Objective To investigate the clinical autopsy results of patients died of cardiovascular disease or other disease complicated with cardiac damage. Methods Complete autopsy was performed on 86 cases with uncertain cause of death. Through integrating clinical diagnosis and treatment with gross autopsy findings and microscopic observations, 86 autopsies were determined the major cause of death. Results In 86 autopsies, 69 cases were heart disease. Differences between pathological diagnosis and clinical diagnosis were compared. Twenty-seven cases were cardiac deaths, with diagnosis accrodance rate of 81. 5%. Fortytwo cases died of non-cardiac disease but complicated with heart disease or involving the heart which accelerated the death in patients, with accordance rate of 78.6%. Conclusion Scientific and correct performance of autopsy was important to determine the causes of death, to promote development of related disciplines and to improve the diagnosis and treatment of the diseases.

Objective To investigate the effect of bortezomib on proliferation and apoptosis of pancreatic cancer cell lines BxPC3,SW1990 and explore possible mechanisms of bortezomib's killing effect on cancer cells.Methods BxPC3,SW1990 cells were treated by using 1,10,50,100,500 nmol/L and 1,10 μmol/L of bortezomib,and cells without bortezomib treatment were considered as control group.The cell proliferation was determined by MTF assay,and apoptosis was determined by flow cytometry.Bak,Bax,Bcl2,Bcl-xl,survivin mRNA expressions were measured by RT-PCR,and Western blot was applied to determine the expressions of pro-caspase-3,cleaved-caspase-3,Bax,Bcl-2,surviving protein.Results When bortezomib concentration was higher than 50 nmol/L,it inhibited the proliferation of two cell lines in a dose and time-dependent manner.And with the same treatment the rate of proliferation inhibition of BxPC3 cells by bortezomib was greater than that of SW1990 cells,and the difference between the two cell lines was statistically significant (P ＜0.05).Apoptosis rates in the groups of BxPC-3 and SW1990 cells treated by 100 nmol/L bortezomib were (22.56 ± 4.23) ％ and (12.71 ± 2.23) ％,which were significantly higher than those in control group (2.15 ± 0.47) ％ and (2.32 ± 0.54) ％,P ＜ 0.05).In addition,apoptosis rate of BxPC3 cells was significantly higher than that of SW1990 cells (P＜0.05).Bak mRNA expression of BxPC3 and SW1990 cells after 100 nmol/L bortezomib treatment were not significantly changed,but the expression of Bax mRNA and protein was significantly increased (P ＜0.05).Bcl-2 mRNA and protein,as well as Bcl-xl mRNA expressions was significantly decreased (P ＜0.05).The expression of survivin mRNA and protein in BxPC3 cells were decreased,but were increased in SW1990 cells(P ＜0.05).The expression of pro-caspase-3 protein in the two cell lines was decreased,while the expression of cleaved-caspase-3 protein was increased (P ＜0.05).Conclusions Bortezomib can inhibit the proliferation of pancreatic cancer cell Iines BxPC-3 and SW1990 and induce apoptosis,and the effect on BxPC3 cells is more than that on SW1990 cells.The mechanism may depend on activation of the mitochondrial pathway of apoptosis,and be related to survivin-involved drug-resistance.

Objective To study the relationship between PDD and the polymorphism of apolipoprotein E(apoE) gene,to inquire the etiological basis of PDD.Methods 11 Patients with PDD 40 patients with PD without dementtia and 52 unrelated controls were collected to detect the genotype of apoE gene by PCR－ RFLP. Results There was no difference in the apoE allele frequencies and genotype distribution in PDD group,PD without dementia group and control group(P >0.05). Conclusion There is no relationship between the polymorphism of apoEgene and the onset of PDD.The pathogenesis of PDD differs from that of AD.

Purpose:To evaluate the effects of thymosin ?1 (T?1) in chemotherapy of NSCLC. Methods:We have conducted a prospective randomized controlled clinical trial.40 non-treated cases of stage Ⅲ-Ⅳ NSCLC were randomized into T?1 group ( chemotherapy combined with thymosin ?1) and control group (chemotherapy alone). The number of T cell subgroups, the activity of NK cell and phagocytic index of neutrophilic granulocyte in peripheral blood were detected and quality of life and changes of cancer lesions were evaluated before and after treatment. Results:After treatment,the levels of CD4 in the T?1 group was significantly higher than before treatment(P0.05). There was no significant difference of myelosuppression between the two groups. No infections or severe toxicity occurred in the T?1 group. One severe lung infection was seen in the control group.There was better quality of life for the T?1 group compared with the control group(P

