Objective To investigate the effect of Mahong decoction on serum VEGF and b-FGF of rat model bronchus asthma airway remolding. Method Forty SD rats randomly divided into four groups: blank group, asthma group, hormone group, Chinese medicine group. The asthmatic model was established by sensitization and challenge with ovalbumin, and the rats in the hormone group and Chinese medicine group conferred hormone and Chinese medicine before the challenge. ELISA was used to measure the level of serum VEGF and b-FGF. Results The serum VEGF and b-FGF in asthma group was higher than in other groups (P0.05). Conclusion Mahong decoction may control the level of serum VEGF and b-FGF of rat model of bronchus asthma airway remolding, which has the similar result with hormone.

Professor XU Jian-zhong thought that the main pathologic mechanism of chronic obstructive pulmonary disease was phlegm,stasis,and deficiency.The treatment must aptly take action by integrated traditional and western medicine,integrated differential diagnosis of diseases and differentiation of symptoms and signs,integrated current medicine research production and TCM,so that the diseases can be cured.In acute stage,we should eliminate exogenous pathogen at first.Then,use clearing lung-heat and resolving phlegm,warming and resolving cold phlegm,dispersing the lung to stop coughing and relieve asthma.Yinqiao powder,dingchuan decoction,zhisou powder,Qian Jin weijing decoction,maxingshigan decoction,lingguizhugan decoction,wuling powder are the commonly used prescriptions.In paracmasia,replenishing qi,nourishing yin,consolidating the exterior,invigorating the spleen,reinforcing the kidney to improving the kidney,s function of receiving qi are the commonly used treatment methods,and yupingfeng powder、shengmai powder、xiangshaliujunzi decoction,qiweiduqi pills are the commonly used prescriptions.It is very helpful for critical patients to recover by aptly use mechanical ventilation.

Objective To investigate the existence of HBV DNA YMDD mutation in patients with chronic hepatitis B and the related significance. Methods HBV DNA YMDD mutation was detected in 90 patients with hepatitis B. The liver function, HbeAg, HBVDNA, and HBV DNA YMDD mutation in patients with HBV DNA YMDD mutation were analyzed. Results HBV DNA YMDD mutation was found in 20 out of 90 patients with hepatitis B (positive rate 12.00%). HBV DNA YMDD mutation was found in 9 out of 36 patients receiving lamivuding therapy (positive rate 25.00%), but HBV DNA YMDD mutation was found in 11 out of 54 patients without lamivuding therapy (positive rate 20.37%). In the 20 patients with HBV DNA YMDD mutation, 5 patients were negative in HBeAg. HBV DNA, ALT, and Tb of the 20 patients with HBV DNA YMDD mutation were 3.0221?10 5-2.369?10 8 (5.41?7.75?10 7) copies/ml, 34 -1 216 (288.20?338.07) IU/L, and 8.9-326.7 (48.74?72.20) ?mol/L, respectively. Conclusion HBV DNA YMDD mutation may occur during the process of lamivuding therapy or may exist naturally. YMDD mutation may co-exist with pre-C gene mutation, suggesting that mutation often occurs in many sites in HBV genes. The reproduction level of HBV DNA ranges from the middle to the high levels. The pathogenicity of YMDD mutation species is various. The liver function may be normal and may also be abnormal in various degrees in these patients with HBV DNA YMDD mutation.

This paper summarized the experience of caring a patient with pancreatic cancer-related depression treated with pancreaticoduodenectomy and postoperative delayed gastric emptying.The nursing included several key points.On the base of collaboration of muhi-disciplinary teams,to strengthen supportive psychological intervention and safety management after admission;to use multimodal analgesia combined with cognitive behavioral therapy to reduce postoperative pain.After the patient was complicated with gastric emptying obstacles,solution-focus mode,sham feeding and nutritional support programs were implemented.Long-term follow-up with physician-nurse collaboration mode was implemented to enhance quality of life of the patient.

Objective To evaluate the effectiveness of repeated intravitreal conbercept injection in patients with macular edema (ME) of retinal vein occlusion (RVO),guided by optic coherence tomography (OCT).Methods It is a retrospective case study.Forty patients (40 eyes) diagnosed as ME secondary to RVO were enrolled in this study.There were 19 males (19 eyes) and 21 females (21 eyes),with the mean age of (53.58 ± 13.19) years and the mean course of 1.5 months.The best corrected visual acuity (BCVA),indirect ophthalmoscopy,fundus fluorescein angiography (FFA) and OCT were performed.The mean baseline of BCVA,central macular thickness (CMT) were 0.25 ± 0.18 and (509.48 ± 170.13) μm respectively.All the patients were treated with 10.00 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg).Follow-up of these patients was 1 to 6 months after treatments,the BCVA,fundus manifestations,OCT were retrospectively observed by every month,the FFA was retrospectively observed by every 3 months.When there was retinal edema or CMT ≥ 50 μm by OCT during follow-up,those patients were retreated with intravitreal conbercept injection.The changes of the BCVA,CMT were evaluated before and after treatment.Meanwhile,complications in eyes related to medicine and treatment methods were evaluated too.Results At the 6 months,the BCVA was improved (increase≥2 lines) in 25 eyes (62.50％),stabilized (± 1 line) in 13 eyes (32.50％) and decreased 2 lines in 2 eyes (5.00％).Retinal hemorrhage and exudates were absorbed in most patients.FFA showed no fluorescein leakage in 1 1 eyes (27.50％),minor fluorescein leakage in 26 eyes (65.00％),and retinal capillary non-perfusion in 3 eyes (7.50％).OCT showed absorption of the subretinal fluid.The mean CMT were (235.20± 100.44) μm at 6 months.Intravitreal injection of conbercept was applied for 4 times in 8 eyes (20.00％),3 times for 18 eyes (45.00％),and 2 times for 14 eyes (35.00％).The mean number of intravitreal injection was 2.85 times.There were no ocular or systemic adverse events observed in all patients.Conclusion Intravitreal conbercept injection is an efficacy and safe treatment for the patients with ME of RVO guided by OCT.It can stabilize and improve the visual acuity.

