AIM:To investigate the histone modification changes of topoisomerase Ⅱα( TOPOⅡα) promoter regulatory factor Sp1 in the patients with chronic benzene poisoning .METHODS:The bone marrow samples were collect-ed from 25 chronic benzene poisoning cases and 25 controls.The chromatin immunoprecipitation assay was carried out to study the possible mechanism of TOPOⅡαpromoter regulatory factor Sp 1 expression changes .The mRNA expression of Sp1 was detected by RT-PCR.RESULTS:Compared with the controls , the histone H4 acetylation and histone H3 acetyla-tion of Sp1 in the chronic benzene poisoning patients significantly decreased (P<0.01), and histone H3K9 methylation level of Sp1 increased (P<0.01), but the histone H3K4 methylation level of SP1 was not obviously changed (P>0.05). The mRNA expression of Sp1 in the chronic benzene poisoning patients was significantly lower than that in the controls (P<0.05).CONCLUSION:In chronic benzene poisoning patients , the histone acetylation and methylation modification changes of TOPOⅡαpromoter regulatory factor Sp 1 accompanied with the changes of mRNA level are observed .Histone H4 and H3 acetylation and H3K9 methylation modification of Sp1 may play an important role in the benzene ’s hematopoiet-ic toxicities.

Objective To study the responsibilities of nurses at different levels in providing clini cal care for patients in wards.Methods On the basis of conducting hierarchical management on nurses,the tasks of nurses in providing patients in wards with clinical care were summed up by means of data analysis and field observation.According to the tasks,a questionnaire about the responsibilities of nurses at all levels was designed.The 132 nurses from a Grade-3 Class-A general hospital in Chongqing Municipality who were responsible for providing clinical cares for patients in wards completed these questionnaires.Results Nurses in charge of providing clinical care for patients in wards usually undertook 11 tasks which could be divided into four aspects,which were,clinical nursing,nursing management,teaching on nursing and research into nursing.Based on the 11 tasks,44 responsibilities these nurses shouldered were defined,which included 4 responsibilities for N0-level nurses,6 for N1-level nurses,10 for N2-level nurses,11 for N3-level nurses,8 for N4-level nurses and 5 for N5-level nurses.Conclusions By defining in a scientific and systematic way the responsibilities and tasks of nurses at different levels in providing clinical cares for patients in wards,the research offered clinical nurses clear guidance on their work,and provided basis for the hospital's decision on clinical nurses,such as the personnel allocation,performance assessment and training; it could also help promote the position management on the work of nurses in China.

Objective To identify risk factors associated with the severity of acute kidney injury (AKI) in-duced by crush syndrome and whether the patient required hemodialysis (HD). Method A retrospective study was designed. Within 19 days after the Chinese Wenchuan earthquake (May 12, 2008), 63 victims (33 men, 30women) of 2139 cases were hospitalized at Mianyang Central Hospital (Siehuau, China) because of crush syn-drome caused by crush injuries. The patients with renal dysfimcfion before the earthquake were excluded. Totally 63 patients with AKI associated with crush syndrome were included in this study and were divided into two groups: group 1, 25 patients, requiring HD (when urine volume <250 mL/d;serum potassium> 6 mmol/L) ; and group 2, 38 patients, without HD. The following data were collected retrospectively for all patients: (1) epidemiological parameters: age, gender, race, time under the rubble, liquid treatmem before being rescued; (2) clinical param-eters: blood pressure, body area crushed, amputation, fasciotomy, blood transfusion, quantity of fluid infusion, urine output in the first 24 hours; (3) initial laboratory data: complete blood count, urine analysis, serum chem-istry, arterial blood gas analysis. Comparisons between the two groups were made using SPSS 10.0. The quantita-tive data and categorical data were analyzed using t tests and χ2 tests, respectively. P -values < 0.05 were consid-ered to indicate significant differences. The significant variables were entered into logistic regression models to de-termine the risk factors for the severity of AK1 in patients with crush syndrome and whether the patient required HD. Results Four significant risk factors with P -values < 0.05 were identified: fasciotomy, cystatin C (Cys C)level, myoglobin (MB) level and lactic acidosis. The odds ratios (95% confidence intervals) were 8.641 (3.027～76.479), 6.956 (3.027～76.479), 5.379 (3.027～76.479) and 4.833 (2.569～32.764), respectively. Conclusions In addition to urine output and potassium levels, we found that four risk factors, namely faseiotomy, Cys C and MB levels, and lactic acidosis, were significanfly associated with the severity of AKI and whether the patient required hemodialysis.

