Objective To investigate the early diagnosis value of arterial blood gas analysis , neuron specific enolase and serum glial fibrillary acidic protein in brain injury of premature infant. Methods In the study, 95 premature infants admitted in our hospital were enrolled. 45 premature infants with brain injury were selected as experimental group. 50 premature infants without brain injury were selected as control group. All patients received arterial blood gas analysis , NSE and GFAP on the 1st day and 7th day after birth. Results There is statistically significant difference between the experimental group and the control group on the 1st day after birth in terms of pCO2, pH, BE and lactic acid (P<0.05). In experimental group, there is statistically significant difference between the 1st day and 7th day after birth in terms of pCO2, pH, BE and lactic acid (P < 0.05). The NSE and GFAP levels had statistically significant difference between the experimental group and the control group on the 1st day and 7th day after birth(P < 0.01); the NSE levels of experimental group had statistically significant difference between the 1st day and 7th day after birth (P < 0.05); The GFAP levels of experimental group had statistically significant difference between the 1st day and 7th day after birth (P < 0.01). Conclusion pCO2, NSE and GFAP levels are correlated with brain damage in premature infants in early stage. This could provide evidence of early diagnosis for brain injury in preterm infants.

Objective To investigate the role of mylin basic protein,S100B and arterial blood gas analysis's levels in early diagnosis of brain injury in premature infant.Methods A total of 95 premature infants treated in our hospital were enrolled in the study.Experimental group was 45 premature infants with brain injury.Control group was 50 premature infants without brain injury were the.All patients were detected with arterial blood gas analysis,MBP and S100B on the 1st day and 7th day after birth.Results The pH,PCO2,BE,lactic acid,MBP and S100B's levels in experimental group were significantly different between the 1st day and 7th day after birth.In the 1st day after birth,compared with the control group,the pH,PCO2,BE,lactic acid,MBP and S100B in the experimental group were obviously high than that of control group.Conclusion On the 1st day after birth,monitoring arterial blood gas analysis,S100B protein and MBP's levels could be useful in early diagnosis of brain injury in preterm infants.

AIM:To investigate the effects of glucagon-like peptide-1 (GLP-1) on mRNA expression of SOCS-3 and SREBP-1c in the rats with nonalcoholic fatty liver disease.METHODS:Male SD rats were randomly divided into normal control ( NC) group, high fat ( HF) group and HF+liraglutide ( Lira) group.The rats in HF group and HF+Lira group were given high-fat diet for 16 weeks.After 12 weeks of high-fat diet feeding in HF+Lira group, Lira (600μg? kg-1? d-1 ) was intraperitoneally injected for 4 weeks.At the end of the 16th week, the rats were killed.The pathologi-cal changes of the liver were observed under optical microscope.The serum levels of alanine aminotransferase ( ALT) , as-partate aminotransferase ( AST) , triglyceride ( TG) and total cholesterol ( TC) were detected by automatic biochemical an-alyzer.TG contents of liver were measured by GPO-PAP method.The fasting insulin ( FINS) was determined by ELISA, and insulin resistance index was assessed by homeostasis mode assessment ( HOMA-IR) .The mRNA expression of SOCS-3 and SREBP-1c in the liver tissues was detected by RT-qPCR.RESULTS:Compared with NC group, HOMA-IR, TG of liver, and the serum levels of ALT, AST, TG, TC and FINS in HF group were obviously increased (P<0.01).Compared with HF group, HOMA-IR, TG of liver, and the serum levels of ALT, AST, TG, TC and FINS in HF+Lira group were all obviously decreased (P<0.05 or P<0.01).The mRNA expression of SOCS-3 and SREBP-1c in HF group was signifi-cantly higher than that in NC group (P<0.01).The mRNA expression of SOCSV3 and SREBP-1c in HF+Lira group was significantly decreased as compared with HF group (P<0.05).CONCLUSION:Liraglutide may improve the IR and re-
duce TG of liver through decreasing the mRNA expression of SOCS-3 and SREBP-1c, so as to play a therapeutic role in nonalcoholic fatty liver disease.

Objective To analyze the clinical and pathological characteristics of Alport syndrome in children. Methods Clinical and pathological information gathered from 62 patients during March 1989 to August 2012 was retrospectively analyzed. Results Four autosomal recessive Alport syndromes (AR-AS) and 58 X-linked Alport syndromes (XL-AS) were analyzed. Of the XL-AS, 47 were boys and 11 were girls. Most of patients induced by upper respiratory tract infections, and onset with hematuria and proteinuria. There was no signiifcant gender difference in family history, impaired renal tubular proteins, hypertension, im-paired renal function, hearing loss, ocular abnormalities or renal pathological changes under light microscopy. However, extensive lamination and split of glomerular basement membrane (GBM) dense layers were found in 83.0%male and 18.2%female patients (P=0.000) and the rest patients were presented with limited distribution of typical GBM changes. Proteinuria progressed signiif-cantly with age in XL-AS males (r=0.501, P=0.000). Five XL-AS patients developed to end stage renal disease (ESRD) between 11 to 16 years old. Conclusions XL-AS is the main inherited type and severe changes of GBM are common in XL-AS males. Proteinuria increases remarkably with age. The detection of type IV collagen in renal tissue or skin is helpful to diagnose Alport syndrome and conifrm inheritance modes.

