Objective:To observe the ratio of the syndrome of deficiency in origin to the syndrome of excess in superficiality in chronic renal failure(CRF)and co-existent states,and to analyze the relationship between TCM syndrome types and related biochemical indexes.Methods:TCM syndrome differentiation was carried out and related biochemical indexes were determined in 146 cases of CRF.The data were compared and analyzed with single factor analysis of variance between groups.Results:(1)Deficiency of both qi and yin of spleen and kidney was the most frequently-appeared type in the deficiency syndrome,and damp-heat syndrome was the most frequently-appeared type in the excess syndrome;(2)Serum creatinine(SCr)and blood uria nitrogen(BUN)in the patient of damp-turbid syndrome in the excess syndrome were significantly higher than those in the patient of damp-heat and blood stasis syndrome;(3)Fibrin in the patient of blood stasis was significantly higher than that in damp-heat syndrome and damp-turbid syndrome.Conclusion:Generation and development of CRF are closely related with dampness syndrome,usually marked by syndrome of damp-turbid,damp-heat,blood stasis,damp-stagnation,and was mainly related with abnormal renal function and hemorheologic indexes in the biochemical indexes.

To develop an effective therapeutic HBV DNA vaccine, two eukaryotic expressing plasmids, namely pcDNAS 2 ?S and pcDNAIIF , which respectively encoding HBV middle envelope protein preS 2 ?S and human IL 2/IFN ? fusion protein, were constructed by DNA recombinant technique. After identification by restriction analysis and DNA sequencing, the constructed recombinant plasmids were transfected into COS 7 cells in vitro with transfection reagent Lipofectamine. The expressed product in supernatant was quantified by ELISA , and the biologic activities of IL 2 and IFN ? were assayed by CTLL 2 cell line proliferation and cytopathogenic inhibition, respectively. The results showed that secretive expression of preS 2 ?S and hIL 2/hIFN ? fusion protein peaked at 48h after transfection, and the expression levels were HBsAg(P/N)=7 63, IL 2=10 35ng/ml, and IFN ?=7 90ng/ml. The IL 2 and IFN ? activities in the culture supernatant of COS 7 cells transfected with pcDNAIIF were 998U/ml and 249U/ml, respectively. These results suggested that the recombinant plasmids pcDNAS 2 ?S and pcDNAIIF were correctly constructed and the transfected cells could express secretive active protein.

Research-oriented study is a comprehensive learning method focusing on the experimental process deriving from a main issue.Given our clinical teaching experience in years,we incorporated the research-oriented studies into the undergraduate Clinical Medicine course for grade 2009,integrating the trait of the clinical skills education and our local professional training objectives.In the studies,students selected their own topic,designed and did their experiments,searched for the information,processed and analyzed the experiment result and finally completed the thesis.Practice showed that after the strict implementation of research learning plan,students' learning interest,innovative thinking,practical skills,research ability and cooperation spirit all significantly enhanced.

Objective To investigate the influence provided by irbesartan on aldosterone escape during an-giotensin-converting enzyme inhibitor(ACEI) therapy in patients with essential hypertension (EH). Methods 166 EH patients were treated with ACEI. Plasma angiotensin Ⅱ ( Ang Ⅱ ) and aldosterone(Ald) concentrations were meas-ured by radioimmunoassay following the therapy of 3 months treatment. Aldosterone escape was estimated by the plas-ma Ald level after 3 months treatment. Patients with aldosterone escape were given irbesartan for 6 months. The aldo-sterone escape were observed following the therapy with irebesartan at 1,3,6 months. Results Following the treat-ment of irbesartan for 1 month, plasma Ang Ⅱ and Ald concentrations significantly decreased (P < 0.01 ). However, it began to increase after 3 and 6 months treatment, still lower than that of the therapy not given irbesartan ( P < 0.01 ).The levels of plasma Ang Ⅱ and Aid were higher in 6 months than in 1,3 months ( P < 0.01 ), but there are no differ-ences between 1 and 3 months(P>0.05). Conclusion Irbesartan can reduce aldosterone escape during 6 months.But aldosterone escape may be occur again after 6 months treatment of irebesartan.

