Objective To investigated the association between bone morphogenetic proteins-2 (BMP-2)gene mutation and coal-burning skeletal fluorosis of children in Zhijin Guizhou.Methods In 2010,121 cases of children with skeletal fluorosis were diagnosed based on the standard X-ray Diagnosis of Skeletal Fluorosis (WS192-1999) in coal-burning skeletal fluorosis areas in Zhijin Guizhou,and 50 cases of them were selected as skeletal fluorosis group.Thirty healthy children free of skeletal fluorosis,rickets and other bone related diseases excluded by X-ray were selected as a control group in the same area.Using polymcrase chain reaction combined with DNA sequencing technology,all three exons of BMP-2 gene were conducted sequence screening in skeletal fluorosis and the control groups to detect gene mutations.Results ①The T insertion mutation on exon 1 between 401-402 bp:the T insertion mutantion genotype frequencies of skeletal fluorosis group and the control group were 27.7％ (13/47)and 7.1％ (2/28),and the difference was statistically significant (x2 =4.600,P ＜ 0.05),adjusted OR value of 4.62(1.94-10.90).②)The 894 bp T→G mutation on exon 2:the TG genotype frequencies of skeletal fluorosis group and the control group were 14.0％ (7/50) and 16.7％(5/30),and the difference were not statistically significant (x2=0.103,P＞ 0.05).③The 1 046 bp A→G mutation on exon 2:the AA,AG,GG genotype frequencies of skeletal fluorosis group and the control group was 30.0％ (15/50),24.0％ (12/50),46.0％ (23/50) and 50.0％ (15/30),20.0％(6/30),30.0％ (9/30),and the differences were not statistically significant (x2 =3.099,P ＞ 0.05).Conclusion Exon 1at 401-402 bp,T insertion mutation and skeletal fluorosis are closely related.The relationship between A→Gmutation in exon 2 at 1 046 bp and skeletal fluorosis is not significant.

Objective To investigate the effects of methylprednisolone on severe bronchial asthma treatment and intervention effect. Methods According to the different treatment methods will be January 2016 to March 2017 year in our hospital 90 cases of patients with severe bronchial asthma were selected,and randomly divided into observation group and control group,45 cases in each groups.The control group with conventional treatment method, the observation group used conventional methylprednisolone therapy; two the experimental results were recorded in detail, and the relevant data for comparative analysis, investigate the effects of methylprednisolone in treatment of severe bronchial asthma and intervention effect. Results The observation group (conventional methyl prednisolone) clinical treatment effect is better than that in control group (conventional) clinical efficacy, clinical symptoms disappeared. Time and so on were better than the control group, the adverse reaction rate were lower than the control group, there were significant differences between the groups (P<0.05) .Conclusion Severe bronchial asthma patients choose conventional methylprednisolone treatment significantly, in a short period of time can effectively improve the clinical symptoms and the adverse reaction is less, it is widely used in clinical treatment of severe bronchial asthma patients.

Objective To identify the differentially expressed genes in cardinal ligament between patients with pelvic organ prolapse ( POP) and postmenopausal women without POP by Human Genome Expression Chip and explore the potential molecular mechanism involved in POP.Methods From January to May,2007,cardinal ligament samples were obtained from 3 postmenopausal patients with POP-Q stage Ⅲ and 3 postmenopausal patients underwent hysterectomy due to other benign gynecologic diseases without POP in Peking Union Medical College Hospital.HE and Masson's trichrome staining was used to verify tissue origin and inspect histological changes.Those differentially expressed genes in cardinal ligaments were identified by Human Genome Chip and further interrogated with Gene Ontology (GO) and Pathway Analysis.Those remarkable expressed genes were confirmed by qRT-PCR.Results Alterations of ligament architecture in POP patients included disarrangement and collapse of smooth muscle bundles and collagen fibers.A total of 179 differentially expressed genes were screened between POP and non-POP cardinal ligament tissue,including 20 functional unknown genes.A total of 107 genes were upregulated in POP group,while 72 genes downregulated.Those differentially genes were revealed associated with multiple functional proteins and metabolic pathways by biological analysis.Among these,Wnt signaling pathway exhibited the most remarkable changes.Real-time quantitative PCR showed the genes of COL1Al,DKK1,SFRP1,FZD5,WNT16b in POP group (2.98 ±1.40,3.03 ±0.48,8.13 ±4.42,5.19 ±3.50,12.40± 3.88) were upregulated significantly compared with non-POP group (1.09 ±0.08,1/20 ±0.18,0.41 ± 0.51,0.87 ±0.24,1.40 ±0.47; P < 0.05 ).Conclusions The pathophysiology of POP is complex and associated with multiple functional proteins and metabolic pathways.Among these,the antagonist DKK1,SFRP1 in Wnt signaling pathway may contribute to a neurodegenerative role in POP development.

Objective To investigate the clinical characteristics,diagnosis and treatment of vaginal intraepithelial neoplasia(VAIN).Methods A retrospective study was made of 6 patients with VAIN.who were hospitalized at Peking Union Medical College Hospital from 1980 to 2006.Results Five cases had a history of hysterectomy,two of whom were because of cervical intraepithelial neoplasia(CIN)or invasive cervical cancer.Four cases had the infection of high-risk oncogenic human papillomaviruses detected with hybrid capture Ⅱ(HC-Ⅱ),the other two had no record.In all patients the VAIN lesions were within the upper one third of the vagina.They were all diagnosed by colposcopic examination and directed biopsy after the abnormal cytology by thinprep cytology test(TCT).Six cases of VAIN Ⅱ-Ⅲ were treated by excisional surgery.One case had residual lesion and had another surgery 3 months after the first one.Two patients obtained remission at one-year follow-up,three had abnormal cytology by TCT 6 months after surgery,and one had abnormal cytology by TCT at six-month follow-up but normal at one-year follow-up.Conclusions A history of CIN is the main risk factor for VAIN,so routine vaginal cytology is needed for the patients after hysterectomy due to CIN.Cytology,colposcopic examination and directed biopsy are the mainstays of VAIN diagnosis.Excisional surgery is recommended for the patients with VAIN Ⅱ-Ⅲ.Long term follow-up is necessary after treatment.

Objective? To construct the critical illness patient inter-hospital referral process of primary hospitals based on Delphi method so as to provide a basis for the inter-hospital critical illness patient standardized referral process in the medical alliance model. Methods? The inter-hospital referral process was designed by retrieving literatures at home and abroad, and was demonstrated and revised with the modified Delphi method. Results? We constructed a total of 30 items from four aspects including work preparation of medical staff as well as reception medical staff before inter-hospital referral, risk-prevention during referral and patients' condition after referral. Among two rounds of expert consultation, the active coefficients were all 100% and the authority coefficients were all 0.843 respectively. Conclusions? The critical illness patient inter-hospital referral process of primary hospitals based on modified Delphi method accords with the principle of scientific nature and operability which has positive a meaning for standardizing clinical inter-hospital critical illness patient referral.

There are many factors that may affect the microenvironment of acute and chronic wounds.This article reviews the relationship between temperature factor in the external microenvironment of wound surface and wound healing.The temperature changes in different types and stages of wounds are closely related to the wound healing status.Therefore,wound temperature monitoring provides timely,reliable,and non-invasive method in the evaluation of wound status.As low temperature affects the physiological state of wound,relieving the low temperature state and maintaining normal temperature of the microenvironment of wound can promote wound healing.Further research is needed on the wound repair related effector cell proliferation and the mechanism of regulatory function to determine the optimal constant temperature and heat treatment duration needed for wound healing.