Objective To study the influence of penehyclidine hydrochloride(PHC)on inflammatory factors in patients with acute lung injury(ALI).Methods Total of 96 patients with ALI were randomly divided into treatment group(48 cases)and control group(48 cases).Patients in the treatment group were given conventional therapy,plus penehyclidine hydrochloride injection 1 mg,im,q12 h or q8h,the first dose could be doubled,at least 2 days of continuous application;Patients in the control group were received conventional therapy.Tumor necrosis factor α (TNF-α),interleukin-6 (IL-6),high sensitive C reactive protein (hs-CRP),calcitonin (PCT),oxygenation index (PaO2/FiO2),lung injury score (LIS) and acute physiology and chronic health status score (APACHE II) of patients on each time point were compared between the two groups before and after treatment,and mechanical ventilation time,intensive care (ICU) treatment time,acute respiratory distress syndrome (ARDS) and ICU mortality were recorded.Results On each time point of treatment,TNF-α,IL-6,hs-CRP,PCT,LIS,APACHE II in treatment group were significantly lower than that of control group (P<0.05),PaO2/FiO2 was significantly higher than that of control group(P<0.01).The mechanical ventilation time,ICU treatment time in treatment group were shorter than that of control group(all P<0.05),The incidence of ARDS in treatment group and control group was 20.8% and 39.6%,respectively(P<0.05);ICU mortality rate was 12.5% and 31.2%,respectively(P<0.05).Conclusion Penehyclidine hydrochloride can effectively improve the oxygen metabolism in acute lung injury,regulate the pulmonary inflammatory response and improve the prognosis of patients.

TCM service trades grew rapidly and enjoyed optimistic future during the 12th five-year period, which was in good development trend. However, it is still in its primary stage of development and facing various challenges. This article argued that the development of TCM service trades will meet great opportunities, such as governmental policy encouragement, cooperation with other industries, the increasing acceptance of international market and the acceleration of internationalization of TCM. Meanwhile, there are also some difficulties - small industry scale and weak brand management, absence of legislation, lack of qualified professionals and various service trade barriers.

Objective To observe the influence of ulinastatin (UTI) on curative effect,inflammatory response and cellular immune function in patients with acute respiratory distress syndrome (ARDS).Methods 96 patients with ARDS were randomly divided into two groups:the control group (48 cases) were treated with conventional treatment,and the UTI group (48 cases) were added with UTI injection based on the control group treatment.The changes of oxygenation index,vital signs,inflammatory factors and T lymphocyte subsets of patients in the two groups were compared before treatment and after treatment in 7 days,recorded the duration of mechanical ventilation time,ICU treatment time and mortality rate in ICU in the two groups.Results After treatment in 7 days,the vital signs (RF,HR,MAP),inflammatory factors (TNF-α,IL-6,IL-8,PCT,CRP,WBC),liver function (AST,ALT),renal function (BUN,Cr) and APACHE Ⅱ score,MODS score of UTI patients in the UTI group were lower than those in the control group (P ＜ 0.05 or P ＜ 0.01).Oxygenation index (PaO2/FiO2) and cellular immunity (CD4+,CD4+/CD8+) in the UTI group were higher than those in the control group (P ＜ 0.01).Mechanical ventilation time,ICU treatment time in the UTI group were shorter than those in the control group (all P ＜ 0.05),the mortality rate of ICU in the UTI group was lower than that in the control group (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusions UTI can more effectively improve oxygen metabolism,vital signs for ARDS,liver and kidney function,reduce the APACHE Ⅱ score and MODS score,shorten the mechanical ventilation time and ICU treatment time,reduce the mortality rate of ICU.Its mechanism may relate to clearance of inflammatory factors and regulate cellular immune function of UTI.

