Objective To learn therapeutic effect of the combined treatment of mecobalamin and salvia milti-orrhiza ligustrazine on diabetic peripheral neuropathy.To provide effective and reliable operation method for the treat-ment of disease.Methods 163 cases with diabetic peripheral neuropathy were randomly divided into observation group(86 cases)and control group(77 cases).The observation group was treated with mecobalamin combined salvia miltiorrhiza ligustrazine,the control group was treated with mecobalamin.The sensory conduction velocity (SNCV) and motor conduction velocity (MNCV)were measured in the two groups before and after treatment.The therapeutic effects were evaluated after one course.Results The MNCV and SNCV of the two groups were higher than before treatment,the difference was statistically significant (t =24.298,25.546,18.737,15.733,14.284,14.886,9.337, 9.402,all P <0.05).The SNCV and MNCV in the observation group were significantly higher than those in the con-trol group (t =9.119,11.103,7.429,6.352,all P <0.05).The markedly effective rate of the observation group was 48.8% (42 /86),the total effective rate was 90.7% (78 /86),which were higher than those of the control group,the differences were statistically significant (χ2 =9.010,7.937,all P <0.05).The incidence rate of adverse reaction of the observation group was 5.8% (5 /86),which of the control group was 6.5% (5 /77),the difference was not statis-tically significant (χ2 =0.033,P >0.05).Conclusion In the treatment of diabetic peripheral neuropathy,the com-bined treatment of mecobalamin and salvia miltiorrhiza ligustrazine has better curative effect and low incidence rate of adverse reaction,with good clinical application value.

Objective To analyze the tissue development rule of the Bufo raddei Strauch lung,to observe the expression of transforming growth factor-?(?_1,?_2,?_3)in developing lung,and to discuss their functions and relationships. Methods The tissue development of the(218) Bufo raddei Strauch lungs was studied by biological microscope technology,and the expression of TGF-? was measured in lung development by immunohistochemistry and images were analyzed by IPP,providing a basis for study of the zoology and developmental biology. Results(1) Lung bud occured in larval 22nd stage from pharynx caudal part.In 26th stage the minutenss locule began to appear.The lung bud gave rise to obvious lung cavity in 31st stage.In 33rd stage originality alveolus began to appear.In 36th stage obvious septum and alveolus appeared.There were many capillary vessel in the wall of lung.In 39th stage the lung of tadpole was like as one of young toad.The respiratory epithelium differentiated from columnar into squamous.The entire developmental process was divided into four phases,lung bud Ⅰphase,lung bud II phase,originality alveolus phase and alveolus phase.(2)In the early developmental phase,TGF-? expressed in the lung wall.In the late developmental phase,TGF-? expressed in mesenchymal at high levels.Conclusion The expression of TGF-? displayed intermittent changes during the period of development.The functions of TGF-? might be respectively different in different development stages.They not only stimulate the process of epithelium of the reticular septa,but also modulate epithelium of alveolar sac and differention.

Objective:To explore the therapeutic effect of comprehensive rehabilitation nursing on patients with cere-bral infarction (CI)complicated type 2 diabetes mellitus (T2DM).Methods:According to number table,a total of 118 CI + T2DM patients were randomly and equally divided into comprehensive nursing group and routine nursing group.Comprehensive nursing group received comprehensive nursing based on routine nursing.The evaluating inde-xes included fasting blood glucose (FBG)concentration,limb muscle strength recovery and score of activity of daily living of two groups before hospitalization and discharge.Results:Compared with routine treatment group before discharge,there was significant reduction [(7.9±4.2)mmol/L vs.(5.9±2.8)mmol/L]in FBG concentration in comprehensive nursing group;limb muscle strength recovery of comprehensive nursing group was significantly better than that of routine nursing group (≥ grade III,upper limb 83.1% vs.64.4%,lower limb 76.3% vs.55.9%);percentage of patients with activity of daily living score > 60 scores (33.9%)in comprehensive nursing group was significantly higher than that of routine nursing group (15.2%),P <0.05 all. Conclusion:Comprehensive rehabili-tation nursing could promote the rehabilitation of physical function in patients with cerebral infarction complicated type 2 diabetes mellitus.

