Objective To evaluate the clinical effect of emedastine difumarate eye drops combined with pranoprofen eye drops on histamine (HA), eosinophil cationic protein (ECP), leukotrienes B4(LTB4) and, IgE levels of allergic conjunctival and provide reference for clinical diagnosis and treatment.Methods 76 cases of patients with allergic conjunctivitis were randomly divided into control group and experimental group , control group were treated with fumaric acid emedastine eye drops, experimental group were treated with fumarate emedastine combined with pranoprofen eye drops, and then compare the efficacy and serum ECP, HA, LTB4 and IgE levels between two groups before and after treatment of the symptoms and signs score . Results The total efficacy of experimental group was significantly higher than that in control group (94.70%vs.81.60%)(P<0.05).The serum ECP, HA, LTB4 and IgE levels of experimental group were significantly lower than those in control group(P<0.05).Conclusion The emedastine difumarate combined with pranoprofen eye drops in the treatment of allergic conjunctivitis is better than single medication, and ECP, HA, LTB4, IgE significantly decrease.

OBJECTIVE: To investigate the expression and significance of related receptors of Notch signaling pathway in mouse model of allergic rhinitis (AR). METHOD: Sixteen BALB/c mice of seven-eight weeks old were randomly assigned to two groups,including controls group and model group. AR model mice was sensitized with ovalbumin(OVA). Symptom score, hematoxylin-eosin for pathological alteration and infiltration of inflammatory cells in nasal mucosa were analyzed as well as enzyme linked immunosorbent assay was taken to detect IgE in pe- ripheral serum. Nasal septum mucosa and peripheral blood mononuclear cells were collected from 16 BALB/c mouse(8 Allegic rhinitis,8 controls). Notch 1-4 were checked by real-time quantitative polymerase chain reaction and flow cytometry from different levels. RESULT: BALB/c mice model of allergic rhinitis was established successfully. The mRNA of Notch1, Notch3, Notch4 in nasal septum mucosa of allergic rhinitis mice model groups were obviously higher than that in normal controls, and the difference were statistically significant (P < 0.01). However, The expression of Notch2 is lower than the control group and the difference was statistically significant (P < 0.05). In line with the above, the protein expression of Notch1, Notch3, Notch4 in peripheral blood mononuclear cells (PBMC) of model groups were significantly higher than that in health controls, and the difference were statistically significant (P < 0.01). But comparing control, expression of Notch2 was lower and the difference was statistically significant (P < 0.05). CONCLUSION There were significant changes of Notch genes in mouse model of AR. This intimated that related genes of Notch signaling pathway may paly important roles in the development and progression of AR and provide ideas for in depth study of the pathogenesis of AR.
Animals ; Disease Models, Animal ; Leukocytes, Mononuclear ; Mice ; Mice, Inbred BALB C ; Nasal Mucosa ; RNA, Messenger ; Receptors, Notch ; metabolism ; Rhinitis, Allergic ; metabolism ; Rhinitis, Allergic, Perennial

Objective To describe the CSP genotypic profile in clinical isolates of Aspergillus fumigates from different regions of China,and to investigate if there is a difference in antifungal susceptibility among A.fumigates of different CSP genotypes and from different regions.Methods Totally,112 A.fumigates strains clinically isolated from Fujian,Shanghai,Hebei and Beijing were included in this study,and identified according to macro-and micro-morphological characters,growth temperature and β-tubulin sequence.Classic A.fumigatus strains were typed according to CSP gene sequence.The minimal inhibitory concentrations (MICs) of voriconazole,itraconazole and amphotericin B to A.fumigates were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS) M38-A protocol.Results All the strains were identified as classic A.fumigates,and fall into 11 CSP genotypes.The most common genotypes were t04A (n =32),t03 (n =17) and t01 (n =24) in all the strains,tl0,t04A and t01 in Fujian,t04A and t01 in Shanghai,t01,t03 and t04A in Hebei,t02,t04A,t01and t03 in Beijing.One A.fumigatus strain was identified as a new CSP type t25 in Fujian,which showed no obvious difference in morphology,growth rate or appropriate growth temperature from the other CSP genotypes of A.fumigatus strains.No statistical difference was found in the susceptibility to amphotericin B,itraconazole or fluconazole among different genotypes of A.fumigates,whereas the MICs of itraconazole were significantly lower in A.fumigates isolates from Fujian than in those from the other three regions.Conclusions The CSP genotypic profile of A.fumigates varies in clinical isolates from different regions.No significant difference is observed in the susceptibility to amphotericin B,itraconazole or fluconazole among different CSP genotypes of A.fumigates,but the susceptibility to itraconazole is somewhat different between A.fumigates strains from different regions.

