Epigenetics change has been considered to be the most promising new strategy for disease control and prevention. TCM regulates gene expression through epigenetics, participating in pathological and physiological process including cell apoptosis, proliferation, differentiation, cell cycle regulation, immunity, inflammation, and metabolism. This article reviewed the application of DNA methylation, histone modification and the miRNA regulation in TCM research.

Objective To establish core competence evaluation index system of orthopaedic specialized nurse .Methods Alto‐gether 35 experts from Class Ⅲ Grade Ⅰ hospital in Chongqing ,Beijing ,Jiangshu were consulted by a three‐round delphi survey ,and finally established the core competence evaluation index system of orthopaedic and the weight of each index .Results The core com‐petence evaluation indexes of orthopaedic specialized nurse included 4 first class indexes ,14 second class indexes and 72 third class indexes .The expert authority coefficient was 0 .833 ,the familiar coefficient was 0 .794 ,the determination coefficient was 0 .872 ,The coordination coefficient of primary and secondary and third indicators were 0 .390 ,0 .324 ,0 .308 ,respectively ,and there were statis‐tically significant differences (P< 0 .05) .Conclusion The expert opinions for the core competence evaluation indexes are consist‐ent ,the results are objective and scientific .It can provide quantitative standards for training ,examining and evaluation of orthopaedic specialized nurse .

BACKGROUND: Human dental pulp stem cells are important oral mesenchymal stem cells with strongproliferation and multidirectional differentiation functions. In-depth studies on the Human Genome Project make people gradually reali ze that functional non-coding RNAs play an extraordinary role in regulating gene expression. OBJECTIVE: To discuss the function and application of non-coding RNAs in human dental pulp stem cells. METHODS: Using “ncRNAs, human dental pulp stem cells, regenerative medicine” as keywords in English and Chinese, the first author searched PubMed, Medline, CNKI, and WanFang for relevant articles published from 2005 to 2019. Literatures unrelated to the purpose of the study and repetitive literatures were excluded, and 71 articles that meet the criteria were included for review. RESULTS AND CONCLUSION: It is now generally believed that non-coding RNAs can be used as a signal of specific cell state, providing prognostic value and even providing treatment options for patients. With the continuous development of regenerative medicine applications, human dental pulp stem cells are arousing increasing attentions. Exploration on the relationship between non-coding RNAs and human dental pulp stem cells provides a new approach for the clinical application of human dental pulp stem cells.

To report the clinical course of 5 cases of pediatric plastic bronchitis and review the related literature.A total of 113 cases of pediatric plastic bronchitis occurring in China from 2000 to 2012 were retrieved through the databases of CNKI and Wanfang Med Online.Retrospective analyses were performed for the main symptoms,courses,etiologies,imaging findings,histopathological classifications,therapies and prognosis of 118 cases.Pediatric plastic bronchitis was one of critical diseases.Most of them had a rapid onset and a mortality rate.Bronchoscopy examination was essential for definite diagnosis and effective treatment.Airway management and chest physiotherapy were primary adjuvant tools.Early diagnosis and bronchoscopic treatment might result in improved prognosis.

Objective To study the change of immune factor in COPD rats after intravenous injection of regulatory T cells.Methods Twenty-one SPF rats was divided into three groups at random,rat COPD model was built by smoking.We used magnetic bead isolation technic to separate CD4+CD25+ regulatory T cells.Regulatory T cells were cultured and injected into rats though rats' caudal vein according to different dose,5 × 104/mL,5 × 105/mL,5 × 106/mL respectively.Flow cytometry was used to analyze cell factors.ELISA was used to analyze IL-6 and CRP.Restlts Adding JJ316 or IL-2 into medium benefited the proliferation of CD4+CD25+ regulatory T cells.On the 20 th day,regulatory T cells CD4+CD25+ proliferation stopped by adding JJ316 or IL-2 respectively.Regulatory T cells were cultured and injected into rats though rat caudal vein according to different dose.The levels of CRP and IL-6 were decreased when rats were injected by CD4+CD25+regulatory T cell after one week.Conclusions Injection of regulatory T cells is helpful to control inflammation progression of COPD,so the increase of regulatory T cells of patients with COPD may decrease inflammation progression of COPD.

