AIM: To elucidate the effects of platelet-activating factor (PAF) on eosinophil activation and the action of dexamethasone or theophylline during this process. METHODS: Eosinophils (EOS) from the peripheral blood of normal subjects were isolated. The hypodense eosinopil (HE) and normodense eosinophil (NE) were studied with electron microscopy. The effects of PAF on eosinophil activation and the action of dexamethasone or theophylline during the above process were measured. RESULTS: Hypodense eosinophil had significantly smaller individual granules than normodense eosinophil had. PAF induced eosinophil peroxidase release, and generated. Eosinophils incubated with 10~(-8) mmol/L PAF and 10~(-5) mmol/L dexamethasone released (101.17?10.32) mg/L eosinophil peroxidase (P

An analysis of the present development of general practitioners in China,probed into the bottlenecks found.The paper proposed to set forth from the training,use and incentives of GPs to promote the systematic design of China's GP system.These measures center on the regulation of GPs development,while building a multi-channel and multi-level GP development system.Other recommendations include raising the professional standing and attractiveness of GPs as a discipline,and enhancing GPs capacity building to promote general practitioners development.

Objective To investigate the role of microRNA-490-5p (miR-490-5p) in the regulation of visceral sensitivity in rats with intestinal dysfunction.Methods The lentivirus vector system was used to construct the rno-miRNA-490-5p lentivirus expression vector.The rats were divided into normal group,diarrhea-predominant irritable bowel syndrome (IBS-D) group,lentivirus empty vector group and the siRNA silent group and the latter three groups were model groups.The efficiency of siRNA was measured by real-time polymerase chain reaction (PCR).The rats were gavaged with 10％ India ink,and then the time of first black stool,water content of feces and threshold of expansion capacity caused abdominal elevation or back arching were calculated.The visceral sensitivity of rats after miRNA-490-5p silenced was evaluated with abdominal withdrawal reflex (AWR) score by stimulating with different intensities of colonic dilatation.The abdominal electrical activity of rats stimulated by colonic distension was measured by BL-420F biological and functional experimental system.The change of the tension of rats isolated colon intestinal stimulated with acetylcholine chloride was also detected by BL-420F biological and functional experimental system.T test was used to compare the differences between the model groups and the normal group.One way analysis of variance was performed for multi-group comparison after miRNA-490-5p interfered.For comparison between two groups among multiple groups,least significant difference (LSD) method was used when the variance was equal,and Games-Howell method was used when the variance was unequal.Results The gastrointestinal propulsion time and the threshold of expansion capacity caused abdominal elevation or back arching of model groups were both lower than those of the normal group ((8.54±4.07) hvs (12.33±2.23) h,(0.56±0.08) mL vs (0.84±0.09) mL),and the differences were statistically significant (t =2.62 and 6.37,both P ＜ 0.05).After distension with 0.8 mL and 1.2 mL sodium chloride solution,the AWR scores of model groups were significantly higher than those of the normal group (3.20±0.56 vs 1.20±0.45,3.73±0.46 vs 2.60±0.55),and the differences were statistically significant (t=7.20 and 4.58,both P＜0.01).There was no significant difference in AWR score between the model groups and the normal group when distended with 1.6 mL sodium chloride solution (3.93 ±0.26 vs 3.80 ± 0.45) (P＞0.05).After miRNA-490-5p silenced,gastrointestinal propulsion time of normal group,IBS-D group,lentivirus empty vector group and the siRNA silent group was (11.12±1.01) h,(6.23±3.17) h,(6.09 ± 2.26) h and (12.36±1.97) h,and the differences among four groups were statistically significant (F=10.55,P＜0.01).The abdominal electrical activity of normal group,IBS-D group,lentivirus empty vector group and the siRNA silent group distension stimulated with 0.8 mL and 1.2 mL sodium chloride solution was (64.91 ± 10.50),(101.79 ±11.73),(80.49±1.27),(66.92±3.24) μV,and (105.09±52.40),(131.71± 16.74),(111.00±6.41) and (95.49± 4.2) μV,and the differences among four groups were statistically significant (F=16.82 and 9.14,both P＜0.05).There was no significant difference in abdominal electrical activity amplitude between silenced group and normal group ((66.92±3.24) μV vs (64.91±10.49) μV and (95.49±4.22) μV vs (105.09±2.40) μV) (all P＞ 0.05).After distension with 1.6 mL sodium chloride solution,the abdominal electrical activity amplitudeof silenced group was lower than the other groups,and the differences were statistically significant (F=11.09,P＜0.01).After adding 1∶1 000 acetylcholine chloride added,the tension of colon of normal group,IBS-D group,lentivirus empty vector group and the siRNA silent group increased by 0.71 ± 0.21,0.81±0.06,0.88±0.21 and 0.43±0.07,however there was no significant difference among the four groups (F=2.57,P =0.100).Conclusions Visceral hypersensitivity existed in rats with intestinal dysfunction.miRNA-490-5p may be involved in the regulation of visceral sensitivity.

