Objective To observe the performance of two-dimensional echocardiography and CDFI of metastatic cervical lymph nodes in nasopharyngeal carcinoma before and after induction chemotherapy,and to predict the short-term effect of the lymph nodes after sequential chemoradiotherapy.Methods Forty patients with sixty-five metastatic cervical lymph nodes which were confirmed as nasopharyngeal carcinoma by biopsy and CT were studied.CDFI was used to observe its size,the peak systolic velocity (PSV),resistivity index (RI),and record its classification of blood flow before and after induction chemotherapy,after radiotherapy 1 to 2 months for ultrasound,respectively,and the measured values and short-term effect in cervical lymph node metastasized were compared.Results According to the changes of blood supply after induction chemotherapy,lymph nodes were divided into three groups,the group of improve blood supply was given priority (55 ％),blood supply to reduce and no change groups were 23 ％,22％,respectively.After induction chemotherapy and sequential radiotherapy,all lymph nodes were narrow,regression rate after induction chemotherapy in blood supply to reduce,improve and no change groups were 52％,36％,25％,respectively,the regression rates of sequential chemoradiotherapy were 90％,81％,70％,respectively,among three groups are in degressive tendency,differences were significant (P ＜ 0.05).The blood supply changes after induction chemotherapy related well with the regression rate of chemotherapy(r =0.572,P =0.000) and sequential radiotherapy(r =0.553,P =0.000).The regression rate of chemotherapy related well with the regression rate of sequential chemoradiotherapy(r =0.621,P =0.000).After chemotherapy three groups of lymph node RI decreased,the difference was significant compared with that before treatment (P ＜ 0.05).After chemotherapy the groups to reduce and improve of PSV had significant differences compare with that before treatment (P ＜ 0.05),the group of blood supply no change of PSV had no significant difference (P ＞ 0.05).Conclusion Application of CDFI can clearly and accurately observe changes of metastatic cervical lymph nodes from nasopharyngeal carcinoma before and after induction chemotherapy,and the changes of blood supply and size after induction chemotherapy can predict the short-term effect after chemoradiotherapy.

Objective To evaluate the clinical effect of trans reformed catheter infusion for treatment of fallopian tube obstrution with Yuebei infertility.Methods 86 cases of fallopian tube obstrution were recanalized by trans reformed catheter infusion. Results 86 cases with 169 obstructive fallopian tube altogether, among them 119 were recanalized by once of this procedure, 33 by twice. The total effective rate was 89.9%. 86 cases were all followed up including 39 cases got pregnant after once of this procedure, 18 were pregnant after twice of the performance. The total pregnancy rate reached 66.3%. Conclusions Trans reformed catheter infusion therapy is a safe and effective method to treat infertility resulted from fallopian tube obstruction.

Objective To explore the efficacy and safety of glucocorticoids+cyclophosphamide+tacrolimus capsules (GC+CTX+FK506) in the treatment of patients with type Ⅲ+V and Ⅳ+Vlupus nephritis. Methods The 31 cases with first diagnosis as systemic lupus erythematosus (SLE) with type Ⅲ+V and Ⅳ+Vlupus nephritis (LN) were selected, then divided into group A (CTX+GC) with 16 cases and group B (FK506+CTX+GC) with 15 cases. The group A received CTX+GC during treatment, group B received GC+CTX+FK506 for the first three months, and received FK506+GC for the last three months. The patients were followed up once monthly to observe the efficacy and safety,the efficacy was analysed after 6 months. Results After treatment, the total efficacy in group B was significantly higher than group A (86.7%vs.50.0%, P<0.05). The 24 h urine protein of group B was lower than group A(P<0.05). The plasma albumin of group B was higher than group A (P<0.05). After treatment, the systemic lupus erythematosus disease activity index (SLEDAI) in two groups were lower and C3 level was higher than those pre-treatment(P<0.05), but there was no significant difference in above indicators between two groups. There was one case menelipsis in group A, and one case with transient increasing of creatinine. Conclusion The FK506+CTX+GC could reduce urine protein sifnificantly compared with CTX+GC without serious adverse reaction.

