Objective To investigate the level of care burden and self efficacy of caregivers of patients with spinal cord injury,and analyze their correlation.Methods By convenience sampling method,150 cases of spinal cord injury patients and their caregivers were investigated with Zarit Caregiver Burden Scale and general self-efficacy scale.Results The score of care burden of caregivers with spinal cord injury was (52.91 ± 11.56) points,self-efficacy score of caregivers was (19.63 ± 4.85) points.The score of care burden of caregivers and self-efficacy was highly negatively correlated.Conclusions We should pay more attention to improve the self-efficacy of caregivers of patients with spinal cord injury (SCI),in order to mitigate the care burden,improve care ability and health level of the patients' families.

Objective To investigate the real situation of the burden of the caregivers who take care of patients with spinal cord injury.Methods Using phenomenological research methods of qualitative study,information of 15 family caregivers of patients with spinal cord injury were collected through semi-structured interviews in Jiangxi province,and data were analyzed with Colaizzi 7-step analysis method.Results Four themes were summarized:weak social support system,heavy economic burden,insufficient care ability,mental and physical exhaustion; mental and physical exhaustion concluded three sub-themes:burnout,lifestyle changes,sad/helplessness.Conclusions Care burden of caregivers of patients with spinal cord injury includes four aspects:social,physical,psychological,and less caring capacity.Care workers should be concerned about the health status of the caregivers,give targeted care intervention,so that caregivers can be adapted to the caregivers' role,maintain and promote a high level of health of the patients and their families.

Objective To identify the factors related to radiation pneumonia (PR) in lung cancer treated with intensity modulated radiotherapy (IMRT).Methods Data from 163 lung cancer patients treated with IMRT were analyzed with clinical factors and physical parameters related to the dose-volume histogram.The patients were followed for 6 months after radiotherapy.The relationship between survival status and PR was analyzed.Results The incidence rate of over grade 2 patients was 28.22 ％ (46/163).Univariate analysis revealed a significant relationship between many parameters associated with such as the site of lobe (P =0.033),COPD (P =0.020),chemotherapy (P =0.020) and prophylactic using of glucocorticoid and antibiotic (P =0.025).Multilogistic regression analysis showed that V20 in the contralateral site,the V5 of the all lungs and PTVV were independent factors.Conclusion The RP is associated with multiple factors.Individualized treatment plans should be made according to the specific circumstances of patients.

ObjectiveTo find specific biomarkers related to HAART treatment in plasma samples of AIDS patients for clinical therapeautic efficacy evaluation and guidance for the prognosis of HIV treatment.MethodPlasma samples of AIDS patients were collected from Infectious Disease Department 1 of Shanghai Public Health Clinical Center in June of 2008 to February of 2009,including 11 successfully HAART treated cases (HIV load ＞ 50 copies/ml) and 11 unsuccessfully HAART treated cases (HIV load ＜50 copies/ml).Patients' age ranged from 22 to 63.Plasma samples were treated by Bio-rad AurumTM Serum Protein Mini Kit to remove high abundant proteins:albumin and immunoglobulin were removed.The treatedplasmaproteinswereseparatedbytwo-dimensionalelectrophoresisandanalyzedby electrophoretogram using Imagemaster software to find differentially-expressed proteins related to therapeutic efficacy.After digestion by trypsin,the differentially-expressed proteins were identified by online reversed-phasenano-flow liquid chromatography coupled with electrospray ionization ion trap mass spectrometry.ResultsLow abundant proteins were efficiently enriched after the AurumTM Serum Protein Mini Kit treatment.Six differentially-expressed proteins were detected while comparing successfully and unsuccessfully HAART treated group.These proteins were accurately identified by tandem Mass spectrometry (MS), including serum transferrin, serum β-fibrinogen, etc.ConclusionsOur proteomic research revealed that the differentially-expressed proteins such as transferrin,which is related to plasma virus loading in AIDS patients in the process of treatment,might be potential biomarkers evaluating HAART therapeutic efficacy.

