Objective:To investigate the effects of ginkgo biloba tablets plus relevant mechanism on HPA axis in patients with steroid-dependent asthma.Methods:80 patients with steroid-dependent asthma were divided into control group and experimental group at random,40 cases in every group.The control group were treated with pulmicort respules(1 mg/d) ,patients in the experiment group were given ginkgo biloba tablets in addition to routine treatment(120 mg/d).The therapeutic courses were both 12 weeks.The effective rate of reducing hormone,lung function,the plasma concentrations of ACTH and COR and the levels of PBMC GCR were deter mined before and after treatment.Results:The effective rate of reducing hormone was 89.47%in experimental group,which was 66.67%in control group.There were significant difference at the tows groups(P<0.01).There were no significant difference at lung function,the plasma concentrations of ACTH and COR and the levels of PBMC GCR at pre-treatment( P>0.05).After treatment,the lung function, the levels of plasma concentrations of COR and the levels of PBMC GCR were increased significantly than control group( P<0.01,P<0.05),the levels of plasma concentrations of ACTH was decreased significantly than control group(P<0.01).There was a significant positive correlation between the value of FEV1/FVC and the plasma concentrations of COR,the levels of PBMC GCR( r=0.724,0.632, P<0.01).There was a significant negaitive correlation between the value of FEV1/FVC and the plasma concentrations of ACTH( r=-0.668,P<0.01).Conclusion:Ginkgo biloba tablets combined with routine treatment therapy can increase the effective rate of reducing hormone in patients with steroid-dependent asthma,which can improve the lung function maybe by regulate the HPA axis and upgrade the levels of GCR.

Objective To survey the scientific research integrity situation of community health care organizations in Yangpu district in Shanghai,meanwhile,provide a reference for scientific research integrity management in any community health care organization.Methods Using the convenience sampling method,we sampled 200 health staff from 4 community health service centers.They were surveyed with uniform questionnaires.Results No dramatically relationship existed in health staff's knowledge about scientific research integrity breach and their age.However,education background,their academic titles,how many times they have learned relative information,publicity about science research integrity would impact their awareness on research integrity.Conclusions There is dramatically discrepancy on the scientific research integrity among these community health staff.

Objective To investigate the protective effects ofDasangju Mixture on the liver injury induced by delayed-type hypersensitivity in mice; To discuss its mechanism of anti-inflammatory-immunity.Methods After enterocoelia intravenous injection of cyclophosphamide was used, 2,4,6-picryl chloride was used twice for exterior coating for skin of abdomen to cause sensation of skin. Then percutaneous transhepatic puncture was used to attack for modeling. Male Kunming mice were randomly divided into blank group, model group, high-, medium- and low-dose treatment groups. The high-, medium- and low-dose treatment groups were given Dasangju Mixture for gavage, once a day for 7 days. ELISA was applied to determine the serum levels of aspartate aminotransferase (AST), alamine aminotransferase (ALT) and tumor necrosis factor (TNF)-α. Pathological features of liver tissue were observed by HE staining.Results Compared with the blank group, the levels of AST, ALT and TNF-α in the model group increased significantly (P<0.05); Compared with the model group, the levels of AST, ALT and TNF-α in the high-, medium- and low-dose treatment groups decreased significantly (P<0.05,P<0.01,P<0.001); Compared with the model group, high-, medium- and low-dose treatment groups can better alleviate topical inflammation infiltration and edema of liver tissue.ConclusionDasangju Mixture has certain protective effects on the liver injury induced by delayed-type hypersensitivity in mice.

