Objective To discuss the matrix metalloproteinase ( MMP- 13 ) and insulin-like growth factor (IGF)-1 in knee osteoarthritis (OA) and Kashin-Beck disease (KBD) and to explore the mechanism of synovial lesions and their similarities and differences are compared. Methods Synovial fluid of 18 OA patients, 13 KBD patients, 6 normal controls were collected and their synovium were obtained at the same time.The synovium MMP-13 and IGF-1 were examined by immunohistochemistry, while those of the synovial fluid were tested by enzyme-linked immunosorbent assay (ELISA). One way ANOVA and LSD-t test were used for statistical analysis. Results The results of these 37 synovial tissue and synovial fluid samples showed that: ① The average optical density of the positive staining of the KBD synovial tissue (692±131,354±101, 415±62) was not statistically significant from that of the OA group (452±57, 366±65, 652±86)(P＞0.05) and the control group (541±98, 524±202, 379±94, P＜0.05). ②There was significant different between the expression of IGF-1 of synovial tissue in the KBD group (311±174, 235±95, 412±109) and the OA group (452±57, 652±75, 544±64) as well as the control group (251±29, 336±54, 388±76)(P＜0.05).③ Compared with the concentration of MMP-13 in the synovial fluid of the OA group (0.93±0.51), there was no significant difference between the OA and the KBD group (2.02±1.12) (P＞0.05); but, there was significant differences when compared with the control group (2.33 ±0.29, P＜0.05). ④ When compared the the concentration of IGF-1 in the synovial fluid in the KBD group [ (2.87±1.48) and the OA group (1.27±0.33)as well as that of the eontrol group (0.93±1.07)] the difference was significant. Conclusions ① Cartilagedegeneration and joint damage may be a part of the articular synovial lesions in KBD patients, just like that of the OA, and the may exist as a part of the pathogenesis. ② MMP-13 may be involved in the synovial damage,and is the major degenerating factors in cartilage extracellular matrix (ECM) in OA patients and KBD patients. ③ As one of the ECM synthesis factors, IGF-1 may play an important role in the synovial damage of OA and KBD disease, but the repair mechanism may be different between the two diseases.

Objective To study the teaching effects of using case discussing-analysis method in the teaching course of Nursing Research among nursing students,and then make suggestion for relative teaching improvement. Methods Nursing students of Grade 2003 in main school and Grade 2004 in the affiliated WUZHOU school were divided into the trial group and control group at random. Part of teaching contents of nursing research were taught to the trial group students by case discussing-analysis method,and to the control group students by the methods of lecture-based learning. The teaching effect was evaluated after the course end. Results The ability of design to scientific research,recognition of Nursing research,learning attitude and learning interest,etc,in the trial group students were obviosly better than those in the control group students,and there was significant by statistical test. Conclusions Case discussing-analysis method can effectively excite the interest and the potential of students,and improve the ability of discovering and solving problems.

Objective To examine the expression of VEGF,MMP-1,and CXCR4 in breast cancer stem cells and its significance.Methods Flow cytometry was employed to separate breast cancer stem cells from MCF-7 cell.Then the expression of VEGF,MMP-1,and CXCR4 was detected by PCR in different subsets of cells.ResultsCompared with the non-stem cells of breast cancer,the expression of VEGF,MMP-1,and CXCR4 in breast cancer stem cells was significantly higher,but the expression of MMP-1 was not different.ConclusionsThe breast cancer stem cells could achieve increased metastasis ability by enhanced expression of VEGF and CXCR4,which are the key factors in metastasis of breast cancer.

