Objective To investigate the levels of transformation growth factor-β1 (TGF-β1),vascular endothelial growth factor (VEGF) and insulin growth factor-Ⅰ (IGF-Ⅰ) role in the pathogenesis of serum of patients with combined pulmonary fibrosis and emphysema (CPFE).Methods Recruited 20 patients with CPFE,40 cases with idiopathic pulmonary interstitial fibrosis (IPF) and 40 cases with emphysema who were admitted to our hospital during July 2011 to February 2012.Serum levels of TGF-β1,VEGF and IGF-Ⅰ were detected by ABC-ELISA.Results Serum levels of TGF-β1 and IGF-Ⅰ were significantly higher in patients with CPFE and IPF than these in patients with emphysema (TGF-β1:(160.73 ± 40.62) ng/L vs.(167.35 ± 42.82) ng/L vs.(128.75 ±35.77) ng/L; IGF-Ⅰ:(179.65 ±60.73) ng/L vs.(192.32 ±58.75) ng/L vs.(148.73 ±49.67) ng/L,P ＜ 0.05 or P ＜ 0.01).The IPF group had significantly higher serum level of VEGF than the emphysema group ((506.12 ±82.37) ng/L vs.(437.31 ±62.58) ng/L,P ＜0.01).Serum levels of TGF-β1 and IGF-Ⅰ in CPFE and emphysema groups were positively correlated (r =0.885,0.918 respectively,P ＜ 0.01).Smokers in the CPFE group had significandy lower level of serum VEGF than those who did no smoke ((406.19 ± 66.94) ng/L vs.(482.88 ± 79.91) ng/L,t =-2.287,P =0.035).Conclusion Serum level of VEGF increased significantly in the IPF group,suggesting the participation of VEGF in pulmonary interstitial fibrosis.IGF-Ⅰ involved in the pathogenesis of pulmonary interstitial fibrosis.TGF-β1 and IGF-Ⅰ have a positive linear regressive relationship,which indicates that they may work synergistically in the process of the fibrosis.

Objective To evaluate the values of the combined eGFR and qualitative determination of urine albumine on in both during and 3 years after hospitalization prognosis of after PCI.Methods One thousand and five PCI patients were divided into 4 groups by level of eGFR and qualitative determination of urine albumine.A group:eGFR ＜ 60 ml/min,urine albumine negative ( n =34 ) ; B group:eGFR ＜ 60 ml/min,urine albumine positive ( n =34) ; C group:eGFR ≥60 ml/min,urine albumine negative ( n =797 ) ; D group:eGFR ≥60 ml/min,urine albumine positive (n =140).The levels of serum creatinine and urine albumine of PCI patient were measured,and then compare body mass index,smoking,hypertension,hyperlipaemia,diabetes mellitus,previous MI,perioporative PCI and etc.All patients were followed up from 30 d to 3 years.The prognostic facters of PCI patients were analyzed by COX proportional hazards models.Kaplan-Meier survival analysis was used to compare survival curves between the four groups stratified by level of eGFR.The log rank statistic was used to test for differences between groups.Results By multivariate COX regression adjustment for body mass index,smoking,hypertension,hyperlipaemia,diabetes mellitus,previous MI,perioperative PCI,the relative risk (RR) of albuminuria for cardiac events was 2.006 ( 95％ CI:1.020 - 3.947,P ＜ 0.05 ),perioperative PCI 3.375 ( 95％ CI:2.106 - 5.410,P ＜0.05 ).The cardiac events rate of B group with PCI after 1,2 and 3 year was 20.59％,2.94％,2.94％respectively,have statistical significant(x2 =8.774,P ＜ 0.05 ).The cardiac events rate of the first year in A,B,C,D groups was 5.89％,20.59％,4.01％,2.86％ respectively.The different cardiac events rate among four groups had statistical significant(x2 =22.050,P ＜0.01 ).B group cardiac events rate of the first year was significant higher than C,D group,which had statistical significant (x2 =20.020,14.520,P ＜0.01 ).The survival rate of 3 year follow-up after PCI was 91.2％,73.5％,91.6％,93.6％ respectively in four group,the different survival rate among four groups have statistical significant(x2 =16.750,P ＜0.01 ).Conclusion For the identification and treatment of high incidence of cardiac events in patients undergoing PCI,eGFR and qualitative determination of urine albumine are simple and effect tools.

