To obtain the optimal preparation technology of Fang-bing nasal inhalant from components of traditional Chinese medicine by central composite design, with an apparatus containing nasal inhalant that simulated the expiration and inspiration of nose, the dissolution in vitro of different optimized inhalant samples designed through central composite design were investigated. The accumulative release of linalool, borneol, menthol was detected with GC. Response surface methodology was used to optimize the conditions of preparation technology by establishing multiple linear regression and second-order quadratic models. Then, deviation was carried out through comparing the observed and predicted values. It was showed that the coefficient of correlation of second-order quadratic model was high. The related coefficient reached 0.999 3, 0.998 0, 0.944 9, separately. The optimum conditions of preparation technology were as following: 84.39% of alcohol concentration, the weight of starch 1.45 g and the weight of carmellose sodium (CMC-Na for short) 1.22 g. The deviations between observed and predicated values showed -0.36%, 1.52%, 2.40%, separately. In this experiment, the established model can describe the good relation between factors and indexes from preparation technology of Fang-bing nasal inhalant and the outcome of prediction is well. This optimal Fang-bing nasal inhalant was used to study its in vivo effect on model rats deprived from sleep and showed sedative and sleep aiding, which will bring an instruction on inhalants of components from traditional Chinese medicine.

Objective To evaluate the effects of strict dietary salt restriction on blood pressure and proteinuria in chronic glomerulonephritis (CGN) patients. Methods From October 2007 to April 2009, 32 CGN inpatients were enrolled. Among them, 15 patients followed a strict dietary salt restriction menu (sodium 100 mmol/d, potassium 50 mmol/d, protein (0. 8-1. 0) g · kg~(-1) · d~(-1) , calorie (105-125) KJ · kg~(-1) · d~(-1) ) for 7 days, while the other 17 patients were fed freely offered by hospital as controls. 24 h urinary sodium excretion (24h-UNa) was used to monitor the salt intake. No changes of drug therapy were made during the study. Blood pressure was monitored every day. 24-hour urinary protein and serum biochemical parameter were measured before and after the study. Results There was no significant difference of baseline 24h-UNa between the two groups [(135.1 ±50.4) mmol/d vs (137.4 ±28.6) mmol/d) ]. During the study, the average 24h-UNa of patients with strict dietary intervention was (97. 2 ± 8.6) mmol/d. Both SBP [ (117. 7 ± 10. 0) mm Hg( 1 mm Hg=0. 133 kPa) vs (106.2 ±9.9) mm Hg] and DBP [ (76. 3 ± 6. 1 ) mm Hg vs (67. 5 ± 5. 5 ) mm Hg] decreased significantly ( P < 0. 001 ) . Proteinuria decreased significantly too [ 1. 57 (0. 3-3. 0) g/d vs 0. 57 (0. 16-2. 72) g/d,P = 0. 006]. The reduction of SBP was positively correlated with the reduction of 24h-UNa (r =0. 572, P =0. 026) , while the reduction of proteinuria correlated with both the reduction of SBP (r = 0. 568, P = 0. 027) and 24h-UNa (r =0. 525, P =0. 044). In the control group, only SBP decreased significantly [ ( 122. 6 ± 15. 5) mm Hg vs (115.8 ±10.4) mm Hg, P = 0.02] without significant changes of DBP and proteinuria When comparing the subgroups who took ACEI/ARB from both groups, the reduction of proteinuria wasmore prominent of those from the study group than the control group [ - 0. 4 ( -0. 95-0. 07) vs 0. 07 ( - 0. 39-0. 42), P = 0. 014 ]. Conclusion Strict dietary salt restriction is effective in reducing blood pressure and proteinuria in CGN patients.

