[ Objective] To observe the effect of removing phlegm,softening and removing blood stasis on pulmonary morphology and hydoxyprolin of pulmonary fibrosis rats. [Methods]The experimental pulmonary fibrosis models were produced by injecting BLMA5.All animals were randomly divided into 5 groups which were control group, model group, Chinese herb high-dose group, Chinese herb low-dose group and prednisone group respectively, the drugs were given daily starting from the second day and the rats were killed on the 7th and 28th day. The shape of rats’ lung tissues was observed, the levels of hydroxyproline in lung tissues were measured. [Results] In model group, alveolitis increases(much inflammatory cell infiltration), pulmonary interstitial fibroblast increases. There is less pulmonary tissue inflammatory cell infiltration in drug-given groups than that in model group and so is fibroblast. Compared with the model group, the content of HYP of pulmonary tissues of the drug-given groups is remarkably decreased. [Conclusion] The Chinese herb of removing phlegm, softening and removing blood stasis can effectively inhibit the formation of pulmonary fibrosis caused by BLMA5.

[Summary] The general status of glycemic control and insulin initiation are not optimistic in Chinese patients with type 2 diabetes.Chinese patients experience pancreatic β-cell dysfunction and reduction of early phase insulin spike earlier and more severely compared to Caucasians.These can cause more significant postprandial hyperglycaemia which is further deteriorated by traditional carbohydrate-rich Chinese diet.Therefore,premixed insulin may be a more appropriate option of insulin initiation therapy for Chinese patients with type 2 diabetes mellitus.

Objectives: To evaluate the analgesic effect of electronic dental anesthesia(EDA).　Methods: Sixty patients with dental caries in need of cavity preparation and 15 patients with pulpitis in need of pulp treatment were anesthetized with EDA, another 60 patients with dental caries in need of cavity preparation and 15 patients with pulpitis in need of pulp treatment were anesthetized with traditional local anesthesia(LA).　 Results: For patients with dental caries in need of cavity preparation, the effective rates in EDA group and LA group were 93.33% and 98.33% respectively(P>0.05).For patients with pulpitis in need of pulp treatment ,the effective rates in EDA group and LA group were 26.7% and 93.33% respectively(P<0.01).　Conclusions: EDA can be an effective analgesic method for cavity preparation, but not for pulp treatment.

OBJECTIVE To explore the risk factors in elderly patients with ventilator-associated pneumonia(VAP) and to provide the corresponding clinical prevention strategies.METHODS The ages,underlying diseases,mechanical ventilation method,use of antibiotics,and pathogenic bacteria of the VAP patients were investigated and analyzed.RESULTS Totally 105 elderly patients with VAP had serious underlying diseases,and were treated with broad-spectrum antibiotics,tracheal intubation or trachea incision.Most pathogenic bacteria were multiresistant.CONCLUSIONS Prevention of VAP is the priority of treatment for elderly patients.In order to control the occurrence and spread of VAP,clinicians should shorten the time of ventilator treatment,pay more attention to sterilization and isolation,and strengthen the attendance of the patients.

Objective To evaluate the clinical effectiveness of heat-sensitive moxibustion for knee osteoarthritis ( KOA) by systematic evaluation and Meta analysis methods. Methods Electronic information retrieval combined manual retrieval methods were used for collecting clinical randomized control trial of heat-sensitive moxibustion for KOA. The systematic evaluation was conducted by two individual researcher following the principles of Cochrane Review Handbook 5.1, and RevMan5.0 software was applied for the statistical analysis. Results Fifteen randomized controlled trials (RCT) were enrolled into the analysis, which involved 1228 cases. The results of systematic evaluation showed that the quality of most of the enrolled RCT were not so high. The results of Meta analysis were as follows: ( 1) Between heat-sensitive moxibustion and traditional moxibustion, the weighted mean difference (WMD) and 95%confidence index (CI) were-1.76, [-2.33, -1.18] for visual analog scale ( VAS) scores ( P<0.001) , were -2.36, [-3.42, -1.30] for the scores of guiding principle of clinical research on new drugs ( GPCRND) for KOA ( GPCRND-KOA) ( P<0.001) , and were 13.61, [7.60, -19.61]for Lysholm knee joint function scores (P<0.001), respectively; (2) Between heat-sensitive moxibustion and acupuncture, WMD and 95%CI were 6.19, [ 0.01, 11.37] for Lysholm scores ( P<0.05);(3) Between heat-sensitive moxibustion and warm-needling acupuncture, WMD and 95%CI were -10.14, [-17.47, -2.81] for the Western Ontario and McMaster Universities ( WOMAC) osteoarthritis index scores ( P<0.05). Conclusion It is indicated that heat-sensitive moxibustion shows certain therapeutic effect for knee osteoarthritis, better than traditional moxibustion.

Objective To investigate the evaluation value of serum procalcitonin(PCT) change rate determination on the prognosis of patients with severe pneumonia.Methods A total of 98 patients with pneumonia,patients were selected and divided into severe pneumonia group (50 cases) and mild pneumonia group (48 cases).The changes of serum PCT,blood routine,C reactive protein (CRP) and interleukin (IL)-6 concentration were observed dynamicly.The severe pneumonia hospitalization time,mechanical ventilation rate and mortality rate was recorded.Results The serum PCT and CRP levels in severe pneumonia group were significantly higher than those in mild pneumonia group [(19.8 ± 21.6) μ g/L vs.(1.5 ± 0.8) μ g/L,(34.3 ± 13.1) ng/L vs.(11.5 ± 5.2) ng/L],the difference was statistically significant (P＜ 0.05); but there was no significant between two groups in white blood cell count (WBC),IL-6 (P＞ 0.05).Severe pneumonia in patients with serum PCT decreased rapidly as the disease was effectively controlled,WBC,CRP and IL-6 had been maintained at a high level.CRP decreased (10.3 ± 7.8)％,IL-6 decreased (12.4 ± 6.9)％,PCT decreased (43.5 ± 12.3)％,the difference was statistically significant (P＜ 0.05).Conclusion Compared with the traditional inflammatory indexes WBC,CRP and IL-6,PCT can assist in the diagnosis of infection,and the rate of change has certain clinical value in judging the prognosis in patients with severe pneumonia.

