BACKGROUND: The rare earth elements (Res) have multiple bio-activities and some extent neurotoxicity, Because of their distinct physical and chemical properties. The studies on neuromuscular junction and sympathet ic ganglia have shown that some Res, such as lanthanum(La), gadolinium (Gd),etc, exert considerable effects on synaptic transmission, but the effects and mechanism of Samarium on synaptic transmission are still unknown.OBJECTIVE: To investigate the effects and impossible mechanism of Samarium Chloride (SmCl3) on the nicotinic transmission in the isolated sympathetic ganglia, superior cervical ganglion (SCG) of rats.DESIGN: Controlled experimental study based on cells.SETTING: Department of Pharmacology, Guangxi Medical University. MATERIALS: Totally 40 adult Wistar rats (weighing 250-300 g) of either sex, provided by the Experimental Animal Center of Guangxi Medical University, were used in this study. SmCl3 was made by the chlorination of Samarium Oxide with purity 99.5% and relative molecule mass 348.7, presented by Professor Liu Da-yuan, Guangxi Medical University. Acetylcholine chloride (Ach) and carbachol (Carb) were purchased from Sigma.METHODS: The experiment was completed at the neuropharmacology lab of the experimental center of Guangxi Medical University from September 2001 to December 2002. After sacrificing animals by acute exsanguination,SCG together with their preganglionic nerve trunks were isolated rapidly,then transferred to the recording chamber, the preganglionic nerve trunk was drawn into a suction electrode for orthodromic stimulation. The ganglia were superfused continuously with a Krebs solution, saturated with 950 mL/L 02 and 5mL/L CO2, pH 7.4±0.05, (34±0.5) ℃.The fiber containing glass microelectrodes filled with 3 mol/L KC1 (30-60 MΩ tip resistance) were used to impaled cells and do intracellular recording. The fast excitatory postsynaptic potentials (FEPSPs) were evoked in SCG neurons by single pulse stimulations (0.2-0.5 Hz, 0.5-1.0 ms, 2-10 V)on preganglionic nerve trunk. The remarkable membrane depolarization would be recorded in SCG neurons by superfusing ganglia with exogenous Ach (0.1 mmol/L) or Carb(0.1 mmol/L) for 30-60 s. The effects of 1×(10-7-10-4) mol/L SmCl3 on FEPSPs, membrane potentials, membrane resistance, exogenous Ach and Carb-induced membrane depolarization of SCG neurons were investigated in this experiment.The effects of SmCl3 on the facilitation of high Ca2+ (10 mmol/L ) on FEPSPs were also be observed, namely, first superfusing the ganglia with high Ca2+ (10 mmol/L)to facilitate FEPSPs, then superfusing the ganglia with Ca2+(10 mmol/L)contained SmCl3. All the drugs were solved in Krebs solution or improved Krebs solution and applied to ganglia by superfusion in known concentration.The bioelectricity difference before and after the drug superfusion were analyzed by paired Student's t test.MAIN OUTCOME MESURES: ①Effects of SmCl3 on FEPSPs.②Effects of SmCl3 on membrane potentials and membrane resistances. ③Effects of SmCl3 on exogenous Ach and Carb-induced membrane depolarization. ④Effects of SmCl3 on the facilitation of high Ca2+ (10 mmol/L ) on FEPSPs.RESULTS: ① 1 ×(10-7-10-4)mol/L SmCl3 could reversibly depressed the FEPSPs of rats SCG neurons [the amplitude inhibitory percentage of FEPSPs of l×10-4, 1×10-5, 1×10-6, 1×107 mol/L SmCl3 was (49.78±13.85)%(n=20),(39.05±4.05)%(n=10),(29.83±9.73)%(n=10)and (16.30±2.16)%(n=10)respectively (P ＜ 0.05-0.01)].1×10-4 mol/L SmCl3 could chang Aps into FEPSPs (n=5).②The membrane depolarization induced by Ach (n=5) and Carb (n=7) were not significantly changed by 1×10-4 mol/L SmCl3(P ＞ 0.05).③The membrane potential and membrane resistance were not significantly altered by 1×(10-7-10-4)mol/L SmCl3(n=67), P ＞ 0.05. ④1×10-4 mol/L SmCl3 could antagonized the facilitation of high Ca2+ (10 mmol/L ) on FEPSPs (n=5), P ＜ 0.01.CONCLUSION: SmCl3 can depresses nicotinic transmission in rats sympathetic ganglia by presynaptic mechanisms, perhaps due to its inhibition on Ca2+ influx.

