Search

在线性算子相应主特征值条件下，运用拓扑度方法和不动点理论，获得了带Neumann边界条件的半正超线性四阶方程y(4)(x)+(k1+k2)y″(x)+k1k2y(x)=λf(x,y(x)),0≤x≤1,y'(0)=y'(1)=y‴(0)=y‴(1)=0 非平凡解与正解的存在性，其中k1，k2为常数，参数λ>0，f： [0， 1]×R→R连续。

Objective To explore the relationship between the distributions of traditional Chinese medicine (TCM) constitutional types of patients with mammary cancer and their anxiety and depression status. Methods A total of 507 patients with mammary cancer who were admitted and treated in Yunnan Cancer Hospital from July 2019 to July 2020 were selected. Baseline data were collected through questionnaires, and the Constitution in Chinese Medicine Questionnaire (CCMQ) was used to identify their TCM constitutions. Hospital Anxiety and Depression Scale (HADS) was used for assessing the anxiety and depression status of patients. Results Totally 398 patients with mammary cancer were screened. Most of the mammary cancer patients had normal constitution, 136(34. 17%) in total, followed by 80(20. 10%) cases with yang-deficiency constitution, 39(9. 80%) cases with yin-deficiency constitution and 38 (9. 55%)cases with qi depression constitution. There were 75(18. 84%) patients with depression and 89(22. 36%) patients with anxiety. Patients who had normal constitutional types were control group. Except for dampness-heat constitution and yang-deficiency constitution, the other six biased constitutions were all risk factors for the onset of depression. Among them, the top three are blood stasis constitution (OR=14. 71, P

Objective To explore the application effect of continuous quality improvement (CQI) in promoting regional cooperation and development of district-level Central Sterile Supply Department (CSSD). Methods The CQI program had been carried out based on the cooperative development of district-level Central Sterile Supply Department science 2020. The quality of cleaning and disinfection of medical apparatus package collected from district-level CSSD was evaluated before and after implementation of CQI. The knowledge level and satisfaction of nursing staff from district-level CSSD were assessed. Results The rates of qualified preprocessing, cleaning, packaging and storage in CSSD after implementation of CQI were higher than those before implementation of CQI(P＜0. 01). The rate of CSSD-related knowledge mastery and total satisfaction rate after the implementation of CQI were higher than those before implementation of CQI (P＜0. 01). Conclusion The application of CQI in the management of district-level Central Sterile Supply Department can ensure the quality of equipment cleaning and sterilization, improve the work efficiency and the overall level of infection prevention and control of medical institutions in the region. (目的 探讨持续质量改进(CQI)在促进区级消毒供应中心区域合作发展的应用效果。方法 2020年度基于医院的区域化消毒供应中心实施CQI管理。分别于CQI实施前和实施后抽取各合作基层医疗机构送至医院消毒供应中心再处理物品240件, 比较2019年1月—12月(实施前)及2020年1月—12月(实施后)消毒供应中心器械管理质量, 评价区域化消毒供应涉及医护人员消毒供应理论水平和满意度情况。结果 CQI实施后消毒供应中心器械预处理合格率、清洗合格率、包装合格率、存储合格率均高于实施前, 差异有统计学意义(P＜0. 01)。CQI实施后医护人员对消毒供应理论知识及流程掌握度及满意度均较CQI实施前提升, 差异有统计学意义(P＜0. 01)。结论 在区级消毒供应中心管理中应用CQI, 可以确保器械清洗、灭菌质量, 提高工作效率, 整体提升区域内医疗机构感染防控水平, 确保患者安全。)

Myopia, as the most common disease in ophthalmology, has developed into a serious international public health burden, the development situation is not optimistic. It is necessary to put forward new and effective intervention measures to curb the prevalence of myopia. In recent years, red light intervention to delay the progress of myopia has become a new research hotspot. Starting with the epidemic situation and inducement of myopia, this paper briefly introduces the commonly used clinical treatment methods, summarizes the research status of red light intervention in myopia, and discusses the possible mechanism of red light intervention in improving myopia. Some potential laser safety problems are put forward, hoping to provide reference for related research in the future. [ABSTRACT FROM AUTHOR]

