Objective To evaluate the value of bedside index for severity in acute pancreatitis (BISAP) in predicting the severity and prognosis of acute pancreatitis (AP) by comparison with traditional scoring systems.MethodsFour hundred ninety-seven patients of AP admitted into Wuxi People's Hospital from January 2005 to December 2010 were studied retrospectively.BISAP,APACHE Ⅱ,Ranson and Balthazar CT (CTSI) scores were calculated,respectively,in order to evaluate the severity.The AUC of ROC was used to evaluate the ability of BISAP and the other scoring systems in predicting the severity of AP and the occurrence of pancreatic necrosis,organ failure and mortality.Results Among 497 patients,mild acute pancreatitis (MAP) was identified in 396 patients and severe acute pancreatitis (SAP) in 101 patients.The gender,age and etiological factors between MAP and SAP were not statistical different.The BISAP,APACHE Ⅱ,Ranson scores of the 4 9 7 patients were 1.08 ± 1.01,5.79 ± 4.00,1.69 ± 1.59,and the scores were intercorrelated(r =0.612,0.568,0.577,P ＜0.001).In addition,the BISAP,APACHE Ⅱ,Ranson scores of SAP patients were significantly higher than those in MAP patients.The AUC of BISAP for SAP was 0.762(95％ CI 0.722 ～0.799),when the cutoff value was 2,the sensitivity,specificity,positive predictive value (PPV),negative predictive value ( NPV ) were 63.39％,83.08％,48.1％,89.4％ ; the AUC of BISAP for pancreatic necrosis was 0.711 (95％ CI 0.612 ～ 0.797),when the cutoff value was 2,the sensitivity,specificity,PPV,NPV were 84.6％,46.7％,35.5％,89.7％ ; the AUC of BISAP for organ failure was 0.777( 95％ CI0.683 ～ 0.854),when the cutoff value was 2,the sensitivity,specificity,PPV,NPV were 93.1％,51.4％,43.5％,94.9％ ; the AUC of BISAP for mortality was 0.808(95％ CI 0.718 ～0.880),when the cutoff value was 3,the sensitivity,specificity,PPV,NPV were 83.3％,67.4％,25.6％,96.8％.In the cases of SAP,the ability of BISAP and the other scoring systems in predicting the prognosis showed no statistical difference.ConclusionsThe BISAP has the prediction ability for AP severity and prognosis similar to other scoring systems,and it consists of only 5 parameters and can be completed in the fast 24 h of admission,therefore it can be used for early predication of SAP,which is worth of clinical application.

Objective To detect the expression of Survivin and hypoxia inducible factor-1α (HIF-1α) in prostatic hyperplasia and prostatic carcinoma,and investigate their roles and mutual correlations in pathogenesis and progression of prostatic carcinoma.Methods The expression of Survivin and HIF-1α in proliferative lesions of prostate (15 cases) and prostatic carcinoma (62 cases) were detected by immunohistochemistry method.The relationship between the expressions of Survivin and HIF-1α was analyzed,as well as their correlations with clinicopathological features.Results The positive expression of Survivin and HIF-1α were significantly higher in the prostatic carcinoma [71.0 ％ (44/62) and 69.4 ％ (43/62),respectively] compared with those of the prostatic proliferation [6.7 ％ (1/15) and 0] (x2 =20.56,P 0.001; x2 =23.56,P =0.001,respectively).The expression of Survivin and HIF-1α in prostate carcinoma was significantly related with the histological grading,clinical staging (x2 =10.64,5.39,7.62,6.43,all P ＜ 0.05).And there was positively correlated between Survivin and HIF-lα (rs =0.350,P =0.006).Conclusion Survivin and HIF-1α synergistically play important roles in pathogenesis and progression of prostatic carcinoma.

