Objective:To summarize and analyze the clinical status of tumor necrosis factor-α (TNF-α) antagonists.Methods: The clinical trials of TNF-α antagonists registered before August 2,2016 were searched on the National Institutes of Health (NIH) Clinical Trials Register,and SPSS17.0 software was used for statistical analysis of the data.Results: A total of 306 TNF clinical trials were conducted in the world,19 of them were in China.The main research diseases for bone and joint disease,autoimmune diseases,infections,blood tumors.There were 241 items in intervention study,and 56,7,55,60 items in 178 cases,accounting for 73.9% in Ⅱ,Ⅱ/Ⅲ,Ⅲ,Ⅳ,respectively.The interventional study of TNF-α antagonist clinical trials mainly focused on intervention research,The main purpose of the practical application of the process after the listing of further validation and evaluation of drug efficacy and safety.Conclusion: There are many kinds of TNF-α antagonists,and clinical indications are wide.The design of clinical trials is diversified and mature.

Objective To establish the method for detemining the content of chlorogenic acid in Shuanghuanglian Keli by HPLC.Methods Using Diamonsil ODS1 C18 column,with methanol-water-glacial acetic acid(15:85:1) as the mobile phase,detection wavelength as 324 nm and flow rate was 1.0 mL/min.Results The calibration curve was linear at the range of 0.060～1.210 ?g for chlorogenic acid and the equation was Y=105 427X+586.43,r2=0.999 5.The average recovery was 99.3% and RSD was 0.82%(n=6).Conclusion This method was simple,accurate and proper,and the reduplication of the result was good,which provide scientific quantitative analysis method of chlorogenic acid in Shuanghuanglian Keli.

Objective To evaluate of red blood cell as giving instruction in whole white blood cell immunological activity by new nature experimental system of hemaimmune reaction rood map. Methods Plasma 0.3ml were added to whole blood cells (including: red blood cell and white blood cells) or white blood cells 0.2ml, and incubated for 1h at 37℃. The content of IL-8 and IL-12 was determined by enzyme linked immunadsorbent assay (ELISA) method. The expression level of CD4, CD8, CD35 and CXCR4 on white blood cells was determined by method of Flow Cytometry. Results The content of IL-8 (5.96?4.26) and IL-12 (9.84?2.23) in whole blood and plasma nature group was significantly lower than that (13.59?3.69?B?pg~ -1 ?ml~ -1 ) and (15.09?9.86?B?pg~ -1 ?ml~ -1 ) in white blood cell and plasma isolation group (P

Esophageal Atresia ; complications ; Humans ; Infant, Newborn ; Male ; Respiratory System Abnormalities ; complications ; Trachea ; abnormalities ; Tracheoesophageal Fistula ; complications

Objective To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access.Methods Twenty-seven cases (male 17,female 10; age range 32-89 years ) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans,7 with diabetic foot and 2 with thromboangiitis obliterans.According to the Fontaine staging,6 cases were classified as Fontaine Ⅱ,11were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ.All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment,but in vain.So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery,peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting.Results The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms.Hematoma at the puncture site occurred in 3 patients,and paresthesia of toes occurred in 1after dorsalis pedis arteriotomy.No severe perioperative complication occurred.The average ankle brachial index increased from 0.37 ± 0.11preoperatively to 0.85 ± 0.12 postoperatively.Conclusions Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access.

Eight-year-system medical education is a kind of elite education. The object of this education model is to train medical personnel with medical doctorate. Forensic science is a highly practical medical discipline, closely related with the clinical medicine. This paper performs some explorations of the role of forensic science in 8-year-program medical education. Eight-year-program medical education should be combined with the high practicality of forensic science. For the Eight-year-program students, we should focus on cultivating their creative ability, practical ability, and sense of self-protection.

