Objective To study the effects of Tongluo recipe on p38 mitogen-activated protrin kinase (p38 MAPK)- fibronectin(FN) signal pathway in the kidney of streptozotocin-induced diabetic rats, so as to explore the possible mechanism by which Toogluo recipe protects the kidney. Methods Male Sprague-Dawley(SD) rats were randomly divided into 3 groups(n = 7): control group (CON group), model group(DM group)and Toogluo recipe group(DM+TLR group). Rats in the DM group and DM+TLR groups were administered with streptozotocin (65 mg/kg) by intraperitoneal injection to induce diabetic model. Rats in DM + TLR group were also given 1g/(kg·d) of Toogluo recipe orally after successfully establishment of diabetic model, and rats in DM and CON groups were only given equivalent volume of ddH2O. The interference lasted for 12 weeks. Biochemical indices were obtained by automatic analyzer. Coomassie brilliant blue assay was used to measure the 24-hour urine protein. Kidney cortex was subjected to PAS staining. Western blotting analysis was used to detect the protein expression of total p38 MAPK (t-p38 MAPK), phosphorylated p38 MAPK (p-p38 MAPK), total cAMP response element-binding protein (t-CREB), phosphorylated CREB (p-CREB) and FN. Results Compared with CON group, the average left kidney mass/body mass (LKM/BM), blood glucose(BG), blood urea nitrogen(BUN), serum creatinine(Scr), 24-hour urine proteins(24 h UP) and urine protein/creatinine (UP/Ucr) were significantly increased in the DM group (P< 0.05); the average BM was significantly decreased(P<0.05); and the expression of p-p38 MAPK, p-CREB, FN was increased by 2.37, 2.21, and 2.03 folds, respectively (P< 0.05). Compared with DM group, the average LKM/BM, Scr, 24 h UP and UP/Ucr were significantly decreased (P<0.05) in DM+TLR group, and the expression of p-p38 MAPK, p-CREB, FN was significantly decreased(P< 0.05). Conclusion Tongluo recipe can protect the kidney in diabetic nephropathy rats, probably through inhibition of the p38 MAPK-FN pathway.

Objective To investigate the gene polymorphism of HLA-DR locus and feature of HLA haplotypes of Han Population in Tianjin area.Methods Reverse PCR-SSOP typing results of HLA-DR alleles of 3000 cord blood units from Han population pregnant women in Tianjin area were compared to those of European Caucasian and the Han populations in Xi’an area.Results DRB1 *15, allele presented the highest frequency,followed by DRB1 *09,DRB1 *07,DRB1 *12,and DRB1 *04.The main haplotypes were A *02-DRB1 *09,A *02-DRB1 *15,B *13-DRB1 *07,A *02-DRB1 *12,A *30-DRB1 *07 and B *46-DRB1 *09 in sequence.The frequencies of DRB1 *12 and DRB1 *09 alleles were significantly higher than in European Caucasian,while the frequencies of DRB1*01 and DRB1 *03 alleles were significantly lower than those in European Caucasian.As compared with that of the Han population in Xi’an,there was not significantly difference except a decrease in frequencies of DRB1 *04 and DRB1 *13 alleles.Conclusions Distribution of the allelic polymorphism of HLA-DR locus was similar to those in northern Han population,such as in Xi’an area,and it was obviously different from those in European Caucasian.