Objective To explore a more effective way to enhance the clinical efficacy of cluster immunotherapy for perennial allergic rhinitis. Methods A total of 60 perennial allergic rhinitis patients were evenly randomized into treatment goup and control group. The two groups were given cluster immunotherapy, and the treatment group was given daily vesiculating moxibustion additionally . Before and after treatment, the scores of traditional Chinese medical constitution and the rhinitis quality of life ( QOL) were observed, and one year after treatment, the therapeutic effect and safety were evaluated. Results ( 1) One year after treatment, the treatment group showed better total clinical efficiency than the control group ( 96.67% vs 80.00%, P<0.05). ( 2) After treatment, the average scores of Qi deficiency constitution, yang deficiency constitution and special constitution were significantly lower than those before treatment in the treatment group ( P<0.01). The improvement of Qi deficiency constitution and yang deficiency constitution in the treatment group was superior to that in the control group ( P<0.05). ( 3) The total QOL scores and the scores of each dimension of QOL scale were improved in both groups, and the differences were significant except for the emotion dimension ( P<0.01). Insignificant differences were shown between the two groups after treatment ( P>0.05). ( 4) Two cases had grade 1 general adverse reaction and 5 cases had local adverse reaction during cluster immunotherapy. During vesiculating moxibustion, 3 cases had blistering and the blistering disappeared after symptomatic treatment. Conclusion Daily vesiculating moxibustion combined with cluster immunity therapy is effective for the treatment of allergic rhinitis, showing good effect on improving Qi deficiency constitution, yang deficiency constitution and special constitution as well as the quality of life of the patients.

Objective To evaluate the efficacy of single or double-antibiotic regimen for the treatment of complicated appendicitis in children,with the purpose to guide the rational use of antibiotics in clinic.Methods Six hundred and sixty-three patients with acute appendicitis admitted to the department of pediatric surgery in Jinhua Municipal Central Hospital between March 2011 and February 2015.One hundred and seventy-two of 663 patients with complicated appendicitis which confirmed by intra-operative macroscopic or post-operative pathological examination were eligible for the study.These patients were divided into two groups based on the regimen of their postoperative antibiotics:single or double-antibiotic regimen(treatment group,n=66);triple antibiotics regimen(control group,n=106).Demographic data,blood routine test and C-response protein(CRP),length of hospital stay,postoperative complications and duration of antibiotic treatment were recorded and statistically analyzed.Results There was no difference between the treatment group and control group with respect to age distribution,blood routine examination and CRP, length of hospital stay, duration of antibiotic treatment or postoperative complications.Although the number of patients changed of antibiotics on the basis of bacterial culture of pyogenic fluids in treatment group were more frequently than those in the control group(7/66 vs.1/106), the therapeutic effective rate of changed of antibiotics was 100% in both two groups.The culture positive rate of peritoneal fluids was 72.09% (124/172), the most common pathogens were escherichia coli(80.15%, 105/131),pseudomonas aeruginosa(5.34%,7/131)and klebsiella pneumonia (3.05%,4/131).The results of bacterial culture of peogenic fluids showed no difference in both two groups.Conclusion Children with complicated appendicitis can be managed effectively with single or double broad-spectrum antibiotics after appendectomy,and it may be beneficial to guide the rational use of antibiotics and decrease the irrational use of multi-antibiotics combination in clinic.

Objective With various doses of lipopolysaccharide (LPS) intra-amniotic injection in pregnant rats to establish histologic chorioamnionitis (HCA) model,and to determine the effects of HCA on fetal lung maturation and development in preterm fetal rats.Methods Thirty pregnant Sprague-Dawley rats were randomly assigned to four groups.On 19 days of gestation,rats in three model groups (n=8) were given intra-amniotic injection of LPS 2,8,10 μg,respectively,and those in the only one control group (n=6)was given normal saline (NS) 40 μl.Fetal rats were taken out 48 hours after LPS injection.Placenta,fetal membrane,fetal lung and umbilical cord were collected for pathological examination.mRNAs of surfactant protein (SP)-A,B and C and keratinocyte growth factor (KGF) in lung were determined by quantitative real-time polymerase chain preaction.KGF protein expression in lung was measured by immunohistochemistry.Morphologic observation of lung was performed on postnatal day 3.R× C table Chi-square test,KruskalWallis test and analysis of variance were used as statistical methods.Results (1) Fetal rat mortality in control,LPS2,LPS8 and LPS10 group was 0.0％ (0/55),22.5％ (18/80),51.4％ (36/70) and 87.5％(35/40),respectively,which increased with increasing dose of LPS (x2=46.183,P＜0.005).(2) HCA,fetal lung inflammation and umbilical vasculitis were induced in LPS groups,and the severity was dosedependent (fetal lung inflammation:Hc=39.84,HCA:Hc=41.13,umbilical vasculitis:Hc=41.52,all P＜0.01).(3) The expression of SP-A,SP-B,SP-C and KGF mRNAs in the four groups (control,LPS2,8,10) had statistical differences (SP-A mRNA:0.99±0.28,2.48±0.34,1.09±0.31 and 0.09±0.09,F=78.051; SP-B mRNA:0.99±0.34,2.23±0.53,1.49±0.51 and 0.14±0.06,F=28.327; SP-C mRNA:1.20±0.39,2.00±0.20,1.04±0.37 and 0.12±0.16,F=39.546; KGF mRNA:0.97±0.19,2.18±0.61,0.93±0.09 and 0.21±0.11,F=37.544; all P＜0.01).All mRNA expressions in LPS2 group were higher than those in the control group and those in LPS10 group was lower (all P＜0.05).(4) The expression of KGF protein in LPS2 group was significantly higher than that in other groups (0.60±0.20 vs 0.28±0.12,0.37±0.22,0.24±0.12,F=17.280,all P＜0.01).(5) Alveolarization was significantly inhibited in LPS8 group on postnatal day 3,and less maturity of pulmonary tissue was observed.Conclusions Various doses of LPS intra-amniotic injection in rats could induce HCA,fetal lung inflammation and umbilical vasculitis with different degrees.Histological inflammation would be worse with increasing LPS dosage.Moderate inflammation could promote lung maturation without inducing bronchopulmonary dysplasia,and KGF may play a role in this process.

