Objective Ryanodine receptor (RyR) is one of the Ca2+ release channels on the intracellular Ca2+ stores. RyR induced-Ca2+ release is activated by the voltage-dependent Ca2+ entry, that is, calcium-induced calcium release (CICR). Intracellular free Ca2+ concentration (ECa2+]i) plays a key role on cochlear function. Our study is to investigate the differential expression of RyR in the developing rat cochlea, and to analyze the relationship between the expression of RyR and auditory functional development. Methods Immature SD rats, which were 1 day (P1), 5 days (P5), 10 days (P10), 14 days (P14), 28 days (P28) after parturition, and adutl rats(5 rats for each age) were included in the study. Frozen cochlea sectioning and immunofluorescence were applied to observe the differential expression of RyR. Results The RyR expression in the Corti's organ increased during the cochlear development. It's not significant that the stain was observed on the hair cells and supporting cells in the Corti's organ of P1 and P5 rats. The appearance of the Corti's organ of P10 rats trended to maturity. In P14 rats the RyR expression on hair cells located in the synaptic area against the afferent or efferent nerve, and the strain on supporting cells was extensive. There was little different between the strain on cochlea of P14 and P28 rats. In postmature rat spiral ganglion neurons (SGN), the RyR expression verged gradually from extensive whole cell soma to the synaptic area near to the plasma membrane. Conclusion The RyR expression peaked the 14th day after parturition, which was close to that in the mature cochlea. The time course of the RyR expression during the cochlear development was coincident with that of the auditory functional development. The RyR expression on both hair cells and SGNs located in the synaptic area near to the plasmolemma, implying that RyR induced-CICR was related to the auditory functions such as neurotransmission. Extensive RyR expression in the soma of SGNs at the early stage possibly involved in apoptosis of SGNs during neuron development.

Objective To understand the functional exercise situation of the total hip arthroplasty(THA)patients in hospital. Methods Using self-designed functional exercise in patients with TKA outline the structure of observation, observation and collection of Orthopedic Surgery,71 cases (91 hips)received THA in patients with relevant information. Results After the former 3d,22.5% of patients did not exercise;After 14 d continuous passive motion (CPM) ,hip joint exercises were separately accounted for 71.8% and 81.7% ,and static muscle contraction,straight leg raising were accounted for 40.8 percent and 81.7 percent. The four exercise started lately, training methods were not standardized the patients, insisted on a shorter time;single-and double-hip replacement hip replacement in patients with Shimoji routing practice started time respectively, after (6.51 ± 2.90 ) d and ( 10.30 ± 3.21 ) d. In the functional exercise process,CPM was assisted by nurse,in other exercises was assisted by retaining workers and patients families. Conclusion THA patients hospitalized during the actual exercise of the number,frequency,timing and methods vary, nursing staff should be further explored how to ensure that patients really effective rehabilitation exercise to further enhance the effect of patients with rehabilitation exercises.

Background and purpose:The effect of TPF (docetaxel, cisplatin and 5-lfuorouracil) induction chemotherapy plus concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma is unclear. This study aimed to compare the outcomes and tolerance of neoadjuvant chemotherapy with TPF versus cisplatin and 5-lfuorouracil (PF) followed by concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma patients.Methods:Patients with locoregionally advanced nasopharyngeal carcinoma were randomly divided into 2 groups: Group TPF and Group PF. Group TPF: One hundred and sixteen nasopharyngeal carcinoma patients received TPF consisting of docetaxel at 60 mg/m2 on day 1, cisplatin at 60 mg/m2 on day 1, and 5-lfuorouracil at a dose of 750 mg/m2by 24 h continuous infusion for 5 days for 3 cycles with a 21 day interval; Group PF: One hundred and sixteen nasopharyngeal carcinoma patients received PF consisting of cisplatin at 80 mg/m2 on day 1, and 5-lfuorouracil at a dose of 750 mg/m2by 24 h continuous infusion for 5 days for 3 cycles with a 21 day interval. After the completion of neoadjuvant chemotherapy, all the patients received intensity modulated radiation therapy (IMRT) with concomitant chemotherapy consisting of 2 cycles of cisplatin at 80 mg/m2 on day 1 and day 22. The prescribed doses were 6 810 cGy at 2.27 Gy/fraction to the gross tumor volume (GTV) with 5 daily fractions per week for 6 weeks. The acute toxicity and tumor response rate (RR), including complete response (CR) and partial response (PR), were evaluated. Addition-ally, the 5-year progress-free survival (PFS) rates and overall survival (OS) rates were further evaluated.Results:RR of Group TPF was higher than that of group PF at the end of neoadjuvant chemotherapy and within 13 weeks of the completion of concurrent chemoradiotherapy. The median recurrence time of TPF group was 2.98 years, and the 5-year PFS was 84.48%. The median recurrence time of PF group was 2.32 years, and the 5-year PFS was 82.75%. There was no statistically signiifcant difference between the 2 groups (P=0.458). The 5-year OS of TPF group was 87.06%, and for the PF group was 85.34%. There was no statistically signiifcant difference between the 2 groups (P=0.274). The incidence of leukopenia, thrombocyte penia, liver and kidney damage, diarrhea and mucosa necrosis in TPF group were signiifcantly higher than those in PF group (P<0.001). TheⅢ andⅣ degrees adverse reactions in TPF group were sig-niifcantly higher than those in PF group (P<0.001).Conclusion:TPF induction chemotherapy was not superior to the PF regimen for locoregionally advanced nasopharyngeal carcinoma patients. It should not be recommended in terms of more acute toxicity.

