AIM:To investigate the role of potassium channel expression alteration in chronic cigarette smoking-induced increase in pulmonary vascular responsiveness,the effect of chronic cigarette smoking on large-conductance calcium-activated potassium channel(BKCa) and voltage-dependent delayed rectifier potassium channel(Kv1.5) expression in rat pulmonary smooth muscle cells were investigated in vivo.METHODS: HE staining,immuno-histochemistry and in situ hybridization techniques were used.RESULTS:(1) Chronic cigarette smoking downregulates the protein and mRNA expression of BKCa in pulmonary arterial smooth muscles.(2) Chronic cigarette smoking downregulated the protein and mRNA expression of Kv1.5 in pulmonary arterial smooth muscles.(3) In big artery,BKCa decreased more makedly than Kv1.5,but in small artery,both of them decreased equally.CONCLUSION: Chronic cigarette smoking downregulates the levels of BKCa and Kv1.5 in rat pulmonary arterial smooth muscle cells in vivo,which maybe contribute to the mechanism of cigarette smoking-induced increase in pulmonary vascular responsiveness.

Objective To investigate the expression level of Gas6 in patients with Immune Thrombocytopenia (ITP) and its clinical significance.Methods The experimental group was peripheral blood samples collected from 35 cases diagnosed with ITP in hematology department of Changhai Hospital in Shanghai from October 2013 to December 2015.Control group was peripheral blood from 35 healthy examined individuals at the same time.After separating plasm from the two group samples,the protein level of Gas6,IFN-α,IL-4,IFN-γ and IL-17 were measured by Enzyme-linked immunosorbent assay (ELISA),comparison of expressional level of the two groups was measured by t test.Pearson correlation analysis was used to decide the relation between Gas6 and cytokines such as IFN-α.Results The expression level of Gas6 in experimental and control groups was 27.28±7.56 ng/ml vs 20.51±5.39 ng/ml (t=4.314,P＜0.000 1);IFN-γ was 221.67±57.64 pg/ml vs 45.32 ±16.79 pg/ml (t=17.38,P＜0.000 1);IL-4 was 113.86±26.48 pg/ml vs 49.87±14.98 pg/ml (t=12.44,P＜0.000 1);IL-17 was 168.96±47.88 pg/ml vs 109.56±28.97 pg/ml (t=6.28,P＜0.000 1);IFN-α was 34.83±8.12 pg/ml vs 29.89 ± 5.76 pg/ml (t=2.936,P=0.004 5),all with statistical differences (P＜0.05).Pearson analysis showed that Gas6 was positively related with IL-17,IL-4,IFN γ (r=0.564,0.486,0.449,P＜0.05) and there was difference statistically,but Gas6 was not correlated with IFN-α.Conclusion Gas6 may participate in the disease formation of ITP through affection on cytokines secreted by Th cell subsets,and it was the potential therapeutic and predicted target for this disease clinically.

OBJECTIVETo observe the effect of Xinfeng Capsule (XFC) on ankylosing spondylitis (AS) patients' symptoms and signs, serum immunoglobulin levels, peripheral blood lymphocyte autophagy protein, autophagy gene, and to explore its mechanism.

METHODSTotally 59 AS patients were assigned to the treatment group (39 cases) and the control group (20 cases) according to random digit table. Patients in the treatment group received XFC, 0.5 g each pill, three pills each time, 3 times per day, while those in the control group received sulfasalazine (SASP), 0.25 g per tablet, 4 tablets each time, twice per day. Three months consisted of one therapeutic course. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were statistically calculated. Serum immunoglobulins (IgG1, IgG2, IgG3, IgG4, IgA , SIgA, and IgM) were detected using ELISA. Changes of Beclin1, LC3-II, phosphatidylinositol 3-kinase (PI3K), Akt, the mammalian target of rapamycin (mTOR) were detected using Western blot. Serum autophagy related genes such as Atg1, Atg5, Atg12, Atg13, and Atg17 were detected using the polymerase chain reaction (PCR). The correlation between immunoglobulin subtypes and autophagy gene in AS patients using Spearman correlation.