Objective To measure the expressions of programmed death?1(PD?1)and programmed death ligand?1(PD?L1)on peripheral blood T lymphocytes of patients with condyloma acuminatum(CA), and to investigate their role in cellular immunity in these patients. Methods Peripheral blood samples were obtained from 30 patients with CA(CA group)and 20 healthy human controls (control group). Flow cytometry was conducted to detect the expressions of PD?1 and PD?L1 on the surfaces of peripheral blood CD4+and CD8+T lymphocytes, and to determine the counts of CD4+and CD8+T lymphocytes. Enzyme?linked immunosorbent assay(ELISA)was performed to measure the levels of serum interleukin?2(IL?2)and interferon?γ(IFN?γ). Statistical analyses were carried out to compare the above parameters between the two groups, and to assess the relationship of PD?1 and PD?L1 expressions with the counts of CD4+and CD8+T lymphocytes as well as with the serum levels of IL?2 and IFN?γ. Results There was a significant increase in the expression rates of PD?1 and PD?L1 on CD4+T lymphocytes(PD?1:9.48%± 3.31%vs. 7.12%± 2.16%, t=2.81, P<0.01;PD?L1:4.40%± 1.46%vs. 3.26%± 1.13%, t=3.16, P<0.01)and CD8+T lymphocytes(PD?1:12.52%± 3.17%vs. 9.95%± 2.17%, t=3.16, P<0.01;PD?L1:7.07%± 2.23%vs. 5.39%± 1.69%, t=2.88, P<0.01)in the CA group compared with the control group. Moreover, the CA group showed significantly lower counts of CD4+T lymphocytes(727.43 ± 138.59/μl vs. 804.25 ± 92.83/μl, t=2.17, P<0.05)and CD4/CD8 ratio(1.23±0.35 vs. 1.46 ± 0.34, t = 2.24, P < 0.05) than the control group, while no significant difference was observed in CD8 + T lymphocyte counts between the CA group and control group(613.60 ± 121.60/μl vs. 572.45 ± 103.08/μl, t=1.24, P>0.05). The levels of serum IL?2 and IFN?γwere both lower in the CA group than in the control group(t=2.12, 2.16, respectively, both P < 0.05). In the CA group, PD?1 and PD?L1 expression levels on peripheral blood CD4 + T lymphocytes were both negatively correlated with CD4+T lymphocyte counts, the CD4/CD8 ratio, as well as IL?2 and IFN?γserum levels(all P<0.05), and those on peripheral blood CD8+T lymphocytes were also negatively correlated with the CD4/CD8 ratio(all P<0.05), but uncorrelated with CD8+T lymphocyte counts(both P>0.05). Conclusion PD?1 was highly expressed on peripheral blood T lymphocytes from patients with CA, which may inhibit T lymphocyte?mediated immune response, decrease CD4+T lymphocyte counts, the CD4/CD8 ratio as well as IL?2 and IFN?γserum levels by interacting with its ligand PD?L1 and forming the PD?1/PD?L1 signaling pathway.

Objective To investigate the effect of applying specialist nursing assessment indicator system on improving nurse′s health assessment ability in orthopedic department. Methods A specialist nursing assessment indicator system was developed by applying evaluation indicators of nursing care quality. That assessment indicator system consisted of 9 sub-indicators. They were assessments on local blood circulation, sensation and motion, muscle strength, pain, risk of developing pressure ulcer, risk of falling down and assessment on anal sphincter function, etc. In addition, standard assessment process was developed and applied to train 54 nurses in orthopedic department, in order to standardize and improve their ability on specialist nursing assessment. Furthermore, the assessment process was transferred into specific nursing interventions to improve nurse′s health assessment ability, too. The accurate rate on those 9 indicated assessments were evaluated and analyzed regularly, pre and post the indicator system application. In the present study, each of the 54 nurses was required to assess five patients basing on the items in the assessment indicator system. The total assessment times were 270. Results After applying the indicator system, the accurate rates of assessments on local blood circulation, sensation and motion, muscle strength, pain, risk of developing pressure ulcer, anal sphincter function and assessment on developing deep venous thrombosis were 98.89% (267/270), 99.63% (269/270), 99.26% (268/270), 97.41% (263/270), 98.15% (265/270), 91.85% (248/270), 98.15% (265/270), which were higher than 95.19%(257/270), 92.96%(251/270), 96.30%(260/270), 90.37%(244/270), 92.22%(249/270), 85.56%(231/270), 92.22%(249/270) of the time when the system was not used, and the difference was significant (χ2=5.34-16.82, P < 0.05). However, the accurate rates on assessing risk of falling down and assessing ADL were not significant different, comparing to the results before applying the indicator system (χ2=0.34, 0.41, P>0.05). Conclusions Applying the specialist nursing assessment indicator system was able to standardize nursing assessment behavior and improve nurse′s assessment ability. In addition, it was beneficial to improve the quality of specialist nursing care in orthopedic department.

Objective:To observe the efficacy of cytokine-induced killer (CIK) cells on patients with advanced lung cancer. Methods:A total of 90 patients with advanced lung cancer were identified from January 2011 to December 2013. CIK therapy was given to 41 pa-tients in the observation group, whereas the other 49 patients in the control group received the best support treatments without che-motherapy or radiotherapy within one month of inclusion. Following up was conducted for the patients in the two groups, and KPS scores, median survival, and adverse reactions compared. Results:The KPS score in the observation group was higher than that of the control group after treatment (P=0.034). The median survival period of the observation group was eight months, which was one month longer than that of the control group (P=0.044). Major adverse reactions included fever, joint pain, and insomnia, which were recorded 51.22%, 36.58%, and 29.27%of occurrence, respectively. Conclusion:CIK cell therapy improved the quality of life and pro-longed the survival of advanced lung cancer patients with tolerable adverse reactions.

