BACKGROUND: Basic fibroblast growth factor (bFGF), a kind of polypeptide growth factor possessing multifunctional biological activities,can protect neurons and promote the growth of nerves. It has been corfirmed that bFGF has therapeutic effects on retina ischemia/reperfusion injury (RIRI).OBJECTIVE: To establish RIRI model and analyze the effects of bFGF on cellular apoptosis of retina and the expression of regulatory gene protein.DESIGN: Randomized grouping and validating trial.SETTING: Department of Ophthalmology, the Affiliated Hospital of Medical College of Qingdao University.MATERIALS: The experiment was conducted at the Research Laboratory of Pathology, Department of Ophthalmology, Medical College of Qingdao University, from April 2002 to December 2003. Twenty-eight healthy Wistar rats were enrolled in this experiment. Four rats were randomly chosen for normal control group, the left eyes of the other 24 rats were set as normal saline control group, and the right eyes were set as bFGF group.METHODS: Normal saline control group and bFGF group adopted the rat RIRI models established by transiently elevating intraocular pressure. Normal saline of 12 μL was injected into the vitreous cavity of the left eyes of the rats in normal control group. 12 μL bFGF was injected into the vitreous cavity of the right eyes of the rats in bFGF group, 4 rats once. No administration was given in normal control group. The expression of apoptotic cells was detected and apoptosis indexes were calculated with the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) method and immunohistochemical staining method at the 1st, 6th,12th, 24th,48th and 72nd hours after reperfusion and ischemia for 1 hour.MAIN OUTCOME MEASURES: ① The detection results of apoptotic cells in situ of retina tissuesat different time points after reperfusion. ②The expression of Fas and caspases-2 in retina tissues at different time points after reperfusion.RESULTS ① Comparison of apoptosis indexes of retina tissues at different time points after ischemia reperfusion: There were no apoptotic cells in the retina tissues of the rats in normal control group. As compared with those in normal saline control group, apoptosis indexes in bFGF group were significantly decreased at ischemia 1 hour and reperfusion 1, 6, 12, 24, 48and 72 hours, especially at the 12th, 24th and 48th hours after reperfusion (t =5.362-5.595, P ＜ 0.05). ② The change of Fas expression at different time points after ischemia reperfusion: There was hardly any Fas expression in normal control group. As compared with that in normal saline control group, Fas expression in bFGF group was significantlydecreased at ischemia 1 hour and reperfusion 1, 6, 12, 24, 48 and 72 hours, especially at the 6th, 12th and 24th hours after reperfusion (t=3.954-9.327, P ＜ 0.05). ③The changes of caspase-2 expression at different time points after ischemia reperfusion: There was no caspase-2 expression in normal control group.Compared with that in normal saline control group, the number of caspase2 positive cells in bFGF group was significantly decreased at the 6th,12th,24th, 48th and 72nd hours after ischemia for 1 hour and reperfusion (t=4.125-15.641, P ＜ 0.05).CONCLUSION: bFGF can significantly inhibit the expression of apoptosis gene Fas and caspase-2 in the ischemia and reperfusion of retina, thus reducing cellular apoptosis of ganglion cells and exerting therapeutic effects on the ischemia and reperfusion of retina.

The application of cerebrovascular intervention brings the diagnosis and treatment of cerebrovascular disease into a brand-new domain. Many neurological physicians have become physicians of cerebrovascular intervention by training. In the big teaching hospitals carrying out cerebrovascular intervention, advanced physicians are the hard strength in the lot of cerebrovascular intervention. The training aiming at cerebrovascular intervention and comprehensive abilities affects both the training results and the therapeutic results of cerebrovascular intervention. Therefore, it is an important issue to explore how to consummate and standard the training methods of advanced physicians studying cerebrovascular intervention.

Objective To determine whether color doppler ultrasonography (CDU),thyroid function or thyroid autoimmune antibodies could identify Graves' disease in pregnancy(GDP) in pregnant patients with newly diagnosed thyrotoxicosis.Methods It is an observational study.Sixty-eight pregnant patients with newly diagnosed thyrotoxicosis including gestational hyperthyroidism (GHT) subjects (GHT group,n =33) and GDP subjects (GDP group,n =35),and 62 age-and sex-matched healthy subjects (C1 group:pregnant,n =32,C2 group:non-pregnant,n =30) were recruited.Thyroid function,human chorionic gonadotropin(HCG),thyroid autoimmune antibodies were detected.Peak systolic velocity of the superior thyroid artery (STA-PSV) and diastole inner diameter(STA-D) of the superior thyroid artery were measured by CDU.A ROC curve was used to evaluate STA-PSV,STA-D,thyroid function and thyroid autoimmune antibodies for identification of GDP.Results The area under the ROC curve of STA-PSV,STA-D and thyroid stimulating hormone (TSH),free T4 (FT4) for GDP were 0.905,0.887,0.803 and 0.786,respectively.The optimal cut-off points of STA-PSV,STA-D,TSH and FT4 for GDP were 40 cm/s,2.0mm,0.03 mIU/L and 30 pmol/L with the sensitivity of 82.9％,72.1％,81.8％,76.2％ and specificity of 81.8％,87.9％,75.2％,80.3％,respectively.Conclusions Detection of STA-PSV and STA-D by CDU,as well as thyroid function,is useful in screening GDP in pregnant patients with thyrotoxicosis.

