Objective To investigate the therapeutic effect of spleen-strengthening,lung-clearing and phlegm-resolving herbs for the treatment of acute attack of chronic obstrustive pulmonary disease(COPD) complicated with systemic inflammatory response syndrome(SIRS),and to observe their effect on nuclear factor ?B(NF-?B)expression level.Methods Sixty qualified patients differentiated as deficiency of spleen and lung,phlegm-heat accumulating the lung were equally randomized into two groups:the control group received routine western medical treatment including oxygen inhalation,antibiotics and bronchodilator,and the treatment group received Chen Xia Liujunzi Decoction and Weijing Decoction,which have the actions of strengthening spleen,clearing lung,and resolving phlegm,one dose per day,for 7 days.The changes of clinical symptoms and signs,blood gas parameters and NF-?B expression level were observed.Results After treatment,clinical symptoms and signs such as cough,expectoration,dyspnea,shortness of breath,and wheeze were relieved in both groups(P

Objective Based on the international standard cardio-pulmonary resuscitation curriculum, the aim of the study is to investigate the effectiveness and importance of the layered cardio-pulmonary resuscitation emergency training. Method A total of 219 trainee including clinical medical personnel , auxiliary medical personnel and medical staff with standardized training were enrolled . Training included watching course video, team practice and class discussion, and the theoretical score and operation marks before and after layered cardio-pulmonary resuscitation training were compared. Theoretical score were compared by paired T-test, and operation pass ratio was determined byχ2 analy-sis. Results The pre- and post-training theoretical score of medical staff with standardized training, auxiliary medical personnel, and clinical medical personnel were 66.60±7.82 vs. 88.60±6.37;61.60± 7.44 vs. 86.90±5.80;73.45±6.83 vs. 94.75±5.04 respectively. The pre- and post-training operation pass ratio of marks of medical staff with standardized training, auxiliary medical personnel, and clinical medical personnel were 31.1%/85.2%;32.0%/90.7%;59.0%/96.4% respectively. Conclusion There are differences in both the theory and operation results of medical personnel at different levels before and after the training of cardiopulmonary resuscitation. The more targeted and layered training is much effective in cardio-pulmonary resuscitation emergency training.

ObjectiveTo observe the effect of ginsenosides Rb1 on cerebral blood flow of rat models with cerebral ischemia/reperfusion (I/R) injury, which could provide a new theory of cerebral protective mechanism about ginsenosides Rb1.Methods Twenty-four rats were randomly divided into sham-operation group, model group, normal saline control group and ginsenosides Rb1 group, 6 rats in each group. The middle cerebral artery occlusion (MCAO) model was established by thread embolism method. At the end of I/R, in the rat of ginsenosides Rb1 group, ginsenosides Rb1 40 mg/kg was immediately intraperitoneally injected, while in the rat of normal saline control group, an equal volume of normal saline was injected intraperitoneally. After I/R for 24 hours, the cerebral local amount of blood flow was measured, the rats' behavior score was observed, and the volume of cerebral infarction was monitored by 2, 3, 5-triphenyl tetrazolium chloride (TTC) staining.Results The percentage of volume of cerebral infarction [(64.23±8.12)% vs. 0%] and behavior score [3.0 (2.0-4.0) vs. 0 (0-0),P< 0.05] in model group were significantly higher than those in sham-operation group, while the cerebral local amount of blood flow in model group was obviously lower than that in sham-operation group (mL/min: 125.75±57.65 vs. 225.01±78.25,P< 0.05); Compared with the model group and normal saline control group, the percentage of volume of cerebral infarction [(23.62±8.74)% vs. (64.23±8.12)%, 56.72±8.92] and behavior score [0.5 (0.0-2.0) vs. 3.0 (2.0-4.0), 3.5 (1.0-4.0)] in the ginsenosides Rb1 group were significantly lower, the cerebral local amount of blood flow was markedly increased in the ginsenosides Rb1 group (177.25±75.36 vs. 125.75±57.65, 132.65±58.65,P< 0.05).Conclusion Ginsenosides Rb1 can increase the cerebral blood flow in rats with cerebral I/R injury, which maybe one of the mechanisms of cerebral protection of Ginsenosides Rb1.

