ObjectiveTo evaluate therapeutic effect and the possible mechanism of smecta on paraqual plasma concentrations and multiorgans injury induced by paraquat intoxication in rats. Methods A total of 76 healthy adult SD rats were randomly ( random number) divided into group A (control group n =6),group B ( poisoned group n =30 ),group C (smecta-treated group n=30).Rats in groups B and C were treated intragastrically with PQ at 50 mg/kg,the rats in the group C were given with smecta at 50 mg/kg,while the rats in the other two groups were only intragastrically adminstered with saline.Live rats in groups B and C were sacrificed at 2,6,24,48,72 h after administration of PQ for the determination of paraquat plasma concentrations and for HE staining of lung,stomach and jejunum.The rats were executed at the end of trial by the same way in group A.All measurement data were expressed as means + standard deviation ((x) ±s).The data of pathological score were compared with Independent-samples T test and the data of PQ concentration compared with analysis of variance (ANOVA) followed by LSD-t multiple comparison test.P-values of less than 0.05 were considered statistically significant.ResultsThe paraquat plasma concentration ( ng/ml ) was 440.314 ± 49.776 to 4320.6150 ± 413.947.There were different pathological changes of lung,stomach and jejunum in group B. Lung injuries gradually deteriorated,congestion,edema,leukocyte infiltration,incrassated septa and lung consolidation were observed.The pathological changes were obvious such as abruption of mucosa,hyperemic gastric mucosa and leukocyte infiltration in stomach.Haemorrhage of jejunum mucosa,abruption of villus,gland damage and inflammatory cell infiltration were found. Compared with group B,all the pathological changes mentioned above were obviously alleviated in group C ( P ＜ 0.05 ),and the concentrations reduced ( P ＜ 0.01 ).Conclusions Smecta reduced paraquat plasma concentrations and alleviated pathologic injury of rats with PQ poisoning.

Objective To compare the clinical effects and safety of treating newly diagnosed type 2 diabetes patients by combining Glargine insulin with Metformin or/and Acarbose. Methods 84 patients with newly diagnosed type 2 diabetes ,who have a history of weight loss, body mass index( BMI )23 ～ 28kg/m2 and poorly controlled blood glucose in Metformin at least a month ,were randomly divided into three groups. Glargine insulin plus Mefformin were used in group A. Glargine insulin plus Acarbose(without mefformin)were used in group B, Glargine insulin, Acarbos and metformin were used in Group C. All three groups were given a 12-week follow-up. Results FBG,2hBG and HbA1c levels were lower in the patients after treatment( P ＜0. 05 ). HbA1c of patients was partly up to the standard in group A and group B,but HbA1c of patients was all up to the standard in group C. The effects in group C were better than those in group A and group B. It had the shortest time to achieve the target and the smallest dose of insulin in group C. BMI in group A and B did not change but decreased in group C(P＞0.05).The incidence of low blood sugar in all three groups was low and no significant difference observed among three groups (P＞0.05). And in all three groups no severe hypoglycemia occurred. Conclusion The method of combining Glargine insulin with Mefformin or/and Acarbose could effectively control blood sugar had little impact on body weight of the newly diagnosed type 2 diabetes patients, and moreover, the incidence of low blood sugar in the newly diagnosed type 2 diabetes patients was lower. It would be the ideal method to treat newly diagnosed type 2 diabetes patients considering the general safety and effectiveness and convenience.

Objective Through the network informatization management, postoperative pain assessment, nursing records, process the results into the network electronic medical records, more standardized postoperative pain management, improve the effectiveness of postoperative analgesia. Methods A total of 3 680 patients after the operation from November to December in 2015 were selected and divided into control group and observation group according to the operation time. In November for the traditional postoperative pain management in control group (1 850 cases), in December as observation group (1 830 cases), with Hospital Information System and Anesthesia Information System, all of the records in the postoperative pain management content network electronic information management, according to the degree of pain and analgesia method to select a different form, data sharing, wrong alarm to remind, handle in time. To establish a network of WeChat public platform to perform health education and information communication. The analgesia effect and patient′s satisfaction were compared between two groups. Results The incidence of incomplete pain was 12.5%(231/1 850) in control group and 4.2%(77/1 830) in observation group, and there was significant difference between two groups(c2= 82.22, P<0.01). The satisfaction score was (5.9 ± 3.7) points in observation group and (4.4 ± 2.6) points in control group, and there was significant difference between two groups(t = 2.10, P<0.05). Conclusions Postoperative pain management network informatization can effectively improve the effect of postoperative analgesia, improve work efficiency.

