Objective To investigate the effect of ipratropium bromide combined with budesonide /formoterol fumarate inhalation powder on serum FeNO and lung function of bronchial asthma patients.Methods 102 cases with clear bronchial asthma during Jan 2013 and Mar.2015 from the affiliated Qianfo Hill Hospital of Shandong University were randomly divided into three groups, control group A (34 cases) were treated with ipratropium bromide, control group B (34 cases) were treated with budesonide/formoterol fumarate powder, experiment group (34 cases) were given ipratropium bromide combined with budesonide/formoterol fumarate powder, all groups were treated for 6 months.Pulmonary function, serum FeNO and IgE levels, clinical efficacy were compared after treatment.Results The effective rate of control group A, B (70.59%, 67.65%) were significantly lower than experiment group (91.18%), the difference were significant (P<0.05).FEV1, FVC, FEV1%pre of experiment group were significantly higher than control group A and B after the treatment.Serum IgE and FeNO concentration were significantly lower than control group A, B, the difference were significant ( P<0.05 ) .Conclusion Ipratropium bromide combined with budesonide/formoterol fumarate powder for inhalation in bronchial asthma patients can effectively reduce FeNO concentration, improve lung function.

The Pricing and Payment Regulation on Chinese Diagnosis Related Groups (C-DRG) was designed by National Health Development Research Center,directly under the leadership of Department of Finance,NHFPC (formerly Dept.of Planning and Finance,Ministry of Health),which organized a large study group consisted of nearly 1 000 experts since 2010.It introduced the general design of C-DRG and the principles and main points of applying C-DRG system,which could be referenced by all countries in carrying out the pricing and payment reform system.

[Objective]Electrophoretic analysis of rat chemically extracted acellular nerve allograft(CEAN) protein was performed to investigate the protein of CEAN.Dorsal root ganglia of chicken were cultured onto the surface of CEAN slice to observe the effect of CEAN structure on the fiber regeneration.[Method]The CEAN were perpared according to Sondell method and electrophoresed to observed whether the electrophoresis strip of 28-30kDa(Myelin Protein) exited or not.Dorsal root ganglia of chicken were cultured onto thc surface of CEAN slice and dyed with nerve fiber fluorescence to observe the orientation of nerve fiber growth on the surface of CEAN slice.[Result]Electrophoretic analysis of rat CEAN protein showed that the electrophoresis strip of 28-30 kDa totally disappeared.A large number of nerve fibers grew from DRG along the basement membrane of CEAN.[Conclusion]No myelin protein remained in the CEAN,while the basement membrane structure of CEAN can induce the nerve fiber to grow.

[Objective] To investigate the biological characteristics of Wharton’[KG-38x]s jelly-derived mesenchymal stem cells (WJMSCs) and their differentiation into Schwann cell-like cells, and to provide a new cell seed source for nerve tissue engineering or cell therapy. [Methods]Umbilical arteries, veins and umbilical cord tunica externa were removed , and the remaining tissue (Wharton’[KG-38x]s jelly) was harvested.The umbilical cord was cut into small fragments and cultured with DMEM in orderto gather. Cultured WJMSCs were confirmed by the detection of MSC-specific cell-surface markers. WJMSCs were differentiated along a glial cell lineage using an established cocktail of growth factors. Immunocytochemical staining and Western blot were used to evaluate the characteristics of differentiated WJMSCs.[Results]WJMSCs were immunonegative for the haemopoietic cell-surface markers (CD34 and CD45) and neural stem cell marker (nestin), and immunopositive for MSC surface markers CD44, CD105, Stro-1 and vimentin. WJMSCs treated with a mixture of glial growth factors adopted a spindle-like morphology similar to Schwann cells. Immunocytochemical staining and Western blot analysis revealed that the treated cells expressed the glial markers p75 and glial fibrillary acidic protein indicative of differentiation.[Conclusion]WJMSCs can be differentiated into the cells that are Schwann-like in terms of morphologic features and phenotype and may be suitable as Schwann-cell substitutes for nerve repair in clinical application.

