Objective To investigate the relationship of parity and other reproduction-associated factors with metabolic syndrome(MS) in middle-aged and elderly women in Nanchang community.Methods Female permanent residents over 40 years old were sampled for a routine examination and a questionnaire survey covering basic information,5 894 subjects were enrolled and identified as effective cases.MS was diagnosed according to the standard of China Diabetes Society in 2004.Factors including age,education,profession,marital status,parity,child-bearing history of macrosomia,breastfeeding,menarche age,and menopausal age were analyzed in order to find their relationship with MS.The univariate logistic analysis was followed by binary logistic regression analysis if P＜0.05,and OR value and confidence interval were calculated.Results Univariate logistic regression analysis showed that age,education,profession,parity,breastfeeding,and menopausal age were influencing factors of MS (all P ＜ 0.05).There was no correlation to marital status,miscarriage history,child-bearing history of macrosomia,menarche age with MS(all P＞0.05).Binary Logistic regression analysis showed that the risk of MS increased with age:OR =1.51 (95 ％ CI 0.98-2.32) during 50-59 years,OR =2.10 (95 ％ CI 1.34-3.30) during 60-69 years,and OR =2.63 (95 ％ CI 1.61-4.31) in cases aged over 70 years,as compared to the group aged 40-49 years.The risk in non-manual workers increased about 34 percent OR =1.33 (95 ％ CI 1.04-1.70),compared with manual workers.The risk of MS increased with parity,being OR =1.46 (95％ CI 1.14-1.88),OR =1.78 (95％ CI 1.30-2.43),and OR =1.84 (95％ CI 1.24-2.72),with 2,3,and 4 child-bearings respectively as compared to cases with only one childbearing.The risk of MS was reduced with advancing menopausal age being about 6 percent reduction with each increased year of menopausal age(OR =0.94,95％ CI 0.90-0.99).There was no difference between education,breastfeeding and MS(P＞005).Conclusion Multiple parity,earlier menopausal age,less manual work,and aging seem to be the risk factors of MS in women.

Objective To investigate the clinical features and value of white blood cell(WBC) count during influenza diagnosis.Methods Compare with leukocyte count and its classification,clinical features between 38 cases of influenza A and 55 cases of influenza B patients.Results The follow results have were significant difference between these two group(P<0.05):The WBC content (WBC),neutrophil count (NEUT),lymphocyte(LYMPH) count and platelet (PLT).In both group,WBC were mostly in normal range.However,WBC and NEUT% in the group A were 15.79% and 34.21%,higher than the B group 7.27%,25.45%.Additionaly,WBC and NEUT% in upper respiratory tract infection group were 59.26% and 66.67%,higher than the normal ranger,and group influenza A flow patients with higher proportion for headache and crackles,were 47.36% and 52.63%,respectively(P<0.05).Conclusion The WBC count and its classification have significant difference between influenza A and B.Furthermore,patients with influenza A virus are more likely to have co-infection with bacteria.

Objective To investigate the application value of serum tumor necrosis factor alpha (TNF-α) expression in diagnosing colorectal cancer (CRC).Methods One hundred and thirty inpatients with CRC in our hospital from February 2015 to November 2016 were selected and divided into 90 cases of CRC confirmed by operation and histopathology(CRC group),including intestinal cancer with and without metastasis,and 40 cases of benign colorectal diseases(colonrectal benign disease group),at the same time 40 persons undergoing physical examination were selected as the healthy control group.The levels of TNF-α,carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 724 were collected in all subjects.The data of various groups were not normally distributed,and the nonparametric statistical method was used to analyze and compare.Results Serum TNF-α level in clinical TNM stage Ⅱ(median 9.47 pg/mL),Ⅲ(9.95 pg/mL) and Ⅳ(9.67 pg/mL) of the CRC group was significantly higher than that in TNM stage Ⅰ(6.59 pg/mL);which in the CRC with metastasis group (9.95 pg/mL) was higher than 8.03 pg/mL in CRC without metastasis group,the difference was statistically significant (P<0.05);the TNF-α expression had no obvious difference among different ages and between different genders(P>0.05).The area under the ROC curve in each test index:TNF-α was 0.868,CEA was 0.912,CA724 was 0.523,and which of their joint detection was 0.940.Conclusion The expression of TNF-α is increased in the occurrence and development process of CRC,its serum level detection has certain clinical application value,the TNF-α expression has no obvious difference in the subjects with different ages and different sexes and has wide suitability.The combine detection of serum TNF-α,CEA and CA724 in the patients with CRC significantly increases the level,the combined detection of 3-index can have complementary advantages to increase the sensitivity of CRC diagnosis,which serve as the significant indexes in CRC early diagnosis,therapeutic effect evaluation and prognosis monitoring.

