Objective To explore the relationship between cytogenetics with therapy and prognosis in myelodysplastic syndrome.Methods 124 cases of myelodysplastic syndrome from September 2005 to October 2009 were reviewed.124 cases contained 79 males and 45 females,aged 14 to 79 years,median age was 57 years old.26 cases were diagnosed as RA,13 cases as RAS,21 cases as RCMD,29 cases as RAEB-Ⅰ,35 cases as RAEB-Ⅱ.According to the karyotype,124 cases were divided into two groups,79 cases of normal karyotype and 45 cases of abnormal karyotype.Patients were followed up for three years in order to analyze the incidence of myelodysplastic syndrome changed into acute leukemia.Results In 39 patients diagnosed as RA and RAS,32 cases were with normal karyotype and 7 cases (17.9 ％) with abnormal karyotype.15 of 32 cases with normal karyotype achieved hematologic remission after treatment while only 1 of 7 cases with abnormal karyotype achieved remission.1 case with abnormal karyotype changed into acute leukemia after 2 years.In 85 patients diagnosed as RCMD,RAEB-Ⅰ and RAEB-Ⅱ.Difference of the lower incidences of RA and RAS changed into acute leukaemia during 3 years in normal karyotype and abnormal karyotype groups was statistically insignificant (P ＜ 0.05).The incidences of RCMD,RAEB-Ⅰ and RAEB-Ⅱ changed into acute leukemia were higher,especially in the abnormal karyotype group with 42.1 ％.Conclusion Myelodysplastic syndromea with abnormal karyotype is associated with poorer efficacy of therapy,higher incidence of changing into acute leukaemia.The patients can take early allogeneic hematopoietic stem cell transplantation to improve the prognosis.

AIM: To explore the expression changes of bone morphogenetic protein-7 (BMP-7) and its receptors (BMPR-Ⅱ, ALK-2, ALK-3, ALK-6) in the renal tubulo-interstitial lesions induced by unilateral ureteral obstruction (UUO). METHODS: Rats were divided into normal control, sham operation and UUO groups, and sacrificed at postoperative day 1, 3, 7 and 14. The mRNA levels of BMP-7, BMPR-Ⅱ, ALK-2, ALK-3 and ALK-6 were examined by RT-PCR. The protein expression site and level of BMP-7 was detected by immunohistochemistry staining. RESULTS: Compared to sham operation group, the mRNA levels of BMP-7, BMPR-Ⅱ, ALK-2 and ALK-3 were significantly decreased, but the change of ALK-6 mRNA was not marked in UUO rats. The reduction of mRNA expression levels of BMP-7, BMPR-Ⅱ, ALK-2 and ALK-3 in the kidney tissue aggravated along with the delayed post-operated days. The results of immunohistochemistry staining indicated that BMP-7 mainly expressed in renal tubular and interstitial, rarely in glomeruli. In UUO rats, the protein expression of BMP-7 decreased in varying degrees according to the post-operated days. CONCLUSION: The loss of BMP-7 and its receptors (BMPR-Ⅱ, ALK-2, ALK-3) were observed in the early phase of fibrotic process and this may play a very important role in mediating the renal tubulointerstital fibrosis.

Objective To explore ways for the supervision of department directors. Methods Job responsibility agreements with department directors were signed and a series of assessment standards were established. Results The methods adopted were standardized, individualized and easy to use. Conclusion Job responsibility agreements with department directors and a standard assessment system are currently effective measures for the supervision of department directors.

OBJECTIVE:To establish an analytical method for the determination of prednisolone and prednisolone-hemisuccinate in biological media METHODS:Using RP-HPLC,biological media were extracted with a mixture of n-pentane and methyl tert-butyl ether(2∶3) The mobile phase consisted of acetonitrile and trisodium citrate buffer (33∶67) The sample was eluted on C18 column and detected at 254nm RESULTS:The extraction recoveries of two drugs were over 80% and the RSDs of within-day and day-to-day were below 3% CONCLUSION:The method is simple,rapid,sensitive,accurate and good enough to be applied to the pharmacokinetic study of new preparation of prednisolone and can also be applied to other similar glucocorticoids

Objective To explore the role of bone morphorgenetic protein-7(BMP-7) in the renal tubulointerstitial lesions induced by unilateral ureteral obstruction (UUO).Methods After dividing into normal control, sham operation and unilateral ureteral obstruction (UUO) groups, sixty rats were sacrificed at postoperative day 1, 3, 7, 14. The levels of BMP-7 and TGF-?1 mRNA were examined by RT-PCR. The sites and levels of protein expression of BMP-7, TGF-?1 and ?-SMA were detected by immunohistochemistry staining. Results Compared to control groups, BMP-7 mRNA was significantly decreased, but TGF-?1 mRNA was significantly increased in UUO rats. Immunohistochemistry staining studies indicated that BMP-7 mainly expressed in renal tubule and interstitium, rarely in glomeruli. In UUO rats, the protein expression of BMP-7 decreased, but the expression of TGF-?1 and ?-SMA increased in varying degrees according to the obstructed days. The renal tubulointerstitial expression of BMP-7 was significantly negatively correlated with the expression of TGF-?1 and ?-SMA. Conclusion The loss of BMP-7 is explored in the early phase of fibrotic process and may play a very important role in mediating the tubulointerstital lesions.

