Objective To study the relationship between the co‐expression levels of inducible costimulatory molecule (ICOS)and CD28 on peripheral blood CD4+ and CD8+ T cells and Behcet’s disease(BD).Methods Flow cytometry was used to detect the expression levels of ICOS and CD28 on peripheral blood CD4+ and CD8+ T cells of BD patients(n=22) ,including those with active BD(ABD ,n= 14)and stable BD(SBD ,n= 8) ,and of normal subjects(n= 22).Results The proportion of CD28+ ICOS+ CD4+ T cells was significantly increased in ABD patients when compared with normal subjects [(34.72 ± 12.87)% vs.(25.36 ± 8.24)% ,P<0.05].No significant difference was found in the proportion of CD28+ ICOS+ CD8+ T cells [(9.32 ± 4.57)% vs.(7.24 ± 3.36)% ,P>0.05]between the two groups.The proportions of CD28-ICOS+ CD4+ T cells and CD28-ICOS+CD8+ T cells were both obviously increased in ABD patients when compared with those in normal subjects[(2.54 ± 1.63)% vs.(0.76 ± 0.25)% for CD28- ICOS+ CD4+ T cells ,P< 0.05;(8.79 ± 3.41)% vs.(3.04 ± 1.25)% for CD28-ICOS+CD8+ T cells ,P<0.05].Conclusion The increased expression level of ICOS on peripheral blood CD4+ and CD8+ T cells is not closely associated with the expression of CD28 to some extent in BD patients ,suggesting that cells expressing only ICOS play an important role in the development of BD.

Objective To study the clinical application of self-expanding nitinol stent in benign and malignant esophageal obstruction as well as in postoperative anastomotic stenosis and anastomotic leakage. Methods 22 cases of benign or malignant esophageal stenosis were treated by placing metallic stents inserted into the stenosis segment through per-oral intubation under the fluoroscopic guidance. Results The degreee of dysphagia was improved, Stooler′s staging of dysphagia was down from 3.1 preoperatively to 1.2 postoperatively. 2 cases of anastomotic leakage and 1 case of esophagorespiratory fistula were cured. All have been followed up for one to twelve months. 3 cases died with carcinoma cachexia and one succumbed to severe hemorrahage of digestive tract. The other 18 cases are still followed up. Conclusions Placement of esophageal expandable stent is one of the ideal methods to treat benign and malignant esophageal stenosis and anastomotic leakage. It can also play an important role in the improvement of the patients' life quality and prolongation of life.

Topical photodynamic therapy (PDT),a highly effective,safe and non-invasive therapeutic method,exerts good therapeutic effects on various diseases in dermatology,such as actinic keratosis,condyloma acuminatum,acne,and so on.The major drawback of PDT is pain during the treatment.Some patients have to interrupt or terminate the treatment because of pain intolerance.Some progress has been made in the management of PDT-related pain.It has been revealed that multiple factors are associated with PDT-related pain,including individual factors,lesion characteristics,therapeutic parameters (such as light sources,photosensitizers).Many methods can be used to manage PDT-related pain,including local cooling,oral analgesics,two-step irradiance protocol,topical anesthesia,injection anesthesia,inhalation anesthesia,transcutaneous electric nerve stimulation,hypnosis.

Objective To explore the effect of 3-month-exposure to high altitude(4400 m) on military cognitive func-tion.Methods Using pre-post paired t-testdesign, thirty-seven male recruits were enrolled , eight cognitive function variables, including reaction time, speed-perception, time-perception, operating-dexterity, memory span, depth-percep-tion, short-term memory and attention span , were analyzed by paired comparison .Results After 3-month-exposure to 4400 m high altitude, movement time (P<0.05) was shortened, speed-perception became more accurate (P<0.05),memory span and short-term memory both declined slightly(P<0.05), and the errors in depth perception deteriorated (P<0.05). Moreover , the depth-perception was more prone to′see close′.Conclusion During the 3-month-exposure to higher altitude environments , many of the cognitive functions of soldiers may be damaged to different extents , and the negative effect on re-action and movement time , depth-perception and memory is more remarkable .

