Objective To summarize the experience in nursing 2 patients with anti-glomerular basement membrane disease.Method The nursing measures such as close observation of disease condition,careful nursing of medication,nursing during the treatment of double filtrated plasmapheresis and mental care to the patients and their family members.Results After treatment,the concentration of anti-GBM antibody was declined and the level of serum creatinine was also decreased.The renal function got rccovered to a certain extent.Conclusion Such nursing points as close observation of renal and pulmonary pathgenesis,timely and accurate administration of medicine according to doctor's orders and active observation and prevention of complication from double filtrated plasmapheresis are key.

Objective To assess the clinical use of anti-Parkinson's disease(PD)drugs in the patients with PD,and provide a basis to formulate an effective clinical drug program.Methods 190 PD patients were interviewed by questionnaires about resources,dosage and costs of anti-PD drugs from April,2004 to March,2005.Results By retrospective analysis,number of drugs used in per patient per year was 2.88;levodopa dosage and Levodopa Equivalents(LDE)per patient were 323.0 mg/d and 318.6 mg/d respectively,and LDE increased significantly following by scores of Hoehn-Yahr(H&Y)class increasing(P

ObjectiveTo investigate the effect of remifentanil on hepatic ischemia-reperfusion (I/R) injury in rats with liver cirrhosis.MethodsThirty male SD rats weighing 260-300 g were randomly divided into 3 groups (n =10 each):group liver cirrhosis (group C); group liver cirrhosis + hepatic I/R (group I/R) and group remifentanil (group R).Liver cirrhosis was produced in all animals in the 3 goups.I/R injury was induced by 20 min occlusion of the hepatic artery and portal vein entering the middle and left lobes of the liver followed by 4 h reperfusion at 1 week after establishment of hepatic cirrhosis in I/R and R groups.In group R remifentanil was infused iv at 1 μg·kg-1 ·min-1 starting from 10 min before ischemia until the end of 4 h reperfusion.Venous blood samples were taken from inferior vena cava at the end of 4 h reperfusion for measurement of serum ALT and AST activities.The animals were then sacrificed and liver specimens were taken from middle lobe for determination of Bcl-2 and Bax expression (by immuno-histochemistry) and hepatocyte apoptosis (by TUNEL) and microscopic examination.Apoptosis index (percentage of apoptotic cells) was calculated.ResultsI/R significantly increased serum ALT and AST activities,Bax expression and apoptosis index and decreased Bcl-2 expression in group I/R as compared with group C.Remifentanil significantly attenuated the I/R-induced changes in serum ALT and AST activities,Bax and Bcl-2 expression and apoptosis in group R as compared with group I/R.Remifentanil also ameliorated I/R-induced liver damage.ConclusionRemifentanil can auenuate hepatic I/R injury in rats with liver cirrhosis by up-regulating Bcl-2 expression and down-regulating Bax expression and inhibiting apoptosis.

BACKGROUND: Denddtic cells (DCs) constitute the dominant population of antigen presenting cells (APCs) by possessing potent ability to initiate T cell immunity. The ultrastructure study of DCs is less reported. OBJECTIVE: To investigate the ultrastructure of DCs from mice bone marrow at different maturation stages, and the morphology of DCs between CD40 ligation and tumor necrosis factor-alpha (TNF-α) stimulation in vitro. METHODS: Mice myeloid DCs were generated from bone marrow in vitro using granulocyte-macrophage colony-stimulating factor (GM-CSF)and interleukin-4 (IL-4). Immature DCs were loaded with apoptotic tumor cells (AP-DC), and AP-DC was then stimulated with CD40L-CHO cells and TNF-α for 48 hours, respectively. DCs were routinely sectioned, and ultrastructure was observed under transmission electron microscope. RESULTS AND CONCLUSION: Immature DCs showed a few short and blunt cytoplasmic processes, there were specific morphology lysosomes that liked earphone in some cells; DCs engulfing the apoptotic bodies were observed; sub-cellular structures between CD40 ligation and TNF-α stimulated DCs were different, the former had typical morphology of mature DCs which exhibited many dendritic protrusions, however, some DCs displayed apoptosis and autophagy after TNF-α stimulation. In a conclusion, CD40 ligation plays an essential role in myeloid DCs differentiation and maturation, TNF-α can mediate apoptosis and autophaqy of DCs.

