Objective: To compare the clinical effect of Xuebijing or ulinastain combined with the conventional treatment for chronic obstructive pulmonary disease with acute exacerbation (AECOPD) complicated with systemic inflammatory response syndrome(SIRS).Methods: Totally 82 AECOPD patients with SIRS were randomly divided into group A and group B with 41 ones in each and both groups were treated with the conventional therapy.Group A was treated with ulinastatin (dissolved in 100 ml 0.9% sodium chloride injection, intravenous infusion, once daily), group B was given 50ml Xuebijing injection (mixed with 100 ml saline, intravenous infusion, twice a day).The lung function test, blood gas analysis and inflammatory factors were carried out in both groups.Results: After treatment, the lung function indices of FEV, FEV1 and FEV1/FVC in group A and B were significantly higher than those of before treatment (P<0.05), and group B was significantly higher than group A(P<0.05).Two groups of PaO2 and pH were significantly higher than those of before treatment, and PaCO2 was significantly decreased (P<0.05).PaO2 and pH in group B were significantly higher than those in group A, and PaCO2 was significantly lower than that in group A (P<0.05).The levels of APACHE Ⅱ, TNF-α and IL-6 were significantly lower than those of before treatment (P<0.05), and above indices in group B were lower than those in group A(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups (P>0.05).Conclusion: The clinical effect of Xuebijing or ulinastain combined with the conventional treatment is promising for AECOPD complicated with SIRS.Xuebijing injection combined with the conventional treatment shows better effect on the improvement of lung function and blood gas, and the levels of inflammatory cytokines can be reduced more significantly, which is also safe in the clinical application.

Toll-like receptor 5 (TLR5) is one of the pattern recognition receptors and recognizes the flagellin protein of bacteria.It activates innate immune responses and induces production of a series of cytokines.TLR5 functions as a bridge linking innate and adaptive immunities.It is known that TLR5 plays an important role in the occurrence and development of certain infectious diseases.This review summarizes the relationships of TLR5 polymorphisms with the development of infectious diseases and discusses the possible pathogenesis.

Objective To understand hypertension risk factors among adult residents in Hebei province.Methods The adult residents were selected by multistage stratified sampling,and investigated with the same questionnaires,body measurement,blood pressure measurement,blood sample analysis,to analyze risk factors of hypertension by ?2 with simple factor and by logistic regression with mult-factors.Results The prevalence of hypertension in 4200 adult residents(18-69 ages) was 39.6% and age-adjusted rate was 28.5%.The single factors analysis indicated that the prevalence of hypertension was higher in men than in women,in countryside than in city,and increased with age rising.Its prevalence is correlated with education level,marriage status,occupation,income,smoking,passive smoking,manual activity,eating habits,BMI,waist,diabetes,blood fat,status of spirit and health.Multiple logistic regression analysis indicated that city,female,educational level of senior high school and above that,farm working,eating less brined vegetables is protective factors for hypertension,and their OR(95%CI) were 0.777(0.644~0.937),0.674(0.551~0.823),0.654(0.534~0.801),0.826(0.684~0.997),0.844(0.729~0.977) respectively,and more than 35 ages,not usually eating vegetable,bad status of health by self-sensations,high serum TC and TG,overweight and obesity were the main risk factors for hypertension,and their OR(95%CI) were 4.145(3.263~5.266),4.460(1.049~18.969),1.234(1.068~1.425),1.400(1.200~1.634),1.420(1.074~1.878),1.478(1.235~1.768),1.728(1.448~2.061) respectively.Conclusion The prevalence of hypertension in adult residents in Hebei province was correlated with multi-factors,so complicated prevention and control in hypertension should be reinforced.

