Objective:To investigate the effects of Kangyan Decoction-1 on Th1/Th2 in peripheral blood of patients with atopic dermatitis in wet-heat syndrome.Methods:The patients of atopic dermatitis were randomly divided into two groups: the therapy group treated with Kangyan Decoction-1 and the control group treated with loratadine.At the same time,the healthy nornal group was established,taking no medicine.The people's peripheral blood of three groups were detected respectively by flow cytometry.Results:Before the treatment,the level Th1 cell and the ratio of Th1/Th2 was augmented,the Th2 cell was decreased obviously of the therapy group(P0.05),the percentage of Th2 and the ratio of Th1/Th2 had statistic discrepancy(P0.05).Conclusion:The imbalance of Th1/Th2 might be part of the immune character of patients with atopic dermatitis in wet-heat syndrome.Kangyan Decoction-1 could adjust the Th1 and Th2 cells,but especially reduce the level of Th2 cell,adjusting the imbalance of Th1/Th2.This might be one of the possible function mechanism.

Objective:To observe the repair effect of nano hydroxyapatite/magnesium(nHA-Mg)porous composite material modified by poly lactic acid/glycolic acid copolymer(PLGA) on the jaw bone defect of rabbits,and to elucidate the mechanisms preliminary.Methods:The mandibular defect models of 10 mm×5 mm×1 mm in the 18 rabbits were established.Nine rabbits were selected and implanted with nHA-Mg composite materials modified by PLGA in the left as experimental group and the right as blank control group;the other nine were implanted with nHA-Mg in the left as positive control group and the right as blank control group.The rabbits were sacrificed at 4, 8, 12 weeks (respectively 3 of experimental group and positive control group every time)and the mandibular defect areas were intercepted and observed by imaging and histological examination;the sizes of the newborn trabecula area and residual materials in experimental group and positive control group were compared.Results:Compared with positive control group and blank control group, the percentage of newborn trabecula area of the rabbits in experimental group was increased (P<0.05),and there was no statistic difference between positive control group and blank control group (P>0.05).The imaging results showed that the new bone formation can be observed in experimental group and better than positive control group and blank control group.The paraffin section results indicated that there were visible vascular tissue and newborn trabecula,the osteoblasts gathered around the bone trabecula;a lot of pits were located in the bone trabecula, and the pits contained osteocytes in experimental group.As the prolongation of time,thickened newborn trabecula, dense arrangement and trend of converting to lamellar bone were observed in experimental group.The hard tissue section results showed that the remaining amount of materials in experimental group was more than that in positive control group.Conclusion:nHA-Mg porous composite materials modified by PLGA can effectively reduce the rate of degradation in the body, promote osteogenesis and guide the bone regeneration.

Objective To investigate the effective methods for the treatment of periprosthetic fracture after hip replacement.Methods The clinical data of 13 cases underwent the artificial total hip replacement (THR) with postoperative periprosthetic femur fractures were analyzed.Results The happening time was 12 days to 2 years after primary THR.According to Vancouver classification,there were 2 cases of type A,two cases of type B1,7 cases of type B3,and 2 cases of type C.The treatment included nonoperative treatment in 2 cases,3 cases received open reduction with memory alloy encircling fixer fixation,one case received wire binding with autologous iliac bone grafting,7 cases received revisions with modular revision implant combined with wire binding and autologous iliac bone grafting.The stem was loosened in one type B1 patient at 3 months after surgery.X-ray examination showed that the fractures were united and no infection occurred after operation in 12 patients.No migration or breaking of the instruments was observed.The average Harris hip score was 81 (70 ～ 86points).Conclusion The effective treatment method of periprosthetic fracture after THR should determined by Vancouver classification,degree of bone defect and economic situation of the patients.

Objective To discuss the effect of competency based education practice teaching model on vocational nursing students with ability training.Methods Totally 96 vocational nursing students were divided into control group from July 2014 to May 2015,receiving routine mentoring teaching mode and totally 99 vocational nursing students were divided into learning group from July 2015 to May 2016,receiving competency based education practice teaching model.Theoretical examination and clinical operation skill test as well as self evaluation of caring ability and transitional nursing ability were conducted to both groups after the course to compare the test scores and the change of their caring ability and transitional nursing ability.SPSS 19.0 was used for statistical analysis,and independent samples t test was used between the two groups.Results The theoretical scores of the nursing students in the experimental group ([93.70 ± 4.27) vs.(88.00 ± 4.83)] and skill test [[95.70 ± 2.49] vs.(91.40 ± 2.87)] were higher than those of the control group;caring ability score [(189.3 ± 13.5) vs.(179.4 ± 10.4)],with the average score of cognitive dimension (51.6 ± 9.8) vs.(50.2 ± 10.3)],the dimension of courage (70.2 ± 6.5) [vs.(65.7 ± 8.4)],average patient dimension (63.4 ± 4.8) vs.5.4)];transitional nursing ability score [(124.95 ± 24.06) vs.(118.18 ± 20.41)],the dimension of knowledge sharing [(38.43 ± 8.22) vs.(36.08 ± 7.23)],average score of attitude dimension [(54.08 ± 10.66)vs.(51.02 ± 9.16)],average score of behavior dimension [(32.43 ± 6.25) vs.(32.43 ± 6.25)],which were all increased compared with the control group,and the difference was statistically significant.Conclusion Competency based education practice teaching mode achieves good teaching effect and it is worth recommending in clinical teaching.

