Objective To explore the methods to reduce the occlusion of perforating arteries after intracranial stenting of the vertebral artery. Methods Clinical data of 32 cases of Gateway-Wingspan stent implantation for intracranial branch of vertebral artery were retrospectively analyzed. The postoperative stricture and perfusion improvement situation were evaluated, the reason of perforating artery occlusion was analyzed. Results Thirty-two patients were implanted with 33 pieces of Wingspan stent and 1 piece of Apollo bracket. The operation success rate were 100%, and the stenosis rate reduced from (76.6±6.1)%to (27.9±5.2)%. After three months, the transcranial doppler sonography (TCD) and CT angiography were checked, showing no in-stent restenosis in all patients. Two patients occurred the perforating artery occlusion within 24 hours after operation. The possible reason was the change of stability of atherosclerotic plaque at the stenosis and the plaque displacement caused by the mechanical action of the balloon or stent, which may lead to medulla oblongata artery block. After drug and rehabilitation treatment, the symptoms in patients were improved significantly. Conclusion The perforating artery occlusion after stent implantation in intracranial branch of vertebral artery can be prevented by strict evaluation and preoperative preparation, the right selection of intraoperative balloon and stent, which still needs larger sample data to prove.

Idiopathic pulmonary fibrosis(IPF), as one of the chronic and complex diseases, is with high incidence and mortality rate. It is also a difficult to treat disease in modern medicine. Traditional Chinese medicine (TCM) syndrome differentiation and treatment embodies characteristics and advantages. In recent years, the collateral disease theory guiding the prevention and treatment of the chronic and complex diseases has become a hot point and frontier in medical research, and achieved certain effects. This article is to summary the structures and functions of pulmonary collaterals based on the collateral disease theory. Combined with clinical manifestations of IPF, we put forward Fei-Re Luo-Y u as the fundamental role in the pathogenesis of IPF in its acute phase to lay the theoretical foundation to the further exploration of syndrome prevention and differentiation on IPF in its acute exacerbation.

Acute pancreatitis happens rapidly and leads to patient's condition changing swiftly.Acute pancreatitis may be complicated by acute lung injury (ALI) and acute respiratory distress syndrome (ARDS),or even multiple organ dysfunction syndrome,and the mortality rate has been high.The mechanism of acute pancreatitis with complications of ALI and ARDS is intricate.It involves the uncontrolled inflammatory response,the damage and apoptosis of cell,the role of trypsin,the imbalance of coagulation and fibrinolysis,etc.These respects interrelate with each other,forming a complex network.Further study of mechanism of acute pancreatitis complicated with ALI and ARDS will supply more new target for clinical diagnosis and treatment.

Transforming growth factor-β (TGF-β) is a multifunctional protein and regulates a wide variety of cellular bio-effects,such as proliferation,differentiation,migration and apoptosis.Studies have proven that TGF-β is one of the important cytokines that promote fibrosis,and it is confirmed to be closely related to the progression of tumor.Smad signaling is the major pathway in which TGF-β fulfills its functions.These years,it has been found that E3 ubiquitin ligases Arkadia can enhance the biological effect of TGF-β signal transduction pathway through Smad signaling pathway.Therefore,it is increasingly attracting public attention.This study will summarize the effects of Arkadia on TGF-β/Smad signal transduction pathway.

Objective To evaluate immune protective effects of Treponema pallidum(Tp)pcD/Tp92 DNA vaccine delivered through different inoculation routes against Tp-induced skin infection in New Zealand rabbits. Methods A total of 108 New Zealand rabbits were randomly and equally divided into 6 groups:A1 and A2 groups treated with intramuscular injection of empty plasmids pcD and pcD/Tp92 DNA vaccine respectively for 2 sessions, B1, B2, C1 and C2 groups firstly treated with intramuscular injection of the pcD/Tp92 DNA vaccine for 1 session for primary immunization, then receiving nasogastric feeding with pcD/Tp92 DNA vaccine, pcD/Tp92 DNA vaccine+cytosine-phosphate-guanine(CpG)oligodeoxynucleotide (ODN), and recombinant Tp92 protein, and recombinant Tp92 protein+CpG ODN respectively for booster immunization. Enzyme-linked immunosorbent assay(ELISA)was conducted to detect the serum level of anti-Tp92 IgG antibody at week 0, 2, 4, 6, 8 after immunization, the SIgA level in the nasopharyngeal region and vaginal mucosa at week 8 after immunization, as well as levels of interleukin-2(IL-2)and interferon-γ (IFN-γ)in the culture supernatant of rabbit spleen cells at week 8 after immunization, and methyl thiazolyl tetrazolium(MTT)assay was performed to estimate proliferative activity of rabbit splenic lymphocytes in three rabbits from each group. At week 10 after immunization, other 15 rabbits from each group were subcutaneously inoculated with Tp standard strain, and changes of skin lesions at the inoculation site during early-stage infection were observed and recorded. Results At week 8 after immunization, the C2 group showed significantly higher serum level of anti-Tp92 IgG antibody(1.825 ± 0.175), supernatant levels of IL-2 (154.7 ± 14.6)and IFN-γ(277.4 ± 24.4), and proliferative activity of T cells(3.57 ± 0.24)compared with the A2(1.372 ± 0.322, 112.3 ± 13.4, 232.8 ± 25.3, 3.08 ± 0.22, respectively, all P<0.05), B1(0.893 ± 0.297, 76.6 ± 21.5, 165.7 ± 22.6, 2.12 ± 0.14, respectively, all P<0.05)and B2(1.294 ± 0.124, 97.3 ± 18.7, 211.3 ± 24.6, 2.88 ± 0.18, respectively, all P<0.05)groups. In addition, effective immunoprotection was achieved in the C2 group with more production of mucosa-specific SIgA antibody, as well as the lowest Tp-positive rate (6.67%) and ulcer formation rate (6.67%) in skin lesions at the inoculation sites. Conclusion The effective vaccination strategy, namely intramuscular injection of the pcD/Tp92 DNA vaccine for primary immunization followed by nasogastric feeding with mucosal adjuvant CpG ODN combined with recombinant Tp92 protein for booster immunization, can induce the strongest mucosal immune responses and immune protective effects.