Objective To investigate human plasma glycoproteomie changes related to human immunodeficiency virus (HIV) infection,and to identify glycoproteins with potential anti-HIV activity or anti-HIV drug targets. Methods Plasma proteins with lower abundance were enriched through affinity purification to remove albumin and IgG in clinical samples (HIV-positive patient, n= 10, and healthy controls, n= 20). Proteins were separated by two-dimensional electrophoresis (2-DE) and stained by Pro-Q emerald glycoprotein stain kits. The 2-DE image was analyzed by ImageMaster software to find differential glycoproteins. Furthermore, the depleted HIV-positive and healthy control plasma proteins were digested by PNGase F. Glycoproteins were deglycoliszed, separated by 2-DE and analyzed by ImageMaster software. Differential glycoproteins were identified by liquid chromatography combined with high capacity ion trap mass spectrometry (HCT). Results The pretreatment of HIV-positive plasma prior to 2-DE could efficiently remove the high aboundant albumin and IgG in plasma and improve the detection of proteins with low-abundance. High revolution 2-DE gel images of glycoproteins from HIV positive and healthy control plasma samples were obtained. Glycoproteins were successfully deglycolized through PNGase F treatment. Thirteen differential glycoproteins were identified by liquid chromatography combined with mass spectrometry. These proteins included alphalantitrypsin precursor and serine/threonine-protein kinase N1. Conclusions Potential HIV infection related proteins,such as alphal-antitrypsin precursor are successfully identified. Our study may offer some help to understand the molecular mechanism of HIV infection and select new drug targets for preventing HIV infection.

BACKGROUND: Research shows that genetic factors are an important component of the congenital dislocation of the hip(CDH) . However, no susceptibility genes have been identified by now. The homebox-containing (HOX) genes that regulate the embryogenesis and vertebrate limb development may play a role in the pathogenesis of CDH.OBJECTIVE: To investigate whether a correlation exists between CDH and the Hox genes.DESIGN: Controlled study associated with family.SETTING: Department of aevelopmental pediatrics, genetic laboratory, department of pediatric orthopaedics in an affiliated hospital of a university.PARTICIPANTS: All the 101 CDH patients and their parents (altogether 303 members) were the in-patients from the Department of Pediatric Orthopaedics of the Second Clinical College of China Medical University; from December 1999 to January 2001. All the patients presented typical clinical manifestations and were diagnosed by X rays and operations for confirmation.METHODS: Four microsatellite markers D7S1808, D17S1820, D12S1686 and Hox4EP were selected in the chromosome regions of7p14 - 15, 17q21, 12q13and 2q31 where Hox A, Hox B, Hox C and Hox D genes which regulate the embryonic limb development reside respectively. Genotypes of 303 members in 101CDH families were analyzed by the techniques of polymerase chain reaction (PCR) and denaturing polyacrylamide gel electrophoresis. Then transmission disequilibrium test(TDT) was performed to analyze the data of genotypes.MAIN OUTCOME MEASURES: The genotypes of four microsatellite markers D7S1808, D17S1820, D12S1686 and Hox4EP in every CDH family including one child and parents; transmission disequilibrium test between transmission alleles and non-transmission alleles.RESULTS: Transmission disequilibrium was found between CDH and allele 7 of D7S1808(X2 = 6. 045, P = 0. 014) among a total of 10 alleles detected, between CDH and allele 4 of D17S1820(X2 =6. 025, P =0. 014) among a total of 12 alleles detected, between CDH and allele 4 of Hox4Ep (X2 = 6. 461, P =0.011) among a total of 16 alleles detected. But no transmission disequilibrium was found between CDH and D12S1686(X2 = 6. 171,P =0. 965) with 16 alleles detected.CONCLUSION: CDH may be related to Hox A, Hox B, Hox D genes, and Hox A, Hox B, Hox D genes may be susceptibility genes in CDH.

