Objective To study the mechanism of lentinum's promotion on carvedilol's effects on dilated cardiomyopathy's heart function.Methods SD rat model of dilated cardiomyopathy was established with doxorubicin hydrochloride.The rat model was divided into blank control group,carvedilol group,lentinan group,carvedilol + lentinan group.Rats in the blank control group were given 2 mL of 0.9％ sodium chloride solution.Rats in the carvedilol group were given 10 mg·kg-1of carvedilol and 2 mL of 0.9％ sodium chloride solution.Rats in the lentinan group were given 1 mg·kg-1 of lentinan,and 2 mL of 0.9％ sodium chloride solution.Rats in the carvedilol + lentinan group were given10 mg· kg-1 of carvedilol,1 rmg·kg-1 of lentinan,and 2 mL of 0.9％ sodium chloride solution.The heart function,irrflammatory factors and T lymphocytes were compared.Results The left ventricular ejection fraction (LVEF) in carvedilol + lentinan group and carvedilol group were significantly higher than that in blank control group and lentinan group (P ＜ 0.05),while Tei index was significantly lower (P ＜ 0.05).The LVEF in carvedilol + lentinan group was significantly higher than that in carvedilol group (P ＜0.05),while Tei index was significantly lower (P ＜0.05).The hs-CRP,TNF-α,II-6 and IL-8 in carvedilol + lentinan group and lentinan group were significantly lower than that in blank control group and carvedilol group (P ＜0.05),while IL-10,CD3+,CD4+ and CD8+ were significantly higher (P ＜ 0.05).The hs-CRP,TNF-α,II-6 and IL-8 in C + L group were significantly lower than in lentinan group (P ＜ 0.05),while IL-10,CD3+,CD4+ and CD8+ were significantly higher (P ＜ 0.05).Conclusion Lentinan could significantly promote carvedilol's effects on dilated cardiomyopathy's heart function through lowering down inflammatory factors and increasing T lymphocytes.

OBJECTIVETo explore the clinical effects of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine ( Fuchunsan ) on the treatment of postburn hyperplastic scar.

METHODSSixty-three patients with hyperplastic scar after burn injury hospitalized from February 2012 to June 2014 in our department were treated with lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan). Patients were divided into early stage group (E, n = 35), middle stage group (M, n = 25), and late stage group ( L, n = 3) according to the formation time of scar, which was respectively 3 weeks to 3 months, longer than 3 months and less than or equal to 6 months, and 3 to 15 years in groups E, M, and L. The number of times of laser treatment of patients in each group was recorded. The degree of scar pain in patients of the three groups was assessed by the Numerical Rating Scale (NRS) before treatment and after treatment for 1, 2, and 3 times. The scar condition of patients in groups E and M was assessed by the Vancouver Scar Scale (VSS) before treatment and after treatment for 1, 3, and 5 times. Patients in group L did not receive VSS assessment but were evaluated by clinical observation only. Photos of scar in treating area were taken before treatment and after treatment for 3 and 5 times to evaluate the clinical effect. Data were processed with t test.

RESULTSPatients in groups E and M were treated with laser for (4.8 ± 1.1) and (7.7 ± 2.1) times respectively. In group L, the treatment was stopped in 2 patients after laser treatment for 5 times, and 1 patient received laser treatment for 12 times. The degree of pain in patients of groups E and M was alleviated significantly after treatment for one time, and the number of patients scoring 1-4 point(s) in NRS increased from 5 cases to 38 cases. After treatment for 2 and 3 times, the increase in the number of patients scoring 1-4 point (s) in NRS was on a small scale. Before treatment and after treatment for 1 time, VSS scores of patients in groups E and M were similar (with values respectively 0.641 and 0. 082, P values above 0. 05). After treatment for 3 and 5 times, VSS scores of patients in group E were respectively (9.2 ± 0.8) and (7.0 ± 1.1) points, which were significantly lower than those in group M [ (9.7 ± 1.0) and (8.2 ± 1.0) points, with values respectively -1.993 and -4.433 , P < 0.05 or P < 0.01]. After treatment for 3 times, the rate of improvement in appearance was respectively 88.6% (31/35) and 72.0% (18/25) in groups E and M, and it was respectively 100.0% (35/35) and 96.0% (24/25) after treatment for 5 times. No significant effect in appearance was found in the 3 patients in group L.

CONCLUSIONSEarly application of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan) for the treatment of postburn hyperplastic scar is effective.