Objective: To explore mechanism of hedyotis diffusa extract attenuating acute pancreatitis (AP) lung injury in rats from 5'-adenosine monophosphate activated protein kinase (AMPK)/autophagy-related protein 5 (ATG5) signaling pathway. Methods: AP lung injury rat model was established, and rats were randomly divided into model group, extract (hedyotis diffusa extract) group, 3-MA (autophagy inhibitor 3-methyladenine) group, AICAR (AMPK activator) group and extract+AICAR group, with 15 rats in each group, and another 15 rats were selected as sham operation group. ELISA was performed to determine levels of serum amylase (AMY), IL-1β, IL-6 and IL-18; amount of ascites and proportion of lung wet/dry (W/D) in rats were determined; HE was performed to observe pathological damage of pancreas and lung tissues; Western blot was performed to determine lysosomal-associated membrane protein 2 (LAMP2), autophagy substrate p62, IL-1β precursor protein (pro-IL-1β), trypsinogen activation peptide (TAP), AMPK, p-AMPK, ATG5, autophagy marker LC3-II/I, ubiquitin-specific protease 10 (UPS10) expressions. Results: Compared with sham operation group, ascites volume, lung W/D, pancreas and lung tissue pathological damage scores, serum AMY, IL-1β, IL-6, IL-18 levels, pancreatic tissue p62, TAP, pro-IL-1β expressions, lung tissue p-AMPK/AMPK, ATG5, LC3-II/I, UPS10, pro-IL-1β expressions of rats in model group were increased (P<0.05), while LAMP2 protein expression in pancreas and lung tissue was decreased (P<0.05); after model rats were intervened by hedyotis diffusa extract or autophagy inhibitor 3-MA, the above indexes were significantly improved (P<0.05), and improvement effect of hedyotis diffusa extract was better than 3-MA (P<0.05); while AMPK activator AICAR could attenuate improvement effect of hedyotis diffusa extract on lung injury in AP rats (P<0.05). Conclusion: Hedyotis diffusa extract can reduce inflammatory response and autophagy level by inhibiting AMPK/ATG5 signaling pathway, and improve lung injury in AP rats. [ABSTRACT FROM AUTHOR]

Long-term blue light exposure beyond the risk limit is an important factor that causes retinal degenerative diseases, and damage to the retinal pigment epithelium is the key source of retinal light damage. In this study, we investigated the damaging effects of 448 nm blue light on human retinal pigment epithelial (ARPE-19) cells and the mode of apoptosis. ARPE-19 cells were irradiated with 25 mW/cm² blue light for 3, 6, 9 and 12 hours, and cell activity was detected immediately by Calcein AM staining 24 h after irradiation. RT-PCR was used to examine the expression of necrotic apoptosis related genes 24 hours after irradiation, and the Western blotting was used to examine the expression of necroptosis-related and DNA-damage related proteins. The cell morphology changed significantly in the 9-hour and 12-hour groups, the cells swelled, the intercellular space was enlarged, and a large number of cell fragments and non-adhesive cells were observed. Compared with the normal group, the expression levels of the necroptosis-related genes RIPK1 and RIPK3 were significantly higher 3-9 hours after blue light irradiation, and reached the maximum value at 9 h. The expression levels of necroptosis-related proteins RIPK1, RIPK3, P-MLKL markers significantly increased with the increase of irradiation time after 6 ~ 12 h blue light irradiation, and reached the highest value at 12 h. The expression level of DNA damage-related γ-H2AX protein increased significantly after 3 ~ 12 h blue light irradiation, and reached the highest value at 12 h. The expression of necroptosis-related genes reached the maximum after 9 hours of blue light irradiation, while the expression of necroptosis-related proteins reached the maximum after 12 hours irradiation. It was speculated that 25 mW/cm² blue light irradiation for 12 h may cause the necroptosis in ARPE-19 cells, and the degree of DNA damage may be related to the occurrence of necroptosis. [ABSTRACT FROM AUTHOR]