Hepatocellular carcinoma ( HCC) , as one of the most common malignant neoplasms , has a relatively high morbidity and mortality rate worldwide.MicroRNAs (miRNAs),a type of comparatively conserved endogenous small non-coding RNAs, function as pivotal regulators involved in various biological functions through the post -transcriptional regulation of gene expression .Some miRNA genes are arranged into a intandem model and reside close together on the same chromosome , forming miRNA clusters . These clustered miRNAs are mostly located on polycistronic transcripts and expressed at similar levels.In the human imprinted 14q32 region, 52 miRNA genes are organized as a large cluster which spans about 220 kb of the long arm ( q) .Lines of evidence show that dysregulation of miRNAs in this cluster are involved in the development of HCC .This review summarizes the structural characteristics of 14 q32 miRNA cluster as well as its impact on HCC in initiation and progression .

Objective To pay attention to screening family disease and gene examination in patient with congenital adrenal hyperplasia (CAH). Method In this study, we investigated clinical data and performed gene sequencing of the pedigree and his family members with CAH. Results Based on clinical data, 3 of 6 family members were diagnosed CAH. Bone age of two boys nearly reach the maximum value. Genetic sequencing result indicated a T>A mutation of 1 004 position in CYP21A2 gene, which induced protein change I172N. Conclusion Disease screening and gene examine should be actively executed in patient with CAH in order to obtain diagnosis and start treatment as early as possible.

Objective To retrospectively analyzed the current application of warfarin in hospitalized patients with non-valvular atrial fibrillationand ( NVAF), explore the key role of clinical pharmacists in warfarin medication. Methods A retrospective survey of anticoagulant therapy for 179 hospitalized patients with non-valvular atrial fibrillation in Renming Hospotal of Wuhan University from January to December 2013 was retrived,including the usage of warfarin for NVAF and new-onset atrial fibrillation,dosage,international normalized ratio(INR),hemorrhage event and so on.The simple factor like the age,complicated chronic diseases and previous cerebrovascular events on the use of warfarin was explored. Results The total response rate to anticoagulants was 85.6% for patients with high risk of stroke(27.3% with warfarin and 58.3% with antiplatelet therapy),who are recommended to use warfarin,patient were treated with anti-thrombotic therapy.The total of 19.1% of the patients with new-onset atrial fibrillation used warfarin as therapy.The whole monitoring rate of INR was 89.8%,and the good control rate was 11.9%. Univariate analysis showed that some high risk factors such as age and high blood pressure affected the usage of warfarin. Conclusion The anti-thrombotic therapy for NVAF patients in the hospital is good,but usage of warfarin for those with new-onset atrial fibrillation is low,which couldn't reach the INR standard. More attention should be taken by the clinic pharmacists in effective managing the use of anticoagulant to build a safe,economic and effective medication system for warfarin application.

Objective To investigate the level of professional commitment of nursing baccalaureate students,and explore the relationship between the professional commitment and communication ability.Methods Questionnaires were used to investigate 430 nursing baccalaureate students who were studying in the school.Results The professional commitment of nursing students was in the middle level.Correlation analysis revealed that the communication ability was correlated with the professional commitment.Conclusions We should take measures to improve the competency of professional commitment of nursing undergraduate students,strengthen their communication ability,promote the construction of nursing staff.

Four methods of breeding high producing strain of Lipase are studied. As a result, the Lipase activity produced by one strain is 93 times as high as befor, and the Lipase activity produced by another is 3.0 times. On these bases, the effects of four methods in breeding are discussed, and the usinng Fast Neutron is more effective method in breeding.