Objective To evaluate the effects and safety of closed tracheal suction system(CTSS)versus open tracheal suction system (OTSS) for mechanically ventilated patients.Methods All randomized controlled trials (RCTs) comparing CTSS with OTSS for mechanically ventilated patients home and abroad were identified via manual and computer retrieval.All related data were extracted.Meta analysis was conducted using the statistical software RevMan 5.1 on the basis of strict quality evaluation with the methods recommended by the Cochrane Collaboration.Results Fifty-one related papers were found and 12 RCTs involving 1205 patients in CTSS group and 1179 patients in OTSS group were included.The results of meta analysis showed that CTSS was associated with a significant reduction in the duration of mechanical ventilation (WMD =-0.73,95％ CI-1.07--0.40,P＜0.0001),but the incidence of ventilator associated pneumonia and microbial colonization,mortality and length of ICU stay exhibited no difference between the two groups (P ＞ 0.05).However,compared with OTSS,CTSS reduced the incidence of arrhythmia (RR =0.23,95％ CI 0.07-0.74,P =0.01) and minimized the disturbance to heart rate (WMD =-1.97,95％ CI-3.03--0.91,P =0.0003),mean arterial pressure (WMD =-2.01,95％ CI-3.02--1.01,P ＜ 0.0001) and oxygen saturation (SpO2) (WMD =-1.00,95％ CI-1.14--0.86,P ＜ 0.000 01).Conclusions Compared with OTSS,CTSS could reduce disturbance to respiratory and circulatory system by sputum suction and shorten the duration of mechanical ventilation.However,CTSS has no advantage in prevention of ventilator associated pneumonia or microbial colonization,nor does it shorten the length of ICU stay or improve the outcome of mechanically ventilated patients.

Objective To explore the influence of the health belief model education on the life quality of nurses.Methods 200 nurses were randomly divided into the experimental group and the control group with 100 cases in each,the experimental group received health belief model education while the control group was given no intervention.The life quality of nurses before and after the education was compared.Results The life guality of nurses showed no significant difference between the two groups before the health belief model education,one month after health belief model education,life quality of nurses in the two groups showed significant difference.Conclusions Application of the health belief model education can improve the nurses'quality of life.

Objective To systematically review the efficacy of dexmedetomidine or midazolam for sedation in critically ill patients. Methods We searched the PubMed, EMBaes, Cochrane Library, Wanfang Database,CNKI and VIP for all randomized controlled trials (RCTs) about the efficacy of dexmedetomidine versus midazolam for sedation in severe cases. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software. Results Six RCTs involving 613 patients were included in our Meta-analysis. The results of Meta-analysis showed that the length of ICU stay was significantly shorter in group dexmedetomidine than in group midazolam. There were no significant differences in the duration of mechanical ventilation, incidences of bradycardia, hypotension and delirium and mortality rate between the two groups. Conclusion Dexmedetomidin can shorten the length of ICU stay and is beneficial for the outcome in critically ill patients.

Asphyxia ; etiology ; Child ; Dysostoses ; complications ; Female ; Humans ; Osteochondrodysplasias ; Thorax ; abnormalities

Objective The patients with non-syndromic deafness in Shanxi Province were retrospectively an_alyzed for the common deafness gene mutations and frequency of mutations carrying rate ,to understand the molecu_lar pathogenesis of deafness in Shanxi area .Methods Genomic DNAs of 800 patients of non -syndromic deafness within Shanxi were obtained from peripheral blood .Genes GJB2 ,GJB3 ,SLC26A4 and mitochondrial 12SrRNA 1494 and 1555 loci were sequenced after polymerase chain reaction (PCR) amplification and compared with the NCBI website for the analysis of the formation of mutations .ResuIts Among 800 patients ,353 cases (44 .13% ) showed detected deafness related mutations and the genetic etiology was found for 294 patients (36 .75% ) .Among them , 153 cases (19 .13% ) carried double allele mutations in the GJB2 gene .The most frequent mutation of GJB2 gene was 235delC ,and the carrying rate was 13 .5% (216/1 600) .The double mutant allele of SLC26A4 gene was detec_ted in 123 cases (15 .38% ) ,and the most common mutation was IVS7-2A>G ,identified in 7 .44% (119/1 600) of patients .Homogenic mitochondrial 12S rRNA 1494C> T mutation in one patient and 1555A> G mutation in 15 patients were detected .GJB3 gene c .538C > T heterozygous mutation was found in two patients .Altogether , 36 .75% (294/800) of patients with deafness were caused by gene mutations .ConcIusionThe data containing GJB2 gene and SLC26A4 gene carrying rate are consistent with the published data of non-syndromic deafness in the Northwest region of China ,but the carrying rate of mitochondrial gene mutations is lower than the average level of China .Our data show that the gene mutations contribute to 36 .75% of etiology in patients with deafness .This study reflects the importance of deafness related genes screening in Shanxi area for early diagnosis and genetic con_sultation .

