Objective To explore the relevant factors of hypotension in the patients applied hemodialysis.Methods 45 patients who had intradialytic hypotension in our dialysis room were selected for the analysis.Results The patients with diabetic nephropathy,the elderly,high temperature,hyponatremia,higher ultrafiltration volume,stepwise ultrafihration and the constant ultrafihration showed higher incidence of hypotension during hemodialysis(x2 =9.87,81.22,171.02,130.12,all P ＜0.01).Conclusion The primary disease,age of the patient,uhrafiltration volume,temperature,sodium concentration and the ultrafiltration are all the relevant factors for intradialytic hypotension

BACKGROUND: MyoD gene is one of family members of muscle transcription factors. Transfection MyoD gene can switch on the procedure of differentiation of muscles, and transit non-muscle cells into muscle cells.The MyoD gene only expresses in skeletal muscles. Based on the same contractive structure in myocardial cells and skeletal muscle cells, it is imagined that the conversion from exogenous MyoD gene-induced fibroblast in local myocardium into skeletal muscle cells that had contractive function may become another method in the treatment of congestive heart failure on clinic.OBJECTIVE: To construct and identify a recombinant adenoviral vector carrying MyoD gene for further studies on the recovery function of MyoD gene in myocardial injury.DESIGN: Single sample experiment.SETTING: Department of Cardiology, First Affiliated Hospital, Nanjing Medical University.MATERIALS: The experiment was conducted at the Laboratory of Microbiology and Immunology, Nanjing Medical University between September 2004 and September 2005. MyoD gene and non-replicating form expressive vector of adenovirus were taken as research materials.METHODS: MyoD cDNA fragments were extracted from plasmids pEMSV-MyoD with polymerase chain reaction (PCR), and PCR was used to clone the whole-length gene of MyoD. After adding CACC sequence at 5' end, MyoD gene was cloned by orient topology into transfer ventor, pENTR/D-TOPO. Objective gene was transferred into adenoviral expression vector DNA via pENTR/D-TOPO vector. The recombinant adenoviral vectors transfected into HEK293A cells by using lipofectamine were packaged and amplified.MAIN OUTCOME MEASURES: Evaluation of PCR and DNA sequencing were used for confirming the size of segment and correctness of rank of MyoD cDNA and detecting the titre of virus.RESULTS: MyoD recombinant adenovirus contained target segment with precise length confirmed by PCR and DNA sequence that was correct. The titre of virus was 1.3×1011 pfu/mL.CONCLUSION: The recombinant adenoviral vector carrying MyoD gene is constructed successfully.

Objective To explore the mediator effect of coping styles in relationship between hope level and subjective well-being of empty-nesters in urban community.Methods 208 empty-nesters were tested with Herth Hope Scale,Coping Style Questionnaire and Subjective Well-Being to investigate the influence and the pathways of hope and coping styles on subjective well-being with structural equation modeling.Results Influence of hope level on subjective well-being of empty-nesters in urban community accorded with completely-mediated model (x2/df =1.971,GFI =0.955,AGFI =0.911,RMSEA =0.068),and influence of hope level mediated by positive coping styles accounted for 41.76％(Z=3.692,P＜0.01).Conclusion The influence of hope level on subjective well-being is mediated mainly by positive coping styles for empty-nesters in urban community.

Objective This study seeks to use a meta-analytical approach to quantitatively assess the results of applying the problem-based learning(PBL) teaching model and the traditional lecture-based learning(LBL)teaching model to basic medical courses in undergraduate medical edu-cation. Methods The CNKI and VIP databases were electronically searched to retrieve randomised controlled trial studies that examined the use of PBL methods for basic medical courses in under-graduate medical education. In these studies PBL teaching model was used in experiment group and LBL teaching model was used in control group. Pass rate or test scores was used to evaluate the effect of learning. The retrieved documents ranged from the time that each database was first constructed to December 2012. After two researchers performed literature screening independently, data extraction, and quality assessment procedures in strict accordance with the inclusion and exclusion criteria of this study, the Stata 11.0 software package was utilized to conduct the meta-analysis. Results This meta-analysis examined 28 studies that included a total of 3703 subjects. The modified Jadad scores of 20 studies(71.4%) were less than 4, and those of 8 studies(28.6%) were more than or equal to 4. The meta-analysis revealed that compared with the traditional teaching model, the PBL teaching model did not produce improved examination passing rates for a course [relative risk(RR):1.05, 95%confidence interval(CI):(0.99, 1.10), P=0.098] but could improve examination scores for a course [standardized mean difference (SMD): 0.73, 95% CI: (0.51, 0.96), P<0.001]. Conclusion For basic medical courses in undergraduate medical education, compared to LBL teaching, PBL teaching can improve students' test scores but cannot improve students' pass rate. PBL used in basic medical courses has di-versified forms and lacks unified criterion, so there is still a long way to go for the appli-cation of PBL.

Objective To explore molecular mechanisms of apoptosis induced by STI571 in human acute promyelocytie 1eukemia cell lines NB4.nethods The expression of Annexin-V,Fas,Caspase-3 and bcl-2 in NB4 cells were detected by FCM after the treatment of STI571 at(0.5,1.0,5.0 μmol/L)ranging for 24 h,48 h and 72 h.Results With the increasing dose of STI571,the expression of bcl-2,Caspase-3,Annexin-V,Fas in NB4 changed from(10.22±0.62)declining to (5.82±0.52),from(42.21±1.02)ascending to(52.35±0.83),from(25.A2±1.21)ascending to(37.84±0.63),from(18.21±0.81)to(21.41±1.02)respectively.With the dealing time increasing(24,48,72 h),the expression of bcl-2,Caspase-3,Annexin-V,Fas in NB4,changed from (5.81±0.52)declining to(2.51±0.43),from(52.31±0.83)ascending to(69.51±1.12),from(37.81±0.93)ascending to(78.62±0.83),from(23.41±0.73)to(26.53±1.02)respectively.Conclusion STI571 can enhance the apoptosis program to Ni4 in a time-dependence and dose-dependence manner,but no change to Fas was observed.

