Exhaled nitric oxide fraction (FeNO)reflects eosinophilic bronchial inflammation,and has been widely used to assist in the diagnosis of asthma,to monitor the airway inflammation and the responce to treatment effects of asthma in recent years.FeNO as a noninvasive examination,obtains a high degree of cooperation in adults and children over 5 years of age,but there are a lot of problems in children under 5 years of age.At present,there is still a lack of normal values and large sample-sized studies of FeNO in infants and neonates in China.The principle and method,normal reference value,influencing factors,clinical application and so on of exhaled nitric oxide detection are reviewed in this paper.

Objective:Apoptosis inhibitor 6(Api6),also known as AIM(Apoptosis Inhibitor expressed by Macrophage)or SP?(Soluble Protein alpha),is a newly defined member of the group B scavenger receptor cysteine-rich(SRCR)superfamily.Previous studies have suggested its important roles in immune system regulation,but the involvement of Api6 in lipid metabolism is seldomly studied.Methods:The aim of this study was to define the expression pattern of Api6 in lipid loading and inflammatory macrophages.The human monocyte/macrophage lineage THP-1 cells and murine Raw264.7 macrophages were incubated in the presence of 100 ?g/ml oxidized low-density lipoprotein(oxLDL)alone,LDL plus 200 ng/ml lipopolysaccharide(LPS)and LPS alone.Results:Foam cell formation after treatment was evidenced by oil red O staining.Real-time PCR results showed that after LPS or oxLDL treatment,the mRNA levels of Scavenger receptor SRA were increased 6-fold,2.5-fold and 6-fold,44-fold in Raw264.7 cells and THP-1 cellls respectively,but the expression of Api6 in Raw264.7 did not change.The mRNA levels of Api6 increased 2.7-fold after LPS and oxLDL treatment in THP-1 cells.Conclusion:The expression levels of Api6 in these macrophages were highly related to the presence of nuclear receptor liver X receptor(LXR)isoform LXR?.This study revealed that due to the lack of LXR? isoform,the basic expression level of Api6 was low in Raw264.7 macrophages,that makes it an ideal cell line for further study related to pathophysiological function of Api6 in lipid metabolism.

Objective To observe the clinical efficacy of ear acupuncture combined with mirtazapine in the treatment of insomnia.Methods Sixty-two patients with insomnia diagnosed by CCMD-Ⅲ were randomly divided into two groups,31 patients in each group.The patients in the observation group were treated by ear acupuncture combined with mirtazapine,and the patients in the control group were treated by mirtazapine.The clinical efficacy was evaluated by SDRS after 4 weeks of treatment.Results The SDRS score of the observation group significantly decreased after one week of treatment [(13.40±5.79)points vs.(21.79±6.12)points,t=2.204,P＜0.05].The SDRS score of the control group significantly decreased after one week of treatment [(14.68±5.88)points vs.(22.67±6.06)points,t=2.198,P＜0.05].After 4 weeks of treatment,the clinical efficacy of the observation group was significantly better than that of the control group (z=-2.209,P＜0.05),the SDRS score of the observation group was also significantly better than that of the control group (t=2.163,P＜0.05).Conclusion Ear acupuncture combined with mirtazapine has better effect in the treatment of insomnia patients,it has less side effects and lasting effects.

Cloud computing possesses the great, safe and reliable ability to store data, implements the integration and sharing of information resources, and reduces the economic cost.The infringement risks of intellectual property in digital library under cloud computing environment were described , such as infringement risks of intellectual proper-ty due to cloud computing safety , direct and indirect infringement risks of intellectual property of cloud service pro-viders.Measures for how to prevent and control them were put forward in aspects of laws and administrations.

SoLoMo in the mobile Internet time has provided a new way for service marketing in medical library, its meaning and its effect on medical library and how to innovate SoLoMo marketing service model in medical library were thus described in this paper.

Objective To investigate the relationship between plasma N-terminal pro brain natriuretic peptide(NT-proBNP) level and left ventricular(LV) diastolic dysfunction in hypertensive patients without systolic dysfunction.Methods Forty-four cases of primary hypertensive patients with left ventricular ejection fraction more than 50％ were enrolled,14 cases in normal diastolic function group,30 cases in diastolic dysfunction group(18 cases in delayed relaxation group and 12 cases in pseudo normalization filling group).LV diastolic function was assessed with conventional Doppler by means of mitral inflow and with tissue Doppler echocardiography by means of mitral annulus.The ratio of early diastolic transmitral E wave velocities to tissue Doppler mitral annulus early diastolic E' wave velocities (E/E') was used to detect LV filling pressures.Patients were divided into three groups according to E/E' ratios.Plasma concentrations of NT-proBNP were also measured.All related data were statistically analyzed.Results The levels of NT-proBNP were (115.2 ± 78.9)ng/L in LV diastolic dysfunction group,(34.7 ± 17.5) ng/L in normal filling group and (206.6 ± 75.8) ng/L in pseudonormal filling group.The level of NT-proBNP significantly elevated (F =85.263,P =0.000) along with the severity of lefi ventricular diastolic dysfunction.There was significant difference between each of the two groups among the three groups(all P ＜0.01).According to E/E' ratios,the patients were divided into three groups:E/E' ＜10(n =16),10 ＜ E/E ＜ 15(n =18),E/E' ＞ 15(n =10).The level of NT-proBNP were (39.5 ± 20.1) ng/L,(71.2 ± 26.4) ng/L and (203.7 ± 75.2) ng/L respectively in the three groups.The NT-proBNP blood level was positively correlated significantly with E/E' ratio (r =0.80,P ＜ 0.01).The sensitivity was 87％ and the specificity was 100％ for diagnosis of left ventricular filling pressure (E/E' ＞ 15)according to a NT-proBNP value of 119 ng/L.Conclusion Combining of plasma NT-proBNP and Doppler E/E'have potential value for identification of those patients with hypertension to detect early cardiovascular changes,especially LV diastolic dysfunction.

