Objective To investigate the relationship between interaction of peroxisome proliferators-activated receptor alpha (PPARα), cytochrome P450 oxysterol 7α-hydroxylase (CYP7B1) and estrogen receptor (ER) and intrahepatic cholestasis in pregnant rats. Methods Eighty clean SD pregnant rats were selected and divided into four groups randomly with 20 in each. Since the 13th day of pregnancy,rats in the control group was injected subcutaneously with refined vegetable oil 2.0 ml · kg-1 · d -1 , those in the low-dose, moderate-dose and high-dose groups received 17-α-ethynylestradiol (EE) 1.0 mg · kg-1 · d-1,1.25 mg · kg-1 · d-1 and 1.5 mg · kg-1 · d-1, respectively. All rats were sacrificed at the 21at day of pregnancy and maternal hepatic tissues were collected. The serum levels of alanine aminotransferase(ALT), aspartate transaminase (AST), total bile acid (TBA) and bilirubin (BIL) were determined by enzyme linked immunosorbent assay (ELISA). The mRNA expressions of PPARα, CYP7B1, Erα and Erβ in maternal rat livers were examined by real-time PCR. Results (1) Biochemical indicators: the serum levels of ALT,AST, TBA and BIL were significantly lower in the control group than in the rest 3 groups,respectively [ control group: (41.1 ± 2.8 ) U/L, (44.4 ± 3.6) U/L, (26.4 ± 5.6 ) μmol/L and( 2.8 ± 0.2)U/L;low-dose group: (48.2 ±3.4) U/L,(47.9 ±3.7) U/L,(36.4 ±4.2) μmol/L and (4.2 ±0.2) U/L;moderate-dose group: (70.4 ± 5.3 ) U/L, (68.4 ± 5.6) U/L, (64.3 ± 3.8 ) μmol/L and ( 6.2 ± 1.2)U/L; high-dose group: (72.4 ±7.6) U/L, (70.2 ±3.8) U/L, (72.4 ±7.8) μmol/L and (8.2 ±2.2)U/L, P<0.05], and those in the moderate or high-dose groups were higher than in the low-dose group (P<0.05). (2) mRNA expression of Erα and Erβ: the mRNA expression of Erα in pregnant rat livers increased in a dose-dependent manner, which were all significantly higher than that in the control group,respectively ( low-dose group: 0.76 ± 0.02 ); moderate -dose group: ( 0.99 ± 0.04; high-dose group:1.21 ±0.01 ;control group:0.65 ±0.01, P <0.05), but no difference was found among the 4 groups in the mRNA expression of Erβ ( P > 0.05 ). (3) mRNA expression of CYP7B1 and PPARα: the mRNA expression of CYP7B1 in pregnant rat livers increased from the low-dose group to the high-dose group, and were all higher than that of the control group ( low-dose group: 0.93 ± 0.01; moderate-dose group: 0.99 ±0.06; high-dose group: 1.22 ± 0.04; control group: 0.75 ± 0.02, P < 0.05 ). However, the mRNA expression of PPARα decreased from the low-dose group to the high-dose group, and were all lower than that of the control group (low-dose group: 0.83 ± 0.05; moderate-dose group: 0.71 ± 0.02; high-dose group:0.64 ± 0.03; control group: 1.35 ± 0. 05; P < 0.05 ) . Conclusions The down regulated mRNA expression of PPARα, caused by higher dose of estrogen, may increase the expression of CYP7B1 due to the ineffectiveness of the inhibition of PPARα on CYP7B1, which may further stimulate the Erα activity and then induce intrahepatic cholestasis. Abnormal expression of PPARα, CYP7B1 and ER may play a role in the pathogenesis of estrogen-induced intrahepatic cholestasis.

