Objective To analyze the early warning indicators of tuberculous peritonitis (TBP)in patients with cirrhotic ascites.Methods A retrospective analysis was performed on the clinical data of 62 patients with cirrhotic ascites hospitalized in the Second Affiliated Hospital of Chongqing Medical University from January 2010 to December 2012.The chi-square test and Mann-Whitney U test were used for uni-variate analysis,while the logistic regression model was used for multivariate analysis.Results There were significant differences between TBP group and non-TBP group in sex,history of primary peritonitis,erythrocyte sedimentation rate (ESR),serum tuberculosis antibody, percentage of lymphocytes in ascites (≥50%),and prothrombin activity (PTA)(P<0.05 for all).The odds ratios (ORs)of history of primary peritonitis,PTA,ESR,and percentage of lymphocytes in ascites (≥50%)for development of TBP in patients with cirrhotic ascites were 1.933,3.205,2.716,and 11.701,respectively (P<0.05 for all),and the areas under the receiver operating characteristic curve were 0.831,0.815,0.775,and 0.935,respectively (P<0.05 for all).Conclusion History of primary peritonitis,PTA,ESR,and per-centage of lymphocytes in ascites (≥50%)are the early warning indicators of TBP in patients with cirrhotic ascites;these early warning in-dicators,especially percentage of lymphocytes in ascites (≥50%),have good predictive values.

Objective To observe the effects of hyperbaric oxygen combined with rehabilitation training on the motor ability of ischemic stroke patients.Methods Eighty ischemic stroke patients were randomly divided into a treatment group and a control group,with 40 cases in each group.The control group was treated with Bobath' s approach,while the treatment group was treated with Bobath's methods supplemented by hyperbaric oxygen therapy.The United States National Institutes of Health Stroke Scale (NIHSS),the Fugl-Meyer motor assessment scale (FMA) (lower part) and each patient's maximum walking speed (MWS) were used to evaluate the patients before,and after 8 weeks of treatment.Results After treatment the average NIHSS score,FMA score and MWS were 4.17 ± 1.4％,31.2 ± 3.3 and 54,.3 ± 16.2 m/min,respectively,in the treatment group.The control group' s results were 6.81 ± 1.2％,26.2 ± 2.2 and 45.6 ± 18.3 m/min.The intra-group differences in evaluation results before and after treatment were statistically significant in both groups.An inter-group comparison showed that the treatment group performed significantly better after treatment than the control group in terms of FMA and MWS.After treatment,the treatment group showed significantly better walking performance in terms of cadence,stride length,step length on the affected side,gait cycle and double support duration.Conclusion Hyperbaric oxygen can make rehabilitation training more effective in improving the neurologic deficits,motor function and walking ability of hemiplegic stroke survivors.

Objective: To explore the effect of caveolin-1 ( Cav-1 ) on lipopolysaccharide ( LPS )-induced airway mucous hypersecretion.Methods:16HBE human airway epithelial cells with Toll-like receptor 4(TLR4) inhibitor,nuclear factor-kappa B(NF-κB) inhibitor,Cav-1 siRNA or plasmid pr-treated,further stimulated with LPS.The cells were divided into 8 groups:the control group, the LPS group,the LPS+Cav-1 expression group,the LPS+Cav-1 siRNA group,the LPS +negative siRNA group,the LPS +empty vector group,the LPS +E5564 group, the LPS +PDTC group.Cell survival rate was detected by MTT assay.Transcription level of mucin(MUC)5AC was evaluated with RT-PCR.The level of MUC5AC protein was measured by ELISA.The expression of TLR4,Cav-1 and phosphorylated IκBα( p-IκBα) were measured by Western blot.MUC5AC protein changes were observed by immunofluorescence and confocal laser technology.Results:LPS remarkably increased MUC5AC,as well as TLR4,p-IκBα(P<0.05).These effects were prevented by E5564 and PDTC.We found that the overexpression of Cav-1 further enhanced the expression of TLR4, p-IκBαand MUC5AC.However,downregulation of Cav-1 inhibited the expression of TLR4,p-IκBα,MUC5AC.Conclusion: Cav-1 enhances LPS-induced MUC5AC hypersecretion through TLR4/NF-κB signaling pathway.

