Objective To investigate the expression of CRKL in thyroid papillary micro-carcinoma and its clinical significance.Methods 120 patients with thyroid tissue specimens were collected,in which 30 cases of diam-eter >1 cm of papillary thyroid carcinoma,30 cases of thyroid papillary micro-carcinoma,30 cases of nodular goiter, 30 cases for specimen of thyroid disease patients without diabetes.Immunohistochemical(SP)method was used to de-tect samples in CRKL expression.Results In thyroid papillary micro-carcinoma and thyroid papillary cancer group, CRKL expression positive rates were 30.12% and 29.87% respectively,which were higher than that of nodular goiter and normal thyroid group 30.03% and 28.57%(χ2 =52.102,P <0.05);The average absorbance(A)value in thy-roid papillary micro-carcinoma and thyroid papillary carcinoma group which were respectively (0.516 ±0.100)and (0.496 ±0.201),were higher than that in nodular goiter and normal thyroid group (0.246 ±0.050)and (0.117 ±0.015),the difference was statistically significant(F =149.105,P <0.05).Conclusion CRKL is highly expressed in papillary thyroid micro-carcinoma and the clinical detection of CRKL is helpful to determine the surgical plan for papillary thyroid micro-carcinoma.

Objective To evaluate the efficacy of tolterodine in preventing bladder spasm during the operation to BPH.Methods One hundred and twelve cases of BPH patients were randomized to two groups:56 cases in one group were prescribed tolterodine 4-5 d before operation and 3-4 d after operation (2 mg twice daily),another 56 cases did not take any anti-spasm drugs.The bladder spasm occurring or not,frequency and continuing time of bladder were evaluated and recorded.Results In the controlling group:the non bladder spasm in 12.5% (7/56),mild bladder spasm in 14.3% (8/56),severe bladder spasm in 73.3% (41/56),In the treatment group:non bladder spasm in 87.5% (49/ 56),mild bladder spasm in 8.9% (5/56),severe bladder spasm in 3.6% (2/56).There was signifi-cant difference between the 2 groups (P<0.001).Conclusion Tolterodine could alleviate bladder spasm around the operation to BPH.

OBJECTIVE:To compare the efficacy and safety of only paroxetine vs. paroxetine combined with alprazolam in the treatment of diabetes complicated with anxiety and depression. METHODS:Totally 86 patients with diabetes complicated with anxi-ety and depression were randomly divided into observation group and control group. The patients in observation group were given paroxetine 20 mg,qd,and alprazolam 0.4 mg,tid;patients in control group were given paroxetine alone. The treatment course lasted for 8 weeks in 2 groups. The clinical data was compared,including fasting plasma glucose(FPG),2 h postprandial glucose (2 h PG),glycated hemoglobin (HbA1c),cortisol,adrenocorticotropic hormone (ACTH) levels and scores of Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD). The adverse reactions were observed. RESULTS:After treatment,FP-BG,2 h PG,HbA1c,cortisol,ACTH levels and scores of HAMA and HAMD in observation group were significantly lower than control group,with significant difference(P<0.05). There were significant differences in the incidence of adverse reactions be-tween 2 groups(P>0.05). CONCLUSIONS:Compared with paroxetine alone,paroxetine combined with alprazolam can improve more in blood glucose,endocrine levels and adverse mood symptoms in the treatment of diabetes complicated with anxiety and de-pression,with similar safety.

Objective: To describe the prevalence of food allergy in Asian patients with allergic rhinitis. Study Design: A non-randomized prospectively collected patients over a three year period, with complaints of nose congestion, rhinorrhea and/or nasal discharge. Results: There were 435 patients enrolled, 213 children and 222 adults. The children group had a high prevalence of allergen specific IgE to Dermatophagoides pteryonysinus (70%), Dermatophagoides farina (69%), and Blomia tropicalis (55%); followed by dogs (32%), cats (19%) and cockroaches (19%). In the children food allergy category, the top three allergens were egg white (54%), milk (31%) and soya bean (13%). The adult group had results of Dermatophagoides pteryonysinus (71%), Dermatophagoides farina (72%), and Blomia tropicalis (59%); the adult food allergy category, the top 3 allergens were egg white (13%), milk (6%) and soya bean (5%). There was a statistically significant difference in the child and adult group for Dust, D. pteryonysinus, D. farina, B.tropicalis, egg white, wheat, gluten and soya bean. In the age specific child groups, there was an increased in egg food allergy levels, with a peak at the age of five-nine years old and decreasing thereafter (p=0.04). In the children group, the mean Total Nasal Symptom Score (TNSS) was 10.3 (range of 7 to 13); the adult group was similar, with a mean TNSS of 9.8 (range 5 to 12). Conclusion: The prevalence of food allergy in paediatric patients with allergic rhinitis is fairly high and should be considered when treating these children.

