Objective To explore the effect of conventional western medicine combined with Qiangxin Tongmai decotion in the treatment of patients with chronic heart failure (CHF).Methods According to the digital table,60 patients with CHF were randomly divided into two groups,30 cases in each group.The control group was treated with conventional western medicine,while the treatment group received combination therapy of conventional western medicine and Qiangxin Tongmai decotion.The heart function and plasma brain natriuretic peptide (BNP) level were observed.Results The total effective rate of the treatment group was 93.3％,which was significantly higher than 70.0％ of the control group (x2 =5.455,P ＜ 0.05).After treatment,the level of BNP in the treatment group was (211.3 ± 87.7) ng/L,which was significantly lower than that of the control group [(410.8 ± 94.3) ng/L] (t =8.485,P ＜ 0.01).Conclusion Qiangxin Tongmai decotion can obviously improve the heart function and reduce the level of BNP in patients with CHF.

Bile duct stones are a common disease in clinical practice in China,and due to a high incidence rate of complications and complex causes,its clinical diagnosis and treatment has become a difficult problem which needs to solved urgently.With the development of science and technology and the enhanced knowledge of this disease,many treatment methods for this disease have emerged.This article summarizes the successful experience in the treatment of bile duct stones in the Center for Integrated Traditional Chinese and Western Medicine Therapy for Biliary and Pancreatic Diseases in our hospital.With reference to the type and distribution characteristics of bile duct stones,a combination of various endoscopic techniques,such as laparoscopy,choledochoscopy,and duodenoscopy,can achieve the goal of minimally invasive,diverse,and individualized diagnosis and treatment and provide feasible thoughts and strategies for the treatment of bile duct stones.

Objective To investigate the relationship between plasma glucose transporter (Glut) expression and ERK in diabetic patients with obesity. Methods Subjects in this study included type 2 diabetes (T2DM ) with overweight or obesity(T2DM+ OB/OW group ,n=20) ,T2DM with normal weight (T2DM group ,n=22) ,normal glucose with overweight or obesity(OB/OW group ,n=20) ,normal glucose with normal weight (NC group ,n=21). Automatic biochemical analyzer was used to detect the glucose concentrations ;colorimetry was used to detect blood lipid;ELISA was used to detect the level of insulin;Western blot was used to evaluate the expression of Glut1 Glut2 and Glut4 ;RT‐PCR was used to evaluate the mRNA expression of Glut2 ,Glut4 and ERK. Results Fasting plasma glucose (FPG )and two‐hour postprandial plasma glucose (2 hPG)in group T2DM+ OB/OW[(8.9 ± 3.7) ,(20.1 ± 3.5)mmol/L]and T2DM[(9.3 ± 2.8) ,(18.48 ± 4.59)mmol/L]were higher than in group OB/OW[(4.10 ± 0.90) ,(6.60 ± 0.75)mmol/L ]and NC[(3.9 ± 0.7) ,(6.7 ± 0.8)mmol/L](P<0.01).Hemoglobin A1c(HbA1c) in group T2DM+ OB/OW [9.90 ± 3.19)% ] and T2DM [(8.68 ± 2.75)% ] were higher than in group OB/OW [5.05 ± 0.37)% ] and NC[(5.47 ± 0.59)% ](P<0.01).FIns in group OB/OW [(7.98 ± 2.01)μIU/ml] were higher than in T2DM group[(5.91 ± 3.02)μIU/ml]and NC[(5.49 ± 1.36)μIU/ml](P< 0.05).Total cholesterol and triglyceride in T2DM + OB/OW group[(5.06 ± 0.97) ,(3.52 ± 2.68)mmol/L] , T2DM[(5.13 ± 1.27) ,(3.79 ± 3.56)mmol/L]and OB/OW[(4.67 ± 0.83) ,(1.87 ± 0.95)mmol/L]were higher than in group NC[(3.51 ± 0.89) ,(1.41 ± 1.21)mmol/L](P<0.01). Glut1 Glut2 ,Glut4 expression in T2DM+OB/OW group ,T2DM were lower than those in group OB/OW ,NC.Glut2 expression in T2DM+ OB/OW group was significantly lower than in T2DM group.Glut2 and Glut4 mRNA expression in group T2DM+ OB/OW ,T2DM were significantly lower than in group OB/OW ,NC.ERK mRNA expression in group T2DM + OB/OW ,T2DM were significantly higher than those in group OB/OW and NC.Conclusion Glut1 ,Glut2 and Glut4 expression are lower in diabetic patients with obesity ,and there is a negative correlation between the expression of ERK and Glut2 and Glut4.

Objective To explore characteristics and risk factors for surgical site infection(SSI)in patients in the department of neurosurgery,so as to provide theoretical basis for prevention and control of SSI.Methods Clinical data of patients who were admitted to a department of neurosurgery from January to December 2015 were collected with retrospective survey method,SSI and risk factors in patients were analyzed.Results Among 715 patients un-dergoing neurosurgery,40(5.59% )had SSI. SSI mainly occurred in patients following cerebral vascular surgery, accounting for 7 .69% ,followed by patients following intracranial tumor surgery(5 .94% ). 40 patients were all with organ space/intracranial infection. Difference in SSI in patients with different types of operation,duration of opera-tion,length of hospital stay,and National Nosocomial Infections Surveillance (NNIS)scores were all significant(all P<0.05).Conclusion Incidence of SSI in patients in the department of neurosurgery are related with operation type,duration of operation,length of hospital stay,and operation risk index,preventive measures should be taken to reduce the incidence of SSI.

