Objective To explore clinical efficacy of compound sulfamethoxazole combined with conventional atomization in treatment of bronchial tuberculosis.Methods 190 cases were selected from January 2012 to October 2013 who diagnosised bronchial tuberculosis treated in minda hospital affiliated of Hubei institute for Nationalities,then the patiens were randomly divided into two groups(n=95 ),the control group underwent conventional spray treatment,the observation group row treatment on the basis of atomization,while giving sulfamethoxazole treatment,observation and comparison of two groups clinical outcomes and adverse reactions. Result After continuous treatment for 4~6 months in the observation group therapy effective rate of 70.5%,total effective rate was 89.5%in the control group significant efficiency and total efficiency of 48.4%and 76.8%,respectively,two groups of significant efficiency and total efficiency,there were significant differences(P<0.05 );bacterial turn negative time indicator on the observation group and the control group were respectively(2.6 ±0.9)months and(4.2 ±1.1)months,there was significant difference(P<0.05);adverse reactions in observation group and control group was 7.4% and 11.6%,respectively,which compared no significant difference.Conclusion Application of compound sulfamethoxazole combined with conventional atomization in treatment of bronchial tuberculosis,has quickly and significantly effect,and bacterial clearance time is short,with low adverse reactions,safety and reliable.

This article aims to study the present condition and disadvantages of current obstetrics and gynecology teaching and discuss the urgent needs and methods of evidence-based medicine (EBM) introduction to it.

Objectives To assess the efifcacy of nasal bilevel positive airway pressure (nBiPAP) in preventing extuba-tion failure of neonatal respiratory distress syndrome (RDS) in premature infants. Methods Premature infants (≤32 weeks) diagnosed as RDS and treated with mechanical ventilation, admitted to the neonatal intensive care unit from January 2011 to June 2012, were enrolled in the prospective controlled trial. Fifty-six infants receiving non-invasive ventilation due to unrelieved expiratory dyspnea after the ifrst extubation were selected, and were randomly divided into nBiPAP group (n=27) and nCPAP group (n=29). Blood gas analysis before and after non-invasive ventilation, the failure rate of non-invasive venti-lation in seven days and the incidence of various complications were compared between two groups. Results The blood gas analysis for the ifrst time after extubation suggested that infants treated with nBiPAP had a higher PaO2 level ((58.7±6.3) vs. (55.1±5.9) mmHg, P<0.05) and lower PaCO2 level ((46.4±4.9) vs. (49.9±5.0) mmHg, P<0.05) than those treated with nCPAP. Infants treated with nBiPAP had lower incidence of extubation failure in seven days than infants treated with nCPAP (7.4%vs. 31.0%, P=0.042). The incidence of complications between two groups was similar. Conclusions nBiPAP is safe and fea-sible for preventing extubation failure in preterm infants≤32 weeks with RDS and is more effective than nCPAP.

Objective To determine the effects of histone deacetylase inhibitor suberoylanilide hydroxamic acid(SAHA) on the cell proliferation and apoptosis of the human hepatic stellate cell line LX-2.The possible underlying mechanisms were also investigated.Methods The LX-2 cells were treated with SAHA in vitro.The morphology of LX-2 cells in different concentrations groups was observed by inverted microscope;the proliferation of LX-2 cells was measured by MTT assay;the Annexin V-FITC and PI staining was used to detect the apoptosis of LX-2 cells by flow cytometry and fluorescence microscope;the expression of α-SMA,collagen Ⅰ,acH3K9,acH3K14 and acH3K18 were detected by Western blot.Results The morphology change of LX-2 cells showed that SAHA inhibited the proliferation rate of LX-2 cells and in a dose dependent manner(P<0.05).The LX-2 cells were sensitive to SAHA along with time increasing,and in a time-dependent manner(P<0.05).Western blot showed that the expression levels of α-SMA and collagen-Ⅰ were significantly lower(P<0.05),on the contrary,the acetylation levels of acH3K9,acH3K14 and acH3K18 were significantly higher (P<0.05).Conclusions The increased acetylation of the histone acH3K9,acH3K14,acH3K18 and the lower expressed α-SMA and collagen-Ⅰ in LX-2 cells may be one of the mechanisms of SAHA.

The patient was a 51-year-old female. She was admitted to the hospital because of "repetitive convulsions for 1 month". No significant neurological positive signs were found in the examination. D-dimer was in the normal range in several times of detection. Brain CT and electroencephalograph showed no obvious abnormality. Sustained hypoxemia occurred on admission, and CT imaging of pulmonary artery perfusion was performed. In the CT images bilateral distal main pulmonary arteries and their main branches showed vessel filling defect, partial lumen stenosis and occlusion, and bilateral small branches of pulmonary arteries showed extensive similar filling defect. Finally the patient was diagnosed with pulmonary embolism, whose condition was stable after anticoagulation therapy with warfarin.

Hereditary tubular disorders play an important role in the ion transport mechanism of kidney. Hypokalemic salt-losing tubulopathies (SLTs) are a set of rare hereditary diseases, which accompany with hypokalaemic metabolic alkalosis, normo or hypotension, and are associated with high plasma renin activity and hyperaldosteronemia. Bartter syndrome and Gitelman syndrome, characterized by the disability of the thick ascending limb of Henle's loop and/or the distal convoluted tubule, respectively, are two common types of SLTs. Some types of SLTs share similar clinical manifestations, making them difficult to diagnose. Besides, with the development of molecular genetics, new disease-causing genes have been discovered. It's inconvenient for clinicians to refer to the old classification of SLTs. The review mainly covered the newly discovered pathogenic genes of SLTs and the corresponding pathogenic mechanisms. In addition, a new system for classification of SLTs based on physiology and pharmacology was introduced.

