Systemic juvenile idiopathic arthritis (sJIA) is a systemic inflammatory disease characterized with arthritis in one or more joints,fever,rash and serositis.Due to the atypical symptoms and poor prognosis,it's a great challenge in the clinical diagnosis and treatment efficacy evaluation in sJIA.These challenges could be addressed by the identification of clinical biomarkers,aiming at evaluating the disease severity,predicting the activity and prognosis of sJIA.This review will be focus on genetics,serum and cellular markers in sJIA and summarize the relative application on diagnosis and treatment.

Objective To investigate the changes and clinical significance of serum procalcitonin (PCT) level in children with acute phase of Kawasaki disease (KD). Methods The serum PCT levels and their changes before and after the treatment in 120 children with KD at acute phase were retrospectively analyzed. According to the results of ultrasonic echocardiography, all children were divided into coronary artery damage (CAL) group and no coronary artery lesion (NCAL) group. According to the presence of gastrointestinal symptoms, patients were divided into two groups (A: yes and B: no ). According to the presence of abnormal liver function, patients were divided into two groups (C:yes and D:no). PCT levels were compared between groups. Results The serum PCT levels were increased at acute phase in 56 (46.67%) patients before the treatment than those in normal children, which were decreased obviously after treatment (P<0.05). There were 31 cases combined with CAL, the rising rate of PCT was 38.71%, which was no significant difference compared with that of NCAL group (49.44%, P>0.05). There was no significant difference in serum PCT value between CAL group and NCAL group (P>0.05). The serum C-reactive protein level was significantly higher in CAL group than that of NCAL group. There were 35 patients combined with gastrointestinal symptoms in 120 KD patients. There was no significant difference in the rising rate of PCT between patients with gastrointestinal symptoms (62.86%) and patients without gastrointestinal symptoms (40.00%, P<0.05). There was no significant difference in serum PCT level between these two groups of patients. There were 42 cases with liver dyfunction in 120 KD patients, the PCT rising rate (52.38%) was no statistically significant difference compared with that of patients with no liver dyfunction (43.59%, P>0.05). And there was no significant difference in serum PCT value between the two groups (P>0.05). Conclusion PCT can reflect the acute phase of KD patients. The increased PCT level may be related with the emergence of gastrointestinal symptoms, even though it cannot predict CAL and the occurrence of liver damage.

Objective:To explore the status of job burnout among clinical nursing teachers in different depart-ments, in order to provide reference for the nursing education management .Methods:The questionnaire of Maslach Burnout Inventory ( MBI) of revised Chinese Version was distributed to 535 clinical nursing teachers .Results:The incidence of job burnout was 48 .3%, while the incidences with mild , moderate and severe job burnout accounted for 18 .9%, 15 .7%, 9 .3%respectively .Clinical nursing teachers in different departments have diffrences on oc-cupation actions .Clinical nursing teachers in the operation room revealed a significant greater personal accomplish -ment, but the emergency department scored lower .The teachers in emergency department scored higher on emotion-al exhaustion than those in other departments , and the teachers in oncology department is the secondary in scores of emotional exhaustion .The scores of the teachers in oncology department were the highest on depersonalization among all the departments,while the teachers in infection department is at the secondary place .Conclusion:The clinical nursing teachers'job burnout should be paid attention to .Strategies including intervention by nursing education management and teachers'learning and training should be taken to reduce the damage of physical and mental health caused by burnout and increase the clinical care and teaching quality .

Child ; Humans ; Laryngeal Diseases ; pathology ; therapy ; Vocal Cords ; pathology

