Objective To assess the health risk of soil-mouth exposure of soil heavy metal pollution by in vitro method. Methods Collected the soil sampling from the heavy metals contaminated field and roadside. Digested the soil sample by in vitro device and determined the content of Cd, Pb, Zn in the solution in the simulated stomach phase and intestine phase respectively with ICP-MS after centrifuging. Calculated the exposure and assess health risk. Results Bioaccessibility of Cd, Pb and Zn at the stomach phase was 21%-33%, 2%-28%, 33%-43% respectively in the polluted areas, and 27%, 23%, 95% in the control area; At the intestine phase was 16%-19%, 3.4%-4.9%, 8%-14% in polluted areas and 11%,2.6%,18% in control area respectively. The amount of available Cd, Pb and Zn in the stomach phase was 0.04-1.46 ?g/d, 3.09-5.53 ?g/d, 3.86-9.39 ?g/d in polluted areas and 0.01 ?g/d, 0.74 ?g/d ,5.64 ?g/d in control area for children, and 0.01-0.36 ?g/d, 0.77-3.88 ?g/d, 0.97-9.85 ?g/d in polluted areas and 0.00 ?g/d. 0.19 ?g/d, 1.41 ?g/d in the control area for adult ; at intestine phase the amount of available Cd, Pb and Zn was 0.03-0.71 ?g/d, 0.50-9.92 ?g/d, 1.26-9.55 ?g/d in polluted areas and 0.00 ?g/d, 0.08 ?g/d, 1.07 ?g/d in the control area respectively for children, 0.01-0.18 ?g/d, 0.11-2.48 ?g/d, 0.31-2.39 ?g/d in the polluted areas and 0.00 ?g/d,0.02?g/d,0.27 ?g/d in the control area respectively for adult. Conclusion Heavy metals exposure through soil-mouth pathway will increase the total health risk of heavy metal to exposed population.

We innovated video assessment integrated teaching method on the basis of clinical case discussion,teaching rounds,problem-based learning,case method and micro teaching.According to this video feedback teaching,students became teaching subject and teacher acted as guide.In order to realize the purposes of early contact with clinical practice,more clinical practice and repeated clinical practice teaching,we implemented student-centered small class teaching,which was heuristic,inquisitive,interactive and was discussion-based.At the same time with the help of medical simulation equipment and video feedback teaching,this method developed students' life-long learning ability and work competence and combined theory with practice,demonstration with imitation as well as standards with innovation.This method was not only suitable for theoretical study but also for skills training,especially for standardization training.

Objective To investigate the value of nasal continuous positive airway pressure (NCPAP) in the treatment of severe pneumonia. Methods The clinical data of 59 severe pneumonia infants who received NCPAP preferential ventilation strategy were retrospectively analyzed. Results After treatment, 50 infants were effective and 9 infants were ineffective. Before treatment, the age, RR, HR between effective group and ineffective group had no significant differences (P>0.05). But the levels of PaCO2, PaO2/FiO2 in ineffective group were significantly higher than those in effective group and the level of PaO2 in ineffective group was significantly lower than that in effective group (P<0.05). In effective group, the levels of PaO2 and PaO2/FiO2 were significantly increased after treatment for 1, 12 and 24 h, and the levels of PaCO2, RR and HR were significantly decreased (P<0.01). Conclusions NCPAP preferential ventilation strategy can reduce the use of invasive mechanical ventilation, improve oxygenation, ease dyspnea and make vital signs stable.

Objective To investigate the prevalence and risk factors of hyperuricemia (HUA) in rural residents of Gaoyou City,Jiangsu Province.Methods A total of 4504 rural residents were investigated in a cross-sectional study.Questionarre survey and physical examination were used for the stndy.Fatsing venous blood samples were collected for biochemical examination.T-test,chi-square test for multiple-group data comparison and logistic regression analysis were used for statistical analysis.Results The prevalence of HUA was 11.9％,15.7％ in male,which was significantly higher than 8.6％ in the female (P＜0.01),the risks of HUA in male was 1.98 times higher than in female.The average value of serum uric acid in this population was higher than.that of female.The prevalence of HUA in female increased with age.Non-conditional logistic regression analysis showed WHR,Cr,Tg,hypertension were the independent risk factors of male patients with HUA.Age,BMI,Cr,Tg,hypertension were independent risk factors of HUA in female.Conclusion The prevalence of HUA can be affected by age and sex.Weight control,keeping blood pressure and blood lipid profiles in normals levels are important for the prevention of HUA.

