Objective To investigate effect of sorafenib on serum hepatoma marker in patients with advanced hepatocellular carcinoma. Methods 101 patients with advanced hepatocellular carcinoma were selected, and divided into two groups.50 cases in control group were treated with routine clinical treatment, and 51 cases in experimental group were treated with sorafenib on the basis of control group.The survival time, adverse reactions, VEGF, CTGF, HIF-1 and OPN levels were compared after the treatment.Results The survival time of experimental group was higher than control group (P<0.05).Compared with control group, the serum levels of VEGF、CTGF,HIF-1, OPN,AFP, CEA, and CA199 in experiment group were lower (P<0.05,P <0.01).There were no significant differences of total adverse reactions between experimental group and control group. Conclusion Sorafenib can effectively prolong survival time of patients with advanced hepatocellular carcinoma, reduce serum VEGF, CTGF, HIF-1 alpha and OPN levels.

Objective To improve the antenatal diagnosis of placental abruption by ultrasound. Methods A retrospective analysis was conducted on 33 placental abruption cases in our hospital between Jan. 1988 and Apr.2003. Results Among 33 cases, 28(84 8%) were found by ultrasound. There were more cases with anterior placental and severe abruption than posterior placenta and mild abruption without symptoms. The sonographic characteristics of placental abruption was dark and low echo area between placenta and uterine wall. Among these cases, mild and mixed echos were detected in 15 cases, partial thickened placenta 6 cases, protruding masses at the edge of placenta or under chorionic plate 8 cases(one case was misdiagnosed as chorioangioma). No signals of blood flow was shown the abruption area of placenta by color Doppler flow image. Conclusion Antenatal sonography has an important role in diagnosing placental abruption.

[ABSTRACT]AIM:ToexploretheeffectofretinoidXreceptor(RXR)agonistbexarotene(Bex)andvitaminD receptor (VDR) agonist calcitriol (Cal) on the expression of nuclear factor-kappa B (NF-κB) and the development of atherosclerosis in streptozotocin-induced diabetic apolipoprotein E knockout ( STZ-ApoE-/-) mice.METHODS: Male mice were treated for 12 weeks as follows:(1) C57+vehicle;(2) ApoE-/-+vehicle;(3) STZ-ApoE-/-+vehicle;(4) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1);(5) STZ-ApoE-/-+Cal (10 μg/kg, twice a week);(6) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1) +Cal (10 μg/kg, twice a week).Intraperitoneal injection of STZ was performed to establish the diabetic animal model .Western blotting and immunohistochemical method was used to detect NF-κB level in the thorac-ic aorta.Plaque area in the thoracic aorta was measured using HE staining .RESULTS:Compared with the C57 mice, the fasting blood glucose in the ApoE-/-mice was not remarkably changed .The levels of total cholesterol ( TC) and low-densi-ty lipoprotein ( LDL) were greatly increased .The fasting blood glucose and lipid levels in STZ-ApoE-/-group were much higher than those in ApoE-/-group.Compared with STZ-ApoE-/-group, the fasting blood glucose and lipid levels in Bex group and Cal group were not significantly changed .Compared with the C57 mice, the protein expression of NF-κB in the ApoE-/-mice and the STZ-ApoE-/-mice was remarkably increased .Compared with STZ-ApoE-/-group, the levels of NF-κB in Bex group, Cal group and combination group were greatly decreased .Compared with STZ-ApoE-/-group, the thoracic artery plaque areas in Bex group and Cal group were inhibited (both P<0.05).Compared with Bex group, the plaque area of the thoracic artery in combination group was significantly decreased (P<0.05).CONCLUSION:Bexaro-tene or calcitriol decreases the development of atherosclerosis in streptozotocin -induced diabetic ApoE-/-mice.Bexarotene combined with calcitriol affords greater protection than monotherapy .The mechanism may be involved in down-regulating the expression of NF-κB.

