Objective To assess the analgesic effect of continuous infusion of 0.2% ropivacaine with epidural catheter placed at T11-12 or L2-3 after abdominal hysterectomy. Methods Eighty ASA Ⅰ -Ⅱ patients undergoing elective abdominal hysterectomy were randomly divided into 4 groups with 20 patients in each group : in group Al and A2 the epidural catheter was placed at T11-12 and in group Bl and B2 at L2-3 . After surgery two infusion pumps were used. The first pump was used for continuous epidural infusion of 0.2% ropivacaine in the 4 groups. The second pump was used for patient controlled intravenous analgesia (PCIA) with 0.08% lornoxicam in group Al and Bl or with 0.1% morphine in group A2 and B2. The PCIA bolus dose was 1 ml with a lockout time of 5 min. The analgesic effect (assessed using VAS) and the consumption of lomoxicam / morphine were compared among the four groups. Results The ropivacaine consumption was 192 mg during the 24 h after operation in the 4 groups. The lornoxicam and morphine consumption were (3.9?2.8) mg and (4.6?3.5) mg in group Al and A2 with the epidural catheter placed at T11-12 and (7.7?2.5) mg and (7.8?2.4) mg in group B2 and B2 with catheter placed at L2-3.The consumption of lomoxicam or morphine was significantly less with epidural catheter placed at T11-12 than that with epidural catheter at L2-3 (P

Objective To explore the feasibility of C14-urea breath test in the diagnosis of child chronic cough.Methods One hundred and twenty children cases of chronic cough were collected as the research subjects and divided into the C14 group(adopting C14-urea breath test for diagnosis) and combined group(C14-urea breath test combined with routine diagnostic method) according to different diagnostic means,60 in each group.Then the positive diagnostic rate and effectiveness were analyzed and compared between the two diagnostic methods.Furthermore the ROC curve was adopted to evaluate its diagnostic value.Results The positive diagnosis rate in the C14 group was 76.67%,which was significantly lower than 95.00% in combined groups,the difference was statistically significant (P<0.001).The sensitivity and positive predictive value in the combined group were obviously higher than those in the C14 group (P<0.01),but there were no statistically significant differences in specificity and negative predictive value between the two methods (P>0.05).The expression levels of serum hs-CRP and IL-6 in the C14 group were significantly higher than those in the combined group,but the expression level of IL-10 was obviously lower than that of the combined group (P<0.05).The AUC in the ROC curve of combined group was significantly higher than that of the C14 group(P<0.05).Conclusion The C14-urea breath test can serve as a supplementary diagnosis means in child chronic cough,and its combining with the routine diagnosis method can significantly increase the diagnosis effectiveness.

Objective To analyze the epidemiological characteristics of unintentional injuries among children patients at age of ≤ 14 years so as to provide scientific basis for prevention of the children injury. Methods ICD-10 coding was used to retrospectively analyze the epidemiological characteristics of the children patients with unintentional injuries at age of ≤ 14 years admitted from January to December 2009 and the factors affecting the prognosis were discussed. Results There were 3011 patients, with 1991 males (66.12%) and 1 020 females (33.88%). The patients at ages of < 1, 1-4, 5-9 and 10-14 years accounted for 8.24%, 53.30%, 27.90% and 10.56% respectively. The patients from the rural and urban areas accounted for 56.16% and 43.84% respectively. Trauma was the leading sort of injuries in four age groups, accounting for 70.56%, 62.68%, 89.64% and 87.74% respectively. Fall from height was the first cause of unintentional injuries in four age groups, with proportion for 47.58%,36.39%, 51.90% and 56.29% respectively. Muhinomial logistic regression analysis revealed that hospital stay, therapeutic mode ( operation/non-operation), inhabitancy ( urban/rural), causes of injuries and injury severity on admission were the risk factors affecting the prognosis (P < 0.05 ). The rural areas caused higher risk of disability than the urban areas ( OR = 2. 170 ,P < 0.01 ) and non-operation produced higher risk of death than operation (OR = 6.352,P < 0. 01 ). Conclusions The male patients with unintentional injury are more than the female ones, with the highest incidence rate in children at age of 1-4years. Trauma is the main kind of unintentional injury and the fall from height the leading cause of injury.The difference of the rural and urban areas indicates that correct choice of the preventive measures based oh the condition of the local area can attain effective prevention and control of the unintentional injuries.