Mesenchymal stem cells (MSCs) are multipotent stromal cells derived from the mesoderm that can differentiate into a variety of cell types.Recently,as the study of MSCs in the treatment of various autoimmune diseases is maturing,more and more researchers have advocated the immune function of MSCs and the treatment for dry eye.The rate of dry eye is higher.The duration of therapy in dry eye,especially immune related dry eye,is long,and the therapeutic effect is poor.Dry eye has affected people's quality of life,so it is important to find new methods to treat it.This article reviews MSCs function in dry eye.

Mesenchymal stem cells (MSCs) have good immune regulatory function,can inhibit many immune cell proliferation,direct effects on activation and proliferation of T cell,play a role in immune regulation by Treg cells or by the secretion of soluble factors regulating Thl/Th2 secretion and reaction equilibrium,inhibit the inflammation through the anti-inflammatory,regulation of cytokines expression at the same time,so reduce the expression levels of matrix metalloproteinase-2 and-9,which may promote lacrimal gland tissue damage,and thus play a role in immune regulation.MSCs can reduce the autoimmune dry eye clinical index,recovery secretion function of part lacrimal gland.This article reviews the research advances in inmmmne regulation of MSCs on autoimmune dry eye.

Objective To observe protective and repairing effect of Aorui Gel on esophageal mucosa injury in reflux esophagitis rats. Methods Rat models of reflux esophagitis were established by partial pylori ligation plus cardiomyotomy. Model control group,low-,middle-and high-dose Aorui Gel groups,positive control group,excipient control group and sham operation group were set up. Rats were treated with the corresponding drugs 7 days after operation. After treatment for 14 days,the rats'general state,and macroscopic features and pathological features of esophageal mucosa were compared. Results Macroscopic features and pathological features of esophageal mucosa in Aorui Gel groups differed from those in the model control group,inflammation of esophageal mucosa in Aorui Gel groups was alleviated,and pathological features were relieved and arrived to the normal state. Conclusion Aorui Gel can alleviate esophageal mucosa injury in reflux esophagitis rats,indicating that Aorui Gel has protective and repairing effect on esophageal mucosa injury.

Objective: To examine the causal relationship between endometrial cancer and breast cancer using bidirectional two-sample Mendelian randomization (MR) approach. Methods: Genetic association data of endometrial cancer were collected through a meta analysis, including 54 884 participants and 9 464 330 single nucleotide polymorphisms (SNPs), and genetic association data of breast cancer were collected through the Breast Cancer Society Consortium, with 228 951 participants and 10 680 257 SNPs. A forward MR analysis was performed using the inverse variance weighted (IVW) method with 8 endometrial cancer-associated SNPs as instrumental variables and breast cancer as the study outcome, and a reverse MR analysis was performed with 112 breast cancer-associated SNPs as instrumental variables and endometrial cancer as the study outcome. The heterogeneity was assessed using the Cochran's Q test, the horizontal pleiotropy was assessed using the MR-PRESSO test and MR-Egger regression, and the robustness of the results was verified with the leave-one-out. Results: Forward MR analysis results showed that patients with genetically predicted endometrial cancer had an increased risk of breast cancer compared to those without endometrial cancer (OR=1.083, 95%CI: 1.037-1.132). Reverse MR analysis showed that patients with genetically predicted breast cancer had an increased risk of endometrial cancer compared to those without breast cancer (OR=1.070, 95%CI: 1.010-1.134). Cochran's Q test detected no heterogeneity (P>0.05), and neither the MR-PRESSO test nor the MR-Egger regression revealed horizontal pleiotropy of instrumental variables (both P>0.05). Leave-one-out analysis showed robustness of the MR analysis results. Conclusion There are bidirectional causal relationship between endometrial cancer and breast cancer.

Community health service centers provide basic medical and public health service for the residents in community with the contract service mode.In the last five years our center started the construction of primary care team.The family physicians,nurses and public health workers formed the basis of health care team,and pharmacists and nutritionists actively joined the team work.The pharmacists provided health education of rational medication,participated in the ward-rounds of home beds and comprehensive management of chronic disease patients,and also conducted counseling clinic of drug use.The clinical nutritionists provided special nutrition guidance for patients,delivered nutrition education and conducted nutrition clinic.The involvement of pharmacists and nutritionist in contract service has greatly ungraded the primary care team,improved the quality of comprehensive care and provided better service for the people in the community.