Objective To investigate the change of serum ghrelin and sex hormones levels in girls with precocious puberty . Methods 87 girls with precocious puberty were divided into the simple premature thelarche (SPT ) and central precocious puberty (CPP) groups according to the results of gonadotropin releasing hormone(GnRH) stimulation test ,size of ovary and uterus ,and de-velopmental status of the secondary sex characteristics ,with 34 age-matched healthy girls as control group .The serum ghrelin level was quantitatively measured by enzyme-linked immunosorbent assay (ELISA) ,luteinizing hormone(LH) ,follicle stimulating hor-mone(FSH) ,estradiol(E2) ,progesterone(PRGE) ,prolactin (PRL) ,testosterone (TSTO) and LH and FSH stimulated by GnRH after 30 ,60 ,90 min were measured by chemoluminescence technique .Results The ghrelin level in the CPP group was significantly higher than that in the control group(P<0 .05);there was no statistically significant difference between the SPT group and the control group and between the CPP group and the SPT group (P>0 .05) .The 5 indexes of sex hormone (LH ,FSH ,E2 ,PRL , PRGE) in the CPP group were significantly higher than those in the SPT group and the control group (P<0 .05) ,but no statisti-cally significant difference existed between the SPT group and the control group (P>0 .05);the TSTO level had no statistically sig-nificant difference among 3 groups(P>0 .05) .Conclusion The serum levels of ghrelin and 5 indexes of sex hormone (LH ,FSH , E2 ,PRL ,PRGE) in girls with CPP are significantly increased .

Objective To explore the effect of Numb on tubular epithelial-to-mesenchymal transition (EMT) in rat proximal epithelial cells. Methods NRK52E cells were treated with different concentrations of recombinant human transforming growth factor-β1 (TGF-β1) (0, 1, 5, 10, 15, 20 μg/L) for 48 h or 10 μg/L TGF-β1 for different times (0, 24, 48, 72 h) in vitro. The expressions of E-cadherin, a-smooth muscle actin(α-SMA) and Numb in NRK 52E cells were detected by RT-PCR, Western blot and immunofluorescence staining. Meanwhile Numb siRNA oligo was transfected into NRK 52E cells with lipofectamine before TGF-β1 treatment, then Western blot was applied to detect the protein expression of E-cadherin, α-SMA and Numb in NRK52E cells. Results TGF-β1 could induce EMT in NRK52E cells in dose- and time-dependent manner. During the progress of TGF-β1-induced EMT, the protein expression of Numb in 5, 10, 15, 20 μg/L group was 1.33 folds (P=0.024), 1.39 folds (P=0.035), 1.45 folds (P=0.025), 1.51 folds (P=0.000) respectively as compared to 0 μg/L group. Likewise, the protein and mRNA expression of Numb in 24 h, 48 h, 72 h group was 1.48 folds (P=0.046) and 1.56 folds (P=0.012), 1.54 folds (P=0.011) and 1.82 folds (P=0.008), 1.79 folds (P=0.028) and 1.82 folds (P=0.002) respectively as compared to 0 h group. Moreover, large amount of Numb was accumulated in the cytoplasm. Down-regulation of Numb expression by siRNA transfection did not influence the basal expression of E-cadherin and α-SMA in NRK 52E cells, but attenuated the progression of EMT in NRK52E cells induced by TGF-β1. The up-regulation of α-SMA protein was reduced to 18.1% (P=0.004) while the down-regulation of E-cadherin protein was reversed to 2.19 folds (P=0.004). Conclusion Numb can promote EMT in rat proximal epithelial cells.

