Objective To compare the spray characteristics of domestic and foreign nasal spray delivery devices for live attenuated influenza vaccine(LAIV). Methods The particle size distribution(DV10,DV50 and DV90),the proportion of droplets smaller than 10 μm and Span of atomized particles of two brands of nasal spray delivery devices at home and abroad were measured by laser diffraction method,the spray pattern[maximum diameter(D_(max)),shortest diameter(D_(min))and ovality(D_(max)/D_(min))]and spray geometry(spray angle and width)were detected by Spray view,and the comparative analysis was performed. Results There was no significant difference in DV10,DV50,DV90 particle size distribution,proportion of droplets smaller than 10 μm and Span of atomized particles between the two kinds of domestic and foreign nasal spray delivery devices[F-values of Levene's test for equality of variances were 0. 622,0. 135,3. 067,0. 212 and 0. 058,P-values were0. 434,0. 714,0. 085,0. 647 and 0. 810,and significance(two-tailed)values of equal variances assumed were 0. 439,0. 228,0. 281,0. 539 and 0. 910,respectively];D_(max),D_(min)and ovality of the spray patterns showed no significant difference[F-values of Levene's test for equality of variances were 2. 102,2. 666 and 0. 514,P-values were 0. 158,0. 114 and0. 479,and significance(two-tailed)values of equal variances assumed were 0. 651,0. 407,and 0. 160,respectively];The geometric mean ratios of spray angle and width were 0. 92 and 0. 91,respectively,which ranged from 0. 90 to 1. 11.Conclusion Both the domestic and foreign nasal spray delivery devices meet the delivery requirement of the nasal spray LAIV,which can be used for the delivery of nasal spray vaccines and drugs.

Recent studies demonstrate that autistic spectrum disprders children have deficits in executive functiony, particularly the function referred response inhibition. The antisaccade task provides a new tool for direct evaluation of inhibitory function and a new way to explore the character of response inhibition in children with cognitive impairment. Researchers have used the technologies of eye movement to reveal the ability of oculomotor inhibition in children with autistic spectrum disprders, which is poorer than that of normal children.

The state of scale management,structure of hierarchy,professional institutions,educational system and degree,situation of academy and cost of medical education in developed countries was summarized in this article respectively to provide reference for our medical education reform.

Inflammation reaction and immune response are in-separable in the levels of system, tissue, cell and molecule. In-flammatory immune responses ( IIR) is proposed in this paper, which is defined a moderate or abnormal system responses of in-flammatory immune related cells in responding to the internal and external environment changes of body. It is described briefly that the research progresses of inflammatory immune cells ( e. g. , macrophages, dendritic cells, T cells and B cells, etc. ) and non-inflammatory immune cells ( e. g. , glial cells, endothe-lial cells, epithelial cells, fibroblasts, synovial cells and liver cells, etc. ) , and cytokines/receptor signal transduction in-volved in IIR. Moreover, the existing problems about regulating IIR drugs clinically are summarized. It is firstly put forward that soft regulation of inflammatory immune responses ( SRIIR) is a new direction of discovery and development of new drugs for the treatment of IIR related diseases.

