Objective To investigate DNA methylation in the promoter region,mRNA transcription and protein expression of glutathione-S-transferases-P1 (GSTP1) gene and their relation with arsenism.Methods In endemic coal-pollution-borne arsenism area,Jiaole village of Xinren county,Guizhou province,according to the diagnostic criteria of endemic arsenism(WS/T 211-2001),123 cases with endemic arsenism were selected and divided into three groups (mild arsenism group:42 cases,moderate arsenism group:41 cases and severe arsenism group:40 cases).Forty seven residents were selected as controls in a village about 12 km away from the endemic arsenism area.With the informed consent principle,peripheral blood of all respondents was collected in order to analyze DNA methylation and check mRNA.DNA methylation of GSTP1 gene promoter region in peripheral blood was assayed by PCR,and GSTP1 mRNA expression was assayed using real-time quantitative PCR.In addition,other cutaneous specimens originated from 53 cases with arsenism that accepted surgical treatment voluntarily were taken.Of these specimens,general pathological changes were 28 cases,precancerous 20 cases and cancerous 5 cases.Skin tissues of 15 cases of non-tumor surgery patients without abnormal pathological changes were as control group.GSTP1 protein expression in the skin tissue was detected using immunohistochemistry (IHC).Results Among different groups of arsenic poisoning,the positive rate of DNA methylation of GSTP1 gene was 28.57％(12/42) in the mild group,57.10％ (23/41) in the moderate group and 65.00％ (26/40) in the severe group.Compared with the control group (6.38％,3/47),the difference was statistically significant (x2 =7.792,26.000,33.412,all P ＜ 0.01).Among different groups of arsenic poisoning diagnosed by dermapathology,the positive rate of DNA methylation of GSTP1 gene was 21.43％(6/28) in the general pathological change group,50.00％(10/20) in the precancerous group and 80.00％(4/5) in the cancerous group.Compared with the control group(6.67％,1/15),the difference was statistically significant (x2 =3.562,7.468,10.756,all P ＜ 0.05).It showed that the positive rate of DNA methylation of GSTP1 gene increased with aggravation of the disease and dermatic lesion of arsenism (tendency x2 =38.239,x2 =13.659,all P ＜ 0.01).Compared with the control group(0.184 26),the expressions of GSTP1 mRNA in peripheral blood in moderate (0.087 77) and severe arsenic poisoning groups (0.056 93) were significantly reduced(all P ＜0.01),and that of severe group was significantly lower than that of the moderate group (P ＜ 0.01) ; compared with the control group(0.338 45) and the general lesion group(0.276 74),GSTP1 mRNA expression was significantly reduced in precancerous lesion group(0.104 81) and cancerous group(0.043 70),in which the cancerous group was significantly lower than that of the precancerous lesions.The difference of skin tissue GSTP1 protein expression rate between groups was statistically significant (x2 =20.948,P ＜ 0.05),in which the difference between the precancerous lesion group(65.00％,13/20),the cancer group (40.00％,2/5) and the control group(100.00％,15/15)was statistically significant (x2 =12.183,11.778,P ＜ 0.01).Spearman correlation analysis showed that the degree of skin lesion and the level of GSTP1 protein expression was negatively correlated (r =-0.520,P ＜ 0.05).Groups were divided according to DNA methylation of GSTP1 gene,and the mRNA and protein expression of GSTP1 in methylation group(0.038 40,57.14％) was significantly lower compared with that of unmethylated group(0.187 07,95.74％; Z =9.032,x2 =23.134,all P ＜ 0.01).Conclusions Arsenism may lead to DNA methylation of human GSTP1 gene promoter region,thereby inhibiting expression of mRNA and protein.GSTP1 gene plays an important role in arsenism or carcinogenic process.

Objective To evaluate the operative treatment of nonunion of humeral shaft fracture with in- ternal plate fixation and autogenous cancellous hone graft.Methods Forty-one cases of nonunion of humeral shaft fracture operatively treated from February 2002 to December 2004 were analyzed retrospectively.There were 32 males and nine females.Their average age was 37.5 years(range,17 to 67 years).Sixteen nonunions were defined as hypertrophic and 25 as atrophic.We followed all the patients and obtained their complete medical information. Results Our average follow-up was 22.6 months(range,8 to 42 months).Forty fractures(97.6%)were united within an average of 5.8 months(range,3 to 12 months).Complications included iatrogenic radial nerve injury in three patients,wound infection in one patient and fracture nonunion in one patient.At the final follow-up,shou]der and elbow functions were found to be satisfactory.Conclusion Open reduction and plate internal fixation sup- plemented with autogenous cancellous bone graft is an effective treatment for nonunion of humeral shaft fracture.

