Objective To investigate the effect of spironolactone combined with valsartan on renal function in patients with early diabetic nephropathy.Methods 158 early diabetic nephropathy patients from May 2014 to June 2015 in department of endocrinology of Nanxun People’s Hospital of Huzhou were selected and divided into control group (79 cases) and experimental group (79 cases).The control group were treated by valsartan and the experimental group were treated with spironolactone on the basis of control group.The changes of renal function, potassium ion and blood rheology were observed and compared after treatment.Results Compared with control group post-treatment, the systolic pressure and diastolic pressure levels were lower, plasma urinary albumin excretion rates (UAER) level was lower (P <0.05), albumin (Alb), serum creatinine (Scr), blood urea nitrogen ( BUN) , creatinine clearance ( Ccr) and K +levels had no significant differences, whole blood specific viscosity, plasma specific viscosity and whole blood specific reduced viscosity were lower ( P <0.05 ) in experimental group.Conclusion Spironolactone combined with valsartan could effectively improve clinical efficacy of patients with early diabetic nephropathy , improve the renal function of patients, recover ion disorder and reduce blood viscosity.

Objective To observe the clinical efficacy of Tong Du Wen Yang (unblocking the Governor Vessel and warming yang) in treating amyotrophic lateral sclerosis (ALS).Method Twenty-eight eligible ALS patients were randomized into two groups by following the visiting sequence. Thirteen patients in the control group were intervened by orally taking Riluzole tablets; 15 cases in the treatment group were by Tong Du Wen Yang needling in addition to oral administration of Riluzole tablets. Before treatment and after 6-month treatment, the therapeutic efficacies were evaluated by using the Chinese medicine syndrome and sign scoring for Wei-flaccidity diseases and Appel function scale.Result After the treatment, the Chinese syndrome and sign scoring scores for Wei-flaccidity dropped in both groups, and the decrease in the treatment group was more significant than that in the control group (P<0.05). The Appel scores dropped in both groups after the treatment, while the decrease in the treatment group was less significant than that in the control group (P<0.05).Conclusion Tong Du Wen Yang needling plus orally taking Riluzole tablets can produce a more significant efficacy than using Western medication alone in treating ALS.

Objective To explore the molecular mechanism of hypophrenia induced by Down syndrome (DS).Methods Ts65Dn mice were used as DS animal model.Three female mice and three male mice of three to twelve weeks old were mated.Among the 17 first-generation mice alive,five mice remained Ts65Dn trisomy and 12 mice were normal.Five Ts65Dn mice and five normal mice were selected randomly as Ts65Dn group and control group,and bred till 16 to 18 weeks old for experiments.Differential proteins in hippocampus of mice were tested by isobaric tags for relative and absolute quantitation (iTRAQ).Expressions of the differential proteins in Ts65Dn group were detected compared with those in control group.Results A total of 2805 proteins were identified in hippocampus of Ts65Dn group and control group,and significant differences were observed in the expressions of 374 proteins.Compared with those in control group,expressions of 195 proteins increased and 179 reduced in Ts65Dn group.Sorted by P value from low to high,the seven proteins with the lowest P value were uncharacterized protein C2orf47 homolog,isoform 2 of filamin A-interacting protein 1-like,zinc finger protein,isoform 1 of pericentriolar material 1 protein,SEC23 interacting protein,BAG family molecular chaperone regulator 3 and serpin H1.Conclusions Differential proteins are observed in hippocampus of Ts65Dn mice,perhaps closely correlating to neurological defects.The new technology of iTRAQ helps to screen and identify differential proteins in hippocampus.

AIM:Todetecttheeffectofspironolactoneonhyperthyroxine-inducedatrialremodeling.METH-ODS:New Zealand rabbits were divided into control group ( C ) , hyperthyroxine group ( H ) and spironolactone group ( S) .Thyroxin was given to the rabbits in group H and group S by intraperitoneal injection for 4 weeks , and then spirono-lactone was given in group S by gavage for 2 weeks.Atrial fibrillation (AF) was induced by burststimulation after ad-ministration.The inducing rate of AF and atrial effective refractory period ( AERP) were tested by intra-cardiac electro-physiologic instrument.The expression of AF-related Ca2+channel (Cav1.2), K+channels (Kv1.5 and Kv4.3) and con-nexins (Cx40 and Cx43) at mRNA and protein levels was detected by real-time PCR, immunohistochemistry and Western blot.RESULTS:Spironolactone reduced the inducing rate of AF .No significant difference of AERP between group H and group S was observed (P>0.05).Compared with group H, the protein expression of Cav1.2 was significant increased in group S (P<0.05).The expression of Kv1.5 at mRNA and protein levels in group S was significantly lower than that in group H (P<0.05), while the protein expression of Kv4.3 in group S was significantly decreased compared with group H (P<0.05).The mRNA expression of Cx43 in group S was significantly decreased compared with group H (P<0.01), whereas the protein expression of Cx 40 in group H was significantly higher than that in group S ( P<0.05 ) .CONCLU-SION:Spironolactone attenuates the hyperthyroxine-induced atrial remodeling in rabbits , and reduces the susceptibility of the myocardium to AF .

