The primary causative factors of liver failure include direct damage and immune -mediated liver injury.Increasing evidence sug-gests that immune -mediated injury plays a pivotal role in the pathogenesis of liver failure.The new concepts concerning the mechanisms of immune -mediated liver injury in liver failure are reviewed with relevant basic and clinical studies in both humans and animals.The innate and adaptive immunity,particularly the interaction of various immune cells and molecules,as well as apoptosis -related molecules,are dis-cussed in detail.

OBJECTIVE:To provide reference for improving the quality of clinical pharmacy undergraduates in our university. METHODS:Considering about the practice problems of clinical pharmacy undergraduates in our university,pilot reform was con-ducted in the First Affiliated Hospital of our university in respects of teacher arrangement,department rotation assignment,assess-ment method. RESULTS:For new practice mode,in term of teacher arrangement,when the students were practicing in clinical pharmacy department,they were taught by clinical doctors and pharmacists;teacher training should be strengthened,and a variety of teaching methods was carried out. In term of department rotation assignment,to shorten the practice time of basic pharmacy de-partment,and increase the clinical pharmacy practice department and practice time;to integrate the content of clinical medicine and clinical pharmacy practice,and select clinical medical departments equipped with clinical pharmacists to practice. In term of assess-ment method,there were 3 aspects including clinical pharmacy practice skills assessment,drug-related theory examination and ba-sic situation assessment during internship. CONCLUSIONS:The new practice mode focuses on clinical pharmacy application skills training and students practical skills assessment,contributes to cultivate students'thinking of rational drug use and improves clini-cal practice skill of students. It is suitable for clinical pharmacy undergraduate internship of our university.

Objective To investigate the clinical effect of phacoemulsification and individualized intraocular lens implantation in senile cataract patients with super high myopia.Methods Thirty-six cases of senile cataract patients with super high myopia with 49 eyes underwent phacoemulsification and individualized intraocular lens implantation,postoperative uncorrected distance visual acuity,best corrected visual acuity,diopter and surgical complications were observed.Results All surgical eyes visual acuity had improved to varying degrees,the postoperative far visual acuity in 0.05-0.30,the near visual acuity in 0.02-0.50,best corrected visual acuity 0.31-0.40 in 22 eyes (44.9％,22/49),≥ 0.5 in 14 eyes (28.6％,14/49).The postoperative diopter ＜-1.00 D in 3 eyes,-1.00 to-2.00 D in 16 eyes,-2.01 to-3.00 D in 27 eyes,and ＞-3.00 D in 3 eyes.Diopter difference with the goal ＜ ± 0.50 D in 21 eyes,± 0.50 D to ± 1.00 D in 18 eyes,＞ ± 1.00 D in 10 eyes.Postoperative corneal edema in 28 eyes,were completely disappeared within 1 week to 3 months,no retinal detachment and corneal decompensation and other serious complications.Conclusion Senile cataract patients with super high myopia are treated with phacoemulsification and individualized intraocular lens implantation,visions improve ideal and have good clinical efficacy.

Objective To analyze the clinical and pathological characteristics of thyroid nodules.Methods A retrospective analysis of the clinical data of 2843 Han patients with thyroid nodules from January 2009 to June 2011 in Henan province was performed.Results The most high-risk of thyroid nodule resided in the group aged 45-54.The main pathological manifestation was simple nodular goiter.The rate of preoperative misdiagnosis was 2.4％.22.1％ of the patients with thyroid nodules showed abnormal thyroid function,which was mainly as subclinical thyroid dysfunction.The positive rate of thyroid peroxidase antibody (TPOAb) in patients with thyroid nodule was 19.8％ while that of thyroid globulin antibody (TgAb) was 20.0％.Among all 2843 subjects,the prevalence of differentiated thyroid carcinoma (DTC) was 28.8％,and the incidence of DTC was accompanied by raised TSH levels.The prevalence of DTC exceeded 40％ in patients aged between 25 to 34 as well as more than 74 years old.The prevalence of DTC was up to 33.8％ in TgAb positive patients.There was no difference in TPOAb levels between DTC patients and non DTC patients (P =0.406),but the TgAb level in patients with DTC was significantly higher than that of non DTC patients (P =0.033).Conclusion Thyroid nodule patients aged 25-34 or older than 74 formed high-risk groups of DTC.The serum TSH level and TgAb level were positively correlated with the risk of DTC.

