The acute respiratory distress syndrome,a common severe case,can cause life-threaten multiple organ failure.Statins has been clinically applied in prevention of cardiovascular diseases and cerebrovascular disease.Previous studies indicate that statins can modulate inflammatory responses.In this paper,we discussed the mechanisms of statins,mechanisms and application of statins in acute lung injury and acute respiratory distress syndrome,and the effectiveness and safety of statins.

[ABSTRACT]AIM:Toexploretheeffectsofchrysinoninsulinresistance(IRe)inamousemodel.METHODS:Male C57 mice were randomly divided into control group , IRe group, low-dose chrysin group ( IRe+chrysin-low) and high-dose chrysin group (IRe+chrysin-high).After 24 weeks, the body weight, liver index and fat mass in all mice were detected.The blood glucose , insulin level and HOMA-IR were measured to determine the changes of the insulin resistance in the animals.The oxidative stress (SOD, GSH-Px and MDA) was also measured.The mRNA expression of insulin sig-naling pathway molecules (IR, IRS1, IRS2, Glut2 and Glut4) and inflammatory factors (TNF-α, IL-1β, IL-6 and NF-κB) was analyzed by real-time PCR.The protein levels of IRS1 and p65, and their phosphorylation were detected by West-ern blot.RESULTS:After 24-week intervention , the indicators in IRe group were higher than those in control group , in-cluding body fat deposition, serum glucose, serum insulin, HOMA-IR and liver oxidative stress (P<0.01), indicating that the model of insulin resistance was successfully established .Low dose and high dose of chrysin decreased the body weight, serum glucose, serum insulin and HOMA-IR in the IRe mice (P<0.05).The liver oxidative stress was also re-duced in both groups (P<0.05).However, no statistical difference of the indexes between IRe +chrysin-low group and IRe+chrysin-high group was observed.Chrysin upregulated the mRNA expression of IR , IRS1, IRS2, Glut2 and Glut4 (P<0.05), and down-regulated the mRNA expression of various inflammatory factors .The inhibitory effect of chrysin on the mRNA expression of NF-κB was observed (P<0.05), especially in high dose group (P<0.05).It was confirmed that the effect of chrysin on liver IRe was related with the increase in the p-IRS1 levels and decrease in the p-p65 levels by Western blot .CONCLUSION:Chrysin inhibits obesity , hyperglycemia and hyperinsulinemia , and relieves insulin resist-ance and oxidative stress , which might be closely related to the regulation of insulin signaling pathway and the inhibition of inflammatory factor expression .

Objective To investigate the causes of failure of manually rotating fetal head technology and its delivery outcomes.Methods One hundred and Ninety-eight cases with persistent occipito transverse position or persistent occipitoposterior position admitted to our hospital form January 2008 to December 2010 were enrolled as our subjects.According to the result of manually rotating fetal head technology,these patients were divided into the success group (126 cases) and the failure group (72 cases).The information related to delivery was recorded.Results The proportion of fetal weight ≥ 3500 g in the failure group was 76.4％ (55/72),higher than that of the success group(31.7％ (40/126)),and there has statistic significant difference (x2 =30.177,P =0.001).The proportion of uterine inertia in the failure group(58.3％ (42/72)) was higher than that of the success group(38.1％ (48/126)),and there has statistic significant difference (x2 =7.569,P =0.006).The proportion of critical or low-grade narrow birth canal in the failure group(38.9％ (28/72)) was significantly higher than that of the success group (23.8％ (30/126)),and there has statistic significant difference (x2 =5.030,P =0.002).The proportion of the improper time for manually rotating fetal head (opening of cervix was less than 6 cm,and fetal head was above ischial spine and opening of cervix was 8-10 cm,fetal head reach to more than 2 cm lower of ischial spine) in the failure group was 61.1％ (44/72),which was significantly higher than that of the success group (38.9 ％ (49/126)),and there has statistic significant difference (x2 =9.084,P =0.003).The proportion of maternal and neonatal complications (postpartum hemorrhage,puerperal morbidity,fetal distress,neonatal asphyxia) in the failure group were significantly higher than those of the success group (x2 =9.586,P =0.002 ; x2 =9.334,P =0.002 ; x2 =5.910,P =0.015 ; x2 =5.240,P =0.022).The proportion of cesarean section in the failure group(72.2％ (52/72)) was significantly higher than that of the success group(34.1％ (43/126)),and there has statistic significant difference(x2 =26.641,P =0.001).Conclusion The manually rotating fetal head technology can transform from dystocia to normal delivery and decrease the rate of cesarean section.It is necessary to prevent and deal with the failure causes of manually rotating fetal head technology.And it must be cautious to perform the follow-up correction and trial production after the failure of previous correction.