BACKGROUND: There are still few effective methods to repair injured myocardium after myocardial failure and pathologically rebuild reverral myocardium. As a new therapy, normal myocytes and therapeutic gene to interfere injured myocardium have advantageous effects in improving heart function.OBJECTIVE: To observe the efficiency and stability of adenovirus-medicated gene transferred into different passages of bone marrow mesenchymal stem cell (MSC) and investigate the effect of MSC-based sarcoplasmic reticulum Ca2+ ATPase gene (SERCA2a) gene therapy for rats with chronic heart failure. To compare the effects of gene therapy, cell transplantation and MSC-based SERCA2a gene therapy for chronic heart failure. DESIGN: Randomized controlled study.SETTING: Department of Senile Angiocardiopathy, General Hospital of Chinese PLA; Department of Biochemistry, Beijing Medical University. MATERIALS: Male Sprague-Dawley (SD) rats with 4 weeks old, clean grade and weighing 45-50 g provided by the Animal Experimental Center, Peking Medical University were used as donators of bone marrow. Other female SD rats of 12 weeks old, clean grade and weighing 200-250 g were used as receptors of cell transplantation and gene therapy. Sry gene of Y chromosome in male rats was used to evaluate whether transplanted cells of donators lived in myocardium of receptor rats. Ad-SERCa2a and Ad-EGFP were constructed by Doctor Lu Xiao-chun; MSC in the 3rd and 8th generations was isolating cultured on its own. METHODS: The experiment was carried out in the Zhou CY Laboratory (BSL-2), Department of Biochemistry, Beijing Medical University from July 2004 to December 2005. Thirty female SD rats received ligation at the left coronary artery to make models with chronic cardiac failure following acute myocardial infarction. And then, 29 rats were randomly divided into four groups, including gene therapy group (n=7), MSC group (n=7), gene-modified MSC group (n=8) and control group (n=7). Rats in the four groups were given the interventions of SERCA2a gene, MSC transplantation, MSC+Ad/SERCa2a and empty adenoviral vector, respectively. MSCs were separated and cultured, and then Ad-SERCA2a-GFP was used to transfer MSC in the 3rd and 8th generations.MAIN OUTCOME MEASURES: Ad-SERCA2a-GFP transfection rate of MSC was measured by using flow cytometer. Before and at 14 and 21 days after treatment, cardiac function was evaluated by ultrasonic echocardiogram. Expression of cytokine Ⅷ was tested by immunohistochemical staining. SERCA2a gene and protein expression were evaluated by RT-PCR and Western blot respectively, as well as SERCA2a enzyme activity. RESULTS: ① Transfection rate: The infection efficiency of adenovirus-medicated gene into different passages of MSC was over 80%, and there was no difference between passage three (P3) MSC and P8 MSC (P > 0.05). ② Heart function: Left ventricle wall was thickened obviously in group MSC and group MSC+Ad/SERCa2a on the 21st day after treatment, while volume was shortened and gradually rounded. Compared to control group, ejection fraction (EF) and shortening fraction (FS) of group Ad-SERCa2a, group MSC and group MSC+Ad/SERCa2a were elevated significantly on the 14th day after therapy (P < 0.01). While the elevation values of EF and FS began to reduce in group Ad-SERCa2a on 14th day after therapy, it continued to increase in both group MSC and group MSC+Ad/SERCa2a (P < 0.01). Improvement rate of EF at 21 days after therapy (EF D21) increased in group MSC and group MSC+Ad/SERCa2a respectively, but decreased in group Ad-SERCa2a. Compared to group Ad-SERCa2a, peak systolic flow velocity of anterior wall and interventricular septum in group MSC+Ad/SERCa2a increased significantly on the 21st day after therapy, and peak diastolic flow velocity of anterior wall and interventricular septum elevated in group MSC+Ad/SERCa2a, too (P < 0.01). ③ SERCA2a gene, protein expression and enzyme activity in group MSC+Ad/SERCa2a were significantly stronger in group MSC and control group. Parts of MSC transplanted into scar zone expressed Ⅷ.CONCLUSION: ① MSC is an effective platform for the targeted delivery of therapeutic gene. It suggests that different passages of MSC from P3 MSC to P8 MSC are regarded as high-effectively gene vehicles. MSC-based SERCA2a gene therapy showed much strong and lasting beneficial effect on exhausted myocardium. ② Effect of MSC transplantation on improving heart function may be related to promoting vascular neogenesis.

