Objective]Summarizing the thinking and experience for pediatric diseases of Zhi Yu QiaoKe. [Method]Analyse and induce the contents of“Clear-headed of Pediatric”, which was written by Zhi Yu QiaoKe ,elaborating his characteristics in treating pediatric diseases features.[Results]Zhi Yu QiaoKe amended the treatments and academic point of views, which were not conformed to the medical principles and practice proved to be errors, proposed“the differentiation of infantile convulsion of error theory”,“not hungry theory”; he considered that clinical cure, then pathogenesis diagnosis was accurate;medication must be care of primordial qi and spleen and stomach;in addition, we still should also focus on nursing and adhere to the taboo. [Conclusion]The Clear-headed Pediatric with precise arguments and appropriate classification reflects the author ’s advanced medical theory and excellent medication principle of dialectical thinking, rigorous medication principle and exquisite nursing technique, the clinical diagnosis and treatment rules and characteristics of a certain reference value for the modern clinical, worthy of promotion.

Objective:To investigate the role of alloreactive T cell in clonal deletion and regulatory T cells ( Treg) in transplant tolerance.Methods:F1 mice were bred by crossing female BALB/c mice and male C57BL/6 mice.Within 24 h,newborn C57BL/6 mice were inoculated with F1 spleen cells via the orbital branch of the anterior facial vein.Six weeks later,the mice were subjected to F1 skin grafting to evaluate their tolerance.Proliferation,flow cytometry and adoptive transfer assay were used to analyze clonal deletion of alloreactive T cells and the expression of CD4+Foxp3+T cells in neonatal treated mice.Results: Newborn C57BL/6 mice injected with F1 splenic cells could induce transplantation tolerance,the level of tolerance was associated with the dose of splenic cells.3×107 splenic cells from F1 mice could induce long-term skin graft acceptance in C57BL/6 mice ,1×107splenic cells significantly prolonged the survival of F1 skin grafts,but the grafts completely rejected within 50 days.The mixed lymphocyte reaction ( MLR) experiment in vivo showed that alloreactive T cell in long-term tolerant mice was deleted completely,but a certain amount of reactive T cells existed in the low-dose group mice.Flow cytometry ( FCM) analysis showed that the expression of CD4+Foxp3+T cell in the high-dose group and low-dose group mice had no obvious difference compared with the naive mice.When alloreactive T-cells were injected into tolerant mice,the skin graft rejection was observed,and Treg cells upregulated in graft-rejected mice.Conclusion:The degree of transplantation tolerance depended on the clonal deletion of alloreactive T cells,instead of on the expression of CD4+Foxp3+Treg cells.CD4+Foxp3+regulatory T cells upregulated in graft rejected mice,which may be served as a negative feedback mechanism to control the intensity of rejection.

Objective To explore the expression of COX-2 and p38MAPK in patients with trauma MODS. Methods Forty MODS patients were evaluated. The levels of peripheral blood mononuclear cells COX-2 and p38MAPK in MODS patients and 40 normal controls was detected by enzyme linked immunosor-bent assay (ELISA). RT-PCR was used to measure the COX-2 mRNA and p38MAPK mRNA expression of in PBMCs. ANOV and correlation analysis were used in statistical analysis. Results The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in MODS group were higher than in control group (all P <0.05). The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in dead group were higher than in survival group( all P <0.05). The levels of COX-2 and p38MAPK of PBMCs were positively correlated, (r =0.6 147, P<0.01). The expression of COX-2 mRNA, p38MAPK mRNA of PBMCs and APACHE I scoring were positively correlated (r1 =0.5 009, P1 <0.05,r2 =0. 5 316, P2 <0. 05). Conclusions COX-2 and p38MAPK of PBMCs take part in the onset of MODS, and may service as index to judge the prognosis of MODS.