AIM: To evaluate posterior capsular opacification (PCO) with hydrophobic acrylic intraocular lens (IOL, Sensar AR40e) and silicone IOLs after cataract surgery, to use a software program developed to provide an objective assessment of the amount of PCO in the digital images of the posterior capsule to quantify PCO. METHODS: Ninety-eight eyes underwent standardized phacoemulsification and "in the bag" IOL placement, were randomized to receive a three piece lens of hydrophobic acrylic or silicone, but lens materials were different in one case. In year 1 and 2, digitized retro-illumination images were taken from the posterior capsule. Images were analyzed by POCO software program, removing the Purkinje light reflexes, contrast enhancement, filtering to enhance low-density PCO. RESULTS: The percentage of PCO were 0.32±0.13 of hydrophobic acrylic IOLs in year 1, compared with 0.39±0.17 of silicone (P=0.37). In year 2, the percentage of PCO were 0.42±0.20 with hydrophobic acrylic IOLs and 0.34±0.18 with silicone IOLs (P=0.50). Of those patients with PCO in year 1 and 2, severity grades were 0.50±0.30 and 0.82±0.58 of hydrophobic acrylic cases, compared with 0.63±0.35 and 0.55±0.35 of patients with silicone IOLs (P=0.52,P=0.69) with no statistical significance.CONCLUSION: The POCO system is capable of producing an objective and repeatable measure of PCO that is relevant to assessing techniques of PCO prevention.

Objective To investigate the major risk factors of posterior circulation infarction.Methods Clinical data from 216 patients with posterior circulation infarction were analyzed retrospectively. The patients were divided into follow groups (proxima1,middle, dista1 and combination group,or single , multiple, or unilateral, bilateral, or lacune infarct, non lacune infarct ) according to the infarcts locations on MRI.The risk factors in each group were analysed. Also,the major risk factors were compared with that from patients with anterior circulation infarction. Results In 216 patients with posterior circulation infarction, hypertension was the most common risk factor (76.9%), followed by diabetes mellitus (36.6% ),hyperlipedemia (30.1%), previous stroke history(26%), and heart disease(22.2%). The most common location of infarcts was distal territory (49%),followed by middle(24.5%) ,proxima1(6%). The average age of proximal group [(57.92?12.81) years] was significant lower than that of other groups(P

Objective To observe the effect of Chuanxiongqin injection combined with nimodipine on primary open angle glaucoma.Methods 112 patients with primary open angle glaucoma in ophthalmology department were grouped two groups,each with 56 cases.Two groups were treated with nimodipine and observation group was treated another with Chuanxiongqin injection to observe effect.Results After treatment,retinal light sensitivity,visual field defect,blood flow,blood flow velocity,erythrocyte migration rate,PSV,EDV and RI in central retinal artery of observation group were better than control group(P<0.05).There was no significant difference in adverse reactions between groups.Conclusion Chuanxiongqin injection can improve blood flow status of central retinal artery and optic papillary laminar, retinal light sensitivity and visual field defect for patients with primary open angle glaucoma.

Objective To explore the effect of action research based on group learning in hospice care module for nursing students. Methods 82 students were divided into cooperative learning group (40) and conventional teaching group (42). The cognition and attitude of good death questionnaire was used to evaluate teaching effect before and after teaching of hospice care. After teaching, self-feedback and self-feedback questionnaire were made to evaluate the effect of cooperative learning group. SPSS 17 was used to make comparison of data between groups and within groups, and t test, chi square test or Fisher exact probability 2 were also used . Results There were no difference between two groups of nurses before teaching. The students' cognitive level and attitude in cooperative learning group increased significantly, especially their cognitive level of physiological needs (t=5.398, P=0.001), cognition and attitude of death education in intervention group was higher than control group (t=2.992, P=0.004; t=3.661, P=0.001). Although 95% of the nursing students of the cooperative learning group thought group cooperative studying could improve their interests and cultivated their comprehensive abilities, only 50% could accept this kind of studying methods . Conclusions Action research based on group cooperative studying can improve students' cognitive level and attitude of good death, and it is also good for cultivating their ability of au-tonomous learning, innovation, cooperation, and meanwhile, educational action research is a good way to improve both teaching effect and research ability of teacher staffs, but in practice, students' acceptance of group learning needs to be improved.

