Atherosclerosis is a chronic inflammatory disease.Atherosclerotic plaque rupture and thrombosis may result in cardio-cerebrovascular events.Inflammatory mediator CD40L widely exists in cells associated with atherosclerosis.They participate in plaque inflammatory response,release proinflammatory cytokines,degrade extracellular matrix,improve procoagulant activity,and promote the progression of atherosclerosis and plaque vulnerability.Intervening CD40/CD40L signaling system may become an effective treatment strategy to slow the progress of atherosclerosis and stabilize atherosclerotic plaques.

Activator protein-1(AP-1) is a collective term referring to dimeric transcription factors composed of Jun protein family and Fos protein family that bind to the AP-1 sites of many genes,also known as TPA-responsive elements.AP-1 involves in the gene transcriptional regulation of a large number of growth factors and cytokines and leads to a series of physiological and pathophysiological changes of the body.Increasing attention has been paid to the relationship between AP-1 and the allergic diseases in recent years.This article reviewed the structure?activation of AP-1,and the relationship between AP-1 and the allergic diseases.

Objective To analyze the causes of medical disputes and to find an effective way to reduce medical malpractice and medical dispute.Methods The complete identification files of 251 cases of medical malpractice obtained from corresponding Offices of Technical Identification of Medical Malpractice in three cities at prefecture level in Shandong province were analyzed to compare the cause of medical malpractice identified by patients with that identified by experts.Results The main causes that identified by patients included violation(36.41%),default(35.60%),illegality(13.05%),tort(11.89%),and absence of management(3.05%).Among the litigation claims,58.53%were identified as existed factors causing disputes.Among the identified factors,72.66%should have been prevented and controlled.Conclusion Medical malpractice and medical dispute can be effectively prevented and controlled by putting management site forward,ensuring the implemention of the policies,and strengthening the substantive responsibility of the leadership.

Objective To study the standardization of medical records writing by residents in hospitals. Methods With both quantitative and qualitative analysis, medical records made by residents were sampled in groups to study their standardization. Results Recognition rate of such medical records was 82. 55%, and the excellence rate was 24. 50% in the grade evaluation. For senior residents, their rate of writing excellence falls below those of junior ones; whether the evaluators have medical background bears no significant difference for grade evaluation of medical records writing, yet a significant difference was found with the recognition rate. Conclusion Writing of medical records by residents is found with incompliance now and then, and the recognition rate ought to be improved.

Cathepsin S is one of the cathepsins that distributes generally at lysosomes of histiocyte in humans body.It has variety of actions when it is unbalancing,including promote inflammation,atherosclerosis,diabetes and obesity,etc.Studies in recent years have demonstrated that there are certain correlations of adiponectin with vascular risk factor and cerebrovascular disease.

Objective To observe the variation of the levels of γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis before and after treatment.Methods A total of 159 patients with brucellosis were enrolled from the Second People's Hospital of Tianjin between September 2009 and August 2014,of which 122 were with acute phase and 37 with subacute stage.γδT cells,CD4+ and CD8+ T lymphocytes in peripheral blood of all patients before and after treatment were detected by flow cytometry.Thirty healthy controls were also enrolled.Measurement data were analyzed using t test and nonparametric Kruskal-Wallis test.Results The medians of γδT cells,CD4+ and CD8+ T lymphocyte counts of brucellosis patients with acute stage before treatment were 84.0/μL,780.5/μL and 774.0/μL,respectively,and those with subacute stage were 76.0/μL,887.0/μL and 890.0/μL,respectively.Those in control group were 49.0/μL,772.5/μL and 592.5/μL,respectively.γδT cells (U=114.5,P =0.001) and CD8+ T lymphocyte counts (U=1 185.5,P =0.003) in acute phase group were elevated than control group.γδT cells (U=359.0,P=0.013),CD4+ T lymphocyte counts (U=325.5,P=0.004) and CD8+ T lymphocyte counts (U=316.5,P=0.003) in subacute phase group were increased than control group.CD4+ T lymphocyte counts in subacute phase group were elevated than acute phase group (U=1 619.0,P=0.009).There were 31 patients with acute phase and 30 patients with subacute phase who completed 6-week treatment.γδT cells ([120.7 ± 104.9]/μL vs [82.2 ±85.3]/μL;t=3.568,P=0.001),CD4+ T lymphocyte ([802.1±300.6]/μL vs [663.0±280.6]/μL;t=2.904,P=0.007) and CD8+ T lymphocytes counts ([908.1±422.7]/μL vs [651.1±241.7]/μL;t=3.885,P=0.001) of brucellosis patients with acute stage before and after treatment were significantly different.γδT cells ([67.1± 38.4]/μL vs [48.4±32.1]/μL;t=2.695,P=0.012),CD4+ T lymphocytes ([817.1± 147.4]/μL vs [650.8± 196.5]/μL;t=5.301,P＜0.01) and CD8+ T lymphocytes counts ([703.7±191.5]/μL vs [537.4±186.0]/μL;t=5.152,P＜0.01) of brucellosis patients with subacute stage after treatment were significantly decreased compared with those of patients before treatment.Conclusions γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis are all in a state of immune activation.The levels of activation are highly correlated with disease progression.And detection of the variation of these cells contributes to understand the immune state of the acute and subacute brucellosis.

