RNA interference (RNAi) is a process to inhibit specific gene expression via the degradation of the target mRNA induced by the double strand RNA. The use of RNAi in mammals as a tool to study gene function has rapidly developed in recent years. Here we described the novel progress and applications of the vector for mediating RNAi in mammals.

Objectives: To research the effects of recombinant human growth hormone(rhGH) with total parenteral nutrition(TPN) on the old patients following abdominal surgery. Methods: 26 old patients receiving TPN after major abdominal surgery were selected and distributed to study group(rhGH+TPN, n =13) and control group(TPN only, n =13).For 7 days after operation, rhGH (8 U/d) or normal saline(in control group) were used. The patients' weight, serum albumin, right hand grip, sleep time and the time of incision cicatrized were determined. Results: The increase of weight, level of plasma albumin, grip power of right hand and sleep time were improved more in study group than those in control group. The incision cicatrized time was also shortened in study group. Conclusions: Growth hormone can promote protein synthesis, accelerate incision healing and reduce the postoperative fatigue syndrome.

BACKGROUND: Qinggong changchun dan (QGCCD) capsule has efficacy in profiting kidney-yang and bettering muscle or bone, it could treat debility, deficiency of energy, forgettery and tiredness and the ache of waist or knee in clinic.OBJECTIVE: To study the effect of QGCCD capsule on stress capability of mice with kidney-yang deficiency.DESIGN: Completely randomized controlled trial.SETTING: Institute of Traditional Chinese Medicine, Chengde Medical College (Key Laboratory of Research and Exploiture of Traditional Chinese Medicine in Hebei Province).MATERIALS: Totally 60 stirp Kunming mice, weighting 19-21 g, of either gender, of grade Ⅱ, were selected in this study.METHODS: The experiment was conducted in the Department of Pharmacology and Toxicology, Institute of Traditional Chinese Medicine of Chengde Medical College from February 2002 to December 2002. Totally 160 Kunming mice of either gender were randomly divided into three groups:Swimming endurance group (n=60), tolerance of hypoxia at normal pressure group (n=50) and single macrophage function group (n=50); and mice in each group were divided into 5 subgroups, including 0.25, 0.5,1.0 g/kg QGCCD groups, model control group and normal control group.Mice were fasted for 12 hours and injected with 25 mg/kg hydrocortisone for 7 successive days to establish yang-deficiency model. Various dosages of QGCCD were given with the same volume of 20 mL/kg for 7 successive days. Mice in model control group were treated with the same volume of saline. Forty minutes later, testes of swimming tolerance, tolerance time of anoxia and engulfment capability of macrophage were performed on mice [To take 20 μL blood in the eyepit vein plexus after the mice were injected 2 minutes and 10 minutes later respectively, and to count the charcoal particle expurgation index (K) of macrophage] to observe effect of various dosages of QGCCD on swimming tolerance, tolerance time of anoxia and engulfment capability of macrophage.RESULTS: Data of totally 160 mice was entered the final analysis without normal control group were longer than those of mice in model control group [(10.94±3.79), (13.68±5.62), (14.58±5.49), (16.12±2.35), (6.45±4.87) minutes;ia of mice in 0.25, 0.5, 1.0 g/kg QGCCD groups and normal control group were longer than those of mice in model control group [(19.45 ±4.63),(21.18±4.25), (22.58±5.21), (23.12±4.78), (12.35±4.89) minutes; t=1.566,macrophage and K index of mice in 0.25, 0.5, 1.0 g/kg QGCCD groups and normal control group were higher than those of mice in model control group (0.023 6±0.010 6, 0.029 1±0.0092, 0.030 8±0.008 6, 0.031 8±0.010 1, 0.012 5±0.008 1; t=2.63, 4.282, 4.898, 4.714, P ＜ 0.05-0.01).CONCLUSION: QGCCD can prolong the swimming time of mice obviously, prolong tolerance time of anoxia according to dosage dependence,increase engulfment capability of macrophags, and strengthen stress capability of mice with kidney-yang deficiency.