Objective To investigation work stress and its influence factors of neurology nurses in new work pattern.Methods 90 neurology nurses in a grade Ⅲ class A hospital was picked with the convenience sampling method and surveyed with a questionnaire for basic information,nurses stressor,social support and coping styles.Results The overall score work stress of neurology nurses was (2.41±0.43).Major sources of work stress were nursing profession and work (3.03 ± 0.58),work load and time allocation the social support (2.90 ± 0.64 ),working environment and resources (2.53 ± 0.86 ),patients caring ( 2.36 ± 0.54 ) and management and interpersonal relationships ( 1.67 ±0.57).Social support and coping styles scored as (43.94 ±6.22) and (54.43 ± 9.92) respectively.Both social support and coping styles showed positively correlation with the work stress of the neurology nurses( t=7.187,7.071,respectively ;P ＜ 0.01).Better support from the society reduced the stress of the nurses.Conclusions Quality of nursing care services demonstration project is a good starting point for reforming the nursing work.Managers should seize this opportunity to fully understand the work stress status of neurology nurses and effectively provide measures to ease the pressure of nurses,improve the quality of care,and ensure the sustainability "quality care service".

Objective To explore the possible mechanisms of Arsenic Trioxide in treating rheumatoid arthritis(RA)by observing the changes of HE staining and NF-KB expression as well as the apoptosis of syn- oviocytes in adjuvant-induced arthritis rats.Methods After the animal model was set up on Wistar rats sue- cessfully,they were randomly divided into AA model group and arsenic trioxide treatment group.The treat- ment group were injected with 4 mg'kg~(-1)9?d~(-1)arsenic trioxid fluid for 7 days.All of the rats were killed 3 days after the complete of injections.The joint specimens were exposed,fixed,decalcified,wrapped and cut into slices.All slices were examined by HE stain and immunohistological evaluation.Results HE staining showed that when compared with the normal control group,the layers of synoviocytes of the AA group were increased to 6-8,and the arrangement of synoviocytes was disordered and heavy inflammatory cell infiltration were found in the AA group.In the arsenic trioxide treatment group,the layers of synoviocytes increased to 3～4,and medi- um amount of inflammatory cell infiltration were found.The intensity of synovial NF-kB(p65)positive stain in AA model group was significantly higher than that in the normal control group.The synovial expression and ac- tivation of NF-kB in the treatment group were decreased markedly,and did not return to normal level.The average gray scale calculation showed that there were significant differences between the three groups(P

Objective Construct the eukaryotic expression vector of inhibitory member of the ASPP family (iASPP) and trans-fect it into colon carcinoma cell lines SW480 and Lovo by liposome .Then observe the expression of iASPP and detect the cell apop-tosis by flow cytometry .Methods The amplified PCR product was digested and inserted into pMD19-T simple vector and sub-cloned into eukaryotic expression vector pcDNA3 .1(+ ) .The recombinant eukaryotic expression plasmid pcDNA3 .1(+ )-iASPP was transfected into colon carcinoma cell lines SW480 and Lovo by liposome ,the iASPP expression was analyzed by RT-PCR .The cell apoptosis was detected by FCM .Results The eukaryotic expression plasmid pcDNA3 .1(+ )-iASPP was constructed success-fully ,the gene squence of iASPP was consistent with that reported (gi 60457962) in GenBank .The mRNA expression levels of iASPP gene of SW480 and Lovo cell lines which transfect the positive plasmid were increased ,and the cell apoptosis rates were de-creased .Conclusion We successfully constructed the recombinant expression plasmid pcDNA 3 .1(+ )-iASPP ,and the plasmid were successfully expressed in colon carcinoma cell lines SW 480 and Lovo ,the cell apoptosis rates of those cell lines were decreased .These facts indicated that reducing the high expression of iASPP may be a new strategy to renew the abilities of P 53 tumor suppressor .

Objective To analyze epidemiological characteristics of elderly cases with influenza A (H1N1) in Beijing. Methods Descriptive epidemiological methods were used to describe epidemiological characteristics of elderly cases with 2009 influenza A (H1N1) in Beijing. Results The 321 laboratory-confirmed elderly cases with influenza A (H1N1) were reported in Beijing, and the morbidity was 13.2/100 000. The peak of infection occurred during November and December, the cases in this period accounted for 84.7% of the whole year, and 53.0% of them were reported in suburb areas, with the highest morbidity (19.2/100 000) in people beyond 85 years, and the morbidity increased with age (x2 = 7.24, P＜0.01). The mild cases accounted for 63.6 %, severe and critical cases accounted for 36.4%. No significant difference was found between severity and BMI (x2=8.14, P=0.52). Severity was associated with number of chronic diseases (x2= 123.0, P＜0. 01). Conclusions The H1N1 morbidity and proportion of severe cases are high among the elderly in Beijing, more attention should be paid to this population for influenza A (H1N1) prevention and control.

