Objective To explore the application of cognitive intervention and drug intervention in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 86 patients with chronic obstructive pulmonary disease(COPD)admitted from February 2016 to July 2016 were included in this study.The patients were divided into experimental group and control group according to the order of admission.43 patients in the control group received routine measures,In the experimental group,43 patients received cognitive intervention and drug intervention,compared the clinical treatment effect and treatment compliance of the two groups after intervention.Results The compliance rate of disease cognition,smoking,medication,pulmonary function,family oxygen therapy,respiration exercise,rehabilitation therapy,nutritional support and influenza vaccination were significantly better in the experimental group than in the control group(P<0.05)(1.2±0.7)times,the number of acute attack was(2.0±0.8)times and the quality of life was(4.4±0.9)points,which was significantly better than that of the control group(P<0.05).Conclusion Cognitive intervention and drug intervention have a positive effect on the treatment compliance of patients with chronic obstructive pulmonary disease,improve the quality of life of patients,and have significant clinical application value.

Objective To improve the training system of the combined education mode between professional master degree students of clinical medicine and resident standardization training (RST) in Zhe-jiang province, and improve the professional quality of medical graduate students. Methods A question-naire was designed through literature review and expert interview, and the data of 77 clinical training post-graduates were collected, and the effect of the training was evaluated by taking the reaction level, learning level, behavior level and achievement level of Ke's evaluation as the breakthrough point. Statistical analysis was performed by SPSS 20.0, and the mean score was used as the standard deviation. The scores were compared with t test, and the scores of multiple groups were made variance analysis. Results The RST attitude value in reaction layer was 9.26±1.08, RST content value was 29.29±4.36, RST teacher enthusiasm value was 11.13±2.17, RST experience value was 17.38±3.10, which indicated that residents' overall satisfaction to RST was high, but the satisfaction on teachers, evaluation and compensation was relatively low;The grade difference before and after RST in learning layer was statistically significant (P<0.05), indicating that before and after RST the grades were obviously improved, and the sense of belonging is high. The behave layer showed the residents' behavior changed obviously before and after RST (P<0.05), and their abilities in various aspects such as ward round and dealing with common diseases were largely improved;The result layer showed 77 graduate students had no medical accident and complaint , and all of them passed the annual assessment and participated in the research projects. Conclusion In general, RST graduate students are relatively satisfied with the plan, content and methods of the training, on the other hand, there are problems such as the absence of timely information feedback, teachers' poor enthusiasm, lack of effective competition mechanism, etc. Kirkpatrick Model made a comprehensive and objective eval-uation on graduate students RST from a overall perspective, and it can be introduced into the effectiveness evaluation for graduate students RST.

PURPOSE: This study aimed to investigate the effects of PIK3CA on the sensitivity of acute B lymphocytic leukemia cells (Nalm-6 cells) to chemotherapy drugs. MATERIALS AND METHODS: Children's normal B lymphocytes and Nalm-6 cells were cultured. Nalm-6 cells were transfected with PIK3CA siRNA (siPIK3CA group) or its negative control (PIK3CA-Control group). Normal Nalm-6 cells were named Mock group. Nalm-6 cells transfected by PIK3CA siRNA were treated with Akt inhibitor (siPIK3CA+Akti-1/2 group). mRNA and protein expression was detected by qRT-PCR and Western blot. Proliferation and sensitivity to chemotherapeutic drugs was detected by MTT assay. Cell cycle and apoptosis was explored by low cytometry. Transwell assay was performed to test invasion. RESULTS: PIK3CA mRNA (p=0.008) and protein (p=0.006) expression was higher in Nalm-6 cells than that in normal B lymphocytes. Compared with the Mock group and PIK3CA-Control group, Nalm-6 cells of the siPIK3CA group had lower OD495 values (all p < 0.05) and invasion cell numbers (p=0.03 and p=0.025), as well as a higher proportion of G0/G1 phase cells (p=0.020 and p=0.022), percentage of apoptosis (p=0.016 and p=0.022), and inhibition rate (all p < 0.05). pAkt expression in the siPIK3CA group (p=0.026 and p=0.031) and siPIK3CA+Akti-1/2 group (p=0.019 and p=0.023) was lower than that in the Mock group. CONCLUSION: PIK3CA silencing inhibited Nalm-6 cell proliferation and invasion, and promoted their apoptosis and sensitivity to chemotherapeutic drugs, potentially through regulation of the PI3K/AKT signaling pathway.
Apoptosis ; B-Lymphocytes ; Blotting, Western ; Cell Count ; Cell Cycle ; Cell Proliferation ; Drug Therapy ; Leukemia ; Leukemia, B-Cell ; Phosphorylation ; RNA, Messenger ; RNA, Small Interfering

