Objective To compare the clinical efficacy and safety between cyclosporine A combined with low-dose hormone and progestin hormone combined cyclophosphamide( CTX) in the treatment of idiopathic membra-nous nephropathy( IMN) .Methods 42 patients with IMN were randomly divided into group A and group B according to a random number table,21 cases in each group.On the same basic treatment,group A was given adequate glucocor-ticoid and CTX therapy,group B was given small doses of hormones combined with CsA.24hUpro,CR,ALT,ALB and GLU of the two groups at before treatment and 3 months,6 months,12 months after treatment were compared.And the complete remission rate,partial remission rate, relapse rate and adverse reactions in the two groups were also com-pared.Results The indicators of the two groups before treatment showed no significant difference,and 24hUpro of group A was (5.3 ±2.1)g/L,ALB was (21.8 ±8.1)g/L,while 24hUpro of group B was (5.4 ±2.3)g/L,ALB was (20.3 ±7.5)g/L,and 3 months of treatment,24hUpro was significantly decreased significantly and ALB increased in the two groups,24hUpro of group A was (3.2 ±1.2)g/L,ALB was (27.9 ±7.6)g/L,24hUpro of group B was (3.5 ± 1.3)g/L,ALB was (26.4 ±8.1)g/L.24hUpro showed a gradual downward trend(F=5.216,P<0.05),ALB showed a gradual upward trend(F=5.864,P<0.05).At different time points,the overall response rate between the two groups was no significant difference(P>0.05).The recurrence rate was 9.5% in group A,group B recurrence rate was 14.3%,which has no significant difference(P>0.05).The occurrence rate of adverse reactions of group A was 23.8 %and 28.6%in group,the difference between the two groups was not statistically significant(P>0.05). Conclusion The treatment of progestin hormone combined CTX has similar efficacy with CsA,and in clinical treat-ment,develop individualized treatment programs can be chosen according to the specific circumstances of the patients.

Uveitis is mainly T helper cells (Th)-mediated autoimmune disease.It is one of the common eye diseases causing blindness.Dendritic cells (DCs),which are now known as the most potential professional antigen presenting cells (APCs),and can stimulate naive T-cell activation effectively.DCs are believed to be the initial factor of the immune response,which play an important role in autoimmune disease,transplantation rejection and regulation of immune homeostasis.DCs are considered to be the initial cells to cause uveitis,and may be a key factor in pathogenesis and development of uveitis.In recent years,studies have shown that DCs can interact with a variety of immune cells,regulate the balance of Th1,Th2 and Th17,induce immune tolerance and adjust the process of uveitis.The role of DCs in uveitis is attached great importance.In this paper,the basic biological characteristics of DCs or in uveal tissue,the current knowledge on the regulation mechanism of DCs in uveitis and its clinical application prospects were reviewed.

With the current trend of globalization, unprecedented opportunities and enormous changes have emerged for the global development of traditional Chinese medicine (TCM). However, many old and new challenges and problems still remain, including partial or limited comprehension of acupuncture, oriental medicine and TCM, the existence of non-standardized institutes of TCM and acupuncture training schools, unqualified TCM practitioners, and problems concerning Chinese herbal medicine and inexperience in conducting TCM business. These problems will doubtlessly impede the further development of TCM worldwide in the foreseeable future. It is also clear that the globalization of TCM will require a large scale systematic project and constitute an arduous historical task. This paper aims to consolidate 6 strategic development modes to reinforce and facilitate the process of TCM globalization through a detailed analysis of both the present status and existing problems concerning the development of TCM in the United States.

OBJECTIVE: Recent studies of mental health status in undergraduates are reviewed by literatures in mental health standard, measurement and influential factors. It is aimed to analyze the current status of mental health in undergraduates and provide references for related research of mental health, psychological counseling and psychological health in undergraduates. DATA SOURCES: The China Journal Full-text Database (CJFD) and Wanfang database were undertaken to id entify related articles published from January 1995 to August 2005 with the key words of "psyche of undergraduate, mental health, health standard" in Chinese. References of retrieved articles were searched. Mental health related books were retrieved such as Health Psychology, Psychic Health Measurement and so on.STUDY SELECTION: The data were selected primarily, and related articles of mental health standard, measurement and influential factors were included. Studies unrelated to undergraduates were screened out, and fulltexts of the other literatures were looked up.DATA EXTRACTION: A total of 40 articles of mental health standard,measurement and influential factors in undergraduates were selected, of which 17 articles accorded with topic and content were collected. There were 4 articles of mental health standard, 6 literatures (listing 6 types and 20 kinds of questionnaires and tests) of measurement and 7 literatures (6articles) of influential factors.DATA SYNTHESIS: Main content of mental health was intellective health, emotional health and spiritual health. ①No mental health standard was authorized and generally accepted in internal and external studies at present. The four signs of mental health designed by World Psychiatric Association (WPA) were praised and identified, which were harmony of body,intelligence and emotion; adaptation of the environment and modesty in each other; well-being; bringing ones ability into full play and living effective living. Mental health standard of Chinese undergraduates was composed of normal cognition, good emotion, perfect personality, coordinated interpersonal relation and appropriate self-consciousness. ②Present commonly used-mental health measurement for undergraduates was various, but there still was some disadvantage. Big Five Questionnaire (BFQ) and University Personality Inventory (UPI) were commonly used at abroad. Symptom Checklist-90 (SCL-90) was commonly used at home. ③Major factors influencing mental health of undergraduates were family, environment, age,sex, school, subject, religion and so on, and speciality had obvious effect on mental health of undergraduates.CONCLUSION: The importance of mental health of undergraduates is realized gradually by scholars, and more and more scholars at home and abroad study the mental health of undergraduates. How to design exact mental health standard and precise mental health measurement for undergraduates deserve further investigation. Meanwhile, it is necessary to deeply analyze the correlation between speciality and mental health of undergraduates.Fan BB, Zhang CH.Standard and evaluation of mental health in undergraduates.

