Objective To investigate the expression level and clinical significance of serum IL-18 and MCP-1 in patients with Chronic Obstructive Pulmonary Disease(COPD).Methods Serum IL-18 and MCP-1 levels were measured in healthy people( control group,30 cases) and in patients with COPD (acute stage group and stable stage group,30 cases in each group).At the same time,the level of serum CRP and forced expiratory volume in one second ( FEV1 ),the forced expiratory volume in one second/forced vital capacity ( FEV1/FVC％ ) were tested in the three groups.The variation.of the level of serum IL-18 and MCP-1 and the correlation between these index with lung function and CRP were analyzed.Results The levels of serum IL-18 and MCP-1 in acute stage group ( IL-18 [ 69.29 ± 16.14 ] ng/L,MCP-1 [ 123.95 ± 32.06 ] ng/L) were significantly higher than those in stable stage group ( IL-18 [ 53.15 ± 14.74 ] ng/L,MCP-1 [ 96.46 ± 18.24 ] ng/L) ( F =10.975,P ＜0.01 ),and also significantly higher than those in control group ( IL-18 [ 37.53 ± 14.55 ] ng/L,MCP-1 [60.86 ± 17.26] ng/L) ( F =18.101,P ＜ 0.01 ).In acute stage group,positive correlations were obtained among the level of serum IL-18,MCP-1 and CRP ( r =0.688,P ＜ 0.05 ; r =0.663,P ＜ 0.05 ; r =0.825,P ＜0.01 ),and they were correlated negatively with FEV1 and FEV1/FVC％ ( r =- 0.732,P ＜ 0.01 ;r =- 0.586,P ＜0.05 ).In stable stage group,the level of serum MCP-1 was correlated positively with the level of IL-18( r =0.674,P ＜ 0.05 ) and with the level of CRP ( r =0.719,P ＜ 0.05 ),but it was correlated negatively with FEV1 and FEV1/FVC％ ( r =-0.512,P ＜ 0.05 ;r =-0.557,P ＜ 0.05 ).Conclusion The serum IL-18 and MCP-1may be one of the inflammation markers in patients with COPD and may be associated with airway inflammation and limited airflow.

ObjectiveTo study wether muscle spindle afferents have the regulating effects on res piratory movement. MethodsExperiments were performed on 36 anesthetized, immobilized, bilater ally vagotomized and artificially ventilated rabbits. Using the phrenic nerve discharge as the respira tory index, this experiment have assessed the effects of muscle spindle afferents invoked by intraarte rial injection of succinylcholine(Sch) on respiration. Results①In 40(63.49% ) cases which had the facilitated effects, 23 (36.51%) cases had the effect of prolonged inspiratory phase and 17 (26.98 % ) cases had the effect of attenuated expiratory phase and augmented respiratory frequency. In addition,there were 11(17.46% ) cases which had the attenuated effects,and 4(6.35% ) cases which had the biphasic effects,and 8(12.7% ) cases which had no effects;②The effect of prolonged inspiratory phase mainly showed the prolongation of inspiratory duration(Ti), but the effect of at tenuated expiratory phase and augmented respiratory frequency mainly showed the decrease of expi ratory duration (Te) and the augmentation of respiratory frequency(RF) ;③The above facilitated ef fects of Sch were significantly attenuated by intramuscular application of bupivacaine to destroy the muscle spindles. ConclusionThese results suggest that muscle spindle afferents induced by intraar terial injection Sch have a significant facilitated effect on respiration.

Objective To explore the best time interval to extubate catheter for the postoperative gastric cancer patients,and provide the basis for early extubation after operation.Methods To collect 108 cases with gastric cancer in Department of Forensic Surgery of Yuncheng Central Hospital from March 2013 to February 2014 with indwelling catheter preoperatively.According to the admission sequence,they were divided into the observation group and the control group with 54 cases in each group,the observation group began clipping catheter in 10-15 hours after operation,extubating catheter within 24 hours after operation;the control group began clipping catheter on the second day after operation,and extubating catheter during 48-72 hours after operation.The time of extubation,urinary tract irritation symptoms,resetting catheters and the incidence of early postoperative ambulation in patients of two groups were observed.Results The incidence of urinary tract irritation was lower in the observation group than that of the control group [3.7％ (2/54) vs 16.7％(9/54)],the difference was statistically significant (x2=4.960,P＜0.05).Early ambulation compliance of the observation group was higher than that of the control group (complete compliance 52 vs.40,partial compliance 2 vs.8,no compliance 0 vs.6),the difference was statistically significant (x2 =10.565,P ＜0.05).Conclusions The method of extubation catheter within 24 hours after gastric canter operation can reduce the incidence of urinary tract irritation and improve early ambulation compliance.

