The therapeutic effects of dermatological preparations for external use are not only dependent on its peculiar pharmacological action of the basis but also closely related to many factors, such as drug concentrations, types of preparation, excipients etc. On the basis of extensively reading the relevant literatures and of author's practical experiences, the above affected faetors were discussed preliminarily.

Objective: Docetaxel as a newly semi-synthesized anti-tumor drug,exhibits significant cyrotoxic activity and enhanced sensitivity for radiotherapy.The aim of this study was to investigate the correlation of the apoptosis of human Hela cell line with the expressions of TRAIL and its receptors induced by the combination therapy of Docetaxel with radiation.Methods: We treated the Hela line by Docetaxel,radiation,and combination therapy of Docetaxel with radiation,respectively,detected the apoptosis of the Hela cells using Hoechst 33342 staining and the TUNEL method,and observed the changes in the mRNA expressions of TRAIL and its receptors TRAIL-R in the three groups by RT-PCR.Results: Compared with the Docetaxel and the radiation groups,the apoptosis of the Hela cells was increased significantly in the combination therapy group,and so were the mRNA expressions of TRAIL and its receptors TRIAL-R1 and TRAIL-R2.Conclusion: The combination therapy of Docetaxel with radiation increased the apoptosis of the Hela cell line,which might be mediated by the up-regulation of mRNA expressions of TRAIL and its receptors TRAIL-R1 and TRAIL-R2.

To cultivate creative intellectuals, which can be achieved by innovation education, is the special task of universities and colleges in Knowledge-economy Times. And the cultivation of interest is an important part of the innovation education. The author puts forward some new ideas such as pre-inclination and interest plasticity which are necessary supplement for the theory of interest development; furthermore, according to the current situation of high education in China, the author points out that it is significant for the carry-out of innovation education in high schools to be aware of interest plasticity.

Objective To investigate therapeutic mechanism of radiation therapy associated with Doeetaxel on human uterine cervi-cal carcinoma. Method Hela cells were incubated with 0. 5 μmol/L, 1.01 μmol/Docetaxel for 24 hours, and were radiated with 0, 2, 4, 6, 8Gy X ray. The proliferation activity was detected with MTT method. Apoptosis was evaluated with TUNEL method. Expression of caspase-3 protein and the degradation fragment was measured with Western blot. Result Inhibitory effect of radiation therapy associated Docetaxel on Hela cells was significantly stronger than that of radiation group. Treated with 2 Gy and 6MV X ray radiation, inhibitory rate of Hela cells increased with the increment of associated Docetaxel doses (P<0.05). Inhibitory rate of Hela cells in radiation associated Docetaxel group was significantly increased compared with radiation group. Apoptosis index in radiation associated Docetaxel group 48 hours after treatment was significantly increased compared with radiation group or Docetaxel group with TUNEL method (P<0.05). Western blot results indies-ted that caspase-3 protein was degraded and small active fragments were produced. Conclusion The reason that Docetaxel enhanced Hela cell radiation sensitivity may probably he correlated to easpase-3 protein activation.

Objective:To develop a rating scale on the knowledge, attitude and practice of stroke-dysphagia for nurses, and to test the reliability and validity.Methods:Based on theoretical framework of the Knowledge, Attitude, Practice (KAP), the scale items were determined through literature review, expert consultation, pre-investigation, and qualitative interviews. 633 nurses in the department of stroke that from 18 hospitals in Hubei Province were selected for the survey, to further screen the items and test reliability and validity of the scale.Results:The positive coefficient of the two-round expert consultation were both 100%; the expert authority coefficient was 0.930; the level of coordination of experts ′ opinions was good. Exploratory factor analysis extracted 4 factors, the accumulative variance contribution rate was 44.278%, Content validity index S-CVI was 0.984, I-CVI was 0.857-1.000; the Cronbach α coefficient of scale was 0.855, test-retest reliability was 0.909. Eventually, the scale was consisted of 3 dimensions, 32 items. Conclusion:The scale has good reliability and validity, and can be used as a survey tool to test the current knowledge, attitude, practice of clinical nurses about patient with stroke-dysphagia.

