Objective To investigate the effect and influence on inflammatory factors of salbutamol aerosol combined with montelukast in treatment of cough variant asthma.Methods From Jan 2015 to Jan 2016,120 cases of cough variant asthma in our hospital were selected as the subjects.They were randomly and equally divided into 2 groups:control group (n =60) were treated with salbutamol aerosol,and observation group were treated with salbutamol aerosol and montelukast.The clinical effects,the pulmonary function and the serum inflammatory factors were compared between the two groups.Results After 2 months of treatment,the effective rate of the control group and the observation group were 73.3％ and 96.7％ respectively,there was statistical differences between two groups (P ＜ 0.05).The FEV1 and FEV1/FVC of both groups showed remarkable increase.The FEV1,FEV1/FVC of observation group were (2.21 ± 0.17) L,(66.10 ± 4.46)％,and the FEV1,FEV1/FVC of control group (1.82 ± 0.11) L,(52.48 ± 3.34)％.The difference between two groups was statistically significant (P ＜ 0.05).The IL-6 and TNF-α of both groups showed remarkable decrease.IL-6 and TNF-α in observation group were significantly lower than those of control group (14.58 ± 2.90 vs.20.87 ± 3.26,P ＜ 0.05;0.59 ± 0.12 vs.0.97 ± 0.15,P ＜ 0.05).Conclusion The use of montelukast combined with salbutamol aerosol in the treatment of cough variant asthma was safe and effective,and could significantly improve pulmonary function and reduce inflammatory factor.

MicroRNAs(miRNAs,miR) is a class of 21～22 nt small non-protein-coding single strand RNA molecules.In the liver,the phenotypic alternation or expressed abnormality of many miRNAs can influence the hepatitis virus replication at the gene level,which would provocate the development from hepatitis to hepatic fibrosis,cirrhosis,and even primary hepatic carcinoma on target.And so,several miRNAs are confirmed to be a new class of related gene to carcinoma.Furthermore,the dysfunction or abnormal quantity of miRNAs will promote the formation of fatty liver disease by interfering with signal transduction of insulin,inducing insulin resistance and then influencing normal metabolism of endosomatic lipid,Therefore,the specific medicine or methods,which might retrieve the expression or function of miRNAs in the hepatocytes,will provide a new valuable method to manage human liver disease.

Objective To investigate the genetic association between KCNJ10 rs1890532 gene polymorphism and susceptibility to children epilepsy in the Han descent population in the Northern China. Methods Two hundred twelve children with epilepsy were recruited as the epilepsy group. According to seizure types, they were divided?into partial seizures (PS) group (120 cases) and generalized seizures (GS) group (92 cases). Two hundred healthy volunteers without epilepsy were randomly selected from our hospital during the same period as the control group. General clini-cal data was collected and genotype was determined by polymerase chain reaction- restriction fragment length poly-morphism for the polymorphism of the KCNJ10 gene. Results Results showed that KCNJ10 rs1890532 gene polymor-phism was significantly associated with GS in children in both allelic association analysis (OR=1.325, 95%CI 1.014~2.461, P=0.043) and recessive model (OR=3.173, 95%CI 1.097~10.694, P=0.021) after adjustment for sex and age. There was no significant difference in any genetic model between the control group and epilepsy group, neither be-tween the control group and PS group. Conclusion Polymorphism of the KCNJ10 (rs1890532) gene may be associated with the risk of GS in children.

Objective To explore the clinical effect and influence on congnitive function of single use ofvalproate,oxcarbazepine,and levetiracetam in treatment of children epilepsy.Methods Children with epilepsy (96 cases) accepted in Weinan Matemty and Child Health Care Hospital from April 2011 to January 2016 were randomly divided into groups A,B,and C.Children in those three groups were given valproate,oxcarbazepine,and levetiracetam,respectively.Then the clincial efficacy,changes of EEG and congnitive function,and safety were compared.Results The total effective rates of groups A,B and C were 71.88％,78.13％,and 90.63％,respectively,group C was little higher than groups A and B without statistically significance.The epileptiform discharge improvement rate was getting better following extended therapy.The improvement rate of group C was better than that of group B and even much better than that of group A with statistically significance (P ＜ 0.05).The verbal IQ (VIQ),performance IQ (PIQ),and full scale IQ (FIQ) of three groups before treatment had no big difference,but the scores of groups B and C were much better than before and group A after treatment with statistically significant difference (P ＜ 0.05).The adverse reaction rates of groups A,B,and C were 28.13％,12.50％,and 3.13％,respectively with statistically significant difference among them (P ＜ 0.05).Conclusion Valproate,oxcarbazepine,and levetiracetam have similar effect in treatment of children epilepsy,but oxcarbazepine and levetiracetam have positive significance in EGG and recognition function improvement.And the safety of levetiracetam is the highest of three drugs,which is worth of clincial application.

Objective:To survey the level of hospice care and the influencing factors in Shaanxi province. Methods:Interview and return visit method was used to investigate. Results:In total 235 patients, 37. 02% patients received hos-pice care. There is not significant difference between hospice users and no hospice users in sex and geographic differ-ences. There was significant difference between hospice users and no hospice users in personal ages, and in gap between urban and rural areas. and in medical payment, and in basic lesions. Malignant tumor patients receive hospice care most-ly. No patient received hospice care patients with acute trauma. The effect of ages on hospice is maximum ( OR =2. 877). Basic lesions is an important cause of influence whether patients receiving hospice care services(OR=1. 569). Conclusion:The level of hospice care is low in Shaanxi. The age and basic lesions is influencing factors of hospice care. The geographic differences has no effect on hospice care.