Objective The optimal treatment for chronic type B dissection remains controversial. The purpose of this study was to report early and mid-term results of thoracic endovascular aortic repair (TEVAR) of chronic type B aortic dissection. Methods Methods From June 2001 to September 2007, 84 patients with chronic type B aortic dissection received TEVAR. The time between onset of dissection and TEVAR was (13.9 ± 22.0) months (ranged 1 - 120 months). All patients were followed for 6 - 86 months [mean (33.2 ± 19.2) months]. Results The entry tear was completely sealed in 77 cases ( 91.7% ) during TEVAR. The incidence of incomplete seal was 8.3%. One-month mortality was 1. 2%. One patient had retrograde type A dissection 1 month after operation. Four patients received a second TEVAR during follow-up :3 for endoleaking and 1 for newly formed intima tear. Seven patients (8.3%) died during follow-up: 3 thoracic aorta rupture due to endoleaking, 1 abdominal aorta rupture caused by continuous dilation of the abdominal aorta, unrelated to aortic dissection deaths in 2 and 1 died of unknown cause. The Kaplan Meier actuarial survival curve showed a 7-year survival rate of 84.4%. Conclusion Early and mid-term results showed that TEVAR was effective in treating chronic type B aortic dissection. Endoleak was the main cause of death during follow-up. With increasing of physician's experience and refinement of the stent-graft, results are likely to improve in the future.

Objective To study the image segmentation, three-dimensional (3D) reconstruction and simulation operation of choledocholithotomy and T-tube drainage based on the computed tomagraphy (CT) data of patient with choledocholithiasis. Methods Patient with choledocholithiasis underwent 64-slice spiral CT imaging. The images segmentation and 3D reconstruction were performed by Medical Image Process System (MIPS) to construct the 3D model of the hepatobiliary system. The model was modified by FreeForm Modeling System. The virtual surgical instruments were developed by GHOST SDK software, and were imported to the virtual surgery. Results The data of plain, arterial phase, venous phase and portal venous phase scanning were collected, and the data stored in DICOM format were transformed to BMP format. A model of the hepatobiliary system was constructed after the data was segmented by MIPS, and then the model was exported in the STL format. The data in STL format were imported to FreeForm Modeling System for smoothing the model. Different structures were assigned different colors to make the model more vivid. The self-developed virtual surgical instruments were imported to the system, and the virtual surgery for choledocholithiasis was performed with PHANToM. Conclusions With the help of MIPS, the image segmentation and 3D reconstruction of the model are finished rapidly and effectively. After the virtual surgical instruments are developed in FreeForm Modeling System, the virtual surgery can be achieved in the 3D model with the assistance of PHANToM.

Objective To investigate the effects and safety of needle?knife precut papillotomy in diffi?cult common bile duct cannulation of endoscopic retrograde pancreatic duct radiography ( ERCP ) . Methods The data of 104 cases treated with needle?knife precut papillotomy were retrospectively analyzed. The effect of pre incision and short?term complications were observed,and compared with 1326 cases( conventional group) of con?ventional selective intubation in the same period of ERCP. Results Successful cannulation of the bile duct was achieved in 97 of 104 patients who underwent needle?knife precut papillotomy, the total success rate was a?chieved in 93. 3%. The complications of needle?knife precut papillotomy occurred in 8 patients(7. 7%),inclu?ding mild bleeding in 4 cases,mild pancreatitis in 2 cases and billiary infection in 2 cases. There were 1326 ca?ses conventional selective intubation in the same period of ERCP,and 98 cases(7. 4%) with complication. There was no significant difference in the incidence of complications between the needle knife cut group and the con?ventional selective intubation group(χ2=0. 055,P>0. 05 ) . Conclusion In case of difficult common bile duct cannulation of ERCP,needle?knife precut sphincterotomy surgery can be safely and effectively catch the high ?ERCP the success of treatment,is worthy of wider application.

Objective To observe the changes of postprandial blood pressure and heart rate with two types of nasal feeding in the very elderly and explore the method for decreasing the postprandial hypotension (PPH).Methods Totally 49 patients (aged＞80 years) were randomly divided into two groups of continuous versus intermittent nasal feeding.The clinical symptoms and changes in blood pressure and heart rate before and after meals were observed.Results The incidence of PPH was 100.0％(26 cases)in the group of intermittent nasal feeding,and 47.8％ (11 cases) in the group of continuous nasal feeding (P＜0.01).Postprandial blood pressure in the group of intermittent nasal feeding was decreased significantly as compared with the group of continuous nasal feeding (P ＜0.05); and the heart rate was accelerated in the group of intermittent nasal feeding compared with continuous nasal feeding (P＜0.05).The incidence of serious cardio-cerebral ischemia was 7.7％ (2cases)in the group of intermittent nasal feeding.The patients had no clinical symptoms in the group of continuous nasal feeding.Conclusions Continuous nasal feeding for the very elderly with gastrointestinal nutrition can reduce the extent of the falling blood pressure and the incidence of PPH,and avoide cardiocerebrovascular events.