Liver fibrosis is the excessive accumulation of extracellular matrix (ECM) proteins that occurs in most types of chronic liver diseases. Hepatic stellate cells (HSCs) are major sources of the excess ECM deposited in fibrotic liver. Transforming growth factor ? (TGF-?) is considered to play a generic role in the development of tissue fibrosis, as it stimulates the synthesis and deposition of ECM components. Smad pathways are central mediators of signals from the receptors for transfor- ming TGF-? to the nucleus. However, growing biochemical and developmental evidence supports the notion that non-Smad pathways also participate in TGF-? signalling. TGF-? signalling pathways play an important role in regulating tissue homeostasis and have been implicated implicated in diverse pathological conditions. It is oow our challenge to design ways of blocking the fibrosis-specific actions of TGF-? through downstream signalling pathways and mediators without compromising the other activities of this multifunctional cytokine, which is essential for health.

Objective To assess the clinical siginificance of the cardiopulmonary resuscitator in respiratory and cardiac arrest patients by comparing the curative effect of cardiopulmonary resuscitator and bare-handed cardiopulmonary resuscitation. Methods 102 patients on the verge of the death were randomiy divided into two groups and begin to CPR in four seconds after confirmation of respiratory and cardiac arrest. Patients in group 1 were given bare-handed CPR. Patients in group 2 were given cardiopulmonary resuscitation by cardiopulmonary resuscitator. Patients in both group 1 and group 2 received lasting CPR according to the 2010 GUIDE of CPR, then we observed their self-heart-beating, self-breathing, caroid puise, expression, puplillas, ECG. Results In the group 1,the effective case was 1,the non-effcctive cases were 63,the effective rate was 1.56%. In the group 2, the effective cases were 6, the non-effective cases were 31, the effective rate was 16.21%, there was a statistically significant difference between two groups ( <0.01) . Conclusion Cardiopulmonary resuscitator has good effect in cardiopulmomary resuscitation for respiratory and cardiac arrest patients, and the effective rate is significantly higher than bare-handed CPR,so it deserves clinical promotion.

Dignity is the idea that a being has the innate right to be valued, respected, and treated ethically. It reflects the value of life.Dignity therapymainly discusses thedignity during the period of death and dying.It involves symptom control, body integrity, au-tonomy, privacy boundaries, respect, and proper handling of personal affairs and death in peace. Dignity therapy is a unique, individu-alized, and brief psychotherapy that was developed for the purpose of relieving distress, enhancing end-of-life experience, reducing psychological and mental burden, and improving the quality of life for dying patients.

Objective To study the effect of recombinant human endostatin hormone combined with transcatheter arterial chemoembolization (TACE) for the treatment of primary hepatocellular carcinoma (HCC).Methods Fifty-two primary HCC patients were divided into combined group (26 patients) and control group (26 patients) by random digits table method.The patients in combined group received TACE and recombinant human endostatin hormone added in embolism emulsion.The recent curative effect,level of serum vascular endothelial growth factor (VEGF),adverse reactions,recurrence rate and survival rate were compared between two groups.Results The response rate(RR) and clinical benefit rate(DCR) in combined group were 57.69％(15/26),84.62％(22/26),in control group were 34.62％(9/26),73.08％(19/26),there were significant differences (x2 =5.237,P ＜ 0.05 ; x2 =4.284,P ＜ 0.05).The 7th,14th,28th day after TACE,the level of VEGF in two groups was first increased and then a downward trend,the difference were statistically significant (P ＜ 0.05).The level of VEGF in combined group was significantly lower than that in control group (P＜ 0.05).The follow up rate was 94.23％(49/52),the 1-year and 2-year recurrence rate in combined group was significantly lower than that in control group (P＜ 0.05).The 2-year and 3-year survival rate in combined group was significantly higher than that in control group (P ＜ 0.05).Conclusion With TACE plus recombinant human endostatin hormone can effectively inhibit the increase of serum VEGF level,improve curative effect and disease control rate,reduce tumor recurrence and improve survival rate.

Nowadays more and more evidences suggest that glycemic management of the patients in intensive care units needs to be individualized.We should pay more attention to the diabetes history in these patients besides the primary diseases.A brief literature review and a commentary about this topic were presented in this article.

