Objective To study the clinical significance of dexamethasone (DT) in the combined spinal and epidural anesthesia for delivery of elderly parturient women. Methods 134 elderly parturient women were selected as the research object, and randomly divided into two groups. 69 cases in DT group received intramuscular injection of dexamethasone and combined anesthesia, while 65 cases in INN group received intramuscular injection of tramadol (INN) and combined spinal and epidural anesthesia. The anesthetic effect of the two groups were observed. Results After treatment, the interleukin (IL-6), myeloperoxidase (MPO), tumor necrosis factor-α (TNF-α) and methane dicarboxylic aldehyde (MDA) in DT group were significantly higher than INN group (P<0.05). The five kinds of immunoglobulins levels (IgA, IgD, IgE, IgG and IgM) in DT group were higher than those in INN group (P<0.05). The heart rate (HR) in DT group was lower and mean arterial pressure (MAP) was higher than that in INN group(P<0.05). There was 1 cases of macrosomia, 2 cases of premature delivery in DT group, the adverse pregnancy outcomes was 4.35%(3/69). there was 1 cases of macrosomia, 1 cases of congenital deformity, 1 cases of premature delivery and 1 case of postterm delivery in DT group, the adverse pregnancy outcomes was 5.80%(4/69), with no significant difference between two groups. Conclusion Dexamethasone combined with anesthesia is very effective for delivery of elderly parturient women which shows very good anti-inflammatory and immunoregulation.

Among 172 patients with coronary artery disease (CAD),94 received community and hospital joint management (joint group) after percutaneous coronary intervention (PCI) for Ⅰ year and 78 received community-based health education only (control group) after PCI.The compliance of medication,readmission rate,times of hospitalization,medical costs,major adverse cardiac events (MACE),and general quality of life inventory (CQOLI-74),self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were compared between two groups.The rate of readmission,times of hospitalization,medical costs,the sores of SAS and SDS in joint group were lower than those in control group(P ＜ 0.01 or 0.05).The compliance of medication,body health dimension,psychological health dimension and social function dimension in joint group were better than those in control group,but there were no differences in material life dimension and the MACE rate between two groups(P ＞ 0.05).Community and hospital joint management can reduce the readmission rate and medical burden,and improve quality of life for elderly CAD patients after PCI.

Objective To explore the CT and MR features of malignant peripheral nerve sheath tumor (MPNST) of adults.Methods The CT and MRI findings of 20 patients of MPNST confirmed by pathology were analyzed retrospectively.Results Among 20 cases,the lesions were located in the lower extremities (n=4),shoulder and spine (n=4),abdomen (n=3),chest wall (n=2),mediastinum (n=2),breast (n=1),prostate (n=1),scrotum (n=1),scalp (n=1),left maxillary sinus and orbital bottom (n=1).Nineteen cases appeared as solid masses and 1 case appeared as diffuse lesion.The maximum cross section of the lesions were about 1.41 cm× 1.42 cm-17.10 cm× 18.08 cm.Sixteen cases were ill defined margin and 4 cases were well-defined margin.CT scan showed 14 cases were lower density or isodensity and with patchy inhomogeneous density.Multiple calcification were found in 2 cases and osteolytic destruction were found in 7 cases.Enhanced CT of 10 cases showed solid component and gradually delayed enhancement,while cystic lesion and necrosis were not enhancement.The tortuous arteries were displayed in 7 cases.Seven cases were performed MRI and the lesions appeared as hypo-intensity on T1WI and hypo-intensity on T2WI with obviously high intensity of cystic component.Enhanced MRI of 3 cases showed significantly heterogeneous enhancement,cyst and necrosis had no enhancement.MR dynamic enhancement of 1 case showed time-signal intensity curve was platform type.DWI showed high signal.Conclusion MPNST has certain CT and MR characteristics which are helpful to improve the diagnostic accuracy.

Objective To observe the expression of cell proliferation and apoptosis in congenital pulmonary cyst and to investigate their effect in the development of aspergillus.Methods Immunohistochemical method was used to detect the expression of KI-67、BCL-2 and BAX in normal lung tissue from 10 adult(control group 1,CG1),relative normal lung tissue around the aspergillus from 20 aspergillus cases(control group 2,CG2)and abnormal lung tissue from 20 aspergillus cases.Results The expressions of KI-67,BAX and the ratio of BAX/BCL-2 in the bronchial epithelium of aspergillus were significantly higher than those in two control groups(P

