OBJECTIVE:To investigate therapeutic efficacy,safety and economics of budesonide for infant bronchiolitis based on salbutamot. METHODS:In prospective study,160 inpatient children with bronchiolitis during Oct. 2014-Apr. 2016 were divid-ed into observation group and control group according to admission order,with 80 cases in each group. Both groups received conventional treatments. Control group was given Salbutamol solution for inhalation 0.25 mL added into 0.9% Sodium chloride injection 3 mL,q8 h. Observation group was given Budesonide suspension for inhalation 2 mL added into 0.9% Sodium chlo-ride injection 1 mL+Salbutamol solution for inhalation 0.25 mL,q8 h. Both groups received oxygen driven inhalation,and treat-ed for 5-7 d. Clinical symptom disappearance time,hospitalization time and clinical efficacy were compared between 2 groups as well as therapy drug cost(aerosol inhalation,other therapy drugs). The occurrence of ADR was recorded. RESULTS:There was no statistical significance in cough disappearance time,wheezing disappearance time,lung rale disappearance time,tri-re-traction sign disappearance time and hospitalization time between 2 groups(P>0.05). There was no statistical significance in to-tal response rate between observation group (95.00%) and control group (92.50%)(P>0.05). The cost of inhalation drugs in observation group [(355.77±10.98)yuan] was significantly higher than control group [(26.83±2.86)yuan],with statistical signif-icance (P<0.05). There was no statistical significance in the cost of routine therapy drugs between 2 groups (P>0.05). There was no significant ADR between 2 groups during treatment. CONCLUSIONS:For infant bronchiolitis,aerosol inhalation of budesonide based on salbutamol sulfate can not significantly shorten disease,shorten hospitalization time and improve clinical ef-ficacy,but increase therapy cost.

In the development of primary care system,Shenzhen has called into play the model of hospital-centering,and made it a link to build a new urban medical service system of clear-cut levels,rational division of responsibilities and mutual benefit.This design provides the primary care with a good credit,a reasonable medical insurance system,and appropriate technical support.Furthermore,it improved the efficiency of unban health resource allocation and utilization and alleviated residents' burden of medical costs.This study aims to introduce the measures and advantages in the implementation of the primary care system in Shenzhen,analyze the problems found in Shenzhen' s community health service system and make recommendations for the improvement.

Objective:Effects of oxymatrine on the sodium current were studied .Methods:The whole cell voltage clamp technique was used in isolated ventricular cells of guinea-pig.Results:Oxymatrine (0.1,0.3 and 1 mmol/L) showed inhibition to the sodium current in dose-dependence.Conclusion:These results indicate that inhibition of oxymatrine to the sodium current may be one of mechanisms of its antiarrhythmic action.

Objective To explore the curative effect of triple lumen feeding tube on upper gastroin-testinal tract perforation after endoscopic operation.Methods A total of 1 12 patients with upper gastrointes-tinal perforation after endoscopic operation were involved in this prospective control test.The remission rate of abdominal pain and abdominal distension,gastric pH,lesion healing time,length of stay and the success rate of conservative treatment were compared between the control group (indwelling traditional gastric tube and intravenous use of omeprazole injection)and the experimental group (intestinal administration of PPI through triple lumen feeding tube).Results The remission rate of abdominal pain of the experimental group was 61. 3% at 6 hours,and 83. 2% at 12 h,which were significantly higher than those of the control group (P<0. 05 ).The lesion healing time(of cases where lesions were not clipped)and length of hospitalization of the experimental group were significantly shorter than those of the control group(P<0. 05 ).The gastric pH and success rate of conservative treatment of the two groups had no significant difference(P>0. 05 ).Con-clusion The curative effect of triple lumen feeding tube on upper gastrointestinal tract perforation after endo-scopic operation is ideal.