The dried rattan stem of the Fibraurea Recisa Pierre plant contains the active ingredient known as fibrauretine (FN). Although it greatly affects Alzheimer's disease (AD), the mechanism of their effects still remains unclear. Proteomics and transcriptomics analysis methods were used in this study to determine the mechanism of FN in the treatment of AD. AD model is used through bilateral hippocampal injection of Aβ1-40. After successful modeling, FN was given for 30 days. The results showed that FN could improve the cognitive dysfunction of AD model rats, reduce the expression of Aβ and P-Tau, increase the content of acetylcholine and reduce the activity of acetylcholinesterase. The Kyoto Encyclopedia of Genes and Genomes enriched differentially expressed genes and proteins are involved in signaling pathways including metabolic pathway, AD, pathway in cancer, PI3K-AKT signaling pathway, and cAMP signaling pathway. Transcriptomics and proteomics sequencing resulted in 19 differentially expressed genes and proteins. Finally, in contrast to the model group, after FN treatment, the protein expressions and genes associated with the PI3K-AKT pathway were significantly improved in RT-qPCR and Western blot and assays. This is consistent with the findings of transcriptomic and proteomic analyses. Our study found that, FN may improve some symptoms of AD model rats through PI3K-AKT signaling pathway.

Objective SIV30 protein of simian immunodeficiency virus(SIV)was prepared by genetic engineering technique as an antigen diagnostic reagent, to establish an immune comb method for the specific detection of anti SIV IgG in monkey serum. Methods Recombinant expression plasmid of SIV SIV30 gene was constructed by prokaryotic expression vector pGEX-4T-1, and expressed in the competent BL21 cells. The recombinant protein was purified as a diagnostic antigen, and a standardized procedure for the detection of immune comb was established and applied for clinical detection. Results The optimum coating amount of antigen was 0.02 mg/mL. The prepared IC was able to specifically detect the positive serum of SIV. There was no cross reaction between the sera of other viruses. It showed a high specificity of the detection method. Sensitivity analysis showed that the SIV30 protein was able to detect 1:400 times diluted SIV positive sera. The result of stability and repeatability test(the same sample was repeated 3 times) showed that the coefficient of variation(CV)was less than 10%. The serum samples of 10 suspicious monkeys were detected by this method, showing a consistent rate of comb method and ELISA test result of 100%, Kappa =1.000. Conclusions SIV30 protein is expressed in prokaryotic cells. The immune comb is prepared,and is successfullyl applied in clinical examination. It shows that the method has a high sensitivity, strong specificity, good reproducibility and practicability.

A series of triazole derivatives were designed and synthesized based on a natural product cembrane separated from Croton laevigatus Vahl which showed potential antitumor activity against HeLa cells.Twelve novel compounds were synthesized and their structures were characterized by 1H NMR, 13C NMR and HRMS.Their cytotoxicities in vitro were evaluated for HeLa,K562 and K562/A02 cells by MTT assay.The results showed that some cembrane derivatives possessed antitumor activities.Substituted triazole connected to cembrane derivatives exhibited potent activity toward drug-resistant K562/A02 cells.

OBJECTIVETo analyze complications after laparoscopic Ladd operation for intestinal malrotation, related causes and possible solutions.

METHODSClinical data of 81 neonates who underwent laparoscopic Ladd operations for intestinal malrotation in the Children's Hospital, Zhejiang University School of Medicine between January 2015 and January 2018 were reviewed. The abdominal complications and findings during operation and reoperation were analyzed.

RESULTSOperations were successfully completed in all patients, and there was no patient converted to open surgery. The annular pancreas in 6 cases and duodenal diaphragm in 4 cases were confirmed during the operation. The recurrent volvulus developed in 3 patients (3.7%), of whom 2 cases were confirmed to have midgut necrosis during open surgery 1 week and 3 months after laparoscopic Ladd operation, and both finally died; 1 case was corrected by second laparoscopic operation. Cecal perforation occurred in 1 patient (1.2%), which was caused by intensive high frequency coagulation of the appendiceal stump. One patient (1.2%) developed chylous ascites and improved after conservative treatment. Adhesive small bowel obstruction was observed in 3 cases (3.7%), and all relieved after conservative treatment.

CONCLUSIONSLaparoscopic Ladd operation for intestinal malrotation in neonates was effective, and the incidence of abdominal complications may be minimized by experienced skills and strict perioperative management.