Objective To discuss the effect of ill performance characteristics of type A behavior pattern (TABP) in the attack and development of cerebral infarction(CI).Methods The 100 patients with CI and 107 control subjects without any blood disease or tumors were evaluated by applying the Chart of Typical Behaviors of TABP, meanwhile the endothelin (ET) and thrombomodulin(TM) contents in plasma of the patients were measured for the mark of the damage of blood vessel endothelium. The CI group, control groups and part of CI group with the same level of blood pressure were subgroup by the result of questionnaire, correlation analysis was made between the amounts of blood markers and ill performance characteristics of TABP. Results 40% CI patients were TABP. The amounts of ET [(89.78?2.15)ng/ml] and TM [(52.68?3.47)ng/ml]in the plasma of the CI patients with ill performance characteristics were not only obviously higher than those of the control group [ET(57.82?1.83)ng/ml];TM:[36.05?1.07)ng/ml], but also higher than that of part of CI patients without ill performance characteristics of TABP(all P

Objective To discuss the importance of the clinic skill learning center in diagnostics teaching.Methods The experiment group was taught in the clinic skill learning center with the reformed method,while the control group was taught in the traditional laboratories with the traditional one.Results The experiment group's two average scores of diagnostics and skill examine are higher than the control group's,and the difference between the two group's average scores are significant in the statistics analysis.Conclusion The applications of the clinical skill learning center in medicine teaching is the need of developing the medical education business and fostering standardized medical talents.

Objective To discuss the meaning of the method of two-step pattern case teaching in image diagnostics. Methods The experiment group was taught by the two-step pattern case teaching,while the control group by the traditional method. Results The experiment group’s image diagnostics exam average score is higher than the control group’s,and the average scores of other major clinical courses are all higher. Conclusion The applications of the two-step pattern case teaching in medicine teaching is the need of developing the medical education business and improving the medical teaching quality.

Objective To observe the vascular collagen remodeling, apoptosis and Bcl-2/Bax of vascular smooth muscle cells in carotid artery on SHR . Methods 12 SHR treated with Irbesartan ,12 SHR without treated Irbesartan ,12 wistar rats were normotensive control group. The vascular volume fraction of Collagen were determined by picrosirius red staining .The expression of the proteins Bcl-2 and Bax were determined by Immunhistochemia,VSMC apoptosis was identified by in situ TDT-mediated dUTP nick end labeling(TUNEL). Results Significant Fibrosis exists in carotid artery of SHR. After 20 week's treating, the vascular volume fraction of Collagen and the ratio of wall/cavity were descended, but weren't parallel. The expression of the protein Bcl-2 and APOI were higher than the subjects of normotensive control, its reduced after treating; The expression of the proteins Bax was similar with control, it increased after treating. Conclusions The results suggest that vascular collagen remodeling exist, its maybe related with apoptosis , the proteins Bcl-2 and Bax of VSMC. The Irbesartan can treat it.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebral small vessel disease caused by NOTCH3 gene mutations. At present, the pathogenesis and the effective treatments of CADASIL is unclear. This review summarizes the existing pathogenesis of CADASIL, including the dysfunction of cerebral small arteries, the abnormalities of vascular smooth muscle cells, and the possible destruction of blood-brain barrier.

Objective To observe the clinical efficacy of psoriasis treated with avermectin A and astragalus and detect the changes of TNF-a in serum. Preliminarily study the anti-inflammatory and immunomodulatory mechanism of avermectin A and astragalus in the treatment of psoriasis. Methods 20 patients were randomly recruited into a control group (9 cases) and a treatment group (11 cases). Another 20 healthy people were recruited for comparison. The control group was administrated with avermectin A orally, 0.2±0.6 mg/kg·d, with the symptoms turning better, reduced the dosage till the recovery, the treatment group was injected with astragalus injection on the therapeutic basis of the control group. Detect and compare the levels of TNF-α in the serum of the patients with psoriasis before and after the treatment in both groups, then make a contrast to the healthy people. Results 20 patients got clinical cure. The level of TNF-α in the serum of healthy persons is 11.7± 6.7 ng/L, and the level of TNF-α in the serum of psoriasis patients before treatment is (45.4±12.4) ng/L and (46.4±16.9) ng/L in the treatment group and the control group respectively. Compared with healthy control group, the difference is significant. After treatment, is the TNF-αlevels dropped to (13.8± 5.4) ng/L and (20.9±6.3) ng/L in the treatment group and the control group respectively, showing no significant difference compared with healthy control group. The difference between the two group is also significant. Conclusion The efficacy of treating psoriasis with avermectin A and astragalus is better than using avermectin A exclusively. The mechanism may lie in its inhibiting the formation of TNF-α and so thus exerting the anti-inflammatory and immune regulatory functions.

Objective To investigate the effect of Xuebijing injection on release of high mobility group box 1 (HMGB1) in endotoxin-induced cells. Methods HMGB1 concentration and mRNA expression were analyzed by enzyme-linked immunosorbent assay (ELISA) and RT-PCR, respectively. The effects of Xuebijing injection with 2, 10 and 50 mg/ml on HMGB 1 concentration in the culture medium of 200 ng/ml lipopolysaccharide-induced macrophage-like RAW 264.7 cells and BRL-3A hepatocytes, and HMGB1 mRNA expression in lipopolysaccharide-induced macrophages were observed. Results 50 mg/ml Xuebijing injection significantly decreased HMGB1 concentration in the culture medium of lipopolysaccharide-induced macrophages and hepatocytes(P< 0.01), and inhibited HMGB1 mRNA expression in macrophages. Conclusion Xuebijing injection inhibits endotoxin-induced release of HMGB1.

