Abstract:Objective: To survey the prevalence of HIV-1 drug resistance and subtype distribution among population with newly infected with HIV who were younger than 25 years of age and not received antiretroviral treatment. Methods:Blood specimens of HIV infected individuals were collected and HIV-1 pol gene was sequenced. The genetic mutations associated with drug resistance were identified with Stanford HIV Drug Resistance Database online. The phylogenetic tree was built with MEGA4.0 software,and subtypes were analyzed. Results: No mutations associated with HIV-l drug resistance was found in the reverse transcriptase and protease region. There are 4 subtypes,CRF01_AE,B,CRF07_BC and CRF08_BC,identified among 47 isolates. CRF01_AE was predominated,which account for 59.6%,followed by B subtype which reached to 25.5%. Conclusion: The first line regiments of national anti-retrovirus treatment is still effective. Testing drug resistance to HIV is not needed before starting anti-retroviral therapy(ART). Subtype distribution of HIV changed obviously compared with 2006. To further know dynamic HIV prevalence in Jiangsu province,the molecular epidemiology study on HIV-infected population confirmed within the past two years should be conducted.

Abstract:Objective: To analyze and compare the epidemiological characteristics of the patients who received highly active antiretroviral therapy(HAART) during 2005 to 2010 in Jiangsu province. Methods: According to the base data of patients during 2005 to 2010,Excel database was established and statistical analysis was performed using SPSS 17.0 software. Results: There were 1 276 patients during 2005 to 2010 totally,the number of patients were increasing by the year. There was 93.7% of the patients from Jiangsu province;the ratio of male to female was 2.7∶1;the average age was 39.2 years old and the number of young patients aged 16 to 25 was increasing;65.1% of the patients have married;patients were mainly detected and diagnosed by hospitals;76.1% of the patients were infected with HIV through sexual transmission,while the proportion of men who have sex with men(MSM) is significantly higher in 2010 than before;the average CD4+ T cell counts of cases were only 134.9 counts/μl;147 days as the median of the interval between the time of HIV confirmation and anti-retroviral therapy(ART) beginning,both of them are significantly different from those during 2005 to 2009. Conclusion: It’s late for the AIDS to start HAART in Jiangsu province during 2005 to 2010,although it’s earlier than before. In view of the AIDS patients were diagnosed at late stage,earlier detection and diagnosis of HIV positive cases still should be strengthened.

Abstract:Medical anthropology focuses on the health care model and disease treatment research in different cultures with the theories and methods of anthropology. There are two different angle of the view: biological cultural perspective and social cultural perspective. Medical anthropology advocates that theory and practice of diseases essentially should fall into culture category,which represents a huge challenge to traditional biomedicine model and systems.

Abstract:Objective: To understand related knowledge and practical behavior of AIDS on the female sex workers(FSWs) in public amenities in Jiangsu province and provide a more effective theoretical basis for controlling the prevalence of AIDS and increasing the rate of condom use in FSWs. Methods: The trained interviewers randomly interviewed 867 entertainment FSWs and made the questionnaire survey with them in three cities of Jiangsu province using anonymous questionnaire designed by our group. Results: The average age of the entertainment FSWs was 27.12 years old. The respondents,most of whom received primary and secondary school education,are mostly married or having regular sexual partner. Entertainment FSWs have a certain but not comprehensive understanding of AIDS-related knowledge. The rate of condom use during the latest sexual intercourse with their regular sexual partners and customers was 57.0% and 77.7% respectively and the difference was statistically significant between fixed sexual partners and customers on rate of condom use(χ2 = 73.125,P = 0.000),while the rate of condom use of the fixed sexual partners of different ages was not significantly different(χ2 = 2.753,P = 0.431). This suggested that the customers didn’t realize that the use of condom can prevent the spread of the sexually transmitted diseases such as AIDS. Results of a Logistic regression analysis indicated that age,household location,regular sexual partners and the awareness of AIDS prevention measures were associated with condom use during the latest sexual intercourse. Knowledge related to STD/AIDS mostly came from television(69.9%),followed by friends (45.5%). When the respondents were suspicious of suffering from STD/AIDS,85.9% of them choose to seek medical treatment from public hospitals. Conclusion: Raising the awareness of preventive measures is an essential factor to increase the use of condom. The rate of condom use of their regular partners was low and this would lead to the further spread of AIDS. Further efforts should be made to strengthen their health education and behavioral intervention according to the characteristics of this group,such as the level of education,life habit and behavior characteristics. In practice,we can try to work more flexibly and use a more comprehensive strategy to control the prevalence of AIDS.

Abstract:With the implementation of the policy of reform and opening up,the urban-rural dual structure was getting looser. The minority areas presented frequent flow of trends in the background. The population flow was not only a carrier of cultural contact and communication,but also the cause of the transmission of diseases. The author selected Zhaojue county,Liangshan Yi area as the point to do the fieldwork,investigated and analyzed the circumstance and situation of disease prevention and control of minority areas from the perspective of the local social culture.

