Objective To observe the effect of Tongguanluo capsule in treating oviduct obstructive infertility and analyze the potential mechanism. Methods 106 patients with oviduct obstructive infertility were randomly divided into the observing group and the control group, 53 cases of each group. The observing group was treated by Tongguanluo capsule and the control group was treated by Huoxue Huayu Capsule. The effects were compared after 4 weeks. Results For observing group and control group respectively, the re-opening rates were 97.0% and 75.9% (P

Objective To analyze the influence of vasoactive drugs on hemodynamics in septic shock patients and to explore the guiding value of systemic vascular resistance index (SVRI) for the application of vasoactive drugs .Methods 21 cases of septic shock in ICU from March 2010 to April 2012 were retrospectively analyzed .The PiCCO monitor technique was applied to monitor the he-modynamic parameters including the cardiac index (CI) ,intrathoracic blood volume index (ITBI) ,systemic cenous resistance index (SVRI) and mean arterial pressure(MAP) ,once per 6-8 h .ITBI>850 mL/m2 was taken as the normal criterion .The data of 202 cases meeting the criterion were collected .These cases were divided into two groups according to whether MAP reach 65 mm Hg , the differences of hemodynamic parameters between the two groups were compared .The MAP≥65 mm Hg group was redivided in-to the group 1 ,2 and 3 according to SVRI .Blood characteristics of pressure ,CI and ITBI were compared among these 3 groups .Re-sults The ITBI value in the MAP<65 mm Hg group and the MAP≥65 mm Hg group was higher than the normal value .The CI and SVRI values in the MAP≥65 mm Hg group were higher than those in the MAP< 65 mm Hg group(P<0 .05) ,while the ITBI value had no difference between the two groups .The ITBI values in the three groups with different SVRI all were higher than the upper normal limit ,furthermore ,in the comparisons among 3 groups ,only comparison between the group 1 and the group 3 had sta-tistical difference(P= 0 .47) .When SVRI was lower ,the CI value was higher than the normal value .Along with the increase of SVRI ,MAP increased gradually ,and CI gradually declined .When SVRI was too high ,MAP had no significant increase ,but the CI value was lower than the lower limit .Conclusion The SVRI monitoring by PiCCO can help to guide the application of vasoactive drugs in septic shock patients ,lower SVRI means the declined vascular reaction and higher SVRI indicates the low cardiac function , moreover blood pressure can not be further enhanced by vascular excessive contraction .

ObjectiveTo explore the effect of tracer methodology on management of high-risk medicine.Methods The management of high-risk medicine was investigated with tracer methodology to find out the problems in the medicine management, construct effective management system and establish tracer programme and pyramid management mode for high-risk medicine management.The rate of adverse events in high-risk medicine management before the use of tracer methodology was compared with that after the use.Result The incidence of adverse events was significantly lower than that before the use of tracer methodology (χ2=5.379,P<0.05).Conclusion The tracer methodology in the management of high-risk medicine can be effective in the reduction of incidence of adverse events in high-risk medicine management and promotion of safety management.

Objective To detect the changes in vertebral marrow fat fraction (MFF) using T2 *-corrected water-fat MRI and to analyze the relationships between MFF with bone biomarkers of non-dialysis chronic kidney disease (CKD).Methods 78 CKD patients were divided into five groups according to the eGFR and underwent water/fat MRI to obtain MFF.The reliability of MFF measurements by two radiologists was assessed with intra-class correlation coefficient (ICC).Serum calcium,phosphorus,alkaline phosphatase,osteocalcin,intact parathyroid hormone and 25(OH)D3 were determined.Results Mean CV for MFF measurements reproducibility was 2.37％.The inter-observer agreement for MFF was excellent (ICC=0.901).The ICC for each intra-observer agreement was excellent (ICC=0.959 and 0.948,respectively).There were statistical differences in MFF among five groups of CKD.Changes of MFF were earlier than those of serum calcium,phosphorus,parathyroid hormone,alkaline phosphatase and osteocalcin.MFF was positively correlated with serum phosphorus (r =3.011,P =0.003),parathyroid hormone (r=3.852,P＜0.001),and negatively associated with calcium (r=-2.767,P=0.017),25(OH)D3 (r=6.032,P＜0.001),eGFR (r=-5.104,P＜0.001),respectively.Multivariable regression analysis showed MFF was negatively correlated with 25(OH)D3(Sβ=-0.343)and eGFR(S(S=-0.284,P＜0.001).Conclusion CKD patients had higher marrow fat.T2 *-corrected water fat MRI could serve as a useful tool to quantify marrow fat content for CKD patients.

