As one of the chronic disease of respiratory system,chronic obstructive pulmonary disease contributes to a progressive decline of lung function,as well as the extra-pulmonary effects.Malnutrition,one of the extra-pulmonary effects,becoming the common problem for chronic obstructive pulmonary disease patients.It has severe harm to chronic obstructive pulmonary disease patients that need us to pay more attention to it.The choice of nutrition assessment tools has important significance for the correct results of nutrition status of the patients.

Objective To explore the effect of Eight-Section Brocadeon improving extrapulmonary performance and lung function in elderly stable chronic obstructive pulmonary disease (COPD) patients. Methods A total of 120 elderly stable COPD patients were divided into experimental group and control group by random digits table method with 60 cases each. The experimental group received Eight-Section Brocade and the control group took a walk both based on the routine health education. The World Health Organization Quality of Life (WHOQOL)-BREF, 6 min walking test and lung function were conducted before and after intervention 12, 24 and 36 weeks. Results After intervention, the score of each field of WHOQOL-BREF were higher than those before intervention, comparison of two groups of physiological fields Ftime=57.112, Fgroup=10.510, Finteractive=13.653, all P<0.01; psychological field Ftime=240.209, Fgroup=6.201, Finteractive=6.902, all P<0.05;field of social relations Ftime=34.957, Fgroup=7.265, Finteractive=11.554, all P<0.01; environmentfield Ftime=66.431, Fgroup=8.197, Finteractive=18.413, all P<0.01, and there were significant differences in time, groups and interactive. Comparison of two groups of the result of 6 min walking test after intervention, Ftime=327.697, Fgroup=37.181, Finteractive=61.420, all P<0.01. Comparison of two groups of the result of lung function indexforced expiratory volume in one second, Fgroup=5.083, P<0.05, there was significant difference;after intervention the index of Forced expiratory volume in 1 second take up of the expected value, Fgroup=4.141, P<0.05, there was significant difference. Conclusions Eight-Section Brocade can effectively improve the elderly stable COPD patients with exercise endurance and quality of life, improve the extrapulmonary performance, delay the progressive decline of lung function.

This paper was aimed to study effects of diosgenin on expressions of activator protein-1 (AP-1) and vascular endothelial growth factor (VEGF) in synovial tissues of collagen-induced arthritis (CIA) rats induced by bovine type II collagen, in order to investigate the possible mechanism of herbal medicine diosgenin in the treatment of rheumatoid arthritis (RA). After the CIA rats models were successfully established, rats were randomly divided into the blank control group, CIA model group, diosgenin group, and positive medicine control (tripterygium) group. The in situ hybridization was used to detect the expressions of AP-1 (c-fos and c-jun) in synovial tissues of the knee joint. The real-time PCR was used to detect the VEGF mRNA expression in synovial tissues of rats’ knee joints. The results showed that c-jun and c-fos, VEGF mRNA expressions in synovial tissues of rats’ knee joints were obviously higher than that of the blank control group (P<0.01). After treatment of diosgenin and tripterygium, the expressions of c-jun and c-fos, VEGF mRNA were significantly reduced (P<0.01). It was concluded that diosgenin may regulate the expression of VEGF in synovial tissues through c-jun and c-fos of AP-1 in order to inhibit synovial angiogenesis for the treatment of RA.

Objective To evaluate the comprehensive clinical ability of new nurses in hospital of traditional Chinese medicine by the application of obstructive structured clinical examination.Methods New nurses of Nanjing hospital of traditional Chinese medicine (TCM) of the grade 2012 and 2013 were assessed.The examination consisted of four parts including standard patient station,the capacity of the case,the basic nursing skills of medicine and TCM.The scores of the theoretical knowledges and nursing skills were assessed.Results The average score of the nurses was (76.32±6.31)points,complying to the normal distribution;The degree of difficulty of the examination was 0.70-0.85 and the degree of distinguish was 0.28-0.48;The score of the theoretical test was lower than that of nursing skills and there was significant difference between them (P＜0.05).Conclusions The design of the examination is reasonable and the clinical ability of new nurses majored in TCM can be well assessed.

