Objective To explore the changes of CD4~+ cell and relevant cytokines from chronic hepatitis B patients and the significance was discussed. Methods The expression of CD4,CD8 and CD28 molecules on PBMC was detected with Flow Cytometry.The levels of IL-2,IFN-?,IL-4,IL-10 and IL-12 in serum were measured with ELISA,and the liver function test including serum ALT,SB,ALP and albumin was conducted. Results Three conditions of CD4~+ ratio from PBMC in 86 patients were observed,that showed lower,similar or higher comparing with normal controls.According to CD4~+T cell ratio,the patients were divided into 3 groups.In three groups,the changes of CD28 expression paralleled to that of CD4~+T cell ratio.Except IL-4,the level of cytokines related to viral clearance such as IL-2,IFN-?,IL-10 and IL-12 in patients was elevated compared with controls(P

Objective To investigate the effect of comprehensive intervention on asymptomatic hyperuricemia.Methods in this random controlled study,all patients diagnosed with asymptomatic hyperuricemia on health examination according to the diagnostic standards were randomly divided into intervention group and control group.Comprehensive intervention included healthy lifestyle guidance and administration of sodium bicarbonate in the intervention group.Low purine diet was used in the control group.The follow-up period for all the patients was one year.The changes of various indexes in both groups before and after intervention were observcd and compared.Results Compared with the control group,the patients in the intervention group presented significantly lower levels of BMI,serum uric acid,blood sugar,SBP,DBP,triglyceride and less frequent occurrence of obesity,hyperglycemi,hypertension,hipertrigliceridemia (P ＜ 0.05).After intervention,the patients in the intervention group also exhibited significantly lower the levels of BMI,serum uric acid,blood sugar,SBP,DBP,triglyceride and significantly lower incidences of obesity,hyperglycemia,hypertension,hypercholesteremia and hipertrigliceridemia.Conclusion Comprehensive intervention into asymptomatic hyperuricemia can reduce the incidence of complications such as central obesity,hyperglycemia,hyperlipidemia and hypertension.

