Objective To observe the clinical efficacy of mesalazine and bifid-triple viable combination therapy in patients with ulcerative colitis (UC).Methods Thirty-eight UC patients were evenly divided into mesalazine group and combination group. Patients in mesalazine group were administrated with mesalazine (1.0 g/time,four times/day),and on the basis of this,the patients in combination group were added into bifid-triple viable (420 mg/time,three times/day).The course of treatment was eight weeks.The improvement of patients' clinical symptom and manifestation under colonoscope were observed at second day after hospitalization and eight weeks after medication.Mayo disease activity index was used for scoring.Before and after the treatment,the expression of intestinal mucosa nuclear factor kappa B (NF-κB),tumor necrosis factor-α (TNF-a) and cyclooxygenase-2 (COX-2) were tested by immunohistochemical staining and the levels of serum TNF-α,interleukin-8 (IL-8), interleukin-10 (IL-10) were determined by double antibody sandwich enzyme-linked immunosorbent assay.The level of serum superoxide dismutase (SOD) and malondialdehyde (MDA) was detected by nitrite method and thiobarbituric acid coloration method.Before and after treatment was compared with paired t-test,and qualitative data was analyzed with ordinal rank sum test.Results Mayo disease activity index score of the combination group decreased from 7.16±2.01 to 1.63± 1.30 while the mesalazine group from 7.42 ± 1.95 to 3.00 ± 1.25.The difference of reduction was statistically significant (t =2.093,P =0.043).The efficiency of the combination group was higher than that of mesalazine group (16/19 vs 10/19,Fisher's exact test,P=0.039).After treatment,the expressions of NF-κB,TNF-α and COX-2 in colonic mucosa of two groups were both lower than those of before treatment,and in combination group the decrease were more significant (t value was 2.262,2.607 and 2.522 respectively,P value was 0.027,0.012 and 0.014 respectively).After treatment,the concentration of IL-8 of mesalazine group and the combination group both significantly decreased,however IL-10 significantly increased. The difference between these two groups was statistically significant (t value of TNF-α,IL-8 and IL-10 was 4.244,6.858 and 6.802 respectively,all P＜ 0.01). After treatment,both SOD vitality of two groups increased compare with that before treatment,however the level of MDA was lower than that before treatment and the changes of combination group were more significant.Conclusion The combination therapy with mesalazine and bifid-triple viable can effectively suppress inflammatory response in mild and moderate ulcerative colitis,and bifid-triple viable may play a role as adjuvant therapy for patients with UC.

Interventional pulmonary procedures performed by flexible bronchoscopy has been widely used in the adult clinics.However,pediatric interventional pulmonary procedures are different from adult in anesthesia methods,equipment,technology and so on.At present.it is more limited.This review showed the experiences of pediatric bronchoscopy in Taipei Veterans General Hospital of Taiwan,China.

ObjectiveTo study the distribution characters and linkage disequilibrium of vitamin D receptor(VDR) gene ApaI and BsmI polymorphism,and explore the genetic susceptibility of VDR and vitamin D deficiency rickets.MethodsVDR gene ApaI and BsmI polymorphisms were determined by PCRRFLP technology in 56 cases of rickets and 76 cases of normal children.The frequencies of the VDR genotype and allele were compared between the two groups.The software SHEsis was used to make linkage disequilibrium analysis.Results No significant difference was found in either the frequency distribution of VDR gene ApaI and BsmI polymorphism or allele of them between two groups; Two polymorphisms didn't show linkage disequilibrium and D' and r2 were 0.23 and 0.01,respectively.ConclusionsThe ApaI and BsmI polymorphism of VDR gene might be not associated with vitamin D deficiency rickets.Two polymorphisms didn't show linkage disequilibrium.

Objective To evaluate the feasibility of ETView visual endotracheal intubation in elderly patients with a potentially difficult airway under general anesthesia.Methods A total of 80 patients scheduled for elective surgery,with at least three characteristics indicative of an increased risk for difficult tracheal intubation and aged 65-86 years with American Society of Anesthesiologists (ASA) grade [Ⅱ or Ⅲ,were selected and randomly assigned into 2 groups:the control group (Group C) and the ETView visual endotracheal intubation group (Group E) (n=40 for each).After induction with propofol 0.5-1.5 mg/kg,sufentanil 0.2 μg/kg,and rocuronium 0.6mg/kg,regular tracheal intubation and ETView visual endotracheal intubation were conducted in Group C and Group E respectively.Blood pressure and heart rate were recorded before induction (T0),before initial intubation (T1),at successful intubation (T2),and 5min after successful intubation (T3).Duration of catheterization,number of intubation attempts,rate of successful intubation at first attempt and complications within 2 days of intubation were also recorded.Results The duration of catheterization and the number of intubation attempts were lower in Group E than in Group C[(34±6) s vs.(48± 22) s,(1.0±0.0) vs.(1.4±0.4),t=2.484 and 2.373,respectively,P=0.017 and 0.023,respectively].The rate of successful intubation at first attempt was higher in Group E than in GroupC (100％ or 40 cases vs.75％ or 30 cases),x2=5.714,P=0.017).There was no significant difference in hemodynamic changes and the rate of postoperative hoarseness between the two groups (P＞0.05 for both).Conclusions ETView visual endotracheal intubation shows excellent safety in elderly patients with a difficult airway under general anesthesia,with shorter catheterization duration and a higher rate of successful intubation at first attempt than regular intubation.