Objective To discuss the influence of special nursing intervention for the quality of life of outpatients with chronic pelvic inflammatory disease. Methods Divided 80 patients into the observation group and the control group randomly, there were 40 cases in each group. Routine nursing, treatment and disease-related lecture were used in both the groups, while the combined therapy of Chinese and Western medicine was used in the observation group in addition. Evaluated the quality of life and the effects of treatment by the World Health Organization′s quality of surviving chart between the two groups after 3-month intertention and 6-month follow-up. Results The scores of quality of environment field, physiology field ,psychological field, sociological field, independence field and mental field in the observation group was (70.33+16.85 ) (70.38+18.80), (71.43+18.28),(70.13+19.08), (73.10+17.70) and (75.38+7.30) respectively, while in the control group was (61.38+16.17), (56.70+17.69), (43.13+19.77), (55.00+19.08), (53.75+16.45) and (49.80+17.26) respectively, the difference between the two groups was significant, the t values were 2.424-8.631, P < 0.05. The effective rate of treatment in the observation group was 95.00%(38/40), while in the control group was 82.5%(33/40), the difference was significant, U=2.507, P < 0.05. Conclusions Special nursing intervention can promote the quality of life ,effects of treatment and the satisfaction of treatment in outpatients with chronic pelvic inflammatory disease, improve their psychological state and the compliance.

Objective:To observe the clinical effect of deep insertion at Tianshu(ST 25)for colonic slow transit constipation(STC).Methods:120 cases of STC patients were randomly divided,60 cases in a deep insertion group,30 cases in an electroacupuncture group and 30 cases in a medication group by 2:1:1 ratio.The deep insertion group was treated with deep insertion at Tianshu(ST 25).The electroacupuncture group was treated with routine insertion at Tianshu(ST 25).The medication group was treated with oral administration of Lactulose oral liquid.The first voluntary defecation time,and constipation scores before the treatment,four weeks after the treatment and relevant scores of clinical symptoms were assessed in the three groups of the patients.Results:The scores of the clinical symptoms in improvement of constipation were better in the deep insertion group than in the electroacupuncture group and medication group,with differences in statistical significance(P<0.01).The unsuccessful numbers in the improvement of defecation and abdominal pain were also better in the deep insertion group than in the other two groups,and better in instant effect in the deep insertion.Conclusion:The improvement of STC clinical symptoms was better by deep insertion at Tianshu(ST 25)than by medication and routine acupuncture method at Tianshu(ST 25).

Objective To observe the relationship between morphological and hemodynamic changes of female internal genital organs in the patients with hypomenorrhea with transvaginal color Doppler ultrasound (TVCDS). Methods Thirty female patients with hypomenorrhea of unknown origin were studied, and 30 healthy women of eumenorrhea aged 20 to 40 years were selected as control group. The size and shape of uterus, ovaries, and the thickness of endometria of uterus were observed with TVCDS in follicular phase, ovulation phase, luteal phase and luteal atrophy phase, respectively. Hemodynamic parameters of ovarian artery, uterus artery and their branches were measured. At the same time, hormones of female were examined in 30 patients in follicular phase, ovulation phase and luteal atrophy phase, respectively. Results ①No difference of the size of uterus and ovaries, the thickness of endometria and the amount of egg follicles was found between two groups (P＞0.05). ②Compared with that in the control group, type C of endometria increased in hypomenorrhea group (P＜0.05). ③RI, PI and S/D of spiral arteries in hypomenorrhea group were higher than those in control group, but no significance in these parameters of uterine arteries, arcuate arteries and radiate arteries was found. RI of uterine arteries, arcuate arteries and radiate arteries decreased successively. ④RI, PI and S/D of ovarian arteries in hypomenorrhea group was higher than those in control group in ovulation phase (P＜0.05). Conclusion Reduction in blood supply of ovary and endometria may be the causes of hypomenorrhea with unknown origin. TVCDS can be used as a conventional examination method for these patients.

Objective:To observe the clinical efficacy of Qingzhenfang for plasmoby （chronic urticaria）， and to investigate its effect on cellular immune function. Method:One hundred and thirty-two cases patients were divided into control group and observation group evenly according to random number table. The 60 patients in control group finished the study because of 6 cases of dropout， loss of follow-up and withdrawal， and 62 patients in observation group finished the study. Patients in both groups got Yiebastine tablets， 10-20 mg/time， 1 time/day. Patients in control group additionally got Piminxiao capsule， 4 grains/time， 3 times/day， while patients in observation additionally got Qingzhenfang， 1 dose/day. The treatment continued for 8 weeks in both groups. Before the treatment， and at the second， fourth， and eighth week after treatment， scores of urticaria activity for 7 days （USA7） and total symptom score （TSS） were graded. Before and after treatment， scores of chronic urticaria quality of life scale （CU-Q2oL） and syndrome of rheumatic fever were graded. A follow-up of 3 months was conducted for the patients whose score of USA7 was less than 7 to record the recurrence. Complement 3 and 4 （C3， C4）， CD4⁺， CD8⁺ cells were detected， and Th17/ CD4⁺ and Treg/ CD4⁺， CD4⁺/CD8⁺ and Th17/Treg were calculated. Levels of peripheral blood interleukin-10 （IL-10）， IL-17 and IL-23 were detected， and safety was evaluated after the treatment. Result:At the second， fourth and eighth week after the treatment， scores of USA7， TSS， CU-Q2oL and syndrome of rheumatic fever in observation group were lower than those in the control group （P<0.01）. Levels of C3， C4， CD4⁺， Treg， CD4⁺/CD8⁺and IL-35 in observation group were higher than those levels detected in control group （P<0.01）， while levels of CD8⁺， Th17， Th17/Treg， IL-10， IL-17 and IL-23 were lower than those in the control group （P<0.01）. Recurrence rate was 25.58% （11/43） in observation group， lower than 48.48% （16/33） in control group （χ2=4.276， P<0.05）， and the clinical efficacy in observation group was superior to that in control group （Z=2.021， P<0.05）. Conclusion:Yaoyi Qingzhenfang can control the degree of disease and improve the quality of life for patients with chronic urticaria， with superior clinical efficacy. In addition， it can reduce recurrence rate， increase the levels of C3， C4， regulate cellular immune function， and reduce immune inflammatory response， so it is worthy of further clinical research and use.

