Acromegaly is a rare clinical endocrine disorder related to systematic complications such as cardiovascular,respiratory and metabolic disorders which determine its prognosis.Hypertension is the main complication resulting in the increased frequency of morbidity.The mechanism of hypertension in acromegaly is still no real consensus.In this review,we examine the prevalence and danger of hypertension in acromegalic patients and discuss the clinical and experimental mechanisms on the cardiovascular system in order to define the possible pathogenetic factors involved in the development and/or maintenance of high arterial blood pressure in acromegaly.The modern object of acromegalic treatment is normalization of morbidity and the treatment of pituitary tumor involve surgery,medication and radiation.Besides,blood pressure control is also demanded.The lowering of blood pressure observed in a proportion of hypertensive acromegalics,and the normalization of serum GH and IGF-1 level is of great importance.

Objective To explore the correlation between nursing students' hardiness personality and professional commitment.Methods 1 115 undergraduate nursing students from 3 medical universities in Guangzhou were investigated with the scales of hardiness personality and nursing professional commitment.Results The scores of hardiness personality and professional commitment were (2.55 ± 0.44) and (2.70 ± 0.43),respectively,and both of them were at the middle level.Correlation analysis revealed that hardiness personality was positively related to professional commitment (P＜0.01),and the challenge dimension of hardiness personality had positive predictive effect on professional commitment.Conclusions Nursing educators should take measures to improve students' hardiness personality and professional commitment.It would help maintain the stability of the whole nursing team.

Objective To investigate the clinical application value of the laparoscopic intraoperative cholan-giography in laparoscopic cholecystectomy,and summarize the experience.Methods The clinical data of 169 cases of laparoscopic cholecystectomy intraoperative cholangiography were analyzed retrospectively.Results 169 patients were successfully completed,131 cases recovered well and no complications occurred after operation.29 patients showed hyperamylasemia,of which 3 patients had intractable hyperamylasemia,8 patients complicated with secondary acute pancreatitis,with fasting,gastrointestinal decompression,enzyme inhibition(plus somatostatin)and acid,analgesic, anti infection,rehydration treatment after remission.Conclusion Laparoscopic cholecystectomy intraoperative cholan-giography is a safe and reliable diagnostic technique,on the occurrence of biliary residual stones in prevention of post-operative prevention and timely detection of bile duct injury during operation and improves the success rate of repair of bile duct injury has important clinical value;control adaptation of intraoperative cholangiography has important clinical significance of reasonable application license.

Objective To analyze the effect of bifrontal decompressive craniectomy on patients with refractory diffusing of brain swelling after severe traumatic brain injury.Methods The clinical data of 68 patients with refractory diffusing of brain swelling after severe traumatic brain injury were analyzed retrospectively.Thirty-five patients were performed with bifrontal decompressive craniectomy as observed group,continued intracranial pressure monitoring after surgery.Thirty-three patients were treated conservatively to reduce intracranial pressure as control group,continued intracranial pressure monitoring.The Glasgow outcome scale after discharge 6 months were assessed.The efficacy,the incidence of complications were observed in observed group.Results The admission intracranial pressure in observed group was significantly higher than that after surgery [(35.9 ±6.9) mmHg (1 mmHg =0.133 kPa) vs.(17.5 ±5.2) mmHg,P ＜0.05].The admission intracranial pressure in control group was (34.2 ± 8.6) mmHg,after admission 10.5 h was (32.0 ±4.8) mmHg (P ＜0.05),difference was no statistically significant (P＞ 0.05).The intracranial pressure after admission 10.5 h in control group was significantly higher than that in observed group after surgery (P ＜0.05).Two cases of subdural effusion,1 case of postoperative hydrocephalus in observed group.The better prognosis rate in observed group was significantly higher than that in control group [45.7％ (16/35) vs.18.2％ (6/33),P ＜ 0.05].Conclusions Bifrontal decompressive craniectomy is a suitable measure to decrease the intracranial pressure in the patients with refractory diffusing of brain swelling.If carried out early,it could provide better outcome for these patients.

Objective The Study the difference of miRNA expression of AIDS patients with toxic heat accumulation syn -drome with healthy control group .Methods This research used Agilent miRNA chip to test the miRNA of blood preparation ,and used SAS system to screen the differences between groups ,then analyzed the significance function of target gene .Results Compare the heat-toxic accumulation group and the healthy control group ,100 cases of obvious expression difference and of which the differ-ence was 2 times and greater were screened out (in which 64 cases showed up-regulation and 36 showed down-regulation) .Differen-tially expressed miRNAs function involves the role of IL-21 receptor in T cell activation ,C reactive protein ,and the positive regula-tion of the immune response .Conclusion AIDS toxic heat accumulation syndrome patients and healthy control groups exist differ -ences in miRNA expression profiles ,the biological basis of syndrome maybe related to T cell activation and IL-21 receptor .

