Objective To investigate a superior therapeutic method of chloasma with traditional Chinese medicine (TCM) in women of reproductive age. Methods Two stage cross trial were employed in this study. Valuable labels were included pharmaceutical, periodical and layover effect, clinical symptoms, chloasma area, and correlation of them. Therapeutic course had 4 weeks in the first and the second stage, respectively. Clinic final effect was valued by intentional methodology. Results 106 recipients who fulfilled with inclusion criteria were divided into two groups, therapeutic group and controlling group, respectively. Effect rate of treating group arrived at 60.4% after and before the cross treatment. Therapeutic effect in the treating group was significantly superior to that in the controlling group in the end of clinic final. The pharmaceutical and the periodical effect also manifest markedly difference in this study. But there was not cross effect between the pharmaceutical and periodical effect in each group. The symptom effect has no relation with chloasma area effect, both of them also manifests line relation. Conclusion On the basis of pathological factors such as heat-damp, blood stasis and phlegm, harmonizing liver and reinforcing kidney is good way to improve therapeutic effect.

Objective To investigate the clinical effect of regulating Spleen Yangwei Decoction combined with rabeprazole in the treatment of rheumatoid gastritis with hot and humid obstruction.MethodsFrom April 2013 to February 2015, 88 patients with reflux gastritis caused by cholecystectomy in our hospital were selected as the subjects.TCM syndrome differentiation was hot and humid type, and random number table was divided into observation Group and control group of 44 cases, the control group given rabeprazole, citrate xylapril tablets and other Western medicine treatment, observation group on the basis of this plus self-adjusting spleen and stomach soup, are treated for 3 months, (TNF-α) and interleukin-8 (IL-8) levels were measured by enzyme-linked immunosorbent assay (ELISA) in the two groups before and after treatment, and the quality of life scale was used to evaluate the levels of tumor necrosis factor-α (TNF-α) (QOL) and digital pain score (NRS) were compared between the two groups to improve the quality of life and pain, and to observe the recurrence of bile reflux and adverse reactions.ResultsThe effective rate was 93.18% in the observation group and 77.27% higher than that in the control group (P<0.05).The QOL score (121.29±1.88) in the observation group was higher than that in the control group(P<0.05).The results of bile test showed that the levels of pg/mL, IL-8 (8.58±1.64) pg/mL and NRS (2.10±0.71) were lower than those in the control group (P<0.05).There was no significant difference between the observation group (11.36%) and the control group (4.54%).The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P< 0.05).ConclusionModified Spleen Yangwei Decoction combined with rabeprazole can effectively treat rheumatoid reflux gastritis, reduce bile reflux, improve the level of inflammatory factors, quality of life and pain, and mild adverse reactions, it is worth in the clinical promotion application.

Objective To explore the effect of suction toothbrushing in oral care of patients with dysphagia.Methods sixty patients with dysphagia from the neurology department and rehabilitation department in our hospital were equally divided into the experiment group and the control group randomly: the former used suction toothbrushing for oral care and the latter physiological saline for oral care.The two groups were compared in respect of bad breath,oral cleanliness,time for conducting oral care,stomatitis, oral ulcer and pathogenic bacteria in oral cavity.Results The time for conducting oral care in the experiment group was significantly shorter than that in the control group(P<0.001).The score on oral cleanliness of the experiment group was significantly higher than that in control group(P<0.001).The bad breath,stomatitis or oral ulcer,and mucosa damage in the experiments group were all lower than those in the control group.The number of oral bacteria on the 5th day in the experiment group was smaller than that in the control group(P<0.005).Conclusion For the patients with dysphagia,the suction toothbrushing may be effective for cleaning the mouth,reducing oral complications and improving the satisfaction degree.

