Objective To study the effect of nuclear factor-kappa B (NF-κB) inhibition by small interference RNA (siRNA) on the apoptosis of DTC cells treated by 131 I.Methods DNA binding assay was performed at 24 h after 131I treatment (2 × 104 MBq/L) on KTC-1 cells.The cell survival assay was conducted at 48 h after 131 I treatment.Western blot was used to detect the changes of NF-κB p65 at 6 h after 131I treatment,and the changes of anti-apoptotic factors and apoptotic key factors at 24 h after 131 I treatment.The anti-apoptotic factors included in this study were X chromosome-linked inhibitor of apoptosis (XIAP),cellular inhibitor of apoptosis 1 (cIAP1) and B-cell lymphoma extra large (Bcl-xL),and the apoptotic key factors were caspase 3 and poly-ADP-ribose polymerase (PARP).A total of 4 groups were studied for the detection of p65 and anti-apoptotic factors by Western blot:no oligonucleotide transfection control group (A),no oligonucleotide transfection + 131I group (B),scrambled oligonucleotides transfection + 131I group (C) and p65 siRNA transfection + 131I group (D).Another 6 groups of studies were:oligonucleotide transfection control group (1),scrambled oligonucleotides transfection group (2),p65 siRNA transfection group (3),no oligonueleotide transfection + 131I group (4),scrambled oligonucleotides transfection +131I group (5) and p65 siRNA transfection + 131I group (6).One-way analysis of variance and q test were performed for statistical analysis.Results The results of DNA binding assays for the 6 groups (1,2,3,4,5,6) were (100.00 ± 11.65)％,(96.00 ± 17.98)％,(9.28 ±5.01)％,(322.72 ±50.81)％,(311.36 ±44.81)％ and (36.96 ± 15.66)％,respectively (F =137.74,P ＜0.01).NF-κB functions were strengthened with 131 I treatment (qgrouo 4∶1 =10.90,qroup 5∶2 =11.38,both P ＜ 0.01).However,NF-κB p65 siRNA transfection could inhibit NF-κB functions (qgroup1∶3 =18.25,qgroup4∶6 =13.71,both P ＜0.01).Cell survival rates of the 6 groups were (100.00 ± 11.65)％,(96.32 ± 9.44)％,(70.88 ±7.41)％,(64.16 ±9.50)％,(62.24 ±9.37)％ and (28.64 ±6.74)％ (F=52.76,P＜0.01).There were significant differences between groups 3 and 6,groups 4 and 6 (q =10.76 and 7.79,both P ＜ 0.01).Western blot results showed that the expression of NF-κB p65 in the 4 groups (A,B,C,D) were (56.60 ±7.37)％,(111.07 ± 13.31)％,(113.16± 15.04)％ and (12.46 ±2.74)％,respectively (F=60.17,P ＜ 0.01).The t65 levels increased with 131 I treatment (qgroup B∶A =6.20,qroup c∶ A =5.85,both P ＜0.01); while decreased significantly using NF-κB p65 siRNA transfection (qgroup B:D =-12.57; qgroupC∶D =11.41,both P ＜ 0.01).Western blot results showed that XIAP,cIAP1 and Bcl-xL in the 4 groups were (17.59±1.96)％,(16.45± 1.85)％ and (19.92 ±2.22)％; (98.37± 17.92)％,(109.81 ±19.16)％ and (95.59 ±22.20)％ ; (98.43 ±18.71)％,(98.86± 15.88)％ and (100.99 ±21.70)％ ;(7.00 ± 0.95) ％,(5.86 ± 0.35) ％ and (9.52 ± 0.90) ％,respectively (F =44.22,56.51 and 29.11,all P ＜ 0.01).131 I treatment induced higher expression of all the 3 genes (qgroup B∶ A =7.76,8.40 and 5.88,all P ＜0.01),while NF-κB p65 siRNA transfection,on the contrary,reduced the expression of all the 3 genes (qgroupB:D =8.82,9.40 and 6.71,all P ＜0.01).There were significant differences of p19,p17,p116 and p89 in the 6 groups(F =39.03,48.45,32.56,52.20,all P ＜ 0.01),especially among group 3,4 and 6 (q =3.18-9.98,all P ＜ 0.05).Conclusions 131I could activate NF-κB function and enhance the expressions of anti-apoptotic factors.NF-κB p65 siRNA transfection could effectively suppress this effect and therefore magnify 131I induced apoptosis in DTC cells.