Objective To investigate the value of ultrasound elastosonography in the diagnosis of liver fibrosis. Methods One hundred and twenty patients with chronic hepatitis B were examined by ultrasound elastosonography and given elasticity scores,the correlation coefficient between the elasticity scores and the histologic fibrosis stage was evaluated and its difference in the diagnosis of liver fibrosis was compared. Results The Spearman's correlation coefficient between the elasticity scores and the histologic fibrosis stage was 0. 875,which was highly significant ( P＜0. 01). There was no significantly difference between elasticity scores and fibrosis staging in the diagnosis of liver fibrosis by Marginal Homogeneity (Z=- 1. 144, P = 0. 149). The sensitivity,specificity and accuracy of ultrasonic elastography for diagnosing liver fibrosis were 92. 5%, 85.0%, 90.0%, respectively. Conclusions Elastosonography is helpful for the diagnosis of liver fibrosis.

Objective To evaluate the value of grey scale ultrasonography (US) combined with elastography in the difference diagnosis of benign and malignant thyroid lesions. Methods Sixty-two patients with 81 lesions were examined by grey scale US and elastography preoperatively. All the lesions were confirmed by pathology. According to their features of grey scale ultrasonograms and elastograms, two receiver operating characteristic (ROC) curves were drawn, one for gray ultrasound and one for the combination methods. The area under curve (AUC) of them were made a comparison. Results The cut-off value of the grey scale group was equal or more than 5, the sensitivity,specificity was 60. 0% ,98. 5%. And the cut-off value of grey scale US combined with elastography group was equal or more than 6, the sensitivity, specificity was 80.0%, 89.4%. The AUC of grey scale US was 0.860 and that of the combination group was 0. 916. The difference between them was statistically significant Z = - 7. 863, P = 0. 000). Conclusions The grey scale US combined with elastography could improve sensitivity and decrease omission diagnose rate. It may be more helpful in the difference diagnosis of malignant from benign thyroid lesions.

According to the phenomenon that the curriculum of psychological health education for college students is theoretical,lack of experience and the teaching form is single,this research attempts to private a blended teaching which is based on the small private online course (SPOC) and experiential teaching.The content of mental health is divided into theoretical knowledge and experience knowledge.And the theoretical knowledge is taught through online teaching in the form of massive open online courses (MOOC),while the experiential knowledge is taught by pure experiential teaching in the classroom.The study has summed up 3 stages of learning mode:learning before class,teaching experience and reflection after class.This changes the single classroom theory teaching to students experience learning.Besides,formative evaluation is used as assessment methods,which has enhanced the effectiveness of the course and at the same time,it has also promoted the improvement of teachers' teaching level effectively.

Objective To find out the valuable ultrasonographic features for differentiating benign and malignant thyroid solitary nodular, and to apply the binary Logistic regression model in analysis of ultrasonography of thyroid solitary nodular. Methods Two-dimensional ultrasonography was performed in 194 patients with thyroid solitary nodular confirmed with surgical pathology. A Logistic model was obtained on the basis of ultrasonographic features. A receiver operator characteristic (ROC) curve was constructed to assess the performance of the Logistic model. Results Three ultrasonographic features including shape, calcification and heterogeneous texture were finally entered into the Logistic model. The percentage of correct prediction was 91.75%. The area under ROC curve was 0.916±0.035. Conclusion The binary Logistic regression can select the valuable indexes in the differential diagnosis of thyroid solitary nodular. The application of binary Logistic regression model can improve the diagnosis accuracy of thyroid solitary nodular.

Objective To investigate the effects of testosterone (T) replacement therapy (TRT) on carotid artery intima-media thickness (IMT) in middle aged and elderly male patients.Methods A total of 80 middle-aged and elderly male patients with testosterone deficiency and increased carotid artery IMT were selected and randomly divided into two groups:the treatment group (n=38,treated with testosterone for 1 year) and the control group (n=42,without any treatment).The serum T level,IMT and prostate-specific antigen (PSA) before and after treatment were determined.The correlation between the testosterone level and carotid artery IMT was analyzed.Results There were no significant differences in the serum T level and IMT between the control group and the treatment group before treatment [(10.39 ± 1.44) nmol/L vs.(10.88 ± 1.87) nmol/L,(1.25 ±0.11) mm vs.(1.24±0.13) mm,t=1.32,-0.26,P=0.191,0.794].Compared with pretreatment,the serum T level was significantly increased and the IMT was significantly decreased in the treatment group afterTRT [(10.88±1.87) nmol/L vs.(22.83±1.56) nmol/L,(1.24±0.13) mmvs.(1.18±0.16) mm,t=-29.14,2.55,P=0.000,0.015],while no significant differences in the serum T level and IMT were found in the control group before and after treatment [(10.39± 1.44)nmol/L vs.(9.99±1.72) nmol/L,(1.25±0.11) mm vs.(1.27±0.11) mm,t=1.24,-1.00,P =0.219,0.323].Linear correlation analysis showed that the serum T level was negatively correlated with IMT (r-0.605,P=0.000) and multiple regression analysis showed that the T level was an independent factor for IMT.Conclusions Testosterone replacement therapy is an effective treatment to alleviate IMT in middle-aged and elderly male patients,which may play an important role in preventing cardiovascular diseases in middle-aged and elderly male patients.