Objective To investigate the changes in Wnt/β-catenin,bone morphogenic protein (BMP),estrogen receptor (ER) and insulin-like growth factor (IGF) signaling pathways in bone marrow mesenchymal stem cells (BMSCs) differentiation to the osteoblasts after spinal cord injury (SCI) and understand the mechanism of osteoporosis after SCI.Methods Forty 6-week-old male rats were divided into SCI group (n =20) and control group (n =20) according to the random number table.Rats in SCI group were submitted to laminar osteotomy at T10-12 and given lower thoracic cord sharp transection.In control group,rat lower thoracic cord was only exposed without transaction.Femoral bone marrow density (BMD) of rat right side was determined at postoperative 3 months.Femoral bone marrow was harvested from rat left side.After BMSCs osteoblast differentiation,cells were harvested and used for examining expression of genes associated with the signaling pathways in the two groups using microarray technology and real-time PCR analysis.Results BMD in SCI group was significantly lower in the ephiphyses and metaphyses[(0.176 ± 0.017)g/cm2 and (0.170 ±0.016)g/cm2] compared to that in control group [(0.257 ± 0.023) g/cm2 and (0.196 ± 0.013) g/cm2,P ＜0.05].Microarray and PCR analysis revealed Wnt/β-catenin (eg.Wnt1,Wnt3a,Wnt5a,Lrp5,Ctnnb1,Lef1 and Axin),BMP (Tgfb1 and Bmpr1),IGF -1 (eg.IGF1 R,c-fos and c-Jun),and ER (eg.Esr1) signaling pathways in osteoblasts were significantly down-regulated in SCI group compared to these in control group (P ＜ 0.05).Conclusions The Wnt/β-catenin,BMP,ER,and IGF-1 signaling pathways in osteoblasts are significantly down-regulated after SCI,resulting in profound BMD loss.This indicates that these signaling pathways are implicated in the osteoporosis after SCI.

Objective To evaluate the effect of morphine preconditioning on the expression of miR-133b-Sp and Fas in rat cardiomyocytes subjected to hypoxia/reoxygenation (H/R).Methods Cardiomyocytes were isolated from healthy adult male Sprague-Dawley rats by using Langendorff perfusion.The cells were seeded into 24-well plates or 60 mm diameter dishes and randomly divided into 3 groups (n =24 each) using a random number table:control group (group C),group H/R,and morphine preconditioning group (group MPC).The cells in group C were cultured in normal culture atmosphere.In H/R and MPC groups,the cells were exposed to 95％ N2-5％ CO2 for 90 min followed by 120 min reoxygenation.In group MPC,the cells were cultured for 10 min in serum-free DMEM liquid culture medium containing morphine 1 μmol/L,and then were cultured for 30 min in morphine-free DMEM liquid culture medium before hypoxia.At 120 min of reoxygenation,the cells in 24-well plates were selected to detect the cell viability (by MTT),lactate dehydrogenase (LDH) activity in the culture medium,and cell apoptosis (by Hoechst 33234 staining).Apoptosis rate was calculated.Total RNA and protein were extracted from the cells in 60 mm dishes to detect the expression of miR-133b-5p and Fas mRNA (by quantitative real-time PCR) and Fas protein (by Western blot).Results Compared with C group,the cell viability was significantly decreased,LDH activity and apoptosis rate were increased,the expression of miR-133b-Sp was down-regulated,and the expression of Fas mRNA and protein was up-regulated in H/R group.Compared with H/R group,the cell viability was significantly increased,LDH activity and apoptosis rate were decreased,the expression of miR-133b-5p was up-regulatcd,and the expression of Fas mRNA and protein was down-regulated in MPC group.Conclusion The mechanism by which morphine preconditioning reduces H/R injury to rat cardiomyocytesis related to up-regulation of the expression of miR-133b-Sp and down-regulation of the expression of Fas.

Objective To study the effects of exogenous melatonin on plasma corticosterone(CS)and adrenal glucocorticoid receptor(GR)mRNA in neonatal rats after hypoxic-ischemic brain damage(HIBD). Methods One hundred and forteen 7-day-old Sprague-Dawley rats were randomly divided into four groups:model group(K group),sham operation group(H group),melatonin-treated group(T group),and normal control group(S group). Blood was obtained in different time points after HIBD. Plasma CS levels were measured by radioimmunoassay(RIA). The expression of GR mRNA was detected by semi-quantitative reverse transcriptase polymerase chain reaction(RT-PCR). Results Plasma level of CS increased and the expression of GR mRNA decreased significantly after HIBD,however,these changes were markedly reversed by exogenous melatonin. Conclusions Plasma CS and adrenal gland GR were involved in the pathological process of HIBD. Exogenous melatonin could up-regulate the expression of GR by decreasing the level of endogenous CS,so it may alleviate the excess stress injury after HIBD.