Music is a kind of art growing abreast with movie, and helps it go a better way. The art containing in music plays a critical role in promoting the development of movie including the plot as well as sensory affection. In the movie of "Memories of Matsuko", the director applied a way of flashback from multiple angles, integrating as well as counterpoising picture and music, and the thematic music intertwining with component elements of music and patterns of presentation such as objective music and subjective music that penetrates the whole movie, which in totality moulds an atmosphere like in fairy tale and poses a pierce contrast to protagonist's miserable plight so that it triggers a new recognition towards movie. [ABSTRACT FROM AUTHOR]

The acoustic hierarchical arrangement of the choir A Night in the Desert affects the artistic performance and the verve of the work. In order to display the rich musical content of the . work, the director should lay out the melodic lines and deal with the acoustic arrangement of the work, and analyze the sound quality of the piano and the characteristics 0f the accompaniment. Through the analysis and arrangement, the content and artistic verve can be fully revealed. [ABSTRACT FROM AUTHOR]

Li Zhizao is an important figure in the history of Sino-Western cultural communication. We do not know much about his family and his life due to the scarcity of records. Some newly found documents show that Li Zhizao was born in 1571, not in 1565 or 1566 as it is currently held. After successfully passing the imperial examination and getting the Jingshi degree in 1598, he worked in Beijing, not in Nanjing as many scholars supposed. In the local history, we find a poem written by Li Zhizao narrating how he used a European astrolabe to measure the latitude. In 1621, when the Ming Dynasty was in serious crisis, Li Zhizao was appointed by the Emperor as deputy minister of Guanglusi, which was not the result of Xu Guangqi's recommendation. We also get names of his family members from these documents. His great-grandfather was Li Rong; his grandfather was Li Zitang; his father was Li Shixi. Li Zhizao had at least two sons, the elder being Li Changmao and the younger Li Cibin. Li Changmao' son Li Xixiong got the Jingshi degree in 1652 soon after the Qing Dynasty dominated most parts of China. Li Zhizao's life becomes much clearer according to these documents. [ABSTRACT FROM AUTHOR]

Eliot Carter is not only a great composer, but also an excellent chorus director and music. It is a fact that most of his works before 1948 are chorus music. In the composing of chorus music, he has formed his features based on the inheritance. The paper discusses the artistic features of his representative chorus works to display the versatile composing techniques and elegant demeanor. [ABSTRACT FROM AUTHOR]

Complex odontoma is a relatively rare dental dysplasia. In particular, a complex odontoma with dentigerous cyst is seldom observed. A case of complex odontoma with dentigerous cyst is reported in this paper. [ABSTRACT FROM AUTHOR]

Objective: To uncover and identify the differences in salivary microbiota profiles and their potential roles between patients with pulmonary nodules (PN) and healthy controls, and to propose new candidate biomarkers for the early warning of PN., Methods: 16S rRNA amplicon sequencing was performed with the saliva samples of 173 PN patients, or the PN group, and 40 health controls, or the HC group, to compare the characteristics, including diversity, community composition, differential species, and functional changes of salivary microbiota in the two groups. Random forest algorithm was used to identify salivary microbial markers of PN and their predictive value for PN was assessed by area under the curve ( AUC ). Finally, the biological functions and potential mechanisms of differentially-expressed genes in saliva samples were preliminarily investigated on the basis of predictive functional profiling of Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt2)., Results: The α diversity and β diversity of salivary microbiota in the PN group were higher than those in the HC group ( P <0.05). Furthermore, there were significant differences in the community composition and the abundance of oral microorganisms between the PN and the HC groups ( P <0.05). Random forest algorithm was applied to identify differential microbial species. Porphyromonas , Haemophilus , and Fusobacterium constituted the optimal marker sets ( AUC =0.79, 95% confidence interval: 0.71-0.86), which can be used to effectively identify patients with PN. Bioinformatics analysis of the differentially-expressed genes revealed that patients with PN showed significant enrichment in protein/molecular functions involved in immune deficiency and redox homeostasis., Conclusion: Changes in salivary microbiota are closely associated with PN and may induce the development of PN or malignant transformation of PN, which indicates the potential of salivary microbiota to be used as a new non-invasive humoral marker for the early diagnosis of PN., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2023《四川大学学报（医学版）》编辑部 版权所有Copyright ©2023 Editorial Board of Journal of Sichuan University (Medical Sciences).)