Objective To study the reliability and feasibility of video-assisted thorascopic lymphadenectomy for complete resection of non-small cell lung cancer(NSCLC).Methods From May 2007 to October 2008,31 patients with NSCLC underwent video-assisted thorascopic radical lobectomy combined with systemic lymphadenectomy in our hospital.The patients were divided into video-assisted thorascopic surgery(VATS) group(n=14) and video-assisted mini-thoracotomy(VAMT) group(n=17).The numbers of removed and metastatic lymph nodes were counted.The results and the follow-up outcomes were compared between the two groups.Results No patient dead or showed serious perioperative complications in both the groups.No significant differences were found between the VATS and VAMT groups in the operation time [(193?92) min vs(188?101) min,t=0.143,P=0.887],blood loss [(592?123) ml vs(648?120) ml,t=-1.297,P=0.211],number of removed lymph nodes [(14.6?7.5) vs(15.2?4.5),t=0.262,P=0.795],or 1-year rate of recurrence or metastasis [21.4%(3/14) vs 13.3%(2/15),P=0.651].Conclusion For patients with NSCLC,no significant difference exists between the outcomes of video-assisted thorascopic surgery and video-assisted mini-thoracotomy.

Objective To evaluate the ability of multi-slice spiral CT angiography(MSCTA)in showing the celiac trunk and its degree branches,and the value of MSCTA in preoperative evaluation of laparoscopic-assisted gastrectomy for advanced gastric carcinoma.Methods A total of 25 consecutive patients scheduled for laparoscopic-assisted gastrectomy with D2 lymph node dissection were evaluated by MSCT,CT angiography(CTA)were reconstructed separately using a volume rendering algorithm(VR).The space anatomy characteristics of celiac artery and its degree branches were evaluated according to the CTA results,and with anatomy information,laparoscopic-assisted gastrectomy with D2 lymph node dissection was processed with references to anatomy.Results In all the 25 cases,the left gastric artery and gastroduodenal artery were accurately identified on MSCTA.In 12 of them,the right gastric artery was accurately identified.The origin of the spleen artery is relatively constant.Laparoscopic-assisted gastrectomy with D2 lymph node dissection was successfully completed without conversion to open surgery in all the cases.The reconstructed celiac trunk and branches are identical with anatomy.Conclusions Three-dimensional CTA using MSCT clearly reveals the anatomy of celiac artery and their space structure.It plays an important role in guiding lymph node dissection during laparoscopic-assisted gastrectomy for advanced gastric carcinoma.

Lappaconitine hydrobromide can remove inflammation and swelling, lower temperature and relieve heat. It also can be used for local anesthesia. Clinically lappaconitine hydrobromide can be applied via i.v., i.m. or p.o. for analgesic treatment. Lappaconitine has better effect for moderate pain than for severe pain, which may be associated with the low dose. Future efforts should be made in increasing dosage, combining lappaconitine hydrobromide with other drugs and improving drug delivery technique.