Objective To explore the aesthetic efficacy of modified endoscopic rhytidectomy by using the techniques to minimize tissue damage,to obviate injury to the vessels and nerves,and to control bleeding and to firm fixation.Methods Two discontinuous incisions were made in the temporal scalp during the procedure,obviating injury to the branches of the superficial temporal vessels.Endoscopic technique was used to facilitate elevating,hemostasis,slinging and fixation in the plane under superficial temporal fascia.Three transverse incisions were made after the hairline in the forhead scalp,the operation was carried out by using endoscopic equipment,and the elevated forhead flap was slinged and fixed upward to the lamina externa cranii.Results 58 cases were received endoscopic forehead and temporal rhytidectomy,only slight edema was observed after surgery,and no obvisous ecchymosis was found.All patients returned home 7 days after operation.Degree of satisfaction on long-term follow-up showed that 56 cases(96.55%)improved obviously one year postoperatively;35 cases followed up 2 years,33(94.29%)of them improved obviously.None case was suffered from facial nerve injury.Conclusion The purpose of endoscopic rhytidectomy is to avoid carrying out the operation out of sight,to minimize unexpected damage to vessels and nerves,and to facilitate dissection,hemostasis,suturing,slingling and fixation.By refining the technique,we can achieve minimal injury,shorten recovery period,and obtain more satisfactory results,so the indication for operation is extended.

ObjectiveTo investigate fecal diversion in the management of pelvic fractures associated with perineal injuries.MethodsThis retrospective study involved 27 patients of pelvic fractures associated with perineal injuries during April 2005 to April 2011.There were 23 males and 4 females,and the mean age was 32.9 years old (range,16-62 years old).Fractures type according to Tile classification:4 cases were type A,10 cases were type B,and 13 cases were type C.The pelvic external fixator and fecal diversion were selectively used.Results Of the 27 patients of pelvic fractures associated with perineal injuries,24survived.The overall mortality of pelvic fractures associated with perineal injuries in the present study was 11％.The survived 24 patients were totally reviewed clinically.The mean follow-up time of these patients was 10.9 months (range,4-42 months).Of those patients who underwent early fecal diversion (＜ 48 h),none experienced infectious completions.However,of those underwent non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion),four patients experienced infectious completions.Fisher's exact test was used to compare the infection rate of these two groups.And the result of Fisher's exact test demonstrated that those patients who underwent early (＜ 48 h) fecal diversion and non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion).ConclusionStabilization of hemodynamic; selective fecal diversion; early stabilization of pelvic fracture are necessary for the emergency management of pelvic fractures associated with perineal injuries.Rectal injury and severe perineal injury without involvement of rectum should undergo fecal diversion.Early fecal diversion (＜ 48 h) could reduce the infection rate of pelvic fractures associated with perineal injuries.

Objective To investigate the role of nitric oxide (NO) in the protective effects of morphine postconditioning against ischemia-reperfusion (I/R)-induced myocardial apoptoais. Methods Sixty pathogen-free SD rats were randomly divided into 4 groups ( n = 15 each) : group Ⅰ sham operation (S) ; group Ⅱ I/R; group Ⅲ morphine postconditioning ( M ) and group Ⅳ M + L-NAME ( non-selective NOS inhibitor). The animals were anesthetized with intraperitoneal pentobarbital 60 mg/kg, tracheostomized and mechanically ventilated. ECG was monitored. Right carotid artery was cannulated for BP monitoring and left jugular vein was cannulated for drug and fluid administration. Myocardial ischemia was induced by 45 min occlusion of left anterior descending coronary artery (LAD) followed by 120 min reperfusion. In group S LAD was exposed but not occluded; in group M morphine 1.25 mg/kg was injected iv over 5 min from 3 min before reperfuaion to 2 min of repeffuaion and in group M + L-NAME L-NAME 10 mg/kg was injected iv at 20 min before myocardial ischemia. Hemodynamic changes were monitored. The animals were killed at the end of 120 min reperfusion and their hearts removed. Myocardial apoptosis was determined by TUNEL technique. The expression of Akt phosphorylation was assessed by Western blotting. The NO content in myocardium was measured by a chemiluminescence detector.Results A large number of TUNEL positive cells (18.4 ± 1.1 ) % were observed in group I/R. Morphine postconditioning exerted a significant anti-apoptotic effect. The number of TUNEL positive cells was reduced to (10.8 ± 1.2)%. The myocardial eNOS phosphorylation expression and NO content were significantly increased in group M as compared with group I/R. The anti-apoptofie effect and increased NO production were significantly reversed by L-NAME. However, pretreatment with L-NAME did not inhibit the phosphorylation of eNOS in group L + M. Conclusion In vivo, morphine postconditioning can significantly reduce I/R-induced myocardial apoptosis through phosphorylation of eNOS and increase in NO production.