Objective: To investigate the possible mechanism of neuroprotection produced by taurine supplement on brain in young rats. Methods: In vitro, taurine treatment or co-treatment with sodium selenite that produced significant neuronal apoptosis was used in cultured cortical neurons to examine the neuroprotection effect using MTT assay and DNA fragmentation electrophoresis. In vivo, female weanling Sprague Dawley rats were divided into four groups, eight rats per group. The treated groups were fed on diets with different contents of taurine respectively, and the control group was fed on taurine unsupplemented diets. The experiment lasted five weeks. Results: Taurine significantly increased neuronal survival in dose-dependent manner. The typical DNA ladder pattern could be prevented by taurine. Taurine could elevate brain wet weight, and significantly increased the level of taurine, protein and AChE in brain. Conclusion: It is proposed that the neuroprotection effect of taurine could be achieved by modulating expression of related genes and blocking neuronal apoptosis.

PurposeVon Hippel-Lindau (VHL) syndrome is a rare autosomal dominant diseases involved multiple organs. This paper aims to explore the clinical and imaging features of VHL syndrome for the improvement of early diagnosis and treatment of this disease.Materials and Methods The clinical and imaging data, as well as their history of 5 patients with VHL syndrome were retrospectively studied. Follow-up was performed and the related literature was also reviewed.Results Among the 5 patients, 4 were found with angioreticulomas. One out of four patients simultaneously suffered from multiple angioreticulomas in brainstem, and another one had multiple cervical cord angioreticulomas. The typical MRI showed multiple cystic and solid mass with mixed intense signals, and the enhanced MRI displayed obvious enhancement in the solid part of the mass. Three patients were diagnosed with renal clear cell carcinomas. The typical CT scan showed equidensity or slightly low density signals, and the enhanced CT scan noted heterogeneous enhancement. Besides, bilateral epididymis cystadenoma occurred in one case. The ultrasonography presented heterogeneous echo and rich blood vessels. The follow-ups had been conducted till January 2015. According to the Glasgow outcome scale, three patients were in good conditions, while the other two died from renal clear cell carcinomas.Conclusion Patients with VHL syndrome usually have an unsatisfactory prognosis and most may die from renal carcinoma. Genetic test and investigation of family history should be performed as early as possible on patients with highly suspected or confirmed VHL Early treatment, life-long follow-up and periodic imaging examinations may be helpful in the prognosis.

Objective To investigate the potential clinical factors associated with the prognosis and relapse of adult onset Still's disease(AOSD).Methods The factors possibly influencing the prognosis and relapse of AOSD were analyzed by logistic regression and COX regression in the cohort study.Ninety-six con- secutive inpatients of AOSD diagnosed based on Yamaguchi criteria in the hospital from March 1996 to September 2004 were included in the study.Results Nine cases(9.4%)were lost during the follow-up. Eleven patients(12.6%)were diagnosed as other diseases(5 with other rheumatic diseases,4 with tumor and 2 with infections)in the 87 follow-up cases.In 76 cases,3 patients(3.9%)died and 33 patients(43.4%) got remission over one year after treatment.Splenomegaly(OR=3.14,95%CI=1.01～9.74)and treated with methotrexate(OR=0.22,95%CI=0.07～0.67)were associated with the prognosis from the logistic regression analysis of the 76 cases.The serum ferritin(RR=I.05,95%CI=1.01～1.08)and treated with methotrexate (RR=0.13,95%CI=0.02～0.76)were associated with relapse from the COX regression analysis of the 61 remis- sion cases.Conclusion We need to be very cautious in the follow-up of AOSD patients because some of them may change to other diseases.Methotrexate may be an importent therapy of AOSD not only in improve- ment the prognosis but also in reduction of relapse.