Objective To evaluate the effect of clinical pathway in pulmonary thrombus embolism (PTE) .Methods 60 cases of PTE were admitted department of respiratory from 2011 to 2012 and divided into the experimental group and the control group ,30 cases for each group .The control group was implemented with normal process of hospital management while experimental group de-veloped clinical pathways .The efficacy ,department of respiratory drug costs ,complications and patient satisfaction were recorded and computed .Results The average department of respiratory and drug costs in experimental group respectively was (17 .13 ± 2 .22)days ,(16 545 .04 ± 1 557 .44) RMB and (7 050 .83 ± 372 .74) RMB ;less than (19 .77 ± 3 .41)day ,(17 709 .45 ± 1 902 .05) RMB and (7 345 .75 ± 450 .82) RMB in control group ,there were significant difference between the two groups (P<0 .05) .The satisfaction scores of experimental group and the control group respectively were (93 .47 ± 3 .88)sores and (90 .90 ± 5 .30)scores , there was significant difference between the two groups (P<0 .05) .The therapeutic effect and complication rates between experi-mental group and control group were no significant difference (P>0 .05) .Conclusion The effect of clinical pathway in PTE have a positive role in reducing hospitalization time ,total costs ,drug costs and increasing satisfaction ,it is worth to develop in primary hos-pital .

Objective To research the clinical value of cerebrospinal fluid and peripheral blood tuberculosis infection T cell spot test(TSPOT .TB) in the diagnosis of tuberculous meningitis(TBM) .Methods 35 cases of TBM and 40 cases of non-TB intracranial infection in this hospital from September 2015 to September 2016 were selected as the observation group and control group respectively .T-SPOT .TB was adopted to detect mycobacterium tuberculosis effector T cells in cerebrospinal fluid and detect peripheral blood mononuclear cells .Results The T-SPOT .TB detection positive rates of cerebrospinal fluid and peripheral blood in the observation group were 97 .14% and 80 .00% respectively ,which were significantly higher than 2 .50% and 0 .00% in the control group ,the difference was statistically significant(P＜ 0 .05);the sensitivity and negative predictive value in cerebrospinal fluid T-SPOT .TB detection were 97 .14% and 97 .50% ,which were significantly higher than 80 .00% and 85 .11% in peripheral blood T-SPOT .TB detection ,the difference was statistically significant (P＜0 .05);the specificity and positive predictive value in the cerebrospinal fluid T-SPOT .TB detection was 97 .50% and 97 .14% respectively ,while which in peripheral blood T-SPOT .TB detection were 100 .00% and 100 .00% respectively ,but the difference between the two groups was not statistically significant ( P＞0 .05) .Conclusion The detection of cerebrospinal fluid and peripheral blood T-SPOT .TB detection can provide early diagnostic basis for TBM ,moreover cerebrospinal fluid T-SPOT .TB detection has higher sensitivity and possesses an important clinical application value .

Objective : To discuss the changes of serum lipoprotein phospholipase A2 (Lp - PLA2) and c-reactive protein (CRP) levels in atorvastat in treatment for the patients with periodontitis and hyperlipidemia. Methods : 148 patients with periodontitis and hyperlipidemia were involved, and divided into basic group (foundation treatment, 82 cases) and statin group (foundation treatment plus 20 mg atorvastatin treatment, 66 cases). 40 healthy cases from the medical center health personnel were selected as the healthy group. Attachment levels (AL), bleeding index (BI), serum total cholesterol (TC), triacylglycerol (TG), Lp - PLA2, and CRP levels were checked and compared before and after 6 months of treatment. Lp - PLA2 and CRP were checked by enzyme linked immunosorbent assay (ELISA), and their relationship were analyzed by the method of Pearson. Results: When the disease group were compared with the healthy group, the statistics were as follows: AL（3.92 ± 0.51 mm vs 0.42 ± 0.06 mm）, BI（2.81 ± 0.48 vs 0.34 ± 0.05）, TC（5.27 ± 0.83 mmol/L vs 4.02 ± 0.62 mmol/L）, TG（2.67 ± 0.41 mmol/L vs 0.93 ± 0.17 mmol/L）, Lp-PLA2（243.57 ± 58.71 μg/L vs 132.24 ± 34.27 μg/L）, CRP（9.72 ± 3.27 μg/L vs 3.21 ± 0.87 μg/L）, and the statistics of disease group were significantly higher than the healthy group with a significant difference (P< 0.05). When Statin group was compared with basis group, the statistics were as follows: AL（3.70 ± 0.10 mmvs 3.78 ± 0.11 mm）, BI（1.05 ± 0.28 vs 1.43 ± 0.32）, TC（3.82 ± 0.67 mmol/L vs 4.51 ± 0.71 mmol/L）, TG（1.30 ± 0.29 mmol/L vs 1.83 ± 0.34 mmol/L）, Lp-PLA2（157.43 ± 40.18 μg/L vs 199.43 ± 47.24 μg/L）, CRP（4.21 ± 3.02 μg/L vs 6.37 ± 3.28 μg/L）, and the statistics of statin group were lower than that in basis group with a significant difference (P< 0.05). Pearson analysis showed Lp-PLA2 and CRP levels were positively correlated (r = 0.672, P< 0.05). Conclusion It shows the changes of Lp- PLA2 and CRP level were related with the clinical conditions of periodontitis combined with hyperlipidemia, and atorvastatin therapy can effectively reduce the body's blood lipid levels, and improve the treatment effects of periodontitis combined with hyperlipidemia.

