Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome caused by liver damage factors except alcohol and has the major feature of diffuse macrovesicular hepatocyte steatosis.Thetwo-hit hypothesis can partly explain the pathogenesis of NAFLD.Recent studies have found that ceramide is a key molecular messenger involved in the development and progression of NAFLD,and as a sphingolipid,it is closely associated with the two-hit hypothesis.This article reviews the role of ceramide in NAFLD.

Objective To investigate the clinical and imaging features of aortic dissection(AD) with damage in nervous system.Methods The clinical data were retrospectively analyzed in 14 cases of AD with damage in nervous system.Results 13 patients(92.9%) were over age 40.All cases were acute onset and 9 cases had history of hypertensive disease.During onset,the blood pressure was elevated in 9 cases,decreased in 3 cases and could not be measured in 2 cases.The clinical manifestations of patients presented severe pectoralgia in 5 cases,chest-back complaint in 4 cases,bellyache,lumbago with emesia in 2 cases,shock in 2 cases.The appearances of nervous system:circumgyration in 5 cases,conscious disturbance in 4 cases,hemiparalysis in 2 cases,barylalia in one case,paraplegina in 2 cases and hypesthesia in 3 cases(meta-body in 1 case,below T 4 or T6 in 2 cases).The breast and abdominal part CT and CTA of all cases showed clearly the true and false lumens,the position of intimal slit(according Debakeys,2 cases were typeⅠ,7 cases were typeⅡ,5 cases were type Ⅲ) and mural thrombosis.The breast and abdominal part MRI in 8 cases could show conspicuous true and false lumens.The true lumen was presented flow and inane signals but the false lumen was presented higher signals in T1 and T2 WI.Conclusions The clinical manifestations of AD with damage in nervous system are main the ischemic impaired symptoms and signs of brain and spinal cord.Both CT and MRI can show the false lumen and vascular intimal slit of AD.

Objective:To investigate the effects of pristimerin therapy on the functions of Th17 and Treg cells in patients with allergic asthma,and expore the function of immune factors in therapy on allergic asthma. Methods:Extracted mononuclear cells in pe-ripheral blood of patients with allergic asthma,and given pristimerin intervention in vitro. Then used fluorescence-activated cell sorting analysis to detect the contect of Th17 and Treg,enzyme-linked immunosorbent assay to detect cytokine production of IL-17 and TGF-β, and Real-time PCR to detect the contect of RORγT and Foxp3. Results: Compared with the control group, experimental group had reduced expression of CD4+IL-17+T cells ( Th17 cells) ,and increased expression of CD4+CD25+Foxp3+T cells ( Treg cells) ,which all had the statistical significance (P<0. 05);displayed decreased level of IL-17,and increased level of TGF-β,which all had the statistical significance (P<0. 05);had reduced expression of RORγT,and increased expression of Foxp3,which all had the statistical significance (P<0. 05). Conclusion: Pristimerin therapy can remit the unbalance of Th17/Treg in vitro,hinting this drug may regulate allergic asthma by influencing immunologic balance,which offers the theoretical support for pristimerin in clinical application.

OBJECTIVE:To explore the new method for clinical pharmacists training,and provide reference for improving the quality of clinical pharmacists training. METHODS:Based on the full-awareness of Definition and characteristics of stage-progres-sive learning(SPL)and problem-based learning(PBL)teaching method,SPL-PBL teaching method was used in the teaching of the-oretical and clinical practice in the process of students training in clinical pharmacist training base. The teaching course of theoreti-cal knowledge was mainly SPL in first half and PBL in another half. While in the clinical practice teaching of ward rounds,check-ing doctor's advice,participation in the development of treatment programs and case discussion,PBL was mainly used interspersed by SPL;SPL was mainly in inquiry,pharmaceutical care and medication education interspersed by PBL. RESULTS:SPL-PBL teaching method had not only effectively aroused the enthusiasm of the students'learning,enhanced the sense of responsibility and improved their clinical professional knowledge and practice ability,but also strengthened the cultivation of students communication ability,document retrieval ability,writing communication ability and self-learning ability(four abilities) to make students more quickly into the role and improve their subjective initiative. CONCLUSIONS:Practice has proved that the SPL-PBL teaching meth-od not only gives consideratin to the inndividual differences among studengts,but also mobilizes the enthusiam,and not only gives consideration to the teaching about basic theoretical knowledge,but also strengthens the training for clinical thingkig andfour abili-ties,wich can be used for the clinical pharmacists training. Meanwhile,SPL has expanded the aplication surface of PBL beacuse that SPL has reduced the requirements of PBL for overall qulity. However,it needs to be improved because of the short time appli-cation.

Aim To study effects of metfomin(MF) on calmodulin(CaM) mRNA exprssion of the pitutary-gonad axis in rats.Methods The CaM mRNA expression of the pitutary-gonad axis in rats was measured with the real time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) technique. Results MF (270 mg?kg-1?d-1,ig,21 d) significantly inhibited the CaM mRNA expression in testes (P

Objective To investigate the effects of ulinastatin on the number of peripheral blood lymphocyte and the percentage of its subsets in patients with severe sepsis. Methods The scores of APECHE II and SOFA, the number of lymphocyte and the percentage of different subsets in these sepsis patients at different treatment time were measured. Results After treatment, the scores of APECHE II and SOFA of severe sepsis patients were decreased, the number of lymphocyte elevated and the percentages of different subset were corrected. Sepsis caused by Gram- positive pathogens had stronger suppression of peripheral blood lymphocyte and subsets compared with Gram - negative pathogens. Conclusion Patients with severe sepsis had less peripheral blood lymphocyte and abnormal subsets. Ulinastatin could help to correct such abnormality.