Objective To explore the fixation method of tibial helical plate for treatment of proximal and middle one-third of humeral fractures and evaluate the clinical outcome. Methods A review was performed on 15 patients with proximal and middle one-third of humeral fractures treated by tibial helical plate from May 2004 to February 2009. There were 10 males and five females, at age range of 19-65 years ( average 38.0 years). The surgical method was summarized and the shoulder function evaluated.Results The follow-up lasted for 7-24 months (mean 13 months) , which showed bony union in all patients, with mean union time of 4.7 months. There was no implant loosening or failure. According to Neer 's criteria, the result was excellent in seven patients and good in six, with excellence rate of 86.7%.Conclusions Open reduction and internal fixation using tibial helical plate is simple and effective for treatment of proximal and middle one-third of humeral fractures.

Objective Atrioventricular block (AVB) is a common and serious arrhythmia. At present, there is no perfect method of treatment for this kind of arrhythmia. The purpose of this study was to regenerate cardiac atrioventricular conduction by autologous transplantation of bone marrow mesenchymal stem cells (MSCs), and explore new methods for therapy of atrioventricular block. Methods Eleven Mongrel canines were randomized to MSCs transplantation (n=6) or control (n=5) group. The models of permanent and complete AVB in 11 canines were established by ablating His bundle with radiofrequency technique. At 4 weeks after AVB, bone marrow was aspirated from the iliac crest. MSCs were isolated and culture-expanded by means of gradient centrifugal and adherence to growth technique, and differentiated by 5-azacytidine in vitro. Differentiated MSCs (1ml, 1.5×107cells) labeled with BrdU were autotransplanted into His bundle area of canines by direct injection in the experimental group, and 1ml DMEM in the control group. At 1-12 weeks after operation,the effects of autologous MSCs transplantation on AVB models were evaluated by electrocardiogram, pathologic and immunohistochemical staining technique. Results Compared with the control group, there was a distinct improvement in atrioventricular conduction function in the experimental group. MSCs transplanted in His bundle were differentiated into analogous conduction system cells and endothelial cells in vivo, and established gap junction with host cardiomyocytes. Conclusions The committed-induced MSCs transplanted into His bundle area could differentiate into analogous conduction system cells and improve His conduction function in canine AVB models.