In recent years , with the development of error theory and the requirements of the international accreditation bodies , the quality indicators ( QIs) have become one of the important tools in the laboratory quality management .To explore the evolution and origin of QIs , the status and the future of QIs will be helpful for us to understand and to use the QIs .

Objective Through statistical analysis of specimen rejection reasons, aimed at finding the ways to reduce the failed specimen, making sure of continuous improvements in laboratory quality. Methods Department of Laboratory, Beijing ChaoYang Hospital, Capital Medical University had analyzed rejections specimen from October 2013 to September 2014 in CAP Q-TRACKS QT3 ( QT3: Laboratory Specimen Acceptability ) , and compared the laboratory rejection reasons with all laboratories of CAP. Results From October 2013 to September 2014, the total number of rejection specimen number was 2 367, in which 225 were incomplete labeled specimen/inadequate filled-out form, accounting for 9.5%.898 samples were rejected because of specimen clotted, accounting for 37.9%.The samples could not meet the requirement of specimen quantity of 254, accounting for 10.7%.Other reasons accounting for above 1%included wrong collection container, specimen hemolysis, lipemia or icteric specimen.After comparing the first five rejection reasons, Department of Laboratory, Beijing ChaoYang Hospital was found to be different with others laboratories of CAP.Conclusion The quality of the specimen is very important for the accuracy and reliability of the test results, and doing some positive statistical analysis and taking corrective measures can effectively reduce the unqualified specimen of the proportion.

Objective To translate the Personal Diabetes Questionnaire(PDQ),and test the relia bility and validity of the Chinese version of PDQ.Methods Through forward translation,back translation,cultural adjustment,etc.,the Personal Diabetes Questionnaire (PDQ) was introduced to localize it.60 eligible patients with diabetes were selected in a tertiary hospital to make a preliminary investigation.The results were statistically analyzed in order to assess the reliability and validity of the Chinese version of PDQ.Results The Chinese version of PDQ had good reliability,whose total internal consistency coefficient was 0.831 and test-retest reliability was 0.801.The questionnaire has good validity.Total Content Validity Index was 0.938.I-CVI was between 0.800 and 1.000.The questionnaire's dimensions had good parallel validity with glycosylated hemoglobin (HbAlc) and body mass index (BMI).Conclusions The Chinese Version of the personal diabetes questionnaire has good reliability and validity,which can be widely used as the evaluation tool of diabetes self-management education.

Purpose To analyze the clinical pathological characteristics and pathological diagnosis and prognosis of spindle cell carci-noma of the breast. Methods Three cases of spindle cell carcinoma of the breast were studied by morphological and immunohisto-chemical EnVision techniques. Results The females were 48, 63 and 71 years old. The tumors located in the right breast with 4. 0 cm × 3. 0 cm × 3. 0 cm, 3. 0 cm × 2. 0 cm × 2. 0 cm and 3. 5 cm × 2. 8 cm × 2. 3 cm in size and showed cystic lesion. The neoplasm was composed of bland spindle cells and mimicking fibromatosis. Immunohistochemical staining showed that spindle cells were positive for CK(AE1/AE3), CK(34βE12), CK14, CK5/6, p63 and vimentin, negative for ER, PR and c-erbB-2. Ki-67 was positive in 20%, 25% and 20% of the cells. Conclusion Spindle cell carcinoma of the breast is a rare subtype of the metaplastic carcinoma which tend to show cystic changes. It is important to make a definite diagnosis which combine histopathologic features and immunophe-notyping.