Objective To assess the distribution of recombinant fusion protein dTMP-GH in mice and to determine whether it is of tar-geted distribution characteristics. Methods A laboratory scale preparation of dTMP-GH recombinant fusion protein was obtained. Protein dT-MP-GH was labeled with radioactive 125 I,then mice were sacrificed at 5 min,15 min,30 min,1 h,2 h,4 h,8 h,12 h,24 h after tail vein injec-tion of 125 I-dTMP-GH at a dose of 100 μg/kg,and the organs and tissues ( heart,liver,spleen,kidney,bone and thyroid) were collected for radioactive counting. Results Preparation of purified ( >98%) dTMP-G was obtained. 125 I labeling rate was 71. 53%,radiochemical purity was 96. 53%,and specific activity was 0. 22 MBq/μl. 30 min after tail vein injection of 125 I labeled dTMP-GH,radioactivity accounted for 10% of the total injected in femoral,and metabolism was carried via liver and kidney over time. Conclusion Fusion protein mainly distribu-ted in bone marrow via tail vein injection in mice,which expressed that dTMP-GH has the characteristics of selective distribution in bone mar-row tissue.

OBJECTIVE To design a new draining method for near total thyroidectomy. METHODS Bilateral drainages were performed during near total thyroidectomy in 63 cases between December 1998 and July 2004.The bilateral drain incision for near total thyroidectomy was performed at the lower part of the neck.RESULTS All the draining operative procedures produced cosmetic scars and the drainage was effective.The mean amount of drainage was 38 ml(minimum 10 ml,maximum 120 ml)and no patients developed wound infection. Postoperative drain incision was limited under the clavicle,covered by the collar and left the patients satisfied with the results.There were no postoperative hematoma or seroma.CONCLUSION The bilateral drain incision for near total thyroidectomy placed at the lower part of the neck results in a cosmetic scar, which is easily covered by the collar and was safe and effective.

Traditional Tibetan medicine nature theory was the core of Tibetan medicine. This study was aimed to understand the scientific values of Tibetan medicine correctly and catch its unique advantages accurately. The history origin, nature and taste, target, effect, the relationship between diseases and Tibetan medicine and other aspects of traditional Tibetan medicine nature theory were discussed in this paper. Several points were put forward, which included the research of Tibetan medicine nature theory was the premise to maintain and develop Tibetan medicine; it was necessary to carry out literature research, definite and improve the nature theory; the data mining technology and systems biology should be applied to the theory research to elucidate the rules and scientific connotation of Tibetan medicine nature; building the model of experimental study with clinical research to determine its clinical values forward during the development of Tibetan medicine nature theory research.

BACKGROUND:Recently, the clinical repair methods of irregular wound on fingers primarily include local pedicled flap and free mini-flap of upper extremities or lower extremities.
OBJECTIVE:To discuss the application of free mini-flap derived from upper limb in repairing the wound on fingers.
METHODS:From December 2010 to February 2014, 12 patients with irregular wounds on 12 fingers were selected from Department of Traumatic Orthopaedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, China. The size of wounds ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.5 cm with different degrees of bone or tendon exposure. After the debridement, 12 patients were treated by free mini-flaps of upper limb. The donor sites were directly sutured.
RESULTS AND CONCLUSION:Among the 12 patients, al the wounds at recipient and donor sites were healed at stage I, and the free mini-flags survival completely. Al of patients were fol owed up for 3-6 months (average 4.5 months). Free mini-flags had good appearance and needn’t undergo secondary trimming. The active motion of fingers was improved dominantly. According to the criteria of Hand Surgery Association Society of Chinese Medical Association Society for the function evaluation of upper limb, three cases were excellent, eight were good, and only one was bad. The excellent and good rate was 91%. Free mini-flaps of upper limb are an ideal method for repair of wounds on fingers. It has no injury to normal tissue in hands, donor site is very secluded, and the short-term curative effect is good.

Objective To identify whether the branches of cervical nerve roots joined into the accessory nerve trunk or not.Methods In 10 adult cadavers (7 males and 3 females, including 20 laterals of brachial plexus nerves), we observe source of cervical plexus branches to the accessory nerve anatomically.In 10 clinical cases of males with brachial plexus nerve injures, in the supraclavicular approach of brachial plexus exploration, the part of the supraclavicular cutaneous nerve for histological specimen were cut off;in the posterior approach, electrical stimulation of the trunk and branches of cervical plexus were performed to observed istaltrapezius muscle contraction.After accessory nerve transfer, the residual terminal accessory nerve and branch of cervical plexus were taked for histological specimens;and observed and judged of each nerve sample by acetylcholinesterase (AchE) immunohistochemical staining.Results In 10 of 20 lateral cases, cervical plexus communicating branches were derived from the fourth cervical nerve root.The intraoperative electrical stimulation of the accessory nerve trunk, 10 cases of distal trapezius muscle were significantly shrink;electrical stimulation of the cervical plexus branch, 2 cases after stimulation of the mild distal trapezius contraction, the remaining 8 cases without trapezius muscle contraction.10 cases of supraclavicular nerve staining for AchE were negative, 10 cases of accessory nerve terminal branches of AchE staining were mixed,10 cases of branch AchE cervical plexus to the accessory nerve staining were negative.Conclusion The branches of the fourth cervical nerve root constantly joins into the accessory nerve, participating in the trapezius muscle inner vation, the fibers of the branches are sensorial fibers.

