There was a 1 1 -year -old school -aged girl complaining of abdomen intumescing and declining physical fitness for 1 6 months,and hydropericardium for 5 months.The child had a intumescent abdomen and strength diminished strength suddenly.After the strenuous exercise she was more tired than before and lost her appetite.The girl was found cardiac enlargement and calcification of pericardium during security check at the airport.The thoracoabdomi-nal computed tomography(CT)suggested hydropericardium,hydrothorax effusion in the right,and seroperitoneum,pel-vic effusion.The girl had no response to pericardiocentesises,anti -inflammation and antituberculosis therapies.The in-flammatory markers and the findings of autoimmunity were normal after her admission.The purified protein derivatives (PPD)test was (++),but the antituberculosis therapy was invalid,so the diagnosis was unclear.The she had peri-cardiectomy.The pericardium visceral and parietale′s pathology showed hyperplasia,hyalinosis and organization of fi-brous connective tissue,congestion of the blood capillaries,infiltration of inflammatory cells.Terminally,she was diag-nosed as constrictive pericarditis.Symptoms disappeared after treatments with cardiotonic,diuretic and potassium sup-ply.The comprehensive analysis is important clinically,the possible causes should be removed gradually,and pathologi-cal examination must be emphasized during the diagnosis of constrictive pericarditis.

Objective The purpose of this study was to observe the effects of bumetanide on elderly type 2 diabetic patients with middle and advanced stages nephropathy. Methods Forty cases with diabetic nephropathy (DN) were divided into two groups:control group (20 cases) and treatment group (20 cases) . The control group accepted furosemide (20 mg, once a day) and the bumetanide was orally administrated at the dose of 1.0 mg, twice a day to the treatment group for 3 months. The assessment of transferrin (TRF) and urine microalbumin (UALB) was performed at the time points at the end of 1, 4, 8, 12 weeks after treatment. Results (1) The levels of BUN, SCr and UA after treatment were lower than before treatment, but there were no significant differences. (2) In the treatment group, the levels of TRF and UALB have decreased after treatment for 1 week, with no statistically significant. But at the end of 4, 8 and 12 weeks,the differences were statistically significant ( <0.05) . Especially, during the three months follow-up,the levels of TRF and UALB at 12 weeks have decreased obviously. Conclusion The therapeutic effect of bumetanide on DN might be better than that of furosemide.

Objective The changes of CECs,EPCs and CPCs in the old type 2 diabetes mellitus retinopathy(DR)patients and the clinical purpose were discussed.Methods 30 cases of T2DM(including 10 DM cases without complications and 20 DM cases with retinopathy)and 10 cases of health controls were enrolled in this study.Results(1)The changes of CECs in DR Patients were significantly higher while the levels of EPCs and CPCs were significantly lower than those in the patients of the control group.(2)There were some corrlation beteen the level of CECs,EPCs and CPCs and the degree of diabetic retinopathy.(3)The serum EPCs levels in type 2 diabetics were negativey associated with body mass index,waist-hip ratio,abdominal circumference,FPG,triglyceride,UAER,creatinine.Conclusion The levels of EPCs and CPCs in T2DM-DR patients may be the important detected targets for early discovery and monitoring of DR.

Objective To check the changes of endothelial progenitor cell (EPC) number of patients with anaplastic large cell lymphoma (ALCL) in the peripheral blood,investigate their clinical significance.Methods The number of EPC in blood was determined by FCM method in 30 patients with ALCL and 10 healthy cases as the control group.Results The number of EPC in the peripheral blood of patients with ALCL before treatment was significantly higher (15.530±28.659/μl) than that in control group (0.515 ±0.294/μl,P ＜ 0.001).The number of EPC of ALCL patients in the high-risk groups (21.521±36.057/μl) and the middle-risk groups (16.830±24.273/μ1) differently increaasd than that of the low-risk group (6.508±7.356/μl,P ＜ 0.01),but between the high-risk groups and the middle-risk groups there was no significant value (P ＞ 0.05).There were significant difference between the number of EPC of ALK+-ALCL (8.367±9.609/μl) and ALK-ALCL (22.541± 20.845/μl) patients (P ＜ 0.01).The survive curve before 60 weeks had significant difference between groups of ＞20/μl and ＜20/μl of EPC.Conclusion EPC may be correlated with progression of the disease in a certain degree.Dynamic observation with the level of EPC may be used to evaluate the treatment outcomes and act as a prognostic marker for ALCL.

Aim To observe the effect of melittin on human hepatocelluar carcinoma HepG2 cell prolifera-tion in vitro and its further mechanisms.Methods The capacity of cellular proliferation and apoptosis was measured with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay,Hoechst 33258 assay and Annexin V-FITC /PI assay.The mR-NA expression of Shh, PTCH1, SMO, GLi1 and HDAC2 was performed by qRT-PCR.And the protein expression of Shh,PTCH1,SMO,GLi1 and HDAC2 was assessed by western blotting.Results Our study found that melittin effectively inhibited cell prolifera-tion and promoted cell apoptosis in vitro using MTT method and Flow cytometry.The mRNA and protein expression of Shh,PTCH1,SMO,GLi1 and HDAC2 were obviously decreased after treated with various con-centrations of melittin for 48h in HepG2 cells.Conclu-sions Taken together,our data suggest that melittin could inhibit cell proliferation and promote cell apopto-sis,reduce the level of HDAC2 and down-regulate the Hedgehog signaling pathway in this process simultane-ously.