Objective To investigate the clinical value of endoscopy for chronic diarrhea in infants and safety of gastroscopy replacing colonoscopy.Methods According to the Nelson chronic diarrhea definition,data of 52 hospitalized infants under 1 year from March 2006 to April 2014,who underwent colonoscopy because of diarrhea lasting for more than 2 weeks and achieving no improvement after series of treatments,or diarrhea suspected with severe milk protein allergy were collected.Endoscopy and mucosal biopsy were performed under intravenous anesthesia.Results A total of 49 cases (94.2%)were found abnormal under endoscopy.Lymphocytes,plasma cells and a little eosinophils were found in lamina propria in 26 cases,20-100 eosinophils/HPF were found in lamina propria in 21 patients,who were diagnosed as eosinophilic colitis.The 21 patients came back for open food challenge test 4 weeks later,16 cases were positive,who were diagnosed as milk protein allergy.Two infants with Crohn disease and ulcerative colitis respectively were treated with mesalazine and prednisone,but symptoms repeated.No complication was observed during endoscopy.Conclusion The etiology of infant chronic diarrhea is complex,except for peptic infections and lactose intolerance ,eosinophilic colitis may be the major cause.Ulcerative colitis and Crohn disease are rare in infants,but cannot be ignored .Endoscopy and mucosal biopsy are important in di-agnosis and treatment.Gastroscopy instead of colonoscopy is safe and effective.

Objectives To evaluate the effect of thyroid hormone therapy with low dose of thyroxin on cardiac function in elderly patients with heart failure and sick euthyroid syndrome. Methods Forty-seven patients (33 males and 14 females, mean age 85.9+4.6 years,ranging from 80 to 99 years) with chronic heart failure (NYHA Ⅱ-Ⅳ) and low triiodothyronine (T3) state were randomly allocated to the treatment group or control group. The treatment group patients received oral administration of levothyroxine sodium (Euthyrox) 25-50mg/d in addition to conventional therapy of heart failure, whereas patients in control group were given conventional therapy only. Serum level of total T3 (TT3), free T3 (FT3), total thyroxine (TT4), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were determined. For both groups, left ventricular ejection fraction (LVEF) and stroke volume (SV) were assessed by two-dimensional echocardiography before and at 8 weeks after treatment. The changes of these parameters after the treatment were evaluated by adjusting heart rate in the two groups. Results The reduced serum T3 level in the treatment group was corrected after thyroid hormone therapy,and these patients had a significant improvement in cardiac function after treatment. By contrast, in the control group only changes of serum TT3 and TT4 levels and SV and LVEF after treatment were statistically significant. The heart rate-adjusted mean SV and LVEF in both groups were also increased, which was significantly greater in the treatment group than in the control group. Conclusion In the elderly patients with heart failure and sick euthyroid syndrome, addition of thyroxine at a low dosage to the conventional treatment could effectively improve the low T3 state and cardiac function independent of changes of heart rate.

Objective To study the variation of the level of NOS,NO and Ang (1-7) in spontaneously hypertensive rat(SHR).Methods SHR were divided randomly into 3 groups:Bushenyixin group(n=8),valsartan group (n=8),and model group (n=7).Each group was given Bushenyixin tablet,valsartan,and saline by gavage respectively.After 4 weeks,the concentration of NOS,NO,Ang (1-7) in plasma and the concentration of NOS,NO in aorta were be observed.Results The concentration of NO in plasma was significantly lower in the Bushen-Yxin group than for model group(15.500±4.375)μmol/L vs.(26.000±2.828)gmol/L,P＜0.05.The concentration of NO in aorta and Ang1-7 in plasma were significantly higher in the Bushen-Yixin group than in the model group [(35.604±7.505)μmol/L vs.(17.437± 11.649) μ mol/L,(45.542 ± 12.726)ng/L vs.(25.521 ± 2.727) ng/L,P＜0.05].The concentration of NO in aorta was significantly higher in Bushen-Yixin group than in the valsartan group [(21.537± 13.484) μmol/L,P＜0.05].Conclusion Bushen-Yixin tablet had effects of increasing of NO level in aorta and Ang (1-7) level in plasma in spontaneously hypertensive rat.

To discuss clinical diagnosis and treatment of cow’s milk protein allergy and cow’s milk protein-induced FPIES (food protein induced enterocolitis syndrome). Methods We retrospectively analyzed clinical data of one infant with milk protein allergy-induced FPIES. Results A 67 days old female on mixed breast and formula feeding developed recurrent diarrhea, abdominal distension, vomiting, mucousy and bloody stools, feeding dififculty, anemia, and failure to thrive since 2 weeks after birth. Laboratory studies showed anemia, increased CRP level and elevation of peripheral white blood count and eosinophil proportion. Milk-speciifc IgE was negative. She was previously hospitalized 4 times, all with admitting diagnosis of“necrotizing enterocolitis”. We treated her with milk protein elimination for 4 weeks and all symptoms were resolved. Milk protein re-challenge test was positive, consistent with clinical features of cow’s milk protein allergy-induced infant FPIES. Conclusions Cow’s milk protein allergy and cow’s milk protein-induced FPIES can present with non-speciifc and variable clinical symptoms and signs, and should be considered in the differential diagnosis.