Objectives To investigate changes in serum levels of adiponectin,leptin and erythrocyte membrane insulin receptor among patients with gestational diabetes (GDM),and to study their relation to insulin resistance.Methods Fasting plasma glucose (FPG),fasting serum insulin (FINS), serum levels of adiponeetin and leptin,indices of lipid metabolism,2 h plasma glucose during oral glucose tolerance test (2 h PG),2 h serum insulin during oral glucose tolerance test (2 h INS),as well as number of erythrocyte membrane insulin receptors with high and low appetency and its constants,were determined in 40 patients with GDM and 34 controls with normal glucose tolerance.Insulin resistance index (IRI) was calculated.Results ① Serum levels of leptin and adiponectin were (11.7?2.8) ?g/L and (7.8?1.6) ?g/L,respectively,and number of high appeteney erythrocyte membrane insulin receptor (R_1) and low appetency erythrocytemembrane insulin receptor (R_2) was (43?9) / red cell and (2297?525) / red cell,respectively.Serum level of leptin was significantly higher in those with GDM than those of normal controls (P

In order to develop clinical diagnostic tools for rapid detection of the SARS-CoV (severe acute respiratory syndrome-associated coronavirus) and to identify candidate proteins for vaccine development, the C-terminal portion of the nucleocapsid (NC) gene was amplified using RT-PCR from the SARS-CoV genome, cloned into a yeast expression vector (pEGH), and expressed as a glutathione S-transferase (GST) and Hisx6 double-tagged fusion protein under the control of an inducible promoter. Western analysis on the purified protein confirmed the expression and purification of the NC fusion proteins from yeast. To determine its antigenicity, the fusion protein was challenged with serum samples from SARS patients and normal controls. The NC fusion protein demonstrated high antigenicity with high specificity, and therefore, it should have great potential in designing clinical diagnostic tools and provide useful information for vaccine development.
Antigens, Viral ; immunology ; Cloning, Molecular ; Enzyme-Linked Immunosorbent Assay ; Genetic Vectors ; Genome, Viral ; Humans ; Nucleocapsid Proteins ; genetics ; immunology ; Recombinant Fusion Proteins ; genetics ; isolation & purification ; metabolism ; SARS Virus ; genetics ; immunology ; Yeasts ; genetics

Objective: A graded response system based on pediatric early warning score (PEWS) was constructed to provide a scientific basis for clinical intervention and management by clinical nurses. Methods: Domestic and foreign literature and the results of previous research were reviewed to build a preliminary framework of graded response strategies. Two rounds of expert consultation were conducted by Delphi method and the results were statistically analyzed. Meanwhile, the results were integrated into the electronic medical record system to form the PEWS grading response system. Results: The positive coefficient of experts in the first and second rounds of consultation both were 15/15, and the average of the expert authority coefficient was 0.87 and 0.89 respectively. The expert coordination degree Kendall′s W value was 0.292 and 0.301 respectively (P<0.05), indicating that the experts′ opinions tended to be consistent. Finally, four segmented response systems were formed, with PEWS scored on the scale of 0-1, 2, 3 and 4 or single 3 points. Conclusions The graded response system based on pediatric early warning score constructed by using Delphi expert consultation method can be used in clinic, which can promote the nurses′ participation in clinical intervention decision-making and improve the quality of nursing.