Non-alcoholic fatty liver disease(NAFLD), as a metabolic stress liver injury disease, is one of the most common chronic liver diseases, which seriously threatens people's health. The pathogenesis of NAFLD is very complex. A large number of studies show that the hepatic mitochondrial dysfunction leads to the disorder of hepatic glucose and lipid metabolism, oxidative stress, and inflammation, thus inducing hepatocyte apoptosis, which plays an important role in the progression of NAFLD. In recent years, researchers have begun to focus on developing drugs that slowed the progression of NAFLD by regulating the hepatic mitochondrial function. Chinese medicine has a good curative effect on the treatment of NAFLD, with the advantages of high safety and few side effects. Various studies have shown that Chinese medicine prevented and treated NAFLD by regulating the mitochondrial function. Therefore, this paper summarized the relationship between NAFLD and mitochondria, and the mechanism of Chinese medicine(single Chinese medicine, Chinese medicine monomer, and Chinese medicine compound prescription) in the prevention and treatment of NAFLD by regulating mitochondrial function. This paper is expected to provide references for clinical application of traditional Chinese medicine in the treatment of NAFLD by regulating mitochondrial function.

Objective To evaluate the early and mid-term results after surgical repair of thoracoabdominal aortic aneurysm(TAAA)in patients with DeBakey typeⅠor Ⅲ aortic dissection. Methods The clinical data of 130 patients who underwent TAAA repair for chronic DeBakey typeⅠ(groupⅠ, n =47)or type Ⅲ(group Ⅲ, n =83)aortic dissections in our center between January 2009 and December 2017 were retrospectively analyzed.Early postoperative results,midterm survival,and re-interventions were compared between these two groups. Results The 30-day mortality rate was 6.9%( n =9)in the overall cohort,with no statistic difference between groupⅠand group Ⅲ(10.6% vs. 4.8%; χ 2 =0.803, P =0.370).The incidence of major adverse events(38.3% vs. 51.8%; χ 2 =2.199, P =0.138),5-year actuarial survival rate [(81.7±5.9)% vs. (87.2±4.2)%; χ 2 =0.483, P =0.487],and 5-year actuarial freedom from all reinterventions [(84.5±6.7)% vs. (85.5±4.8)%; χ 2 =0.010, P =0.920] showed no significant differences between these two groups. Conclusions The early and mid-term outcomes after surgical repair of TAAA are similar for DeBakey typeⅠ and type Ⅲ patients.However,studies with larger sample sizes are still required.

To study the protective effects of Wuzi Yanzong recipe on testis germ cell apoptosis in natural ageing rats through endoplasmic reticulum stress (ERS), 16-month-old male SPF grade SD rats were randomly divided into three groups: ageing model group, and low and high-dose Wuzi Yanzong recipe groups (WZ, 1 and 4 g·kg⁻¹), with 10 rats in each group. In addition, 2-month-old SD male rats were used as adult control group. The ageing model group and the adult control group were fed with normal diet for 4 months. WZ groups were given the medicated feed for 4 months. After fasting for 12 hours, the rats were put to death. Then, the testes were immediately collected. The change of testicular tissue morphology was observed by HE staining. The expression levels of ER stress-related proteins GRP78, p-PERK, p-eif2 α , ATF4, p-IRE1, XBP1, ATF6 and apoptosis-related proteins CHOP, caspase12 and p-JNK in testes were detected by Western blot. Compared with the ageing model group, Wuzi Yanzong recipe alleviated the morphological changes of testicular tissue. Western blot results showed that Wuzi Yanzong recipe significantly increased the expression levels of endoplasmic reticulum stress-related proteins GRP78, p-PERK, p-eif2 α , ATF4, p-IRE1, XBP1, ATF6 and significantly decreased the expression levels of endoplasmic reticulum-induced apoptosis-related proteins CHOP, caspase 12 and p-JNK. In conclusion, Wuzi Yanzong recipe can alleviate the ageing-related apoptosis of testicular germ cells in natural ageing rats by regulating endoplasmic reticulum stress., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