Objective:To explore whether the introduction of web problem based learning (WPBL) teaching method in medical humanities English class under the background of new medical science is helpful to the course learning and the improvement of students' humanistic quality.Methods:Taking 602 students from Batch 2017 clinical medicine in Xi'an Medical University as the experimental group and 610 students from Batch 2018 as the control group, the research lasting a semester was carried out around eight modules. The control group adopted the traditional teaching mode, while the experimental group used the WPBL mode for teaching relying on the Blue Pigeon Cloud Network Language Learning Platform. After teaching, through comparing the final exam results and issuing self-made questionnaires, the teaching effects of the two methods on students' self-study ability, thinking ability, teamwork ability and knowledge application ability were compared. The data were statistically processed by SPSS 20.0.Results:The final average score of the experimental group (62.13±2.11) was higher than that of the control group (60.42±2.03), with significant differences ( P < 0.05). According to the statistical analysis of the questionnaire, there were differences between the two groups in evaluating the teaching effect, and the proportion of the experimental group was over 60%, significantly higher than that of the control group. 93.3% of the students in the experimental group were satisfied with the WPBL teaching method, while only 43.0% of the students in the control group were satisfied with the traditional teaching method, showing a significant difference between them. The evaluation of students in the experimental group were higher than the control group in terms of self-study ability, data access ability, knowledge exploration ability, language expression ability and problem finding and solving ability. 91.1% of students in the experimental group believed that the introduction of WPBL teaching mode in the course would help to improve their medical humanistic quality, which was significantly higher than the proportion of students in the control group. Conclusion:The empirical study shows that the introduction of WPBL teaching method in medical humanities English course can not only enable students to master learning skills, but also strengthen students' humanistic quality, thus promoting the development of medical education.

Objective To assess the clinical siginificance of the cardiopulmonary resuscitator in respiratory and cardiac arrest patients by comparing the curative effect of cardiopulmonary resuscitator and bare-handed cardiopulmonary resuscitation. Methods 102 patients on the verge of the death were randomiy divided into two groups and begin to CPR in four seconds after confirmation of respiratory and cardiac arrest. Patients in group 1 were given bare-handed CPR. Patients in group 2 were given cardiopulmonary resuscitation by cardiopulmonary resuscitator. Patients in both group 1 and group 2 received lasting CPR according to the 2010 GUIDE of CPR, then we observed their self-heart-beating, self-breathing, caroid puise, expression, puplillas, ECG. Results In the group 1,the effective case was 1,the non-effcctive cases were 63,the effective rate was 1.56%. In the group 2, the effective cases were 6, the non-effective cases were 31, the effective rate was 16.21%, there was a statistically significant difference between two groups ( <0.01) . Conclusion Cardiopulmonary resuscitator has good effect in cardiopulmomary resuscitation for respiratory and cardiac arrest patients, and the effective rate is significantly higher than bare-handed CPR,so it deserves clinical promotion.

Objective To investigate the curative effect of leflunomide in the treatment of diabetic nephropathy-Ⅳ (DN-Ⅳ).Methods Sixty cases with DN-Ⅳ were assigned to the leflunomide treatment group and the control group.Both groups were given hypoglycemic,antihypertensive,regulate lipid and angiotensin converting enzyme inhibitors or angiotensin Ⅱ inhibitor class of drugs.Meanwhile patients in the treatment group were orally administered leflunomide once daily for two month with a dose of 50 mg/d in the first three days and 20 mg/d afterwards.24 hour pre-and post-treatment values of urinary protein,C-reactive protein (CRP),endogenous creatinine clearance rate (Ccr),triglyceride (TG),total cholesterol (TC),albumin (ALB),glycosylated hemoglobin (HbA1c) and blood pressure were measured.Analyzed the correlation of Ccr with other laboratory indicators after treatment for one year.Results At 24 hour before treatment,after treatment for two months and one year,the level of 24 h urinary protein of the treatment group (n =26) were (3.75 ± 0.94)g/24 h,(2.02 ± 0.45) g/24 h,and (2.46 ± 0.55) g/24 h respectively,and the level of Ccr were (69.04 ± 13.35) ml/min,(71.35 ± 11.25) ml/min,and (67.48 ± 10.58) ml/min respectively.While in the control group(n =28),the 24 h urinary protein level of were (3.68 ± 1.03) g/24 h,(3.43 ± 0.65) g/24 h,and (5.46 ±0.47) g/24 h respectively at the three time points,and the Ccr level were (68.55 ± 10.09) ml/min,(66.76 ± 9.45) ml/min,(57.50 ± 15.75) ml/min respectively.The levels of 24 h urinary protein in the treatment group after treatment for two months and one year were significantly lower than before treatment in the treatment group as well as at the corresponding period of the control group (P ＜ 0.05),while the level of Ccr in the treatment group was higher than that of the control group at the same period,and the difference was statistically significant(P ＜ 0.05).The levels of CRP,TG,TC,HbAlc and systolic pressure in the treatment group after treatment for two months and one year were significantly lower than that of control group at the same period,while ALB was significantly higher than before treatment in the treatment group as well as at the corresponding period of the control group (P ＜ 0.05).The 24 h urine protein,TC,systolic blood pressure were significantly correlated with Ccr after treatment for one year (β =-0.771,-0.682,0.656,-0.530respectively;P ＜0.01).Conclusion Leflunomide treatment of diabetic nephropathy was safe and effective,but the duration of leflunomide treatment and second selection time of leflunomide therapy needed to further study.

