Objective To detect the effect ofTanreqing injection combined with conventional western medicine therapy on children with bronchioliti.Methods A total of 116 children with bronchioliti were enrolled in this study. Children were randomly divided into the control group (n=58) andTanreqing injection observation group (n=58). The control group received continued low flow oxygen, anti-infection treatment, and salbutamol aerosol to relieve asthma. The observation group receivedTanreqing injection based on the intervention of control group. Each group was treated for 7 d. The Th17 and Treg cells were detected by cytometry analysis and the expression of IL-17 and IL-10 were detected by ELISA analysis. The clinical effect of the two groups was compared.Results After treatment, compared with the control group, the Th17 cells (5.91% ± 0.83%vs. 7.23% ± 1.25%,t=2.346) and IL-17 (14.62 ± 3.24 ng/mlvs. 22.52 ± 5.14 ng/ml,t=2.412) decreased significantly, and the Treg cells (7.32% ± 1.24%vs. 5.32% ± 1.03%,t=2.352) and IL-10 (15.84 ± 2.23 ng/mlvs.11.72 ± 2.12 ng/ml,t=2.365) increased significantly in the observation group (P<0.05). The temperature recovery time (t=2.264,P=0.048), disappearance time of coughing (t=2.437,P=3.406), wheezing(t=2.258,P=2.352), pulmonary rales (t=0.032,P=0.034) and hospital duration (t=0.046,P=0.042) in the control group were significantly higher than those in the observation group. The clinical effective rate (94.8%, 55/58) in observation group was higher than that (79.3%, 46/58) in control group (χ2=2.327,P=0.041). ConclusionTanreqing injection can regulate Th17/Treg cell balance, and its curative effect is superior to conventional therapy in children with bronchiolitis.

Objective To investigate the inhibitory effects of IBI302 on experimental choroidal neovascularization (CNV).Methods Affinity of IBI302 to vascular endothelial growth factor (VEGF) family cytokines (including VEGF-A165,VEGF-A121 and placental growth factor PlGF) and complements (C3b,C4b) was determined by enzyme-linked immunosorbent assay (ELISA).The antagonist effect of IBI302 on VEGF was measured by proliferation,migration and tube formation tests of human umbilical vein endothelial cells (HUVEC).The anti-complement activity of IBI302 was measured by hemolysis test mediated by complement classical pathway and alternative pathway.Rhesus laser-induced CNV model was divided into 5 groups including model control group,bevacizumab group,IBI302 0.25 mg group,IBI302 0.50 mg group and IBI302 1.25 mg group.Fluorescein angiography and optical coherence tomography were performed on these monkeys at 14 and 28 days after drug delivery to observe the fluorescein leakage area and retinal thickness.The aqueous VEGF concentration was measured at 29 days after drug delivery.Results IBI302 showed good affinity to VEGF-A165,VEGF-A121 and PlGF,as well as C3b and C4b.IBI302 significantly inhibited the proliferation,migration and tube formation of HUVEC induced by VEGF-A165.IBI302 inhibited the hemolysis induced by complements obviously.At 14 and 28 days after drug delivery,the area of fluorescein leakage and retinal thickness in IBI302 0.25 mg group,IBI302 0.50 mg group,IBI302 1.25 mg group were reduced.The differences of the area of fluorescein leakage and retinal thickness in three IBI302 groups were not significant (P＞0.05).At 29 days after drug delivery,the VEGF concentration in the aqueous of rhesus monkey in bevacizumab group [(38.644 ± 6.521) pg/ml] was decreased than that in model control group [(94.203± 17.360) pg/ml],the difference was significant (P＜ 0.05).The VEGF concentration in the aqueous of rhesus monkey in three IBI302 groups were less than 31.300 pg/ml.Conclusion IBI302 inhibited experimental CNV through blocking the activity of VEGF and complement.

