Laryngeal cartilage dysplasia,also known as congenital laryngeal cartilage softening or con-genital laryngeal stridor,a clinical common laryngeal disease in infant. It is often shown as airflow makes special sound through larynx or tracheal stenosis,also known as laryngeal stridor. Obstruction can be caused by airway lumen or external pressure. Airway obstruction position can be located in the nose,pharynx and larynx and tra-chea. Laryngeal stridor can be caused by many diseases,such as congenital laryngeal stridor,acute laryngeal,or acute laryngotracheobronchitis,respiratory tract foreign bodies,congenital laryngeal stenosis and laryngeal web, etc. The pathogenesis,pathology,clinical manifestation,diagnosis and treatment are reviewed.

Objective:To investigate the different techniques and wave characteristic of applying non-invasive stimulation in blink reflex.Methods:Thirty volunteers participated in this study.Using the electrodiagnostic techniques,the orbital nerve and mental nerve were stimulated and the waves were respectively recorded at orbicularis oculi and levator labli superioris,then concluded the latency and amplitude of R1,R2,R2'.Results:The results of blink reflex were basically identical with the normative criteria.The wave of stimulating the orbital nerve and recording at levator labli superioris resembled BR.The images were steady and repeatable.The waves of stimulating mental nerve and recording at orbicularis oculi and levator labli superioris were unstable and partial R1 absent.Conclusion:The techniques of stimulating orbital nerve and recording at orbicularis oculi and levator labli superioris are valuable in the initial investigation of trigemino-facial reflex.The techniques of stimulating mental nerve and recording at orbicularis oculi and levator labli superioris can be used to examine assistantly.

Objective: To evaluate the efficacy of neoadjuvant chemotherapy (NC) for locally advanced gastric cancer by Meta-analysis. Methods: A computer-based online search of PubMed, Embase, Cochrane Library, China Biology Medicine disc (CBMdisc), National Knowledge Infrastructure (CNKI), China Academic Journals Full-text Database (CJFD), Wanfang Data, China Conference Paper Database (CCPD) and China Cancer Database was performed. In accordance with the inclusion and exclusion criteria, the randomized controlled trials (RCTs) were selected. After evaluating the quality of the included studies and extracting the data, a Meta-analysis was perfomed by using RevMan 5.0 software. Results: A total of 8 RCTs including 1 260 patients were included in this Meta-analysis. The resection rate [odds ratio (OR): 1.04, 95% confidence interval (CI): 0.76-1.43; P = 0.79], radical resection rate (OR: 1.02, 95% CI: 0.57-1.83; P = 0.94) and perioperative mortality (OR: 1.06, 95% CI: 0.56-2.00; P = 0.86) beween the neoadjuvant chemotherapy combined with surgical operation group and surgical operation alone group were not statistically different. The difference in one-year survival rate was not statistically significant (OR: 1.05, 95% CI: 0.79-1.41; P = 0.72) between the two groups, but the 2-year (OR: 1.33, 95% CI: 1.03-1.72; P = 0.03) and 3-year (OR: 1.61, 95% CI: 1.23-2.09; P = 0.000 5) survival rates of the neoadjuvant chemotherapy combined with surgical operation group were higher than those of the surgical operation alone group. Conclusion: Neoadjuvant chemotherapy for locally advanced gastric cancer may not increase the resection rate and the operation risk, and it can improve the long-term survival rate. Copyright © 2014 by TUMOR.

OBJECTIVE To study the absorption,distribution and excretion of 2-fluorine-6-trifluoromethylpyridine (JJBD) in rats.METHODS [14C] Radioactivity isotope tracing method was used.Male SD rats were ig given a single dose of JJBD 10 and 100 mg·kg-1 (radioactivity:3.7 GBq·kg-1).Concentrations of rat plasma,tissue,feces,urine and bile were determined with a liquid scintillation counting (LSC) analyzer.Toxicokinetics (TK) parameters were fitted using WinNonlin.RESULTS TK parameters of JJBD 10 and 100 mg · kg-1 in male SD rats were as follows:area under the curve (AUC（0-t）) was 22 548±1579 and (203 395±27 586) h·iμg Eq.·L-1,half time (t1/2) was 15.8±1.0 and (14.1±0.9) h,peak time (Tmax) was 4.0±3.0 and (6.0±5.0) h,peak concentration (Cmax) was 1450±355 and (7776±1703) μg Eq.·L-1.JJBD was mainly distributed in fat,livers,kidneys,stomachs and intestinal walls.The concentration of JJBD in most of the tissues reached peak values after 4 h.However,JJBD couldn't be detected in the muscle,thymus gland,brain,gonad or spleen.Excretion rate of JJBD was 43.1％ in urine,29.7％ in feces and 9.97％ in cleaning solution within 0-168 h.JJBD could be excreted through bile at a rate of 28.1％ within 0-72 h.CONCLUSION JJBD can be absorbed immediately and excreted slowly in SD rat.There is no accumulation risk.The distribution of JJBD in vivo is very extensive,but cannot go through the blood-brain barrier.JJBD is mostly excreted through feces and urine.