To explore the relationship between thyroid autoantibodies and thyroid function in school children aged 8-10 years,adults,pregnant women,and lactating women in China,in order to provide reference for the prevention and monitoring of thyroid disease.Healthy 8-10 years old school children (693 cases),adults (698 cases),pregnant women(325 cases),and lactating women(332 cases) from six iodine sufficient areas were enrolled.Serum TSH,FT4,and FT3 were determined by chemiluminescent immunoassay,while antithyroid antibody by radioimmunoassay.The positive rate of thyroid autoantibodies in females was significantly higher than that in the male (5.6％ vs 2.0％ in school children,and 22.8％ vs 3.2％ in adults) ; while positive rate of autoantibodies in pregnant and lactating women (8.9％,8.7％) were significantly lower than that in the other healthy adult women (22.8％).The incidence of abnormal thyroid function in antibody-positive people was higher than that in negative ones in all groups,and abnormal thyroid function showed mainly as subclinical hypothyroidism.In addition,lactating women with negative autoantibodies presented a higher incidence of abnormal thyroid function,mainly as low FT4.The abnormal thyroid function is related with the positive thyroid autoantibodies,indicating that it is essential to follow-up these people with positive antibodies in order to facilitate prevention,early diagnosis,and treatment of thyroid disease.Reference data for thyroid hormones in lactating women should be establisbed as soon as possible.

Objective To investigate the effects of tumor-necrosis factor α (TNF-α) on the expressions of proprotein convertases (PC) and its relationship with the inhibition of hepatitis B virus (HBV) replication.Methods HepG2.2.15 cells cultured routinely were exposed to 20 μg/L recombinant TNF-α and/or 20 μmol/L PC inhibitor (DEC) for 18 h.Then Followed cells werecollected and cell total RNA and HBV DNA were extracted.PC mRNA and core-associated HBV DNA were measured using real-time polymerase chain reaction (PCR) techniques.Measurement data was compared using t-test.Results When PC mRNA expressions in the blank group was as to 1,the expressions of PC1/3、PC2、furin、PC4 、PC5/6 、PACE4 and PC7/8 mRNA in HepG2.2.15 cells treated with 20μg/L TNF-α treatment for 18 h were all up-regulated,which were 3.3±0.7、79.3±3.3、77.5±1.3、19.2±3.1、1.3±0.1、1.4± 0.2、274.8± 7.1,respectively (all P＜0.05).Treatment of 20 μg/L recombinant TNF-α for 18 h significantly reduced core-associated HBV DNA compared with blank gourp (0.21∶1,t =8.79,P =0.002),while 20 μmol/L DEC significantly up-regulated core-associated HBV DNA (3.84∶ 1,t=7.67,P=0.004).Moreover,core-associated HBV DNA in group of DEC and TNF-α treatment was significantly higher than group of TNF-α treatment (0.31∶0.21,t=10.49,P=0.007).Conclusion Up-regulated PC mRNA expression induced by TNF-α is significantly associated with the inhibition of HBV replication.

objective To describe the clinical features of patients with posterior circulation ischemic stroke.Methods 216 patients with posterior circulation ischemic stroke admitted in our department during 2004-2006 were analyzed retrospectively.All patients were undertaken MRI on admission and responsble lesions were identified at the posterior circulation territories.The patients'clinical symptoms and signs were evaluated and the relationships between lesion locations and clinical characteristics were analyzed.Results The common symptoms of posterior circulation ischemic stroke were unilateral limb Weakness(81.9%),speech difficulty(46.3%),dizziness(33.8%),and unilateral limb numbness (31.O%).The common signs of posterior circulation ischemic stroke were unilateral limb weakness (81.9%),central facial or lingual palsy(61.1%),dysarthria(46.3%),unilateral limb sensory loss (31.0%),and ataxia(30.1%).The incidence of crossed paralysis was low(2.8%).Isolated vertigo was rare (1.4%).Predominant clinical features such as bulbar paralysis,unconsciousness,visual disorder and amnesia can help to localize the lesions.Typical brainstem syndromes had topographic meanings.Conclusions The clinical features of patients with posterior circulation ischemic stroke were complex.Predominant symptoms can help to diagnose the posterior circulation ischemic stroke.