Objective To improve the clinical skill training courses in order to meet the new challenges and different requirements. Methods Totally 327 clinical physicians of different levels in 36 departments were enrolled and 286 physicians were randomly surveyed with the questionnaire , including subjects' general characteristics, participation rate, training courses and training model. Results Among the trainees, most of them were attending physician and resident physician, and their participation rate was 88.5%(77/87) and 90.0% (172/191) respectively. The most popular and well acknowledged training courses were emergency treatment course such as AHA basic/advanced life support course. Training model like ‘group class, one topic, one hour’ was well accepted by 84.1%(275/324) physicians and course time of 16:30-17:30 was preferred by 65.5% (214/327) physicians. Conclusions A series of most popular and significant training courses are developed. More important-ly, physicians' real need and new expectation to the training course are well recognized, which is im-portant to plan the further training program and courses.

Objective To investigate proteolipid protein 1 (PLP1) mutations in six pedigrees with Pelizaeus-Merzbacher disease (PMD),and to provide prenatal consulting and prenatal diagnosis.Methods Subjects were six probands with PMD admitted in Department of Pediatrics,Peking University First Hospital from July 2006 to November 2011 and their family members.Genomic DNA sarnples were extracted from peripheral bloods of probands and their family members.Multiplex ligation-dependent probe amplification (MLPA) technique was used to detect PLP1 duplication mutation.Direct DNA sequencing was used to detect point mutation.Genetic diagnosis were based on PLP1 mutation genotype from probands.Prenatal diagnosis of nine fetuses were performed from seven PLP1 mutation female carriers by fetuses' DNA extracted from amniocytes or villus cells.Results PLP1 duplications were found in probands 1-4 (P1-4) whose mothers and the aunt of proband 1 (P1) were PLP1 duplications carriers.The two cases of point mutation,c.96C＞G(p.F32L) and c.623G＞T (p.G208V),were found in proband 5 (P5) and proband 6 (P6).Hcterozygous changes of the same mutations were found in P5' and P6' mothers with normal phenotypes.Seven female PLP1 mutation carriers were pregnant again.Prenatal diagnosis of PLP1 for nine fetuses presented one PLP1 duplication,one point mutation,one PLP1 duplication carrier,and six wildtypes.A segmental crossing over of X chromosome was detected in one male fetus of PLP1 wildtype.Conclusions PLP1 mutation analysis could help to diagnose PMD pedigree and to identify female PLP1 mutation carrier in the family.The following prenatal diagnosis and proper genetic counseling are very important to prevent PMD child from being delivered.

Primary liver cancer has various potential causes and insidious onset, and its progression is affected by many factors. Immunotherapy and targeted drug therapy have been used as non-radical treatment methods for primary liver cancer, but they cannot achieve a satisfactory effect and may lead to drug resistance. In recent years, the wide application of 16s high-throughput sequencing and the in-depth studies of microbiology have revealed the key role of microorganisms in the development and progression of liver cancer. The association of the liver with oral and intestinal flora is gradually clarified, and the regulation of oral and intestinal flora has brought new treatment methods for the disease. This article reviews the microbial theory of the oral-gut-liver axis and its application and development in the treatment of primary liver cancer.

Objective:To investigate and compare the value of cross-sectional area measurement and width measurement by high frequency ultrasound in the diagnosis of congenital adrenal hyperplasia (CAH) in infants.Methods:The abdominal ultrasound images of 20 infants who were diagnosed as CAH in Tianjin Children′s Hospital and clinical diagnosised from November 2013 to August 2018 were analyzed retrospectively. The maximum cross-sectional area of adrenal gland and the maximum width of single limb were measured respectively to assess the size of adrenal gland. Fifty normal full-term infants were selected as control group at the same period. The differences of maximum cross-sectional area of adrenal gland, the maximum width of single limb between CAH group and control group were compared. ROC curve was plotted to compare the diagnostic values of cross-sectional area measurement and width measurement.Results:①There was significant difference in maximum cross-sectional area of adrenal gland between infants with CAH and normal infants[(129.47±37.39)mm 2 vs (54.42±20.85)mm 2; t=10.004, P<0.001]. There was significant difference in maximum width of adrenal gland between infants with CAH and normal infants [(4.56±1.20)mm vs (3.25±0.66)mm; t=5.445, P<0.001]. ②The area under ROC curve(AUC) of cross-sectional area measurement was 0.966, the best cutoff value was 87.5 mm 2, the sensitivity was 95.0%, and the specificity was 92.5%. AUC of width measurement was 0.817, the best cutoff value was 5.25 mm, the sensitivity was 90.0%, and the specificity was 62.5%. The difference of AUC between cross-sectional area measurement and width measurement was 0.149, which was statistically significant ( Z=2.309, P=0.021). Conclusions:Both cross-sectional area measurement and width measurement by high frequency ultrasound have diagnostic values for CAH in infants, with the former more valuable than the latter.