Objective To investigate the values of combined detection of serum pancreas autoantibodies (PAB),anti-saccharomyces cerevisiae antibodies(ASCA),goblet cell autoantibodies(GAB) and antineutrophil cytoplasmic antibodies(PANCA) and fecal calprotectin(FC) in the diagnosis and differential diagnosis of inflammatory bowel diseases(IBD).Methods The serum and feces samples from IBD patients,including 107 with definite Crohn's disease(CD) and 98 with definite ulcerative colitis(UC),and 79 non-IBD patients as the control were collected.Serum PANCA,ASCA,GAB and PAB were detected by an indirect immunofluorescence assay,and FC concentration by double-antibody sandwich ELISA.The results from different patients were compared and analyzed.Results The positive rates of serum PANCA,GAB,PAB and ASCA in 205 IBD patients were 36.1％,29.8％,38.0％ and 4.9％,respectively.The FC concentrations in IBD,CD and UC patients were significantly higher than that in the control(P ＜ 0.01),while there was no statistical difference between CD and UC patients (P ＞ 0.05).The positive rates of PANCA in CD and UC patients were 8.4％ and 66.3％,respectively,while those of PAB in CD and UC patients were 65.4％ and 8.2％,respectively.The sensitivity and specificity of PAB,PANCA,GAB,ASCA,FC and their combination in the differential diagnosis of IBD and non-IBD were 38.0％,36.1％,29.8％,4.9％,54.1％,63.4％ and 98.7％,96.2％,94.9％,100％,68.4％,93.7％,respectively.The area under the ROC of the combination of 5 markers was 0.819 in differentially diagnosing IBD and non-IBD.The area under the ROC of PANCA for the differential diagnosis of UC was 0.816,while that of PAB for the differential diagnosis of CD was 0.823.Conclusion GAB is an autoantibody associated with IBD,which may be helpful for the auxiliary diagnosis of IBD.PAB and PANCA are the important serological markers for the diagnosis of CD and UC,respectively.The combination of FC with PAB,PANCA,GAB and ASCA may be used for the differential diagnosis of IBD and non-IBD,but has little value in distinguishing CD and UC.

Objective To explore the relationship between neuroticism and memory in patients with first-episode depression and the mediating effect of depression in this relationship.Methods Hamilton de pression rating scale (HAMD),Eysenck personality questionnaire (EPQ),repeatable battery for the assess ment of neuropsychological status (RBANS) were used to evaluate 278 patients with first-episode depression.Results (1) Neuroticism was negatively correlated with immediate memory(r=-0.26,P＜0.01),delayed memory (r=-0.30,P＜0.01),and positively correlated with depressive symptom (r =0.30,P＜ 0.01).Depres-sive symptom was negatively correlated with immediate memory (r=-0.55,P＜0.01),delayed memory (r=-0.44,P＜0.01).(2) The effect of neuroticism on immediate memory and delayed memory was partially mediated by depressive symptom (β=-0.521,-0.388,P＜0.01).The ratio of mediating effect to total effect in immediate memory was 0.597,and the ratio of mediating effect to total effect in delayed memory was 0.383.Conclusion Memory can be affected by neuroticism through the indirect effect of depression.