ObjectiveTo explore regulation effect of miR-340-5p on regulating bone morphogenetic protein 4(BMP4) expression and the differentiation of rat's NSCs.MethodsNSCs of rats were divided randomly into three groups: normal group (Mock),group with nonsense oligonucleotide (Anti-Con) and group with antisense oligonucleotide of miR-340-5p (Anti-miR-340-5p).The qRT-PCR was used to detect the relative expression of miR-340-5p.The expression of NF200 and MAP-2 was detected by immunocytochemical staining and immunofluorescence,respectively.Western blot was used to detect the expression of BMP4 protein.ResultsThe relative levels of miR-340-5p expression were significantly decreased in Anti-miR-340-5p group (0.14±0.01) compared with that of Mock group(1.01±0.17) and Anti-Con group(1.07±0.13) (P<0.01).Immunocytochemical staining indicated that NF200 was positive in cells of Anti-miR-340-5p group.The proportion of MAP2 positive cells was increased in Anti-miR-340-5p group compared with other groups (P<0.05).Western blot showed the increased expression of BMP4 protein in Anti-miR-340-5p group (0.84±0.09) compared with Mock group(0.53±0.04) and Anti-Con group (0.63±0.09) (P<0.05).ConclusionThe miR-340-5p may exert a potential function in regulating differentiation of NSCs into neurons through a negative regulation of BMP4.

Objective To study the roles of Toll-like receptor 2(TLR2)and Toll-like receptor 4(TLR4)in the progress of pulmo-nary infection with candida glabrata in experimental mice .Methods The mice were divided into three groups ,the control group (group A) ,mice infected with candida glabrata(group B)and immunosuppressive mice infected with candida glabrata(group C) .6 mice in each group were killed at 1st and 3rd day after the success in pulmonary infection with candida glabrata .The lung tissues from each group were collected for pathological analysis and PT-PCR to detect the expression level of TLR2 and TLR4 .Protein TNF alpha(TNF-α)level was measured by ELISA method .Results The pathological analysis showed the structure was normal and there was no inflammatory reaction in lungs in group A .The infiltration of inflammatory cells ,weak injuries but no conidia or hyphae in lungs were found in group B .Most of the alveolar collapse and severe damage ,part of the expansion ,a large number of in-flammatory cells infiltration ,accompanying with conidia and hyphae accumulation were observed in group C .The expression levels of TLR2 mRNA and TNF-αprotein in mice lungs at the 1st day and the 3rd day in group C were significantly higher than in group A and B(P<0 .05) ,while group B was higher than group A(P<0 .05);The expression levels of TLR2 ,TLR4 mRNA and TNF-αprotein in group C at the 3rd day was higher than the 1st day(P<0 .01) ,meanwhile ,the expression of TLR4 was higher than in group A(P<0 .05) .Conclusion TNF-αand TLR2 expression maybe involve in the infection and process of candida glabrata ,and TLR4 may play a synergistic effect .