To study the protective effects of Wuzi Yanzong recipe on DNA oxidative damage of testis germ cells in natural ageing rats based on Nrf2/HO-1 signaling pathway and base excision repair (BER). In the study, 16-month-old SPF grade male SD rats were randomly divided into three groups, namely ageing model group, and low and high-dose Wuzi Yanzong recipe groups (WZ, 1, 4 g·kg⁻¹). In addition, 2-month-old SD rats were used as adult control group (10 rats in each group). The ageing model group and the adult control group were fed with normal diet for 4 months. WZ groups were given medicated feed for 4 months. After fasting for 12 hours, the rats were put to death. Then, the testes were immediately removed. The vitality of superoxide dismutase (SOD) and malondialdehyde (MDA) content in testis were detected by xanthine oxidase method and thiobarbituric acid (TBA) method. The levels of Nrf2 and 8-OHdG were detected by immunofluorescence. The protein expression levels of Nrf2, HO-1, NQO1, APE1, OGG1 and XRCC1 were detected by Western blot. Compared with the ageing model group, WZ significantly increased the SOD vitality and decreased MDA content of testis. In addition, immunofluorescence results showed that WZ significantly attenuated testicular DNA oxidative damage and improved antioxidant capacity. Such changes were accompanied by the down-regulation of DNA oxidative damage response protein 8-OHdG levels and the up-regulation of Nrf2 levels. Moreover, Western blot results showed that WZ significantly increased the protein expression levels of Nrf2, HO-1 and NQO1 of the testis germ cells, when compared with ageing model group. In parallel, the protein expression levels of APE1, OGG1 and XRCC1 were significantly decreased. In conclusion, WZ improves ageing-related DNA oxidative damage via Nrf2/HO-1 and BER pathways., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Objective To investigate the effect of siRNA-mediated chemokine receptor 7 (CCR7) silence on the proliferation, migration, invasion and apoptosis of human MG-63 osteosarcoma cells. Methods The study designed and synthesized siRNA targeting CCR7 (CCR7-siRNA). After MG63 cells were transfected with CCR7-siRNA, the expression of CCR7 was identified by Western blotting; cell apoptosis was detected by annexinV-FITC/PI double staining combined with flow cemetery; cell proliferation was tested by MTT assay; and cell migration and invasion abilities were examined by Transwell TM migration/invasion assays. Results CCR7 expression in MG63 cells was significantly inhibited after transfected with CCR7-siRNA. At the same time, cell proliferation, migration and invasion abilities were distinctly suppressed, and cell apoptosis rate increased. Conclusion Down-regulating CCR7 expression in MG63 cells could apparently inhibit cell proliferation, migration and invasion abilities of MG63 cells, and also induce cell apoptosis.

Aim: To construct, express and purify a human fusion protein, which is composed of a single-chain antibody fragment scFv that recognizes HER2 protein and an oligo-9-arginine, and to analyze the binding activity of the expressed fusion protein., Methods: Pairs of oligonucleotide primers were designed and used to amplify the scFv-9R. The fusion protein gene scFv-9R was then cloned into expression vector pQE30 and expressed in E.coli M15.Expressed protein was detected by SDS-PAGE and Western blot and purified by Ni-NTA chelating agarose. Then, the purified protein was refolded by dialysis and concentrated by ultrafiltration. The antigen-binding activity of the scFv-9R fusion protein was confirmed by ELISA, and the siRNA binding ability was confirmed by electrophoretic mobility shift assay (EMSA)., Results: HER2 scFv-9R encoding sequence was correctly cloned into the expression vector. The recombinant protein was insolubly expressed in E.coli M15 induced by IPTG. ELISA confirmed that it had specific antigen binding activity; EMSA assured that it had siRNA binding activity., Conclusion: The scFv-9R fusion protein can specially bind with both HER2 antigen and siRNA.