RESULTSCompared with before treatment, BASDAI, IgG1, lgG3, and IgA decreased (P < 0.01); PI3K, Akt, and mTOR protein expressions decreased (P < 0.01); ATG1, ATG12, ATG13, and ATG17 mRNA expressions decreased, ATG5 mRNA expression increased (P < 0.01) in the treatment group. But BASDAI, IgG1, and IgA levels decreased (P < 0.05, P < 0.01); PI3K, Akt, and mTOR protein expressions decreased (P < 0.05); ATG1 and ATG13 mRNA expressions decreased (P < 0.05, P < 0.01) in the control group. Compared with the control group, BASDAI, IgG1, and IgA levels decreased (P < 0.05); PI3K, Akt, mTOR protein expressions decreased (P < 0.01); ATG12 and ATG17 mRNA expression decreased, ATG5 mRNA expression increased (P < 0.01) in the XFC group. Correlation analysis showed AS patients' IgG1, IgG2, IgG3, IgA, SIgA, IgM had negative correlation with ATG17; IgG4 and ATG17 were positively correlated (P < 0.05, P < 0.01).

CONCLUSIONXFC could elevate clinical efficacy of AS patients and enhance their autophagy, which might be achieved by acting on PI3K/Akt/mTOR signal, affecting autophagy gene and autophagy protein expression, taking part in the regulation of proliferation and differentiation of lymphocyte B, and strengthen humoral immunity.

Apoptosis Regulatory Proteins ; metabolism ; Autophagy ; drug effects ; Beclin-1 ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Lymphocytes ; drug effects ; Membrane Proteins ; metabolism ; Phosphatidylinositol 3-Kinases ; metabolism ; Spondylitis, Ankylosing ; drug therapy ; Sulfasalazine ; therapeutic use ; TOR Serine-Threonine Kinases ; metabolism

Objective To establish a safe emergency and out-patient clinic nursing care system based on JCI standard.Methods We used a safe nursing care conception, improved our administration structure, perfected our safe administration regulations and processes, performed safe nursing care steps, prepared and carried out various emergency plans. We established a safe nursing care system which emphasizes the prevention priority.Results After implantation of JCI standard, the reporting rate of near miss increased 205%, which is not reported before. The rate of unsafe affair decreased 81.5%. Nursing care quality score increased 5.5%. The satisfaction rate of patient increased 22% and the satisfaction rate of the nursing staff increased to 99%.Conclusions JCI standard is helpful to promote the quality and level of nursing care which can reach the scientific, standardized and advanced level.

OBJECTIVETo investigate the risk factorsthat predict pain during colonoscopy for decision of sedation or analgesia before the examination.

METHODSA total of 283 consecutive patients undergoing colonoscopicexamination at Nanfang Hospital between July, 2016 and September, 2016were retrospectively analyzed. The clinical data and visual analogue scale after the examination were analyzed to identify the risk factors for pain during colonoscopy using univariate analysis and multivariate logistic regression. A risk stratification model for predicting pain in colonoscopy was established.

RESULTSThe completion rate of the procedure was significantly lower in patients with a visual analogue scale ≥5 (P<0.000). Univariate analysis showed that female patients, previous abdominal surgery, no previous experience with colonoscopy, complaint of abdominal pain before colonoscopy, insufficient experience of the endoscopists, patient's anticipation of high painlevelbefore examination, and a low body mass index (BMI) were all associated with the experience of pain in colonoscopy (P<0.05). Multivariate logistic regressionanalysis identified BMI index (X), level of experience of the endoscopist (A, A, A) and the patient's anticipation of painlevel (X) as the risk factors of pain in colonoscopy(P<0.05), and the establishedmodel with the 3 variables was: P=e/(1+e),Y=0.049-0.124×X-0.97×X+1.713×A+0.781×A+0.147×A, which showed a sensitivity of 70.3% and a specificity of 67.5%for predicting pain in colonoscopy.