Objective To investigate expression level of sphingosine kinase 1 (SPHK1) and nuclear factor-κB (NF-κB) in non-small cell lung cancer (NSCLC) and their relationships with invasion, metastasis and prognosis of NSCLC. Meth-ods Ninety-three NSCLC specimens and paraneoplastic normal lung tissue from conventional surgery were confirmed by histology. Expression of SPHK1 and NF-κB were detected by Immunohistochemistry on paraffin sections. Primary antibody were Rabbit Anti-Human SPHK1 and Rabbit Anti-Human NF-κB p65, which were incubated 1 hour in water bath. The secondary antibody was HRP-Polymer anti Mouse IgG, which was incubated 20 minutes in water bath. Results SPHK1 ex-pression was positive in 96.8% (90/93) of NSCLC specimen which is higher than in paraneoplastic normal lung tissue in which the positive rate is 18.3%(17/93);NF-κB expression was positive in 89.2%(83/93) NSCLC which is higher than the in paraneoplastic normal lung tissue in which the positive rate is 12.9%(12/93). The expression of SPHK1 and NF-κB in NSCLC was positively correlated (r=0.464, P＜0.01). TThe expression levels of SPHK1 and NF-κB p65 in NSCLC patients with were positively related to TNM staging and lymph node metastasis. SPHK1 expression and NF-κB p65 expression lev-el were higher in the deads than in survivals. There was no statistical significance in different expression intensity of SPHK 1 and NF-κB p65 in patients with NSCLC who had differences in gender, age, tumor size, tumor location, histological type. Survival analysis showed that survival time of patients of NSCLC with high expression of SPHK1 was shorter than those in the group with low SPHK1 expression, and the difference was statistically significant (χ2=14.025, P ＜ 0.01). Conclusion In the process of NSCLC invasion and metastasis,SPHK1 may play an important role through NF-κB, and it can predict prognosis of NSCLC patient. Moreover, it will become a potential target for NSCLC target.

Objective The objective of this study was to explore the construction of a comprehensive and systematic quality management system for pharmacy intravenous admixture service (PIVAS) and form quality management method and model reflecting distinct gradations,specific responsibility and all staff participation,so that we can provide safe and effective intravenous solutions for the patients and guarantee the quality and safety of intravenous infusion and improve management quality.Methods According to Quality Management Standards of PIVAS published by Ministry of Public Health and JCI Standard,with the theory and methods of feed forward control and delicacy management,by establishing and completing three-grade-quality management organization,defining the quality control indicators,selecting and demonstrating with the application of expert meeting method and Delphi method,a scientific quality control system was formed.Statistics on unreasonable prescriptions,adverse drug reaction of intravenous infusion,defect of pharmacy intravenous admixture and satisfaction of medical staff and patients were compiled and evaluated throughout the implementation of the practice changes in 38 wards.Results Significant differences were observed in various indicators,comparing statistics collected during 6 months of the same season throughout the implementation of the practice changes.x2 value was 160.54,21.39 and 10.29 by comparison of unreasonable prescriptions,adverse drug reaction and number of drug preparation errors.The satisfaction degree of medical staff and patients improved evidently,x2 value was 14.34 and 26.76.Conclusions The construction and implementation of three-grade-quality management system adapt to high-risk,high strength,high sense of responsibility,process-oriented and intensive management of PIVAS.The impact on the continuous improvement PIVAS quality and assurance in safety of intravenous infusion is remarkable.

Objective To compare the influence of tracheotomy after two wet fluid on airway and provide the basis for clinical treatment and care. Methods A total of 30 patients with severe brain injury stay neurosurgery tracheotomy were divided into 0.45% sodium chloride group and ambroxol hydrochloride group with 15 cases each by random digits table method, two airway humidification liquid (0.45%sodium chloride,0.9% sodium chloride + ambroxol hydrochloride) were each instilled in the trachea inner sleeve. Blood gas analysis was performed and the levels of serum lung surface active substances related protein-A (SP-A protein), interleukin-6, interleukin-8, tumor necrosis factor-alpha(TNF-α) were measured by enzyme linked immunosorbent assay (ELISA) before 1 d and after 3,7,14 d of tracheotomy. Results There were significant differences in arterial blood oxygen partial pressure, arterial carbon dioxide partial pressure, oxygenation index after 14 d of tracheotomy between ambroxol hydrochloride group and 0.45% sodium chloride group:(110.72±26.75) mmHg(1 mmHg=0.133 kPa) vs.(89.39±21.98) mmHg, (30.44±6.75) mmHg vs. (35.12±7.28) mmHg, 333.23±80.56 vs. 270.93±77.21, t=29.49,-8.63,7.44, P<0.01.There were significant differences in the levels of serum SP-A protein, interleukin -6, interleukin -8, TNF-α after 14 d of tracheotomy between ambroxol hydrochloride group and 0.45% sodium chloride group:(191.34 ±1.21) ng/L vs. (61.92 ±12.0) ng/L, (2.62 ±0.23) ng/L vs. (5.42 ±0.16) ng/L, (124.56 ±2.10) ng/L vs. (185.91 ±1.48) ng/L, (31.32±1.38) ng/L vs.(69.13±1.16) ng/L, t=75.72,-13.51,-23.89,-20.97, P<0.01. Conclusions The airway humidification effect of ambroxol hydrochloride group is better than 0.45%sodium chloride group, it can improve the wetting effect, and better protect the lung tissue, reduce the incidence of lung infection, make it an ideal airway humidification liquid.

