Objective To evaluate the therapeutic effect of Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation for acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 86 patients with acute exacerbation of COPD were enrolled and randomly divided into a salmeterol/fluticasone group (41 patients) and a combined treatment group (45 patients). The salmeterol/fluticasone group was treated by salmeterol/fluticasone inhalation, and the combined treatment group by Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation. Serum C-reactive protein (CRP) was detected by a immunonephelometric assay, and Toll-like receptor 9 (TLR9) in hemocytes was detected by flow cytometry. The score of the syndromes in traditional Chinese medicine (TCM), such as cough, sputum, gasping and shortness of breath, as well as pulmonary function and therapeutic effect were evaluateds. Results After the treatment, the serum C-reactive protein in the combined treatment group was significantly lower than that in the salmeterol/fluticasone group (4.3 ± 1.2 mg/L vs. 8.4 ± 2.5 mg/L;t=5.417, P<0.01), and the TLR9 expression was significantly higher (1.9 ± 0.7 vs. 1.6 ± 0.4;t=3.418, P<0.05). The scores of the syndromes in TCM, such as cough (1.7 ± 0.6 vs. 3.8 ± 1.1;t=2.859, P<0.05), sputum (1.6 ± 0.4 vs. 3.9 ± 1.2;t=3.027, P<0.05), gasping (1.2 ± 0.5 vs. 3.4 ± 1.3;t=3.416, P<0.05) and shortness of breath (1.5 ± 0.7 vs. 3.7 ± 1.6;t=3.468, P<0.05) in the combined treatment group were significantly lower than those in the salmeterol/fluticasone group. The forced expiratory volume in first second (75.4 ± 5.8 L vs. 62.8 ± 6.9 L;t=3.526, P<0.05) and the percentage of forced expiratory volume in first second to forced vital capacity (85.7%± 10.3%vs. 71.9%± 15.4%;t=5.648, P<0.01) in the combined treatment group were significantly higher than those in the salmeterol/fluticasone group. The time to symptoms alleviated (3.4 ± 0.7 d vs. 5.6 ± 1.2 d; t=3.256, P<0.05) and the use dose was (1.8 ± 0.2) ×103μg vs. (5.3 ± 0.4)×103μg, and use times of salmeterol/fluticasone (7.4 ± 1.3 vs. 16.5 ± 3.4;t=4.574, P<0.05) in the combined treatment group were significantly decreased than those in the salmeterol/fluticasone group. The total effective rate in in the combined treatment group were significantly decreased than those in the salmeterol/fluticasone group (84.4% vs. 73.2%; χ2=4.519, P<0.05). Conclusion Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation can improve the pulmonary function in patients with acute exacerbation of COPD, its effiency is suppior to salmeterol/fluticasone inhalation alone.

Biliary atresia(BA) is a serious digestive system disease caused by the obliteration of intrahepatic and extrahepatic biliary system of infancy.Without prompt treatment,BA can cause biliary cirrhosis,and ultimately cause liver failure,leading to death.The early diagnosis of BA is crucial to the early treatment.At present,liver biopsy is considered to be the gold standard of diagnosis of BA,but this method has some shortcomings such as invasive,repeated sampling and subjectivity.In contrast,ultrasonography (US),magnetic resonance imaging (MRI) and hepatobiliary scintigraphy(HBS) gradually play important roles in clinical diagnoses of BA and become the hotspot of BA diagnoses.This paper focuses on reviewing the clinical applications of BA imaging diagnoses and the latest research progress.

Objective:To screen the high performance,specific and nontoxic anti HBV antisense oligonucleotide fragment.Methods:Taking 2.2.15 cells as cell model,the antisense oligodeoxynucleotides(ASON)toward the HBV regulation genesenhancerⅡ(HBV EFⅡ)were designed and synthesized.The role played by ASON in inhibiting the secretion and expession of HBsAg and HBeAg by the host cells was detected by ELISA method.The effect of ASON on prolifezation and metabolism of the cells was detected by MTT method.Results:The inhibitory rate of HBsAg by ASON was 92% and 75%,respectively,indicating that itsdifference from that of noncomplementary sequence control group(inhibitory rate was 11%)had considerable statistical significance( P 0.05).Conclusion:ENⅡ is one of the most important target oriented sequencial selective regions of research on anti HBV nature of antisense oligonucleotide.

Objective To investigate the clinical application of examination of specific IgG4 to food allergens.Methods Specific IgG4 as well as specific IgE to ten kinds of food allergens in sera of 51 patients with chronic eczema was examined by ELISA.Results Food allergen specific IgG4 was positive in 35 patients (68.6%) and food allergen specific IgE was positive in 45 patients(88.2%)of the 51 cases (P

Objective To explore the mechanism of immune tolerance in chronic B hepatitis, the effects of HBV infection on the functions of macrophages and related mechanism of signal transduction by transfection in vitro were studied. Methods Peritoneal macrophages of mice were isolated regularly and cultured, transfected transiently with pcDNA3-HBV or pcDNA3 plasmid DNA and cultured under the stimulation of LPS. After 72 h, RT-PCR was performed to detect the expression of PreS1, TNF-? or IL-1? mRNA. To detect the expression of NF-?B RelA protein by FCM, and the level of nitric oxide in cultural supernatant was measured with Griess reaction. Results After being transfected with pcDNA3-HBV,peritoneal macrophages had the expression of PreS1 mRNA, but have lower level of TNF-?、IL-1? mRNA and transcriptional factor NF-?B, compared with pcDNA3-transfected control group; the level of nitric oxide in pcDNA3-HBV group was also decreased. Conclusions Transient transfection of pcDNA3-HBV could decrease the function of macrophages directly by inhibiting NF-?B activity and effector molecules production, which may be one of the mechanisms of immune tolerance in chronic B hepatitis.