CONCLUSIONThe patient's anticipation of a high pain level in colonoscopy, insufficient experience of the endoscopist, and a low BMI are the independent risk factors for pain in colonoscopy, and evaluation of these factors can help in the decision-making concerning the use of sedation or analgesia before colonoscopy.

Abdominal Pain ; etiology ; Analgesia ; Colonoscopy ; adverse effects ; Conscious Sedation ; Female ; Humans ; Male ; Pain Management ; Pain Measurement ; Retrospective Studies ; Risk Factors

OBJECTIVE: To describe characteristic of hand-wrist bone development in adolescents of 14 years old in China, and to estimate trend of bone development of them. METHODS: A total of 109 adolescents of 14 years was selected as subjects (males: 53, females: 56). X-rays examination of their left hand-wrist bone were performed and analyzed. The development characteristics of each position in accordance with Gu's mapping of skeletal age were compared with Gu's results and ours. RESULTS: Compared with Gu's, osteoepiphysis of distal radius, the first metacarpal bone, the fourth proximal phalanx were more advanced in boys, osteoepiphysis of distal radius, the second-fifth metacarpal bones, the first-fifth proximal phalanxs, and the second-fifth middle phalanxs were more advanced in girls. CONCLUSION The results suggested that a forward trend of 14 years old adolescents bone development currently exists in our country, especially in girls. As an important age of criminal responsibility, this forward trend of development of bones among adolescents currently should be kept in mind when estimating bone age of criminals.
Adolescent ; Age Determination by Skeleton/methods* ; Bone Development/physiology* ; Female ; Forensic Anthropology ; Humans ; Male ; Metacarpal Bones/diagnostic imaging* ; Radius/diagnostic imaging* ; Wrist Joint/diagnostic imaging*

Electrospray ionization is most commonly used in mass spectrometry for analysis of biological molecules such as peptides and proteins. However, peptides and proteins ions produced by electrospray ionization usually have multiple charges, and produce multiple spectrum peaks, making the mass spectrum complicated. Gas phase proton transfer ion/ion reaction can effectively regulate the charge states of peptides and proteins ions after electrospray ionization, simplifying the spectrogram, and thus is significant to the analysis of complex proteins and peptides samples. In this study, a dual-polarity linear ion trap ( LIT) mass spectrometer was used to control the charge state of peptide ions by proton transfer ion/ion reaction. The detection effect of the method was verified by using glutathione ( oxidation type) , oxytocin and dynorphin as typical samples. The results showed that this method could remove excess charges in the positive ions. When injecting enough negative ions for eaction, peptide ions with multiple charge valence state could be reduced to the minimum, therefore simplify the spectrogram effectively.

To understand the genetic characteristics of hemagglutinin (HA) and neuraminidase (NA) of type B influenza viruses in Guangzhou in 2006, three virus strains from etiology surveillance and seven strains from outbreaks were investigated. Genome RNAs of type B influenza viruses were extracted and reverse-transcripted into cDNAs using random primers. The whole-length DNA of HA and NA were amplified by polymerase chain reaction (PCR), cloned into T-A plasmid and sequenced, and analyzed phylogenetically by DNAstar software. The results showed that the HA of type B influenza viruses were similar and the homology were more than 99%. The type B influenza viruses belong to Victoria lineage. The NA of the type B influenza viruses were similar and the homology were more than 98%. Phylogenetic trees of HA and NA showed that the isolates from etiology surveillance formed a cluster, and the isolates from outbreaks were separated from the cluster. The homology of the type B influenza viruses with B/Shanghai/361/2002, which is the WHO recommended influenza vaccine strain in 2005-2006, were 88.9%-89.7%. It suggested the protective effect of influenza vaccine against type B influenza viruses used in 2005-2006 in Guangzhou may not be afforded.
China ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; Influenza B virus ; genetics ; Neuraminidase ; genetics ; Phylogeny ; Time Factors

OBJECTIVETo investigate the clinical results of pedicle-screw placement and reduction on the level of injured vertebrae in treating thoracolumbar fractures.

