Objective To evaluate CT diagnositic value for endo-bronchial tuberculosis(TB).Methods CT findings of 14 cases with endo-bronchial TB proved by fibro-bronscopy(FOB) were studied retrospectively.Results The bronchiarctia was seen at lobar bronchas or segmental bronchas in all 14 cases.Of them,in 6 cases,the bronchiarctia appeared as conic stenosis accompanied with atelactasis and a large amount of plearal effusions,in 8 cases,the bronchial walls were thichened including centrality stenosis in 3 cases,unilateral stenosis in 5 cases and accompanied with polyus in 3 cases.No hilar mass and opposite "S" sign were found.The "bronchial air sign" was showed at the area of ateectasis.9 cases were accompanied by active pulmonary TB(64.3%).Conclusion CT is of important value in diagnosing endo-bronchial TB and differentiating the tumorous or no-tumorous bronchiarctia,while the diagnonsis at early stage of this disease has to depend on FOB.

Objective: To observe the effects and immunological mechanism of continuous blood(purification)(CBP) in treatment of children with infectious shock.Methods: Twelve children with infectious shock treated with continuous veno-venus hemofiltration(CVVH) in intensive care unit(ICU) from June 2002 to October 2005 were selected as CBP treatment group,and 20 children with infectious shock without the(treatment) were selected as controls at the same time.The levels of pH,oxygenation index,HCO~-_3,base(excess(BE)),blood urea nitrogen(BUN),serum creatinine(SCr),blood pressure and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) were examined before and 24,48 hours after treatment dynamically,while the levels of tumor necrosis factor?(TNF?),interleukin1(IL1),IL6 and IL8 were detected and analyzed by SPSS 10.0 software.Results: Among the 12 patients,8 cases survived,4 cases died and the mortality rate was 33.3%.In CBP treatment group,APACHE Ⅱdecreased after treatment,and other biochemical parameters were all improved,plasma concentrations of TNF?,IL1 and IL8 decreased(P

Objective:To observe the effects of acupuncture-moxibustion on symptoms,signs,and Th1/Th2 cytokine,and regulation on Th1/Th2 in patients with perennial allergic rhinitis(PAR) to provide experimental basis for acupuncture treating allergic rhinitis and investigate the mechanism.Methods:Thirty patients with allergic rhinitis were treated with acupuncture-moxibustion,and 30 healthy cases were the control.Clinical symptoms,signs,and nasal mucosa were observed,and contents of IL-4,IFN-γ,and granulocyte-macrophage colony stimulating factor (GM-CSF) in the supernatant of peripheral blood monocyte cultured with PHA by ELISA,before treatment,after one course of treatment,and after two courses of treatment.Results:Before the treatment,the contents of IL-4,and GM-CSF were higher (P＜0.01) and IFN-γ was lower (P＜0.01) in the PAR cases than in the control cases.In the PAR cases,the content of GM-CSF was positive correlation with that of IL-4 (P＜0.01),and negative correlation with IFN-γ (P＜0.01).After the treatment,contents of IL-4 and GM-CSF were lowed (P＜0.01),content of IFN-γ was increased (P＜0.05),and all IL-4,GM-CSF and IFN-γ had no difference compared with those in the control cases.Conclusion:Acupuncture moxibustion could improve the symptoms and signs in PAR patients,enhance the immune function.It may be achieved by regulating the expression of Th1 and Th2,correcting the imbalance of Th1/Th2.