Objective To examine HOXA11,ER and PR expression in human endometrial hyperplasia and adenocarcinoma.Methods The immunohistochemistry was applied to analyze the level of HOXA11、ER and PR expression in the proliferative endometria,simple hyperplasia and endometrial adenocarcinoma.Results The expression level of HOXA11 in the endometrial hyperplasia and adenocarcinoma was significantly higher than that of proliferative endometrium(P

Objective To investigate the effects of Dihuangyinzi(DHYZ) on behaviors and RAGE/p38 pathway in APP/PS1 mice.MethodTwenty APP/PS1 dementia mice were randomly divided into model group(n=10) and Chinese medicine group(n=10).The blank group was C57 BL/6 J normal mouse(n=10).The mice in Chinese medicine group were intragastric administration with DHYZ (9.75 g·kg-1·d-1).The mice in model group and blank group were treated with distilled water.After 30 days,the abilities of learning and memory of mice were detected by Morris water maze.The expression of amyloid-beta1-42(Aβ1-42) in the hippocampus and cortex was detected by immunohistochemistry.Reactive oxygen species of brain tissue were detected by DCFH-DA Methods in the brain of APP/PS1 mice.Gene expression level of receptor for advanced glycation end products(RAGE) was measured by real-time polymerase chain reaction (RT-PCR) in the cortex and hippocampus of APP/PS1 mice.The expression of phospho-mitogen-activated protein kinases (p38) was analyzed with Western blot and immunofluorescence analysis in the cortex and hippocampus of APP/PS1 mice.Results Behavioral Results showed that DHYZ significantly increased the distance((23.088±7.083)cm) and residence time((1.961±1.230)s)of effective area in Morris water maze on the fifth day(P<0.05,P<0.01)and remarkably increased the number of effective area crossings((1.607±0.405) times) and plats((0.893±0.283) times) in Morris water maze on the fifth day(P<0.01,P<0.05).DHYZ also significantly reduced the intracelluar ROS level(122.611±7.630) in the brain(P<0.01),and DHYZ could depress the expression of RAGE(1.467±0.081,7.983±0.136) and phosphorylation of p38 (0.376±0.026,0.538±0.016)in the cortex and hippocampus of APP/PS1 mice(P<0.01,P<0.05).Conclusions The Results demonstrate that DHYZ can partly improve memory impairment of APP/PS1 mice by the inhibition of RAGE/p38 pathway.

Objective To review the publication of general practice education in China mainland in 20 years from 1993 to 2012.Methods The research articles of general practice education published between January 1,1993 and December 31,2012 were searched from CNKI and Wanfang databases, and analyzed with bibliometric and literature management software NoteExpress 2, Epidata 3.1 and SPSS 13.0.Results Total 4 281 articles were retrieved and 241 education relevant articles were selected.29.9％ (72/241) of the 241 articles were on on-campus education, 67.6％ (163/241) were on continuing medical education and 4.5％ (11/241) were on post-graduation education.As to the published institutions, 58.5％ (141/241) were from the medical colleges and research institutions, 25.7％ (62/241 were from the tertiary hospitals, 3.7％ (9/241) were from primary care institutions, 1.7％ (4/241 were from the secondary hospitals and 5.8％ (14/241) were from the government departments.The general practice education grants increased from 1 in 2001 to 46 in 2012;20 of which were supported by provincial and ministerial level funds.Conclusion The contents of general medical education literature in China is mainly on on-campus education and continuing medical education;most of which were from the tertiary hospitals and the medical colleges and research institutions.The amount of research grants of general practice education were increasing year by year during 1993-2012, indicating that more attention had been paid to general practice education in mainland China in the last two decades.