Objective To investigate the changes of plasma bone morphogenetic protein-4 (BMP-4) levels in patients with coronary heart disease (CHD) and rosuvastatin intervention effect on BMP-4 level.Methods Fifty-two patients with CHD and 35 health people were enrolled in this study as CHD group and control group.ELISA method was used to detect the concentration of plasma BMP-4.Analyzed the relationship between plasma BMP-4 and blood lipids,flow-mediated dilation (FMD),nitric oxide (NO),cyclooxygenase-2 (COX-2),malondialdehyde (MDA) and superoxide dismutase (SOD).And observed the changing of plasma BMP-4 before and after rosuvastatin intervention.Results Plasma BMP-4 level in CHD patients was (7.53 ± 1.20) μg/L,higher than that of control group ((3.81 ± 0.79) μ g/L,t =3.541,P =0.006).After rosuvastatin treatment,plasma BMP-4 level in CHD patient was decreased from (7.53 ± 1.20) μg/L to (5.40± 0.98) μg/L (t =1.436,P =0.001).Plasma BMP-4 level was positively correlated with COX-2,MDA,low-density lipoprotein cholesterol,total cholesterol (r =0.395,0.350,0.274,0.288 respectively,P ＜ 0.01 or P ＜0.05).But,it was negatively correlated with NO,high-density lipoprotein cholesterol,SOD,FMD (r =-0.291,-0.253,-0.476,-0.320 respectively,P ＜0.01 or P ＜0.05).COX-2,SOD and FMD were independent risk factors of plasma BMP-4 in patients with CHD.Conclusion Oxidative stress and endothelial dysfunction are in patients with CHD.Rosuvastatin treatment can remarkably reduce plasma BMP-4 level,alleviate vascular endothelium injury induced by oxidative stress and improve endothelial function in patients with CHD.

Idiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic and progressive fibrosing inter-stitial pneumonia. Till now, it is lack of effective and safe treatment. In recent years, more and more clinical trials of traditional Chinese medicine (TCM) have been conducted with different evaluation criteria and indexes. The knowl-edge is disunity and unsystematic. From the perspective of combination of disease and TCM syndrome model, this ar-ticle summarized and organized the current data and medical standards, and then come up with the new evaluation system of clinical effect and describe important indexes and methods. This article was aimed to improve the clinical trial design and provide high quality evidences for evidence-based medicine.

This study was aimed to discuss the anti-inflammatory and immunization properties ofRe-Du-Ning (RDN) injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with phlegm-heat stagnated in the lung syndrome. A total of 110 in-patients were collected from January 2012 to December 2013. Cases were randomly divided into the treatment group (basic treatment plan + 20 ml RDN injection + 250 mL of 5% GS injection, once a day, intravenous injection) and the control group (basic treatment plan + 20 ml of 0.9% NS injection + 250 mL of 5% GS injection, once a day, intravenous injection), with 55 cases in each group. The treatment course was 14 days. Observations were made on traditional Chinese medicine (TCM) symptom score, clinical effect, blood routine examination, blood gas analysis and T lymphocyte subgroups before and after the treatment in both groups. The results showed that in the aspects of TCM symptom score and clinical effect, the posttreatment TCM symptom score and total integration in the treatment group were obviously improved compared to the control group except for shortness of breath, dry mouth and thirsty, flushing (P < 0.05). The total effective rate was obviously better than that of the control group. In the aspect of anti-inflammation, the total white blood cell (WBC) count and the normal neutrophil percentage of both pretreatment and posttreatment in the treatment group were obviously decreased compared to pretreatment (P < 0.05). However, there were no statistical differences on WBC count and normal neutrophil percentage compared to posttreatment in the control group. In the aspect of blood gas analysis, the posttreatment PaCO2 and PaO2 of the treatment group were obviously better than the control group (P < 0.05). In the aspect of immune regulation, the posttreatment T lymphocyte subgroups CD3+ and CD4+ of the treatment group were higher than the control group. The expression inhibition / cytotoxic lymphocyte (CD8+) was obviously lower than the control group (P < 0.05). The CD4+ / CD8+ was back to the normal reference level. It was concluded that in the treatment of AECOPD with phlegm-heat stagnated in the lung syndrome, on the basis of western medicine symptomatic treatment plan, RDN injection was assisted to clear heat, relieve toxin and remove phlegm. It can obviously improve patient’s clinical symptoms and increase the clinical therapeutic effects. The treatment was especially targeted to infection-induced respiratory failure patients combined low immunity with possible identified therapeutic effects.

This article elaborated the theory of chronic and complex disease treatment based on collaterals. It put forward that complex virtual evil stasis was the common pathogenesis of chronic and complex disease treatment. Combined with articles published in recent 5 years, from the perspective of cytokines and genes, it summarized traditional Chinese medicine (TCM) compound targets in chronic and complex disease treatment. It put forward the transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), vascular endothelial growth factors (VEGFs), matrix metalloproteinases/tissue inhibitor of metalloproteinase (MMPs/TIMPs) were its high-frequency targets. It provided a basis for future experiment design on chronic and complex disease treatment based on collaterals as well as new drug development.