Objective To investigate the ED50 and ED9 5 of subarachnoid 0.375% bupivacaine in elderly patients undergoing elective total hip arthroplasty (THA ) in high altitude area. Methods Twenty-three elderly patients,aged 73-99 years old,ASA Ⅱ or Ⅲ,selected for total hip ar-throplasty (THA)under combined spinal-epidural (CSE)anesthesia were enrolled in this study and predose of 3.0 mg,0.375% (m/v)bupivacaine administered in subarachnoid,following dosage in-creased by ratio of 0.8.Calculate the ED50 and ED9 5 of subarachnoid 0.375% bupivacaine and 95%CI.Results Twenty of 23 underwent the test completely.The ED50 (95%CI)and ED9 5 (95%CI)of 0.375% (m/v)bupivacaine were 4.81 mg (3.98-5.81 )and 7.29 mg (6.03-8.81 ),respectively. Conclusion Subarachnoid 0.375% bupivacaine (7.5 mg)can be used effectively and safely in elderly patients undergoing total hip arthroplasty in high altitudes area.

AIM: To quest the relationship bwteen BDNF and seizures. METHODS: BDNF and other correlative proteins in the hippocampus of audioepileptic rat (P77PMC) have been detected by immunohistochemistry at different stages of seizures including quiet stage, preconvulsive stage, convulsive stage and postconvulsive stage. Wistar rats were served as controls. RESULTS: At quiet stage, the BDNF in the hippocampus of P77PMC were less than that of control group and stepped up after stimulation, trkB in the hippocampus of P77PMC were high at every stages, but PY20 were increased only after stimulation. NPY in the hippocampus of P77PMC were in a low level before seizures. CONCLUSION: The endogenetic BDNF may alter the excitement of P77PMC by adjusting the expression of NPY in hippocampus and activating its receptor trkB.

One hundred fifty-three patients with hypoxia of both sexes,underwent hip arthroplasty from January 2012 to January 2014,aged 65-97 yr,weighing 41-80 kg,living in areas at altitude above 1800 m,of American Society of Anesthesiologists physical status Ⅱ-Ⅵ,were selected.The hemoglobin (Hb) at 3-4 days after operation was collected,and the patients were divided into 3 groups depending on whether or not postoperative anemia occurred:no anemia group (Hb＞ 110 g/L);mild anemia group (90 g/L≤ Hb≤ 110 g/L);moderate anemia group (70 g/L ≤ H b＜ 90 g/L).The 36-item Short-Form Health Survey score and Harris Hip Score at 28 days after operation were collected.There was no significant difference between the three groups in the postoperative 36-item Short-Form Health Survey score and Harris Hip Score (P＞0.05).Postoperative mild and moderate anemia did not affect the short-term outcome after hip arthroplasty in elderly patients in high-altitude regions.

Objective To investigate the relationship between 9p21 single nucleotide polymorphism (SNP) and myocardial infarction(MI) in Yunnan Yi nationality. Methods One hundred and ten patients with MI and 110 controls were enrolled. DNA sequencing was used to detect 9p21 gene locus and SNP typing and analysis. Results Hardy-Weinberg equilibrium was found in 9 sites of chromosome 9p21 in myocardial infarction group and control group.The frequency of rs1333049 GG genotype was 30.91% and 18.18% in case group and control group respectively, G The frequencies of rs2383206 GG genotype were 31.82% and 18.18%, respectively, and the frequencies of G allele were 55.3% and 41.1%, respectively. There were significant differences between the two groups 58.3% and 44.9%, The difference between the two groups was statistically significant(P<0.05). Conclusion This study demonstrates an association of rs1333049 polymorphism locus on chromosome 9p21 with risk for MI in in Yunnan Yi nationality.

At present,domestic medical drama has entered a period of rapid development,and has widespread attention.Medical drama is not only an industry play,but also a soul drama;not only fully demonstrates the medical staff's practice situation,but also more profound humanistic connotation.This paper analyzed the humanistic connotation of current domestic medical drama from four aspects of public understanding of medicine,metaphor of human nature and life motif,professionalism and realistic dilemma and humanistic care,and put forward the enlightenment to nurses.

OBJECTIVETo summarize and analyze the clinical literature regarding moxibustion at Yongquan (KI 1) for insomnia, and to provide clinical evidence of moxibustion at Yongquan (KI 1) for insomnia.