ObjectiveTo seek experimental evidence of epidermal barrier dysfunction in psoriasis,and to provide a basis for adjuvant therapy of psoriasis.MethodsPhysiometric methods were used to determine the value of sebum content,transepidermal water loss(TEWL) and water content of stratum corneum in 60 patients with psoriasis and 48 normal human controls.The ultrastructure of lamellar bodies was observed with transmission electron microscopy,and the expression of acid ceramidase in normal skin and psoriatic lesions was detected by using immunohistochemical techniques.ResultsCompared with the normal skin,TEWL value was increased(P ＜ 0.01),but water content of stratum corneum decreased(P ＜ 0.01 ) in psoriatic lesions,and sebum content was similar between normal skin and psoriatic lesions.As electron microscopy showed,lamellar bodies in keratinocytes were reduced in number with a disorganized arrangement and irregular size in psoriatic lesions.The expression of acid ceramidase also decreased in psoriatic epidermis.Conclusions The function of epidermal barrier in psoriasis is impaired,and to restore epidermal barrier function and enhance hydration may serve as an important adjuvant therapy of psoriasis.

Objective To evaluate the effects of Prinsepia utilis Royle oil (PURO) on the synthesis of ceramide and expression of acid ceramidase N-acylsphingosine amidohydrolase 1 (ASH1),and to explore the mechanisms underlying its moisturizing and skin barrier-repairing effects.Methods Keratinocytes from human foreskin tissue were classified into 2 groups to be cultured in keratinocyte-serum free medium (K-SFM) with or without the presence of PURO.Enzyme linked immunosorbent assay (ELISA) was performed to measure the level of ceramide in the culture supernatant of keratinocytes at 0,3,8,24 and 48 hours.The back of nude mice was divided into 4 areas,i.e.,test area,matrix area,blank control area and negative control area.Acetone and ether were used to destroy the epidermal barrier in the test,matrix,and blank control areas,then,the former 2 areas were topically treated with emulsions containing 1％ PURO and matrix,respectively,and the blank control area remained untreated.The epidermal barrier remained intact and untreated in the negative control area.Noninvasive methods were used to determine transepidermal water loss (TEWL),epidermal moisture content and skin lipid content in these areas on day 0,1,3,and 7.Skin tissue was obtained from these areas on day 0 and 7 followed by an immunohistochemical study for the quantification of ASH1 expression.Results The level of supernatant ceramide increased with time in the PURO-treated keratinocytes,which was significantly higher at 24 hours and 48 hours than at 0 hour (1.3817 ± 0.100 and 1.3737 ± 0.047 vs.0.7630 ± 0.143,both P ＜ 0.05).The supernatant ceramide was also elevated in the PURO-treated keratinocytes compared with untreated keratinocytes at 24 and 48 hours (both P ＜ 0.05).Noninvasive skin tests showed a gradual decrease in the TEWL,but an increase in the epidermal moisture content and skin lipid content with time in the 3 epidermal barrier-destroyed areas.As far as the test area was concerned,TEWL value was significantly lower on day 3 and 7 than on day 0 (10.85 ± 0.64 and 8.01 ± 0.58 vs.12.65 ± 0.71,both P ＜ 0.05),while a significant increment was observed in the skin lipid content on day 3 and 7 compared with day 0 (29.14 ± 0.40 and 31.30 ± 0.88 vs.27.02 ± 0.65,both P ＜ 0.05),as well as in the epidermal moisture content on day 1,3 and 7 compared with day 0 (13.98 ± 0.28,15.00 ± 0.38 and 15.86 ± 0.18 vs.11.74 ± 0.62,all P＜ 0.05).On day 7,there was a statistical decline in TEWL value,but an elevation in epidermal moisture content,skin lipid content and ASH1 expression in the test area compared with the matrix area and blank control area (all P ＜ 0.05).Also,the expression of ASH1 was upregulated on day 7 compared with day 0 in the 3 barrier-destroyed areas (all P ＜ 0.05).Conclusion PURO may exert skin-moisturizing and barrier-repairing effects by enhancing the synthesis of ceramide and expression of acid ceramidase ASH1.