Objective To observe the effect of antisense hypoxia inducible factor-1?(HIF-1?) on (chemosensitivity) of human pancreatic cancer cell line BxPC-3 under hypoxia. Methods BxPC-3 cells were divided into 3 groups:(1)BxPC-3 cells were non-transfected with antisense HIF-1? plasmid and exposed to 0.5% O_2 for 4hr(hypoxia control);(2)normoxic BxPC-3 cells were non-transfected with antisense(HIF-1?) plasmid(normoxia control);(3)BxPC-3 cells were transfected with antisense HIF-1? plasmid and exposed to 0.5% O_2 for 4hr(experimental group).Expression of HIF-1? and survivin was detected by RT-PCR and Western Blot.Growth inhibition rates and apoptosis rates of BxPC-3 cells under different(dosages) of chemotherapeutic agents(5-fluorouracil,doxorubicin and gemcitabine) were measured by MTT(colorimetric) assay and flow cytometry (FCM).Results Expression of HIF-1? was obviously down-regulated and at the same time susvivin expression was markedly down-regulated in experimental group(P

Objective To study the clinical effect and significance of integrative medicines of TCM and WM combined with fast-track surgery concept on perioperative nursing in colorectal surgery.Methods One hundred and twenty patients with surgery were randomly divided into the observation group and the control group,60 cases in each group.The control group was treated with conventional nursing,while the observation group was treated with fast track surgery nursing of integrative medicines of TCM and WM.Results Bowel sound recovery time,anus exhaust time,defecation time,length of hospital stay and postoperative complications of observation group was significantly less than the control group (P＜0.05).Nursing total satisfaction of observation group was significantly higher than the control group (P＜0.05).Conclusion Integrative medicines of TCM and WM combined with fast-track surgery concept on perioperative nursing in colorectal surgery can reduce stress,speed up the recovery,reduce complications.So it is a safe and effective way of perioperative nursing,and worthy of clinical popularization and application.

The control handles( including financing, provider payment, organization, regulation and behavior) proposed by World Bank in health policy research as the basic framework,and the nature and positioning of family doctors′ contract-based service as the precondition, we recommended the system framework of such a mechanism, comprising one contract, three regulations, five control handles and seven supporting policies. Such a framework can serve as the cornerstone for family doctors′ contract-based service experiment in Zhejiang province for the sake of hierarchical medical system.

Objective To analyze the medical service capacity of primary healthcare in Zhejiang province since the ongoing healthcare reform and put forward suggestions. Methods Key indicators of healthcare resources and medical service utilization from 2009 to 2015 reflecting the primary healthcare were identified,for a quantitative analysis in terms of the structure-process-outcome dimensions. Results In terms of structural service capacity,the average headcount growth rate of primary healthcare′s technical personnel was 5. 7% per year; the personnel competence structure kept improving; the hospital beds at primary institutions and their ratio among all were slightly decreased,with better devices and informatization. In terms of procedural service capacity,the proportion of primary institutions with contract-based services amounted to 89. 9%,with the standard contract signing rate up to 18. 8%. In terms of consequential service capacity,the average growth rate of the number of outpatient visits at primary institutions was 6. 3%. The amount and proportion of inpatients were slightly decreased,while the hospital bed utilization ratio was increased slightly. Conclusions It is necessary to further strengthen the training and introduction of primary healthcare professionals. The functional orientation of hospitals at various levels should be clarified, encouraging contract-signing of general practitioners, promote the medical insurance payment reform featuring the capitation payment at primary level,and improve the income distribution and incentive mechanism.

Objective Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described brainstem-predominant inflammatory disorder responsive to steroids with characteristic magnetic resonance imaging(MRI) feature.There was no case report in China.The aim of this study was to characterize the clinical and imaging patterns of CLIPPERS for early diagnosis and treatment.Method Clinical and imaging data and therapeutic methods and following up after treatment of 1 patient diagnosed CLIPPERS were reviewed retrospectively.Results The patient presented with subacute weakness of the lower extremities,gait ataxia and facial numbness.Cerebellar ataxia and pyramidal signs were the main positive signs on neurological examinations.Brain MRI showed punctate gadolinium enhancement peppering the pons and cerebellar.Treatment with steroids led to rapid clinical improvement and marked resolution of MRI lesions which accorded with characteristics of CLIPPERS.Conclusions There are no characteristic clinical manifestations of CLIPPERS.Punctate gadolinium enhancement peppering the pons is the distinct magnetic resonance imaging feature which may suggest the clinical diagnosis of CLIPPERS.Early treatment with steroids can improve the prognosis.