Herpes simplex viruses type 1(HSV1)is among the most ubiquitous human pathogens that cause a wide variety of disease states.The latent infection of the central nervous system and sporadically reactivation is the central part of HSV1 pathogenesis,which also brings challenges to antiviral therapies.At present,the mechanism of establishing,maintaining and reactivation of HSV1 has not been fully clarified,whereas it has been generally accepted that the epigenetic regulation may play an important role.Accumulating researches have also indicated that the lytic and latent viral genomes exhibit the different chromatin structures,and the accumulation of diverse post-translational modifies the histones endow viral genes with transcriptional activation or repression features.In addition,the latency-associate transcripts of virus may also participate in the genome epigenetic modification.In this review,we summarize the research progress of epigenetic regulation of HSV1 and highlight the critical role of chromatin remodeling in HSV1 lytic proliferation and establishment of latent infection.

ObjectiveTo explore the clinical efficacy of Gouteng prescription in treating the patients with primary hypertension with anxiety disorder due to yang hyperactivity and heat toxin and the impact of the formula on the balance of inflammatory cytokines. MethodA total of 98 patients diagnosed with primary hypertension and anxiety disorder were randomized into control and observation groups. On the basis of conventional western medicine treatment for hypertension， the control group （47 patients） was treated with Shugan Jieyu capsules for 8 weeks， while the treatment group （51 patients） with Gouteng prescription for 8 weeks. The two groups were compared in terms of the blood pressure level， 24-hour blood pressure variability， Hamilton anxiety scale （HAMA） score， Pittsburgh sleep quality index （PSQI） score， quality of life （SF-36 scale） score， traditional Chinese medicine （TCM） syndrome score and efficacy， incidence of adverse reactions， and the levels of interleukin （IL）-1β， IL-6， IL-10， and IL-4 in the serum of peripheral blood. ResultThe final trial was completed with 95 patients， including 46 in the control group and 49 in the observation group. The treatment in both groups lowered the blood pressure and blood pressure variability （P<0.05， P<0.01）. The observation group outperformed the control group in recovering the systolic blood pressure （SBP）， 24-hour mean systolic blood pressure （24 h SBP）， 24-hour systolic blood pressure variability （24 h SBPV）， and 24-hour diastolic blood pressure variability （24 h DBPV） （P<0.05）. After treatment， the HAMA and PSQI scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower HAMA and PSQI scores than the control group （P<0.05）. Compared with those before treatment， the SF-36 scores in both groups increased （P<0.05， P<0.01）. After treatment， the observation group had higher scores of physiological function （PF）， bodily pain （BP）， social function （SF）， role-emotional （RE）， and mental health （MH） indicators than the control group （P<0.05）. After treatment， the TCM syndrome scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower score than the control group （P<0.05）. The total response rate regarding TCM syndrome in the observation group was 85.71% （42/49）， which was higher than that （63.04%， 29/46） in the control group （χ²=6.621， P<0.05）. The treatment in both groups lowered the levels of pro-inflammatory cytokines （IL-1β， IL-6） and elevated the levels of anti-inflammatory cytokines （IL-10， IL-4） （P<0.05， P<0.01）， and the changes were more obvious in the observation group than in the control group （P<0.05）. There were no adverse events during the research process. ConclusionGouteng prescription can recover the blood pressure level， reduce blood pressure variability， suppress anxiety state， improve sleep and quality of life， decrease TCM syndrome score， increase total response rate， lower serum IL-1β and IL-6 levels， and elevate serum IL-10 and IL-4 levels in the patients with primary hypertension complicated with anxiety disorder due to yang hyperactivity and heat toxin. It may exert the effects by regulating the balance of pro-inflammatory and anti-inflammatory cytokines.