ObjectiveTo explore the effect of cognitive therapy and progressive relaxation training (CTPRT) on the operation anxiety of patients undergoing chemonucleolysis with collagenase.Methods120 patients undergoing chemonucleolysis with collagenase were randomly assigned to the experimental group and the control group.The experimental group received routine care and CTPRT,while the control group only received routine care.The perioperative anxiety status,back and leg pain,heart rate,blood pressure,status of sleeping and urination of the two groups were evaluated respectively.ResultsAnxiety and pain degree in the experimental group was significantly lower than that of the control group (P<0.01).About 30 min pre operation and postoperation,the heart rate and blood pressure of the experimental group were much lower than that of the control group (P<0.01).The experimental group also showed better sleep and urination status.ConclusionsThe cognitive therapy and progressive relaxation training can reduce degree of operation anxiety,release the pain and help promote sleep for patients undergoing chemonucleolysis with collagenase.

OBJECTIVE To explore the characteristics and intervention measures of nosocomial infection in ICU.METHODS Retrospective investigation was used to analyze the nosocomial infection cases in 145 patients discharged from ICU.RESULTS Of 145 inpatients,35 developed nosocomial infection with an infection rate of 24.14%.Elderly patients with severe diseases were the high risk group.The causes of infection were related to the increase of traumatic operation,hypoimmumity and unreasonable antibiotics usage.Lacking awareness of cross infection in medical and nursing staff was another factor facilitating the occurrence of infection.CONCLUSIONS Nosocomial infection rate in patients in ICU is high.Close attention should be paid to the old patients.Nursing intervention of respiratory tract,gastrointestinal tract and urinary tract should be given to the patients with severe diseases.The illegal use of antibiotics and traumatic operation should be limited.

Aim To study the effects of chronic morphine treatment on the contents of cAMP and cGMP in sympathetic ganglia,superior cervical ganglia(SCG) of rats.Methods The chronic morphine dependent model of rats was established by subcutaneous injection of morphine in gradually increasing doses for 5 days,the dependence and the tolerance of the model was estimated by naloxone precipitation test and 55℃ tail-flick trail test respectively.The contents of cAMP and cGMP in SCG were detected by means of 125I radioimmunoassay.Results ① Compared with control group,the content of cAMP in SCG of morphine-acute group rats was descended(P0.05;compared with morphine-acute,P0.05).Conclusion There was an up-regulation of cAMP in sympathetic ganglia of chronic morphine treated rats.

Aim To study effects of morphine tolerance and dependence on the fast excitatory synaptic transmission in sympathetic ganglia of rats.Methods The isolated sympathetic ganglia,superior cervical ganglia(SCG), were made from control and morphine tolerant and dependent rats respectively.Effects of morphine tolerance and dependence on the fast excitatory synaptic transmission in rat sympathetic ganglia were studied by means of intracellular recording technique.Results ① Morphine(0.1～1.0 mmol?L~(-1))reversibly inhibited the amplitude of the fast excitatory postsynaptic potentials(f-EPSPs) in SCG neurons of control rats.② Compared with control group,inhibitory effects of morphine(0.5 mmol?L~(-1) and 1.0 mmol?L~(-1)) on f-EPSPs in SCG neurons of morphine tolerant and dependent rats were obviously decreased;③ Naloxone(0.1 mmol?L~(-1)),which had no significantly effect on f-EPSPs in SCG neurons of control rats,could reversibly facilitate the amplitude of f-EPSPs in SCG neurons of morphine tolerant and dependent rats;④ No significant difference of RMP and Rm was founded between SCG neurons of control and morphine tolerant and dependent rats.Conclusion The morphine tolerant and dependent of the fast excitatory synaptic transmission in rat sympathetic ganglia has been formed in morphine tolerant and dependent rats.

