Aim To investigate the effect of the inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA)reductase enzyme,simvastatin on E-Selectin ex-pression and adhesive function assay induced by CD40L.Methods Human umbilical vein endothelial cell(HUVEC)was cultured from ECV304 cell strain.Then E-Selectin expression and adhesion of lymphocytes to endothelial cells induced by CD40L and interfered with different concentrations of simvastatin or simvastatin(5 ?mol?L-1)+mevalonic acid were determined by RT-PCR and FCM analysis.Results Preincubation of HUVECs with simvastatin(0~10 ?mol?L-1)decreased the expression of E-Selectin induced by CD40L in a concentration-dependent manner.Mevalonic acid(400 ?mol?L-1)inhibited the restrain of simvastatin on E-Selectin expression.Moreover,preincubation with simvastatin,decreased significantly adhesion of lymphocytes to endothelial cells induced by CD40L.Conclusions Simvastatin inhibits activation of endothelial cells induced by the CD40L/CD40 pathway through HMG-CoA dependent effect.

In this paper the causes of deficiency of public welfare were analyzed in medical research,and some strategies were proposed to enhance the public welfare of public health care services according to the cardinal principles of new healthcare reform package in 2009.These were benefit to maintain the public welfare of public medical and health care services,and to reach the goal of medical research served as the clinic and the patients.

Objective To comprehend the metabolic disorder of the obese patients with type 2 diabetes mellitus(T2DM).Methods According to body mass index( BMI),176 cases of T2DM were divided into 2 groups;obesity(95 cases) and non-obesity(81 cases),the waist circumference(W) ,hip circumference(H) ,fasting plasma glucose(FBG) ,2-hour postprandial plasma glucose(2hBG) ,fasting blood insulin(FINS),2 hours postprandial blood insuline(2hINS), renal function, triglycetide(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C ), glycosylated hemoglobin(HbA1c) and blood pressure(BP) were tested.Results The BMI,the ratio of W/H (WHR), serum uric acid (BUA), FINS, 2bINS, FCP and 2hCP in the obese group were higher than those in non-obese group(P <0.01);systolic blood pressure and diastolic blood pressure in obese patients were higher than those in the non-obese group(P >0.05) ,while the prevalence of abdorminal obesity.Hypertension significantly increased in obese group than those in non-obese group.Conclusion Among the T2DM ,metabolic disorder in obese patients is even more serious.It is very improtant for obese patients with T2DM to be given combined treatment to improve the metabolic disorder,that includes controlling blood glucose, decreasing weight and lightening insulin resistance.

Objective To explore the relation between glucose fluctuation state and diabetic chronic compli-cations in type 2 diabetes mellitus. Methods 169 cases with type 2 diabetes mellitus were divided into two groups: 78 cases with constant high glucose(group Ⅰ) and 91 cases with glucose fluctuation state( group Ⅱ ). The clinical data such as fasting plasma glucose(FBG) ,fasting blood insulin(FINS) ,fasting blood C peptide,2 hours postprandial plasma glucose (2hPG) ,2 hours postprandial blood insuline (2hINS) ,2 hours postprandial blood C peptide, glycosy-lated hemoglobin A1c (HbA1c), and blood pressure (BP), body mass index ( BMI ), urinary albumin excretion rote (UAER) ,triglyeeride(TG) ,total cholesterol(TC) ,high density lipoprotein cholesterol(HDL-C) ,low density lipopro-tein cholesterol(LDL-C) were measured. Results 2hPG in group Ⅱ was much higher than that in group Ⅰ (P<0.01) ,but 2 hours postprandial blood insuline and 2 hours postprandial blood C peptide in group Ⅱ were much lower than those in group Ⅰ (P<0.01). The incidence of diabetic chronic complications was higher in group Ⅱ compared with that in group Ⅰ (P<0.01). Conclusion These findings suggest that glucose fluctuation state with type 2 dia-betes mellitus had increased diabetic chronic complications.

