Effect of individualized blood pressure management on postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor / 中华麻醉学杂志

Objective:To evaluate the effect of individualized blood pressure management on postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor.Methods:One hundred and sixty elderly hypertensive patients of both sexes, aged 60-80 yr, with body mass index of 19-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective radical resection for gastrointestinal tumor under general anesthesia, were divided into 2 groups ( n=80 each) using a random number table method: standardized blood pressure management group (group S) and individualized blood pressure management group (group I). Combined intravenous-inhalational anesthesia was performed, and BIS values were maintained at 40-60 and heart rate at 50-100 times/min during surgery in both groups. In group S, intraoperative systolic blood pressure was maintained above 90 mmHg with a decrease of less than 30% of the baseline value, while intraoperative fluctuation of systolic blood pressure was maintained less than 10% of the baseline value in group I. The use of vasoactive agents, numerical rating scale scores within 3 days after operation, and length of hospital stay were recorded. Postoperative delirium was evaluated by Confusion Assessment Method within 5 days after surgery. Results:Compared with group S, the intraoperative usage rate of norepinephrine was significantly increased, the incidence of postoperative delirium was reduced( P<0.05), and no significant change was found in the numerical rating scale scores and length of hospital stay in group I ( P>0.05). Conclusions:Individualized blood pressure management can reduce the development of postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor.

Mechanism of Shenqi Yiliu Prescription Combined with Cisplatin on H22 Liver Cancer-bearing Mice Based on NLRP3/Caspase-1/GSDMD Pyroptosis Pathway / 中国实验方剂学杂志

ObjectiveTo explore the anti-tumor effect and mechanism of Shenqi Yiliu prescription in the intervention of pyroptosis. MethodTen male BALB/c mice were randomly selected and assigned to the blank group. The remaining 40 mice underwent the induction of the liver cancer xenograft model. After 5 days of modeling， 40 surviving mice were randomly divided into model group， cisplatin group ［2.5×10-3 g·kg-1·（3 d）-1］， Shenqi Yiliu prescription group （27 g·kg-1·d-1）， and a combination group （Shenqi Yiliu prescription group + cisplatin）. The mice in the blank group and the model group were treated with an equal volume of normal saline for 10 days. The general conditions of mice in each group were observed. After the intervention， the tumor weight of the mice was weighed and the tumor inhibition rate was calculated. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in tumor tissues. The levels of mouse liver function indicators， including alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were detected. The TdT-mediated dUTP-biotin nick end labeling （TUNEL） assay was used to detect DNA damage in mouse tumor tissue cells. Immunohistochemistry （IHC）， immunofluorescence （IF）， and Western blot were used to detect the protein expression levels of NOD-like receptor protein 3 （NLRP3）， cysteinyl aspartate-specific protease-1 （Caspase-1）， and gasdermin D （GSDMD） in tumor tissues. The levels of interleukin-1β （IL-1β） and interleukin-18 （IL-18） in tumor tissues were detected by enzyme-linked immunosorbent assay （ELISA）. ResultCompared with the mice in the blank group， those in the model group were in a poor mental state， sleepy， and lazy， and their fur color was dull， with increased levels of serum ALT and AST in liver function tests （P<0.01）. Compared with the model group， the groups with drug intervention showed improved mental state， inhibited tumor growth to varying degrees， and decreased tumor weight， and the tumor inhibition rate in the combination group was the highest （P<0.01）. HE staining showed that the pathological and morphological lesions of the tumor tissues in the model group were significant， while those in all groups with drug intervention were improved to a certain extent. The karyolysis and nuclear rupture in the Shenqi Yiliu prescription group and the combination group were more significant. In the liver function test， the serum ALT and AST levels of mice in the Shenqi Yiliu prescription group and the combination group decreased （P<0.01）， and the inflammatory factors IL-1β and IL-18 in each group with drug intervention decreased （P<0.05， P<0.01）. Among them， the declining trend of IL-1β and IL-18 in the Shenqi Yiliu prescription group was the most significant （P<0.01）. TUNEL staining showed that the positive TUNEL staining in each group with drug intervention decreased after intervention （P<0.05， P<0.01）， especially the cisplatin group and Shenqi Yiliu prescription group （P<0.01）. Western blot， IHC， and IF found that the protein expression levels of NLRP3， Caspase-1， and GSDMD in each group with drug intervention decreased （P<0.05， P<0.01）. Compared with the mice in the cisplatin group， those in the Shenqi Yiliu prescription group and the combination group had better mental state and regular tumor morphology， and the tumor weight of the mice in the combination group decreased （P<0.05）. The levels of ALT and AST in the Shenqi Yiliu prescription group decreased （P<0.05）， and the levels of IL-1β and IL-18 in the Shenqi Yiliu prescription group and the combination group decreased （P<0.05， P<0.01）， especially in the combination group （P<0.01）. The results of IHC showed that the expression of GSDMD protein in the tumor tissues of mice in the combination group was reduced （P<0.01）. IF detection showed that the expression of NLRP3 in the tumor tissues of the Shenqi Yiliu prescription group was reduced （P<0.01）. The results of Western blot showed that the expression level of NLRP3 protein in the Shenqi Yiliu prescription group and the combination group decreased （P<0.01）， and the expression level of Caspase-1 protein in the combination group decreased （P<0.01）. The decrease in GSDMD protein expression was not significant， and the difference was not statistically significant. ConclusionShenqi Yiliu prescription combined with cisplatin has an obvious anti-tumor effect， which may be achieved by down-regulating the NLRP3/Caspase-1/GSDMD inflammatory pyroptosis pathway to inhibit cell pyroptosis， and relieve the inflammatory response in mice with liver cancer.

