Objective To observe the effect of PDK ( phosphoinositol -3-kinase, PI3K)/Akt-Nrf2 (Nuclear factor -E2 related factor) signal pathway on γ-glutamylcysteine synthetase (γ-GCS) in the bronchial epithelial cells of rats treated with cigarette smoke extract (CSE). Methods The bronchial epithelial cells were dealt with 10% concentration of CSE for different time and pretreated with PI3k inhibitor (LY294002). The expressions of Nrf2,p-Akt and γ-GCS proteins were examined by immunocytochemistry, flow cytometry, immunofluorescence and western blot. The expressions of γ-GCS mRNA were detected by reverse transcription-polymerase chain reaction (RT-PCR). Reduced glutathione(GSH) content and the lev-el of γ-CCS activi-ty were examined. Results GSH content in CSElh group was significantly decreased, but still higher in CSE3 and 6 groups compared to the control. Nrf2 protein mainly located in the cytoplasm. Nrf2 plasmosin mainly increased in the nucleus in control group, and Nrf2 nucleic protein significantly enhanced in CSE1, 3 and 6 groups. P-Akt protein was up-regulated at lh, reached its peak at 3h, declined slightly at 6h after exposure to CSE. The tendency of the percentage of p-Akt positive cells was as same as p-Akt protein. γ-GCS mRNA, protein and activity, gradually increased in CSE lh, CSE 3h,CSE 6h groups. Pretreated with LY294002, the expression of p-Akt protein was markedly decreases, while Nrf2 plasmosin expressed strongly, and γ-GCS mRNA, protein, activity and GSH content were significantly decreased compared to CSE3h group. Linear correlation analysis demonstrated that there were a positive correlation among Nrf2 and γ-GCS,γ-GCS activity, and among p-Akt and Nrf2,GSH,γ-GCS,γ-GCS activity. Conclusion P13K/Akt signal path might participate in Nrf2 nuclear translocation via regulating the expression of γ-GCS.

Objective To study the differences in retinoic acid receptor γ(RARγ) mRNA expression levels in blood leukocytes between antipsychotic-free and antipsychotic-naive schizophrenic patients and healthy control,especially in different genders. Methods Forty-three acute schizophrenic patients who were antipsychotic-naive or antipsychotic-free for at least three months (male = 34, female = 9) and 39 age- and sex-matched healthy subjects (male =25 ,female = 14) were included for blood leukocytes expression of RAR γ mRNA ,using real-time PCR technique. Results Kolmogorov-Smirnov Z analysis showed a significant increase of RARγ mRNA (P =0.041) level in blood leukocytes of pooled schizophrenic patients(0. 027 ± 0. 003) than in the healthy subjects (0. 020 ± 0.002). The elevation was mainly found in the female patients (0. 030 ± 0.003). Within-sex analysis showed that the female schizophrenic patients showed a trend increase (P = 0. 166) of RAR γmRNA expression compared with the male patients (0. 026 ± 0. 001) and exhibited greater RARγ mRNA expression (P = 0. 014)when compared with the female healthy subjects(0. 018 ±0.004). Conclusions The present findings showed an abnormal expression of leukocyte RARγ mRNA level in antipsychotic-free and antipsychotic-naive schizophrenia especially in the female patients. Blood RARγ markers could add to the diagnosis and individualized pharmacotherapy of schizophrenic patients ,especially the female patients.

Objective To study the effects of taking clopidogrel on relevant indicators of platelet aggregation function in 138 cases acute coronary syndrome (ACS) .Methods The platelet function analyzer and flow cytometry were adopted to detect the ADP‐induced platelet aggregation rate ,P selectin and activated GP Ⅱ b/ Ⅲ before medication and on 7 d after taking clopidogrel . Results The platelet aggregation rate after taking clopidogrel for 7 continuous d was decreased significantly (P<0 .01);the P se‐lectin level and activated GP Ⅱ b/ Ⅲ a expressed on platelet surface were significantly reduced (P<0 .01) as well .Conclusion Taking clopidogrel could reduce the platelet aggregation significantly in the patients with ACS and has the effect for inhibiting the platelet aggregation .