Objective To investigate the effect of acupuncture decompression operation on the quality of life of patients with mild to moderate essential hypertension. Methods 74 cases of mild to moderate essential hypertension were divided into experimental group and control group by random number table, 4 cases were lost. Finally, a total of 70 patients were included in the data analysis. In the control group, 35 cases were given routine drug taking and health guidance, the experimental group of 35 patients increase the treatment of acupuncture decompression operation points on this basis. The two groups of patients were measured with blood pressure before and after intervention, and World Health Organization Quality of Life (WHOQOL-BREF) was used to evaluate the quality of life, and the data were analyzed. Results The scores of physiological and psychological fields in the experimental group were (15.23 ± 2.66) points and (16.68 ± 2.23) points while the control group were (13.98 ± 2.18) points, (15.25 ± 2.52) points, the difference was statistically significant (t=2.305, 2.522, P<0.05). The experimental group of social relations, environmental score were respectively (1.37 ± 2.24) points, (14.16 ± 1.24) points, while the control group were (13.29 ± 2.30) points, (13.56 ± 1.36) points, 2 groups were not statistically significant (t=0.770, 3.063, P > 0.05). The experimental group systolic blood pressure, diastolic blood pressure were (121.43 ± 6.43) mmHg (1 mmHg=0.133 kPa), (71.74 ± 3.88) mmHg, compared with the control group were (128.34±5.72) mmHg, (76.06±4.43) mmHg. The difference was statistically significant (t=-4.753,-4.210, P<0.05). Conclusions acupuncture decompression operation can improve blood pressure in young and middle-aged patients with hypertension, improve the quality of life.

Objective To evaluate the sensitivity of combination of itraconazole and amphotericin B to20clinical isolates of Cryptococcus neoformans and their in vitro interactions.Methods The sensitivity of combination of itraconazole and amphotericin B and their in vitro interactions were determined with20clinical isolates of C.neoformans by a checkerboard titration broth microdilution-based method in accord with the recommendations of the National Committee for Clinical Laboratory Standards(NCCLS),USA.Results When both drugs were given in combination,there was significant reduction of geometric means of MICs for itraconazole(from0.2730to0.1195?g/mL)and for amphotericin B(from0.6830to0.2102?g/mL).Synergistic effects were found in35%of isolates,additive effects in55%of isolates,and indifferent effects in10%of isolates.Antagonistic effects were not observed.The colony formation unit(cfu)per millilitre was significantly decreased in an isolate which was treated with different concentrations of the combination of both drugs,in comparison to that with the corresponding concentrations of individual drug.Conclusion The combination of itraconazole and amphotericin B is significantly more active against C.neoformans in vitro than individual drug alone.

Objective We tried to observe the effects of Chinese herb fumigation and washing combined with electromyographic biofeedback on stroke patients with muscle cramp on limbs.Methods 84 patients who had muscle cramp on limbs were selected and divided into two groups randomly,namely the intervention group and the control group and both groups had 42 stroke patients.The intervention group was treated with routine treatment,Chinese herbal fumigation and washing and electromyographic biofeedback treatment.The control group received only routine treatment and electromyographic biofeedback treatment.We had compared and analyzed the Ashworth Spasticity Scale and the Daily Life Abihty Score (Barthel index) of the two groups at the time of the pre therapy,two weeks after the treatment and at the end of the treatment(after four weeks),respectively.Results There were no significant differences between the two groups in Barthel index,however,there were significant differences in Ashworth Spasticity Scale scores between the two groups four weeks after treatment,t=-3.84,P ＜ 0.05.Conclusions The effect of Chinese herb fumigation and washing combining with the electromyo-graphic biofeedback treatment is better than usage of the electromyographic biofeedback treatment alone on stroke patients with muscle cramp on limbs.