Objective To study the clinical application of 3-dimensional arterial spin labeling technology (3D-ASL) in brain tumors.Methods Twenty patients with the pathological diagnosis of brain tumors were selected in this study,with low grade glioma in 4 cases,the high grade glioma in 2 cases,lymphoma in 1 case,metastatic tumor in 7 cases,meningioma in 6 cases.All patients were appLIed preoperative 3D-ASL and dynamic contrast-enhanced perfusion magnetic sensitive (DSC) MR imaging line two methods,to analyze the value of 3D-ASL in brain tumors.Results 3D-ASL examination lesions in patients with brain tumors might be displayed in high or low perfusion; 3D-ASL and DSC were obtained from tumor tissue blood supply,the local relative cerebral blood flow (rCBF),there was no significant difference (P ＞ 0.05).The high grade glioma in 3D-ASL image showed a high perfusion,rCBF was 3.0 ± 1.3; Low grade gliomas showed low perfusion,rCBF was 0.6 ± 0.2,the rCBF between the high-and low-grade gliomas was significantly different (P ＜ 0.01).Metastatic tumor 3D-ASL showed ring high perfusion,central necrosis and edema area of low perfusion.Lymphoma 3D-ASL showed slightly higher perfusion.Meningioma showed high perfusion,and highest rCBF,3.5 ± 1.9.Conclusions 3D-ASL in the diagnosis of brain tumors,has high repeatability,non-invasive,without contrast agent.3D-ASL can be further developed into the brain blood flow dynamics of conventional evaluation methods,and can be used for brain tumors level assessment,has broad application prospects.

This paper started from the relevant concepts of nursing students'professional values , discussed the core value of nursing profession and nursing students occupational choice , which are included in the nursing students'professional values .Based on the current status , the author proposed some suggestions: emphasizing on curriculum and teaching content reform , strengthening the guiding role of the teachers;cultivating professional val-ues in practice; improving evaluation system; implementing sectional training plan , etc.In addition, the values education in nursing students should make efforts at national , hospital and school levels .

Objective:To improve the hospital degree of attention to SPECT quality control. Methods: To introduction the basic principle and test methods of the Brightview produced by Philips company, and to analyze some common troubles.Results: According to understanding the working principle, parameter testing, maintenance and troubleshooting, to master quality control method.Conclusion: The quality control of the SPECT is the demand of UM workers. To master the test methods, improve the quality of medical imaging, minimize unnecessary exposure and serve the patients better.