Objective To explore the effect of self efficacy combined with mobile health information service applied in pulmonary rehabilitation in residence in elderly patients with chronic obstructive pulmonary disease. Methods Sixty-eight elderly patients in stable situation were divided into the control group and the intervention group with 34 cases in each group accoridng to the random digit table. In the control group, the nursing intervention included health education and telephone follow-up. The intervention group adopted self efficacy theory combined with mobile health information service. The items such as persistence in pulmonary rehabilitation, Exercise Self-Regulatory Efficacy Scale (Ex-SRES) and health condition were assessed. Results After intervention for 12 weeks, the scores of persistence in pulmonary rehabilitation in residence in the intervention group scored 5.35 ±1.42, which was higher than that in the control group (2.03±1.40), the difference was significant (t=160.43, P<0.01). Ex-SRES of the intervention group scored 62.06±13.10,91.21±11.12, which were higher than those of the control group, 50.38±18.03,42.56±18.23, the difference was significant (t=9.32,176.88, P<0.01) . The interaction between treatment effects and time effect was significant in COPD Assessment of Tool (CAT) and Ex-SRES respectively(F=489.95,P=0.00;F=134.80, P=0.00). Comparing value of CAT in baseline (24.97±4.74,24.62±5.39) and at the end of the twelfth week(24.94±4.74,24.65±5.35), the difference was not significant in two groups respectively(P>0.05). The improvement of CAT was significant at the end of the twenty-forth week (21.90±4.67) in the intervention group (t=-12.09, P<0.01). Conclusions Self efficacy theory and the application of mobile health information services can help patients persist in long-term rehabilitation exercise training.

Objective To investigate the effectiveness and safety of carotid stenting for progressive cerebral watershed infarction (PCWI) patients with ipsilateral internal carotid stenosis or occlusion during the progressive stage. Methods The clinical data of 23 PCWI patients with ipsilateral internal carotid stenosis or occlusion treated with carotid stenting during the progressive stage were analyzed retrospectively. Among them, 18 were severe internal carotid artery stenosis, and 5 were carotid artery occlusion. Carotid artery stenting were performed in patients with severe internal carotid artery stenosis. The first-stage angioplasty and second-stage stenting were performed in patients with internal carotid artery occlusion. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin scale (mRS) were used to evaluate preoperative and postoperative neurologic deficits. Results Twenty-two of 23 patients were stented successfuly, the Thrombolysis In Myocardial Infarction (TIMI) flow grade was 3, and the technical success rate was 95. 7% . None of the patients demonstrated hyperperfusion in the ipsilateral hemisphere. At day 30 postprocedure, the NHISS scores were significantly improved compared with before procedure (4. 41 ± 1. 88 vs. 10. 00 ± 1. 47; t = 11. 234, P < 0. 001). The preprocedural TIMI flow grade was 3 in 12 patients (52. 2% ). Proportion of patients with TIMI flow grade 3 after procedure was significantly increased compared with before procedure (95. 7% vs. 52. 2% ; χ2 = 11. 274, P = 0. 002). The proportion of patients with mRS scores 0-2 at day 90 after procedure was significantly increased compared with before procedure (69. 6% vs. 0% ; χ2 = 24. 533, P < 0. 001). Conclusions Carotid stenting during the progressive stage is safe and it may improve the prognosis in PCWI patients with ipsilateral internal carotid stenosis or occlusion.

Objective Onto investigate the significance of the pleth variability index (PVI) in predicting hypotension after epidural anesthesia for cesarean delivery. Methods Sixity seven pregnant women, with ASAⅠ~Ⅱ, aged 19 ~ 34 years, were enrolled for elective cesarean delivery. SBP, BDP, MAP, HR, PI and PVI were measured at 5 min after the parturients arrived in the operation room. SBP, BDP, MAP and HR were measured every 3 min after epidural anesthesia. According to the change rate of SDP or MAP was higher than 30% or not, the parturients were divided into two groups (the hypotension group and the non-hypotension group). Results No significant differences were found in parturients'age, body height, weight, BMI, gestational weeks, SDP, DBP, MAP and HR before anesthesia between two groups. The PVI in the hypotension group was significantly higher than that in the non-hypotension group (P<0.05). A receiver operator characteristic curve analysis showed the area under curve was 0.888 when PVI was used for boundary value. When PVI over 17.35 was used as the occurrence of hypotension, the sensitivity of PVI was 0.727, and specificity was 0.895. Conclusion PVI can be used to predict the occurrence of hypotension after epidural anesthesia for cesarean delivery.

The left lateral incisor with occlusal soreness of a 30-year old female was examined and treated.Radiographic examination re-vealed periradicular radiolucency around the apical and 3 canals.The 3 root canals were treated by root canal therapy,the tooth was restored by all-ceramic crown for the prevention of fracture.12 month follow-up showed that the treatment was effective.