In order to explore the role of connective tissue growth factor (CTGF) in the pathogenesis of renal tubulointerstitial fibrosis, 48 Wistar rats were randomly divided into sham-operated and unilateral ureteral obstruction (UUO) group. On the postoperative day 1, 3, 7 and 14, the rats were killed and the kidneys were removed. The renal tubulointerstitial injury index was evaluated according to the MASSON staining. The mRNA levels of CTGF, transforming growth factor-β1(TGF-β1), collagen Ⅰ (col Ⅰ ), and plasminogen activator inhibitor-1 (PAI-1) were detected using reverse transcriptional-polymerase chain reaction (RT-PCR). Immunohistochemistry was performed to evaluate the protein expression of the above factors, and the relations among them were analyzed. Quantitative expression of CTGF protein in the kidneys was also assessed using Western blot. The results showed that TGF-β1 mRNA level was increased at first day after UUO, followed by a marked elevation of CTGF mRNA level, which began to increase 3 days after UUO (P＜0.01). With the progression of the disease, the mRNA expression of CTGF, col Ⅰ and PAI-1 was increased progressively. Immunohistochemistry revealed that the CTGF protein expression was significantly increased in fibrotic areas and tubular epithelial cells 3 days after UUO. On the post-UUO day 7, the protein level of CTGF was positively related to the renal tubulointerstitial injury index (r =0.62, P＜0.01), the expression of TGF-β1 (r=0.85, P＜0.01), col Ⅰ (r=0.78, P＜0.01),and PAI-1(r=0.76, P＜0.01). Upon Western blot analysis, CTGF protein expression began to increase 3 days after UUO, and appeared progressively throughout the time course (P＜0. 01, as compared with sham-operated group). It is concluded that CTGF can be induced by TGF-β and mediate various profibrotic actions of this cytokine, such as increasing extracellular matrix (ECM)synthesis and decreasing ECM degradation. The increased expression of CTGF may play a crucial role in the development and progression of tubulointerstitial fibrosis.

Objective Studies show that women infected with human papillomavirus (HPV)induced cervicitis,cervical intraepithelial neoplasia (CIN) and on to develop cervical cancer their cervical mucosal exfoliated cells telomerase activity changes,to explore its clinical value in screening and early diagnosis and treatment of female patients with cervical cancer.Methods Elections of HPV testing negative control group 26 cases,HPV-positive group 28 cases,HPV-positive cervicitis group of 27 cases,HPV-positive CIN group 26 cases,24 cases of cervical cancer,HPV-negative cervicitis group 26 cases,HPV-negative CIN group of 23 cases of seven test group,cervical mucosa cytology specimens collected in 293 cells as positive standards for real-time fluorescence quantitative detection of telomerase TRAP Quantitative value of telomerase activity.Results Normal control group,ranging from 0 to 3.15,average 0.36; HPV-positive group,ranging from 0 to 21.6,with an average 1.98,＞ 10,3 cases; HPV-positive cervicitis group,ranging from 0 to 71.5,with an average 4.88,＞ 10,4 cases; HPV-positive CIN group,ranging from0 to 407,with an average 20.8,＞ 10,5 cases; cancer group,the range 1.2-5.5 × 106,median 346,where ＜ 10.4 cases; HPV-negative cervicitis group,ranging from 0 to 66.6,with an average 4.19,＞ 10,3 cases; HPV-negative CIN group,ranging from 0 to 158,with an average 14.2.Statistical analysis of cervical cancer group and the other groups are statistically significant (P ＜0.01),HPV-positive CIN group compared with the control group was statistically significant (P ＜ 0.05) the rest of the comparison between two groups was not statistically significance (P ＞ 0.05).Conclusions Women infected with HPV and cause cervicitis,CIN stage,the cervical mucosa telomerase activity gradually increased and in cervical cancer stage increased the most significant.And therefore take cells exfoliated cervical mucosa quantitative detection of telomerase activity can be used as effective method in screening and early diagnosis for cervical cancer in women.