[Objective]It is to observe the clinical effect of bleeding in Zhongfu on pulmonary arterial hypertension induced by chronic cor pulmonale. [Methods]60 cases of patients with chronic cor pulmonale were randomly divided into two groups. Control group was given standardizing normal drugs , and the treatment group was added with bleeding in Zhongfu on the basis treatment above. Pulmonary artery pressure and index of blood rheology were compared between the two groups after 14 days. [Results]Compared with each other,the difference was significant( P<0.05). Indexes of pulmonary artery and blood rheology were al improved obviously after treatment in both groups, especial y in treatment group( P<0.05). [Conclusion]Combination with bleeding in Zhongfu can more effectively increase the clinical effect, low down pulmonary artery pressure and improve blood viscosity.

C-C motif chemokine ligand 2 (CCL2) and its receptor CCR2 are closely related to tumorigenesis and tumor progression. The CCL2/CCR2 signaling axis promotes tumor progression through multiple mechanisms: CCL2 binds to CCR2 on the surface of tumor cells, and thus promotes tumor growth/survival and metastasis; more importantly, CCL2 recruits a variety of immunosuppressive cells to aggregate in the tumor microenvironment, and inhibits the function and activity of immune cells, promoting tumor progression. The article reviews the CCL2/CCR2 signaling axis and its role in tumors and tumor microenvironment, with particular focus on the advances in clinical research on drugs targeting CCL2/CCR2 signaling axis, in order to gain an in-depth and overall understanding of the mechanism of action of CCL2/CCR2 axis in tumor progression and develop more effective anti-tumor immunotherapeutic agents.

Objective: To evaluate the intervention effect of clinical pharmacists in hypertension chronic disease management. Methods:All the patients with hypertensive chronic diseases from Ziyang community, Xingan Street, Beilun district were involved in the study. Combined with community doctors, clinical pharmacists provided pharmaceutical care for the patients, such as regular face-to-face medication guide, telephone communication, home follow-up, special lectures on health and so on. The cognitive level, blood pressure control level and medication compliance were statistically analyzed and compared before and after the pharmacy intervention. Results:After the intervention of clinical pharmacists, the level of hypertension cognition and the level of antihypertensive drug under-standingof the patients was improved significantly (P<0. 05 or 0. 01), the level of blood pressure control and medication compliance of the patients were improved significantly (P<0. 01), and unscheduled outpatient rate, emergency rate, hospitalization rate and fre-quency were decreased (P<0. 05 or 0. 01). Conclusion: Pharmacy intervention carried out by clinical pharmacists for the patients with hypertension chronic diseases can provide reasonable medication security and improve the quality of life, and the pharmacy inter-vention mode for the hypertension chronic disease management is worthy of promotion.

Objective To compare the effects of remifentanil infused at different rates on median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion and determine the optimum infusion rate of remifentanil when used for fiberoptic bronchoscopy in pediatric patients.Methods Eighty-four ASA Ⅰ or Ⅱ pediatric patients,aged 7 months-3 years,scheduled for elective fiberoptic bronchoscopy,were randomly assigned into 3 groups (n =28 each):normal saline group (group C),remifentanil infused at 3 ng· kg-1 ·min-1 group (group R1) and remifentanil infused at 5 ng· kg-1 · min-1 group (group R2).Responses to LMA insertion were defined as body movement and/or bucking during insertion.The initial target plasma concentrations of propofol were 5.2,4.8 and 4.4 μg/ml in groups C,R1 and R2,respectively.The target plasma concentration of propofol was determined by up-and-down sequential allocation.Each time the target plasma concentration increased/decreased by 0.2μg/ml.EC50 and 95 ％ confidence interval of propofol blunting responses to LMA insertion were determined by probit method.Results EC50 (95 ％ confidence interval) of propofol was 5.03 (4.92-5.12) μg/ml,4.71 (4.58-4.84) μg/rnl and 4.46 (4.20-4.94) μg/ml in groups C,R1 and R2,respectively.There was no significant difference in EC50 of propofol between groups R1 and C (P ＞ 0.05).EC50 of propofol was significantly lower in group R2 than in groups C and R1 (P ＜ 0.05).Conclusion The infusion rate of remifentanil should not be lower than 5 ng· kg-1· min-1 when combined with propofol in pediatric patients undergoing fiberoptic bronchoscopy.

Cultivation of Medical Humanism Spirit has special value in the teaching of psychiatry,but which was ignored in the teaching. This paper explored the way to integrate humanistic spirit education into the teaching process of psychiatry.