Objective To explore the protective effect of resveratrol (RSV) on intestine barrier injury induced by hemorrhagic shock and its mechanism in rats.Methods According to random number table method,sixty-four SPF grade male Sprague-Dawley (SD) rats were divided into four groups:Sham operation group (only the catheters were indwelled in arterial and venous passages after anesthesia),hemorrhagic shock model group (model group,the catheters were indwelled in arterial and venous passages after anesthesia,and 0.3 mL solvent was administrated after hemorrhagic shock),RSV group (the catheters were indwelled in arterial and venous passages after anesthesia,15 mg/kg RSV was administered after hemorrhagic shock),superoxide dismutase 2 (SOD2) specific inhibitor,2-Methoxyoestradiol (2-ME) group (on the basic treatment of RSV group,0.1 mmol/L 2-ME was administered).The hemorrhagic shock model was reproduced by femoral artery bleeding.After drug administration,all rats were divided into two parts.One part was used for observations on 24-hour survival rate and survival time,while in the other part,2 hours after the hemorrhagic shock,the blood was collected for determination of the content of serum D-lactic acid,and afterward the rats were executed to obtain small intestine tissues for the examination of histopathological changes and Chiu's score.Moreover,differences of expression levels of tight junction proteins (Occludin,Claudin,ZO-1) of small intestine tissue and the oxidative stress related indexes SOD2 activity and reduced glutathione (GSH),oxidized glutathione (GSSH),malonaldehyde (MDA) contents were compared among the groups.Results Compared with the sham group,the model group demonstrated decreased survival rate,SOD2 activity,GSH content,GSH/GSSH ratio,reduced survival time,significantly increased serum D-lactic acid activity,Chiu's score and MDA content,and decreased expressions of tight junction proteins in small intestine tissue.Compared with model group,the RSV group showed significant increased survival rate [75.0％ (6/8) vs.37.5％ (3/8)] and prolonged survival time (hours:21.0±4.3 vs.10.4±5.8,P ＜ 0.05),significantly decreased serum D-lactic acid (μg/L:380.18 ± 70.59 vs.500.88 ± 97.53) and Chiu's score (1.75 ± 0.71 vs.4.00± 0.53) in small intestine (both P ＜ 0.05),obviously increased expressions of tight junction proteins,SOD2 activity,GSH and GSH/GSSG [Occludin (gray value):0.89 ± 0.10 vs.0.43 ± 0.77,Claudin (gray value):0.78±0.06 vs.0.33 ± 0.05,ZO-1 (gray value):0.83 ± 0.06 vs.0.34 ± 0.07,all P ＜ 0.05],and the elevated SOD2 activity (kU/L:0.85 ± 0.12 vs.0.51 ± 0.11,P ＜ 0.05],as well as increased GSH content and GSH/GSSG ratio [GSH (μmol/L):7.25±1.01 vs.3.86±0.54,GSH/GSSG:6.39± 1.14 vs.1.56±0.25,both P ＜ 0.05] in the small intestine,and markedly reduced MDA content (ng/g:5.00± 1.31 vs.8.63±0.92,P ＜ 0.05).Compared with RSV group,the 2-ME group demonstrated significantly decreased survival rate [50.0％ (4/8) vs.75.0％ (6/8)] and further shorter survival time (hours:12.2 ± 5.7 vs.21.0±4.3),increased serum D-lactic acid (μg/L:463.88 ± 60.16 vs.380.18 ± 70.59),obviously elevated Chiu's score (3.13 ± 0.99 vs.1.75±0.71,P ＜ 0.05),decreased expressions of tight junction proteins [Occludin (gray value):0.55±0.04 vs.0.89±0.10,Claudin (gray value):0.38±0.05 vs.0.78±0.06,ZO-1 (gray value):0.41±0.04 vs.0.83±0.06,all P ＜ 0.05];moreover,the activity of SOD2,GSH content,GSH/GSSG ratio were greatly reduced [SOD2 activity (kU/L):0.58 ± 0.13 vs.0.85 ± 0.12,GSH (μmol/L):4.49 ± 0.52 vs.7.25 ± 1.01,GSH/GSSG:1.57 ± 0.39 vs.6.39 ± 1.14,all P ＜ 0.05],and increased MDA content (ng/g:6.25 ± 1.04 vs.5.00 ± 1.31,P ＜ 0.05).The small intestine tissue was basically normal in Sham group,and no significant pathological changes were seen;in the model group,the small intestine epithelial mierovilli were collapsed and the mucosal barrier was destroyed obviously;in the RSV group the damages of small intestine microvilli and barrier were markedly alleviated;in 2-ME group the pathological changes were more evident compared with those in the RSV group.Conclusion RSV can improve intestinal barrier injury following hemorrhagic shock in rats;its mechanism may be related to SOD2 activation.

This paper was aimed to study the human plasma protein binding rate of diterpene ginkgolides meglumine injection.The equilibrium dialysis was used to determine the human plasma protein binding rate of ginkgolide A (GA),ginkgolide B (GB) and ginkgolide K (GK) in diterpene ginkgolides meglumine injection.The LC-MS/MS method was used for the content determination of ginkgolides.And then,the plasma protein binding rate was calculated.The results showed that there was no interference from other ingredients for the determination of ginkgolides.The calibration curve of the analytes was in good linearity in certain range of contents.The precision and stability of the analytes met the methodology requirements.After 8 h incubation,the human plasma protein binding rate of GA,GB and GK achieved balance.The human plasma protein binding rate of GA (0.34,1.70 and 8.51μg·mL-1) was 84.03%-88.11%; the human plasma protein binding rate of GB (0.62,3.09 and 15.5μg·mL-1) was 41.21%-53.56%; the human plasma protein binding rate of GK (0.04,0.20 and 1.01μg·mL-1) was 45.24%-59.59%.It was concluded that the method was simple,rapid and sensitive,which met the analysis requirement for biological samples.GA had a high plasma protein binding rate; GB and GK had medium plasma protein binding rate.

