Objective To explore the relationship between the expression of Dishevelled2 and Vangl2 proteins and the development of mouse palate. Methods Twenty-four pregnant mice were randomly divided into eight groups, and the mouse embryos were obtained at eight clock of the pregnant day of thirteen(p13d8h), p13d14h,p13d22h,p14d8h,p14d14h,p14d22h,p15d8h and p15d22h respectively, then paraffin sections were made conventionally.The distrubution and dynamic changes of Dishevelled2 and Vangl2 proteins in the embryonic palatal shelves were detected by immunohistochemistry and image analysis. Results It was found that the two kinds of proteins expressed in the epithelium and mesenchyma of the mouse palatal shelves at different development stages. The expression levels of the Dishevelled2,in both of the epithelium and mesenchyme of the palatal shelves, increased first (p13d8h-p13d22h),then decreased rapidly(p13d22h-p14d14h), and then increased again(p14d14h-p15d22h). The expression of Vangl2 protein in the mesenchyma showed a similar trend to that of the Dishevelled2, but there was no obvious regularity in the epithelium. In addition, the expressive levels of both kinds of proteins in the epithelium were significantly higher than those in mesenchyma of the palatal shelves. Conclusion Dishevelled2 and Vangl2 proteins might directly or indirectly take part in the regulation process of mouse palate morphogenesis.

Objective To study the effects of mitochondrial permeability transition (MPT) on hepatocyte apoptosis and mitochondrial damage,and investigate the effects of curcumin on MPT and the related mechanisms in septic rat.Methods Fifteen healthy male Sprague-Dawley (SD) rats were randomly divided into three groups:sham group,sepsis group and curcumin group,with 5 rats in each group.Septic rat model was reproduced by cecal ligation and puncture (CLP).The rats in sham group were flipped the cecum without perforation and ligation.The rats in the curcumin group were treated with curcumin 100 mg·kg-1·d-1 (dissolved in saline to 10 mL/kg) by oral gavage for 7 days,while the other groups were treated with normal saline.Tissue samples were harvested in each group at 12 hours after operation.Pathological changes in hepatic mitochondria were observed under electron microscopy,concentration of free calcium was examined with confocal laser scanning microscope.After Fluo-3/AM staining,protein and mRNA expression of active caspase-3,Bcl-2 and Bax were examined by Western Blot and reverse transcription-polymerase chain reaction (RT-PCR).Results Under the transmission electron microscope,intact cell membrane,adqulis cytoplasm,and normal and clear mitochondrion was found in the sham group.Mitochondria in sepsis group swelled obviously with mitochondrial cristae broken or disappearance,unclear bilateral membrane structure,while the curcumin group showed much less pathological changes,with few mitochondria swell,and smear bilateral membrane structure.The fluorescence intensity index of sham group,sepsis group and curcumin group was raised successively (417.33 ± 15.88,772.95 ± 42.37,1 560.84 ± 160.78,respectively,F=184.149,P=0.000).The protein and mRNA expression of active caspase-3 and Bax had the highest level in sepsis group,followed by the curcumin group,and that in the sham group was the lowest [active caspase-3 protein (gray scale):1.698 ± 0.061,0.694 ± 0.045,0.246 ± 0.027,F=1 289.667,P=0.000; active caspase-3 mRNA (2-Δ△Ct):1.031 ±0.135,0.578 ± 0.144,0.183 ±0.036,F=66.958,P=0.000; Bax protein (gray scale):1.826 ±0.126,1.254 ±0.140,0.623 ±0.901,F=94.536,P=0.000; Bax mRNA (2-ΔΔCt):2.774 ±0.338,1.661 ±0.226,0.656 ±0.114,F=124.710,P=0.000],all of these values had statistical significance among the three groups (all P＜0.01).While Bcl-2 protein and mRNA had the highest level in curcumin group and lowest level in the sham group [Bcl-2 protein (gray scale):0.716 ±0.091,1.328 ±0.147,1.656 ±0.104,F=84.918,P=0.000; Bcl-2 mRNA (2-△ΔCt):0.617 ±0.118,1.393 ±0.096,1.650 ±0.167,F=83.846,P=0.000].The protein and mRNA expressions of Bcl-2/Bax ratio were lowest in sepsis group,then sham group,and highest in curcumin group [Bcl-2/Bax protein (gray scale):0.726 ± 0.055,1.150 ± 0.043,1.333 ± 0.163,F=46.265,P=0.000; Bcl-2/Bax mRNA (2-Δ△Ct):0.505 ±0.041,0.944±0.097,1.006 ±0.168,F=12.211,P=0.001].Conclusions MPT can lead to mitochondrial dysfunction and further cause hepatocyte apoptosis.Mechanism of effect of curcumin on MPT may be related to reduction of intracellular calcium concentration,promotion of anti-apoptotic Bcl-2 gene expression,inhibition of caspase-3 activation and Bax gene.