OBJECTIVE:To study the targeting of folic acid(FA)-modified docetaxel(DOC)nano-liposome(L-DOC-FA)to hepatocellular carcinoma Bel-7402 cells in vivo and in vitro. METHODS:The cell viability and survival rate of Bel-7402 cells was tested by CCK-8 kit after treated with 0,1,2,5,10 and 20 μg/ml DOC,L-DOC and L-DOC-FA for 24 h. And then,the fluores-cein isothiocyanate was used to label L-DOC and L-DOC-FA nano-liposome,and the rate of L-DOC and L-DOC-FA absorbed by hepatocellular carcinoma Bel-7402 cells were detected. 125I was used to label L-DOC and L-DOC-FA nano-liposome,and then the contents of them in the subcutaneous tumor tissues were detected. 28 Balb/c naked mice were selected and given liver cell suspen-sion via back ih to induce tumor model. After modeling,naked mice were divided into blank control group(normal saline),DOC group(3 mg/kg),L-DOC(3 mg/kg,by DOC)and L-DOC-FA(3 mg/kg,by DOC). They were given relevant medicine intrave-nously once a day for consecutive 30 d. The relative tumor volume in naked mice was detected. RESULTS:DOC,L-DOC and L-DOC-FA all inhibited the cell viability of Bel-7402 cells,the survival rate of cells decreased in concentration-dependant manner;compared with DOC and L-DOC,the cell viability decreased after treated with L-DOC-FA,the survival rate of cells decreased (P<0.01). The rate of L-DOC and L-DOC-FA absorbed by Bel-7402 cells in descending order as L-DOC-FA(69.5%)>L-DOC (31.2%),with statistical significance (P<0.01). The content of L-DOC-FA in tumor was significantly more than that of L-DOC (P<0.01). In addition,3 mg/kg L-DOC-FA showed better inhibitory effect than 3 mg/kg L-DOC and DOC on tumor,and the rela-tive tumor volume was smaller(P<0.01). CONCLUSIONS:L-DOC-FA has obvious targeting to Bel-7402 cells in vivo and in vi-tro,and shows good inhibitory effect on tumor in vivo and in vitro.

Objective To produce a comprehensive transcript dataset of Oncomelania hupensis before and after Schistosoma japonicum infection,so as to provide experimental data for perfecting genetic structural information and excavating related mo-lecular markers of O. hupensis infected by S. japonicum. Methods O. hupensis snails were divided into the following 3 groups:one week after S. japonicum miracidium infection,4 weeks after S. japonicum miracidium infection,and normal condition. Mil-lion high-quality reads were obtained from the normalized cDNA of the pooled samples,which were assembled into transcripts. Results A total of 63686 unigenes were identified and were classified into 4 main categories,including general functional pre-diction(15.36%),signal transduction mechanism(11.75%),posttranslational modification(8.89%),and functional unknown (12.20%). Conclusions The transcriptome information of O. hupensis snail after the invasion of S. japonicum shows that sever-al genes are significantly up-regulated or down regulated expression,and that the availability of transcriptome information might provide a strong foundation for further understanding the schistosome-snail interaction at the molecular level.

Objective To investigate the present situation of elective course,find out the problems,explain the causes and offer some suggestions.Methods Using the information collected from self-made questionnaires,and analysis data.Results The survey shows that there are the problems of elective courses in the installation,time,management,contents,teachers,exam,and so on.Conclusion The system of elective course should be made perfect in construction,management and operation.