Objective To conduct a systematic review on the safety and efficacy of enhanced recov -ery after surgery ( ERAS) in perioperative management of hepatectomy .Methods A literature search was conducted on databases which included the PubMed , Embase, Cochrane Library, Sinomed, Wangfang, VIP and CNKI for randomized controlled trials ( RCTs) on application of ERAS in patients after hepatectomy . The data collection ended in August 2015.A meta-analysis was performed using RevMan 5.3 software.Re-sults Eleven RCTs which included 1074 patients were selected into this study .There were 530 patients in the ERAS group and 544 patients in the control group .On Meta-analysis, when compared with the control group, the ERAS group had significantly shorter length of hospital day (WMD=-2.36, 95%CI: -3.19~-1.54 , P<0.05 ) , shorter time for functional recovery ( WMD=-2.30 , 95%CI: -3.77 ~-0.83 , P<0.05), lower total complication rate (RR=0.65, 95%CI:0.52~0.80, P<0.05), and significantly decreased rates of postoperative pulmonary infection (RR=0.36, 95%CI:0.14~0.91, P<0.05) and nausea and vomiting (RR=0.48, 95%CI:0.26~0.89, P<0.05).There were no significant differences between the two groups on the rates of postoperative bleeding , biliary fistula, abdominal infection, delayed incisional healing, wound infection and urinary tract infection (P>0.05).The ERAS group had significant-ly lower hospitalization cost (SMD=-1.61, 95%CI:-2.42~-0.80, P<0.05), but the differences between the two groups on mortality and re-admission rates were not significant (P>0.05).When compared with the control group , the drainage tube removal time ( WMD=-2.83 , 95% CI:-3.92~-1.76 , P<0.05), time to first mobilization (SMD=-2.34, 95%CI:-2.98~-1.70, P<0.05), time to first feeding ( SMD=-5.08 , 95%CI: -9.33~-0.83 , P<0.05) , time to passage of first flatus ( SMD=-3.60, 95%CI:-4.85~-2.34, P<0.05) in the ERAS group were significantly shorter , but there was no significant difference on the time to the first bowel motion ( P>0.05 ) .Conclusions ERAS in the peri-operative management of hepatectomy was safe and beneficial .

Objective To evaluate the dual blood supply of lung adenocarcinoma and squamous cell carcinoma using dualinput perfusion CT.Methods A total of 40 patients confirmed with lung cancer pathologically underwent CT perfusion (CTP) scanning.The pulmonary flow (PF),bronchial flow (BF),perfusion index (PI,PI=PF/[PF+BF])and tumor volume,location were measured and recorded by 2 experienced radiologists.The differences in CTP parameters between lung adenocarcinomas and squamous cell carcinomas,the central lung cancers and peripheral lung cancers were analyzed.The correlation between the tumor volume and CTP parameters was analyzed.Interobserver agreements were assessed with intraclass correlation coefficient (ICC).Results The average of PF,BF and PI of all 40 cases was (54.26± 21.07)ml/ (min · 100 ml),(64.41±22.06)ml/(min · 100 ml) and (43.38±16.07)％,respectively.Tumor histology was consistent with adenocarcinomas in 23 cases and squamous cell carcinomas in 17 cases,lung adenocarcinomas showed lower PI than that of squamous cell carcinomas (t=-2.196,P=0.034).There were 17 peripheral lung cancers and 23 central lung cancers,and the PI of the peripheral lung cancers was higher than that of the central lung cancer (t=2.305,P=0.027).No statistically significant differences were found for BF and PF between two types of lung cancers and central lung cancers and the peripheral cancers (all P＞0.05).Tumor volume was negatively associated with PI (r =-0.39,P=0.01).Good agreement was found between the two observers,the ICC for BF,PF and PI was 0.97,0.93 and 0.91,respectively.Conclusion Dual-input CTP technique can be used to evaluate the differences of blood supply between different pathological types and locations of lung cancer,with PI depending both on tumor size and location.

