Chronic obstructive pulmonary disease and asthma are complex inflammatory diseases with airway obstruction as the main characteristics, and have become common respiratory diseases that seriously affect human health. Compared with the clinical use of PDE3 or PDE4 inhibitors alone, dual PDE3/4 inhibitors have synergistic anti-inflammatory and bronchodilator effects, and have attracted widespread attention in recent years. This article reviews the representative research results of dual PDE3/4 inhibitors currently in the preclinical and clinical research stages, summarizing their latest progress and their potential for the treatment of chronic obstructive pulmonary disease and asthma.

Objective To summarize the clinical experience of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis. Methods A total of 93 cases of acute cholecystitis treated by LC from May 2003 to May 2005 was retrospectively reviewed, including 15 cases of preoperative endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (EST) for common bile duct stones and 6 cases of intraoperative cholangiography. The LC was performed within 48 hours after admission. Results The LC was successfully completed in 91 cases (97.8%), whereas a conversion to open surgery was required in 2 cases (2.2%). The operation time was 35~160 min (mean, 65 min). Postoperatively, biliary leakage occurred in 3 cases (3.2%) and residual stones in the common bile duct were found in 3 cases (3.2%), which were all cured by open surgery combined with ERCP, EST, and endoscopic nasobiliary drainage (ENBD). No iatrogenic injuries happened. Conclusions With proper selection of ERCP and EST, LC for the treatment of acute cholecystitis is feasible and safe. But the incidence of conversions and complications may be high.

[Objeetive] To compare the expression level of CD44V6,?-catenin in osteosarcoma cells with controls,and to investigate the correlation with invasion of osteosarcoma cells.[Methods]Expression of CD44V6 and ?-catenin was examined by immunohistochemistry SP method in 35 specimens of human osteosarcoma tissue.The control group was 15 samples of normal bone tissue and 15 samples of osteochondroma.[Results]The expression of CD44V6 and ?-catenin was correlated significantly with clinical stage,neoplasm metastasis(P0.05).In osteosarcoma,CD44V6 was positively correlated with the expression of ?-catenin(u=3.77,P

The morphologic changes of human hepatocaranoma transplanted in nude mice afler photodynamic therapy (PDT) with sulfonated aluminum phthalocyanine (ALSPQ were studied The cancer cells after PDT with ALSPC showad vacuolar degeneration and separation from each other. The endothelium of blood vessel was damaged and hemorrhage occured Under electron microscope the endoplasmic reticulum enlarged, mitochondria swelled, perinudear space dilated, and chromosome aggregated and condensed. The membrane of nuclei and cells broke off and tumor cells died at last The endothdial cells had the same changes mentioned above. This result suggests that ALSPC has photodynamic effect on the human hepatocellular carcinoma tranaplanted in nude mice. And the membrane system of cells is probably the main target.

Objective To evaluate the effect of infiltration anesthesia at Calot's triangle on postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.Methods One hundred and forty patients,aged 18-64 yr,with 18 kg/m2 ≤ body mass index ≤ 31 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,were randomly divided into 2 groups (n =70 each):control group (group A) and infiltration anesthesia at Calot's triangle group (group B).In group B,1％ ropivacaine 10 ml was injected into Calot's triangle before dissection of the gallbladder,while the equal volume of normal saline was injected into Calot's triangle in group A.The patients in both groups received patient-controlled intravenous analgesia (PCIA) for 48 h starting from 10 min before the end of surgery.The VAS score was maintained below 4 during PCIA.When VAS score ≥ 4,lasting for more than 30 min,tramadol 1.5 mg/kg was injected intravenously.The consumption of physic liquor for PCIA,and requirement for tramadol were recorded.The incidence of puncture-related damage to Calot's triangle and local anesthetic intoxication and adverse effects such as nausea and vomiting within 48 h after surgery were also recorded.The first postoperative flatus time was recorded.Results Compared with group A,the consumption of physic liquor for PCIA,requirement for tramadol,and consumption of tramadol were significantly reduced,and no significant change was found in the incidence of nausea and vomiting and the first postoperative flatus time in group B.No puncture-related damage to Calot's triangle occurred in A and B groups.There was no local anesthetic intoxication in group B.Conclusion Infiltration anesthesia at Calot's triangle can optimize postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.

Objective To evaluate the differential diagnostic value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) and diffusion weighted imaging(DWI) in adenosis of the breast and breast cancer.Methods 30 cases of adenosis and 45 cases of breast cancer with pathological verification were scanned with DCE-MRI and DWI.The MRI features of the lesions were analyzed, including shape,margin,T2WI singal, features of enhancement, time intensity curve(TIC) type, early enhancement rate(EER),peak time, background enhancement and ADC value.Results The irregular margin with or without spiculation and the heterogeneous enhancement were mostly seen in breast cancer (P=0.002,P=0.009, respectively).The TIC type Ⅲ, EER larger than 100% and peak time within 2 minutes were mostly seen in breast cancer(P<0.001).The ADC of breast cancer and adenosis were (1.03±0.24)×10-3mm2/s and (1.34±0.30)×10-3mm2/s respectively(P<0.001).The features of shape,T2WI singal and background enhancement had no statistical significance between adenosis and cancer(P>0.05).Conclusion DCE-MRI combined with DWI will be helpful to the diagnosis of breast lesions.

