Inflammatory bowel disease(IBD) is characterized by chronic non-specific inflammatory dis ease.The inflammation caused by abnormal immune response in intestinal mucosa exerts an important role in the pathogenesis of IBD.T helper 17 cells(Th17)are involved in the development of chronic inflammation and auto immune disease,whereas regulatory T cells can inhibit the function of autoimmune,and thus the balance of Th17/Treg balance plays an important role in intestinal homeostasis.Various strategies can be done to modulate Th17/Treg balance,such as antigen-presenting cells,microoganisms,some key molecules,natural compounds,proving a promising therapeutic method for IBD.

Objective To investigate and analyze the effects of problem-based learning used in clinical nursing education. Method The research papers on the effect of problem-based learning used in clinical nursing education were retrieved via CNKI, Wanfang,VIP,PubMed,ProQuest and Google scholar websites and then analyzed by Revman5.0 software.Results Totally 11 RCTs were included.Meta-analysis showed that PBL could significantly promote students’examination scores,self-study ability, critical thinking and clinical skill,but insignificantly improved the effect in improvement of their theory learning,interest and ability in cooperation.Conclusions PBL is a scientific clinical teaching method,which can stimulate students’initiative and exploratory learning and enhance effects of clinical teaching.Meanwhile,we suggest formulating evaluation criteria and implementing rigorous RCT designs in the future.

Inflammatory bowel disease is a chronic non-specific intestinal tract inflammation,currently,its etiology and pathogenesis are not clear.The current conventional treatments include salicylic acid drugs, steroids, immunosuppressive agents, biological agents and surgery, but the prognosis is still not very optimistic.In recent years, a variety of other treatment options have emerged, such as anti-cytokine antibody, anti-chemokine antibodies.Clinicians pay more attention to treatment of inflammatory bowel disease.

L-theanine (γ-glutamylethylamide) is the main free amino acid component of tea and its favorable physiological effects on mammals have been reported. An enzymatic method for optically pure L-theanine production with a new L-aminoacylases-production fungi Cunnighamella echinulata 9980 was developed. The optimum conditions for enzymatic catalysis were at pH 6.5 with 50 mmol/L N-Acyl-DLtheanine and 40 mmol/L CoCl2. After 12-h incubation at 50℃,22.5 mmol/L L-theanine was obtained, the conversion rate against N-Acyl-L-theanine being 90%. Cunnighamella echinulata and the aminoacylase were applied in preparation of L-theanine.

Objective:To assess the effectiveness and safety of radiotherapy combined with surgery for gastric cancer compared with single surgery. Methods:We retrieved relevant randomized controlled trails in Cochrane Library (Issue 2, 2009), PubMed (Jan 1966-Jun 2009), EMBASE (Jan 1974-Jun 2009), Chinese Biomedical Literature Database (Jan 1978-Jun 2009), Chinese Science and Technology Periodicals Database (Jan 1989-Jun 2009) ,China National Knowledge Infrastructure (Jan 1994 to Jun 2009) and Wanfang database (Jan 1997-Jun 2009). Two researchers assessed the quality of included randomized controlled trials (RCT) and extracted data independently. The RevMan 5.0 software was used for Meta-analysis. Results:Nine RCTs including 1 548 patients were selected for Meta analysis. Five RCTs were related with comparison of preoperative radiotherapy plus surgery with single surgery. Two RCTs were about the comparison of surgery plus perioperative radiotherapy with single surgery. Two RCTs were the comparative studies between surgery plus postoperative radiotherapy and single surgery. The Meta analysis results showed that: (1)compared with surgery alone, preoperative radiotherapy combined with surgery can increase 3 years [OR = 1.78, 95% confidence interal (CI):1.14-2.78], 5 years (OR = 1.67, 95%CI :1.22-2.29),and 10 years (OR = 1.64, 95%CI 1.03-2.60) survival rate,and reduce the tumor recurrent rate(OR = 0.59, 95%CI :0.37-0.92) and metastasis rate (OR= 0.44, 95%CI :0.27-0.73); (2) The tumor recurrent rates (OR = 0.19,95%CI :0.03-1.14 )and tumor metastasis rates (OR = 0.09, 95%CI :0.00-1.77)had no difference between single surgery group and peri-operative radiotherapy plus surgery group;(3) Postoperative radiotherapy compared with surgery had no significant effects on 1 year (OR = 0.83, 95%CI :0.60-1.15) and 3 years (OR = 0.75, 95%CI :0.51-1.11) survival rate compared with single surgery, but the 5 years (OR = 0.57,95%CI :0.34-0.95) survival rate of the patients who received surgery alone was higher than those who received combined therapy. No difference of the tumor recurrence rate(OR=0.59,95%CI :0.33-1.05) and tumor metastasis rate (OR=0.90,95%CI:0.51-1.59) were observed between the two groups. Conclusion:Preoperative radiotherapy combined with surgery is more rational and effective than surgery alone in the treatment of gastric cancer. However in terms of the clinical effects of perioperative or postoperative radiotherapy combined with surgery, more RCTs with larger samples and higher quality need to be carried out to make further verification.

The curriculum system of Proteomics was analyzed based on the teaching practice,the characteristics of ability training and gradation teaching were summarized and the prospect of curriculum optimization was proposed.These measures were conceived to enrich the course content and teaching methods for Proteomics course.