Thrombotic diseases in different forms become a great threat to human health. Such anti-platelet aggregation drugs as aspirin and clopidogrel are common drugs in clinic. However, along with the appearance of resistance and side effects of western anti-platelet aggregation drugs, anti-platelet aggregation traditional Chinese medicines promoting blood circulation to remove blood stasis have gradually become an important study orientation. Platelet is one of major participant in thrombosis, and plays an important role as a bioactive material in studies on traditional Chinese medicines promoting blood circulation to remove blood stasis, mainly involving two aspects--the evaluation for the anti-platelet aggregation activity of traditional Chinese medicines and the screening of their active components. This paper summarized the applications of platelets in studies on traditional Chinese medicines promoting blood circulation to remove blood stasis, so as to provide basis for further studies.
Animals ; Blood Circulation ; drug effects ; Blood Platelets ; drug effects ; physiology ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Thrombosis ; drug therapy ; physiopathology

ObjectiveTo determine the potential natural foci of new bunyavirus,and isolate and identify the new bunyavirus strain in sera from suspected new bunyavirus-infected patients.MethodsImmunofluorescence assay was used to detect the antigens of new bunyavirus in different tissue specimens of wild rodent animals in Tiantai area of Zhejiang province.Fluorescence quantitative real-time RT-PCR was applied to detect the viral nucleic acid in sera of suspected new bunyavirus-infected patients and the amplification products were analyzed by sequencing.The new bunyavirus in the pateints'sera was isolated using Vero cells.Using nucleocapsid protein encoding gene of new bunyavirus as the target gene,the isolated suspected new bunyavirus strain was identified by RT-PCR and sequencing of the amplification product.Moreover,sequence identity of the amplification product of nucleocapsid protein encoding gene of new bunyavirus was analyzed and compared.ResultsOf the 70 wild rodent animals,5.71% were positive in the immunofluorescence assay.The fluorescence quantitative real-time RT-PCR confirmed that two of the four detected patients'serum specimens were positive.One suspected strain of new bunyavirus was isolated from one pf the two positive patients'serum specimens.The results of RT-PCR and sequencing confirmed that the viral strain exactly belongs to new bunyavirus with 92.2% sequence identity to that of the new bunyavirus isolates in Hubei province but distinct with the new bunyavirus isolates from other areas in China.ConclusionThe presence of natural foci of new bunyavirus and new bunyavirus-infected patients in Zhejiang province are firstly confirmed by this study.There is a geographical diversity of the distribution of new bunyavirus in different groups.

Objective To study the impact of antiviral therapy on patients with postoperative intrahepatic recurrence of hepatitis B related hepatocellular carcinoma (HCC).Methods According to the inclusion and exclusion criteria,65 patients with HCC who were managed in our hospital from January 2004 to December 2011 for intrahepatic recurrence and had indications for antiviral treatment were included into this study.The patients were divided into two groups ; the antiviral and the control groups.Relevant data between these two groups such as cumulative survival after recurrence,Child-Pugh grade,HBV-DNA,HBeAg,AFP at the time of recurrence and 6 months later were studied.An analysis on multiple-factors was carried for survival after recurrence at 2 years.Results When compared with the control group,the antiviral group had better cumulative survival in all the cases and in the TACE cases (P ＜ 0.05 respectively).The cumulative survival in the RFA cases was not significantly different between the two groups (P ＞ 0.05).A comparison was carried out in patients who received antiviral therapy which was combined with one or more other therapies (TACE,RFA,reoperation):(a) antiviral therapy only (8 patients) ; (b) combined with one therapy (22 patients) ; (c) combined with two therapies (10 patients) ; (d) combined with three therapies (2 patients).All P values of a:b,a:c,a:d,b:c,b:d were less than 0.05.The blood HBV-DNA of the two groups was significantly different at the time 6 months after recurrence (P ＜ 0.05).The results of multivariate analysis showed the 2-year survival was significantly correlated with recurrent tumor size,primary tumor class,antiviral therapy or not after recurrence,presence of absence of cirrhosis.All P values were less than 0.05.Conclusions Antiviral therapy had remarkable clinical impact on HCC patients with postoperative intrahepatic recurrence and with indication for antiviral treatment.Patients had better prognosis if antiviral therapy was combined with one or more other therapies.