Objective To analyze the changes of thyroid function of healthy primipara before 20 weeks of gestation to establish normal gestational age-specific reference interval of thyroid hormones,and to investigate the prevalence of maternal thyroid disorders during the first half of pregnancy.Methods A total of 1605 healthy primipara without risk factors of thyroid diseases before 20 gestational weeks and 200 non-pregnant healthy women who accepted pre-conception care in Beijing Friendship Hospital from September 2010 to June 2011 were tested for serum thyroid stimulating hormone (TSH),free thyroxine (FT4) and thyroid peroxidase antihody (TPOAb) by chemiluminometric immunoanalysis.One thousand two hundred and fourty-three pregnant women among them with negative thyroid antibooly and without previons thyroid diseases were selected as the standard population for normal interval.Gestational age-specific percentile categories for TSH and FT4 were calculated.The prevalence of maternal thyroid disorders was examined by gestational agespecific intervals.Results (1) Compared with non-pregnant women,the median value of serum TSH in pregnant women decreased by 29.56％ to the value of 0.91 mU/L; while that of FT4 rose by 7.79％ to the value of 11.33 pmol/L before 12 weeks; and TSH increased while FT4 decreased during 13 to 20 weeks.(2) The median values and reference intervals (2.5th percentile,97.5th percentile) for TSH were 1.59 mU/L (0.15 mU/L,5.19 mU/L) in no-pregnant women,1.12 mU/L (0.03 mU/L,3.67 mU/L) at 8-12+6 gestational weeks,1.21 mU/L (0.05 mU/L,3.74 mU/L) at 13-16+6 gestational weeks,1.50 mU/L (0.31 mU/L,4.33 mU/L) at 17-19+6 gestational weeks; and the median values and reference intervals (2.5th percentile,97.5th percentile) for FT4 were 9.91 pmol/L (6.69 pmol/L,14.03 pmol/L),10.68 pmol/L (7.98 pmol/L,18.66 pmol/L),10.04 pmol/L (6.18 pmol/L,16.22 pmol/L),9.40 pmol/L (6.44 pmol/L,13.51 pmol/L) respectively.(3) According to gestational age-specific reference intervals,the general prevalence of maternal thyroid disorders,including hyperthyroidism,hypothyroidism,subclinical hypothyroidism and hypothyroinemia,was 3.55％ (57/1606).At 8-12+6 gestational weeks,13-16+6 gestational weeks and 17 19+6 gestational weeks,the occurrence of hyperthyroidism was 0.00％,0.13％ and 0.00％;that of hypothyroidism was 0.00％,0.13％ and 0.00％; the incidence of subclinical hypothyroidism was 3.60％,2.76％ and 3.00％; the occurrence of hypothyroxinemia was 0.16％,0.26％ and 0.86％,respectively.The positive rate of TPOAb at 8-12+6,13-16+6 and 17-19+6 gestational weeks were 22.91％ (140/611),16.56％ (126/761) and 15.45％(36/233),and the total positive rate of TPOAb was 18.82％ (302/1605).The median level of TPOAb was 38.90,41.87 and 39.10 mU/L,respectively.Conclusions Before 20 gestational weeks,specific changes occur in maternal thyroid function.TSH level decreases during 8 to 12 gestational weeks,and then increases gradually; while FT4 level increases during 8 to 12 weeks,and then decreases gradually.Thyroid dysfunction during pregnancy is common and subclinical hypothyroidisum is the leading problem in thyroid disorders.Screening for thyroid function during early pregnancy is suggested.

Objective To evaluate the relationship of biological status of HPV 16 and expression of L1 protein with the degree of cervical tumorigenesis.Methods Sixty-one patients with cervical lessions were enrolled and divided into five groups according to pathology of cervical lesions,including chronic cervicitis(n = 27),cervical intraepithelial neoplasia(CIN) Ⅰ-Ⅱ(n = 10),carcinoma in situ(n = 8),early-stage(n =7)and mid/late-stage(n = 9)of cervical carcinoma.HPV type and its biological status were detected by PCR amplification,and L1 protein in HPV 16 positive tissues was detected by Western blot.Kruskal-Wallis was used to compare between the groups,and Pearson correlation analysis was used to evaluate the relationship of HPV biological status and L1 protain expression with cervical lesions.ResultsFifty-three out of 61 patients with cervical lesions were detected with HPV positive(86.9%).All 25 patients with chronic cervicitis were in HPV free mode; in CIN Ⅰ-Ⅱ group,6 patients were in free and 2 in integral mode; in carcinoma in situ group,1 patient in free,3 in mixed and 3 in integral mode; in the early-stage cervical cancer group,2 patients in mixed and 4 in integral mode; in mid/late-stage cancer group,1 patient in mixed and 6 in integral mode.A strong positive correlation was found between the HPV in integral mode and the severity of cervical lesions(r = 0.705,P ＜0.01).The expression of L1 protein was negatively correlated with the aggravation of cervical lesions in HPV 16-positive patients(r = -0.755,P ＜0.01).Conclusion The integral mode of HPV16 and low expression of L1 protein may have predictive value for the severity of cervical lesions.