Objective:To compare expression levels of matrix Gla protein (MGP) and bone morphogenetic protein 2 (BMP-2) in Randall's plaque of renal papillary tissues in patients with calcium oxalate kidney stones and the underlying mechanism for stone formation.Methods:A total of 30 samples of Randall's plaque in renal papillary tissues from patients with calcium oxalate kidney stones were collected from the Department of Urology of Xiangya Hospital of Central South University from April,2015 to December,2015 and served as an experimental group.Ten samples of renal papillary tissues in patients undergone renal tumor nephrectomy were collected from the same hospital and served as a control group.The expressions of MGP and BMP-2 mRNA and protein were detected by quantitative real-time PCR and Western blot.Meanwhile,immunohistochemical technique was used to observe the expressions of MGP and BMP-2 in different parts of renal papillary tissues in the 2 groups.Results:1) The mRNA expression levels of MGP in the experimental group and the control group were 0.760±0.804 and 1.365±0.348,respectively,with significant difference between them (P＜0.05).Them RNA levels of BMP-2 in the experimental group and the control group were 2.500±0.725 and 1.485±0.870,respectively,with significant difference between them (P＜0.05).The expression levels of MGP protein in the experimental group and the control group were 0.130±0.424 and 0.202±0.704,respectively,with no significant difference between them (P＞0.05).The expression levels of BMP-2 protein in the experimental group and the control group were 0.885±0.220 and 0.682±0.272,respectively,with significant difference between them (P＜0.05).T-he immunohistochemistry showed that the protein expression of MGP in the experimental group was lower than that in the control group,while the protein expression of BMP-2 in the experimental group was higher than that in the control group (both P＜0.05).Conclusion:The BMP-2 expression is increased while MGP expression is decreased in renal papillary tissues in patients with calcium oxalate kidney stones,and the formation of calcium oxalate kidney stone might be a kind ofosteogenetic reaction or ectopic calcification.

Objective To report specific clinico-radiological syndromes in neuropsychiatric systemic lupus erythematosus (NPSLE).Methods Ten patients with NPSLE in Peking Union Medical College Hospital from 2005 to 2011 were studied retrospectively with magnetic resonance imaging, computer tomography or positron emission tomography. Results Posterior reversible encephalopathy syndrome was diagnosed in 2 patients with radiological features,headache and tonic-clonic seizure;3 patients with bilateral diffuse leukoencephalopathy,cognitive disorder and acute confusional state; 1 Fahr' s disease patient,with cognitive disorder and psychiatric symptom,movement disorder; 2 Parkinsonism patients with tremor and cogwheel rigidity,and 2 chorea patients. Conclusions The emergence of diffuse brain calcinosis,leukoencephalopathy and edema may happen in lupus encephalopathy particularly.Autoantibody reaction and vascular disease may play an important role in movement disorder including Parkinsonism and chorea.

Objective To investigate the level of nurses′preparedness and influencing factors of nurses with low seniority in Anhui province. Methods Totally 295 nurses with low seniority were recruited by convenience sampling method. They were investigated by a self-designed demographic data questionnaire and the Disaster Preparedness Evaluation Tool. Results The score of the disaster nursing ability of the nursing managers was 163.85 ± 32.41, the mean score was 3.64 ± 0.72. Regression analysis showed that the gender, the experience of disaster rescue,disaster training were the influencing factors of disaster preparedness. Conclusions The capacity of disaster preparedness for nurses is not ideal. There is still room for improvement among nurses in Anhui province to enhance disaster preparedness, and improved disaster nursing training system is needed to achieve this.

