Objective To investigate the influence of spleen aminopeptidase lyophilized powder on serum levels of transforming growth factor -β1 (TGF -β1),monocyte chemoattractant protein -1 (MCP -1),stromal cell derived factor 1 (SDF -1 )in pediatric asthma.Methods 128 patients with asthma were randomly divided into observation group(64 cases)and control group (64 cases).Two groups of children were given symptomatic treat-ment.The control group was orally administered montelukast,the observation group was treated with montelukast and splenic ammonia lyophilized powder for 3 months.The levels of TGF -β1,MCP -1,SDF -1 of the two groups were compared before and after treatment.Results After treatment,the asthma control test table (ACT)score,expiratoryvolume in one second (FEV1 )and peak expiratory flow rate (PEF)in the observation group were (24.25 ± 3.98)points (80.25 ±4.25)%,(7.25 ±0.69)L/min,which were significantly higher than those in the control group [(20.12 ±4.02)points,(75.02 ±3.96)%,(5.82 ±0.70)L/min,t =7.203,6.757,14.459,26.677,P <0.01].After treatment,the serum levels of TGF -β1,MCP -1,SDF -1 of the observation group were (42.23 ± 6.02)ng/mL,(48.56 ±3.96)pg/mL,(252.36 ±32.22)ng/L,which were significantly lower than those in the con-trol group [(42.23 ±6.02)ng/mL,(59.02 ±4.22)pg/mL,(425.25 ±40.62)ng/L,t =6.757,14.459,26.677,all P <0.01].Conclusion Montelukast combined with splenic aminopeptidase lyophilized powder for asthma can effec-tively reduce serum TGF -β1,MCP -1,SDF -1 levels and improve clinical symptoms and lung function,improve the treatment of children.

Objective To observe the clinical effect and side effect of Xiaozhitang combined with western medicine .Methods Eighty male patients with hyperlipidemia in our hospital was selected from January 2010 to January 2013 and divided randomly into observation group(n=40)and control group(n=40) .Patients in the control group received treatment with atorvastatin calcium (10 mg/d)while patients in the observation group were administrated with Xiaozhitang besides the routine measures .The values of total cholesterol (TC) ,triglyceride(TG) ,high density lipoprotein cholesterol(HDL‐C)and low‐density lipoprotein cholesterol(LDL‐C) serum creatinine(Scr) ,alanine transaminase(ALT) ,aspartate aminotransferase(AST) ,creatine kinase(CK)were assessed before and after 8 ,16 weeks treatment .Drug‐induced adverse effects were also observed .Results TC ,TG ,LDL‐C were (5 .87 ± 0 .89) , (1 .62 ± 0 .62) ,(3 .62 ± 0 .55)mmol/L in the observation group before treatment and significantly reduced after 16 weeks treatment [(4 .59 ± 0 .52) ,(1 .53 ± 0 .53) ,(2 .69 ± 0 .41)mmol/L](P<0 .05) .TC ,LDL‐C were(5 .88 ± 0 .91) ,(3 .78 ± 0 .43)mmol/L in the control group before treatment and also significantly reduced after 16 weeks treatment[(5 .01 ± 0 .49) ,(2 .97 ± 0 .27)mmol/L](P<0 .05)while TG remained unchanged during 16 weeks in the control group(P>0 .05) .The observation group achieved a significantly greater reduction in LDL‐C and TC than the control group (P<0 .05) .There was a significantly differences in adverse reaction(P<0 .05)but all could be well tolerated .The quality of life score of the observation group was significantly higher than that of the con‐trol group(P<0 .05) .Conclusion The Xiaozhitang combined with atorvastatin calcium could achieve a significantly greater reduc‐tion in lipid‐lowering effect than pure western medicine ,and it shows satisfactory safety and have less side effect .

