Diabetic nephropathy is caused by manifold factors .Increasing evidences suggest that immunoregulation abnormality caused by inflammatory cell infiltration and proinflammatory factor overexpression in kidney tissue has a key role in the occurrence and development of diabetic nephropathy .As a novel immunomodulator , activated vitamin D 3 could inhibit inflammatory factor and regulate immunity response .The author reviews the effect of activated vitamin D 3 related to diabetic nephropathy , from the pointviews of immu-nocyte, cytokines and rennin-angiotensin system.The roles of macrophage, T lymphocytes, dendritic cell, transforming growth factor-β1, and rennin-angiotensin system in kidney injury and immunal regulation of activated vitamin D 3 are discussed.

The nuclear factor erythroid 2 related factor 2 (Nrf2) is a key protein of endogenous antioxidant defense systems in the body. In response to oxidative stress, Nrf2 translocates to nucleus and binds to antioxidant response elements (ARE), regulating the expression of a large amounts of antioxidant genes and maintaining a proper redox balance. The pathological processes of neurodegenerative diseases are associated with generation of reactive oxygen species, which cause oxidative stress. Oxidative stress plays a cardinal role in the onset and progression of neurodegenerative diseases. Nrf2-inducer compounds can reduce oxidant stress and have shown therapeutic efficacy in many neurodegenerative disease models. How to activate the Nrf2 signaling pathway effectively has been received much attention. Here we provided an overview of specific mechanism of Nrf2-ARE pathway and the protective effects of Nrf2 in different neurodegenerative diseases, and summarized the Nrf2 activators recently in preclinical study.

A lot of problems have turned up with the development of the urban employee's basic medical system. So we need to establish a set of scientific medical evaluation index system to weigh it. This article discusses the evaluation index of the medical insurance from the respects of fairness, efficiency and development.

Objective Tc explore the value of application of Sevoflurane anesthesia induction in anesthesia management of foreign matter removal from trachea in children.Methods Sixty five cases of children with tracheal foreign matter related in our hospital from January 2015 to December 2016 were selected as the study objects,and were divided into two groups according to random number table method.The control group of 32 cases was given 2.5 mg/kg propofol to induce anaesthesia,and the observation group of 33 cases was given 8％ Sevoflurane inhalation to induce ancsthesia.One shot success rate,deoxygenation time,operation time,recovery time and the relative parameters (systolic pressure,diastolic pressure,respiratory rate and pulse oxygen saturation) at entrance time,before and after setting the mirror were contrasted and analyzed,and the intraoperative and postoperative adverse reactions were recorded in the two groups.Results There were no significant differences in respiratory rate,blood oxygen saturation,systolic blood pressure and diastolic blood pressure between two groups at entrance time and before setting the mirror (P ＞ 0.05).The respiratory rate and blood oxygen saturation of the observation group were higher than those of control group after setting the mirror and at withdrawing mirror time,with statistically significant differences (P ＜ 0.05).No statistically significant differences in other indexes (P ＞ 0.05).Deoxygenation time,operation time and recovery time of the observation group were significantly lower than those in the control group (P ＜ 0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusions Sevoflurane anesthesia induction can obviously shorten operation time and recovery time in foreign matter removal from trachea in children,and reduce the incidence of intraoperative and postoperative adverse reactions.It has good clinical effect.

The Fukushima nuclear accident happened in 2011.This article introduced the recent studies about thyroid dose estimation,incidence of thyroid nodule,thyroid cyst and thyroid cancer in the children in Fukushima prefecture after the accident.The results suggested that the incidence of thyroid nodule and thyroid cyst had no significant increase.Nevertheless,the present research noted that the incidence of thyroid cancer was obviously higher than that in other areas in Japan,but high incidence may be due to the choice of the control group or the screening effect.Meanwhile,the contribution of 132Te to the thyroid dose and the incidence of thyroid cancer might not be ignored.The continuous monitoring before and after the operation of the nuclear power plant and the health evaculation after the accident are of importance.

ObjectiveTo compare and evaluate the effectiveness of Airtraq laryngoscope combined with a Bougie and Airtraq laryngoscope alone for tracheal intubation in simulated difficult airway.Methods Four anesthetists and 4 clinical physicians of standardized training were enrolled in the study.The participants intubated the trachea of the ALS simulator manikin in 5 tongue edema scenarios simulating modified Cormack-Lehane grade 1,2a,2b,3,and 4 views and 1 cervical immobilization scenario.Results No significant difference in the rate of successful intubation was detected between two techniques(P＞ 0.05 ).In Cormack-Lehane grade 1,2a views,the duration of successful intubation in Airtraq laryngoscope alone [ ( 14.3 ± 1.3),( 17.1 ± 2.9) s] was shorter than that in Airtraq laryngoscope combined with a Bougie [ (26.6 ± 3.8),(36.4 ± 3.6) s ] with significant difference (P ＜ 0.01 ).Cormack-Lehane grade 2b,3,4 views,the duration of successful intubation in Airtraq laryngoscope alone[ (74.5 ± 6.5 ),(116.3 ± 9.8),(53.0 ± 6.1 )s] was longer than that in Airtraq laryngoscope combined with a Bougie [ (35.4 ± 4.3 ),(52.3 ± 5.0),(40.4 ± 3.8 ) s ] with significant difference (P ＜ 0.05).ConclusionAirtraq laryngoscope combined with a Bougie can be quickly intubated in simulated difficult airway compared with Airtraq laryngoscope alone.