Objective To investigate the mRNA expressions of IFN-gamma receptor and TNF-alpha receptor in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris and their role in the pathogenesis of psoriasis. Methods Fifty patients with psoriasis vulgaris (37 cases of active psoriasis and 13 cases of stable psoriasis) and 24 healthy human controls were included in this study. PBMCs were isolated from blood samples obtained from all patients and controls. The mRNA expressions of IFN-gamma receptor and TNF-aipha receptor in PBMCs were detected by RT-PCR. The disease severity in patients was evaluated by psoriasis area and severity index (PASI). Results The mRNA expressions of IFN-gamma receptor and TNF-alpha receptor were observed in the PBMCs of all subjects. The mRNA expression levels of IFN-gamma receptor were 0.72 ± 0.17 in healthy controls, 1.11 ± 0.55 in all patients with psoriasis, 1.13 ±0.57 in patients with active psoriasis and 1.03 ± 0.52 in patients with stable psoriasis, respectively. A signifi-cant increase was observed in the expression levels of IFN-gamma receptor mRNA in all psoriatic patients and in patients with active psoriasis compared with those in healthy controls (both P < 0.05), but there was no significant difference between the healthy controls and patients with stable psoriasis (P ＞ 0.05). The expres-sion levels of TNF-alpha receptor mRNA were 2.05 ± 1.34 in healthy controls, 2.70 ± 3.80 in all psoriatic patients, 2.90 ± 4.40 in patients with active psoriasis, 2.14 ± 1.05 in patients with stable psoriasis, respectively;there was no significant difference between psoriatic patients and healthy controls (P ＞ 0.05). However, no correlation was found between the mRNA expression of IFN-gamma receptor, that of TNF-alpha receptor,and disease severity in psoriatic patients. Conclusions The mRNA expression of IFN-gamma receptor in PBMCs is up-regulated in patients with psoriasis vulgaris, which is unrelated to the activity of psoriasis.

Objective To observe the safety and efficacy of ultrasound-guided radiofrequency ablation(RFA)with artificial pleural effusion for cancer of the liver located under the diaphragm.Method Fifteen lesions in 11 patients with cancer of the liver located under the diaphragm were treated by RFA with artificial pleural effusion,for which 500-1000 ml normal saline was injected into the pleural cavity.Results Artificial pleural effusion was finished successfully,the whole tumor for all of 15 lesions were visualized by ultrasound and the ideal puncture pathway were easy to find.The artificial pleural effusion was vanished within 1 week after operation.All of the lesions were treated with RFA and complete necrosis was obtained in 13(86.7%)of the 15 lesions by CT or MRI.No severe complication was observed.Conclusion RFA with artificial pleural effusion is a safe and effective treatment option for patients with liver cancer under the diaphragm.

It is particularly important to confirm that whether subjects were repeated to participate in the clinical trial, the time interval from the last dose in the recent clinical trial, whether the physical conditions of subjects accord with the clinical trial protocol in phase I clinical trials and so on.This paper will introduce two types of the subject database, one was established by our hospital, another one is subject networking database, and will introduce the operation mode, the present situation of subjects screening under the database management. To explore the existing problems, optimize the use of subject database and give long-term prospects of subject networking database.

Objective To study the methylation status of p16 gene in peripheral blood mononuclear cell (PBMC) of patients with plaque psoriasis, and to study its significance in the pathogenesis of the disease. Methods Thirty-four cases of psoriatic patients and 35 healthy controls were measured for the status of promoter methylation in p16 gene by methylation specific PCR (MSP). A region containing CpG site in p16 gene promoter was amplified by MSP. The severity of psoriasis was evaluated by PASI scores. Results The methylation rates of p16 gene in PBMC were significantly higher (P

Objective To investigate the expression of HLA-G in lymphocytes,CD3+ T cells,and CD14+ monocytes from patients with rheumatoid arthritis (RA) and their associations with disease activity,disease duration,medication used and clinical parameters.Methods We studied 68 RA patients as well as 63 healthy controls.HLA-G expression was analyzed by flow cytometry in peripheral blood mononuclear cells (PBMCs).Mann Whitney U tests and Spearman rank correlation coefficient test were used for statistical analysis.Results We found that lymphocytes as well as CD3+ T cells,and CD14+ monocytes in RA patients showed a diminished expression of HLA-G compared with healthy controls [1.98％(1.17％-3.66％) vs 2.93％ (1.70％-5.40％),U=1624.5,P＜0.05; 1.35％(0.57％-2.79％) vs 2.16％(1.15％-4.45％),U=1387,P=0.000; 22.65％ (10.59％-36.81％) vs 32.76％ (20.73％-44.62％),U=1526,P＜0.01].Spearman analysis showed that the levels of HLA-G+ lymphocytes as well as CD3+ HLA-G+ T cells was negatively associated with DAS28 score(r=-0.288,P=0.017; r=-0.373,P=0.001),but no significant correlation was detected between the levels of CD14+HLA-G+monocytes and DAS 28 score (P＞0.05).In addition,the levels of expression of HLA-G was not correlated to disease duration,medication used,ESR,CRP,RF,anti-CCP and ANA (P＞0.05).Conclusion Decreased expression of HLA-G are detected in lymphocytes,CD3+ T cells,and CD14+ monocytes from pa-tients with RA,and the abnormality of HLA-G may play an important role in the development of RA.