Objective To analyze the factors which influence the present nursing management ability in the alliance and to provide theoretical evidences and methods to improve the management. Methods 120 nursing administrators from 7 hospitals in the alliance were selected in convenience sampling for the site survey with customized questionnaires on nursing management ability appraisal. Results The valid return rate of the questionnaires is 100%;the average score of all respondents is 82.84±10.10;the differences in nursing management between the leading hospital and its members are statistically significant (P <0.05)while the differences among the members are not.Conclusion The leading hospitals play a very important role in improving the nursing management ability and administration in the alliance,which should integrate and leverage leadership roles to develop high quality nursing management among the hospitals in the alliance.

BACKGROUND:microRNA-17 is confirmed to play an important role in the development of pulmonary hypertension. Some research has shown that hypoxia-induced proliferation in human pulmonary artery smooth muscle celldepends on the induction of arginase II. There is no report about whether there is some interaction between microRNA-17 and arginase II in human pulmonary artery smooth muscle cells.
OBJECTIVE:To investigate the possible interactions between microRNA-17 and arginase II in hypoxic human pulmonary artery smooth muscle cells.
METHODS:Passage 4 human pulmonary artery smooth muscle cells were cultured in 21%O 2 and 5%CO 2 (normoxia) or 1%O 2 and 5%CO 2 (hypoxia), and then transfected with mimic or inhibitor of microRNA-17 or arginase II-smal interfering RNA. RNA, microRNA and protein were isolated separately. Expression of microRNA-17 and arginase II was detected with real-time quantitative PCR and western blot assay. RESULTS AND CONCLUSION:The level of microRNA-17 was significantly increased in cultured human pulmonary artery smooth muscle cells exposed to 1%O 2 hypoxia, as was arginase II mRNA and protein expression. Furthermore, inhibition of microRNA-17 expression decreased the mRNA and protein levels of arginase II in the human pulmonary artery smooth muscle cells under hypoxia. Conversely, over-expression of microRNA-17 increased the mRNA and protein levels of arginase II in the human pulmonary artery smooth muscle cells under normoxia and hypoxia. Knockdown of arginase II by siRNA abolished the hypoxia-induced up-regulation of microRNA-17 expression. These findings indicate that arginase II is a target gene of microRNA-17 and can regulate the expression of microRNA-17 in human pulmonary artery smooth muscle cells.

[ ABSTRACT] AIM:To explore the regulatory effect of intermedin ( IMD) on pulmonary collagen synthesis and ac-cumulation in rats with pulmonary hypertension induced by high pulmonary blood flow.METHODS: Healthy male SD rats (n=20) were randomly divided into control group (n=7), shunt group (n=7) and shunt with IMD group (n=6).The shunting of abdominal aorta and inferior vena cava was produced in rats of shunt group and shunt with IMD group.After 8 weeks, IMD was administered into the rats of shunt with IMD group subcutaneously by mini-osmotic pump for 2 weeks.Mean pulmonary artery pressure (mPAP), relative medial thickness (RMT) of pulmonary arteries, contents of hydroxyproline, collagen type I and III, bone morphogenetic protein-2 (BMP-2), and the mRNA expression of procollagen I and III in lung tissues were measured and compared.RESULTS:Compared with control group, mPAP and RMT of medium and small pul-monary arteries in the rats of shunt group were significantly increased.Meanwhile, the lung hydroxyproline, collagens I and III and BMP-2 contents, and the mRNA expression of lung procollagen I and III were all significantly increased compared with control group.However, IMD significantly decreased mPAP, alleviated the changes of pulmonary vascular micro-struc-ture, decreased the collagen accumulation and pulmonary tissue homogenate BMP-2 contents, and inhibited the mRNA ex-pression of procollagen I and III in the lung tissue of shunting rats.CONCLUSION:IMD plays a protective role in the de-velopment of pulmonary hypertension and pulmonary vascular structural remodeling induced by high blood flow by inhibiting pulmonary collagen synthesis and accumulation, possibly in association with the BMP-2 pathway.