AIM:To investigate the changes of histone modifications during the activation of primarily cultured rat hepatic stellate cells ( HSCs) and the relationship between histone modification patterns andα-smooth muscle actin (α-SMA) expression, and to explore the roles of histone modifications in the activation of HSCs.METHODS:The rat HSCs were isolated by in situ perfusion of collagenase combined with density gradient centrifugation, cultured in vitro and identi-fied by immunofluorescence staining.The morphological features of the cells were observed under inverted microscope.The changes of desmin and α-SMA during the activation of HSCs were detected by immunofluorescence staining and Western blotting.The levels of histone 3 lysine 4 dimethylation (H3K4me2), histone 3 lysine 9 dimethylation (H3K9me2), his-tone 3 lysine 9 acetylation (acH3K9) and histone 4 lysine 12 acetylation (acH4K12) in quiescent HSCs and activated HSCs were determined by Western blotting.RESULTS: The morphology of HSCs shifted from a quiescent phenotype to highly activated myofibroblast during the culture.Immunofluorescence staining and Western blotting showed that the expres-sion levels of α-SMA and desmin were increased over time and reached maximum at 15 d.According to the results of cell morphology and immunofluorescence staining, the cells cultured for 24 h and 15 d were quiescent and activated HSCs, re-spectively.Compared with quiescent HSCs, there were higher H3K4me2 and lower H3K9me2, acH3K9 and acH4K12 modification levels in activated HSCs ( P<0.01 ) .CONCLUSION: Histone modifications show anomalous expression during the activation of primarily cultured rat HSCs.Histone modifications may contribute to the transdifferentiation of HSCs and the development of hepatic fibrosis.

Objective Modified the medium that can increase single\|clone formed rate and confirmed the single clone spheres had the multipotential of differentation. Methods We modified the medium, that is, the medium contained half of primary culture medium and half of fresh culture medium. A great deal of neurospheres dervied from a single cell were plated averagely into 24 well plates and added into the DMEM differentiation medium (containing serum). After culturing for 14 days, cultures were stained with the neuronal\| ang glial\|specific markers (MAP\|2 for neurons, GFAP for astrocytes and CNP for oligodendrocytes). Results Each 96 well plate containing half of primary culture medium generated two to three single clone spheres, in control plate containing only fresh medium generated half to one single clone sphere. After differentiation, these cell clones expressed MAP\|2, GFAP and CNP positive respectively.Conclusion\ Using half of primary culture medium can increase single\|clone formed rate and these cell clones had the multipotential of differentiation.\;[

AIM: To investigate the effect of a Chinese medicime, Dan-Shao-Hua-Xian capsule, on liver fibrosis induced by CCl_4 by observation of apoptosis and cell cycle variation in the liver cells. METHODS: Animal models were produced through eight-week treatment of the rats with CCl_4, alcohol and diet of high fat/low proteins, and then administration of Dan-Shao-Hua-Xian to the rats (1 g/kg) via stomach-tube-pouring for eight weeks was performed. Liver index, serum hyaluronic acid (HA) and glutamate pyruvate transaminase (ALT) were measured and hydroxyproline (Hyp) content in urine were determined. The extent of the liver fibrosis was observed under light microscope and apoptosis and cell cycle were also examined by cytometry between the two groups. RESULTS: Compared to the liver fibrosis group, the liver index, serum HA, ALT in the treatment group decreased, the development of liver fibrosis delayed, the urine Hyp and the number of apoptosed cells and the ratio of G_0/G_1 cells increased, as well as the S phase cells decreased, yet unable to return to normal. All those changes detected were statistically significant. CONCLUSIONS: The Dan-Shao-Hua-Xian is effective in treating the CCl_4-induced liver fibrosis in rats partly by virtue of inhibition of the growth of hepatic stellate cells and induction of apoptosis.

Objective To set up the rolling circle amplification (RCA) system for detecting hepatitis B virus (HBV) covalently closed circular DNA (cccDNA), and to evaluate the specificity and sensitivity of this system. Methods Plasmids containing full-length of wild-type HBV genome were treated with restriction enzyme and T4 DNA ligase, and then were concentrated. The DNA fragments were recovered by the nucleic acid purification kit and severed as standard HBV cccDNA. Total DNA was extracted from hepatic tissues of seven chronic hepatitis B patients. RCA method was used to amplify genomes from tissue samples. Standard HBV cccDNA, 3.2 kb liner HBV DNA, normal hepatic tissue samples and 15 serum samples of patients with chronic HBV infection were used as controls to determine the specificity of RCA. Ten-fold serial dilutions of standard HBV cccDNA were used for determining the sensitivity. Results The standard HBV cccDNA was successfully constructed and could be detected by RCA method. HBV cccDNA could be amplified from 2 mg hepatic tissue samples at least of HBV infected patients, and could be detected as low as 1 ×102 copy/μL. cccDNA was not detected in 3.2 kb liner HBV DNA, normal hepatic tissue samples and 15 serum samples of chronic HBV infected patients. Conclusion RCA method can be used for rapid and simple detection of HBV cccDNA with high specificity and sensitivity.