Objective To investigate the diagnostic value of non-invasive cardiac output parameters:cardiac index (CI) and minute distance (MD), in premature infants with patent ductus arteriosus (PDA) and determine the cut-off value. Methods Clinical data of 98 premature infants admitted to the neonatal intensive care unit from January 2015 to June 2015 were collected. These premature infants were divided into the treated PDA group (n=30),the untreated PDA group (n=28) and the normal premature group (n=40) based on the results of echocardiogram in the first three days after birth and the use of drugs. Non-invasive cardiac output parameters were measured in the first three days after birth. The data were analyzed by t test, analysis of variance and SNK-q test. The diagnostic value of CI and MD for PDA was analyzed by the receiver operating characteristic curve. Results By preliminary analysis of the ROC curve,CI and MD were the most representative parameters for the diagnosis of PDA which need to be treated clinically, we thus chose CI and MD in this study. The aortic and pulmonary arterial CI and MD in the treated PDA group were significantly higher than in the untreated PDA group and the normal premature group (all P<0.05). There were no significant differences between the untreated PDA group and the normal premature group in the aortic and pulmonary arterial CI and MD (all P>0.05). The cut-off value of the aortic CI and MD was 2.95 L/(min·m2) and 21.50 m/min, respectively, while that of the pulmonary arterial CI and MD was 4.55 L/(min·m2) and 26.50 m/min, respectively. The sensitivity and specificity of the combined aortic CI and MD for the treated PDA group were 0.90 and 0.82, and those of combined pulmonary arterial CI and MD were 0.87 and 0.82;and those of combined aortic and pulmonary arterial CI and MD were 0.80 and 0.88, respectively. Conclusions The non-invasive cardiac output parameters CI and MD have good diagnostic value for the PDA needing clinical treatment, and the combined use of the two parameters can improve specificity, and help formulate the early treatment strategy for premature infants with PDA. When aortic CI was ≥ 2.95 L/(min·m2) and MD was ≥ 21.50 m/min, a preliminary diagnosis of the PDA needing clinical treatment, can be made, and simultaneously when the pulmonary arterial CI was ≥4.55 L/(min·m2) and MD was≥26.50 m/min, the arterial duct should be closed timely.

AIM: To assess the effect of RNAi on suppressing the exogenous reporter gene expression in mammalian neurons,and explore the effect of siRNA quantitation on interference efficiency.METHODS: Exogenous green fluorescent protein(GFP) expression vector was transferred into neuro-2a cells,and then the small interference RNA targeting GFP mRNA(siGFP) synthesized by transcription in vitro at three different concentration was used in this experiment.RESULTS: The results showed that the neuro-2a cells can be transfected efficiently and siGFP can inhibit GFP expression greatly.CONCLUSION: RNAi can be applied into mammalian neurons successfully.The research on siRNA quantitation will provide technique support for studying the gene function of neurons in the future.

BACKGROUND: The formation of an inhibitory inflammatory microenvironment after spinal cord injury (SCI) remains a great challenge for nerve regeneration. The poor local microenvironment exacerbates nerve cell death; therefore, the reconstruction of a favorable microenvironment through small-molecule drugs is a promising strategy for promoting nerve regeneration. METHODS: In the present study, we synthesized curcumin-loaded micelle nanoparticles (Cur-NPs) to increase curcumin bioavailability and analyzed the physical and chemical properties of Cur-NPs by characterization experiments. We established an in vivo SCI model in rats and examined the ability of hind limb motor recovery using Basso–Beattie– Bresnahan scoring and hind limb trajectory assays. We also analyzed neural regeneration after SCI using immunofluorescence staining. RESULTS: The nanoparticles achieved the intelligent responsive release of curcumin while improving curcumin bioavailability. Most importantly, the released curcumin attenuated local inflammation by modulating the polarization of macrophages from an M1 pro-inflammatory phenotype to an M2 anti-inflammatory phenotype. M2-type macrophages can promote cell differentiation, proliferation, matrix secretion, and reorganization by secreting or expressing pro-repair cytokines to reduce the inflammatory response. The enhanced inflammatory microenvironment supported neuronal regeneration, nerve remyelination, and reduced scar formation. These effects facilitated functional repair in rats, mainly in the form of improved hindlimb movements. CONCLUSION Here, we synthesized pH/temperature dual-sensitive Cur-NPs. While improving the bioavailability of the drug, they were also able to achieve a smart responsive release in the inflammatory microenvironment that develops after SCI. The Cur-NPs promoted the regeneration and functional recovery of nerves after SCI through anti-inflammatory effects, providing a promising strategy for the repair of SCIs.

