Background:Gastroesophageal reflux disease( GERD)that does not respond satisfactorily to standard proton pump inhibitor is defined as refractory gastroesophageal reflux disease( rGERD). Combined therapy is used to treat rGERD, however,the addition of baclofen is rarely studied. Aims:To investigate the efficacy of baclofen combined with esomeprazole and mosapride on rGERD. Methods:Seventy-two patients with rGERD from March 2013 to April 2014 at the First Hospital of Putian City were enrolled and randomly divided into group A and group B. Patients in group A were orally administrated with esomeprazole 20 mg bid + mosapride 5 mg tid + baclofen 5 mg tid. Patients in group B were treated with esomeprazole 20 mg bid + mosapride 5 mg tid. The treatment course was 8 weeks. The efficacy on symptoms, esophagitis under endoscopy and adverse effects were compared between the two groups. Results:After 8-week treatment, score of heartburn,regurgitation,retrosternal pain,dysphagia and overall symptom were significantly decreased in the two groups than before the treatment. The overall symptom alleviating rate was significantly higher in group A than in group B (90. 6% us. 70. 0%;χ2 =4. 585,P=0. 032). Esophagitis under endoscopy in the two groups was significantly improved, the effective rate was significantly higher in group A than in group B(93. 8% us. 75. 0%;χ2 =4. 500,P=0. 034). The main adverse effects of baclofen were somnolence,dizziness and fatigue,all the patients were well tolerated. Conclusions:Baclofen combined with esomeprazole and mosapride is an efficient option for rGERD.

Objective To explore the immunoregulatory and lethal effects of natural killer T lymphocytes(NKTs) in vitro .Meth‐ods The mixed lymphocyte cultured(MLC) system was established ,in which the B16F10‐luc‐G5 cells were set as target cells ,the total lymphocyte cells were set as effector cells .(1)In the experiment on immunoregulatory effects ,NKT lymphocytes or CD4+CD25+ T lymphocytes were set as regulating cells ,there was three groups ,including the NKT group ,CD4+CD25+ T group and pure target cell control group .Otherewise ,the 1640 blank control group was set by only adding RPMI1640 solution .(2)In the ex‐periment on antitumor effects ,the NKT or natural killer(NK) lymphocytes were set as killer cells ,there was three groups ,inclu‐ding the NKT group ,NK group and pure target cell control group .Mixed culturing 24 ,48 and 72 hours ,the bioluminescence of target cells in MCL system was detected by using the in vivo imaging system .Results (1)In the experiment on immunoregulatory effects ,there were statistically significant differences in measured average photon numbers between NKT group ,CD4+ CD25+ T group and the two control groups(P<0 .05) .The statistically significant differences were also found in the NKT group between 24 hours and 72 hours (P<0 .05) .(2)In the experiment on antitumor effects ,there were statistically significant differences in meas‐ured average photon numbers ,when the NKT group and NK group were compared to the pure target cell control group(P<0 .05) . After culturing 24 and 72 hours ,statistically significant differences were found between NKT group and NK group(P<0 .05) .Con‐clusion The NKT cells could inhibit the lethal effects of lymphocyte cells on target cells ,and the inhibitory effects are changed by the length of culturing .Compared with the CD4+CD25+ T lymphocytes ,NKT lymphocytes have strongger regulatory effects .Addi‐tionally ,the NKT cells have lethal effects on target cells ,which might be weaker than that of NK cells .

OBJECTIVE To compare the effect and safety of coblation plasma surgery and beclomethasone dipropionate nasal spray in the treatment of perennial allergic rhinitis. METHODS A stratified,randomized,controlled trial of surgery and medicament was performed in the treatment of perennial allergic rhinitis. A total number of 102 patients were involved in the trial,including 56 cases with swelling of inferior turbinate,28 cases in surgery group,28 cases in medicament group; and 46 cases without swelling of inferior turbinate,23 cases in surgery group,23 cases in medicament group. Coblation plasma surgery was performed in all surgery groups. Each patient was given 50?4?2 ?g/d of beclomethasone dipropionate nasal spray in all medicament groups,Treatment time was 3 months. The symptom scores (SS)and visual analogue scale(VAS)were recorded. RESULTS Effect assessment showed that both methods had significant repressive effect on allergic symptoms,the effect of surgery group was better than that of medicament group at the 14th day,28th day and 3th month in cases with swelling of inferior turbinate. Difference between the surgery group and medicament group in cases without swelling of inferior turbinate had no statistic significance. CONCLUSION Both coblation plasma surgery and beclomethasone dipropionate nasal spray are effective to treat perennial allergic rhinitis. But coblation plasma surgery is better than medicament in cases with swelling of inferior turbinate.