BACKGROUND:Previous studies have found that cyclic tensile stress can induce the proliferation of human periodontal ligament fibroblasts in a certain time. OBJECTIVE: To observe the effect of cyclic tensile stress on the expression of connective tissue growth factor in human periodontal ligament fibroblasts, and to clarify the role of JNK, p38MAPK, PI3K pathway in the cyclic tensile stress-induced expression of connective tissue growth factor in human periodontal ligament fibroblasts. METHODS:Human periodontal ligament fibroblasts culturedin vitro were given stimulation of cyclic tensile stress in vitro for 1, 6, 12, 24 hours using multi-channel cel stretch stress loading system (experimental group). Control group was set up and not given any stimulation at the same time. The cels under stress application for 12 hours were given specific inhibitors of JNK, p38MAPK, PI3K respectively at the beginning, and were compared with those with no inhibitors. The concentrations of connective tissue growth factor in the culture supernatant were measured by ELISA. The mRNA expression of connective tissue growth factor in human periodontal ligament fibroblasts was detected by real-time RT-PCR. RESULTS AND CONCLUSION:Compared with the control group, the expression of connective tissue growthfactor in human periodontal ligament fibroblasts under cyclic tensile stress began to increase at 1 hour, increased manifestly at 6 hours, reached the peak at 12 hours, and then decreased at 24 hours. The expression of connective tissue growth factor was reduced by the specific inhibitors of JNK, while the specific inhibitors of p38 MAPK, PI3K had not the same effect. In a certain time, the cyclic tensile stress can induce a time-dependent increase in mRNA and protein levels of connective tissue growth factor. Along with the extending of time, the expression of connective tissue growth factor begins to decrease. Cyclic tensile stress can regulate expression of connective tissue growth factor in human periodontal ligament fibroblasts via the JNK pathway.

Objective To observe the effects of dexmedetomidine on inflammatory responses and insulin resistance during cardiac operations with cardiopulmonary bypass(CPB).Methods Fifty patients scheduled for elective cardiac valve replacement with CPB were equally and randomly divided into two groups using a random number table:observation group and control group(n =25).A loading dose of dexmedetomidine 1.0 μg/kg was injected intravenously over 1 5 min after induction,followed by continuous infusion at 0.4 μg·kg-1 ·h-1 until the end of CPB in doservation group.While the e-qual volume of normal saline was given in control group.After induction(T1 ),at 30 min after the be-ginning of CPB(T2 ),at the end of CPB(T3 ),and at 2 h after the end of CPB(T4 ),the jugular venous blood samples were taken for determination of serum concentrations of TNF-a,IL-6,insulin and blood glucose.The insulin sensitivity index (ISI ) = 1/(glucose × insulin )was obtained. Results Compared with control group,the serum TNF-a and IL-6 concentrations at T2-T4 were sig-nificantly decreased in observation group(P <0.05),the serum insulin and blood glucose concentra-tions at T2 ,T3 were significantly decreased in observation group(P <0.05 ),the ISI at T2 ,T3 were significantly increased in observation group(P <0.05).Conclusion Dexmedetomidine can reduce in-flammatory responses,thus reducing insulin resistance and blood glucose during cardiac operations with CPB.

OBJECTIVETo summarize laws of acupoint selection of prescriptions for treatment of cervicogenic headache by acupuncture in modern literature.

METHODSRandomized controlled trials (RCTs) involving acupuncture and moxibustion for treatment of cervicogenic headache were recruited from CBM (1978-2012), VIP (1989-2012), Wanfang Database (1998-2012), CNKI (1979-2012), PubMed (1966-2012), EMbase (1980-2012), and Cochrane Library (Volume 4, 2012). Hand recruitment was also auxiliarily used. The frequency and percentage of common acupoints, the distribution of acupoints along 14 meridians and across each part of the body, the application of specific acupoints, and features of using prescriptions for specific acupoints were statistically described.

RESULTSTotally 37 recruited papers included 42 acupoints and 159 times. Common acupoints covered Fengchi (GB20, 28 times), Jingjiaji (EX-B2, 21 times), Baihui (DU 20, 12 times), Tianzhu (BL9, 1 times), and Ashi point (11 times). Meridians along which acupoints were used mainly covered Foot-shaoyang Gallbladder Meridian, Foot-taiyang Bladder Meridian,and DU meridian. Acupoints were mainly needled from head, neck, and upper limbs. Eight confluence points and luo-connecting point were commonest used as specific acupoints. Acupuncture prescriptions were mostly composed of multiple acupoints. Filliform needle was mainly used in acupuncture methods, followed by electro-acupuncture needle.

CONCLUSIONSModern acupuncture treatment of cervicogenic headache focuses on local specific points and acupoints along meridians. Acupoints were mostly selected from head, neck, and upper limbs by syndrome typing of Chinese medicine.