Objective To investigate the role of APRIL in SW480 cell line.Methods The CRC model was established in the nude mice,all the mice were divided into 3 groups,the mice were separately treated with APRIL siRNA,pGC-vector and PBS solution.The APRIL mRNA was detected by RT-PCR and the APRIL protein was surveyed by the way of immunohis-tochemistry (IHC).The proteins of TIMP-3,Syndecan-1and MMP-9 also were assessed by IHC.Results ①Tumor mass in the group of nude mice injected with PBS (2.15±0.30 g)was significantly higher than the injection APRIL siRNA group (0.95±0.15 g,P<0.05),and was not statistically significant (P>0.05)compared with the injection of empty vector group (2.20±0.25 g).②APRIL mRNA/18S rRNA ratio (2.48±0.25)in the group of mice injected with PBS was signifi-cantly higher than the injection APRIL siRNA group (0.39±0.15,P<0.05),and was not statistically significant (P>0.05)compared with the injection of empty vector group (2.51±0.30).③SW480 cells injected with APRIL siRNA signifi-cantly inhibited invasion and metastasis.TIMP-3 Allred scores in three groups were 7.70±0.35,1.10±0.16 and 1.15± 0.12,Syndecan-1 protein was 7.80±0.30,1.05±0.20 and 1.10±0.22 MMP-9 protein was 1.20 ±0.10,8.00±0.25 and 8.20±0.20,respectively.Conlusion APRIL was closely connected with the growth and metabasis of CRC.

Objective To prepare and identify monoclonal antibody against LRR-WSC domain of polycystin-1 and to investigate the distribution of polycystin-1 in kidney tissues and kidney cell lines. Methods BALB/c mice were immunized with fusion protein PC1-e of polycystin-1 LRR-WSC domain. The splenocytes were fused with myeloma cells by PEG 4000 and the hybridomas were selected in HAT medium. The hybridoma clones secreting antibodies against polycystin-1 LRR-WSC domain were detected by enzyme-linked immunosorbent assay ( ELISA) and cloned by limiting dilution. The specificity of anti-polycystin-1 LRR-WSC domain monoclonal antibody from hybridoma was verified by ELISA and Western blot. The distribution of polycystin-1 in tissues and cells was detected by immunohistochemical method. Results One cell line of hybridoma secreting monoclonal antibody against polycystin-1 was established. Western blot analysis showed that the monoclonal antibody reacted strongly and specifically to polycystin-1 LRR-WSC domain. Distribution of polycystin-1 in fetal kidney was localized in tubular epithelium. In normal adult kidney tissues, our study showed that polycystin-1 was mainly expressed in the medullary collecting ducts and distal convoluted tubules. Positive staining was also found in the majority of cyst-lining epithelial ceEs of cystic tissue from autosomal dominant polycystic kidney disease ( ADPKD) patients. Expressions of polycystin-1 were found in either ADPKD cyst-lining epithelia cell line and LLC-PK1, clearly plasma membrane and intracytoplasmic staining of polycystin-1 were observed. Conclusion Specific monoclonal antibody against polycystin-1 LRR-WSC domain were obtained. The antibody is important to researching the mechanism of ADPKD. The distribution of polycystin-1 in kidney tissues and cells show that polycystin-1 was important in tubular elongation and the maintenance of tubular architecture.

Objective To investigate the clinical value of circulating miR-125b-5p in coronary atherosclerotic heart disease.Methods With case-control study,80 cases of coronary atherosclerotic heart disease were recruited in Affiliated Hospital of Nantong University from February 2014 to august 2015.According to coronary angiography result they were divided into two groups: there are coronary artery stenosis group(n=49)and control group(n=31).All patients were also divided into non-ST-segment elevation myocardial infarction and ST-segment elevation myocardial infarction group(n=35),unstable angina group group(n=25),stable angina group(n=20).The level of miR-125b-5p before coronary angiograph was detected.By independent sample t test and variance analysis,the levels of miR-125b-5p were compared between the groups of coronary artery stenosis and the group with no stenosis of the coronary artery,the coronary artery lesions in each group,and between the various types of coronary atherosclerotic heart disease respectively.Results MiR-125b-5p expression level of Coronary artery stenosis group(0.35±0.10)was lower than that in group coronary artery with no stenosis(0.95±0.12),the difference was statistically significant(t=24.179,P<0.000 1).With the increase in the number of diseased coronary arteries,miR-125b-5p expression level decreased gradually.There is also statistical significance(t=8.399,P<0.000 1; t=13.067,P<0.000 1)in miR-125b-5p expression among NSTEMI+STEMI,UA and SAP groups.miR-125b-5p expression level was negatively correlated with Gensini score(R2=0.822,P<0.05).The area under the ROC curve(AUC)of miR-125b-5p was 0.86(95％CI 0.67-0.90),and 0.66 was the optimal cut-off value with sensitivity of 81.22％and specificity of 78.62％.Conclusions With the increase of the number of stenosis,plasma miR-125b-5p expression level decreased gradually.The expression level of miR-125b-5p was negatively correlated with the Gensini score of coronary artery,which indicated that the expression level of miR-125b-5p may be a potential biomarker that can reflect the lesion degree of coronary artery.

