Language,as a cartier of specified social culture,is closely and complementarily associated with it.Considering the especial education targets of medical universities and colleges,the present curriculum and the trend of international communication,College English is obliged to focus on humanistic value and necessarily plays its constructive role in heightening students' humanistic quality.

AIM: To observe the changes in heme oxygenase-1(HO-1) expression in the lung after ischmia-reperfusion of hind limbs in rats.METHODS: Hind limbs ischemia was made by clamping infrarenal aorta with a microvascular clip and lung injury was made by following reperfusion. Lung tissue was obtained from the animals subjected to sham operation, 4 h ischemia without reperfusion and 4 h, 8 h, 16 h, 24 h, 48 h reperfusion following 4 h ischemia. The levels of HO-1 mRNA and protein were measured at different times by Northern blot and Western blot. Immunohistochemistry technique was used to determine the cell types responsible for limb ischemic reperfusion induced HO-1 expression. RESULTS: After ischemia-reperfusion of limbs, HO-1 mRNA increased by 4 h, reached a peak at 16 h, and returned toward baseline at 24-48 h. This time course correlated with increased HO-1 protein. Immunohistochemical studies showed HO-1expressed in a variety of cell types, including the airway epithelium, alveolar macrophages and vascular smooth muscular cells. There were no positive signals in sham group and ischemia group both in mRNA levels and protein levels. CONCLUSION: The expression of HO-1 in the lung is not induced by limb ischemia or sham operation, but induced by limb reperfusion after ischemia in rats.

AIM:To look for a way of produ cing mild therapeutic hypothermia through regulating transient re-ceptor potential cation channel subfamily V member 1 (TRPV1) pathway by dihydrocapsaicin (DHC).METHODS:Mice were subcutaneously injected with DHC at different doses (2 mg/kg, 3 mg/kg and 4 mg/kg) in order to find the best dose for reaching the target temperature (32~34℃).20%DMSO dissolved in normal saline was used as control group .After a single subcutaneous injection of DHC at an optimal dose was given , awaken CD1 mice were continuously infused with DHC at dose of 1 mg? kg-1? h-1 for providing a more rapid and stable temperature drop and duration of therapeutic mild hypothermia.The adult mice (9~10 weeks) and aged mice (24~27 months) were subcutaneously injected with DHC at the same dose, and the changes of the body temperature were monitored .RESULTS:DHC at 2 mg/kg resulted in a de-crease in the core temperature within the target therapeutic range (32~34 °C).After a bolus dose (2 mg/kg) was deliv-ered at 0 min followed by continuous infusion (1 mg? kg-1? h-1 ) beginning at 30 min, a rapid drop of body temperature to 34 ℃was achieved and the body temperature was maintained within the ranges of 32 to 34℃for the duration of the 6 h continuous infusion .DHC-mediated hypothermia did not lose its effectiveness in the adult and aged models .CONCLU-SION:DHC-induced activation of TRPV1 pathway produces mild therapeutic hypothermia .Besides, this method achieves stronger and longer center hypothermia and is suitable for the animals at different ages .

Objective To assess the efficacy of intedeukin (IL)-1Ra,a recombinant human IL-1receptor antagonist,plus methotrexate ( MTX ) in patients with active rheumatoid arthritis ( RA ) refractory to MTX therapy.Methods A total of 54 patients with active RA,who had been taking MTX at a stable dosage,were randomized to receive daily subcutaneous injections of IL-1Ra (80 mg) or placebo.The proportion of patients who had a response as assessed by ACR20,ACR50 and ACR70 was analyzed using Chi-square test measures.Baseline variables and DAS28 were analyzed using Student's t-test (parametric) or Wilcoxon's rank sum test (nonparametric) as appropriate.Results After 24 weeks,more patients achieved clinical benefits treated with IL-1Ra plus MTX compared with MTX alone (64％ vs 17％,P=-0.004) as determined by the ACR20 improvement.In the IL-1Ra group,an ACR50 response was observed in 38％ and an ACR70 response in 17％.None of the patients treated with MTX alone achieved ACR50 or ACR 70 improvement.However,9 of 42 (21％) patients in the IL-1Ra group,who showed therapeutic response initially,had secondary drug failure to IL-1Ra therapy thereafter.A significant increase in mean DAS28 from baseline was found in the nonresponders to IL-1Ra,compared with placebo.Conclusion IL-IRa is effective for the treatment of patients with active RA by blocking IL-1.However,the efficacy of IL-1Ra is lost soon in about one-fifth of patients in soite of initial good resoonse.

AIM:To observe the changes in heme oxygenase-1(HO-1) expression in the lung after ischmia-reperfusion of hind limbs in rats.METHODS:Hind limbs ischemia was made by clamping infrarenal aorta with a microvascular clip and lung injury was made by following reperfusion. Lung tissue was obtained from the animals subjected to sham operation, 4 h ischemia without reperfusion and 4 h, 8 h, 16 h, 24 h, 48 h reperfusion following 4 h ischemia. The levels of HO-1 mRNA and protein were measured at different times by Northern blot and Western blot. Immunohistochemistry technique was used to determine the cell types responsible for limb ischemic reperfusion induced HO-1 expression. RESULTS:After ischemia-reperfusion of limbs, HO-1 mRNA increased by 4 h, reached a peak at 16 h, and returned toward baseline at 24-48 h. This time course correlated with increased HO-1 protein. Immunohistochemical studies showed HO-1expressed in a variety of cell types, including the airway epithelium, alveolar macrophages and vascular smooth muscular cells. There were no positive signals in sham group and ischemia group both in mRNA levels and protein levels. CONCLUSION:The expression of HO-1 in the lung is not induced by limb ischemia or sham operation, but induced by limb reperfusion after ischemia in rats.