Objective To study the influence of Captopril preconditioning on apoptosis and the expression of gp 130 in rats of acute myocardial injured. Method Wistar rats were randomly divided into three groups:control group, Iso group and Cap preconditioning group. Cardiomyocytes apoptosis was detected with TUNEL method. The expressions of Bcl-2 and Bax proteins in myocardium were tested by immunohistochemistry. The expression of gp 130 was tested with Western blot method. Results The index of cardiomyocytes apoptosis was decreased, the expressions of Bax proteins and gp 130 were decreased and the expression of Bcl-2 proteins was increased in Cap preconditioning group compared with Iso group (P<0.01 or P<0.05). Conclusion The expression of gp 130 could be decreased through Cap preconditioning, which can reduce the cardiomyocytes apoptosis.

Objective To identify the clinical differences between central nervous system (CNS) infection and neuropsychiatric lupus in patients with systemic lupus erythematosus (SLE). Method Clinical manifestations, lab test results and prognosis of 12 SLE patients complicated with CNS infections, hospitalized in Nanjing Drum Tower Hospital in the past four years, were reviewed and compared with those of 15 concomi-tantly treated patients with central neuropsychiatric lupus (NPL). Two-indenpendent samples t test, Mann-whitney test and Fisher exact test were used for statistical analysis. Results 83% of SLE patients with CNS infections were female and the average disease onset age was (37±4) years. As compared to neuro-psychiatric lupus patients (the control group), those patients with CNS infections (infection group) had lower lupus disease activity (SLEDAI score 14.3±1.6 vs 6.4±1.2, P<0.01) and took higher dose of corticosteroids [average prednisone dose (28.3±2.5) vs (8.4±3.0) mg/d, P<0.01 ] and more immunosuppressives agents (83% vs 33%, P<0.05) before the occurrence of CNS symptoms. Headache and fever were more common in the infection group (100% vs 46.7% and 91.7% vs 20%, both P<0.01) and simultaneously higher serum albumin levels [(34.2±1.2) g/L vs (29.9±1.6) g/L] were detected in those patients compared to the NPL patients (P<0.05). Cerebrospinal fluid examination showed that agents for a long time but without strong evidence of lupus disease activity, CNS infection should be considered at the appearance of headache and fever, and timely cerebrospinal fluid examination is required for the diagnosis.

Objective To assess the clinical features of newly diagnosed primary Sjogren's syndrome (pSS). Methods Patients were diagnosed according to the international consensus criteria for Sjogren's Syndrome published in 2002. Clinical manifestations and laboratory tests of 86 pSS cases hospitalized in Nanjing Drum Tower Hospital in the past two years were reviewed. Results Among the 86 patients, 95.3% were female and the average disease onset age was 38.6 years. The median time from disease onset to diagnosis was 6 months. Dry mouth, dry eyes and arthralgia were the most common symptoms. Hematologic involvement was found to be prominent in these patients (69.8%). The incidence of abnormal liver function, interstitial lung disease and pulmonary arterial hypertension was 19.8%, 8.2% and 5.8% simultaneously. Younger patients (less than 18 years old) had lower frequency of dry mouth and dry eyes but higher ffrequency of fever and lymph nodes enlargement than the elderly patients (P<0.05). Patients with positive anti-SSA or anti-SSB antibodies had higher incidence of hematological changes as well as ESR than those with negative auto-antibodia. Elevated globulin/IgG and positive antinuclear antibody or rheumatoid factor (P< 0.05). Conclusion pSS is not always a benign disease. Some patients will develop vital organ damages very early and thus need to be identified and treated in time. It should not be overemphasize the importance of dry mouth and dry eyes for the diagnosis of pSS, especially in young patients. Those patients who have fever, high globulin level and positive rheumatoid factor of unknown origin should be screened for pSS.

Objective To approach the effects of MMP-9 antisensc oligonucleotide(ASODN)on human lung adcnocarcinoma(A549) cell apoptosis and proliferation capability.Methods MTT.was used to analyze the effect that MMP-9 transfection on A549 cell growth.Flow cytometry was used to analyze the ratio of cell proliferation and apoptosis.RT-PCR WaS used to detect the expression of MMP-9mRNA and Western blot was used to detect the changes of MMP-9 protein.Results In some degree,MMP-9 ASODN that inhibited the survival rate of the A549 cell presented concentration and time dependence manner.The best dependence concentration of ASODN was 600nmol/L for 24 hour.After trasnfection of MMP-9ASODN to A549 cell.the perceive of A549 apoptosis cell was significandy higher than that in control group(P＜0.01).When the antisense oligonucleotides concentration is 600nmol/L and the action time is 48 hours,the relative expression level of MMP-9mRNA and MMP-9 protein are obviously less than that in control group(P＜0.01).Conclusion MMP-9ASODN may down regulate the expression of MMP-9mRNA and MMP-9 protein,effectively inhibit the proliferation of A549 cell and promote the apoptosis of A549 cell.

