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 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 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 explore the diagnostic value of prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-Dimer(DD),antithrombin Ⅲ(ATⅢ),platelet(PLT)in activity and severity assessment of ulcerative colitis(UC),and to analyze whether they could evaluate the degree of activity UC in children.Methods The data of UC patients in the Department of Gastroenterology,Children's Hospital of Nanjing Medical University from January 2012 to September 2016 were analyzed,25 cases of remission and 36 cases of active UC patients were selected as the study subjects.Thirty healthy children were selected as healthy control group,combined with the coagulation function indicators for analysis.Results Receiver operating characteristic area under the curve(AUC)of PT,APTT,FIB,DD,ATⅢ and PLT in UC patients was 0.659,0.840,0.744,0.776,0.599 and 0.792,the activity of UC patients was 0.849,0.889,0.836,0.912,0.964 and 0.966,respectively.The results of PT,APTT,FIB,DD and PLT in children with active UC were significantly higher than those in the healthy control group,and ATⅢ was significantly lower than that in the healthy control group.Compared with the healthy controls,the levels in remission UC patients were not significantly different(P>0.05).The 3 subgroups of activity UC had no significant differences among PT and APTT(F=0.652,1.755,all P>0.05),However,there were significant differences among FIB,DD,ATⅢ and PLT(F=66.495,32.817,88.284,22.892,all P<0.05).FIB,DD and PLT were moderately positively correlated with severity of activity UC patients(r=0.857,0.648,0.654,all P<0.05),and ATⅢ had moderately negative correlation(r=-0.789,P<0.05).Progressive regression analysis showed that the severity of UC was associated with FIB,DD and ATⅢ(R2=0.830,F=39.962,P<0.05).Conclusion FIB,DD and ATⅢ can be used as index for the activity and evaluation of UC.

Objective To study the changes of serum high-sensitivity C-reactive protein (ha-CRP) and depression in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),and investigate the relationship between them.Methods Thirty healthy volunteers (control group) and 54 OSAHS patients (OSAHS group) were recruited for the study.The level of serum hs-CRP was determined by scatter rate nephelometry,and the state of depression was assessed by self-rating depression scale (SDS).Results The level of serum hs-CRP and SDS score were higher in OSAHS group than those in control group [(48.8 ± 12.7) scores vs.(36.3 ± 6.3) scores,(3.3 ±0.7) mg/L vs.(1.4 ± 0.4) mg/L](P＜0.01).SDS score and the level of serum hs-CRPwere positively correlated to apnea-hypopnea index(AHI) (r = 0.636,0.628 ;P<0.01) and negatively related to the MSaO2 (r =-0.509,-0.614;P <0.01) and LSaO2 (r =-0.607,-0.512;P <0.01).The level of serum hs-CRP was positive correlation to SDS score (r = 0.536,P<0.01).SDS score was related to the AHI,the level of serum hs-CRP and LSaO2 in multiple linear regression(F= 33.31,P = 0.002).Conclusion Depression is correlated to AHI and the level of serum hs-CRP in patients with OSAHS.

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.

Objective To study the polysomnography(PSG) indexes which can reflex the severity of anoxia in obstructive sleep apnea-hypopnea syndrome(OSAHS) more comprehensively. Methods Sixtythree OSAHS patients' PSG indexes, including the apnea-hypopnea index (AHI), apnea time/total sleeping time (AM), hypoventilation time/total sleeping time (HM), mean oxygen saturation (MSaO2),the lowest oxygen saturation (LSaO2) and the longest apnea time (LAT) were analyzed retrospectively. Results In patients with OSAHS,the AHI was positively correlated with AM, HM and LAT(P ＜ 0.01 or ＜ 0.05 ), and was negatively correlated with MSaO2 and LSaO2(P ＜ 0.01 ). The AHI had linear regression relationship with AM,HM and LSaO2 (F =202.264,P ＜0.01). Conclusions Among the PSG indexes,AM is intimately associated with AHI. Therefore,compared with LSaO2,AM and HM can reflex the severity of anoxia in patients with OSAHS more accurately.

Objective:To explore the intervention effect of proteasome inhibitor MG132 in rats with collagen-induced arthritis(CIA),which resembles human rheumatoid arthritis(RA).Methods:Forty-eight female SD rats were randomly divided into three groups,including blank control group,CIA model group and MG132-treated group.There were sixteen rats in each group.Rats in CIA model group and MG132-treated model group were injected with type Ⅱ collagen to established CIA rats.21 days after the initial immunization,the rats in the MG132-treated model group were injected subcutaneously with 1 mg/kg MG132 once daily for 2 weeks.42 days after the initial immunization,the change of paw-swelling and the arthritis scores were determined.The synovial pathology examination was performed with HE staining.The 20S proteasome activity in synovial tissue was measured by fluorescence substrate assay.The expression of NF-κB/p65,IκBα in synovial tissue were analyzed by Western blot.Results:Proteasome inhibitor MG132 significantly attenuated the severity of arthritis and histopathological changes in CIA rats.Compared with the blank control group,the 20S proteasome activity was increased significantly in the CIA model group(P<0.05),and decreased after injection of MG132.Compared with CIA rats,the expression of NF-κB/p65 significantly decreased in rats treated with MG132(P<0.01).Compared with the blank control group,the expression of IκBα protein decreased in CIA model group.After injected with MG132,the protein was significantly increased(P<0.01).Conclusion:The proteasome inhibitor MG132 may attenuates the severity of arthritis and histopathological changes in CIA rats.These effects may be mediated through the inhibition of NF-κB activity.

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.