Objective To evaluate the effect of clinical nursing pathway in emergency treatment of for-eign body in respiratory tract of children. Methods Retrospective analysis was carried out in 555 children with foreign body in respiratory tract from February 2005 to December 2007, who were divided into the control group (271 cases) and the experimental group (284 cases). The experimental group was given managed with standardized clinical pathway,the control group received routine management. The preoperative preparation time, average hospital stay, cost of hospitalization, the extent of mastering of health knowledge by patients'par-ents were observed and the data underwent χ2 and t test. Results All patients of the two groups were cured and no nursing complications happened.The mean preoperative preparation time of the experimental group was 10 hours, which was shorter than that of the control group(27 hours). The average length of hospital stay of the experimental group was (4.13 + 0.81)days, which was shorter than that of the control group ,(6.03 + 1.30) days.The average hospitalization cost of the experimental group was (3498.55 + 269.13) yuan, while the control group was(4246.40 + 977.10) yuan. The extent of mastering of health knowledge by patients' parents, including basic knowledge of the disease, preoperative cooperation knowledge,prevention knowledge and diet knowledge, was superior to that of the control group. Conchusions The establishment of clinical pathway of children with foreign body is conducive to the standardized treatment of the disease, it can shorten the preoperative prepara-tion time, improve the capability of emergency treatment, shorten the length of hospital stay, reducing hospital-ization costs, increase the extent of mastering of health knowledge by patients and their families.

BACKGROUND: How to establish a stable in vitro culture system, including location of corneal limbal epithelial stem cells, in vitro sample harvest, in vitro culture, vector selection, as well as identification methods, play a key role in corneal limbal epithelial stem cells culture. OBJECTIVE: To culture the isolated rabbit corneal limbal epithelial stem cells and to identify the biological properties of cultured cells. METHODS: The primary rabbit cornel limbal epithelial stem cells were isolated and cultured with tissue inoculation using human amniotic membrane as vector. The growth features of cells were observed under an inverted microscope. The morphology of cells was observed by hematoxylin-eosin staining and a scanning electron microscope. Furthermore, the monoclonal antibody AE5 and P63 two-step immunohistochemical staining were used to identify limbal epithelial stem cell protein expression. RESULTS AND CONCLUSION: The rabbit corneal limbal epithelial stem cells could be successfully cultured and maintained a relatively high value-added potential in vitro. Rabbit corneal limbal epithelial stem cells cultured on the amniotic membrane pull netted cellular layer. The AE5 monoclonal antibody positive rate of primary cultured cells was about 5% and P63 monoclonal antibody positive up to 90%. AE5-positive rate increased and P63-positive rate decreased with the increase in the number of subculture. The rabbit limbal epithelial stem cells can be successful culture and amplified on human amniotic membrane in vitro by limbal tissue culture method. The cultured cells maintain the characteristics of corneal epithelial cells. The rabbit corneal limbal epithelial stem cells can form grafts on the amniotic membrane.

Objective To investigate and compare the level of food specific IgG antibody between children with chronic diarrhea and healthy children,analyze the correlation between chronic persistent diarrhea and food intolerance.Methods The research objective of 105 cases was obtained from in-patient children in Shenzhen children′s hospital diagnosed as chronic persistent diarrhea and 94 cases diagnosed not diarrhea as control group in the year of 2015.The level of fourteen food allergen specific IgG in serum was detected using enzyme-linked immunosorbent (ELISA) in 199 cases.Results Chronic persistent diarrhea was more observed in 0-1 years old of infants.The positive rate of 14 food allergen specific IgG in 105 cases of children with chronic persistent diarrhea in turn from high to low was milk,eggs,tomatoes,rice,wheat,cod,corn,beef,soybeans,chicken,pork,mushrooms,shrimp and crab;14 food allergen specific IgG in 94 cases of children not with diarrhea in turn from high to low was arranged as follows:milk,eggs,tomatoes,rice,wheat,soybeans,cod,corn,beef,crab,chicken,mushroom,shrimp and pork.Among them the level of milk,beef and soybeans in the comparison of the two groups was significantly different(P<0.05).Conclusion Food intolerance was one of the important factors caused chronic persistent diarrhea in children.Reasonable diet for children may be the effective treatment of chronic persistent diarrhea.