Objective To investigate the effect of different forbidden drink schemes on anesthesia induction and postoperative nausea and vomiting during pediatric interventional heart surgery.Methods One hundred and twenty pediatric patients underwent cardiac interventional procedures under general anesthesia were randomized into group A,B and C,with 40 patients in each group.Patients in cach group were fasted for 8 h preoperatively.Water was prohibited for patients in group A for 6 h preoperatively.Patients in groups B and C orally took 10％ glucose solution and a multivitamin drink (Outfast) at 2 h preoperatively,respectively.Nausea and vomiting after anesthesia induction were recorded for 24 h postoperatively.Results The sedation and mask acceptance scores were significantly higher in group B and C than those in group A,and were significantly higher in group C than those in group B (P ＜ 0.05,resoectively).Following anesthesia induction,MAP was significantly higher in group B and C than that in group A (P ＜ 0.05,resoectively).Both the severity and incidence of postoperative nausea and vomiting were higher in group B and C than those in group A,and was lower in group C than that in group B (P ＜ 0.05,resoectively).Conclusions Taking clear water orally 2 hours before surgery can decrease the restlessness of pediatric interventional heart surgery during anesthesia induction period,with stable smooth hemodynamics,reducing the degree of PONV.

Objective To study the impact and mechanism of continuous venovenous hemofiltration (CVVH) in different uhrafihration rates on plasma cytokines in porcine endotoxemic shock. Methods Eighteen anesthetized mechanically ventilated pigs weighing 21-34 kg were randomly divided into three groups. In control group (n=6), the pigs received a 15.7 μg/kg endotoxin (E.coli 0111:84) infusion. In CVVH group (n=6) and high volume hemofihration (HVHF) group (n=6), the pigs received CVVH after the endotoxin infusion for 24 hours with an was taken before endotoxin infusion and at 0, 1, 6, 12, 24 h during CVVH. The plasma levels of TNF-α, IL-6, IL-10 and IL-18 were tested by ELISA. Results The survival time in control group was (15.4±5.2) h,CVVH group was (21.4±7.1) h,HVHF group was (22.4±6.7) h. The survival time in CVVH and HVHF group was significantly longer than that of control group (P< 0.05 ). Heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP) and cardiac output (CO) showed no significant differences among three groups. Plasma BUN and Ser increased gradually after the establishment of porcine endotoxemic shock model. BUN and Scr of CVVH and HVHF group were lower compared to control group (P<0.05), but there was no significant difference between CVVH and HVHF group (P>0.05). Plasma TNF-α and IL-6 peaked at T1, IL-10 peaked at TO, then they declined gradually. While IL-18 increased at TO and did not change after TO. A significant decrease of plasma IL-10 level was observed at T6, T12 and T24 in CVVH group compared with control group (P<0.05). HVHF group accomplished a greater decrease in plasma TNF-α (T6) and IL-10 (T6, T12, T24) levels compared with control group and CVVH group (P< 0.05). The levels of IL-6 and IL-18 showed no significant differences among three groups. There was a negative correlation between IL-6 and survival time (P<0.05). Conclusions HVHF and CVVH can prolong the survival time of porcine endotoxemic shock. IL-10 can be removed effectively with CVVH and HVHF. HVHF can also remove TNF-α effectively. CVVH and HVHF treatment can both remove BUN and Scr effectively. IL-6 is a powerful independent predictive factor for survival time of porcine endotoxemic shock.

Objective:To investigate the feasibility and its action of the therapeutic DNA vaccine for treatment of HBV infection.Methods:By genetic recombinant technique,have constructed 2 eukaryotic expressing plasmids namely pS2.S and pFP,encoding HBV envelope middle protein(preS2+HBsAg) and human leukocyte cytokines fusion protein(IL 2/IFN ?) genes respectively and evaluated its efficacy for inducing cellular immunity in healthy BALB/c mice and HBsAg serum conversion in HBV transgenic(Tg) mice after immunization of the plasmids by intramuscular administration.Results:1.The T cell proliferation by in vitro HBsAg stimulation closely correlated with HBsAg concentration,with its stimulation index(SI=5.6?0.9) in pS2.S immunized group,being significantly higher than that (2.0?0.5) of the control.The IL 2 and IFN ? secretion level in supernatant of the DNA vaccine immunized spleen cell culture were significantly higher than that of the control,while the IL 4 secretion level was not affected.2.The dendritic cells(DCs) extracted from the local draining lymph node(LN) after DNA vaccination induced a HBsAg specific T cell proliferation with its SI(4.20) being higher than that(2.55) of the control.3.In each group of high dose pS2.S and the middle dose combined with pFP inoculation,the HBsAg serum conversion occurred in one HBV Tg mouse,with the serum anti HBs level increasing as the time prolonged,while the serum HBsAg level of the rest mice were significantly lower than that of the control.Conclusion:The results suggest that HBV DNA vaccine can effectively induced cellular immunity in healthy mice;and the preliminary results of the immunized HBV Tg mice may provide an experimental evidence for further investigation of DNA vaccine for its use in treatment of HBV infection.