BACKGROUND:There are many internal fixation methods for tibial plateau fractures with their own merit and demerit. Knee joint internal fixation for Schatzker type V and VI bicondylar tibial plateau fractures has better outcomes, but it is unclear about the specific difference in the repair of these two kinds of fractures.
OBJECTIVE: To observe the repair effects of metal implants insertedviaanterolateral and posteromedial knee joint approach on Schatzker type V and VI bicondylar tibial plateau fractures.
METHODS: From January 2009 to December 2012, 67 patients with Schatzker type V and VI bicondylar tibial plateau fractures were admitted at the Department of Orthopedics, Beijing Changping Hospital, China, including 38 cases of Schatzker type V and 29 cases of Schatzker type VI. Al these patients underwent internal fixation with metal implantsvia the anterolateral and posteromedial knee joint approaches. During the folow-up, differences in fracture healing and functional recovery between the two groups were observed.
RESULTS AND CONCLUSION: The wounds of al patients after active treatment were healed. By the last folow-up, Schatzker VI patients had better outcomes than Schatzker V patients in the aspects of varus-valgus scores, Rasmussen radiology scores, flexion and extension scores, joint range of motion, joint stability scores and good rate of knee joint function (P < 0.05). In addition, there were insignificant differences in colapse, condyle widening scores, ability to walk, knee pain scores, fracture healing time, and incidence of complications between the two groups (P > 0.05). Schatzker V patients showed better recovery of the articular surface and reliable internal fixation. These findings indicate that the internal fixation viathe anterolateral and posteromedial knee joint approaches has better clinical efficacy in the treatment of Schatzker type V bicondylar tibial plateau fractures than Schatzker type VI bicondylar tibial plateau fractures.

BACKGROUND:Decidua tissue is one of the most important sources of endometrial stem cel s, from which stromal stem cel s can differentiate into various kinds of cel s under contain inductions. OBJECTIVE:To observe the differentiation of endometrial stromal stem cel s isolated from early-pregnancy decidua into endometrial epithelial cel s. METHODS:Endometrial stromal stem cel s from early-pregnancy decidua were cultured, identified and directional y induced. Then induced cel s were randomized into test group cultured in conditioned medium and control group cultured in normal culture medium containing fetal bovine serum. Expression of keratin was detected by immunofluorescence assay and western bolt assay in the two groups. RESULTS AND CONCLUSION:The endometrial stromal stem cel s from early-pregnancy decidua were successful y isolated and cultured, and presented with a S-shaped curve. Within 1-48 hours after inoculation, cultured cel s were in the adaptation phase;then, the cel s proliferated rapidly and began to grow logarithmical y at 48 hours after culture;after 60 hours of culture, the cel growth rate decreased, with a steady rise in the cel curve. Results from the flow cytometry detection showed that the endometrial stromal stem cel s could express CD73 and CD90, but not express CD34, CD45 and cytokeratin. Immunofluorescence findings showed the expression of keratin negative in the control group, and mostly positive in the test group. Besides, the relative expression of keratin in the test group was significantly higher than that in the control group (P<0.05). These results suggest that the endometrial stromal stem cel s can be isolated from the human decidua in early pregnancy, and differentiate into endometrial epithelial cel s by directional induction.

The acute respiratory distress syndrome,a common severe case,can cause life-threaten multiple organ failure.Statins has been clinically applied in prevention of cardiovascular diseases and cerebrovascular disease.Previous studies indicate that statins can modulate inflammatory responses.In this paper,we discussed the mechanisms of statins,mechanisms and application of statins in acute lung injury and acute respiratory distress syndrome,and the effectiveness and safety of statins.

Objective To study the effects of metformin on the blood glucose (BG), insulin (Ins), serum plasminogen activator inhibitor-1 (PAI-1) and blood lipid levels in diabetic patients. Methods Clinical data of 124 cases of diabetic patients admitted between Jan. 2010 and Dec. 2012 were retrospectively analyzed. The diabetic patients were randomly divided into the observation group (62 cases) and control group (62 cases). Patients in the observation group were treated with metformin, while the control group underwent Gliclazide sustained-release tablets treatment. Changes in BG, Ins, PAI-1 and blood lipid levels of the two groups were observed, and the contrast analysis was carried out. Results The BG, Ins and PAI-I levels of the observation group was significantly lower than that of the control group, and the differences were statistically significant (P<0.05).The cholesterol, triglyceride and low density lipoprotein cholesterol levels of patients in the observation group were significantly lower than that of the control group, and the differences were statistically significant (P<0.05). Standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD) and percentage of adjacent NN intervals in a 24 hour recording which differ by at least 50 ms (PNN50) of the observation group were significantly higher than that of the control group, and the differences were statistically significant (P<0.05). Conclusions Metformin can effectively control the BG, Ins, PAI-1 and blood lipid levels of diabetic patient and improve the SDNN, RMSSD and PNN50, which is very favorable for the patients. Along with good safety, Metformin is suitable for clinical recommendation.

