The fibroblasts have long been considered as structural elements and playing a main role in wound healing. Recent studies indicated that fibroblasts are heterogenic cells and function as resident sentinel cells in inflammatory reaction. When activated by substances released during tissue injury or derived from infectious microorganisms or by proinflammatory cytokines, tissuespecific fibroblasts can transiently produce certain chemokines and initiate a cascade of inflammatory reaction. In addition fibroblasts can produce prostanoids that participate in inflammatory and immune responses. In this review, the new role of fibroblasts in regulation of inflammation and immune reactions and possible molecular mechanism will be discuss.

Objective To observe the effects of liver-discharging and stomach-harmonizing therapy on quality of life in senile patients with reflux esophagitis and to evaluate the therapeutic effect of traditional Chinese medicine (TCM) on chronic diseases. Methods Sixty patients with senile reflux esophagitis selected from in-patients and out-patients of Henan Province Hospital of TCM from March 2012 to October 2013 were randomly divided into experimental group and control group(each,30 patients). The experimental group was treated with Xiaoyao powder (its ingredients could be added or subtracted according to the patient's individual situation)combined with omeprazole and domperidone,while in the control group,only western drugs,omeprazole and domperidone were applied. The therapies in both groups lasting for 8 weeks constituted one therapeutic course. The MOS 36-item short form healthy survey(SF-36)was used to evaluate the degree of improvement of patients,quality of life,and clinical effects and adverse drug reaction were observed. Results The total scores of SF-36,physical and mental health scores of both groups were increased significantly,and the degree of elevation in scores in the experimental group was markedly higher than that in the control group(total scores of SF-36:124.2±11.5 vs. 117.1±10.9,physical health scores:67.9±5.3 vs. 62.9±6.2,mental health scores:56.1±6.7 vs. 55.0±6.6,all P<0.05). The total effective rate of experimental group was much superior to that of control group(96.7%vs. 80.0%,P<0.05). No obvious adverse reactions happened in the two groups. Conclusion Liver-discharging and stomach-harmonizing therapy can improve the quality of life in aged patients with reflux esophagitis.

Objective: To investigate the efficacy and possible mechanism of action of warm needling moxibustion combined with entecavir in the treatment of compensated cirrhosis due to chronic hepatitis B (CHB).Methods: Ninety patients were randomly divided into a control group and an observation group, with 45 patients in each group. The control group was given oral entecavir, and the observation group was given additional warm needling moxibustion. The serum alanine transaminase (ALT), aspartate transaminase (AST), albumin (ALB) levels, portal vein internal diameter, splenic vein internal diameter, spleen thickness, and liver hardness were compared before and after treatment. The serum hyaluronic acid (HA), laminin (LN), procollagen type Ⅲ (PCⅢ), type Ⅳ collagen (Ⅳ-C), interleukin (IL)-21, and platelet-derived growth factor (PDGF) levels were also measured. Results: After treatment, the serum ALT and AST levels decreased (P<0.05), and the serum ALB levels increased (P<0.05) in both groups. The serum ALT and AST levels were lower in the observation group than in the control group (P<0.05), and the ALB level was higher in the observation group (P<0.05). The portal vein internal diameter, splenic vein internal diameter, spleen thickness, and liver hardness values were reduced in both groups after treatment (P<0.05), and were lower in the observation group than in the control group (P<0.05). The serum HA, LN, PCⅢ, and Ⅳ-C levels were reduced in both groups (P<0.05), and were lower in the observation group than in the control group (P<0.05). In the control group, the serum IL-21 level decreased (P<0.05), but the serum PDGF level did not change significantly (P>0.05); in the observation group, the serum IL-21 and PDGF levels decreased significantly (P<0.05) and were lower than those in the control group (P<0.05). Conclusion: Warm needling moxibustion combined with entecavir treatment can improve liver function, reduce the inner diameters of the portal vein and splenic vein, spleen thickness, and liver hardness, and improve liver fibrosis indicators in patients with CHB cirrhosis, which may be related to the reduction of serum IL-21 and PDGF levels.

