Objective To investigate the effect of coenzyme Q10 combined with Shenmai injection on serum enzyme in the treatment of brain hypoxic injury after asphyxia by meconium in newborn.Methods 64 cases with brain hypoxic injury after asphyxia by meconium from Medical University of Tianjin Jinghai Clinical College were selected and randomly divided into 2 groups, 32 cases in each group.The control group received maintained ventilation and circulation function and routine drug therapy adequate, and the experiment group received more with coenzyme Q10 combined with Shenmai injection for 7 days.Serum enzymes and myocardial injury markers, oxidative stress and inflammation related factors and the clinical effect and complications were compared after the treatment.Results Compared with before treatment, levels of CK-MB, AST, LDH, CK and α-HBDH decreased in two groups after the treatment, levels of CT-1, CTnI and Mb decreased, levels of SOD and MDA decreased, contents of GSH-Px, APN, IGF-1 increased, contents of Leptin decreased (P<0.05).Compared with the control group, the levels of CK-MB, AST, LDH, CK and α-HBDH in the experiment group were lower, levels of CT-1, CTnI and Mb were lower, levels of SOD and MDA were lower, contents of GSH-Px, APN, IGF-1 were higher, contents of Leptin were lower(P<0.05).The clinical curative effect rate of control group(65.63%) was lower than the experiment group (87.50%)(P<0.05).Conclusion Coenzyme Q10 combined with Shenmai injection in the treatment of brain hypoxic injury after asphyxia by meconium in newborn is curative effective with high safety, and it can reduce serum enzyme and myocardial injury.

Objective To observe the effects of interferon ? (IFN?) on thyroglobulin (TG) and thyroid peroxidase (TPO) gene expressions in FRTL5 cells induced by thyroid stimulating antibody (TSAb). Methods TSAb crude fraction was extracted by polyethylene glycol 4000. Recombinant rat interferon ? (0, 1, 10, 10 2, 10 3 U/ml) was added to the FRTL5 cells induced by TSAb, and then expressions of TG, TPO mRNA were measured by Northern blot, the cell growth was measured by 〔 3H〕 thymidine incorporation. Results (1)TSAb increased TG, TPO gene expressions, and 〔 3H〕 thymidine incorporation. (2)Interferon ?inhibitedTSAb inducedTG, TPOgeneexpressionsand〔 3H〕 thymidine incorporation. Conclusion Interferon ? inhibits the growth and function of thyrocytes induced by TSAb, which suggests that interferon ? might regulate thyroid function in Graves' disease.

Objective To investigate the feasibility and effectiveness of ‘ group-head responsibility teaching method' in the physiology experiment teaching.Methods Totally 422 students of clinical medicine major in 2010 grade were randomly divided into two groups:212 students in control and 210 in study group.For students in control group,principles,procedures,items of experiment and computer operation were first taught,then experiment was performed while for those in study group,initial procedures were firstly explained,then the group heads were called together to observe the experiment preformed by teacher,after that the group heads returned to assist other students performing the experiment.Finally,experiment success rates,scores of final-term experiment operation,theoretical exam and report of two groups were compared and analyzed.Meanwhile,questionnaire survey was conducted.Results Success rates were improved significantly in study group than in control group (x2 =37.42,P =0.0000).There were significant differences in operation scores (t =4.3213,P =0.0000),theoretical exam scores (t =6.8744,P =0.0000) and report scores (t =15.298,P =0.0000) between the two groups.Conclusions ‘ Group-head responsibility teaching method' is better than traditional lecture-style teaching method and it can promote comprehensive capabilities of students.

Objective To evaluate the clinical efficacy of ultrasonic-harmonic scalpel in open thyroid surgery.Methods Totally 70 patients with thyroid surgery from January 2012 to January 2014 in some hospital were selected as the study objects, who were divided into a control group and an observation group equally. The patients in the control group went through traditional surgery, and the ones in the observation group underwent open thyroid surgery. Then the operative time, blood loss, postoperative hospital stay before and after surgery and body stress-related serum markers of two groups were analyzed and compared.Results The observation group had the operative time, blood loss and postoperative hospital stay significantly better than those of the control group, and the body stress-related serum markers 5 days after operation significantly lower than that of the control group, with P<0.05.Conclusion The short-term clinical effect of ultrasonic-harmonic scalpel in open thyroid surgery is significantly better than that of traditional surgery, which has high safety and lower degree of adverse physical stress.

