Takayasu arteritis (TA) is a devastating vasculitis of the aorta and its major branches,coronary and pulmonary arteries.The clinical manifestations in children are less specific than in adnlts:the disease in children presents with fever,arthralgias,vomiting,weight loss and hypertension.Conventional angiography,which is recognized as the golden standard in evaluating vascular lesions in TA,combined with computer tomography angiography (CTA),magnetic resonance angiography (MRA),ultrasonography,could not only provide important information for early diagnosis,but also detect disease activity.New immunosuppressive agents and biological therapies,such as TNF-a blocking agents,have been verified to be effective although corticosteroids and conventional immunosuppressive agents are still basic treatment.

Objective To develop a score based on clinical symptoms and signs for evaluating the severity of obstructive sleep apnea syndrome (OSAHS). Methods A total of 158 OSAHS patients were enrolled. Five clinical features,including habitual snore,sleep apnea,daytime sleepiness,obesity and hypertension were used to arrive at a clinical score and its value to evaluate severity of OSAHS was determined. Results The clinical score of the two assessors was (7.94 ± 3.22) and (7.62 ± 3.08) scores respectively and a highly significant positive correlation was obtained (r = 0.97,P= 0.00). The clinical score of mild (43 cases ), moderate(47 cases ) and severe OSAHS ( 68 cases ) was ( 5.53 ± 2.25 ), ( 7.66 ± 2.05 ) and (9.29 ± 2.27) scores respectively,and there was significant difference among three groups (P = 0.00). The general clinical score of the two assessors was (7.78 ± 2.68) scores,the apnea-hypopnea index was 37.15 ±19.53,and there was a significant positive correlation between them (r = 0.70,P= 0.00). By analysis of ROC curves, the cut-off values of clinical score for differentiating moderate-severe OSAHS from mild OSAHS was 7 scores, and the sensitivity, specificity and accuracy was 83.5%, 74.4% and 80.4% respectively. Conclusion Clinical score,with good reliability,validity and high sccuracy,is a simple method to evaluate severity of OSAHS.

Objective To investigate the role of RhoA/Rho associated kinase-2 (RhoA/ROCK-2) in the development of pulmonary hypertension (PH) in patients with obstructive sleep apnea-hypopnea syndrome (OS-AHS). Methods Thirty patients diagnosed as OSAHS by polysomnograshy(PSG) test in our sleep laberatoty were recruited as the observation group, and fifteen healthy subjects matched in gender, age and body mass index (BMI) were recruited as the controls. Pulmonary arterial pressure was measured by echocardiography. Serum RhoA/ROCK-2 levels were measured. Results The level of PAP was (47.30±12.85)mm Hg in OSAHA patients complicated with PH, (22.31±3.07)mm Hg in OSAHA patients without PH, which were significantly higher than that in the controls (19.47±1.92) mm Hg (W=175.50, P < 0.05). The serum RhoA and ROCK-2 in OSAHA patients with-out PH (10.43±3.10 and 22.31±16.10 μ/L, respectively) were significantly higher those in the controls (2.94±1.20)μg/L and (6.04±0.28)μg/L, respectively) (W=120.00, W= 121.00, respectively, P<0.05), whereas significantly lower than that in OSAHA patients complicated with PH(14.85±8.49)μg/L, (36.81±12.69) μg/L, respectively) (H =29.172, H =30.242, respectively, P <0.05). There was a positive correlation between PAP and AHI in patients with OSAHS, whether complicated with PH or not(r_s=0.793, r_s=0.887,P <0.05), and there was a negative correlation between PAP and LSaO2 in patients with OSAHS (r_s=-0. 562,r_s = -0.751, P <0.05). There were positive correlations between the level of RboA/ROCK-2 and PAP in patients with OSAHS(r_s = 0.793,r_s = 0.887,P < 0.05). Finally, there was a positive correlation between the level of RhoA and ROCK-2 in patients with OSAHS (r_s = 1.000,r_s = 1.000,P < 0.05). Conclusions OSAHS is an inde-pendent risk factor for pulmonary hypertension. The levels of serum RhoA/ROCK-2 in OSAHS patients with PH were increased in the development of the disease. It may play an important role in the process of pulmonary hyper-tension in patients with OSAHS.