Objective The aim of this study was to investigate the mechanism underlying pruritus by comparing the epidermal growth factor receptor inhibitor(EGFRI)-erlotinib mouse model with the substance P(SP)-induced pruritus mouse model. Methods Two randomized groups of mice were treated with erlotinib or SP to induce pruritus. Behavioral and skin manifestations were observed. Pathological images and neurokinin 1 receptor(NK-1R)expression of the skin were determined. Concentration of interleukin(IL)-31, IL-33, histamine, leukotriene B4, and SP was analyzed by enzyme-linked immunosorbent assay. Nitric oxide was analyzed by colorimetry. Results Transient pruritus induced by erlotinib appeared 2 to 5 days after treatment. In contrast, continuous pruritus was observed during the first hour, but was then gradually relieved. These two shared similar scratching behavior. Concentration of neurotransmitters showed similar trends in changes among the erlotinib group and SP group. Immunohistochemical expression was also consistent between the erlotinib group and SP group. Conclusions Erlotinib-associated pruritus is related to release of signaling factors through the SP/NK-1R signaling pathway.

Objective To investigate the effects of curcumin on myosin light chain kinase(MLCK)in the intestinal mucosa of rats with nonalcoholic fatty liver disease(NAFLD). Methods 35 SD rats were randomly di-vided into the normal control group ,the high fat group and the curcumin group. The high fat group ,curcumin group were given high fat diet for 16 weeks. After 8 weeks of high fat feeding in the curcumin group ,the rats were gavaged with 200 mg/(kg·d)curcumin for 8 weeks. The levels of ALT,AST,LPS and DAO in blood and expres-sion of MLCK in the intestinal mucosa were detected. The changes of liver pathology and tight junction(TJ)of the intestinal mucosa were observed. Results Compared with the control group,the blood levels of ALT,AST,LPS and DAO in the high fat group were obviously increased(P<0.05);Compared with the high fat group,the blood levels of ALT、AST、LPS and DAO in the curcumin group were obviously decreased (P < 0.05). In the high fat group ,hepatocellular steatosis was obvious ,while in the curcumin group hepatocellular steatosis was decreased. TJ was disrupted in the high fat group ,and the intercellular space was larger in the TJ group than the control group (P<0.05). The intercellular space was narrower in the curcumin group than the high fat group(P<0.05). The expression of MLCK in the high fat group was significant higher than that in the control group(P<0.05). The pos-itive staining in the curcumin group was significant lower than that in the high fat group (P < 0.05). Conclusion Curcumin can ameliorate hepatic steatosis by downregulating expression of MLCK in the intestinal mucosa of rats with NAFLD,improving TJ structure of the intestinal mucosa.

OBJECTIVE To investigate the effect of diallyl sulfide (DAS) in protection against acute lung injury in rats induced by paraquat(PQ). METHODS A total of 100 male Wistar rats were randomly divided into normal control group,PQ 70 mg·kg-1 model group,and DAS 25,50 and 100 mg·kg-1 treatment groups,with 20 rats in each group. A poisoning model was estalolished after administration ig at a single dose of PQ 70 mg·kg-1,while the normal control group was ip given the same volume of normal saline. DAS 25,50 and 100 mg · kg-1 was intraperitoneally injected 30 min before and after PQ exposure. Five rats in each group were sacrificed at 1,3,6 and 12 h,respectively. The inferior lobe of the right lung was observed by HE staining under an optical microscope. Tissue of the upper lobe of the right lung was used to detect the content of nitric oxide (NO). Alveolar macrophages (AMs) were collected and cultured for 24 h,and the content of nitric oxide synthase(iNOS)in the supernatant was detected. AMs were cultured for 72 h and the expression of iNOS protein in AMs was detected by immunocytochemistry method. RESULTS Compared with normal control group,the alveolar structure of PQ group was severely damaged and the pathological score was significantly increased(P<0.01). The NO content of PQ group was significantly higher than in normal control group(P<0.01). The content and protein expression of iNOS were significantly increased in PQ group(P<0.01). Compared with PQ group,the lung injury score of rats in DAS 50 mg·kg-1 group at 3,6 and 12 h and in the DAS 100 mg·kg-1 group at each time point was decreased(P<0.05). Compared with PQ group,the NO content of DAS 25 and 50 mg · kg-1 group was decreased(P<0.05),and the NO content of DAS 100 mg · kg-1 group was significantly reduced(P<0.01). The content of iNOS was reduced in DAS 100 mg · kg-1 group(P<0.05). Compared with PQ group,the expression of iNOS protein in DAS groups was decreased(P<0.05). CONCLUSION DAS can inhibit the oxidative damage in rats induced by PQ.