Objective To detect the changes of function of blood-aqueous barrier in different Syndrome stages of patients with Vogt-Koyanagi-Harada (VKH) syndrome in order to provide the appropriate therapy. Methods According to clinical manifestation, 77 patients (144 eyes) with VKH syndrome were divided into 4 groups: 10 cases in posterior uvietis stage group (20 eyes), 27 in anterior uveal involvement stage group (50 eyes), 23 in recurrent anterior uvitis stage group (41 eyes), and 17 in convalescent stage group (33 eyes). The other 50 cases (100 eyes) were in the control group. Flare and cells of anterior chamber in patient with VKH Syndrome at different stages were graded and measured by laser flare and cell meter (LFCM) and slitlamp microscope. Results According to the results of slitlamp biomicroscopy, anterior chamber flare and cells were at the 0 grade in the patients at posterior uvietis stage (20 eyes). The results of LFCM examination revealed that the flare value and cells were (9.7?3.4) pc/ms and (0.9?0.6)/0.5 mm3 in posterior uvietis stage group, and (5.3?2.3) pc/ms and (0.8? 0.6)/0.5 mm3 in the control group. The differences between the two groups were significant (P

The clinical data of 380 patients undergoing loop electrosurgical excision procedure(LEEP) conization for cervical intraepithelial neoplasia grade 3(CIN3) at the Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2019 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of positive margin and residual lesions following conization. One hundred and twelve cases (29.5%) had positive margins, and the risk factors for positive margins were positive high-risk human papillomavirus ( OR=4.92, 95% CI: 1.81-13.36), high-grade lesions on thin cytologic test (TCT)screening ( OR=3.95, 95% CI: 2.42-6.42), and glandular involvement ( OR=3.58, 95% CI: 1.93-6.63). The hysteretomy was performed following conization in 169 hundred and sixty-nine patients who had difficulty in follow-up or no fertility intension, among whom 51 (30.2%) had residual lesions; logistic regression analysis showed that positive margins on LEEP were a risk factor for residual lesions at the time of hysterectomy ( OR: 2.83, 95% CI: 1.44-5.59). The study indicates that positive HR-HPV, high-grade TCT lesions, and lesions involving glands are risk factors for positive margins in CIN3 patients undergoing LEEP conization; and positive margins is risk factor for residual lesions following conization,to which more attention should be paid in clinical practice.

Objective To analyze the methylation status and protein expression of Ras association domain family- 1A (RASSF1A) in endometriosis (EMS). Methods The ectopic and corresponding eutopic endometrium tissues were collected from 45 women with EMS and normal endometrium tissues of 20 women without EMS. The methylation status of RASSF1A was examined by methylation specific PCR (MSP). Immunohistochemistry was performed to measure the level of RASSF1A in endometrium tissues. Results The RASSF1A protein expression rate in ectopic endometrium, eutopic endometrium, and normal endometrium was 37.78%(17/45), 60.00%(27/45) and 85.00%(17/20), and there was significant difference (χ2 = 13.136, P = 0.001). The frequency of aberrant methylation of RASSF1A was 55.56%(25/45), 33.33%(15/45) and 0 in ectopic endometrium , eutopic endometrium, and normal endometrium, and there was significant difference (χ2 =18.770, P = 0.000). The frequency of aberrant methylation of RASSF1A had no significant differnce throughout the menstrual cycle in ectopic endometrium and eutopic endometrium: 66.67%(14/21) vs. 45.83%(11/24), 38.10%(8/21) vs. 29.17%(7/24), P>0.05. In ectopic endometrium, the frequency of aberrant methylation of RASSF1A inⅢ-Ⅲstage was significantly higher than that in Ⅰ-Ⅱstage (χ2=5.940, P=0.015). In ectopic endometrium and eutopic endometrium, the RASSF1A protein expression had negative correlation with aberrant methylation of RASSF1A (r =- 0.594、- 0.577, P<0.01). Conclusions Epigenetic inactivation of RASSF1A through aberrant promoter methylation may be strongly correlated with the formation and progression of EMS, and assessment of RASSF1A methylation status in eutopic endometrium may be a potentially useful biomarker to enhance the early detection of EMS.