Objective: According to the medical system reform’s requirement of “strengthening supervision, increasing the public health investment, reforming the compensation mechanism of public hospital, establishing public hospital performance evaluation and incentive system”, public hospitals should continue to reform its management system optimization, performance appraisal is the core content of hospital internal reform performance appraisal method, which is an important guarantee for the results of hospital performance evaluation. Methods: The study on the assessment methods of hospital performance, use “public hospital”, “performance” and“performance evaluation” as the keywords to search the Chinese HowNet and Wanfang database retrieval and 142 articles; by reading the whole passage and the method of stratified sampling, the common performance appraisal method are used to collect and collate, eventually the assessment method of hospital performance of 32 Chinese literature references are included in the study. Results:Summarize the evaluation methods of hospital performance application condition advantages, disadvantages and present situation, and establish a set of performance evaluation methods with the management of public hospitals more perfect, scientific and detailed theoretical basis. Conclusion: In the process of the medical system reform, according to the characteristics of hospitals, to choose suitable and effective performance appraisal methods to help the performance management in hospital, and receive more economic benefits while maximize social benefits.

OBJECTIVE: To study the changes of SOD, GSH and MDA in the renal tissues of diabetes rat models through the comparison of their metabolic features. METHODS: Two types of diabetes rat models were established by feeding high-lipid food along with small dose injecting of streptozotocin (STZ) (model group 1) and repeated small dose injecting of STZ with complete Freund's adjuvant (CFA) (model group 2). And changes of the following were observed: body weight, urine volume, blood sugar, blood lipid, serum insulin, insulin sensitive index (ISI),superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA) of the renal tissues. RESULTS: The body weight of the two model groups of rats decreased, while the urine volume and the blood sugar increased predominantly. These indexes of the two model groups were significantly different from those of the normal group (P<0.05). The renal tissue MDA level increased while the SOD and GSH level decreased in both model group 1 and model group 2, but the changes in model group 1 were more obvious than those in the model group 2. The serum insulin level which decreased in model group 2 did not decrease significantly in model group 1, but the ISI in model group 1 decreased more significantly than that in model group 2 (P<0.05). CONCLUSION: The antioxidase activity decreased in renal tissues of diabetes rats and hyperlipidemia was the main cause of the corresponding oxidations.

OBJECTIVE: To study the modifying effect and mechanism of Tangshenning Recipe on micro-albuminuria in rats with early diabetic nephropathy (DN). METHODS: Male Wistar rats were randomly divided into the normal group (n=8) and model group (n=24). Intraperitoneal injecting of streptozotocin (STZ) plus complete Freund's adjuvant (CFA) was applied once a week for 3 times to induce the DN rats model. Three weeks later, the model group rats were randomly divided into pathologic group (n=8), monopril group (n=8) and Tangshenning Recipe group(n=8) according to the 24 h U-Alb. Each group's renal hemodynamics index and SOD, GSH, MDA in renal tissue were determined by radioimmunoassay (RIA) and colorimetric method respectively. RESULTS: The levels of plasmatic TXB(2), the ratio of TXB(2) and 6-keto-PGF1alpha, and the CGRP in pathologic group were significantly higher than those in normal group. The levels of plasmatic ET decreased obviously, SOD decreased and MDA increased significantly in the rats' renal tissue of pathologic group. The levels of plasmatic TXB(2), the ratio of TXB(2) and 6-keto-PGF1alpha decreased significantly in both Tangshenning Recipe group and monopril group, and the therapeutic effect of Tangshenning Recipe group was better than that of monopril group. SOD was higher and MDA was lower in Tangshenning Recipe group than that in pathologic group. CONCLUSION: The results indicates that Tangshenning Recipe can lower the micro-albuminuria in early DN rats, the mechanism of which probably lies in the modification of glycometabolism, the ratio of TXB(2) and 6-keto-PGF1alpha, the plasmatic CGRP and the renal lipid preoxidation.