0.05).The C myc and N ras protein expression of 2.2.15 were reduced after ASONs were used 3 days.There was a significant difference between ASON group and control group ( P

Objective To explore the mechanism of effects of cardiac sympathetic anesthesia on left ventricular ejection fraction(LVEF) and left cardiac cavity size of patients with dilated cardiomyopathy.Method 121 consecutive patients with dilated cardiomyopathy were divided into cardiac sympathetic nerve blockade group(TEA group) and control group(c group).In TEA group,5％ lidocaine was injected into thoracic epidural cavity for about 4 to 8 weeks in addition with routine therapy.In c group,only routine therapy was used.We observe the changes of LVEF and left cardiac cavity size before and after treatment in both groups. Result In TEA group,after anesthesia,LVEF was increased from(31.3± 12.8) to(47.3± 21.3),P<0.001;left ventricular end－ diastolic diameter was reduced from(69.1± 7.1)to (65.1± 8.0),P<0.001;left atrial diameter was decreased from(44.0± 6.2)to(39.4± 7.2),P< 0.001. Conclusion Cardiac sympathetic anesthesia can effectively improve the ejection performance of dilated cardiomyopathy and make the dilated cardiac cavity turn to normal level.

Aiming at the existing problems in the teaching hospital,teachers and practical students during clinical practice teaching,we explored actively in talent training and teaching base construction and promoted the improvement of clinical practice ability for medical students.

Objective To observe the changes of serum calcium, phosphorus, calcium-phosphorus product and para-thyroid hormone(PTH)levels after treatment with different concentrations of calcium dialysate in combination with calcitri-ol. Methods Thirty-six patients on maintenance hemodialysis were randomly divided into Dca1.25 group and Dca1.5 group, 18 cases in each group. Patients took different doses of calcitriol on the different values of PTH basis. Changes of se-rum calcium, phosphorus, calcium-phosphorus product,PTH and bone alkaline phosphatase (BAP) levels were recorded re-spectively on four time points from prior treatment and 1, 3 and 6 months of therapy. The levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also observed. Results There was an interaction between treatment effects and time effects in serum calcium, phosphorus, calcium-phosphorus product levels in two groups (P＜0.05). With the dura-tion of treatment, there was a trended to decrease and increase respectively in DCa 1.25 group and DCa 1.5 group, and trend-ed to stabilize for therapy 3 to 6 months. There was no interaction between serum PTH and BAP levels and time effects in two groups. There was no statistical difference in simple treatment effects and time effects. The serum PTH level showed a trend of increase gradually in DCa1.5 group with the duration of treatment. In DCa 1.25 group, the serum PTH level trended to stabilize after 3-month therapy and showed a trend of decrease gradually. There was an interaction between treatment effects and time effects in SBP in two groups, but no interaction in DBP. There was a significant difference in SBP before and after treatment in two groups. The level of SBP reduced tardily with time of treatment and reduced significantly after 3 and 6-month therapy. Conclusion The application of DCa1.25 dialysate in combination with calcitriol decreased serum calci-um effectively and kept the lower limit of normal value, which increased tolerability of active vitamin D and calcium carbon-ate therapy, and decreased SBP in maintenance hemodialysis patients.

Objective To explore the predictive value of serum CEA and cytokeratin-19 fragments (CYFRA21-1)prior treatment for the epidermal growth factor receptor (EGFR) mutation and efficacy of tyrosine kinase inhibitors ( TKI ) in patients with non-small cell lung cancer.Methods The study was a clinical research.Totally 101 matched tissue and plasma samples were collected from Peking University People′s Hospital from 2012 to 2013.All clinical specimens were analyzed for EGFR mutations in exons of 18, 19, 20 and 21 by ADx-ARMS and direct sequencing, and the serum levels of CEA and CYFRA21-1 were analyzed by ECLI.The correlation between EGFR mutant status and efficacy of EGFR-TKI and clinicopathological parameters were analyzed by χ2 test, Log-rank text and Cox proportional hazards regression model.Results The mutation rate was 60.4%(61/101) by ADx-ARMS and 33.7%(34/101) by direct sequencing.Mutations were more frequently observed in the higher serum CEA level patients(≥5μg/L,78.8%).However, the rates of EGFR mutations of different CEA levels were similar.Among the patients receiving TKI therapy, the efficacy of EGFR-TKI was closely related to serum CYFRA21-1 level prior treatment and EGFR mutation (χ2 =8.903, P =0.003; χ2 =28.590, P <0.001 ).And serum CYFRA21-1 level prior treatment and EGFR mutation were independent factors for EGFR-TKI treatment affecting PFS (RR=0.298, P<0.001;RR=0.086, P<0.001).Conclusion The mutation rate of EGFR was significantly related with the expression level of CEA prior treatment, and serum CEA and CYFRA21-1 levels prior treatment could be potential predictors of EGFR-TKI efficacy.