Objective To investigate the expression of vascular endothelial cell growth factor(VEGF) and its upregulation of matrix metalloproteinase-2(MMP-2)activation in synovial fluid of patients with rheumatoid arthritis(RA)as well as its role in the pathogeneses of RA.Mathods Expression of VEGF and receptor KDR in mononuclear cell(MNC)of synovial fluid of RA patients and controls were determined by Western blot;VEGF levels of supernantants from MNC was determined by ELISA;supernantants from KDR~+ MNC of synovial fluid of RA patients collected after incubation in serum-free medium with or without VEGF, their activity of MMP-2 was measured by gelatinolytic zymography;Boyden chamber-matrigel in vitro invasion assay was used to detect the invasive capacity in vitro in KDR~+ MNC of synovial fluid of RA patients incubat- ed with or without VEGF.Results The expressions of VEGF/KDR in MNC of synovial fluid of RA patients were significantly higher than those of controls;the MMP-2 activity and invasive ability of co-cuhured KDR~+ MNC with VEGF was higher than those of without VEGF.Conclusion VEGF upregulates MMP-2 activation and promotes invasion of MNC of synovial fluid of RA patients by interacting with receptor KDR,indicating that VEGF plays an important role in RA pathology.

Objective To explore the best way to diagnose and cure the nephrosis with ureteropelvic junction obstruction(UPJO) in children.Methods The diagnosis of 26 cases of nephrosis with UPJO were confirmed by ultrasonogram and IVU examinations.All patients underwent AndersonHynes procedures.These results were analyzed and summarized.Results All the diagnosis were proved to be correct by operation and pathology examinations,the operations were carried out successfully.Twenty-four cases were followed up for 6 months to 2 years.After the operation,the hematuria,urinary frequency,abdominal mass and distention disappeared,the urine analysis was normal,all cases cured clinically.Ultrasonogram examinations showed the thickness of parenchyma increased and the large kidneys lessened.Significantly improved renal fuoction on IVU examinations was observed in the 24 cases compared with that before the operations.The ureters of 20 cases displayed well.Conclusions The combination of ultrasonogram and IVU is very effective method to diagnose UPJO in children.Anderson-Hynes technique is the best procedure to cure the UPJO.

Availability of appropriate drugs for children has been a bottleneck both at home and abroad for years.As a result, drugs for adults that are market available emerge a choice of convenience for children's treatment instead.For unique physiological and psychological characteristics of children, these drugs must be dispensed on individual basis before usage to children in question.Such drugs play a key role in children's treatment, and incur many problems on the other hand in their use and practice, such as drug stability, dosage accuracy, potential risks, as well as legitimacy in drug dispensing and use.A safe, reasonable and normalized use of such drugs calls for an orchestrated effort among pharmacists, trade associations and drug regulators as well.

Objective To explore the sonographic characteristics and to evaluate its diagnostic value of hepatic lymphoma (HL). Methods The clinical data and abdominal sonographic ifndings of 18 consecutive patients with histological proven diagnosis of lymphoma with liver involvement were reviewed, including contrast-enhanced ultrasound (CEUS) images. Results The liver sonographic features of 18 HL were differentiated as three types including nodular, diffuse and mixed type. Nodular type showed well-deifned hypoecho lesions in 6 cases with penetrating vascular lfow signals in 2 cases and no vascular lfow signals in 6 cases by color Doppler imaging. In 3 cases by CEUS, all the hepatic focal nodulars showed variable arterial enhancement but wash-out in the portal venous and late phases. For diffuse type cases, hepatomegaly without nodule was showed in 11 cases. Vasular in liver showed normal in 8 cases and abnormal in 3 cases. For mixed type cases, hepatomegaly and multiple ill-deifned hypoechoic lesions with normal vascular in liver were showed in 1 case. Hepatosplenomegaly and abdominal lymphoadenopathies were identiifed in 11 cases. Conclusions The characteristics and the types of sonographic ifndings may be helpful in differentiating HL from other liver lesions.