Objective: To investigate the roles of matrix metalloproteinase-9, -2 (MMP-9, 2), and tissue inhibitors of metalloproteinase-1, 2 (TIMP-1, 2) in pathogenesis of the accretio placenta., Methods: The women with the placenta accrete were recruited and the placenta (23) and deciduas tissues (9) after labor were obtained, and the placenta (28) and deciduas (11) from women without the placenta accreta were obtained as control to get, too. The expressions of MMP-9, -2, TIMP-1, 2 in the placental and decidual tissues were analyzed by real-time PCR., Results: mRNA expression of MMP-9 in the placenta accreta was (3.21 +/- 0.76) copies/microg total RNA, significantly higher (P < 0.05) than that of normal placenta [(3.84 +/- 0.24) copies/microg total RNA)]. MMP-9 transcription in the decidua accreta was (2.50 +/- 0.49) copies/microg total RNA, significantly higher (P < 0.05) than that of normal decidua [(3.81 +/- 0.66) copies/microg total RNA]. mRNA expression of TIMP-1 in normal placenta and placenta accreta was (5.91 +/- 0.56) and (5.92 +/- 0.46) copies/microg total RNA, respectively, with no significant difference between the two groups. mRNA expression of TIMP-1 in the accrete deciduas was (6.63 +/- 0.51) copies/microg total RNA, significantly lower (P < 0.05) than that of normal decidua (7.09 +/- 0.55) copies/microg. mRNA expression of MMP-2 in the accrete placenta was (4.55 +/- 1.13) copies/microg total RNA, significantly higher (P < 0.05) than that of normal placenta (5.53 +/- 0.59) copies/microg. mRNA expression of MMP-2 in the accrete decidua and normal decidua was (6.07 +/- 0.83) and (5.97 +/- 0.76) copies/microg total RNA, respectively, with no significant difference between the two groups. mRNA expression of TIMP-2 in the accrete placenta was (4.69 +/- 0.60) copies/microg total RNA, significantly higher (P < 0.05) than that of normal placenta (3.79 +/- 1.06) copies/microg. mRNA expression of TIMP-2 in the accrete decidua was (5.06 +/- 0.33) copies/microg total RNA, higher significantly (P < 0.05) than that of normal decidua (3.98 +/- 0.60) copies/microg., Conclusions: The upregulation of MMP-9, MMP-2 in placenta and downregulation of TIMP-1 in decidua were involved in occurrence of the placental accreta, and the roles of TIMP-2 in occurrence of the placental accreta need to elucidated.