Objective To evaluate the precision and accuracy of blood glucose meter(BGM ) for community home use testing . Methods According to the In Vitro Diagnostic Test Systems‐Requirements for Blood Glucose Monitoring Systems for Self‐Testing in Managing Diabetes Mellitus in DIN EN ISO15197 :2013 .Capillary blood and venous blood were tested by BGM and the laborato‐ry biochemical analyzer respectively .The measurement results of each BGM were compared with the results of the biochemical ana‐lyzer for conducting the bias analysis .Results In evaluated 20 BGM ,none of them met the requirements of ISO15197 :2013(when blood glucose concentrations < 5 .5 mmol/L ,the bias in 95% of detection results is within the range of ± 0 .83 mmol/L ;when blood glucose concentrations ≥ 5 .5 mmol/L ,the bias in 95% of detection results is within the range of ± 15% .Only 11 imported BGM (55% ) met the state standard .Conclusion The bias of 20 BGM ranged - 28 .7% - 3 .8% ,with the average bias of - 12 .2% . These detection results will bring the large risk of therapy in the diabetic patients .The regular and standardized evaluation of BGM performance may ensure the quality of blood glucose self - monitoring .

Objective To observe the curative effect of low molecular heparin for treating secondary high coagulation state in the patients with nephrotic syndrome(NS) .Methods Total 87 cases of NS in our hospital were divided into the conventional treat‐ment group (n=42) and the low molecular heparin treatment group (n=45) .The routine treatment group was given the prednisone treatment and the low molecular heparin treatment group was treated by low molecular heparin combined with prednisone .The re‐lated indicators of blood coagulation before and after treatment were detected and the clinical curative effects in two groups were an‐alyzed .Results The coagulation related indicators in the conventional treatment group had no statistically significant difference be‐tween before and after treatment (P>0 .05) ,the prothrombin time(PT) and activated partial thrombin time(APTT) after treat‐ment in the low molecular heparin treatment group were significantly extended compared with before treatment ,while the concen‐trations of D‐dimer and fibrinogen were significantly decreased and the concentration of antithrombin Ⅲ was markedly increased compared with before treatment ,showing statistically significant differences between the two groups (P<0 .05);the patients of the low molecular heparin group patients had no bleeding after treatment .Conclusion Low molecular heparin combined with predni‐sone can reduce the secondary high condensation state in NS without bleeding and has a significantly clinical effect .

Objective To develop a simple high-resolution melting ( HRM) analysis method for differentiation of Pc and P2 variants in class 1 integron.Methods DNA fragments containing Pc and P2 variants were amplified from plasmids pACW ( PcW ) and pACWP2 ( PcW-P2 ) respectively , then these purified PCR products and P 2 promoters were analyed full-length amplicon by HRM .Eight DNA fragments containing different Pc promoters were amplified and site-specific mutated from plasmids pACS ( PcS ) , pACH2 ( PcH2 ) , pACH1 ( PcH1 ) , pACW ( PcW ) , genomic DNA of Klebsiellar pneumonia HS07-68 (PcWTGN-10)and HS05-1792(PcH2TGN-10)respectively.The purified PCR products and eight Pc variants were characterized by HRM analyses of an unlabeled probe and full-length amplicon.This assay was applied to the differentiate Pc and P2 variants in 109 class 1 integrons from 95 urine clinical Escherichia coli isolates in Huashan Hospital during 2004 -2007.The differentiation results were compared with that determined by direct sequencing .Results P2 promoter with a significant higher melting temperature ( Tm ) can be identified by HRM analysis clearly .P2 promoters were identified in 2 class 1 integrons and consistent with direct sequencing results .Eight Pc variants were classified into three groups: PcS, PcSTGN-10 , PcW, PcWTGN-10, PcH1, PcH1TGN-10.Using direct HRM analysis.PcH2, PcH2TGN-10 were classified into four groups:PcS, PcH1, PcH2, PcW, PcSTGN-10 , PcH1TGN-10 , PcH2TGN-10 , PcWTGN-10 according to the melting curves of the unlabeled probe .Combined the HRM analyses of the whole amplicon and unlabeled probe , the eight Pc variants can be differentiated from each other .Five different Pc variants, PcS, PcW, PcH1, PcH2TGN-10 and PcWTGN-10 , were identified and consistent with direct sequencing results .Conclusions This developed a simple Pc and P 2 variants differentiation method via simultaneous HRM analyses of an unlabeled probe and full-length amplicon .This method is cost-effective and accurate , could be used in differentiation of Pc and P2 variants of class 1 integrons in clinical isolates .

