The present study was designed to examine the morphological pattern of primary afferent projections into the spinal dorsal horn by labeling the lumbar dorsal root ganglia with carbocyanine fluorescent dye DiI in mouse embryos and neonatal pups aged embryonic day 12 to postnatal day 3 (E12-P3). Primary afferent fibers projected into dorsal funiculus at E13, but did not penetrated into gray matter of dorsal horn until E15. The afferent projections became dense and entered the spinal gray matter more deeply at E16 and E17. By E18 the intensity of primary afferent in the deep part of the dorsal horn increased and their branching patterns became more complicated. Some of these primary fibers were also observed to ramify extensively in the superficial laminae. The projection pattern of primary afferent remained unchanged after birth, but the intensity of afferent terminals increased in the superficial laminae. In addition, afferent fiber collaterals that projected into the contralateral dorsal horn were also observed. They were first examined at E16 and mainly originated from the medial and deep part of the dorsal horn. Around birth, the contralateral projections were also found to originate from the lateral part of dorsal horn. Our results indicate that laminar organization of primary afferents in the spinal dorsal horn is established during the late embryonic and early postnatal stages.This organization then undergoes further refinement to match the pattern seen in the adult.

Immunocytochemical staining technique by using specific antibody against 5-HT1A receptor subtype (5-HT1AR) wasused to observe the distribution of 5-HT1AR immunoreactivity in the rat nervous system. The highest level of 5-HT1AR im-munoreactivity was observed in piriform cortex, septum, ventraldorsal thalamic nucleus, reticular thalamic nucleus, basolateralamygdaloid nucleus, Purkinje cell layer, red nucleus, facial nucleus and nucleus of the trapezoid body. Considerably weaker im-munoreactivity was detected in hippocampus, frontal cortex, mediodorsal thalamic nucleus, interpeduncular nucleus, mesen-cephalic trigeminal nucleus, dorsal raphe nucleus, spinal trigeminal nucleus, the superficial layers of the spinal dorsal horn, dor-sal root and trigeminal nerve ganglia, Very weak immunoreactivity was found in the olfactory bulb, caudate putamen,globus pal-lidus, nucleus diagonal band, bed nucleus stria terminalis, habenular nucleus, substantia nigra and superior olive. The presentresults indicate that 5-HT1AR immunoreactive structures are widely distributed in the rat nervous system and might play impor-tant role in mediating the multiple effects of 5-HT in the nervous system.

Objective To investigate the status of clinical nursing teaching in the department of infection.Method To investigated the teachers and nursing students in the department of infection with a self-designed questionnaire.Results The evaluation from students to the teachers are:overall satisfaction score is(4?90±0?04),the lowest points are the advanced nursing of common diseases and the teaching attitude.While the evaluations from teachers are:overall satisfaction score is(4?45+0?04),the lowest are communication with patients and their families,conducting basic nursing operation and familiarity of common drugs.Conclusions To enhance teaching quality of clinical nursing teaching in the department of infection,it is efficient by improving the quality of teachers and their teaching methods,consolidating students’knowledge,and exercising their skills?

Nursing management is an important part of hospital management,the head nurses,as leaders and organizers of first-line clinical nursing work of the hospital,play a decisive role in hospital nursing management.As the first-line managers and organizers,the head nurse management level and ability is directly related to the hospital nursing quality and the overall quality of nurses.The implementation of the performance appraisal and management by objectives in current nursing management has been more and more used in the hospital.This article aimed to review the management by objective and quantitative assessment home for head nurse at home and abroad,in order to help nursing managers to learn and master performance appraisal of head nurses,comprehensively improve quality of head nurses,promote the improvement of nursing quality,and push the development of nursing course.

Aim To investigate the expression of vascular endothelial growth factor(VEGF) and its receptors in human hepatocellular carcinoma cell lines SMMC7721, HHCC and HepG2. Methods Immunohistochemical staining and reverse-transcriptase polymerase chain reaction(RT-PCR) were used to detect the mRNA and expression of VEGF and its receptors: VEGF-R1(Flt-1) and VEGF-R2 (KDR) in three human hepatocellular carcinoma cell lines, SMMC7721, HHCC and HepG2, as compared with ECV304 cells(human umbilical vein endothelial cells) and L929 cells(mouse fibroblast). Results All three human hepatocellular carcinoma cell lines expressed VEGF protein. Flt-1 mRNA and protein could be detected in SMMC7721 cells while KDR in HHCC and HepG2 cells. Conclusion The expressions of Flt-1 and KDR suggests that VEGF may be an autocrine growth factor for human hepatocellular carcinoma, at least for cell lines in vitro.

Objective To observe the effect of electroacupuncture on back three-acupoints ( namely bilateral Dazhu, Fengmen, Feishu) on the protein and mRNA expression of transforming growth factor-beta 1 (TGF-β1) and Smad3 in asthmatic rat airway remodeling model, and to explore its therapeutic efficacy and molecular mechanism. Methods Rat asthma model was established by inhalation of ovalbumin. After sensitization for 6 weeks, rats were killed. And then the airway morphological parameters of rats were measured by image analysis. The protein and mRNA expression of TGF-β1 and Smad3 in lung tissues were detected by immunohistochemistry and real-time quantitative polymerase chain reaction (qRT-PCR) respectively. Results Compared with the blank group, the standardized values of muscle cross-sectional area including airway smooth muscle area (WAm) /perimeter of the basement membrane (Pbm), and bronchial inner wall area (WAi)/Pbm were increased in the model group. The protein and mRNA expression levels of TGF-β1 and Smad3 were also increased in the model group. In electroacupuncture group, the above observation indexes were decreased, and the differences were statistically significant ( P<0.05 compared with the model group). Conclusion The experimental results indicated that back three-acupoint electroacupuncture has an effect on remodeling airway, and one of the mechanisms is probably associated with the regulation of TGF-β1/Smad3 signaling pathway.

