Objective To investigate the change of the permeability of endotoxin-induced blood-labyrinth barrier(BLB) in guinea pigs.Methods Endotoxin was injected into each tympanic cavity of 27 guinea pigs via superior bulla and Evans blue(EB) was injected via jugular vein before sacrification.Another 27 guinea pigs were served as control by injecting normal saline instead of endotoxin.On 12,24,72 h after injection of endotoxin or normal saline,EB content in BLB was detected after the cochlea were immersed in formamide for 24 h and the pathological change of lateral wall was observed by light microscope and transmission electron microscope.Results The BLB permeability to EB increased in endotoxin-induced cochlea of guinea pigs with prolonged time,and the content of EB was significantly different at 24 h in endotoxin-treated cochlea as compared with that at 12 h and 72 h.No marked morphological changes in the stria vascularis and spiral ligament were observed in control group.The pathologic changes in the lateral wall of cochlea in endotoxin-treated group were inflammatory cell infiltration,blood capillary engorgement,intercellular conjunction cleft.Conclusion The BLB permeability can be increased by endotoxin in the cochlea of guinea pigs,which is mainly caused by the capillary interendothelial cleft and continuous break of endothelial cells in stria vascularis.

Public hospital's public property is mainly reflected in providing people with equitable access, quality and efficiency of basic medical services. However, due to lack of understanding in importance of the medical services positive and negative externalities, lead to the dilution of commonweal of public hospital. Meanwhile, externalities caused by transaction costs and unclear property rights in medical services activities further exacerbate welfare fade. The government should take effective measures to protect and encourage positive externalities, prevent and control the negative externali-ties, and, by way of reducing transaction costs, clear property rights to resolve external effects, as far as possible to pro-tect the public interest in public hospitals.

ObjectiveTo observe the effect of enema with Chinese medicine Changduqing combined with plasma exchange for treatment of endotoxemia in patients with acute-on-chronic liver failure.Methods A prospective randomized controlled trial was conducted, and 68 patients with acute-on-chronic hepatic failure who were hospitalized from January 2009 to June 2012 in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were randomly divided into treatment and control groups, 34 cases in each group. The patients in control group were treated with plasma exchange combined with western medicine comprehensive treatment such as protecting liver, reducing enzyme, removing jaundice, and in cases with hepatitis B, antiviral therapy was added. The treatment in patients of treatment group was the same as that in the control group, but additionally Changduqing enema of TCM decoction was given(ingredients: radix et rhizoma ginseng 10 g, flos magnolia officinalis 6 g, radix et rhizoma rhei 6 g, fructus aurantii immaturus 6 g, radix paeoniae rubra 10 g),twice a day combined with 3-4 times of plasma exchange treatment, once every 72 hours. The course of treatment of both groups was 4 weeks. The changes of total bilirubin (TBil), alanine aminotransferase(ALT), albumin(ALB), prothrombin activity(PTA), endotoxin, the improvement of clinical symptoms and signs such as lacking in strength, poor appetite, abdominal distension, oliguria, bleeding tendency, hepatic encephalopathy, infection and ascites were observed before and after treatment, and the survival rate in 24 weeks of follow-up was also investigated.Results Before treatment, the comparisons of TBil,ALT, ALB and PTA between the two groups were of no statistically significant differences(allP>0.05); compared with those before treatment, the levels of TBil and ALT were obviously decreased, and PTA was markedly increased after treatment in both groups, the degree of change being more prominent in treatment group〔TBil(μmol/L): 89.6±52.3 vs. 124.6±64.4, ALT(U/L):52.4±32.1 vs. 98.3±42.5, PTA:(53.8±11.5)% vs.(41.2±10.2)%, allP<0.05〕. The ALB levelsbefore and after treatment of both groups showed no significant difference(bothP>0.05). After treatment, the endotoxin(kU/L) in both groups were decreased in inchoate, developing and fully-developed stages and the descent being more significant in treatment group(inchoate stage: 0.094±0.015 vs. 0.109±0.032, developingstage: 0.102±0.019 vs. 0.146±0.062, fully-developed stage: 0.124±0.022 vs. 0.196±0.074, allP<0.05). The 24-week survival rates of developing and fully-developed stages in patients of both groups were lower than the rate in patients of inchoate stage, and the rates of treatment group in inchoate and developing stages were remarkably higher than the rate in control group〔inchoate stage: 94.1%(16/17) vs. 83.3%(15/18), developed stage: 85.7%(12/14) vs. 42.9%(6/14),bothP<0.01〕.ConclusionEnema with TCM Changduqing combined with plasma exchange for treatment of patients with acute-on-chronic liver failure can remove bilirubin, ameliorate endotoxemia, elevate PTA level and increase the survival rate of patients in 24 weeks of follow-up.

