The aim of this study is to investigate the effect of fluoxetine (FLX) on the expressions of BDNF and Bcl-2 in the hippocampus, the amygdala and the prefrontal cortex of conditioned fear (CF) model mice. Forty eight mice were randomly divided into three groups, normal control group, CF stress group and FLX-pretreated CF group. The FLX-pretreated CF group was given FLX (10 mg x kg(-1) x d(-1)) for 7 days before CF stress. After CF stress model was established, all mice were given behavioral experiments to test whether FLX impaired or improved the auditory and contextual fear conditioning. Then mice were sacrificed. The expressions of BDNF and Bcl-2 were detected by Western blotting. The results showed that the freezing time of FLX-pretreated CF group was significantly lower than that of CF group; FLX pretreatment up-regulated the expression of Bcl-2 in the hippocampus at 1 d after CF stress (P < 0.001), but no significant differences was observed at 7 d; BDNF significantly increased in the hippocampus at 7 d (P < 0.001), but no differences at 1 d; the expressions of BDNF and Bcl-2 in the amygdala and the prefrontal cortex were of no obvious differences between CF group and FLX-pretreated CF group at 1 d or 7 d after CF stress. Parallel to these changes, pretreatment with FLX could affect histopathologic changes induced by CF stress. Furthermore, the results indicated that FLX pretreatment could protect against CF stress-induced neurological damage via the activation of BDNF and Bcl-2 in hippocampus.

Cytokine-induced killer cells (CIK) is the fourth largest cancer treatment after surgery,chemotherapy and radiotherapy,and it is the development direction of cancer treatment.It is a new type of immune cell,and it is named after natural killer cell samples T lymphocytes as it express CD3 and CD56.Currently,CIK treatment has a broader range of clinical applications,and it has achieved the better clinical efficacy in the blood system cancer and solid tumors,The CIK adoptive immunotherapy is considered to be a new hope for the anticancer treatment.

[Objective]To study the effect of Qingre Yiqi Tongluo(QRYQTL) preseription on proteinria in diabetic nephropathy(DN) rats by means of ob-servation on the expressions of fibroblast-specific protein 1(FSP1) and P-cadherin in in glomerulus in rats.[Methods]60 Sprague-Dawleg rats were divided into normal control group(N), Diabetic nephropathy model group(M), QRYQTL preseription treatment group(Q) and Irbesartan treatment group(I). DN model rats were prepared by intraperitoneal injection with STZ after unilateral nephrectomy. The rats were sacrificed after 12 weeks of the treatment. The creatinine clearance(Ccr),blood urea nitrogen(BUN) and 24h urinary protein(UPro) were tested. Immunohistochemical staining was performed to explore the expressions of P-cadherin and fsp1 in glomerulus.[Results] ①Compared with M group, the levels of 24-hour upro in Q group were significantly de-creased(P<0.01).The levels of Ccr and BUN in Q group were both lower than those of M group( P<0.05). ② Compared with M group, the expressions of P-cadherin in glomerulus in Q group were increased( P<0.01) and the expressions of FSP1 were obviously decreased( P<0.01). The expressions of FSP1 in Q group were decreased compared with that of I groups(P<0.05).[Conclusions]QRYQTL preseription weakened the epithelial-mesenchymal transition (EMT) of podocyte by means of increasing the expression of P-cadherin and reducing the expression of FSP1, thereby decreased the Upro and protect the renal function.

[Objective]To investigate the mechanism of Qingre Yiqi Tongluo(QRYQTL) fang in treating the diabetic nephropathy. [Methods]60 Sprague-Dawleg rats were divided into normal control group(N), Diabetic nephropathy model group(M) (model rats were prepared by intraperitoneal injection with STZ after unilateral nephrectomy), then the model rats were assigned into model control group, QRYQTL fang treatment group(Q) and Irbesartan treatment group(I). After 12 weeks of the treatment, the contents of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px) and malondialdehyde (MDA) in renal tissue were examined by enzyme linked immunoassay(ELISA); the glomerular area(GA), mesangium area(MA),MA/GA, mean width of the podocyte foot processes(FPW) ,foot process fusion rate(FPFR) and average thickness of glomerular basement membrane(GBMT) were measured. [Results]Compared with N group, the contents of MDA in kidney homogenate and the GA,MA, FPW,FPFR,GBMT were markedly increased (P<0.01or P<0.05),the contents of SOD,CAT, GSH-Px and MA/GA were significantly decreased( P<0.01or P<0.05). QRYQTL fang reduced the level of MDA and decreased the GA, FPW, FPFR and GBMT(P<0.01or P<0.05). Compared with I group ,the QRYQTL fang was superior to Irbesartan in reducing the MDA, FPFR as wel as increasing the SOD,CAT(P<0.05).[ Conclusions]QRYQTL fang has a protective effect on the experimental diabec-tic nephropathy rats. The mechanism may be related to inhibiting oxidative stress, improving the body ’s antioxidant ability and al eviating the glomerular morphologic injury.