Objective To assess the relationship between auditory evoked potential (AAI) index and plasma concentration of propofol administered by target-controlled infusion (TCI) in Chinese.Methods Ten ASA Ⅰ～Ⅱ tumor patients (5 males,5 females) scheduled for elective abdominal surgery under general anesthesia was enrolled in this study.Age ranged from 34 to 61 years,body weight from 52 to 79 kg and height from 155 to 178 cm.Radial artery was cannulated for blood sampling.The patients were premeditated with intravenous injection Midazolam 0.06 mg/L.Anesthesia was induced by fentanyl 2μg/kg,vecuronium 0.1 mg/kg and TCI of propofol which the target plasm concentration was set at 3 mg/L.After intubation,the target plasma concentration of propofol was adjusted at 1.7～2.5 mg/L.Vecuronium was continuous infusions at 2～3mg/h.Anesthesia was maintained with fentanyl-TCI of propofol-vecuronium and inhalation of 0.5 MAC isoflurane.The TCI system was composed of Base Primea company orchestra infusion pump using,the schnider pharmacokinetics model.ECG,Bp,HR,PETCO2,SpO2 and TETISO were monitored during anesthesia.Danmeter company A-line depth of anesthesia monitor recorded AAI index.Blood samples were taken at induction of anesthesia (To baseline),1,3,5,10,15,30,60 min (T1-7) and after cessation of infusion 10 and 20 min (T9-10).Plasma propofol concentration were determinated by fluorescence photometry.Results Compared with target concentrations,the measured concentrations of propofol were significantly lower during TCI(P＜0.05).There was negative correlation between AAI and plasma propofol concentrations(r=-0.818,P＜0.01).Conclusion On base of the Schnider pharmacokinetics model,the target propofol concentrations are not paralleled to plasma propofol concentrations which is descending with time prolongation.From negative correlation between AAI index and plasma propofol concentrations,AAI index will reflect indirectly plasma propofol concentrations.

Objective To investigate the correlations of FcεRI-βgene polymorphisms with clinical manifestation and prognosis inwheezing infants. Methods One hundred and forty-six wheezing infants were recruited and divided into two groups by FcεRI-βdetection using Fluorescent quantitative PCR: Risk genotype group (n = 41) or normal genotype group (n = 105). The genotype distributions,clinical manifestation and asthma,and morbidity were analyzed and compared between the two groups. Results FcεR1 E237G AG/GG was more serious than FcεR1 AA in wheezing infants. (χ2 = 14.202; P = 0.003). No significant differences were found in AS morbidity between the two groups after two years follow-up (χ2 = 2.25;P = 0.13). Conclusion FcεRI-βgene polymorphisms are strongly related with infantile wheezing. Th risk genotype may be the severity of asthma but may not be the major influencing factor of asthma.

Objective To investigate the current status of self-efficacy and care ability among stroke patients′ family caregivers and explore the correlation between them. Method A total of 79 stroke patients and family caregivers were engaged in the investigation by demographical data questionnaires, general self-efficacy scale and questionnaire for assessing the comprehensive care-giving ability of stroke caregivers. Results The score on self-efficacy of the family caregiver was (27.16 ± 5.64) and the total score on care ability was (90.01 ± 16.57). There was a positive correlation between self-efficacy and care ability of family caregivers(P<0.05). Conclusions The self-efficacy and care ability of stroke patient′s family caregivers are at middle level. Their self-efficacy is positively correlated with their care ability. The nurses can improve the ability of daily caring of family caregivers by enhancing their self-efficacy.

Objective To explore the status of glucocorticoid application in patients with systemic lupus erythematosus (SLE) in China.Methods Epidemiological survey was used.The SLE patients who met the 1997 classification criteria of American College of Rheumatology were enrolled.The usage of glucocorticoid and related adverse reactions were recorded and analyzed.Results A total of 400 SLE patients were enrolled,including 35 men and 365 women.The average age was (37.4 ± 14.0) years old,and the average duration of disease was (6.7 ± 5.8) years.There were 310 patients using glucocorticoid as maintenance.Sixty-one percent (n =244) patients started using medium dose (prednisone 30-＜ 60 mg/d) as the initial treatment of glucocorticoid,which lasted for (37 ± 11) days.The time of drug duration in patients with low dose prednisone (7.5-＜30 mg/d)and high dose (60-100 mg/d) was(92 ± 20)and (17 ± 3) days respectively (P ＜ 0.05 between 3 groups).However,patients receiving different initial dosage were of no discrepancy in the maintenance therapy.During maintenance,even though 51.0％ (n =158) patients were on prednisone 2.5-5 mg/d,the duration of drug use in ＞ 5-10 mg/d groupwas longer [(29.9 ± 3.3) months].Patients with involvement of internal organs had a higher tendency to use 60-100 mg/d prednisone or pulse-dose therapy in the initial treatment,nevertheless these two groups had no difference of maintenance dosage.Among all 400 patients,62 patients withdrew glucocorticoid,including 17 patients with disease remission (4.3％),44 by self-withdrawal and one with adverse reaction.Conclusion In China,the medium dosage of glucocorticoid is the most common initial treatment in patients with SLE.Prednisone 2.5-5 mg/d was the most common choicefor maintenance therapy.Currently,the proportion of glucocorticoid withdrawal remains low in SLE patients achieving remission.