Objective To explore the differences in mental health self-help status of empty-nesters between urban and rural areas for providing the basis and strategies in mental health self-help and promoting development of the self-help potential.Methods Inner Mongolia Chifeng district,441 cases of urban and rural empty-nesters was valuated with the mental health questionnaire.Results Urban empty-nesters were higher than the ratio of rural empty-nester on the aspects of residential satisfaction,participating in activities,talking about their problems in families,communicating health informations and seeking professional help,x2=8.193,15.930,6.500,13.089,18.857,P ＜ 0.05.Urban empty-nesters were lower than the ratio of rural empty-nester on the aspects of feeling helpless and hiding bad mood,x2=9.930,14.873,P ＜ 0.05.The awareness on mental health knowledge was in low level for both urban and rural areas(17.11％,32/187 and 9.55％,19/199).Conclusions Both urban and rural empty-nesters were in bad conditions of mental health self-help ability,especially for rural empty-nesters.The awareness rate of knowledge on mental health is in highly need.

Objective To know the relationship between loneliness and the quality of life of urban and rural absent parents in the Inner Mongolia Autonomous Region,clear the influence factors of loneliness in the absent parents.Methods 441 cases of urban and rural absent parents were selected from the Chifeng district of the Inner Mongolia Autonomous Region were valuated with the general information questionnaire,UCLA Loneliness Scale and MOS 36 item short form health survey (SF-36).Results Rural cases had a higher level of loneliness when compared with the urban cases,t=4.60,P＜0.01.There were significant differences in the general score and the scores of each dimension between the two groups,P＜0.05.Loneliness score was significantly negative correlation with the quality of life in all dimensions,P＜0.01.Regression analysis showed that health,marital status,income and the education level were the main influence factor of loneliness in the urban and rural absent parents.Conclusions Compared with the urban absent parents,rural cases had more obvious loneliness and lower quality of life.Loneliness levels influence the quality of life of absent parents.Loneliness condition of urban and rural absent parents were influenced by various factors,the cases with characteristic of frail,single,low education level and poor economic condition should be the focus group to intervene.

Objective To develop a clinical practice satisfaction scale for the nursing interns,and to test its reliability and validity.Methods Original scale was formed on the basis of literature review and existing clinical practice satisfaction measurement tools of nursing interns.Totally 270 nursing interns of six tertiary first-class hospitals were investigated with the clinical practice satisfacfion scale of nursing intern by convenience sampling.SPSS13.0 and AMOS 17.0 were used to test the reliability and validity.Then the original scale was modified and the eventual scale was formed.Results The Cronbach's Alpha between each entries and the total scale were 0.548～0.752.The Cranbach's Alpha of total scale was 0.965and the split-half reliability of Guttman was 0.885.Five factors were extracted by exploratory factor analysis and they could explain 65.307％ of the total variance.The confirmatory factor analysis revealed a good model fit of the first and second order,and the fit indices x2/df,GFI,AGFI,RMR,RMSEA,NFI,CFI,TLI were 1.176/1.095,0.893/0.900,0.856/0.864,0.034/0.033,0.026/0.019,0.918/0.924,0.987/0.993,0.983/0.991.Conclusions The clinical practice satisfaction scale of nursing intern is reliable and valid,and can be used to assess the clinical practice satisfaction of nursing intern.

Objective To improve recognition of posterior reversible encephalopathy syndrome (PRES) in children. Methods Two children with PRES admitted to children's hospital were included. Clinical data were retrospectively studied and related literatures were reviewed. Results The primary diseases of the two patients are systemic lupus erythematosus and nephritic syndrome, respectively. They all developed an acute onset of headache, visual changes, consciousness disturbance, hypertension and seizures. Cranial MRI showed bilateral parietal, temporal and occipital cortical or subcortical lesions with hypointensity on Tl-weighted imaging and hyperintensity on T2-weighted imaging. Clinical symptoms resolved soon and radiographic recovery occurred within 14 to 21 days with prompt anti-hypertension treatment and supportive care. Among the mechanisms which might contribute to the development of PRES, acute elevated blood pressure seems to be the most important factors in these two cases. Prompt anti-hypertension treatment usually can reverse the PRES lesion. Conclusions It is important to improve cognition of PRES in children. Delayed treatment can cause permanent neurological impairment. Doctors should be alert to this syndrome. Early diagnosis and prompt treatment are very important. (J Clin Pediatr,2010,28(2):168-170)