Exhaled nitric oxide fraction (FeNO)reflects eosinophilic bronchial inflammation,and has been widely used to assist in the diagnosis of asthma,to monitor the airway inflammation and the responce to treatment effects of asthma in recent years.FeNO as a noninvasive examination,obtains a high degree of cooperation in adults and children over 5 years of age,but there are a lot of problems in children under 5 years of age.At present,there is still a lack of normal values and large sample-sized studies of FeNO in infants and neonates in China.The principle and method,normal reference value,influencing factors,clinical application and so on of exhaled nitric oxide detection are reviewed in this paper.

Cloud computing possesses the great, safe and reliable ability to store data, implements the integration and sharing of information resources, and reduces the economic cost.The infringement risks of intellectual property in digital library under cloud computing environment were described , such as infringement risks of intellectual proper-ty due to cloud computing safety , direct and indirect infringement risks of intellectual property of cloud service pro-viders.Measures for how to prevent and control them were put forward in aspects of laws and administrations.

SoLoMo in the mobile Internet time has provided a new way for service marketing in medical library, its meaning and its effect on medical library and how to innovate SoLoMo marketing service model in medical library were thus described in this paper.

Objective:Apoptosis inhibitor 6(Api6),also known as AIM(Apoptosis Inhibitor expressed by Macrophage)or SP?(Soluble Protein alpha),is a newly defined member of the group B scavenger receptor cysteine-rich(SRCR)superfamily.Previous studies have suggested its important roles in immune system regulation,but the involvement of Api6 in lipid metabolism is seldomly studied.Methods:The aim of this study was to define the expression pattern of Api6 in lipid loading and inflammatory macrophages.The human monocyte/macrophage lineage THP-1 cells and murine Raw264.7 macrophages were incubated in the presence of 100 ?g/ml oxidized low-density lipoprotein(oxLDL)alone,LDL plus 200 ng/ml lipopolysaccharide(LPS)and LPS alone.Results:Foam cell formation after treatment was evidenced by oil red O staining.Real-time PCR results showed that after LPS or oxLDL treatment,the mRNA levels of Scavenger receptor SRA were increased 6-fold,2.5-fold and 6-fold,44-fold in Raw264.7 cells and THP-1 cellls respectively,but the expression of Api6 in Raw264.7 did not change.The mRNA levels of Api6 increased 2.7-fold after LPS and oxLDL treatment in THP-1 cells.Conclusion:The expression levels of Api6 in these macrophages were highly related to the presence of nuclear receptor liver X receptor(LXR)isoform LXR?.This study revealed that due to the lack of LXR? isoform,the basic expression level of Api6 was low in Raw264.7 macrophages,that makes it an ideal cell line for further study related to pathophysiological function of Api6 in lipid metabolism.

Objective To observe the clinical efficacy of ear acupuncture combined with mirtazapine in the treatment of insomnia.Methods Sixty-two patients with insomnia diagnosed by CCMD-Ⅲ were randomly divided into two groups,31 patients in each group.The patients in the observation group were treated by ear acupuncture combined with mirtazapine,and the patients in the control group were treated by mirtazapine.The clinical efficacy was evaluated by SDRS after 4 weeks of treatment.Results The SDRS score of the observation group significantly decreased after one week of treatment [(13.40±5.79)points vs.(21.79±6.12)points,t=2.204,P＜0.05].The SDRS score of the control group significantly decreased after one week of treatment [(14.68±5.88)points vs.(22.67±6.06)points,t=2.198,P＜0.05].After 4 weeks of treatment,the clinical efficacy of the observation group was significantly better than that of the control group (z=-2.209,P＜0.05),the SDRS score of the observation group was also significantly better than that of the control group (t=2.163,P＜0.05).Conclusion Ear acupuncture combined with mirtazapine has better effect in the treatment of insomnia patients,it has less side effects and lasting effects.