Objective To compare the result of different method of airway humidification in cerebral infarction patients after tracheotomy. Methods 60 cerebral infarction patients after tracheotomy were divided into experiment group and control group randomly. 0.45% normal sodium was dropt with infusion pump consistently to humidify airway in experiment group and liquid was dropt with injector every 30 ～ 60 minutes in control group. Cough, sputum crusts,mucosa bleeding and pulmonary infection were compared between two groups. Result Therapeutic effect of experiment group was significantly better than control group (P ＜ 0.05). Conclusion 0. 45% normal sodium been dropted with infusion pump consistently to humidify airway could reduce the incidence of sputum crusts and pulmonary infection, prevent cough and mucosa bleeding obviously.

AIM: To investigate the antimicrobial activity of linezolid,vancomycin and other antibacterials against 111 methicillin resistant staphylococcus aureus.METHODS: Broth dilution method was used to determine the minimum inhibitory concentrations(MICs) of linezolid,vancomycin and other antibacterials against 111 methicillin resistant staphylococcus aureus identified by cefoxitin.RESULTS: The resistant rates of 111 MRSA to ?-lactam,erythromycin,aminoglycosides(netilmicin and gentamycin),fluoroquinolones(gatifloxacin,moxifloxacin and levofloxacin) and chloromycin were 100%,92.8%,99.1%,91.9%-99.1%,3.6%.All 111 MRSA were sensitive to linezolid and vancomycin,and MIC50 and MIC90 of vancomycin were 0.5 and 1 ?g/mL,MIC50 and MIC90 of linezolid were 2 ?g/mL.CONCLUSION: 111 MRSA were resistant to most antibacterials including ?-lactam,erythromycin,aminoglycosides and fluoroquinolones.Linezolid and vancomycin have strong antimicrobial activity against MRSA.

Objective To study the influence of valsartan combined with indapamide on the UmAlb level and blood pressure in patients with hypertension and diabetes mellitus.Methods 90 patients with hypertension and diabetes mellitus were selected and randomly divided into three groups by number table.30 cases of the control group A were treated with indapamide,30 cases of the control group B were treated with valsartan,30 cases of the observa-tion group were treated with indapamide combined with valsartan.After treatment,the clinical parameters and effect of the three groups were compared.Results After treatment,the systolic blood pressure and diastolic blood pressure of the three groups were decreased(all P <0.05),and the observation group decreased obviously(all P <0.05).The total effective rate of the observation group was 96.7%,which was higher than 86.6% of the control group A and 83.3% of the control group B(χ2 =4.1 2,4.22,all P <0.05).Conclusion In the treatment of hypertension and diabetes,the antihypertensive effect of indapamide combined with valsartan is obvious and can protect the renal func-tion,which should be promoted in clinical use.

The main pathological change of Alzheimer’s disease (AD) was the formation of senile plaques (SP) induced by the abnormal accumulation ofβ-amyloid protein (Aβ). Blood-brain barrier (BBB) can regulate the Aβ metabolism in the brain through relevant transporter to complete the across BBB transport. This paper introduced two main transporters, which were the receptor for advanced glycation end products (RAGE) and the low density lipoprotein receptor-related protein-1 (LRP-1) in BBB for the elucidation of neuronal cell toxicity induced by inflammatory factors from Aβ accumulation within the brain. It further explored the regulation on two transport proteins, which were RAGE and LRP-1 in BBB for the reduction of abnormal accumulation of Aβ, relieving of inflammation in the brain, and protection of cerebral neurons by traditional Chinese medicine (TCM).