Objective To investigate the effects of dexmedetomidine continuous intravenous infusion on the hemodynamic response of ephedrine and the recovery process of patients undergoing neck surgery under general anesthesia.Methods Select elective fitting line surgery under general anesthesia of 100 patients with cervical disease from January 2015 to December 2015 in the First People's Hospital of Yongkang,randomly divided into low dose group and high dose group, 50 cases in each group, before induction of anesthesia, patients received continuous intravenous pumping of dexmedetomidine 0.4μg/kg in low dose group or 0.8μg/kg in high dose group,after ten mins 0.4μg/kg prior to anesthesia induction,until the end of operation withdrawal;5 min after laryngeal mask insertion, ephedrine 0.1 mg/kg were intravenous administered in two groups.Observe the following indicators:the after entering the operation room ( T0 ) , anesthesia before induction ( T1 ) , after induction ( T2 ) , administration of ephedrine ( T3 ) , the maximum value time(TBP,THR) of heart rate and blood pressure in 10 minutes.Increased of HR,SBP,DBP,recovery related indicators.Results HR, SBP and DBP levels compared no significant difference of T0 with two groups,T1, T2 and T3,HR,SBP, DBP were lower than T0 with two groups(P<0.05),high dose group were lower than low dose group of HR, SBP, DBP(P <0.05);TBP and THR no significant difference of two groups,high dose group were higher than low dose group of Increased of HR,SBP,DBP(P<0.05);high dose group were lower than low dose group of after extubation cough score and sedation agitation score(P<0.05).Spontaneous breathing recovery time and extubation time, called the open time, orientation recovery time,the difference between the two groups was not statistically significant.Conclusion 0.8μg/kg dexmedetomidine continuous intravenous injection of ephedrine in patients with neck pressor effect stronger than the 0.4μg/kg,0.8μg/kg compared with 0.4μg/kg can reduce the recovery period of cough and restlessness,different doses had no effect on recovery.

Objective To explore the effect of intermittent hypoxia (IH) on RhoA/ROCK pathway in lung and on the muscularization in pulmonary vascular in rat model. Methods Wistar rats (n=40) were randomly divided into two groups:the normal oxygen control group (n=20) and the IH group ( n=20). For 4 weeks, rats in control group and IH group were ex?posed to intermittent normal oxygen (21%O2) or IH (5%-21%O2) respectively. Then, mRNA transcription and protein trans?lation levels of RhoA/ROCK were examined by Real-time PCR and Western blot. Expression of proliferation cell nuclear an?tigen (PCNA) andα-smooth muscle actin (SM-α-actin ) of lung and pulmonary artery were detected by immunohistochemis?try. Results RhoA mRNA transcription level(0.463 ± 0.067 vs 0.182 ± 0.040), ROCK mRNA transcription level(0.384 ± 0.062 vs 0.192 ± 0.052), RhoA protein expression level(0.827 ± 0.065 vs 0.424 ± 0.075)and ROCK protein expression level (0.488±0.088 vs 0.336±0.102)were higher in IH group than those in control group(P<0.05);Levels of PCNA in lung tissue [(54.67±1.80)%vs (9.14±0.91)%], PCNA in pulmonary artery [(49.40±1.21)%vs (8.38±1.13)%], SM-α-actin in lung tis?sue [(42.66±1.63)%vs (35.44±1.41)%] and SM-α-actin in pulmonary artery [(62.62±2.53)%vs (45.54±2.58)%] were also higher in IH group than those in control group(P<0.05). Conclusion Rho/ROCK pathway may play an important role in developing pulmonary hypertension (PH) associated with IH;and IH can promote the muscularization in pulmonary vascular to accelerate PH.

Objective To investigate the effect of adenovirus-mediated IL-24 (Ad-IL-24)gene expression on the apoptosis in a human squamous cell carcinoma cell line COLO 16, and to explore the underlying molecular mechanism. Methods Cultured COLO 16 cells were divided into two groups to be transfected with an adenovirus vector carrying the IL-24 gene (Ad-IL-24 group)or green fluorescent protein (Ad-GFP group), while those receiving no treatment served as the control group. After culture for different durations, qPCR was performed to quantify IL-24 gene expression, methyl thiazolyl tetrazolium (MTT) assay to evaluate the proliferative activity of COLO 16 cells, flow cytometry to detect the apoptosis of COLO 16 cells, laser scanning confocal microscopy (LSCM) to observe the morphological changes of COLO 16 cells, Western blot to determine the levels of Bax and Bcl-2 proteins and to evaluate the activation of caspase-3, qPCR to determine the levels of Bax and Bcl-2 mRNAs, an immunofluorescence assay to observe the expression of Bax and Bcl-2 proteins. Statistical analysis was carried out by a two-sample t-test with the SPSS 19.0 software. Results MTT assay showed that the proliferation of COLO 16 cells in the Ad-IL-24 group was significantly inhibited as early as 4 days after the transfection; thereafter, the inhibitory effect increased in a time-dependent manner, and peaked on day 6(P<0.05). However, there was no significant difference in cellular proliferative activity between the Ad-GFP group and control group (P>0.05). Flow cytometry revealed that the apoptosis rate was significantly higher in the Ad-IL-24 group(13.10%± 0.92%)than in the control group(3.69%± 0.36%, P<0.05)and Ad-GFP group(3.39%± 1.06%, P<0.05), but no significant difference was observed between the control group and Ad-GFP group (P>0.05). LSCM demonstrated that the apoptosis of COLO 16 cells was accelerated in the Ad-IL-24 group. The immunofluorescence assay, Western blot and qPCR all showed that the mRNA and protein expressions of Bax were increased, but those of Bcl-2 were decreased in the Ad-IL-24 group compared with the Ad-GFP group and control group. Moreover, Western blot showed a protein band that could specifically bind to the anti-cleaved caspase-3 antibody in the Ad-IL-24 group, but not in the Ad-GFP group or control group. Conclusions Ad-IL-24 can induce apoptosis in human COLO 16 squamous cell carcinoma cells, probably by up-regulating Bax expression, down-regulating Bcl-2 expression, and activating caspase 3.

