Objective: To investigate the effect of sinomenine on expression of toll like receptor(TLR) 2 and TLR4 of dendritic cells in patients with rheumatoid arthritis in vitro.Methods: The peripheral blood mononuclear cells were isolated from 10 rheumatoid arthritis patients and differentiated into dendritic cells by stimulating with cytokines.Dendritic cells were exposed to high(5mM),middle(2mM),low(1mM) concentration sinomenine and control medium.TLR2 and TLR4 mRNA were detected by real time PCR.Western blot was used to measure the expression of TLR2 and TLR4.Results: In contrast to control,signifi cant lower expression of TLR2,TLR4 mRNA and protein were found in dendritic cells treated with sinomenine,especially in high and middle concentration.Conclusion: The therapeutical effect of sinomenine on rheumatoid arthritis is probably by inhibiting dendritic cells expressing TLR,which can transduce the in? ammatory signal.

Study of kidney deficiency syndrome may utilize the modern molecular biology technique, such as gene chip, representational difference analysis (RDA) and genes sequence analysis, to clone the different genes of kidney deficiency syndrome from single TCM syndrome type of the disease, to investigate the inner connection between the various phenotypes of kidney deficiency syndrome and their genes expression pattern and their function products, then to definite the related genes of kidney deficiency syndrome. The research method may also be used for the study of other TCM syndrome types.

Objective To explore the methods and effects of the general resident nurse on duty system,and thereby to play an effective role of skilled nurses to ensure the quality and safety of nursing.Methods Using the management experience of general resident doctors for reference,a general resident nurse on duty system was established.The general resident nurses were strictly selected,trained and examined.At the same time,the management regulations were formulated.Results This practice cultivated a general resident nurse team with well-prepared nursing knowledge,skilled techniques,good capacity to cope with emergency,which could play important roles in the guidance and quality control of clinical nursing.Conclusion The implementation of general resident nurse on duty system can help train the backbone of specialized care,reserve the force of handling emergency and improve the quality of nursing.

OBJECTIVE:To analyze the treatment of anti-diabetics medicines and use of essential medicines in Chinese hospi-tal,and provide evidence for developing medicine policy,preventing and treating diabetes. METHODS:Data about annual con-sumption from 2012 to 2014 were extracted from the IMS CHPA database to analyze the object medicines of the target drugs with top 60% consumption volume of oral anti-diabetics and insulins,and the proportion of consumption volume and consumption amount in insulin,its analogues and three generations of insulin by 2 administration mode in Chinese hospital. RESULTS & CON-CLUSIONS:Acarbose tablet manufactured by Beijing Bayer HealthCare Co.,Ltd. and Metformin tablet manufactured by Shanghai Squibb Pharmaceutical Co.,Ltd. had occupied the top 2 of volume consumption in Chinese hospitals,totally accounting for 25%-26%. The 60% volume consumption of insulins and its analogues concentrated on one cheap local animal insulin(volume ac-counting for 13%-16% and amount accounting for 1%)and those imported or joint venture-made the second and third generation of insulins and analogues administrated by pen/cartridge. No matter insulins or oral anti-diabetics,the top consumption was listed as National Essential Medicine System,but none was recommended by WHO. Multi-pharmas dominate the Chinese anti-diabetic mar-ket through introducing new combined formulations and new dosage forms. WHO non-listed anti-diabetics have beautiful sales in Chinese hospitals,while traditional cheap medications for the general public grew slowly and with low profits. Chinese hospitals generally consumed more expensive new generations and original research manufacturers of anti-diabetics. As a lower middle in-come country that just established a universal coverage of basic health insurance,China still has a huge population with very limit-ed benefit package. Efficient use of limited health resources is essential for a successful health reform and a sustainable development of the health system in China.