OBJECTIVE:To know the status quo of clinical pharmacy in main hospitals of Jiangsu province primarily,and to provide reference for promoting the construction of clinical pharmacist system and playing active role of clinical pharmacists on rational drug use and pharmaceustical care.METHODS:A mailed questionnaire investigation was conducted among 28 committee members (coming from 28 hospitals) of the Clinical Pharmacy Branch of the Medical Association in Jiangsu Province regarding the status quo of the clinical pharmacy practice,and the correlated data and results were summarized to statistical analysis.RESULTS:A total of 28 questionnaires were distributed and 28 valid questionnaires were collected,with recovery rate of 100％.Among 28 hospitals,there were 25 general hospitals and 26 third grade class A hospitals.There were 312 full-time and part-time clinical pharmacists;there were 7.32 full-time clinical pharmacists and 3.82 part-time clinical pharmacists in each visited hospital;the proportion of full-time clinical pharmacists with master's degree and intermediate title was significantly higher than that of part-time clinical pharmacists (P＜0.05).There were 144 full-time clinical pharmacists who had been trained to obtain clinical pharmacists qualifications (70.24％).In 13 hospitals with the qualification of clinical pharmacist training base of National Health and Family Planning Commission (NHFPC),the average number of teachers was 3.77;in 5 hospitals with the qualification of provincial clinical pharmacist training base,the average number of teachers was 5.80;in a hospital with the qualification of clinical pharmacist training base of NHFPC,the number of teachers was 5.The surveyed hospital had the highest proportion of clinical pharmacy related work to participate in daily physician rounds,doctor's advice and prescription review,special review of antibiotics,drug record writing,pharmaceutical information service,outpatient drug consultation and ADR monitoring,all being 100％.Expert consultation clinic occupied the lowest proportion of clinical pharmacy work (10.71％).Setting up pharmacy for operation and anaesthesia department (28.57％),community pharmaceutical care (57.14％),pharmacogenomic testing (46.43％) and participating in the management of drug clinical trials (53.57％) occupied the lower proportion of clinical pharmacy related work.The proportion of clinical pharmacy work in training base hospital was higher than that non-training base hospital.Compared to surveyed hospitals,there was statistical significance in the proportion of special review for antineoplastic drugs,hormone drugs and blood products,expert consultation,setting up pharmacy for operation and anaesthesia department,community pharmaceutical care,pharmacogenomic testing and participating in the management of drug clinical trials in provincial clinical pharmacist training base (P＜0.05).There was statistical significance in the number of specialist consultation,case analysis,inpatient injection medical orders,check pharmacy intravenous admixture medical orders and checked outpatient prescriptions,varieties and number of monitored therapeutic drugs as well as case number of pharmacogenomic testing (P＜0.05).CONCLUSIONS:It is suggested to strengthen the construction of clinical pharmacist team in third grade class A hospital in Jiangsu province,accelerate the transition of part-time clinical pharmacists,at the same time,further improve the development of clinical pharmacy related work.

Objective To access the efficacy of the arterial based complexity (ABC) scoring system in predicting complexity of LPN.Methods A total of 70 patients underwent laparoscopic partial nephrectomy from January 2013 to November 2015 were enrolled in the retrospective analysis.Among those patients,53 (75.7％) were males and 17 (24.3％) were females.Their mean age was 52 years,ranged from 44 to 61 years.The average BMI was 28 kg/m2,ranged from 25 to 32 kg/m2.Before operation,the average creatinine was 70.5 μmol/L,ranged from 60.5 to 81.0 μmol/L.43 patients accepted the procedure via retro-peritoneal approach and 27 patients accepted the procedure via peritoneal approach.38 tumor located in the left kidney and 32 tumor located in the right kidney.By using ABC scoring system,four readers independently scored contrast-enhanced computed tomography images of 70 patients who underwent laparoscopic partial nephrectomy.Interobserver variability was assessed with kappa values and percentage of exact matches between each pairwise combination of readers.Logistics regression was used to evaluate the association between reference scores and ischemia time,estimated blood loss,operation time.Results The operative duration ranged from 100 to 180 min,mean 147 min.The mean ischemic time ranged from 15 to 37 min,mean 24 min.The average blood loss was 210 ml (ranging 50-380 ml).The mean hospitalization was 16 days (ranging 11-21 days).The urine leakage was noticed in 2 patients after the operation.The size of tumor ranged from 1.8 to 3.0 cm,mean 2.5 cm.The pathological classification included renal cell carcinoma in 65 cases,renal cell carcinoma with cystic changing in 2 cases,renal chromophobe cell carcinoma in 2 cases,right renal solitary fibroma in 1 case.Based on the ABC scorirng system,15 cases were in 1 degree,29 cases were in 2 degree,17 cases were in 3S degree and 9 cases were in 3H degree.Pairwise comparisons of readers' score assignments were significantly correlated;average kappa =0.492,across all reader pairs.The average proportion of exact matches was 65％,the average proportion that differ between a level or less than a level was 98.6％.Logistics regression between the complexity score system and surgical outcomes showed significant associations between reference category assignments and warm ischemia time and estimated blood loss (P ＜ 0.05),but showed no significant associations with operation time (P ＞ 0.05).Conclusions The ABC scoring system for LPN demonstrated good correlation with perioperative morbidity.This system is a novel anatomy-reproducible tool developed to help patients and doctors understand the complexity of renal masses and predict the outcomes of kidney surgery.