Objective To explore the relationship between interleukin(IL)-13 RS20541 gene polymorphism and susceptibility of enterovirus 71 (EV71) infection in children's hand-foot-mouth disease.Methods Blood samples were collected from 123 children with EV71 infection from the Central Hospital of Xiangtan (experimental group),and they were divided into mild EV71 infection group (n =62) and severe EV71 infection group (n =61) according to their severity.And 52 healthy children without EV71 infection were selected as the controls,with age and sex matched.Two mL blood samples stored in the-80 ℃ freezer,were collected from all subjects,and DNA was extracted by Beijing ubiolab genetic technology company limited.The SNaPshot was used to determine genotype for G/A polymorphism at RS20541 position of IL-13 gene.SPSS 18.0 software was used to analyze the data.Results IL-13 RS20541 loci had 3 genotypes:AA,GA,GG;the frequency of AA,GA,GG in the experimental group was 4.07％,44.71％,51.22％,which was significantly lower than that in the healthy control group (the frequency of AA,GA,GG were 11.54％,32.69％,55.77％),there was no statistically significant difference in genotypes (x2 =4.676,P ＞ 0.05);there was no statistically significant difference in allele frequency (the frequency of A,G in experimental group was 26.42 ％,73.58 ％,and that of the healthy control group was 27.88 ％,72.12 ％;x2 =0.080,P ＞ 0.05).EV71 infection caused by mild group,severe group and healthy controls genotype frequencies between the 3 groups [(AA + GA) were 53.22％,44.26％,44.23％;GG were 46.78％,55.74％,55.77％;x2 =1.294,P ＞ 0.05] and allele frequency (A were 30.65％,22.13％,27.88％;G were 69.35％,77.87％,72.12％;x2 =2.349,P ＞ 0.05) among the mild group,severe group and healthy control group had no statistical significance.Conclusion There is no correlation between the IL-13RS20541 gene polymorphism and EV 71 infection in children with the hand-foot-mouth disease.

Objective To explore the relationship between the interleukin-6 (IL-6) RS1800796 gene polymorphism and susceptibility of Enterovirus 71 (EV71) infection.Methods One hundred and twenty-three children with EV71 infection were selected as infection experimental group from March 2012 to December 2014 in the Central Hospital of Xiangtan,and they were divided into mild EV71 infection group (62 cases) and severe EV71 infection group (61 cases).And 52 age-and gender-matched healthy children were selected as the healthy control group.Two mL blood samples were collected from all subjects,and DNA was extracted by Beijing Optimal Boland Gene Technology LTD.The SNaPshot was used to determine the genotype for G/C polymorphism at RS1800796 position of IL-6 gene.Results The genotype frequency of IL-6 RS1800796 GG in the infection experimental group [73.2％ (90/123 cases)]was significantly higher than that in the healthy control group[48.1％ (25/52 cases)],and the difference was statistically significant (x2 =10o 215,P =0.002,OR =2.945,95 ％ CI:1.500-5.782).No significant difference was found in the distribution of genotype frequency of the IL-6 RS1800796 GG between the mild EV71 infection group and the severe EV71 infection group[71.0％ (44/62 cases)vs.75.4％ (46/61 cases),x2 =0.309,P =0.685].The G allele in IL-6 RS1800796 G/C was more frequent in the infection group (85.0％)than that in the control group (70.2％),and the difference was statistically significant (x2 =10.183,P =0.002,OR =2.399,95％ CI:1.389-4.143).No significant difference was found in allele frequency of the IL-6 RS1800796 G between the mild EV71 infection group and the severe EV71 infection group (83.1％ vs.86.9％,x2 =0.703,P =0.477).Conclusion The G allele of IL-6 RS1800796 confers susceptibility to infection of EV71.But G allele carrier will not increase the risk of severity after infection.