Objective To study the role of soluble intercellular adhesion molecule-1 ( sICAM-1 ) in the pathogenesis of adults bronchial asthma and analyze the relationship between the level of sICAM-1 and the severity of bronchial asthma.Methods Serum levels of sICAM-1 in 134 cases with different periods of bronchial asthma patients and healthy volunteers were measured by ELISA and pulmonary functions of acute asthma patients were determined by pulmonary function analyzer. Results Serum sICAM-1 levels in 63 cases of acute asthma patients were increased significantly when compared with those in remission asthma patients and healthy volunteers and its value was increased significantly with the exacerbation of asthma;A negatively correlation between FEV1％ of pulmonary function and serum sICAM-1 level in patients with acute asthma was found in this study. Conclusion sICAM-1 was one of the important adhesion molecules in the pathogenesis of bronchial asthma. It could be used as one indicator of disease severity and guide the drug application in clinic.

Objective To study the correlation between immune imbalance mediated by Th 17 and Treg cells and impaired lung function in patients with chronic obstructive pulmonary disease ( COPD ) . Methods Ninety-five patients with moderate or severe COPD , thirty-five smokers with normal lung function and thirty-one healthy non-smokers from Yinzhou People′s Hospital from January 2009 to December 2012 were recruited in this study .The percentages of circulating Th 17 and Treg cells in peripheral blood samples were determined by flow cytometry .The concentrations of cytokines in serum samples and supernatants of in-duced sputum samples were measured by enzyme-linked immunosorbent assay (ELISA).The expression of ROR-γt and Foxp3 at mRNA level in peripheral blood mononuclear cells ( PBMC) were determined by quan-titative real-time PCR.The potential association between ratios of Th 17/Treg cells and lung function was evaluated.Results Compared with smokers and healthy subjects , patients with moderate or severe COPD showed high levels of Th17 cells, IL-17A, IL-6 and IL-23, and an up-regulated expression of ROR-γt at transcriptional level .However, the percentage of Treg cells , IL-10 level and the expression of Foxp 3 at mRNA level were down-regulated in patients with COPD .The levels of cytokines in supernatants of induced sputum samples varied in the same way as that of Th 17/Treg in peripheral blood samples .The ratio of Th17 to Treg cells was negatively correlated with the values of forced vital capacity ( FVC) , forced expiratory vol-ume in one second (FEV1), and FEV1/FVC.Conclusion Th17/Treg cells imbalance was closely associ-ated with the deterioration of pulmonary function in patients with moderate or severe COPD .Th17/Treg cells imbalance might be involved in the progression of COPD .

AIM:To investigate the roles of microRNA-134 (miR-134) in the cisplatin resistance of lung ade-nocarcinoma cells.METHODS:miRNA microarray was applied to compare the miRNA expression profile between A549/CDDP and A549 cells.Real-time PCR was used to confirm the expression of miR-134.miR-134 mimics and inhibitors were transfected into A549/CDDP and A549 cells, respectively.MTT assay was used to detect the sensitivity of lung cancer cells to cisplatin.Western blot was applied to test whether miR-134 regulated forkhead box protein M1 ( FOXM1 ) and multi-drug-associated protein 1 ( MRP1 ) expression.RESULTS: Based on the data of miRNA microarray, 13 miRNAs were found to be differentially expressed in A549/CDDP cells compared with A549 cells, among which miR-134 was the most significantly down-regulated one.Compared with control group, A549/CDDP cells transfected with miR-134 mimics showed greatly enhanced sensitivity to cisplatin as indicated by IC50 values (P<0.01).In contrast, suppression of the miR-134 level in the A549 cells resulted in a decreased sensitivity to cisplatin (P<0.01).FOXM1 siRNA down-regulated the pro-tein levels of FOXM1.A549/CDDP cells transfected with si-FOXM1 showed enhanced sensitivity to cisplatin (P<0.01). In addition, the result of Western blot showed that miR-134 repressed MRP1 protein expression.CONCLUSION: miR-134 effectively increases the sensitivity of lung adenocarcinoma cells to cisplatin, and this effect of miR-134 may be partly due to its regulation of FOXM1 and MRP1 expression.