Objective:To investigate the changes of expression levels of TLR9 and IL-6 in the periodontal tissue during the experimental tooth movement of the rats, and the effecst of the MT01 on the expression of TLR9,TRAF6 and IL-6 in periodontal tissue,and to clarify its related mechanisms.Methods:Thirty Wistar rats were randomly divided into MT01 intervention group(n=6) and non-MT01 group(n=24).Force of 0.49 N was applied to move the upper first molars mesially. The rats in Non-MT01 intervention group were sacrificed on the days 3,7,14 and 21, and the rats in MT01 intervention group were all sacrificed on the day 7. RT-qPCR was used to detect the expression levels of TLR9,TRAF6 and IL-6 mRNA in maxillary first molar alveolar bone in each group.Results:The expression levels of IL-6 and TLR9 mRNA in loaded side were higher than those in control side(P<0.05), and reached the maximum levels on the day 7(P<0.01);with the interpose of MT01, the expression levels of TLR9 and TRAF6 mRNA were lower than control side(P<0.01).Conclusion: MT01 could down-regulate the expression levels of TLR9 and TRAF6 during orthodontic tooth movement and eventually resists the inflammation during the tooth movement.

BACKGROUND:Fibroblast-like synoviocytes (FLS) in the synovial lining layer are related to the cell proliferation, invasion, migration and apoptosis as well as bone resorption in rheumatoid arthritis. OBJECTIVE:To compare the migration and invasion abilities of FLS (MH7A) in rheumatoid arthritis and normal FLS (HFLS). METHODS:The capacities of cell migration and invasion were evaluated by Transwell cell migration and invasion assays. The primers of the indicated microRNAs were designed and synthesized, and the expression levels of miRNAs were determined by real-time PCR according to the SYBR?PrimeScript?miRNA RT-PCR Kit instruction. RESULTS AND CONCLUSION:MH7A possessed stronger migration and invasion abilities than HFLS. Compared with HFLS, obviously upregulated miR-132, -155, -203, -223 and -124, and significantly downregulated miR-15a, -16, 18a, -19a, -26a and -146a were found in MH7A. These findings suggest that the differentially expressed 11 kinds of rheumatoid arthritis-associated miRNAs participate in the pathogenesis of rheumatoid arthritis probably by enhancing the migration and invasion capacities of MH7A.

OBJECTIVE:To evaluate the availability and equipment of antidiabetic drugs in public hospitals from Shaanxi prov-ince. METHODS:Using a standardized methodology developed by WHO and Health Action International,the availability and equipping rate of the most common oral antidiabitic drugs were investigated and evaluated in public hospitals of Shaanxi province. RESULTS:The availability and equipping rate of tertiary hospitals and secondary hospitals were all higher than those of community health service centers. Among generic drugs,the availability of metformin was the highest (94.4%),and those of glibenclamide and repaglinide were the lowest(5.6%). Among original drugs,the availability of acarbose was the highest(68.1%). The equip-ping rate of original drugs was higher than that of generic drugs. The equipping rate of generic drugs(25.0%)was higher than that of original drugs(12.5%)in community health service center,but the equipping rates of generic drugs and original drugs were in low level. CONCLUSIONS:General hospitals (especially tertiary hospitals) have high equipping rate of original antidiabetic drugs,the community health services have low availability and equipping rate. Comprehensive measures should be taken to im-prove the availability of drugs in primary medical institutions and ensure drug use of chronic disease patients in primary hospitals.

Objective:To understand the effect of a new tracheal tube fixation device in the "double fixation" of oral tracheal intubation for critically ill patients in adult emergency department.Methods:A retrospective analysis of patients with oral tracheal intubation admitted to our EICU from January 2016 to June 2017 was performed using traditional tape and inch band fixation as a control group; the experience of treatment from July 2017 to December 2018 for patients with oral tracheal intubation, the new double-fixation method of tracheal tube fixation device was used as the observation group. The degree of displacement, oral cleanliness, facial skin allergies and injuries, and comfort of the two groups of patients was compared.Results:The rate of tracheal displacement in the experimental group was mildly 11.2% (11/98), moderately 5.1% (5/98), and the control group was mildly 24.2% (15/62), moderately 14.5% (9/62) and severe 6.5% (4/62). The incidence of facial skin allergy and skin damage was 6.1% (6/98), 0, and the control group was 24.2% (15/62), 11.3% (7/62), the difference was statistically significant ( Z value was -4.021, χ2 value was 24.48, P<0.05). The comfort score of the test group was (1.05±1.01) points, which was significantly higher than (2.10±1.71) points of the control group ( t value was 4.920, P<0.01). Conclusions:The new type of tracheal tube fixation device "dual fixation" for critically ill patients with mechanical ventilation through oral endotracheal intubation is visually beautiful, and has good firmness and comfort. It can effectively reduce the occurrence of adverse events and has good application value.

Objective:To evaluate the knowledge, attitudes and practices ( KAP) on National Essential Medi-cine System among pharmacists from secondary public hospitals in Shaanxi province. Methods: The quantitative re-search of KAP questionnaire is used, and the content of questionnaire includes personal information, knowledge, atti-tudes and practices. Results: A total of 520 copies of questionnaires were distributed and 82. 3% were effective. Respondents’ overall knowledge and attitudes are at the middle level;the main way to obtain knowledge is via training and meeting;respondents’ education level and frequency of participating in training have a significant impact on their level of knowledge;the degree of attention paid by hospitals has yet to be strengthened; and respondents are mostly concerned about the supply and distribution of essential drugs. Conclusion: In order to improve the awareness and recognition levels of pharmacists on the implementation of National Essential Medicine System in secondary public hospitals, the government should take the relevant measures, including introducing the high educated persons into secondary public hospitals, organizing related training programs and standardizing the daily monitoring of essential drugs in secondary public hospitals, etc.