OBJECTIVE: To discuss advances in intrahepatic and intrabiliary stent application and evaluate their biocompatibility.METHODS: A computer-based online search of CNKI between 1989 and 2009 was performed to search related articles with the keywords of "bile duct, hepatic duct, stent, treatment". A total of 51 articles were searched and 20 were included according to inclusion and exclusion criteria. The articles were summarized from aspects of treatment advances in intrahepatic and intrabiliary stent application and prevention of obstruction following intrahepatic and intrabiliary stenting; the clinical application of intrahepatic and intrabiliary stent, biocompatibility and prevention of stent obstruction were discussed.RESULTS: Intrabiliary stent mainly includes metal stent and plastic stent. The metal stent is superior over plastic stent in preventing bacteria and keeping stent patency, but its cost is large. The plastic stent is easy for bacteria attachment and stent obstruction, but it is simple to change the stent and the cost is low. Intrabiliary stent implantation is the best method to treat malignant obstruction of bile duct with few complications. Intrahepatic stent in combination with various radiotherapies can prolong effective patent time of the stent and effectively prevent stent obstruction. CONCLUSION: Intrabiliary stent implantation is the most effective clinical method to treat malignant obstruction of bile duct.However, the biocompatibility of various intrabiliary stents should be improved. Intrahepatic stent in combination with radiotherapies can prevent stent obstruction.

Objective To investigate the relationships between serum inflammatory mediators and myocardial injury in rats with sepsis.Methods Thirty male Sprague Dawley (SD) rats were randomly divided into normal control group and sepsis (0,24,48,72 h) groups.The rats subjected to sepsis were induced with cecum ligation perforation (CLP).Tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),cardiac troponin Ⅰ (cTnI) and B-type natriuretic peptide precursor (NT-proBNP) in the venous blood were measured at 0 h,24 h,48 h,and 72 h after CLP.The lactic acid (Lac) of the arterial blood,cardiac index (CI),acute physiology and chronic health evaluation (APACHE) Ⅱ score were also determined simultaneously.Results The levels of TNF-α,IL-6,cTnI,NT-proBNP,and Lac in sepsis (24 h,48 h,and 72 h) groups were significantly elevated compared to normal control and sepsis (0 h) group.In addition,the number of sepsis (24 h,48 h,and 72 h) groups progressively increased (P ＜0.05).Conclusions It existed a close relationship between serum inflammatory mediators and myocardial injury,and made myocardium damage after CLP.

Objective To investigate incidence and severity of retinopathy of prematurity (ROP)screened by RetcamⅢ and the related factors.Comparative case series were designed.Methods A study was performed among infants who required screening by RetcamⅢ in the second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University,and carried out between May 2012 and April 2013.A total of 1097 infants met the study criteria,and were divided into group Ⅰ (n =333 from outpatient screening) and group Ⅱ (n =764 from inpatient screening).Variables were recorded,including birth weight (BW),gestational age (GA),number of births (NOB,singleton/twins/triplets),gender,neonatal respiratory distress syndrome (NRDS),patent ductus arteriosus (PDA),neonatal asphyxia,neonatal hyperbilirubinemia,intracranial hemorrhage,congenital heart disease,neonatal anemia,neonatal sepsis,necrotizing enterocolitis (NEC),and bronchopulmonary dysplasia (BPD).The results of ophthalmological examinations by RetcamⅢ were also recorded.Spearman correlation analysis was used to identify the variables most significantly associated with ROP.Results There were 98 infants of ROP in group Ⅱ (total 764,12.8％).There was a significant association of ROP with variables (P ＜0.05),including BW,GA,and NOB.There was a significant association of ROP with diseases (P ＜ 0.05),including NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD.However,there was no association of ROP with diseases (P ＞ 0.05),including PDA,neonatal hyperbilirubinemia,and congenital heart disease.Conclusions RetcamⅢ can be used to screen retina of infants.ROP is still the most common eye disease in preterm infants.The incidence of ROP was 12.83％ in Wenzhou.Variables,including BW,GA,NOB,NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD,were the most significant factors associated with ROP.

Objective To investigate the effect of COX-2 in the DSS-induced UC mouse model and the effects of probiotics in the pathogenesis of UC. Methods DSS-induced UC mouse model was used in the study. A total of 60 mice were divided into 6 groups (Blank control group, DSS model group, Saline group, SASP group, Lactovacillus group and Bifidobactefia group). After 8 days, all mice were sacrificed. Histological injury score and pathological change and COX-2 in mucous of colon membrane were evaluated. Results The stages and histological changes were obviously improved and the expression of COX-2 in the colonic mueosa of mouse with UC was decreased when using probiotics and SASP. Conclusions Lactobacillns and Bifidobacterla can decrease the expression of COX-2 in the colonic mucosa of mouse with UC. The effect has no difference between SASP and probiotic group.