METHODSWith "moxibustion" "acupuncture-moxibustion" "Yongquan (KI 1)" "insomnia" and "sleep disorder", etc. as key terms, the clinical literature regarding moxibustion at Yongquan (KI 1) for insomnia was retrieved in CNKI, and VIP databases, and reviewed, summarized and analyzed.

RESULTSA total of 27 clinical papers were retrieved, including 14 randomized controlled trials. In recent years, the number of clinical papers had increased. Few papers selected moxibustion at Yongquan (KI 1) as independent treatment for insomnia; most papers combined moxibustion with acupuncture, massage, etc. Moxibustion was commonly manipulated by patients or family members, and few papers applied moxibustion instruments to make the manipulation easier and safer.

CONCLUSIONMoxibustion at Yongquan (KI 1) for insomnia has attracted more and more attention. It is suggested to apply convenient and safe moxibustion instruments in clinical treatment, which is benefit to clinical generalization, but also provides convenient manipulation for further study regarding its clinical effect and mechanism.

Objective To investigate the inhibiting effect of CGP77675 (CGP),a Src inhibitor,on epithelial-mesenchymal transition (EMT) of human retinal pigment epithelial (RPE) cells induced by transformation growth factor-β1 (TGF-β1).Methods Human RPE cell line (ARPE19 cells) was cultured in vitro and divided into control group,TGF-β1 group and TGF-β1 +CGP group.Corresponding agent was added into culture medium based on grouping.The morphology of the cells were examined under the optical microscope 3 days after culture.The expressions of EMT-related genes and proteins in the cells were detected by real-time quantitative PCR and Western blot,respectively,including fibronectin 1 (FN 1),and plasminogen activation inhibitor 1 (PAI1),and the expressions of zonula occludens protein 1 (ZO1) and cytoskeleton protein filamentous actin (F-actin) were detected by immunofluorescence staining.MTT assay was employed to evaluate the cell proliferation rate.The migration distance of the cells was measured by scratch test.Results The ARPE19 cells in the control group showed an epithelial-like morphology and F-actin and ZO-1 were expressed along cell membrane.In the TGF-β1 group,the cells appeared to be fibrous-like,and the fluorescence staining of F-actin was disordered and ZO-1 was discontinuous on the cell membrane.The cells in the TGF-β1 +CGP group remained to be an epithelial-like in shape with clear and complete expressions of F-actin and ZO-1.The relative expressions of FN1 mRNA and PAI1 mRNA in the cells were 0.211 ± 0.080 and 0.116±0.073,1.000±0.001 and 1.000±0.001,0.368±0.097 and 0.362±0.048 in the control group,TGF-β1 group and TGF-β1 +CGP groups,showing significant differences among the groups (F=33.14,82.92;both at P＜0.01),with the highest expressions ofFN1 mRNA and PAI1 mRNA in the TGF-β1 group (all at P＜0.05).The relative expressions of FN1 and PAI1 proteins were 0.166±0.055 and 0.327±0.066,1.000±0.001 and 1.000± 0.001,0.143 ± 0.030 and 0.260 ± 0.077 in the control group,TGF-β1 group and TGF-β1 + CGP group,with significant differences among three groups (F=181.90,48.85;both at P＜0.01),and the expressions FN1 and PAI1 proteins were significantly higher in the TGF-β1 than those in the control group and TGF-β1 +CGP group (all at P＜0.05).The cell proliferative rate in the TGF-β1+CGP group was (79.30±3.44) ％ and (54.80±7.39) ％ at the third day and seventh day after culture,which were significantly reduced in comparison with (99.50 ± 1.00)％ and (99.10±0.50)％ in the control group as well as (95.10±4.20)％ and (92.10±4.50)％ in the TGF-β1 group (all at P＜0.05).The migration distance was disappeared in the TGF-β1 group,and the scratch width was not obviously changed in the TGF-β1 +CGP group.Conclusions Src inhibitor can inhibit EMT process of ARPE19 cells induced by TGF-β1,indicating that Src signaling pathway may play a critical role in EMT of RPE cells.