Objective To study the X-ray characteristic of non-bacterial infectious pneumonia in children.Methods In 218 cases of non-bacteria infectious pneumonia, the pathogenic agents included influenza virus,parainfluenza virus,respiratory syncytial virus(RSV),adenovirus,mycoplasma(MYCO) and chlamydia.Of them,mono-pathogenic infection were 152,mixed infection were 66.All the cases had chest conventional radiograph,129 cases were followed up for 2 times or more.The average period of the follow up were 7 days.The findings of chest conventional radiograph were analysed.Results The radiographic features included lung marking heavy 197,disorder 187,straight 105 and obscure 194;pulmonary hilum enlarged 91,hilum obscure 93,emphysema 82,point opacities 81,pulmonary radio-translucent diminution 34,patch opacities 33.In 129 cases followed up the lesions were perfectly absorbed 9(6.97%),partly absorbed 56(43.41%),non-absorbed 53(41.08%),progress 7(5.42%).Conclusion The absorbed period of non-bacteria infectious pneumonia is more 7 days.There are some radiographic characteristcs in RSV and MYCO pneumonia.

Objective To investigate the correlation between external dose equivalent rate (EDER)and residual radioactivity in DTC patients after 131I therapy.Methods A total of 70 DTC patients (15 males,55 females;average age (45.7±12.8) years) who received 131I therapy from January 2015 to May 2015 were reviewed.Patients were divided into remnant ablation group (Group 1,43 patients) and the group of therapy for persistent disease (Group 2,27 patients).The determination of dose equivalent rate at 1,2 and 3 m from the patients was performed at 1,6,18,24,30,42,48,54,66 and 72 h after the administration of 131 I.Simultaneously,the residual radioactivity was estimated through collecting their urine and monitoring the excretion of radioactivity.The correlation between EDER and residual radioactivity was analyzed.Results The functions of standard EDER (μSv · h-1 · MBq-1) at 1 m from the patients of Group 1 and Group 2 were H=0.044 77e-0.063 8t +0.015 04e-0.396t.and H=0.039 71e-0.0629t +0.014 12e-0.325t,respectively.And the functions of residual radioactivity (MBq) of the two groups were A =A0(0.84e-0.061 7t+ 0.16e-0.158 4t)and A =Ao(0.69e-0.087 7t+ 0.31e-0.047 3t),respectively.There was a positive correlation between EDER and residual radioactivity in DTC patients after the administration of 131I (r=0.95,P＜0.001).The fitting function of the dose equivalent rate at 1 m from the patients was H(μSv/h)=0.048A (MBq).Conclusions The residual radioactivity in DTC patients after 131 I therapy can be estimated by determining the EDER.The dose equivalent rate at 1 m from the patients of lower than 19.2 μSv/h can be used as the limitation of radiation isolation.

Objective To analyze the efficacy of 131I therapy for Graves' disease,and to investigate the incidences of complete remission and hypothyroidism after single or multiple treatments.Methods Altogether 2 125 patients with Graves' disease (614 males,1 511 females) aged (39.8 ± 10.2) years received 131I treatment.The diagnostic and therapeutic procedures were carried out as follows:physical examination,determination of thyroid hormones and antibodies,undergoing 131I uptake test to obtain maximum of thyroid uptake value and effective half-life time,ultrasonography,thyroid imaging,calculating 131I therapeutic dosage,131I treatment,follow-up appraisal of curative effect.The data were analyzed by x2 test,optimal scale regression,logistic regression and discriminant analysis.Results The rates of complete remission,hypothyroidism,partial response,and invalid in the 2 125 cases more than half a year after 131I therapy were 54.3 ％,21.3 ％,20.3 ％,and 4.1％ respectively.In all patients the rate of clinical cure (including complete remission and hypothyroidism) and rate of effectiveness were 75.6％ and 95.9％ respectively.The rate of recovery and incidence of hypothyroidism in patients who accepted single 131I treatment were 52.4％ and 21.2％ respectively,while in patients who accepted twice or multiple 131I therapy the respective figures became 66.2％ and 21.8％ accordingly.The influential factors in the effectiveness of 131I treatment included age,thyroid weight,TSH receptor antibody (TRAb),and dose of 131 I per gram of thyroid.Conclusions Patients who did not achieve clinical cure for over 6 months after first 131 I treatment,may receive another131 I therapy to further improve the remission rate.Age,thyroid weight,TRAb etc,contribute to the efficacy of 131I therapy for Graves' disease.The multi-perspective and multi-factor analysis would have the benefit to establish individualized treatment strategy.

