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 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 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 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.

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.

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:To explore the immune response in mice fed orally with the conjugated antigen of HpaA-CtxB(HCTB).Methods:A recombinant strain which could express bivalent antigen of HpaA and CtxB subunit was constructed. HpaA and CtxB gene was amplified by PCR. The DNA products of HpaA and CtxB were inserted into a prokaryotic expression vector pQE-30 respectively, and then translated into E.coli strain DH5? to express HCTB fusion protein. Its immunogenicity was analyzed by Western blot. After purification, to fed mice by oral immunization. The change of antigen-specific ASC antibody(IgG and IgA) in the mucosa of the animals were detected by ELISPOT and ELISA assay. Results:HCTB fusion gene was sequenced as 1 161 bp, the fusion protein encoded polypeptides of 387 amino acid residues.The molecular weight was 40 kD analysed by SDS-PAGE. The level of soluble expression product was about 41.67% of total cell protein. After affinity chromatography, the purity of fusion protein was above 92%.Western blot analysis confirmed that fusion protein could be specifically recognized by the serum of anti-HpaA and anti-CT. Antigen-specific ASC and antibody response in animals immunized with HCTB or HpaA was determined by ELISPOT and ELISA. The results showed that the number of sIgA and IgG-ASC increased significantly in PP and gastric mucosa, especially those of the sIgA-ASC by orally immunization with HCTB. The levels of specific antibody were also higher than those of controls. Conclusion:The results indicated that the oral immunization with HCTB induces effective mucosal immune respones and produced higher levels sIgA. The recombinant fusion protein HCTB can be used as an effective oral vaccine for prevention and treatment of infection of Hp.