Patients with isolated posterior cruciate ligament rupture had a higher posterior intercondylar eminence.

BACKGROUND: To evaluate the anatomic geometry of the posterior intercondylar eminence and its association with PCL injury risk. METHODS: Patients who underwent primary PCL reconstruction from 2015 to 2018 were retrospectively analyzed. The control group included inpatients diagnosed with ACL rupture because of a sports-related accident during the same period, matched by age, gender, height, weight, and side of injury. Measurements of the height of the apex of the posterior intercondylar eminence (HPIE), the slope length (SLPIE) and the slope angle (SAPIE) of the posterior intercondylar eminence were performed using conventional MRI scans assessed by 2 blinded, independent raters. Intraclass correlation coefficients (ICCs) was used to evaluate the consistency of measurement results. Independent sample t tests, Chi-square tests, and logistic analyses were used to compare the two group, with P < 0.05 considered statistically significant. RESULTS: Fifty-five patients with PCL rupture met the inclusion criteria and 55 PCL-intact matched controls were included. There were no significant differences between the groups in gender (P = 1.000), limb side (P = 0.848), age (P = 0.291), BMI (P = 0.444) or height (P = 0.290). Inter-observer reproducibility was excellent agreement in HPIE, SLPIE and SAPIE of case and control groups (ICC: HPIE = 0.81, SLPIE = 0.77, SAPIE = 0.85). Patients with PCL rupture had significantly greater HPIE, SAPIE (both P < 0.001), and SLPIE (P < 0.05) than PCL-intact patients. The multivariable analysis showed that HPIE (OR, 1.62 [95% CI, 1.24-2.11], P < 0.001) and SAPIE (OR, 1.17 [95% CI, 1.05-1.31], P < 0.001) were independent factors associated with PCL rupture. CONCLUSION: Through this retrospective observational study, we found that patients with PCL rupture may have a higher posterior intercondylar eminence compared to PCL-intact patients. LEVEL OF EVIDENCE: III.