Objective To explore the effects of timing of enteral nutrition (EN) in the severe acute pancreatitis (SAP).Methods The rabbit model of SAP was constructed,and 40 experimental rabbits were divided randomly into the experimental group (20 rabbits) and the control group(20 rabbits).(1) The parenteral nutrition (PN) was administered to rabbits in the experimental group,and then EN was administered after bowel sound restoration.(2) EN was administered to the rabbits in the control group at hour 12 after PN.The values of TNF-α,IL-6 and IL-8 on post-modeling day 1,3 and 7 and intra-abdominal pressures at hour 1 before EN and on post-modeling day 1 and 3 were respectively examined.The experimental animals were sacrificed on post-modeling day 7 and 10.The expression of nuclear factor-kappa B (NF-κB) was detected by immunohistochemistry and bacteria from mesenteric lymph nodes were cultured.The measurement data with normal distribution were presented as (x) ± s.The trend comparison between groups and pairwise comparison were analyzed using the repeated measures ANOVA and t test.Results The 40 rabbit models of SAP were constructed successfully.(1) The results of serum test showed that the values of TNF-α,IL-6 and IL-8 in the experimental group on post-modeling day 1,3and 7 were (6.9 ±2.1)ng/L,(5.9 ± 1.8) ng/L,(5.3 ± 1.8) ng/L and (109 ± 17) ng/L,(96 ± 16) ng/L,(83 ± 17)ng/L and (89 ±20)ng/L,(78 ±21)ng/L,(70 ± 19)ng/L,respectively.The values of TNF-α,IL-6 and IL-8 in the control group on post-modeling day 1,3 and 7 were (7.4 ± 1.5) ng/L,(7.1 ± 1.6) ng/L (6.8 ±1.7) ng/L and (101 ± 19) ng/L,(98 ± 18) ng/L,(93 ±20) ng/L and (91 ± 14) ng/L,(91 ± 16) ng/L,(83 ±19)ng/L,respectively.There were significant differences in the changing trends of TNF-α and IL-6 between the 2 groups (F =7.947,19.386,P ＜ 0.05),with no significant difference in the changing trend of IL-8 between the 2 groups (F =2.756,P ＞ 0.05).(2)The intra-abdominal pressures in the experimental group at hour 1 before EEN and on post-modeling day 1 and 3 were (3.5 ± 1.6) cmH2O (1 cmH2O =0.098 kPa),(4.3 ± 1.7) cmH2Oand (3.6 ± 1.8) cmH2O,which were significantly different from (4.9 ± 1.9) cmH2O,(5.7 ± 2.2) cmH2O and (4.5 ± 1.6)cmH2O in the control group (F =7.042,P ＜0.05).(3) The expression of NF-κB in the tissues of pancreas was localized mainly in the cell nucleus.The expression of NF-κB in the experimental group on postmodeling day 7 was 5.0 ± 2.7,which was significantly different from 7.0 ± 2.9 in the control group (t =2.236,P ＜ 0.05).(4) The amount of bacteria culture from mesenteric lymph nodes in the experimental group on postmodeling day 7 and 10 were (4.7 ±0.9) × 103 cfu/g and (4.1 ±0.7) × 103 cfu/g,which were significantly different from (5.5 ± 1.0) × 103 cfu/g and (4.6 ± 0.7) × 103 cfu/g in the control group (t =2.382,2.126,P ＜0.05).Conclusion The selective timing of EN can effectively improve the recovery of rabbits with SAP,and the efficacy of EN administering based on the recovery of bowel function may be better than immediate EN administering.

Objective To observe the therapeutic effect of Shenmai injection on rats with acute edematous pancreatitis (AEP) and its mechanism.Methods The model of AEP in rats was induced by intraperitoneal injection of caerulein every one hour for 7 times.One hour after last injection,intravenous Shenmai injection (5 ml · kg-1 · d-1) was given to rats in Shenmai injection treatment (SI) group,while same amount of normal saline was given to rats in control (AEP) group.One hour and 1,3,5,7 d after AEP induction,the blood was taken,and the method of double antibody sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of amylase,platelet activating factor (PAF),vascular endothelial growth factor (VEGF).The rats were sacrificed at 7 and 14 d,and pancreatic tissue samples were harvested.RT-PCR and Western Blot were used to determine the expression of NF-κB mRNA and protein,and normal pancreatic tissue samples were used as control.The positive expression of CD31 in pancreatic tissue was determined by immunohistochemical method to calculate microvascular density (MVD).Results The serum levels of amylase and PAF in both groups were increased and gradually decreased 3 days later,while the decrement in SI group was greater than that of AEP group.At the 5th day after AEP induction,the serum levels of amylase in SI group and AEP group were (4569 ± 158),(5056 ± 198) U/L,and the serum levels of PAF were (25.30 ± 4.76),(36.06 ± 5.57)μg/L,and the difference between the two groups was statistically significant (P ＜ 0.05).The serum levels of VEGF were increased 1 d after AEP induction,and the increase in SI group was greater than that of AEP group 3 d later,and the serum levels of VEGF were (139.78 ±24.30),(118.51 ±21.70)pg/ml at 5th day,and the difference between the two groups was statistically significant (P ＜ 0.05).The expression levels of NF-κB mRNA and protein of pancreatic tissue in SI group were O.834 ±0.031 and 0.49±0.24,and MVD was 6.41 ± 1.14,while the corresponding values in AEP group were 1.000 ± 0.059,0.93 ± 0.45,3.62 ± 0.89,and the difference between the two groups was statistically significant (P ＜ 0.05 or P ＜ 0.01).Conclusions In the course of acute pancreatitis,Shenmai injection has the therapeutic effects of promoting new angiogenesis,improving the microcirculation,reducing the inflammatory cascade.