Objective Qualitative research was used to study the psychological experience of caregivers of children with Down syndrome so as to give them necessary support. Methods Objective sampling method was used to select 8 children with Down syndrome caregivers as the research object, using unstructured interviews to collect data and carefully read, analyze, encode and collect the records of interviews, and then sublimate the theme concept reflecting the psychological experience of the research object. Results A total of 4 themes had been raised:the pain and helplessness of the child, the stress and exhaustion of the body, the feeling of hopeless, the desire for support and understanding. Conclusions The psychological stress of the main caregivers of Down syndrome is great, we should help them relieve the pressure, instruct them to train the children correctly, make them strengthen their self-confidence and take better care of their children.

Objective:To compare the performance of chemiluminescent microparticle immunoassay ( CMIA) and enzyme-linked immunosorbent assay ( ELISA) for the determination of Anti-PR3 and Anti-MPO.Methods:Concentration of Anti-PR3 and Anti-MPO in serum samples from 166 patients with autoimmune diseases and 50 healthy donors were determined by using CMIA (Method A) and ELISA(Method B),respectively.The results from both assays were analyzed and compared by statistical methods .Results:Method A showed better intra-assay reproducibility and inter-assay reproducibility than Method B for the determination of high ,medium and low levels of control serum .Both methods met the accuracy requirement .The correlation coefficient of Anti-PR3 and Anti-MPO were 0.987 8 and 0.989 6 for Method A and Method B ,respectively.And the Kappa coefficients were 0.897 and 0.882 for Method A and Method B,respectively.Conclusion:The performance of Method A is superior to Method B for the deter-mination of Anti-PR3 and Anti-MPO, which makes Method A to be a potentially better choice for clinical application .

Objective To investigate the expression and significance of IDO and c-myc in bladder urothelial carcinoma.Methods IDO mRNA expression from fresh tumor and mucosa specimens from 20 cases were detected by fluorescence quantitative PCR,and SP was used to detect the IDO,c-myc protein in paraffin-embeded specimens from 84 cases and mucosa specimens from 22 cases.Results In bladder urothelial carcinoma,IDO,c-myc protein expression level had no relationship with age and sex.Expression of IDO protein in invasive bladder urothelial carcinoma was significantly higher than that of no-invasive (x2 =5.600,P =0.018).With the increase of the histological grade (x2 =20.268,P =0.000) and UICC stage (x2 =12.075,P =0.007),the positive expression rate of IDO protein was increased.There was not positive expression of c-myc protein in normal bladder tissue,but in bladder urothelial carcinoma,44 cases (52.4 ％) were positive expression (x2 =10.733,P =0.001).The expression of c-myc protein had no relationship with the histological classification,histological grade and UICC stage.In bladder urothelial carcinoma tissue,IDO protein expression level was positively correlated with c-myc protein expression (r =0.205,P =0.047),and was positively correlated with the histological classification,histological grade and UICC stage (r =0.258,P =0.018; r =0.491,P =0.000; r =0.365,P =0.001).Expression of IDO mRNA in bladder urothelial carcinoma (7.696 1±1.745 2) was significantly higher than that in normal bladder tissue (6.397 0±1.205 1)(t =2.367,P =0.023).The average expression level of IDO mRNA in bladder urothelial carcinoma of Ta-T1 stage was 6.803 4±1.567 5,which was significantly lower than that in T2-T4 stage (9.183 8±0.690 3) (t =4.955,P =0.000).The average expression levels of IDO mRNA in grade Ⅰ,Ⅱ,Ⅲ bladder urothelial carcinoma were 7.058 7±1.771 5,7.934 2±1.530 5,9.290 7±0.574 5,respectively,which were increased with the grade increasing (t =2.729,P =0.011).Conclusions The high expression of IDO correlates with bladder urothelial carcinoma progression,and expression of c-myc is irrelevant with bladder urothelial carcinoma progression,but maybe associate with bladder urothelial carcinoma occurrence.IDO may be a predictive factor of prognosis.IDO and c-myc may be therapeutic target in the treatment of bladder urothelial cancer.