Objective To investigate the effect of all-trans retinoic acid (ATRA) on transforming growth factor β1 (TGF-β1)/Notch signaling pathway in injured podocytes induced by adriamycin (ADR) in vitro.Methods Podocytes cultured in vitro were randomly divided into normal group,model group,ATRA treatment control group,12-hour ATRA intervention group and 24-hour ATRA intervention group.Morphological changes were observed by using light microscope.The expressions of TGF-β1,podocin,Notch 1,Jagged 1 mRNA were evaluated through real-time polymerase chain reaction (RT-PCR) and the corresponding proteins were detected by using Western blot.Results (1) No obvious changes between normal group and ATRA treatment control group were revealed as the plump podocytes and distinct outline were found in light microscope,while podocytes in model group showed disordered arrangement,fuzzy boundary,atrophy,hypertrophy and increased cellular debris.Of note,the podocytes in 12-hour ATRA intervention group and 24-hour ATRA intervention group almost returned to normal.(2) In contrast with those in model group,the amounts of TGF-β1,Notchl,Jaggedl mRNA levels decreased in 12-hour ATRA intervention group (1.34 ±0.43 vs.4.16 ±0.31,1.67 ±0.2 vs.4.21 ±0.92,2.08 ±0.27 vs.5.14 ±0.63,q =23.83,11.45,19.67,all P ＜0.05) and 24-hour ATRA intervention group (1.22 ± 0.16 vs.4.16 ± 0.31,1.73 ± 0.53 vs.4.21 ± 0.92,2.08 ± 0.29 vs.5.14 ± 0.63,q =24.85,11.18,19.67,all P ＜ 0.05),and the differences were significant;similar trend was detected in the protein levels (1.04 ± 0.03 vs.4.31 ± 0.10,1.06 ± 0.04 vs.4.47 ± 0.24,1.07 ± 0.04 vs.4.20 ± 0.16,1.06 ±0.03 vs.4.31 ±0.10,1.07 ±0.03 vs.4.47 ±0.24,1.09 ±0.03 vs.4.20 ±0.16,q =163.50,69.61,90.36,162.50,69.40,89.78,all P ＜ 0.05),and the differences were significant;whereas the level of podocin mRNA (1.13 ±0.05 vs.0.40 ± 0.06,1.16 ± 0.03 vs.0.40 ± 0.06,q =36.50,38.00,all P ＜ 0.05) and protein (1.01 ± 0.01 vs.0.44 ±0.01,1.02 ±0.01 vs.0.44 ±0.01,q =180.25,183.41,all P ＜0.05) increased,and the differences were sig nificant.(3) The expressions of Notch1,Jagged1 mRNA were positively correlated with TGF-β1 mRNA (r =0.84,1.00,all P ＜ 0.05),but negatively correlated with podocin mRNA (r =-0.95,-0.94,all P ＜ 0.05) in model group.Conclusions ATRA might alleviate podocyte injury through cutting the expressions of TGF-β1,Notch1,Jagged1 and raising the expression of podocin in injured podocytes induced by ADR.

We systematically analyse and summarize on the literature(1996-2016) by reading and analysing them.Active ingredients and pharmacological activity of traditional Chinese medicine pigment composition(Saffower Yellower Injection) is introduced and its response characteristics, factors and potential causes of ADR are revealed, which provides the reference for safe, rational clinical management of drugs.Also it reminds that clinicians should master the characteristics of adverse reactions of traditional Chinese medicine pigment and grasp the ADR potential causes and control measures, in order to reach the goal of rational drug use.

Objective To study the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with intraductal ultrasonography (IDUS) for bile duct stricture diseases.Methods The results of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography,intraductal uhrasonography,bile duct brushing cytology,the liquid-based cytology and the histopathological examination were analyzed retrospectively.The final diagnosis was made based on clinical data,histopathology and follow-up results(≥4 months).Results Twenty-one patients were diagnosed as having malignant biliary diseases,including 9 biliary tract carcinoma,4 duodenal papilla carcinoma,4 pancreatic cancer infiltrated common bile duct,4 cancer of the liver infiltrated common bile duct ; 15 were diagnosed as having benign biliary diseases,including 9 bile duct stones,4 liver fluke disease,lbile duct inflammatory stenosis,1 bile duct stricture caused by external compression.The accuracy rate of the EUS,ERCP,IDUS and ERCP + IDUS in the differential diagnosis of the bile duct stricture disease were 77.8％,88.9％,91.7％ and 94.4％,respectively.The accuracy rates of IDUS,ERCP,ERCP combined with IDUS were significantly higher than that of EUS (P ＜ 0.05).The sensitivity,specificity,positive predictive value and negative predictive value of ERCP combined with IDUS were 95.2％,93.3％,95.2％ and 93.3％ respectively which were higher than those of EUS,ERCP and IDUS.After the bile duct brushing cytology and the liquid-based cytology or histopathological examination,19 patients were diagnosed as having malignant biliary diseases,17 were benign biliary diseases.The sensitivity,specificity and accuracy of the procedures for malignant bile duct stricture disease were 90.5％,100.0％,94.4％ respectively.Conclusion ERCP combined with IDUS can improve the diagnostic accuracy.The diagnostic positive rate will be higher with the help of ERCP,IDUS and targeted brush.