Objective To investigate the relationship between hepatitis B surface antigen (HBsAg) levels and liver pathology at different phases of natural history in chronic hepatitis B (CHB) patients, and to establish a non-invasive liver fibrosis diagnostic model based on HBsAg quantification.Methods A total of 145 CHB patients were enrolled and underwent liver biopsy from January 2013 to January 2015, among which 73 patients were hepatitis B e antigen (HBeAg) positive.HBsAg levels and HBV DNA levels were compared between patients at different phases of natural history and between patients with different HBeAg statuses.Logistic analysis was used to analyze the risk factors associated with fibrosis in HBeAg-positive patients, and to evaluate the predictive value of non-invasive liver fibrosis diagnostic model based on HBsAg quantification.Analysis of variance was used for statistical analysis, and t test analysis was used for the comparison between two independent samples.Results The serum HBsAg levels at the immunologic tolerance phase, immunologic clearance phase, low copy phase and reactivation phase of CHB patients were (4.29±0.69), (3.56±0.61), (3.22±0.64), and (3.54±0.50) lg IU/mL, respectively (F=16.72, P<0.01), and the HBV DNA levels were (8.48±0.58), (6.69±1.44), (3.80±0.59), and (6.21±1.06) lg IU/mL, respectively (F=76.73, P<0.01).In HBeAg-positive CHB patients with liver inflammation stage (G)≤G1, G2, G3 and G4, the serum HBsAg levels were (4.44±0.65), (4.00±0.72), (3.74±0.62), and (3.28±0.50) lg IU/mL, respectively (F=9.198, P<0.01).In HBeAg-positive CHB patients with liver fibrosis stage (S)≤S1, S2, S3, and S4, the serum HBsAg levels were (4.55±0.54), (4.04±0.89), (3.59±0.63), and (3.34±0.50) lg IU/mL, respectively (F=10.66, P<0.01).Logistic analysis showed that age (OR=1.091, 95%CI: 1.013-1.175) and HBsAg level (OR=0.190, 95%CI: 0.066-0.542) were independent factors for predicting fibrosis stage.The area under receiver operating characteristic curve of the non-invasive fibrosis model based on age and HBsAg level was 0.849, which was higher than aspartate aminotransferase to platelet ratio index (0.749) and fibrosis index based on the 4 factors (0.763).Conclusions The serum HBsAg levels are significantly different among the different phases of natural history in CHB patients.The serum HBsAg levels decline with the progression of liver fibrosis in HBeAg-positive CHB patients.The non-invasive diagnostic model that based on HBsAg quantification could be used to evaluate the stage of liver fibrosis.

Objective To investigate the damaging traits of cognitive function in first episode depression patients with the assessment of neuropsychological status ( RBANS) and Stroop Color-word Test. Methods Two hundred and thirty first-episode depression patients as experimental group and one hundred and seventy-eight health person as control were evaluated separately by repeatable battery for the RBANS and Stroop Color-word Test. Results In Stroop Color-word Test,the time required for completing the words,color,double-word,two-color in depression patients ( (14.37 ±6.65)s,(21. 58 ±8. 70) s,( 16. 56 ±8. 23)s, (37. 88 ± 13. 67) s) were longer than the control group ((12.38 ±3.34)s, (18.01 ±5.51) s, (14. 17 ±4. 37) s, (32. 87 ± 10.28) s). The difference between the two groups was found in cognitive function in first episode depression patients (P ＜ 0.05). The scores of color interference and meaning interference were no difference between the two groups (P＞0.05) . The patients'scores of the RBANS test in all items( (72.19 ± 17.22), (80.89 ± 15.29), (82.00 ± 16.37) , (98.74 ± 17.01) ,(82.09 ± 14.62) )were significantly poorer than those in healthy controls. Compared with control group, scores of the scales were significant difference between two groups. Pearson correlation analysis showed that RBANS total score and five factors had no correlation with HAMD total score and factors. It positively correlated with education level (P＜0.05) ,but not with sex (P＞0.05). Immediate memory,verbal function,delayed memory in five factors and RBANS total score negatively correlated with age and course of disease respectively, but breadth of vision,attention were not did(P＜0.05). Conclusion First-episode depression patients suffer from more serious and comprehensive damage of cognitive function such as memory,attention,executive function.