Objective:To use polylactic-co-glycolic acid(PLGA) as vector material to prepare the compound total flavonoids of Rhizoma Drynariae(TFRD) and total flavonoids of Chrysanthemum(TFC) sustained release microcapsule TF-PLGA microcapsules,and to investigate the the best preparation technique of TF-PLGA microcapsules and their sustained release characteristics in vitro.Methods:The TF-PLGA microcapsules were prepared with TFRD,TFC,and PLGA by emulsifying-solvent evaporation technique under certain conditions.With the encapsulation efficiency(EE) as the evaluation indicator,the optimal formulation was verified by single factor experiment and orthogonal design;the general morphology,the particle size and distribution of the microcapsules were observed by light microscope(LM) and scanning electron microscope(SEM);the cumulative drug release rate of TF-PLGA microcapsules was detected by constant temperature commotion method in vitro and the release curves of the TF-PLGA were drawn.Results:The optimal prescription was as follows:the concentration of PLGA was 140 g·L-1,oil phase volume was 1.4 mL,emulsifying speed was 900 r·min-1,emulsifying time was 5 min,the average EE was(83.89±2.30)%,and the average drug loading rate(DL) was(5.90±0.07)%.The LM and SEM resluts showed that the TF-PLGA microcapsules presented as round ball,the average particle size was(44.34±14.68)μm,and the distribution was relatively narrow.The drug release in vitro results showed that the initial drug release rate(24 h)was about 40%,and the cumulative drug release rate was over 90% after 50 d.Conclusion:The TF-PLGA sustained release microcapslue has better drug-loaded and sustained-release effects with simple preparation technique and better repeatability.

Objective:To explore the regulation of Recipe Xiaoban No.1 on the expression of p53 in dystrophy of vulva.Methods:Expression of p53 was determined by immunohistochemical technique in skin lesion of prior treatment and posttreatment from 30 cases with chronic vulvar dystrophy,and normal skin from 23 health adults were served as controls.Results: Expression of p53 in various of chronic dystrophy of vulva before treatment was obviously higher than control group(P0.05).Conclusion:Recipe Xiaoban No.1 can obviously improve the clinical symptoms and decrease the expression rate of P53.

Objective To observe the efficacy and safety of different doses of mizoribine to prevent rejection after renal transplantation. Methods Sorted by time of operation and odevity, 206 primary kidney transplant recipients were divided into 3 groups, including MMF group, MZR Ⅰ group and MZR Ⅱ group. All recipients in 3 groups were administrated CsA and Pred, combined with mycophenolate mofitile (MMF) in MMF group and mizoribine (MMF) in MZR Ⅰ and Ⅱ groups.The dosage of MMF was 1. 0 g/day, while dosage of MZR in MZR Ⅰ and Ⅱ groups was 100 and 200 mg/day, respectively. There was no difference in usage of cyclosporine (CsA) and prednisone (Pred) among 3 groups. 100, 60 and 30 recipients were followed up in MMF, MZR Ⅰ and MZR Ⅱ groups respectively in 5 years. During the follow-up period of 5 years, the incidence of acute rejection, patient/graft survival and adverse effects associated with drugs in three groups were observed. Results The patient/graft survival was 88. 3 % (53/60), 85 % (51/60) in MZR Ⅰ group, 90 % (27/30),86.7 % (26/30) in MZR Ⅱ group, and 88% (88/100), 86% (86/100) in MMF group, respectively (P>0. 05). There was no significant difference in incidence of acute rejection among MZR Ⅰ (10 %, 6/60), MZR Ⅱ (6. 7 %, 2/30) and MMF groups (9 %, 9/100). The incidence of severe pulmonary infection in MZR Ⅰ group was 3. 3 % (2/60), and 10 % (3/30) in MZR Ⅱ , and the former was lower than MMF group (15 %, 15/100) significantly. There was significant difference in mortality of severe pulmonary infection between MZR Ⅰ group (0, 0/2) and MMT group (73. 3 %, 11/15). The rate of ACR in MZR Ⅱ group (10 %, 3/30) was lower significantly than MMF group (30 %, 30/100) and MZR Ⅰ group (31.7 %, 19/60). There was significant difference in the incidence of hyperuricacidemia between two MZR groups (30 %, 56. 7 %) and MMF group (10 %)(P<0. 05), while the incidence of diarrhea and myelosuppression was lower significantly in MZR Ⅰ group than in MMF group. Conclusion MZR can prevent acute rejection after kidney transplantation effectively and safely. Immunosuppressive therapy including mizoribine is the best choice especially for high risk group because of susceptibility to infection and those who suffer from tenacious diarrhea owing to the side effect.