Burns ; Cicatrix ; etiology ; prevention & control ; Humans ; Lasers, Gas ; therapeutic use ; Medicine, Chinese Traditional ; Postoperative Care ; methods ; Postoperative Complications ; prevention & control ; Treatment Outcome

Background Trachoma is a serious blinding eye disease.At present,the incidence rate of trachoma in China has been greatly reduced with the unremitting efforts of World Health Orgnization (WHO) and Chinese government.However,in some economically underdeveloped areas,there is still active trachoma.Ohjective This study aimed to survey the prevalence of children's active trachoma in rural area of Naxi district and Jiangyang district of Luzhou city and assess the prevention and treatment outcome of trachoma during 10 years.Methods A cross-sectional study was performed in Naxi district and Jiangyang district of Luzhou city,the economic underdeveloping and water-starved regions in the year 2000.The active trachoma was screened in 214 school-age children with the male 113 and female 101 based on simplified trachoma grading system and trachoma rapid assessment survey standards and requirements of WHO.The symptoms of active trachoma were divided into trachomatous follicular (TF),trachomatous inflammation intense (TI),trachomatous scarring (TS),trachoma trichiasis (TT) and corneal opacities (CO).The epidemiological survey was re-assessed in 100 school-age children (with the male 58 and female 42) in these regions in the year 2013 to evaluate the prevalence change of children active trachoma during 10 years.Results In the year 2000,214 children were screened in 4 villages of Naxi district and Jiangyang district,and the prevalence rate of TF was 49.07％ (105/214) in the year 2000.The prevalence rate of TF was 49.05％ (52/106) in the Naxi district and 49.07％ (53/108) in the Jiangyang district,showing no significant difference between them (x2 =0.01,P =0.99).In the 100 school-age children who received survey in Naxi district and Jiangyang district in the year 2013,no TF,TF,TI,TS,TT and CO was found,showing no active trachoma.Conclusions The active trachoma has been controlled in rural areas of Luzhou city following the prevention and treatment of trachoma and the improvement of economic status in past decade.

Objective To report the treatment outcome of nonunion of tibial fractures with local muscle flap transfer and injection of autogenous bone marrow. Methods 15 patients who had suffered from nonunion of tibial fracture 10 to 42 (mean 22) months after the initial injury underwent open reduction, internal fixation with locking intramedullary nail, wound coverage with locally transferred muscle flap and injection of autogenous bone marrow into the fracture site 12 to 15 days after operation. Results The follow-ups revealed bone union in all the cases of this series with a mean healing time of 22 (3 to 11) months. Except for limited necrosis of the skin edge in 2 cases which healed after dressing changes, the wounds healed primarily in all the cases without infection and implant failure. Conclusion Besides stable internal fixation and bone graft, coverage of fracture site with locally transferred muscle flap and injection of autogenous bone marrow can be used to treat nonunion of tibial fractures with satisfactory results.

Tumor associate macrophages ( TAMs) play a significant role in the interaction of tumor inflam-mative microenvironment and tumor cells .TAMs originate from monocytic precursors ,recruiting into tumor tissue by colony stimulating factor ( CSF) .This review summarized that TAMs promote tumor progression and metastasis though angiogenesis ,lymphogenesis , immunosuppression , matrix remodeling and affecting cancer stem cells .The article pointed that targeting TAMs is a new strategy for future tumor therapy .

Objective The objectives of this study were to investigate the relationship between DKK1 protein expression and lymph node invasion,and prognosis in patients with intrahepatic cholangiocarcinoma.Methods From January 2005 to December 2012,78 patients with intrahepatic cholangiocarcinoma were treated with endoscopic resection.Tissue microarray of intrahepatic cholangiocarcinoma and adjacent tissues were done and biochemical indexes were measured before operation.The patients were recruited every 3 months after operation.The Kaplan-Meier method was used to analyze the recurrence-free survival curve and the overall survival curve.The Cox proportional hazards regression model was used to analyze the multivariate analysis and to determine the factors that affect the disease-free survival(RFS)and overall survival(OS).Results There were significant differences in the expression of GGT,hepatic portal lymph node invasion,Child-Pugh grade,MMP9 and DKK1 protein in the negative and positive expression of intrahepatic cholangiocarcinoma(P ＜ 0.05).The positive expression rate of DKK1 protein in intrahepatic cholangiocarcinoma was 35.90％ (28/78),and the positive expression rate of DKK1 protein in hilar cholangiocarcinoma was 14.10％ (11/78).RFS and OS in 78 cases of intrahepatic cholangiocarcinoma were 51.28％ (40/78) and 50.00％ (38/78),41.03 ％ (32/78) and 38.46％ (30/ 78),25.64％ (20/78) and 23.08％ (18/78) after surgery for 1,3 and 5 years,respectively.The results from univariate and multivariate analysis showed that GGT,CA19-9,CEA,tumor size,DKK1 and hilar lymph node invasion were the prognostic factors of OS in patients with intrahepatic cholangiocarcinoma.CEA,tumor size,DKK1 and hilar lymph node involvement were prognostic factors for RFS in patients with intrahepatic cholangiocarcinoma.DKK1 protein expression positive and negative OS curve or RFS curve showed that 5 years after intrahepatic cholangiocarcinoma patients DKK1 protein expression positive and negative OS were 28.20％ and 20.51％;RFS were 24.36％ and 21.79％.Conclusion The expression of DKK1 protein is closely related to lymph node invasion in patients with intrahepatic cholangiocarcinoma.The expression of DKK1 protein is the prognostic factor of OS and RFS in patients with intrahepatic cholangiocarcinoma.

