Objective To investigate immunological mechanism underlying leflunomide ( LEF ) against experimental allergic encephalomyelitis ( EAE) by studying the effects of LEF on peripheral blood CD28/CTLA-4 costimulatory molecules expression in guinea pig with EAE.Methods 50 adult female guinea pigs were randomly divided into normal control group,low dose group,EAE control group,middle dose group,and high dose group, 10 guinea pigs in each group respectively.Low, medium and high dose group were treated with LEF 10 mg/kg· D, 20 mg/kg· D and 40 mg/kg· D orally, 1 times/day, to the termination of the experiment.The expression of CD28, CTLA-4 were detected by flow cytometry, incidence was recorded at the same time.Results Compared with EAE control group,high dose and middle dose group incubation period were prolonged, progress period were shorten and neurological dysfunction score decreased(P<0.05).Compared with normal control group, the expression of CD28 of EAE control group increased and the decreased expression of CTLA-4 (P<0.05).High, middle dose treatment group compared with EAE control group CD28 down regulated expression (P<0.05), but the expression of CTLA-4 increased(P<0.05).Among the treatment groups, of CD28 molecules with high dose group decreased significantly(P<0.05), the expression of CTLA-4 molecules with high dose treatment groups upregulated significantly (P<0.05).Correlation analysis showed that the EAE control group, the treatment group the CD28/CTLA-4 ratio in peripheral blood and nerve dysfunction score is proportional ( r=0.85, P=0.002; r=0.77, P=0.000).Conclusion LEF can reduce EAE guinea pig neurological symptoms, the better and the higher dose effect.Its mechanism may be through down-regulation of CD28 molecules in peripheral blood, upregulation of the expression of CTLA-4 molecule.so as to reduce the inflammatory response, relieve the clinical symptoms.

Objective To investigate the value of the Changsha version of the Montreal Cognitive Assessment Scale (MoCA) in the assessment of vascular cognitive impairment after cerebral infarction .Methods 112 cases of clinically diagnosed cerebral infarc-tion were selected and divided into the normal cognition (NC) group and vascular cognitive impairment(VCI) group .The Changsha version of MoCA and the mini-mental state examination(MMSE) were adopted to detect the cognitive function ,the correlation of two scales was analyzed and the cutoff values of the Changsha version of MoCA were preliminarily studied .Results The total scores of the Changsha version of MoCA and MMSE in the VCI group were 15 .12 ± 4 .60 and 20 .44 ± 3 .22 respectively ,which were lower than 22 .75 ± 1 .79 and 25 .21 ± 1 .74 in the NC group ,the difference had statistical significance (P< 0 .05);the total scores of the Changsha version of MoCA was positively correlated with the total scores of MMSE (r=0 .84 ,P<0 .01);the best cut-off value of the Changsha version of MoCA was 20/21 ,the sensitivity and specificity were 92% and 95% respectively .Conclusion The Changsha version of MoCA can screen VCI well and has a high screening value ,and its optimal cutoff value is 20/21 .

Objective: To research the character of Chinese Medicine syndrome and syndrome factor on COPD by analyzing the neoteric literature of COPD,and to make the names of Chinese Medicine syndrome canonical.Methods: To search the neoteric literature of COPD,build up a literature data-base by epidata2.0 software and analyze the data.Results: The number of the names of Chinese Medicine syndrome changes from 322 to 178.In the acute stage,the highest frequency of Chinese Medicine syndrome is: blockage of the lung by phlegm-heat,heat phlegm,blockage of the lung by phlegm-heat and the stagnant blood.In the stable stage,the highest frequency of Chinese Medicine syndrome is: deficiency of vital energy of lung and kidney,deficiency of vital energy of lung,deficiency of vital energy and Yin, deficiency of lung and kidney,deficiency of vital energy of lung and spleen.The position of the illness is lung,kidney and spleen.The character of the illness is phlegm,deficiency of vital energy,heat,stagnant blood and deficiency.Conclusion: The names of Chinese Medicine syndrome are multiform and need to be canonical.The main character of COPD in the acute stage is affected by outside illness factors.The main character of COPD in the stable stage is weak inside.The syndromes are different when the illness in the different stages.

Objective To explore the effect of vasoactive intestinal peptide (VIP) on the content of IL-17A in the brain tissue of rat models of experimental autoimmune encephalomyelitis ( EAE) .Methods Sixty healthy female Wistar rats were randomly divided into normal control group, EAE control group, low-dose VIP group and high-dose VIP group. Ten healthy guinea pigs were used to prepare anti-IL-17A antibody.Myelin basic protein ( MBP) +complete adjuvant ( CFA) were used to establish the EAE model.Since the first day of modelling, the low-dose and high-dose VIP groups received intraperitoneal injection of VIP 4 nmol/kg (0.2 mL) and 16 nmol/kg (0.8 mL), respectively, every other day for 10 consecutive days.The normal control group and EAE group were injected with 0.8 mL saline instead of VIP.The incubation period, progression and the peak of neurological dysfunction scores ( NDS) of the rats were recorded.The levels of IL-17A in the brain tissue was determined by ELISA assay, and the GFAP+astrocyte activation in brain at morbidity peak in the rats was examined using anti-GFAP ( glial fibrillary acidic protein) antibodies.Results The incubation period were extended, the progression period was shortened and the peak neuological dysfunction score ( NDS) was decreased in the VIP-treated groups, in a dose-response relationship.The cytokine levels of IL-17A and the astrocyte activation degree in brain tissue were reduced in each VIP dose group, in a dose-response relationship.Conclusions VIP exerts therapeutic effect on experimental autoimmune encephalomyelitis through lowering the IL-17A content and inhibition of astrocyte activation in the brain tissue.

In view of the challenges and opportunities presented in the new century and after rational deliberations on five occasions, the completely new model of "hi tech+humanistic solicitude=the green hospital" was put forward and the overall framework of "one line of thought", "two cornerstones", and "three goals" was carefully formulated. In the meantime, all staff members of the hospital were called on to be involved in the "six major activities". As a result, great changes have taken place in the appearance and development of the hospital. It has been proved through practice that "the green hospital" is a successful model conforming to the trends of the times.

Humans ; Esophageal Squamous Cell Carcinoma ; Esophageal Neoplasms/pathology* ; Carcinoma, Squamous Cell ; Microbiota