Abstract:Two solutions by God and medicine is an important traditional conception of treatment in Zhuang society and culture,which diversifies Zhuang people’s treatment practice. The article tried to discuss the relationship between folk treatments and traditional culture of Zhuang nationality by treatment choice.

Abstract:Objective: To investigate the effects of OX40 ligand(OX40L) reverse signaling on the expression and activity of matrix metalloproteinase-9 (MMP-9) in the cultured mouse aortic endothelial cells (MAECs). Methods: Aortic endothelial cells were isolated from C57BL/6J mice aged 8 to 10 weeks and cultured to the second passage for experiments. The cultured MAECs were divided into 4 groups:control group,sOX40 group,sOX40+anti-OX40L group and sOX40+Bapta-AM group,and stimulated with DMEM,soluble OX40,anti-OX40L monoclonal antibody and calcium chelator Bapta-AM,respectively. The mRNA and protein expressions of MMP-9 were determined by RT-PCR and Western blot. The activity of MMP-9 was assayed by zymography. The intracellular calcium ([Ca2+]i) in MAECs was detected by calcium imaging using fura-2. Results: A significant increase in intracellular calcium level of MAECs was observed after stimulation with soluble OX40 (0.1 mg/L) for 48 hours compared to the control,and MMP-9 mRNA and protein levels were also markedly elevated. The activity changes of MMP-9 in cell culture supernatant was consistent with that of intracellular level. Notably,these elevations can be blocked by soluble anti-OX40L monoclonal antibody(0.1 mg/L) or Bapta-AM(20 μmod/L). Conclusion:The stimulation of OX40L reverse signaling can activate the expression of MMP-9 on both mRNA and protein levels through the elevation of intracellular calcium of MAECs,suggesting that the OX40/OX40L signaling pathway may be one of the pathways contributing to the MMP-9 elevation in progression of atherosclerosis.

Abstract:Through analyzing and explaining the contradictory data of an HIV/AIDS risk survey at a highway construction site,the author revealed that the comprehension of some key concept of public heath between the investigators and survey participants were different,which impaired the information acquistion and the effect of intervation,then advanced that anthropology could provide a unique analytical perspective to approach the issues.

Abstract:The governance structure is regarded as the self-protection mechanism of the parties of the hospital (investor, doctor, management, patient and supplier). Lack of the protection, the parties will increase the price as the compensation. Who will be the member of the public hospital governance structure is the critical issue important issue. The author applied the transaction cost theory to analyze this issue and concluded that the investor (government), doctor and the management should be the member who had the voting rights and the supplier, the patient should be the member who had the informed rights. The board of the director should consist of the voting-rights member and the supervising board should consist of the informed rights member.

Abstract:Objective:To elucidate whether Ginsenosides-Rbl (Gs-Rb1) improved myocardial remodeling and whether Gs-Rb1 improved myocardial fibrosis related protein/mRNA in rat heart with chronic heart failure(CHF) induced by adriamycin. Methods:CHF models of rats were performed by adriamycin. CHF rats were randomly divided into CHF group (n = 15) and Gs-Rb1 group(n = 17) that received 70 mg/(kg·d) Gs-Rb1. In addition,age-matched health rats were referred as control group(n = 10). At the 4th week,the heart to body weight (HW/BW) and the left ventricular to body weight (LW/BW) was analyzed by echocardiography. Histology was used to assess myocardial interstitial fibrosis in the heart. The expression of transforming growth factor β1 (TGF-β1),connective tissue growth factor (CTGF) and endothelin 1 (ET-1) were detected by Western blot and RT-PCR. Results: Compared to CHF group,Gs-Rb1 significantly improved HW/BW(P = 0.005) and LW/BW(P = 0.000);The protein expression of TGF-β1,CTGF and ET-1 were more significantly down-regulated in Gs-Rb1 group than in CHF group,which in those both group were significantly higher than those in control group(P < 0.05);The mRNA expression of TGF-β1,CTGF and ET-1 were more significantly down-regulated in Gs-Rb1 group than in CHF group,which in the both group were significantly higher than in control group(P < 0.05). Conclusion:The effects of Gs-Rb1,on improving myocardial remodeling in CHF rats,were fulfilled by increasing protein and mRNA of TGF-β1,CTGF and ET-1.

Abstract:Objective: To investigate the mechanism of astragaloside IV(As-IV) on alleviation of hypoxia/reoxygenation induced myocardial injury. Methods: Cultured cardiomyocytes from neonatal SD rats were exposed to 6 h of hypoxia followed by 3 h of reoxygenation(H/R). Meanwhile,As-IV (30 -滋mol/L) was treated in H/R cardiomyocytes. Myocytes injury was determined by the release of creatine kinase (CK-MB) in supernatant. Myocardial SERCA2a activity was measured,PKA C subunit α (PKA-Cα) gene expression and Ser16 phosphorylated phospholamban(Ser16-PLN) protein expression level were detected by real-time PCR and Western blot respectively. Results: Cultured cardiomyocytes exposed to hypoxia/reoxygenation presented statistically higher CK-MB in supernatant,decreased myocardial SERCA2a activity,reduced PKA-Cα gene and Ser16-PLN protein expressions(P < 0.05). But As-IV treatment significantly prevented the alterations in H/R cardiomyocytes mentioned above. Conclusion: These results suggest that the cardioprotective effects of As-IV may be associated with upregulation of PKA-Cα gene and Ser16-PLN protein expressions,thus restoring the SERCA2a function in hypoxia/reoxygenation injury.