Aim To observe the ameliorating effects of sophocarpine on mice with neuropathic pain induced by spared nerve injury(SNI), and to explore the analgesic mechanism.Methods Sixty male ICR mice were randomly divided into six groups: sham-operated, neuropathic-pain model(SNI), SNI+Pregabalin(Pre) 10 mg·kg-1, SNI+SC 40 mg·kg-1, 20 mg·kg-1 and 10 mg·kg-1 group.Neuropathic-pain mouse models were established by SNI of the sciatic nerve.The paw withdrawal mechanical threshold(PWMT), paw withdrawal thermal latency(PWTL), and cold withdrawal times(CWT) were detected to assess the analgesic effects of sophocarpine on mice with neuropathic pain induced by spared nerve injury.The expressions levels of TLR4, p38 MAPK, IL-1β and TNF-α mRNA and protein in spinal cord tissue were detected by reverse transcription-polymerase chain reaction(RT-PCR) and Western blot methods.Results Compared with sham group, the SNI group′s PWMT decreased, PWTL was shorten, CWT increased, and the expression levels of p38 MAPK, TLR4, TNF-α and IL-1β mRNA and protein in spinal cord tissue were up-regulated.Compared with SNI model group, the sophocarpine 40 mg·kg-1 group′s PWMT increased, PWTL was lengthened, CWT decreased, and the expression levels of p38 MAPK, TLR4, TNF-α and IL-1β mRNA and protein in spinal cord tissue were down-regulated.Conclusion Sophocarpine has the analgesic effects on neuropathic pain induced by SNI, and its mechanism may be related to the down-regulation of TLR4, p38 MAPK, IL-1β and TNF-α expression levels.

Objective To analyze the trend of maternal mortality ratio (MMR) and cause of death in Shanghai from 1996 to 2015.Methods To collect the material about the maternal death and the maternal death audit from 1996 to 2015,and to analyze the MMR,the cause of death and the result of the maternal death audit of Shanghai from 1996 to 2015 retrospectively.Results (1) The change of MMR:the MMR in Shanghai decreased from 28.84 per 100000 live births in 1996 to 6.66 per 100000 live births in 2015.(2) The characteristic of maternal death:the proportion of Shanghai citizens was 27.4％(121/441) and the proportion of migrant women was 72.6％(320/441).The women with advanced maternal age was 8.2％(20/243) since 1996 to 2005,and increased to 16.7％ (33/198) since 2006 to 2015.Maternal deaths during pregnancy increased from 27.6％(67/243) in the first 10 years (1996-2005) to 35.4％(70/198) in the recent 10 years(2006-2015).The intrapartum maternal deaths was 6.2％(15/243) in the first 10 years and in the recent 10 years it was zero.The proportion of postpartum deaths in the first 10 years and in the recent 10 years were 66.3％ (161/243) and 64.6％(128/198) respectively.(3) The cause of maternal death:During the recent 10 years,indirect obstetric causes [63.1％(125/198)] was more than direct obstetric causes [36.9％(73/198)] for the first time.The death causes changed significantly.Postpartum hemorrhage remained the leading cause of maternal deaths,but the specific mortality rate (SMR) of postpartum hemorrhage decreased significantly from 7.42 per 100000 live births in the first 10 years to 1.51 per 100000 live births in the recent 10 years.The maternal deaths because of heart disease and cerebrovascular disease rose to the second and the forth reasons.(4) Maternal death audit:the avoidable maternal death ratio decreased from 3.66 per 100000 live births in the first 10 years to 1.86 per 100 000 live births in the recent 10 years.Conclusions During the past 20 years,the MMR of Shanghai decreased significantly and was close to the level of developed countries.In recent years,the causes of maternal death become more complicated.With the implementation of the second child policy,women with high risk factors increase,so government investment,policy support should be strengthened to optimize the management.

Objective To understand major risk factors associated with end-stage liver disease (ESLD) among patients with human immunedeficiency virus (HIV)/hepatitis B virus (HBV) co-infection.Methods Patients with HIV/HBV co-infection were followed-up and factors related to ESLD were analyzed using logistic regression model to estimate odds ratios (ORs) for them. Results A total of 255 patients with HIV/HBV co-infection were investigated, with an incidence of ESLD of 19. 2% ( 49/255 ). Major risk factors associated with ESLD among patients with HIV/HBV co-infection included count of CD4 below 200 cells/μl at baseline, HIV RNA load decreasing to the lower limit of its detection level within six months after antiretroviral treatment (ART), abnormal of serum activities of transaminase (ALT or AST), longer persistently positive of HIV RNA and HBV DNA, and use of lamivudine-based ART, with OR of 6. 503,14. 456, 0. 049, 1. 814, 1. 536 and 0. 012, respectively. Conclusions Lower CD4 count, abnormal serum transaminases, persistent replication of HIV and HBV all are closely related to ESLD in patients with HIV/HBV co-infection. Therefore, lamivudine-based ART should be of choice for patients with HIV/HBV coinfection to decrease incidence of ESLD.