Objective To investigate the epidemiological characteristics,clinical features,diagnosis,treatment and prognosis of benign tumor of the bile ducts.Methods The retrospective cross-sectional multicenter study was conducted.The clinical data of 136 patients with benign tumor of the bile ducts who were admitted to the eight hospitals between January 2007 and December 2016 were collected,including 70 in the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University,19 in the First Affiliated Hospital of Zhengzhou University,15 in the First Affiliated Hospital of Xi'an Jiaotong University,11 in the First Affiliated Hospital of Dalian Medical University,7 in the Affiliated Hospital of North Sichuan Medical College,6 in the Southwest Hospital of the Third Military Medical University,4 in the Cancer Center of Sun Yat-Sen University and 4 in the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.All the patients received laboratory and imaging examinations,and then underwent corresponding surgery when treatment planning was respectively determined by comprehensive hospitals according to clinical features and results of examinations.Surgical procedures were performed based on the results of intraoperative frozen section in rapid pathological diagnosis.Observation indicators:(1) epidemiological characteristics;(2) clinical features;(3) results of laboratory and imaging examinations;(4) treatment situations;(5) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients up to March 2017.Measurement data with normal distribution were represented as-x±s.Results (1) Epidemiological characteristics:Of 136 patients,the male to female ratio was 1.78 ∶ 1.The incidence of whole bile duct tumors was from high to low,including 52 patients with duodenal papilla adenoma,32 with extrahepatic bile duct adenoma,24 with intrahepatic biliary cystadenoma,11 with intrahepatic papillary adenoma,9 with intrahepatic bile duct epithelial tumor,7 with epithelial tumor of duodenal papilla and 1 with neuroendocrine tumor of duodenal papilla.Among 136 patients,adenomas (including cystadenoma) was detected in 108 patients,papillomas in 11 patients,intraepithelial neoplasias in 16 patients,neuroendocrine tumor in 1 patient;intrahepatic bile duct benign tumors in 44 patients and extrahepatic bile duct (including duodenal papilla) benign tumors in 92 patients.(2) Clinical features:of 44 patients with intrahepatic bile duct benign tumors,29 had abdominal pain,fever and abdominal masses,4 had jaundice,11 had no obvious clinical symptoms and were diagnosed by physical examination.Among 92 patients with extrahepatic bile duct benign tumors,76 developed obstructive jaundice,68 were accompanied by abdominal pain or colicky pain,8 were combined with pancreatitis and 2 deveIoped hemobilia,some patients were combined with multiple clinical symptoms.(3) Results of laboratory and imaging examinations:82 patients received CA19-9 test,results of 22 patients were abnormal,with a level of (148-± 126)U/mL.Ninety-seven patients received carcinoembryonic antigen (CEA) test,with a level of test of (2.7±2.0) μg/L,and a level of CEA in 1 patient was slight abnormal,with a level of 11.2 pμg/L.One hundred and thirty-six patients underwent preoperative ultrasound examinations,showing unqualified hepatic and bile duct space occupying lesions and bile duct dilatation.Ninetyfive patients underwent preoperative computed tomography (CT),80 underwent preoperative magnetic resonance imaging (MRI) or magnetic resonanced cholangio-pancreatography (MRCP),and 13 underwent preoperative endoscopic ultrasonography (EUS).Twenty-nine patients were considered for intrahepatic bile duct benign tumors;76 were diagnosed with obstructive jaundice,with uncertain benign or malignant tumors;other patients had bile duct space occupying,considering bile duct tumor (including cancer).Twelve patients with bile duct obstruction underwent ERCP,showing obstruction site and morphology.(4) Treatment situations:among 136 patients,65 underwent pancreaticoduodenectomy,17 underwent right hemihepatectomy + cholecystectomy,16 underwent cholecystectomy + hepatic left lateral lobectomy,11 underwent left hemihepatectomy + cholecystectomy,11 underwent duodenal papillary local excision+papilla reconstruction,11 underwent Roux-en-Y choledochojejunostomy anastomosis,4 underwent cholecystectomy + extrahepatic bile duct local excision + end-to-end bile duct anastomosis and 1 underwent endoscopic mucosal resection of duodenal papillary adenomna.Of 136 patients with postoperative complications,25 were complicated with pancreatic leakage,11 with bile leakage,2 with postoperative hemorrhage and 1 with hepatic failure.Two patients with pancreatic leakage died of massive hemorrhage caused by abdominal infection,1 died of hepatic failure and other patients were discharged from hospital after symptomatic treatment.(5) Follow-up situations:47 of 136 patients were followed up for 3-123 months,with a follow-up rate of 34.6％.During follow-up,2 patients undergoing duodenal papillary local excision + papilla reconstruction had canceration,and other patients had good survival.Conclusions There is a low clinical incidence of benign tumor of the bile ducts,which is more common in male than in female,and in adenomas (including cystadenoma) and papillomas.The preoperative imaging examinations or ERCP biopsy pathological examination can increase an accuracy of preoperative diagnosis.Benign tumors with high canceration rates need positive surgical treatment.