Objective To observe the effects and security of rapamycin drug-eluting stents implanting in eld-eay patients with coronary heart disease(CHD).Methods 107 patients with CHD treated with Firebird rapamycin drug-eluting stents,the immediate angiographic outcome,complication in hospitalization.six months'follow-up results were assessed.Results 175 Firebird stents implanted successfully,the successful stenting procedure achieved in 98.9% patients,1 patient(0.9%) died of thrombosis instent during hospitalization.there were no myocardial infarction occurred during six months'follow-up,angina recrudesced in 6 patients,and the ratio of instent restenosis was 2.6%,the MACE rate during 6 months follow-up was 2.8%.Conclusion Firebird rapamycin drug-eluting stents implanta-tion in CHD in elderly was safe and effective.

Objective To explore the relationship between abnormal copy number of mitochondrial DNA (mtDNA) and prognosis of the patients in colorectal cancer (CRC).Methods A total of 60 cases of CRC and corresponding adjacent noncancerous tissue specimens were selected.Genomic DNA was extracted.The mitochondrial ND1 gene was detected by quantitative real-time polymerase chain reaction and β-actin was set as internal control.And then the copy number of mtDNA was caculated and analyzed by t-test.The prognosis of patients was determined by Kaplan-Meier survival analysis.Results The mean mtDNA copy number of CRC tissue was 108.60±20.11,while that of the corresponding adjacent noncancerous tissues was 153.68±25.72,the former was significantly lower than that of the latter (t=10.69,P＜0.01).The rate of low mtDNA copy number in case with positive lymph nodes metastasis was higher than that in cases with negative lymph nodes metastasis (x2 =4.022,P＜0.05),however there were no obvious correlation with gender,age,pathological type,TNM stage.The survival rate of high mtDNA copy number group was higher than that of low mtDNA copy number group,however there was no statistical significance (P＞ 0.05).Conclusions mtDNA copy number of CRC was significantly lower than that of the adjacent noncancerous tissues.However the change of copy number was not correlated to the prognosis.

Objective To evaluate the implementation feasibility of the nurse performance appraisal and allocation plan based on the holistic nursing mode, and the clinical effect in mobilizing nursing staff's work enthusiasm and ensuring the quality of nursing service. Methods The nurse performance appraisal and allocation plan were further improved based on the previous research of this index system construction. The model were implemented in 32 clinical departments of Yidu Center Hospital of Weifang City. Four aspects data were collected for analysis six months later to evaluate the effect. They were nurses on merit pay distribution satisfaction, patients′satisfaction, doctors′satisfaction with nursing job, different clinical departments′nursing quality scores. Results Six months later, four factor scores of nurses to the satisfaction of merit pay distribution were significantly improved. The scores of fairness and impartiality evaluation of the merit pay distribution, incentive effect evaluation, pay and return on equity evaluation and performance pay gap rationality evaluation were higher than before [(3.39 ±0.64) points vs. (1.88 ±0.33) points, (3.28 ±0.74) points vs. (1.84 ±0.49) points , (3.28 ±0.71) points vs. (1.88 ±0.42) points and (3.38 ±0.67) points vs. (2.01±0.53) points, t=19.28, 16.22, 18.08, 16.79, all P<0.05]. Patients′satisfaction, doctors′satisfaction with nursing job and different clinical department' nursing quality scores were significantly increased as well [(99.14±0.82) points vs. (96.78±0.84) points, (96.59±0.91) points vs. (93.59±1.27) points and(97.67±0.41) points vs. (95.70±1.13) points]. Difference had statistical significance (t=11.79, 11.63, 9.60, P<0.05). Conclusions The performance salary allocation plan can effectively improve the hospital nurses on performance salary allocation satisfaction, patients′satisfaction, doctor′s satisfaction with nursing work and the quality of nursing department, and has good incentive in arousing the work enthusiasm of nursing staff and in ensuring the quality of nursing service.

