Objective To investigate the effect of ipratropium bromide combined with budesonide /formoterol fumarate inhalation powder on serum FeNO and lung function of bronchial asthma patients.Methods 102 cases with clear bronchial asthma during Jan 2013 and Mar.2015 from the affiliated Qianfo Hill Hospital of Shandong University were randomly divided into three groups, control group A (34 cases) were treated with ipratropium bromide, control group B (34 cases) were treated with budesonide/formoterol fumarate powder, experiment group (34 cases) were given ipratropium bromide combined with budesonide/formoterol fumarate powder, all groups were treated for 6 months.Pulmonary function, serum FeNO and IgE levels, clinical efficacy were compared after treatment.Results The effective rate of control group A, B (70.59%, 67.65%) were significantly lower than experiment group (91.18%), the difference were significant (P<0.05).FEV1, FVC, FEV1%pre of experiment group were significantly higher than control group A and B after the treatment.Serum IgE and FeNO concentration were significantly lower than control group A, B, the difference were significant ( P<0.05 ) .Conclusion Ipratropium bromide combined with budesonide/formoterol fumarate powder for inhalation in bronchial asthma patients can effectively reduce FeNO concentration, improve lung function.

Abstract: TGF-β/Smad signaling pathway has a wide range of biological activities and plays an important roles in regulating cell growth, adhesion, differentiation, cell dynamic balance, and immune responses. The higher activity of TGF-β/Smad signaling pathway may promote scar formation, organ fibrosis, immunosuppression, and late-stage cancer progression, while low activity may lead to inflammation, dysplasia, poor healing and oncogenesis. The function of the TGF-β/Smad signaling pathway is extremely complex and can exhibit inhibitory or enhancing effects on immunity and inflammation under different circumstances, but immunosuppressive and anti-inflammatory effects are dominant. During HIV infection, the TGF-β/Smad signaling pathway interacts with HIV in a complex manner as HIV proteins tat and gp120 can induce TGF-β expression. Meanwhile, this signaling pathway may also play a role in HIV infection and replication, latent virus reservoir, host immune deficiency and HIV-related inflammation. It is worth noting that even though TGF-β, which mainly exhibits anti-inflammatory effects, is induced by HIV, high levels of TGF-β do not seem to inhibit HIV-related inflammation. So far, the relationship between TGF-β/Smad signaling pathway and HIV infection has not been elucidated, and its role and mechanism in HIV infection and related illnesses need further exploration and validation. This review summarizes the relevant research progress on the TGF-β/Smad signaling pathway and HIV infection, and provides a reference for further understanding of HIV pathogenesis and exploring strategies of AIDS treatment.

Objective To explore the correlation of pathological changes and imaging through a control study on pathology and imaging of 4 cases of senile dementia of the Alzheimer type (SDAT).Methods By HE and Gallyas silver dyeing,four immunohistochemical methods were carried out The loss of neurons cells of all lobes of cerebral cortex,cingulate gyrus,amygdaloid nucleus,hippocampal gyrus,parahippocampal gyrus,meynert basal nucleus,substantia nigra,locus ceruleus,dorsal nucleus of vagus nerve,senile plaques (SP) and the changes of neurofibrillary tangles (NFT) were observed in detail The control study of pathology and imaging was carried out by comparison of CT in different phases before and after death of the patient.Results The degeneration of temporal lobe was marked: (1) The degeneration of middle frontal gyrus of cortex of frontal lobe was the most evident; (2) The degeneration of long gyrus was more evident than that of the short gyrus as the cortex of insular lobe was concerned; (3) The degeneration posterior part of cingulated gyrus was more evident than that of the anterior part.Conclusion The pathological findings of SDAT mentioned above are basically in conformity with the changes of imaging.

Objective To observe the effects of dexmedetomidine on inflammatory responses and insulin resistance during cardiac operations with cardiopulmonary bypass(CPB).Methods Fifty patients scheduled for elective cardiac valve replacement with CPB were equally and randomly divided into two groups using a random number table:observation group and control group(n =25).A loading dose of dexmedetomidine 1.0 μg/kg was injected intravenously over 1 5 min after induction,followed by continuous infusion at 0.4 μg·kg-1 ·h-1 until the end of CPB in doservation group.While the e-qual volume of normal saline was given in control group.After induction(T1 ),at 30 min after the be-ginning of CPB(T2 ),at the end of CPB(T3 ),and at 2 h after the end of CPB(T4 ),the jugular venous blood samples were taken for determination of serum concentrations of TNF-a,IL-6,insulin and blood glucose.The insulin sensitivity index (ISI ) = 1/(glucose × insulin )was obtained. Results Compared with control group,the serum TNF-a and IL-6 concentrations at T2-T4 were sig-nificantly decreased in observation group(P <0.05),the serum insulin and blood glucose concentra-tions at T2 ,T3 were significantly decreased in observation group(P <0.05 ),the ISI at T2 ,T3 were significantly increased in observation group(P <0.05).Conclusion Dexmedetomidine can reduce in-flammatory responses,thus reducing insulin resistance and blood glucose during cardiac operations with CPB.

With the rapid development of computer technology and informatization of the society,hospital network security and reliability becomes more and more important.According to HIS maintenance in our hospital,this paper discusses security measures in hospital from such aspects as system security,data security,network security,and security management.