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients, aged 3-12 yr, weighing 10-40 kg, scheduled for elective ear-nosethroat or urological surgery, were randomly divided into 2 groups with 15 patients in each group:2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ). Anesthesia was induced with iv injection of propofol 2 mg/kg and TCI of remifentanil. Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentrations of remifentanil were set at 2 or 4 ng/ml. Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness. The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil, iv infusion of propofol and intermittent iv boluses of vecuronium. The target plasma concentration of remifentanil remained unchanged and bispectral index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 by adusting the infusion rate of propofol.Arterial blood samples were taken at 5, 10, 20, 30, 40, 50 and 60 min after TCI remifentanil was stared for determination of blood remifentanil concentrations by high performance liquid chromatography. Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated. Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations in both groups (P＜0.05). The MDPE, MDAPE and wobble were 20.0% , 30.0% and 25.0% respectively in group Ⅰ , and 17.5%, 17.5% and 12.5% respectively in group Ⅱ . TheMDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ(P＜0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old, the accuracy is not high.

The aim of the eight year medical education program is to cultivate high-leveled and high qualified clinical and research personnel.Constructing forensic interest group for medical students of eight year program can not only cultivate the students' English learning,innovative thinking and practice ability,which is their Achilles heel but also combine eight year medical education with forensic science teaching reform.

Objective To investigate the effects of a miRNA family member, let-7e, and a combi-nation of miR-106b and miR-20a on the expression of cytokines by THP-1 cells with Luminex xMAP technol-ogy.Methods The efficiency of transfection was evaluated by immunofluorescence assay after transfecting THP-1 cells with micrONTM mimic negative control (Cy3) for 24 h, 36 h and 48 h.The three miRNA mim-ics (let-7e, miR-106b and miR-20a) were respectively used to transfect the THP-1 cells for 24 h, 36 h and 48 h and the expression of each miRNA was analyzed by qRT-PCR analysis for screening out the optimal transfection time.The transfected THP-1 cells were stimulated with1 mg/L of LPS for 1 h.The Luminex xMAP technology was used to detect the expression of IL-8, interferon-inducible protein-10 (IP-10), mono-cyte chemotactic protein 1 (MCP-1), IL-1α, IL-6, IL-10, TNF-α, IFN-αand IFN-βin the supernatants of cell culture.A statistical analysis was performed to analyze the data obtained by using SPSS16.0 software. Results More than 90% of the transfected THP-1 cells were labeled with red fluorescence.The optimal transfection times for let-7e mimic and miR-106b/miR-20a mimics were 48 h and 24 h, respectively.Com-pared with the corresponding negative control (NC), the expression of IL-8, IP-10 and MCP-1 by THP-1 cells were enhanced after the transfection with let-7e mimic, but were inhibited after the co-transfection with miR-106b and miR-20a mimics.Conclusion The expression of IL-8, IP-10 and MCP-1 were enhanced in let-7e transfected THP-1 cells, but were inhibited in miR-106b and miR-20a co-transfected THP-1 cells.

Objective To identify the potential risks in the process of nursing care for children with tracheal foreign body removal and improve the skills and the process, to promote the quality of nursing care and the success rate of tracheal foreign body removal. Methods The failure mode and effect analysis (FMEA) were used to analyze the potential risks in children with tracheal foreign body removal, preoperative, intraoperative and postoperative care, and to find out the possible risks in each medical treatment. For pediatric venous puncture technology was not skilled, surgical position placement inappropriate (especially in the case of foreign body removal surgery posture), surgical instruments and equipment management, intraoperative nursing cooperation and observation of the disease, postoperative transfer and other aspects of the transfer of training and improvement. Results The medical risk value (RPN) in the treatment of pediatric tracheal foreign body removal in the process of nursing in the control group was reduced from 1 284.2 to 213.2 of the experimental group. The average value of doctors' satisfaction was increased from 79.33% in the control group to 93.33%in the experimental group, P<0.05, the difference was statistically significant. Conclusions The use of FMEA in the treatment of pediatric tracheal foreign body removal surgery care and medical risk management improve the quality of surgical care and help improve the success rate of tracheal foreign body removal. It also ensures the safety of the children in the operation process and improves the quality of nursing work.