Objective To estimate the effect of a tretinoin derivative ECPIRM on retinoic acid receptors (RARs),and to observe skin irritation responses to it in mice.Methods Cultured SCL-1 cells were divided into 2 groups to be treated with culture medium containing 10 μmol/L ECPIRM (ECPIRM group) or 10 μmol/L all-trans retinoic acid (ATRA) (ATRA group) for 24 hours,and those treated with drug-free culture medium served as the control group.Western blot analysis and real-time fluorescence-based quantitative PCR were performed to quantify the protein and mRNA expressions of RARs (RARα,RARβ,RARγ and RXRα) respectively.In addition,real-time fluorescence-based quantitative PCR was conducted to measure the mRNA expressions of two target genes of the activated RAR signaling pathway,i.e.,cytochrome P450 26A1 (CYP26A1) and tazarotene-induced gene 1 (TIG1).Eight BALB/c mice were equally divided into 2 groups to be topically treated with 0.075％ ECPIRM gel or 0.05％ ATRA cream at equal molar concentrations on the shaved skin once daily for 21 successive days.Skin irritation reactions were assessed in these mice.Results Compared with the control group,the ATRA group showed significantly increased protein and mRNA expressions of RARα,RARβ and RARγ (all P ＜ 0.05).The mRNA expressions of CYP26A1 and TIG1 genes in the ATRA group were 25.49 and 3.88 times that in the control group respectively (both P ＜ 0.01).However,there was no significant difference in the protein expressions of RARα,RARβ,RARγ and RXRα,or mRNA expressions of RARα,RARβ,RARγ CYP26A1 and TIG1 between the ECPIRM group and control group (all P ＞ 0.05).Obvious Skin irritation reactions such as erythema and desquamation were observed in BALB/c mice after 2-day topical treatment with ATRA cream,and their degree peaked after 5-day treatment.However,neither erythema nor desquamation was observed in BALB/c mice during 21-day treatment with 0.075％ ECPIRM gel.Conclusion Unlike ATRA,ECPIRM cannot activate the canonical RAR signaling pathway or cause skin irritation reactions.

Objective To investigate the value of application of multi-slice helical CT(MSCT) indiagnosis of basicranial fracture. Methods Sixty-two patients with basicranial fracture were scanned withthin-section scanning mode after conventional CT scanning The images were transferred to the work-station for reconstruction including multiplanar reconstruction (MPR), volume rendering (VR). Comparison between thin-section scanning images and conventional CT scanning images were performed. Results Compared with the conventional CT scanning (67.9% and 45.0% respectively),the rates of fracture displayed of images acquired from thin-section scanning in diagnosis of fractures of anterior and middle cranial fossa (100.0% and 95.0% respectively) ,P＜0.01. The two scanning mode in diagnosis of fractures of posterior cranial fossa( 88.9% and 100.0% respectively )differed from each other unstatistically(P＞0.05 ). ConclusionThe thin-section scanning of MSCT can improve the diagnostic correctness of basicranial fracture.

