Asthma ; prevention & control ; therapy ; Child ; Disease Management ; Family ; Humans

Objective To investigate the effects of transforming growth factorβ1(TGFβ1)and β3 (TGFβ3)gene transfer on MMP-2,MMP-9 and TIMP-1 expression in hepatic stellate cells(HSC-T6).Methods TGFβ1 and TGFβ3 expression plagmids were constructed.The recombinant expression plasmid pcDNA3.1(+)-=TGFβ1 and pcDNA3.1(+).TGFβ3 were transfected or cotransfected into HSC-T6.At 24,48 and 72 h after transfection,the expression of MMP-2,MMP-9 and TIMP-1 mRNA were detected by real-time quantitative PCR,and the expression of MMP-2,MMP-9 and TIMP-1 protein were detected by Western blot.The recombinant expression plasmid pcDNA3.1(+).TGFβ1 was transfected into HSC-T6,and positive clones were selected by G418.The positive clones were transfected by the recombinant expression plasmid pcDNA3.1(+).TGFβ1,and the expression of MMP-2,MMP-9 and TIMP-1 were detected at 48 h after transfection.Results After transfection with peDNA3.1-TGFβ1,MMP-2 and TIMP-1 increaged remarkably in HSC-T6 cells(P＜0.05),but MMP-9 remained at the sanle level;After transfection with pcDNA3.1-TGFβ3,expression levels of MMP-2,MMP-9 and TIMP-1 mRNA were not changed,but TIMP-1 protein increased remarkably(P＜0.05);in cotransfection group,the expression of MMP-2 was higher than that in the blank and the control groups(P＜0.05),but MMP-9 level was not changed and TIMP-1was decreased compared with that in the TGF-β1 transfection group(P＜0.05).After TGFβ3was transfected into positive clones,the change of MMP-2 wag not significant(P＞0.05).but MMP-9 increaged and TIMP-1 decreased significantly at 48 h after transfection(P＜0.05).Conclusions TGFB3 may inhibit liver fibrosis by increase the activity of MMP-2 and MMP-9,and decrease the activity of TIMP-1.

Standardized training of residents is a necessary way for clinical medical personnel train-ing. Residents graduating from medical colleges and universities should accept the standardized, scientific, strict pre-service training, in order to realize role conversion from medical students to hospital physicians. This paper summarizes and analyzes the pre-service training, focusing on the training object, course design, organization implementation, evaluation, questionnaire survey, and puts forward some thoughts and sugges-tions on strengthening and improving pre-service training form, expanding the content of training, and quan-tifying the evaluation of training effect.

Objective To investigate the relationship between extracellular matrix metalloproteinase inducer (EMMPRIN), the upstream regulatory factor of matrix metalloproteinase (MMPs), and the formation of atherosclerosis and the clinical type of coronary heart disease. Methods A total of 223 patients were classified into four groups according to results of coronary angiography (CAG) and clinical data: STEMI group (65 patients with ST-segment elevation myocardial infarction), NSTE ACS group (42 patients with non-ST-segment elevation acute coronary syndrome), SAP group (75 patients with stable angina pectoris) and normal control group (41 patients of CAG-negative). The mean fluorescence intensity (MFI) of EMMPRIN on monocytes of peripheral blood (PBMCs)were examined by flow cytometry. MMP-9 in serum was measured with ELISA; high-sensitivity C-reactive protein (hs-CRP) in serum was measured with immune velocity method. Results The EMMPRIN MFI on PBMCs in SAP group, STEMI group and NSTE ACS group was higher than that in the normal control group (P<0.05 or P<0.01). The EMMPRIN MFI in STEMI group and NSTE ACS group was higher than that in SAP group (P<0.05 or P<0.01). The expression characteristic of EMMPRIN on the PBMCs was consistent with that of hs-CRP and MMP-9 in each group. The EMMPRIN MFI of the PBMCs had positive correlation with the level of MMP-9 and hs-CRP in serum (r=0.168,P<0.05;r=0.305,P<0.01). Conclusion EMMPRIN may has promotive effect on the formation of atherosclerosis and unstablility of coronary heart disease as an upstream regulatory factor of MMPs

To establish the HPLC fingerprints of Eucommia ulmoides at different ages of different varieties with pi-noresinol diglucoside as the reference material to provide the basis for the HPLC fingerprints in the enterprise quality standards of Eu-commia ulmoides from the GAP base of Chenzhou Dacheng Chinese Herbal Medicine Co. Ltd. . Methods: A column of ZORBAX E-clipse XDB-C18 (250 mm × 4. 6 mm, 5μm) was used. The mobile phase consisted of methanol-0. 1% phosphoric acid with gradient e-lusion. The detection wavelength was 277 nm, the column temperature was 25℃,the flow rate was 1. 0 ml·min-1 , and the injection volume was 5 μl. Results:The Eucommia ulmoides HPLC fingerprints including 14 common peaks were established with pinoresinol diglucoside as the reference material. The similarity of the HPLC fingerprints of 10 samples was over 0. 939. Conclusion:The method is accurate and reliable. The HPLC fingerprints can be used as the enterprise quality standards of Eucommia ulmoides for Chenzhou Dacheng Chinese Herbal Medicine Co. Ltd. .

