Objective To investigate the clinical significance of the electrocardiogram (ECG) to cardiac involvements in Systemic lupus erythematosus (SLE). Methods 80 cases without sign and syndrome of cardiac involvements were analyzed retrospectively in our hospital between January 2004 and April 2009.Results In 80 cases without sign and syndrome of cardiac involvements, 46 cases had ECG changes,with the positive rate being 57.5% . In the next echocardiography examination, 39 cases had heart struction or function change,with the positive rate being 48.8% . Conclusion For SLE patients, ECG examinations can find the change,and in the next echocardiography examination, cardiac involvements degree can be sure. It can provid an early important information for diagnose and treatment.

Objective To discuss the role of p38MAPK signal pathway in the process of TWEAK inducing rheumatoid arthritis(RA) fibroblast-like synoviocyte(FLS) to synthesize MMP-9 and look for a new target for RA treatment. Methods RA FLS were primarily cultured and stimulated with TWEAK. Western blot was used to detect the expression of p-p38MAPK and p65 in RA FLS. FLS were pretreated by SB203580 or not. ELISA was used to detect the concentration of MMP-9 in cell-cultured fluid. The mRNA expression of MMP-9 was measured by RT-PCR. Results TWEAK( 100 ng/ml) can make p38MAPK phosphorylated and increased the expression of p65 protein in the cell nucleus. SB203580 can partially inhibit the expression of MMP-9 and MMP-9 mRNA produced by RA FLS which is induced by TWEAK. Conclusion TWEAK induced RA FLS to synthesize MMP-9, in that process, the p38MAPK signal trausduction pathway was in active state, and induced the expression of NF-κB.

Objective To study whether p38 mitogen-activated protein kinases (p38MAPK) signal pathway were activated in the process of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) which then induces rheumatoid arthritis (RA) fibroblast-like synoviocyte (FLS) to synthesize matrix metalloproteinase-1 (MMP-1) and look for the relative mechanisms of how TWEAK was involved in the destruction of articular bones and cartilage. Methods RA FLS were primarily cultured and stimulated with TWEAK. FLS were pretreated with SB203580 or not. ELISA was used to detect the concentration of MMP-1 in cell-cultured supernatant. Western blotting was used to detect the expression of p-p38MAPK and P65 in RA FLS. Results TWEAK (100 ng/ml) could induce RA FIS to synthesize MMP-1. SB203580 could partially inhibite the expression of MMP-1 producted by RA FLS which was induced by TWEAK. TWEAK could make p38MAPK phosphorylated and increase the expression of P65 protein in the cell nucleus. Conclusion TWEAK induces RA FLS to synthesize MMP-1. In this process, p38MAPK signal transduction pathway is activated and then induce the expression of NF-κB.

Objective To investigate the signal transduction pathway mechanisms of rats with liver fibrosis regulated by leptin and interfering effects of mistletoe alkali .Methods The hepatic fibrosis in rats model was established by injecting carbon tetrachloride .Forty-five SD rats were randomly divided into normal group ,model group and therapeutic group.All rats except rats in normal group were intraperitoneally injected with 40%carbon tetrachloride in peanut oil with a dose of 2.0 mL/100g according to the body weight twice a week for 8 weeks.Then, the therapeutic group was given mistletoe alkali (8g/(kg· d)) for 8 weeks via gastrogavage.Rats in normal and model group were served with distilled water at the same time.At the end of the 16th week, blood and tissue specimens were taken from all the rats .The influence of mistletoe alkali on liver morphology in liver fibrosis rat model was reviewed by HE and Masson staining .The effects of mistletoe alkali on the expression of Leptin and its receptor ( OB-Rb ) in HSC in fibrosis rat model were determined by immunohistochemistry (IH).The expression of JAK2, STAT3 and the activity of phospho -JAK2, phospho-STAT3 were detected by Western blotting analysis .Results The degree of fibrosis of the model group was more severe than the normal group and the treatment group , which suggested that mistletoe alkali can reverse liver fibrosis in rats . Immunohistochemical staining showed that mistletoe alkali reduced the hepatic expression of leptin and OB -Rb in rats with liver fibrosis in comparison with their expression in the model group .Compared with the normal group , the expression of JAK2 and STAT3 increased in the model group .However, the expression of JAK2 and STAT3 decreased in the medication groups compared with the model group .Conclusion Mistletoe alkali can effectively ameliorate liver fibrosis in rats possibly through inhibiting hepatic leptin and its receptor expressions , which through inhibiting hepatic leptin and its receptor expressions , thus inhibit the JAK2/STAT3 signaling pathway .