A spurobenzopyran-based probe ( L) for the detectuon of Cu2+ and hydrazune was synthesuzed by usung 4-methyl-2, 6-duformylphenol and 1, 3, 3-trumethyl-2-methyleneundolune, and uts structure was characteruzed by 1 H NMR, 13 C NMR, FT-IR and H RMS( ESI-MS) . The recognutuon propertues of the probe L wuth nuneteen kunds of metral uons, eughteen kunds of anuon uons and nune kunds of amune compounds had been unvestugated un Trus-HCl ( pH = 7. 40 )-ethanol solutuon ( 1 ∶ 1, V/V ) by UV-Vus, fluorescence spectrophotometry, 1 H NMR tutratuon and MS. The results showed that the probe L exhubuted hugher selectuvuty and sensutuvuty towards Cu2+ and hydrazune over other unterferung objects un Trus-HCl ( pH=7. 40 )-ethanol solutuon(1∶1, V/V), and the color changes of L caused by Cu2+ and hydrazune could be observed by naked eyes. Thus, L could be loaded as test paper for detectung Cu2+ at μmol/L level un water solutuon by naked eyes. Notably, probe L could be used to detect hydrazune un luquud and gas state wuth dufferent concentratuons by detectung the color changes from readuly prepared TLC plates. On the basus of thus, the probe L was used un the determunatuon of Cu2+ un the water and drug samples wuth recoverues of 83. 5%-111. 0% and RSD of 4 . 0%. The results showed that thus probe L had potentual applucatuons un the monutorung of envuronmental pollutuon and the analysus of Cu2+ and hydrazune un drug.

Objective To construct and implement the training model of eight-year medical education with characteristics of Shanghai Jiaotong University. Methods Based on survey,discussion and consultation,the experiences of long schooling medical education in Shanghai Jiaotong University School of Medicine were summarized.Training plan and education reform scheme were established. Results Training objective,guideline and major reform measures had been clarified.The training plan and reform scheme were under process of implementation. Conclusion The training objective of eight-year medical education should be further confirmed.The curriculum should be in accordance with the training objective,and education reform is important and necessary for the eight-year medical education.

Objective To establish a new rat model of perinatal brain damage. Methods Wistar rats were randomized into 3 groups: lipopolysaccharide （LPS） plus hypoxia (H) group: 17 d pregnant rats exposure in utero to LPS followed by hypoxia; hypoxia (H)/ ischemia (I) group: postnatal day 7 (P7) pups ligated the right common carotid artery followed by exposure to hypoxia (8% O2 ) for 2 h; control group: P7 pups incised the anteriorl cervical skin only. The footprint analysis, compound muscle action potential (CMAP) and pathological observation were performed after 4 weeks. Results The left limb footprint repeatability of rat in HI and LPS plus H groups was poorer than that in control group （P<0.05）. The hindlimb quadriceps CMAP of rats in HI and LPS plus H groups showed that the wave amplitude was lower than that in control group （P<0.05）. The periventricular cells were irregular, and the periventricular leukomalacia was seen. The morphous of the neurocytes was irregular obviously, part of the nuclear membranes was broken down with the content leakage under transmission electron microscope. Conclusion The animal model for cerebral palsy has established, that mimics more the occurrence of this disease in human.

Background and purpose:Intensity-modulated radiotherapy(IMRT) can significantly improve the dosimetric distribution of both the target and organs at risk compared to tangential irradiation for whole breast. However,its optimized methods remain different and conflicting for many radiotherapy institutions.In order to achieve the optimized planning of IMRT for the irradiation of intact breast,we investigated different optimizing methods in three dimensional radiotherapy planning system.Methods:Ten patients with early-stage breast cancer after breast conserving surgery were eligible for the study.Two kinds of plans were performed on each patient in three-dimensional treatment planning system,inverse planning IMRT and forward planning IMRT which included 3 different optimizing methods as manual optimizing(MO),multiple points optimizing(PO) and automated inverse optimizing(AO).Various parameters were used to evaluate the efficacy of different IMRT plans.All plans were compared using dose volume histograms(DVH) for the planning target volume(PTV) and organs at risk(OARs).Results:For MO,PO,AO forward plans and inverse plans,median number of segments were 5,5.5,5 and 20 respectively,and mean total MU were 225.8, 228.4,226.4 and 345.8 MU,respectively.Comparing the different forward planning optimizations,the best target coverage and dose homogeneity of PTV was observed in AO plans(P(?)0.01),and PO and AO plans showed a better reduction of OARs exposure compared with MO plans(P(?)0.05).A further improvement of dose homogeneity in the PTV and better sparing of OARs was achieved using inverse planning(P(?)0.05).Conclusion:Forward planning IMRT with AO optimization for intact breast irradiation could provide both efficacy and dosimetric advantages better than others.The inverse IMRT plan showed more potential in improving the dosimetric outcomes.However,further studies are required for inverse optimizing plans.