Recently,alveolar recruitment maneuver is one of effective management of mechanically ventilated patients with acute respiratory distress syndrome.Recruitment maneuvers are widely used in clinical practice to open the lung and prevent lung injury by derecruitment,improving the compliance,increasing PaO2,increasing the PaO2/FiO2 ratio,and reducing the pulmonary shunt fraction,although the evidence is still discussed.This review discussed recruitment maneuvers in pediatric patients with acute respiratory distress syndrome.

Objective:To improve the hospital degree of attention to SPECT quality control. Methods: To introduction the basic principle and test methods of the Brightview produced by Philips company, and to analyze some common troubles.Results: According to understanding the working principle, parameter testing, maintenance and troubleshooting, to master quality control method.Conclusion: The quality control of the SPECT is the demand of UM workers. To master the test methods, improve the quality of medical imaging, minimize unnecessary exposure and serve the patients better.

BACKGROUND:High expression of CD4+CD25+ regulatory T cels is proved to exist in many patients with malignant tumors in vivo. Recent studies have found that CD4+CD25+OBJECTIVE:To analyze the characteristics of expression of CD4 regulatory T cels also show a high percentage of expression in the peripheral blood of patients with acute myeloid leukemia.+CD25+METHODS:Ninety-two patients with newly diagnosed acute myeloid leukemia were enroled and divided into middle-young age group (< 60 years old,n=22) and aged observation group (> 60 years old,n=70). Thirty-two patients in the aged observation group underwent standardized chemotherapy and showed complete remission, who acted as complete remission group; and the remaining 38 patients acted as aged group, including 6 cases of M2, 19 cases of M3, 7 cases of M4, and 6 cases of M5 according to FAB classification. At the same period, another 42 healthy persons for hospital examination were selected as control group. Peripheral blood samples were extracted to detect the expression of CD4 regulatory T cels in aged patients with acute myeloid leukemia.+CD25+RESULTS AND CONCLUSION:The proportions of CD4 regulatory T cels.+CD25high FOXP3+ Treg cels and CD4+FOXP3+ T cels in the aged and complete remission groups were higher than those in the control group (P < 0.01), and moreover, these two proportions were higher in the aged group than the complete remission group (P < 0.01). The proportions of CD4+CD25high FOXP3+ Treg cels and CD4+FOXP3+ T cels in the aged group were higher than those in the middle-young age group (P < 0.01). There were no difference in the proportions of CD4+CD25high FOXP3+ Treg cels and CD4+ FOXP3+T cels among different subgroups of the aged group (P > 0.05). The proportion of CD4+CD25high FOXP3+Treg cels in the peripheral blood was positively related to the proportion of CD4+FOXP3+ T cels in aged patients with acute myeloid leukemia (r=0.87,P=0.019). The proportion of CD4+CD25+ Treg cels in the aged patients with newly diagnosed acute myeloid leukemia is higher than that in healthy individuals and young patients with acute myeloid leukemia.

Transcranial doppler (TCD) was used to measure the flow velocities of middle cerebrial artery (MCA) in 4 patients of clinical brain death. The reaults showed that the changes were similar in all the patients studied; 1) the dierotic notch (DN) was deeper in the spectrum of flow velocities of MCA, end diastolic flow rate (VD) significantly decreased, and the pulastility index (PI) increased ; 2) VD decreased progressively; 3) all patients showed characteristic to-and-fro TCD pattren with antegrade flow in systole and retrograde flow in diastole; 4) the pattern totally disappeared when the patients were claimed dead. It is found that TCD is valuable for the determination of brain death.