Objective To evaluate the effect of dexmedetomidine on p38 mitogen -activated protein kinase (p38MAPK)signaling pathways in ventilator -induced lung injury of rats.Methods 100 SD rats were divided into 5 groups(n =20)by random number table.The control group(Group C),mechanical ventilation(Group H)and different dosage of dexmedetomidine group (Group DEX1 -3 ).Group C:no mechanical ventilation with natural breathing air for 4h;Group H:high tidal volume ventilation for 4H,inhaled oxygen concentration was 21%;Group DEX1 -3:20min before mechanical ventilation,infusion of dexmedetomidine(0.5,1.0,and 2.0μg/kg)with loading dose (5mL,0.5,1.0,and 2.0μg·kg -1 ·h -1 )for 4 hours.Femoral arterial blood were collected after mechanical ventilation for 1h,2h and 4h(T1 -4 )in basic status,the arterial blood gas and the PaO2 were analysized and recorded. concentration of total protein,TNF -αand macrophage inflammatory protein -2(MIP -2)in bronchoalveolarlavage fluid(BALF)were detected in rats after ventilation for 4h;myeloperoxidase(MPO)activity in lung tissue was deter-mined;intercellular adhesion molecule -1(ICAM-1)expression and lung wet/dry weight(w/d)ratio were detected;p -p38MAPK protein expression was detected by Western blot;pathological changes of lung tissue in each group and cell apoptosis were observated.Results Compared with the group C,expression of P -p38MAPK(5.4 ±0.5)and p38MAPK/p -p38MAPK(1.64 ±0.17)increased in Group H(F =3.22,3.28,all P <0.05),accompanied by the increased expression of CAM-1 in lung tissue,MPO activity,total protein,TNF -αand MIP -2 concentration in the BALF[(6.4 ±1.1),(1.95 ±0.16)U /g,(1 459.39 ±0.29)mg/L,(182 ±9)ng/L,(436 ±31)ng/L](F =3.53, 3.66,3.21,3.32,3.43,all P <0.05);.And compared with group H,expression of p -p38MAPK and p38MAPK/p -p38MAPK in DEX2 groups and DEX3 fell(F =3.22,3.28,all P <0.05)accompanied by decreased expression of CAM-1 in lung tissue,MPO activity,total protein,TNF -a and MIP -2 concentration in the BALF(F =3.53,3.66, 3.21,3.32,3.43,all P <0.05).Compared with the group H,PaO2 at each point showed no statistically significant difference in group DEX1 -3(F =1.43,P >0.05),and no significant difference of W/D in group DEX 2 ~3(F =2.89,P >0.05 ).Heavy pathological damage of lung tissue and significant apoptosis were observed in group H. Conclusion Dexmedetomidine can inhibit the development of ventilator -associated lung injury.The mechanism may associated with the inhibition of phosphorylation of p38MAPK,thereby inhibiting the expression of downstream inflam-matory factors.

Objective To study the condition of rehabilitation in Community Health Service (CHS) in rural areas after earthquake. Methods 274 medical personnels of CHS were invistigated with the questionnaire. Results There was no rehabilitation therapist in those medical personnel, and no difference of requirement, referral will and acquaintance of therapy between rehabilitation and acupuncture in CHS （P=0.056，P=0.293，P=0.654）. There was a significant difference in acquaintance of rehabilitation among different ages of medical personnel （P<0.01）, but there wasn't of acupuncture （P=0.104）. Conclusion It still lack rehabilitation therapist in CHS. Techniques and resources were the key points in the development of community-based rehabilitation.