[ABSTRACT]OBJECTIVETo investigate the relationship between upper airway MRI parameters and the severity of patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Then the values of upper airway MRI parameters in waking state were assessed.METHODS The MRI upper airway parameters of 37 OSAHS patients and 18 nonsnoring normal subjects were measured and compared. Then data analysis were carried out to find out significant correlations between the MRI upper airway parameters and the severity of patients (the apnea hypopnea index, AHI; the lowest oxygen saturation, LSaO2; the oxygen desaturation index, ODI) with OSAHS.RESULTSThe correlation between cross-sectional areas and left-right diameter in the narrowest retropalatal region, the thickness of lateral pharyngeal wall, the length of the tongue, the length and thickness of the soft palate and the cross-sectional areas of the soft palate on midsagittal planes and severity of OSAHS were found (P<0.05).CONCLUSIONThe MRI upper airway parameters can be used in evaluating the severity of OSAHS in some ways, locating the obstruction sites and choosing the best treatment planning.

Objective To compare the effects of moderate and deep hypothermic circulatory arrest (DHCA) during aortic arch surgery in the adult patients,to offer the evidence for the detection of which temperature provides best brain protection in the subjects who accept the great aortic surgery.Methods A total of 109 patients undergoing the surgery of aortic arch were divided into the moderate hypothermic circulatory arrest group and deep hypothermic circulatory arrest group.We recorded the characters of the patients and their cardiopulmonary bypass time,aortic clamping time,cerebral perfusion time and postoperative recovery time,tracheal intubation time,time of intensive care unit (ICU) and postoperative cognitive dysfunction.Results Patients' characteristics were similar in two groups.All the patients were cured.There were no significant differences in aortic clamping time of each group [(111.4 ± 58.4) min vs.(115.9 ± 16.2) min];selective cerebral perfusion time [(27.4 ± 5.9) min vs.(23.5 ±6.1) min] of the moderate hypothermic circulatory arrest group and deep hypothermic circulatory arrest group.There were significant differences in the cardiopulmonary bypass time[(207.4 ± 20.9) min vs.(263.8 ± 22.6) min],the postoperative recovery time [(19.0 ± 11.1) h vs.(36.8 ± 25.3) h],intubation time [(46.4 ± 15.1) h vs.(64.4 ± 6.0)h];length of ICU [(4.7 ± 1.7) d vs.(8.± 2.3) d],and postoperative cognitive dysfunction of the two groups.Conclusion Compared to the deep hypothermic circulatory arrest,the moderate hypothermic circulatory arrest can provide better brain protection and achieve good clinical results.

Objective To evaluate the development of fetal cerebellar vermis using 3D transabdominal ultrasound,and provide evidence for prenatal screening fetal cerebellar vermis anomalies.Methods Totally 387 normal fetuses at 20～36 gestation weeks were examined by three-dimensional extended imaging(3DXI) to observe the fetal cerebellar vermis.The width,anteroposterior diameter,craniocaudal diameter of the cerebellar vermis,the angle between brain stem and vermis,a ratio between the area of anterior vermis and posterior vermis were measured,and the relationship between the gestational age and parameters mentioned above were analyzed.Results The multi slice view of 3DXI and 3D reconstructed sagittal section well evaluated the integrity of vermis morphous and vermis size,identified characteristic signs of vermis:the fourth ventricle apex and vermis crack.In normal fetus,brain stem and vermis were almost parallel,the angle between them was 3.97°±1.65°.There was no significant correlation between the angle and the gestational age.The area of the anterior vermis was smaller than that of posterior vermis,with a ratio of 0.76±0.06,which was also not related to gestational age.The width,anteroposte rior diameter and craniocaudal diameter of the cerebellar vermis were positively correlated with gestational age.Conclusions The multi slice view of 3DXI and 3D reconstructed sagittal section should help evaluate the development of the cerebellar vermis,accurately show the cerebellar vermis and its surrounding strutures,and provide a new way to evaluate the fetal cerebellar vermis.

Objective To investigate the value of endovascular surgery for the treatment of thromboangitis obliterans (TAO). Methods Sixteen patients (18 limbs) with thromboangitis obliterans were treated by percutaneous transluminal plasty (PTA). Results Angiographic success on the limb basis was achieved in 15 of 18 treated limbs and the initial technical success rate was 83.34%. Doppler anklebrachial index (ABI) increased from 0.33±0.16 to 0.79±0.23 one week after PTA. The follow-up time was 2～24 months, the average time was 10.84 months. The 3-month, 12-month accumulated primary patency rate were 81.33% and 60. 23% respectively. Conclusion PTA is effective primary invasive treatment for thromboangitis obliterans yielding acceptable primary clinical success with a low complication rate and resulting in moderate long-term clinical patency and a high limb salvage rate.