OBJECTIVE:To investigate the expression difference and its mechanism of miR-497 and miR-34a in platinum-sen-sitive and platinum-resistant epithelial ovarian carcinoma(EOC)patients. METHODS:A total of 72 EOC patients underwent ovari-an cancer staging surgery or cytoreductive surgery were selected from department of gynaecology and obstetriscs of our hospital dur-ing Jan. 2008-Jan. 2012. They received standardized platinum chemotherapy after surgery and were followed up (during Jul.2008-Jul.2016). According to the sensitivity to platinum,those patients were divided into platinum-sensitive group (42 cases) and platinum-resistant group (30 cases) . Real-time fluorescent quantitative PCR was adopted to detect the expression of miR-497 and miR-34a in tumor tissue,and the relationship of it with total survival period was investigated. The levels of DNA methylation of miR-497 and miR-34a promoter region were determined by nest type land type methylation specific PCR. Western blot assay was used to detect the H3K9 dimethylation(H3K9me2)levels. The H3K9me2 levels of miR-497 and miR-34a promoter region were de-termined by chromatin immunoprecipitation method. RESULTS:The expression levels of miR-497 and miR-34a in platinum-sensi-tive group were significantly higher than platinum-resistant group,with statistical significance (P<0.05). Total survival period of 72 patients was(45.7±17.5)months,which was positively correlated with the expression levels of miR-497 and miR-34a(r2 were 0.2714,0.3782,P<0.01). The DNA methylation of miR-497 and miR-34a promoter region in platinum-resistant group was signif-icantly higher than platinum-sensitive group,and H3K9me2 level of promoter region was significantly higher than platinum-sensi-tive group,with statistical significance (P<0.05 or P<0.01). H3K9me2 levels of platinum-resistant group were slightly higher than that of platinum-sensitive group,but there was no statistical significance (P>0.05). CONCLUSIONS:The expression of miR-497 and miR-34a in tumor tissue of EOC patients are related to the sensitivity of platinum chemotherapy and the survival time of patients. DNA methylation and histone methylation of promoter region may be one of the mechanisms of their expression changes.

Aim To study the effects of HSP70 on hepatic ischemia-reperfusion injury after heat preconditioning in rats.Method To establish the models of the hepatic ischemia-reperfusion injury. 42 Wistar rats were randomly divided into 6 groups, (each group had 7 rats): normal group(N); quercetin injection group(Q); ischemia-reperfusion group(I); heat preconditioning 16 hours before ischemia-reperfusion group(H+I); quercetin injection before heat preconditioning group(Q+H+I); quercetin injection before ischemia-reperfusion group(Q+I).We detected the activity of serum enzyme of ALT,AST and the pathological changes of the liver;The expressions of HSP70 of the rats were observed by Western blotting. Results The expressions of HSP70 from high to low were:group H+I,group I,group Q+H+I,group Q+I,group Q,group N; The serum levels of ALT and AST from high to low were: group Q+I,group I,group Q+H+I,group H+I,group Q,group N;All groups had visibly hepatic histological changes respectively.Conclusion The protection of heat stress pretreatment from ischemia reperfusion injury was possibly performed by inducing the expression of HSP70.

Objective To investigate the features of vascular damage in metabolic syndrome (MS) by a comparison of changes in vascular structure and function between spontaneous hypertension (SH) and MS in rats. Methods Pathological study of changes in arteries was carried out. The contractile response of aorta ring and the expression of RhoA, ROCK, eNOS and iNOS were also determined. Results Besides the thickening of arterial wall and proliferation of both intima and smooth muscle layer, marked infiltration of inflammatory cell appeared in large and medium arteries of MS rats, and obvious hyaline degeneration was found in mesenteric arterioles. Moreover, the relaxant response of aorta ring was weakened markedly in MS rats, while the contractile response increased in SH rats dramatically. The expression of RhoA, ROCK increased and that of NOS decreased in MS rats, but the up-regulation of the RhoA, ROCK expression was not as much as in SH rats. Conclusion The damage to both arterial structure and function was much more serious in MS rats than that in SH rats. Activation of RhoA/ROCK system and reduction of NOS expression might be involved in the mechanism.

The teaching of clinical probation is the main link in the course of training medical talents. In the past fewyears the teaching of clinical probation bears much heavier pressure with the health care reform, some new unveiledpolicies and laws, and the growth of student intake scale of clinical medicine. To better carry out the clinical teaching,this article systematically analyzes many relevant factors that influence the clinical teaching. At the same time thearticle also makes research and discussion in relation to the following aspects:the clinical teaching reform,establishingthe teaching system on standardized patients,setting up simulation center for clinical skill training and implementing thesystem of Bachelor-to-Master program and Master-to-Doctorate program.[