Objective To establish the chip technology‐based real‐time PCR (RT‐PCR) platform and to apply it in the viral loads detection of HIV‐1 and HCV .Methods Based on the primers designed to aim at the conversed regions of HIV‐1 and HCV , The gene chip tube was prepared ,and the RT‐PCR reaction system was established for the simultaneous determination of viral loads .And the melting curves were used to distinguish viral species .The sensitivity and specificity of the method were estimated , and performance of the method was verified by using clinical samples .Results The specificity of the method was good .The lowest detectable limit of the detection method of HCV and HIV‐1 was 1 × 103 copy/mL .The clinical samples with viral loads around 1 × 103 -1 × 106 copy/mL could be detected accurately .Conclusion The method provides a new idea for the detection of HCV and HIV‐1 .

Objective To analyze the effect of sperm factor on recurrent pregnancy lass.Methods Accordingto WHO criteria,we routinely analyzed the sperm of 21 unexplained recurrent pregnancy loss patients as study group.and 20 proven fertility men as control group.Meanwhile,we evaluated sperm chromosome aneuploidy for chromosomes 18,X and Y using standard FISH procedure,and sperm DNA ingegrity using sperm chromatin structure assay(SCSA)procedure.Results The percentage of normal morphology sperm is(10.8±2.8)%,and DFI value is(21.7±6.7)%,and the percentage of sperm aneuploidy for sex chromosome and chromosome 18 is(0.80±0.14)%and(0.23 ±0.09)%respectivelyin study group.The differences between the two groups were statistically significant(P＜0.01).Conclusion Sperm morphology,DNA integrity and chromosome aneuploidy are the correlative factors to recurrent pregnancy loss.

Objective To investigate the relationship between Hepatitis B patients with different viral loads and immunoglob-ulin A,G,M and complement C3,C4.Methods Firstly,followed by real-time fluorescence quantitative PCR detection 210 cases of hepatitis B patients with HBV-DNA levels,according to 10n copies/ml different viral load detection results,it was divided into 102 ~108 copies/ml of the experimental groups.Then the experimental groups and control group were simulta-neously detected in immunoglobulin A,G,M and complement C3,C4.Analysed the correlation between HBV loads and im-munoglobulin A,G,M and complement C3,C4.Results When the viral loads of hepatitis B patients were 105 ~108 copies/ml,the testing results of IgA,IgG and IgM were both increasing (U =12.43,10.96,6.42,P <0.01),while C3 and C4 were both decreasing (U =8.37,6.0,P <0.01).When the viral loads of hepatitis B patients were 102 ~ 104 copies/ml,only IgA and IgM were increasing (U =2.36,2.04,P <0.05),the other testing results had no statistical significance.Between the test of 7 experimental groups compared with each other,only 104 group and 105 group had significantly changed (IgA and IgM were increasing,C4 was decreasing,U =2.39,2.46,2.09,P <0.05,IgG was increasing,U = 3.25,P <0.01),but between other low viral loads or high viral loads were not significantly differences.Conclusion The different viral loads of hepatitis B patients could cause the different changes of immunoglobulin A,G,M and complement C3,C4,especially in the 4 groups from 105 to 108 copies/ml.Followed by increasing in viral loads,there were immunoglobulin A,G,M increasing and comple-ment C3,C4 decreasing,and also serious impaction on the immune function of organism.There was a positive correlation be-tween viral loads in vivo and immune damages,correlation coefficient (γ =0.967,P <0.01).When the viral loads from 104 to 105 copies/ml,the testing results had changed significantly.It suggest that should control viral loads under 104 copies/ml in the hepatitis B antiviral treatment,so the effect of immune function damage will be the minimum.

Acute blood loss anemia is the most common surgical complication of total knee arthroplasty. Currently, alloge?neic transfusion has been the major method of managing postoperative anemia. Although allogeneic transfusion can correct anae?mic condition temporarily, it can lead to severe complications, such as postoperative infection, prolongation of physical recovery, increased length of hospital stay, and increased mortality. Perioperative blood management can effectively reduce blood loss and transfusion rate. These strategies mainly focus on three parts:therapy for anemia and autologous blood donation before operation;application of a tourniquet, antifibrinolytic drugs, topical hemostatic agents and acute normovolemic hemodilution during opera?tion; selection of reinfusion systems, restrictive transfusion thresholds, drainage and knee position after operation. Perioperative blood management should run throughout the perioperative period, which mainly aims at reducing blood loss and blood transfu?sion, improving prognosis, promoting the postoperative recovery and lowering the medical cost. Depending on the actual situations of patients, surgeons should combine different major characteristics of each strategy and weigh the pros and cons to make effective and reasonable individualized treatment plan.