Objective To investigate the effect of Dectin-1 on the release of inflammatory factors interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in rat tracheal epithelial cells (RTECs) stimulated with heat-treated Candida glabrata (C.glabrata).Methods RTECs cultivated in vitro were randomly divided into three groups,including control group(RTECs + sterile normal saline),fungal stimulation group(RTECs + heat-treated C.glabrata),and inhibitor intervention group(RTECs + laminarin + heat-treated C.glabrata),cells were harvested after incubation for 0,2,4,6 hours respectively,cell survival rate was determined by MTT method,expression of Dectin-1 was analyzed by Western Blot,expression of IL-10 and TNF-α were detected by enzyme-linked immunosorbent assay (ELISA).Results Heat-treated C.glabrata destroyed cell structure and reduced cell survival rate.At the beginning of the culture (0 h),cell survival rate,expressions of Dectin-1,IL-10 and TNF-α among three groups were all not significantly different(all P＞0.05).After incubation for 2,4,6 hours,expressions of Dectin-1,IL-10 and TNF-α in fungal stimulation group and inhibitor intervention group were both significantly higher than control group;expressions of Dectin-1,IL-10,and TNF-α in inhibitor intervention group was lower than fungal stimulation group(all P＜0.05).The expressions of IL-10 in inhibitor intervention group at 0 h and 2 h was not significantly different,expressions of Dectin-1,IL-10,and TNF-α in fungal stimulation group and inhibitor intervention group at different incubation periods were significantly different(all P＜0.05).Conclusion Dectin-1 is an important receptor for RTECs to recognize the heat-treated C.glabrata,it induces the release of IL-10 and TNF-α,and mediate the occurrence of inflammation.

Objective To evaluate the effect of pepliteal artery endovascular angioplasty for the treatment of diabetic foot. Methods 65 cases (69 limbs) of diabetic foot were treated by long bloon endovascular angioplasty. Results No death occured. 60 cases (64 limbs) were successfully treated and 5 cases (5 limbs) failed. The imme-diately success rate was 92.75%. The pain relieved, the temperature was improved and the ankle brachial index (ABI) was up to 0.84±0.11. Anterior tibial artery or posterior tibial artery of 39 limbs could be touched. 21 limbs were cured by debride and change dressings. 10 limbs were cured after the gangrene was ablated. 6 limbs were cured after the gangrene was debrided. 22 limbs were cured after toe amputation. Half of the foot was amputated. No limb was amputated. Every month was further consulted by Doppler and the rate of follow upwas 100%. 6 limbs of 6 cases were reobliterated (1,1,2,2 cases occurred after 1,6,12,18 month respectively.) and treated by endovascular an-gioplasty again. Conclusion Endovascular angioplasty below the knees for the treatment of diabetic foot is an effec-tive method for the limbs saving, with minimal invasive, safety, less complication and retreatment. It can be used as a first choice for the artery obliteration of diabetic foots.

AIM:To investigate the role of phospholipase C epsilon 1 ( PLCE1 ) in modulating the apoptotic mechanism in lung adenocarcinoma A 549 cells.METHODS:PLCE1 inhibitor U-73122 was used to suppress the expres-sion of PLCE1.The expression of PLCE1 and p53 in A549 cells was evaluated by quantitative real-time PCR and Western blotting.Apoptosis was assessed by flow cytometry .RESULTS:A549 cells expressed high level of PLCE1 and low level of p53.Inhibition of PLCE1 markedly increased the expression of p 53, and increased the apoptosis of A 549 cells.CON-CLUSION:PLCE1 suppresses apoptosis of A549 cells via inhibiting the expression of p53.

This research focused on the doctors' changes based on the performance-payment reform from a district public hospital of Chongqing.The work compared the doctors' work efficiency,medical quality,scientific research,new technology and new project,cost control and patients burden.Performance-payment reform significantly activated doctors' self-study initiative and quality.The main running quotas of hospital,including stuff's positivity,work efficiency,medical quality,scientific research,new technology and new project,presented a better improvement trend.This not only reduced the patient cost burden,relieved the doctor-patient relationship,but also improved the hospital personnel cohesion,and strengthened the core competitiveness of the hospital.