Objective Using chemically synthesized small interfering RNA (siRNA) transfected HepG2.2.15 cells to construct a cell model in interfering hepatitis B virus (HBV) X gene, studying the inhibi-tion of HBV replication and antigen expression in vitro. Methods After transfection of HepG2.2.15 cell for 24 h, 48 h, 72 h, detecting the cell supernatant of HBsAg and HBeAg by chemiluminescence immunoassay, the cell supernatant HBxAg protein by ELISA , the HBx mRNA relative expression of transfected cell was detected by fluorescence quantitative polymerase chain reaction (PCR), the ability of cell proliferation was detected by CCK-8 assay. Results After HBx-siRNA transfected HepG2.2.15 cells, cell proliferation ability was inhibited. The cell of HBx mRNA and the cell supernatant of HBxAg expression decreased (P < 0.05); at the same time it in-hibited the expression of HBsAg and HBeAg. The suppressed peak and the inhibition rate were 66% and 58%respectively at 72 h. The fluorescence quantitative PCR confirmed that expression of HBV DNA in the super-natant was decreased. Conclusion The HepG2.2.15 cell interference model of HBV X gene has been success-fully constructed, which has an effect of inhibiting proliferation of HepG2.2.15 cells and replication and expres-sion of HBV gene in vitro.

Objective To investigate the role and the mechanism of ppk1 gene (coding for polyphosphate kinase 1) in oxidative stress resistance in uropathogenic Escherichia coli (UPEC).MethodsMutant strains with ppk1-deletion (△pk1) and complemented strains (△pk1-C) were constructed based on the UPEC strain CFT073.A comparative analysis was conducted to analyze survival rates of CFT073, △pk1 and △pk1-C strains at different time points while they were under oxidative stress.Differences in protein expression between CFT073 and △pk1 strains were analyzed using mass spectrometric analysis.Differences between CFT073 and △pk1 strains in expression of katG and katE genes were analyzed using real-time quantitative RT-PCR.Results The survival rate of △pk1 strains was lower than that of CFT073 strains at every time point, while the survival rate of △pk1-C strains was basically the same as that of CFT073 strains.Gel image analysis and mass spectrometric analysis revealed that six proteins were down-regulated and one was up-regulated in △pk1 strains as compared with those in CFT073 strains.Expression of the catalase-coding genes katG and katE in △pk1 strains were respectively (20.5±8.2)% and (20.9±6.9)% of those in CFT073 strains (P<0.05).Conclusion The ppk1 gene plays an important role in oxidative stress resistance in UPEC by modulating the expression of catalase-coding genes katG and katE.

To develop the awareness of in student nurses during their clinical nursing practice for the prevention of legal disputes and protection of patients’ safety. Enough efforts should be made to strengthen legal education at the beginning, to enrich legal knowledge in the middle, and to stress nursing safety and related countermeasures towards the end of the clinical nursing practice. It is necessary to have student nurses under the supervision of the teachers make sure that they are aware of and abide by the law all the time.

Objective To compare the blood glucose level and associated hypoglycemia risks between group of insulin glargine combined with repaglinide and group of mixed insulin in the treatment of type 2 diabetes in the elderly. Methods Sixty four type 2 diabetes patients (age≥60 years) with inadequate glyeaemic control by drugs were divided into 2 groups randomly: glargine group (32 cases) and mixed insulin group (32 cases). In glargine group, 32 patients were given repaglinide before breakfast, lunch, supper respectively and injection of glargine hypodermically once at 22 o'clock every night, while the 32 patients in mixed insulin group were injected with the mixed insulin (Novolin 30R) hypodermically before breakfast and supper respectively for 16 weeks. The dose of repaglinide and insulin were adjusted every 3 days according to the level of fasting glucose (FPG)and postprandial glucose (PPG), reaching the aim of FPG less than 7.2 mmol/L and PPG less than 10mmol/L. The blood glucose level and the incidence of hypoglycemia were observed. Results The daily glucose profile and the level of HbAlc of the 2 groups dropped obviously after 16 weeks treatments (all P<0. 05). At the end of the experiment, the PPG of lunch and supper, and the level of HbAlc were markedly lower in glargine group than in mixed insulin group (all P<0. 05), and the body mass index (BMI) increased markedly in mixed insulin group compared with pre-experiment (P<0. 05), but no significant change was found in glargine group (P>0. 05). The incidence of hypoglycemia in glargine group was lower than that in mixed insulin group (2 patients in glargine group, 12 patients in mixed insulin group, P<0.05). Conclusions Both of the mixed insulin and glargine combined with repaglinide have visible effects on controlling the blood glucose, but the latter has better efficacy, lower risk of hypoglycemia and lower increase of BMI than the former.

