Objective To explore the effect of selective gut decontamination in regulation of inflammatory reaction compared with rhubarb and glycerine enema for catharsis in patients with systemic inflammatory response syndrome ( SIRS ), and to discuss its mechanisms. Methods A prospective randomized controlled trial was conducted. Fifty-seven patients with SIRS admitted to Department of General Surgery of Aviation General Hospital from June 2009 to June 2014 were enrolled. The patients were randomly divided into rhubarb decontaminate group, traditional decontaminate group and blank control group, with 19 cases in each group. Besides the treatment for primary disease, including anti-infection, operation, alleviate pain, nutritional support, and maintaining water and electrolyte balance, the patients in rhubarb decontaminate group received aqueous extract from rhubarb 15-20 g by gastric tube, enema, or peros, twice a day;and those in traditional decontaminate group received glycerine enema or glycerol enema, twice a day; while no gavage or enema was prescribed in blank control group. Peripheral blood was collected before and 72 hours after treatment. Enzyme linked immunosorbent assay ( ELISA ) was used to determine the concentration of lipopolysaccharide ( LPS ) and inflammatory mediators. Results Compared with blank control group and traditional decontaminate group, the levels of interleukins ( IL-1, IL-8 ), LPS, platelet activating factor ( PAF ), tumor necrosis factor-α( TNF-α), andγ-interferon ( IFN-γ) before treatment was similar to that of rhubarb decontaminate group [ IL-1 ( ng/L ): 53.154±5.783, 50.564±5.771, 51.082±6.403, F = 0.994, P = 0.377; IL-8 ( ng/L ): 70.492±6.146, 68.376±6.112, 68.673±8.384, F=0.514, P=0.601;LPS (μg/L ):11.630±2.449, 10.858±2.307, 10.463±2.145, F = 1.261, P = 0.291; PAF (μg/L ): 4.173±0.395, 4.051±0.362, 4.078±0.487, F = 0.446, P = 0.642; TNF-α( ng/L ):132.498±10.772, 129.735±12.881, 127.207±11.514, F=0.963, P=0.388;IFN-γ(μg/L ):45.645±4.558, 43.692±5.578, 43.767±5.028, F = 0.904, P = 0.411 ]. The above parameters after treatment were significantly lower than those before treatment in three groups. The effect on the LPS and pro-inflammatory factors of the rhubarb decontaminate group was more obvious than that of the blank control group and traditional decontaminate group [ LPS (μg/L ): 7.571±1.113 vs. 9.008±1.904, 8.874±1.808, F = 4.416, P = 0.017; IL-1 ( ng/L ): 45.309±3.563 vs. 48.731±4.466, 46.112±4.322, F = 3.557, P = 0.035; IL-8 ( ng/L ): 60.492±5.346 vs. 65.553±5.384, 63.437±5.462, F = 4.213, P = 0.020; PAF (μg/L ): 3.519±0.250 vs. 3.832±0.356, 3.766±0.309, F = 5.450, P = 0.007; TNF-α ( ng/L ): 114.988±8.772 vs. 123.230±10.433, 118.534±9.519, F = 3.525, P = 0.036; IFN-γ(μg/L ):38.683±3.190 vs. 41.831±4.122, 39.161±3.972, F=3.820, P=0.028 ]. Conclusion The usage of selective gut decontamination can inhibit the release of endotoxin and inflammatory mediators in patients with SIRS, and it will get a better effect using rhubarb, and the mechanism may be related to the protection of intestinal mucosal barrier function.

Objective To approach the expressions of vascular endothelial growth factor(VEGF) and transforming growth factor-beta(TGF-?) in periosteum in patients with congenital pseudarthrosis of tibia(CPT) and elucidate the pathogenesis possibility.Methods The expressions of VEGF and TGF-? in 19 specimens from patients with CPT were detected by using immunohistochemical method.Ten normal periosteum from the healing site after tibia fracture were taken as negative group;15 fresh periosteum from the close tibia fractures were positive group.Results VEGF and TGF-? expressed in vascular endothelial cytoplasm of periosteum.The expression levels of VEGF and TGF-? of CPT were lower than those in positive group(P0.05).Conclusion The decreasing of expression levels of VEGF and TGF-? in periosteum may be involved in pathogenesis of CPT.

OBJECTIVE: To study the sedative and antistress action of Shenqiwuweizi capsule. METHODS: The sedative and hypnotic experiments were made to observe the action of Shenqiwuweizi capsule on the mice's sleep induced by pentobarbital sodium at subthreshold dosage or hypnotic dosage. The swimming and hypoxia tolerance experiment were performed to observe the effects of Shenqiwuweizi capsule on the swimming time and hypoxia tolerance time in mice. RESULTS: Shenqiwuweizi capsule could obviously prolong the sleeping time of mice induced by pentobarbital sodium, increase the number of sleeping animals caused by pentobarbital sodium at subthreshold dosage, and significantly prolong the time of swimming and hypoxia tolerance in mice. CONCLUSION: Shenqiwuweizi capsule had sedative and anti-stress action.