As the first national“preventive treatment of disease”preventive healthcare service pilot, Changning District in Shanghai has carried out the construction of TCM preventive healthcare service platform under the guidance of district leaders from 2009. By introducing the construction process and implementation key points of the pilot linkage patten of medical institution and social healthcare institutions in Changning District, this article put forward the construction ideas of “Platform for Regional Traditional Chinese Medicine Preventive Healthcare Service”, and further proposed challenges and opportunities for deepening reforms.

Objective To observe the effect of continuous pumped dexmedetomidine on hemodynamics, awakening quality and stress response in double -lumen tube extubation patients.Methods 60 patients with thoracic surgery were divided into saline group(group N,n =30)and Dex group(group D,n =30).Both two groups were continuously pumped NS and dexmedetomidine respectively 20min before anesthesia.MAP,HR and SpO2 at different time points during the surgery were recorded.Extracted 5ml arterial blood at the time point of T0 and T3,centrifugated and stored at -80 ℃ for testing renin levels.The extubation time,restlessness incidence,orientation recovery time, extubation quality score were recorded.Results The values of MAP in group D at time points of T0,T1,T2,T3,T4 were (97 ±15)mmHg,(102 ±12)mmHg,(103 ±11)mmHg,(98 ±12)mmHg,(96 ±13)mmHg.The values of HR in group D at different time points were (69 ±9)times/min,(80 ±6)times/min,(90 ±7)times/min,(74 ±5)times/min,(73 ±6)times/min.The values of SpO2 in group D at different time points were (95 ±3)%,(98 ±2)%,(98 ± 2)%,(95 ±3)%,(96 ±2)%.The values of MAP in group N at time points of T0,T1,T2,T3,T4 were (96 ± 15)mmHg,(112 ±16)mmHg,(120 ±12)mmHg,(117 ±14)mmHg,(102 ±15)mmHg.The values of HR in group N at different time points were (68 ±7)times/min,(84 ±8)times/min,(105 ±6)times/min,(89 ±6)times/min, (80 ±7)times/min.The values of SpO2 in group N at different time points were (96 ±2)%,(98 ±2)%,(97 ± 3)%,(93 ±3)%,(92 ±4)%.The values of MAP,HR,SpO2 at different time points in group D were significantly lower than those in group N,the differences were statistically significant (the t values of MAP at different time points were tT1 =2.74,tT2 =5.72,tT3 =25.63,tT4 =1.66,all P <0.05;the t values of HR at different time points were tT1 =2.20,tT2 =8.91,tT3 =10.52,tT4 =4.16,all P <0.05;the t values of SpO2 at different time points were tT1 =0.00,tT2 =1.52,tT3 =2.58,tT4 =4.9,PT3 <0.05,PT4 <0.05).There was significant difference between the two groups in orientation recovery time[(3.3 ±2.2)min vs (5.2 ±2.3)min,P =0.0018].There was significant difference between the two groups in agitation score[(1.3 ±0.9)vs (2.4 ±1.2)].There was significant difference between the two groups in extubation quality score[(2.1 ±1.2)vs (3.2 ±1.4),P =0.0018].There was statistical difference between the two groups in T3 adrenal hormones[(N:120 ±25.3)pmol/L,(D:93.4 ±23.2)pmol/L,P =0.00].The dose of sufentanil (60.5 ±9.2)μg in group N was higher than (40.4 ±10.2)μg in group D (P =0.001).The dose of remifentanil (3.3 ±0.8)mg in group N was higher than (2.4 ±0.9)mg in group D (P =0.001).Conclusion Continuous pumped dexmedetomidine can effectively improve awakening quality of patients with double -lumen tube.

As a local medical college,taking the school running orientation and characteristic into consideration,our school paid attention to people-oriented policy,optimizing the course structure,strengthening practice teaching in the revised talent cultivation scheme and constructed talent cultivation system which was in line with international norms and had local distinguishing feature.

Objective To investigate the distribution of pathogens isolated from clinical samples and the resistance to the com‐mon antimicrobial agents .Methods Of the 3 745 children ,Hand‐foot‐mouth disease was the most prevalent disease with 1 397 (37 .30% ) cases ,followed by the bronchopneumonia ,rotavirus enteritis and bacterial intestinal infection ;784 strains were isolated from the samples mainly including Haemophilus parainfluenzae (16 .20% ) ,Streptococcus pneumoniae (14 .92% ) ,Moraxella ca‐tarrhalis (12 .88% ) ,Staphylococcus aureus (10 .59% ) and Salmonella enterica(10 .8% ) ;The positive rate of Methicillin‐resistance Staphylococcus aureus(MRSA) was 27 .50% and the ESBLs producing Escherichia coli and Klebsiella pneumoniae were 46 .43%and 81 .40% ,and two or more pathogens could be isolated from sputum .Conclusion Haemophilu ,Streptococcus pneumonia and Moraxella catarrhalis are the main bacterial pathogens in the department of infectious .There is a certain resistance to the common antimicrobial agents .It is important for us to focus on the pathogens and we should pay more attention to the control the resistance of the bacteria .