[ ABSTRACT] AIM:To compare the differences of the genome-wide methylation levels and methylated regions be-tween nasopharyngeal carcinoma ( NPC) cells in the same genetic background but different radiation resistance ( CNE-2 cells and CNE-2R cells).METHODS:Using the method which was developed by Doctor Zhao Cun-you, based on using methyl-sensitive restriction enzyme to measure the genome-wide methylation levels.In addition, MeDIP-Seq was used to analyze the methylated regions in 6 gene functional elements, including the upstream 2k sequence, 5’ UTR, coding se-quence, intron, 3’UTR and downstream 2k sequence, between CNE-2 cells and CNE-2R cells.RESULTS:The genome-wide methylation level was approximately 30%lower in CNE-2R cells than that in CNE-2 cells.No obvious difference on the amount of genes and the coverage of the peak in the 6 gene functional elements was observed.However, the methylation pattern of plentiful genes had altered in the gene function elements.CONCLUSION:The genome-wide methylation levels and methylated regions between NPC cells in the same genetic background but different radiation resistance were quite dif-ferent, indicating that the DNA methylation may be associated with NPC radioresistance.

Objective To observe the antihypertensive effect of compound Yibazhen granules on spontaneous hypertensive rats ( SHR) . Methods Wistar rats were served as normal control group. Sixty SHR were randomly divided into model control group,captopril group,Jane chrysanthemum antihypertension tablet group and compound high dose group,middle dose group and low dose group ( n = 10 each group ) by digital table method. Captopril group was given captopril 30 mg.kg-1 .d-1 ,and Jane chrysanthemum antihypertension tablet group was treated with Jane chrysanthemum antihypertension tablet ( 0. 6 tablet per kg ) , compound Yibazhen granules high dose group, middle dose group and low dose group received compound of 13.18,6.59 and 3.3 mg.kg-1 .d-1 ,respectively. Normal control group and model control group were intragastrically administered with 0.9% sodium chloride solution for 8 weeks. Changes of systolic and diastolic blood pressure of rats and blood urea,creatinine,nitric oxide (NO),nitric oxide synthase (NOS) and angiotensin Ⅱ (Ang Ⅱ) were observed. Results Diastolic pressure of rats in compound Yibazhen granules high dose group, middle dose group and low dose group decreased significantly in 2 weeks. Systolic blood pressure and diastolic blood pressure of compound Yibazhen granules high dose group decreased significantly in 4 weeks,compared with the model control group (P<0.05). Compared with the model control group, concentration of urea and crea in compound Yibazhen granules high dose group, middle dose group and low dose group were significantly lower( P<0.05) . The content of NOS and AngⅡ in rats of compound Yibazhen granules high dose group decreased significantly and the contents of NO increased, which were compared with the model control group ( P<0. 05, P<0. 01 ) . Conclusion The protective effect of compound Yibazhen granules in treating early renal damage in SHR is related to decreasing diastolic blood pressure,concentration of urea,crea and AngⅡ and regulating the levels of NOS and NO.

The practice of general practice emphasizes that the general practitioner is the backbone, and the primary health institution is the main body, which solves the main health problems of the commu-nity and meets the basic health service needs of the residents. Rehabilitation medicine occupies a prominent position in the community health service, and its related knowledge and skills are the important part of the whole medical education. However, rehabilitation medicine has more teaching contents, less training time and out-of-date teaching model, which have made the effect of rehabilitation medicine teaching not good. In the rehabilitation medicine teaching for training general practitioners, by strengthening the concept of reha-bilitation, elaborating teaching content, optimizing teaching ward-round, and outstanding ability as well as reforming evaluation way, we try to exercise the students' clinical thinking and improve clinical skills, to cultivate outstanding qualified general medical practitioners for community rehabilitation ultimately.