Research progress on relationships of circadian rhythm with thyroid function and diseases / 环境与职业医学

Circadian rhythm is a phenomenon of diurnal changes in life activities formed by a transcription-translation feedback loop of biological clock genes affected by external environmental conditions. The circadian rhythm system controls almost all physiological processes in the organism, and these processes will change as the external environment changes. Previous studies have shown that the hypothalamic-pituitary-thyroid axis in mammals is regulated by the central diurnal pacemaker of the suprachiasmatic nucleus of the hypothalamus, so part of the thyroid function is controlled by the biological clock, and the secretion of thyroid hormones in blood can present a circadian rhythm. However, the molecular mechanism of the biological clock's regulatory effect on thyroid is still unclear. Whether circadian rhythm interference is related to the disorder of thyroid function or the occurrence of thyroid diseases is worthy of attention. This paper focused on the research progress of biological clock, circadian rhythm, and thyroid function, specifically the characteristics of circadian rhythm of thyroid physiological function and the effects of sleep deprivation, light at night, and night shift work on thyroid function, elaborated the relationships of circadian rhythm disorder with thyroid function and thyroid diseases represented by thyroid malignant tumors. The review summarized that circadian rhythm disorder may disrupt the rhythmic secretion of thyroid hormones, but no clear conclusion is reached yet on any effect on thyroid diseases, especially thyroid malignant tumors, so it is necessary to further strengthen the relevant epidemiological and molecular mechanism research.

Puerarin-loaded ultrasound microbubble contrast agent used as sonodynamic therapy for diabetic cardiomyopathy rats.

In this study, a puerarin-loaded ultrasound sulfur hexafluoride microbubble contrast agent as a sonodynamic therapy (SDT) was developed to improve targeted drug delivery and pharmacodynamic effects in diabetic cardiomyopathy (DCM) treatment. Fluorescence microscope morphology was applied to confirm the fabrication of the puerarin - microbubbles (PMBs). The average size distribution and zeta potential of PMBs were 760.0 ± 101.2 nm and -20.4 ± 6.59 mV, respectively. In vitro and in vivo experiments were carried out to study the pharmacodynamic effects and targeted drug delivery of PMBs. The cytotoxicity, assessed by the cell viability of human umbilical vein endothelial cells (HUVECs), showed that the microbubbles were nontoxic even in high concentration of 2.500 mg/mL, and the wound healing scratch assay proved that PMBs cloud obviously improve the migration ability of HUVECs. Furthermore, streptozotocin (STZ) accompanied with high-energy diets was employed to build the DCM rat model. The blood glucose, histological changes of the pancreas and heart, and cardiac function were used to confirm the obtainment of the DCM rat model. Histological and physiological changes of the PMBs treatment group indicated that PMBs had a significant therapeutic efficacy when compared to the DCM model group. Therefore, PMBs are a promising strategy for a targeted drug delivery system and a novel noninvasive treatment for DCM.

Research advances in fecal microbiota transplantation for the treatment of HBeAg-positive chronic hepatitis B / 临床肝胆病杂志

HBeAg seroconversion is an important process during antiviral therapy for patients with HBeAg-positive chronic hepatitis B (CHB), while the first-line antiviral drugs, such as entecavir and tenofovir disoproxil fumarate, tend to have low HBeAg clearance rate and/or seroconversion rate, and at present, there is still a lack of effective radical treatment regimens. Latest studies have shown that fecal microbial transplantation (FMT) can induce HBeAg clearance in HBeAg-positive CHB patients receiving long-term antiviral therapy. This article reviews the research advances in the role of FMT in inducing HBeAg clearance in HBeAg-positive CHB patients and points out that FMT may become a new treatment regimen for HBeAg-positive CHB patients.