Objective To observe the expression changes of 5-hydroxytryptamine (5-HT),brainderived neurotrophic factor (BDNF) in rats with chronic manganism.Methods Sixty healthy male Sprague-Dawley rats were randomly divided into control group (n =15) and experimental group (n =45).The experimental group was divided into three subgroups:low-dose group (n =15),middle-dose group (n =15),high-dose group (n =15).The rats in control group were given intraperitoneal injection of normal saline while the rats in low-dose group,middle-dose group,high-dose group were given intraperitoneal injection of 5 mg/kg,15 mg/kg and 25 mg/kg manganese chloride tetrahydrate,respectively for 5 days oncea week and lasted for 12 weeks.The depressive behavior changes of rats were observed by sucrose preference test and open field test.The concentrations of manganese in the striatum of rats were detected by inductively coupled plasma-atomic emission spectrometry.The expression of 5-HT in frontal cortex,hippocampus of rats was determined by high performance liquid chromatography.The expression of BDNF in frontal cortex,hippocampus of rats was examined by Western blotting.The expression of BDNF mRNA was detected using real-time fluorescence quantitative polymerase chain reaction.Results The chronic manganese poisoning rats presented depression-like behavior based on the sucrose preference test and open field test,which was more distinct in high-dose rats.As compared with the control group (frontal cortex (459.65 ± 16.81) ng/g,hippocampus (323.92 ± 17.41) ng/g;tissue wet weight),the expressions of 5-HT were significantly decreased in frontal cortex ((423.45 ± 17.19) ng/g,(376.89 ± 18.87) ng/g,(280.17 ± 25.46) ng/g),hippocampus ((265.71 ± 17.89) ng/g,(214.35 ±23.63) ng/g,(172.67 ± 18.24) ng/g) of the experimental group (F =132.68,69.66,both P ＜ 0.05).As compared with the control group (frontal cortex 0.962 ±0.111,hippocampus 0.873 ± 0.101;the expressions of BDNF were significantly decreased in frontal cortex (0.855 ± 0.106,0.649 ± 0.112,0.506 ± 0.121) and hippocampus (0.731 ± 0.092,0.626 ±0.104,0.544 ± 0.113) with the increasing concentration of MnCl2 which showed dose dependence (F =13.26,18.54,both P ＜ 0.05).As compared with the control group (frontal cortex 0.000 87 ± 0.000 07,hippocampus 0.000 82 ± 0.000 09),the expressions of BDNF mRNA were decreased significantly in frontal cortex (0.000 71 ± 0.000 06,0.000 48 ± 0.000 03,0.000 36 ± 0.000 03) and hippocampus (0.000 57 ± 0.000 05,0.000 49 ± 0.000 04,0.000 38 ± 0.000 05) in the treated group with the increasing concentration of manganese (F =18.46,12.76,both P ＜ 0.05).Conclusion Rats with chronic manganese poisoning could present depression-like behavior and the expression of 5-HT and BDNF is decreased in the frontal cortex and hippocampus with the increased accumulation of manganese.

Objective To explore the integrity of white matter changes in patients with vascular mild cognitive impairment (VaMCI)based Leukoaraiosis.Methods The patients which appeared white matter hyperintensities in subcortical were performed psychological testing,then 48 VaMCI patients and 18 without cognitive impairment volunteers(NC)were choosed and performed DTI scanning,to determine the white matter’s values of FA and ADC in the following bilaterally symmetrical regions of interest(ROI):entorhinal cortex lobe,hippocampal vault,anterior of corpus callosum,posterior of corpus callosum,inferior frontal lobe,superior temporal lobe and angular gyrus of occipital lobe. Then the differences of the data of DTI between two groups and the relevance between neuropsychological score and DTI’s data were analysed.Results ADC values were significantly higher of VaMCI group in the left inferior frontal lobe,left anterior of corpus callo-sum,left hippocampus vault and right angular gyrus compared with NC group(P <0.05),and in the left hippocampus ADC values and MoCA scores was negatively correlated(r=-0.34,P =0.02).There was no significant difference of FA values between groups. Conclusion The ADC values in many cognitive related areas was reduced in VaMCI patients.

Objective To compare the efficiency and safety of regimens of empiric antibiotic therapy in neutropenic hematological maligence patients.Methods The clinical data of empiric antibiotic therapy for 260 febrile episodes in 125 neutropenic hematological maligence patients were analyzed retrospectively.Results A total of 45 febrile episodes were treated with tazocin plus amikacin(regimen TA).80 episodes were treated with ceftazidime plus amikacin(regimen CA),75 episodes with imipenem plus amikacin(regimen IA) and 60 episodes with maxipime plus amikacin(regimen MA).The medians of initial therapy in each regimen were 7～8 days.Percentage of satisfactory response had no significant difference in episodes treated with regimens TA,IA and MA(65%,70% and 79% respectively),and it was better than regimen CA(P