AIM: To observe the protein expression of vascular endothelial growth factor 1 (VEGF-1) in pulmonary arterial endothelial cells and VEGF-1 gene expression in lung tissue in rats with hypoxia-induced pulmonary hypertension and treated with heparin. METHODS: Twenty four male adult SD rats were randomly divided into three groups (8 rats each): a control group (group A), a group with hypoxia for 4 weeks (group B) and a group with hypoxia for 4 weeks and injected with heparin to abdominal cavity simultaneously (group C). Mean pulmonary arterial pressure (mPAP), right ventricle hypertrophy index (RVHI) and vessel morphometry were measured. The morphology of pulmonary artery was observed by HE staining. The expression of VEGF-1 protein in pulmonary arterial endothelial cells was determined by immunohistochemistry. The level of VEGF-1 mRNA in lung tissue was measured by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: mPAP, RVHI, pulmonary artery remodeling parameters, VEGF-1 protein expression in pulmonary arterial endothelial cells and VEGF-1 gene expression in lung tissue of the three groups from high to low were group B, group C and group A. It was statistically significant when compared between either two groups of the three (P<0.01). Linear correlation analysis showed that VEGF-1 protein was positively correlated with pulmonary artery remodeling parameters (r=0.974, P<0.01), and VEGF-1 mRNA was positively correlated with VEGF-1 protein (VEGF 120 mRNA, r=0.919, P<0.01; VEGF164 mRNA, r=0.896, P<0.01). CONCLUSION: Heparin may down-regulate the expression of VEGF-1 at the levels of transcription and translation, resulting in the inhibitory effect on rats with hypoxia-induced pulmonary hypertension.

Objective To compare everolimus (EVR) with calcineurin inhibitor (CNI) minimization or withdrawal on renal function of liver transplant patients with standard CNI therapy.Methods A search was conducted on databases which included the PubMed,Embase and Cochrane library for randomized controlled trials (RCTs) comparing EVR with CNI with minimization or withdrawal (the EVR group) with standard CNI therapy (the standard CNIs group) on renal function of liver transplant patients.A metaanalysis was performed using RevMan 5.3 software.Results Five RCTs which included 1 264 patients were selected into this study.There were 790 patients in the EVR group and 474 patients in the standard CNIs group.On meta-analysis,the EVR group had significantly better renal function (SMD =0.36,95％ CI 0.09 ～ 0.64,P ＜ 0.05),but higher rates of infection (RR =1.37,95％ CI 1.08 ～ 1.74,P ＜ 0.05),dyslipidemia (RR =2.46,95％ CI 1.79 ～ 3.38) and leukopenia (RR =2.37,95％ CI 1.32 ～ 4.26).No significant differences were found on the mortality and the acute rejection rates between the two groups (all P ＜ 0.05).Conclusions EVR with CNI minimization or withdrawal after liver transplantation provided effective immunosuppression and improved patients' renal function.The treatment increased the rates of infection,dyslipidemia and leukopenia.

Objective To investigate the relationships among cerebellar mutism (CM), relapsed medulloblastoma (MB) and the primary tumor location.MethodsA retrospective analysis was conducted in 114 children over 3 years old with MB from November 2011 to April 2015.ResultsThe median onset age was 84.7 months (36.4 to 184.7 months) in 114 children with MB (77 boys and 37 girls), of whom there were 48 cases of recurrence. There were twenty two cases of CM and the overall incidence of CM was 19.3% (22/114). The incidence of CM was 19.7% (13/66) in non-recurrent cases and 18.8% (9/48) in recur-rent cases, and there was no signiifcant difference between two groups (P=0.899). The incidence of CM was 17.6% (9/51) in cas-es with primary tumor in the fourth ventricle, 7.1% (1/14) in cases with primary tumor in the cerebellar vermis, 21.4% (3/14) in cases with primary tumor in both fourth ventricle and cerebellar vermis, 45.5% (5/11) in cases with primary tumor in fourth ven-tricle and other parts of the brain, and 50.0% (4/8) in cases with primary tumor in cerebellar vermis and other parts of the brain. No CM incidence was observed in cases with primary tumor in central nerve system except for the fourth ventricle and cerebellar vermis. The incidence of CM between the cases with fourth ventricle/cerebellar vermis involvement and those without fourth ventricle/ cerebellar vermis involvement had signiifcant difference (P=0.039). ConclusionsThere is no relationship between CM and relapsed MB. Children with MB whose primary tumor is located in the fourth ventricle and/or the cerebellar vermis is susceptible to CM.