Parkinson's disease (PD) is a common disabling and neurodegenerative disease.As the disease progresses,the patient's respiratory system will be affected.PD leads to obstructive and restrictive airway diseases,and PD medications may produce pulmonary side effects,such as pleuropulmonary fibrosis related to dopamine agonists.Finally,motor fluctuations in advanced PD may trigger respiratory symptoms.Abnormal central control of ventilation,obstructive sleep apnea,emotional disorders will influence respiratory system.Recognizing these pulmonary complications will assist the clinician in appropriately managing the disease and potentially reducing the impact of the abnormal respiratory system on overall PD patient health.

ObjectiveTo investigate the effects of the imbalance between regulatory T cells (Treg) and T helper 17 cells (Th17) in patients with chronic hepatitis B virus (HBV) infection.MethodsThe serum concentration of Treg/Th17 differentiation-related cytokines in 34 patients with chronic hepatitis B (CHB),20 patients with HBV related acute on chronic liver failure (ACHBLF),and 20 healthy controls (NC) were measured by enzyme-linked immunosorbent assay (ELISA) and proportion of peripheral Th17 and Treg cells were analyzed by flow cytometry.Numeration data was analyzed by Fisher's exact propability method and measurement data was tested by one-factor analysis of variance or Turkey multiple comparison.Results The levels of Th17 differentiation-related cytokines,II-1β (3.97±2.85) pg/mL,IL-6 (12.75±-8.87) pg/mL,and IL-21 (360.0±335.7) pg/ mL in patients with ACHBLF were significantly increased than those in NC,which were (1.87 ±0.94) pg/mL(q=4.559,P＜0.01),(5.28±0.72) pg/mL(q=7.309,P＜0.01) and (46.68±20.17) pg/mL(q=6.946,P＜0.01 ),respectively.The proportion of Th17 increased markedly in patients with ACHBLF than that in NC(q=3.972,P＜0.05).However,compared to NC and patients with ACHBLF,the Treg differentiation-related cytokine,TGF-β,in patients with CHB,increased significantly (q=4.536 and 5.323,respectively; both P＜0.01).And the population of Treg also increased markedly in CHB patients.The level of IL-17A which was the characteristic effector cytokine of Th17 was the highest in patients with ACHBLF.The peripheral Th17 cell proportion was positively correlated with the level of serum total bilirubin in patients with ACHBLF (γ=0.74,P＜0.01).Conclusions Th17 and Treg imbalance including cytokine profiles and cell numbers exists in patients with chronic HBV infection.The Th17 are active in patients with ACHBLF and Treg are active in patients with CHB.

Objective To investigate the efficacy and safety of different optimal therapy strategies for hepatits B e antigen (HBeAg) positive chronic hepatitis B (CHB) patients with suboptimal response to peginterferon-α-2a (peg-IFN-α-2a) at 24 weeks.Methods This open-label,single-center and prospective clinical observational study was conducted in Department of Infectious Diseases at Shanghai Changhai Hospital between January 2009 and December 2011.The cases of HBeAg-positive CHB with suboptimal response to peg-IFN-α-2a at week 24 were enrolled.Based on virological markers and patient preference,patients were treated with either peg-IFN-α-2a add-on adefovir dipivoxil (ADV) or switch-to telbivudine (LdT).Hepatitis B virus (HBV) virological and serological data were collected at week 12,24 and 48 after the initiation of optimal therapy.Adverse reactions were also monitored.Therapeutic efficacy was compared between two groups of patients before and after treatment by x2 test.Kruskall Wallis test and Mann-Whitney test were used for analysis of continuous variables.Results Among 193 HBeAg positive CHB patients treated with interferon,67 had suboptimal response and were enrolled.Forty five cases received peg IFN-α-2a add-on ADV treatment and 22 cases received switch-to LdT treatment.After 48 weeks of optimized therapy,the total tBeAg seroconversion rate was 25.3 ％.The rates of HBeAg loss,HBV DNA negative and alanine aminotransferase normalization were 26.8％,73.1％ and 83.5％,respectively.The peg-IFN-α-2a switch-to LdT strategy had better HBV DNA inhibition efficiency compared with the peg-IFN-α-2a add-on ADV strategy at week 12,24 and 48 (P=0.00,0.00 and 0.01,respectively).However,there was no significant difference of HBV DNA negative rate between two groups at week 48 (x2 =0.01,P=0.89).The obviously intolerable adverse reaction was not reported in two optimized strategy groups.Conclusions The 48-week optimized treatment for HBeAg positive CHB with suboptimal response to peg-IFN-α-2a at week 24 could achieve a higher HBeAg seroconversion rate.The switch-to LdT strategy may have better HBV DNA inhibition efficiency.Both strategies show satisfactory safety and tolerance.

With the development of business of manned spaceflight, the body damage of astronauts on the space en-vironment has received growing concern. Weight loss is the most important cause of various diseases, and the weightlessness muscle atrophy is one of urgent problems to be solved in aerospace medicine. Although there is no concept of weightlessness or weightlessness muscle atrophy in the theory of traditional Chinese medicine (TCM), TCM can grasp the pathogenesis of complex diseases, and provide important theoretical references for the prevention and management of weightlessness diseases, especially weightlessness muscle atrophy. In this paper, TCM Cognition of weightlessness and the pathogenesis of weightlessness muscle atrophy was studied by the sight of TCM theory of qi hoisting. The discussion was made from aspects of circulation of qi and blood, zang-fu function. This work is wished to be beneficial to apply the TCM theory in aerospace medicine.