Objective To explore the relevant factors influencing the prognosis of progressive cerebral infarction,in order to provide basis for clinical trentment and improve the prognosis of patients.Methods Clinical data of 163 patients admitted as progressive cerebral infarction and 355 patients admitted as non-progressive cerebral infarction were retrospectively analyzed.All patients were followed up by interview or telephone at the time of 30 and 90days,the clinical data were recorded.The relevant factors influencing the prognosis of progressive cerebral infarction were analyzed.Results Multiple linear regression analysis of patients with progressive cerebral infarction showed that total anterior circulation infarcts,respiratory infection,coronary heart disease history,imbalance of water and electrolyte,white blood cell increasing were leading influence risk factors for the higher National Institutes of Health Stroke Scale(NIHSS) in hospitalized patients.Analysis of patients with progressive cerebral infarction showed that total anterior circulation infarcts,lack of physical activity,NIHSS at admitting,the elderly and respiratory infection were leading influence risk factors of the higher Activities of Daily Living(ADL) and modify Rankin Scale(mRS) scores at 30d and 90d of following up.The scores of ADL and mRS at 30d and 90d were significantly higher in progressive cerebral infarction than those of non-progressive cerebral infarction patients (t =6.6179,P =0.000,t =5.2788,P =0.000,t =5.0608,P =0.000,t =4.0725,P =0.000,respectively).The recurrence of cerebral infarction in progressive cerebral infarction group and death events at 30d were also significantly higher than that of non-progressive cerebral infarction(x2 =8.423,P =0.004 and x2 =5.135,P =0.023,respectively).But the recurrence of progressive cerebral infarction and death events at 90d,there were no significant differences between progressive cerebral infarction and non-progressive cerebral infarction (x2 =1.938,P =0.159 and x2 =3.518,P =0.061,respectively).Conclusion The relevant factors influencing the prognosis of progressive cerebral infarction are common effect of various factors.In the treatment of progressive cerebral infarction should be actively considered as much as possible to improve the prognosis of patients.

B lymphocyte stimulator (BLyS), a tumor neurosis factor ligand superfamily, is an important factor of B cell survival and activation. However, BLyS also regulates T cell activation and survival, playing key roles in T cell-mediated autoimmune disorders. In the paper, we introduced the mechanisms of BLyS and a proliferation-inducing ligand (APRIL) regulating T cell responses and their roles in rheumatoid arthritis (RA).

Objective To investigate the use of anti-infective drugs in outpatients of our hospital, and to pro-mote rational administration in clinic. Methods Collecting the prescriptions of out-patient during June 2007 in our pharmscy,then statistically analyze the anti-infective drugs information in combination with adverse drug reaction (ADR) reports. Results The percentage of prescriptions was 45. 8%, the average amount of the prescriptions was 62. 56 yuan,the cost of anti-infective drugs accounted for 41.8% ,prescriptions of combined use and injection were 39.5% and 37.2% ,the ratio of ADR was 80. 6% ,irrational administration accounted for 10. 8%. Conclusion The use of anti-infective drugs in our prescriptions of out-patients has some problems, but rational use is the main trend in our hospital.