Objective To explore the effect of azithromycin sequential therapy on inflammatory cytokines and humoral immune function in the treatment of children with mycoplasma pneumonia.Methods 342 children with mycoplasma pneumonia were divided into control group(168 cases)treated with erythromycin sequential therapy and observation group (174 cases)treated with azithromycin sequential therapy based on the random number table.The changes of inflammatory cytokines and humoral immune function were recorded and compared.Results The levels of interleukin 4(IL -4),interleukin 6(IL -6),C -reactive protein(CRP)and tumor necrosis factor -α(TNF -α) had no significant differences between the two groups before accepting different treatments (P >0.05).The decreased levels of IL -4,IL -6,CRP and TNF -αof the observation group after treatment were greater than the control group (t =10.913,11.047,9.919,53.207,all P <0.01).The levels of immunoglobulin M(IgM),immunoglobulin G(IgG) and immunoglobulin A(IgA)had no significant differences between the two groups before accepting different treat-ments (P >0.05).After treatment,the decrease of IgM and IgG between the two groups had significant differences (t =3.178,3.034,all P <0.01 ).Conclusion Azithromycin sequential therapy for the treatment of children with mycoplasma pneumonia has better clinical efficacy than erythromycin sequential therapy,which can improve inflamma-tory cytokines index and regulate humoral immune function.It has considerable value in the clinical application.

Objective To investigate the relationship of clinical pathological features and FOXC1 expression in NPC tissues.Methods 101 cases of nasopharyngeal tissues and 64 cases of chronic inflammatory nasopharyngeal mucosa tissue were selected and detected by immunohistochemistry SP method,and the relationship between the ex-pression of FOXC1 and the clinical pathological features were analyzed.Results The expression of Foxc1 in nasopha-ryngeal carcinoma and nasopharyngeal mucosa inflammatory tissue mainly located in the nucleus,the positive expres-sion rate (84.16%)in nasopharyngeal carcinoma (NPC)was significantly higher than that in chronic nasopharynge-al mucosa (44.44%),(χ2 =65.213,P<0.05).There was no significant relationship among FOXC1 positive expres-sion and sex,age,and clinical stage.FOXC1 positive expression with lymph node metastasis was higher than that with-out lymph node metastasis.Conclusion The expression of FOXC1 in nasopharyngeal carcinoma tissues is significant-ly up-regulated,which may play an important role in the development of nasopharyngeal carcinoma,and has a guid-ing significance for clinical diagnosis of nasopharyngeal carcinoma.

Objective To investigate the effect of ultrasonic scalpel combined with hemostatic gauze to reduce the postoperative axillary wound drainage in breast cancer patients after surgery .Methods 243 cases of breast cancer patients admitted from Mar .2011 to May.2014 were selected as the research object , and they were divided into four groups according to the envelope method:group A(67 cases), group B(59 cases), group C(56 cases), and group D(61 cases).The four groups were given different surgical hemostatic methods: ultrasonic scalpel combined with hemostatic gauze in group A , ultrasonic scalpel without hemostatic gauze in group B , elec-tric knife and hemostatic gauze in group C , and electric knife in group D .The operation time , intraoperative blood loss , postoperative drainage , and drainage tube indwelling time were observed and compared between the four groups.Results The operation time and intraoperative blood loss had no significant difference between group A and group B(P>0.05), yet there was significant difference in postoperative drainage and drainage tube indwelling days ( P<0.05 ) .There was no significant difference between group C and group D in the operation time group(P>0.05), yet there was significant difference in the intraoperative blood loss , postoperative drainage and drainage tube indwelling days (P<0.05).There was significant difference when the same indicator of group A and group B compared with group C or group D ( P<0.05 ) .Conclusion Ultrasonic scalpel combined with hemostatic gauze used in breast cancer surgery can effectively reduce the axillary wound exudation , and shorten the drainage time .

Objective To study the changes and clinical significance of DKK1 level before and after treatment in primary liver cancer.Methods 120 cases with primary liver cancer were selected as the study group,120 healthy people were selected as the control group.The serum level of DKK1 before and after treatment was detected by enzyme-linked immunosorbent assay (ELISA),and its relationship with clinical features was analyzed.Results Before treatment,the serum level of DKK1 in the study group was (54.2 ± 1.8) pg/mL,which was significantly higher than (25.8 ± 2.4) pg/mL in the control group (t =10.692,P =0.024).The level of DKK1 had relationship with tumor capsule,hilar lymph node metastasis,TNM stage and vascular invasion (x2 =12.528,11.792,14.829,13.078,P =0.024,0.028,0.015,0.019) ; The level of DKK1 in the first day after interventional treatment was (53.9 ± 1.3) pg/mL,which had no statistically significant difference compared with before treatment(t =6.038,P =0.075) ; 7 days and one month after treatment,the DKK1 levels were (35.2 ± 1.5) pg/mL and (28.9 ±0.32) pg/mL,which were significantly lower than those before treatment (t =9.056,10.639,P =0.019,0.017).Conclusion Before treatment,the serum DKK1 level is contribute to the diagnosis of hepatocellular carcinoma,and related with clinical characteristics,DKK1 level significantly decreased after treatment,which can help in evaluating the therapeutic effect.