Objective To evaluate the efficacy of different treatment regimens for children with acute promye-locytic leukemia (APL)with positive PML -RARa fusion gene.Methods Thirty -two newly diagnosed APL patients were included in this study,treated either with all -trans -retinoic acid (ATRA)and chemotherapy (CT)(group A) or with ATRA and arsenic trioxide (ATO)(group B).Clinical situation and clinical efficacy were analyzed in patients in different groups.They were also separated into low risk group,intermediate risk group and high risk group according to different risk criteria.Clinical characteristics,complete remission,long -time survival and urine arsenic concentra-tion were analyzed and compared.Results (1 )Fourteen of 1 5 patients (93.3%)in group A achieved hematological complete remission (HCR)with a median time of 38 days (28 -63 days).Sixteen of 1 7 patients (94.1 %)in group B achieved HCR with a median time of 29 days (1 0 -42 days),which was significantly shorter than group A,and there was a significant difference between 2 groups(t =3.53,P =0.002).(2)The 5 -year event -free survival (EFS)of group A and group B was (60.0 ±1 2.6)% and (81 .9 ±9.5)%,respectively;the 5 -year EFS of group B was almost 20% higher than group A;while there was no significant difference between the 2 groups(χ2 =1 .1 5,P =0.28).The 5 -year overall survival (OS)of group A and group B was (72.2 ±1 1 .9)% and (94.1 ±5.7)%,respectively,the 5 -year OS of group B was almost 20% higher than group A;while there was no significant difference between the 2 groups(χ2 =2.88,P =0.1 6).(3)The 5 -year EFS of low plus intermediate group and high risk group patients was (74.0 ±1 0.1 )% and (64.8 ±1 4.3)%,the 5 -year EFS of low plus intermediate group was almost 1 0% higher than high risk group,but there was no significant difference between the 2 groups(χ2 =0.1 4,P =0.71 ).The 5 -year OS of low plus intermediate group and high risk group patients was (84.7 ±8.1 )% and (71 .3 ±1 4.1 )%,the 5 -year OS of low plus intermediate group was almost 1 0% higher than high risk group,while there was no significant difference be-tween the 2 groups(χ2 =0.36,P =0.55).(4)ATO related side effects were mild,including abnormal liver tests and e-lectrocardiogram,but were invertible after supportive therapy.At the end of each chemotherapy course,the urine arsenic concentration remained low and no chronic arsenic toxicity or second malignancies were found during the follow -up period.Conclusions The ATRA plus ATO regimen is a promising and better treatment for childhood APL with positive PML -RARa fusion gene compared with conventional chemotherapy.It was necessary to take risk stratification in APL patients.

In order to investigate the levels of stem cell factor (SCF) and its receptor c-kit protein and mRNA in pediatric aplastic anemia (AA) and their relevance to the pathogenesis, immunocytochemical and in situ hybridization were utilized to detect the expression of SCF and its receptor c-kit gene protein and mRNA, respectively in 59 children with AA and 51 normal controls. The relationship between SCF and c-kit and the pathogenesis of AA was analyzed subsequently. The results showed that the positive rate of SCF protein and mRNA expression in children with AA was significantly lower than that in healthy controls (P < 0.05). However, there was no significant difference in the positive rate of c-kit protein and mRNA expression between children with AA and control group (P > 0.05). It was concluded that the expression of SCF is significantly decreased in children with AA, which may be closely associated with the pathogenesis of the AA. c-kit may be unrelated to the development of pediatric AA. Therefore, AA in children may have abnormalities at SCF/c-kit signal transduction levels.
Anemia, Aplastic/etiology ; Anemia, Aplastic/*metabolism ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Receptors, Colony-Stimulating Factor/*biosynthesis ; Receptors, Colony-Stimulating Factor/genetics ; Stem Cell Factor/*biosynthesis ; Stem Cell Factor/genetics

Objective To evaluate the short-term outcome of local intraarterial thrombolysis in patients with acute ischemic stroke of the anterior circulation. Methods 24 patients with acute ischemic stroke of the anterior cir-culation within 8 hours were treated by local intraarterial thrombolysis. Arterial recanalization was divided into total, partial and occlusive respectively according to angiography. Evaluation of clinical outcome was performed on the 30th day after thrombolysis,and was classified as good for Modified Rankin Scale (MRS) scores of 0 to Ⅲ and poor for MRS scores of Ⅳ to Ⅵ. Results Total recanalization was obtained in 54.2 % of patients, partial recanalization in 25.0%. Clinical outcome was good in 15 patients (62.5%). Cerebral hemorrhage occurred in 4 patients (16.7%). Four patients died (16.7%). Conclusion Local intraarterial thrombolysis is an effective method for treatment of a-cute iachemic stroke of the anterior circulation. It needs further practice and long-term follow-up study on safety and long-term efficacy.