Objective To investigate the relation between TMB and the efficiency of PD-1/PD-L1 inhibitors treatment for non-small-cell lung cancer. Methods Studies were searched from PubMed, Embase, Cochrane Library database, Chinese Biomedical Literature Database and Wanfang Database up to March 25, 2020. RevMan 5.3 software and STATA15.0 were used for analysis. Results Twelve literatures were involved, including 1209 patients. TMB significantly improved PFS (HR=0.54, 95%CI: 0.42-0.70, P < 0.001) but reduced the ORR (OR=4.41, 95%CI: 2.54-7.63, P < 0.001) of NSCLC patients treated with PD-1/PD-L1 inhibitors. The subgroup analyses showed that the predictive value of TMB was significant in non-small cell lung cancer treated by PD-1/PD-L1 inhibitors combined with anti-CTLA-4 therapy or chemotherapy. No significant publication bias was observed by the Begg's test and Egger's test. Conclusion High tumor mutation burden may predict the improved PFS of non-small cell lung cancer by PD-1/PD-L1 inhibitors treatment, but its predictive value for OS, ORR and long-term survival need more exploration.

Objective:To explore the application of 6MWT and handgrip strength test in the nursing evaluation of arterial stiffness in community-dwelling elderly.Methods:From September 2019 to January 2020, 129 community-dwelling elderly people (age 60 years or older) were selected as the research subjects. Arterial stiffness was detected by pulse wave detector, and handgrip strength test and 6MWT were performed. Pearson correlation analysis and multiple linear regression methods were used to analyze the relationship between handgrip strength and 6MWT test indicators and aortic pulse wave velocity (aPWV) and augmentation index75 (AIx75).Results:The community-dwelling older people of aPWV was (10.50 ± 1.36) m/s and was negatively correlated with 6MWT distance and 6WMT work, of which the correlation coefficients were -0.404 and -0.285 respectively ( P<0.05). The community-dwelling older people of AIx75 was (28.51 ± 10.81) % and was negatively correlated with handgrip strength, relative grip strength, 6MWT distance and 6MWT work, of which the range of correlation coefficients were from -0.261 to -0.226 ( P<0.05). After adjusting for age, gender, and blood pressure, 6MWT distance and grip strength were independently related to aPWV and AIx75, respectively. Conclusions:In community-dwelling elderly people, both the grip strength test and 6MWT can be used for nursing evaluation of early arterial stiffness, but the specific evaluation role is different.

Objective According to the clinical and gene mutation characteristics of ACADVL-related very long chain acyl-CoA dehydrogenase deficiency(VLCADD),the types that contribute to the gene mutation of ACADVL were summarized.Methods By analyzing clinical,laboratory and genetic data of 1 case with ACADVL-related very long chain acyl-CoA dehydrogenase deficiency diagnosed from Department of Pediatrics,the Affiliated Hospital of Inner Mongolia Medical University in August 2016,based on the agreement signed by both the litde patient's parents and the hospital,plus the high-throughput sequencing analysis and PCR sequencing test for the 2 generation genes,some presented mutation sites were analyzed and concluded,in addition to taking "ACADVL" as key words to search the databases from CNKI,Wanfang(updated in 2016) as well as PubMed and related documents from On-line Mendal Inheritant databases of Man (OMIM) and HGMD.Results Through physical examination,VLCADD was diagnosed.After being given Levocamitine and the diet likemedium-chain fatty acid food for a week,the metabolism returned to normal.Tracking him for 3 months,his hepatitis obviously rebounded,within the reach of 3 cm under the right rib and 1 cm under the xiphoid.The exome sequencing study (trios) was identified the novel heterozygous mutation according to the statistics below A CAD VL (N M_000018.3) Exon7:c.608 C ＞ T;p.(Pro203 Leu) (heterozygous) and A CAD VL (NM _000018.3) Exon18:c.1748C ＞ T;p.(Ser583Leu) (heterozygous) in ACADVL.Relevant literature reported suggest these two mutations from both the parents are pathogenic genes,which can account for the reason why the boy got ill.However,these two mutations had not been reported in ACADVL-related VLCADD so far.Up to now,73 types of mutations from documents index were related to the VLCADD,but the clinical case included 75 kinds of gene mutations.Conclusions The apparent symptoms of the boy with the gene mutation were reflected in abnormal heart rates,hepatomegaly and hypoglycemia.VLCADD was diagnosed through genetic testing,and systematic treatment can partly control the development of the disease.In conclusion,the findings (exon 7 and 18) show that according to the genetic tests,disease-causing genes from both parents are new mutations of ACADVL and they are pathogenic.