Objective Differentiation of breast fibroadenoma from breast cancer is of great importance. The purpose of the ar-ticle was to evaluate the diagnostic efficacy of magnetic resonance imaging(MRI) in the differentiation of breast fibroadenoma from breast cancer in DCE-TIC ( dynamic contrast enchancement-time intensity curve) platform type ( typeⅡ) . Methods Between March 2014 and May 2016, 64 patients were included in our study, 19 patients with breast fibroadenoma and 45 patients with breast cancer. All the patients underwent DCE-MRI ( dynamic contrast-enhanced magnetic resonance imaging) examination before operation. Morpho-logic characteristics, hemodynamic characteristics, EER ( early enhancement rate) and ADC ( apparent diffusion coefficient) values were calculated and statistically compared. Results Among 19 cases of breast fibroadenoma, 9 cases were round or ovoid, 8 cases are lobulated, 2 cases were irregular, 15 cases with clear boundary, 14 cases in mammary gland vascular enlargement, 2 cases of slowinflows, 4 cases of moderate inflows, 13 cases of rapid inflows, and the average ADC value was ( 1. 47 ± 0. 38) × 10-3 mm2/s. Low signal separation present in 11 lesions of fibroadenoma. Among the 45 cases of breast cancer, 17 cases were round or ovoid, 7 cases were lobulat-ed, 21 cases were irregular, 11 cases with clear boundary, 38 cases of mammary gland vascular enlargement, 1 case of slow inflows, 5 ca-ses of moderate inflows, 39 cases of rapid inflows, and the averageADC values was (0.98±0.40)×10-3mm2/s. The shape, (χ2=9.176), margin (χ2=16.452), EER(χ2=18.489) and ADC between breast fibroadenoma and breast cancer were of significantly difference. No significant difference was found in the increased and enlarged blood vessels. The success of ADC values in differentation of breast fibroadenoma from breast cancer was statistically significant( P<0.001), and the area under the curve(AUC)of the ROC, sensitivity and specificity of VE were 94.7% and 71.1%. Conclusion Breast fibroadenoma are in fast inflows in the early phase on the DCE-MRI, and there are differences in morphologic characteristics and mass enhancement ways between patients with breast fibroadenoma and breast cancer. Morphologic characteristics combined with inter-nal low signal separation contribute to the differentiation of breast fibroadenoma from breast cancer.

The expression of the cytokines IL-2, IL-10, TNF-alpha and their roles in mice with herpes simplex viral encephalitis (HSE) were studied. By using semiquantitative reverse transcription polymerase chain reaction (RT-PCR), the expressions of IL-2, IL-10 and TNF-alpha mRNA in control group, HSE group and acyclovir (ACV)-treated group were detected and the pathological changes of brain were observed. It was found that after HSV1 infection, the cerebral lesions of haemorrhage and necrosis in mice were observed under the microscopy, and the levels of IL-2, IL-10 and TNF-alpha were increased remarkably. After treatment with ACV after HSV1 infection, the cerebral lesions in mice were improved, the level of IL-2 maintained stable, IL-10 was increased consistently, and TNF-alpha was decreased significantly as compared with those in HSE group. In acute HSE, many cytokines are upregulated, including IL-2, IL-10 and TNF-alpha to eliminate virus and TH1 type response is dominant. In convalescence, there is a shift in the cytokine expression profile from TH1 profile to TH2 profile and the shift can inhibit the overexpression of immune response in animals. ACV has remarkable effects in the treatment of HSE.

This thesis found the female homicide cases present its own characteristics because of differences in psychological, physiology characteristics, character between males and females through the statistical analysis of age distribution, the relationship between criminal suspects and victims, the classification of crime scenes, injury tools and the mortal wound positions of 116 female homicide cases in Lianyungang between 1993 to 2014. Mostly, the relationship between criminal suspects and victims is family, especially couple or valentine; the crime scenes are frequently indoor, especially bedrooms. They always choose production and life tools when victims are in deep sleep or drunk time to make the victims asphyxia, posioning or drowning. The injuries focus on vitals and usually hit many times lead to mortal wound, agonal trauma and postmortem injury.

BACKGROUND: Microglial cells are prominently involved in certain neurologic diseases such as Parkinson disease and Alzeheimer disease. In vitro primary culture is commonly used in studies on the functions of microglia.However, these classical culture methods have some defects including complex procedures and low out-put.OBJECTIVE: To establish a simplified high-output primary culture of microglia.DESIGN: An explorative experiment with microglial cells as the single sample.SETTING: Department of Neurology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: The study was finished at the Central Laboratory of Union Hospital from April to October 2004. Microglial cells were obtained from 10 newborn(one day) male Kunming mice that were selected.METHODS: The author' s culture method was based on McCarthy method, we developed a new culture method and made some improvements,including the increased cell density for primary culture and nutritional deprivation. The microlglial cells were isolated with low-concentration trypsin-EDTA(ethylene diamine tetraacetic acid) digestion and immunochemically labeled with MAC-1 antibody, so as to measure the output and purity of microglia.MAIN OUTCOME MEASURES: ① Morphologic features of microglial cells, observed with inverted microscope; ② Purity and activity of microglia cultured with these two methods, were measured immunohistochemically.RESULTS: For microglia cultured with McCarthy method, the culture cycle was 20 days and the output was 2 × l05 cells per flask with a purity of 95% -97%. The new method shortened the culture cycle to 15 days and the output reached 1 × 106 cells per flask with a purity of 96-98%. Cell purity and activity had no significant difference between these two culture methods.CONCLUSION: The new method has a similar purity and activity with classical method; however, it may simplify procedures, shorten cycle, and increase output, and therefore can be a useful method for studies on microglia function and for nerve repair.