Abstract:This article expounded the main idea of medical organizations with various forms from the game observation,then put forward the path choice,which including fair developing circumstance,perfect the regional health planning,overall planning the function of private hospitals and public hospitals,accelerating the separation between public hospital regulation and management affaires,and establishing the corporate governance configuration.

Abstract:Objective: To explore the induced expression of human anti-Trop-2 antibody fragment Fab in E.coli TOP10F ′ and to optimize the expression and purification conditions of protein. Methods: The plasmid containing anti-Trop-2 Fab antibody gene was transformed into E.coli TOP10F ′. It was tested to replace the culture medium before induction of anti-Trop-2 Fab expression. The effects were compared in different induction temperatures,induction times and glucose added before induction on protein expression. Anti-Trop-2 Fab was purified by affinity chromatography and its immunological characteristics were evaluated by immunofluorescence and flow cytometry. Results: In the culture medium by adding 5 g/L of glucose,the expression of anti-Trop-2 Fab significantly increased. The temperature of 16℃ can induce more expression of Fab than other temperatures. The expression of anti-Trop-2 Fab reached peak after adding inducer for 12 hours. Conclusion: This study provides the basis of large-scale preparations of anti-Trop-2 Fab in prokaryotic expression system and subsequent utilization of anti-Trop-2 Fab in tumor targeted therapy.

Abstract:The reform of medical liability for damage in China affirmed the basic status of tort responsibility in the field of medical damage liability,formed the dominant mechanism to resolve medical malpractice liability by direct action,adopted the general personal injury compensation system to compensate the medical damages. The direct litigation of medical malpractice liability system,the general compensation of medical damage, and the inconsistent of medical evidence identification system were the basic problems of medial malpractice liability reform in China.

Abstract:Objective:To construct the full-length nonstructal-1 (NS1) gene of influenza A (H3N2) into a eukaryotic expression vector and express NS1 gene in mammalian cells,as well as to investigate the effects of NS1 on proliferation of 293T cells. Methods:The NS1 gene of influenza A (H3N2) was amplified by RT-PCR and cloned into pMD18-T simple vector to construct a plasmid,named pMD18-T/NS1. the pMD18-T/NS1 and the pXJ40-HA were double-digested,to yield the recombinant eukaryotic expression vector pXJ40-HA-NS1. The expression of the NS1 gene in transfected 293T cells was identified by Western blot. The effects of NS1 gene on cell proliferation were measured with 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide(MTT) method. Results: The recombinant eukaryotic expression vector pXJ40-HA-NS1 was successfully constructed. The expression of NS1 protein was detected by Western blot. NS1 over-expression inhibited the proliferation of 293T cells. Conclusion: The full-length NS1 gene has been obtained and its recombinant eukaryotic expression vector has been successfully constructed. And we found that the proliferation was dramatically inhibited in 293T cells over-expressed with NS1 protein. The construction of eukaryotic expression plasmid of NS1 gene made it possible to set up the cell model expressing NS1 protein and further study the effects of NS1 protein on cell proliferation and apoptosis.

Abstract:Outpatient finance scheme is important policy guidance to enhance the attractiveness of new rural cooperative medical system(NCMS). By analyzing the current situation of the financing operation for outpatient service of NCMS in Zhangjiagang city from 2007 to 2009,the article proposed the suggestions to keeping sustainable and stable operation of the financing operation for outpatient service of NCMS in Zhangjiagang city,as well as providing reference for relevant work in other regions.

Abstract:Objective: To investigate the expression pattern of microRNA(miRNA) in pancreas of 2 type diabetes rats treated with ramipril by miRNA array technique. Methods: Male Spmgue-Dawley (SD) rats were injected in peritoneal with streptozocin (40 mg/kg) and fed with high sugar and fat for 1 weeks,then treated with ramipril [50 mg/(kg·d)] for 28 days. When the rats were sacrificed,total RNA was extracted from myocardium and the differential expressions of miRNA were detected by miRNA array. Results: Contrast to control group rats,the expression level of 27 miRNAs changed significantly in ramipril group rats,20 of them was up-regulated and the other 7 were down-regulated. Conclusion: The expression profile of miRNA changes in pancreas of 2 type diabetes rats treated with ramipril,which implies that those changed miRNAs may play an important role in improvement of pancreas function in SD rats.