AIM:This study continuously monitors the hemodynamic changes in conscious and anesthetic rats during rapid ascent to high altitude to investigate whether there is difference between the 2 conditions and discuss the rela-ted underlying mechanism.METHODS: Sprague-Dawley rats were randomly divided into conscious group, anesthetic group, anesthetic-5000-control ( A-5000-control) group, anesthetic-5000-aminoguanidine ( A-5000-AG) group, conscious-5000-control ( C-5000-control ) group and conscious-5000-aminoguanidine ( C-5000-AG ) group.The rats in anesthetic group and conscious group were kept in a hypobaric chamber, in which the simulated altitude was increased from 2 260 m to 5 000 m at 2 m/s, and the rats in other 4 groups were at 5 000 m.The system arterial pressure ( Psa) , central venous pressure ( CVP) , heart rate ( HR) and breathing rate ( BR) were directly and continuously displayed and digitally recorded by a high-performance data acquisition (PowerLab 16/35, AD Instruments) at 200 Hz.RESULTS: The HR and BR in the conscious rats were higher and MAP was lower than those in the anesthetic rats obviously.A significant decrease in mean arterial pressure ( MAP) in conscious and anesthetic groups was observed following the increase in the altitude levels, and the net decrease in MAP in conscious group was significantly greater.Additionally, HR in the conscious rats was sig-nificantly lower at 5 000 m than that of the initial level.The rats in C-5000-AG group and A-5000-AG group showed a sig-nificant increase in the arterial pressure after the intravenous injection of AG, a selective inhibitor of inducible nitric oxide synthase ( iNOS) , and no marked change of HR and BR was found.CONCLUSION: Blood pressure and HR decrease during rapid ascent to high altitude, while the change of BR is not obvious.The mechanisms of self-safety would be trig-gered in the early stage of hypoxia, which activates iNOS and then leads to a larger number of nitric oxide.Plentiful NO di-astolizes the vessels to improve the ventilation-perfusion mismatch and lower the blood pressure.When the altitude arise to 5 000 m, even more earlier, a decompensatory stage may occur in the body, leading to decreased HR and blood pressure further more than those in the anesthetic rats.Due to the effects of pentobarbital sodium, the depression of blood pressure requires a lag period and the net decrease in MAP is less than that in the conscious rats.Therefore, hemodynamic changes during rapid ascent to high altitude in conscious rats are more comprehensive and authentic.

Objective To investigate the status of depression with anxiety symptoms, and analyze the influencing factors of anxiety symptoms from demographic data and social psychological factors. Methods Hamilton depression rat?ing scale (HAMD), Hamilton anxiety rating scale (HAMA), Eysenck personality questionnaire (EPQ), life event scale (LES), trait coping style questionnaire (TCSQ) and social support scale (SSS) were used to evaluate 729 patients with de?pression. According to HAMA scores, patients were divided into non anxiety symptoms group (HAMA<7) and anxiety symptoms group (HAMA>14). Social psychological factors were compared between two groups, and the influencing fac?tors of anxiety symptoms were analyzed. Results The incidence of anxiety symptoms in depression was 58.85% (429/729), and 119 cases (16.32%) were certainly without anxiety symptoms. Compared with the group without anxiety symp?toms, the anxiety symptoms group had higher scores on neuroticism, psychoticism, negative life events and negative cop?ing style (P<0.001), but lower scores on introversion and extroversion (P=0.010). Degree of depression (OR=9.255, 95%CI:4.726~18.127), neuroticism (OR=1.595, 95%CI:1.197~2.125), negative life events (OR=1.009, 95%CI:1.001~1.017) and negative coping style (OR=1.046, 95%CI:1.013~1.080) were the risk factors of anxiety symptoms (P<0.05). Conclu?sion The incidence of anxiety symptoms in patients with depression is high. Patients with higher degree of depression and typical neurotic personality experiencing more negative life events and those with tendency to adopt negative coping style are more susceptible to anxiety symptoms.