Objective To systematically evaluate the influence of acupuncture-moxibustion on the peroneal nerve conduction velocity in type 2 diabetic peripheral neuropathy (DPN), and to provide clinical references for acupuncture-moxibustion treatment for DPN.Method By searching the CBM, CNKI, VIP, Wanfang, Pubmed, Springer and Medline databases, randomized controlled trials (RCT) of acupuncture-moxibustion for the type 2 DPN published from January 2000 to January 2014 were retrieved and the relevant data of the peroneal nerve conduction velocity were collected for methodological evaluation. RevMan 5.1 software was adopted to conduct the meta-analysis.Result Totally 10 RCTs were recruited with 685 cases involved, including 355 cases in the treatment group and 330 cases in the control group. The meta-analysis results indicated that acupuncture-moxibustion can produce a better effect in improving the motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of peroneal nerve in type 2 DPN than the treatments used in the control group, and the differences were statistically significant between the two groups [MD=3.55, 95%CI (0.79, 6.31); MD=4.10, 95%CI (0.22, 7.99)].Conclusion Acupuncture-moxibustion can improve the peroneal nerve conduction velocity in type 2 DPN, and thus is worth application in clinic. Due to the limitation of the included studies, such as small sample size and low quality of the articles and high probability of bias, RCTs of large sample size and high quality are required to confirm the above conclusions.

With the emerging of aging society and advances of information sciences, telemedicine has gradually become a new medical model.Telemedicine can be used in health monitoring, disease diagnosis, counseling, education, chronic disease management and long-term care in elderly population;particularly in management of chronic heart failure, diabetes and other chronic diseases, as well as in referral and continuous medical care.To promote telemedicine in the elderly population can break the physical limitations of different health care settings, so that geriatrician and the allied team members are enable to maximize their values in providing corresponding health services.This article reviews the progress of telemedicine in foreign countries, which would be of reference value for development of telemedicine for elderly people in China.

OBJECTIVE:To provide empirical reference for protecting the supply of clinical drugs. METHODS:Literature re-view was combined with the conditions of drugs that lost the bidding in the centralized bidding in Anhui province to determine the short drugs need to investigate. Questionnaire was adopted to investigate the situations and reasons of short drugs in 5 third-grade class-A hospitals of 5 areas in Anhui province from Nov. 2013 to Oct. 2014. RESULTS:A total of 5 questionnaires were sent out, and 5 were received with effective response rate of 100%. There were totally 54 short drugs in the 5 third-grade class-A hospitals, including the most serious shortage of drugs for neurocirculatory system,accounting for 20.37%. Shortage was mainly due to the low price of drugs,accounting for 48.15%,and insufficient supply,less suffering patients/low dosage and other reasons. CON-CLUSIONS:In view of the shortage of drugs,government departments should improve the drug pricing and bidding policy,pro-duction enterprises should enhance the enterprise production and development capabilities,business companies should optimize the distribution pattern of network and medical institutions should establish drug management system with a clear division of power and responsibility to relieve the drug shortages.

Aim To investigate the effect of total flavonoids of Chrysanthemum indicum on proliferation of synoviocytes and TRAIL/TNF-? expression of synovial tissue with adjuvant arthritis rats.Methods SD rats were divided randomly into six groups including normol,model,TFC(84,168,336 mg?kg-1)and control drug Tripterygium glycosides(30 mg?kg-1)groups.Adjuvant arthritis rat model was induced by a single intradermal injection of 0.1 ml of the complete Freund's adjuvant into the the right hind feet pads of the SD rats.The proliferation of synoviocyte was measured by MTT;The expression of TRAIL and TNF-? on synovial tissue were detected by means of immunofluorescence.Results TFC was shown to suppress the excessive synoviocyte proliferation;The expression of TRAIL was lower in model group than that of the normal group.TFC can increase the expression of TRAIL protein;The contrary to TNF-? protein.Conclusions TRAIL play a role in the development of AA.TFC can increase the lower expression of TRAIL protein,that maybe one of the mechanisms of TFC improvement AA.

Objective To investigate early diagnosis and treatment of tumor of duodenal papilla.Methods Their clinical data of 64 cases of tumor of duodenal papilla confirmed by operation and pathology were analyzed retrospectively.They included 60 cases of carcinoma of duodenal papilla and 4 cases of adenoma.Results The main clinical symptoms were jaundice(42 cases),digestive tract symptoms(35 cases),recurrent cholangitis(7 cases) and hemorrhage of upper digestive tract(1 case).The diagnosis rate accuracy of ERCP,Fiberoptic duodenoendoscopy,MRCP,BUS and CT were 100%,97.3%,82.4%,82.8% and 76.1% respectively.Fifly-five cases underwent pancreatoduodenectomy,5 cases received local resection,and the remaining 4 cases were treated by palliative surgery.The surgical complication rate was 16.1% and the surgical mortality rate was 3.6%.The 1-year,3-year and 5-year survival rate of pancreatoduodenectomy were 67.4%,40.6% and 36.3%.Conclusions Jaundice and abdommal pain are the main symptoms of tumor of duodenal papilla.Fiberoptic duodenoendoscopy and ERCP are most effective methods for diagnosis of tumor of duodenal papilla.It is essential to early select radical resection operation so as to improve the results of surgical treatment.

Objective To analyze the related factors of nursing risk in department of nephrology and to explore strategies of risk management.Methods Risk management was implemented to 39 nurses in department of nephrology of our hospital.The KAP scores,the incidence of nursing risk events,nursing complaints and patients' satisfaction degree before and after the implementation of nursing risk management were compared.Results After the implementation of nursing risk management,nurses' KAP score was significantly higher; the incidence of nursing risk events and complaints significantly reduced; patients' satisfaction degree to nursing were significantly higher compared with those before the implementation.Conclusions The implementation of nursing risk management can effectively improve the quality of nursing and reduce the incidence of nursing risk events.