Objective To explore the role of OAZ gene in the pathogenesis of systemic lupus erythe-matosus (SLE) by using RNA interfering technique. Methods Peripheral blood mononuclear cells (PBMC) from SLE patients were collected. Each sample was equally divided into four groups for cell culture in 96 well plates. Specific siRNA for OAZ and GAPDH were concordantly added to the experimental group and the positive control group, while nonspecific siRNA was added to the negative control group and only culture medium was added to the Mock control group. Cells and supernatants were harvested after culturing for 72 hours, then RNA was extracted and reverse transcripted to cDNA. OAZ, Id1, Id2, Id3, Id4 mRNA expression levels were analyzed by using real-time PCR. Levels of IFN-γ, IL-4, IL-10, IL-12, IL-21, CCL2, ANA in the supernatant were tested by ELISA. Relationships between the expression levels of OAZ mRNA with levels of cytokines and ANA were analyzed. Results OAZ, Id1, Id2, Id3 gene mRNA expression levels (△Ct: 12.5±1.4, 8.9±1.5, 4.3±0.8, 8.04±1.1) in the experimental group were significantly decreased comparing to those in the negative control group (△Ct: 10.2±1.1, 6.5±1.2, 2.4±1.3, 6.2±1.2 respectively, P<0.05). Levels of IFN-γ, IL-10, IL-12, IL-21 and ANA in the experimental group were significantly lower than those in the negative control group (P< 0.05), but level of CCL2 was higher than the negative control group (P<0.05). Difference of OAZ mRNA expression levels (△△Ct) between the experimental group and the negative control group was negatively correlated with changes of ANA, IL-21 levels, but positively correlated with changes of Th1/Th2, CCL2. Conclusion OAZ siRNA can effectively reduce the expression of genes involved in the OAZ signaling pathway in SLE. OAZ may lead to abnormal production of ANA via regulating Id genes and cytokines.

Objective To study the expression of 2 bone morphogenetic protein (BMP) related microRNA (miR-21,miR-155) in SLE patients,and to analyze their correlation with clinical features.Methods Peripheral blood was obtained from 59 SLE patients and 25 healthy controls,and total RNA was extracted and reverse transcribed into complementary DNA (cDNA).Real-time PCR technique was used to detect gene expression at transcrptional level.Disease activity was determined by SLEDAI score.Patients were divided into different groups based on their manifestations or antibody profiles,then comparison of miRNA expression was carried out using Mann-Whitney test.Results The expression levels of miR-21 and miR-155 were increased in active SLE patients (SLEDAI≥8) as compared to those with mild disease (SLEDAI≤7) or healthy controls (both P＜0.05).Patients with positive anti-dsDNA or lupus nephritis had higher expression levels of miR-21 and miR-155 than those without (P＜0.05).Conclusion The miR-21 and miR-155 expressions are elevated in active SLE patients and are associated with anti-dsDNA and renal involvement.The results suggest that these two miRNAs might play a role in the pathogenesis of SLE disease.

Objective To study the function of core protein (CORE) of genotype 1b hepatitis C virus (HCV) of different strains (T: derived from tumor tissues; NT: derived from non-tumor tissues; C191: HCV-J6) and different domains (1-172, 1-126, 1-58, 59-126, 127-172 AA) of T CORE in the pathogenesis of HCV infection and to find the therapy target. Methods Different truncated genotype 1b HCV CORE eukaryotic expression plasmids (T, NT, C191) and different domains of T CORE were constructed and transfected to HepG2 cells. Cell apoptosis and necrosis were quantified by flow cytometry. Cell growth curves were observed with real time cell growth instrument. Results COREs from different strains of genotype 1b and different domains of CORE induced cell apoptosis and necrosis, and inhibited HepG2 cell growth at different levels. CORE derived from T induced apoptosis and necrosis and inhibited cell growth higher than that derived NT and C191. N terminal 1-58 AA of CORE derived from T induced cell apoptosis and necrosis and inhibited cell growth higher than any other domains. Conclusion COREs from different strains of genotype 1b HCV and different domains of CORE from the same HCV strain play different roles in their molecular pathogenesis of HCV. Among different domains of CORE, N terminal 1-58 AA might play an important role in its pathogenesis and be one target of gene therapy.