Analysis of factors influencing the efficacy of extracapsular arthroscopic surgery for refractory tennis elbow / 中华外科杂志

Objective@#To investigate the mid-term efficacy of extracapsular arthroscopic surgery for refractory tennis elbow and explore prognostic factors.@*Methods@#A retrospective study of 38 patients suffered from refractory tennis elbow and underwent extracapsular arthroscopic surgery performed by the same group of doctors during March 2012 to January 2016 at Institute of Sports Medicine, Peking University Third Hospital. There were 15 males and 23 females with age of 44.2 years(range: 32-59 years). Fifteen cases on the left and 23 cases on the right. Visual analogue scale(VAS), Mayo elbow performance score and Disability of Army, Shoulder and Hand (DASH) score were collected preoperatively and postoperatively, and compared by paired-t test. Independent sample t test, χ2 test, multivariate logistic regression were used to analyze the relationship between scores and various potential influencing factors.@*Results@#All 38 patients were followed up for 24 months. There was no complication such as infection or nerve injury recorded. VAS decreased from 7.0(1.2) (M(QR)) preoperative to 0(1) (Z=-5.40, P=0.00), Mayo increased from 55(26) to 100(0) (Z=-5.38, P=0.00),DASH decreased from 56.7(27.3) to 0.8(5.8)(Z=-5.37,P=0.00). The Mayo elbow performance score was excellent in 36 cases (94.7%) and good in 2 cases (5.3%). Women was significantly associated with poor prognosis.@*Conclusions@#The mid-term effect of extracapsular arthroscopic treatment of refractory tennis elbow is satisfactory with few postoperative complications. Women was associated with poor prognosis.

Surgical technique and mid-and-long curative effect analysis of primary repair of chronic Achilles tendon rupture / 中华外科杂志

Objective@#To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture.@*Methods@#From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment-Achilles(VISA-A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired-t test.@*Results@#The patients were followed up for (45.6±17.2) months (range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow-up,the VAS decreased from 1.0(2.0) (M(QR) preoperative to 0.0(0.8)(Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA-A increased from 51.3±9.8 to 87.8±18.0(t=-17.656, P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524, P=0.00) and ATRS increased from 40.0±3.5 to 97.9±3.9(t=-64.133, P=0.00). Twenty-eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner-Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single-limb heel rise painlessly.@*Conclusions@#Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid-and-long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Multicenter investigation and analysis of neonatal respiratory distress syndrome in parts of Inner Mongolia / 中国小儿急救医学

Objective To investigate the diagnosis and treatment status of neonatal respiratory dis-tress syndrome (NRDS) in Inner Mongolia and explore the problems and countermeasures for NRDS diagno-sis and treatment. Methods Data of infants with NRDS in 4 hospitals(3 hospitals were in the west,which were the Affiliated Hospital of Inner Mongolia Medical University,Baotou Steel Three Hospital and Ordos Central Hospital,1 hospital was in the east,which was the Affiliated Hospital of Chifeng Institute) participat-ing in the study during the period from 1th January,2016 to 30th June,2018 were investigated retrospectively with descriptive epidemiological survey,including basic situation,perinatal period, clinical manifestations, treatment,complications and prognosis. Results Among 11406 newborns admitted in 4 hospitals during the study period,748 infants were diagnosed with NRDS,accounting for 6. 56％ . In the eastern region,279 infants were diagnosed with NRDS,the rate was 9. 30％ ,and in the western region were 469(5. 58％ ). The average hospitalization time in the eastern region was longer than that in the western region,and the age of motherswas higher than that in the western region. There were significant differences between the two groups(P <0. 05). The antenatal hormone use,cesarean delivery,multiple gestation,low Apgar score,premature rupture of membrane in the western region were higher than those in the eastern region(P < 0. 05). The proportion of NRDS grade Ⅰ and gradeⅢ,pulmonary surfactant(PS) utilization ratio and INSURE technology usage in the eastern region were higher than those in the western region. The ratio of NRDS(grade Ⅱ) and the first dose of PS in the western region were higher than those in the eastern region(P < 0. 05). The total mortality of neonates with NRDS was 6. 15％ (46 / 748). The incidence rates of patent ductus arteriosus,bronchopulmo-nary dysplasia,necrotizing enterocolitis,ventilator-associated pneumonia in the western region were higher than those in the eastern region(P < 0. 05). Conclusion The level of diagnosis and treatment of NRDS in four hospitals in two districts of Inner Mongolia varies widely. But overall compared with other areas,the treatment of NRDS in Inner Mongolia has the problems of low antenatal hormone use,insufficient use of PS and INSURE technology,and late use of PS. The treatment of NRDS should continue to standardize antenatal hormone use,early and sufficient use of PS,the promotion of the use of INSURE technology.

