Objective To investigate the effect of Mahong decoction on serum VEGF and b-FGF of rat model bronchus asthma airway remolding. Method Forty SD rats randomly divided into four groups: blank group, asthma group, hormone group, Chinese medicine group. The asthmatic model was established by sensitization and challenge with ovalbumin, and the rats in the hormone group and Chinese medicine group conferred hormone and Chinese medicine before the challenge. ELISA was used to measure the level of serum VEGF and b-FGF. Results The serum VEGF and b-FGF in asthma group was higher than in other groups (P0.05). Conclusion Mahong decoction may control the level of serum VEGF and b-FGF of rat model of bronchus asthma airway remolding, which has the similar result with hormone.

This paper summarized the experience of caring a patient with pancreatic cancer-related depression treated with pancreaticoduodenectomy and postoperative delayed gastric emptying.The nursing included several key points.On the base of collaboration of muhi-disciplinary teams,to strengthen supportive psychological intervention and safety management after admission;to use multimodal analgesia combined with cognitive behavioral therapy to reduce postoperative pain.After the patient was complicated with gastric emptying obstacles,solution-focus mode,sham feeding and nutritional support programs were implemented.Long-term follow-up with physician-nurse collaboration mode was implemented to enhance quality of life of the patient.

Objective To investigate the existence of HBV DNA YMDD mutation in patients with chronic hepatitis B and the related significance. Methods HBV DNA YMDD mutation was detected in 90 patients with hepatitis B. The liver function, HbeAg, HBVDNA, and HBV DNA YMDD mutation in patients with HBV DNA YMDD mutation were analyzed. Results HBV DNA YMDD mutation was found in 20 out of 90 patients with hepatitis B (positive rate 12.00%). HBV DNA YMDD mutation was found in 9 out of 36 patients receiving lamivuding therapy (positive rate 25.00%), but HBV DNA YMDD mutation was found in 11 out of 54 patients without lamivuding therapy (positive rate 20.37%). In the 20 patients with HBV DNA YMDD mutation, 5 patients were negative in HBeAg. HBV DNA, ALT, and Tb of the 20 patients with HBV DNA YMDD mutation were 3.0221?10 5-2.369?10 8 (5.41?7.75?10 7) copies/ml, 34 -1 216 (288.20?338.07) IU/L, and 8.9-326.7 (48.74?72.20) ?mol/L, respectively. Conclusion HBV DNA YMDD mutation may occur during the process of lamivuding therapy or may exist naturally. YMDD mutation may co-exist with pre-C gene mutation, suggesting that mutation often occurs in many sites in HBV genes. The reproduction level of HBV DNA ranges from the middle to the high levels. The pathogenicity of YMDD mutation species is various. The liver function may be normal and may also be abnormal in various degrees in these patients with HBV DNA YMDD mutation.

Objective To study the clinical effect and significance of integrative medicines of TCM and WM combined with fast-track surgery concept on perioperative nursing in colorectal surgery.Methods One hundred and twenty patients with surgery were randomly divided into the observation group and the control group,60 cases in each group.The control group was treated with conventional nursing,while the observation group was treated with fast track surgery nursing of integrative medicines of TCM and WM.Results Bowel sound recovery time,anus exhaust time,defecation time,length of hospital stay and postoperative complications of observation group was significantly less than the control group (P＜0.05).Nursing total satisfaction of observation group was significantly higher than the control group (P＜0.05).Conclusion Integrative medicines of TCM and WM combined with fast-track surgery concept on perioperative nursing in colorectal surgery can reduce stress,speed up the recovery,reduce complications.So it is a safe and effective way of perioperative nursing,and worthy of clinical popularization and application.

Professor XU Jian-zhong thought that the main pathologic mechanism of chronic obstructive pulmonary disease was phlegm,stasis,and deficiency.The treatment must aptly take action by integrated traditional and western medicine,integrated differential diagnosis of diseases and differentiation of symptoms and signs,integrated current medicine research production and TCM,so that the diseases can be cured.In acute stage,we should eliminate exogenous pathogen at first.Then,use clearing lung-heat and resolving phlegm,warming and resolving cold phlegm,dispersing the lung to stop coughing and relieve asthma.Yinqiao powder,dingchuan decoction,zhisou powder,Qian Jin weijing decoction,maxingshigan decoction,lingguizhugan decoction,wuling powder are the commonly used prescriptions.In paracmasia,replenishing qi,nourishing yin,consolidating the exterior,invigorating the spleen,reinforcing the kidney to improving the kidney,s function of receiving qi are the commonly used treatment methods,and yupingfeng powder、shengmai powder、xiangshaliujunzi decoction,qiweiduqi pills are the commonly used prescriptions.It is very helpful for critical patients to recover by aptly use mechanical ventilation.