Abstract:After 30 years’ development the commercial medical insurance in China obtained the initial results. For example,the business had been expanded and the insurance density had increased steadily,insurance product was variety with more and more proprietors,the service areas had been broaden continually while the social influence became greater. However,some problems also existed,such as the low health insurance penetration rate,the small proportion of GDP,the obvious contradiction between supply and demand,the tense conflict between market potential and risk and so on. The article advanced that commercial medical insurance should grasp the favorable opportunity of the new medical reform,use the experience of other countries for reference,and accelerate the healthy development,in order to meet the diversified needs of the masses of medical security.

Abstract:Objective:To investigate the pharmacokinetics and bioavailability of rabeprazole in healthy Chinese volunteers. Methods: A total of 20 male subjects were recruited and randomly assigned at the beginning of the study to receive a single dose of rabeprazole(20 mg) administrated either intravenously or orally. Following a 7-day washout period,all subjects received another 20 mg dose via the alternate route. Intravenous dose was given in constant infusion over 30 min,and the oral dose was given in two 10 mg tablets. Results: In intravenous administration,the terminal half-life was (62.4 ± 10.7) min;the Cmax was (1 308.6 ± 266.4) ng/ml;the total body clearance was (0.21±0.05) L/min;the AUC0-τ and AUC0-∞ were (99.6 ± 21.9) mg·min/L and (102.4 ± 23.3) mg·min/L,respectively. In oral administration,the half-life was (64.2 ± 15.5) min;the Cmax was(508.3 ± 180.2) ng/ml;Tmax was attained at about 229.5 min;the total body clearance was (0.31 ± 0.10) L/min;the AUC0-τ and AUC0-∞ were (69.5 ± 20.0) mg·min/L and (70.6 ± 20.2)mg·min/L,respectively. Conclusion: The bioavailability of rabeprazole was estimated to be 70.1% in healthy Chinese volunteers. The total body clearance after oral administration was significantly higher than that after intravenous administration (P < 0.01).

Abstract:Objective: To observe the depot-specific regulation of sex hormones on 11β-hydroxysteroid dehydrogenase type 1(11βHSD1) mRNA expression in adipose tissue in child-bearing and menopausal women. Methods: Subcutaneous(Sc) and omental(Om) adipose tissues were obtained from 6 child-bearing(aged 29.83 ± 3.43 years) and 16 menopausal women(aged 65.19 ± 6.81 years). Pieces of adipose tissue were incubated with estrogen or testosterone for 24h. The expression of 11βHSD1 mRNA in adipose tissues was measured by real time PCR. Results: Estrogen increased 11βHSD1 mRNA expression in Sc adipose tissue (P < 0.05) but decreased 11βHSD1 mRNA expression in Om adipose tissue by 30% among menopausal women. Androgen decreased 11βHSD1 mRNA expression in Sc adipose tissue of child-bearing period women by 40%(P = 0.001),and up-regulated 11βHSD1 mRNA expression in Om adipose tissue of menopausal women by 1.9 fold(P = 0.005). Conclusion: The sex hormones stimulate 11βHSD1 mRNA expression in adipose tissue in age- and depot-specific pattern,which may be important molecular mechanism of distribution of body fat in child-bearing period and menopausal women.

Abstract:As the most outstanding representative of the animal rights movement,Tom Reagan used large amount of fierce language to appeal for animal rights. However,lacking persuasive theoretical arguments in the origin of the animal rights theory,basis of existence,definition of the protective scope etc made his proposition of “empty cage theory”did not have realistic feasibility in practical level. Undeniably,as a realistic theoretical representation form,animal rights theory was still be regarded as one of the most significant progress on the development of human ethics.

Abstract:At present, the majority of younger Chinese medical personnel has high professional quality and personal morality, while the moral situation of the minority of them has a worrying trend. The article introduced the current state of the morality of the medical personnel and presented a brief logical analysis of the causes, then explored how to strengthen the ethical standards of medical personnel from the following aspects, such as the ideal and faith, institutional framework, behavioral science, hospital culture and team construction.

Abstract:Objective: To explore the expression and significance of P34h in the patients with obstructive azoospermia. Methods:Reverse transcription-polymerse chain reaction(RT-PCR) and Western blot assay were used to examine different mRNA and protein expressions of P34h in epididymis tissues in 30 cases of obstructive azoospermia due to different obstruction sites which located at the vas deferens or ejaculatory duct. Results: The mRNA expression level of P34h in epididymis tissues was different. P34h mRNA expression of the group with obstructive site at vas deferens was lower than that with obstructive site at ejaculatory duct(mean value of P34h/-茁-actin:0.418 ± 0.045 vs. 0.719 ± 0.069,P < 0.05). P34h protein in the group with obstruction at vas deferens was significantly lower than that with obstruction at ejaculatory duct (protein:0.095 ± 0.014 vs. 0.276 ± 0.054,P < 0.05). Conclusion: The mRNA and protein expressions of P34h were significantly different in epididymis tissues due to various obstructive factors. It may play an important role in sperm mature obstacles in the patient with obstructive azoospermia.