Objective To explore the causes of ambiguous genitalia.Methods Clinical data of 106 cases with ambiguous genitalia from Ruijin Hospital of Shanghai Jiaotong University School of Medicine were retrospectively analyzed.DNA fragments of related genes from parts of patients were amplified by means of polymerase chain reaction (PCR) and were directly sequenced to detect gene mutations.Results (1)The 106 ambiguous genitalia patients presented a variety of clinical phenotypes.Karyotype of 42 cases(39.6％)were 46,XX,while 62 cases(58.5％)were 46,XY and 2 cases(1.9％)were abnormal.(2)Forty(95.2％)patients with 46,XX were diagnosed with congenital adrenal hyperplasia(CAH) ;one case(2.4％) was adrenal cortical tumor and one case (2.4％) was 46,XX [sex determining region of Y choromosome (SRY) positive] male syndrome.(3) Fifty-three cases (85.5 ％) out of 46,XY karyotype were directly sequenced with steroid-5-alpha-reductase,alpha polypeptide 2 gene (SRD5A2),androgen receptor gene (AR) and steroidogenic factor-1 gene(SF-1).Sequencing analysis of SRD5A2 revealed 8 patients with compound heterozygous or homozygous mutations.A patient carried a novel missense mutation of SF-1 and another patient had a mutation of AR.(4) One abnormal karyotype was 46,XX/46,XY and the other was 46,XX/46,XY/46,X.+ may.ish (DYZ3 +) (DXZ1-).Conclusions (1) CAH is the most common cause of genital ambiguity in 46,XX patients but some rare causes such as adrenal cortical tumors or SRY positive should not be ignored.(2) To find the causes of 46,XY genital ambiguity,direct DNA sequencing analysis of candidate genes would be the better choice because of the complicate pathogenesis.(3)Abnormal karyotype also can lead to ambiguous genitalia.

Objective To investigate the effects of Dihuang Yinzi (DY) on the receptor for advanced glycation end-products(RAGE)/reactive oxygen species(ROS)/apoptosis pathway in SH-SY5Y cells induced by amyloid-beta1-42 (Aβ1-42) oligomer. Methods Firstly, we adopted methyl thiazolyl tetrazolium(MTT) method to detect the cell vitality in fetal bovine serum (FBS) group, blank serum group, and low-, middle- and high- dose DY-containing serum groups, so as to confirm the optimal concentration and treatment time of DY-containing serum. Secondly, we applied MTT method to detect cell vitality and applied Annexin V/propidium iodide (PI) staining method to observe the apoptosis of SH-SY5Y cells treated with 0~20 μmol/L Aβ1-42 for 24 and 48 h, so as toconfirm the optimal concentration and treatment time of Aβ1-42 for establishing Alzheimer's disease (AD) model in vitro. Thirdly, MTT method was used for the detection of cell vitality, and Annexin V/PI staining method was used for detection of the apoptosis of SH-SY5Y cells in blank serum group, model group, western medicine control group and low-, middle-and high-dose DY-containing serum groups, and Dihydroethidium (DHE) method was used for the assay of ROS contents, so as to observe the effect of DY on the recovery of injured SH-SY5Y cells induced by Aβ1-42. Finally, we applied Western blot method to detect the expression level of RAGE in SH-SY5Y cells of blank group, model group and DY-containing serum group; after Aβ1-42-induced SH-SY5Y cells were transfected with RAGE gene, we adopted DHE staining method and Annexin V/PI staining method to detect ROS content and cell apoptotic rate in all of the above groups, so as to observe the effect of DY on SH-SY5Y cell apoptosis and RAGE expression. Results The cell vitalities were increased in low- and middle-dose DY-containing serum groups at 24 h (P < 0.05 or P < 0.01 compared with that in the blank serum group). The conditions for the establishment of AD model in vitro were as follows: the optimal concentration of Aβ1-42 was 5μmol/L, and the treatment time was 24 h. The cell vitalities were significantly enhanced, the cell apoptotic rate and ROS content were significantly lowered in Aβ1-42-induced SH-SY5Y cells of the medication groups(P <0.05 or P < 0.01 compared with those in the model group) , and the cell vitality was the highest and the cell apoptotic rate was the lowest in the middle-dose DY-containing serum group. The RAGE expression level was decreased in Aβ1-42-induced SH-SY5Y cells of the middle-dose DY-containing serum group(P < 0.05 compared with that in the model group) . ROS content and cell apoptotic rate were decreased in Aβ1-42-induced SH-SY5Y cells transfected with RAGE gene in the middle-dose DY-containing serum group (P<0.01). Conclusion DY may play an anti-oxidative role through inhibiting the production of ROS and cell apoptosis, thus to suppress RAGE protein and to achieve the preventive and therapeutic effect for AD.