Objective To observe the effect of Sanqi Oral Liquid on the podocytes and the expression of slit diaphragm-associated molecules (including Nephrin, Podocin and CD2AP proteins) of diabetes mellitus (DM) rats after unilateral nephrectomy, so as to explore its mechanism for protecting renal function. Methods SD male rats were randomized into sham operation group, model group and Chinese medicine group. The experimental diabetes mellitus ( DM) model was given unilateral nephrectomy and intraperitoneal injection of 35 mg/kg of streptozocin (STZ). And then the model rats were given intragastric administration of Sanqi Oral Liquid (2.5 g· kg-1·d-1) and the same volume distilled water respectively for 8 weeks. After treatment, the density of podocytes and the podocytic foot process width of different groups were measured. Immunohistochemistry was used to observe the changes of the expression of Nephrin, Podocin and CD2AP in renal tissues of different groups. Results After treatment with Sanqi Oral Liquid, the density of podocytes was increased, the foot process lesion was relieved, and the expression levels of Nephrin, Podocin and CD2AP proteins were increased (P<0.05 or P<0.01 as compared with those in the model group). Conclusion The protective mechanism of Sanqi Oral Liquid for renal function of unilateral nephrectomy DM rats is possibly related with the alleviation of podocyte injury and with the regulation of the expression of Nephrin, Podocin and CD2AP proteins in podocytes.

Objective To study the effect of mechanical ventilation guided by esophageal pressure on hemodynamics and oxygen metabolism of severe acute pancreatitis (SAP) swine model with intra-abdominal hypertension (IAH) Methods By self-controlled study,SAP model was made by infusing sodium taurocholate (5％) into the pancreatic duct in 6 domestic swine.Mechanical ventilator mode was volumeassist control with tidal volume 10 ml/kg ; FiO2 40％ and PEEP 5 cm H2O (routine ventilation) given to SAP model swine.After 3 h ventilation,pneumo-peritoneum was made with N2 gas to increase the intraabdominal pressure (IAP) to 25 mm Hg in SAP swine.Three more hours later,PEEP was adjusted as the measurement of esophageal pressure (Pes guided ventilation) to such a level that trans-pulmonary pressure stayed above 0 cm H2O during end-expiratory occlusion.During the investigation period,heart rate (HR),cardiac output index (CI),central venous pressure (CVP),mean arterial pressure (MAP) and pulmonary arterial wedge pressure (PAWP) were continuously recorded with the aid of Swan-Ganz catheter and ECG monitor,and oxygen partial pressure of artery (PaO2) and carbon dioxide partial pressure of artery (PaCO2) were measured by blood-gas analysis.In addition,systemic oxygen delivery (DO2) and systemic oxygen consumption (VO2) were calculated by using the data of blood-gas analysis of arterial and central venous blood.Results No swine model was subjected to barotrauma.After routine mechanical ventilation,there were significant differences in HR,CI,MAP,CVP,PAWP,Ppeak,Pplat,Pes,pulmonary compliance (Cstat),PaO2,and DO2 between SAP and IAH in swine (all P ＜ 0.05).Compared with routine ventilation,however,PaO2 and Cstat improved significantly with lower CI and increased Pplat after PEEP adjusted according to measurements of esophageal pressure (all P ＜ 0.05).The lactate decreased significantly after esophageal pressure guided ventilation (all P ＜ 0.05).There were no significant changes in PaCO2,HR,MAP,CVP and PAWP in IAH swine after mechanical ventilation with routine parameters (all P ＞ 0.05).Conclusions There were remarkable effects on oxygen metabolism in response to mechanical ventilation guided by esophageal pressure.In case of clinical application of mechanical ventilation,the results of this study are in favor of setting transpulmonary pressure according to measurements of esophageal pressure in SAP patients with IAH in an early stage.