Objective To describe the interpositional omentum and demonstrate its clinical significance.MethodsCT and clinical data of the cases whose suprahepatic gaps widen were reviewed and the contrast of CT was adjusted to observe further.ResultsIn 1 916 cases with upper abdominal CT data,suprahepatic gap was widen in all 152 cases,and 119 cases showed fat density(6.21％ ).There were 3 cases of trauma and 3 cases of acute abdomen in the 119 cases CT in the 119 cases displayed free gas under diaphragma,but displayed fat density after contrast adjusted.There were 11 cases undergoing operations,1 for sigmoid rupture 4 liver cirrhosis and portal hypertension,3 gastric cancer,and 1 acute cholecystitis,1 bile duct carcinoma and Ⅰ case congenital cystic dilatation of common bile duct.The other 108 cases did not undergo surgical operation.ConclusionsInterpositional omentum is a clinical phenomenon that the omentum was shift in suprahepatic gap covering the liver surface.It is not rarely,the incidence rate being 6.21％ ( 119/1 916) in our study.The occurrence mechanism may be similar to that of Chilaiditi syndrome.It is difficult to differentiate interpositional omentum from free gas under diaphragms on CT plain scan picture,but it is easy after contrast adjusted of CT.Free gas under diaphragma should not be identify incorrecdied and patients should not undergo unnecessary surgical procedure.

[Abst ract] Objective To explore the relationship between expression of S100B in hippocampus of depression model rats induced by chronic stress and its depression like behavior,and the antidepressant effect of fluoxetine.Methods 40 rats were put into control group,fluoxetine group,CUS group and CUS plus fluoxetine group,using random number table.Rats in each groups received corresponding treatment.Chronic unpredictable stresses (CUS) were performed on rats for 42 days.Fluoxetine (5 mg/(kg · d)) were delivered to rats by intragastric administration from day 22 to day 42.Then,S100B protein were marked and observed by immunohistochemical method.Open-field test,sucrose consumption and body weight were used to evaluate behavioral changes.Results Scores in behavioral test were reduced significantly by 42 days of stress (main effects of stress,P＜0.05).Effects of stress on behavioral scores were reversed by 21 days fluoxetine treatment (interactions,P＜0.05).CUS resulted in elevated expression of S100B in CA1,CA3 and DG sub-regions in experimental rats (OD values,CUS,0.331 ±0.01,0.353 ± 0.01,0.381 ± 0.007 ; control,0.238 ± 0.007,0.237 ± 0.010,0.228 ± 0.006.Simple effects of stress,P=0.000; P=0.000; P=0.000).Fluoxetine treatment reversed the elevated expression of S100B in CA1,CA3 and DG sub-regions in model rats (OD values:CUS plus fluoxetine,0.233 ± 0.015,0.240 ± 0.005,0.254± 0.015; fluoxetine,0.241±0.007,0.233±0.013,0.227±0.017; Interactions between fluoxetine and CUS,P=0.000; P=0.000; P=0.000).Conclusion Sub-regional over expression of S 100B in hippocampus is associated with depression like behavior of rats.Reversed S100B expression in these sub-regions is an indicator of effective antidepressant treatment but not a mechanism for it.

BACKGROUND: Previous studies demonstrated that construction of eoexpression plasmid containing multiple genes on the same vector could improve transfection and expression rates.OBJECTIVE: To construct eukaryotic expression plasmid pcDNA3.1 (+)-MUC1 -GM-CSF by human polymorphic epithclial mucin (MUC 1) and granulocyte macrophage colony stimulating factor.(GM-CSF) and to observe expression of recombinant plasmid in COS-7 cells.DESIGN,TIME AND SETTING: Gene recombination design,which was carried out in the Animal Central Laboratory,the Fourth Military University of Chinese PLA from September 2005 to December 2006.MATERIALS: Eukaryotic expression vector pcDNA3.1 (+) was presented by Pro.Taylor-Papadimitriou;pGEM-3zf()-GM-CSF plasmid,COS-7 cells,pUCI 8 vector,and E.coli DH5α were made in the center; female BALB/c mice were provided by Experimental Animal Center of the Fourth Military University of Chinese PLA.METHODS: Signal peptide was synthesized with encoded MUCI gene sections to obtain repeated sequence coneatemer after renaturation.Next,the accepted concatemer was cloned with GM-CSF following enzyme identification and sequencing analysis,and then they were put in eukaryotic expression vector pcDNA3.1(+) to construct eukaryotic coexpression plasmid pcDNA3.1 (+)-MUCI -GM-CSF in order to transform COS-7 cells.MAIN OUTCOME MEASURES: Gene expression was detected by indirect immunofluorescence and enzyme linked immunosorbent assay (ELISA).RESULTS: Enzyme identification and sequencing analysis showed that recombinant plasmid contained a fusion gene encompassing human MUC1 repeated sequence concatemer and GM-CSF; moreover,MUC1 expression was detected in COS-7 cells,while recombinant plasmid could induce the production of anti-GM-CSF antibody.CONCLUSION: The recombination between human MUC1 repeated sequence concatemer and GM-CSF gene successfully constructs eukaryotic coexpression plasmid.