Objective To analyze the potential risk factors of infantile spasms (IS) relapse through following up the respondents with IS after different treatment protocols.Methods Sixty-nine cases were collected in the Department of Pediatric Neurology,Jiangxi Children's Hospital from May 2011 to September 2013,who had complete cessation of spasms for at least 28 days or more after the different treatment protocols.The follow-up was performed on these patients until spasms seizure relapse or at least 1 year for those without recurrence.According to the literature review,8 possible risk factors of IS recurrence (gender,age of onset,course of diseases,etiology,high irregular types of electroencephalogram,development quotient,onset time,treatment protocols) were selected,and then Logistic multiple regression was used to analyze the relationship of various potential risk factors with the relapse of spasms.Results (1) The recurrence rate at 6 months and 12 months were 40.6％ (28/69 cases)and 43.5 ％ (30/69 cases),respectively.(2) Among the various potential factors,the age at onset and the time to response were closely related to the IS recurrence.Namely,the non-classic onset(early-onset and late-onset) of IS were more likely to relapse than the classic onset[66.7％ (14/21 cases) vs 33.3％ (16/48 cases),x2 =6.605,P =0.010];the responders beyond 1 week were more likely to relapse than those within 1 week[63.6％ (14/22 cases) vs 34.0％ (16/47 cases),x2 =5.341,P =0.021].There were significant differences between the 2 groups (all P ＜ 0.05).(3) Logistic multiple regression analysis demonstrated that age at onset (Wald =3.603) was most closely related to the relapse of spasms.Conclusions (1) The relapse rate of IS in children was high,and the majority of them relapsed within 6 months.So a long-term,rational and effective clinical management solution should be explored.(2) The age at onset and the time to response are very important risk factors of the IS recurrence,and the former was more significant.So,early diagnosis and early treatment are more likely to improve the efficacy of IS,and reduce the risks of recurrence and improve the prognosis.

ostic sensitivity and specificity of EUS are high in distinguishing benign and malignant character of upper digestive tract GIMTs. EUS plays an important role in guiding the clinical management of upper digestive tract GIMTs.

Objective To explore the program of cultivating the nursing master students according to the present situation of China.Methods Delphi method was used in this study.Results In the type of scientific research,the order were the basic knowledge of nursing,clinical knowledge,research ability,ability of adapting society,teaching,management and the community nursing ability.In the type of clinic,the order were the basic knowledge of nursing,clinical knowledge,ability of adapting society,management,research ability,teaching and the community nursing ability.Conclusion According to the present situation of our country,the basic knowledge of nursing and the clinical skills should not be ignored.

Objective:To validate the physical activity model for the elderly in nursing homes based on the self-determination theory (SDT) under the Chinese scenario and provide a theoretical basis for future interventions by clarifying the relationship between autonomy support, basic psychological needs, motivation and physical activity in the elderly in nursing homes.Methods:Totally 204 senior citizens from 6 nursing homes in Shenyang City were selected by convenient sampling from March 7 to 13, 2018. The self-made general information questionnaire, Perceived Autonomy Support (PAS) , Psychological Need Satisfaction in Exercise Scale (PNSE) , Revised Behavioral Regulation in Exercise Questionnaire (BREQ-2) and pedometers were used to collected their basic information, autonomy support, psychological satisfaction in exercise, motivation and physical activity. The statistical method of structural equation model was employed to validate the model.Results:The coefficient of 14 paths in the model was significant [χ 2=44.81, degree of freedom ( df) =31, χ 2/ df=1.45, comparative fit index ( CFI) =0.99, root-mean-square error of approximation ( RMSEA) =0.05, standardized root-mean-square residual ( SRMR) =0.03], showing the model simulation was sound. Autonomy support could predict the level of physical activity through the complete mediation of basic psychological needs and motivation. The positive effect of autonomy support on basic psychological needs was 0.96, and the predictive power of the three basic psychological needs for motivation was attribution (0.93) , autonomy (0.88) , and competence (0.81) from high to low. The positive effect of basic psychological needs on autonomous motivation was 0.82, and their negative effect on controlled motivation and amotivation was -0.94 and -0.65, respectively. The positive effect of autonomous motivation on physical activity was 0.64. The negative effect of controlled motivation on physical activity was -0.22, and the negative effect of amotivation on physical activity was -0.19. Conclusions:As a model for understanding the generation and development process of physical activity motivation, SDT is universal and applicable to the elderly population in the context of Chinese culture.

OBJECTIVETo investigate the role of miR-21 in airway immunologic dysfunction induced by cold air irritation.

METHODSImmortalized human airway epithelial cell lines BEAS-2B and 16HBE cells were cultured in air-liquid phases. The differential expressions of endogenous miR-21, miR-164, and miR-155 in the cells induced by cold air exposure for different time were detected by real-time PCR. The reporter plasmid containing wild-type or mutated 3'UTR of TLR-4 were constructed and co-transfected into BEAS-2B cells or 16HBE cells together with miR-21 mimic, miR-21 mimic control, miR-21 inhibitor, or miR-21 inhibitor control. Following the transfection, dual luciferase reporter assay was performed to verify the action of miR-21 on TLR-4. miR-21 mimic, miR-21 mimic control, miR-21 inhibitor, and miR-21 inhibitor control were transfected via lipofectamine 2000 in BEAS-2B or 16HBE cells that were subsequently exposed to a temperature at 37 degrees celsius; or cold irritation (30 degrees celsius;), and the protein levels of TLR-4/MyD88 were detected by Western blotting.