Objective To investigate the pathogen distribution and drug resistance of gram-negative bacteria causing lower respiratory tract infections in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) .Methods A total of 742 sputum samples were collected from AECOPD patients with lower respiratory tract infections in Taizhou Hospital of Zhejiang Province during January 2013 and December 2014.Vitek 2 Compact system combined with disk diffusion was used for strains identification and drug susceptibility test.Modified Hodge test and ethylenediamine tetraacetic acid (EDTA) synergic test were used to screen carbapenem-resistant strains.Statistical analysis was performed using WHONET 5.6 and SPSS 20.0 software.Results A total of 593 strains of gram-negative bacteria were isolated , in which 367 strains were nonfermentative bacteria (61.89%), 220 strains were enterobacteriaceae (37.10%), and the rest 6 strains ( 1.01%) were other gram-negative bacteria.Acinetobacter baumannii ( 186 strains ), Pseudomonas aeruginosa (99 strains), Stenotrophomonas maltophilia (33 strains) and Burkholderia cepacia (22 strains ) were top 4 nonfermentative bacteria , and they all showed high resistance to ampicillin , ampicillin/sulbactam, cefazolin, ceftriaxone, cefotetan and nitrofurantoin with resistant rates of 67.20%-100.00%. Drug resistance rates to other β-lactams, fluoroquinolones, aminoglycoside, compound sulfamethoxazole and minocycline were significantly higher in carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains than those in non-carbapenem-resistant strains , and the differences were statistically significant (P <0.05 or <0.01).Stenotrophomonas maltophilia and Burkholderia cepacia strains were only sensitive to levofloxacin , compound sulfamethoxazole and minocycline . Klebsiella pneumonia (89 strains), Escherichia coli (80 strains) and Enterobacter cloacae (25 strains) were top 3 enterobacteriaceae , which were almost completely resistant to ampicillin , but were sensitive to piperacillin/tazobactam , cefoperazone/sulbactam , amikacin and carbapenems ( with resistant rates <15%) .More than 50%strains of extended spectrum β-lactamases ( ESBLs )-producing Klebsiella pneumonia and Escherichia coli were moderately or highly resistant to ampicillin/sulbactam , most cephalosporins ( except cefotetan and cefoperazone/sulbactam ), gentamycin, tobramycin, fluoroquinolones, aztreonam, compound sulfamethoxazole and minocycline , and the resistant rates were higher than those in non-ESBLs-producing strains (P <0.05 or <0.01).Conclusions Nonfermentative bacteria and enterobacteriaceae are the most prevalent gram-negative bacterial pathogens in lower respiratory tract infections in patients with AECOPD . Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains, as well as ESBLs-producing Klebsiella pneumonia and Escherichia coli strains are highly resistant to most antibacterial agents .

In order to promote the integration between disciplines, the convergence between basic course and clinical teaching, increasing students ability including the active learning and life-long learning ability, finding problem and solving problem ability, teamwork spirit and so on. After nearly 3 years preparation, Hebei Medical University successfully carried out the PBL teaching in Seven-year Clinical Medicine Science. Combining with the teaching activities, formative assessment was carried out, and PBL teaching website was established. The reform has already achieved initial results, got good responds from teachers and students. Through the study, it has been confirmed that the PBL teaching method in Hebei Medical University is effective and worthy to reference.