Objective To explore the related factors of anxiety and gloomy mentality people aged 60-80 years and investigate the effectiue methods to intervention.Methods A follow-up study was proportional and carried out in Xicheng district of Beijing.Multi-phase,stratified,unequal cluster sampling was adopted to investigate old people in 2011 with WHO-QOL,Memorial University of Newfoundl and Scale of Happiness,Social Support Rating Scale,Self-Rating Anxiety Scale and Self-rating Depression Scale.2342 old people were randomly divided into control group and trial group.The trial group received health education,community social support,lightening the psychological stress in face to face,psychology guiding and group discussion.The control group received general observation only.Results Among 2342 old people,126 (5.3％) obtained anxiety and 201(8.6％) had gloomy mentality.The anxiety in the elderly was significantly related to age,marriment,culture,job,family type,family relationship,housing,income,medical insurance,retirement type,reading,keeping pets,character,training,feeling adjusting,life quality,subjective well-being,social support,depression (all P ＜ 0.05).The depression in the elderly was significantly related to gender,marriment,culture,job,family type,family relationship,housing,income,medical insurance,retirement type,reading,watching plays,character,feeling adjusting,drinking,training,life quality,subjective well-being,social support,anxiety (all P＜0.05).Scores of two groups had no significant difference before intervention.The change in scores of anxiety and depression in the trial group was obviously lower than in control group (P＜0.05).Conclusions The anxiety and gloomy mentality are common in old people aged 60-80 years in Xicheng District,which independently associated with related factors such as life quality,subjective well-being,social support and so on.After 6 months of treatment,the scores of anxiety and depression in the trial group is obviously lower than in control group.

Objective:To evaluate the efficacy and safety of dienogest (DNG) in the treatment of refractory endometriosis-associated pain (REAP).Methods:In this study, REAP was defined according to the following criteria: (1) the pain duration was ≥12 months and visual analogue scale (VAS)≥60 mm; (2) the previous treatments with over two medicines like oral contraceptives and levonorgestrel-releasing intrauterine system failed to achieve satisfactory relief of pain, with VAS reduction less than 50%; with gonadotropin-releasing hormone agonist or mifepristone, the pain could be controlled temporarily, but it recurred after discontinuation of medicines; (3) the pain could not be relieved by surgery or even repeated surgeries. In the present study, 48 patients with REAP were treated with DNG 2 mg/day orally and the clinical outcomes were retrospectively analyzed. The VAS scores, levels of CA 125, estradiol, FSH, LH and changes in the size of endometriotic lesions before and after treatment were compared respectively. The side effects were also analyzed. Results:The average duration of DNG treatment was (20.1±12.8) months. After 3 months of medication, the VAS score was significantly reduced from (77.9±15.8) mm to (20.8±10.7) mm ( P<0.01), and CA 125 level was significantly reduced from (95±139) kU/L to (38±45) kU/L ( P<0.05). The effects were maintained with continuation of DNG treatment. Endometriotic lesions tended to shrink, after 12 months of DNG treatment, the size of ovarian endometriomas was reduced significantly from (3.1±1.0) cm to (1.9±1.2) cm ( P<0.05). The mean level of estradiol was maintained at 124.82-221.04 pmol/L and levels of FSH and LH did not change significantly during the treatment. The major side effect was irregular bleeding (75%, 36/48). Conclusions:DNG could effectively relieve REAP and is a well-tolerated therapy. It may supply an alternative option for patients with REAP.