Objective To evaluate the effects of dexmedetomidine on the expression of phosphor-cAMP response element binding protein (p-CREB) in isoloated hippocampal neurons of fetal rats.Methods SpragueDawley rats on 16-18 days of gestation were sacrificed and the fetal rats were obtained.The hippocampi of fetal rats were isolated and hippocampal neurons were seeded in culture medium for 8 days.The cells were then divided into 4 groups (n =12 each) using a random number table:control group (group C),dexmedetomidine 0.001 μmol/L group (group D1),dexmedetomidine 0.010 μmol/L group (group D2),and dexmedetomidine 0.100μmol/L group (group D3).In D1.3 groups,dexmedetomidine with the final concentrations of 0.001 μmol/L,0.010 μmol/L,and 0.100 μmol/L was added to the culture medium,respectively,and then the cells were incubated for 3.5 h.The apoptosis in hippocampal neurons was detected by flow cytometry.The expression of p-CREB in hippocampal neurons was determined by RT-PCR and Western blot.Results Compared with group C,apoptosis rate was significantly decreased and the expression of p-CREB was up-regulated in D1.3 groups.Conclusion Dexmedetomidine inhibits apoptosis in isolated hippocampal neurons of fetal rats by up-regulating the expression of p-CREB.

Objective To approach the correlation between the bone density measured by quantitative CT and the blood sugar level of the aged patients with non-insulin-dependent diabetes mellitus,and observe the effects of the blood sugar level on the bone density.Methods The lumbar bone densities and the blood sugar levels of 160 aged patients with non-insulin-dependent diabetes mellitus (hyperglycemia group 80 cases,euglycemia group 80 cases ) and the healthy aged people (80 cases) were detected by quantitative CT and serum biochemical detection; the correlation between the blood sugar level and the bone density and the osteoporosis occurrence status of aged people in various groups were analyzed.Results The bone density in the non-insulin-dependent diabetes and hyperglycemia group was lower than those in normal(control) group and non-insulin-dependent diabetes and euglycemia group (P

Objective:To analyze the effect of comprehensive nursing education on anxiety, depression, quality of life and survival of patients with hepatocellular carcinoma (HCC) after surgery.Methods:A total of 136 HCC patients were randomly divided into two groups: general nursing education group and comprehensive nursing education group. The comprehensive nursing education group carried out 12 months of health belief education, psychological care, care activities and telephone condolence. The routine nursing group received basic education for 12 months. The changes of anxiety and depression were assessed by hospital anxiety and depression scale (HADS). The quality of life (QOL) of participants within 12 months was assessed using the European research and treatment cancer quality of life questionnaire (QLQ-C30). The 3-year survival of the two groups was compared.Results:There was no significant difference between the two groups in baseline data. At the 9th and 12th month, the HADS-A score of the comprehensive nursing education group was significantly lower than that of the general nursing group ( P< 0.05). In the 12th month, the overall health of QLQ-C30 in the comprehensive nursing education group was better than that in the general nursing group ( P<0.05). The QLQ-C30 function score of the comprehensive nursing education group at the 12th month was better than that of the general nursing group ( P<0.05). There was no significant difference in QLQ-C30 symptom scores between the two groups at all time points ( P>0.05). The overall survival of the patients in the comprehensive nursing education group was better than that in the general nursing group ( P=0.026). Conclusion:the comprehensive nursing education can reduce the anxiety and depression of HCC patients after surgery, and can improve their quality of life and survival.

Objective To evaluate the efficacy and safety of single intra-articular etanercept injection in patients with rheumatoid arthritis (RA) and spondyloarthropathy (SpA) who had knee arthritis.Methods This was a randomized, single-blind, parallel, controlled clinical trial. The subjects were the RA or SpA patients with the knee arthritis without deformity, moderate or severe bone erosion and obvious joint space narrowing in radiography in the target knees, who had taken at least 6-week therapy with routine dosage of disease modifying anti-rheumatic drugs (DMARDs) before the study. The subjects were randomized in 2:1 ratio to receive either single intra-articular 25 mg etanercept injection or 2 ml compound betamethasone to the target knees joint after their synovial fluid being drawn away at baseline. They were followed up four weeks after injection. The primary end-point was the 4-week change in the modified Hospital for Special Surgery (HSS) knee score for the target knee. Results Forty-seven subjects in the experimental group and twenty-three subjects in the controlled group were included in the trial. The modified HSS knee score for the experimental group was baseline mean 65.6 ± 14.0, follow-up 84.3 ±11.1 (P ＜0.0001 ), the controlled group baseline mean 68.2 ± 11.4, follow-up 79.4 ± 15.5(P =0.0015). A mean (34.9 ±38.9)% improvement on the modified HSS knee score was achieved in the experimental group, while ( 17.9 ±24.5)% improvement on the modified HSS knee score was achieved in the controlled group (P =0.0467). Adverse events were observed in eight patients (19.0% ) in the experimental group and eight patients (44.4%) in the controlled group. No serious adverse event had been observed. Conclusions Single intra-articular 25 mg etanercept injection had a better efficacy than 2 ml compound betamethasone. It was an effective and safe therapeutic option for SpA and RA patients who had knee arthritis without obvious change in radiography.