AIM: To investigate the effect of treatment based on syndrome differentiation only and combined with Shexiang Baoxin Pill for acute ischemic stroke(AIS). METHODS: Fifty-eight cases of AIS were randomly (allocated) to two groups.Thirty cases of group A were treated with treatment based on syndrome differentiation combined with Shexiang Baoxin Pill and twenty-eight cases of group B with the treatment based on syndrone differentiation. Therapeutic effects were observed in one month after medication. RESULTS: The total effective rate was 90% in group A and 89.3% in group B, the difference being not significant. However, the difference of markedly-effective rate was significant (P

OBJECTIVE:To compare clinical efficacy and safety of intravenous dripping of methotrexate and uterine arterial perfusion embolization combined with complete curettage of uterine cavity (CCUC) in the treatment of cesarean scar pregnancy (CSP).METHODS:A total of 90 CSP patients were randomly divided into group A and B,with 45 cases in each group.Group A was given Methotrexate (MTX) injection 50 mg/m2 intravenously before CCUC.Group B received Seldinger catheterization in supine position before CCUC,and was given sequential infusion of MTX injection 50 mg/m2 and gelatin sponge particles into the uterine artery;the catheter was removed after satisfactory embolization by imaging examination.The levels of β-HCG of 2 groups were reexamined every 24 h,and CCUC was performed when serum β-HCG level was below 1 000 mU/mL.Perioperative bleeding volume,postoperative bleeding volume,the time of blood β-HCG returning to normal,the time of menstruation returning to normal,hospitalization time as well as the lesion diameters,the levels of blood β-HCG,the occurrence of compliance and ADR before and after treatment were compared between 2 groups.RESULTS:The intraoperative bleeding amount and postoperative bleeding amount of group B were significantly lower than those of group A,while the time of blood β-HCG returning to normal,the time of menstruation returning to normal and hospitalization time were significantly shorter than group A,and the incidence of total compliance was significantly lower than group A,with statistical significance (P＜0.05).Before medication,there was no statistical significance in lesion diameters between 2 groups (P＞0.05).Before CCUA,the lesion diameters of 2 groups were significantly smaller than before medication,and the group B was significantly smaller than group A,with statistical significance (P＜0.05).Before medication,there was no statistical significance in blood β-HCG levels between 2 groups (P＞0.05).Before and after CCUC,blood ββHCG levels of 2 groups were significantly lower than before medication,and the group B was significantly lower than group A,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Compared with methotrexate by intravenous drip,methotrexat by uterine artery embolization combined with CCUC for CSP can effectively reduce intraoperative bleeding amount,promote the decrease of blood β-HCG and menstrual recovery,and contribute to the reduction of complication risk with good safety.

OBJECTIVE: To provide references for the improvement of categorized management of drugs in China. METHODS: The problems in China's categorized management of drugs were analyzed by drawing a comparison between China and USA in the categorized management of drugs. RESULT & CONCLUSION: China should draw on useful experiences from the developed countries to improve the categorized management of drugs from multi-aspects.

Objective To asses the clinical applied value for the salpingian recanalization by means of interventional procedure.Methods 80 cases ranged in age from 23～35 with sterility diagnosed by uterosalpingography were included in this study.They had bilateral and unilateral salpingian narrow,adhesion or stenosis.According to the interventional radiologic theory,using same-axis catheter system,and recanalization fluid the narrow,stenosis and adhesion of salpingian were treated.Results There were 113 salpingians suffered with narrow,adhesion and stenosis in 80 cases.Of them,87 salpingians were recanalized.The successful rate was 84.5%,among them the recanalization rate was 94.8% in the patients with interstitial lesion and 25 cases had been pregnancy (approximate 31.9%) after operation. Conclusion The recanalization of salpingian by interventional radiology in the treatment of sterility caused by salpingian stenosis,narrow and adhesion is an effective means.The pregnancy rate is relevant to the selection of indication.