Objective: To determine the indication, optimal operative procedures, plan and the estimation of the prognosis depending on the subtype of aortic dissection defined by the extension and extent of dissection., Methods: The outcome of 708 patients with aortic dissection between January 1994 and December 2004 was analyzed. Among them 477 patients suffered from Stanford type A aortic dissection were treated. Type A dissection can be classified into 3 subtypes based on the pathological change of the aortic root. Type A1 (No pathological change type): 212 patients underwent ascending aorta replacements; Type A2 (mild pathological change type): 63 patients underwent ascending aortic replacement with concomitant aortic valve and valsalva sinus plasty and David procedure was performed in 9 patients; Type A3 (severe pathological change type): 193 patients underwent Bentall procedure. The method of aortic arch repair was determined by the pathological type of distal aorta. Total aortic arch replacement was performed in 78 patients with complex type (type C). There hundred and ninety-nine patients with simple type (type S) underwent partial aortic arch replacement. 231 patients suffered from Stanford type B aortic dissection. Type B dissection can be classified into 3 subtypes based on dilated extension of proximal descending aorta. Type B1 (no dilation was confined in the proximal of thoracic descending aorta): endoluminal stent graft repair was performed in 103 patients. Replacement of the partial proximal thoracic descending aorta and replacement combined with stented elephant trunk procedure were performed in 32 and 12 patients respectively; Type B2 (aneurysm in thoracic descending aorta): 32 patients underwent the part proximal thoracic descending aorta replacement combined with aorta plasty. 21 patients underwent the replacement of entire thoracic descending aorta; Type B3 (aneurysm in thoracic descending and abdominal aorta): thoracoabdominal aortic replacement was operated in 31 patients with deep hypothermia circulatory arrest; Type BC (complex type): 44 patients were performed the operation with the use of deep hypothermia circulatory arrest because their left subclavian arteries or distal aortic arch were affected by the dissection; Type BS (simple type): 103 patients were underwent endoluminal stent graft repair. In the 60 patients, the operations were performed by using the technique which preserved blood was transfused back by pump via the femoral artery. Femoro-femoral bypass was performed in 24 patients., Results: Type A: the operative mortality was 4.6% (27/477), and the hospital morbidity was 14.5% (69/477). Type B: the hospital mortality of endoluminal stent graft repair was 1.9% (2/103). 9.7% (10/103) had mild leakage from proximal communications. The morbidity was 2.9% (3/103) in stent group. The mortality was 3.1% (4/128), and the hospital morbidity was 18.8% (24/128) in the operative group., Conclusion: The subtype of aortic dissection is much useful in determining the optimal procedure, operative indication and plan, estimating the prognosis.

Objective: To investigate the long term efficacy as well as the side-effects of small dose budesonide turbuhaler in mild bronchial asthma., Methods: Fifty-two patients with mild asthma were randomly divided into groups A, B and C. Twenty-two cases in group A received 200 microg budesonide turbuhaler by inhalation every night. Fifteen cases in group B received oral prednisone 5 mg/d and theophyllin control release tablet 0.2 g twice daily, as well as ventolin aerosol inhalation 200 microg three times daily during asthmatic attack. Fifteen cases in group C received no glucocorticoids, but theophyllin control release tablet 0.2 g twice daily as well as ventolin aerosol inhalation (200 microg/d) were given during asthmatic attack. All three groups received treatment consecutively for 3 years, and followed for one year after stopping treatment. During the total 4 years, pulmonary function measurements (FEV1, Raw, Gaw), bronchial hyperreactivity (BHR), clinical effects, plasma cortisol level and the activated reaction of ACTH were evaluated., Results: (1) Before the treatment, BHR of the three groups were similar, with most cases graded III-IV, being 91% (20/22), 100% (15/15) and 93% (14/15) respectively. After the treatment, the BHR of 18 (82%) cases of group A was reduced to grades I-II. However, 13 cases (87%) of group B still remained at grades III-IV and 15 cases (100%) of group C were still at grades III-IV. The results of the three groups showed a significant difference (P < 0.01). (2) Compared to measurements before the treatment, Raw was (623 +/- 103)% vs (158 +/- 24)% in group A, (605 +/- 90)% vs (340 +/- 61)% in group B, and (638 +/- 108)% vs (420 +/- 81)% in group C, the difference among the three groups being significant (P < 0.01). (3) Compared to the measurements before the treatment, Gaw was (22 +/- 4)% vs (83 +/- 15)% in group A, (27 +/- 6)% vs (42 +/- 9)% in group B, and (27 +/- 5)% vs (31 +/- 6)% in group C, the difference among the three groups being significant (all P < 0.01 respectively). (4) Compared with the measurements before the treatment, FEV1 was (2.3 +/- 0.4) L vs (2.9 +/- 0.4) L in group A, (2.3 +/- 0.4) L vs (2.6 +/- 0.4) L in group B, and (2.3 +/- 0.4) L vs (2.7 +/- 0.4) L in group C, the difference among the three groups being significant (P < 0.01). (5) With asthmatic symptom control as the criteria of therapeutical effects, the effective rate of group A, B and C were 91%, 53% and 33% respectively, which showed significant difference among the three groups (all P < 0.01 respectively). (6) The plasma cortisol levels of group A and B were (326 +/- 103) nmol/L and (308 +/- 29) nmol/L before treatment, compared with (318 +/- 78) nmol/L and (299 +/- 98) nmol/L after treatment, the difference in group A or in group B was not significant (all P > 0.05). When the measurements before and after treatment were compared, the cortisol levels of group A and B were (365 +/- 102) nmol/L vs (373 +/- 102) nmol/L and (343 +/- 79) nmol/L vs (346 +/- 103) nmol/L respectively after the stimulation of ACTH, which showed no significant changes even after the stimulation of ACTH (all P > 0.05)., Conclusions: Long term small dose budesonide turbuhaler inhalation could effectively decrease BHR and the Raw, while increase the Gaw of asthmatic patients, hence improving the pulmonary function and preventing acute attack. In addition, it did not induce suppression of HPAA axis function in the patients.