Objective To discuss the long term clinical effect of ileal orthotropic neobladder.Methods From 1991 to 1998,79 patients,mean age 55(41～75)years,male 74,female 6,were followed up.The serum creatinine and urea,electrolytes,blood routine,B ultrasonic scan of the neobladder residual urine and IVU or MRU of the patients were followed up.The max transverse diameter of renal pelvis and the max verticaI/level diameter of neobladder were measured in 5,10 to 14,15 years of postoperative when IVU or MRU.All results of different time were compared by the multiple comparisons.The local or distant cancer recurrence and the complications of the operation Were evaluated. Results Sixty-four cases,58 male,6 famle,were long term followed up:mean time was 167 (range,121～216)months.Seven cases died of other diseases.Seven cases had pelvic recarrence.Two cases had urethral recurrence.Three cases died of tumor metastasis.One case had ureter recurrence.Forty-eight patients were alive more than 10 years.The value of the serum creatinine,urea,electrolytes and bloods routine of the patients were normal after 5,10 to 14 and 15 vears postoperative (P＞0.05).The max transverse diameter of the renal pelvis in 5,10 to 14 and 15 years Dostoperative were 14.0 mm,14.1 mm and 13.7 mm,respectively,P＞0.05.The max vertical/level diameter of the neobladder in 5,10 to 14,15 years of postoperative were 110.4 mm/90.4 mm,111.5 mm/95.3mm and 127.0 mm/97.0 mm,respectively,P＞0.05.The residual urine of 5 cases was more than 50 ml and had not increased during follow up.Eight cases with neobladder stone were cured by the intracavitary lithothrypsis.Two cases with uretheral stricture were cured by the intracavitary therapy.Twelve cases of 14 cases with inguinal hernia were cured by reoperation,2 cases accepted conservative treatment.Only 17 cases had no complication involve of the cancer and the operation. Conclusion The upper urinary tract and neobladder of the ileal orthotopic neobladder could be stable for long time,the cure rate of tumor is satisfactory and the lifetime follow up is necessary.

Objective To explore the effect of quality control circle ( QCC) activities on increasing early neonatal contact rate of mother and early breast sucking rate .Methods Set up a QCC,then follow the steps of QCC with professional tools to solve existing problems in early skin-to-skin contact for mothers and their healthy newborn infants and early breast sucking .Rate was compared before and after the improvements .Results The early neonatal contact rate of mother and early breast sucking rate increased from 80.94% to 93.57%,and the difference was significant (χ2 =35.07,P<0.001).Conclusions The application of the quality improvement tool of QCC could improve the early skin-to-skin contact for mothers and their healthy newborn infants and early breast sucking , and helps the mother to breastfeed successfully .

Objective To investigate the current status of psychological capital, career plateau and turnover intention in ICU nurses and to analyze the influence of psychological capital and career on turnover intention. Methods A total of 233 ICU nurses from the 2nd Affiliated Hospital of Wenzhou Medical University who met the criteria were selected by convenient sampling from February to April 2017. The nurses were investigated with the Psychological Capital Questionnaire-Chinese (PCQC), Career Plateau Questionnaire (CPQ) and Turnover Intention Scule (TIS). Totally 233 questionnaires were handed out and 224 valid questionnaires were collected. Results The total score of psychological capital in the 224 ICU nurses was (88.53±13.16), and the highest score was found in the dimension of self-efficacy, while the lowest score was in the dimension of hope; the total average score of career plateau was (3.83±0.92); and the score of turnover intention was (16.82±5.01). According to the hierarchical stepwise regression analysis, contractual employment, hope, hierarchical plateau and content plateau were the main influencing factors of ICU nurses' turnover intention, which could account for 39.8% of the total variation. Conclusions ICU nurses show a strong turnover intention, and contractual employment, hope, hierarchical plateau and content plateau may affect their turnover intention. ICU nursing managers should formulate proper and effective improvement strategies for psychological capital and alleviation strategies for career plateau based on the current status of psychological capital and career plateau in nurses and take proper measures to enhance their enthusiasm and job satisfaction of contractually employed nurses, and reinforce the stability of ICU nursing team.

Objective:To investigate the effects on perceived quality of a management assessment system for orthopedic surgery in elderly patients.Methods:Based on the concept of lean management and process nodes in systems, an information management system was established to evaluate the perceived quality of surgical service for elderly orthopedic patients.Four hundred and two elderly orthopedic patients receiving orthopedic surgery after the implementation of the management system were included in the observation group, while 402 elderly patients undergoing orthopedic surgery before the implementation of management system formed the control group.Results:The incidence of hypothermia in patients admitted to the resuscitation room after surgery was lower in the observation group than in the control group(1.7% vs.4.5%, χ2=5.136、 P=0.023). The incidence of shivering during resuscitation was lower and the satisfaction rate of surgical services was higher in the observation group than in the control group(0.7% vs.3.2%) χ2=5.279、 P=0.022, 96.55(95.58, 97.28)分, vs.87.9(83.2, 89.95)分, Z=-4.16, P=0.00). Conclusions:A perceived quality assessment system composed of lean management and information technology for surgical services can reduce complications and improve satisfaction for patients receiving surgery.