Sijunzi Decoction polysaccharide (SJZDP) is the active component contributing to the function of intestinal immunoregulation, which is the highest content in Sijunzi Decoction. SJZDP can activate immunological response in peyer’s patch, mesenteric lymph nodes, intestinal epithelial cells and intestinal intraepithelial lymphocytes, but the mechanism is unknown. The reported mechanisms of SJZDP’s intestinal immunoregulation activity are related to its regulation of intestinal flora and polyamine signaling pathway. This review is to give a comprehensive summary of information regarding the intestinal immunoregulation of SJZDP and mechanism to help us take the action for reasonable clinical utilization and further researches.

Objective: To explore the impact and mechanism of disease management of caregivers on self-management behaviors among patients with chronic heart failure. Methods: A total of 231 dyads of outpatient chronic heart failure patients and their caregivers were assessed by caregivers contribution to self-care of heart failure index (CC-SCHFI), self-care of heart failure index (SCHFI) and Atlanta heart failure knowledge test (AHFKT-V2). IBM SPSS 22.0 was used to conduct the paired t test and Pearson correlation analysis. LISREL 8.80 was used to conduct the path analysis. Results: There were significant differences between caregivers and patients in maintenance behavior (P=0.015), management behavior (P=0.023) and self-efficacy (P=0.001). There was no correlation between caregiver self-efficacy and patient heart failure knowledge and skill, but other variables were positively correlated, and r value ranged from 0.129 to 0.575 (P<0.05). Patient self-management behaviors were directly influenced by caregiver disease management, patient heart failure knowledge and skill and patient self-efficacy, and indirectly influenced in part by caregiver disease management through patient heart failure knowledge and skill and patient self-efficacy. Conclusion: Caregiver disease management not only can directly influence patient selfmanagement behaviors, but also can indirectly influence patient self-management behaviors through patient heart failure knowledge and skill and selfefficacy. Health care workers should carry out family-centered health education, and help caregivers actively participate in disease management of patients with heart failure; for those patients whose caregivers can't change their disease management behaviors, health care workers should also improve their selfmanagement behaviors by improving patients' heart failure knowledge and skill and self-efficacy.

Objective To evaluate the value of calcium-based quantitative spectral CT imaging in differential diagnosis of benign and malignant thyroid nodules.Methods Totally 82 patients with 98 thyroid nodules confirmed by pathology underwent unenhanced and dual-phase enhanced spectral CT scans before operation.Thyroid nodules were divided into malignant group (61 nodules) and benign group (37 nodules),according to histopathologic results.Besides,contralateral normal thyroid tissue of 50 patients was selected as normal group.The calcium concentration of malignant,benign and normal group in non-enhanced scanning was analysed.The optimal threshold to predict malignancy and the corresponding diagnostic sensitivity and specificity were obtained by ROC curve.Results The calcium concentrations for malignant, benign and normal group in non-enhanced scanning were (5.52±2.72) mg/cm3, (10.72±4.68) mg/cm3 and (24.66±7.58) mg/cm3 respectively.There were significant differences statistically in any two groups (P<0.001).For malignant thyroid nodules, the best diagnostic threshold of calcium concentration was 6.065 mg/cm3,and the diagnostic sensitivity and specificity were 65.6% and 91.9% respectively.Conclusion Spectral CT imaging can quantitatively assess the calcium concentration of thyroid nodules,which provides promising quantitative approach for distinguishing malignant thyroid nodules from benign nodules.

OBJECTIVETo observe the inhibitory effect of gefitineb on the proliferation and its inducing effect on the apoptosis of mouse I-10 Leydig testicular cancer cells in vitro.

METHODSWe treated I-10 Leydig testicular cancer cells of mice with gefitineb at 0, 1.25, 2.5, 5, 10, 20, and 40 µmol/L. Then we determined the inhibitory effect of gefitineb on the growth of the cells by MTT, detected their early and late apoptosis by Annexin V-FITC/propidium iodide double staining and Hoechst 33258 nuclear staining, respectively, and observed the expressions of apoptosis-related proteins Bcl-2, Bax and caspase 3/9 by Western blot.

RESULTSCompared with the blank control group, gefitineb significantly inhibited the proliferation of the I-10 cells at 10 and 20 µmol/L (P < 0.05). The survival rate of the cells was (32.4 ± 2.8)% (P < 0.01) and their early and late apoptosis rates were (26.7 ± 4.2)% and (59.33 ± 10.2)% in the 40 µmol/L group, significantly different from those in the control (P < 0.05 and P <0.01). In comparison with the blank control group, gefitineb at 10, 20, and 40 µmol/L increased the expression of pro-apoptotic protein Bax by (41.9 ± 7.1), (60.1 ± 9.8), and (69.0 ± 11.3)% (all P < 0.05), decreased that of apoptosis-inhibitory protein Bcl-2 by (50.3 ± 8.9), (63.9 ± 6.9), and (88.7 ± 13.9)% (all P < 0.05), and elevated that of the cleft proteins caspase-3 by (69.0 ± 6.9)% (P < 0.05), (71.5 ± 8.1)% (P < 0.05), and (110.9 ± 14.2)% (P < 0.01) and caspase-9 by (51.8 ± 4.9), (54.7 ± 6.7), and (43.8 ± 11.8)% (all P < 0.05).

