Objective To observe the clinical effects of budesonide inhalation combined with psychotherapy on patients with chronic obstructive pulmonary disease.Methods 90 cases diagnosed with chronic obstructive pulmonary disease from January 2014 to June 2015 were randomly divided into two groups, 45 cases in each group.The control group received budesonide inhalation, and observation group received psychotherapy on the basis of control group.The serum airway remodeling indexes, sputum inflammatory indicators and blood gas indexes were compared between two groups .Results After two weeks’ treatment, the serum basic fibroblast growth factor (b-FGF), nerve growth factor (NGF) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in observation group were significantly lower than those in control group (P <0.05), the sputum interleukin-8 (IL-8), IL-18 and tumor necrosis factor-α(TNF-α) in observation group were significantly lower than those in control group (P<0.05), PaO2in observation group was higher and PaCO2was lower than those in control group (P <0.05).There was no significant difference in pH value between two groups (P <0.05). Conclusion Budesonide inhalation combined with psychotherapy has a good effect on patients with chronic obstructive pulmonary disease, which is better than that of budesonide alone.

This project starts with the teaching of clinical anatomy for eight-year medical students, selects specialists to enter the courses according to the content of clinical anatomy, and explores the deep integration of basic and clinical education. This study used the self-made questionnaire to evaluate the effect of the integrated teaching model, and Likert scale was used to score. Meanwhile, the correlation between the scores of each question and total points was analyzed with the item analysis. Moreover, we assessed the principal components through the exploratory factor analysis. The results showed that more than 95% questioned students thought the preclinical education integrated with clinical medicine teaching model is necessary and practical, which can assist medical students in the anatomical structure learning combined with clinical disease, and meanwhile cultivate students' clinical thinking. Only fewer than 10% thought it can connect the basic knowledge and clinical cases effectively, and over 35% thought there are difficulties. Additionally, more than half students (54%) hold the negative attitude which clinicians can't completely replace basic teachers in teaching. Our finding suggests that the integrated teaching model is attractive and feasible. Nonetheless, clinicians can’t replace preclinical teachers completely in the clinical anatomy education yet.

Objective:To investigate the influencing factors for textbook outcome (TO) after hepatectomy for hepatolithiasis.Methods:The retrospective case-control study was conducted. The clinicopathological data of 216 patients with hepatolithiasis who were admitted to The First Affi-liated Hospital of Anhui Medical University from January 2015 to March 2023 were collected. There were 69 males and 147 females, aged 61(range, 22-85)years. Observation indicators: (1) treatment situations; (2) TO after hepatectomy; (3) Influencing factors for TO after hepatectomy. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were expressed as absolute numbers. Logistic regression models were used for univariate and multifactorial analyses. Results:(1) Treatment situations. All the 216 patients underwent hepatectomy, including 45 cases of laparoscopic hepatectomies and 171 cases of open hepatectomies, 161 cases of anatomical hepatectomies and 55 cases of non-anatomical hepatectomies. All the 216 patients underwent intraoperative choledochoscopy exploration and lithotripsy. There were 170 patients with normal Oddi sphincter function and 46 patients with Oddi sphincter dysfunction. All the 216 patients underwent biliary drainage, including 198 cases of external T-tube drainage and 18 cases of internal bile-intestinal drainage. The operation time was (226±75)minutes and volume of intraoperative blood loss was (106±82)mL. There were 29 patients with perioperative blood transfusion and 14 patients with intraoperative severe adverse events. There were 189 patients achieved immediate stone clearance. Of 183 patients with intraoperative bile cultures, 76 cases were positive for bacteria culture. (2) TO after hepatectomy. Of 216 patients, 93 cases had postoperative complications, all of which were successfully discharged after active treatment. One patient had surgery-related death within 90 days after surgery, and the cause of death was liver failure. Five patients were readmitted within 90 days after surgery, and 18 patients had postoperative stone residual. Of 216 patients, 164 cases achieved TO postoperatively and 52 cases did not achieve TO postoperatively. (3) Influencing factors for TO after hepatectomy. Results of multivariate analysis showed that cholangitis, stone distribution, surgical approaches, anatomical hepatectomy, immediate stone removal and postoperative review of choledochoscopy were independent influencing factors for TO after hepatectomy in patients with hepatolithiasis ( P<0.05). Conclusion:Cholangitis, stone distribution, surgical approaches, anatomical hepatectomy, imme-diate stone removal and postoperative review of choledochoscopy are independent influencing factors for TO after hepatectomy in patients with hepatolithiasis.

Objective Interleukin 6(IL-6)is an important cytokine featuring pleiotropic activity in the cardiac microenviron-ment and improves cardiomyocyte regeneration to favor cardiac repair after injury.Thereby this study aimed to investigate the effects of IL-6 on murine embryonic cardiomyocyte proliferation and unveil the possible developmental changes.Methods Single cardiomyocyte was obtained from mouse through enzyme dissociation at the early embryonic developmental stage(EDS)and late embryonic developmental stage(LDS).The cells were cultured for 24 h in 20％DMEM and then treated with 10 ng/mL IL-6 or 50 ng/mL IL-6 for 24 h.The effect of IL-6 on cardiomyocyte proliferation was comprehensively studied by tracing BrdU+α-acti-nin+nuclei and BrdU+α-actinin+mononuclear cardiomyocyte with immunofluorescence staining.Western blot was performed to unveil the changes in phosphorylation levels of the key proteins under IL-6 treatments.Results The 10 ng/mL IL-6 did not change the proliferation capacity of EDS myocardium,but significantly promoted the proliferation capacity of LDS myocardi-um.The 50 ng/mL IL-6 significantly inhibited the proportion of EDS BrdU+α-actinin+monocytes,and increased the proportion of LDS BrdU+α-actinin+nuclei and BrdU+α-actinin+monocytes.This might be related to the various effects of IL-6 at differ-ent concentrations on signal transduction pathways of EDS and LDS cardiomyocytes:10 ng/mL IL-6 and 50 ng/mL IL-6 inhibi-ted the phosphorylation of Akt in EDS cardiomyocytes,and had no significant effect on the phosphorylation of STAT3 and ERK.In LDS,10 ng/mL IL-6 and 50 ng/mL IL-6 inhibited phosphorylation of Akt and increased the phosphorylation of STAT3,but had no significant effect on the phosphorylation of ERK.Finally,the basic phosphorylation states of these three proteins were detected and the total protein amount and phosphorylation levels of STAT3,Akt and ERK showed a development-dependent decline.Conclusion IL-6 influenced the fetal cardiomyocyte proliferation in a developmental-and dose-dependent manner.It might be related to the developmental changes in the basic status of the target signaling pathways.These observa-tions provided new knowledge of cardiac proliferation and might propose new clues for the microenvironment in cell therapy.