· Currently, refresher doctors’training is an important form of continuing medical education in our country, effectively promoting and improving the clinical ability and the service level of practitioners in basic -level medical organization. We combine ophthalmic professional features with refresher doctors’training in practice to explore ophthalmic continuing clinical training specifications.Training on the current status and new changes has been analyzed in order to further improve the training quality. The competent administrative departments and clinical teaching hospital should make full use of its advantages to institutionalize, specialize and standardize the training. We suggest linking the continuing clinical training with job promotion;strengthen core clinical ability and being strict with appraisal system so that after the training the trainees can spread standardized guidelines and technology, alleviating the current medical demand and the difficulties in the reform.

Objective To investigate the development trend of drinking-water-borne endemic fluorosis in Jiangsu Province,and to provide the basis for further prevention and treatment of the disease.Methods In 2009,eight major counties were chosen,and in each county all diseased villages were classified into light,moderate and severe disease types according to water fluorine content based on historical data,and one village was chosen from each type.In monitoring villages with improved water,one source water and three tap water samples were collected,respectively.Five water samples were collected in water unimproved monitoring villages according to water well locations of the east,the west,the south,the north and the center.The fluorine content in water was determined according to the Standard Testing Methods for Drinking Water (GB/T 5750-2006).Children aged 8 to 12 were examined for dental fluorosis by Dean method.Residents over the age of 16 were examined for clinical osteofluorosis,and two monitoring counties were chosen,then one village was respectively chosen in each county,and clinically diagnosed patients with skeletal fluorosis were examined again by X-ray.Both clinical and X-ray diagnosis were on the basis of Diagnostic Criteria of Endemic Skeletal Fluorosis (WS 192-2008).Urine samples of 30 children aged 8 to 12 and of 20 adults over the age of 16 were randomly collected and urinary fluoride was determined by F-ion selective electrode method(WS/T 89-1996).Results Of all the 24 villages of 8 counties,20 villages were water improved,and water-improvedprojects ran normally in 18 villages,while scrapped in the rest 2 villages.One hundred and two samples were tested,and the mean of water fluoride in water-improved villages was 1.10 mg/L,while in water unimproved villages and villages with water improved projects scrapped was 1.90 mg/L.The prevalence of dental fluorosis was 42.51％(854/2009).The prevalence of clinical skeletal fluorosis was 23.23％ (2024/8713) and the X-ray detection rate was 32.00％ (24/75).Six hundred and sixty-four urine samples of children were determined,and geometric mean of urinary fluorine was 1.59 mg/L,while 370 adult urine samples were determined,and geometric mean of urinary fluorine was 2.20 mg/L.Conclusions Endemic fluorosis in Jiangsu Province has not been fully controlled and there are signs of recovery.We must pay attention to water improvement measures to reduce fluoride and the management and maintenance of water improvement projects,and further strengthen the prevention and control of endemic fluorosis.

Objective To evaluate the effect of health education on endemic fluorosis in Jiangsu province,and to provide reference data for further prevention and control of the disease.Methods In 2011,according to history prevalence of endemic fluorosis in Jiangsu province,a total of 10 countries were selected,and 3 townships were chosen in each county.Health educational activities were carried out in the classes of grade 4 - 6 in thecentral primary school.In the meantime,3 villages were chosen in each selected township where the health educational activities in the community were carried out.Before and after the health education activities,questionnaire surveys on knowledge of endemic fluorosis were conducted in each county.Thirty students in one classof the fifth grade in the central primary school were randomly selected,and 15 housewives near the central primaryschool were also randomly selected.Results After the health educational activities,the rates of knowledgeawareness in the students and the housewives were 95.90％ (2946/3072) and 92.85％ ( 1752/1887 ),respectively,and increased significantly compared with those before the intervention[71.53％(2015/2817),77.40％( 1384/1788 ) ],and the difference was statistically significant(x2 =657.337,174.894,all P ＜ 0.01 ).Before the health educational activities,the rates of knowledge awareness in the students were lower than those in the housewives,and the difference was statistically significant (x2 =6.120,P ＜ 0.05 ).After the health educational activities,the rates of knowledge awareness in the students were higher than those in the housewives,and the difference was statistically significant(x2 =21.847,P ＜ 0.01 ).ConclusionsThe rates of knowledge awareness in the students and the housewives are increased significantly after the health educational activities.The consciousness and activity of the target people to take part in preventing and controlling of the endemic fluorosis have been enhanced greatly.The good behaviors in the target people are gradually formed,the desired effect is achieved.