This paper summarized the work of nursing acute chest pain pre-examination and triage from the following 4 aspects: the general situation of the work of nursing acute chest pain pre-examination and triage at home and abroad, the factors influencing the decision-making of nurses' chest pain triage, the mode of acute chest pain pre-examination and triage, and the tools of acute chest pain pre-examination and triage, so as to provide reference for improving the quality of nursing pre-examination and triage.

Objective To evaluate the effectiveness and safety of acupuncture in the management of post-stroke spasticity.Methods Six domestic and abroad databases were screened by computer.Randomized controlled trials (RCT)were included if acupuncture treatment was used as the sole intervention or as an adjunction to another conventional treatment on post-stroke spasticity. Two independent reviewers screened the articles,extracted data and assessed the risk of bias.The evaluation of the quality was performed using Cochrane Risk of Bias Tool and the data was analyzed by using RevMan 5.3.Mean difference (MD)and 95% confidence interval (CI)were used to describe quantitative data.Results A total 29 RCT were included,7 of them had high risk of bias and the rest of them had unclear risk of bias. Acupuncture was better than rehabilitation therapy in remission of spasticity (-0.40 [-0.68,-0.12]).The 4 or 8 weeks of treatment in studies of unmentioned spasmodic regions showed that acu-puncture with rehabilitation therapy was better than rehabilitation therapy (-0.31 [-0.50,-0.11],-0.41[-0.54,-0.28]).The studies of 4 weeks of treatment showed superior effect of acupuncture with conventional treatment compared with rehabilitation therapy with conventional treatment (-0.96 [-1.73,-0.19]),and acupuncture with rehabilitation therapy was superior to conventional treatment with rehabilitation therapy (-0.57[-0.80,-0.34]).After 6 months of treatment,acupuncture with nerve block therapy and rehabilitation therapy was better than nerve block therapy with rehabilitation therapy (-0.63[-1.12,-0.14]),and acupuncture with nerve block therapy was better than nerve block therapy (-0.70[-1.08,-0.32]).In improving the physical activity,acupuncture,acupunc-ture with rehabilitation therapy,acupuncture with conventional treatment and rehabilitation therapy 1 or 4 weeks of follow-up,and acupuncture with nerve block therapy was better than that of control group. Conclusion Acupuncture could remiss the spasticity after stroke and improve the ability of daily life and motor function of patient,but the conclusion of subgroups are not the same.The high quality RCT studies with clear spasmodic position and measurement at more time points are needed to confirm the effectiveness and safety of acupuncture in post-stroke patients with spasticity.

Objective:To investigate the effects of Wumei-Fangfeng drug on Treg/Th17 immune balance in allergic rhinitis(AR)mice via regulating MMP9 derived from mast cell exosomes.Methods:Potential targets of Wumei and Fangfeng were screened,and the intersection was taken from the targets and AR risk genes,subsequently GO analysis and protein-protein interaction analysis were performed to screen therapeutic targets.AR mice model were constructed,mast cells and exosomes were separate from femurs of mice.Wumei-Fangfeng drug and exosomes were used to treat mice.The behavioral scores of mice in each group were evaluated,mRNA expressions of Foxp3,RORγt were detected in nasal mucosa of mice.After knocking down of MMP9 in exosomes,the behavioral score,Foxp3 and RORγt mRNA expressions were observed in AR mice.Results:Bioinformatics results showed that Wumei-Fangfeng drug may act on AR by mast cell exosomes derived IL-1β and MMP9.Compared with normal mice,mRNA expression of Foxp3 in AR mice was decreased,while RORγt mRNA expression was increased,and MMP9 expression was increased(all P<0.05).Expression of Foxp3 mRNA was increased,and expressions of RORγt and MMP9 were decreased in AR mice treated with Wumei-Fangfeng drug,however,mast cell exosomes could further counteract the effects of Wumei-Fangfeng drug,and the effects of mast cell exosomes was weakened after MMP9 knockdown.Conclusion:Wumei-Fangfeng drug regulates the imbalance of Treg/Th17 in AR mice by inhibiting the exosomal MMP9 of bone marrow-derived mast cells.