Effects of long-term studying abroad on scientific research ability of clinical doctors / 中华医院管理杂志

Objective To analyze whether studying abroad has any influence on clinicians′scientific research ability, and study the rationality of the indicators reflecting the scientific research ability. Methods A total of 36 clinicians who studied abroad more than 3 months between 2008 and 2010 were selected as the abroad group, and the control group of 36 clinicians was selected from the clinician information database of the hospital by the method of Propensity Score Match.A comparison and analysis were made regarding the number of papers(SCI), grants and scientific and technological achievements between the two groups. Meanwhile, covariance analysis was used to compare the difference in the number of scientific research achievements between the two groups.Logistic regression analysis was used to compare the changes in scientific research achievements of clinicians before and after their abroad study. Results The number of articles( SCI) published and grants obtained in the 3 years after going abroad was significantly higher than that of the control group, and the number of grants obtained in the 4-6 years after going abroad was also significantly higher than that in the control group.The number of papers(SCI)published in the three years after going abroad was more than that in the 3 years before going abroad.The number of grants obtained in the 4-6 years after going abroad was more than that in the 3 years before going abroad.These differences were statistically significant. Conclusions Studying abroad has a beneficial effect on the improvement of clinicians′ scientific research ability. It is reasonable and practical to take the number of SCI articles published as the indicator of short-term changes and the number of funds obtained as the indicator of long-term changes in scientific research ability.

The impact of the hospital-level initial funding for overseas returnee on the ability of scientific research projects of young people in the third class hospital / 中华医学科研管理杂志

Objective Through the investigation of the research funding status of returnees before and after their long-term (more than 3 months) study at abroad in a three class hospital,this paper analyzed the influence of the hospital level initial funding to help young talent to obtain scientific research funding,discussed appropriate measurement to enhance the scientific research capacity of hospital young talents to provide reference for management.Methods Long-term sponsored study abroad returnees from 2005 to 2015 of this hospital were recruited as subjects,divided into two groups according to whether they got the hospital-level initial funding after returning,comparative analysis was conducted to understand the influence of such funding to help obtaining subsequent research projects of these young talents.Results The number of subjects per capita returned to the obtained group was higher than that of the non obtained group,and the proportion of high-level subjects at provincial and ministerial levels was higher than that of the non-obtained group (P＜0.05),and the average time interval between the groups after returning home was less than that of the non-obtained group (P＜0.05).Conclusions The hospital-level initial funding for overseas returnee can obviously improve the quality and speed of the subsequent projects of the young talents in the hospital,and have a significant positive effect on mobilizing the enthusiasm for scientific research,improving their scientific re search ability,and improving the overall scientific research level and competitiveness of the hospital.

Advances in the relationship between Kruppel-like factor 15 and cardiovascular disease research.

Kruppel-like factor 15 (KLF15) is a subtype of the Kruppel-like family of transcription factors (KLFs). KLFs have three high-fidelity zinc fingers at the carboxyl terminus that enable them to regulate the biological processes of proliferation, differentiation, cellular development, and apoptosis. KLF15 is highly expressed in the kidney, pancreas, and cardiac and skeletal muscle, and plays an essential role in the development and occurrence of multiple system diseases. In this paper, we underscored the important relationship between KLF15 and cardiovascular diseases such as atherosclerosis, heart failure, arrhythmia, aortic lesions, etc. On this basis, we identified KLF15 as a potential therapeutic target for the treatment of cardiovascular disease.