ObjectiveTo evaluate clinical significance of serum free light chains (sFLC) in diagnosis and response to the therapies of patients with multiple myeloma (MM).MethodssFLC (κ,λ and κ / λ ratio)were examed by immumoassay from 62 patients with MM at different stage. The results were analyzed associated with clinical data,and 35 cases of chronic renal failure(CRF)patients and 62 cases of healthy donors were taken as controls.ResultsMedium sFLC of normal κ value was (13.25±6.46) mg/L,λ value was (18.39±11.42) mg/L; and κ / λ ratio was (0.97±0.64) mg/L (range 0.33-1.61).sFLC κ and λ of CRF patients were (200.01±299.87) mg/L,(191.02±245.98) mg/L,significantly higher than that of the normal control group (t =-17.804,-16.894,both P ＜ 0.001),but the κ/λ ratio was at normal range (1.11±0.29).κ value range was at 16.20- 35 250 mg/L in newly diagnosed intact immunoglobulin MM patients with IgGκ,IgAκ and IgDκ type.The range of λ values was 15.70-4885 mg/L in IgGλ,IgAλ,IgDλ type,and κ/λ ratio was abnormal in 96.5 ％ (55/57) patients (＜0.5 or ＞1.5).The κ,λ value and κ/λ ratio were close to that of the normal after remmision.ConclusionsFLC ( κ,λ,and κ / λ ratio) are very good monitoring markers for MM.

Objective To evaluate the effect of dexmedetomidine and small dose of ketamine on the expression of P2X4 receptor (P2X4 R) mRNA and P2X7 receptor (P2X7R) mRNA in the dorsal root ganglion of rats with neuropathic pain.Methods Ninety male Sprague-Dawley rats,aged 6-9 weeks,weighing 180-220 g,were randomly divided into 5 groups (n =18 each):sham group (group S),chronic constrictive injury group (group CCI),dexmedetomidine group (group D),ketamine group (group K) and dexmedetomidine + ketamine group (group DK).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 400 mg/kg.Neuropathic pain was induced by CCI in CCI,D,K and DK groups.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1mmintervals with 4-0 silk thread.In group S,the sciatic nerves were only exposed but not ligated.In D,K and DK groups,dexmedetomidine 50μg/kg,ketamine 10 mg/kg and dexmedetomidine 25μg/kg + ketamine 5 mg/kg were injected intraperitoneally,respectively,while the equal volume of normal saline was injected in S and CCI groups,once a day for 14 consecutive days after CCI.Mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before CCI,and 3,7 and 14 days after CCI.Six animals were sacrificed after measurement of pain threshold at 3,7 and 14 days after CCI and the lumbar segments (L4-6) of the dorsal root ganglion were removed for determination of P2X4 R mRNA and P2X7 R mRNA expression by RT-PCR.Results Compared with group S,MWT and TWL were significantly decreased at 3,7 and 14 days after CCI in groups CCI,D,K and DK,the expression of P2X4R mRNA and P2X7R mRNA was up-regulated at 3,7 and 14 days after CCI in groups CCI,D and K,and the expression of P2X4 R mRNA and P2X7 R mRNA was up-regulated at 3 and 7 days after CCI in group DK (P ＜ 0.05).Compared with group CCI,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in groups D,K and DK (P ＜ 0.05).Compared with D and K groups,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in group DK (P ＜ 0.05).Conclusion The mechanism by which the combination of dexmedetomidine and small dose of ketamine produces a synergistic antinociception in rats with neuropathic pain may be related to down-regulation of the expression of P2X4 R mRNA and P2X7 R mRNA.

Objective To evaluate the effects of dexmedetomidine on the activity of cAMP response element binding protein (CREB) and c-fos in the spinal dorsal horn in a rat model of neuropathic pain.Methods Fifty-four adult male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =18 each):sham operation group (group S),chronic neuropathic pain group (group C) and dexmedetomidine group (group D).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The sciatic nerve was exposed and 4 ligatures were placed on the right sciatic nerve at 1 mm intervals with 4-0 silk thread in C and D groups.In group D,dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until 1 day before the animals were sacrificed,while the equal volme of normal saline was injected instead of dexmedetomidine in S and C groups.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured on 1 day before operation and 3,7 and 14 days after operation.The animals were sacrificed after measurement of MWT and TWL.Their lumbar segments (L4-6) of the spinal cord were removed for measurement of the expression of phosphorylated CREB (pCREB) and c-fos by immunohistochemistry.Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of pCREB and c-fos was up-regulated on 3,7 and 14 days after operation in C and D groups (P ＜ 0.05).Compared with group C,MWT was significantly increased,TWL was prolonged,and the expression of pCREB and c-fos was down-regulated on 3,7 and 14 days after operation in group D (P ＜ 0.05).MWT was significantly lower,and TWL was shorter on 3,7 and 14 days after operation than on 1 day before operation in C and D groups (P ＜ 0.05).MWT was significantly lower,TWL was shorter,and the expression of pCREB and c-fos was higher on 7 and 14 days after operation than on 3 days after operation in C and D groups (P ＜ 0.05).MWT was significantly higher,TWL was longer,and the expression of pCREB and c-fos was lower on 14 days after operation than on 7 days after operation in C and D groups (P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine reduces neuropathic pain is related to inhibition of the activity of CREB and c-fos in the spinal dorsal horn of rats.