Objective To observe the sedative effects and analyze the cost-benefit of dexmedetomidine and midazolam for severe patients undergoing mechanical ventilation (MV) in intensive care unit (ICU). Methods A prospective randomized controlled trial was conducted. Eighty patients undergoing MV (24 hours < time of MV < 72 hours) with tracheal intubation and necessity of analgesic therapy in ICU from January 2014 to October 2014 in Affiliated Hospital of Guiyang Medical College were divided into midazolam group (39 cases) and dexmedetomidine group (41 cases) by random numerical table method. Both groups used intravenous continuous pump infusion of fentanyl 0.7 - 1.5μg·kg-1·h-1 as an analgesic therapy. The analgesic goal was critical care pain observation tool (COPT) score kept at 0 - 3, and the score was taken once per hour; when COPT score > 4, 0.5μg/kg fentanyl was added, when the analgesic goal was reached, the sedative treatment was given. In midazolam group, the patients received midazolam whose loading dose was 0.05 mg/kg intravenous injection (IV) in 2 minutes, followed by continuous IV pump infusion 0.03 - 0.30 mg·kg-1·h-1. In dexmedetomidine group, the patients received dexmedetomidine whose loading dose was slowly intravenous pump infusion of 0.5 - 1.0μg/kg, followed by continuous pump IV infusion of 0.2 - 0.7μg·kg-1·h-1; the sedation goal was richmond agitation-sedation scale (RASS) at 0 - 2, the score being taken once per hour, and as RASS > 0 point, the dosage of sedative was increased, and as RASS < -2, the dosage of sedative was reduced or discontinued. During the course of study, the heart rate (HR), blood pressure, the amount of sedative and analgesic used, duration of MV, extubation time, ICU stay time, total costs of sedative and fentanyl drugs, total ICU treatment costs and adverse reactions of patients were observed.Results Compared with midazolam group, the total amount of sedative used (mg/kg: 0.03±0.01 vs. 3.35±1.39), the dose of sedative used per hour (μg·kg-1·h-1: 0.66±0.13 vs. 59.78±19.44), the dose of fentanyl used (μg·kg-1·h-1: 0.40±0.21 vs. 0.57±0.26), the total costs of fentanyl used per hour (yuan: 1.41±0.86 vs. 2.00±0.84), the total costs in ICU per hour (yuan: 264.42±99.55 vs. 297.80±138.70) in dexmedetomidine group were significantly less (allP < 0.05); compared with midazolam group, the total costs of sedative in dexmedetomidine group was significantly higher (yuan: 8.97±5.05 vs. 7.78±4.22); the duration of MV [hours: 43.58 (39.83, 53.58) vs. 58.58 (46.17, 65.50)], extubation time [hours: 1.00 (1.67, 0.58) vs. 3.67 (2.00, 5.50)] and the time for staying in ICU [hours: 57.25 (47.33, 67.37) vs. 75.58 (64.67, 90.83)] were significantly shorter in dexmedetomidine group (allP < 0.05); the incidences of adverse reactions in dexmedetomidine group were significantly higher [hypotension: 29.27% (12/41) vs. 7.69% (3/39), bradycardia: 24.39% (10/41) vs. 5.13% (2/39), bothP < 0.05]; the incidence of delirium in dexmedetomidine group was lower [2.43% (1/41) vs. 15.38% (6/39),P < 0.05].Conclusion For ICU patients, dexmedetomidine is an ideal effective sedative, as it may shorten the duration of MV, the time for extubation, the period staying in ICU, reduce the dosage of analgesic used and the cost of treatment in ICU.

BACKGROUND:Clinical studies have shown that early use of methylprednisolone can promote neurological functional recovery, reasonable initial dose, interval time and treatment duration are the key to the methylprednisolone treatment of acute spinal cord injury. OBJECTIVE:To observe the differential protein expression profile in spinal cord tissue after intrathecal injection of high-dose methylprednisolone was given in rat model of acute spinal cord injury. METHODS:Eight Sprague-Dawley rats were included in this study to establish acute spinal cord injury model and the models were randomly divided into two groups, receiving intrathecal injection of methylprednisolone 7.5 mg/kg at 0 and 8 hours after modeling. The injured spinal cord tissue was harvested after 24 hours of injection. The differentialy expressed proteins and nerve regeneration-related differential proteins in two groups were analyzed using isotope labeling and quantitative technical analysis. RESULTS AND CONCLUSION: Totaly 87 differentialy expressed proteins were identified in this study. Compared with 0 hour group, there were 43 up-regulated differential proteins and 44 down-regulated differential proteins in the 8-hour group. Eighteen differential proteins were related to neural regeneration, including 8 up-regulation proteins and 10 down-regulation proteins. OMgp as a potential neural axon growth inhibitory factor specificaly bound with NgR/P75/TROY/Lingo-1 to form receptor complexes and activated RhoA through the second messenger cAMP, thus inhibiting the colapse of axon growth cone. Folowing intrathecal injection of methylprednisolone for treatment of acute spinal cord injury in rats, differential proteins and nerve regeneration-related factors in spinal cord are identified and analyzed for protein database retrieval and protein function analysis, their expression may serve as the indicator of monitoring nerve regeneration after acute spinal cord injury.