ObjectiveTo estimate the value of transthoracic coronary flow Doppler imaging to detect coronary flow reserve (CFR) changes in patient with obstructive sleep apnea syndrome (OSA). Methods Fifty patients with OSA who hospitalized or were outpatient in Aerospace 731 Hospital during the period of 2010 March to 2013 December were enrolled in this study and were divided into three groups according to apnea hypopnea index (AHI). Eighteen cases of patients which AHI was greater than 5 and less than 20 were defi ned as mild group, 16 cases of patients which AHI was more than 20 and less than 40 were defi ned as middle group, 16 cases of patients which AHI was greater than 40 were defi ned as severe group. The diastolic peak velocity (PDV) and meanfl ow velocity (MDV) of the distance segment of left anterior descending coronary (LAD) were measured by transthoracic echocardiography at rest and after intravenous infusion of adenosine triphosphate (ATP). Meanwhile, CFR was calculated. Forty healthy persons were chosen as control group. Thettest was used to compare the difference of PDV, MDV and CFR between OSA group and healthy controls. The single factor analysis of variance was used to compare the difference of PDV, MDV and CFR in patients with different AHI. SNK -q test was used to compare in different OSA groups. Thet test was used to compare the difference of PDV, MDV among OSA group, healthy control and OSA groups with different AHI at rest and after intravenous infusion of ATP.ResultsCoronaryfl ow velocity Doppler signals were successfully obtained in all the groups. PDV ([92.78±7.68] cm/s) and MDV ([85.93±6.98] cm/s) after intravenous infusion of ATP in control group were significant higher than those at rest ([28.09±4.55] cm/s and [21.76±5.09] cm/s) (t=49.687 and 58.259, bothP<0.001). PDV ([82.73±6.91] cm/s) and MDV ([77.39±6.73] cm/s) after intravenous infusion of ATP in OSA group were signifi cant higher than those at rest ([29.93±3.66] cm/s and [22.28±4.15] cm/s) (t=55.381 and 47.700, bothP<0.001). There was no statistically signifi cant difference between PDV and MDV at rest in OSA group and control group. The difference of PDV and MDV between OSA group and normal group was statistically signifi cant after intravenous infusion of ATP (t=6.524 and 5.884, bothP<0.01). There was no statistically signifi cant difference between OSA groups with different AHI at rest. There were statistically signifi cant difference between OSA groups with different AHI after intravenous infusion of ATP (5≤AHI<20:t=-32.903 and-32.771, both P=0.000; 20≤AHI<40:t=-37.122 and-32.623, bothP=0.000; AHI>40:t=-28.197 and-20.184, both P=0.000). PDV and MDV of patients with AHI>40 were less than those of patients with 5≤AHI <20 and 20≤AHI<40 and the differences were statistically signifi cant (PDV:q=21.048 and 15.667, bothP<0.05; MDV:q=12.958 and 18.182, bothP<0.05). However, the differences of PDV and MDV was not statistically signifi cant between patients with 5≤AHI<20 and patients with 20≤AHI<40.The CFRmax and CFRmean in OSA group were lower than those in control group (t=5.310 and 6.430, bothP=0.000). There were statistically signifi cant difference for CFRmax and CFRmean in patients with different AHI and the difference decreased with severity of OSA increased. The CFRmax and CFRmean in patients with 5≤AHI<20 were higher than those in patients with 20≤AHI<40 and AHI>40 (CFRmax:q=2.889 and 4.142, bothP<0.05; CFRmean:q=3.080 and 4.204, bothP<0.05). There was no statistical signifi cant difference for CFRmax and CFRmean between patients with 20≤AHI<40 and patients with AHI>40.ConclusionsIn patients with obstructive sleep apnea syndrome, transthoracic coronaryfl ow imaging combined with intravenous infusion of adenosine triphosphate shows impaired in CFR. It means the patients with OSA have a coronary artery microcirculation impairment in early stage. Assessing CFR in the patients with OSA is of important clinical value for the evaluation of treatment effective of medicine and surgery and follow-up.

BACKGROUND:Macrophage migration inhibitory factor is involved in the process of a variety of diseases, and plays a very important role in the tumor, autoimmune diseases, inflammation, angiogenesis, fibrotic diseases and so on. These biological characteristics are similar to keloids. OBJECTIVE: To compare the distribution and number of macrophage migration inhibitory factor in normal skin, hypertrophic scar and keloid. METHODS: We colected 40 clinical pathological scar specimens after surgery, including 20 hypertrophic scars and 20 keloids. Another 10 samples of the normal skin were used as control group. Hematoxylin-eosin staining and immunohistochemistry staining were performed to test the expression of macrophage migration inhibitory factor in pathological scars and normal skin. RESULTS AND CONCLUSION:Macrophage migration inhibitory factor was positively expressed in the normal skin, hypertrophic scar and keloid, and the expression of macrophage migration inhibitory factor in keloid was significantly higher than that in hypertrophic scar and normal skin (P < 0.01). It means that the abnormal infiltration of macrophage migration inhibitory factor may be associated with the formation of keloid.