Objective To study the effect of inducible nitric oxide synthase(iNOS)on the occurrence of ischemic cerebral stroke in passive smoking female.Methods 100 passive smoking female patients with ischemic cerebral stroke(passive smoking group) according to the passive smoking index were divided into sub-groups index 900;25 cases in each group.The level of serum iNOS and the situation of carotid atherosclerosis were detected.The resules were compared with healthy female who without smoking and passive smoking(normal control group).Results Compared with the normal control group,the levels of serum iNOS,the intimal media thickness(IMT)s of carotid artery and the positive rates of carotid atherosclerosis plaque in each passive smoking index sub-group were significantly increased(all P

Objective To explore the teaching effect ofOrgan-system-based curriculum in-tegrated model on clinical graduation field work. Method 150 clinical medical undergraduates of Grade 2009 from Shenyang Medical College selected, were randomly divided into the experimental group (75 persons) and the control group (75 persons). The experimental group adopted the means of the Organ-system-based curriculum integrated model, namely practicing according to human organ-system and the control group accepted the traditional pattern of discipline centered practice during the clinical graduation internship. The two groups of students carried out questionnaire survey and comprehend examinations when the practice ended, and then statistics analysis (the chi square test, t test) was done by the SPSS 19.0 software between the two groups in order to explore the teaching effect. Result The students' satisfaction degree from six aspects of the questionnaire survey showed in the experimental group was significantly higher than that in the control group (the degree of recognition of practicing pattern: χ2=11.437, P=0.003; the architectonic integrality: χ2=9.881, P=0.007; the im-provement of the autonomic learning ability χ2=9.643, P=0.008; the teaching method and means: χ2=11.006, P=0.004; motivating learning interest: χ2=13.550, P=0.001; increasing the ability of clinical thinking: χ2=13.309, P=0.001), and the average test scores of students from three parts of examination results showed by comprehend examinations (speculative knowledge examination: t=2.768, P=0.006;technical skill examination: t=2.212, P=0.029; clinical capability examination: t=5.015, P=0.000) in the experimental group was obviously higher than that in the control group and the difference was sig-nificant. Conclusion Organ-system-based curriculum integrated model on clinical graduation in-ternship is generally approved by the students, which has significantly improved the students' clinical thinking ability, and the quality of graduation internship teaching.

Objective To investigate the current status and the related influencing factors of humanistic care quality of nurses in department of aged homes in Guangzhou,for the future to carry out humanistic care education,and provide a reference for improving humanistic care quality of nurses.Methods 270 nurses from 8 department of aged homes in Guangzhou were investigated by convenience sampling and evaluation table on humanistic care quality of nurses.The affected factors were analyzed by multiple stepwise regression.Results The aggregate score of humanistic care quality of nurses in this study was (113.59±9.78),which was lower than the reference score (118.36±16.75) of humanistic care quality of nurses of some general hospitals in Shanghai in 2010,offered by Liu Yuxiao,the designer of the evaluation table.The scores were correlated with 4 impact factors including home,politics status,care index of colleagues,whether to accept the education and training of humanistic care;multiple stepwise regression analysis indicated that care index of colleagues and whether to accept the education and training of humanistic care were the main factors.Conclusions Humanistic care quality of nurses in department of aged homes in Guangzhou was in lower level,and especially caring ability and the attitude towards caring.Department of aged homes should cooperate with universities,to establish a set of training courses on humanistic care quality of nurses in department of aged homes.Through the systematic,standardized training,to improve humanistic care quality of nurses and the quality of nursing service.

Objective:To summarize the complications' prevention and nursing experience for patients after autologous transplantation of the microvascular submandibular gland for severe keratoconjunctivis sicca.Methods:Retrospective analysis of 141 patients(151 sides) after autologous microvascular submandibular gland transfer operation was undertaken to record the timing and incidence of major complications and to summarize the nursing experience.Results: The main complications after the transplantation were: vascular crisis,catheter obstruction,salivary fistula and temporary paralysis of hypoglossal nerve.Related nursing measures in response to these complications were discussed.Conclusion:Targeted nur-sing interventions for patients with autologous transplantation the submandibular gland have a positive effect on the prevention of the surgical complications.