Simvastatin,a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor,is widely prescribed to patients with hypercholesteremia and its muscular toxicity has been widely reported.The metabolism of simvastatin depends on the enzymic activity of cytochrome P450 3A4 (CYP3A4) and inhibitors of CYP3A4 can result in clinical events by interacting with simvastatin.Diltiazem is a moderate inhibitor of CYP3A4,which is known to increase the serum concentration of simvastatin.Here we report a patient with unrecognized hypothyroidism who had been stable for more than one year on low-dose simvastatin therapy of hypercholesteremia and rhabdomyolysis occurred with the addition of diltiazem.This is one of scanty reports of rhabdomyolysis induced by simvastatindiltiazem drug interaction,especially in hypothyroid patient.This case reminds the clinicians that although diltiazem as a moderate CYP3A4 inhibitor can be used cautiously with small doses of CYP3A4-dependent statius (eg,simvastatin),these two commonly used drugs should be avoided in hypothyroid patient.

Objective To investigate the role of ski in proliferation of astrocytes and the molecular mechanisms in rats. Methods Astro-cytes were obtained from cerebral cortex of a three-day old rat and cultured in vitro. siRNA targeted to ski and negative control sequences were prepared. The astrocytes were divided into ski-siRNA group, siRNA negative control group and untreated control group, while the spe-cific siRNA targeting ski negative control sequences were transfected into astrocytes with Lipofectamine? RNAiMAX Reagent. The protein levels of ski, glial fibrillary acidic protein (GFAP) and Cyclin D1 were determined with Western blotting. The proliferation of astrocytes were measured with CCK8 assay. The cell-cycle of astrocytes were analyzed with flow cytometer. Results The protein level of ski (F=38.611, P<0.01), GFAP (F=7.547, P<0.05) and Cyclin D1 (F=3.901, P<0.05) reduced in ski-siRNA group, the proliferation of astrocyte was significantly inhibited since twelve hours after culture (F>30.507, P<0.01), and less cells were in S phase and more in G1/G0 phase (F>48.425, P<0.01), compared with the control groups. Conclusion ski knocking down by siRNA significantly inhibits the proliferation of astro-cytes, which may associate with the down-regulation of Cyclin D1 expression.

Objective:To explore influence of nursing intervention according to comprehensive geriatric assessment (CGA)on quality of life (QOL)in aged patients With coronary heart disease (CHD).Methods:A total of 96 aged CHD inpatients admitted in department of cardiology from Mar 2012 to Mar 2013 Were enrolled.According to num-ber table method,they Were randomly divided into routine nursing group (n=48,received specific nursing of cardi-ology department)and CGA group (n=48,received nursing intervention according to CGA based on routine nurs-ing).Chinese questionnaire of quality of life in patients With cardiovascular disease (CQQC)Was used to score and compare each dimension of QOL betWeen tWo groups at admission and on 6-month after discharge.Results:Com-pared With routine nursing group after intervention,there Were significant increase in scores of physical strength [(7.35±4.12)scores vs.(10.86±5.06)scores],patient's condition [(4.57±0.85)scores vs. (8.75±4.54) scores],medical condition [(4.72±0.82)scores vs.(5.90±0.40)scores],general living [(3.85±1.45)scores vs. (5.22±1.95)scores],social psychological conditions [(3.67±1.52)scores vs.(8.41±3.22)scores],Working sta-tus [(0.70±0.64)scores vs.(0.97±0.66)scores]and total score of CQQC [(24.86±4.43)scores vs.(40.11± 9.05)scores]in CGA group,P<0.01 or<0.05.Conclusion:Nursing intervention according to comprehensive geri-atric assessment can improve quality of life in aged patients With coronary heart disease.