Reform and explorations on appraisal and incentives mechanism for senior medical professionals at hospitals / 中华医院管理杂志

The paper presented the " Professors Evaluation System" initiated by the hospital since July 2009, which was designed for quantitative assessment of senior medical professionals of non-management category in terms of their performance in medical, teaching, research and management work. Seven periods of appraisal have witnessed a significant elevation of the rate of excellence among such professionals, proving that such a system can motivate and guide these professionals to continuously improve their competence in medical, teaching, research and management work.

Changing analysis of allergic rhinitis inhalant allergen spectrum in Xinjiang region / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the aeroallergen spectrum in allergic rhinitis in Xinjiang area and analyze its relating factors.@*Methods@#Skin prick test was carried out in 480 cases with allergic rhinitis using 20 inhaled allergens. The major change in recent years with allergic rhinitis and allergen distribution was compared.SPSS 17.0 software was used to analyze the data.@*Results@#Among 480 cases, 406 showed positive reaction. The most common allergens found in patients were chenopodium (61.6%) and mugwort (44.1%), followed by willow(37.7%), maple(37.7%), poplar(30.3%), house dust mite(30.3%), plantain(29.8%), acacia(25.9%), dust mite maple(25.4%), and so on. The rate of positive reaction to only one allergen was 9.6%, of which 21 were mite allergens. The positiverate to allergensin male and female were 84.2% and 85.1%, the distribution of allergens in both sexes did not differ(χ2=0.001, P=0.978). The positiverate to allergens in patients aged 21 to 35 years old was 88.6%, in patients aged 36 to 54 years old was 78.4%, the difference was statistically significant(χ2=0.258, P<0.01). The positive rate to allergens in Kazakhs was slightly higher than that in other ethnic groups (91.7%). The positive rates to allergens in the Han, Uygur and other ethnic groups were 84.8%, 86.4% and 63.3% respectively, the difference was statistically significant(χ2=9.779, P=0.044). Seventy-five point four percent of all allergen-positive patients(306 cases) combined with asthma.@*Conclusions@#The major allergen with allergic rhinitis is chenopodium. Among them, Kazakh allergic positive rate is higher than other ethnic groups.

Advances on open surgery of tennis elbow / 中华骨科杂志

Currently,surgical treatments in tennis elbow include open,arthroscopic and percutaneous procedures.Open surgery,having definite curative effects,is commonly used.There are different surgical methods based on different hypotheses about the pathogenesis of tennis elbow,such as detachment of common extensor origin,resection of annular ligament,denervation surgery and resection of microvascular nerve bundle.There is a huge difference in open surgery of tennis elbow between China and abroad.Debriding or releasing extensor carpi radialis brevis and common extensor tendon are mostly used abroad though it remains controversial whether we should release or debride with tendon,as well as whether it is better to decorticate on lateral epicondyle or not.In China,tennis elbow is treated with resection of microvascular nerve bundle except for debridement and release of tendon.As for evaluation criteria,the following methods,grip strength,grading system and visual analogue scale have been used in researches.However,cure rate and response rate are valuation criteria for resection of microvascular nerve bundle in China.The evaluation criteria are different among various surgical methods,even in the methods,especially for grading system.Each research has unique standards to define excellent,good,fair and poor outcomes.Complications of tennis elbow open surgery are rare,while subcutaneous hematoma is the common complication.