RESULTSCold irritation caused a time- dependent up-regulation of miR-21 in both BEAS-2B and 16HBE cells (P<0.05) without obviously affecting the expressions of miR-164 and miR-155. Dual luciferase reporter assay demonstrated a direct combination of miR-21 and its target protein TLR-4. The synthesis levels of TLR-4/MyD88 protein were decreased in miR-21 mimic group even at a routine culture temperature (P<0.05), as also seen in cells with cold irritation (P<0.05). Treatment with the miR-21 inhibitor partially attenuated cold irritation-induced down-regulation of TLR-4/MyD88 protein (P<0.05).

CONCLUSIONCold air irritation-induced airway immunologic dysfunction is probably associated with TLR-4/MyD88 down-regulation by an increased endogenic miR-21.

3' Untranslated Regions ; Blotting, Western ; Cell Line ; Cold Temperature ; Down-Regulation ; Epithelial Cells ; immunology ; metabolism ; Humans ; Luciferases ; MicroRNAs ; metabolism ; Myeloid Differentiation Factor 88 ; metabolism ; Real-Time Polymerase Chain Reaction ; Signal Transduction ; Toll-Like Receptor 4 ; metabolism ; Transfection ; Up-Regulation

Objective To evaluate the clinical efficacy and safety of different doses of prednisone combined with topiramate(TPM) in the treatment of infantile spasms(IS),in order to provide a new choice of the therapy of IS.Methods Fifty-six cases were collected in the Department of Neurology of Jiangxi Children's Hospital from May.2011 to Dec.2012.They were randomly divided into 2 groups:control group and trial group.The patients in control group took prednisone tablet of 1 mg/kg,2 times a day for 2 weeks;and the patients in trial group took prednisone tablet of 10 mg/ d,4 times a day for 2 weeks.In addition,TPM was used in both groups by initial dose 1 mg/(kg · d) or 2 times a day,and then was gradually increased to 3-5 mg/(kg · d) within 2 weeks.For those children in whom the spasms seizure completely ceased after 2 weeks,prednisone was then reduced by degrees to be discontinued for a 7-weeks course(extending to 4 weeks with the initial doses if spasms continued after 2 weeks).All patients underwent the assessment of spasms seizure and a 3-12 h video-electroencephalogram monitoring including wake and sleep states,which were performed before treatment,after 2 weeks and the end of the courses (7 or 9 weeks after treatment),respectively.Meanwhile,the side effects of the drugs during the treatment were recorded.The developmental quotient (DQ) tests of children with complete cessation of spasms more than 6 months were performed before treatment and after 6 months.All patients had been followed up for 2-18 months.Results 1.After 2 weeks of the therapy,the rate of cessation of spasms were 75.00％ (21/28 cases) and 28.57％ (8/28 cases) in the trial group and the control group,respectively,there was significant difference (x2 =12.087,P =0.001).And in the same term,the rate of complete resolution of hypsrrhythmia were 60.71％ (17/28 cases) and 21.43 ％ (6/28 cases),respectively,there was significant difference (x2 =8.928,P =0.003).At the end of treatment,the rate of cessation of spasms were 67.86％ (19/28 cases) and 35.71％ (10/28 cases) in the trial group and control group,respectively,there was significant difference (x2 =5.793,P =0.016).And in the mean time,the rate of complete resolution of hypsrrhythmia were 57.14％ (16/28 cases) and 14.29％ (4/28 cases),respectively,there was significant difference (x2 =11.200,P =0.001).2.Weight gain and increased appetite were the most frequent side effects.The incidence of side effects were 82.14％ (23/28 cases) and 67.86％ (19/28 cases) in the trial group and control group,respectively,there was no significant difference between the 2 groups (x2 =1.524,P =0.217).No death occurred in this clinical trail and no one discontinued the treatment protocol as result of the adverse events.3.The recurrence rate in the trial group and the control group were 31.82％ and 72.73％,respectively.And there was significant difference between the 2 groups (x2 =4.950,P =0.026).In the trial group,there were 9 cases with cessation of spasms more than 6 months,whose average business development values had no significant difference before and after treatment (t =2.271,P =0.053).Conclusion The efficacy of large-dose prednisone combined with TPM for IS was significantly better than that of conventional dose prednisone combined with TPM.

High Altitude Military Hygiene is the professional core course of high-altitude medicine, which is significant to the cultivation of military medical talents urgently needed by plateau troops. Under the background of "golden course" construction and army curriculum reform, aiming at the problems such as outdated content of course materials, single teaching mode and insufficient capacity of practical courses, we actively explored the effective path of "golden course" construction, including the renovation of the curriculum-construction concept, the optimization and reorganization of the teaching content, the expansion of case teaching and equipment teaching methods, and the implementation of curriculum ideological and political education and examination reforms. The reform has further improved the learning effect of students and the level of curriculum construction, and also provided beneficial reference for the construction of similar courses in military colleges and universities.