Objective To study the relationship between the expression of nm23- H1 gene product and early distant metastases in nasopharyngeal carcinoma (NPC). Methods The S- P immunohistochemical method was used to detect the expression of nm23- H1 in 95 cases of NPC. Results The positive rate of nm23- H1 was 47.4 % (45/95). The positive rate of nm23- H1 in early distant metastases group (26.7 %) was much lower than those without distant metastases group (60.0 %) (P

DNA, Circular ; blood ; Hepatitis B ; blood ; drug therapy ; virology ; Hepatitis B Surface Antigens ; blood ; Hepatitis B virus ; Humans ; Nucleosides ; therapeutic use

siRNA drug research and development is becoming one of the main objectives in the future. However, due to the in-stability of siRNA and the complex environment in vivo, the safe and effective delivery of siRNA is limited in vivo. Thus, special vectors are used to assist siRNA to express biological effects. This paper reviews the advances in non-viral vector for delivery of siRNA in vivo.

This study reviewed the reasons for encounter (RFE),diagnoses and the diagnostic categories of patients aged 0-14 y in general practice clinic affiliated to a tertiary hospital from June 2011 to May 2012.The results showed that the most frequent RFE was cough,at a rate of 29.6 per 100 encounters;the second one was fever (21.4％) and the third was nasal problems (9.5％).Medical examinations,skin rashes and follow-up encounters occurred at equal rates (5.2％).The most frequent diagnosis was acute upper respiratory tract infection (41％).Medical examination (6.3％),other viral diseases (5.1％),pneumonia (3.6％) and no detected disease (3.6％) were also common diagnoses.The diagnostic categories included all systems,and the problems of the respiratory system (56.4％) were most common.The results suggest that pediatric care comprises a very important part of primary care.

Objective To study the expression of programmed death 1(PD-1) on the peripheral T lymphocytes and the serum cytokine levels in different phases of hepatitis B virus (HBV) infection (immune tolerance,immune clearance and non-replicating phases).Methods A total of 105 HBV infected patients in different phases of infection were enrolled in Wuxi No.5 People's Hospital from Apr to Sep 2011,and divided into three groups:the immune tolerance group (35 cases),the immune clearance group (35 cases) and the non-replicating group (35 cases).Meanwhile,20 healthy people were enrolled as controls.The peripheral blood was collected and PD-1 expressions on the surface of T lymphocytes were assessed by flow cytometry.The cytokine levels in different groups were analyzed by enzyme-linked immunosorbent assay (ELISA).The data were analyzed by t test and Pearson correlation analysis.Results The PD-1 expression on surface of CD8+ T lymphocytes of HBV infected patients was (12.35± 3.48)％,which was significantly higher than healthy control group [(4.65±1.21) ％] (t=9.76,P＜0.01).The PD-1 expression on CD4+ T lymphocytes was (4.95±2.87) ％,which was not significantly different from the healthy controls [(4.08±2.14) ％] (t =1.29,P＞0.05).The PD-1 expressions on CD8+ T lymphocytes of patients in the immune tolerance group,the immune clearance group and the non-replicating group were (15.87±3.18)％,(7.69±3.64)％and (10.12±2.84) ％,respectively; that in the immune tolerance group was higher than the immune clearance group (t=10.01,P＜0.01) and that in healthy control group was lower than those in the other 3 groups (t=15.12,3.61 and 8.17,respectively; all P＜0.01).The PD-1 expression on the surface of CD8+ T lymphocytes in chronic HBV infected patients was positively correlated with the serum interleukin-10 (IL-10) level (γ=0.377,P＜0.05),while that was negatively correlated with interferon-γ (IFN-γ) level (r=-0.620,P＜0.05).Conclusions PD-1 is up-regulated on the surface of CD8+ T lymphocytes from chronic HBV infected patients.And PD-1 is negatively correlated with serum IFN-γ levels and positively correlated with serum IL-10 levels.The expression of PD-1 on the surface of CD8+ T lymphocytes influences the balance of helper T cell (Th)1/Th2,which might play a role in the persistence of HBV infection.

SD.The lung index was increased in the model group(P

Objective To investigate the role of natural killer cells (NK cells) in patients with chronic hepatitis B (CHB). Methods Blood samples and liver biopsies from 108 CHB patients including 43 mild, 28 moderate and 37 severe CHB patients were collected. The levels of interferon (IFN) gamma in liver tissues and peripheral blood were detected by intracellular cytokine staining.The data were analyzed by t test. Results The levels of IFN gamma produced by NK cells in liver tissues and peripheral blood of patients with severe CHB were (8. 12±4. 26) % and (4. 59±2. 95) % ,respectively, which were significantly higher than those in patients with mild CHB [(3. 53±1. 56)%and (2. 26±0.61)%, respectively; t=3. 80 and t = 4. 30, respectively; both P<0. 05] and those in patients with moderate CHB [(4. 59±1. 98)% and (2. 48±1. 05)%, respectively;t=2. 62 and t =3. 28, respectively; both P<0. 05]. While there were no differences of IFN gamma produced by NK cells both in liver tissues and peripheral blood between mild and moderate CHB patients (t=0. 99 and t=1. 27, respectively; both P>0. 05). The levels of IFN gamma produced by NK cells in liver tissues and blood samples in severe phase of severe CHB were (10. 02 ± 4. 15)% and (6. 78 + 2. 91)%, respectively, those in recovery phase were (6. 13±2. 01)% and (3. 13± 1. 52)%, respectively (t = 1. 89 and t=1. 74, respectively; both P<0. 05]. Conclusion NK cells may play a pivotal role in the pathogenesis of severe CHB.