Objective To study the regulatory effect of interleukin-17 on the production of inflammation and bone erosion related factors of fibroblast-like synoviocytes (FLSs) from rheumatoid arthritis (RA) patients and to investigate whether signal transducer and activator of transcription 3 (STAT3) is implicated in this regulatory effect.Methods FLSs were acquired through primary culture from RA patients.Receptor activator for nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) expression in FLSs were determined using western blot analysis.The level of IL-6,granulocyte-mac rop hage colony stimulating fac tor (GM-CSF)and IL-8 were determined by enzyme linked immunosorbent assay (ELISA) assay.Statistical product and service solutions (SPSS) 17.0 statistical software was used for single factor analysis of variance and LSD-t comparison between each two groups.Results IL-17 stimulated FLSs and promoted the release of IL-6,GM-CSF and IL-8 (t=2.135,P＜0.01) and increased the production of RANKL (t=2.105,P＜0.01) and reduced the production of OPG (t=2.502,P＜0.01).However,targeted silencing of STAT3 could inhibit the effect of IL-17 on FLSs [control group:IL-6 (512±18) pg/ml;GM-CSF (591±25) pg/ml;IL-8 (473±10) pg/ml;RANKL (2.310±0.096);OPG (0.614±0.311);IL-17 group:IL-6 (1 630±39) pg/ml;GM-CSF (1 825±18) pg/ml;IL-8 (2 804±41) pg/ml;RANKL (4.010±0.256);OPG (0.131±0.101);STAT3 silent group:IL-6 (405±21) pg/ml;GM-CSF (451±12) pg/ml;IL-8 (370±9) pg/ml;RANKL (0.850±0.298);OPG (1.120±0.342)].Conclusion STAT3 pathway is critical to IL-17-induced regulatory effect on the release of inflammation and bone erosion related factors of FLSs.IL-17 can induce the inflammation and bone erosion of RA via STAT3.

OBJECTIVE:To improve the work quality in Pharmacy intravenous admixture service(PIVAS). METHODS:The major working links of PIVAS(labeling and drug admixture)were optimized,the work efficiency and error before and after optimi-zation were compared. RESULTS:The work efficiency was improved and error was decreased by adding logo and adjusting work range of personnel when labeling and improving distribution principles of drugs to be allocated in horizontal laminar flow table when drug admixture;compared with before,the labeling time for each bag decreased from(2.69±0.17)s to(2.19±0.08)s,to-tal time for admixture decreased from (104 ± 2) min to (83 ± 2) min,error rate of drug admixture decreased from 0.34% to 0.16%. CONCLUSIONS:The optimized work flow had improved the work quality of PIVAS.

Objective To investigate the subthreshold depression for long-term survivors after breast cancer surgery and its effect on their quality of life (QOL). Methods The self-made general questionnaire, Centre for Epidemiological Studies Depression Scale (CES- D), Hamihon Rating Scale for Depression and Functional Assessment of Cancer Therapy- Breast were used to investigate the subthreshold depression and its effect on their QOL for 210 long-term survivors after breast cancer surgery. The difference in general conditions and score of QOL between the subthreshold depression and non-subthreshold depression groups was also compared. Results The subthreshold depression with incidence rate of 46.67%(98/210) was observed for the log-term survivors after breast cancer surgery in this study. The results indicated that the age (≤50) (OR=5.627, 2.662,P<0.01), marriage (unmarried, divorced or widowed) (OR=5.087, P<0.01), employment (unemployed, sick leave or retired) (OR=2.077,P<0.05) and low income (<3000 RMB/month) (OR=3.375,P<0.01) were the key factors that led to the occurrence of subthreshold depression. The score of QOL for the subthreshold depression group were lower than those of the non-subthreshold depression group (t=-6.653--2.926,P<0.01), and had a significantly negative correlation with score of depression and QOL (β=-0.362--0.132). Conclusions A high incidence rate of subthreshold depression for long-term survivors after breast cancer surgery was observed. The incidence rate of subthreshold depression increased for the patients with younger age, low income,unmarried or unemployment. Due to their low QOL, attentions should be paid to the early detection and early prevention for the long-term survivors with subthreshold depression after breast cancer surgery.