Objective To investigate the effects of reducing APE/Refl expression in the cultures of rat spiral ganglion cells with oxidative damage induced by H2O2.Methods Primary cultured rat spiral ganglion cells were infected with small interfering RNA to APE/Refl (Apel siRNA) for 72 h,followed by treating with H2O2(0,10,25,50,100 and 300 μmol/L) for 1 h,and then cultured in normal medium for 24 h.Western blot were used to detect the level of APE/Refl protein and phosphorylation of histone protein H2AX in the infected cells.The caspase3 activation was tested by spectrophotometric method.The cell viability was determined by MTT and the apoptosis of spiral ganglion cells was determined by terminal-deoxynucleotidyl transferase mediated nick and labeling (TUNEL).Results Western blot showed that infection with Ape1siRNA resulted in APE/Ref1 reduced expression in the spiral ganglion cells.Exposing spiral ganglion cultures with reduced expression of APE/Ref1 to H2O2 (50,100,300 μmol/L) for 1 h resulted in increasing in the phosphorylation of histone protein H2AX.The reduction in APE/Refl significantly reduced cell viability in cultures 24 h after 1 h expression to 50-300 μmol/L H2O2.The apoptosis of cells and caspase 3 activity was detected significantly improved.Conclusions The induced of APE/Refl results in significantly decrease in spiral ganglion cells viability in oxidative stress.The repairing function of APE/Refl is necessary for optimal levels of neuronal rat spiral ganglion cells survival.

Objective:To understand the epidemiological characteristics of an outbreak of Chikungunya fever (CHIK) in Ruili city at Sino-Myanmar border area in Yunnan province, China, 2019.Methods:The data of CHIK cases in Ruili city were collected. Serum samples were collected from acute phase of the patients for the detection of the viral nucleic acid with real-time reverse transcription PCR assay.Results:A total of 121 CHIK cases (laboratory-confirmed cases) were reported in Ruili city in 2019, in which 98 were indigenous cases (80.99%) including 2 pregnant women and 3 neonatal cases (twin boys and 1 girl) were observed with vertical mother-to-child transmission), and 23 were imported cases (19.01%) from Myanmar. CHIK mainly occurred in Urban area (Mengmao town) and port area (Jiegao development zone) of Ruili city. The epidemic of CHIK lasted from September to November. The epidemic peak was in October (74.38%). The majority of patients were aged from 20—59 years (77.69%), in addition to 3 cases of mother-to-child transmission, the youngest was 3 months and the oldest 72 year-old. The male to female ratio was 1∶1.28 (53∶68). Occupational distribution of CHIK cases was mainly for the commercial service personnel (33.06%), home workers and unemployed persons (21.49%) and retiree (11.57%).Conclusions:During the outbreak of CHIK in Ruili in 2019, both indigenous and imported cases were detected. The imported CHIK cases from Myanmar were the main sources for local transmission of CHIK in Ruili city. This is the first time that a local epidemic of CHIK has occurred in Yunnan Province. It is necessary to strengthen control of the cross-border spread of CHIK in this area.

In the research of artificial joint biomechanics, it is a common method in the world to evaluate the biomechanical properties of the implanted fixtures through experiments . The domestic research started late, and the corresponding testing methods were lacking. There is still no unified standard. In this paper, a complete hardware test system was designed and built around the existing mechanical testing machine, including:binocular vision catcher, torque bearing clamp, film pressure sensor and so on. The system can accurately measure the relative motion angle value, external torque value, and inter pressure value of each joint. It has some reference significance for the forming and standardization of the artificial joints' evaluation system.
Biomechanical Phenomena ; Joint Prosthesis ; Motion ; Pressure ; Torque

In the research of artificial joint biomechanics, it is a common method in the world to evaluate the biomechanical properties of the implanted fixtures through experiments . The domestic research started late, and the corresponding testing software were lacking. There is still no special software. In this paper, an integrated software test system was designed and built based on the existing hardware system, including:hardware control, data collection, data save, data processing and display. It can directly show the 3D motion trajectory and the angle curve of joints. The system can accurately measure the relative motion angle value, external torque value, and inter pressure value of each joint. It has some reference significance for the development of the artificial joints' evaluation system.