Objective To discuss the clinical effect of self made Jianpi Yiqi Xiaoyu decoction combined with FMC chemotherapy for treatment of elderly patients with moderate to advanced gastric cancer and its impact on their quality of life.Methods One hundred and two elderly patients with moderate to advanced gastric cancer accompanied by the Chinese medicine dialectical syndrome belonging to deficiency of spleen and stomach qi and blood stasis admitted to Zhengzhou Traditional Chinese Medicine Hospital from January 2013 to January 2016 were enrolled,they were divided into observation group and control group according to random number table method and 2 patients who missed the follow-up in each group were excluded,resulting in 49 patients in each group;the patients in the control group were treated with FMC chemotherapy [including mitomycin 15 mg/m2,cisplatin 60 mg/m2 and fluorouracil 1000 mg/m2,slow intravenous drip (drop) after dilution with 60 mL 0.9％ sodium chloride injection];the patients in observation group were treated with FMC chemotherapy combined with Jianpi Yiqi Xiaoyu decoction (consisting of astragali 30 g,codonopsis pilosula 20 g,atractylodes macrocephala 15 g,Chinese yam 15 g,hoelen 15 g,ligustici 10 g,moutan cortex 10 g,aurantii 10 g,rehmannia dride rhizome 10 g,caulis dendrobii 10 g,500 mL water was added to make a decoction,boiled and concentrated to 200 mL decoction,100 mL taken in the morning and another 100 mL in the evening orally in one day).The clinical efficacy,the change of quality of life and incidence of adverse reactions were compared between the two groups.Results The proportion of patients whose quality of life improved in the observation group was significantly higher than that in the control group [55.10％ (27/49) vs.16.33％ (8/49),P ＜ 0.05].The total effective rate was obviously higher in the observation group than that in the control group [51.02％ (25/49) vs.22.45％ (11/49),P ＜ 0.05];the incidence of reduction of hemoglobin [30.61％ (15/49) vs.63.27％ (31/49)],aleucocytosis [28.57％ (14/49) vs.67.35％ (33/49)],thrombocytopenia [28.57％ (14/49) vs.69.39％ (34/49)],nausea and vomiting [44.90％ (22/49) vs.71.43％ (35/49)],diarrhea [32.65％ (16/49) vs.63.27％ (31/49)] and neurotoxicity [34.69％ (17/49) vs.55.10％ (27/49)] were significantly lower in observation group than those in the control group (all P ＜ 0.05).Conclusions Self made Jianpi Yiqi Xiaoyu decoction combined with FMC chemotherapy can significantly improve the clinical efficacy of theelderly patients with moderate to advanced gastric cancer.It can improve the patients' quality of life and reduce the incidence of adverse reaction of chemotherapy.

Objective To explore the expression of protein phosphotase-2A(PP-2A) in plasma in the patients with mild cognitive impairment. Methods The expression of PP-2A was measured by Western-blot in control group(n=11),1-year MCI group(n=10),2-year MCI group(n=10) and 3-year MCI group(n=10). Results The expression of PP-2A in 1-year MCI group(0.96±0.06) and in 2-year MCI group(0.93±0.07) was not obviously lower as compared with control group(1.00±0.08)(P>0.05),but a significant difference was induced between 3-year MCI group and control group(P<0.05),and between 3-year MCI group and 1-year MCI group(P<0.05),but wasn't between 3-year MCI group and 2-year MCI group(P>0.05). Conclusion Lower expression of PP-2A in plasma implies a possible value of MCI diagnosis.

Objective:To investigate the expression of NKG2D in peripheral blood of patients with ovarian benign or malignant tumors, and the expression of the human MHC class Ⅰ chain-related gene A(MICA) on the correspondent tumor tissues. To analyze and discuss the function of NKG2D in anti-ovarian cancer mechanism and its relation with immune escaping of cancer.Methods:Flow cytometry analysis was used to detect NKG2D in the peripheral blood of 42 ovarian carcinoma patients, 23 ovarian tumor patients and 20 health persons. The expressions of MICA in part of the correspondent tissues were examined by means of reverse transcription-polymerase chain reaction (RT-PCR).Results:The expression of NKG2D were (94 23?6 02)%?(98 70?0 98)%?(98 61?1 59)% respectively, compared with the other two groups, the NKG2D expression in malignant group was significantly low; The rate of MICA mRNA expression in ovarian carcinomas was significantly higher than that in benign and normal tissues. No evident relation was found between the expression of MICA mRNA and the clinical factors.Conclusion:The activity of NK cell and the anti-cancer cellular immunity level reduce in patients with ovarian cancer; The decrease of the receptor NKG2D is a reason for the descend of the activity of NK cells; MICA mRNA expression is relative to malignant transformation; the immune-escape of ovarian cancer probably is relative to the down-regulation of NKG2D and the up-regulation of its ligand MICA.