ObjectiveTo improve the diagnosis, treatment and prophylaxis of fungal infections following orthotopic liver transplantation (OLT). Methods Medical records from 175 consecutive patients who underwent 180 OLT at our centre from 1993 and 2002 were retrospectively reviewed for fungal infection. ResultsTwenty nine patients(16 6%) developed invasive fungal infection. Median posttransplantation interval was 26 days (range 3 to 96) and respiratory tract was the most common infectious site (37%). Pathogens were Candida species (24 of 43, 98%) and Aspergillus (1 of 43, 2%). Fungal infections occurred significantly more often in patients with the length of time in parenteral nutrition, antibiotic use over 3 weeks or hepatic artery complications. After treatment with Fluconazole (26 patients) and liposomal amphotericin B (8 patients with serious fungal infections), 16 patients were cured and 13 patients died. The mortality related to fungal infection was 4 0% (7/175). Conclusion Fungal infections are associated with mortality following OLT. Eliminating the various risk factors will decrease the incidence of fungal infection. Amphotericin B or liposomal amphoterin B are effective for patients with serious fungal infection.

OBJECTIVETo study that low-intensity microwave whether or not enhances the genotoxic effects of mitomycin C(MMC) on human lymphocytes.

METHODSSingle strand DNA breaks and chromosomal aberrations were measured by comet assay and cytokinesis-blocked micronucleus(CBMN) test in vitro when human lymphocytes were exposed to 2,450-MHz microwave (5.0 mW/cm2) alone and in combination with mitomycin C.

RESULTSIn the comet assay, the average comet lengths of microwave group[(29.1 +/- 8.1) micron in male and (25.9 +/- 7.5) micron in female] were not significantly different from those of control groups [(26.3 +/- 6.6) and (24.1 +/- 4.3) micron respectively] (P > 0.05). The average comet lengths of MMC group(0.0125, 0.0250, 0.0500, 0.1000 microgram/ml) were significantly longer than those of control groups (P < 0.01) and were increased with the dose of MMC. The average comet lengths of microwave combined with MMC (MW + MMC) also were increased with the doses of MMC and were significantly longer than those of control groups (P < 0.01). When MMC was > or = 0.0250 microgram/ml, microwave and MMC synergistically increased the single strand DNA breaks. In the micronucleus test, the average micronucleus rates of microwave groups were not higher than those of control groups (P > 0.05). The average micronucleus rates of MMC groups and MW + MMC groups were significantly higher than those of control groups (P < 0.01) when MMC was > or = 0.0500 microgram/ml. The average micronucleus rates of MW + MMC groups seemed higher than those of corresponding MMC groups, however the difference was not significant (P > 0.05).

CONCLUSIONLow-intensity(2,450-MHz) microwave did not induce DNA and chromosome damages on human lymphocytes, but enhanced the effects of DNA breaks induced by MMC.

Chromosome Aberrations ; Comet Assay ; DNA Breaks, Single-Stranded ; Female ; Humans ; Lymphocytes ; drug effects ; radiation effects ; ultrastructure ; Male ; Micronuclei, Chromosome-Defective ; Microwaves ; adverse effects ; Mitomycin ; toxicity

Objective To develop the social support system for family caregivers of schizophrenic patients in community. Methods Based on the previous field investigation and the principle of comprehensiveness,feasibility,pertinence,suitability,generality and classification,the social support service item pool was established. Fifteen experts with intermediate or higher professional titles and working in the mental health fields were selected from government departments,specialized hospitals and community health service centers. The experts were consulted by Delphi and the results were analyzed. Results The average age of the consultation specialists was (40.7 ± 8.0) years, and the duration of working in mental illness rehabilitation was (14.9±7.6) years. The positive coefficients of the two rounds of consultation were 100％,the authoritative coefficients of experts were 0.795,and the coordination coefficients of opinions were from 0.252 to 0.344, respectively. The 67 items of social support service for family caregivers of schizophrenic patients in Beijing were obtained after two rounds of expert consultation, but fewer of the services were for schizophrenic caregivers only. Conclusion The authority and society should take measures to establish a social support system for family caregivers of patients with schizophrenia, in order to reduce their family burden and improve the quality of rehabilitation for mental patients in the community.