Objective:To explore the influence of new labor standards on the indications in the birth process and the prognosis of mothers and infants.Methods:186 cases treated in our hospital from January,2015 to January,2016 were divided into the observation group (85 cases) and the control group (101 cases),the observation group received new labor standards,the control group adopt Friedman labor standards.The clinical indications,pregnant complications,pregnant outcome,neonatal-perinatal outcome were compared between two groups.Results:The cesarean delivery rate,number of using oxytocin,forceps delivery rate of observation group were significantly lower than those of the control group(P＜0.05);the duration time of both first and second stage of labor were obviously longer than those of the control group (P＜0.05);the duration time of active phase,bleeding volume in birth process in both groups showed no statistical difference (P＞0.05);there was no adverse maternal and infant events in both groups;the incidence rate of pregnancy complications,fetal distress in uterus,asphyxia neonatorum and neonatal body weight were of no statistical difference (P＞0.05).Conclusion:The new labor standards prolong the duration time of birth and give women fully trial opportunities,could effectively reduce the rate of cesarean section,reduce the over intervention production.

Objective: To evaluate the efifcacy and safety on clopidogrel combining proton pump inhibitor (PPI) for treating the patient after percutaneous coronary intervention (PCI) by Meta analysis.
Methods: We searched MEDLINE, EMBASE, Cochrane Library and conference databanks, the retrieval time ended at 2014-03 and 14 references were selected for Meta analysis by RevMan 5.2 software. A total of 52274 patients were enrolled and divided into 2 groups, Control group, the patients received clopidogrel, n=43809 and Combination group, the patients received clopidogrel and PPI n=8465. The efifcacy and safety were compared between 2 groups.
Results: Compared with Control group, the patients in Combination group showed increased all cause death rate (OR=1.20, 95% CI 1.05-1.37), re-myocardial infarction (MI) (OR=1.19, 95% CI 1.07-1.33) and in-steut re-vascularization (OR=1.22, 95% CI 1.08-1.39), all P<0.05; while the MACE (OR=1.29, 95% CI 0.98-1.69), in-stent thrombosis (OR=1.22, 95% CI 0.97-1.54) and gastro- intestinal bleeding (OR=0.95, 95% CI 0.55-1.67) were similar between 2 groups, all P>0.05. Further analysis found that PPI (such as omeprazole and esomeprazole) could compete the CYP2C19 enzyme location of clopidogrel, increase the risk of cardiovascular events and decrease the gastrointestinal protection.
Conclusion: Clopidogrel combining PPI may increase the risk of all cause death, MI, in-stent revascularization and decrease the gastrointestinal protection in patients after PCI, especially for omeprazole and esomeprazole which may compete the CYP2C19 enzyme location of clopidogrel.

To evaluate the differences of Ophiopogonjaponicus from different cultivations, the metabolomics based method was conducted to compare the effects of Hangmaidong and Chuanmaidong (Chinese name) on plasma endogenous metabolites of normal rats. Data were collected by ultra performance liquid chromatography quadrupole time of flight mass spectrometry (UPLC-Q-TOF/MS), and were analyzed by multivariate statistical method, such as Principal Component Analysis and Orthogonal Signal Correction Partial Least Square Discriminant Analysis. Results revealed that the plasma metabolites profiling of low and middle dose group of Chuanmaidong were similar to the control group, but different from the high dose group obviously. Meanwhile the high, middle and low dose groups of Hangmaidong were different from control group notably, and the difference is dose dependent. Lysophosphatidylcholines, the possible endogenous metabolites which contribute to the classification most significantly, are closely related to cardiovascular system diseases. Compared with the group of Chuanmaidong, Hangmaidong has greater impact on the plasma metabolic profiling of normal rats. Hangmaidong and Chuanmaidong showed significant differences pharmacodynamically.

Objective: To investigate the development of public health human resource of the Centers for Disease Control and Prevention (CDCs) in Zhejiang Province from 2016 to 2020, so as to put forward the strategies for the talent team construction of CDCs. Methods: The general information of personnel of CDCs in Zhejiang Province from 2016 to 2020 was collected through China Information System for Disease Control and Prevention. A questionnaire survey and a qualitative interview were conducted to collect the data of staffing, talent training, salary and employee turnover, and to analyze the development of the talent team of CDCs. Results: By 2020, there were 105 CDCs, including 1 provincial, 11 prefectural and 93 county-level CDCs, and 5 277 staff on-the-job. From 2016 to 2020, the number of staff per 10 000 permanent residents in the province, prefecture and county levels were 0.062-0.070, 0.170-0.188 and 0.585-0.604, respectively, which did not meet the standard for the personnel establishment in Zhejiang CDCs; the proportion of the staff with bachelor degree or above increased from 90.05% to 94.25%; the proportion of the health professionals decreased from 82.91% to 80.01%; the proportion of the staff with senior professional titles increased from 35.20% to 45.25%. The results of the qualitative interview indicated a lack of health professionals and high-end talents, a gap between the approved staffing and post requirements, as well as demands for a stable team and higher pay. Conclusion From 2016 to 2020, the structure of educational background, major and professional title among the on-the-job staff of CDCs in Zhejiang Province has been improving; however, the total allocation of human resource is insufficient, and the stability and treatment of staff need to be further improved.