CONCLUSIONGefitineb can increase the cytotoxicity of I-10 Leydig testicular cancer cells of mice and induce their apoptosis via the mitochondria-mediated apoptosis signaling pathway.

Animals ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; metabolism ; Caspase 3 ; metabolism ; Caspase 9 ; metabolism ; Cell Proliferation ; drug effects ; Cell Survival ; Leydig Cell Tumor ; drug therapy ; metabolism ; pathology ; Male ; Mice ; Neoplasm Proteins ; metabolism ; Neoplasms, Germ Cell and Embryonal ; drug therapy ; metabolism ; pathology ; Quinazolines ; pharmacology ; Testicular Neoplasms ; drug therapy ; metabolism ; pathology ; bcl-2-Associated X Protein ; metabolism

Objective: To investigate the feasibility of deep convolutional neural network (CNN) to classify the pathological type of sub-soild pulmonary adenocarcinoma of ≤3 cm based on CT images, and to visualize the medical imaging features derived from the activation area of CNN. Methods: A total of 200 sub-solid lung nodules, which were confirmed as adenocarcinoma by immunohistochemical staining, were classified as preinvasive lesions (including atypical adenomatous hyperplasia and adenocarcinoma in situ), microinvasive adenocarcinoma and invasive adenocarcinoma, in which 160 (80%) were used to train the inception v3 CNN architecture, and the other 40 (20%) were used to test the model and visualize the activation area. The characteristics of the activated area were defined as 14 CT signs. Results: The CNN yielded an accuracy of 87.5% to classify three categories of lung nodules. The visualization study found that the CNN activation area mainly focused on the non-solid component (43.0%) and smooth margin (20.2%) of the preinvasive lesions, on the spiculated margin (18.3%) of the microinvasive adenocarcinoma, and on the solid component (18.9%) and the spiculated margin (14.1%) of the invasive adenocarcinoma. Conclusion: CNN can classify the pathological type of lung adenocarcinoma based on CT images. The visualization of activation area of CNN indicates the medical imaging characteristics of diagnosis.

The buccoversion malpositon of maxillary second molars is one kind of common malocclusion.It can lead to damages to stoma-tognathic system.The adjustable maxillary molar retractor is an effective tool in the early treatment of this kind of malposition.

Objective To compare the effectiveness and safety of central venous catheters inserted from the left side and right side during peripheral inserted central catheterizations (PICC). Methods Totally 458 adult patients undergoing PICC between May 2007 and May 2008 were enrolled in this study and divided randomly into right-sided group (n = 228)and left-slded group (n = 230). Chest X-ray was performed immediately after catheterization to identify the initial tip locations. Other parameters were evaluated during follow-up. Results The rate of difficult insertion was significantly lower in right-sided group than in left-sided group (14.9% vs 24. 8% , P =0.003). The rate of tip projection angle ＞40°was also significantly lower in right-sided group (2.2% vs 23.4% ,P = 0. 000). The rate of tips reaching the central veins was not significantly different between two groups (54.4%vs 53.0% , P = 0. 538). Compared with right-sided catheters, the tip positions in the left-sided group was significantly less frequently located in the inferior segment of superior vena cave in the central tip locations (6. 6% vs 21.0% , P =0. 001)and more commonly positioned in the nominate vein in non-central tip locations (66. 7% vs 48.1% , P = 0. 008). In addition, the catheter detaining time (P = 0. 617), incidence of local phlebitis after puncture (P = 0. 561), catheter obstruction rate (P = 0. 774), and catheter-related infection rate (P = 0. 854)showed no significant differences between two groups. The incidence of swollen limb was significantly lower inright-sided group than in left-sided group (4. 4% vs 8.3%, P = 0. 043). Conclusions Right-sided catheters provide better outcomes than left-sided catheters. PICC through the right elbow veins should be preferred in clinical practices.

The disadvantages of Admas clasp include inconvenient manual adjustment and being unsuitable to the deciduous molars.The modified Admas clasp can overcome the shortcomings.

OBJECTIVE:To observe the efficiency and safety of budesonide,azithromycin combined with terbutaline in the treatment of infantile acute bronchitis. METHODS:150 children with acute bronchitis were randomly divided into control group(75 cases) and observation group(75 cases). All children were given electrolyte supplement,antiasthmatic,antispasmodic and other conventional treatment;based on it,control group was treated with 10 mg/kg Azithromycin injection,adding into 250 ml 5% Glu-cose injection,by intravenous infusion with time of more than 60 min,once everyday+2 mg Terbutaline sulfate spray solution,add-ing into 2 ml 0.9%sodium chloride injection,aerosal inhalation,twice a day,15 min for every times. Observation group was addi-tionally given 1.0 mg Budesonide aerosol;3 times a day,10 min for every times. The treatment course for both groups was 10 d. FEV1,MEF50,PEF before and after treatment,total effective rate and disappearance time of clinical symptoms,hospitalization time and incidence of adverse reactions were recorded. RESULTS:The total effective rate in observation group were significantly higher than control group,disappearance time of clinical symptoms and hospitalization time were significantly shorter than control group,the differences were statistically significant(P<0.05). After treatment,FEV1,MEF50 and PEF in 2 groups were significant-ly higher than before,and observation group was higher than control group,the differences were statistically significant(P<0.05);there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Based on conventional treament,budesonide,azithromycin combined with terbutaline is effective in the treatment of infantile acute bronchi-tis,and it can significantly improve lung function,with good safety.