Effect of budesonide inhalation combined with psychological intervention on chronic obstructive pulmonary disease / 中国生化药物杂志

Objective To explore the clinical effect of budesonide inhalation combined with psychological intervention in the treatment of chronic obstructive pulmonary disease (COPD).MethodsSelected in Zhuji city center hospital from July 2012 to April 2017 year to receive treatment in patients with chronic obstructive pulmonary disease in 80 cases as the research object, after the patient related clinical data, all patients were randomly divided into treatment group and control group two groups, each group of 40 cases of patients in the study group of patients with a doctor inhaled budesonide combined with psychological intervention treatment, inhalation therapy on the comparison group of patients treated with budesonide, observe the changes of two groups, serum blood gas index change and remodeling index sputum viscous indicators clinical statistics.ResultsAfter treatment the corresponding treatment after the intervention, the study group of serum basic fibroblast growth factor Xian (b-FGF), nerve growth factor (NGF) and tissue inhibitor of metalloproteinase-1 (TIMP-1), sputum interleukin-8, tumor necrosis factor alpha and PaO2, PaCO2 and other aspects of the statistical index is obviously better than the contrast group;the study group of patients treatment effect is much higher than that of contrast group patients.ConclusionBudesonide inhalation combined with psychological intervention in the treatment of chronic obstructive pulmonary disease is more effective than conventional treatment, which is worthy of popularization and application in clinical medicine.

Tanshinone ⅡA attenuates PM2 .5-induced vascular endothelial cell injury via p38 MAPK signal pathway / 中国病理生理杂志

AIM:To investigate the effect and the mechanism of tanshinone ⅡA in attenuating PM2.5-induced human umbilical vein endothelial EA.hy926 cell injury.METHODS:The samples of fine particulate matter (PM2.5) were collected in Guangzhou and made into suspension.Different concentrations (0, 20, 200 and 400 mg/L) of PM2.5 were added to EA.hy926 cells.The viability and apoptosis of EA.hy926 cells, the protein levels of p-p38 MAPK, Bax and Bcl-2 in the EA.hy926 cells, the contents of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and malonaldehyde ( MDA) , and the activity of superoxide dismutase ( SOD) and lactic dehydrogenase ( LDH) in the EA.hy926 cell culture supernatant were measured by MTT assay, flow cytometry, Western blot, ELISA and colorimetry, respectively.Tanshinone ⅡA at different concentrations (5, 10 and 20 μmol/L) or a specific inhibitor of p38 MAPK pathway, SB203580 (20μmol/L) , was added into the EA.hy926 cells to observe the effect of tanshinone ⅡA.RESULTS:Compared with control group, PM2.5 significantly increased the apoptosis, the contents of IL-6, TNF-αand MDA, the activity of LDH, and the protein levels of p-p38 MAPK and Bax/Bcl-2 ratio, but decreased the viability and SOD activity in the EA.hy926 cells (P<0.05).Compared with PM2.5 group, tanshinone IIA significantly decreased the apoptosis, the contents of IL-6, TNF-αand MDA, the activity of LDH, and the protein levels of p-38 MAPK and Bax/Bcl-2 ratio, but increased the viabil-ity and SOD activity in the EA.hy926 cells (P<0.05).CONCLUSION:Tanshinone ⅡA attenuates PM2.5-induced EA. hy926 cell injury via the inhibition of p38 MAPK pathway.

Allicin prevents EA. hy926 endothelial cell injury induced by PM2. 5 via inhibiting ERK1/2 pathway / 中国药理学通报