Objective To investigate the effects of endovascular cooling in different degrees on severe traumatic brain injury in dogs.Methods Eighteen dogs of both sexes,weighing 12-15 kg,were randomly divided into 3 groups ( n =6 each):hypothermia at 31 ℃ group (group A),hypothermia at 35 ℃ group (group B) and normothermia group (group C).The model of severe traumatic brain injury was established according to the improved Feeney's free-fall method.Six hours of endovascular cooling was performed using an endovascular cooling system in A and B groups.The cerebrospinal fluid (CSF) was collected before traumatic brain injury (T0),and at 24,48 and 72 h after traumatic brain injury (T1-3) for measurement of the concentrations of neuron-specific enolase (NSE),S-100β,myelin basic protein (MBP),aspartate (Asp),glutamie acid (Glu),glycine ( G ly) and gammaaminobutyric acid (GABA).Results The concentrations of NSE,S-100β,MBP,Asp,Glu and Gly in CSF were significantly lower at T1-3,while the concentration of GABA in CSF was significantly higher at T1-3 in groups A and B than in group C (P ＜0.05 or 0.01).The concentrations of NSE,Asp,Glu and Gly in CSF were significantly lower at T1-3,while the concentration of GABA in CSF was significantly higher at T1-3 in group B than in group A ( P ＜0.05 or 0.01).Conclusion Endovascular cooling can reduce severe traumatic brain injury in dogs,and the efficacy is better when the temperature is reduced to 35 ℃ than that when reduced to 31 ℃.

Objective To evaluate the effect and safety of tiotropium plus sustained-release theophylline in treating stable moderate chronic obstructive pulmonary diseases (COPD) . Methods A randomized clinical trail was conducted in 80 patients with stable moderate COPD, who were admitted to our hospital from March 2008 to December 2009. All patients were divided into two groups randomly and accepted tiotropium (groupⅠ ,n =40) or tiotropium plus sustained-release theophylline (group Ⅱ ,n =40) treatment for 12 weeks. Results Seventy patients completed the study,in which 36 cases had tiotropium alone and 34 cases had combination therapy. At the end of treatment, no statistically significant difference was found between the two groups in the comparisons of FEV1, FEV1%, FVC, FEV1/FVC, activity score and impacts score of the St George's Respiratory Questionnaire (SGRQ) (Ps > 0. 05). While the symptoms score (53.08 ± 12.25 vs.59.39±9.74,t=2.39,P<0.05) and total score (23. 91 ±2. 57 vs. 25. 27 ±2.14, t =2.40, P <0.05) of SGRQ were significantly lower in group Ⅱ compared to group Ⅰ. Six adverse events,including dry mouth (n =4), palpitation (re = 1) , constipation (n = 1), were observed in tiotropium alone group during the treatment period. Eleven adverse events were observed in combination treatment group, including dry mouth (re = 3) ,stomach discomfort or nausea (n = 3), diarrhea (re = 2) , palpitation (n = 2), constipation (n = 1) . The incidences of adverse reactions of two groups had no significant difference (P > 0. 05). Conclusion Compared with the single application of tiotropium, tiotropium plus sustained-release theophylline therapy can alleviate symptoms and improve life quality in patients with stable moderate COPD,without significantly increasing adverse reactions.

BACKGROUND: The transcription factor Runx2 is the key factor that regulates osteogenic differention and bone development. It has been reported that the C2C12 mesenchymal cells can be induced to differentiate into osteoblasts by Runx2 overexpression, but the molecular mechanism of induction is stil largely unclear. OBJECTIVE: To investigate the role of the members of the miR-376 family during Runx2-induced osteogenic differentiation in C2C12 cells. METHODS: The expression of the members of the miR-376 family was detected by real-time quantitative PCR at different time points using C2C12/Runx2Dox sub-line with conditional Runx2 expression. In miR-376b-3p-transfected C2C12/Runx2Dox cells, the expression of osteoblast markers, such as alkaline phosphatase and osteocalcin, was detected by real-time quantitative PCR, and the alkaline phosphatase activity was also examined by alkaline phosphatase staining. The putative miR-376b-3p targets were commonly predicted by online tools (miRanda, miRWalk and TargetScan). The functional classification of these putative targets was performed by DAVID Bioinformatics Resources database. RESULTS AND CONCLUSION: The expression of miR-376b-3p was significantly increased during Runx2-induced osteogenic differentiation of C2C12 cells, but the expression of other members was not changed. Transfection of miR-376b-3p mimic upregulated alkaline phosphatase expression, but had no effect on osteocalcin expression. The alkaline phosphatase activity was also increased by transfection of miR-376b-3p. The functional classification of miR-376b-3p putative targets showed that miR-376b-3p is involved in the skeleton development, indicating the role of miR-376b-3p in osteoblast differentiation. Taken together, these results suggest that Runx2 promotes early osteogenic differentiation in C2C12 cells by regulating the expression of genes related to osteogenic differentiation through upregulation of miR-376b-3p.