Objective To investigate the effect of exogenous atrial natriuretic peptide on airway inflammation in allergic asthma mice model and its mechanism.Methods A total of 48 SPF 48 BALBc mice were selected and randomly divided into the normal group (equal quantity normal saline intervention),model group (equal quantity normal saline intervention),experimental group A (exogenous atrial natriuretic peptide 0.5 μg/g) and experimental group B(exogenous atrial natriuretic peptide 0.5 μg/g-+-A71915).The model group,experimental group A and B were given the corresponding treatment measures after successfully constructing the model,at 24 after the last provocation test,serum and bronchoalveolar lavage fluid in each group were collected for detecting inflammation factors.The HE staining was used to observe the pathological changes of lung tissue,the expression level of GATA3 protein in lung tissue was detected by Western blot technology.Results The blood EOS,lymphocyte and neutrophil ratio in the model group were higher than those in the normal group (P＜0.05),which in the experimental group A were higher than those in the model group and experimental group B (P＜0.05);bronchoalveolar lavage fluid EOS,lymphocytes,neutrophil ratio,IL-6,TNF-α levels in the model group were higher than those in the normal group (P＜0.05),alveolar lavage fluid EOS,lymphocyte,neutrophil count,IL-6 and TNF-α levels in the experimental group A were higher than those in the model group and experimental group B (P＜0.05);the expression level of GATA3 protein in lung tissue of the model group was higher than that in the normal group(P＜0.05),the expression level of lung tissue GATA3 protein in the experimental group A was higher than that in the model group and experimental group B (P＜0.05).Conclusion Exogenous atrial natriuretic peptide can further aggravate airway inflammation reaction in allergic asthma mice model,which is related to the activation of inflammatory cells,the release of inflammatory cytokines and the increase of GATA3 protein expression in lung tissue.

ObjectiveTo observe the clinical efficacy of hair needle therapy in treating dry eye syndrome (DES).Method Eighty patients diagnosed with DES were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened by 0.1% Sodium Hyaluronate eye drops plus Hair needle therapy; the control group was by 0.1%Sodium Hyaluronate eye drops alone. The subjects were re-examined after 1-month treatment. The therapeutic efficacy was evaluated by observing the subjective symptoms, SchirmerⅠtest (SIT), tear break-up time (BUT), and fluorescein test (FL).Result The subjective symptoms, SIT, BUT, and FL scores were significantly improved after intervention in the treatment group (P<0.05);the control group only had the subjective symptoms improved after intervention (P<0.05), while other indexes didn’t show significant differences (P>0.05); after treatment, there were significant differences in comparing the subjective symptoms, SIT, BUT, and FL scores between the two groups (P<0.01).ConclusionHair needle therapy plus Sodium Hyaluronate eye drops can produce a more significant efficacy than Sodium Hyaluronate eye drops alone in treating DES.

BACKGROUND: The quality of life(QOL) of patients with lung cancer is ffected due to depression, reduced lung function, subjective reduced body force, fatigue, and poor stamina, etc., and the survival of the patientswould be affected by complications or advanced stage cachexia.OBJECTIVE: To investigate the relationship between three gene proteins including p53, p27 and bcl-2 and the pathological characters of non-small cell lung cancer (NSCLC).DESIGN: An experimental trial by employing pathological specimens as subjects.SETTING: Department of respiration of a university affiliated hospital and the Central laboratory of a university.PARTICIPANTS: Totally 76 specimens of NSCLC after surgical resection between June 1997 and December 2002, which were all primary lung cancer without any other therapy.METHODS: The expression of three gene proteins in 76 NSCLC specimens was detected by SP immunohistochemical analysis.MAIN OUTCOME MEASURES: Positive expression of p53, p27 and bcl-2.RESULTS: Among 76 specimens, 28 cases(37%, 28/76) with excessive expression of p53, 34 cases(45%, 34/76) with excessive expression of p27, 37 cases(49%, 37/76) with excessive expression of bcl-2, and 7 cases with excessive expression in all three proteins. The positive expression of p53 elevated with the reduced gradation in differentiation; bcl-2 and p27positive expressions reduced with the reduced gradation in differentiation and there was significant difference between high-differentiation group and low-differentiation group( P ＜ 0. 05) . However, there was no significant relationship between the positive expressions of three proteins and the histological classification, lymph node metastasis, and pathological aging of lung cancer( P ＞ 0.05).CONCLUSION: The excessive expression of p53, p27 and bcl-2 genes might be related with the occurrence and development of NSCLC.