Objective To investigate instant messenger management on moderate asthma control in young and middle-aged patients.Methods Sixty young and middle-aged asthma patients enrolled were divided into 2 groups by random number table,traditional management group (group A) and messenger management group (group B),and received the asthma treatment with traditional management or messenger management for 1 year.The compliance,control condition,pulmonary function and Saint George respiratory questionnaire(SGRQ) were compared between two groups.Results After one year management,there were 20 patients in proceeding of the standard treatment,15 total control,10 partial control and 5 uncontrolled in group A,while there were 26 patients in proceeding of the standard treatment,21 total control,7 partial control and 2 uncontrolled in group B.Compared with group A,the treatment adherence(x2 =6.331,P ＜ 0.05),satisfaction degree (t =6.051,P ＜ 0.01),asthma control rate (x2 =6.490,P ＜ 0.05),efficacy satisfaction (t =6.051,P ＜ 0.01) were all increased in group B.Forced expiratory volume in 1 second was elevated more significantly in group B than that in group A [(0.132 ± 0.175) L vs.(0.326 ± 0.125) L] (t =5.099,P＜ 0.01).SGRQ scores were decreased more obviously in group B than that in group A (t =4.316,P ＜ 0.01).Conclusions The asthma control,respiratory and pulmonary function can be improved by messenger management in young and middle-aged patients.So promoting the messenger management model actively is advantageous to improve the level of prevention and treatment of asthma in China.

ObjectiveTo evaluate the value of serum galactomannan platelia aspergillus kit in the diagnosis and treatment of invasive fungal infection(IFI) patients. MethodsA total of 178 serum samples from 74 high risk patients were collected. ELISA assay was used to detect the level of GM antigen. Refer to domestic IFI diagnostic criteria, 16 patients include the proven cases and probable cases were defined as study group, while 29 patients of improbable cases defined as control group. Fourflod table was founded,by which the sensitivity,specificity,positive predictive value, negative predictive value of this GM test were calculated. Meanwhile, a total of 53 patients received antifungal therapy which divided into GM-positive group(21 patients with I≥0. 5) and GM-negative group(32 patients with I ＜0. 5). The therapeutic effect comparison of two groups was made according to curative effect criterion. ResultsAccording to the certainty level of IFI diagnosis, 1,9,10 and 4 patients were identified as GM positive in proven, probable,possible and improbable IFI groups respectively. The prevalence of GM in these 4 groups was 50％ ,64％ ,34％ and 14％ ,respectively. The sensitivity and specificity of galactomannan ELISA assay were 63％ ,86％ respectively. The positive and negative predictive values were 71％ and 81％ respectively. The diagnose accordance rate was 78％, the Younden index was 0. 49. The efficacy of fluconazole in GM-positive patients was significant lower than in GMnegative patients( x2 =4. 95 ,P ＜0. 05) ,while The efficacy of non-fluconazole drug was superior to that in GM-negative patients( x2 =4. 88,P ＜ 0. 05). After antifungal therapy, the GM value of GM-positive patients decreased significantly( t =2. 13 ,P ＜0. 05). ConclusionThe galactomannan ELISA assay with high specificity, could be helpful in diagnosis and choicing effective anti-fungi drug in clinic.

The purpose of education is to cultivate talents who can master the ability of self-learning lifelong. With the rapid development of multimedia technology, the knowledge carrier represented by micro curriculum plays a very important role in improving students' self-learning ability. In traditional Chinese medicine college, due to the short of time, weak learning foundation, the ability of self-learning is hard to improve in the modern medical courses such as biochemistry. This is not conducive to the cultivation of modern talents of Chinese medicine. In this paper, we chose the biochemistry teaching in TCM college as an example, and discuss how we can make the application of micro courses reasonably in the teaching process. This study was regarded as a starting to improve the students' self-learning ability effectively.