Abstract:With the deepening of medical care reform,the hospitals and doctors bear more and more responsibility to the society and patients. It is very important to cultivate the medical personnel professional spirit and adjust the doctor-patient relationship.

Abstract:Objective:Fibrodysplasia ossificans progressiva(FOP) is a rare and disabling genetic condition of congenital skeletal malformations and progressive heterotopic ossification(HO),associated with the mutation in the activin A type 1 receptor / activin-like kinase 2(ACVR1/ALK2) gene. The purpose of this study was to report one FOP patient with atypical clinical findings and to identify the genetic entity. Methods: Clinical diagnosis was based on physical examination,radiological findings and biochemical tests. For mutation detection,the blood samples from the FOP patient,his parents and 60 normal controls were collected with informed consent. Genomic DNA was isolated from peripheral lymphocytes and all the exons of ACVR1 were amplified by PCR. The PCR products sequenced directly with the cycle sequencing methods. Then we generated the three-dimensional model of protein structure for the cytoplasmic domain of the R258S in ACVR1 to evaluate its receptor function. Results: The patient had congenital minimal malformations of the great toes and radiographic evidence of heterotopic ossification at the time of evaluation. The process of heterotopic bone formation was a mild course and did not follow the typical temporal and spatial patterns. Analysis of ACVR1 gene revealed that the patient had a heterozygous missense mutation,c.774 G>C(R258S),which is located in the kinase domain of ACVR1. We also find that all the people,including the patient,the parents and 60 normal controls,occurred nonsense mutation,c.690 G> A(E230E). In the protein modeling,ARG258 and SER194 can form the H-bonds. When the ARG258 is substituted by SER,the H-bonds are lost,so the αGS1 and the αC helix conformations do shift and make ACVR1 into an“open” conformation and constituently activated. Conclusion: Most patients showing typical FOP phenotypes have the heterozygous c.617G>A(R206H) mutation belonging to the GS domain of ACVR1. Our report describes a patient affected with FOP showing mild progressive symptoms,and these atypical FOP phenotypes may associate with a novel mutation(c.774 G>C),affecting a conserved residue of the ACVR1 kinase domain.Our findings make the relations between phenotypes and genotypes of FOP better understood.

Abstract:Noble medical ethics is the core component of values of medical students. The article analyzed the significance of the construction of integrity culture of university on the early education of medical ethics of medical students, advanced to bulid the “first line of defense” in the values of medical students by extending the meaning of honest and clean university culture and innovating the carrier of integrity culture.

Abstract:Employment value is the individuals’ judgment on value of an occupation,which plays critical role in professional life,directly determines career behavior,and affects work attitudes and enthusiasim. Under the influence of traditional gender culture,there still is gender difference of the employment value of highly educated postgraduates. From the feminist perspective,the article investigated the employment value of female postgraduates of medical university,explored the possible pathway to promote vocational values then realize the life value of the female postgraduates.

Abstract:Objective: To determine the prevalence and characteristics of mitochondrial DNA (mtDNA) 12S rRNA gene and tRNASer (UCN) gene mutations in Chinese subjects with non-syndromic hearing impairment. Methods: The peripheral blood samples were obtained from 135 patients with non-syndromic hearing loss and 126 normal hearing controls. Genomic DNA was isolated from the peripheral leukocytes of all participants using the Puregene DNA Isolation Kits. The subject’s DNA fragments spanning the entire mitochondrial 12S rRNA gene and tRNASer(UCN) gene were PCR amplified. Each fragment was purified and subsequently analyzed by direct sequencing to identify deafness-associated mutations. Results: There were totally eleven 12S rRNA sequence variants detected in 135 hearing-impaired subjects. Of those,4 variants are known deafness-associated mutations with variable frequencies of 4.4% in A827G,1.5% in T961C,0.7% in T1095C and 1.5% in A1555G. Other variants,such as T1005C,C1048T,T1119C,G709A,C752T and A1382C,seem to be polymorphisms rather than causes of disease. On the other hand,we did not find C1494T mutation in the 12S rRNA gene and any of the known deafness-associated mutations in tRNASer (UCN) gene in all individuals. Conclusion: The 12S rRNA gene may be a hot spot for mitochondrial mutations causing non-syndromic hearing loss in the Han nationality population in Nanjing,Jiangsu province,with a total carrier frequency of 8.1% for deafness-related mutations.

