The‘prevention and early treatment of diseases’conception as‘Huangdi Neijing’suggested,is the highest academic realm among the Chinese medical theory,it flows through the entire process of Chinese medical theory and diseases prevention.Four aspects of the prevention conception manifested in the process of Chinese medical prevention of diseases are: Taking preventive measures before confirmed diagnosis(health cultivation),impeding diffusion after confirmed diagnosis, deterring diffusion from deterioration,and restraining deterioration from being malignant.The malignant causal chain conversion of the coexistence of asthenia and sthenia is considered as the inducing links of critical illness’occurrence,evolution and transformation.Therefore,to intercept the malignant causal chain conversion comes to the key technique of Chinese medical remedy for critical illness.The‘prevention and early treatment of diseases’conception must impenetrate the versal process of treating critical illness.The overall clue and method of Chinese medical remedy for critical illness is to identify and grasp the vital contradiction and each respect of the malignant causal chain conversion which concurs with the evolution of the critical illness,simultaneously utilize the method which combined the prevention in etiology and pathogenesis with the remedy in etiology and pathogenesis,then actuate the pathologically changed organism to extricate from critical conditions at the first opportunity, finalizing with convalescence and recuperation thereafter.

Objective To compare the efficacy in radical cure of H.Pylori (Hp) by different proton pump inhibitor (PPI)-based treatment regimens.Methods One thousand two hundred and three H.Pyloriinfected patients diagnosed by both endoscopic pathology and a rapid urease test were enrolled in this study.Reviewed 13 C-urea breath test at the end of Hp eradication treatment for more than 4 weeks,and retrospective analyzed the different effect of Hp eradication regimens.All patients were given treatment regimens,which including PPI (esomeprazole azole,bella,esomeprazole,pantoprazole omeprazole,2 times/d) plus antimicrobial for 7,10,14 d.According to antimicrobial,patients were divided into A,B,C,D,E group.Patientss in group A(421 cases) were given amoxicillin 1.0 g,2 times/d,clarithromycin 0.5 g,2 times/d;In group B (49cases) were given amoxicillin 1.0 g,2 times/d,levofloxacin 0.2 g,2 times/d;In group C(69 cases) were given amoxicillin 1.0 g,2 times/d,metronidazole 0.4 g,2 times/d;In group D(559 cases) were given clarithromycin 0.5 g/d,2 times/d,levofloxacin 0.2 g,2 times/d and in group E(105 cases) were clarithromycin 0.5 g,2times/d,metronidazole 0.4 g,2 times/d.Bismuth were colloidal bismuth pectin 200 mg,2 times/d.Results The radical cure rate of Hp was 84.04％ (453/539) in the group treated by regimens with Amoxicillin,and significant higher than that of without Amoxicillin (69.12％ (459/664),x2 =36.104,P =0.000),and the radical cure rate of Hp was 14.92％.The Hp radical cure rate of quadruple therapy was 76.85％ (767/998),while triple therapy was 70.73％ (145/205).However,no significant difference between these two regimens was found(x2 =3.476,P =0.062).The Hp radical cure rates of 14-,10-and 7-day course therapies were 84.28％ (134/159),75.79％ (579/764),71.07％ (199/280) respectively,and there was significant different among the three groups (x2 =9.644,P =0.008).There was significant increases trend in the 14-day therapy group comparing to 10-and 7-day regimen groups (x2 =5.399,11.719,P =0.020,0.001 respectively),while no significant difference was shown between the 10-and 7-day therapy groups(x2 =2.398,P =0.121).The radical cure rates were 84.80％ (357/421),81.63％ (40/49),81.16％ (56/69),69.95％ (391/559),64.76％(68/105) respectively in A,B,C,D and E groups,and there was significant difference among the groups (x2 =37.999,P =0.000).Conclusion Radical cure therapy of Hp should be PPI-based.A 14-day triple or quadruple treatment regimen with combination of Amoxicillin and clarithromycin is suggested as a first-line therapy.It is worth to clinically popularize such regimens in the light of the superior efficacy.

Objective To investigate neurological recovery effect and mechanisms of blood activating and phlegm removing decoction in the treatment of patients with hypertensive cerebral hemorrhage.Methods 68 patients with hypertensive cerebral hemorrhage in our hospital were divided into two groups.34 patients of the control group were given conventional western medicine,and 34 patients of the observation group were taken conventional western medicine combined with blood activating and phlegm removing decoction.The clinical outcomes, hematoma volume change and neurological recovery were compared,and analyzed its mechanism of action.Results The effective rate of the observation group(94.12%) was significantly higher than 73.53%of the control group (χ2 =5.31,P<0.05). After 7d,14d,21d treatment,NIHSS scores of the observation group [(12.87 ±1.43) points,(8.55 ±1.11) points and (5.67 ±0.76) points] were significantly lower than those of the control group [(20.43 ±2.57) points, (17.66 ±2.08)points,(14.54 ±1.44)points],and the differences were statistically significant (t=14.99,22.53, 31.76,all P<0.05).After treatment,hematoma volume of the observation group[(6.44 ±0.54)mL]was significant-ly lower than before treatment[(16.30 ±1.90)mL]and after treatment in the control group [(12.11 ±1.44)mL] (t=29.11,21.50,all P<0.05).After treatment,ALD score of the observation group [(66.34 ±5.22)points] was significantly lower than before treatment[(27.53 ±2.20)points]and after treatment in the control group[(47.55 ± 3.33)points],and the differences were statistically significant(t=39.95,17.70,all P<0.05).Conclusion The effect of blood activating and phlegm removing decoction in the treatment of patients with hypertensive cerebral hemor-rhage is significant,can significantly improve neurologic impairment and daily living skills,has no obvious conflict of interest and high application value,worthy of promotion and application.