This study is to investigate the mechanism of human promyelocytic leukemia HL-60 cells proliferation induced by alteronol in vitro. Human promyelocytic leukemia HL-60 cells cultured in vitro were treated with different concentrations of alteronol. Inhibition rate was detected by SRB assay. Cellular morphological changes were observed by Hoechst and AO/EB (acridine orange/ethidium bromide dye) staining. The apoptosis rate was determined by Annexin V-FITC/PI assay. Cell cycle distribution was determined by flow cytometry. Western blotting analysis was carried out to determine the cell cycle related proteins. The proliferation of HL-60 cells treated with alteronol was inhibited in a concentration-dependent manner. Based on cell viability assay, observation on cell morphology and apoptosis rate, it confirmed that alteronol played an obvious role in proliferation inhibition of human promyelocytic leukemia HL-60 cells, but it did not induce apoptosis in human promyelocytic leukemia HL-60 cells in different concentrations groups. Alteronol could effectively inhibit the proliferation of human promyelocytic leukemia HL-60 cells inducing cell cycle arrest at G1 phase, as well as, alteration expression of cell cycle proteins level of CyclinD1 and pRb.

Objective To analyze the prognosis and risk factors for antineutrophil cytoplasmic antibody?associated vasculitis (AAV) patients on maintaining dialysis. Methods AAV patients on maintaining peritoneal dialysis (PD) or hemodialysis (HD) in First Affiliated Hospital Zhejiang University from June 2007 to June 2015 were included, and were followed up until death, kidney transplant, changed dialysis modalities or January 31, 2016. Patients were divided into PD group and HD group for comparison. Their survival rates and risk factors were analyzed by Kaplan?Meier analysis and COX regression model respectively. Results A total of 123 cases were chosen, with a median duration of dialysis for 854 (388, 1573) days, and with 88 cases (71.5%) on HD and 35 cases (28.5%) on PD. Fifty?two patients (42.3%) were more than 65 years old. At the median follow?up time of 36 months, 39 patients (31.7%) died. The main causes of death were cardiovascular events (30.8%) and infection (23.1%). COX regression analysis showed that patients older than 65 years old (HR=3.289, P=0.001), with cardiovascular disease (HR=3.241, P=0.003) and interstitial pneumonia (HR=2.173, P=0.048) at the dialysis onset were independent risk factors affecting survival. Conclusions Factors including age (older than 65 years), pre?dialysis cardiovascular disease and interstitial pneumonia were independent risk factors affecting survival of AAV patients on maintaining dialysis, then infections and cardiovascular events were the main causes of death.

Objective To evaluate the efficacy of Disposcope endoscope for tracheal intubation in patients with difficult glottis exposure.Methods Sixty adult patients of both sexes,aged 22-68 yr,scheduled for elective oro-tracheal intubation under general anesthesia,whose glottis was not visible under Macintosh laryngoscope (grade Ⅲ or according to Cormach-Lehane Grading of laryngoscopic view),were randomized into 2 groups (n =30 each) using a random number table:group Macintosh laryngoscope-assisted Disposcope endoscope (group DM) and group Disposcope endoscope (group D).The glottis exposure condition and time,intubation condition and time,assisted lifting mandible,laryngeal mucosa bleeding and postoperative sore throat and hoarseness were recorded.Results The success rate of intubation at second attempt achieved 100％ in the two groups.Compared with group DM,the incidence of assisted lifting mandible was decreased,and no significant changes were found in the success rate of glottis exposure,glottis exposure time,intubation time,success rate of intubation at first attempt,incidence of laryngeal mucosa bleeding,and postoperative sore throat and hoarseness in group D.Conclusion Disposcope endoscope can improve the condition for tracheal intubation significantly after lifting mandible in patients with difficult glottis exposure.

The knowledge of endocrine metabolic diseases represented by type 2 diabetes mellitus is highly specialized, complicated, and has many clinical guidelines. In this context, team based learning teaching combined with case teaching based on evidence-based medicine was applied in the actual class teaching. The class was divided into several groups and the students were encouraged to discuss and study from each other with the guidance of teachers. Consequently, students' learning interests and spirit of team-work were greatly enhanced, the way of thinking using evidence-based medicine and their ability to solve the practical clinical problems were also improved.