Objective To evaluate the clinical significance of detecting serum anti-Saccharomyces cerevisiae antibody (ASCA)IgG and IgA in the diagnosis of Crohn′s disease(CD).Methods A total of 51 patients with CD were enrolled as CD group and 22 healthy volunteers as healthy control group.The serum samples of both groups were collected.ASCA-IgG and ASCA-IgA were determined with enzyme linked immunosorbent assay (ELISA).According to Montreal standard,patients with CD were divided into subgroup according to the age of onset (A),lesion (L),clinical behavior (B).The sensitivity, specificity and positive predictive value of both groups were calculated.Chi-square test was performed for count data analysis.Results The sensitivities of ASCA-IgG and ASCA-IgA in CD group were 45 .1 % and 35 .3%,respectively,while in the healthy control group which were 0 and 9.1 %,respectively.There were significant differences between two groups (χ2 =14.49 and 5 .31 ,both P <0.05 ).The specificities and positive predictive values of ASCA-IgG in CD group were both 100.0%,and those of ASCA-IgA were 91 .0% and 90.0%.The sensitivities of ASCA-IgG in A1 ,A2 and A3 groups were 75 .0%,36.4% and 57.1 %,respectively,and those of ASCA-IgA,were 25 .0%,30.3% and 50.0%,respectively.The sensitivities of ASCA-IgG in L1 ,L2 and L3 groups were 38.5 %,37.5 % and 57.1 %,respectively,and those of ASCA-IgA were 30.8%,31 .3% and 42.9%,respectively.The sensitivities of ASCA-IgG in B1 , B2 and B3 groups were 45 .2%,50.0% and 25 .0%,respectively,and those of ASCA-IgA were 29.0%, 50.0% and 25 .0%,respectively.There was no significant difference in the sensitivities of ASCA-IgG and IgA between the subtgroups of CD group (all P >0.05 ).The sensitivities of ASCA-IgG in CD patients with complications and without complications were 56.3% and 26.3%,respectively,and there was significant difference (χ2 =4.31 ,P <0.05).Conclusions Serum ASCA-IgG is not suitable for population screening,however it has certain value for the differential diagnosis of CD.The clinical value of detecting ASCA-IgG is higher than that of detecting ASCA-IgA.

Objective To explore the value of hysteroscopy in diagnostic curettage, the incidence of complications and preventive measures in senile women. Methods One hundred and thirteen senile patients who underwent hysteroscopy from January 2002 to December 2007 were recruited in the study, and one hundred and fifty-seven non senile patients were selected as control group. All the patients were operated with diagnostic curettage and hysteroseopy. The success rate of hysteroscopy operation, the incidence of complications and control effect were recorded and compared between two groups. Results The success rate of hysteroscopy operation was 88. 5% (100/113) in the senile group and 100% (157/157) in the non senile group, and there was significant differenee(P <0. 01). The incidence of complications was higher in the senile women group than that in the non senile women group (P< 0. 01). In senile group, the accuracy of diagnostic curettage and hysteroscopy was higher than diagnostic curettage alone, and the success rate was 95.5% (64/67)in estrogen group and 69.6%(32/46) in blank control group (P<0. 01) ,which indicated that estrogen was positively related with the success rate of operation. Compared with misoprostol, estradiol-pretreatment operation was safer and had higher success rate. Conclusions It is safe and feasible to perform hysteroscopy and diagnostic curettage for older women, though it has higher incidence of complications and lower success rate compared with non senile women. Hysteroscopy and diagnostic curettage are more accurate than diagnostic curettage alone, and it is a good choice to apply estradiol before operation.

The experience of "Zhenjing Anshen" acupuncture method originally created by professor WANG Fuchun for treatment of insomnia was introduced in this paper. From aspects of insomnia pathogenesis, theoretical foundation, characteristics of acupoint selection, needing methods, needing time, etc., the experience of Professor WANG Fuchun for treatment of insomnia was explained. The "Zhenjing Anshen" acupuncture method proposed, for the first time, "new three layers" method of acupoint selection, including Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6). This method presents the principles of acupoint selection along meridian, acupoint selection based on essence-qi-spirit, harmony of yin and yang. The acupuncture manipulation is emphasized, and treating time (the period of the day from 3 pm to 5 pm) is focused on; acupoint selection is simple but essential, and acupoint combination is scientific, which receives notable therapeutic effect in clinic.
Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Humans ; Meridians ; Sleep Initiation and Maintenance Disorders ; therapy

Objective:To analyze and compare the volatile components in vinegar-processed schisandrae sphenantherae fructus and vinegar-processed schisandrae chinesis fructus.Methods:The volatile components in vinegar-processed schisandrae sphenantherae fruc-tus and vinegar-processed schisandrae chinesis fructus were extracted by headspace solid phase-microextraction (HS-SPME) and quali-tatively analyzed by GC-MS.Results:Totally 20 kinds of constituents were identified from vinegar-processed schisandra sphenanthera fructus, which accounted for 99.55%of the total volatile components , and totally 21 kinds of constituents were identified from vinegar-processed schisandra sphenanthera fructus, which accounted for 99.90% of the total volatile components .Conclusion: The type and content of volatile components in vinegar-processed schisandrae sphenantherae fructus and vinegar-processed schisandrae chinesis fructus are quite different , and the study can provide scientific basis for the two traditional Chinese medicinal materials .