Objective To analyze the clinical features of pure red cell aplasia (PRCA),and to improve the recognition of its pathogenesis and treatment.Methods Among 35 PRCA patients from 1990-01 to 2003-04 in our hospital,17 patients(group Ⅰ) had immunologic abnormality,and the other 18 patients (group Ⅱ)were normal at every immunologic index.Removed the primary affection,all patients were given the combine treatment with drugs:androgen,immunosuppressive agent or/ and glucocorticoid.Results Nine patients in group Ⅰ appeared T subgroup ratio inversion in peripheral blood,eleven patients had higher level than normal with TNF?,and six patients' IL-2 level was higher.The response was 70.6%.Some patients shifted to normal in immunologic index.The response was 86.7% in group Ⅱ.But 11 cases relapsed of the 25 cured and remission patients.They responded again to the initial therapy.Conclusion Dysimmunity is the most important pathogenesis in PRCA patients.Most patients respond to immunosuppression therapy.The relapse patients also respond to initial therapy.

Objective To discuss the role of p38MAPK signal pathway in the process of TWEAK inducing rheumatoid arthritis(RA) fibroblast-like synoviocyte(FLS) to synthesize MMP-9 and look for a new target for RA treatment. Methods RA FLS were primarily cultured and stimulated with TWEAK. Western blot was used to detect the expression of p-p38MAPK and p65 in RA FLS. FLS were pretreated by SB203580 or not. ELISA was used to detect the concentration of MMP-9 in cell-cultured fluid. The mRNA expression of MMP-9 was measured by RT-PCR. Results TWEAK( 100 ng/ml) can make p38MAPK phosphorylated and increased the expression of p65 protein in the cell nucleus. SB203580 can partially inhibit the expression of MMP-9 and MMP-9 mRNA produced by RA FLS which is induced by TWEAK. Conclusion TWEAK induced RA FLS to synthesize MMP-9, in that process, the p38MAPK signal trausduction pathway was in active state, and induced the expression of NF-κB.

Objective To establish a method for content determination of harpagide and harpagoside in Mailuoning injection by HPLC. Methods The experimental condition of HPLC method was as follows: SunfireTM C18 column (4.6 mm ×150 mm, 5 μm), with gradient elution using acetonitrile and 0.03% phosphoric acid; the detected wavelength was 210 nm, and the flow rate was 1.0mL/min.ResuIts Harpagide and harpagoside demonstrated good linear relationship in the range 0.1424~0.8544 μg/mL(r=0.9998) and 0.0732~0.4392μg/mL (r=0.9997) respectively.The average recovery rate were 98.22% and 99.27% with RSD of 1.46% and 1.42%(n=6)respectively.ConcIusion The method is simple, reliable, accurate, reproducible and stable, and it could be used in the determination of harpagide and harpagoside in Mailuoning injection.

Objective To evaluate the performance of enzyme linked immunosorbent assay (ELISA) kit in detection of Hepatitis B virus(HBV) markers by using improved and optimized method ,so as to provide a practical and feasible method and reagents for clinical laboratory .Methods ELISA test was used for the detection of HBV markers .The gradient dilution method was used to e‐valuate the lower limit .The verifiation of cut off value was carried out based on clinical and laboratory standards institute (CLSI) EP12‐A2 document .Samples with cut off values were collected to evaluate the precision ,including repeatability and intermediate precision .The coincidence rates were counted through comparing the results of ELISA with those of external quality assessment and those detected by using Abbott i4000SR chemiluminescence instrument .Results The lower detection limit of HBsAg ,HBsAb , HBeAg ,HBeAb and HBcAb were 0 .2 IU/mL ,20 mIU/mL ,1 NCU/mL ,0 .75 NCU/mL and 0 .05 NCU/mL respectively .The cut‐off value(C50 )± 20% concentration included the concentration range between C5 and C95 .The within‐run coefficient of variation (CV)≤15% ,in sandwich method the between‐run CV≤25% ,in competition method the between‐run CV≤35% .The positive and negative coincidence rates in accuracy and comparing with i 4000SR all were more than 95% and all κ>0 .75 .Conclusion ELISA tests for HBV markers in our laboratory could meet the requirements of the detection performance and clinical needs .

BRICS has been dealing with the problem of increase in the number of the patients who require an-tiretroviral therapy and this therapy’s price-rise by promoting medicine to domestic production and reducing the impor-ted drug price. This paper reviewed the situation of BRICS HIV epidemic and prevention, anti-retroviral therapy drugs production and supply, drug security policy and strategy, and the following seven recommendations are straight forwarded to China based on the BRICS AIDS antiretroviral treatment coverage strategic comparison:(1) The estab-lishment of an ARV drugs co-ordination mechanism;(2) The reduction of the drug patent licenses while increasing the domestic generic drugs possibility;(3)Negotiations with the original research process of domestic pharmaceutical enterprises to obtain a voluntary license or speed up the technology transfer;(4) The use of antitrust laws to promote access to medicines for a voluntary license pharmacy localization; ( 5 ) If necessary, starting the compulsory medi-cines licensing to achieve localization;(6) Reducing the drug prices by bargain and negotiation;and (7) Strengthe-ning NGO built-in capacity.