Objective To compare with the characteristics of different demographic and blood donation behaviors of the first blood donors and the repeated blood donors,to analyze the related factors influencing the repeated blood donation behavior,to provide the evidence to develop the recall strategy for the retention of the first-time donors strategies.Methods Use methods such as the composition ratio of descriptive analysis,and logistic regression analysis,Retrospectively analyzed the data of 3 226 571 cases of the whole blood donors in Zhejiang province from 2006 to 2015.from BIS2.0 Results ZheJiang repeated blood donors in 2006-2015 is accounted for 30.8％,men (57.8％),the proportion of aged 25 above is higher than the first blood donors;71.7％ of men in the repeated blood donors are 60-79 kg,52.2％ of women repeated blood donors are 50 to 59 kg;40％ of the repeat donors blood for the first time donate 400 mL;71.6％ of the repeated blood donors to donate again in 0.5-2 years,and of these,40.8％ back in 0.5-1 year.Conclusion The main factors on the demographic aspects that influence the repeated blood donation is occupation,cultural degree,the quantity of blood donation for the first time.The characteristics of the precise recall people are as follows:Age 26 to 45 years old,stable career,donate 400 mL for the first-time,weight 70-89 kg of male,weight 55 kg above of women.The better recall intervention Interval is preferred to 0.5-2 years,and 0.5-1 year is the best.

Objective To determine clinical characteristics and the effects of drug-eluting stents on the occurrence of major adverse cardiac events during percuteneous coronary artery interventional(PCI)and long- term outcomes in patients with chronic renal insufficiency(CRI).Methods Nine hundreds and seventy three patients with angiographically-documented coronary artery disease(lumen inner diameter narrowing＞50%), included 516 patients complicated with experienced renal impairment(CRI group)and 457 with normal renal function(control group).Baseline clinical data and coronary angiographic features were recorded.Results Comparing with control group,patients in CRI group were older with higher incidence of hypertension or diabetes and simultaneously complicated by reduced left ventricular ejection fraction,and more complex coronary lesions(type C).During follow-up(mean 17 months),the mortality was significantly higher in CRI than in control group(6.2% vs 3.3%,P＜0.05),but the former with CRI was significantly lower by using drug-eluting stents in comparing with bare-metal stents(4.1% vs 8.5%,P＜0.05).Conclusion Patients with CRI often complicated with severe coronary artery disease,the mortality after PCI would be significantly reduced by using drug-eluting stents.

Objective To investigate the gross tumor volume (GTV) changes in nonoperatively treated lung cancer patients during radiotherapy by off-line analysis using kilovoltage cone-beam computed tomography (KVCBCT).Methods Eighteen nonoperatively treated lung cancer patients were divided into group A (n =13) to receive conventional radiotherapy (1.8-2.2 Gy/fraction) and group B (n =5) to receive accelerated radiotherapy (5-8 Gy/fraction).Group A was further divided into subgroup A1 (n =10) and subgroup A2 (n =3) according to GTV changes.Each patient in group A underwent KVCBCT scan before treatment once a week,and each patient in group B underwent KVCBCT scan before each treatment.KVCBCT and CT images were registered in the treatment planning system to analyze GTV changes.Results Of all patients in group A,77％ showed ＞ 20％ GTV reduction.Subgroup A1 had the maximum GTV reduction in the 4th week of treatment (the 20th treatment) ;Subgroup A1 had a mean reduction of (0.94 ± 9.94)％,with a maximum value of-56.76％.Subgroup A2 showed no correlation between GTV changes and treatment time.Group B had a mean GTV reduction of (-7.41 ± 1.76)％,with a maximum value of -15.91％.Of all patients in group B,71％ showed ≤ 10％ GTV reduction.Small GTV changes were observed in group B.Conclusions There are no regular GTV changes in nonoperatively treated lung cancer patients during radiotherapy.Adaptive radiotherapy is recommended in the cases where GTV is reduced over 20％ in the 20th treatment.