BACKGROUND:High expression of CD4+CD25+ regulatory T cels is proved to exist in many patients with malignant tumors in vivo. Recent studies have found that CD4+CD25+OBJECTIVE:To analyze the characteristics of expression of CD4 regulatory T cels also show a high percentage of expression in the peripheral blood of patients with acute myeloid leukemia.+CD25+METHODS:Ninety-two patients with newly diagnosed acute myeloid leukemia were enroled and divided into middle-young age group (< 60 years old,n=22) and aged observation group (> 60 years old,n=70). Thirty-two patients in the aged observation group underwent standardized chemotherapy and showed complete remission, who acted as complete remission group; and the remaining 38 patients acted as aged group, including 6 cases of M2, 19 cases of M3, 7 cases of M4, and 6 cases of M5 according to FAB classification. At the same period, another 42 healthy persons for hospital examination were selected as control group. Peripheral blood samples were extracted to detect the expression of CD4 regulatory T cels in aged patients with acute myeloid leukemia.+CD25+RESULTS AND CONCLUSION:The proportions of CD4 regulatory T cels.+CD25high FOXP3+ Treg cels and CD4+FOXP3+ T cels in the aged and complete remission groups were higher than those in the control group (P < 0.01), and moreover, these two proportions were higher in the aged group than the complete remission group (P < 0.01). The proportions of CD4+CD25high FOXP3+ Treg cels and CD4+FOXP3+ T cels in the aged group were higher than those in the middle-young age group (P < 0.01). There were no difference in the proportions of CD4+CD25high FOXP3+ Treg cels and CD4+ FOXP3+T cels among different subgroups of the aged group (P > 0.05). The proportion of CD4+CD25high FOXP3+Treg cels in the peripheral blood was positively related to the proportion of CD4+FOXP3+ T cels in aged patients with acute myeloid leukemia (r=0.87,P=0.019). The proportion of CD4+CD25+ Treg cels in the aged patients with newly diagnosed acute myeloid leukemia is higher than that in healthy individuals and young patients with acute myeloid leukemia.

Objective To observe the clinical effect and side effect of Xiaozhitang combined with western medicine .Methods Eighty male patients with hyperlipidemia in our hospital was selected from January 2010 to January 2013 and divided randomly into observation group(n=40)and control group(n=40) .Patients in the control group received treatment with atorvastatin calcium (10 mg/d)while patients in the observation group were administrated with Xiaozhitang besides the routine measures .The values of total cholesterol (TC) ,triglyceride(TG) ,high density lipoprotein cholesterol(HDL‐C)and low‐density lipoprotein cholesterol(LDL‐C) serum creatinine(Scr) ,alanine transaminase(ALT) ,aspartate aminotransferase(AST) ,creatine kinase(CK)were assessed before and after 8 ,16 weeks treatment .Drug‐induced adverse effects were also observed .Results TC ,TG ,LDL‐C were (5 .87 ± 0 .89) , (1 .62 ± 0 .62) ,(3 .62 ± 0 .55)mmol/L in the observation group before treatment and significantly reduced after 16 weeks treatment [(4 .59 ± 0 .52) ,(1 .53 ± 0 .53) ,(2 .69 ± 0 .41)mmol/L](P<0 .05) .TC ,LDL‐C were(5 .88 ± 0 .91) ,(3 .78 ± 0 .43)mmol/L in the control group before treatment and also significantly reduced after 16 weeks treatment[(5 .01 ± 0 .49) ,(2 .97 ± 0 .27)mmol/L](P<0 .05)while TG remained unchanged during 16 weeks in the control group(P>0 .05) .The observation group achieved a significantly greater reduction in LDL‐C and TC than the control group (P<0 .05) .There was a significantly differences in adverse reaction(P<0 .05)but all could be well tolerated .The quality of life score of the observation group was significantly higher than that of the con‐trol group(P<0 .05) .Conclusion The Xiaozhitang combined with atorvastatin calcium could achieve a significantly greater reduc‐tion in lipid‐lowering effect than pure western medicine ,and it shows satisfactory safety and have less side effect .

Recently,alveolar recruitment maneuver is one of effective management of mechanically ventilated patients with acute respiratory distress syndrome.Recruitment maneuvers are widely used in clinical practice to open the lung and prevent lung injury by derecruitment,improving the compliance,increasing PaO2,increasing the PaO2/FiO2 ratio,and reducing the pulmonary shunt fraction,although the evidence is still discussed.This review discussed recruitment maneuvers in pediatric patients with acute respiratory distress syndrome.