Objective To investigate the protective effects of astragaloside Ⅳ on blood-brain barrier(BBB) and influence on expression of ZO-1 protein after cerebral ischemia and reperfusion in rats.Methods 72 SD rats were randomly divided into:sham operation group,model group and two astragaloside Ⅳ therapy groups [group A(10 mg/kg,group B(20 mg/kg)].Method of Evans blue leakage and water content in the brain tissue were used to investigate the permeability of the BBB,and method of immunohistochemistry combined with image analysis was used to measure the expression of ZO-1 protein in microvessels.Results Compared with those in the model group,Evans blue leakage and water content were less and the number of ZO-1 possitive vessels was increased in the two astragaloside Ⅳ therapy groups.There were statistical differences between therapy groups and model group(all P

Objective To explore the effect and mechanism of glucose regulated protein 78 (GRP78) on autophagy and apoptosis in ovarian carcinoma, and to investigate the influence on the growth and sensitivity to cisplatin on the ovarian cancer cells.Methods The human ovarian cancer cell line SKOV3 were treated by the GRP78 regulator BAPTA-AM and A23187, which were used to decrease or increase the expression levels of GRP78, respectively.The experiment were divided into three groups.Cells in the group of BAPTA-AM were treated by BAPTA-AM at the final concerntration of 40 μ mol/L for 1 hour.Cells in the group of A23187 were treated by A23187 at the final concerntration of 4 μmol/L for 24 hours.While, cells in the control group were treated by culture medium without any GRP78 regulator for 24 hours.The expressions of GRP78, beclin1, Bcl-2 and CHOP mRNA and protein were detected by reverse transcription (RT)-PCR and western blot.The autophagy levels was observed by green fluorescent protein-microtubule-associated protein 1 light chain 3-Ⅱ (GFP-LC3-Ⅱ) fluorescence staining.The flow cytometry was used to analyse the apoptosis rates of cells.The effect on cell growth and the sensitivity to cisplatin of SKOV3 were accessed by methyl thiazolyl tetrazolium (MTT).Results (1)The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of BAPTA-AM were 0.583±0.025, 0.860± 0.055, 0.714±0.032 and 0.811±0.004, respectively.The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of A23187 were 0.840± 0.044, 0.654 ± 0.065, 0.908 ± 0.047 and 0.620 ± 0.062, respectively.The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the control group were 0.687± 0.032, 0.772 ±0.029, 0.845 ±0.018, 0.712 ± 0.077, respectively.While the protein expressions of GRP78, beclin 1, Bcl-2 and CHOP in the group of BAPTA-AM were 0.423±0.035, 0.952±0.022, 0.385±0.032, 0.681± 0.095, respectively.The protein expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of A23187 were 0.743 ±0.032, 0.638±0.025, 0.596±0.029, 0.431 ±0.095, respectively.The protein expressions of GRP78, beclin1, Bcl-2 and CHOP in the control group were 0.617±0.031, 0.789±0.083, 0.492±0.036, 0.531 ± 0.003, respectively.The mRNA and protein expressions of beclin and CHOP in the group of BAPTA-AM were both higher than those in the control group (P＜0.05).While, the mRNA and protein expressions of beclin and CHOP in the group of A23187 were both lower than those in the control group (P＜ 0.05).(2) The autophagy fluorescence of SKOV3 in the group of BAPTA-AM, A23187 and the control group were 706±117, 473±128, 595± 126, respectively, in which there were significant differences among three groups (P＜0.05).(3) The apoptosis rate of SKOV3 in the group of BAPTA-AM was (27.4±2.2)％, which was higher than that in the control group [(19.6± 1.4)％, P＜0.05].The apoptosis rate of SKOV3 in the group of A23187 was (12.2± 1.9)％, which was lower than that in the control group (P＜0.05).(4) The comparison of the sensitivity to cisplatin in 3 groups of SKOV3.The 50％ inhibition concentration (IC50) of SKOV3 to cisplatin was (3.02±0.62) mg/L.After treated by BAPTA-AM + cisplatin, the IC50 was (2.00±0.17) mg/L and the sensitivity of SKOV3 to cisplatin was increased by 33.8％, and there was significant difference (P＜0.05), compared with the control group.And after treated by A23187 + cisplatin, the IC50 was (4.91±2.52) mg/L and the sensitivity of SKOV3 to cisplatin was decreasd by 62.6％;and there was significant difference (P＜0.05), compared with the control group.Conclusion GRP78 could regulate autophagy and apoptosis of ovarian cancer cells by regulating the expressions of beclin1, Bcl-2 and CHOP, thereby affecting the sensitivity to cisplatin in ovarian carcinoma, which may be a new method for the treatment and improvement of the sensitivity to cisplatin in ovarian carcinoma.