Objective To explore the changes of gut microbiota in response to abdominal and pelvic radiotherapy and its potential relationship with intestinal infection.Methods Irradiation was delivered to the abdominal region of BALB/c mice,following the regular human pelvic-radiotherapy protocol,2.0 Gy/d,continuous 5 d/week.Samples of ileum tissue and the intestinal content were collected at different time points of irradiation procedure,including after 3 and 5 weeks,and at 1 week after 6 weeks of irradiation.Quantitative RT-PCR was used to measure the mRNA level of antimicrobial peptides and pro-inflammtory factors.Bacterial translocation was determined by PCR.The gut microbiota was characterized by the denaturing gradient electrophoresis assay.Results The expressions of cryptdin-1 and cryptdin-4 were decreased after 3 weeks of irradiation and at 1 week after 6 weeks of irradiation(t =-7.43,-3.54,-4.72,-4.27,P ＜ 0.05),while they were significantly increased at the 5 weeks of radiation (t =6.15,5.75,P ＜ 0.05).The diversity index and richness of gut microbiota after 3 or 5 weeks irradiation were significantly decreased (t =-3.49,-4.19,-3.44,-4.97,P ＜ 0.05).The gut microbiota dysbiosis of the irradiated mice was characterized with the decrease of probiotics of Lactobacillus and the increasing of opportunistic pathogen of Escherichia coli,Shigella flexneri,et al.Bacterial translocation episodes were more frequently in the irradiated mice than that of control animal.The mRNA levels of IL-1β、IL-6 and TNF-α were significantly increased after 3 or 5 weeks of irradiation (t =4.85,6.16,7.71,4.60,4.86,5.97,P ＜ 0.05).Compared with the control,the expression levels of IL-1β and TNF-α at the 1 week after 6 weeks of irradiation ending was also obviously enhanced (t =3.67,5.88,P ＜0.05).Conclusions Pelvic radiotherapy can induce abnormality of enteric antimicrobial peptides and may result in gut microbiota dysbiosis.The disturbed gut microbial flora may further trigger an incurrence of bacterial translocation and enteritis.Therefore,the gut microbiota may be a potential interfering target to alleviate radiotherapy adverse effect.

Objective To investigate the significance of early diagnosis and intervention in cases with severe hand-foot-mouth disease. Methods Nine severe cases were chosen from 220 hospitalized children with hand-foot-mouth disease for retrospective analysis, including onset, disease progression, the blood and cerebrospinal fluid tests, electroencephalogram data, patients' treatment responses and prognosis. Pearson X2 test and t test were utilized for statistical analysis. Results All cases showed nervous systems involved symptom, including meningeal irritation sign and (or) other pathological signs of nervous system (9 cases), drowsy (7 cases), trembling (6 cases), voiding dysfunction (3 cases), hypersensitivity(3 cases), autonomic nervous system disorders (2 cases), ataxia (1 case), left leg mild paralysis (1 case) and early stage of pulmonary edema (1 case). Early intervention, such as high dose gamma globulin, methylprednisolone, mannitol treatment restriction of fluid input, started before the development of heart and lung failure. No case died but one patient with encephalomyelitis showed hobbling left leg, which didn't recover until 6 weeks later. One case with brainstem encephalitis still showed abnormal electroencephalogram after 8 weeks follow-up but without clinical symptom. Conclusions Enterovirus 71 can cause severe hand-foot-mouth disease complicated by encephalitis, meningitis and pulmonary edema. Early active intervention before the development of neurogenic pulmonary edema can improve the prognosis and reduce the mortality.