Objective To investigate and compare the effects of sustained inflation (SI) and pressure controlled ventilation (PCV) on lung recruitment in patients with ARDS, and on hemodynamics and respiratory mechanics of patients. Methods Ten patients with ARDS were included in this randomized clinical trial ( RCT), and SI (40 cmH20, 40s) and PCV (20 cmH20, 2 min) were successively applied to each patient under sedation, non-muscle relaxation state. There was a elution period between two types of recruitment maneuver (RM). Parameters of respiratory mechanics, gas exchange and hemodynamics were measured before RM (T0), 5 min after RM (T2) and one hour after RM (T3). Parameters of respiratory mechanics and hemodynamics were measured during the period of RM (Tl). Results (1) The PaO2 at T2 and T3 increased significantly in comparison with that at To ( P < 0.05), and there was no significant difference in PaO2 between two types of RM (P > 0.05). There were no significant differences in PaCO2 between two types of RM at each interval (P > 0.05). (2) The cardiac index ( CI) at T1 decreased significantly compared with that at To in two types of RM (P < 0.05), but there was difference in CI between two types of RM (P > 0.05). There were no differences in MAP and HR at these intervals (P > 0.05). (3) The functional residual capacity (FRC) at T2 and T3 increased significantly in comparison with that at To in two types of RM (P < 0.05). The static compliance (Cs) at T1 improved significantly (P < 0.05), but there was no difference in Cs between two types of RM ( P > 0.05). There was no difference in plateau pressure (Pplat) at all intervals (P >0.05). Conclusions The oxygenation, FRC, and Cs improve significantly in both SI-RM and PCV-RM, and the effects of two types of RM are similar. The SI-RM and PCV-RM have the similar impact on circulatory system during RM.

Objective To study the regulation effect of salvianolic acid A and C molecular compatibility on inflammatory chemokine monocyte chemotaxis protein 1(CCL2)and CXC chemokine ligand 10(CXCL10)in human renal tubular epithelial(HK-2)cells intervened by human serum albumin(HSA),and to explore the anti-inflammatory and antioxidation effects of salvianolic acid A,C molecular medicine-pair compatibility.Methods The cultured human renal tubular epithelial cells were randomly divided into 5 groups:control group,model group,salvianolic acid A group(20 μmol/L),salvianolic acid C group(20 μmol/L),salvianolic acid A+C group(10 μmol/L salvianolic acid A+10 μmol/L salvianolic acid C).Except for the control group,the other groups were added with HSA intervention for 24,48,72 h,then the each treatment group was simultaneously added with the drug treatment.The enzyme linked immunosorbent assay(ELISA)method was used to detect the expression of CCL2,CC chemokine 7(CCL7)and CXCL10,and SOD,GSH and MDA were detected by WST-1,DTNB,TBA.Results Compared with the control group,the levels of CCL2,CCL7,CXCL10 and MDA at 3 time points of 24,48 72 h in other groups were significantly increased,while the GSH and SOD levels were significantly decreased(P＜0.05).Compared with the model group,the levels of CCL2,CCL7,CXCL10 and MDA in each treatment group were relatively decreased,while the GSH and SOD levels were relatively increased(P＜0.05).In the comparison of various treatment groups,the levels of CCL2,CCL7,CXCL10 and MDA in the salvianolic acid A+C group were lower than those in the salvianolic acid A group and salvianolic acid C group(P＜0.05),while the GSH and SOD levels were higher than those in the salvianolic acid A group and salvianolic acid C group(P＜0.05).Conclusion The salvianolic acid A and B molecular medicine-pair compatibility may improve renal fibrosis by decreasing the expression of inflammatory chemokines and antioxidation.

Objective:To explore the effect of cascade training appraisal effect in improving the young nurses ethics humanities cultivated manners.Methods:Since 2013 within three years of the new nursing staff in hospital, through simple after complex first, after the first standardized routine training characteristic simulation and case op-eration step training appraisal method, comparing before paramedics humanistic literacy assessment, evaluation of excellence and patient satisfaction.Results:New training evaluation method for young nurses in the clinical opera-tion assessment obviously improving the patient-centered nursing service consciousness, appraisal excellence rate of 31.25%, higher than a year before the inspection the excellence rate of 19.82%, with significant difference (P<0.05);In patients to nursing staff satisfaction survey comparison, has significant advantage (P<0.05).Con-clusions:New training appraisal method significantly improves the young nurses′own quality and medical ethics ac-complishment, can better pay attention to the humanistic care in the clinical practice, communicate with the nurse, improve the judgment in the work of the nurses in the clinical ability, emergency ability, communication ability, flexible ability and emergency ability of emergency response.For young nurses in practice to deal with the doctor-patient relationship, medical international relations, improving clinical practice ability and the patient′s comprehen-sive satisfaction has important value.