Objective To evaluate the effectiveness of repeated intravitreal conbercept injection in patients with macular edema (ME) of retinal vein occlusion (RVO),guided by optic coherence tomography (OCT).Methods It is a retrospective case study.Forty patients (40 eyes) diagnosed as ME secondary to RVO were enrolled in this study.There were 19 males (19 eyes) and 21 females (21 eyes),with the mean age of (53.58 ± 13.19) years and the mean course of 1.5 months.The best corrected visual acuity (BCVA),indirect ophthalmoscopy,fundus fluorescein angiography (FFA) and OCT were performed.The mean baseline of BCVA,central macular thickness (CMT) were 0.25 ± 0.18 and (509.48 ± 170.13) μm respectively.All the patients were treated with 10.00 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg).Follow-up of these patients was 1 to 6 months after treatments,the BCVA,fundus manifestations,OCT were retrospectively observed by every month,the FFA was retrospectively observed by every 3 months.When there was retinal edema or CMT ≥ 50 μm by OCT during follow-up,those patients were retreated with intravitreal conbercept injection.The changes of the BCVA,CMT were evaluated before and after treatment.Meanwhile,complications in eyes related to medicine and treatment methods were evaluated too.Results At the 6 months,the BCVA was improved (increase≥2 lines) in 25 eyes (62.50％),stabilized (± 1 line) in 13 eyes (32.50％) and decreased 2 lines in 2 eyes (5.00％).Retinal hemorrhage and exudates were absorbed in most patients.FFA showed no fluorescein leakage in 1 1 eyes (27.50％),minor fluorescein leakage in 26 eyes (65.00％),and retinal capillary non-perfusion in 3 eyes (7.50％).OCT showed absorption of the subretinal fluid.The mean CMT were (235.20± 100.44) μm at 6 months.Intravitreal injection of conbercept was applied for 4 times in 8 eyes (20.00％),3 times for 18 eyes (45.00％),and 2 times for 14 eyes (35.00％).The mean number of intravitreal injection was 2.85 times.There were no ocular or systemic adverse events observed in all patients.Conclusion Intravitreal conbercept injection is an efficacy and safe treatment for the patients with ME of RVO guided by OCT.It can stabilize and improve the visual acuity.

Objective To observe the effect of antisense hypoxia inducible factor-1?(HIF-1?) on (chemosensitivity) of human pancreatic cancer cell line BxPC-3 under hypoxia. Methods BxPC-3 cells were divided into 3 groups:(1)BxPC-3 cells were non-transfected with antisense HIF-1? plasmid and exposed to 0.5% O_2 for 4hr(hypoxia control);(2)normoxic BxPC-3 cells were non-transfected with antisense(HIF-1?) plasmid(normoxia control);(3)BxPC-3 cells were transfected with antisense HIF-1? plasmid and exposed to 0.5% O_2 for 4hr(experimental group).Expression of HIF-1? and survivin was detected by RT-PCR and Western Blot.Growth inhibition rates and apoptosis rates of BxPC-3 cells under different(dosages) of chemotherapeutic agents(5-fluorouracil,doxorubicin and gemcitabine) were measured by MTT(colorimetric) assay and flow cytometry (FCM).Results Expression of HIF-1? was obviously down-regulated and at the same time susvivin expression was markedly down-regulated in experimental group(P