Objective To search for the normal value and developmental regular rule of motor norve conduction in children.Methods One hundred and fourty-nine children aged from 0 to 14 years old were divided into 7 groups in accordance with age. There were 19 pecrsons aged from 20 to 35 years old in adult group. The motor nerve conduction function of median nerve, ulnar perve, tibial nerve and peroneal nerve of every suhject was determined by nerve evoked potential meter.Results The terminal latency of action potential of every nerve is decreased along with growing up of age before 6 years old and increased after 6 years old. The conduction velocity of ulnar nerve is the fastest,then the peroneal nerve and median nerve, that of tibial nerve is the slowest. Median nerve development quicken after 3 months of birth and approch ulnar nerve at the time of 3 years old. Tibial nerye get into fast development period from 3 months to 1 years old and catch up peroneal nerve. The conduction velocity of every nerve extend to adult level in th period of 3~6 years old.Conclusion The every parameler of nervous conduction has a great difference of age in the period of child,particularly in that of infancy. therefore, the normal values should be set up in accordance with proper age groups. This study shows that it's suitable to divide groups in accordance with new-born, 3 and 6 months, 1, 3 and 6 years old. Adult criterion should be used in the children dbove 6 years old.

OBJECTIVE:To improve rational drug use and reduce potentially inappropriate medication (PIM). METHODS:PIM of 700 elderly inpatients in internal medicine department of our hospital was evaluated by Beers criteria(2012 edition)and STOPP/START criteria. RESULTS:700 inpatients whose mean ages were (76.3 ± 7.2) years old took (12.1 ± 4.9) kinds of drugs per patient. 144 cases involved PIM(20.6%). The number of PIM was 220 in total,among which there were 117 cases/times relat-ed to drugs and 22 cases/times related to disease in according to Beers criteria,9 cases/times of STOPP and 72 cases/times of START. Drug with most frequency of PIM in accordance with Beers was benzodiazepines and most frequency in STOPP was thia-zides that used by patients with gout histonry. The most omission frequency of START prescription were absence of metformin thera-py for type 2 diabetes and absence of antiplatelet therapy for diabetes complicated with cardiovascular risk. CONCLUSIONS:A high prevalence of PIM in elderly inpatients in our hospital requires various measures to prevent its occurrence.

Objective A distintegrin and metalloproteinase 33 (ADAM33) is one of the asthma susceptibility gene, which is closely related to the pathogenesis of asthma and airway hyperreactivity.The aim of this study was to evaluate the expression of serum ADAM33 in patients with different severity of asthma and the relation to airway chronic inflammation through clinical trials.MethodsPatients diagnosed as mild-to-moderate asthma (n=54), severe asthma (n=35) and healthy controls (n=30) were recruited from May 2015 to May 2016.The serum IgE, ADAM33, IL-4 and IL-13 1evels and Eosinophil (EOS) in peripheral blood were detected, and the correlation analysis was performed Results The serum levels of ADAM33 in mild-to-moderate asthma group, severe asthma group and healthy control group were 23.8±6.21pg/mL,64.8±12.8pg/mL and 18.3±4.49pg/mL, respectively.The ADAM33 levels in mild-to-moderate asthma group and severe asthma group were higher than those in control group (P<0.05).The ADAM33 levels in severe asthma group were higher than those in mild to moderate asthma group.(P<0.05).The correlation analysis showed that ADAM33 had positive correlation with IL-4 and IL-13(r=0.79 and r=0.81), but no correlation with EOS and IgE(r=0.54 and r=0.46).Conclusion The expression of serum ADAM33 was up-regulated in asthmatic patients along with the severity of asthma.ADAM33 was positively correlated with serum IL-4 and IL-13, implying that the expression of ADAM33 may be regulated by Th2 type cytokines.