Objective To investigate the influencing factors of successfully switching to sequential ventilation in patients with prolonged weaning due to acute respiratory failure (ARF) after thoracolaparotomy based on the initial rapid shallow breathing index (RSBI) at 60 min after spontaneous breathing trial (SBT), namely, the f/VT optimal value range of 80-120 times/ (min · L), thus providing the basis for determining the ideal timing of weaning in clinical practice.Methods A prospective observational study of sequential ventilation [RSBI during the initial SBT (60 min), 80-120 breaths/ (min · L)] was carried out in 42 patients on mechanical ventilation (≥ 48 h) due to post-thoracolaparotomy ARF in the ICUs.According to the duration of the mechanical ventilation, the patients were divided into 2 groups : successfully prolonged weaning group (≥ 7 days, n =24) and refractory weaning group (＜ 7 days, n =18).The patients with cardiac failure, aged less 18 or over 80, with hepatic dysfunction, or those needing gastrointestinal decompression after esophageal surgery or upper abdomen surgery were excluded.The demographics, APACHE Ⅱ scores and duration of mechanical ventilation of both groups were recorded, and the respiratory work and oxygen metabolism variables before the switch to sequential ventilation (within 24 hours after admission to ICU) and at the time of switching (24 hours in the ICU after admission) were recorded, respectively: clinical puhnonary infection score (CPIS), assessment of cough severity, pH, PaO2, PaCO2 and PaO2/FiO2;hemodynamic and microcirculation-related variables: HR, MAP, fluid balance, BNP and Lac;endocrine and metabolism variables : Hb, ALB and random serum cortisol (COR).The clinical features and the changes of the above-mentioned variables before and at the time of switching were compared between both groups.The independent sample t test was used for the single factor comparison and Mann-Whitney U test was applied to the non-normal distributions.The Fisher exact probability test was used for the single factor comparison of ranked data such as categorical variables.Results There were no significant differences in age, gender and severity of disease between two groups (P ＞ 0.05);the successfully prolonged weaning group had longer duration of invasive mechanical ventilation and ICU stay compared with the refractory weaning group (P ＜ 0.05).There were significant differences in cough severity, PaCO2, pH, HR and fluid balance between two groups before switching (P ＜ 0.05).Compared with those before switching, in the refractory weaning group there were marked decrease in Lac (P ＜ 0.05), obvious increase in cough severity, pH, Hb and ALB (P ＜ 0.05), but there was no significant difference in COR (P ＞ 0.05);while in the successfully delayed weaning group, there were significant decrease in CPIS, PaCO2, HR, MAP, BNP, fluid balance and Lac (P ＜ 0.05), and cough severity, pH, ALB and COR showed an upward trend (P ＜ 0.05).Conclusions The key of successful sequential ventilation is within the values of RSBI ranging from 80 to 120 times/ (min · L) during the initial SBT (60 min) selected as the switching point in patients with prolonged weaning after thoracolaparotomy.The major influencing factors for determining the ideal timing of switching include the matching status between respiratory endurance and respiratory work, the balance between myocardial strength and both cardiac preload and afterload, the severe disease associated with adrenal insufficiency, and malnutrition.

Objective To evaluate the accuracy of point-of-care testing (POCT) for blood glucose monitoring in critically ill patients.Methods Two hundred and forty critically ill patients,of both sexes,aged 20-88 yr,with Acute Physiology and Chronic Health Evaluation Ⅱ score of 1-45,were enrolled.The venous,arterial and capillary blood samples were collected to determine the real-time blood glucose level using glucose oxidase (GOD) and glucose dehydrogenase (GDH) methods.The blood glucose level measured by central laboratory hexokinase method simultaneously was served as standard level.Error Grid analysis (EGA) and Bland-Altman analysis were used to determine accuracy and consistency,respectively.The accuracy of real-time blood glucose levels within the consistent limits was evaluated.Results 1.The results of EGA showed that 98.7 ％,98.3 ％,98.3 ％(GDH method) and 96.2％,96.6％,96.7％ (GOD method) of the difference between venous,arterial and capillary blood glucose levels measured and the standard level were located in the A and B zones,respectively,and 1.2％,1.7％,1.7％ (GDH method) and 2.9％,3.3％,3.3％ (GOD method) in the D zone.0.8％ (GOD method) of the difference between venous blood glucose levels and the standard level were located in the C zone.2.Bland-Altman analysis showed that the difference between the standard level and glucose level measured in blood samples from the vein,artery and capillary.was-0.1,-0.3,-0.2 mmol/L (GDH method) and-0.9,-1.0,-0.9 mmol/L (GOD method),respectively,and the incidence beyond the upper and lower limits of consistency zone was 4.5 ％,6.7 ％,6.6 ％ (GDH method) and 4.6 ％,5.0 ％,7.1％ (GOD method),respectively.The accuracy of venous,arterial and capillary blood glucose levels within the consistent limits was 94.3 ％,92.1％,93.7％ (GOD method) and 96.6％,95.1％,95.5％ (GDH method),respetively.Conclusion The accuracy of POCT for blood glucose monitored by GOD and GDH methods is good in critically ill patients,but it is possible to overestimate the patient's real glucose level.