Objective To investigate the expression level of Ezrin and its clinical significance in nontraumatic os-teonecrosis of femoral head. Methods Expression level of Ezrin in 38 patients with nontraumatic osteonecrosis of femoral head ( experimental group) and 16 patients with femoral neck fractures ( control group) were detected by immunohistochemistry and RT-PCR analysis. Results The expression level of Ezrin was significantly lower in ex-perimental group than that in control group (P<0. 05). It was correlated with the Ficat Stage, and had no rela-tionship with gender, age, BMI, profession and etiological factor. Conclusion Ezrin may involve in the develop-ment of nontraumatic osteonecrosis of femoral head, and play an important role in regulation.

To compare the efficacy and side effects of bupivaeaine(Bup)at two concentrations and fentanyl for caudal analgesia in children. Method:One hundred-fifty children undergoing hernia repair procedures under caudal anesthesia, were randomly assigned to five groups. Group A: 1% lidocaine (Lid), group B: 10% Lid+0.1% Bup, group C: 1% Lid+0.25% Baeup, group D: 1%Lid+0.15%Bup with 2?g?kg~(-1) fentanyl, group E: 1%Lid+0. 25%Bup with 2?g?kg~(-1) fentanyl for caudal analgesia, The degree of pain(LPS), nausea and vomiting (NV) were as sessed at 4, 8, 12 and 24 h after operation. Result: The numbers of LPS

BACKGROUND:Systemic lupus erythematosus is a kind of heterogeneous disease, and the difference of clinical features may also be the risk factors of osteonecrosis besides of treatment with glucocorticoids according to the literature. However, it remains controversial on the risk factors of osteonecrosis in systemic lupus erythematosus patients.
OBJECTIVE:To systematical y review the major risk factors of osteonecrosis in the Chinese patients with systemic lupus erythematosus.
METHODS:The CNKI database, CBMdisc database and Wanfang database were retrieved for the published case-control study literatures on the risk factors of osteonecrosis in the Chinese patients with systemic lupus erythematosus. The literatures met the inclusion and exclusion criteria were included, and a Meta-analysis was conducted by RevMan 5.0 and Stata software. Then, the pooled odd ratio and 95%confidence interval of each risk factor were calculated.
RESULTS AND CONCLUSION:Ten case-control study literatures were included involving 332 cases in the case group and 986 cases in the control group. The pooled odd ratio and 95%confidence interval of each risk factor of osteonecrosis in the Chinese patients with systemic lupus erythematosus were as fol ows:Raynaud’s
phenomenon 3.28(1.69-6.38), dental ulcer 2.95(2.13-4.09), renal involvement 1.21(0.83-1.74), vasculitis 5.64(2.84-11.21), hyperlipidemia 5.11(3.10-8.42), anti-phospholipid antibody 2.32(1.49-3.61) and joints involvement
2.02(1.33-3.07). It has been clear that the glucocorticoids is an independent risk factor of osteonecrosis in the patients with systemic lupus erythematosus. However, it is not the one and only risk factor. The fol owing risk factors of
vasculitis, hyperlipidemia, Raynaud’s phenomenon, dental ulcer, positive anti-phospholipid antibody and joints involvement are the risk factors of osteonecrosis in the patients with systemic lupus erythematosus.

Objective To observe the effect of propofol target controlled infusion with different blood plasma target concentration on stress reaction during the nasal endoscope operation. Methods Sixty patients with ASA Ⅰ - Ⅱ scheduled for the nasal endoscope operation were divided into three groups by random digits table: each group was 20 patients, group A, B, C was given propofol target controlled infusion with blood plasma target concentration 3,4,5 μ g/mi respectively. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2), blood glucose, serum cortisol, bispectral index ( BIS ), extubation time were recorded before anesthesia,at 30 min after the operation starting and 60 min after the extubation.Results The descent degree of HR and MAP at 30 min after the operation starting were group C ＞ group B ＞ group A (P = 0.024,0.010 );the descent degree of MAP at 60 min after the extubation were group C ＞group B ＞ group A (P = 0.011 ). BIS and extubation time were 65 ± 8 and (25 ± 7) min in group A, 53 ± 11 and( 36 ± 13 ) min in group B, 45 ± 12 and(45 ± 9 ) min in group C, there were significant differences among three groups(t = 2.476,P= 0.023;t = 2.657,P= 0.012). The blood glucose was increased at 30 min after the operation starting and 60 min after the extubation, the ascensus degree were group A ＞ group B ＞ group C (P= 0.000、0.000);the serum cortisol was decreased at 30 min after the operation starting, the descent degree was group C ＞ group B ＞ group A (P= 0.000), increased at 60 min after the extubation, the ascensus degree was group A ＞ group B ＞ group C (P= 0.001 ). Conclusions Propofol target controlled infusion with blood plasma target concentration 4-5 μ g/ml can ensure eligible depth of anesthesia, decrease pain stimulus, remain stable vital sign,depress the stress reaction caused by nasal endoscope operation efficiently,with short extubation time. It is an eligible blood plasma target concentration.