Abstract:Objective:To explore the methylation status and expression of Ras association domain family 1A (RASSF1A),and the possible effect between promoter aberrant methylation and the pathogenesis of pancreatic cancer. Methods: We detected the methylation status of RASSF1A promoter CpG island (CGI) in pancreatic cancer cell line PANC-1,normal pancreatic tissue and 1 pairs of pancreatic tissues(cancer and para-cancerous tissue) by using bisulfite genomic sequencing PCR (BSP) combined with TA clone for sequencing. The methylation rate of RASSF1A in PANC-1 was compared before and after treatment of the inhibitor of DNA methyltransferase (5-aza-2-deoxycitydine,5-aza-dC),and reverse transcription PCR(RT-PCR) were used to explore mRNA expression of the RASSF1A gene. Results:The average methylation rate of RASSF1A promoter CGI was 100.00% in PANC-1,1.79% in normal pancreas,93.75% in para-cancerous tissues,and 100.00% in cancer tissues. The methylation rate of para-cancerous or cancer tissue was higher than that of normal pancreas(P < 0.01),but there was no significant difference between para-cancerous tissues and cancer tissues(P > 0.05). After the treatment of 5-aza-dC,the methylation rate in PANC-1 was decreased to 88.89%(P < 0.05),but the mRNA of RASSF1A had no change. Conclusion: This promoter hypemlethylation is correlated with RASSF1A gene expression in pancreatic cancer cell line PANC-1 and pancreatic tissues,and plays a key role in RASSF1A silencing. Aberrant hypermethylation of RASSF1A could probably become early diagnosis index and treatment target of pancreatic cancer.

Abstract:Objective:To investigate the association of a single nucleotide polymorphism(SNP),rs7574865 G>T,of the signal transducer and activator of transcription 4 (STAT4) with Crohn’s disease(CD) in the Chinese Han population. Methods: Genomic DNA from 636 individuals of Chinese Han origin including 318 patients with CD and 318 healthy controls was analyzed for the SNP (rs7574865) of the STAT4 gene. SNP rs7574865 G>T was genotyped by polymerase chain reaction and direct sequencing. A Chi-square test was used to determine the association of SNP with CD. Results: The frequencies of genotypes GG,TG and TT at SNP rs7574865 G>T were 0.110,0.431 and 0.459 in CD patients,while 0.097,0.450 and 0.453 in healthy controls. The frequency of G or T allele was 0.325 or 0.675,respectively in CD patients,while 0.322 or 0.678 in healthy controls. Conclusion: These findings indicate that no significant difference is observed between STAT4 polymorphism and Crohn’s disease in the Chinese Han population.

Abstract:In view of existing sitnation of teaching quality in independent medical colleges,the authors proposed monitoring system of “four in one” through four years of education practice combining the international standard of ISO9004-2,that were “theory and practice”,“management and teaching”,“monitoring and mechanism of evaluation”,“the dislocation of college and independent medical college”.

Abstract:Objective: To evaluate the severity of acute pulmonary embolism (APE) patients by cardial troponin T(c-Tn-T) and brain natriuretic peptide(BNP) and explore its prognostic value. Methods: From January 2005 to July 2009,251 patients diagnosed with APE were enrolled in this study. The level of c-Tn-T and BNP,PaO2 and PaCO2,heart doppler index and clinical outcomes situation were collected. According to the results of PaO2 and PaCO2,patients of APE were divided into three groups. We compared differences between groups and analyzed the correlation. According to the clinical outcome,patients of APE were divided into good outcome group and bad outcome group. We compared the differences between two groups of c-Tn-T,BNP,PaO2,PaCO2 and the predictive values from c-Tn-T and BNP. Results: Along with serious degree of APE increased,c-Tn-T and BNP index significantly increased,and the right cardiac insufficiency significantly increased with statistically significant difference (P < 0.05). Right ventricular enlargement was positively correlated with c-Tn-T and BNP (r = 0.614,P = 0.001;r = 0.598,P = 0.005);Systolic ventricular septal retrorse motion positively correlated with BNP(r = 0.791,P = 0.000);Pulmonary hypertension positively correlated with c-Tn-T (r = 0.711,P = 0.000). To the group with bad outcome,the c-Tn-T,BNP,PaO2,PaCO2 and right cardiac insufficiency were obviously poorer than the group with good outcome (P < 0.05). ROC curves analysis showed that the area under curve(AUC) were large in the curve of the BNP and c-Tn-T. The optimum operating point for c-Tn-T and BNP were 0.94 ng/ml and 458.12 pg/ml,respectively. Conclusion: c-Tn-T and BNP can assess severity of disease for APE patients. At the same time,they also provide an objective basis for clinical treatment and prognosis assessment.