Objective To validate the accuracy of the colorectal cancer model of the Association of Coloproctology of Great Britain and Ireland(ACPGBI-CCM),and to find out the relationship between clinical risk factors and the predictive value produced by ACPGBI-CCM.Methods The patients diagnosed definitely as colorectal cancer in the department of anal-colorectal surgery,West China hospital from April 2007 to July 2007 were analyzed retrospectively.And the predictive value of mortality for each patient was calculated by ACPGBI-CCM,then the difference of risk factors was compared by classifying the patients into lower risk group and higher risk group by making the median predictive mortality as a cut point.Results From April 2007 to July 2007,a total of 99 patients diagnosed definitely as colorectal cancer accepted treatment,and among which 67 patients included in this study were admitted whose average age was 60.09 years.And there were 34 male and 33 female patients;15 right hemicolon cancer,9 left hemicolon cancer,43 rectal cancer;Dukes staging:A 0 case,B 37 cases,C 24 cases,D 6 cases.The observed mortality 30 days after operation was 0,whereas the predictive mortality was 0.77%-25.75% with a median value of 3.36%.Then the patients whose predictive mortality were ≤3.36% were grouped as lower risk group(34 cases),the others higher risk group(33 cases),and there was strikingly different predictive mortality between two groups 〔(8.86?4.51)% vs(1.76?0.68)%,P0.05).Furthermore,stratification analysis was made for risk factors,and it came out that there were great differences of predictive mortality for different age groups and ASA grading,having internal medicine complications or not,having chemotherapy or not,and for cancer resected or not,and the differences were statistically significant(P0.05).Conclusion The clinical applicability of the ACPGBI-CCM is ascertained in such a large volume single medical centre,but the ACPGBI-CCM overpredicts the mortality in this study which may be attributed to the different areas,nations,or the different cultures.The complications and the neo-adjuvant or adjuvant therapy are further found out that they may be independent predictive factors of survival,and more research will be needed to prove this.

Objective Bone marrow mesenchymal stem cells ( BMSCs) , a kind of stem cells with multiple differentiation po-tentials, exist in the bone marrow and other organizations.This study aimed to investigate the repairing effect of the exogenous basic fi-broblast growth factor ( bFGF) against chronic obstructive pulmonary disease ( COPD) and its action mechanism, and to determine the expression of the bFGF gene in transfected rat BMSCs. Methods BMSCs were isolated, cultured and identified.The recombinant plasmid bFGF-pcDNA3.1 was constructed and sequenced.Liposome-mediated bFGF-pcDNA3.1 plasmid was transfected into the BM-SCs of the rat (bFGF-pcDNA3.1 transfection group), liposome-mediated pcDNA3.1 transfected into the BMSCs (pcDNA3.1 transfec-tion group) , and untransfected BMSCs used as the control.G418 screening was performed for 14 days.The gene and protein expres-sions of bFGF were determined by qRT-PCR and Western blot. Results The full-length sequence of the bFGF gene was consistent with that of the GenBank.The expression of the bFGF gene was significantly higher in the bFGF-pcDNA3.1 transfection group (7.028 ±0.568) than in the pcDNA3.1 transfection group (1.000 ±0.082) and the non-transfection control (1) (P<0.01), but with no statistically significant difference between the latter two groups (P>0.05).The expression of the bFGF protein was also re-markably higher in the bFGF-pcDNA3.1 transfection group (1.017 ±0.054) than in the pcDNA3.1 transfection group (0.217 ± 0.009) and the non-transfection control (0.165 ±0.013) (P<0.05), with no statistically significant difference between the latter two groups (P>0.05). Conclusion Mediated by the liposome reagent, the recombinant eukaryotic expression vector bFGF-pcD-NA3.1 can be transfected into rat BMSCs and expresses the bFGF gene and protein.