Objective To investigate the clinical effect of two different anaesthesia methods in removing the tracheobronchial foreign bodies in children.Methods This was a retrospective study with 56 hospitalized children through fiberoptic bronchoscope foreign body removing since September 2010 to July 2013 in Gansu Provincial Maternity and Child-Care Hospital.All of the children whose age from 8 months to 11 years were diagnosed of tracheal-bronchial foreign body.Among 56 cases,30 cases were operated with deep sedation anesthesia(deep sedation anesthesia group),and 26 cases with general anesthesia(general anesthesia group).The clinical effect of the two kinds of anesthesia were compared.Results The success rate of foreign bodies in deep sedation anesthesia group and general anesthesia group were 83.33％ and 96.15％ respectively (P ＞ 0.05),there were no statistical differences in oxygen desaturation (86.67 ％ vs 92.31％),cyanosis(30.00％ vs 26.92％),bleeding (16.67％ vs 15.38％),fever (6.67％ vs 3.85％),voice hoarse (40.00％ vs 34.62％),vomiting (26.67 ％ vs 19.23 ％),and other complications between two groups (P ＞ 0.05,respectively).There were significant differences in the rate of choking cough(11.54％ vs 93.33％) and resistance (0 vs 73.33％) between general anesthesia group and deep sedation anesthesia group (P ＜ 0.05).Compared with the deep sedation anesthesia group,the average hospitalization cost[(4 718.73 ± 1 012.61) (￥) vs (4 050.25 ± 1 176.75) (￥)] was bigger,and the average setup time [(18.54 ± 3.46) min vs (6.50-± 1.70) min] was longer,but the average removal of foreign body time [(13.32 ± 6.38) min vs (39.52 ± 15.68) min] was smaller in general anesthesia group,there were significant differences between two groups(P ＜ 0.05,respectively),while there was no statistical difference in the average hospitalization days [(5.46 ± 1.65) d vs (5.67 ± 1.65) d] between two groups (P ＞ 0.05).Conclusion Compared with the deep sedation anesthesia,the success rate of removal foreign bodies is higher,and the removal foreign body time as well as comfort are all significantly improved through general anesthesia,but the average hospitalization cost and average preparation time of general anesthesia are bigger than those of deep sedation anesthesia.

Objective:This study aimed to observe the synergistic effect of a new tumor vaccine combined with metronomic che-motherapy in vivo on breast cancer. This study was also conducted to investigate the mechanism of this combination. Methods:Balb/c mice inoculated with 4T1 mouse breast cancer cell were used as tumor models. High-mobility group nucleosome-binding protein 1 (HMGN1) gene was used to transfect 4T1 cell lines as cancer vaccines. After 4T1 cell was inoculated, the mice were randomized into four groups:normal saline (NS);metronomic gemcitabine (GEM) alone;cancer vaccine alone;and combination therapy group. Tumor growth and potential toxicities of these regimens were observed. The Foxp3 expression of regulatory T cells (Tregs) was detected by western blot and immunohistochemical staining. The microvessel density (MVD) of the tumor was also detected by immunohistochemi-cal staining. Results:The tumor volume of the mice was significantly lower in the combination group than in the MET group or cancer vaccine group (P<0.05). This result exhibited a higher significant difference than the tumor volume of the mice in the NS group (P<0.01). Foxp3 expression was significantly lower in the mice treated with GEM (combination or MET group). MVD was significantly lower in these two groups than in the cancer vaccine group or NS group (P<0.05). Furthermore, adverse reactions slightly occurred in each group. Conclusion: The combination of cancer vaccines and metronomic GEM is a very active and well-tolerated regimen for breast cancer in mice.

Objective To evaluate the systolic function of left ventricle(LV) in the short axis views in diabetic patients with ejection fraction (EF) value ＞ 50％ with velocity vector imaging (VVI) and dobutamine stress echocardiography (DSE).Methods 30 diabetic patients,which were excluded from coronary artery disease,hypertension,valvular heart diseases,congenital heart diseases,and EF value ＞50 ％by echocardiography,and 20 volunteers with age and sex matched were involved in the study.Twodimensional VVI echocardiographic cine loops were stored at baseline and dobutamine stress (10,20,30 and 40 μg · kg-1 · min-1) in the basal,middle and apical short axis views of LV.The maximum systolic velocity (Vs),strain (ε) and strain rate (SR) were obtained from sygno VVI software.Results The Vs,ε and SR showed decrement tendency from basal to apical short axis view whether in the control group or in the DM group.At baseline,the SR in the apical view decreased significantly in the DM group than that in the control group (P ＜0.05),other parameters were comparable between the two groups.After 10 μg· kg-1 · min-1 dobutamine stress,the SR in the middle and apical views and Vs,ε in the apical view decreased significantly in the DM group than those in the control group (all P ＜ 0.05).After 20μg· kg-1 · min-1 dobutamine stress,the SR in the basal,middle and apical views and Vs,ε in the middle and apical views decreased significantly in the DM group than those in the control group (all P ＜0.05).After the maximum dobutamine stress,all parameters decreased significantly in the DM group than those in the control group (all P ＜0.05).Conclusions The systolic function impairment of DM patients appeared first in the apical tissue of LV,SR was more sensitive index than velocity arnd strain,DSE could increase the sensitivity of VVI parameters in detecting the myocardial systolic function impairment in the earlier stage.