Objective To investigate the state of endemic fluorosis, running status of water improvement project to reduce fluoride in Jiangsu province, and to provide a scientific basis for prevention and control of endemic fluorosis. Methods In 2008, in the ten key counties of endemic fluorosis (zone), in Xuzhou,Lianyungang and Suqian, a stratified sampling method was employed to select 40 diseased villages according to their past water fluoride survey data. All children aged 8 to 12 were examined dental fluorosis, and all adults over 16 years were examined clinical skeletal fluorosis. Thirty per cent of the 40 diseased villages were selected, and 20 adults over the age of 16 in each selected village were examined by X-ray, respectively;50% of the 40 diseased villages were selected, and 30 any time urine samples of children aged 8 to 12 in each diseased village were tested urine fluoride. In each city, select a county, the status of water improvement project to reduce fluoride, water supply capacity and coverage in the county were investigated. Results A total of 3560 children aged 8 to 12 were examined, the detection rate of dental fluorosis was 38.51% (1371/3560), tooth defect rate was 5.34% (190/3560), and dental fluorosis index was 0.8. Seven hundred and eight urine samples were tested, the median urinary fluoride was 1.47 mg/L and the range was 0.08 ~ 10.08 mg/L. Clinical detection of skeletal fluorosis was 21.3% among adults over the age of 16, and X-ray detection rate of skeletal fluorosis was 39.2% (123/314).Investigated a total of 248 facilities of centralized water improvement projects, no funds to run or damaged 49, the water fluoride > 1.0 mg/L was 18. Conclusions Endemic fluorosis in Northern Jiangsu province has not been controlled completely, but has a rising trend, we should further strengthen the supervision of water fluoride reduction.

Objective To evaluate the effect of health education on drinking-water-borne endemic arsenic poisoning in Jiangsu province in 2010.Methods Nine villages(townships) were selected from high-arsenic regions of Jiangsu province,and one primary school in each village(township) and one village from the 9 villages(townships)were selected as investigation points.Thirty pupils in the same class of grade 5 in each school,and 15 housewives in each village were chosen as research subjects.Referring to the health education questionnaire in Technique Scheme of Endemic Disease Prevention Granted by the Central Government in 2010,5 questions were selected.The reason,harm and prevention measures were reflected by the first,second and third questions.The way of knowledge acquisition and the situation of family drinking water were reflected by the forth and fifth questions.The awareness of prevention knowledge of drinking-water-borne endemic arsenic poisoning in pupils and housewives were investigated by calculating the awareness rate.Results Three hundred and nine pupils in the fifth grade and 144housewives were investigated in the baseline survey.Thenumber of response was 927 and 432,respectively; the number of correct answer was 537 and 234,respectively; the awareness rate was 57.93％(537/927) and 54.17％(234/432),respectively.Two hundred and seven pupils in the fifth grade and 135 housewives were investigated in the evaluation survey.The number of response was 810 and 405,respectively; the number of correct answer was 778 and 386,respectively; the awareness rate was 96.05％ (778/810) and 95.31％ (386/405),respectively.Conclusions Health knowledge of drinking-water-borne endemic arsenic poisoning has been improved among pupils and housewives in these areas.

In this study, chemiluminescence technique was employed to compare the effect of tonifilyneedling and ginger-seperated moxibustion on Zusanli in regulating the phagocytosis of the neutrophil in the aged rats. As a result, both methods were proved to be able to elevate the phagocytosis and anti-bacteria effect of the neutrophil, and the later method was found more remarkable. So it concluded that acupuncture and moxibustion are both the effective ways in anti-aging and health-protection.