Objective To observe the influence of short-term continuous subcutaneous insulin infusion(CSII)on ?-cell function in newly diagnosed type 2 diabetes(T2DM).Methods A total of 32 inpatients with newly diagnosed T2DM who had a 14-day course of CSII were randomly assigned to two groups of OGTT and arginine stimulating test(AST).Before and after 3 days and 14 days CSII treatments,OGTT and AST were performed respectively.The changes of the values of plasma glucose,HOMA-IR,HOMA-? and △C30/△G30,△C120/△G120 or arginine-induced acute C-peptide reaction(ACRARG)in two groups were compared.Results In OGTT,the values of plasma glucose and HOMA-IR were decreased,HOMA-? and △C120/△G120 were increased significantly after CSII therapy,both in day 3 and day 14;and △C30/△G30 were unchanged after 3 days but increased markedly after 14 days.However,in ACRARG,the above mentioned parameters almost remained unchanged after CSII treatment in 3 days or 14 days.Conclusions In newly diagnosed T2DM with elevated fasting glucose levels,intensive insulin therapy can partly improve ?-cell function showed by OGTT,not by AST.

Type 1 diabetes mellitus and autoimmune thyroid disorders are the most common combination of autoimmune polyendocrine syndrome type Ⅲ(APS Ⅲ). However, APS Ⅲ combined with myasthenia gravis is rare. We described a male patient with myasthenia gravis, type 1 diabetes mellitus, and Hashimoto thyroiditis, who was diagnosed as APS Ⅲ. The human leukocyte antigen (HLA)type was analyzed in this patient. We subsequently reviewed 11 cases of APS Ⅲ combined with myasthenia gravis. This review revealed that HLA-DR9/DQ9 might be a specific HLA subtype associated with APS Ⅲ and complicated with myasthenia gravis .

Objective To investigate the clinical significance and mechanism of WW domain containing oxidoreductase (WWOX) gene and p73 gene abnormal expression in acute lymphocytic leukemia (ALL).MethodsCase-control study was used in the research.Forty-eight cases of bone marrows from ALL patients were collected,including 32 cases newly diagnosed,11 cases with complete remission and 5 case with relapse.Thirty-one cases of bone marrows from non-leukemia patients were used as control group.All the samples were collected from First Affiliated Hospital of Guangxi Medical University from July 2010 to July 2011.The doctors punctured patients' bone marrows 3 milliliters from the left of posterior superior iliac spine.Samples were bottled up with EDTA anti-coagulation tube.1 milliliter bone marrow was used to extract genome RNA with purity from 1.8 to 2.0.And then,the level of WWOX and p73 gene transcripts were tested immediately using reverse transcriptase-polymerase chain reaction (RT-PCR).Meanwhile genome DNA was also extracted from the other 2 milliliter bone marrow with purity from 1.7 to 1.9,which was used to detect the promoter methylation of WWOX gene and the first exon methylation of p73 gene by methylation PCR (MS-PCP).x2 test and Fisher's exact test were used to compare tbe methylation status of WWOX and p73 gene.Results In 31 controls,expression of WWOX and p73 gene mRNA was 94.00％.The total expression frequency of WWOX gene mRNA in 48 ALL samples was 48.00％ (23/48),much lower than control (x2 =17.434,P =0.000 ).There was significant difference (x2 =10.471,P =0.001 ) between newly diagnosed cases 34.38％ ( 11/32),complcte remission cases (90.91％,10/11 ) and control.The total expression frequency of p73 gene mRNA in 48 ALL samples was 56.00％ (27/48),much lower than control (x2 =12.697,P =0.000).There was significant difference (P =0.012 ) between newly diagnosed cases 43.75％(14/32) and complete remission cases 90.91％(10/11).It was unmethylation in 31 controls.The total methylation frequency of WWOX gene promoter region in 48 ALL samples was 44.00％(21/48),much lower than control (x2 =18.473,P =0.000).There was significant difference (P =0.012) between newly diagnosed cases 56.25％ (18/32),complete remission cases 9.09％ (1/11 ) and control.The total methylation frequency of p73 gene the first exon region in 48 ALL samples was 35.00％(17/48),much lower than control (x2 =13.990,P =0.000).There was significant difference (P =0.033) between newly diagnosed cases 46.88％ (15/32),complete remission cases 9.09％ ( 1/11 ) and control.There was a negative correlation between the expression of WWOX gene mRNA and its methylation status(r =- 0.678,P =0.000),the same as p73 gene ( r =- 0.577,P =0.000).ConclusionsThe abnormal methylation of WWOX and p73 gene may be the major mechanism of gene silence in ALL,which leads to no expression of WWOX mRNA or p73 mRNA.And the abnormal methylation of WWOX and p73 gene may be relevant with the process of occurrence and development in ALL.It may be an effective and significant to detect methylation status of WWOX gene and p73 gene for the diagnosis and treatment of ALL patients.(Chin J Lab Med,2012,35:820-825)