Objective To investigate the expression and significance of bin 1,C-myc in bladder urothelial carcinoma.Methods SP method was used to detect the expression of bin 1,C-myc protein in paraffin specimens from bladder urothelial carcinoma of 84 cases and mucosa of 11 cases,and its relationship with clinical pathological charac-teristics was analyzed.Results The positive expression rate of bin1 in normal bladder tissues was 81.81%,that in bladder urothelial carcinoma was 46.43%,the difference was not significant (χ2 =4.873,P=0.051).No expression of C-myc was observed in normal bladder tissue ,the positive expression rate of C-myc in bladder urothelial carcinoma was 52.38%,the difference was statistically significant (χ2 =10.733,P=0.001).The expression of bin1 in invasive bladder urothelial carcinoma was significantly lower than the non-infiltrating type(χ2 =7.685,P =0.007),with increased histological grade and UICC stage ,the positive rate of bin1 expression decreased (χ2 =15.817,P=0.000;χ2 =11.104,P=0.010).The expression of C-myc had no relationship with the histological classification ,histological grade and UICC stage .Correlation analysis showed that the expression of bin 1 was negatively correlated with histologi-cal classification,histological grade and UICC stage (r=-0.302,P=0.005;r=-0.411,P=0.000;r=-0.302, P=0.005).With the increased expression of bin1,C-myc expression decreased,but the difference was not statistical-ly significant.Conclusion Low expression of bin1 or loss of bin1expression were associated with the progression of bladder urothelial carcinoma , the expression of C-myc was related with bladder urothelial carcinoma lesions .The results suggest that bin1 may be predictive factor for prognosis of urinary bladder urothelial carcinomas ;bin1,C-myc may be viewed as molecular targets for tumor chemotherapy .

Objective To detect the expression and significance of suppressor of cytokine signaling 3(SOCS3) in the placentas of pregnant women with intrahepatic cholestasis of pregnancy (ICP). Methods Totally, 44 ICP gravidas, including 21 severe ICP and 23 mild ICP who delvered through cesarean section at the Second Xiangya Hospital of Central South University from April 2008 to January 2009, were selected as the ICP group, and another 25 healthy pregnant women were chosen as control. Placentas of the above gravidas were collected and the expression and localization of SOCS3 were determined by immunohistochemical peroxidase streptomyces-avidin link (SP) method (indicated by the percentage ofpositive cells and average gray scale) and the levels of interleukin-10 (IL-10) and interferon-γ (IFN-γ)from placenta homogenation were measured by enzyme linked immunoadsorbent assay (ELISA). Results(1) SOCS3 were expressed in placentas of both groups mainly in the intracytoplasma of trophocyte.However, weakly positive, positive, and strongly positive expressions were found in the severe ICP, mild ICP and the control group, respectively. Almost no expression was detected in membrane and nucleus of the trophoblasts. (2) The percentage of SOCS3 positive cells in the severe ICP group was significantly lower than in the control and the mild ICP group, respectively [ (0.15±0.08)% vs (0.69±0.12)% and (0.42±0.09) % , P < 0.01 ]. The average gay SOCS3 in placental tissue in the severe ICP group was significantly higher than that in control and mild ICP group, respectively (204 ±7 vs 81 ±7 and 147 ± 7, P <0.01 ).(3) Significant lower level of IL-10 in placenta homogenation was found in the severe ICP group than in the control and mild ICP group [ ( 1.16 ± 0.68) μg/L, vs ( 1.39 ± 0.08) μg/L and ( 1.22 ± 0.75 ) μg/L,P < 0.01 ]. (4) The opposite results were found in the level of IFN-γin trophoblasts and the ratio of IFN-γ/IL-10 [ severe ICP group: ( 16.8 ± 0.7 ) μg/L and 16.02 ± 2.79; control group: ( 10.5 ± 0.3 ) μg/L and8.56 ±0.14; mild ICP group: ( 13.4 ±0.5) μg/L and 8.56 ±0.14, P <0.01]. (5) Negative correlation was shown between the percentage of SOCS3 positive cells in trophoblasts and the ratio of IFN-γ/IL-10 ( r =-0.685 and -0.702, P < 0.01 ), and the average gay SOCS3 was positively correlated with the ratio of IFN-γ/IL-10 (r=0.621 and 0.891, P<0.01) in both mild and severe ICP group. Conclousions SOCS3 may participate in the pathogenesis of ICP and its expression may affected by the severity of ICP, and SOCS3may also play a role in the immunological regulation in ICP patients.