Objective To study the effects of short hairpin RNA (shRNA) targeting STAT3 gene on the proliferation and apoptosis of A375 human malignant melanoma cells.Methods Sense and antisense oligonucleotides with small hairpin structures targeting STAT3 gene were designed,synthesized and cloned into the plasmid vector psiRNA-hHlneo after annealing.Cultured A375 cells were divided into 3 groups: control group receiving no treatment,psiRNA-H1 group transfected with empty plasmid,and psiRNA-H1/STAT3 group transfected with the recombinant plasmid containing the shRNA.After additional culture for different durations,reverse transcription PCR and Western blot were performed to detect the expression of STAT3 mRNA and protein,methyl thiazolyl tetrazolium (MTT) assay to evaluate cell proliferation,flow cytometry to assess cell cycle and apoptosis.Results The expression level of STAT3 mRNA and protein in A375 cells in psiRNA-H1/STAT3 group (0.2136 ± 0.0626,0.8214 ± 0.043,respectively) were significantly lower than that in the control group (0.7826 ± 0.0701,3.1693 ± 0.0846,respectively,both P ＜ 0.01) and psiRNA-H1 group (0.8518 ± 0.0783,3.218 ± 0.078,respectively,both P ＜ 0.01 ).The inhibition rates of cell proliferation at 24,48 and 72 hours were 21.35％ ± 2.12％,32.52％ ± 2.64％ and 40.4％ ± 3.08％ respectively in psiRNA-H1/STAT3 group,statistically different from those in the control group (1.39％ ± 0.53％,3.05％ ± 1.16％,4.41％± 1.42％,respectively,all P ＜ 0.01) and psiRNA-H1 group (2.63％ ± 1.38％,5.84％ ± 2.47％,10.32％ ±2.48％,respectively,all P ＜ 0.01).Flow cytometry showed a statistical increase in cell apoptosis rate in psiRNA-H1/STAT3 group compared with the control and psiRNA-H1 group (81.06％ ± 2.10％ vs.26.28％ ±0.47％ and 27.31％ ± 1.05％,both P ＜ 0.01 ).The psiRNA-H1/STAT3 group exhibited a higher percentage of cells at G0/G1 phase (68.43％ ± 4.00％) but a lower percentage of cells at S phase (17.4％ ± 2.05％) compared with the control group (60.07％ ± 2.47％,P ＜ 0.05; 28.40％ ± 2.09％,P ＜ 0.01 ) and psiRNA-H1 group (60.29％ ± 2.26％,27.34％ ± 3.63％,both P ＜ 0.05 ).Conclusions The small interference RNA targeting STAT3 gene can specifically down-regulate the expressions of STAT3 mRNA and proteins in,inhibit cellular proliferation of,and induce apoptosis in,A375 cells.

Objective To evaluate clinical efficacy of multiple regimen combination in treatment of osteoporosis of perimenopausal or postmenopausal women. Methods From Jul. 2008 to Dec. 2009, 109 women with low bone mineral density (BMD) or osteoporosis treated in Department of Obstetrics and Gynecology, Affiliated Second Hospital, Wenzhou Medical College were enrolled randomly into 3 group,including 36 women in Group A managed by osteoform 1000 mg/d + alfacalcidol 0. 25 μg/bid orally, 40 women in group B managed by osteoform 1000 mg/d + alfacalcidol 0. 25 μg/bid + tibolone 1.25 mg/d orally and 33 women in group C managed by ostcoform 1000 mg/d + alfacalcidol 0. 25 μg/bid +bisphosphonates 70 mg/w orally. After 48 weeks BMD on lumbar 1 -4 (L1-4) and left femur were detected by X-ray. Bone alkaline phosphatase(BALP) ,cross linked clelopeptide of type Ⅰ collagen(CTX) and 25-hydroxychole calciferol [25 (OH) D3] was measured by enzyme linked immunosorbent assay (ELISA).Result Seven women (6. 4%, 7/109) were withdrawed form this study, including 2 cases losing follow up in group A, 3 cases stopping treatment in group B, 2 cases giving up treatment due to severe adverse effect (burning in upper abdomen) in group C. (1) Pain relieve: after 48 weeks treatment, women in 3 groups improved symptom of pain significantly, the rates of pain relieve were 85% (29/34)in group A, 92% (34/37) in group B and 94% (29/31) in group C. (2) BMD: BMD was improved significantly in women in 3 groups after treatment. BMD of L1-4 were (0.88±0.15) g/cm2 in group A,(0.89±0.18) g/cm2 in group B and (0.87±0.10) g/cm2 in group C before treatment, and converted to (0.90±0.01) g/cm2 in group A, (0.93±0.09) g/cm2 in group B and (0.91±0.11) g/cm2 in group C after treatment. BMD of left femur were (0.87±0.07) g/cm2 in group A, (0.87±0.07) g/cm2 in group B and (0.85±0. 12) g/cm2 in group C before treatment and converted to (0.90± 0.03) g/cm2 in group A, (0.91±0.08) g/cm2 in group B and (0.89 ±0.12) g/cm2 in group C after treatment. It was shown significantly different BMD between group B or C and group A (P < 0. 01), however, there was no significant different BMD between group B and C (P >0. 05). (3) Index of bone metabolism: BALP were (26±6) μg/L in group A, (26±9) μg/L in group B and (28±7) μg/L in group C before treatment and converted to (22±5) μg/L in group A, (20±9)μg/L in group B and (22±8)μg/L in group C after treatment, which showed statistical difference (P < 0.05). CTX were (0.85±0.20) ng/L in group A, (0.84±0.47) ng/L in group B, and (0. 88 ±0. 11) ng/L in group C before treatment and converted to (0. 81 ±0. 19) ng/L in group A, (0. 77±0.33) ng/L in group B, and (0.82 ±0. 14) ng/L in group C after treatment, which showed statistical difference (P < 0. 05). Conclusions Those 3 regimens combination could be used in treatment of osteoporosis by decreasing bone conversion, increasing bone density, decreasing bone absorption. Regimen A was only suitable for basic therapy,the other two regimens could provide better treatment.

