Objective:To investigate the effect of Xuebijing injection against blood-brain barrier(BBB)damage in the mice with anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis,and to elucidate its regulatory effect on the imbalance of helper T cells 17(Th17)/regulatory T cells(Treg).Methods:The active immunization models of anti-NMDAR encephalitis in the mice were established using glutamate receptor N1 subunit(GluN1)356-385 antigen peptide,and the serum anti-NMDAR immunoglobulin G(IgG)antibody levels were detected by enzyme-linked immunosorbent assay(ELISA).The healthy mice without modeling were served as control group,and the mice with successful modeling were randomly divided into model group,low dose of Xuebijing injection(XBJ-L)group,and high dose of Xuebijing injection(XBJ-H)group,with 10 mice in each group.After modeling,the mice in XBJ-L and XBJ-H groups were intraperitoneally injected with 5 and 10 mL·kg-1 Xuebijing injection,respectively.The Longa score was used to assess the neurological impairment of the mice in various groups;evans blue(EB)staining was used to determine the BBB permeability;immunofluorescence staining was used to detect the expressions of zonula occludens 1(ZO-1)and Occludin in cerebral cortex of the mice in various groups;Western blotting method was used to determine the expression levels of ZO-1,Occludin,Claudin-5,and neuron-specific nuclear protein(NeuN)in cerebral cortex of the mice in various groups;ELISA method was used to determine the levels of Th17-and Treg-related cytokines including interleukin(IL)-17,IL-22,and IL-10 in serum of the mice;flow cytometry was used to determine the percentages of Th17 and Treg cells in peripheral blood of the mice in various groups,and the Th17/Treg ratio was calculated.Results:The serum of the mice induced with the GluN1 356-385 antigen peptide was positive for NMDAR IgG antibodies,indicating that the models were successfully established.Compared with control group,the neurological impairment score of the mice in model group was significantly increased(P＜0.05),and the EB level in brain tissue was significantly increased(P＜0.05);the fluorescence staining intensities of ZO-1 and Occludin in the cerebral cortex were decreased,and the expression levels of ZO-1,Occludin,Claudin-5,and NeuN proteins in the cerebral cortex were significantly decreased(P＜0.05);the serum levels of IL-17 and IL-22 were significantly increased(P＜0.05),while the IL-10 level was significantly decreased(P＜0.05);the percentage of Th17 cells in peripheral blood was significantly increased(P＜0.05),while the percentage of Treg cells was significantly decreased(P＜0.05),and the Th17/Treg ratio was significantly increased(P＜0.05).Compared with model group,the neurological impairment scores of the mice in XBJ-L and XBJ-H groups were significantly decreased(P＜0.05),the EB levels in brain tissue were significantly decreased(P＜0.05),the fluorescence staining intensities of ZO-1 and Occludin in cerebral cortex were increased,and the expression levels of ZO-1,Occludin,Claudin-5,and NeuN proteins were significantly increased(P＜0.05);the levels of IL-17 and IL-22 in serum were significantly decreased(P＜0.05),and the level of IL-10 was significantly increased(P＜0.05);the percentages of Th17 cells in peripheral blood were significantly decreased(P＜0.05),the percentages of Treg cells were significantly increased(P＜0.05),and the Th17/Treg ratios were significantly decreased(P＜0.05).Compared with XBJ-L group,the neurological function injury score of the mice in XBJ-H group was significantly decreased(P＜0.05),the EB level in brain tissue was significantly decreased(P＜0.05);the fluorescence staining intensities of ZO-1 and Occludin in the cerebral cortex were increased,and the expression levels of ZO-1,Occludin,Claudin-5,and NeuN proteins were significantly increased(P＜0.05);the serum levels of IL-17 and IL-22 were significantly decreased(P＜0.05),and the level of IL-10 was significantly increased(P＜0.05);the percentage of Th17 cells in peripheral blood was significantly decreased(P＜0.05),the percentage of Treg cells was significantly increased(P＜0.05),and the Th17/Treg ratio was significantly decreased(P＜0.05).Conclusion:Xuebijing injection can improve BBB injury,regulate Th17/Treg balance,and thereby alleviate the neurological functional damage in anti-NMDAR encephalitis.

Objective To investigate the research status of head nurses of 10 secondary hospitals in Yichang area,to understand the research attitudes and intentions,to provide a reference basis for further research training program.Methods A total of 161 head nurses in 10 secondary hospitals in YiChang were recruited and a questionnaire survey was conducted.Results There are 11.7％ of head nurse involved in research projects,44.7％ of them did not publish paper,and 80％ of them had never received scientific research knowledge and training in school.95.1％ of head nurse think the nursing research is very important,and willing participate in research study,69.6％ of them want to take part in the practical activity.Conclusions The foundation for research in Head nurse is weak inthe secondary hospital with low research achievements,however they have shown a positive scientific attitude,that may improve research ability,the hospital should pay attention to the head nurse research needs,provide effective training,promote nursing research capacity.

Objective To analyze the difference of macular retinal thickness between normal subjects and diabetic patients without retinopathy,and discuss the relationship between macular thickness and the course of diabetes,blood glucose level.Methods Twenty-two cases of patients with diabetic without retinopathy without retinopathy in our hospital of fourth Department of Internal medicine from April 2016 to November 2016 were selected as diabetic without retinopathy group,and another 22 normal pemons were selected as the normal group.The central subfield retinal thickness (CSRT),cube volume(CV) and cube average thickness(CAT) of all patients were determined by optical coherence tomography (OCT),and the difference of CSRT,CV and CAT between diabetic patients and normal group were analyzed.Then,the patients with diabetic retinopathy were sub-grouped according to the course of diabetes (group A,B,C,) and blood glucose status (group D and E),and the differences of CSRT,CV and CAT among them were compared.Results With the increase of diabetes duration in the diabetic without retinopathy group,CSRT,CV and CAT were gradually increased,and there was significant difference (P ＜ 0.05).With rising blood sugar in diabetics in the diabetic without retinopathy group,CSRT,CV and CAT were gradually increased,and there was significant difference (P ＜ 0.05).There were positive correlation between CSRT,CV,CAT and course,blood sugar of diabetes mellitus (all P ＜ 0.05).Conclusion Compared with normal population,CSRT,CV and CAT are significantly thickened in diabetes mellitus patients,and CSRT,CV and CAT are increased gradually with the increase of diabetes and blood glucose,which provide reliable reference for the diagnosis of early diabetic retinopathy.

Objective The aim of this article is to research the radical mastoidectomy and primary tympanoplasty to attain radical cure of the mastoid focus as well as rebuilding the sound- conducting structure of the tympanic cavity to improve the audition. Method The autobone and temporal fascia were taken as the transplants after the radical mastoidectomy under microscopy, and then to carry out the operation of Portmann｀ s tempanoplasty of 2nd and 3rd types of 2nd class.Result Non of the cholesteatoma was relapsed after follow- up for 1～ 4 years.The efficiency rate of tympanoplasty is of 89.47% .The average audition increased was 19 dB HL. Conclussion Radical operation for cholesteatoma should be associated with tympanoplasty if having condition. We recommend that the opening tympanoplasty should be used, and use autobone as a artificial auditory ossicles.