Objective To analyze retrospectively the death pattern, risk factors, and death time of 253 patients at the Respiratory Care Unit of General Hospital of PLA in order to improve care quality and reduce mortality.Methods The information of patients was extracted from the hospital information system ( HIS) , and then classified and calculated accord-ing to different time points.Results Between November and next March,the mortality rate was higher than in other months (P<0.05), accounting for 19.5%.Mortality of those admitted between 8∶01 and 9∶00 or between 23∶01 and 24∶00 was higher than at other times(P<0.05), accounting for 41.7%and 50.0%, respectively.There was statistically significant difference(P<0.01) in mortality between days of the week,with the highest on Saturday, accounting for 43.1%.Mortality on non-work days was higher than on workday(P<0.01), accounting for 38.3% and 13.2%, respectively.Mortality at off-hour was higher than at office time(8∶00-11∶30 and 14∶30-18∶00 on workday) (P<0.01), accounting for 31.3%and 5.2%, respectively.Logistic regression analysis showed that age, month of admission, and the hour of discharge were associated with the outcome.Conclusion The high mortality between November and next March may be related to the higher incidence of respiratory diseases in winter, air pollution and cold weather.High mortality is also significantly associ-ated with the care quality of the medical staff.

Objective Acute kidney injury (AKI) frequently occurs after catheter-based interventional procedures and increases mortality. How-ever, the implications of AKI before thoracic endovascular aneurysm repair (TEVAR) of type B acute aortic dissection (AAD) remain un-clear. This study evaluated the incidence, predictors, and in-hospital outcomes of AKI before TEVAR in patients with type B AAD. Meth-ods Between 2009 and 2013, 76 patients were retrospectively evaluated who received TEVAR for type B AAD within 36 h from symptom onset. The patients were classified into no-AKI vs. AKI groups, and the severity of AKI was further staged according to kidney disease:im-proving global outcomes criteria before TEVAR. Results The incidence of preoperative AKI was 36.8%. In-hospital complications was significantly higher in patients with preoperative AKI compared with no-AKI (50.0%vs. 4.2%, respectively;P<0.001), including acute renal failure (21.4%vs. 0, respectively;P<0.001), and they increased with severity of AKI (P<0.001). The maximum levels of body tem-perature and white blood cell count were significantly related to maximum serum creatinine level before TEVAR. Multivariate analysis showed that systolic blood pressure on admission (OR:1.023;95%CI:1.003–1.044;P=0.0238) and bilateral renal artery involvement (OR:19.076;95%CI:1.914–190.164;P=0.0120) were strong predictors of preoperative AKI. Conclusions Preoperative AKI frequently oc-curred in patients with type B AAD, and correlated with higher in-hospital complications and enhanced inflammatory reaction. Systolic blood pressure on admission and bilateral renal artery involvement were major risk factors for AKI before TEVAR.

Objective To study the effect of ginsenoside Rb1(Rb1) and total saponin of dipsacus asper(tSDA) on intracellular free calcium concentration([Ca2+]i) mediated by β-amyloid protein(A β).So as to lay a foundation for developing effective Chinese traditional medicine to treat Alzheimer's disease(AD).Methods The technique of laser scanning confocal microscopy combining primary cultured neurons was adopted to quantitatively analyze the change of [Ca2+]i.Results The [Ca2+]i of primary cultured hippocampal neurons was (185.76±56.22)nmol*L-1 on basal levels.Control group showed obvious change of calcium vibration,[Ca2+]i was elevated to (1383.78±62.83)nmol*L-1.The peak of [Ca2+]i of Rb1 group reached (311.95±32.67)nmol*L-1 and was lower than that of control group (P＜0.01).The tSDA group displayed distinct change of calcium vibration too,and [Ca2+]i reached (358.01±35.42)nmol*L-1.There was a significant difference in [Ca2+]i between control and tSDA group (P＜0.01).Conclusion The research indicated that one of mechanisms by which Rb1 and tSDA protected the neurons was to maintain the balance of [Ca2+]i.