Abstract:Objective: To investigate the effects of ulinastatin on inflammation reaction and postoperative cognition disorders (POCD) in patients undergoing cardiac valve replacement surgery. Methods: Total 42 patients undergoing cardiac valve replacement therapy with cardiopulmonary bypass(CPB) were randomly divided into two groups. Group U(n = 21):the patients received ulinastitin 12 000 U/kg before incision by intravenously pumping,6 000 U/kg ulinastatin was added to the priming solution,and 6 000 U/kg ulinastatin was given before 5 min of the aortic decamping. Group C (n = 21):the control group was used the same dose of saline. Blood plasma concentrations of IL-6,IL-10,TNF-α and S100β concentration were determined before incision (T1),10 min after CBP (T2),30 min after CBP (T3),1 h after CBP (T4),3 h after CBP (T5),24 h after CBP (T6). Cognition state of every patient was evaluated by minimental state examination (MMSE) at 1d before operation and 3d after operation to record the number of the incidence of POCD. Results: The plasma concentrations of IL-6,IL-10,TNF-α and S100β of two groups at each time point of T2 to T6 were significantly higher than those at T1 point,(P < 0.05);Compared to Group C,the plasma concentrations of IL-6,TNF-α,S100β in Group U were significantly lower and IL-10 in Group U was higher at each time point of T2 to T6(P < 0.05);The incidence of POCD in group C (7 patients) was significantly higher than that in group U (2 patients) (P < 0.01). Conclusion: Prophylactic of ulinastatin in patients undergoing the cardiac valve surgery can decrease the incidence of POCD. The possible mechanism was that ulinastatin could cut down the relationship between inflammatory reaction in CBP and POCD.

Abstract:Objective: To investigate the relatedness in 60 drug-resistant Escherichia coli(E.coli) strains. Methods: Drug-resistance related genes were analyzed by PCR,including 4 kinds of housekeeping genes and 45 kinds of horizontal transfered genes related to 3 kinds of antimicrobial agents:beta-lactams,aminoglycosides,quinolones,as well as 7 kinds of genetic markers of integrons,transposons,insertion sequences and conjugal plasmids. They were used for the sample clustering analysis. Results: Polymorphism were distinct in 60 E.coli strains. Most strains showed evolution. Only 3 strain groups which consisted of strain 6 and 53,strain 10 and 14,strain 7,8,26 and 40,were the same clones carried the same genes. Conclusion: Sample clustering analysis of drug-resistance related genes could distinguish the strains with the same antimicrobial resistance characteristics,which was significant in epidemiologic research and provide convenience for tracing transmissible routes of drug-resistant strains.

Abstract:Objective: To investigate the distribution of acquired resistance-related genes and markers of mobile genetic elements,and their relationships in pandrug-resistant Acinetobacter baumannii(PDR-ABA). Methods: From March 2010 to May 2010,20 strains of PDR-ABA were collected from clinical specimen. Then,57 kinds of acquired resistance-related genes against beta-lactams,aminoglycosides,quinolones,and 8 kinds of genetic markers of mobile genetic element were analyzed by PCR. The index cluster analysis was used to investigate their relationships. Results: In 20 strains of PDR-ABA,5 kinds of acquired beta-lactam-resistance genes,4 kinds of acquired aminoglycoside-resistance genes,1 kinds of acquired quinolone-resistance genes,and 5 kinds of genetic markers of mobile genetic elements were detected. Index cluster analysis showed that acquired resistance-related genes were associated with mobile genetic elements. TEM-1,ADC-like,OXA-23,aac(6′)-Ⅰb,ant(2＂)-Ⅰ,ant(3＂)-Ⅰ,aphA1 and adeB had close relations with tnpU,ISCR1,IS26,ISaba1;DHA-1 and CARB also had relations with IS903. Conclusion: In this group of PDR-ABA,acquired resistance-related genes played an important role in resistant phenotypes of antimicrobial agents,and acquired resistance-related genes were associated with mobile genetic elements.

Abstract:Objective:To investigate resistance to pathogens isolated from blood culture of the First Affiliated Hospital of Nanjing Medical University in 2010,which can be used to guide clinical therapy. Methods: Total 3 625 blood culture samples were collected from this hospital in 2010. Bacteria and fungus were identified by API systems;bacterial drug sensitivity was determined by disk diffusion method;drug sensitivity of fungi were determined by Rosco method;and Whonet 5.5 software was used for data analysis. Results: Among the 3 625 blood culture samples,419 cases showed positive. Gram-positive bacteria accounted for 57.8%,Gram-negative bacteria accounted for 38.4%,and fungi accounted for 3.8%. The resistance analysis showed that there was no resistant strain to vancomycin and teicoplanin in Staphylococcus and Enterococcus. Enterobacteriaceae isolates were highly sensitive to carbapenem. Non-fermenting bacteria showed a relatively high resistance to many antimicrobial drugs. Conclusion: There are many different kinds of pathogens isolated from blood culture,which showed high resistance to many antimicrobial agents.

Abstract:Objective: To determine prevalence and multiple-antimicrobial-resistant spectrum of Salmonella contamination on chicken carcasses. Methods: According to GB 4789-2008,Salmonellas were separated and identified,and drug resistance of the strains was analyzed using broth dilution method. Results: Salmonella was detected in 34.8%(71/204) of samples. Two Salmonella serovars were identified;predominant ones included Albany(29.6%) and Indiana(50.7%). Most of the Salmonella isolates tested,exhibited resistance to more than three antimicrobial agents used. Twenty-four strains(33.8%) were resistant to three to seven kinds,nineteen strains(26.8%) were resistant to eight to twelve,and twenty-six strains(36.6%) resistant to thirteen and sixteen antibiotics. Resistance to the following antibiotics was common among isolates:nalidixic acid (100%),sulphadiazine(98.6%),ampicillin (97.2%),sulfamethoxazole(85.9%),minocycline (85.9%) and amoxicillin/clavulanic acid (84.5%). Conclusion: High prevalence of Salmonella and the relatively high resistance among the bacteria suggested monitoring of the Salmonella infection and drug resistance on chicken carcass should be strengthened in the future.