Objective To investigate the values of clinical examinations and ultrasonography in diagnosing acetabular labrum injury . Methods Fifty-three hip dysfunction patients consisting 60 hips were enrolled in this research ,include 46 unilateral hips and 7 bilateral hips . Patients underwent physical examinations such as impingement test ,FABER test and resisted straight leg raise test ,then they underwent ultrasound examitation to observe the morphology ,boundry and internal echo of the labrum . The types of tears were classified into radial flaps( Ⅰ type) ,radial fibrillated( Ⅱ type) ,longitudinal peripheral( Ⅲ type) and unstable ( Ⅳ type) by Lage Classification system .The purpose of this study was to evaluate the application values of the sonographic findings and clinical examinations according to arthroscopic or intraoperative findings as gold standard in diagnosis of labral tears of the hip ,as well as evaluate the accuracy in diagnosis the type of tears . Results ① The sensitivity ,accuracy and positive predictive value for the diagnosis of acetabular labrum tears by sonography were 81 .1% ( 47/58) ,78 .3% ( 47/60) and 95 .9%( 47/49 ) . And the sensitivity , specific , positive predictive value and negative predictive value for the diagnosis of anterosuperior labrum tears by sonography were 95 .9% ( 47/49) ,81 .8% ( 9/11) ,95 .9% ( 47/49) ,81 .8% (9/11) ;the accuracy of sonographic in diagnosis the types of tears was 92 .3% ( Ⅰ type) ,90 .9%( Ⅱ type) ,80 .0% ( Ⅲ type) and 86 .7% ( Ⅳ type) respectively ; ② The accuracy of clinical examinations in diagnosing acetabular labrum tears were 89 .5% ( impingment test) ,60 .0% ( FABER test) and 75% ( resisted straight leg raise test) ;sonographic has a higher veracity in diagonoses of anterosuperior labrum tears than any clinical examinations . Conclusions Sonographic can efficiently diagonose anterosuperior labrum tears , and would be highly used in classified the types of labrum tears .

Objective To evaluate the triage value of high-risk human papillomavirus (HR-HPV)detection in women with atypical squamous cells of undetermined significance (ASCUS).Methods Two huandred women with atypical squamous cells of undetermined significance (ASCUS) were selected by thinprep cell test(TCT) simultaneously using HPV DNA testing by hybrid capture Ⅱ (HC) and biopsy under the colposcopy,compared the HR-HPV DNA testing with final pathological diagnosis.CIN (cervical intraepithelial neoplasia) means cervical biopsy positive.Results The positive rate of cervical biopsy in HPV positive patients was 60.38％(96/159),and in HPV negative patients was 21.95％(9/41),the difference was obviously (P ＜ 0.05).Conclusion HR-HPV detection is a good triage approach for the patients with ASCUS.

Objective:To explore the effect of the virulence factor OatA during Staphylococcus aureus infection.Methods: In vitro,wild type of Staphylococcus aureus USA300,OatA gene deletion strain or OatA gene complemented strain were used to infect mice bone marrow divided macrophages (BMDMs).Subsequently BMDMs were separated and the case of cell death were detected.In vivo,mice pulmonary infection model was constructed with nasal inhalation of Staphylococcus aureus.Alveolar macrophages were isolated and the case of cell death were detected.Results: In contrast to wild type and OatA gene complemented strain,OatA gene deletion strain induced severer macrophage death both in vitro and in vivo.Conclusion: The virulence factor OatA inhibits Staphylococcus aureus infection-induced macrophage death.

Objective To investigate the changes of fractalkine (FKN) in rat model of acute liver failure (ALF) and the role of FKN in liver inflammatory injury.Methods SD rats were divided into tWO groups:6 in normal group and 36 in model group.D-galactosamine(D-Gal) was used to induce ALF in model group.The sera and hepatic tissue samples were collected at 12,24,48,72,120 andl68 h.After D-Gal injection.FKN mRNA and nuclear factor(NF)-kB mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at 12 h were(208.3±43.5)U/L and (375.2±117.3)lJ/L,respectively,which were both significantly higher than those in normal group[(31.8±2.9)U/L and (90.8±3.1)U/L](t=-9.912 and-5.935,respectively,both P<0.01);the levels of ALT and AST peaked at 72 h after D-Gal injection.The levels of FKN mRNA(O.086±0.009)in model group at 12 h were significantly higher than those (O.044±0.009) in normal group(t=-7.999.P<0.01),and peaked at 72 h (O.333±0.033),then decreased obviously at 120 h. The levels of NF-KB mRNA in the liver of normal rats were very little;and the levels in model group were increased gradually over time,then peaked at 72 h (O.583±0.i01,t=-12.607,P<0.01).FKN mRNA and NF0kB mRNA were positively correlated (r=0.760,P<0.01).Conclusion The FKN expression may play all important role in liver inflammatory injury in rat model of acute liver failure, which could provide a new approach for ALF therapy.

Objective To evaluate the efficacy of a two-step infusion therapy with meropenem against noso-comial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmonary disease.Methods 112 elderly patients with nosocomial multi-drug resistant Pseudomonas aeruginosa infections and chronic obstructive pulmonary disease were randomized into two groups:two-step infusion therapy group ( rapid first-step infusion in 30 minutes and slow second-step infusion in 2.5 hours) and traditional 30 minutes infusion therapy group.The antibiotic clinical efficacy and bacteriological efficacy were observed between two groups .Results The clinical efficacy of observation group and control group were 82.2%(46/56) vs 57.1%(32/56).The difference was statistically significant(χ2 =10.185,P<0.05);The bacteriological efficacy of observation group and control group were 75.0%(42/56) vs 46.4%(26/56),The difference was statistically significant (χ2 =10.265,P<0.05). Conclusion The clinical efficacy and bacteriological efficacy of two-step infusion therapy with meropenem against nosocomial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmo -nary disease were superior to the traditional therapy .