BACKGROUND: Intervertebral disk (IVD) degeneration, which can cause lower back pain, is a major predisposing factor for disability and can be managed through multiple approaches. However, there is no satisfactory strategy currently available to reconstruct and recover the natural properties of IVDs after degeneration. As tissue engineering develops, scaffolds with embedded cell cultures have proved critical for the successful regeneration of IVDs. METHODS: In this study, an integrated scaffold for IVD replacement was developed. Through scanning electron microscopy and other mechanical measurements, we characterized the physical properties of different hydrogels. In addition, we simulated the physiological structure of natural IVDs. Nucleus pulposus (NP) cells and annulus fibrosusderived stem cells (AFSCs) were seeded in gelatin methacrylate (GelMA) hydrogel at different concentrations to evaluate cell viability and matrix expression. RESULTS: It was found that different concentrations of GelMA hydrogel can provide a suitable environment for cell survival. However, hydrogels with different mechanical properties influence cell adhesion and extracellular matrix component type I collagen, type II collagen, and aggrecan expression. CONCLUSION This tissue-engineered IVD implant had a similar structure and function as the native IVD, with the inner area mimicking the NP tissue and the outer area mimicking the stratified annulus fibrosus tissue. The new integrated scaffold demonstrated a good simulation of disc structure. The preparation of efficient and regeneration-promoting tissueengineered scaffolds is an important issue that needs to be explored in the future. It is hoped that this work will provide new ideas and methods for the further construction of functional tissue replacement discs.

Objective: Sialidosis type 2 has variants that are both catalytically inactive (severe), while sialidosis type 1 has at least one catalytically active (mild) variant. This study aimed to discuss the structural changes associated with these variants in a newly reported family carrying N-acetyl-α-neuraminidase-1 (NEU1) variants and explore the clinical characteristics of different combinations of variants in sialidosis type 1. Methods: First, whole-exome sequencing and detailed clinical examinations were performed on the family. Second, structural analyses, including assessments of energy, flexibility and polar contacts, were conducted for several NEU1 variants, and a sialidase activity assay was performed. Third, previous NEU1 variants were systematically reviewed, and the clinical characteristics of patients in the severe-mild and mild-mild groups with sialidosis type 1 were analyzed. Results: We report a novel family with sialidosis type 1 and the compound heterozygous variants S182G and V143E. The newly identified V143E variant was predicted to be a mild variant through structural analysis and was confirmed by a sialidase activity assay. Cherry-red spots were more prevalent in the severe-mild group, and ataxia was more common in the mild-mild group. Impaired cognition was found only in the severe-mild group. Moreover, patients with cherry-red spots and abnormal electroencephalographies and visual evoked potentials had a relatively early age of onset, whereas patients with myoclonus had a late onset. Conclusion Changes in flexibility and local polar contacts may be indicators of NEU1 pathogenicity. Sialidosis type 1 can be divided into two subgroups according to the variant combinations, and patients with these two subtypes have different clinical characteristics.

Objective:To evaluate the 8 th edition of AJCC/UICC staging system for stage Ⅲ nasopharyngeal carcinoma (NPC) by the survival analysis. All patients were treated with intensity-modulated radiotherapy (IMRT). Methods:Among 1351 treatment-na?ve NPC patients who received radiotherapy/chemoradiotherapy in our hospital from December 2008 to October 2014, 742 and 784 cases were classified as clinical stage Ⅲ based on the criteria of the 7 th and 8 th edition of AJCC/UICC staging systems, respectively. These patients were classified into three subgroups according to the 7 th and 8 th edition of AJCC/UICC staging systems: T 3N 0-1 as G 1( n=226, n=245), T 1-2N 2 as G 2( n=180, n=187) and T 3N 2 as G 3( n=336, n=352). The 5-year overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS) and local-regional recurrence-free survival (LRRFS) were analyzed with Kaplan- Meier method. The differences among different groups were evaluated by log-rank test. Results:There were 93.6% patients evaluated by the 8 th AJCC/UICC staging system remained the same cohort with those by the 7 th AJCC/UICC staging system. The 5-year OS, PFS, DMFS and LRRFS of the 8 th and 7 th staging systems were 84.8% and 85.4%, 76.2% and 77.0%, 80.4% and 81.3%, 89.8% and 90.6%, respectively (all P>0.05). The OS, PFS or DMFS significantly differed among three subgroups classified by the 8 th staging system (all P<0.001). In addition, statistical significance was observed between G 1 and G 2, and between G 1 and G 3(both P<0.05), whereas no statistical significance was noted between G 2 and G 3( P=0.183, 0.310, 0.248). Conclusions:The distribution features and clinical endpoints of clinical stage Ⅲ defined by the 8 th AJCC/UICC staging system are similar to those defined by the 7 th AJCC/UICC staging system. The distribution of survival risk significantly differs among different subgroups. N 2 plays a major role in assessing the survival risk of patients with stage Ⅲ NPC. In the era of IMRT plus chemotherapy, the effect of local tumors on clinical prognosis has been diminished. The 8 th AJCC/UICC staging system remains to be further improved.