Objective To study the role of cutaneous nerve and protease activated receptor 2 (PAR2)in the development of pruritus in atopic dermatitis(AD).Methods Dermal sheets were prepared from chronically pruritic skin lesions of 7 patients with AD,as well as from the normal skin of 7 healthy human controls.Double labeled immunofluorescence was performed using mouse anti-protein gene product 9.5(PGP9.5)monoclonal antibody and rabbit anti-substance P(SP)polyclonal antibody to observe the morphological changes in cutaneous nerve fibers,and Image-Pro Plus 6 software was used to semiquantitively assess the length,diameter of nerve fibers,integral optimal density of PAR2 and SP in dermal sheets.Results Immunofluoresence double staining showed that PAR2 co-expressed with PGP9.5 or SP in cutaneous nerve fibers.Compared with the normal control skin,both the total length and average diameter of PGP 9.5-expressing nerve fibers were increased(11051.8±1900.9 μm vs 7264.0±2659.9 μm,4.23±0.15 μm vs 3.95±0.15 μm,both P＜0.01)in pruritic lesions,while only the average diameter of SP-expressing nerve fibers was up-regulated(3.99±0.20 μm vs 3.80±0.07 μm,P＜0.05),and the total length of them remained unchanged(4304.7±1455.0 μm vs 3380.0±1735.4 μm,P＞0.05).Also,increased integral optimal density was observed for SP and PAR in pruritic lesions in comparison with the normal control skin (27.71±16.52 vs 12.63±4.31.35.99±8.63 vs 22.69±9.56.both P＜0.05).Conclusion Our results indicate a hyper-plasia of cutaneous nerve fibers in chronic itchv skin lesions of AD and an increase in the expression of PAR2 and SP in the cutaneous nerve fibers,suggesting that the signal enhancement in PAR2 pathway may be related to the mechanism of pruritus in patients with AD.

Objective To evaluate the effect of exogenous wild PTEN gene stable transfected into human ovarian cancer cell line HO-8910 on phosphatidyl inositol 3-kinase( PI3K)/protein kinase B (Akt)siganal pathway and cells proliferation. Methods Wild-type PTEN recombinant eukaryotic expression plasmid was constructed and then was transfected into HO-8910 cells by lipofectamine 2000. The expression of PTEN, Akt1, Akt2, PI3K mRNA and protein of PTEN were tested by reverse transcription( RT)-PCR and Western blot. The proliferation of HO-8910 after wild PTEN gene transfected was measured by methyl thiazolyl tetrazolium(MTT). Results Wild-type PTEN gene was successfully transfected into HO-8910 cells. The results of RT-PCR and western bolt showed that there were the significant expression high level of PTEN mRNA and protein after infected by wild-PTEN plasmid than those in the control[ ( 17 372 ±23)vs.(39±1 )vs. (78 ±4)copies/ml,P ＜0. 05 ]. While the expression of mRNA of Akt1, Akt2 and PI3K were decreased clearly than those in the control [ (28 ± 2 ) vs. ( 115 ± 5 ), (7 ± 1 ) vs. ( 18 ± 2), (61 ± 2 ) vs.(84 ± 2)copies/ml , all P ＜ 0. 05 ]. The proliferation rate of HO-8910 cells was obviously slower than those in the control (90 158 ±47 vs. 148 251 ±65 vs. 250 115 ±62, P＜0.05). Conclusion Transfection of PTEN may increase the expression of PTEN and inhibit the proliferation of HO-8910 cells, in which PI3K/ Akt siganal pathway is inhibit significantly.

Objective: To investigate the role of nuclear factor ?B (Rel/NF-?B) in pathogenesis of atopic dermatitis(AD) and the effect of topical 0.1%(mass fraction) or 0.03%(mass fraction) tacrolimus ointment on expression of NF-?B in lesional AD skin. Methods: Immunohistochemistry has been employed to study the expression of NF-?B in normal skin and lesional AD skin before and after using topical tacrolimus ointment. Results: The expressions of NF-?Bp50 and NF-?Bp65 were scattering or negative in normal keratinocytes. NF-?Bp50 was overexpressed on nuclear of basal and suprabasal keratinocytes in 9 cases of AD, NF-?Bp65 was overexpressed in cytoplasm and perinuclear of basal and suprabasal keratinocytes. After using topical tacrolimus ointment for three weeks , nuclear NF-?Bp50 expressed on basal and suprabasal keratinocytes were lost and NF-?Bp50 was expressed sparsely on basal keratinocytes cytoplasm or nuclear. NF-?Bp65 was expressed sparsely on basal and suprabasal keratinocytes cytoplasm. Conclusion: These data suggest that increased NF-?B activity may represent the basis of initiation or maintenance of the skin inflammatory response in atopic dermatitis. Topical tacrolimus may directly or indirectly inhibit NF-?B nuclear expression in keratinocytes and inhibit skin innate immuno-inflammatory response in atopic dermatitis that related to NF-?B.