Objective To investigate the clinical effect and safety of continuous intravenous pumping of sodium nitroprusside and dopamine on treating elderly patients with refractory heart failure. Methods Two hundred and seventy elderly patients with refractory heart failure were selected as our subjects and they were randomly divided into sodium nitroprusside group,dopamine group and the combined group( 90 cases for each group). All the patients were given the corresponding symptomatic treatment,including oxygen,diuretics, angiotensin converting enzyme inhibitors,digitalis,aldosterone receptor antagonist,etc. Patients in sodium nitroprusside group,dopamine group were treated sodium nitroprusside or dopamine respectively,and patients in combined group were given both of sodium nitroprusside and dopamine by continuous intravenous pumping. Serum brain natriuretic peptide( BNP ),left ventricular ejection fraction( LVEF ),LV end systolic volume index(LVESVI),left ventricular end diastolic volume index(LVEDVI),left ventricular diastolic early, late filling velocity ratio( E/A ),mean arterial pressure and heart rate( HR ) level were measured or recorded. Results The levels of BNP,LVEF,LVESV,LVEDV,E/A,mean arterial pressure and the level of HR among three group before treatment were no significant differences( F =4. 000,1. 434,0. 503,3. 622,3. 589, 4. 135,2. 752;P﹥0. 05). After treatment,the levels of BNP,LVEF,LVESV,LVEDV and HR in combined group were(201. 6 ±66. 8)pg/L,(45 ± 4)%,(29. 8 ± 4. 8)ml/m2,(45. 1 ± 7. 3)ml/m2,(73. 2 ± 11. 2)times/min,in sodium nitroprusside group were( 298. 6 ± 75. 3 ) pg/L,( 37 ± 4 )%,( 35. 5 ± 4. 6 ) ml/m2 ,( 51. 8 ±7.5)ml/m2,(92.9 ±11.5)times/min,and in dopamine group were(293.7 ±78.2)pg/L,(37 ±3)%, (35. 6 ± 5. 8)ml/m2,(52. 1 ± 7. 3)ml/m2,(93. 6 ± 12. 3)times/min respectively,and the differences were significant(F=41. 683,129. 400,43. 600,28. 800,328. 600;P﹤0. 05). The total effective rate in combination group was 97. 8%( 88/90 ),significantly higher than that of sodium nitroprusside group( 86. 7%,8/90 ) or dopamine group( 88. 9%,80/90 ),and the differences were statistically significant(χ2 =7. 683,P ﹤0. 05). There were 3 cases(3. 3%)with adverse reaction in combination group after treatment,including 1 cases of headache and 2 cases of nausea and vomiting. All above symptoms disappeared after stopping drugs. There was 1 cases(1. 1%)with adverse reaction in sodium nitroprusside group,1 cases(1. 1%)in dopamine group,and there was no significant differences seen among three groups(χ2 =1. 630,P﹥0. 05). Conclusion Continuous intravenous infusion of sodium nitroprusside combined with dopamine on cardiac function in elderly patients with refractory heart failure can improve clinical effect and enhance the medication security.

Exfoliated cells in abdominal cavity were studied in 142 patients with gastric cancer. The cells were mainly obtained by irrigation with normal saline during operation. In this series, 53.5%(76/142) of the patients have malignant exfoliative cells. The relationships between the localization and the pathological types of cancer and the positive rate of the exfoliative cells in the abdominal cavity were discussed. No significant differences were found with regard to the TNM staging of the gastric cancer, the positive rate of stage I was 4/5, while those of the stage II,III,IV were 36%, 42.6% and 66.2%, respectively. The five-year follow-up study showed that in the positive exfoliative group, none lived more than 3 years, including 4 cases of TNM stage I, 9 cases of stage II and 63 cases with advanced cancer. However, in the 66 cases with negative cytology, 1 case of stage I patient was alived more than 7 years after operation, and in the 26 cases of stage II, 10 survived more than 5 years. This method is recommanded to detect the early metastasis of gastric cancer in the abdominal cavity. It may be useful in planning a reasonable management for the patient and may give a better understanding about the prognosis.

Population genetic data of the STR D13S325 locus in a sample of 216 unrelated individuals of Han population in Wuhan was studied with the method of PCR. 11 alleles and 30 different genotypes were observed.There is no significant deviation from the Hardy Weinberg equilibrium.The DP value was 0 9292,PE 0 6137 and PIC 0 7755.The results of study of 200 meiosis showed no mutation.The results prove that this STR Locus is useful in the forensic sicence practice in Han population in Wuhan.

The role of the hematuria examination by urinary analyzer in forensic medicine practice was evaluated in the present study.By using the chemical analysis of urinary analyzer and urinary sediment microscopy,the erythrocytes in 418 urine samples were examined simultaneously.The results showed that the negative outcome was found in 276 cases,+ in 58,++ in 35,≥++ in 84 by urinary analyzer,while negative outcome in 274 cases, +- and + in 31, ++ in 1 ,≥++ in 37 with consistent rates of 99 26%, 53 45%, 2 86% and 44 05% respectively.There was high significant difference between the positive and negative outcome and between the trauma mild (≥++) and slight trauma outcome (≤+) as determined by these two methods ( P

