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 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 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 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 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 compare imaging quality and radiation dose on DR and dual-sided reading of CR system.Methods The TRG of ALVIM statistics phantom was exposed by DR and dual-sided reading of CR with the same radiation dose,then the exposure factor and the entrance surface dose (ESD) were recorded.After that,the phantom was exposed by dual-sided reading of CR with various mAs ( 3.2,4.0,4.3,4.8 and 5.2 mAs) and the same kV,and the ESD was recorded,too.The acquired images were read by three radiologists on the monitor of diagnosis work station with the same window width and window level,then the total points of the images were given with the method of a five-level confidence scale.ROC curves were drawn and probability Pdet was calculated.Then the data was analyzed statistically by analysis of variance (ANOVA).Results The ROC analysis of bone substitute with diameter from 0.5 to 1.0 mm and muscle substitute with diameter from 0.9 to 2.0 mm showed A (z) values of 0.742 to 0.923 and 0.635 to 0.900 for DR system when the radiation dose was 137.5 μGy.The ROC analysis of bone substitute and muscle substitute showed A(z) values of 0.526 to 0.586 and 0.473 to 0.560 for dual-sided reading of CR at the same radiation dose.The probability Pdet discrepancy of bone substitute in two systems was from 0.216 to 0.337,with the highest of 0.337 in the diameter of 1.0 mm.The probability Pdet discrepancy by muscle substitute in two systems was from 0.075 to 0.342,with the highest of 0.342 in the diameter of 2.0 mm.There was significant statistical difference between the two groups ( F =35.30,P ＜ 0.01 ).When the exposure factor of dual-sided reading of CR system was 75 kV,4.8 mAs,the ESD was 180.4 μ Gy,the ROC analysis in the bone substitute with diameter from 0.5 to 1.0 mm and muscle substitute with diameter from 0.9 to 2.0 mm showed A(z) values was the same.The probability Pdet discrepancy of bone substitute in two systems was from - 0.003 to 0.009.The probability Pdet discrepancy of muscle substitute in two systems was from -0.005 to 0.008,and there was no statistical difference between the two groups ( F =5.23,P ＞0.05).When the probability Pdet of two systems was the same,the ESD was 180.4 μGy by dual-sided reading of CR system,and the ESD was 137.5 μGy by DR system.Conclusion Detection with DR system was proved to be superior to dual-sided reading of CR system at the same radiation dose.When the image quality was similar,the radiation dose of DR system was less than the dual-sided reading of CR system.

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.

The aim of this study was to observe whether necroptosis is involved in the process of cardiac hypertrophy induced by pressure overload. SD rats underwent transverse abdominal aortic constriction (TAC) operation for establishing cardiac hypertrophy model. The structure and function of the left ventricle of rats were evaluated via echocardiography, left ventricular mass index, the expression of markers of cardiac hypertrophy and histological detection. Real-time PCR and Western blot were used to measure the gene and protein expression of receptor interacting protein kinase 1 and 3 (RIPK1 and RIPK3, the necroptosis markers) respectively. Four weeks after TAC operation, rat model for cardiac hypertrophy was established. The experimental data showed that the gene and protein expressions of RIPK1 and RIPK3 in the rat heart hypertrophic tissues after TAC for 4 weeks were increased significantly compared with those in the sham group. HE staining showed cardiomyocytes injury and hypertrophy in the hearts of TAC rat models. By transmission electron microscope, we observed that mitochondria of cardiomyocytes were damaged seriously in the TAC models. Treatment with losartan used, the selective antagonist of angiotensin II type I receptor could improve the cardiac function of TAC rats. Moreover, losartan treatment decreased the expression of RIPK1 and RIPK3 in heart tissues of TAC rats. The results suggest that necroptosis occurrs in the process of cardiac hypertrophy with pressure overload, and losartan could alleviate the cardiac hypertrophy and inhibit necroptosis.
Animals ; Apoptosis ; Cardiomegaly ; pathology ; Disease Models, Animal ; Echocardiography ; Heart ; physiopathology ; Losartan ; pharmacology ; Myocytes, Cardiac ; Pressure ; Protein-Serine-Threonine Kinases ; metabolism ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Receptor-Interacting Protein Serine-Threonine Kinases ; metabolism