Purpose To explore the value of direct CT venography (CTV) for the diagnosis of varicose veins of lower limb. Materials and methods Forty patients diagnosed as varicose veins of lower limbs were enrolled. 40 patients with 56 involved limbs underwent direct CTV examination, and their images were stratified and evaluated according to the severity and the scope of the disease. Main assessment:definition and scope of CT axial scans combined with volume rendering (VR) and maximum intensity projection for the display of the varicose veins; situation for the display of perforating veins, deep veins and iliac veins;diagnostic compliance between CTV and DSA. Results All of the 56 involved limbs underwent laser intra-cavity occlusion surgery, among them 7 cases with 11 limbs underwent venous angiography under DSA at the same time. In the evaluation of the VR, excellent proportion was 92.86%(52/56), moderate proportion was 7.14%(4/56). Among the deep veins, ratio of the imaging that was able to meet the diagnostic standard was 94.34%, 88.46%and 27.27%, respectively for calf vein, femoral vein and external iliac vein. The total demonstration rate of perforating veins was 98.21%(55/56). Diagnostic compliance between CTV and DSA was 100.00%. Conclusion Lower extremity direct CTV imaging is convenient and noninvasive for patients with varicose veins, with high compliance with DSA results, thus is significantly valuable for the guide of clinical treatment.

ObjectiveTo explore the relationship between the expression of Dishevelled2 and Vangl2 and the embryonic neural tube defects (NTDs) induced by all-trans retinoic acid (RA)in Kunming mouse. Methods Fifty pregnant mice were randomly divided into control and RA-treated groups.RA-treated mice were fed with 30mg/kg RA dissolved with peanut oil on embryo 7.75 days, while the mice of control group were administrated with an equal volume of peanut oil on the same time. Then all the embryos were sampled from pregnant mice at the 4th, 18th, 42nd, 66th and 90th hour after treatment. In situ hybridization and immunohistochemical staining technique were used to detect the expression of Dishevelled2 and Vangl2 in embryonic neural tube. Results The two proteins both existed in the epithelial tissue of the mouse embryonic neural tube and displayed different expression modes at various developmental stages.Compared with the control group, the RA treated group showed a significant decrease (P≤0.05) at the 18th and 42nd hour and a significant increase (P≤0.05) at the 66th hour in Dishevelled2 protein after maternal treatment, and no significant difference was found at the 90th hour. Compared with the control group, the Vangl2 mRNA expression in the RA treated group displayed a significant decrease (P≤0.05) at the 4th and 18th hour and a significant increase (P≤0.05) at the 66th hour after RA treatment, and no difference was found at the 42nd hour. Compared with the control group, the expression of Vangl2 protein in the RA treated group decreased (P≤0.05) at the 18th and 42nd hour, and increased (P≤0.05) at the 90th hour after RA treatment, no difference was found at the 66th hour. Conclusion Excessive RA may interfere with the normal embryonic neural tube closure by regulating the expression of Dishevelled2 and Vangl2.

Objective To investigate the clinical value of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and red blood cell distribution width in discriminating disease activity of rheumatoid athritis.Methods Eighty-nine rheumatoid arthritis out-patients of the Affiliated Hospital of Jiangsu University from Jan.2012 to Mar.2013 were recruited into this study.The disease activity index,such as swollen joint count and tender joint count were made by rheumatologists,and laboratory parameters（blood cell analysis,erythrocyte sedimentation rate and C-reactive protein) were measured as well.The enrolled patients were divided into the active RA group and remission RA group based on the DAS28 definition.Differences of NLR,PLR and RDW among groups were analyzed by t test and relations between variables were assessed by Spearman correlation analysis.The t test,non-parametric test and Spearman analysis were used for statistical analysis.Results The levels of NLR (3.2±2.0,2.4±0.9,respectively) and PLR (167±70,133±43,respectively) in active RA group were higher than that of the RA remission group (t=2.28 and 2.50,P=0.02 and 0.01).The level of RDW [(13.9±2.5)％,(13.9±2.4)％,respectively] was not significantly different between the active RA group and the RA remission group (t=0.14,P=0.89).However,compared with healthy controls,the level of RDW [(13.9±2.5)％,(13.2±0.2)％,respectively] was significantly increased in RA patients (t=2.74,P=0.006 9).NLR and PLR were positively correlated with DAS28 (r=0.23,P=0.03;r=0.26,P=0.04,respectively),ESR (r=0.28,P=0.03;r=0.43,P＜0.01,respectively) and CRP (r=0.33,P=0.006;r=0.41,P＜0.01,respectively).However,there was no association between RDW and DAS28 (r=0.01,P=0.93),ESR (r=0.20,P=0.15) and CRP (r=0.05,P=0.71).Areas under curve of receiver operating characteristic (ROC) for assessing disease activity of rheumatoid athritis by NLR and PLR were 0.802 and 0.753 respectively.The cut-off values for discriminating active/remission RA were 2.86 and 143.05,with the sensitivity as 0.66 and 0.63,specificity as 0.72 and 0.65.Conclusion NLR and PLR are significantly associated with the disease activity of RA and can be useful to understand the activity state of the illness.

