmol/L group was higher than that of ≤7.8mmol/L group, so was when taking 8.8 mmol/L as the demarcation point. Conclusions There was instructive signifi-cance for nurses to observe a stress rise of blood glucose timely in evaluating the prognosis of patients with a-cute myocardial infarction. Nurses should strengthen disease observation and preventive nursing of admission patients whose fasting blood glucose are above 7.8 mmol/L as well their blood glucose monitoring.

Objective To investigate the effects of recombinant tissue-type plasminogen activator (rt-PA) combined with mild hypothermia on the hemorrhagic transformation after cerebral ischemia-reperfusion within or out of the therapeutic time window in rats.Methods The focal cerebral ischemia-reperfusion 3 and 4 hours models of rats were established by middle cerebral artery occlusion (MCAO) 3 or 4 hours. The rats were randomly divided into the normal saline group (group NS), normothermia rt-PA group (group rt-PA), rt-PA combined with hypothermia group (group rt-PA +HT), and sham-operation group. Brain mild hypothermia was achieved after ischemia reperfusion and maintained 3 hours. Rats were sacrificed 24 h after ischemia reperfusion, and the amount of bleeding was measured.Results The amount of bleeding significantly reduced in the group rt-PA+HT compared with group rt-PA, which obviously increased in the group rt-PA compared with group NS ( P<0.05); there was a significant difference between rt-PA groups MCAO 3 hours and 4 hours ( P<0.05).Conclusion rt-PA can increase hemorrhagic transformation volume; hemorrhagic transformation volume is higher if treated by rt-PA within 3 h therapeutic time window than treated beyond the time window; mild hypothermia should possibly prevent the development of hemorrhagic transformation and prolong the therapeutic time window of thrombolytic intervention in ischemic stroke.

Objective To investigate the advantage of detaining peripherally inserted central catheter through the veins of lower extremity in neonatal intensive care unit.Methods 165 cases of infants were randomized into veins of lower extremity group (first saphenous veins,then popliteal vein) and veins of upper extremity group (first basilic vein,then median cubital vein,cephalic veins) from January to December 2012.We observed the success rate of detaining,catheter tip location,and complications such as phlebitis in the two groups.Results The success rate of detaining of lower extremity group was higher than that of upper extremity group,and ectopic rate of lower extremity group was lower than that of upper extremity group.There was no significant difference in complications such as phlebitis between two groups.Conclusions Peripherally inserted central catheter through the veins of lower extremity has more advantage over through the veins of upper extremity group.

Objective To investigate the possible correlation of the clinical parameters, such as age, obesity, Epworth sleepiness score (ESS), with the severity of snoring and obstructive sleep apnea hypopnea syndrome (OSAHS). Methods One hundred and forty-eight patients with snoring during sleep admitted from May to Jul. 2008 were asked to answer the questions from a questionnaire concerning snoring, daytime sleepiness, and habits such as smoking and drinking, etc. All patients underwent at least a polysomnography (PSG) and the physical examination included height, weight, and body mass index (BMI). Age, BMI, the lowest SaO_2(%), ESS score, the biggest reduction of oxygen (%), a total suspension of time, the average correlation between respiratory disorder index (RDI) applied computing Pearson correlation test. Simple snoring and OSAHS group of mild, moderate and severe inter-group comparison analysis using generalized linear models. Results The prevalence of OSAHS was increased with age, higher in males than in females. A statistically significant correlation between ESS, BMI, the lowest SaO_2 with the RDI was detected. The difference of ESS, the lowest SaO_2 and the BMI was significant between the different serious patients (P<0.05). Conclusions OSAHS has a high morbidity rate in outpatients with snoring. Age and obesity are liability factors of OSAHS. BMI, the lowest SaO_2, ESS and RDI have well correlationship, which can be used to assess the pathogenetic condition, even make a primary diagnosis.

Aim To investigate the expression and im-plication of HIF-1α, ROCK-2 , FoxM1 in PC12 cell in-jury induced by lead acetate. Methods PC12 cells were treated with lead acetate at the doses of 100 , 200 and 400 μmol·L-1 . The cell viability was determined by MTT reduction assay and LDH assay, the intracellu-lar production of oxygen species was measured by as-sessing SOD and MDA levels, cell apoptosis was deter-mined by Hoechst 33342 staining, the expressions of HIF-1α, ROCK-2 , FoxM1 , Bcl-2 and Bax were deter-mined by immunoblotting analysis. Results Lead ac-etate induced cell injury in PC12 cells in a dose-de-pendent manner, and it potentiated oxygen radical pro-duction and cell apoptosis. In addition, lead acetate enhanced HIF-1α and ROCK-2 expressions, increased Bax/Bcl-2 ratio and decreased FoxM1 expression. Conclusion Lead acetate can induce PC12 cell apop-tosis, which may be related with the expressions of HIF-1α, ROCK-2 and FoxM1 . Cellular oxidative stress may contribute to the injury as well.