Objective: To analyze the prevalence and predictor for left ventricular reverse remodeling (LVRR) in patients of primary hypertension combining left ventricular systolic dysfunction (LVSD) with tailored medication.
Methods: A total of 118 consecutive patients admitted in our unit from 2010-08 to 2012-10 with the base line left ventricular ejection fraction (LVEF)≤40%were enrolled. The demographic and clinical information with the findings of echocardiography at admission were collected. The patients were followed-up until 2013-12 or until the all cause death/cardiac transplantation. According to echocardiography, LVRR was deifned by 2 criteria at the same time:①the absolute elevation of
LVEF≥10%than base line and the follow-up LVEF≥50%,②the relative reduction of left ventricular end-diastolic diameter (LVEDD) index≥10%than base line and the follow-up LVEDD index≤27 mm/m2. LVRR prevalence with its base line predictor was investigated.
Results: The overall mean follow-up time was (23 ± 15) months, and 39/118 (33.1%) patients acquired LVRR as LVEF from the base line level (30.6 ± 6.8)%increased to the follow-up level (57.0 ± 4.9)%;LVEDD index from the base line level (31.6 ± 3.9) mm/m2 decreased to the follow-up level (24.4 ± 1.9) mm/m2, all P<0.01. The average time length for reaching LVRR was (11 ± 9) months, and 27/39 (69.2%) patients reached LVRR within 12 months. There were 79 patients not reached to LVRR, while their LVEF also from the base line level (28.6 ± 6.1)%increased to the follow-up level (39.0 ± 13.2)%;LVEDD index from the base line level (38.1 ± 5.6) mm/m2 decreased to the follow-up level (36.1 ± 6.9) mm/m2. Multivariable logistic regression analysis indicated that the patients with the shorter duration of heart failure (HF) as>6 months vs≤6 months (OR=0.244, P<0.01), shorter QRS interval as≥120ms vs<120ms (OR=0.276, P<0.05) and the higher quartile of systolic blood pressure (SBP)/LVEDD index (OR=2.724, P<0.01) at admission were the independent predictors for LVRR.
Conclusion:With tailored medication, about 1/3 of patients with hypertension combining LVSD could acquire LVRR, the patients with shorter duration of HF, shorter QRS interval and higher ratio of SBP/LVEDD index had more possibilities.

Objective: To investigate the prevalence of hyponatremia and the relationship between hyponatremia and prognosis of dilated cardiomyopathy (DCM) for in-hospital patients. Methods: A total of 515 consecutive in-hospital DCM patients treated in HF center of Fu Wai Hospifal from 2008-10 to 2013-10 were retrospectively studied. Hyponatremia was deifned as the serum level of sodium < 135 mmol/L at ifrst admission. The prevalence of hyponatremia and the relationship between hyponatremia and DCM prognosis were studied including the risk of in-hospital time and mortality, the rates of all cause death and HF worsening death after discharge. Surviving patients were followed-up by clinical or telephone visit until 2014-11 or until the death. Results: There were 134/515 (26.0%) patients suffered from hyponatremia at admission, the serum level of sodium was related to HF symptom duration, NYHA functional classiifcation, systolic blood pressure (SBP), left atrial diameter and total bilirubin level, allP<0.01. Compared with non-hyponatremia, the patients with hyponatremia presented longer in-hospital time(14.8±11.1) days vs (11.2±5.8) days and higher in-hospital mortality (18.7% vs 1.8%), bothP< 0.01. There were 483 survivors discharged and were followed-up for (30.7 ± 19.5) months, during that period, the rates of all cause death and HF worsening death were 26.5% and 21.9% respectively. The patients with hyponatremia had the higher rates of all cause death (47.7% vs 20.3%) and HF worsening death (44.0% vs 15.5%), bothP<0.01. Multiple Cox regression analysis showed that with adjusted HF history (> 6 months vs≤ months ), NYHA functional classiifcation (Ⅱ-Ⅳ), SBP (per 10 mmHg elevation), total bilirubin level (per 1 mg/dl change) and LVEDD (per 5 mm change), the hyponatremia at admission is still one of the important independent predictors for all cause death (HR=1.836, 95% CI (1.248-2.702),P<0.01 and HF worsening death HR=2.139, 95% CI (1.406-3.253),P<0.01 in DCM patients after discharge. Conclusion: Hyponatremia is a common electrolyte disorder for in-hospital DCM patients, it is related to longer in-hospital time and higher mortality; higher rates of all cause death and HF worsening death after discharge in DCM patients.