Objective To study the effects of medicated serum with total saponins from Rhizoma Dioscreae Nipponicae (RDN) on VEGF mRNA expression and AP-1 activity in rat synovial cell strain RSC-364 induced by IL-17 and TNF-α. To investigate the mechanism about total saponin from RDN inhibition of angiogenesis. Methods Medicated serum of total saponins from RDN and tripterygium (positive control) were prepared. Rat synovial cells RSC-364 were divided into four groups: the blank control,IL-17+TNF-α model,tripterygium medicated serum,and total saponins medicated serum groups. After one hour of incubation,all groups except for the blank control were incubated with both IL-17(10 μg·L-1 ) and TNF-α(10 μg·L-1 ) for 24 hours. VEGF mRNA expression in RSC-364 was detected by PrimeScriptTM real-time quantitative PCR (RT-PCR) detection kit,and the AP-1 DNA-binding activity was detected by electrophoretic mobility shift assay (EMSA). Results Compared with the control blank group,both of the VEGF mRNA expression and AP-1 activity in rat synovial cell strain RSC-364 induced by IL-17 and TNF-α increased remarkably (P<0. 05,P<0.01). The VEGF mRNA expression and AP-1 activity in tripterygium medicated serum group and total saponins medicated serum group were remarkably lower than those of the model control group (P<0.05). There was no significant difference between the two medicated serum groups. Conclusion Serum medicated with total saponins from RDN can remarkably decrease VEGF mRNA expression and AP-1 activity,indicating that the total saponins from RDN could influence VEGF secretion by inhibiting the AP-1 signal transduction pathway,VEGF is the key factor of angiogenesis,thereby to restrain angiogenesis.

Objective To construct lentiviral vectors containing peptide P1-GFP fusion genes.Umbilical cord derived mesenchymal stem cells were infected with lentivirus carrying peptide P1 and GFP fusion genes.To inject the targeted umbilical cord derived mesenchymal stem cells into mice and to detect GFP expression in the spleen.Methods Umbilical cord derived mesenchymal stem cells were cultured with adhered tissues of umbilical cord smaller than 1 mm3 . Lentiviral vector containing P1-GFP fusion genes with engineering technology was constructed and infected the umbilical cord derive mesenchymal stem cells.Targeted umbilical cord derived mesenchymal stem cells were intravenously injected in the mouse tail vein and after 18 hours GFP expression was detected with immunohistochamical staining of the spleen tissues.Results Harvested umbilical cord derived mesenchymal stem cells grew well in culture medium. Green fluorescence on umbilical cord derived mesenchymal stem cells were observed under fluorescence microscope at 18 hours after infected with lentivirus.Green fluorescence intensity of umbilical cord derived mesenchymal stem cells was increasing over time and reached a peak at 72 hours.Umbilical cord derived mesenchymal stem cells highly expressed CD105 (90.0%)/CD44 (98%) and CD73 (85.0%)/CD90 (98.5%) molecules.GFP expression was detected in the spleen after intravenous injection of targeted umbilical cord derived mesenchymal stem cells in the mice 18 hours later.GFP expressing cells intimately contacted with lymphocytes.Conclusions Targeted umbilical cord derived mesenchymal stem cells contain P1-GFP fusion genes are constructed.Targeted umbilical cord derived mesenchymal stem cells can be targeted to mouse spleen and intimately contact with lymphocytes after intravenous injection.Our results lay the groundwork for further studies.

There are a large number of atypical symptoms and undifferentiated diseases in general practice, in which sociological factors are deeply involved. So to incorporate social factors into clinical thinking and to interpret disease from the perspective of the patient′s social life will enrich the multidisciplinary medical model and holistic care in general practice. This article shares author′s clinical experience through introducing typical cases, in which the patient′s social life and behavior characteristics played certain roles in disease development. The article also explores a new way from the sociological perspectives to interpret the complex symptoms that are difficult to be explained clinically by biomedicine or psychology.