Abstract:Objective: To evaluate the safety and efficacy of radio-chemotherapy for middle-late stage patients with pancreatic carcinoma. Methods: MEDLINE,EMBASE,the Cochrane Library,CNKI and Wanfang Database were searched without language limitation. The end of time was at January 1st,2011. All randomized controlled trials comparing chemotherapy or radiotherapy alone with radio-chemotherapy for treating middle-late stage pancreatic carcinoma were identified and screened by two reviewers and the methodological quality of the included randomized controlled triads were evaluated by mediated Jadad scale. The RevMan4.2 software Wits was used for the analysis of the dam extracted from the included randomized controlled trials. Results: Eighteen randomized controlled trials involving 944 patients were included with 17 trials published in Chinese and 1 in English language. Meta-analysis of the data extracted from the included randomized controlled trials showed the radio-chemotherapy could significantly improve the overall survival rates compared with chemotherapy or radiotherapy alone,the corresponding relative risk(RR) values(95%CI) for the 6-month,l,2,and 3-year survival rate were 3.01(1.88~4.79),1.97(1.48~2.63),3.55(2.04~6.17)and 3.92(1.07~14.34)respectively;and the effective rate of tumor and pain relief rate were 3.18(2.25~4.50) and 2.85(1.85~4.41). Side effects of the radio-chemotherapy were reported in 15 randomized controlled trials mainly hematopoietic toxicity including leucopenia and thrombocytopenia;gastrointestinal tract effect including nausea,vomit,hiccups,loss of appetite,indigestion,the bowel movement times increasing,gastric and duodenal mucosal ulcer,diarrhea;The neuro-toxicity and fever were observed in some patients. Conclusion: The general analysis showed that compared with radiotherapy and chemotherapy alone,radio-chemotherapy could improve total survival rate for patients with late-stage pancreatic carcinoma,the catabatic rate of pain and tumor focus efficacy rate,higher safety and was a better method of treating middle-late stage pancreatic carcinoma.

Abstract:Objective: To evaluate the association between coronary heart disease(CHD) and serum concentration of monocyte chemoattractant protein-1(MCP-1). Methods: CNKI,WanFang,VIP and PubMed databases were searched,and the end time was December 31,2010. Statistical analysis was performed with the software program review manage,version 4.2. Fixed-effects model and random-effects model were applied to process these data. Results: There were 13 clinical trials qualified under our selection criteria. The study included 396 stable angina(SA) patients,366 unstable angina(UA) patients,268 acute myocardial infarction(AMI) patients and 446 healthy control group. Meta-analysis showed that the standardized mean difference(SMD)of MCP-1 concentrations in the patients with SA was 0.71(95%CI:0.30~1.12),SMD of UA group was 1.98(95%CI:1.15~2.81),SMD of AMI group was 2.69(95%CI:1.67~3.70). Each SMD of those three groups was higher than that of the healthy control group(P < 0.01). Moreover,serum MCP-1 concentrations in the patients with UA were 0.77 to 2.20 times of standard deviation higher than those in the patients with SA,and the concentrations of serum MCP-1 in the patients with AMI were 0.32 to 0.67 times of standard deviation higher compared to those in the patients with UA. Conclusion: High serum MCP-1 level is associated with the severity of CHD,while the precise relationship between serum MCP-1 concentration and CHD in Chinese population requires prospective study.

Abstract:Objective:To investigate the efficacy and safety of magnetic navigation system in patients with non-ST-elevation acute coronary syndromes(NSTE-ACS). Methods: Total 37 consecutive patients with NSTE-ACS were assigned to undergo magnetic guide-wire navigation PCI(MPCI). Time to cross lesion,fluoroscopy time,contrast usage to cross lesion and procedure-related complication were recorded and analyzed. Results: Of the 37 culprit lesions in MPCI,36 were crossed successfully giving a success rate of 97.3%. The average stenosis of the target lesions was(88.07 ± 8.33)%,mean length was(27.08 ± 8.98) mm. The procedure and the fluoroscopy time to cross the lesion in the magnetic PCI were (82.0 ± 67.9) s and(62.6 ± 57.6) s,respectively. The contrast medium used to cross lesion were(6.3 ± 4.6) ml. The failed lesion was a subtotal stenosis combined with severe calcification. No magnetic navigation system associated complications or major adverse cardiac events were observed in MPCI. Conclusion: It is feasible and safe to use the magnetic navigation system as a tool for treatment in patients with NSTE-ACS.