The 53rd ASH meeting was held in San Diego in December 2011. The meeting has received many advanced reports on the diagnosis and treatment of multiple myeloma (MM).On therapy,with the application of thalidomide, lenalidomide and bortezomib as inductive treatments, the clinical outcomeshave been improved greatly in MM patients.Pomalidomide,a new immunomodulator,can be hopefully used as a frontline medicine for MM because of its high response. Bendamustine combination with other treatments induced efficient response and good response rates in MM patients with renal insufficiency or relapsed/refactory disease. Currently autologous stem cell transplantation is still the standard care for newly diagnosed young MM patients.At this time other kinds of novel agents have entered into clinical trials and have shown a bright future of application.

OBJECTIVE: To establish the high-performance thin layer chromatographic(HPTLC) fingerprints of volatile oil and flavonoids in Alpinia katsumadai Hayata so as to provide scientific information for its quality control, and determine the fingerprints similarity of with its related species. METHODS: The separation was performed on the pre-coated HPTLC GF254 silica gel plates. The volatile oil was developed with solvent system of toluene-ethyl acetate(9: 1). The relative humidity was 18%. The spots were visualized with 5% vanillin sulfuric acid solution. The flavonoides compounds were developed with solvent system of toluene-ethyl acetate-acetic acid (8: 1.5: 0.5). The spots were visualized with 5% aluminium chloride ethanol solution which needed to be observed at 365 nm. The common patterns of HPTLC fingerprints were obtained by CHROMAP 1.5 solution software, and authentication and quality assessment were performed by similarity and principle component analysis. RESULTS: The common patterns of the volatile oil and flavonoids consisted of 10 characteristic peaks and 7 characteristic peaks, respectively. Eucalyptol and alpinetin were identified by chemical reference substances. CONCLUSION: The qualities of Alpinia katsumadai Hayata collected from different areas are not distinctly different. Obvious difference exists in the chemical compositions of the volatile oil and flavonoids between Alpinia katsumadai Hayata and its counterfeit and other related species. This method is simple and rapid, which can serve as an effective identification and quality assessment method for Alpinia katsumadai Hayata.

This paper introduces the nursing care of 1556 patients with nasal packing silicone ventilation tube after func-tional endoscopic sinus surgery. Meticulous nursing care during nasal packing silicone ventilation tube could alleviate patients' discomfort obviously. It was emphasized to suck at exact time according to the patients' demands, adopt effective suction means to alleviate the damage of nasal mucosa,such as suction in the tube or in the bottom of the tube, take measures to promote the cleaning of secretion,which could improve the breath and sleep,as well as shorten the time of recovery.