Objective:To study the relationship between atrophy of the thymus and disease severity in EAE.Methods:MOG35-55 peptide induced EAE in C57BL/6 mice and analyzed the relationship between the severity of EAE and thymic atrophy,Flow cytometry analysis was used to evaluate thymic CD4+CD8+DP cells,CD4+CD8-,CD4-CD8+SP cells in relation to the severity of the disease.Results:The number of thymocytes in mice with decreased tail tone was (20.25 ±3.49) ×106 ,hindlimb weakness(4.93 ± 0.85)×106,complete hindlimb paralysis(1.8 ±0.19) ×106,and forelimb and hindlimb paralysis(0.52 ±0.07) ×106,there were statistically significant differences between groups ( P<0.05 ).As the disease progresses, CD4+CD8+DP cells ratio decreased, CD4+CD8-,CD4-CD8+SP cell ratio increased,different disease groups was statistically significant difference (P<0.05).Conclusion: The atrophy of thymus was closely related to the severity of EAE.Migration of activated T cells in EAE may cause atrophy of thymus.

BACKGROUND:There are many methods to treat thoracolumbar fractures However,it remains unclear whether a simple operation to treat a thoracolumbar burst fracture can decrease the trauma and obtain better effect to avoid the enlargement of operation.OBJECTIVE:To investigate the clinical outcome of posterior short-segmental transpedicular screw system internal fixation in treatment of single-level thoracolumbar burst fracture without nerologic deficit.METHODS:A total of 186 patients with single.level thoracolumbar burst fracture but without nerologic deficit treated in the First Affiliated Hospital of Soochow University between September 2003 and January 2008,including 152 males and 34 females,aged18 10 65 years.were treated by posterior pedicle screw The intraspinal bone fragments were treated with indirect decompression.All patients were checked with radiography and CT scan before/after operation as well as before implant removal.The correction of anterior vertebral body height and the ratio of bone fragment to cross section area of spinal canal were measured.RESULT AND CONCLUSION:Compared with normal.the anterior vertebral body height was 42%before operation,98%after operation,and 98%before implant removal The ratio of bone fragment to cross section area of spinal canal was 34%before operation,13%after operation.and 8%before implant removal.Internal posterior short-segmental transpedicular screw fixation treating single-level thoracolumbar burst fracture without nerologic deficit can obtain stability of spinal column,and it is beneficial to recovery of body height,physiologic postu ral contour and canal volumn .

Background and purpose:Bladder cancer is the most common urological tumor, and its pathogen-esis is still not fully understood. The study was aimed to observe the expressions of key genes in many tumor-associated signaling pathways in normal bladder tissue and bladder carcinoma, and to provide further evidence for the subsequent study of bladder cancer recurrence and metastasis.Methods:Twenty-seven cases of bladder cancer specimens were col-lected, and normal bladder tissues and bladder cancer tissues were distinguished by frozen section. Then, the expressions of 84 genes of cancer-related signaling pathways in bladder cancer tissues and normal bladder tissues were screened by Cancer Pathway Finder PCR Array produced by QIAGEN company.Results:Compared with the normal bladder tissues, the bladder carcinoma tissues had 8 up-regulated genes and 19 down-regulated genes. In this study, the impact of epithe-lial-mesenchymal transition (EMT) signaling pathway was selected as a research direction in which theGSC,KRT14,DSP were up-regulated,SNAI2,SNAI3 were down-regulated. ThereforeGSC,KRT14,DSP,SNAI2 andSNAI3 were chosen as target genes, and verified by qRT-PCR in many examples. The result showed that the expressions ofGSC gene in bladder cancer tissues were up-regulated, but with no statistical significance;KRT14,DSP expressions in bladder cancer were higher than those in normal bladder tissues (P<0.05);SNAI2,SNAI3 expressions in bladder cancer were lower than those in normal bladder tissues (P<0.05), andSNAI3 showed the most obvious expression differences.Conclusion:KRT14,DSP andSNAI3 may play an important role in bladder cancer’s occurrence, development and metastasis.