ObjectiveTo investigate the feasibility of using pulse oximetry plethysmographic waveform (POP) to identify the restoration of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR).Methods An observational research was conducted. A porcine model of ventricular fibrillation (VF) arrest was reproduced. After 3 minutes of untreated VF, animals received CPR according to the latest CPR guidelines, providing chest compressions to a depth of 5 cm with a rate of 105 compressions per minute and instantaneous mechanical ventilation. After 2 minutes of CPR, animals were defibrillated with 100 J biphasic, followed by continuous chest compressions. Data of hemodynamic parameters, partial pressure of end-tidal carbon dioxide (PETCO2) and POP were collected. The change in POP was observed, and the characteristics of changes of the waves were recorded during the peri-CPR period using the time and frequency domain methods.Results VF was successfully induced in 6 pigs, except 1 death in anesthesia induction period.① After VF, invasive blood pressure waveform and POP of the animals disappeared. PETCO2 was (18.83±2.71) mmHg (1 mmHg=0.133 kPa), and diastolic arterial pressure was (23.83±5.49) mmHg in compression stage. Animals attained ROSC within 1 minute after defibrillation, with PETCO2 [(51.83±9.35) mmHg] and diastolic arterial pressure [(100.67±10.97) mmHg] elevated significantly compared with that of compression stage (t1 = 8.737,t2 = 25.860, bothP = 0.000), with appearance of arterial blood pressure waveform.② Characteristic changes in POP were found in all experimental animals. During the stages of induced VF, compression, ROSC, and compression termination, POP showed characteristic waveform changes. POP showed disappearance of waveform, regular compression wave, fluctuation hybrid and stable pulse wave in time domain method; while in the frequency domain method waveform disappearance, single peak of compression, double or fusion peak and single peak of pulse were observed.Conclusion Analysis of POP using time and frequency domain methods could not only quickly detect cardiac arrest, but also show a role as a feasible, non-invasive marker of ROSC during CPR.

Objective To investigate the dynamic changes and coordination of macrocirculation and microcirculation in rats with severe hemorrhagic shock and septic shock. Methods A total of 20 male Sprague-Dawley rats (450～550 g) were randomly divided into two groups (n = 10) : hemorrhagic shock group (H-Shock) and septic shock group (S-Shock). 40％ of the systemic blood volume was withdrawn in 1 hour in H-Shock group.While in the S-Shock group, cereal ligation and puncture (CLP) was performed and then the abdomen was closed.Mean arterial pressure (MAP) and the end-tidal carbon dioxide (ETCO2) were recorded continuously. Cardiac ultrasonography and sublingual microcirculation were performed per hour till 12 hours or the rat die (End). A total of 12 hours were observed or the rat die. Arterial blood gas was measured at baseline (BL) , MAP ≤ 65 mmHg (Shock) and at the termination of observation respectively. Results The values reflect macrocirculation or microcirculation in the H-Shock group were all decreased than BL respectively at each time. In the S-Shock group, the values that reflect macrocirculation such as MAP, ETC02 and cardiac output (CO) showed no significant changes within 3 hours (P> 0.05) , while the values of microcirculation were decreased compared with BL respectively at each time (P < 0.05). With the progress of shock, the pH was decreased compared with BL in both groups, while the level of Lac were increased (P < 0.05). Conclusions The changes of macrocirculation and microcirculation in severe hemorrhagic shock are basically the same; while they are inconsistent in septic shock, the changes of microcirculation occurred earlier than that of macrocirculation.

Objective To analyze the correlation between internal iliac artery calcification and delayed graft function (DGF) and short-term prognosis of kidney transplant recipients. Methods Clinical data of 222 kidney transplant recipients were retrospectively analyzed. According to the recovery of renal function, all recipients were divided into the DGF group (n=50) and immediate graft function (IGF) group (n=172). According to whether the recipients were complicated with severe internal iliac artery calcification, DGF and IGF groups were further divided into the high-risk DGF (n=22), low-risk DGF (n=28), high-risk IGF (n=41) and low-risk IGF(n=131) subgroups, respectively. Clinical data of donors and recipients were statistically compared between two groups. The incidences of postoperative DGF and internal iliac artery calcification were recorded. The risk factors of DGF after kidney transplantation, and the correlation between internal iliac artery calcification and clinical parameters were analyzed. Short-term prognosis of recipients with DGF complicated with severe internal iliac artery calcification was evaluated. Results The incidence of DGF was 22.5% (50/222). Among all recipients, 28.4% (63/222) were complicated with severe internal iliac artery calcification. In the DGF group, 44% (22/50) of the recipients were complicated with severe internal iliac artery calcification, higher than 23.8% (41/172) in the IGF group (P < 0.05). Univariate analysis showed that high serum creatinine (Scr) level of donors, male donor, high triglyceride level and severe internal iliac artery calcification of recipients were the risk factors for DGF after kidney transplantation (all P < 0.05). Multivariate logistic regression analysis revealed that Scr≥143 μmol/L of donors and severe internal iliac artery calcification of recipients were the independent risk factors for DGF after kidney transplantation (both P < 0.05). Correlation analysis indicated that internal iliac artery calcification was weakly correlated with the age of recipients and renal artery anastomosis (both P < 0.05). In the DGF group, the Scr level at postoperative 1 month was significantly higher, whereas the estimated glomerular filtration rate (eGFR) was significantly lower than those in the IGF group (both P < 0.05). The eGFR at postoperative 12 months in the high-risk DGF subgroup was significantly lower than those in the low-risk DGF, high-risk IGF and low-risk IGF subgroups (all P < 0.05). Conclusions Internal iliac artery calcification is not only a risk factor for recovery of renal allograft function, but also negatively affects short-term prognosis of renal allograft function.