Emotional and cognitive disorders (EACD),such as depression and anxiety,have become very common in today′s society,seriously affecting human lives and health. Neural plasticity can reflect the anti-stress ability of the nervous system to the internal and external stimulation,and is capable of dynamic changes in structure or function to adapt to environmental changes,as is often manifested in the process of compensation and repair of nerve injuries. EACD is often accompanied by macroscopic and cellular morphological changes in brain tissues and functions. Thus,studies on the mechanisms of neural plasticity will contribute to the treatment of EACD. In this paper ,the role of neural plasticity in the active components of Chinese herbal medicine(ACCHM) is reviewed. The effects of ACCHM on 5-hydroxytryptamine(5-HT)system,and the antioxidant activities and neurotrophic effects of ACCHM are described. ACCHM can affect neural plasticity,playing a neuroprotective role by improving 5-HT levels,reducing oxidative stress in brain cells,and increasing the expression of brain derived neurotrophic factor(BDNF). In summary,one ACCHM could affect neural plasticity through one or more mechanisms. There are interactions between different mechanisms of the same ACCHM. Different ACCHM can play a synergistic effect on the enhancement of neural plasticity because of their different mechanisms.

Objective To establish a knowledge management skills evaluation tool for nursing undergraduates and then try to provide an objective basis for evaluation of their knowledge management skills.Methods After reviewing literature and research group discussion,defining the theoretical dimensions of the knowledge management skills system and developing this evaluation tool.A total of 1 139 nursing undergraduates were picked out and investigated.The data were analyzed with the SPSS 20.0 and AMOS 7.0 statistic software packages,including exploratory factor analysis,confirmatory factor analysis,reliability and validity analysis.Results The knowledge management skills evaluation tool of nursing undergraduates was a multilayered and multidimensional system,including 3 subscales (knowledge management cognition,knowledge management attitude,knowledge management behavior),8 factors (the cognition of knowledge management connotation,the intention and the belief of knowledge management,the ability of obtaining,storing,sharing,applying and innovating knowledge),36 items.Exploratory factor analysis showed that all items' factor loading were 0.433-0.851.Confirmatory factor analysis displayed a good degree of fitting.The total scale's Cronbach α was 0.933,sub-scales were 0.807-0.892.The total scale's split coefficient was 0.873,sub-scales were 0.700-0.870.The correlation coefficient between 3 sub-scales score and the total scale score were 0.875-0.912.Conclusions Because of its good reliability and validity,nursing undergraduates can evaluate their knowledge management skills by using this evaluation tool.

Objective To investigate the relationship between peripheral atheroselerosis and coronary heart disease(CHD) in the elderly.MethodsCarotid and femoral intima-media thickness (IMT),total plaque area and carotid total plaque score were measured in 152 elderly inpatients by vascular ultrasound one week before coronary angiography,meanwhile carotid atherosclerosis was classified.The severity of CHD was estimated by the number of vessel lesions and Gensini score. ResultsCarotid and femoral IMT,plaque morbidity,total plaque area and total plaque score were much higher in the patients with CHD than in those without(all P<0.05).Carotid total plaque area,total plaque score,femoral total plaque area and femoral IMT were much higher in the patients with two-vessel lesions[(1.57±0.37)mm~2,(4.595±3.39),(0.51±0.21)mm~2 and (1.07±0.15)mm] or three-vessel lesions [(1.885±0.15) mm~2,(6.67±5.90),(0.59±0.23) mm~2 and (1.15±0.14) mm] than in those with single-vessel lesion [(0.58±0.11 )mm~2,(3.82±2.11),(0.24±0.26) mm~2 and (0.97±0.11)mm,all P<0.05)].There was positive correlation between the classification of carotid atherosclerosis(r= 0.282,P< 0.01),total plaque score (r= 0.307,P < 0.01),total plaque area ( r=0.494,P<0.01) and the number of vessel lesions.There was also positive correlation between carotid total plaque area and Gensini score(r=0.472,P<0.01),between femoral IMT(r=0.415,P<0.01),total plaque area and the number of vessel lesions(r=0.692,P<0.01),and between femoral IMT(r=0.404,P<0.01),total plaque area ( r=0.648,P<0.01 ) and Gensini score.Using multiple stepwise regression analysis,the following parameters were found to be independent predictors of coronary artery Gensini score: carotid total plaque area (OR=2.2; 95% CI:0.79 ～2.46),femoral total plaque area(OR= 1.6;95% CI:O.28～1.35) and femoral IMT (OR=1.6;95% CI:1.20～15.10).Conclusions The assessment of peripheral atherosclerosis by ultrasonography is significantly associated with the prevalence and severity of CHD.