Objective:To explore the pathogenesis of coronary artery lesions in Kawasaki disease(KD) by detecting expression of CD40L on T-cells from patients with KD.Methods:Blood samples were collected from 26 patients with KD before and after intravenous immunoglobulin(IVIG) treatment. Age-matched febrile 16 children with various diseases were studied in parallel as controls. Age-matched normal control 15 children were studied as controls. CD40L expression on T-cells was detected by flow cytometry, soluble E-selection and soluble CD40L levels were measured by enzyme-linked immunosorbent assay.Results:CD40L expression on CD4+T-cells and soluble E-selection levels were significantly higher in patients with KD than that in the febrile control(FC) group and normal group(P

OBJECTIVE To study the mechanism of drug-resistance of multi-resistant Pseudomonas aeruginosa,and provide the guideline for treatment and control of P.aeruginosa infection in hospital.METHODS Fifty strains of multi-resistant P.aeruginosa were selected with K-B susceptibility method.The three-dimensional method was taken to differentiate the various beta-lactamases.The relative drug-resistance gene was detected by polymerase chain reaction(PCR).RESULTS Among 50 strains of multi-resistant P.aeruginosa,there were 2 strains(4%)producing ESBLs,20 strains(40%)producing AmpC beta-lactamases,and 11 strains(22%) producing ESBLs and AmpC beta-lactamases at the same time.There were 8 positive genes in the detected drug-resistance gene,the most common sources of gene were CTX(56%),OprD(60%) and aac(6′)-Ⅱ(60%),respectively.CONCLUSIONS The main beta-lactamases are AmpC beta-lactamases and the main genotype is CTX in the multi-resistant P.aeruginosa cultured in our area.The main course of imipenem-resistance was deletion of outer membrane proteins,and the aminoglycoside modifying enzyme gene and disinfectant-resistance gene in multi-resistant P.aeruginosa are acquired.In order to reduce the drug-resistance strains and control the infection of P.aeruginosa,antibiotics should be used reasonably according to drug susceptibility testing clinically.

Objective:To explore the effects of hierarchical and diversified training model in clinical nursing training for nursing staff.Methods:Totally 102 nursing staff who participated in clinical nursing training at Chun'an Second People's Hospital from January 2018 to January 2019 were selected. A total of 51 nursing staff who participated in training from January to June 2018 were divided into the control group, while another 51 nursing staff who participated in training from July 2018 to January 2019 were divided into the observation group. Nurses in the control group adopted the traditional nursing training model, while nurses in the observation group adopted a hierarchical and diversified training model on this basis. The skills assessment scores and their satisfaction with the training process among the nursing staff, and the patient's satisfaction with nursing work were compared between the two groups.Results:The nursing knowledge, clinical skills operation, emergency treatment, nursing quality and other related skills assessment scores, the total satisfaction with the training work, and the patients' overall satisfaction with the nursing work in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The hierarchical and diversified training model can improve the nursing staff's clinical nursing ability and operation assessment results, and can enhance the trainees' satisfaction with the training work, which helps to improve clinical nursing quality and nursing efficiency continuously and bring a sound doctor-patient relationship. It is safer and worth promoting in clinical practice.

Objective: To construct an index system for evaluating the effectiveness of dynamic pricing adjustment of medical services, for the purpose of providing a set of evaluation tools for price regulatory authorities to evaluate the effectiveness of pricing adjustment of medical services, to keep track of pricing trends, to implement dynamic monitoring and to guide decision-making. Methods: Oriented to public hospitals in Guangdong province, literature analysis and Delphi method were used to construct the index system for evaluating the effectiveness of dynamic adjustment of medical service price. Descriptive analysis, consistency test and index importance evaluation were applied to statistical analysis. Results: Thirty-two experts evaluated the importance of 41 alternative indicators. The index system for evaluating the effectiveness of dynamic adjustment of medical service price was finally constructed, including six structural indicators, six process indicators and six result indicators. Conclusions Experts are representative, authoritative and well-coordinated. The consultation results are reliable. The evaluation index system has high reliability and validity, and can be used to objectively evaluate the dynamic adjustment effect of medical service price.