Both microRNA and DNA methylation are the important contents of epigenetic modification.Lots of studies have confirmed that mutual regulation of microRNA and DNA methylation involve in tumorgenesis and development of cancer.The studies of their mechanisms bring some new ideas for investigating the pathogenesis of tumors,and provide a theoretical basis for the early diagnosis and treatment.

The diagnostic rate of intraductal papillary mucinous neoplasms (IPMNs) has been increased as the improvement of imaging and endoscopic techniques.All main duct type and mixed variant IPMNs should be resected as long as the patient is a good surgical candidate with reasonable life expectancy.Evaluation of resection margin ( especially circumferential margins) is very important to prevent the recurrence of IPMNs,and intraoperative pancreatoscopy plays an important role in determining the appropriate size for pancreatic resection.In this article,the experience in the treatment of 1 patient with IPMNs by precise pancreatectomy guided by endoscopy-assisted intraoperative pancreatic duct inspection was introducted.

Objective To investigate the expression of PMN Fas/FasL,Caspase-3 from peripheral blood in patients with SIRS and observe the effect of emodin on the PMN apoptosis and explore its mechanism.Methods The samples of peripheral blood were collected from 8 patients(all suffer from acute pancreatitis)with SIRS and 6 healthy volunteers.The circulating neutrophils were isolated and cultured.There were three groups of in our study:control group,SIRS group and emodin-treated group.The change of the PMN apoptosis and the expression Ieve]of Fas/FasL.Caspas-3 were observed.Results Compared with healthy volunteers.the percentage of PMN apoptosis significantly reduced in patients with S1RS(P＜0.05).After emodin was used,the percentage of PMN apoptosis in patients with SIRS increased(P＜0.05).Compared with healthy volunteers,the expression of Fas and Caspase-3 reduced in patients with SIRS(P＜0.05).Emodin could significantly induce the expression of Fas and Caspase-3(P＜0.05).After 24 hours of in vitro culture.the expression of FasL was not detected.Conclusion PMN from patients with SIRS shows profoundly delayed rates of apoptosis in vitro compared with PMN from healthy volunteers,and the decreased percentage of PMN apoptosis is associated with the reduced expression of Fas and Caspase-3.Emodin can significantly inhibit the delayed PMN apoptosis in patients with SIRS by inducing the expression of Fas and Caspase-3.

Objective To compare the treatment responses of the inhaled salmeterol and fluticasone (50/500 μg) for three months in the different clinical phenotypes of chronic obstructive pulmonary diseases (COPD) which were chronic bronchitis phenotype and emphysema phenotype and to explore the difference of the treatment responses.Methods To enroll and follow up the stable COPD patients from outpatient department who received the treatment of inhaled salmeterol and fluticasone (50/500 μg).Patients with low attenuation area (LAA,the density on CT scan ＜-950 HU) ≥15％ of the while lung area％ (LAA％) were defined as emphysema group,while patients with LAA％ ＜ 15％ were defined as chronic bronchitis group.All the subjects received lung function test before and after three-month treatment.Results Totally,84 patients (49 male and 35 female patients) with stable COPD were enrolled with an average age (61.04 ±9.23) years old,30 patients in emphysema group and 54 patients in chronic bronchitis group.Before treatment,forced expiratory volume in one second (FEV1) ％ predicted value and residual volume (RV) ％ predicted value in emphysema group were lower than those of chronic bronchitis group (P =0.04 and P =0.01),while inspiratory capacity (IC)％ predicted value was higher than that of chronic bronchitis group (P =0.02).After three-month salmeterol and fluticasone inhalation treatment,FEV1 and RV were improved in both groups,but FEV1 and RV in chronic bronchitis group were improved more significantly than those of emphysema group (P =0.02 and P =0.03).Conclusions The treatment responses of different clinical phenotypes of COPD to inhalation of combination of salmeterol and fluticasone were different,chronic bronchitis phenotype had better treatment response compared to emphysema phenotype.

Sepsis is defined as an organ dysfunction caused by systemic inflammatory response induced by infection,and may eventually developed into multiple organ failure (MOF).The onset of sepsis often involves the activation of inflammatory cells,over expression of inflammatory cytokines,immune dysfunction,damage of tissue and organ,excessive apoptosis of cell.Mesenchymal stem cells (MSCs) have a wide range of biological activities,including anti-inflammatory,antibacterial,immune regulation,regeneration and repair of tissue and organ,anti-apoptosis,etc.In recent years,a large number of preclinical studies had demonstrated that MSCs has good actions on sepsis.The purpose of this review is to describe the mechanism of MSCs in the treatment of sepsis,and to point out the possible clinical challenges.

Objective To study the clinical significance of the proinflammatory cytokines and anti-inflammatory cytokines in acute pancreatitis with systemic inflammatory response syndrome. MethodsIn this study, 13 cases of mild acute pancreatitis (MAP), and 19 cases of severe acute pancreatitis(SAP) were recruited to evaluate acute physiology and chronic health evaluation (APACHEⅡ) on post admission day 1,3,5,7 and Balthazar CT criteria on post admission day 1,7. Values of serum IL-6?IL-8?IL-10?IL-12 were measured. ResultsThe scores of APACHEⅡ and Balthazar CT criteria were lower in the MAP patients than those in the SAP patients(5.6?2.1 and 1.5?0.6 vs. 13.6?4.3 and 6.3?1.5, all P