Aim To investigate the protective effect of allicin against EA. hy926 endothelial cell injury in-duced by PM2. 5 and the possible mechanism. Meth-ods The samples of fine particulate matter ( PM2. 5 ) were collected and made into suspension. Different concentrations of PM2. 5 ( 20 , 200 , 400 mg · L-1 ) were added to EA. hy926 cell. The viability and apop-tosis of EA. hy926 cell, the protein levels of p-ERK1/2, Bax and Bcl-2 in the EA. hy926 cell, the contents of tumor necrosis factor-α( TNF-α) , interleukin-6 ( IL-6 ) , and malonaldehyde ( MDA ) , the activities of su-peroxide dismutase ( SOD ) and lactic dehydrogenase ( LDH) in the EA. hy926 cell culture supernatant were measured by MTT assay, flow cytometry, Western blot, enzyme-linked immunosorbent assay ( ELISA ) and colorimetry, respectively. Allicin at different con-centrations(5,20,40 mg·L-1 ) or a specific inhibitor of ERK1/2 signaling pathway PD98059 ( 20 μmol · L-1 ) was added into the EA. hy926 cell to observe the effect of allicin. Results Compared with control group, PM2. 5 significantly increased the apoptosis, the contents of TNF-α, IL-6 and MDA, the activity of LDH, the protein levels of p-ERK1/2 and Bax/Bcl-2 ratio, but decreased the viability and SOD activity in the EA. hy926 cell(P<0. 05). Compared with PM2. 5 group, allicin significantly decreased the apoptosis, the contents of TNF-α, IL-6 and MDA, the activity of LDH, the protein levels of p-ERK1/2 and Bax/Bcl-2 ratio, but increased the viability and SOD activity in the EA. hy926 cell ( P <0. 05 ) . Conclusion Allicin displays a significant protective effect against EA. hy926 endothelial cell injury induced by PM2 . 5 and its mechanism may be related to the attenuations of in-flammation and oxidative stress via the inhibition of ERK1/2 pathway.

Study on Inhibitory Effects of Berberine on Vascular Endothelial Cells Injury Induced by PM2.5 and Its p38 MAPK Signal Pathway Mechanism / 中国药房

OBJECTIVE:To study the inhibitory effects of berberine on EA.hy926 human umbilical vein endothelial cells (EA. hy926 cells) injury induced by particulates with no more than 2.5 μm air aerodynamic diameter in atmospheric (PM2.5),and its p38 mitogen-activated protein kinase(MAPK)signal pathway mechanism. METHODS:PM2.5 samples were collected and hatched EA.hy926 cells with concentrations of 0(blank control),20,200 and 400 mg/L for 24 h. The survival rate and apoptosis rate of cells,contents of IL-6,TNF-α and MDA,activities of SOD and LDH,protein levels of p-p38 MAPK,Bcl-2 and Bcl-2 associated X protein (Bax) were detected. The above indexes of EA.hy926 cells in blank control group,PM2.5 group (200 mg/L PM2.5), p38 MAPK pathway-specific blocker SB203580 group (20 μmol/L SB203580+200 mg/L PM2.5),berberine low-,medium- and high-concentrations groups(5,10,20 μmol/L berberine+200 mg/L PM2.5)were also determined. RESULTS:Compared with blank control,survival rate of cells,SOD activity and Bcl protein decreased after 200,400 mg/L PM2.5 hatched;apoptosis rate of cells, contents of IL-6,TNF-α and MDA,LDH activity,protein levels of p-p38 MAPK and Bax increased (P<0.05),in concentra-tion-dependent manner. Compared with PM2.5 group,survival rate of cells,SOD activity and Bcl-2 protein increased in berberine medium-,high-concentrations groups and SB203580 group;apoptosis rate of cells,contents of IL-6,TNF-α and MDA,LDH ac-tivity,protein levels of p-p38 MAPK and Bax decreased (P<0.05). CONCLUSIONS:Berberine attenuates PM2.5-induced EA. hy926 cells injury via the inhibition of p38 MAPK pathway.

Effect of Mild Moxibustion on the Rehabilitation Efficacy in Patients with Cerebral Palsy / 上海针灸杂志

ObjectiveTo observe the clinical effect of warm needling based on conventional rehabilitation in treating cerebral palsy.MethodSixty patients with cerebral palsy were randomized into an observation group and a control group, 30 in each group. The control group was intervened by physiotherapy (PT), occupational therapy (OT), speech therapy (ST), conductive education (CE), etc.; the observation group was by mild moxibustion at Baihui (GV20), Zusanli (ST36), and Guanyuan (CV4) in addition tothe above rehabilitation therapies.ResultThe rehabilitation result in the observation group was superior to that inthe control group (P<0.05).ConclusionMild moxibustion can significantly enhance the rehabilitation result in patients with cerebral palsy.