Objective:To investigate the blood lipid status and its variation regularity of a population of teaching staff in order to provide evidence for preventing hyperlipidemia.Method:Lipid indexes such as TC,Triglyceride(TG),LDL-C and HDL-C are inspected of a group of teaching staff over 40 years old in some certain university,and data statistics and analysis are conducted.Conclusion:Main behaviors of male and female teaching staff's hyperlipidemia are high TG and high LDL-C.Special focus should be put on blood lipid's variation level of middle aged males around 40 years old,periodical clinical monitoring should be done for female teaching staff over 50 years old.Medical information instruction on the prevention and control of high blood lipid should be strengthened in order to realize the unity of self control and social control.

Objective To investigate the effects of preconditioning with 3-nitropropionie acid on myocardial apoptosis induced by ischemia-reperfusion injury.Method Twenty-four rabbits were randomly divided into control group(group C,n=8),precondition group(group 3-NPA,n=8)and 5-HD group(group 5-HD,n=8).The group 5-HD was treated intravenously with 5 mg·kg-1 5-HD(ATP-sensitive potassium channels blocker),group C and group 3-NPA received normal saline instead of 5-HD.Ten minutes later,5-HD group and 3-NPA group were injected with 3-NPA(3 mg·kg-1)and the group C was injected with normal saline.Twenty-four hours later,the left anterior descending coronary artery was ligated for 30 min and then unclamped for 120 min to estabhsh ischemi-a-reperfitsion injury model.After reperfusion,the infarct sizes of ventricular myocardium,apoptotic myocardial cells and the expressions of Bcl-2 and Bax protein were measured.Results Infarct sizes and apoptotic myocardial cells in group 3-NPA were less than those in the others(P＜0.01).The expressions of Bcl-2 in group 3-NPA.in-creased as compared with group C(P＜0.05)and group 5-HD(P＜0.05),whereas the expressions of Bax in group 3-NPA decreased as compared with group C(P＜0.05)and group 5-HD(P＜0.05).Conclusions Preconditioning with 3-nitmpropionie acid reduces myocardial apoptosis induced by isehemia-reporfusion injury which is attributed to the opening of mitochondrial KATP channels.

Objective To investigate the change of the fibrin monomer (FM) level in the venous thromboembolic disease (VTE).To compare the diagnostic value of FM combined Wells score with the other detection methods.Methods In this case control study,121 cases were selected from the patients who were from general and orthopeadic surgery (including thrombosis group in 60 cases and non thrombosis group in 61 cases).The patients were assessed by Wells score.From one day before surgery, Plasma d-dimer (D-D) and fibrin monomer (FM) were periodic measured by CP-2000 d-dimer and fibrin monomer.Evaluation the value of d-dimer,fibrin monomer and fibrin monomer combined with Wells score in diagnosis of venous thromboembolic disease.The receiver operation cure(ROC) was drew to determine the diagnostic performance.Results The plasma FM level of patients with VTE in the thrombus group (26.11±38.34) μg/ml is higher than the non thrombus group (6.56±6.81) μg/ml and the control group (2.37±0.89) μg/ml (t=-3.82, t=-4.78,P<0.01);the sensitivity of FM was lower than the D-D (85% vs 93%);then the positive predictive value was lower than D-D (82% vs 87%) (χ2=27.01,P=0.000)but its specificity and negative predictive value (65%) are both higher than D-D (65% vs 44%)(71% vs 62%)(χ2=11.67,P=0.001);the sensitivity,the specificity,the positive predictive value and the negative predictive value of FM combined Wells score are increased (90%,85%,83%,89%)(χ2=20.95,χ2=16.65,P<0.01).The increased level of FM is earlier than imaging changes, and the elevated of plasma D-D is not obvious in a certain period of time.Conclusions The sensitivity and specificity of FM combined with Wells′ score is higher in the diagnosis of VTE, its prediction value in the diagnosis of VTE is higher.The FM level can be changed in the early stage of VTE, which has a certain value of early diagnosis.