‘Warming-dredging needling technique’ is one of the specific needling techniques created by Prof. Zheng Kui-shan for treating intractable and difficult diseases. Developed from ‘Shao Shan Huo (Mountain-burning Fire)’ and ‘warming- reinforcing method’, this method displays the effects of ‘warming’, ‘dredging’ and ‘reinforcing’. The ‘scapula-penetrating heat’ and ‘eye-transmitting heat’ belong to the representative needling techniques of ‘warming-dredging needling technique’. In order to promote the clinical application of ‘warming-dredging needling technique’, its theoretical foundation and clinical experience are summarized.

Objective To understand the status of resistance to multiple insecticides and the frequencies of kdr mutations in Culex pipiens pallens from north?central Anhui Province. Methods From July to September,2014,the C. pipiens pallens mosquito larvae were collected in Huaibei,Bengbu and Chuzhou cities of the north?central Anhui Province and reared to adults. The female adult mosquitoes at 3-5 days post emergence were tested for susceptibility to the four insecticides,namely 0.05%deltamethrin,5%malathion,0.1%bendiocarb and 4%DDT,by using the standard WHO resistance tube bioassay. The detec?tion of the point mutations of the kdr gene at codon 1014 was conducted by PCR and DNA sequencing in the deltamethrin?resis?tant and?susceptible mosquitoes. Results High levels of resistance to all the four insecticides were found in all the three tested populations,although mosquito mortality varied among populations and test insecticides. Among the test insecticides,DDT showed lowest mortality with no significant difference(F=1.027,P>0.05)in all test populations,whereas significantly differ?ent mortalities were observed among populations for the remained three insecticides tested(deltamethrin,malathion,and ben?diocarb)(F = 23.823,33.955,128.841;all P < 0.01). Two types of non?synonymous kdr mutation at codon position 1014 (L1014F and L1014S)were observed. A positive correlation between L1014F mutation frequencies and deltamethrin resistance levels were detected in the three mosquito populations(r2=0.718,P<0.01). Conclusions The observed high levels of resis?tance to multiple?insecticides coupled with the occurrence of medium to high kdr frequencies in populations of C. pipiens pallens could profoundly affect the mosquito vector control programme in China. The local health departments need to strengthen vector dynamic monitoring and implement rational resistance management strategies.

Objective To analyze the influence factors of medical staff blood-bome occupational exposure by structural equation modeling,in order to improve medical staff of blood-borne occupational exposure protection performance of the system to provide the theory basis for operation.Methods The influence factors of medical staff blood-borne occupational exposure and their correlation were analyzed by exploratory factor analysis and structural equation modeling fitting.Results Model fitting was ideal,hospital decision-makers and department management directly affected the behavior intention of medical staff,department management greatly influenced by the behavioral intention to the medical personnel,path coefficient was 0.27.Hospital decision-makers of behavioral intention to the medical personnel directly affect smaller,path coefficient was 0.03,but its indirect impact on behavioral intention by department management.Behavioral intention of occupational exposure protection action,the path coefficient was 0.80,behavioral intention determined the basic medical personnel blood-borne occupational exposure protection behavior.Conclusions Hospital should improve the system of standards and to establish effective communication channels,at the same time enhance the care ability.Enforcement departments should improve the standard system,equipped with adequate safety equipment,for the medical staff to provide the best working environment,so as to improve the medical staff of blood-borne occupational exposure protection behavior compliance.

Objective To systematically analyze and evaluate the intervention effect of foreign and domestic research about needlestick injuries in medical staffs and provide the basis for reducing the rate of occupational exposure of medical staffs.Methods The intervention study of needlestick injuries in medical staffs between 1981 and 2013 were collected in CNKI,VIP,Wanfang and PubMed databases,Metaanalysis was conducted for the included studies by RevMan5.2 software.According to I2 and P value heterogeneity was determined,choose a fixed or random effect model to analyze and merge the data to measure the effect of the intervention by OR and 95％ confidence intervals (C I).Results The total of included studies was 19,the number of the intervention group and the control group was 20 592 and 19 855,the OR and 95％ CI of intervention effect as shown below:comprehensive intervention OR=0.40,CI 95％ (0.27～0.59),education and training OR=0.24,CI 95％ (0.11～0.55),safety management OR=0.09,CI 95％ (0.06～0.13),engineering intervention OR=0.30,CI 95％ (0.16～0.55),safe operation OR=0.15,CI 95％ (0.09～0.26).The intervention group and the control group were statistically significant on reducing the incidence of needlestick injuries.Conclusions Education and training,safety management,engineering intervention,and safe operation can reduce the incidence of needlestick injuries,improve the quality of life of medical staffs.