Objective:To study the differences of ventilation function in patients between chronic right heart failure secondary to pulmonary arterial hypertension and chronic whole heart failure secondary to left heart diseases.
Methods:A total of 102 patients with clinical stable chronic heart failure (CHF) were studied. The patients were divided into 2 groups:Whole heart failure (WHF) group, n=41 and Right heart failure (RHF) group, n=61. The ventilation function test at rest and cardiopulmonary exercise test (CPX) were conducted and compared between 2 groups.
Results: The rest ventilation function was similar between 2 groups. For CPX examination, compared with WHF group, RHF group had the lower peak minute ventilation (VE), higher anaerobic threshold and peak minute ventilation/CO2 production (VE/VCO2), higher peak dead space volume/tidal volume (VD/VT), all P<0.05.
Conclusion:At exercise condition, RHF patients had decreased ventilation function and ventilation index due to severe abnormality of ventilation/perfusion (V/Q).

Objeetive To study the differences of the biological characteristics and immune regulation function of adipose mesenchymal stem cells (AMSCs)from psoriasis patients and healthy people.Methods AMSCs were isolated and cultured from human psoriatic and healthy adipose tissue,the phenotypes and cell cycle of AMSCs taken from three generation were detected by flow eytometry.Alkaline phosphate enzyme staining and oil red o staining were used respectively to identify their adipogenic and osteogenic capacity.Next,the levels of inflammation antimicrobial proinflammatory factor were detected by PCR and ELISA.Then gene expression profile of AMSCs were screen by gene expression profile chip,as so to bolting the the gene array related with immunology gene.Results There was no significant change in cell morphology,and cell surface markers were expressed high for CD29,CD44,CD73,while lower for CD31,CD45 and HLA-DR.AMSCs of psoriasis patients and healthy people both had the ability of adipogenic and osteogenic differentiation.But the cell cycle showed the third generation AMSCs proliferation rates were slower than that of normal control,as compared with healthy controls,adipogenic differentiation ability was stronger.What'more,the level of inflammatory cytokines in psoriasis group was lower than that in controls such asIL-10,IDO,TGF-β,on the contrary the levels of proinflammatory factor in psoriasis group were higher than that in controls,such as TNF-α,IFN-γ.In addition,gene chip results suggested that psoriasis group AMSCs had obvious expression differences on JAK-STAT pathway with healthy controls.Conclusions Compared with the control,there are significant differences in patients AMSCs proliferation and adipogenic differentiation ability,immune inflammation suppression control ability is weaken,this phenomenon may be associated with JAK-STAT immune pathways related to downgrade.

Objective: To study clinical application value of dobutamine stress echocardiography (DSE) and nitroglycerin stress single photon emission computed tomography (SPECT) for evaluation of restenosis after percutaneous coronary intervention (PCI). Methods: A total of 39 patients after PCI were examined by DSE and SPECT one week before coronary angiography (CAG). Dose incremental program of dobutamine included five levels：5μg•kg-1•min-1, 10μg• kg-1• min-1, 20μg•kg-1•min-1, 30μg•kg-1•min-1, 40μg•kg-1•min-1, and each level maintained for three minutes. Sensitivity, specificity and accuracy of DSE and SPECT were determined according to CAG examined result and examined results were compared between DSE and SPECT. Results: Compared with CAG, SPECT and DSE were no significant differences （P>0.05）in sensitivity (83.3% vs. 75.0%) and accuracy (71.8% vs. 87.2%) for evaluating restenosis after PCI, but compared with SPECT, DSE possessed higher specificity (66.7% vs. 92.6%). Conclusions: Dobutamine stress echocardiography is accurate, and its specificity is better than that of SPECT for evaluating restenosis after percutaneous coronary intervention.

Objective To explore the association between HLA-A and B alleles and alopecia areata.Methods HLA-A and-B alleles were studied by LABTypeTM SSO in 44 patients with alopecia areata and 200 healthy controls.Results The frequencies of HLA-A＊11（χ2=6.08,P 〈 0.05）,HLA-B＊13（χ2=29.80,P 〈 0.01）,HLA-B＊40（χ2=8.04,P 〈 0.01）,HLA-B＊46（χ2=5.86,P 〈 0.05）and HLA-B＊51（χ2=8.82,P 〈 0.01）alleles were significantly increased in alopecia areata patients compared with the control.Conclusion HLA-A＊11,HLA-B＊13,HLA-B＊40,HLA-B＊46 and HLA-B＊51 might be the susceptible alleles of the patients with alopecia areata.