Objective To discuss the relationship between the expression of programmed death-1 (PD-1) in liver with traditional Chinese medicine (TCM) syndromes and pathological diagnosis in chronic hepatitis B.Methods 156 CHB patients treated in our hospital of infectious diseases department were recruited as an observation group. Based on the principle of informed voluntary and approved by the ethics committee, liver biopsy was adopted to make clear liver tissue pathology. According to TCM classification criteria, CHB patients were divided into five groups: a blood stasis group, a damp heat resistance group, a liver and spleen deficiency group, a liver and kidney yin deficiency group, and a spleen and kidney yang deficiency group. In the same period, 12 healthy persons were recruited as a control group. The PD-1 expression was detected with immunohistochemical SP method, and the correlation between expression of PD-1 in liver tissue and TCM syndrome type and liver pathology was analyzed.Results Different degrees of positive cell expression were found in the liver tissue. With the liver inflammation and fibrosis severity, the number of PD-1 positive cells also increased. The PD-1 expression levels varied with mild, moderate, and severe CHB patients (0.24 ± 0.03, 0.36 ± 0.05 vs. 0.43 ± 0.05) , which were statistically significant (P<0.05) . PD-1 expression levels also varied among different TCM type CHB patients, of which, PD-1 expression of blood stasis type was the highest (0.35 ± 0.04), while the liver and spleen deficiency type was the lowest (0.23 ± 0.03).Conclusion The expression levels of PD-1 has a certain correlation with the patients illness, chronic mechanism, and TCM syndromes. CHB patients can be treated by controlling the expression of PD-1.

SUMMARY Traffic noise pollution problem is increasingly emerging with the rapid developmentof urban traffic. Researchers have paid close attention to the health effects of traffic noise. This review has summarized the recent research progress in the health effects of traffic noise both at home and abroad. Traffic noise can have various ad-verse health effects, and most of them are extra-auditory effects. The main aspects include that traffic noise can af-fect the cardiovascular system, which is verified by the evidence that exposure to traffic noise significantly increases the risk for cardiovascular diseases, such as high blood pressure, myocardial infarction, coronary heart disease, and so on. In addition, traffic noise can induce adverse effects on nervous system, leading to the increasing levels of anxiety, noise annoyance, and occurrence of insomnia. Furthermore, traffic noise is significantly associated with adverse pregnant outcomes, and can affect the endocrine system and digestive system. As traffic noise and traffic related air pollutants co-exist in the traffic environment, whether there are joint effects between these two factors have become areas of research focus nowadays. Although there is sufficient evidence that traffic noise has adverse health effects, inadequacies still existe. Analysis of the shortages of current studies and the prospects of the future studies are pointed out in this review.

Objective To observe the effects of stationary cycle training on lower limb muscle tension and motor function in children with spastic cerebral palsy.Methods Sixty-seven children with spastic cerebral palsy were divided into a treatment group (n =34) and a control group (n =33).Both were treated with routine rehabilitation therapy,including neurodevelopment treatment,massage and physical agent therapy.The treatment group additionally cycled on a stationary bicycle for 20 min a day,five days a week for 3 months.Muscle tension in the children's adductor,hamstring and gastrocnemius muscles was evaluated using the modified Ashworth scale (MAS),while the adductor angle,popliteal fossa angle and foot dorsiflexion angle were measured using a joint protractor.Moreover,the 88-item version of the Gross Motor Function Measure (GMFM-88) was used to evaluate gross motor function.Results After treatment the average muscle tension of both groups was significantly lower than before treatment.The average muscle tension scores of the adductors,hamstrings and calf muscles of the treatment group [(1.79±0.54),(1.00±0.60),(2.29 ±1.77)] were significantly lower than those of the controls [(1.82 ± 0.53),(1.15 ± 0.44),(2.52 ± 1.89)].The adductor angles,popliteal fossa angles and foot dorsiflexion angles of both groups were significantly larger than before treatment,and the angles in the treatment group [(97.06 ± 19.03) °,(53.38 ± 12.54) ° and (8.38 ± 9.11) ° respectively] were significantly larger on average than those in the control [(98.94 ± 21.42) °,(56.52 ± 12.90) ° and (5.30 ± 14.30) ° respectively].After treatment the total GMFM scores of both groups were better than before treatment,but the treatment group's average score(138.18 ± 54.86) was significantly better than that of the control group(112.21 ± 62.44).Conclusion Three months of stationary cycle training can effectively reduce the muscle tension of children with spastic cerebral palsy and improve their motor function.

Objective: To study the impression of Chinese people on Chinese urban children, their main source of information about the Chinese people, and the infvuence of age, school, and gender upon their evaluation. Methods: 383 Chinese urban children ranging from 5 to 12 years were interviewed individually or investigated with the questionnaire. Results: Most of the children reported that the Chinese were happy, clean, peaceful, clever, hardworking, kind and nice. However, the urban children's positive impression of the Chinese people was decreased with their growing up. The study also found that children's information on the Chinese people was mainly in order from television, newspapers, books and cartoons, parents, classmates, friends and teachers, and radio, and that the information source became increasingly diversificed with age. No significant difference in gender and between two schools was found. Conclusion: Chinese urban children had a positive impression of Chinese people, and they had a preference and identity for Chinese people . Mass media were the main source of information.

By analyzing the situation that large general hospitals face at present in their development and the background of reform in the system of overall responsibility by the attending physician in the hospital, the authors offer an account of the guiding ideology for large general hospitals to adopt the system of overall responsibility by the attending physician, the specific steps taken and the initial results attained. They also discuss the impact of the system of overall responsibility by the attending physician on the hospital from the perspectives of human resources, technological innovation, managerial system, and information system. The positive significance of the system of overall responsibility by the attending physician in the management of the hospital reform is also identified.