METHODSFrom March 2006 to May 2009, 27 patients with thoracolumbar fractures were treated with short-segment fixation system and pedicle-screw placement on injured vertebrae through posterior approach. There were 19 males and 8 females with an average age of 36 years old ranging from 24 to 68 years. Eleven patients were injuried by traffic accident, 9 patients were injuried by falling from high, 5 patients were injuried by crush from weighty object, 2 patients were others injuries. Thoracolumbar fractures were classified according to Gertibein classification: 2 cases were of type A1, 3 cases A2, 12 cases A3, 5 cases B1, 5 cases B2. Among them, 14 cases were accompanied with spinal cord injuries,functional assessment of nerves was assessed according to Frankel criteria: 5 cases were of grade B, 3 cases C, 6 cases D. Lumbago according to Denis standard, grade P5 was in all cases. The injured level of 5 cases was in T11, 11 cases in T12, 8 cases in L1, 3 cases in L2. From injury to operation it was 2-15 days with an average of 4 days. The ratio of vertebral height between anterior and posterior border, anteroposterior Cobb angle were compared before and after operation. Function of nerves and index of lumbago were evaluated by Frankel and Denis classification.

RESULTSAll patients were followed up from 14 to 17 months with the mean of 15.5 months. At final follow-up,according to Frankel score system to evaluate function of nerve,2 cases were of grade B, 4 case grade C, 3 cases grade D, 5 cases grade E; according to Denis score system to evaluate index of lumbago, there was P1 (without pain) in 17 cases, P2 (between whiles minute pain, need not treatment) in 8 cases, P3 (moderate pain, between whiles need medication) in 2 cases. The ratio of vertebral height between anterior and posterior border from preoperatively 0.32 +/- 0.14 to postoperatively 0.85 +/- 0.03 (P<0.01); anteroposterior Cobb angle from preoperatively (25.3 +/- 7.8) degrees to postoperatively (11.1 +/- 1.5) degrees (P<0.01). At final follow-up, the ratio of vertebral height between anterior and posterior border, anteroposterior Cobb angle were respectively 0.81 +/- 0.06 and (11.8 +/- 1.9) degrees, there was no significant difference between postoperative and at final follow-up (P>0.05). No complications such as infection, internal fixation failure,nerve injuries were found during follow-up.

CONCLUSIONPosterior short-segment fixation system and pedicle-screw placement on level of injured vertebrae is one kind of effective method in treating thoracolumbar fracture, which can maintain corrective effect and obtain better clinical outcomes.

Adult ; Aged ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Thoracic Injuries ; surgery ; Treatment Outcome ; Young Adult

Objective To assess and summary the guideline best evidence on malnutrition risk screening in adult inpatients so as to provide a reference for malnutrition risk screening of adult inpatients. MethodsGuidelines on malnutrition risk screening in adult inpatients were systematically retrieved in nutrition association official website, guideline website and database and were screened. All of the guidelines were assessed by 4 trained researchers with the Appraisal of Guidelines for Research and Evaluation (AGREEⅡ). Guidelines with level C were excluded, and guidelines with level A and B were selected to extract, translate and summary the recommendations. ResultsA total of 213 guidelines were retrieved and 140 were selected after eliminating repetitive guidelines. Finally, 13 guidelines were included after eliminating 128 guidelines by reading titles and abstracts. AGREE Ⅱ evaluation results showed that there were 3 guidelines with level A and 10 guidelines with level B. Analysis and summary showed that a total of 16 items of 3 classes best evidence on malnutrition risk screening in adult inpatients were selected including screening qualification, population, time and tools. ConclusionsIn this study, guidelines best evidence on malnutrition risk screening in adult inpatients provides a credible reference for clinical practice. Population with high risk of malnutrition should be assessed in comprehensive nutrition and should be treated in nutritional department when necessary.