Objective To investigate the role of CD4+CD25+regulatory T cells and CD4+CD25gigh regulatory T cells in peripheral blood and decidua in the pathogenesis of intrahepatic cholestasis of pregnancy (ICP).Methods Peripheral blood and decidua CD4+CD25+regulatory T ceHs and CD4+CD25high regulatory T cells in 30 ICP patients(15 mild ICP and 15 severe ICP)and 28 normal pregnant women were analyzed by flow cytometry.Results The percentage of CD4+CD25+ regulatory T cells and CD4+cD25high regulatory T cells in the CD4+T cells population in both peripheral blood and decidua in ICP patients were significantly lower than those in control women[(7.96±1.32)%vs(17.05 ±2.86)%,(17.18±2.27)%vs(32.01±3.88)%;(0.78±0.22)%vs(1.71±0.69)%,(2.25±0.89)%vs(8.30±1.13)%;P<0.01].Meanwhile,a significantly higher percentage of CD4+CD25+regulatory T ceHs and CD4+CD25high regulatory T cells in the C4+T cells population was observed in all decidua samples compared to peripheral blood both in ICP patients(P<0.01)and in control women(P<0.01).In addition,the percentages ofCD4+CD25+ regulatory T cells and CD4+CD25high regulatory T ceHs in the CD4+ T cell population in both decidua and peripheral blood in severe ICP[(15.94±1.95)%,(7.17±1.17)%,(1.87±0.90)%,(0.68±0.19)%]were lower than those in mild ICP [(18.43±1.90)%,(8.74±0.96)%,(2.62±0.72)%,(0.89±0.20)%] and normal pregnancy(all P<0.05).Conclusions CD4+CD25high regulatory T cell may play all important role in the pathogenesis of ICP and control of disease progression.

Objective To study the effect of night large dose of sodium valproate on epileptiform discharges,and cognitive function of benign childhood epilepsy with centrotemporal spikes. Methods Ninety cases of benign childhood epilepsy with centrotemporal spikes were randomly divided into treatment group and control group (n= 45), both groups received regular total doses of sodium valproate therapy 25-30 mg?kg-1 ?d-1 . Patients in the treatment group received treatment that night doses of sodium valproate was double of morning doses. Every night dose was (17.96±1.21) mg?kg-1 , and every morning dose was (8.92±0.62) mg?kg-1 . The control group received the same dose [(13.37±0.80) mg?kg-1 ] of sodium alproate therapy twice a day, morning and evening. The epileptiform discharges, cognitive function, therapy effect were compared between two groups. Results Total effective rate of treatment group was 82.22% which were was significantly higher than that of the control group 62.22%(P<0.05);Epileptiform discharges reduction of treatment group was significantly higher than that of the control group (P<0.05), the effective rate of EEG improvement (84.44%)in treatment group was significantly higher than that in the control group 66.67% (P<0.05); FIQ, VIQ, PIQ in treatment group were significantly higher than those in the control group (P<0.05); There were no statistical differences of adverse reactions between two groups. Conclusion Night large dose of sodium valproate treatment can help control epileptic discharge, increase the plasma concentration, improve cognitive function, and therapy effect.

Cellular immunotherapy such as that.initiated by dendritic cell (DC) is capable of eradicating cancer stem cells and restoring the homeostasis imbalance,and therefore has emerged as a promising approach to cure tumor.The first therapeutic DC vaccine in world has been approved by American FDA.However,the satisfactory therapeutic benefits of DC vaccine observed in vitro and in vivo (animal) studies could barely be recapitulated in clinical settings.The advantages of DC immunotherapy,achievements and challenges are introduced.

Since the beginning of clinical use in the 1970s,hemoglobin A1c (HbA1c) has become the standard tool for monitoring glycemic control in patients with diabetes.The role of the HbA1c test was broadened in 2010,when the American Diabetes Association added HbA1c as a diagnostic criterion for diabetes.However,hemoglobin variants,various clinical scenarios and drugs may yield false results that would mislead clinical diagnosis and treatment.

Objective To investigate the possible mechanism of Gongqing Granule(Granule for Clearing the Uterus) on shortening the duration of vaginal bleeding after medical abortion.Methods The 120 unwanted pregnancy women within 49d of intrauterine gestation were randomly divided into three groups.Gongqing Granule combined with mifepristone and misoprostol was administered orally in Group A(treatment group).Qianzhi Capsule combined with mifepristone and misoprostol was administered orally to Group B(control group),and only mifepristone plus misoprostol was administered orally to Group C(blank group).Other 40 women(Group D,induced abortion group),were treated with vacuum aspiration for abortion.Chorionic villi and decidual tissue were collected and expression of Bax and Bcl-2 were detected by immunohistochemical method and Bax mRNA and Bcl-2 mRNA by situ hybridization.Results The expression of Bax,Bcl-2,Bax mRNA and Bcl-2 mRNA was found in all groups.The expression of Bax and Bax mRNA in the treatment group was higher than those in the control group,then the blank group,and then induced abortion group.While the expression of Bcl-2 and Bcl-2 mRNA of the treatment group was lower than those in the control group,then the blank group,and then induced abortion group(P