Objective To observe the effects of mind-regulating brain-developing acupoint magnetic therapy in patients with mild cogni-tive impairment (MCI). Methods From May to October, 2015, 60 patients with MCI were randomly divided into control group (n=30) and observation group (n=30). The control group received magnetic therapy on Yangming meridians, and the observation group received magnet-ic therapy on mind-regulating brain-developing acupoints, for two months. They were assessed with Montreal Cognitive Assessment (Mo-CA), digit-span and digit symbol of Wechsler Adult Intelligence Scale (WAIS). Results After treatment, the scores of MoCA, digit-span and digit symbol of WAIS significantly increased in the observation group (t>4.858, P<0.001), and were higher than that in the control group (t>2.188, P<0.05), however, only the scores of MoCA and digit symbol of WAIS significantly increased in the control group (t>5.527, P<0.001). The scores of visual space and execution, and delayed recall of MoCA increased in the observation group (t>2.324, P<0.05), and were higher than that in the control group (t>2.262, P<0.05) after treatment, and no significant difference was found in other domains (P>0.05). Conclusion Magnetic therapy on acupoints related with cognition could improve the cognitive function in patients with MCI.

Objective To observe the influence of exterior-interior meridian acupoint selection on hippocampal cell apoptosis and c-Jun N-terminal kinase ( JNK) in ischemia-reperfusion injury rats, and to explore the possible protective mechanism for ischemia-reperfusion injury. Methods One hundred and twenty SD rats were randomly divided into sham-operation group (SH), model group (I/R), electroacupuncture (EA) group and JNK inhibitor SP600125 ( SP) group. The ischemia-reperfusion model was established by occlusion of middle cerebral artery with intraluminal thread. EA group was given EA on acupoints of Zusanli ( ST 36) , Sanyinjiao ( SP 6) , Chize ( LU 5) , Hegu ( LI 4) , once a day, based on the method of exterior-interior meridian acupoint selection. We observed the neurological behavioral changes by Longa neurological function standard, detected the activation of phosphorylated JNK ( p-JNK) by immunohistochemical method and examined the hippocampal apoptotic index by TUNEL method. Results The neurologic impairment scores of EA group and SP group were lower than I/R group (P<0.05) . Apoptotic index of I/R group was higher than SH group (P<0.01) and that of EA group and SP group was lower than I/R group (P <0.05) . The level of p-JNK in I/R group was higher than SH group ( P <0.01) and that of EA group and SP group was lower than I/R group ( P <0.05). Conclusion Exterior-interior meridian acupoint selection therapy has certain effect on alleviating neurologic impairment and reducing apoptosis in ischemia- reperfusion injury rats, and the mechanism might be associated with the inhibition of the activation of JNK signaling pathway.

Objective To evaluate the occupational competency of clinical post-graduate students by the 360-degree feedback system.Methods The occupational competencies of the 102 clinical post-graduate students were evaluated by department directors, teachers, the superior band taught physicians, peers, post-graduate themselves using a self-designed questionnaire.The evaluation content of professional competence included 12 core elements, such as medical knowledge, clinical skills, and professional ethics and so on.EpiData 3.02 was used to establish the database, SPSS 19.0 software was used to carry on the statistical analysis, and the statistical analysis method was mainly for the descriptive statistics analysis, the single factor analysis of variance.Results 5 kinds of evaluation subjects were statistically significant (P＜0.05) in medical knowledge, clinical skills, clinical thinking ability, lifelong learning ability, professional ethics, team cooperation ability, self cognition and management ability and total score.Students themselves and their peers scored high in various aspects, teaching superior doctors rated middle and the director and mentor gave low grade in all aspects and the scores rated by the department directors and teachers were lower than students themselves(P=0.003, P=0.047).Conclusion The 360-degree evaluation system can comprehensively and objectively evaluate the clinical post-graduate students' occupational competency and offer beneficial assistant to clinic and practice.

OBJECTIVE:To determinate the release rate and in vitro transdermal rate of asarinin in Cancer pain cataplasm. METHODS:Using homemade devices and modified France diffusion,isolated skin of rats as barrier,normal saline as solvent,the content of asarinin was determined by HPLC. Release rate of Cancer pain cataplasm within 20,50,80 and 120 min and transder-mal amount within 2,4,8,12,24 h were investigated,and accumulative release rate and accumulative transdermal rate were cal-culated. RESULTS:Accumulative release rate by 120 min of asarinin in Cancer pain cataplasm was 73.01%;24 h in vitro transder-mal rate was 26.01%,and transdermal kinetics equation of asarinin was Q=5.717 7t1/2-0.385 4(r=0.979). CONCLUSIONS:Cancer pain cataplasm has good release and transdermal performance. Its transdermal kinetics is in line with Higuchi equation.

Objective To explore the risk and treatment of laparoscopic cholecystectomy(LC) in patients with liver cirrhosis and cholelithiasis.Methods To summarize the clinical data of 28 patients with liver cirrhosis and cholelithiasis.The patients were repeated right upper quadrant pain,including 4 cases of gallbladder neck stones incarcerated,gallbladder effusion.Among them,there were 20 cases of hepatitis B cirrhosis,5 cases of schistosomiasis cirrhosis,3 cases of alcohol.Results There were 6 patients with hemorrhage during operation.Among them,5 patients were treated with gelatin sponge,hemostatic gauze and bio-glue spray to stop bleeding,1 case was transferred to open surgery because of bleeding.The remaining 27 cases of LC were successful.Complications occurred in 8 patients,3 cases of increased liver function abnormalities,1 case of upper gastrointestinal bleeding,1 case of mild hepatic encephalopathy,2 cases of significant ascites formation,1 patient underwent subtotal resection of the gallbladder with Hartmanns bag,and bile was found in the ascites after surgery,but the bile disappeared after five days.All patients with complications after symptomatic treatment were cured,no death,no major bleeding and liver failure,bile duct injury,severe biliary fistula and other serious complications.Conclusion Although the risk of LC in patients with liver cirrhosis is higher than that in the general population,with the help of current high-tech surgical instruments,we can safely accomplish this with an improved surgical procedure.As these patients require high technical requirements of surgery,surgeons must have a wealth of experience and familiar laparoscopic liver and gallbladder anatomy.