Objective To investigate the effects of active vitamin D (VD) on the expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in renal tissue of diabetic nephropathies (DN) rats and to explore the impact of TREM-1 on adhesion and migration capacity of macrophage.Methods DN rat models were established by streptozotocin.Rats were randomly distributed into four groups:control (NC) group,VD group,DN group and DN+VD group (DN rats with 0.1 μg · kg-1 · d-1 calcitriol by garages).Rats were sacrificed respectively at 8 weeks and 12 weeks after treatment.Pathological changes in kidney tissue were detected and the expressions of CD68 and TREM-1 were acquired by immunohistochemistry stain and Western blotting.In vitro,RAW264.7 cells were divided into NC group,VD group,high glucose (HG) group and HG+VD group.In HG+VD group rats were treated by high glucose with 10-8 mol/L 1,25(OH)2D3.TREM-1 expression was measured by immunohistochemistry stain and Western blotting,and the ability of macrophage in migration and adhesion was evaluated by Transwell migration assay and adhesion assay.TREM-1 siRNA was transferred to silence TREM-1 expression,while plasmid of TREM-1 was transferred for high expression.Their ability of adhesion and migration in macrophage and the effect of 1,25(OH)2D3 were examined.Results (1) Compared with the NC group,the expressions of CD68 and TREM-1 were increased in DN group (P ＜ 0.05),whereas markedly decreased in DN+VD group (P ＜ 0.05).(2) The number of adhesion and migration cells,and the expression of TREM-1 protein in macrophage were obviously increased in HG group as compared with those in NC group (all P ＜ 0.05);whereas above changes were markedly decreased in HG+VD group than those in HG group (P ＜ 0.05).(3) The number of adhesion and migrated macrophage was reduced after TREM-1 siRNA intervention (all P ＜ 0.05).VD could significantly decrease the effect of high glucose on adhesion and migrated macrophages after TREM-1 siRNA (all P ＜ 0.05).(4) Adhesion and migration of macrophage were increased via TREM-1 overexpression (all P ＜ 0.05),but the effects of VD on high glucose-induced adhesion and migration of macrophage were disappeared.Conclusions VD can suppress the adhesion and migration of macrophage via reducing the expression of TREM-1,and inhibit infiltration of macrophage in renal tissue of DN rats.

Alzheimer’ s disease ( AD) , the most prevalent type of neurodegenerative disease, characterized by extracellular β-amyloid ( Aβ) plaque deposition, intracellular neurofibrillary tangles, and the loss of diverse neurons. Neuron loss might be the main cause that induces irreversible decline of cognitive function in AD patients. At present, AD therapy only relieves symptoms instead of fundamentally affecting the major pathologi-cal characteristics of the disease. Recently, rapid advances in neurogenesis and stem-cell biology have provided a new and pro-spective potential for AD treatment. Stem-cell types in the treat-ment of neurodegenerative diseases include neural stem cells ( NSCs ) , embryonic stem cells ( ESCs ) , mesenchymal stem cells ( MSCs ) , and induced pluripotent stem cells ( iPSCs ) . Stem cell therapy shows anti-AD function by replacing the dam-aged and lost neurons, rebuilding the cellular loop, inhibiting amyloidogenesis, promoting neurotrophic factor release, and reg-ulating immune reaction. This review highlights the recent pro-gress, mechanisms, and preclinical evidence of exogenous trans-planted stem cell, and addresses the current major challenges of stem cell transplantation in clinic. In addition, this review also summarizes the research status of compound promoting endoge-nous neurogenesis in brief.

Objective:We estimated the effect of Xinxuetong on the left ventricular function in hyperten-sion. Methods :Transaortic and transmitral flow velocity was studied by pulsed Doppler echo cardiographybefore and after vein administration of Xinxuetong. Results: It was shown that Peak A, IRP andPeak A/Peak E decreased after administration of Xinxuetong. Conclusion:This study suggests that Xinx-uetong can significantly improve the diastolic function and the treatment of hypertension.

Objective To investigate the expression of integrin β1 and VEGF in gastric carcinoma and evaluate its correlation with invasion and metastasis.Methods Immunohistochemistry techniques were used to study the expression of integrin β1 and VEGF in 63 gastric carcinoma specimens.We analyzed the variance with histological grade and stage and classification of clinical date.Results No significant relationship was observed among age,sex and histological classification of the expression of integrin β1 in the gastric cancer group (P>0.05).With the depth of invasion and lymphatic metastasis increasing,integrin β1 expression improved.The positive rate of integrin β1 among tubular adenocarcinoma,papillary carcinoma,mucinous carcinoma and undifferentiated carcinoma was 70.00 %,55.56 %,57.14 % and 64.86 %.No significant relationship was observed in it.Integrin β1 in cases with lymphnode metastasis was significantly higher than those without lymph node metastasis (P<0.05).No significant relationship was observed among VEGF expression and age,sex,histological classification and depth of invasion (P>0.05).Significant relationship was observed among VEGF expression and lymphatic metastasis.VECF in cases with lymph node metastasis was significantly higher than those without lymph node metastasis (P<0.05).Conclusion Immunohistochemistry techniques indicated that integrin β1 participated in the procession of invasion and metastasis.The expression of integrin β1 and VEGF are important factor,forecasting the invasion and metastasis.VEGF is an important factor for lymphnade metastasis of gastric carcinoma.VEGF in cases with lymphnode metastasis was significantly higher than those without lymphnode metastasis(P<0.05).The usage of integrin β1 and VEGF will improve the rightness in forecasting the invasion and lymph node metastasis of gastric carcinoma.