Objective To investigate the synergistic efficacy of different antibiotic combinations against KPC-2 carbapenemase producing Klebsiella pneumoniae strains in vitro and search for effective antibiotic combination.Methods During 2008 - 2009,a total of 24 strains of K.pneumoniae producing KPC-2 carbapenemase were collected from 8 hospitals in the First Affiliated Hospital of Medical School of Zhejiang University,Ningbo LiHuiLi Hospital,Zhejiang People's Hospital,Hangzhou Third Hospital,the Second Hospital of Shaoxing,Hangzhou First Hospital,Fudan University Huashan Hospital,General Hospital of Nanjing Military Region.MLST technique was used for epidemiological analysis.The MIC of antibiotics,such as amikacin,minocycline,imipenem,amoxicillin/clavulanic-acid,ceftazidime,meropenem,gentamicin,cefoxitin,cefepime,rifampicin,polymyxinB,ciprofloxacin were determined by an agar dilution method,the MIC of tigecycline and piperacillin/tazobactain were determined by Etest.The antibacterial activities of cefepime in combination with amoxicillin/clavulanic-acid,amikacin,or ciprofloxacin,amikacin with ciprofloxacin,imipenem with amikacin,ciprofloxacin,polymyxinB,or minocycline,polymyxin B with rifampicin,ceftazidime with amoxicillin/clavulanic-acid were assessed by chequerboard synergy agar dilution tests against all the isolates.Results MLST showed 5 STs among 24 strains of KPC-2 carbapenemase producing K.pneumoniae,and the most prevalent clone was ST11 (15 strains).All isolates were susceptible to polymyxin B and tigecycline,and the resistance rate of minocycline was 4.2％.The synergetic effects were observed in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin,ceftazidime-amoxicillin/clavulanic acid combinations as 19 isolates,13 isolates,and 13 isolates,respectively.Conclusions KPC-2 carbapenemase producing K.pneumoniae is sensitive to polymyxin B,tigecycline and minocycline.The synergetic effect is predominant in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin ceftazidime-amoxicillin/clavulanic acid combinations in vitro,their clinical efficacy are worthy of further observation.

Objective To analyze and compare the clinical application values of procalcitonin (PCT),leukocyte count (WBC) and C-reactive protein(CRP) in elder patients with infection.Methods In patients(age≥ 65 yrs,axillary temperature ＞38.0℃)with infection or suspected infection,PCT,WBC,CRP and other bacteriological examination were performed.The electronic medical records from the HIS system of our hospital were analyzed retrospectively in combination with medical history.Results Of the enrolled 219 patients,65 ones were in control group,48 ones SIRS,51 ones sepsis and 55 ones MODS.There was a positive correlation between the level of serum PCT and the infection degree.The Spearman correlation coefficient was 0.706 (95％CI:0.616-0.797,P=0.000).Based on the highest Youden index (sensitivity+specificity-1),the best cutoff point of diagnosis for PCT was ＞0.341 μg/L (sensitivity 84.5％,specificity 55.8％),a analysis of receiver operating characteristic(ROC) curve about PCT,WBC and CRP was carried.Area under the curve (AUC) of PCT to controlled infection was 0.916 (95％CI:0.864-0.967,P=0.000).Based on the highest Youden index (sensitivity+ specificity-1),the judging threshold of PCT to infection controlled or not was 0.73 μg/L (sensitivity 84.6％,specificity 88.0％).PCT level after treatment ＞0.73 μg/L showed the uncontrolled infection,＜ 0.73 μg/L controlled.Conclusions PCT has a higher specificity for elder patients with infection.The variation of PCT level can guide the application of antibiotics,avoid abuse and decrease the occurrence of drug-resistant bacteria.

Objective Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described brainstem-predominant inflammatory disorder responsive to steroids with characteristic magnetic resonance imaging(MRI) feature.There was no case report in China.The aim of this study was to characterize the clinical and imaging patterns of CLIPPERS for early diagnosis and treatment.Method Clinical and imaging data and therapeutic methods and following up after treatment of 1 patient diagnosed CLIPPERS were reviewed retrospectively.Results The patient presented with subacute weakness of the lower extremities,gait ataxia and facial numbness.Cerebellar ataxia and pyramidal signs were the main positive signs on neurological examinations.Brain MRI showed punctate gadolinium enhancement peppering the pons and cerebellar.Treatment with steroids led to rapid clinical improvement and marked resolution of MRI lesions which accorded with characteristics of CLIPPERS.Conclusions There are no characteristic clinical manifestations of CLIPPERS.Punctate gadolinium enhancement peppering the pons is the distinct magnetic resonance imaging feature which may suggest the clinical diagnosis of CLIPPERS.Early treatment with steroids can improve the prognosis.