Objective To evaluate the effects of total glucosides of paeony (TCP) on cell proliferation of and expression of VECF and IL-23 in human HaCaT keratinocytes and their potential mechanisms. Methods MTT assay was performed to detect the cell proliferation of HaCaT cells incubated with various concentrations (0.5 to 312.5 mg/L) of TGP. HaCaT cells were classified into 8 groups, control group without any treatment, TGP groups treated with 6 different concentrations of TGP, SB203580 group treated with TGP of 125 mg/L after 2-hour pretreatment with SB203580 of 10 μmol/L After additional culture, reverse transcription (RT)- PCR and enzyme linked immunosorbent assay (ELISA) were conducted to determine the expression levels of VEGF and IL-23 mRNA and protein, Western blot to test the phosphorylation of p38 mitogen-activated protein kinase (MAPK) in these cells. Results The proliferation of HaCaT cells was promoted by TGP of low concentrations (0.5 and 2.5 mg/L), but inhibited by TGP of equal to or more than 12.5 mg/L, and peaked at the concentration of 125 mg/L. TGP of 0.5 and 2.5 mg/L enhanced the mRNA and protein expressions of VEGF and IL-23, while TGP of 12.5 to 125 mg/L suppressed the expression of VEGF mRNA and protein, and TGP of 62.5 to 125 mg/L downregulated the expression of IL-23 mRNA and protein. The phosphorylation of p38 protein kinase in HaCaT cells was induced by TGP of 125 mg/L in a time-dependant manner. Concretely, the level of phosphorylated p38 kinase in HaCaT cells was 0.3314 ± 0.0245 (peak) at 5 minutes, decreased to 0.2173 ± 0.0189 at 10 minutes (still statistically higher than untreated HaCaT cells) and 0.1664 ± 0.0201 at 30 minutes after treatment with TGP of 125 mg/L. SB203580 attenuated the effect of TGP on p38 phosphorylation, and the level of phosphorylated p38 kinase was 0.1529 ±0.0147 in HaCaT cells pretreated with SB203580 prior to the treatment with TGP. Conclusion TGP can inhibit the cell proliferation of and expressions of VEGF and IL-23 mRNA and protein in HaCaT cells, likely mediated by the p38 MAPK signaling pathway.

In order to improve the clinical outcomes and promote the development of enhanced recovery after surgery(ERAS),a full-time specialized role of nurse navigator(NN) was established in Department of Surgery in February,2016. Clinical pathway for ERAS was designed,and role functions,core competencies and responsibilities of NN were formulated. According to the functions and the working frame,NN connected and coordinated teamwork activities,monitored the implementation of ERAS during the overall process. After implementation,the NN had dealt with 10 unusual incidents,the execution efficiency of the 14(82.4%) measurements were 100%,1 measurement was 97%,2 measurements were 94.1%,and 33 patients and 42 medical staff thought highly of the NN. This practice effectively promoted the development of ERAS team and specialist nurse role in our hospital.

Objective To evaluate the impact of standardized health management and treatment on asthma control and the quality of life of the patients.Methods One hundred asthma patients were recruited in our hospital and were assigned to the health management (n=50) or the control group (n=50).The control group subjects were treated with conventional therapy,while those of the heahh management group received standardized asthma management and health education.The control of asthma and the quality of life were evaluated at baseline and six months after the intervention.Student's t test and Chisquare test were used for data analysis.Results At 6 months treatment,the rate of effective control of asthma of the health management group (56％) was higher than that of the control group (22％) (x2=12.15,P＜0.05).In the control group,the activity limitation,asthma symptoms,mentality asthma,the stimulus response,the personal health concerns and the total score of Quality of life were (47.4±5.8),(35.3±6.2),(28.2±4.3),(22.7±3.5),(17.6±3.9),(151.2±14.7),and they were (38.2±4.5),(27.1±4.8),(23.1±5.7),(18.3±4.3),(13.7±4.2),(121.4± 12.6) in the control group,they were all significantly higher in the management group than that of control group(t values were 6.17,4.42,4.98,5.76,5.43 and 6.35,all P＜0.05).Conclusion The standardized health management and the health education can effectively control asthma and significantly improve the quality of the patient's life.