Objective To study the relationship between the mutation of the inverted repeat (IR) gene in the multiple transferable resistant (mtr) system and multiple antibiotic resistance of Neisseria gonorrhoeae. Methods The antimicrobial susceptibilities of isolated strains were tested. An agar plate dilution method was used to determine the minimum inhibitory concentrations. The target genes were amplified by PCR and subjected to sequencing. Results No mutation was found in the IR gene of either of 2 sensitive or 5 penicillin-resistant Neisseria gonorrhoeas strains. Among the 17 multiple-antibiotic-resistant strains, a strain with both azithromycin- and penicillin-resistance had T/A and T/A insertions, and another had A/T deletion. Conclusion Mutations in the IR gene of the mtr system of Neisseria gonorrhoeae might result in multiple antibiotic resistance.

Objective To investigate the effect of cold atmospheric plasma (CAP) on the healing of skin ulcers using Balb/c mice. Methods Wounds with a diameter 6 mm were created on each side of the backs of BalB/c mice ( n = 150) using a punch bioptome. The mice were assigned randomly into a control group ( wounds healed naturally), a laser group (wounds treated with a He-Ne laser for 10 min daily) and a CAP group (wounds treated with CAP for 10 min daily). Wound healing was evaluated on postoperative days (PODs) 4, 7, 10 and 14 in terms of percent wound closure. Ten mice per group were sacrificed on each of the evaluation days. Both wounds were removed and a histological examination was conducted. A scoring system was used to evaluate the wounds. The expression of vascular endothelial growth factors (VEGFs) in the wounded tissue was detected by using immunohistochemical methods on POD 7. The results were quantified using an HPIAS-1000 system. Results Compared with the control group, the average percentage of wound healing was significantly greater in the CAP group on PODs 7 and 10. The average scores on the histological examination were significantly higher in the CAP group on PODs 7, 10 and 14. Compared with the other two groups, the expression of VEGF was up-regulated significantly in the CAP group.Conclusions CAP can positively affect the wound healing process. This might be related to the up-regulation of VEGF in the wounded tissues.

In clinical practice, the teachers should lead students to integrate the basic medical and clinical medical knowledge, and promote their comprehensive ability. Taking the department of gynaecology as an example, we learn from the analysis of specific practice that teachers need to pay attention to the reasonable conversion between doctors and teachers, strengthen their own basic medical knowledge reserves and teaching ability, strengthen the experience exchange with the teachers who teach basic course and give students clear interpretation of the relevant basic medical knowledge, pro-mote students to converse from basic medical skills to clinical skills, from theory to practical skills, and enable students to adapt to the role of interns as soon as possible.

Objective To observe the effect of Shengmai Injection (a Chinese herbal medicine preparation) on the serum levels of TNF-α used as indicators of organ function in post cardiopulmonary resuscitation rabbits.Methods Rabbit cardiac arrest model was made with asphyxia by clamping the trachea of rabbit.A total of 30 rabbits were randomly (random number) divided into two groups,namely the normal saline group (n =15) and the Shengmai injection group (n =15).Rabbits in Shengmai injection group were injected with 2 ml/kg Shengmai Injection immediately at the beginning of cardiopulmonary resuscitation (CPR),and the same dose of Shengmai injection given 10 min after CPR.Rabbits in saline group were injected with the same volume of physiological saline instead at the same intervals as previous group.The rate of restoration of spontaneous circulation (ROSC) and survival rates at 6,12,24 and 48 h after ROSC were observed.The serum levels of TNF-α were measured by enzyme-linked immunosorbent assay (ELISA).Biochemical methods were used to detect myocardial MB-isoenzyme of creatine kinase (CK-MB),alanine aminotransferase (ALT),creatinine (Cr),glucose (Glu) and arterial partial pressure of oxygen (PaO2) before resuscitation and 12,24 and 48 h after ROSC simultaneously in the two groups.Results There was no statistically significant difference in the ROSC rate and survival rate after resuscitation between the two groups (P ＞ 0.05).Before asphyxia,there was no significant difference in the level of TNF-α found between the two groups (P ＞ 0.05),but at 12,24 and 48 h after ROSC,the levels of TNF-α in Shengmai group were much lower than those in Saline group (P ＜ 0.05).At 24 h after ROSC,the levels of serum CK-MB,ALT,and Cr in Shengmai group were much lower than those in Saline group (P ＜0.05).Furthermore,at 48 h after ROSC,the levels of CK-MB and ALT in Shengmai group were still lower than those in Saline group (P ＜ 0.05),but there was no significant difference in the level of Cr between the two groups (P ＞ 0.05).There was also no significant difference in the blood glucose and arterial partial pressure of oxygen between the two groups (P ＞ 0.05).Conclusions Shengmai Injection has significant inhibiting effect on the serum level of TNF-α in post cardiopulmonary resuscitation rabbits,and it also has more or less some degrees of protective effect on organ function of heart,liver and kidney in rabbits after ROSC.