Objective To investigate the relationship between plasma N-terminal pro brain natriuretic peptide(NT-proBNP) level and left ventricular(LV) diastolic dysfunction in hypertensive patients without systolic dysfunction.Methods Forty-four cases of primary hypertensive patients with left ventricular ejection fraction more than 50％ were enrolled,14 cases in normal diastolic function group,30 cases in diastolic dysfunction group(18 cases in delayed relaxation group and 12 cases in pseudo normalization filling group).LV diastolic function was assessed with conventional Doppler by means of mitral inflow and with tissue Doppler echocardiography by means of mitral annulus.The ratio of early diastolic transmitral E wave velocities to tissue Doppler mitral annulus early diastolic E' wave velocities (E/E') was used to detect LV filling pressures.Patients were divided into three groups according to E/E' ratios.Plasma concentrations of NT-proBNP were also measured.All related data were statistically analyzed.Results The levels of NT-proBNP were (115.2 ± 78.9)ng/L in LV diastolic dysfunction group,(34.7 ± 17.5) ng/L in normal filling group and (206.6 ± 75.8) ng/L in pseudonormal filling group.The level of NT-proBNP significantly elevated (F =85.263,P =0.000) along with the severity of lefi ventricular diastolic dysfunction.There was significant difference between each of the two groups among the three groups(all P ＜0.01).According to E/E' ratios,the patients were divided into three groups:E/E' ＜10(n =16),10 ＜ E/E ＜ 15(n =18),E/E' ＞ 15(n =10).The level of NT-proBNP were (39.5 ± 20.1) ng/L,(71.2 ± 26.4) ng/L and (203.7 ± 75.2) ng/L respectively in the three groups.The NT-proBNP blood level was positively correlated significantly with E/E' ratio (r =0.80,P ＜ 0.01).The sensitivity was 87％ and the specificity was 100％ for diagnosis of left ventricular filling pressure (E/E' ＞ 15)according to a NT-proBNP value of 119 ng/L.Conclusion Combining of plasma NT-proBNP and Doppler E/E'have potential value for identification of those patients with hypertension to detect early cardiovascular changes,especially LV diastolic dysfunction.

OBJECTIVE: To discuss advances in intrahepatic and intrabiliary stent application and evaluate their biocompatibility.METHODS: A computer-based online search of CNKI between 1989 and 2009 was performed to search related articles with the keywords of "bile duct, hepatic duct, stent, treatment". A total of 51 articles were searched and 20 were included according to inclusion and exclusion criteria. The articles were summarized from aspects of treatment advances in intrahepatic and intrabiliary stent application and prevention of obstruction following intrahepatic and intrabiliary stenting; the clinical application of intrahepatic and intrabiliary stent, biocompatibility and prevention of stent obstruction were discussed.RESULTS: Intrabiliary stent mainly includes metal stent and plastic stent. The metal stent is superior over plastic stent in preventing bacteria and keeping stent patency, but its cost is large. The plastic stent is easy for bacteria attachment and stent obstruction, but it is simple to change the stent and the cost is low. Intrabiliary stent implantation is the best method to treat malignant obstruction of bile duct with few complications. Intrahepatic stent in combination with various radiotherapies can prolong effective patent time of the stent and effectively prevent stent obstruction. CONCLUSION: Intrabiliary stent implantation is the most effective clinical method to treat malignant obstruction of bile duct.However, the biocompatibility of various intrabiliary stents should be improved. Intrahepatic stent in combination with radiotherapies can prevent stent obstruction.