Objective To study the influence of bFGF gene transfected bone marrow-derived mesenchymal stem cells (BMSCs) on the inflammatory cytokines of COPD rat. Methods The BMSCs were separated from SD rat and cultured and then bFGF gene was imported to BMSCs by liposome transfection method. The samples were prepared into six groups: normal control group, COPD group (A), BMSCs group (B), pcDNA3.1-BMSCs group (C), bFGF-pcDNA3.1-BMSCs group (D), and bFGF group (E). The expressions of TNF-α and IL-1β by QRT-PCR were detected. Results Compared with COPD group, TNF-α and IL-1β genes from groups B to D dropped significantly (P < 0.05). The changes of TNF-α and IL-1β genes among groups B to D showed no significant difference (P > 0.05). Conclusion BFGF transfected BMSCs, sample BMSCs and pcDNA3.1 transfected BMSCs can inhibit the expression of inflammatory cytokines of TNF-α and IL-1β, but there is no obvious advantage in comparison to bFGF transfected BMSCs and sample BMSCs in respect of inhibiting the expression of inflammatory cytokines of TNF-α and IL-1β.

Objective To investigate the effect of HIF-2a silencing by transfection of siRNA into MG-63 cells un-der hypoxia. Methods HIF-2αexpression level in MG-63 cells under hypoxia was determined by Western Blot. Small in-terfering RNA (siRNA) was used to construct MG-63/siHIF-2α(siHIF-2α)cells and control MG-63/scramble (NC) cells. The expression levels of HIF-2α, Vascular endothelial growth factor (VEGF), p-Erk/ErK and Mcl-1 in MG-63, NC and si-HIF-2αcells was determined by Western Blot. NC and siHIF-2αcells were cultured under hypoxia. Cell viability was as-sessed by MTT assay. Migration was identified by scratch migration assay. Tumor formation was identified by clone formation assay. Nude mouse subcutaneous xenograft model was used to investigate tumor development in vivo. Results Hypoxia im-proved HIF-2αexpression in MG-63 cells in a time-dependent manner (F=2 037.412,P<0.001). HIF-2αexpression un-der hypoxia in siHIF-2αcells was lower than that in NC cells (P<0.01). Cell viability of siHIF-2αcells under hypoxia for 12 h and 24 h were lower than that in NC cells (P<0.05 or P<0.01). The relative width of scratch in siHIF-2αgroup under hypoxia for 12 h and 24 h were larger than that in NC group (P<0.01 or P<0.01). When cell counts reach 1 000-5 000, the clone formation rates of siHIF-2αcells were lower than that in NC cells (P<0.05 or P<0.01). The expression of VEGF, p-Erk/Erk and Mcl-1 protein under hypoxia in siHIF-2αcells was lower than that in NC cells(P<0.01). Tumor sizes, weights and density of siHIF-2α group in nude mice were suppressed compared with those in NC group (P<0.01). Conclusion Blocking HIF-2αsignal pathway warrants its investigation as a potential strategy in osteosarcoma treatment.

Human leukocyte antigen G ( HLA-G) is a member of the non-classical HLA classⅠb family. It is considered to play a crucial role in immune tolerance. A unique feature of HLA-G is the struc-tural diversity as surface expressed and as secreted molecules, which is mainly attributed to alternative spli-cing of the primary transcript. HLA-G can promote the invasion and metastasis of tumor cells through various ways. In addition, HLA-G has been described included in exosomes. Exosomes released by most cell types are nano-sized vesicular bodies that contain lipid bilayer and rich contents. As a new marker for diseases, exosomes are extensively involved in the occurrence and development of diseases. Recent studies have found that exosomes can express soluble HLA-G, which reveal a new way by which HLA-G regulates tumor micro-environment. In this review, we focus on the expression of HLA-G on exosomes to provide new thoughts for the early detection and treatment of tumors.

Objective To evaluate the effect of applying emergency care simulator (ECS)on cardiopulmonary resuscitation skill training. Methods Clinical doctors and nurses(n=1 472)received the skill training of unarmed cardiopulmonary resuscitation (CPR),electric defibrillation and tracheal intubation by using simple CPR simulator (n=667)or ECS (n=805)respectively. After training,the examination was carried out and questionnaires were handed out. The completion time of operations, the scores and pass rates of examinations,the evaluations of training methods were compared between the two groups. The statistical data were analyzed by t(t')-test or Chi-square test with SPSS 19.0 and P <0.05 was considered as the criterion of significance. Results Compared with those of group using simple CPR simulator,the group using ECS showed obviously shortened completion time((309±125)s vs. (242±61)s,t'=12.65,P=0.00;(87±36)s vs. (55±31)s,t'=20.28,P=0.00;(239±87)s vs. (145±53),t'=24.4,P=0.00),significantly increased scores ((83.5±14.8)vs. (90.2±17.6), t'=7.93,P=0.00;(84.7±19.3)vs. (92.1±21.5),t'=6.95,P=0.00;(81.6±15.3)vs. (89.6±13.5), t'=10.53,P=0.00)and pass rates of examinations (84.1%(561/667)vs. 92.5%(745/805),χ2=25.96, P<0.01;82.2%(548/667)vs. 91.2%(734/805),χ2=26.41,P<0.01;80.8%(539/667)vs. 91.4%(736/805),χ2=35.48,P<0.01)as well as higher evaluation of training methods. Conclusions Application of ECS can obviously improve the training effect of CPR and it can be widely popularized in the edu-cation and training of emergency medicine skills.