Objective To investigate the clinical characteristics and therapeutic plan of Miller Fisher syn-drome( MFS) complicated with Guillain-Barrésyndrome( GBS) .Methods The clinical data of one patient of MFS complicated with GBS was reviewed retrospectively,and analysis combined with literature review was given.Results The patient had infectious history before the onset of MFS and GBS.Clinical manifestations included MFS triad,bulbar paralysis,bilateral facial paralysis,protein-cell dissociation of cerebrospinal fluid and neurogenic damages in electro-myography.Plasm exchange and adrenocortical hormones treatment were effective.Conclusion MFS complicated with GBS is an independent disease which is different from MFS or GBS.It has its distinct clinical features which should apply appropriate treatment.

Objective To investigate the role and action mechanism of chemokine (C-X-C motif)receptor 3 (CXCR3)in hepatic ische-mia-reperfusion injury (IRI).Methods Forty-eight mice were divided into operation group and sham-operation group.The operation group was treated to establish a mouse model of IRI.Liver tissues were obtained at 3,6,12,and 24 h after IRI,with 6 mice at each time point.The expression of chemokine (C-X-C motif)ligand 9-1 1 (CXCL9-1 1 )and their receptor CXCR3 were measured by real-time PCR and Western blot.The effect of CXCR3 was blocked by its specific antagonist C6.Hepatic injury was estimated based on the activity of hepatic transaminase and morphological indices.The distribution of subsets of infiltrating T cells was analyzed by flow cytometry.All data were expressed as mean ±standard deviation.Comparison between groups was made by one-way analysis of variance.Results Compared with the sham-operation group,the operation group had significantly upregulated expression of CXCL9-1 1 and CXCR3 at all time points after IRI (P<0.05).Blocking CXCR3 significantly protected liver function and morphology (P<0.05).Antagonist C6 significantly re-duced Th1 cell infiltration (P<0.01),but significantly increased Treg infiltration (P<0.01).Conclusion CXCR3 is an ideal therapeu-tic target in IRI treatment due to its relationship with immunoregulation.

Acute ischemic stroke has become one of the important causes of death and disability in human beings, especially in elderly patients. Intravenous thrombolysis with alteplase is an important treatment. However, there are many underlying diseases and poor overall conditions in elderly patients, which increase the risk of intracranial hemorrhage. Intracranial hemorrhage transformation makes the patient′s condition worse, which is the most serious complication of alteplase intravenous thrombolysis, and also one of the important reasons for the low treatment rate of alteplase intravenous thrombolysis in elderly patients. Therefore, we need to pay close attention to the occurrence mechanism and risk factors of intracranial hemorrhage transformation after alteplase intravenous thrombolysis in elderly patients, so as to reduce the risk of intracranial hemorrhage transformation, improve the prognosis and reduce the risk of morbidity and mortality.

Objective To determine the median effective concentration (EC50) of lidocaine for obturator nerve block (ONB) guided by a nerve stimulator in patients undergoing transurethral resection of bladder tumor (TURBT).Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients with bladder tumor,scheduled for elective TURBT,required ONB according to the results of cystoscopy or CT examination performed before operation,with body mass index of 19-30 kg/m2,aged 18-64 yr,were enrolled in the study.ONB was performed with lidocaine using the suprainguinal approach under the guidance of a nerve stimulator.The concentration of lidocaine was determined by up-and-down sequential trial.The initial concentration of lidocaine was 1.5％,and the ratio between the two successive concentrations was 1.2.Successful ONB was considered to be positive response.The EC50 and 95％ confidence interval of lidocaine for ONB guided by a nerve stimulator was calculated.Results The EC50 of lidocaine was 0.57％,and the 95％ confidence interval was 0.55％-0.59％ when used for ONB guided by a nerve stimulator.Conclusion The EC50 of lidocaine is 0.57％ when used for ONB guided by a nerve stimulator in the patients undergoing TURBT.

To explore the efficacy of managing benign prostatic hyperplasia (BPH) by family doctor system service in a local community.Among 132 BPH patients recruited from January 2012 to December 2013,74 of them received family doctor system service while the remainder medications only.After 6 months,international prostate symptom score (10.3 ± 5.6) and quality-of-life (2.98 ± 0.95) significantly improved in management group versus control group.And there were significant statistical differences (P ＜ 0.05).The intervention management of family doctor system service is effective for improving the symptoms and quality-of-life of BPH patients.