Objective To evaluate the ability of multi-slice spiral CT angiography(MSCTA)in showing the celiac trunk and its degree branches,and the value of MSCTA in preoperative evaluation of laparoscopic-assisted gastrectomy for advanced gastric carcinoma.Methods A total of 25 consecutive patients scheduled for laparoscopic-assisted gastrectomy with D2 lymph node dissection were evaluated by MSCT,CT angiography(CTA)were reconstructed separately using a volume rendering algorithm(VR).The space anatomy characteristics of celiac artery and its degree branches were evaluated according to the CTA results,and with anatomy information,laparoscopic-assisted gastrectomy with D2 lymph node dissection was processed with references to anatomy.Results In all the 25 cases,the left gastric artery and gastroduodenal artery were accurately identified on MSCTA.In 12 of them,the right gastric artery was accurately identified.The origin of the spleen artery is relatively constant.Laparoscopic-assisted gastrectomy with D2 lymph node dissection was successfully completed without conversion to open surgery in all the cases.The reconstructed celiac trunk and branches are identical with anatomy.Conclusions Three-dimensional CTA using MSCT clearly reveals the anatomy of celiac artery and their space structure.It plays an important role in guiding lymph node dissection during laparoscopic-assisted gastrectomy for advanced gastric carcinoma.

OBJECTIVETo summarize laws of acupoint selection of prescriptions for treatment of cervicogenic headache by acupuncture in modern literature.

METHODSRandomized controlled trials (RCTs) involving acupuncture and moxibustion for treatment of cervicogenic headache were recruited from CBM (1978-2012), VIP (1989-2012), Wanfang Database (1998-2012), CNKI (1979-2012), PubMed (1966-2012), EMbase (1980-2012), and Cochrane Library (Volume 4, 2012). Hand recruitment was also auxiliarily used. The frequency and percentage of common acupoints, the distribution of acupoints along 14 meridians and across each part of the body, the application of specific acupoints, and features of using prescriptions for specific acupoints were statistically described.

RESULTSTotally 37 recruited papers included 42 acupoints and 159 times. Common acupoints covered Fengchi (GB20, 28 times), Jingjiaji (EX-B2, 21 times), Baihui (DU 20, 12 times), Tianzhu (BL9, 1 times), and Ashi point (11 times). Meridians along which acupoints were used mainly covered Foot-shaoyang Gallbladder Meridian, Foot-taiyang Bladder Meridian,and DU meridian. Acupoints were mainly needled from head, neck, and upper limbs. Eight confluence points and luo-connecting point were commonest used as specific acupoints. Acupuncture prescriptions were mostly composed of multiple acupoints. Filliform needle was mainly used in acupuncture methods, followed by electro-acupuncture needle.

CONCLUSIONSModern acupuncture treatment of cervicogenic headache focuses on local specific points and acupoints along meridians. Acupoints were mostly selected from head, neck, and upper limbs by syndrome typing of Chinese medicine.

The Pricing and Payment Regulation on Chinese Diagnosis Related Groups (C-DRG) was designed by National Health Development Research Center,directly under the leadership of Department of Finance,NHFPC (formerly Dept.of Planning and Finance,Ministry of Health),which organized a large study group consisted of nearly 1 000 experts since 2010.It introduced the general design of C-DRG and the principles and main points of applying C-DRG system,which could be referenced by all countries in carrying out the pricing and payment reform system.

BACKGROUND:Previous studies have found that cyclic tensile stress can induce the proliferation of human periodontal ligament fibroblasts in a certain time. OBJECTIVE: To observe the effect of cyclic tensile stress on the expression of connective tissue growth factor in human periodontal ligament fibroblasts, and to clarify the role of JNK, p38MAPK, PI3K pathway in the cyclic tensile stress-induced expression of connective tissue growth factor in human periodontal ligament fibroblasts. METHODS:Human periodontal ligament fibroblasts culturedin vitro were given stimulation of cyclic tensile stress in vitro for 1, 6, 12, 24 hours using multi-channel cel stretch stress loading system (experimental group). Control group was set up and not given any stimulation at the same time. The cels under stress application for 12 hours were given specific inhibitors of JNK, p38MAPK, PI3K respectively at the beginning, and were compared with those with no inhibitors. The concentrations of connective tissue growth factor in the culture supernatant were measured by ELISA. The mRNA expression of connective tissue growth factor in human periodontal ligament fibroblasts was detected by real-time RT-PCR. RESULTS AND CONCLUSION:Compared with the control group, the expression of connective tissue growthfactor in human periodontal ligament fibroblasts under cyclic tensile stress began to increase at 1 hour, increased manifestly at 6 hours, reached the peak at 12 hours, and then decreased at 24 hours. The expression of connective tissue growth factor was reduced by the specific inhibitors of JNK, while the specific inhibitors of p38 MAPK, PI3K had not the same effect. In a certain time, the cyclic tensile stress can induce a time-dependent increase in mRNA and protein levels of connective tissue growth factor. Along with the extending of time, the expression of connective tissue growth factor begins to decrease. Cyclic tensile stress can regulate expression of connective tissue growth factor in human periodontal ligament fibroblasts via the JNK pathway.

[Objective]Electrophoretic analysis of rat chemically extracted acellular nerve allograft(CEAN) protein was performed to investigate the protein of CEAN.Dorsal root ganglia of chicken were cultured onto the surface of CEAN slice to observe the effect of CEAN structure on the fiber regeneration.[Method]The CEAN were perpared according to Sondell method and electrophoresed to observed whether the electrophoresis strip of 28-30kDa(Myelin Protein) exited or not.Dorsal root ganglia of chicken were cultured onto thc surface of CEAN slice and dyed with nerve fiber fluorescence to observe the orientation of nerve fiber growth on the surface of CEAN slice.[Result]Electrophoretic analysis of rat CEAN protein showed that the electrophoresis strip of 28-30 kDa totally disappeared.A large number of nerve fibers grew from DRG along the basement membrane of CEAN.[Conclusion]No myelin protein remained in the CEAN,while the basement membrane structure of CEAN can induce the nerve fiber to grow.