Objective To evaluate the efficacy,safety and impact of recombinant human cytotoxic T lymphocyte-associated antigen (CTLA)-4 fusion proteins (rhCTLA-4Ig) on serum human tumor necrosis factor (TNF)-α and CX3CL1 in active rheumatoid arthritis (RA) patients.Methods Forty-four RA patients were treated with rhCTLA-4Ig and placebo.Clinical response was assessed by American College of Rheumatology (ACR) criteria and disease activity score in 28 joints (DAS28).The levels of serum TNF-α and CX3CL1 were determined in 44 RA patients and 20 healthy controls by enzyme-linked immunosorbent assay (ELISA).Comparisons between groups were performed by t-test or x2 test.Results At week 12,ACR20,ACR50and ACR70 responses in RA patients with rhCTLA-4Ig were achieved by 95％(20/21 ),76％( 16/21 )and 19％(4/21) respectively,but no patient with placebo achieved ACR20,ACRS0 and ACR70 responses.There were significantly statistical differences in ACR20 and ACR50 responses (x2=39.17,26.69,P＜0.01 ).At week 12,the mean DAS28 in the rhCTLA4Ig group was 3.1±1.3 versus 6.2±1.1 at baseline (P＜0.01).Similarly,health assessment questionnaire (HAQ) improved significantly,declining from 1.4±0.5 at baseline to 0.4±0.5 at week 12 (P＜0.01).However,the mean DAS28 in the placebo group was 5.8±1.2 versus 6.0±0.7 at baseline (P＞0.05),HAQ declined from 1.6±0.4 to 1.6±0.6 (P＞0.05).In addition,there were higher levels of TNF-α and CX3CL1 in the active RA patients than those of the healthy controls (P＜0.01).After 12 weeks therapy,Serum TNF-α and CX3CL1 levels in the rhCTLA-4Ig group decreased significantly (P＜0.01).There weren't decline in the placebo group (P＞0.05).Conclusion This study has shown that rhCTLA-4Ig is very effective in reducing disease activity,improving function during the 12 weeks treatment.rhCTLA-4Ig therapy for 12 weeks can lead to significant decrease of serum TNF-α and CX3CL1.

Objective To investigate the incidence and risk factors of end-stage liver disease (ESLD) in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infected patients after antiretroviral therapy (ART).Methods The demographic and clinical data of HIV-HCV coinfected patients in Zhongnan Hospital,Wuhan University and local Centers for Disease Control and Prevention (CDC) from Jan 2003 to Dec 2010 were analyzed retrospectively. Single factor and multiple factor Logistic regression were used to analyze the correlation between the variables and incidence of ESLD,such as baseline age ≥40,male,previous blood transfusion history,duration of HCV persistent infection,hepatitis B virus (HBV) co-infection (HBsAg positive),HIV RNA≥-1 ×104 copy/mL at last visit,HCV RNA≥ 1.× 105 copy/mL at last visit,CD4 count ＞ 200 / μL at last visit,alanine aminotranferase (ALT) ≥ 2 × upper limit normal (ULN) at last visit,ART containing nevirapine (NVP),follow-up duration,ART duration＞5 years and HCV genotype 1b.The effect of ESLD on the survival of HIV-HCV co-infected patients was analyzed by Kaplan-Meier method.Results Totally 427 HIV-HCV co-infected patients were followed up with average of 3.7 years. Fifty-five patients (12.9％) developed ESLD,and 52 patients (12.2％) died.Factors independently associated with ESLD included baseline age≥40 (OR=2.385,P=0.039),ALT ≥2× ULN (OR=16.374,P=0.000),HBV-coinfection (OR=2.507,P=0.042),duration of ART ＞ 5 years (OR=3.232,P=0.010),and CD4 count ≥200/μL (OR=0.364,P=0.011).The cumulative mortality of HIV-HCV co-infected patients with ESLD was 50.9％,whereas that of HIV-HCV co-infected patients without ESLD was 6.5％ (P=0.000).Conclusion In the ART era,ESLD is common among HIV-HCV co-infected patients in China,which is responsible for reducing the survival time of the patients.