Objective To investigate the role of Notch signaling in the progression of peritoneal fibrosis in a rat model induced by high glucose dialysate. Methods Male Sprague Dawley rats were subjected to daily peritoneal dialysis (PD) with a lactate-buffered solution containing 4.25% glucose. They were sacrificed at 2 and 4 weeks after PD. The parietal thickness was measured with Masson staining. The expression of TGF-β1, E-cadherin, α-SMA and collagen Ⅰ was examined by immunoblotting. The expression of Notch ligand Jagged-1 and the negative Notch signaling regulato--Numb was analyzed by both immunoblotting and RT-PCR. The expression of a Notch nuclear target gene Hcs-1 was examined by RT-PCR. Results Both HE and Masson trichrome staining revealed an increase in peritoneal thickness with a loss of mesothelial cells and a rich of collagen matrix deposition in the submesothelial zone was evident at 4 weeks after PD. Meanwhile, compared to healthy rats, the expression of TGF-β1, ct-SMA and collagen Ⅰ was significantly increased, but the expression of E-cadherin was decreased in peritoneum after PD treatment. It was difficult to detect the Jagged-1 and Hes-1 expression in normal peritoneum, but their expression was graduaUy increased after PD. In contrast, the expression level of Numb, a negative regulator of Notch signaling, was dramatically decreased after PD. Conclusions Notch signaling is activated during the process of PD-induced peritoneal fibrosis and the activation of Notch signaling is associated with the loss of negative regulation of Notch signaling via decreased expression of Numb. Inhibition of Notch signaling via overexpression of its negative regulators such as Numb may be a novel therapeutic approach for peritoneal fibrosis in PD patients.

BACKGROUNDRecently chemoradiotherapy becomes a standard treatment of un-resectable advanced non-small cell lung cancer (NSCLC) instead of radiotherapy alone. This study is to evaluate the clinical effect and toxicities of concurrent chemoradiotherapy in patients with stage III NSCLC after 2 cycles of induction chemotherapy with cisplatin-based regimens.

METHODSNinety-two patients with stage III NSCLC were divided randomly into two groups: forty-seven patients received concurrent chemoradiotherapy (chemoradiotherapy group), the other 45 patients received only radiotherapy (radiotherapy group). For both groups, the same radiation technic was given with the conventional fraction. The total dose was 60-65Gy/30-33Fr/6-6.5Wk. For the chemoradiotherapy group, the patients were also given with concurrent chemotherapy (navelbine 15-18mg/m² on the 1st and 8th day, cisplatin 60mg/m² on the 1st day).

RESULTSThe response rate in the chemoradiotherapy group was similar to that in the radiotherapy group (59.6% vs 51.5%, P > 0.05), but the complete response rate in the chemoradiotherapy group was significantly higher than that in the radiotherapy group (14.9% vs 6.7%, P < 0.05). The 1- and 2-year survival rates in the chemoradiotherapy group were similar to those in the radiotherapy group (65.9% and 42.5% vs 53.3% and 33.3%, P > 0.05). The 1- and 2-year local control rates in the chemoradiotherapy group were significantly higher than those in the radiotherapy group (63.8% and 53.2% vs 51.1% and 44.4%, P < 0.05). The incidences of grade III-IV radiation esophagitis and leukopenia in the chemoradiotherapy group were significantly higher than those in the radiotherapy group (21.2% and 12.7% vs 4.4% and 0, P < 0.01).

CONCLUSIONSConcurrent chemoradiotherapy has the potential of improving the survival rate of stage III NSCLC, it can also increase the acute toxic effect, but all patients can tolerate this treatment regimen.