Objective To explore the effects and mechanisms of anti-endothelial cell antibody (AECA )in the alveolar cell apoptosis of the emphysema rats induced by smoking,and to discuss the intervention effects of methylprednisolone.Methods 39 male Sprague-Dawley rats were randomly divided into normal control group,model group,and intervention group,with 13 rats in each group.Emphysema models were established in the latter two groups.After exposing to cigarette smoking for one month,methylprednisolone injected intraperitoneally in the intervention group(10 mg/kg,1 time/d),6d/week.On the 90th day,inferiora vena cave blood samples were collected and all rats were sacrificed.The levels of AECA were detected in bronchial alveolar lavage fluid (BALF )and serum,respectively.Pathological changes were observed in lung tissues stained by hematoxylin eosin, quantitative determination of lung average mean linear intercept(MLI)and mean alveolar number(MAN)were preformed. Results Compared with normal group and intervention group,the levels of AECA in BALF and serum,MLI in the model group were higher(P<0.05 ),but the levels of MAN was lower (P<0.05);There is a positive correlation between AECA in BALF and MLI of rats(r=0.821,P<0.05),a negative correlation between AECA in BALF and MAN(r=-0.894,P<0.05.Conclusions ACEA may enroll the pathogenesis of emphysema in rats induced by smoking and related with the severity.Methylprednisolone may inhibit the formation of emphysema by reducing the expression level of AECA in airway.

Objective Evaluation of efficacy and safety of combination of Yinxin Damo injection and low molecular heparin for deep venous thrombosis (DVT) in orthopedics operation.Methods Randomized controlled trials of combination of Yinxin Damo injection and low molecular heparin intervention study of DVT in orthopedics operation were searched from the Cochrane Library,clinicaltrials,gov,PubMed,EMBASE,CNKI,Wanfang database,VIP database,and Chinese biomedical database (CBM).According to the Cochrane Handbook 5.1,Meta analysis was performed by Revman 5.3 software.Results A total of 4 studies included 358 patients.The results of Meta-analysis showed that,compared with control group,incidence of DVT was significantly reduced (P =0.01),value of D-D significantly decreased (P ＜0.000 01) and value of PT increased (P =0.04),and increased value of APTT (P =0.07) in combined group.Heterogeneous sources of PT and APTT were analyzed,and the results after excluding literature 7,as compared with the control group,APTT and PT were significantly increased in combined group (P ＜ 0.000 1).Conclusion Based on the current clinical evidence,combination of Yinxin Damo injection and low molecular heparin treatment for DVT of orthopedics operation patients is effective and safe,but there is certain heterogeneity between the studies,therefore it is necessary to design a randomized controlled trial of high quality,large scale and multicenter to research.

Objective: To examine expression patterns of focal adhesion kinase (FAK) and its activated form, phosphorylated FAK (pFAK),in human osteosarcoma and to investigate the correlation of FAK expression with clinicopathological parameters and prognosis. Functional consequence of manipulating FAK protein levels was also investigated in human osteosarcoma cell lines. Methods: Immunohistochemical staining was used to detect FAK and pFAK levels in pathologically archived materials from 113 patients with primary osteosarcoma. Kaplan-Meier survival and Cox regression analyses were used to evaluate prognoses. The role of FAK in cytological behavior of MG63 and 143B human osteosarcoma cell lines was studied via the FAK protein knockdown with siRNA. Cell proliferation, migration, invasiveness, and apoptosis were assessed using cell counting kit-8, Transwell, and Annexin V/PI staining methods. Results: Both FAK and pFAK were overexpressed in osteosarcoma patients. Tumor cells exhibited cytoplasmicity and occasional membranous immunoreactivity for FAK. A total of 42 cases (37.17%) mainly showed expressed pFAK in cytoplasm of osteosarcoma cells. No overexpression staining of anti-FAK and anti-pFAK antibodies was observed in normal cancellous bone tissues or negative controls. Significant differences were observed in overall survival between FAK-/pFAK- and FAK+/pFAK- groups (P=0.016), FAK+/pFAK- and FAK+/pFAK+ groups (P=0.012), and FAK-/pFAK- and FAK+/pFAK+ groups (P<0.001). All groups showed similar metastasis-free survival. Cox proportional hazard analysis showed that FAK expression profile is an independent indicator of both overall andmetastasis-free survival. siRNA-based knockdown of FAK significantly reducedmigration and invasion of MG63 and 143B cells and affected proliferation and apoptosis in osteosarcoma cells. Conclusion: Osteosarcoma malignancies in vitro and in vivo were correlated with overexpression and phosphorylation of FAK. These findings suggest that FAK plays an important biological role in osteosarcoma carcinogenesis. This study provides a better understanding of diagnostic and prognostic relevance of FAK overexpression and phosphorylation in osteosarcoma patients. Therefore, FAK and pFAK can be used as independent predictors of overall and metastasis-free survival in osteosarcoma patients.