Objective To study the effect of 1,25-dihydroxyvitamin D3 on bone metabolism in diabetic rats and the related molecular mechanism.Methods A total of 45 healthy 6-8 weeks old male Sprague Dawley (SD) rats were treated with streptozotocin.The streptozotocin-induced diabetic rats were randomly assigned to diabetic group (DM),low dose vitamin D treated group(LD),and high dose vitamin D treated group(HD).Another 12 healthy SD rats were used as normol control group(NC).The rats in NC group and DM group were fed with 0.05 ml/d nut oil;those in the LD group and HD group were fed respectively with 0.03 and0.10 μg · kg-1 · d-1 1,25-dihydroxyvitamin D3 dissolved in 0.05 ml nut oil.12 weeks later,serum calcium,phosphorus,osteocalcin,type Ⅰ collagen cross-linked telopeptide (NTX),and 24 h urinary calcium were determined.Right femurs were harvested for pathohistological analysis by hematoxylin-eosin (HE) staining.Expressions of osteoprotegerin,receptor activator nuclear factor κB ligand (RANKL),core binding factor α1(Cbfa1) were detected by immunohistochemical staining.The osteoprotegerin,RANKL,Cbfa1,osteocalcin mRNA levels of bone tissue were performed by realtime quantitative reverse transcription polymerase chain reaction assay.Results (1) Compared with the NC group,serum calcium and 24 h urinary calcium in LD and HD groups were significantly higher (P＜0.05) ; 24 h urinary calcium in DM group was significantly higher than that in NC group (P ＜ 0.05).(2) Serum osteocalcin level in DM and LD groups was significantly lower than that in NC group (P＜0.05) ; there was no significant difference between the serum NTX levels of all groups (P＞0.05).(3) There was no significant difference in the mRNA expression of Cbfa1 in all groups (P＞0.05).The mRNA expression of osteocalcin in DM group was significantly lower than that in NC group (P ＜0.05).The mRNA expression of RANKL in DM group was significantly lower than that in NC group (P＜0.05) ; and that in LD and HD group was significantly higher than that in DM group (P＜0.05),and that in HD group was significantly higher than that in LD group (P＜0.05).The mRNA expression of osteoprotegerin in DM group was significantly lower than that in NC group (P＜0.05).The ratio of RANKL to osteoprotegerin in HD group was significantly higher than that in DM group (P＜0.05).Conclusions Vitamin D may promote bone metabolism in diabetic rats by up-regulating the expressions of osteocalcin and RANKL or in addition to other means.

Objective To evaluate the value of ultrasonic Graf methods in screening developmental dysplasia of the hip (DDH)in infants .Methods 1 580 cases of 0-6 monthes old infants without severe limb anomalies were examined .Bilateral hip joints were examined mcluded analyzed according to Graf method .Results A total of 1 580 cases included 3 160 hip joints were analyzed ,827 were male (52 .34% ) and 753 were female (52 .34% ) among them .104 cases (6 .58% ) were diagnosed with abnormalities of the hip joints .Among the 104 cases ,88 cases (5 .57% ) were type Ⅱa hip joints ,9 cases (0 .57% ) were type Ⅱ b ,5 cases (0 .32% ) were type Ⅱc ,1 case (0 .06% ) and 1 case (0 .06% ) were type Ⅲ and type Ⅳ respectively .In each month of age abnormalities of the hip joints were diagnosed as followed :79 cases(9 .69% ) were one month old ,13 cases (3 .98% ) were two month old ,2 cases (2 .15% ) were three month old ,6 cases (2 .26% ) were four month old ,1 cases (2 .44% ) was five month old and 3 cases (7 .69% ) were six month old .Conclusion Ultrasonic Graf method can provide the basic data for incidence of developmental dysplasia of hip in infants in local region and may be helpful to offer the related standards for early screening the abnormalities of the hip joints .

Objective To explore the optimum voltage for digital chest radiography in adult. Methods PMMAs of Different thickness (7.2, 9.0, 10. 8 and 12. 6 cm) were used to simulate chest of different depth ( 17. 5, 22. 5, 27.0 and 32. 5 cm). The combinants of contrast-detail Cdrad 2.0 phantom and above PMMAs were exposed with automatic exposure control (AEC) and different tube voltages. The images of these combinants were obtained and the entrance surface dose (ESD) was recorded. The imaging quality factor (IQF) was calculated and the curves were drawn between the ESD,IQF and kV. The PMMAs of different thickness, on which a contrast object ( PMAA of 5 cm diameter and 1.8 cm thickness ) was placed, were exposed with the same condition used for above test. Their images were obtained and SNRs were calculated. Results The ESD, SNR and IQFinv of different chest depth decreased with increase of kV.When tube voltages of 70, 100 and 140 kV were used, for 17. 5 cm chest depth, the ESD was 0. 22, 0. 09 and 0. 06 mGy, the IQF was 43.3, 58. 8 and 72. 0, the SNR was 7.5, 6. 2 and 5.0; for 22. 5 cm chest depth, the ESD was 0.37, 0.12 and 0.06 mGy, the IQF was 56. 0, 61.4 and 65.3, the SNR was 6. 4, 5.2 and 3. 8; for 27. 0 cm chest depth, the ESD was 0. 52, 0. 20 and 0. 09 mGy, the IQF was 54. 2, 64. 3 and 91. 0, the SNR was 6. 0, 4. 8 and 3. 5; for 31.5 cm chest depth, the ESD was 0.53, 0.24 and 0. 10 mGy,the IQF was 53.2, 66. 8 and 95.3, the SNR was 5. 7, 4. 5 and 3. 0. Conclusion To balance ESD, SNR and IQF, proper tube voltage should be chosen for chest radiography according to thickness and constitution of patients.