BACKGROUND:Studies demonstrated that matrix metalloproteinase-1(MMP-1) and tissue inhibitor of metalloproteinases-1(TIMP-1) exhibit important role in corneal defect of rats with alkali burns.OBJECTIVE:To observe the promoting effect of recombinant human epidermal growth factor(rhEGF) on rats' corneas following alkali burns,in addition,to explore the effect and significance of rhEGF on the expression of MMP-1 and TIMP-1 in alkali burned rats.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed at the Laboratory Animal Center,Liaoning Medical College from March 2008 to May 2009.MATERIALS:Sixty healthy SD rats,weighting 180-210 g,with 6-8 weeks old,half male and half female.All rats were confirmed that no anterior segment disease before the experiment with slit lamp microscope examination.METHODS:Sixty rats were randomly divided into experimental and control groups,with 30 animals in each group.After the preparation of corneal alkali burn models,cornea of rats in the experimental and control groups were given rhEGF eye drops,and physiological saline eye drops respectively,fourth a day,consecutive for 21 days.Six rats of each group were killed at days 1,4,7,14 and 21 after operation.MAIN OUTCOME MEASURES:①Changes of cornea after alkali burned was observed by slit lamp microscope.②The expressions of MMP-1 and TIMP-1 in cornea were detected with immunohistochemistry and computer image analysis system at different time points.RESULTS:The slit lamp microscope results showed that the area of corneal ulcer in the experimental group was obvious smaller than the control group at the corresponding time points.The expression of MMP-1 gradually increased and reached a peak level at 14 days after surgery,then began to decrease.TIMP-1 expressed in the early phrase,but later,its activity gradually decreased,reached the lowest level at 14 days,then began to increase,and peaked at 21 days.The level of MMP-1 in the experimental group was greatly lower than that in the control group at each time points.However,the level of TIMP-1 of the experimental group was greatly higher compared with the control group.CONCLUSION:The rhEGF eye drops can improve effectively the healing of corneal epithelial defect by adjusting the proportion of matrix metalloproteinase and its tissue inhibitor.

On the anatomy, posterior vitreous cortexneighbors with retina, the relationship of vitreous and retinal is both independent and closely linked. Under pathological condition, changes in the vitreous provides a good environment for occurrence and development of a number of vitreoretinal diseases, which indicates that vitreous plays a crucial role in many vitreoretinal diseases occurrence and growth. Elimination of vitreous change in disease, is an issue of great concern of the ophthalmic industry in recent years. Based on the description of vitreous and vitreoretinal interface structure, changes in the vitreous and retinal adhesion mechanisms and interfaces retinal disease risk factors and the impact on the retinal disease were discussed, And the posterior vitreous detachment impact on the vitreoretinal interface disease, the testing methods and its importance were described in this article.

?AlM: To discuss the artificial tears on the tear film of diabetic patients with dry eye preoperatively, and the influence on the tear film’s fuctional after phacoemulsification.
?METHODS: Fifty-four diabetic patients with dry eye (60 eyes) were followed up before phacoemulsification. Preoperatively, group A ( 30 eyes in 28 cases ) was treated with Hydroxyl lndican eye drops and group B (30 eyes in 26 cases) was not treated. Postoperatively, both group A and B were treated with Tobramycin Dexamethasone eye drops, Oprah Winfrey lbuprofen eye drops and Hydroxyl lndican eye drops. Dry eye symptoms, break up time (BUT), SchirmerItest (SIt), fluorescein stain test ( Fl ) were measured at 3d preoperatively, and 1, 7, 30, 90d postoperatively.
? RESULTS: At 3d preoperatively, there was no statistical differences between the two groups for dry eye symptoms, BUT, S I t, Fl ( P>0. 05 ). At 1 and 7d postoperatively, there were significant statistical differents between the two groups for dry eye symptoms (P<0. 05). And dry eye symptoms scores of group A were less than that of group B. At 1, 7, 30d postoperatively, BUT was longer, FL was less, Slt was increased in group A, with significant statistical differences (all P<0. 05). At 90d postoperatively, two groups of dry eye symptoms, BUT, S I t, Fl had no statistical significance (P>0. 05).
? CONCLUSlON: Using artificial tears before phacoemulsification can improve symptoms of the diabetic patients with dry eye and accelerate the recovery of the tear film.