Objective To investigate the relationship between molecular subtypes of breast cancer and postoperative loco-regional recurrence (LR) in early breast cancer patients with 1-3 positive axillary lymph nodes (pN1) and to improve the individualized indications for post-mastectomy radiotherapy (PMRT)in these patients.Methods A total of 547 patients with pT1-2 N1M0 breast cancer,who received mastectomy between December 1998 and December 2009 in Sun Yat-sen University Cancer Center,were retrospectively analyzed.None of them received adjuvant radiotherapy after mastectomy.The patients were divided into luminal A group,luminal B group,HER-2-overexpressing group,and triple-negative group according to the molecular subtypes of breast cancer determined by immunohistochemistry and fluorescence in situ hybridization.The patients in different groups were compared in terms of LR rate (LRR) and LR-free survival (LRFS),and the risk factors for LR were analyzed in combination with clinical and pathological features.The Kaplan-Meier method was adopted to calculate LRR and LRFS;the Logrank test was used for survival difference analysis and univariate prognostic analysis.The Cox proportional hazards model was used for multivariate prognostic analysis.Results The luminal A group,luminal B group,HER-2-overexpressing group,and triple-negative group accounted for 30.0％,48.6％,9.3％,and 12.1％,respectively,of all the patients.The follow-up rate was 97.1％ ;334 patients were followed up for at least 5 years,and 127 were followed up for at least 10 years.Univariate analysis showed that,compared with the luminal A group,the HER-2-overexpressing group and triple-negative group had significantly higher 5-year LRRs (19.0％ vs 5.3％,x2 =4.28,P =0.026; 14.9％ vs 5.3％,x2 =5.02,P =0.015) and significantly lower LRFSs (73.5％ vs 91.1％,x2=7.27,P=0.005;80.6％ vs 91.1％,x2=4.77,P=0.021).Multivariate analysis revealed that HER-2 overexpression,triple-negative phenotype,age of ≤ 35 years,and stage pT2 were poor prognostic factors for survival (LRR and LRFS) (x2 =2.29,2.08,18.22,and 6.86,P =0.020,0.016,0.001,and 0.005;x2 =1.90,1.41,8.58,and 3.94,P=0.006,0.025,0.002,and 0.039).The 10-year LRRs of patients with 0,1,and ≥2 of the above risk factors were 4.3％,14.1％,and 31.9％,respectively (x2 =28.03,P =0.000).Conclusions Molecular subtyping is helpful for individualized evaluation of LR risk in early breast cancer patients with 1-3 positive axillary lymph nodes (pN1).PMRT should be recommended for the patients with 2 or more risk factors for LR.

Objective To investigate the efficacy and adverse reactions of azithromycin sequential therapy for the treatment of children with mycoplasma pneumonia.Methods 84 children with mycoplasma pneumonia were randomly divided into study group and control group according to the digital table,with 42 cases in each group.The study group was given azithromycin treatment,and the control group was given erythromycin treatment.The clinical curative effect and adverse reaction were compared between the two groups.Results The total effective rate of the study group (97.62％) was significantly higher than that of the control group (76.19％),and the difference was statistically significant (x2 =11.95,P ＜ 0.05).The pyretolysis time [(3.78 ± 1.57) d],cough improvement time [(3.29 ± 0.74) d],rate disappearance time[(5.88 ± 2.35) d],average hospitalization time [(8.89 ± 1.76) d] of the study group were significantly shorter than those of the control group [(4.49 ± 1.71) d,(4.28 ± 0.77) d,(7.69 ±2.54) d,(10.05 ± 2.27) d],and the differences were statistically significant (t =2.01,6.33,3.29,2.46,all P ＜0.05).The incidence rate of adverse reactions such as nausea,abdominal distention,abdominal discomfort,local injection pain,rash,elevated alanine aminotransferase of the study group (4.76％) was significantly lower than that of the control group (19.05％),and the difference was statistically significant (x2 =4.86,P ＜ 0.05).Conclusion Azithromycin sequential therapy is effective in the treatment of children with mycoplasma pneumonia.It can effectively shorten the disappearance time of clinical symptoms and signs,and average hospitalization time,and has low incidence rate of adverse reactions.It is worthy of clinical use.

[ ABSTRACT] AIM:To investigate the expression of calprotectin ( CALP) in the rats with renal ischemia-reperfu-sion injury ( IRI) .METHODS:Male Sprague-Dawley rats were randomly divided into sham operation and IRI group ( n=25 in each group) .Blood samples and the kidneys were obtained at 6 h, 12 h, 24 h, 48 h and 72 h after reperfusion.The pathological changes of the kidneys were observed.The serum concentrations of blood urea nitrogen ( BUN) and serum cre-atinine (SCr) were measured.The serum levels of CALP, tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) were detected by ELISA, and the expression of CALP, Toll-like receptor 4 ( TLR4) and NF-κB p65 in the renal tissues were de-termined by the methods of immunohistochemistry and Western blot.RESULTS: Different serial ischemia changes were observed in the renal tissues, mainly in the renal tubular epithelial cells and the mesenchyma, with the infiltration of in-flammatory cells.The serum levels of BUN, SCr, CALP, TNF-αand IL-6 in IRI group were markedly increased as com-pared with sham group (P<0.05).The protein expression of CALP, TLR4 and NF-κB p65 in the renal tubular epithelial cells in IRI group was greatly enhanced in comparison with that in sham group ( P<0.05) .CONCLUSION:The serum concentrations of CALP, TNF-αand IL-6, and the protein expression levels of CALP, TLR4 and NF-κB p65 in the renal tissue are significantly increased in the rats with IRI, suggesting that calprotectin plays an important role in the inflamma-tion in rats with IRI.