The activation of NK cell , mediated by natural killer group 2 ( NKG2 ) family receptor , plays an important role in antiviral immune response and disease progression after hepatitis B virus (HBV) infection.To explore the NKG2 receptors-mediated NK cell activation and its mechanism may be of value for anti-HBV targeting immune treatment .This article reviews the recent research progress on the role of NK cells and its NKG2 family receptors in immunity of chronic HBV infection and its mechanisms .

Objective To investigate the expression and significance of adiponectin(Adip) and the it's receptor 1, 2( AdipoR1, AdipoR2) in the pathogenesis of alcoholic liver disease ( ALD). Methods Fifty male Wistar rats were acclimatized for 7 days and then 10 rats were randomly assigned to be control. Others were to develop the rats mod-el of ALD by intragastric alcohol of increasing concentration and volume gradually [30% ～ 60%, 5 ～9 g/(kg · d)] , 8, 8, 8 and 9 rats were sacrificed randomly at the end of 4th, 8th, 12th and 16th week, liver samples and liver homogenate (10% ) were collected respectively. The concentration of triglyceride (TG) in the liver homogenate and the level of adiponectin and tumor necrosis alpha (TNFα) in the serum were measured by bi-ochemical chromatometry and ELISA method respectively. The mRNA and protein expression of Adip, AdipoRl and AdipoR2 in the hepatic tissue were performed by reverse transcription polymerase (RT-PCR) and Western blot. Results The model of rats alchoholic liver disease was developed. With the progress of ALD,the level of TG and TNFα in serum increased and the contention of Adip decreased gradually. The expression of Adip and AdipoR2 mRNA and protein decreased and no significant change was found in the AdipoRl. There is a negative correlationbetween the expression of serum Adip and AdipoR2 in hepatic tissue and the level of serum TNF-α and TG in the liver homogenate. ( r =-0. 98 ～-0. 90, P < 0. 01 ). The expression level of Adip protein was positively correlated with the contents of Adip in the serum ( r = 0. 90, P < 0. 01 ). Conclusion There is a close correlation between the decreased expression of Adip and AdipoR2 and adipose degenaration and inflammation in hepatic tissue.

Objective To evaluate the clinical efficiency and safety of thiazolidinediones (TZDs) on treat-ment of patients with nonalcoholic fatty liver disease (NAFLD). Methods The published controlled clinical trials about TZDs on treatment of patients with NAFLD from 1998 to 2008 were identified by searching in the full-text data base,such as Medline, PubMed, Ovid, EMCC, CBM Disc, CNKI, Wanfang, Weipu data and so on, as well as by searching of cross references from original articles and reviews. The enrollment standard was formulated strictly ac-cording to the designs of trials, and Meta analysis was performed by software package of Review Manage 4.2. Further-more, the statistic test, sensitivity and publication bias about the combined statistic data were revealed by referring to forest-graph and funnel-plot. Results All of the 473 patients in 18 controlled clinical trials were enrolled in this study. The weighted mean diffrerence of serum ALT, AST,TC,TG and BMI, HOMA-IR before and after treatment with TZDs 32. 24 (18.98-45.49) (Z=4.77,P<0.05),20.32 (2.30-38.35) (Z=2.21,P<0.05),0.26 (-0.01-0.54)(Z=1.88,P=0.06),0.63 (0.33-0.93) (Z=4.14,P<0.01),and -0.06 (-0.66-0.55) (Z=0.19, P=0.85),2.63 (1.33-3.93) (Z=3.96, P<0.01). In all papers, the improvement of hepatic tissue after treatment with TZDs in patients with NAFLD was observed in only 6 articles, which demonstrated the hepatic steatosis, inflammation and fibrosis [WMD (95% CI) 1.59 (1.08-2.10), 1.45 (0.90-2.00), 0.72 (0.12-1.32), Z= 6.08,5.16,2.33,P<0.05],especially the degree of NASH activity index,whose WMD (95% CI) was 4.21 (3.13-5.28) and Z=7.66,P<0.01, were improved significantly in the 104 NASH patients taken this kinds of drugs. There were 7 patients exiting from the all chnical trial, and the main adverse effects in patients accepting treat-ment with TZDs were debility, dizziness, edema of lower extremity, weight gain, indisposition of gastrointestinal tract, elevated liver enzyme and so on, which were similar to the control group. Conclusions The therapeutic effects of TZDs on NAFLD is confirmed. Not only are the serum liver enzyme,TC,TG and HOMA-IR in patients with NAFLD improved, but this new euglycemic agent has no acutely adverse effect in clinical application,which confirms the clin-ical efficiency and safety of TZDs on treatment of patients with NAFLD.

We investigated the psychological condition of 70 inpatients who had esophageal and cardiac carcinoma before radical operation with Hamilton Anxiety Scales.For the patients with anxiety,we carried out psychological intervention before operation which includes general care,follow-up,collective psychotherapy,keep disease condition individually and so on.The results showed the treatment had great benefit to most of the patients.

Resident standardization training is an essential way in cultivating medical professionals. It is important for subject development and talent reserve. For cultivating high-quality resident physicians with comprehensive theory, independent clinical thinking, great practical ability, and innovative scientific idea, it recourses to both optimizing training scheme and evaluation system with highly specialization and comprehensive quality. In this study, the authors proposed incorporate training patterns includingoptimiz-ing design, innovating training, and standardized assessment based on their recent experience on resident standardization training.