Objective To observe the protective effect of ulinastatin (UTI) on the intestinal barrier function of septic rats.Methods Septic rat model was established using Sprague-Dawley rats by cecal ligation and puncture (CLP) method.Thirty Sprague-Dawley rats were randomly divided into 3 groups (n =10 for each grop) : sham group, septic group and UTI group.All rats received intraperitoneal injections of 0.9％ saline (10 mL/kg) after and 8 h after surgery.In UTI group, UTI (10 × 104 U/kg in 10 mL/kg saline) was injected after and 8 h after surgery.Collect blood samples after 0, 8, 12 h after surgery to examine levels of procalcitonin (PCT), intestinal fatty acid binding protein (iFABP) and diamine oxidase (DAO) by enzyme-linked immunosorbent assay (ELISA) method.Rats were killed 12 h after surgery to collect intestine tissue samples.Pathological changes of intestine were observed under microscopy, and the expression of tight junction protein-1 (ZO-1) and occludin were analyzed by Western blot.Results In sham group, the mucosa structure was complete and the shape was normal, and villi stood neatly.In septic group, intestinal was expanded, intertinal mucosal was atrophic, villi were scanty.An inflammatory infiltrate with numerous nuetrophils was found in the mucosal.In UTI group, the level of severity was relatively slight.The relative optical density of Western blot images were decreased on ZO-1 and occludin in CLP and UTI groups, and decreased more in CLP group (F =43.15 and 52.23, P ＜ 0.05).At 0h after surgery, the plasma values of PCT, iFABP and DAO were similar in three groups (F =11.17, 22.45 and 13.58, P ＞ 0.05).At 8h and 12h after surgery, values of PCT, iFABP and DAO in septic and UTI groups were much higher than those in the sham group, and those in UTI group were also significantly higher than those in septic group (F8h=85.26, 44.59 and 101.47, F12h =59.44, 49.26 and 69.57, all P＜0.05).PCT, iFABP and DAO levels were first increased and then fell down in sham group, those in septic group were keeping increasing, and those in UTI group were first increased and then kept stable.Conclusion UTI shows protective effect to intestinal barrier function in rats with sepsis.

Objective:To observe the correlation among cardiac function ,inflammation factor and plasma testoster‐one level in aged male patients with chronic heart failure (CHF) .Methods :A total of 91 male CHF inpatients were selected from our hospital ,including 31 cases with NYHA cardiac function class Ⅱ ,30 cases with class Ⅲ and 30 ca‐ses with class Ⅳ .Another 40 corresponding male patients without CHF were regarded as non‐CHF control group . Plasma levels of testosterone ,interleukin (IL)‐6 ,tumor necrosis factor (TNF)–α and brain natriuretic peptide (BNP) and cardiac function were compared between two groups .Results:Compared with non‐CHF control group , there were significant reductions in plasma testosterone level , P<0. 05 or 0. 01 ,and they more reduced along with NYHA cardiac function class rose in all CHF subgroups ,P<0.05 or <0.01 .Correlation analysis indicated that tes‐tosterone level was inversely correlated with IL‐6 and TNF‐α levels (r= -0.244 , -0.322 , P<0.05 both) ,and positively correlated with LVEF (r=0.322 ,P=0.01) .Conclusion:In patients with chronic heart failure ,the poo‐rer cardiac function is ,the lower plasma testosterone level is .Testosterone level measurement contributes to judging disease degree and prognosis of patients with chronic heart failure .