Objective To evaluate the effect of total glucosides of paeony (TGP) on the expression of interleukin-18 (IL-18) in human HaCaT keratinocytes,and to explore the roles of extracelluar signal-regulated protein kinase1/2 (ERK1/2) and c-Jun N-terminal kinase 1/2 (JNK1/2) signaling pathways in the effect.Methods Some cultured human HaCaT keratinocytes were classified into three groups:control group treated with dimethyl sulfoxide (0.031％),TGP groups treated with 6 different concentrations (0.5,2.5,12.5,62.5,125.0 and 312.5 mg/L) of TGP respectively,inhibitor groups treated with TGP of 125 mg/L after 2-hour pretreatment with PD98059 (an ERK1/2 inhibitor) and SP600125 (a JNK1/2 inhibitor) of 10 μmol/L respectively.After additional culture for 48 hours,reverse transcription (RT)-PCR was performed to measure the mRNA expression level of IL-18,and enzymelinked immunosorbent assay (ELISA) to determine the level of IL-18 protein in the culture supematant of HaCaT cells.Some HaCaT keratinocytes were classified into two groups to be treated with TGP of 125 mg/L for 15,30 and 60 minutes with or without the pretreatment with PD98059 and SP600125 of 10 μmol/L; then,Western blot was carried out to determine the phosphorylation levels of ERK1/2 and JNK1/2 in HaCaT cells.Results The levels of IL-18 mRNA and protein in culture supernatant were significantly increased by TGP of 0.5 and 2.5 mg/L,but decreased by TGP of 62.5 and 125.0 mg/L,and TGP of 125.0 mg/L showed the strongest inhibitory effect.After treatment with TGP of 125.0 mg/L,the level of phosphorylated ERK1/2 in HaCaT cells peaked at 15 minutes (0.448 ± 0.018),decreased to 0.213 ± 0.005 at 30 minutes and 0.217 ± 0.005 at 60 minutes,with significant differences between TGP-treated and untreated cells at 15 minutes (0.448 ± 0.018 vs.0.204 ± 0.005,P＜ 0.05) but not at 30 or 60 minutes (both P ＞ 0.05).The phosphorylation level of ERK1/2 was 0.237 ± 0.010 in HaCaT cells pretreated with PD98059 prior to the treatment with TGP,significantly different from that in HaCaT cells treated with TGP only (P ＜0.01).TGP of 125.0 mg/L had no obvious effect on JNK phosphorylation,and there was no significant difference in the level of phosphorylated JNK1/2 between HaCaT cells untreated and those treated with TGP of 125.0 mg/L for different durations (all P ＞ 0.05).Conclusions TGP can inhibit the expression of IL-18 mRNA and protein in HaCaT cells,likely through the ERK1/2 signaling pathway.

Objective Mikulicz's disease (MD) was considered to be a subtype of Sj(o)gren's syndrome (SS) due to the clinical and histological similarities between them.Evidence had shown that there were differences between MD and typical SS.The purpose of this study was to investigate the correlation between MD and SS,by means of analyzing the expression of IgG4 in salivary glands and the clinical characteristics of patients who were previously considered as SS.Methods The paraffin sections of salivary glands from SS patients were stained with monoclonal antibodies to IgG4 and CD38.Patients were divided into two groups based on the pathological results.Analysis of the symptoms,the signs and the laboratory results were carried out in these patients.The difference in laboratory parameters and histopathological gradings in the two groups was analyzed.Normal and abnormal distributed data comparison was conducted using random independent samples t-test and rank sum test respectively.Two-sample rates were compared with Chi-square test.Results Based on immunohistochemistry of IgG4 distribution,the 58 patients with SS were divided into two groups:IgG4 related (9 cases) and non-IgG4 related (49 cases).Histopat-hologically,IgG4 related cases showed IgG4+ plasma cells/IgG+ plasma cells infiltration and there were more IgG4 related monoclonal antibody expressed when compared to IgG4 unrelated cases.In addition,there were also significant differences in clinical features between the two groups.IgG4 related disease was associated with male gender,higher level of plateletconnt,lymphocytes [(2.4±0.8)×109/L vs (1.4±0.7) ×109/L] count and CRP [(52±60) mg/L vs (15±17) mg/L] levels and lower titer of IgM [(1.2±0.7) g/L vs (1.8±0.8) g/L],antinuclear antibody (56％ vs 87％) and anti-SSB antibodies (13％ vs 54％) (P＜0.05),when compared with IgG4-unrelated cases.There was no significant difference in other indicators (P＞0.05).Conclusion The present study has demonstrated that some of the MD patients misdiagnosed as SS.Some of the laboratory tests such as the level of platelet and lymphocyte count,serum level of CRP,IgM,antinuclear antibody,anti-SSB antibodies,the serum levels of IgG4 and the histopathological presentations in the salivary gland are different between these two disorders.Because of good response to steroid in MD,so laboratory tests and pathological examinations for IgG4 can help to avoid misdiagnosis.