After the management models of chronic diseases were described and the disadvantages of traditional management model of chronic diseases and Internet + management model of chronic diseases were summarized, the whole course management-basedInternet+ management model of chronic diseases was proposed according to the studies on and the implementation of Internet + management model of chronic diseases with its connotations studied in order to better service its users.

Objective To investigate the relationship between Hepatitis B patients with different viral loads and immunoglob-ulin A,G,M and complement C3,C4.Methods Firstly,followed by real-time fluorescence quantitative PCR detection 210 cases of hepatitis B patients with HBV-DNA levels,according to 10n copies/ml different viral load detection results,it was divided into 102 ~108 copies/ml of the experimental groups.Then the experimental groups and control group were simulta-neously detected in immunoglobulin A,G,M and complement C3,C4.Analysed the correlation between HBV loads and im-munoglobulin A,G,M and complement C3,C4.Results When the viral loads of hepatitis B patients were 105 ~108 copies/ml,the testing results of IgA,IgG and IgM were both increasing (U =12.43,10.96,6.42,P <0.01),while C3 and C4 were both decreasing (U =8.37,6.0,P <0.01).When the viral loads of hepatitis B patients were 102 ~ 104 copies/ml,only IgA and IgM were increasing (U =2.36,2.04,P <0.05),the other testing results had no statistical significance.Between the test of 7 experimental groups compared with each other,only 104 group and 105 group had significantly changed (IgA and IgM were increasing,C4 was decreasing,U =2.39,2.46,2.09,P <0.05,IgG was increasing,U = 3.25,P <0.01),but between other low viral loads or high viral loads were not significantly differences.Conclusion The different viral loads of hepatitis B patients could cause the different changes of immunoglobulin A,G,M and complement C3,C4,especially in the 4 groups from 105 to 108 copies/ml.Followed by increasing in viral loads,there were immunoglobulin A,G,M increasing and comple-ment C3,C4 decreasing,and also serious impaction on the immune function of organism.There was a positive correlation be-tween viral loads in vivo and immune damages,correlation coefficient (γ =0.967,P <0.01).When the viral loads from 104 to 105 copies/ml,the testing results had changed significantly.It suggest that should control viral loads under 104 copies/ml in the hepatitis B antiviral treatment,so the effect of immune function damage will be the minimum.

Objective To investigate the cardioprotective effect of losartan o n subtotal nephrectomy renal failure rats. Methods Renal failure rats were estab lished by subtotal nephrectomy, and then divided into RF group with subtotal nep hrectomy,RF+Los group with additional losartan(10 mg?kg-1?d-1) gavage. Rats underwent sham operation(sham group) with normal saline gavage as control. Hear t changes of experimental rats were observed 12 weeks after operation. Results T he RF group developed hypertension of arterial systolic blood pressure(SBP) and myocardiac myocytes hypertrophy. The levels of collagen type Ⅰ,type Ⅲ,and fi bronectin in endocardium and surrounding intracardial coronary arteries adventit ia of the RF group were significantly increased as compared to those of the sham group. The SBP and the levels of collagen type Ⅰ,Ⅲand fibronectin were marked ly decreased in the RF+Los group as compared to those of the RF group.Expressio n of angiotensin Ⅱsubtype 1 receptor (AT1R) mRNA in the myocardium of the RF+L os group was significantly down regulated as compared to that of RF group. Concl usions Losartan can prevent the cardiac ventricular remodeling with left ventric ular hypertrophy (LVH) and myocardial interstitial fibrosis by the depression of renin-angiotensin system through the down-regulation of myocardiac AT1R mRNA.