Objective To establish the model of autoimmune dry eye and analyze the level of cytokines and the pathological changes of autoimmune dry eye rabbits treated with human umbilical cord mesenchymal stem cells (MSCs).Methods Twentyfour female New Zealand rabbits were randomly divided into three groups:Normal control group,dry eye group and MSCs treatment group,8 cases in each group.After treated with MSCs for six weeks,the pathological changes were observed,and the expression of Th1 and Th17 cell differentiation related cytokines mRNA in lacrimal gland tissue was detected by real-time quantitative PCR.The percentage of regulatory T cells (CD4 +Foxp3 + cells) in the lacrimal gland and spleen tissues of the dry eye model group and MSCs treatment group was measured by flow cytometry.Results After treatment with MSCs for 6 weeks,HE staining from each rabbit lacrimal gland showed that,the normal control group showed no or only a few lymphocytes;The lacrimal gland cells were atrophied in the dry eye group,the distribution of lymphocyte scattered around the gland and small blood vessels;Compared with dry eye group,the lacrimal gland lymphocyte infiltration reduced in MSCs treatment group,and the cell morphology were better.Compared with dry eye group,lymphocyte infiltration and aggregation in the conjunctival conjunctiva in MSCs treatment group were significantly reduced,the epithelial structure was intact,and the degeneration and atrophy cells were rare.The expression of inflammatory factors including interferon-γ(IFN-γ),Interleukin-17 (IL-17) and transcription factor T-bet mRNA were decreased in MSCs treatment group,there were significant difference compared with dry eye group (all P ＜ 0.05);Thl7 cell associated cytokines IL-17 expression levels were decreased,but no significant difference was found between two groups (P ＞ 0.05);The expression of transcription factor RORrt mRNA in dry eye group was significantly decreased,the difference was statistically significant (P ＜ 0.05).The expression of inflammatory factors TNF-α in the lacrimal gland tissue of MSCs treatment group was significantly lower than that in the dry eye model group,while the expression of the anti-inflammatory factor TGF-β was significantly higher than that in the dry eye model group,and the differences were statistically significant (all P＜0.05).The regulatory T cells (CD4 + Foxp3 + cells) in the lacrimal gland of dry eye model group accounted for 10％ of lymphocytes was,while the treatment group accounted for 27.8％,MSCs group was significantly higher than dry eye group,the difference was statistically significant (P ＜ 0.05).Conclusion MSCs can reduce the histopathological changes of the immune dry eye,and they may have immunoregulatory effects on autoimmune dry eye.The mechanisms of immunomodulatory effects may be related to the balance of inflammatory cytokines and anti-inflammatory cytokines.

Objective To investigate the effect of fungus Aspergillus fumigatus and Candida albicans on the expression of endocellular interferon-γ (IFN-γ) and interleukin-4 (IL-4) in cytokineinduced natural killer (NK) cells.Methods NK cells were cultured with Aspergillusfumigatus or Candida albicans by non-contact or direct-contact methods with a ratio of NK cells to fungus of 10 ∶ 1.The expressions of IFN-γ and IL-4 in NK cells were evaluated by flow cytometry after co-cultured for 6 h.Analysis of variance or SNK-q test was used to compare the expressions of IFN-γ and IL-4 among different groups.Results The IFN-γexpression rates in NK cells with direct contacting to Aspergillus fumigatus hyphae,or to different morphotypes of Candida albicans were (20.12 ± 0.53) ％,(20.69 ± 0.34) ％ and (20.8 ±0.37)％ respectively,while IFN-γexpression in NK cells with indirect contacting to fumigatus hyphae,or to different morphotypes of Candida albicans were (21.40 ± 0.53) ％,(20.57 ± 1.09) ％ and (20.20 ±0.51) ％ respectively,and all were significantly higher than that in the blank group [(15.11 ± 2.60) ％,all P ＞ 0.05].The IFN-γ expression rates in the Aspergillus fumigatus spores direct and indirect contacting groups were (14.33 ± 0.98) ％ and (14.97 ± 1.53) ％,which were not of significant difference compared with the blank group (P ＞ 0.05).The IL-4 expression rates in NK cells with direct contacting to different morphotypes of Aspergillus fumigatus and Candida albicans were (1.25 ± 0.06) ％,(1.21 ± 0.03) ％,(1.22 ± 0.46) ％ and (1.26 ± 0.11) ％,while those in indirect contacting groups were (1.21 ± 0.06) ％,(1.25 ±0.04)％,(1.27 ±0.03)％ and (1.26 ±0.1)％,which were not of significant difference compared with the blank group [(1.23 ± 0.05) ％,all P ＞ 0.05].Conclusion Fungus stimuli can reduce the secretion of IFN-γ in NK cells,but have not significant influence on the secretion of IL-4.