Objective To compare the effects of ephedrine and phenylephrine on hemodynamics in the patients undergoing surgery in prone position under general anesthesia.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-60 yr, with body mass index of 18.5-2:5.0 kg/m2, scheduled for elective posterior lumbar interbody fusion under general anesthesia, were randomized to ephedrine group (group E, n =30) or phenylephrine group (group P, n =30).When hypotension [decrease in systolic blood pressure (SBP) ＞20％ of the baseline value, T0] occurred in supine position, SBP, diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI) and central venous pressure (CVP) were recorded, and ephedrine 0.1 mg/kg (group E) or phenylephrine 1 μg/kg (group P) was injected via the central veins.The parameters mentioned above were recorded within 10 min after administration (T1-T10).Results Both ephedrine and phenylephrine could maintain the parameters of hemodynamics at the normal level.Compared with the baseline values at T0 , SBP, DBP, MAP and HR at T1-T10 and CO and CI at T2-T10 were significantly increased, and no significant change was found in CVP at each time point after administration in group E, and SBP and MAP at T1-T6, DBP at T1-T5, CVP at T2 and T3, and CO and CI at T1-T3 were significantly increased, and HR was decreased at T2 and T3 in group P.Compared with group P, SBP was significantly decreased at T1, and increased at T2-T10, DBP and MAP were decreased at T1, and increased at T3-T10, HR was increased at T1-T10, CO and CI were increased at T2-T10, and CVP was decreased at T1-T3 in group E.Conclusion Compared with phenylephrine, although ephedrine provides no significant effect on hemodynamics clinically, it can increase cardiac output to some extent in the patients undergoing surgery in prone position under general anesthesia.

Objective To study the effects of propofol used alone and in combined with opioids in gastroscopy,in order to select the more suitable anesthesia protocol.Methods A total of 285 pa-tients undergoing gastroscopy were selected in April ,201 5 in our hospital,including 105 males,180 females,ranging from 18 to 65 years old,weighing 40-90 kg,falling the category of ASA Ⅰ or Ⅱ. According to random number table,subjects were divided into four groups:dezocine group(group D, n =76),fentanyl group (group F,n =87),oxycodone group (group O,n = 71 )and control group (group C,n =5 1).Each group was implemented the corresponding anesthesia.SBP,DBP,HR,SpO 2 in baseline(T0 ),1(T1 ),3(T2 ),5(T3 )min after entering gastroscope were recorded.Choking cough, body movement,extra propofol,awakening time and inspecting time were observed.Results Among four groups,there was no statistical significance in age,gender,weight,blood pressure,heart rate and oxygen saturation and other general information.There were more cases given extra propofol in group C than in the other three groups (P <0.01 ).While for the experimental groups,there were more cases needing extra propofol in group O than in group D and group F (P < 0.01 ).The incidences of body movement and choking cough in group C were higher than those in the other three groups (P <0.01 ).Compared with the group C,dosage of propofol ,awakening time in the three groups,especially in group D,were much lower (P < 0.01 ).Conclusion Propofol in combination with opioids for sedation during painless gastroscopy can alleviate adverse reaction caused by propofol used alone.The more suitable anesthesia protocol is propofol with dezocine.

Objective To analyze implementation outcomes of the new health reform policy at a provincial hospital for the past six months.Methods Trend analysis,factor analysis and ratio analysis approaches were used in monthly surveillance,along with comparative study of the data before and after the reform,to probe into impacts of the new policy on hospital operations.Results Medical income increased by 22.09％,mainly contributed by volume growth (22.28％) of medical services; Medical income dropped by 0.16％ due to pricing policy factors; medicine proportion deceased by 4.84％; following the reform,the income per outpatient and inpatient increased by 12.32％ and 5.35％ respectively.Conclusion Following the drug zero profit policy and rise of the charging standards for medical treatment service at the hospital,the growth of total income mainly comes from growing volume of medical services instead of pricing policy factors.The new health reform is conducive to optimizing the hospital's income structure and raising value to doctors' technical service.