[ ABSTRACT] AIM:To investigate the role of the Notch pathway in Toll-like receptor 4 ( TLR4 )-mediated in-flammatory response in renal ischemia reperfusion injury ( IRI) in rats.METHODS: A total of 75 male sprague-Dawley rats were randomly divided into sham operation group , IRI group and DAPT treatment group .Blood samples and the kid-neys were obtained at 6 h, 12 h, 24 h, 48 h and 72 h after reperfusion .The concentrations of blood urea nitrogen ( BUN) and serum creatinine (Scr) were measured.The serum levels of tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) were detected by ELISA, and the expression of Notch1, TLR4 and NF-κB p65 in the renal tissues was assessed by im-munohistochemistry and Western blot .RESULTS: The serum levels of BUN, Scr, TNF-αand IL-6 in IRI group were markedly increased as compared with sham group (P<0.05).The protein levels of Notch1, TLR4 and NF-κB p65 in re-nal tubular epithelial cells in IRI group was significantly enhanced as compared with sham group ( P<0.05 ) .In DAPT group, the serum levels of BUN, Scr, TNF-αand IL-6 were significantly reduced compared with IRI group (P<0.05), and the protein levels of Notch1, TLR4 and NF-κB p65 were apparently less than those in IRI group (P<0.05).CON-CLUSION:Significant changes of renal function , a rise of serum inflammatory factor including TNF-αand IL-6 and en-hanced expression of Notch 1, TLR4 and NF-κB p65 in the renal tissue occurred in the rats with IRI .γ-Secretase inhibitor DAPT attenuates TLR4-mediated inflammatory response in the renal IRI through the inhibition of Notch 1 and down-regula-tion of NF-κB.

Objective To explore the expression and significance of neutrophil gelatinase-associated lipocalin (NGAL) in lupus nephritis (LN) in mice. Methods Female MRL/lpr lupus mice (n=36) were randomly divided into the experimental group and intervention group, and female Kunming mice (n =18) served as controls. Each mice in the intervention group received intraperitoneal injection of 20 μg anti-mice interleukin (IL)-17 antibody. The serum concentrations of NGAL, IL-17,matrix metalloproteinase(MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 were measured by enzyme-linked immunosorbent assay (ELISA). And the protein expressions of NGAL, IL-17, MMP-9 and TIMP-1 in renal tissue were detected by immunohistochemisty. One-factor analysis of variance (ANOVA) or nonparametric rank sum test was used for the comparisons between the three groups. Associations between these factors were analyzed by Pearson′s test. Results The levels of serum NGAL, IL-17, MMP-9 and TIMP-1 in the experimental group were obviously increased as compared to those in the control group and intervention group [NGAL: (30.31±1.22) ng/ml vs (11.36±0.14) ng/ml, (20.09±0.35) ng/ml, F=986.524, P<0.001]. The protein expression of NGAL, IL-17, MMP-9 and TIMP-1 in the renal tubular epithelial cells in the experimental group was increased as compared to the control group and intervention group[NGAL:(11.27±0.58) vs(0.45±0.19),(9.22±0.67), H=15.158, P =0.001]. In the experimental group, a positive correlation was found between the level of serum NGAL
and the serum levels of IL-17, MMP-9 and MMP-9/TIMP-1(r=0.899, 0.789, 0.925, P<0.01). The protein expression of NGAL in renal tissue was positively correlated with IL-17, MMP-9 and MMP-9/TIMP-1 levels (r=0.929, 0.899, 0.723, P<0.01). Conclusion The level of NGAL in the serum and renal tissue is signifi-cantly increased in the MRL/lpr lupus mice. And it is closely correlated with the levels of IL-17 and MMP-9. Our results suggest the potential role of NGAL in the inflammation of lupus nephritis.

The aim of this study was to systemically analyze the proteins that adsorbed on the surface of hemodialysis membrane. The Fresenius F6 reused polysulfone dialyzers were selected as the research objects. The methodology we used encompassed the digestion of protein in rinsed solution and the separation of peptide mixture in virtue of RP-HPLC followed by ESI-MS/MS identification in orde to get their adsorption behavior, species and characteristics. The results illustrated that, after being rinsed by reverse osmosis (RO) water, 179 species of the protein adsorbed on the hemodialysis membrane, most of which were acidulous and middle or small weight protein molecules. The data from counting the numbers of peptides showed there were 5 species of high-abundant proteins (the contents being above 5% each), namely Ficolin-2 precursor, Complement C3 precursor (Fragment), Mannan-binding lectin serine protease 1 isoform 2 precursor, Complement-activating component of Ra-reactive factor precursor, and Mannan-binding lectin serine protease 1 isoform 3. These proteins are in close relationship with human immune system; moreover, they are of great significance to the clinical mechanism for cleaning reuse hemodialyzers and to the development of new hemodialysis materials.
Adsorption ; Complement C3 ; analysis ; Equipment Reuse ; Humans ; Lectins ; analysis ; Mannose-Binding Protein-Associated Serine Proteases ; analysis ; Membranes, Artificial ; Renal Dialysis ; instrumentation