Objective To investigate the expression of FHIT,WWOX and MDR1 gene in nasopharyngeal carcinoma and FHIT and WWOX mechanism of inactivation.Methods Real-time PCR was used to test FHIT,WWOX and MDR1 gene′s mRNA expression in 89 nasopharyngeal carcinoma patients (experimental group) and 61 inflammatory patients (control group).Q-MSP was used to test the FHIT and WWOX promoter methylation status.Denatured polyacrylamide gel electrophoresis was used to test the LOH of FHIT and WWOX gene.Results (1)The three genes′ mRNA expression were different between experimental group and control group (P<0.05).After grouped according to the histological type and clinical stages,the expression of FHIT and WWOX mRNA between the patients with serious illness or poorly differentiated squamous cell carcinoma and mild cases or highly differentiated squamous cell carcinoma were significantly different in the experimental group,the difference is statistically significant (P<0.05)Meanwhile,the FHIT and WWOX mRNA expression had statistical association with the clinical stage and histological type(r=-0.731,P=0.000;r=-0.816,P=0.000;r=-0.626,P=0.000;r=-0.536,P=0.001).The MDR1 mRNA expression was different between poorly and highly differentiated squamous cell carcinoma (P=0.021),which was statistical associated with the histological type (r=-0.697,P<0.001).(2)The degrees of FHIT and WWOX promoter methylation in the experimental group was higher than those in the control group,the difference was statistically significant (P<0.05);Also,the expression of FHIT and WWOX mRNA were closely related to the degree of promoter methylation(r=-0.689,P=0.000;r=-0.594,P=0.000).(3) In the experimental group,there were 39 cases (43.8%) of LOH in the FHIT gene,and 42 cases (47.2%)of the WWOX genes were significantly higher than those in the control group (4.9% and 3.3%),the difference was statistically significant (P<0.05).The FHIT and WWOX gene mRNA were negatively correlated with the loss of heterozygosity(r=-0.239,P=0.049;r=-0.364,P=0.013).Conclusion Promoter methylation is the main reason for the down-regulation of FHIT gene and WWOX gene expression in nasopharyngeal carcinoma patients,which may be the main reason for the occurrence and development of nasopharyngeal carcinoma.The higher expression of MDR 1 mRNA is statistical association with the histological type.

Objective:To compare the therapeutic effects between immediate breast reconstruction (IBR) after skin-sparing mastecto-my and modified radical mastectomy (MRM) in young breast cancer patients (≤35 years), as well as to analyze the prognostic factors of IBR in these patients. Methods:The clinicopathological data of young breast cancer patients who had undergone IBR after skin-spar-ing mastectomy (60 cases) and MRM (68 cases) in Liuzhou People's Hospital from July 2008 to June 2014 were retrospectively ana-lyzed. Local recurrence, disease-free survival, and overall survival of the patients between the two groups were compared. The influ-encing factors for survival of the IBR group patients, such as age, tumor size, and nipple-areolar complex preservation, were analyzed. Results:All patients were followed-up for a period ranging from 15 to 88 months with a median of 51. In the IBR group, local recur-rence, distant metastasis, and death occurred in 3, 8, and 5 cases, respectively. The 3-and 5-year disease-free survival rates (DFSR) were 91.7%and 81.7%, respectively, whereas the overall survival rate (OSR) was 91.7%. In the MRM group, local recurrence, distant metastasis, and death occurred in 2, 9, and 5 cases, respectively. The 3-and 5-year DFSRs were 94.1%and 83.8%, respectively, where-as the OSR was 92.6%. No statistical difference was noted between the two groups (P>0.05). The analysis of prognostic correlation fac-tors in the IBR group patients shows that lymph node metastasis and estrogen and progesterone receptor-negative correlated with the tumor-free survival and overall survival rates (P<0.05). Conclusion:No apparent statistical difference in the comparison of the local re-currence and long-term survival rate was observed between the two groups' young breast cancer patients who underwent IBR after skin-sparing mastectomy and MRM. IBR after skin-sparing mastectomy is safe for young breast cancer patients with early-stage, and nipple-areolar complex preservation does not increase the risk of recurrence in the IBR group patients. Lymph node metastasis and es-trogen and progesterone receptor-negative are the major prognostic factors of IBR after skin-sparing mastectomy in young breast can-cer patients.