Objective To preliminarily reveal the neurovascular effect of electroacupuncture and adrenomedullin (ADM) in cerebral ischemia-reperfusion injury.Methods Rat changes after middle cerebral artery ischemia and reperfusion, and the effect of electroacupuncture and ADM on them were investigated using the neurological deficit score, somatosensory evoked potentials and TTC staining technique.Results Electroacupuncture and ADM can significantly improve the neurological deficit score after cerebral ischemia and reperfusion (P<0.05), but there was no significant difference between the two (P>0.05). The P1-N1 and N1-P2 peak values of somatosensory evoked potentials decreased significantly at 30 min after ischemia (P<0.05), recovered somewhat at 60 minutes and decreased significantly again during reperfusion (P<0.05). Electroacupuncture or ADM during reperfusion could significantly improved somatosensory evoked potentials at the end of experiment (P<0.05). Electroacupuncture and ADM could significantly reduce the size of cerebral ischemia-induced infarct (P<0.05), but there was no significant differencebetween the two (P>0.05).Conclusions Electroacupuncture can reduce neurological impairment and improve brain blood supply after cerebral ischemia and reperfusion. That is similar to the neurovascular effect of ADM.

Objective To investigate the application and needs' survey of mobile App health software in the patients with respiratory chronic disease. To make mobile App health software development more targeted and practical in the near future. To provide the foundation for continuous nursing service. Methods A survey research method was adopted in which self-designed questionnaires were administered to 163 patients with respiratory chronic disease from respiratory ward and outpatient clinic. Results Totally 119(73.0%) patients used smartphone, the mean score of experience in using mobile phones was (32.4 ± 14.1), which was in the medium range. There were 80 patients had ever installed and used this kind of App. The frequency of use of mobile App health software was Breathing Exercises App, Healthy Exercise App, Healthy Diet App and Medicine Remind App. The major reason for using of these App was disease prevention, self health care, disease and health monitoring and rehabilitation exercises. There were 120 patients would like to install App health software specific to respiratory chronic disease. They hope the characters of these App were simple operated, practical and without product placement. These App health software should include following function:timely feedback and guidance, providing practical method and help to register. Conclusion Most patients with respiratory chronic disease had the hardware basis and experience basis of using mobile App health software. More targeted and practical mobile App health software for the patients with respiratory chronic diseases should be developed to provide the foundation for continuous nursing service and patient′s self-management.

Purpose With the progression of brain tissue aging, the transport and drainage characteristics of metabolites and secretory products for neurons in extracellular space occurs irreversible change. This paper aims to investigate and quantify MR tracer diffusion characteristics in cerebral interstitial fluid of elderly SD rats. Materials and Methods MR contrast agent Gd-DTPA was injected into the caudate nucleus of two groups of rats including 8 in experimental group (15-17 month old) and 15 in control group (7-10 month old). MR scan was performed at 0.25 h, 0.5 h, 1 h, 2 h, 3 h and 4 h to observe the dynamic distribution in the caudate and measure the diffusion and clearance rate. Results There was no statistically significant difference in diffusion rate and D* between control group with (3.32±0.70)×10-4 mm2/s and experimental group with (3.25±0.46)×10-4 mm2/s (t=1.739, P>0.05). The clearance rate k' was significantly different between control group (0.62±0.12)×10-4/s and experimental group (0.29±0.08)×10-4/s (t=11.602, P<0.05). Conclusion The degeneration of aging brain tissue changes the composition of extracellular space resulting in decreased speed of ISF clearance. This may cause accumulation of metabolites which eventually triggers a variety of age-related diseases.

Objective To evaluate the long-term outcomes of patients with advanced N-stage nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT) and the effects of IMRT combined with different chemotherapies on the patients' prognosis.Methods A retrospective analysis was performed on the clinical data of 179 patients with advanced N-stage NPC who were admitted to our hospital from January 2001 to January 2008.Of the 179 patients,33 received IMRT alone,and 146 received chemoradiotherapy (CRT).Among the 146 patients,71 received concurrent chemoradiotherapy (CCRT),66 received induction chemotherapy (IC) plus CCRT,and 9 received CCRT plus adjuvant chemotherapy (AC).Results The follow-up rate was 96.5％,and 133 patients were followed up for at least 5 years.The 5-year overall survival rate was 69.0％.The patients receiving IMRT alone and patients receiving CRT had 5-year overall survival rates of 47.7％ and 73.7％ (x2 =13.91,P =0.000),5-year distant metastasisfree survival (DMFS) rates of 49.2％ and 68.3％ (x2 =4.97,P =0.026),relapse-free survival rates of 74.5％ and 92.4％ (x2 =9.87,P =0.002),and progression-free survival rates of 37.5％ and 65.1％ (x2 =11.65,P =0.001).Among the patients receiving CRT,those receiving CCRT,IC plus CCRT,and CCRT plus AC had similar survival rates.IC plus CCRT resulted in a significantly higher DMFS than IMRT alone (x2 =4.65,P =0.031).Conclusions The distant metastasis rate is still high in patients with advanced N-stage NPC after IMRT,for whom IC plus concurrent chemotherapy and IMRT may be a better treatment regimen.