Objective To investigate the short-term clinical outcomes and perinatal risk factors in very low birth weight infants (VLBWI) with delayed enteral feeding (DEF).Methods Three hundred and fifty-five cases of VLBWI admitted to neonatal intensive care unit from Jan 2007 to Oct 2011 served as study objects,and the clinical data of which were analysed retrospectively.According to days to initiate enteral feeding after birth,355 VLBWI were divided into two groups:DEF group (initiate enteral feeds ≥5 days,n =55)and early feeding group (initiate enteral feeds ≤4 days,n =298).The short-term clinical outcomes were compared in 299 cases,including DEF group 44 cases and early feeding group 255 cases,in which cure or improvement were achieved and hospital stay ＞ 14 d.The perinatal risk factors were subjected to univariate and multivariate logistic regression analysis.Results The incidence of DEF was 16.05％ (57/355) in VLBWI.The time to regain birth weight in DEF group was significantly longer than early feeding group [(11.86 ± 3.86) d vs (9.76 ± 3.83) d,P ＜ 0.01],and the incidences of parenteral nutrition associated cholestasis [27.27％ (12/44)] and extrauterine growth retardation at discharge [79.55 ％ (35/44)] in DEF group were also significantly higher than early feeding group respectively [11.76％ (30/255) and 61.57％ (157/255),P ＜ 0.05].Multivariable logistic regression analysis showed that infants born to mother with placental abruption had higher risk of exposure for DEF than those without placental abruption (OR =2.74,95％ CI 1.06 ～7.05,P ＜ 0.05).Similarly,infants with mechanical ventilation had also higher odds of DEF than those with-out mechanical ventilation (OR =3.51,95 ％ CI 1.92 ～ 6.42,P ＜ 0.01).Conclusion Placental abruption and mechanical ventilation are independent risk factors for DEF in VLBWI.Improving neonatal outcome through enhancing obstetric quality and strengthening cooperation between obstetric and neonatology department is still the key to reduce DEF in VLBWI.

Objective To evaluate the efficacy and safety of mometasone furoate dry powder inhalation(MF DPI) in treating mild and moderate asthma .Methods The databases of PubMed ,EMBASE ,CINAHL were retrieved .The randomized ,controlled trials(RCT) on mometasone furoate dry powder inhalation in treating mild and moderate asthma were collected .The quality evalua‐tion and the data extraction were performed according to the Cochrane systematic evaluation method .The RevMan 5 .0 .2 software was adopted for conducting statistical analysis .Results A total of 9 RCT involving 1 795 patients with mild and moderate asthma were included .The meta‐analysis results showed that MF DPI 200 mcg/d improved FEV1(MD=0 .24 ,95% CI:0 .17 -0 .30) ,am‐PEF(MD= 25 .25 ,95% CI:8 .18 -42 .32) ,pmPEF(MD= 16 .00 ,95% CI:2 .10 -29 .90);MF DPI 400 mcg/d improved FEV1 (MD=0 .32 ,95% CI:0 .25-0 .39) ,amPEF(MD=36 .44 ,95% CI:23 .82-49 .05) ,pmPEF (MD=28 .50 ,95% CI:14 .11-42 .89) , which suggested that MF DPI 200 mcg/d and MF DPI 400 mcg/d improving FEV1 ,amPEF and pmPEF was higher than the place‐bo ;for reducing patient′s early morning dyspnea and albuterol dose ,MF DPI 200 mcg/d and MF DPI 400 mcg/d were superior to placebo .For reducing patient′s early morning wheezing ,MF DPI 200 mcg/d and MF DPI 400 mcg/d were not superior to placebo . For the occurrence of adverse events ,there was no statistical difference between MF DPI 200 mcg/d and MF DPI 400 mcg/d with placebo(P>0 .05) .Conclusion The existing evidence indicates that MF DPI has higher effect and safety in treating mild and mod‐erate asthma .

Objective To design a checklist (NICU-PoHC) for postoperative handover in the NICU (Neurosurgery Intensive Care Unit) in case of information omissions or task errors during the handover process,thus to improve patient safety.Methods Team discussion and literature review was conducted to compose the preliminary version of the NICU-PoHC.Then two rounds of panel review were conducted using the Delphi methods to revise the preliminary checklist and to calculate its Content Validity Index (CVI).Results The authority coefficient of experts was 0.86.Twenty experts proposed 7 suggestions for revision.The NICU-PoHC was developed,and its CVI was 0.88.Conclusions Our study developed the NICU-PoHC,which can be used as an assistant tool guiding the postoperative handover,preventing information omissions and task errors,and thus improving patient safety.