Objective To analyze the characteristic of articles,authors and citations in Journal of Clincal Neurology from 2005 to 2007. Methods The data about articles,authors and citations in Journal of Clincal Neurology from 2005 to 2007 were analysed by bibliometrics method.Results There were 674 papers published in Journal of Clincal Neurology during the 3 years. The average number of articles per isseu was 37.4. The average number of article per paper was 0.47.The papers with funded projects were 142( 21.1%).The authors distributed in 28 mainland provinces,municipality cities and autonomous region. And main of them came from Jiangsu,Shandong,Shanghai and Beijing,and 93.1% of them shared with co-author. The coporation rate was 4.1. The ratio of the papers with citation was 86.6%,and 97% of all the citations came from journals. The average number of citation per paper were 8.6 items. The Price's indicator was 43.7%. Conclusion Journal of Clincal Neurology is an academic journal of higher quality,with stronger influence in field of clincal neurology.

OBJECTIVE:To establish an LC-MS method for the determination of nimesulide in human plasma. METHODS:The separation was performed on Agilent Zorbox SB-Cl8 column,using acetonitrile-0.1% formic acid (65 ∶ 35) as the mobile phase at a flow rate of 1.0 mL?min-1. The column temperature was set at 35 ℃ and valsartan was served as internal standard. Positive electrospray ionization detection was applied to monitor m/z 309(nimesulide,[M+H]+)and m/z 436(valsartan,[M+H]+). RESULTS:The linear range of nimesulide was 5～50 ng?mL-1(r=0.998 9). The method recovery of nimesulide ranged from 87.1% to 92.9%. The intra-day and inter-day RSD were 3.1%～5.8%,6.4%～9.2%,respectively.CONCLUSION:The method is sensitive,simple,convenient,accurate and reproducible,and it is suitable for clinical plasma concentration monitoring and pharmacokinetics research of nimesulide.

High salt intake over four months caused high blood viscosity as well as hypertension in rats, reflected by the obvious increases of blood viscosity, plasma viscosity and hematocrit, and the decrease of erythrocyte sedimentation rate. With some vicious circle resulted from certain blood viscous factors in circulatory (especially in microcirculatory) system the high blood viscosity might relate to chronic sodium chloride toxicity and easily induce hypertension.

Objective To evaluate the CT features of solitary inflammatory nodules of the lung. Methods CT features in twenty-three cases of solitary inflammatory nodules of the lung confirmed by operation or clinical were analyzed retrospectively. Spiral CT including plainscans and contrast enhanced scans was done in all patients. Thin-slice target scan and multiple plane reconstruction were used on the area of nodule. Different width and level of window were used to show the characteristic sign of the nodule.Results No calcification,satellite lesion,concentrated vessels and enlarged lymph nodes were found in or around all of the nodules. The size of these nodules were 10 mm?15 mm～30 mm?40 mm with round or irregular margin. Superficial lobular or spiculated margin was seen in only three nodules. Hyperemia and clouding appearance were found in 19 nodules and reflecting thickening pleura in 18 nodules. Unsteady edge enhancement were found in 18 nodules and no enhancement in 5 nodules. Effused change around the nodules could be seen perfectly when the level was about -400. MPR was the most accurate technique to show the relationship of nodule and pleura. Conclusion Solitary inflammatory nodules of the lung have obvious CT characterizes. By analyzing various CT manifestations comprehensively most nodules can be diagnosed correctly. Suitable width and level of window as well as MPR are helpful in showing the characterizes of the nodules.

Objective:To construct the recombinant adenovirus expressing human mdr1 gene.Methods:The cDNA of mdr1 gene was subcloned into the shuttle plasmid pAdTrack-CMV and then clone the homologous recombinant adenovirus genomic plasmid pAdEasy in bacteria.We tranfected the DNA of identified recombinant plasmid into 293 cells via liposome,and then did the package and amplification of adenovirus.The mononuclear cells of mouse were infected with Ad5-mdr1 and the target gene was determined by fluorescence microscope and flow cytometry.Results:Restriction endonuclease and PCR analysis confirmed that the recombinant adenovirus vector of mdr1 gene was successfully constructed.The titer of the recombinant adenovirus was 8.3?1011pfu/ml,and the infection efficiency to the mononuclear cell achieve 10%~15%.The expression of mdr1 gene was observed at 48h after the transfection of the mononuclearcell with Ad5-mdr1.Conclusion:The recombinant adenovirus expressing mdr1 gene was successfully constructed,which paves the way for the following studies related to mdr1.