Objective To investigate the mechanism of pulmonary fibrosis induced by paraquat (PQ),and the effect of Xuebijing injection in treatment of PQ poisoning.Methods Seventy-two male Wistar rats were randomly divided into control group,PQ poisoning group,and Xuebijing intervention group,with 24 rats in each group.Pulmonary fibrosis was induced by single garage at the dosage of 50 mg/kg of PQ,while 1 mL of distilled water was given by gavage in control group.Xuebijing injection at the dosage of 4 mL/kg were given intraperitoneally at 30 minutes after exposure to PQ in Xuebijing group,and it was repeated every 12 hours; same amount of physiological saline was given intraperitoneally in PQ group and control group.The experiment lasted for 14 days.Six rats in each group were sacrificed on 1,3,7,14 days,respectively,after insult,and 30 minutes after the last intervention.The lung tissues were harvested,the changes in pathology in lung tissue and the degree of pulmonary fibrosis were observed with optical microscope with hematoxylin-eosin (HE) staining and Masson stain.The ultrastructure changes in lung tissues were observed with transmission electron microscopic,and the content of hydroxyproline (HYP) in the lung tissue was determined by alkaline hydrolysis.The expression of mitochondrial fusion protein 2 (Mfn2) was determined by Western Blot.Results ① HE staining:in PQ group,inflammation was most marked on the 3rd day.On the 7th day,exudates in the alveoli started to be organized,and hypertrophic fibroblasts were seen to secrete slim collagen fibers,and fibrosis could be seen in alveoli.On the 14th day,intensive hyperplasia of fibroblasts could be observed,and the alveolar structure was destroyed and collapsed,with deposition of collagen deposited with formation of pulmonary fibrosis.At the same time,pathologic changes were milder in Xuebijing group than those in PQ group.② Masson staining:the degree of inflammation in alveoli and pulmonary fibrosis were less marked in Xuebijing group than those of PQ group on the 14th day.③ Under the transmission electron microscopy,it was found that the mitochondria of lung tissue cells was relatively less in number on the 14th day in PQ group,and the majority of them underwent degeneration,swelling and damage.Basement membrane became folded,alvcoli were collapsed,and fibrosis was obvious.These changes were less serious in Xuebijing group.④ Content of HYP (μg/g):contents of HYP in lung tissues on the 3rd day in PQ group and Xuebijing group were significantly higher than those in control group (743.3 ± 50.2,718.1 ± 34.0 vs.665.8± 6.6,both P＜0.05),it then increased gradually,but the contents of HYP in Xuebijing group were significantly lower on the 7th day and 14th day than those in PQ group (790.5 ± 23.8 vs.876.7 ± 42.0,812.9 ± 72.3 vs.931.3 ± 33.0,both P＜0.05).⑤ Expression of Mfn2:the expression of Mfn2 in control group was relatively lower.The expression of Mfn2 in PQ group was increased gradually under stress,but its rate was low.The expression of Mfn2 (A value) in Xuebijing group was significantly higher than that in PQ group on the 1st day (0.731 ±0.035 vs.0.618 ±0.029,P＜0.05),and it was elevated steadily,reaching the peak on the 7th day (0.732 ± 0.037 vs.0.669 ± 0.034,P＜0.05),but it was lower than that of PQ group on the 14th day (0.708 ± 0.034 vs.0.765 ± 0.041,P＜0.05).Conclusions Xuebijing reduces lung inflammatory reaction and pulmonary fibrosis as a result of PQ poisoning.The mechanism is that Xnebijing regulates and increases expression of Mfn2 in lung tissue.

Programmed cell death 5(PDCD5)is a new kind of programmed cell death regulation and control gene. PDCD5′s expression is widespread,and evolution is conservative. PDCD5 has the effect of promo-ting a wide variety of tumor cells to apoptosis and inhibiting proliferation,such as lung cancer,liver cancer et al. Several laboratories′ discoveries show that PDCD5′s expression is significantly decreased when in some dis-ease cases,especially in tumor cases. PDCD5,which is related to the clinical relevance of the tumor,has a great clinical value of discovering,diagnosis and treatment of the tumor.

Objective To study the anti-tumor effects of SFPS against human colon cancer cells.Methods Inhibition of the cell proliferation was measured by MTT assay.SFPS induced apoptosis of lovo and RKO cells was observed by electron microscopy and flow cytometry.The potential of SFPS in inhibiting lovo and RKO cells viability was assessed by MTT assay.Results SFPS significantly exhibited antiproliferative activity which depended on dosage.Morphological examination showed chromosomal condensation, karyotheca margination,cell shrinkage and the presence of apoptosis bodies.The overall effect of SFPS on the cell cycle distribution was examined by flow cytometry.However,it was also found that SFPS arrested the human colon cancer cell line RKO at G0/G1 phase,and the RKO cells at S phase decreased significantly,while no change in cell cycle distribution from SFPS treated lovo cells was observed.Conclusion SFPS may induce the apoptosis of lovo and RKO cells in vitro through anti-tumor proliferation.