Objective To observe the effect of Ulinastatin (UTI) on intestinal barrier function of elderly patients with sepsis in order to explore an optimized program of early treatment for such patients instituting a guidelines for clinical practice.Methods All selected patients randomly (ramdom number) divided into conventional treatment group (n =34) and UTI treatment group (n =34).Peripheral venous blood samples of elderly patients with sepsis were routinely taken at days 0,2,3,7 (D0,D2,D3,D7) after admission for detecting the changes of ptasma values of Intestinal fatty acid binding protein (IFABP),Diamine oxidase (DAO),and D-lactate (D-Lac).While patients' APACHE Ⅱscores,length of ICU stay and 28 d mortality also were recorded at the same time.Results At admission,there were no significant differences in patients' APACHE Ⅱscores,plasma values of IFABP,DAO and D-Lac between two groups (P ＞ 0.05).During the course of treatment,the patients' APACHE Ⅱscores,plasma values of IFABP,DAO and D-Lac were declining in both groups,while those declinations in UTI group showed significantly more prominent.Compared with conventional therapy group,IFABP level was significandy lower in UTI group (P ＜ 0.05),and the plasma values of DAO and D-Lac were significantly lower at D2 and D3 in UTI group (P ＜ 0.05),but not at D7 (P ＞ 0.05).The plasma levels of IFABP,DAO and D-Lac were positively associated with APACHE Ⅱscores,but not with length of ICU-stay (P ＞0.05).After treatment,28d mortality did not differ significantly between the two groups (P ＞0.05).Conclusions UTI has a protective effect on intestinal barrier function in elderly patients with sepsis.UTI can improve the prognosis of elderly patients with sepsis and reduce ICU stay,while has no significant effect on reducing 28 d mortality.

Objective To investigate the effects of trimetazidine on renal function in patients with shock.Methods A prospective randomized controlled double-blind study was conducted.128 patients with shock admitted to intensive care unit (ICU) of Guangzhou Red Cross Hospital from April 2011 to April 2013 were enrolled and randomly divided into control group and trimetazidine treatment group,each n＝64.All patients received anti-shock treatment,while the patients in trimetazidine group received trimetazidine treatment (20 mg orally,tid) for 7 days,and patients in control group received placebo (10 mL of sterile water for injection,tid) for 7 days.The urinary output,serum creatinine (SCr),blood urea nitrogen (BUN),cystatin C,and creatinine clearance (CCr) reflecting renal function were recorded in both groups,and the values were compared before treatment,48 hours after treatment,and 1 week after the treatment.At the same time,dynamic mean arterial pressure (MAP) was monitored,and 48-hour and 1-week mortality rates were recorded.Results There was no significant difference in results in all the renal function parameters before the treatment between two groups.The levels of SCr,BUN,cystatin C were gradually decreased after treatment in both groups,but CCr and MAP were gradually increased.Compared with the control group,cystatin C at 48 hours after treatment was significantly decreased,while CCr was significantly increased in treatment group [cystatin C (mg/L):0.85 ± 0.81 vs.1.01 ± 0.91,t=2.562,P=0.017; CCr (mL/s):0.93 ± 0.64 vs.0.69 ± 0.40,t=2.155,P=0.033].SCr and BUN at 1 week after treatment were significantly decreased in treatment group [SCr (lμmol/L):94.23 ± 88.31 vs.104.99 ± 98.37,t=2.921,P=0.003 ; BUN (mmol/L):9.46 ± 8.24 vs.11.87 ± 8.65,t=2.611,P=0.010].Urine output per hour and MAP was improved after treatment in both groups,and no significant difference was found between treatment group and control group [urine output (mL):48 hours after treatment 55.67 ± 31.43 vs.45.34 ± 11.79,t =0.934,P=0.323 ; 1 week after treatment 71.67 ± 37.23 vs.75.35 ± 22.88,t=1.280,P=0.210; MAP (mmHg,1 mmHg=0.133 kPa):48 hours after treatment 72.13 ± 33.24 vs.69.28 ± 39.98,t=1.408,P=0.179; 1 week after treatment 71.44 ± 21.98 vs.72.32 ± 31.11,t =1.184,P =0.252].Mortality rate in treatment group was lowered compared with control group,however no statistical significance was found [48 hours after treatment:31.2％ (20/64) vs.32.8％ (21/64),x2=0.084,P=0.785; 1 week after treatment:32.8％ (21/64) vs.35.9％ (23/64),x2=2.084,P=0.173].Conclusions Trimetazidine can improve renal function in patients with shock.

Objective To discuss the effectiveness of implementation of blending learning in teaching of Fundamental of Nursing.Methods 234 nursing undergraduates were divided into the experimental group and the control group.The experimental group adopted blending learning method,while the control group used traditional teaching method.The final term exam and technical test results were compared between two groups.Results Students' practice scores in the experimental group were higher than those of the control group.In the experimental group,about 90.2％ undergraduates accessed learning resources through online teaching platform,82.4％ students considered that their nursing skills improved and 78.4％ students thought that their self-learning capacity strengthened.Conclusions Blending learning gives students a potential time,environment and recourse to learn.By integrating in-class and after-class studying,undergraduates' self-learning ability and nursing skills improved.