Objective:To explore the relationship between the nitric oxide(NO)and the pathogenesis of the pulmonary hypertension(PH)induced by congenital heart disease(CHD). Method:NO content in plasma of CHD patient's pulmonory artery and superior vena cava was detected with NO kit. Result:NO content in the pulmonary artery of the patients with PH was much higher than that of patients without PH(37.58?9.99?mol/L vs 19.03?15.25?mol/L,P0.5). Conclusion:NO content in the pulmonary artery of CHD patients with PH increase,which may be involved in the pathogenesis of PH induced by CHD.

Objective To investigate the correlation of p16 gene and p21 gene expression abnormal- ity with the prognosis of bladder carcinoma.Methods Using the search terms“bladder neoplasm”,“prognosis”,“p16”or“p21”,the literature on the correlation of p16 gene and p21 gene expression abnor- mality with the prognosis of bladder carcinoma were searched from MEDLINE database,PubMed database, CBMdisc and China Academic Periodical database,and were evaluated by Meta-analysis with Dersimonian- Laird model.Results A total of 19 trials involving 1584 patients(positive rate of 40.4%)were identi- fied,including 12 trials of 975 patients(positive rate of 37.4%)on p16 gene expression abnormality and 7 trials of 609 patients(positive rate of 45.4%)on p21 gene expression abnormality.The combined relative hazard(RH)of p16 gene expression abnormality on the prognosis of bladder carcinoma,p21 gene expression abnormality on the prognosis of bladder carcinoma and both p16 gene and p21 gene expression abnormality on the prognosis of bladder carcinoma was 3.70(95% CI,3.42-3.99),3.01(95% CI,2.81-3.21)and 3.18(95% CI,3.01-3.35),respectively.Conclusions Both p16 gene and p21 gene expression abnor- malities are biomarkers for poor prognosis of bladder carcinoma.The detection of these biomarkers may be helpful in making the treatment strategy.

BACKGROUND:Currently, cellular composition and the features of the nucleus pulposus are stil not to be clarified.
OBJECTIVE:To establish the in vitro culture system of rat nucleus pulposus-derived mesenchymal stem cells and to identify their multi-lineage differentiation potential.
METHODS:Mesenchymal stem cells from the nucleus pulposus tissues of Sprague-Dawley rats were cultured in vitro. Then, cells at passage 3 were induced to differentiate into osteoblasts, adipocytes and chondrocytes as experimental group. cells cultured with basic culture medium served as controls.
RESULTS AND CONCLUSION:cells isolated from rat nucleus pulposus could form the sunflower-like colonies and exhibit clone-like growth when they cultured at a low density. cells at passage 3 became homogeneous and exhibited fibroblast-like morphology. After 28 days of osteogenic induction, arizarin red positive signals were detected in the experimental group. The mRNA expressions of RunX2, osteopontin and osteocalcin were significantly increased in the experimental group, compared to the control group (P<0.05). After 21 days of adipogenic induction, oil red-O positive cells were detected in the experimental group. The mRNA expressions of C/EBPαand PPARγ2 were significantly increased in the experimental group, compared to the control group (P<0.05). After 21 days of chondrogenic induction, safranin O/fast green staining was positive in the experimental group. The mRNA expressions of aggrecan and Col2a1 were significantly increased in the experimental group, compared to the control group (P<0.05). Our findings in this study suggested that nucleus pulposus-derived mesenchymal stem cells could be isolated from the Sprague-Dawley rat nucleus pulposus and exhibited clonal-like growth when they were cultured in vitro. These cells were confirmed to have the potential to differentiate into adipocytes, osteoblasts and chondrocytes in vitro.

Objective To study the variation of D-dimer after the off-pump coronary artery bypass grafting(OPCAB),and to evaluate its value for the assessment of postoperative cardiovascular ischemia events.Methods This is a retrospective cohort study.203 patients with non-ST-segment elevation myocardial infarction(NSTEMI) were random selected from the Tianjin medical university general hospital from 2010 to 2012,including 151 males and 52 females with a mean age of (66.9 ±8.4) years.The level of D-dimer was analysed by using the Biomerieux VIDAS fluor-euzymelinked immunoassay Analyzer assay.Receiver operating characteristic curve (ROC) was used to evaluate the sensitivity and specificity,the relevance between D-dimer and clinical pathological factors was analysed by x2 test,the effect on prognosis was evaluated by using cox regression analysis model.Results Compared the group with stable disease,the level of D-dimer was increased remarkable in the group with poor recovery on the 14th day after surgery,(U =75.09,P ＜0.01).The optimum cut-off point with D-dimer(the 14th day after surgery) for the diagnosis of ischemic events within the 31th-90th day after surgery was 2 590μg/L,the area under ROC curve was 0.867(95％ confidence interval:0.791-0.943).The logistic analysis showed that the D-dimer was influenced by the sex,age,left ventricular ejection fraction,left main coronary artery disease,the number of vascular with bypass grafts,using internal mammary artery,hypertension and other factors,OR value was 0.495(95％ CI:0.327-0.694),0.527(95％ CI:0.370-0.812),0.564(95％ CI:0.419-0.638),0.331(95％ CI:0.278-0.426),0.592(95％ CI:0.440-0.785),2.093(95％ CI:1.533-2.856),0.580 (95 ％ CI:O.451-0.709) respectively (P ＜ 0.01).The Cox analysis showed that the level of Ddimer on the 14th day after surgery was not the independent assessment parameter for long-term prognosis.Conclusion The serum D-dimer was influenced by multiple pathological factors after the OPCAB,the level of serum D-dimer(on the 14th day after surgery) could be used as effective estimate parameter for the adverse events within the 31 th-90th after OPCAB.