Objective To investigate the effect of mycophenolic acid on the proliferation of smooth muscle cells (SMCs) in rats' pulmonary arterial at cellular level. Methods Growth curve, MTT tests, and flow cytometry were used to detect the number of proliferative cells, the A-value of living cells and the DNA content of the control and drugs groups respectively and the number of cells in G1-phase, S-phase, G2M- phase and the proliferation index were calculated. Results Compared with the control group, the number of living cells in the mycopbenolic acid groups (with the concentration of 1, 10, 100 μmol/L) decreased, except the lowest dosage group (100 nmol/L). The difference was statistically significant (P<0.01). The living cells measured by MTT dose-dependently reduced in the mycophenolic acid groups. In the mycophenolic acid groups, the fraction of living cells in the S-phase and G2M-phase decreased respectively while that in G1- phase increased, and the proliferation index decreased. All these responses presented with a dose-dependent manner. Conclusion Mycophenolic acid can effectively inhibit the proliferation of rats' pulmonary arterial SMCs. This process happens mainly in ONA synthesis phase, and is dose dependent. In addition, these effective concentrations are all in the available range for clinical application.

Objective To investigate the cognition and care needs of the patients with acute stage fracture thus providing reference for the construction of intermediate care model. Methods The data of 504 patients with acute stage fracture from December 2014 to April 2015 were investigated through questionnaire, and analyzed. The issues included gender, age, marital status, cultural level, degree of understanding of intermediate care, care needs, etc. Results 63.29%(319/504) of the patients didn′t know intermediate care before they filled in the questionnaire,only 3.97%(20/504) of the patients understood the conception of intermediate care; different stage of age had different cognition towards intermediate care, the differences were statistically significant( χ2=148.771, P<0.01); different stage of age, sex, marital status, cultural level had different care needs, the differences were statistically significant (H/u=9.692-129.097, P<0.05). Conclusions At present, the majority of patients have no conception about intermediate care, so it is necessary to build the model of intermediate care. As nursing staff we should provide different help according to different type people, thus we can promote patients' physical and mental health, improve patient satisfaction to the greatest extent.

Object To observe the effect of total flavones isolated from Metasequoia glyptostroboides Hu et Cheng (FMG) on platelet aggregation, 5 HT of release, content of NO in plasma and hemorrheological parameters in rats. Methods Platelet aggregation was quantified by turbidimetry, release of 5 HT was assayed by fluorescence technique, and content of NO in plasma was determined by spectrophotometry. Results Inhibition of platelet aggregation and release of 5 HT, increase of NO content in plasma, as well as decrease of whole blood viscosity, plasma viscosity, red cell electrophoresis time, red cell specific volume, red cell count and K value in ESR equation were observed in the acute blood stasis rat, thereby the rat's hemorrheological properties were improved. Conclusion FMG is able to inhibit the platelet aggregation and improve the hemorrheological parameters in acute blood stasis rat. The inhibition of release of 5 HT, increase of NO content in plasma and antagonistic action of Ca 2+ may be the mechanism of its actions.

Current research,application,advantages and disadvantages of wearable health monitoring items based on soft sensor technology in foreign countries and China were introduced and analyzed,and the application in diseases monitoring,emotion monitoring,monitoring of rehabilitation training,monitoring of sport training,operational safety monitoring in special environments,casualty search during war and disaster,monitoring of the elderly and children and etc were also described.The characteristics of the items were analyzed,and some countermeasures were put forward to solve the problems in materials safety,data quality,industrial standard,unclear efficacy and etc.The study and prospective of soft physiological sensing technology were expounded in detail.

Objective To identify the clinical features of malignancy mimic vasculitis (MMV),and to increase the knowledge and alertness of MMV to avoid misdiagnosis and mistreatment.Methods Clinical records and laboratory index with test results were collected and retrospective study was employed to analyze twenty-four MMV patients,who were admitted to the department of Rheumatology of Peking Union Medical College Hospital during the period from January 2001 to January 2015.All data were analyzed by Fisher exact probability test.Results ① Twenty-four MMV took up to 2.5％ (24/927) of all the systemic vasculitis,and 0.15‰(24/157 883) of all the malignancy diagnosed during the same period.② The average age at the diagnoses being established was (43±19) years and the male to female was 3:1.③ Skin lesions (16/24),mucous injury (12/24),pulmonary involvement (10/24),thrombosis (7/24) and neurological involvement (7/24) were the mose common clinical manifestations that could mimic systemic vasculitis;Beh(c)et's disease (6/24),granulomatous with polyangiitis (6/24) and polyarteritis nodosa (5/24) were types of systemic vasculitis that MMV most frequently mimic.④ Among 22 MMV with definite pathological evidence,there were sixteen hematological malignancies and fourteen non-Hodgkin's lymphoma (NHL).⑤ For hematological malignancies mimic vasculitis patients,skin lesions (P=0.023),elevated LDH (P=0.046),leukocyte disorder (P=0.015) were more common than those nonhematological malignancy patients.⑥ Those with long disease duration (＞12 months) (n=6) tended to present more skin lesions (P=0.024) especially skin ulcers P=0.038) were than short course patients.Conclusion MMV should be proposed for those systemic vasculitis patients with atypical manifestations and poor response to routine therapy.Even if the disease duration is as long as more than 12 months,MMV should not be excluded imprudently as hematological malignancies could have long disease durations.