To investigate the effects of Sangen Decoction, a compound Chinese herbal medicine, on osteoclastogenesis and bone resorption function of osteoclasts induced by polymethylmethacrylate particles in vitro.

Objective To investigate the relationship between the proportion of Th17 cells and IL-17 expression in the peripheral blood and their clinical significance in patients with non-small cell lung cancer (NSCLC).Methods The proportion of Th17 cells determined by flow cytometry (FCM) and IL-17 detected by enzyme-linked immunosorbent assay (ELISA).The data was analyzed from 60 untreated patients with NSCLC (NSCLC group) and 20 healthy volunteers (control group).Results The Th17 cells proportion in CD+3 T-cells in NSCLC group was significantly higher than that in control group [(1.23±0.41) ％ vs (1.05±0.28) ％,t =1.679,P =0.097].The expression levels of Th17 cells in peripheral blood of patients with squamous cell carcinoma was significantly higher than that in adenocarcinoma patients [(1.31±0.39) ％ vs (1.09±0.41) ％,t =2.093,P =0.041].The concentration of IL-17 of patients with NSCLC was significantly higher than that in control group [(21.11±7.87) pg/ml vs (17.64±5.07) pg/ml,t =2.280,P =0.027].The expression levels of serum IL-17 of squamous cell carcinoma patients was significantly higher than that of adenocarcinoma patients [(23.11±8.73) pg/ml vs (18.54±6.38) pg/ml,t =2.203,P =0.032].As clinical stage progressed,the proportion of Th17 cells and IL-17 expression were significantly downtrend [F =3.151,P =0.032,F =4.132,P =0.010].Conclusion The levels of Th17 cells and IL-17 in the peripheral blood of patients with NSCLC significantly correlated with the pathological types and TNM stage,might play an important role in the course of the disease.

Objective To investigate the highly-recognized job evaluation factors among the doctors from tertiary general hospitals and to establish a doctor-oriented job evaluation factor system for general hospitals followed with the reliability and validity analyses.Methods A questionnaire about the highly-recognized 23 job evaluation factors was launched among 791 doctors by the stratified sampling from six tertiary general hospitals in Beijing,and the factors were from a job evaluation model of tertiary general hospitals.Initial factor solutions were obtained by the principal components analysis of all evaluation factors and the main factors whose eigenvalues were over one were extracted as evaluation dimensions. Factor loadings were attained through Varimax and the factor whose factor loading was lower than 0.5 was eliminated.A reliability analysis by calculating Cronbachαcoefficient and a validity analysis with structural equation modeling were sequentially conducted on the job evaluation factor system.Results A doctor-oriented job evaluation factor system for general hospitals including 22 factors subject to 3 dimensions was established while the factor of job relevance was removed. The internal consistency coefficients of the dimensions were greater than 0.8 according to the calculation of Cronbachα, which showed a nice reliability. Several main indexes for evaluating the model fitting were all close to 0.9,which indicated a fair structural validity. Conclusion A doctor-oriented job evaluation factor system for general hospitals is established with fair reliability and validity,which could provide more references to the job evaluation of the doctors in tertiary general hospitals.

Objective To study the effect of S-adenomethionine on early stage recovery of transplanted liver.Methods From January 2010 to October 2012,57 liver transplantation patients were divided into 2 groups beginning the first day:group A,23 patients were treated with routine liver-protecting therapy,including glycyrrhizin,glutathione,albumin; group B,34 patients treated with additional S-adenomethionine (Transmetil).AST,ALT,T-BIL,D-BIL,γ-GT,ALB and ALP were compared between the two groups at pre-operation and post-operation day 1,day 4,day 7 and day 14.Results All patients suffered from preoperative hyperbilirubinemia,decreased ALB and elevated concentration of AST,ALT,γ-GT and ALP.On the first day after transplant,AST,ALT,T-BIL,D-BIL and γ-GT elevated and ALB decreased significantly in all cases compared with that before operation (respectively t =10.493,7.089,6.584,15.134,5.164,10.344,5.289,13.034,3.389,4.366,all P ＜ 0.01).On the contrary,the value of ALB was lower (respectively t =8.239,11.662,all P ＜ 0.05).On the fourth day posttransplant,ALB level was higher and that of other parameters were lower in group B when compared with group A (respectively t =2.536,2.736,2.218,3.318,4.804,2.892,all P ＜ O.05).This tendency of liver function improvement continued till postoperative day 7 in all cases while the differences between the two groups remained significant (respectively t =6.107,3.256,2.929,11.688,8.964,2.857,all P ＜ 0.05)except for γ-GT.On day 14,while T-BIL and D-BIL in group B were lower than that in group A (respectively t =4.413,8.493,all P ＜0.001),differences of liver functions were not significant between the two groups (respectively t =1.916,1.414,1.168,1.035,1.604,all P ＞ 0.05).Conclusions Transmetil promotes the recovery of transplanted liver's function,elevates the concentrantion of ALB and reduces the concentration of AST,ALT,T-BIL,D-BIL,γ-GT and ALP at early stage after liver transplant.