Objective To study the effect of the respiratory amplitude on the dose distribution of volumetric modulated arc therapy (VMAT).Methods Respiratory motion simulation phantom (QUASAR) was used to simulate the respiratory movement from head to toe,and a two-dimensional ionization chamber matrix was used to collect the dose distribution in isocenter with different respiratory amplitude.Verisoft software and absolute dose analysis were used to analyze dose distribution,percentage errors of absolute dose in isocenter,passing rates of radiation field for the data collected,and results were compared to planned dosage.Results The effect on isocenter target dose of respiratory motion was below dose tolerance 5％ (t =-22.614--10.756,P ＜ 0.05).The respiratory movement made the dose on the edge of the target area higher,with fewer hot spots and more cold spots in the target area.As the respiratory amplitude increased,the effect of respiratory movement on the overall dose distribution in the target area was greater.The difference of the whole beam γ passing rate between 6,8,10 mm and stationary state was significant (t =3.095,8.685,14.096,P ＜ 0.05).The difference of target γ passing rate between 8,10 mm and stationary state was significant (t =6.081,9.841,P ＜0.05).Conclusions The respiratory movement could cause the dose transmission errors of VMAT,the error increased with increased range of motion.The actual radiation dose for normal tissues along the direction of respiratory movement on the target edge was higher than what was planned.

Objective The plasma levels of fibrinogen degradation products (FDP),D-dimer(DD) and fibrinogen (Fg) in patients with rheumatoid arthritis (RA) were tested and the relationship between the upregulated coagulation system and disease activity were explored.Methods Patients were divided into the active group and the remission group and 50 patients were included in each group.Hematological variables,including FDP,DD,Fg,and disease activity parameters including erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) levels and rheumatoid factor (RF) titer were measured.Two-sample t-test,linear correlation test and Chi-square test were nsed for data analysis by SPSS 11.0 software.Results Age and sex were comparable in the two groups (P＞0.05).The FDP,DD and Fg were significantly higher in patients with active disease [(12.0±8.2) μg/ml, (3.1±3.1) μg/ml, (4.6±1.4) g,/L] than those in patients with remission [(2.1±1.1) μg/ml, (0.4±0.4) μg/ml, (3.0±0.6) g/L,all P＜0.01 ].There was no difference in gender distribution in FDP and DD (P＞0.05).However,Fg was significantly higher in men than that in women (P＜0.05).FDP showed a significantly positive correlation with DAS28 (r=0.48,P＜0.01) and ESR(r=0.28,P＜0.05).DD correlated positively and significantly with ESR and DAS28 (r=0.69,0.52,all P＜0.01).Fg was significantly positively correlated with DAS28,CRP and ESR (r=0.57,0.64,0.68,all P＜0.01).FDP,DD and Fg were not correlated with RF (r=-0.07,0.06,-0.01,all P＞0.05).Conclusion FDP and DD correlate well with disease activity and may be important disease activity parameters for RA.The rank of sensitivity of FDP,CRP,DD,ESR,Fg and RF for disease activity assessment of RA presents in a declined manner.

Objective To retrospectively analyze the prognostic factors for locoregionally recurrent early?stage extranodal nasal?type natural killer/T?cell lymphoma ( NKTCL) . Methods A total of 56 patients with early?stage extranodal nasal?type NKTCL, who had locoregional recurrence after initial treatment and then received salvage treatment from 1995 to 2014, were enrolled as subjects. The effects of salvage treatment on the overall survival ( OS) rate were analyzed after initial treatment and recurrence. Univariate and multivariate prognostic analyses were performed on the OS rate after recurrence. Results The median follow?up time was 35. 9 months after initial treatment and 14. 8 months after recurrence. The 3?year OS rate was 73% after initial treatment and 58% after recurrence. Compared with chemotherapy alone, radiotherapy?containing salvage treatment significantly improved the OS rates after initial treatment and recurrence ( P=0. 040, 0. 009 ) , and re?irradiation also significantly improved the OS rates after initial treatment and recurrence (P=0. 018, 0. 019). Most (84%) of the acute and late adverse reactions after re?irradiation were grade 1?2 ones. The univariate and multivariate analyses showed that the Karnofsky Performance Status score, radiotherapy in initial treatment, and radiotherapy in salvage treatment were influencing factors for the OS rate after recurrence. Conclusions Radiotherapy achieves improved survival and tolerable toxicities, making it indispensable in the treatment of locoregionally recurrent extranodal nasal?type NKTCL.