Objective To assess the effects of image fusion of CT spectral monochromatic imaging on image quality in small hepatocellular carcinoma (HCC).Methods Thirty patients with 40 pathologically proven small HCCs (≤3 cm) underwent upper abdominal plain CT and dual-phase enhanced spectral CT scan were analyzed retrospectively.Conventional 140 kVp polychromatic images (group A) and monochromatic images with energy levels from 40 to 140 keV were reconstructed by using spectral imaging viewer.Monochromatic images with highest CNR (group B)and 70 keV images with lowest noise (group C) were fused to generate fused images (group D) with image fusion software.Objective evaluation of 40 HCCs [contrast-to-noise ratio (CNR) of lesion,image noise in HU] and subjective rating score of 30 patients (image noise score,overall image quality score,and lesion conspicuity score) among the four groups were compared by using One-way ANOVA and Kruskal-Wallis H test.Results CNR (1.3±0.6,2.1±0.6,1.5±0.6 and 2.4± 1.3 respectively) and image noise [(20±7),(32±9),(18±3) and (24±6) HU respectively] among group A,B,C and D all had statistical differences (F =5.724 and 13.619,both P values ＜ 0.01).CNR in group D was higher as compared with group A and C (both P values ＜ 0.05),but was similar to group B (P ＞ 0.05).Image noise in group D was lower than group B and higher than group C,but showed no difference from group A (all P values ＞ 0.05).Image noise scores [(3.5±0.5),(3.3±0.4),(3.6±0.5)and(3.5±0.4)point,respectively],overall image quality scores [(3.2 ± 0.4),(3.3 ± 0.3),(3.1 ± 0.3) and (3.7 ± 0.4) point respectively] and lesion conspicuity scores [(3.3 ±0.4),(3.9±0.4),(3.2±0.4) and (3.7 ±0.4) point,respectively] among the four groups all had statistical differences (Z =9.581,37.495 and 43.436,all P values ＜ 0.05).Scores of the four groups were all greater than 3 and met the clinical diagnostic level.Group D was higher than group B in image noise score,higher than the other three groups in overall image quality score,higher than group A in lesion conspicuity score (all P values ＜ 0.05).Conclusion Combined use of CT spectral monochromatic imaging and image fusion can improve overall image quality while maintaining or increasing CNR in small HCC.

Objective To investigate the effect of dexmedetomidine on the expression of hypoxia-inducible factor-1α (HIF-1α) during hypoxia/reoxygenation (H/R) in human renal tubular epithelial cells.Methods Human renal tubular epithelial cells (HK-2 cells) cultured in vitro were randomly divided into 4 groups (n =24 each) using a random number table:control group (group C),dexmedetomidine group (group DEX),H/R group and H/R+ dexmedetomidine group (group H/R + DEX).In group C,the cells were incubated for 28 h in an incubator filled with normoxia at 37 ℃.In group DEX,dexmedetomidine 0.1 nmol/L (final concentration) was added to the culture medium and the cells were incubated for 2 h,and then incubated for 28 h in an incubator filled with normoxia at 37 ℃.In group H/R,the cells were incubated in an anaerobic chamber for 24 h at 37 ℃,and then incubated for 4 h in an incubator filled with normoxia at 37 ℃.In group H/R + DEX,the cells were incubated for 2 h in the culture medium containing dexmedetomidine 0.1 nmol/L (final concentration),incubated in an anaerobic chamber for 24 h at 37 ℃,and then incubated for 4 h in an incubator filled with normoxia at 37 ℃.After treatment in each group,the cell viability was measured by MTT assay,cell apoptosis was measured using flow cytometry,the expression of HIF-1α mRNA was detected using RT-PCR,the expression of HIF-1α and activated caspase-3 protein was detected by Western blot,and the cell growth was observed.The apoptosis rate was calculated.Results Compared with group C,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of HIF-1α mRNA and protein and activated caspase-3 protein was up-regulated in H/.R and H/R + DEX groups,and no significant change was found in group DEX.Compared with group H/R,the cell viability was significantly increased,the apoptosis rate was decreased,the expression of HIF-1α mRNA and protein was up-regulated,the expression of activated caspase-3 protein was down-regulated,and the cell status was significantly improved in group H/R + DEX.Conclusion The mechanism by which dexmedetomidine attenuates H/ R-induced damage to human renal tubular epithelial cells may be related to up-regulated expression of HIF-1 α and inhibited cell apoptosis.