Objective We aimed to explore the experience of posttraumatic growth in patients with cervical cancer who had a hysterectomy at the childbearing age.Methods The phenomenological methodology was used in the study.An in-depth interview was conducted among 12 patients chosen by purposive sampling method.Results Through careful analysis and collation,three themes were identified:smashing the original assumption,searching the meaning of existence and rebuilding the new cognitive schemata.The experience of patients' was conformed to the model which was put forward by Tedeschi,and the theme changes in personal relationships,personal strength,altruism born from sufferings and new philosophy of life were conformed to theoretical connotation of PTG.Conclusions Clinical medical staff should update psychological nursing concept timely and taking advantages of PTG to help patients pass through their difficult period.

Objective To investigate the molecular epidemiology and infectious risk factors of linezolid-resistant Enterococci (LRE) isolates in the First Affiliated Hospital of Chongqing Medical University.Methods Thirteen LRE isolates were collected from 2011 to 2013 and confirmed by broth dilution susceptibility testing.The minimum inhibitory concentrations (MIC) of twelve antimicrobial agents were analyzed using Vitek 2 compact.The molecular epidemiology of LRE isolates was determined by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE) and the Diversilab.A casecontrol study was conducted for the analysis of risk factors, and Logistic regression was performed to evaluate the independent risk factors.Results All thirteen LRE isolates showed low-level resistance to linezolid, and most of these isolates were resistant to tetracycline, erythromycin and ciprofloxacin.However, they had high sensitivity to penicillin, ampicillin and tigecycline.Sequence type 480 was predominant in the hospital, and three isolates (isolates 3, 4, and 5) from July to September 2013 were found to have the same ST, PFGE pattern and rep-PCR group, indicating the same resistance clone.Admission to intensive care unit (ICU), peripheral vascular disease, males, hypoalbuminaemia, enema and linezolid therapy were identified as significant risk factors for LRE infections.Among these factors, admission to ICU, enema and linezolid therapy were independent risk factors for the acquisition of LRE.Conclusions Thirteen LRE isolates collected in the hospital showed a multidrug-resistant phenotype, and a small-scale prevalence was detected from 2011 to 2013.Therefore, attention should be paid to monitor the LRE in the hospital to decrease the prevalence of LRE infections.

Objective To study the killing effects of the killer cell immunoglobulin-like receptors (KIR) KIR2DS1-positive natural killer (NK) cells against leukemia cells.Methods High-purified NK cells separated by RosetteSep NK cell enrichment kit from healthy donor peripheral blood were taken as effector cells,and the freshly isolated bone marrow mononuclear cells from newly diagnosed acute myelogeneous leukemia (AML) patients were taken as target cells.The cytotoxic activity of NK cells were detected by CCK8 kit assay.HLA-Cw,KIR gene of the healthy donors and patients were detected by polymerase chain reaction and sequence specific primer (PCR-SSP) genotyping techniques,respectively.NK cells were divided into KIR2DS1-positive group and KIR2DS1-negevitive group,and then anti-KIR2DS1 mononuclear antibody was used to block KIR2DS1 of NK cells.Meanwhile based on HLA-Cw,KIR2DS1-positive NK cells and target cells were divided into C1 homozygote group(expressing HLA-Cw 01,03,07,08,12,14,16 alleles),C2 homozygote group (expressing HLA-Cw 02,04,05,06,15,17,18 alleles) and the C1/C2 heterozygote group (co-expressing the alleles in C1 group and C2 group).Results The purity of NK cells was (91.2±5.94) ％ through flow cytometry analysis.At the same effector-target ratio,cytotoxicity of KIR2DS1-positive NK cells against target cells was higher than that of KIR2DS1-negetive NK cells.While the E:T =10:1,cytotoxicity of KIR2DS1-positive NK cells against target cells [(2.82±6.81) ％] was significant higher than that of KIR2DS1-negetive NK cells [(28.61±5.14) ％] against target cells.The killing effects of KIR2DS1-positive NK cells was significantly weakened after KIR2DS1 blockaded with specific antibody (t =-3.00,P =0.05).When focusing on the C1 group NK cells,KIR2DS1-positive NK cells against C2 group [(4.39±3.46) ％] target cells was significantly higher than than against C1 group [(41.22±3.68) ％] (t =8.33,P ＜ 0.05) and C1/C2 group [(41.32±5.09) ％] (t =6.37,P ＜ 0.05) target cells.Conclusions The killing effects of KIR2DS1-positive NK cells are significantly higher than that of KIR2DS1-negetive NK cells.The HLA-C1 group KIR2DS1-positive NK cells could recognize HLA-C2 loci and then kill the target cells.