Background Researches showed that wild-type p53(wtp53)and Rb94 genes inhibit the growth of retinoblastoma(RB),and these genes are involved in signal pathway in the induction and maintenance of cellular senescence.Thus the combination of two genes to inhibit growth of RB is concerned.Objective This study was to observe the inhibitory effect of the co-transfection of Rb94 and wtp53 gcnc into subretina on RB with ultrasound microbubble.Methods HXO-Rb44 suspension was subretinally injected to establish the RB model in 40 SPF female Balb/c nude mice.The RB models were randomized into model control group,wtp53 group,Rb94 group and wtp53+Rb94 group,and 0.1 ml relevant gene microvesicle suspension was injected via caudal vein in the different groups,but no any gene was used in the model control group.Seven days after modeling,followed by 0.5 W/cm2ultrasonic wave irradiated the eyeballs immediately for 4 seconds ×2 times and interrupted for 24 seconds.Eyeballs were extracted 7 days after gene transfection,and the expressions of wtp53 mRNA and Rb94 mRNA in tumor tissuc were detected by RT-PCR,and wtp53 and Rb94 protein in tumor tissue were assayed using Western blot.Immunochemistry was used to exam the VEGF expression,and TUNEL was used to evaluate the apoptosis of the tumor cells.Results The model successful rate after HXO-Rb44 suspension was 80％ (32/40)and obvious malformation cells were seen under the light microscope.In 7 days after gene transfection,no response band for wtp53 mRNA and Rb94 mRNA were found.The relative expression valuc of wtp53 mRNA was 0.65±0.07 in the wtp53 group,and that in wtp53+Rb94 group was 0.32±0.02,showing a significant difference between them (t =11.743,P =0.000).Rb94mRNA relative value was 0.42 ±0.03 in Rb94 group,and that in the wtp53 + Rb94 group was 0.23 ± 0.03,with a significant difference(t=5.041,P=0.001).The response bands of wtp53 and Rb94 proteins were seen in wtp53group,Rb94 group and wtp53+Rb94 group.Immunochemistry showed that the positive reactive intensity for VEGF in tumor tissue was obviously weaker in wtp53+Rb94 group than that in the wtp53 group,Rb94 group and model control group.Apoptotic index(Al) was 37.35±2.14 in the wtp53+Rb94 group,showing a significant increase in comparison with model control group (0.46 ± 0.05),wtp53 group (5.05 ± 0.80) and Rb94 group (6.43 ± 1.02) (t =-34.395,-28.206,-26.006,P＜0.01).Conclusions Ultrasound microvesicle enable double gene transfecting into RB tumor tissue,and Rb94 gene cooperation with wtp53 gene enhance the inhibitory effect on RB by promoting the apoptosis of RB cells.

Objective To study the influence of periacetabular muscle contraction on acetabular] fractures.Methods Twenty intact adult cadaveric pelvis(40 hip joints)treated antiseptically with bilat- eral 1/2 femoral shafts were selected and divided randomly into two groups(20 hip joints in each group). Then,the specimens were trimmed to fit the RMT-150B rock mechanics measuring system and the special in- creasing pressure system.After pressure of 3 500 N was pressed to the control group and pressure of 4500 N to the experimental group,acetabular fracture model was made by beatening with special striking machine,when striking force was recorded.Results We made forty aeetabular fracture models from 40 cadaveric hips. Pearson correlation coefficient of pressing force and striking force was -0.923(P＜0.01).The striking force of the control group and the experimental group was 445-550 N and 290-400 N,respectively(t= 14.727,P＜0.01).Conclusion The increase of contraction force of the periaeetabular muscles can decrease aeetabular stress and strain,influence the result of violent injury and play a vital role in inducing acetabular fractures.