Objective To evaluate the efifcacy and inlfuencing factors of 3%hypertonic saline (HS) inhalation in treatment of bronchiolitis. Methods Clinical data together with the detection of 16 types of respiratory tract virus from hospitalized pediatric patients with primary diagnosis of bronchiolitis from June 2009 to December 2012 were retrospectively analyzed. The endpoint indicators for evaluation on the efifcacy of nebulized 3%HS inhalation were the percent decrease of clinical severity (CS) score after 2 days' treatment and the hospitalization time. Factors affecting efifcacy were further explored. Results The CS score in nebulized 3%HS treated group decreased in average of 42.86%(11.11%-66.67%), signiifcantly higher than that (26.79%, 0.00%-50.00%) in the untreated group (P=0.006). No difference of between the two groups (P=0.26). Multiple linear regression analysis showed that nebulized 3%HS inhalation has better efifcacy on the patients older than 3 months having breastfeeding, respiratory synthetic syncytial virus (RSV) infection and extensive wheezing sound auscultation of the lungs. The multiple linear regression analysis model was statistically signiifcant (R2=0.58, P<0.001). Conclusions After 2 days' treatment with 3%hypertonic saline inhalation, the CS score of bronchiolitis patients was decreased. The treatment can be recommended in hospitalized patient older than 3 months with breastfeeding, RSV infection, and extensive wheezing sound auscultation of the lungs.

Objective To explore the indication,operative methods,operation skill and prevention of complications of mammotome(MMT) in breast diseases.Methods From Aug.2009 to Aug.2013,3676 breast lesions in 1356 patients received MMT micro-invasive operation by decussation process with different incision and needle tracks according to the location of lesions.Experience of the indication,operation technique and prevention of complications were summed up.Results 775 lesions were in left breast and 639 in right breast.652 patients had single lesion and 865 patients had multiple lesions.The pathology results:320 cysts (8.71％,320/3676) were adenosis of breast with mammary duct ectasia or with metaplasia apocrine.36 solid and cystic tumors (0.98％,36/3676)were intraductal papillomas.3310 solid tumors (90.04％)included 13 breast cancers (0.39％,13/3310),2246 fibroadenomas(67.85％,2246/3310) and 1051 adenosis(31.75％,1051/3310).10nodules of calcification were adenosis of breast.13 patients with breast cancer received modified radical mastectomy.The postoperative results:skin bruises in 184 cases(5％),hematoma in 36 cases(0.98％).No postoperative residual was found.Conclusion According to the strict application of MMT minimally invasive surgery and by decussation process based on the appropriate incision and needle track,MMT minimally invasive surgery can achieve safe,minimally invasive,good-looking and completely removal effect.

Objectives To evaluate the relationship between the expression of B7-1 in liver tissue and the effect of interferon-alpha(?-IFN) treatment in patients with chronic hepatitis B(CHB).Methods The expression of B7-1 in liver biopsy specimens from 68 CHB patients was studied with immunohistochemistry before ?-IFN treatment.Results B7-1 was expressed in 45(66 2%) liver tissues among 68 patients with CHB,but none in 5 normal controls.The total response ratio of ?-IFN in patients with B7-1 positive was 66 7%(30/45),which was significantly higher than 39 1%(9/23)in the patients with B7-1 negative (? 2=7 20,P

Objective: GLAZER assessed using biofeedback instrument diagnosis of postpartum pelvic floor muscle extent of damage, and thus guides the doctor through scientific electrical stimulation and biofeedback for patients with precise rehabilitation. Methods: Using MyoTrac infiniti's SA9800 type biofeedback instrument, for June 2011-June 2013 897 cases of hospital maternity maternal stress testing,Ⅰ,Ⅱ-type muscle fiber function assessed. 450 randomly selected group of electrical stimulation of human observation and biofeedback therapy; 447 as control group not treated. Results: After three months, for 897 cases of maternal second assessment, 450 cases of maternal observation group, the results tend to be normal; 447 cases of maternal control group also improved, but the result was worse than the observation group. Conclusion:Use SA9800-based biofeedback treatment, with GLAZER evaluate the results of patients diagnosed played a guiding role. In GLAZER evaluation criteria, you can quantify pelvic floor muscle strength and the extent of damage to the pelvic floor muscles, through proper rehabilitation; reduce the incidence of postpartum risk of common diseases.

Objective To compare the short term outcome of PPH with Milligan Morgan hameorrhoidectomy. MethodsNinety cases of Ⅲ ? Ⅳ ?degree hemorrhoids admitted for surgical treatment were randomly assigned to PPH ( n =45) or Milligan Morgan( n =45).ResultsThe difference was statistically significant between the two groups in terms of pain index ?operative time?length of hospital stay? time required for returning to normal activity and hospital fee. The above factors were found more favourable in PPH group, with no severe complications developed in neither of the two groups.The symptom improvement rate was 88% in PPH group and 81% in Milligan group.ConclusionPPH is a safe and effective procedure for Ⅲ ? Ⅳ ?hemorrhoids and its shorter term outcome is better than Milligan Morgan procedure.