Objective To evaluate the effects of different reconstruction settings of knowledge-based iterative reconstruction technique (IMR) on noise reduction and image quality in hepatic contrast-enhanced CT(CECT) at different radiation dose levels.Methods Patients who underwent hepatic CECT because of their diseases were enrolled in this prospective study.According to random number table,patients were randomly assigned to two groups (standard dose group,SD-group,n=29; low dose group,LD-group,n=25).All patients underwent both non-enhanced CT and triphasic CECT scan including hepatic arterial phase (HAP),portal-venous phase (PVP) and delayed phase.PVP images of SD-group were acquired with tube voltage of 120 kVp and tube current-time products of 250 mAs,and 80 kVp and 500 mAs for LD-group.PVP images were reconstructed with both filtered back projection (FBP) and IMR techniques.Settings applied in IMR reconstructions consisted of body routine (BR) and body soft tissue (BST) with three levels (L1 to L3),and image series included:L1BR,L2BR,L3BR,L1BST,L2BST and L3BST.Subjective assessment of image quality including low contrast detectability (LCD),image distortion (ID) and diagnostic confidence (DC) as well as objective image quality including image noise,signal to noise ratio (SNR) and contrast to noise ratio (CNR) were compared between groups.Effective radiation dose was recorded.Objective image quality and subjective image quality were compared by using Friedman H test and ANOVA,respectively.In addition,Student t test was used to compare effective radiation doses between groups.Results In SD-group,IMR settings of L2BST,L3BST scored highest in LCD with median score of 4;L3BST and L2BST scored lowest in ID with median score of 3,while FBP and L1BR scored highest with median score of 4; L1BR,L2BR and L1BST scored highest in DC with median score of 4,while L3BST scored lowest with median score of 3.In LD-group,the distribution of all reconstruction settings scores in LCD and ID were similar to those in SD-group; however,L1BST scored highest with median score of 4,and FBP scored lowest with median score of 2 in DC.There were statistical differences in LCD,ID and DC among all the reconstruction settings for both groups (P＜0.05).In terms of FBP technique,the image noise,SNR and CNR were (9.8±2.0)HU,13.3±3.3 and 6.0±1.9 in SD-group,and (16.2±4.1)HU,12.9±3.3 and 6.6± 2.3 in LD-group,respectively.In SD-group,image noise exhibited a trend of decrease from L1BR to L3BST [from (4.5±0.9) HU to (3.2±0.2)HU],while SNR,CNR trended to increase (SNR:from 21.4±1.4 to 24.6±4.6; CNR:from 9.4±2.2 to 10.9±2.9,respectively).The image noise,SNR and CNR in LD-group showed the same trends as SD-group [image noise:from (5.8±0.2)HU to (3.9±0.6)HU; SNR:from 26.3±4.5 to 33.1±6.9; CNR:from 13.6±4.0 to17.4±5.1,respectively].In both groups,there were statistically differences in image noise,SNR and CNR among all IMR settings and FBP (F values were 15.50 to 131.39,P＜0.01).The effective radiation dose of the LD-group was significantly lower than that of the SD-group [(4.19±0.22) versus (7.32±0.58) mSy,t=15.27,P＜0.01).Conclusions IMR can reduce image noise and improve image quality in hepatic CECT at both standard and low dose levels.L1BR,L2BR and L1BST are the most optimized reconstruction settings for the standard dose protocol,while L1BST performs best for the low dose protocol.