Objective: To study the effects of TNF ? on wound healing. Methods: The skin lesion and incisions were made on mice and rh TNF ? was applied in both skin lesion and incision. Tissue strips were evaluated for tensiometry and histologic features after healing. Results: It was found that rh TNF ? markedly improved wound healing both in skin lesion and incision wound model, it also markedly enhanced the breaking strength of treated incision and increased wound cellularity in rh TNF ? treated groups. Conclusion: The results suggest that TNF ? play an important role in regulating inflammatory reactions of local injured tissues and it may improve the functions of fibroblasts, mononuclear phagocytes and endothelial cells. rh TNF ? of suitable doses can promote wound healing. This shows that TNF ?, as a wound healing promoter, has the potentials for clinical application.

Objective: To study the relationship between interleukin(IL) 6, IL 8, tumor necrosis factor alpha (TNF ?) and wound healing. Methods: In lower jaw gunshot wound, the expression of IL 6, IL 8, TNF ? in local soft tissues was assayed by using immunohistochemistry methods. The current levels of IL 6, IL 8, TNF ? in wound tissues was analysed by using image assay. Results: High expressions of these cytokines were observed in local soft tissues of wounds during the first 3 d after the gunshot. The cytokines expressions were different between the area near the bullet path and that far from the path. There was only one peak of the cytokines concentration in the area far from the bullet path, while there were 2 peaks of the cytokines concentration in the area near the bullet path.Conclusion: These results suggest that IL 6, IL 8, TNF ? play an important role in regulating inflammatory reactions of local injured tissues. They may improve the functions of fibroblasts, mononuclear phagocytes and endothelial cells and stimulate wound cells to produce and release other cytokines.

Objective：To explore the effect of group psychological service on mental health of the children left behind in rural areas.Methods：Totally 222 children left behind in rural areas were selected randomly and divided into intervention group and control group.The intervention group accepted 8 times of group psychological service.The Eysenck Personality Questionnaire(EPQ),Center for Epidemiological Studies of Depression scale for Children(CES-DC),Rutter Children's Behavior questionnaire for completion by teacher,Piers-Harris Children `s Self-concept Scale(PHCSS)were used in both groups to evaluate the effect at baseline,the end of the 7th intervention,and 6 months after the end of the intervention.Results：After intervention,the intervention group got lower scores than control group in EPQ-N [(8.2±5.8)vs.(10.2±6.1),P<0.05]in the first retest,and in CES-DC [(15.9±7.3)vs.(18.8±7.7),P<0.05]in the second retest.The group gained higher scores in anxietyand happy and satisfaction factors of PHCSS [(6.6±3.4)vs.(5.6±2.7),(6.5±1.9)vs.(5.7±1.8);Ps<0.05]. Conclusion：Group psychological service are effective to children left behind in rural areas with depression emotion and had a role in children's personality remodeling.

Objective To explore effects of Naikan cognitive therapy on improving clinical symptoms in patients with convalescent schizophrenia. Methods The 69 convalescent schizophrenic patients with convalescent clinical state were consecutively recruited. All the patients were divided into Naikan cognitive therapy ( NCT) group an control group at random and were pretreated with antipsychotic agent therapy. In NCT group,the patients received NCT for successive 7 days. In control group,the patients only received antipsychotic agent therapy. Pre-and post-treatment positive and negative syndrome scale( PANSS) , Nurses'observation scale for inpatient evaluation (NOSIE) were administered to all subjects. Results ① A significant decrease occurred in PANSS total score, negative symptom score, positive symptom score, compound scale score, general psychopathology score, reaction retardation score and paranoid score in NCT group ( t = 2. 672～7. 370, P < 0. 05). In the post-treatment, PANSS total score, negative symptom score, positive symptom score, compound scale score, reaction retardation score and thought disorder score were significantly lower in NCT group than those in control group ( t ' = 2. 696, P = 0. 009; t = 5. 186, P=0.000; t = 3.757, P = 0.001; t = 2.634,P = 0.011; t ' =2.376, P = 0.021). ②A significant decrease occurred in NOSIE total negative score( 10.43 ± 9. 24 vs 13. 87 ± 8. 03, t = 3. 463 , P = 0. 002) , irritation score(3. 13 ±0.43 vs8.53 ±4.98, t = 6. 139, P=0.000) and retardation score(1.07 ± 1.64 vs 2. 20 ±2.85, t = 2.067, P = 0.048) in NCT group. Conclusion NCT can possibly improve part clinical symptoms of patients with convalescent schizophrenia to a certain extent,especially negative symptom,but need to further prove the effect of NaiKan cognitive therapy.

Background and purpose:The risk of recurrence for colorectal cancer after curative surgery is up to 30%-40%. We aimed to evaluate the relationship between time to relapse (TTR) of colorectal cancer with clinical pathological parameters and overall survival after recurrence. Methods:We carried out the analysis of clinical data, pathological examination and follow up information of 375 colorectal cancer patients who admitted to Liaoning Cancer Hospital. Patients were categorized into relapse at<2, 2-5 and>5 years following their initial surgery. Results:TTR was associated with the clinical stage at diagnosis and liver or lung metastasis status. Short TTR (<2 years) was positively associated with survival. However, there was no significant difference in survival between patients who relapsed at 5 years or later compared with those who relapsed between 2 and 5 years. Conclusion:TTR within 2 years is an important predictor of shorter survival for colorectal cancer patients who experienced a relapse.