BACKGROUND: Huangiao granule is pure Chinese drugs pharmaceu-tics, which can eliminate heat by purgatingfu-organs, clear unconscious-ness and stop endogenous wind as well as promote blood flow and removeblood stasis etc.OBJECTIVE: To observe the effect of huangjiao granule on apoptosis ofneurocytes in rat models with middle cerebral arterial occlusion, and probeinto the possible mechanism of huangjiao granule in the treatment of acutecerebral infarction.DESIGN: Complete randomized grouping design, control animal experi-ment.SETTING: Department of Neurology, Affiliated Hospital of TraditionalChinese Medicine Combined with Western Medicine, Tongji Medical Col-lege of Huazhong University of Science and Technology.MATERIALS: The experiment was conducted in the Central Laboratory,Hubei College of Traditional Chinese Medicine. Sixty old Wistar rats aged22 months were selected. After 3-day-feeding for adaptability, rats wererandomized into 6 groups according to body mass: Normal control group,model group, nimodipine gorup, 10 g/kg huangjia ogranule group and 5 g/kghuangjiao granule group with 10 rats in each group.METHODS: ①Rats were made into cerebral ischemic models with mid-dle cerebral arterial occlusion method. Thirty minutes before modeling, ratsin the 10, 5, 2.5 g/kg huangjiao granule (main gredients were radix et rhi-zoma rhei, cornu bubali etc. provided by Manufacturing Laboratory ofWuhan First Hospital with the batch number of 021120) groups respec-tively received gastric perfusion of 1, 0.5, 0.25 g/mL huangjiao water so-lution containing crude drug at the dose of 10, 5, 2.5 g/kg with each rats perfused once; Rats in the nimodipine group received gastric perfusion of1 mg/mL nimodipine water solution, containing crude drug at the dose of 10 mg/kg with each rats perfused once; Rats in the model group and normal control group received gastric perfusion of normal saline at the dose of 10 mL/kg with each rats perfused once. ② Apoptotic stainning sections in situ were observed under light microscope, 5 fields were observed under high power (20×10). Observed the number of mean positive cells of each highpower field, and then caculated the percentage of apoptosis. Histologic changes of local and peripheral ischemic cortexes were observed under light microscope. Changes of ultramicrostructure of cells in cerebral cortexes of rats were observed under electron microscope. ③Differences of measurement data were compared with F test and Q test.MAIN OUTCOME MEASURES: Morphologic effects of huangjiao granule on apoptotic rate of neurocytes in brain tissues of old rats with middle cerebral arterial occlusion (MACO) and cells in cerebral cortexes.RESULTS: A total of 60 Wistar rats were involved in the analysis of results. ①Number of apoptotic positive cells in brain tissues and apoptotic rate in rats of model group were significantly higher than those in the normal control group (P ＜ 0.01); Those in each huangjiao granule groups and nimodipine group were obviously lower than those in the model group (P ＜ 0.01); Differences in numbers of apoptotic positive cells in brain tissues and apoptotic rates in rats of 10 g/kg huangiao group and nimodipine groupwere not obvious (P ＜ 0.05). Number of apoptotic positive cells in brain tissues and apoptotic rate in rats of 10 g/kg huangjiao granule group were markedly lower than those in the 5, 2.5 g/kg huangjiao granule groups (P ＜ 0.05, 0.01).②Observation with light microscope and electron microscope showed that there were obvious apoptosis in local cells of brain tissues in rats of model group, which can significantly ameliorate by haungjiao granule.CONCLUSION: Huangjiao granule has some antagonistic effects on acute ischemic apoptosis of neurocytes, which may be one of the possible mechanisms of huangjiao granule in the treatment of acute cerebral infarction.

It is a trend that clinical researchers overemphasize on hypothesis testing and the P value. However, P value has some limitations in the presentation of study results. Power is a tool for study design and results explanation, especially for negative results. Confidence interval contains more information for clinical results than P value. P value, power, and 95% confidence interval should be provided in the clinical reports to facilitate the interpretation of the results.

Objective To investigate the ABO blood type and sepsis complicated with acute kidney injury,to provide the basis for prevention and treatment.Methods A total of 130 patients with sepsis from renmin hospital of Wuhan University intensive care unit from january 2015 to december 2015 were enrolled in this study,divided into complicated AKI group (64 patients in the observation group) and non-complicated AKI group (66 patients in the control group),analyzed two groups of general data,laboratory indicators,multivariate logistic regression analysis was used to screen out the risk factors for AKI in patients with sepsis.Results A total of 64 patients with AKI were collected from the observation group and 66 patients with non-AKI in the control group,the age of the observation group was higher than that of the control group (65.7 ± 13.1 years old vs 58.5 ± 15.4 years old,P =0.005),male proportion was higher than control group (76.6％ vs 56.1％,P =0.014),drop calcium pigment original quantitative was higher than control group (28.1 ± 21.0pg/L vs 21.1 ± 13.61μg/L,P =0.026),positive blood culture rate was higher than in the control group (30.2％ vs 15.3％,P =0.006).There was no significant difference in ABO blood group distribution between the two groups (P =0.825).The levels of white blood cell count,C-reactive protein and partially activated thrombin were higher in the observation group than in the control group,the platelet count and albumin level were lower than those in the control group,the difference was not statistically significant.The risk factors associated with the incidence of sepsis with AKI were analyzed by multivariate analysis of the logistic regression model:age(P =0.021,OR =0.965),gender (P =0.003,OR =5.321),calcitonin-original(P =0.047,OR =0.975),positive blood culture (P =0.002,OR =1.009),comparison of type A blood and type O blood (P =0.037,OR =5.409) were associated with sepsis complicated with AKI.Conlusion Type A blood and sepsis with AKI associated with the existence of independent correlation,type A blood may increase the risk of sepsis with AKI.