Objective: To study the effect of treatment of renal anemia by combination of Bushen Jianpi Recipe (BJR, a Chinese experience recipe for supplementing Shen and supporting Pi) and low dosage erythropoietin (EPO), and the influence of treatment on change of serum tumor necrosis factor alpha (TNF-alpha) so as to explore the possible mechanism of integrative Chinese and western medicine (ICWM) in treating renal anemia., Methods: Patients with renal anemia were randomly divided into two groups, the ICWM group and the control group, symptomatic and supporting treatment such as dialysis, supplementing of ferrous, foliac acid and vitamin B12, was given to both groups. Additionally, to the ICWM group, 50 IU/kg of EPO subcutaneous injection for twice every week, and oral intake of BJR, one dose per day taken in two parts, were given, and to the control group, EPO alone, 50 IU/kg by subcutaneous injecting, 3 times per week, was given. The therapeutic course for two groups was 3 months. Blood levels of hemoglobin (Hb), hematocrit (Hct), TNF-alpha were measured before treatment and the therapeutic effect was observed., Results: After treatment, the levels of Hb and Hct increased significantly in both groups (P < 0.01), comparison between the two groups in Hb and Hct after being treated for 3 months showed significant difference (P < 0.05). The serum level of TNF-alpha was markedly higher than normal range in both groups before treatment, it significantly lowered after treatment in the ICWM group (P < 0.05), but unchanged in the control group., Conclusion: Combination of BJR and EPO could significantly inhibit the production of TNF-alpha, this may be an important factor for ICWM in effectively improving sensitivity to EPO.

Objective: To observe the effect of different analgesic methods and the influence of catecholamine response to elective abdominal surgery., Methods: 42 ASA I-II patients undergoing elective abdominal surgery were randomly divided into five groups. After receiving combined general and epidural anesthesia, postoperative patient-controlled epidural analgesia was provided in group RF, BF, BM with 1.2 g.L-1 ropivacaine + 2 mg.L-1 fentanyl, 1.2 g.L-1 bupivacaine + 2 mg.L-1 fentanyl, 1.2 g.L-1 bupivacaine + 80 mg.L-1 morphine respectively. Group EM received general-epidural anesthesia and patient-controlled intravenous analgesia with 0.5 g.L-1 morphine. Levels of analgesics (VAS, VRS), plasma concentrations of adrenaline and noradenaline were measured., Results: Effective analgesia could be achieved in all groups. VAS in groups BM and M was significantly less than that in groups RF, and VRS in groups BM was higher than that in groups RF, EM and M. There were more side effects in groups BM, M and EM, and the incidence of nausea was highest in group M(5 cases). The adrenaline concentrations in group BM one hour postoperation was lower than that in group BF, and noradrenaline in group EM was lower than that in group RF. The 24-hour postoperative values of the adrenaline and noradrenaline in group M were higher than their preoperative values., Conclusions: Postoperative patient-controlled epidural or intravenous analgesia could provide effective analgesia. Epidural anesthesia during operation or epidural analgesia postoperation could depress stress responses, thus it is a more effective analgesic method.