Objective To improve the recognition of treatment of adult T lymphoblastic lymphoma (TLL) with Hyper-CVAD regime.Methods The turnovers of 7 cases treated with Hyper-CVAD regime were summarized.Results Among the 7 cases,1 case died after the first unfinished chemotherapy,1 case gained complete remission before autologous stem cell transplantation but relapsed after transplantation,3 cases gained complete remission until now,2 cases without transplantation relapsed and then gave up following treatments after treating with ICE regime or the virgin regime,but the therapeutic effects were poor.Conclusions Adult TLL should get early chemotherapy treatments,and some special characteristics should be noted,the treatment does not relate to the stage,the chemotherapy treatment should be carried out regularly and enough,radiation of mediastinum mass can be applied after 4 cycles of Hyper-CVAD regime,choose suitable transplantation method.

Objective To investigate the effects of remote ischemic postconditioning (RIPoC) on global cerebral ischemia-reperfusion (I/R) injury in rats.Methods One hundred and twenty-eight male adult SD rats weighing 200-250 g were randomly divided into 4 groups ( n =32 each):sham operation group (group S),group I/R,group I/R + RIPoC and remote I/R group (group RI/R ).Global cerebral I/R was induced by four-vessel occlusion.Group I/R + RIPoC received 3 cycles of 15 min reperfusion followed by 15 min ischemia in bilateral femoral arteries at the beginning of cerebral reperfusion.The rats were sacrificed at 24 and 48 h of cerebral reperfusion,and brains were removed for determination of neuronal apoptosis (by TUNEL method) in hippocampal CA1 region and the parietal cortex,Bcl-2 and Bax expression (by Western blot) in hippocampal CA1 region.The superoxide dismutase (SOD) and catalase (CAT) activity and malondialdehyde (MDA) content in hippocampal CA1 region and the parietal cortex were also measured at 48 h of cerebral reperfusion.Morris water maze task was used to test the learning and memory function at 4 d of cerebral reperfusion,and the rats were sacrificed at 7 d of cerebral reperfusion,and brains were removed for determination of neuronal density in hippocampal CAl region and the parietal cortex.Results Cerebral I/R significantly increased the number of apoptotic neurons and MDA content,upregulated Bcl-2 and Bax expression,decreased neuronal density,SOD and CAT activity and learning and memory function in group I/R as compared with group S.RIPoC significantly attenuated these cerebral I/R-induced changes.Conclusion RIPoC could protect brain against global cerebral I/R-induced injury,and the mechanism may be related to inhibiting lipid peroxidation,regulating the balance between Bcl-2 and Bax and inhibiting apoptosis.

Objective To investigate the efficacy and influential factors of 131I treatment for lung metastases from DTC.Methods Fifty patients (18 males,32 females;age (40.8±13.2) years) with lung metastases from DTC who underwent 131I treatment from October 2007 to December 2012 were retrospectively analyzed.The efficacy of 131 I treatment was assessed using 131I imaging and determination of serum Tg level after 6 months.The possible factors affecting efficacy included patients' age,gender,operation method,pathological classification,the diagnostic time of pulmonary metastasis,serum Tg level at diagnosis,131I uptake pattern,characteristics of other imaging modalities,cervical lymph node metastases and extrapulmonary distant metastases (assign 1 for metastases,0 for no metastases).Univariate and multivariate analyses (Student t test,Fisher exact test and logistic regression) were performed to investigate the factors.Results The rates of complete remission,partial response and invalid of 131I treatment were 20％ (10/50),74％ (37/50) and 26％ (13/50) respectively.Univariate analysis showed that age(t =2.019,P＜0.05),gender (P =0.032),serum Tg level at diagnosis (t =2.646,P＜ 0.05),findings of other imaging modalities (P =0.039),and extrapulmonary distant metastases(P=0.023) were the factors influencing outcome of 131I treatment.Multivariate logistic regression analysis showed that the influential factors included age,serum Tg levels and extrapulmonary distant metastases.The regression equation was as follows:logit P =2.127-0.056× age-0.163×Tg level-1.280×extrapulmonary distant metastasis (x2=10.484,P＜0.001).Aged patients,a significant increase of Tg level and extrapulmonary distant metastases indicated a poor prognosis.Conclusions 131I treatment is an effective method for lung metastases from DTC.The patients with younger age,lower Tg levels,no other distant metastases had good response to 131I treatment.