Objective To investigate the epidemiological characteristics of inpatients with acute cerebral hemorrhage, and to observe the different influencing factors on the outcome of the disease, so as to provide a reference for formulating prevention and treatment measures. Methods Four hundred in-patients with acute cerebral hemorrhage admitted to Haikou People's Hospital from May 2016 to May 2018 were enrolled, and their diagnoses were confirmed by magnetic resonance imaging (MRI), the CT, digital subtraction angiography (DSA). The patients' relevant information, including gender, age, occupation, life habits (drinking alcohol, smoking), onset season, hemorrhagic site, past medical history and complication (hypertension, cardiovascular disease, diabetes), blood glucose, first episode and recurrence, etc clinical data were collected from the self-designed case information table, the epidemiological characteristics of patients with acute cerebral hemorrhage were analyzed, and the indexes with statistical significance obtained from univariate analysis were included in the multivariate Logistics regression analysis, and the risk factors affecting the 28-day disease outcome of patients with cerebral hemorrhage were screened out. Results Among the 400 in-patients with acute cerebral hemorrhage, the patients with age ≥ 70 years old, being workers, winter onset, hemorrhage mainly in the cerebral lobe and having history of hypertension were the highest [35.00% (140/400), 36.00% (144/400), 36.75% (147/400), 27.00% (108/400), 58.75% (235/400)], and the proportion of males was significantly higher than that of females [68.25% (273/400) vs. 31.75% (127/400)]. Among the 400 inpatients, 88 died after admission, accounting for 22.00%, and 312 patients were discharged, accounting for 78.00%. Univariate analysis showed that workers [odds ratio (OR) = 2.416, 95% confidence interval (95%CI) = 0.258-6.859, P = 0.011], unhealthy living habits:smoking [OR = 1.792, 95%CI = 1.107-2.895, P = 0.015], drinking alcohol (OR = 1.664, 95%CI = 1.024-2.713, P = 0.040), hypertension (OR = 1.730, 95%CI = 0.701-4.266, P = 0.031), fasting blood glucose ≥ 7.0 mmol/L (OR = 8.112, 95%CI = 3.631-20.183, P = 0.000) could be the influencing factors of the cerebral hemorrhage;multivariate Logistic regression analysis showed: occupation being worker (OR = 3.427, 95%CI = 0.221-0.815, P = 0.010), hypertension (OR = 2.974, 95%CI = 1.182-7.489, P = 0.022), fasting blood glucose ≥ 7.0 mmol/L (OR = 8.974, 95%CI = 3.677-21.936, P = 0.000) were the main risk factors affecting the outcome of acute cerebral hemorrhage, effective first aid is a protective factor. Conclusion The age of patients with acute cerebral hemorrhage is mainly ≥ 70 years old, and the males are more than females; the incidence is high in winter, and the cerebral lobe is the main hemorrhagic site; from single and multiple factors analyses, workers, hypertension history, hyperglycemia and unhealthy habits (smoking, drinking) are the risk factors for the disease outcome, effective first aid is a protective factor.

AIM: To study the protective effect of mese nt eric lymph duct ligation on the functions of liver, kidney and heart, and morpho logy in multiple organ dysfunction syndrome (MODS) rats subjected to two-hit. METHODS: Male Wistar rats were divided into three groups: the me senteric lymph duct ligation group, the non-ligation group and sham group. The M ODS model of two-hit was established by bleeding and LPS administration in both ligation group and non-ligation group. After 24 h, all rats were cannulated to f acilitate blood withdrawal for serum sample, then all rats were killed and organ s including kidney, liver, lung and heart were collected for making microscopic sectio ns. The biochemical indexes of hepatic and renal functions and myocardial enzyme in s erum were determined before and after experiment. RESULTS: After two-hit, the serum contents of AST, ALT, TBA, BUN , Cr and LDH-1 in both non-ligation group and ligation group, and UA content in non-ligation group were obviously increased than those in pre-experiment and sh am group (P