Objective: To explore the patterns of cerebral structural abnormalities and cognitive function alterations in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis, and the underlying correlative factors. Methods: Thirty-seven ESRD patients undergoing maintenance hemodialysis without prior stroke in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were selected. All patients underwent brain magnetic resonance imaging (MRI) and assessment of cognitive function by using Mini-Mental State Examination (MMSE). Patients were divided into lacunar infarction group (n=33) and non-lacunar infarction group (n=4), or white matter hyperintensities (WMH) group (n=14) and non-WMH group (n=23). The difference of demographic characteristics, past history, blood parameter and dialysis adequacy between patients and their controls were analyzed by t test, Mann-Whitney U test, χ2 test and Fisher exact test. Spearman correlation analysis were performed to explore the relationship between clinical features, cerebral structural abnormalities and cognitive function. Results: Nineteen male and eighteen female patients participated in the study. The mean age was (59.4±12.3) years. The incidences of lacunar infarction and WMH were 89.2% and 37.8%, respectively. 24.3% of the participants were diagnosed as cognitive impairment. Patients with lacunar infarction were elder, who had lower level of hemoglobin, hematocrit, serum albumin and serum total protein, while parathyroid hormone (PTH), erythrocyte sedimentation rate, tumor necrosis factor-α and interleukin-6 were elevated. Patients with WMH were also significantly elder, lower in transferrin saturation and higher in PTH. The differences between the two groups were statistically significant (all P<0.05). Spearman correlation analysis showed MMSE score had a negative correlation with age (r=-0.471, P=0.003) and had positive correlations with education status (r=0.355, P=0.031) and hypertension (r=0.358, P=0.030). The study did not find the relationship among lacunar infarction, WMH and MMSE score; however, recall function was found negatively correlated with lacunar infarction (r=-0.357, P=0.030). Conclusion: ESRD patients undergoing maintenance hemodialysis have a high prevalence of cerebrovascular disease and cognitive impairment. Older age, anemia, inflammation status, chronic kidney disease-mineral and bone disorder may be the influencing factors of the cerebral structural abnormalities and cognition decline.

Renal calculus is a common disease of urinary system. Calculus formation is associated with dietary factors, genetics, comorbidities, microorganism environment, modulators in the urine and many other factors. It has become a kind of chronic metabolic condition which needs multidisciplinary treatment. Imaging, metabolic evaluation and calculus analysis provide a variety of tools for calculus diagnosis and evaluation. As the first-line imagine examination recommended by guidelines, CT has advantages in distinct sectional anatomy with high sensitivity and specificity, and dual-energy CT makes it possible to discriminate different calculus compositions noninvasively. The 24-hour urine test can help predict the risk of renal calculus. This article reviews recent research progresses in the risk factors, diagnosis and evaluation of renal calculus.

Background and purpose:Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for MR imaging systemic examination, especially the lymph node and bone diseases can be clear, and the imaging result is similar with PET. The aim of this study was to compare the value of clinical application in the diagnosis of malignant metastatic osteopathic between DWIBS and bone scintigraphy mapping. Methods:Thirty-six specimens conifrmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods. Results:Thirty (165 positions in all) of 36 malignant tumor patients were conifrmed as having bone metastasis, compared that 26 patients (143 positions) with DWIBS method and 23 patients (132 positions) with bone scintigraphy mapping were detected, but there was no statistical signiifcance between this two imaging methods (χ2=1.002, P=0.506). The sensitivity, positive predictive value (PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with 86.7%, 96.3%, 86.1%and 76.7%, 88.5%, 72.2%, respectively;but the speciifcity and negative predictive value (NPV) in DWIBS (83.3%and 55.6%) was higher than that of in bone scintigraphy (50.0%and 30.0%). The detection rates of different bone metastasis with DWIBS and bone scintigraphy were 86.7%(143/165) and 80.0%(132/165), and it was no signiifcant difference (χ2=2.640, P=0.104);DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different signiifcant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is ifne consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.

Objectives To discuss the clinical characteristic, cause and measures to prevention and control of nosocomial infection in a neonatal intensive care unit (NICU). Methods Retrospectively analyzed an nosocomial infection outbreak of Klebsiella pneumoniae in NICU. Results From Sept. 3, 2010 to Oct. 3, 2010, there were 7 cases of hospital infection in 12 cases of sputum cultured Klebsiella Pneumoniae. The gestational age (GA) of 7 hospital infection cases was 28.5±2.6 week. The birth weight of infection cases was 941.4±309.8 g. The onset of infection was at 31.7±12.8 d of hospitalization. The nosocomial incidence was 2.41%in the hospital, which was 5.79%in preterm infants, 50.00%in GA<28w infants, and 42.86%in extremely low birth weight infant (ELBW). All sputum culture results were displayed as multi-drug resistant of Klebsiella pneumoniae, penicillin and third-generation cephalosporin antibiotic resistance rate of 75%to 100%. The resistance rates to penicillin and cephem antibiotics were 75% -100%, carbapenems was 58.3%, piperacillin/tazobactam was 25.0%. All nosocomial patients were cured. Conclusions GA<28w and ELBW infants are at increased risk of nosocomial infection in NICU. The emergence of carbapenems resistant Klebsiella Pneumoniae has been increasing with the widespread use of carbapenems. Hospital infection can be controlled by standardized medical behavior, which can decline the nosocomial infection incidence and mortality of preterm infants in NICU.

Abdominal Pain ; etiology ; Child ; Child, Preschool ; Endoscopy, Gastrointestinal ; Female ; Humans ; Male ; Purpura, Schoenlein-Henoch ; complications ; pathology