Objective To explore the application of fuzzy mathematics theory in the evaluation of medical students' comprehensive mental quality. Methods A total of 80 medical undergraduates studying in the Affiliated Huai'an No.1 People’s Hospital of Nanjing Medical University from October to December 2017 were randomly selected to conduct a questionnaire survey on medical students' mental quality. The questionnaires were designed by the study group, containing 3 first-level items (learning pressure, life stress and interpersonal stress), and 19 secondary items, with the recovery rate as 95%. Fuzzy comprehensive evaluation method was used for data processing and analysis. Results By comparing the data obtained from the comprehensive evaluation of the secondary factors with those of the pre-set evaluation set, the study concluded that 25.00% of the medical students need to adjust the future pressure, 41.70% the family health status pressure and 26.79% the appearance pressure according to the principle of maximum mem-bership degree. The comprehensive evaluation of the first four factors (0.249 7, 0.268 9, 0.270 2, and 0.211 2) showed that the comprehensive mental quality of medical students was "good". The quantitative analysis results showed that 27.02% of the medical students had good comprehensive mental quality, 24.97% need the mental quality adjustments, 26.89% had the average mental quality, and 21.12% had outstanding mental quality. Fuzzy comprehensive evaluation indicated that it is necessary to adjust the learning pressure and life stress of medical students, while the interpersonal stress had little effect on the mental quality of medical students. Conclusion The fuzzy comprehensive evaluation adopts the quantitative method to deal with the qualitative indicators uniformly, being scientific and reasonable. The corresponding data of each indicator can be easily identified with the help of the indicator system built up in the evaluation, which provides evidence for distinguishing and improving the corresponding decision-making for improving the medical students' mental quality. This evaluation method has strong applicability and provides new methods and ideas for objectively evaluating the comprehensive mental quality of medical students.

Objective To investigate the significance of fibroblast growth factor 23 in metabolic bone disease of prematuriy.Methods 60 patients who had been treated in our hospital from March 2016 to March 2017 were included in this study.Blood biochemistry was examined two weeks after birth,and values of blood phosphorus, serum calcium and alkaline phosphatase were recorded. Serum levels of 25 hydroxyvitamin D3,parathyroid hormone and fibroblast growth factor 23 were detected two weeks after birth. 20 premature infants with metabolic bone disease were selected as a study group. 40 infants without metabolic bone disease were treated as a control group. Two weeks after treatment,the above indicators were measured and compared in the study group. Results Serum levels of 25 hydroxyvitamin D3,parathyroid hormone and fibroblast growth factor 23 were compared between the two groups 2 weeks after birth,the difference was statistically significant(P<0.05).Levels of serum parathyroid hormone and fibroblast growth factor 23 in the study group were not statistically significant after treat-ment(P > 0.05). Levels of 25 hydroxy vitamin D3 in the study group had statistically significant after treatment (P<0.05).Conclusions Early detection of fibroblast growth factor 23 can reflect metabolic bone disease in pre-term infants.It suggests that vitamin D should be adequately supplemented in early.

Objective:To explore the application effect of the teaching ward-round workshop on the teaching ability training for clinical teachers.Methods:From July to October 2019, 83 clinical teachers from The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University included in the study were divided into 8 groups for the training of teaching ward-round workshop. After the training, the evaluation results of clinical teaching ward-round, the satisfaction of clinical teaching ward-round, and the satisfaction of the workshop teaching model were compared. Chi-square test and t test were performed by SPSS 22.0. Results:The trainees were highly satisfied with the training mode of the teaching ward-round workshop. After the training, the clinical teaching ward-round assessment scores [(96.83±1.77) points] were higher than the average scores of the same period from April to June in 2019 [(91.25±2.86) points], with statistical significance ( P<0.05). In terms of satisfaction with clinical teaching ward rounds, the scores of 7 dimensions including preparation before ward rounds, highlighting the key and difficulties, and standard physical examination after the training were all higher than those before the training, with significant differences ( P<0.05). Conclusion:The training model of the teaching ward-round workshop helps to enhance the training effect, promote the teaching ability of clinical teachers, and improve the clinical teaching ward-round assessment results and satisfaction, which provides new ideas and references for the training of clinical medical professionals.