Objective To investigate whether myocardial dysfunction and perfusion impairment had happened in diabetes mellitus(DM)rats,and to assess the relationship between them by using myocardial contrast echocardiography(MCE)and velocity vector imaging(VVI).Methods MCE and VVI were performed from the short-axis views of the mid-left ventricular level both at rest and after dipyridamole stress in control rats and DM rafs(12 weeks after induction with streptozotocin).MCE-derived myocardial blood flow(MBF)and myocardial flow reserve(MFR)and VVI-derived circumferential strain rate(SRc)and SRc reserve were obtained.Results SRc(absolute value)and MBF in the DM group were significantly lower than those in the control group at rest(P =0.03 for SRc and P =0.005 for MBF).SRc reserve and MFR in the DM group were significantly lower than those in the control group after dipyridamole stress (P =0.000 for SRc reserve and P =0.014 for MFR).There was no significant correlation between SRc and MBF at rest in the DM group(r =0.189,P =0.453).However,significant negative correlation existed between SRc reserve and MFR(r =-0.658,P =0.003).Conclusions Both myocardial systolic function and perfusion are impaired in DM rats.The decrease of MBF might not be the predominant determinant of myocardial systolic dysfunction at rest.However,the impairment of MFR could be an important contributor to the decrease of myocardial contractile reserve.

Objective To assess the systolic strain of left ventricular(LV) in the long axis views in diabeties mellitus(DM) patients with LVEF value ＞ 50％ with velocity vector imaging (VVI) and dobutamine stress echocardiography (DSE).Methods Thirty DM patients,which were excluded from coronary artery disease,valvular heart diseases,congenital heart diseases,hypertension,and LVEF value ＞50％ by echocardiography,and 20 volunteers with age and sex matched were involved in the study.Two-dimensional VVI echocardiographic cine loops were stored at baseline and dobutamine stress in the apical four-chamber,two-chamber and long axis views of LV.The maximum long systolic velocity (Vs),strain (ε)and strain rate (SR) were obtained from sygno VVI software.Results The Vs,ε and SR decreased from basal to apical in the LV walls whether in the control group or in the DM group.At baseline,SR in 7 segments,ε in 4 segments and Vs in 3 segments in the DM group decreased significantly than those in the control group (P ＜0.05).After the maximum dobutamine stress,all parameters decreased significantly in the DM group than those in the control group (all P ＜0.05).In addition,67％ parameters in apical LV and 11％ parameters in middle LV in the DM group were lower than those in the control group.All parameters in basal LV were comparable between the two groups at baseline.Conclusions The Vs,ε and SR showed decreased tendency from basal to apical in the long axis of LV.The Vs,ε and SR impairment in the long axis of DM patients appeared first in apical tissue of LV.DSE could increase the sensitivity of VVI parameters in the earlier stage.

Objective:To investigate the mechanism of histone deacetylase (HDAC) inhibitor in down-regulating the expression of HER-2 in breast cancer cells and to provide an innovative therapeutic option to overcome the disadvantages of anti-HER-2 therapy. Meth-ods:HER-2-positive breast cell lines were treated with HDAC inhibitors. The changes in the gene and protein levels of HER-2 were de-tected by qPCR and Western blot. MiRNA microarray was used to identify the HDAC inhibitors, whereas qPCR was used to verify the miRNA expression. Results:In vitro cell experiments confirmed that the HDAC inhibitors TSA and SAHA can down-regulate the expres-sion of HER-2 in breast cancer cell lines. TSA can down-regulate the expression of HER-2 gene in BT474 and decrease the concentra-tions of 100 nmol by 10.7%and 200 nmol by 38.9%(P<0.05). TSA had no effect on the primary cells. The expression of HER-2 gene of BT474 was down-regulated by 93.9%(P<0.05) in the 5μmol/L group but not in the 1μmol/L group. SAHA significantly affected the pri-mary cells at a concentration of 1μmol/L and reduced the cells at 87.1%at a concentration of 5μmol/L. Seven miRNAs were identified from the miRNA microarray. MiR-762 was used as a basis to identify the changes in miRNA. The miRNA sputum identified by miRNA microarray and qPCR may be associated with the down-regulation of HER-2 by HDAC inhibitors. Conclusion: HDAC inhibitors may down-regulate the expression of HER-2 in breast cancer cells by changing some miRNAs.