Objective To evaluate the effect of penehyclidine hydrochloride on the damage to the non-ventilated lung in the pediatric patients undergoing one-lung ventilation (OLV).Methods One hundred and twenty pediatric patients of both sexes,aged 2-6 yr,with body mass index of 17-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or lⅡ and New York Heart Association class Ⅰ or Ⅱ,undergoing elective lobectomy performed via video-assisted thoracoscope,were randomly divided into 2 groups (n=60 each) using a random number table:control group (group C) and penehyclidine hydrochloride group (group P).At 10 rmin before anesthesia induction,penehyclidine hydrochloride 0.05 mg/kg was injected intravenously in group P,and the equal volume of normal saline was given in group C.At 5 min after drug intervention (T0),immediately after onset of OLV (T1),at 60 min of OLV (T2),immediately after the end of OLV (T3),at the end of surgery (T4),and at 24 h after surgery (T5),venous blood samples were collected for determination of serum tumor necrosis factor-alpha (TNF-o),interleukin-6 (IL-6) and IL-8 concentrations by enzyme-linked immunosorbent assay.The specimens of normal lung tissues around the lung lobe to be resected were obtained at T1 and T3 for determination of the injured alveolus count (with a light microscope) and cell apoptosis (using TUNEL) and for examination of the ultrastructure of epithelial cells (with a transmission electron microscope).The injured alveolus rate (IAR) and apoptosis index (AI) were calculated.Results Compared to the value at T0,the IAR and AI were significantly increased at T3,the serum TNF-α,IL-6 and IL-8 concentrations were significantly increased at T2-5 (P＜0.05),and the pathological changes were obvious in the two groups.Compared to group C,the IAR and AI were significantly decreased at T3,the serum TNF-α,IL-6 and IL-8 concentrations were significantly decreased at T2-5 (P＜0.05),and the pathological changes were significantly reduced in group P.Conclusion Penehyclidine hydrochloride can attenuate the damage to the non-ventilated lung in the pediatric patients undergoing OLV,and the mechanism is probably related to inhibition of systemic inflammatory responses and cell apoptosis in lung tissues.

Objective To evaluate the effects of dexmedetomidine pretreatment on extracellular sig?nal?regulated kinase ( ERK) pathway during acute lung injury in a rat model of liver transplantation. Meth?ods Sixty male Sprague?Dawley rats, weighing 235-250 g, were divided into 4 groups ( n=15 each) u?sing a random number table: sham operation group (group S), liver transplantation group (group LT), low?dose dexmedetomidine pretreatment group ( group LD ) and high?dose dexmedetomidine pretreatment group ( group HD) . In LT, LD and HD groups, the model of orthotopic liver transplantation was estab?lished, and the operation time was about 4 h. Dexmedetomidine 2?5 and 5?0μg·kg-1 ·h-1 were intrave?nously infused for 1 h starting from 1 h prior to clipping the hepatic artery and portal vein in LD and HD groups, respectively. The rats were sacrificed after the end of operation, and the lungs were removed for determination of wet to dry weight ratio ( W∕D ratio) , cell apoptosis and expression of ERK mRNA, ERK, phosphorylated ERK ( p?ERK) , Bcl?2 and Bax in lung tissues and for examination of the pathological chan?ges ( with light microscope) and ultrastructure of lung tissues ( with transmission electron microscope) . The
injured alveolus rate ( IAR) , apoptosis index ( AI) and ratio of Bcl?2 to Bax expression ( Bcl?2∕Bax ratio) were calculated. Results Compared to group S, the W∕D ratio, IAR, AI, expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK, Bcl?2 and Bax and Bcl?2∕Bax ratio were significantly increased in LT, LD and HD groups ( P<0?05) . Compared to group LT, the W∕D ratio, IAR and AI were significantly decreased, the expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK and Bcl?2 and Bcl?2∕Bax ratio were significantly increased, and the expression of Bax was significantly down?regulated in LD and HD groups (P<0?05). Compared to group LD, the W∕D ratio, IAR and AI were significantly decreased, the expression of ERK?1 mRNA, ERK?2 mRNA, p?ERK and Bcl?2 and Bcl?2∕Bax ratio were significantly increased, and the ex?pression of Bax was significantly down?regulated in group HD ( P<0?05) . The pathological changes of lung tissues were significantly attenuated in LD and HD groups as compared with group LT, and in group HD as compared with group LD. Conclusion The mechanism by which dexmedetomidine pretreatment mitigates cell apoptosis during acute lung injury is related to activation of ERK pathway in a rat model of liver trans?plantation.