Objective To evaluate the effect of phosphatidylinositol-3 kinase inhibitor LY294002 combined with dichloroacetate on apoptosis in human pulmonary arterial smooth muscle cells (SMCs) and AKT/GSK-3β/HK-2 signaling pathway.Methods Human pulmonary arterial SMCs were seeded into culture plates at a density of 2 x 104 cells/ml after 3-5 passages.After being incubated for 72 h,the SMCs were cultured in the medium supplemented with 0.2％ fetal bovine serum for 24 h to induce starvation prior to experiments.The cells were then randomly divided into 6 groups (n =6 each) using a random number table:control group (group C),positive control group (group F),LY294002 group (group L),different concentrations of dichloroacetate groups (D1 and D2 groups),and LY294002 combined with dichloroacetate group (group LD1).In group C,the cells were cultured in the medium supplemented with 0.2％ fetal bovine serum.In F,L,D1,D2 and LD1 groups,the cells were cultured in the medium supplemented with 10％ fetal bovine serum.LY294002 2 μmol/L was added to the medium in group L.Dichloroacetate l0 and 20 mmol/L were added to the medium in D1 and D2 groups,respectively.In group LD1,LY294002 (2 μmol/L) was added,and 30 min later dichloroacetate 10 mmol/L was added to the medium in LD1 group.The cells were incubated for 48 h.Flow cytometry was used to measure the cell apoptosis and mitochondrial membrane potential.The expression of phosphorylated AKT (p-Akt),phosphorylated glycogen synthase kinase 3β (p-GSK-3β),and hexokinase-2 (HK-2) was detected using Western blot.Apoptosis rate was calculated.Results Compared with group C,apoptosis rate was significantly increased,and mitochondrial membrane potential was decreased in D2 and LD1 groups,the expression of p-Akt,p-GSK-3β and HK-2 was up-regulated in group F,and no significant changes were found in apoptosis rate and mitochondrial membrane potential in F,L and D1 groups.Compared with group D2,apoptosis rate was significantly increased,mitochondrial membrane potential was decreased,and the expression of p-Akt,p-GSK-3β and HK-2 was down-regulated in LD1 group.The expression of p-Akt,p-GSK-3β and HK-2 was significantly lower in D2 and LD1 groups than in group F.Conclusion LY294002 combined with dichloroacetate can promote apoptosis in human pulmonary arterial SMCs possibly through blocking AKT/GSK-3β/HK-2 signaling pathway.

Objective To investigate the diagnostic value of cyclophilin A(CyPA)for chronic heart failure (CHF).Methods Eighty pateints,made a definite diagnosis as CHF,were classified 30 cases as A phase,29 cases as C phase,21 cases as D phase of them.30 healthy subjects were enrolled in this study.Serum CyP A was detcted by ELISA.NT-proBNP was detec-ted with Roche Cobas 6 000 automatic electrochemilu-minescence immunoassay system.Results The amounts of serum CyP A(x-±s,ng/ml)in healthy subjects and each group with CHF were 110.10±49.73,327.85±82.67,331.70±69.34 and 342.46±92.55.Using Oneway Anova,CyP A concentration of CHF was significantly higher than healthy controls (F=58.45,P<0.01).Further using Post Hoc Tests-Multiple Comparisons,the CyP A concentration of each group with CHF was significantly higher than the healthy control group (Mean differences were 217.75~232.36,P<0.01),but showed no significant difference between the groups with CHFs (Mean differences were 3.37~14.61,P>0.05).Results of ROC curves showed the AUC (CyP A)was 0.97.The best cutoff value was 198.39 (ng/ml).The sensitivity was 91.30%,the specificity was 93.30%.The correlation analysis showed that CyP A and NT-proBNP were correlated (r=0.30,P<0.01). CyP A and NT-proBNP combined detections showed the sensitivity was 93.80% and the specificity was 100%.Conclusion The Cyp A levels in CHF group are significantly higher than the control group,suggesting that Cyp A may be a factor for CHF appearance.These results indicate that combined detections may helpful to early diagnosis of CHF.

Objective To detect the methylation status of p16 gene promoter in CD4~+ T cells of patients with systemic lupus erythematosus(SEE),and its significance in the pathogenesis of SLE.Methods The pl 6 gene promoter methylation in peripheral CD4~+ T cells was detected with the Taqman probe-based realtime PCR(Methylight)technology in 28 patients with SLE and 20 healthy human controls.Results The methylation rate of p16 gene promoter in peripheral CD4~+ T cells was higher in patients with SLE than that in the controls(35.7%VS 10%,x~2=4.11,P<0.05).There was no correlation between SLE disease activity index (SLEDAI)and the normalized index of methylation(NIM)of p16 gene promoter(r_s=-0.29,P>0.05).Conclusion The methylation status of p16 gene promoter is aberrant in CD4~+ T,:ells of SLE patients,suggesting that the hypermethylation of p16 gene plays a certain role in the pathogenesis of SLE.