Objective:To investigate the specific interference of OX40 gene expression induced by RNAi technique in 293T cell lines transfected with rat OX40 gene.Methods:293T cells were transfected with recombined plasmid pEGFP-N1-GFP/OX40,and the positive cell clones were selected by fluorescence protein observation and RT-PCR.One specific dicer siRNA targeted to OX40 mRNA was designed and synthesized,which shared no homology with exons of known human gene.Quantitative real-time PCR was performed to measure the inhibitory rate of target gene expression by comparing OX40 mRNA concentrations before and after siRNA transfection.Results:10 nmol/L siRNA-OX40 elicited the highest level of gene silence in 293T cells which was transfected with siRNA after 48 h (68.3?8.7)%);The time of maximal inhibitory effect was at 48-72 h [(61.7?8.4)%,(39.6?5.6)%].Conclusion:The exogenous OX40 expression can be significantly inhibited by treatment with specific siRNA in a dose and time -dependent manner in 293T cells,which may provide a useful profile for further investigation of inhibition of OX40 protein,and a promising control approach for preventing immune reaction.

Background:The incidence of ulcerative colitis (UC)in developed countries is higher than that in developing countries,which may be related with westernized lifestyle,especially high animal protein and low complex carbohydrate diet. With the increased high fat and meat intake,synthesis and secretion of bile acid in liver is also increased,which may have an impact on the occurrence of UC. Aims:To investigate the expressions of farnesoid X receptor (FXR)and G protein-coupled bile acid receptor 5 (TGR5)in patients with UC. Methods:Thirty patients with active UC from January 2013 to June 2016 at the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled,and 30 healthy subjects were served as controls. Expressions of FXR and TGR5 were determined by immunohistochemistry. Results:Compared with control group,expression of FXR was significantly decreased in UC patients (4. 63 ± 2. 07 vs. 6. 91 ± 2. 62,P =0. 00),however,no significant difference in expression of TGR5 was found between the two groups (6. 70 ± 2. 90 vs. 6. 11 ± 2. 44,P = 0. 40). Expression of FXR was significantly increased in right hemicolon colitis than in left hemicolon colitis (P < 0. 05). Conclusions:There is a significant decrease in FXR in active UC patients,indicating that FXR may have some role in the pathogenesis of UC,however,TGR5 may have no obvious effect in the pathogenesis of UC.

Objective To explore the possible mechanism of action of telomerase in hepatic precancerous lesions, and the regulatory effect of a Chinese medicine prescription HU Qi Shan ( HQS) and its principal drug mistletoe alkali on the telomerase activity in rat liver tissues.Methods Rat model of hepatic precancerous lesions was established by Solt-Farber two-step protocol.The model rats were randomly divided into 5 groups, including the model group, high-dose HQS [8 g/(kg· d)] group, low-dose HQS [4 g/(kg· d)] group, and mistletoe alkali[8 mg/(kg· d)] group.γ-Glutamy-transpeptidase (γ-GT) was analyzed by immunohistochemistry.AFP was detected by immunofluorescence technique.The telomerase activity was detected using a quantitative telomerase detection kit.The expression of NF-κB P65 was detected by immunohistochemistry.The cytoplasmic protein IκB-αwas detected by western blotting.Results After treated with HQS and mistletoe alkali, the areas ofγ-GT-positive foci and number of AFP-positive cells in the liver tissus were significantly decreased than those of the model group ( P<0.05 for both) , the telomerase activity was decreased, the number of NF-κB P65-positive cells was also decreased ( P <0.05 ) , whereas the intracytoplasmic expression of IκB-αproteins was significantly increased ( P <0.05 ) .Conclusions HQS and mistletoe alkali can suppress the telomerase activity.Its possible mechanism may be through inhibition of the over-expressed apoptosis-related genes such as NF-κB P65 and increase the expression of IκB-αdecreasing the telomerase activity.