Objective To analyze anemia in patients with chronic heart failure changes in relevant indicators.Methods 48 chronic heart failure patients(observation group)and 48 healthy people(control group).were erolled the peripheral blood red blood cell count(RBC),hemoglobin(Hb),hematocrit(Hct)and other anemia-related indicators were measured.Results The results of the observation group RBC,Hb,Hct,were(3.37 ±0.49)× 1012/L,(103.64±14.33)g/L,(0.31 ±0.08)respectively,the control group were(4.64 ±0.51)× 1012/L,(121.33 ±17.69)g/L,(0.37 ± 0.07),between the two groups were statistically significant(t =4.46、3.06、4.18,P =0.02,0.04,0.04);treatment,symptoms of heart failure in observation group mitigation,RBC is(3.76 ± 0.58)× 1012/L,compared with the control group the difference was significant(t =0.48,P =0.03); observation group Hb,Hct were (123.77 ± 17.26)g/L,(0.37 ± 0.05),and were not significantly different with the amtrol gronp(P =0.06,0.11).Conclusion Elderly patients with anemia associated with heart failure were lower than healthy people,heart failure and anemia had,a significant correlation with aremia.

Objective To investigate the polymorphism of the vitamin D receptor gene (VDR)TaqⅠin relation to diabetic retinopathy. Method Fragment length discrepant allele specific PCR(FLDAS-PCR) were used to determine VDR genetypes in 158 patients with diabetic retinopathy and in 198 normal subjects. Results The frequency distribution of VDR genotypes in diabetic retinopathy patients was 106 (67.1%) in TT, 33(20.9%) in Tt, 19(12.0%) in tt; and in normal persons was 165 (83.3%) in TT, 23(11.6%) in Tt, 10 (5.1%) in tt. There was a significant difference between diabetic retinopathy patients and normal persons in distribution of VDR gene TaqⅠgenotypes(P

Objective To study changes of serum IL-17 and IL-35 levels in patients with heart failure. Methods 60 patients with heart failure (observation group)were selected as research subjects.60 patients accord-ing to different severity were divided into acute period heart failure (34 cases)and stable stage heart failure (26 ca-ses);60 patients graded according to the NYHA standards were divided into 24 cases of heart failure with grade Ⅱ, 20 cases of grade Ⅲ ,16 cases of grade Ⅳ.According to the different primary diseases :expansion cardiomyopathy group (20 cases in group A),the coronary heart disease group (group B,24 cases),hypertensive heart disease group (group C,16 cases).During the same period,42 healthy elderly people in our hospital were selected as control group. The serum IL-17,IL-35 levels were tested,and the serum IL-17,IL-35 levels in patients with heart failure were ana-lyzed.Results Serum level of IL-17 in the observation group was higher than the control group,and the difference was significant [(15.61 ±4.02)pg/mL vs (9.49 ±3.96)pg/mL,t =9.018,P <0.01].Serum level of IL-35 in the observation group was significantly lower than that of the control group,and the difference was significant[(52.78 ± 4.29)pg/mL vs (61.49 ±4.81)pg/mL,t =11.963,P <0.01].The level of serum IL-17 in acute stage of patients with heart failure was higher than that of stable heart failure,and the difference was significant (t =6.278,P <0.01);IL-35 level in serum of patients with heart failure in acute phase was lower than that of stable heart failure,the difference was significant (t =9.529,P <0.01).With the increase in heart failure grade,serum IL-17 level showed a rising trend,and the differences among three groups had statistical differences (F =6.098,P <0.01);serum IL-35 level decreased,and the differences among three groups had statistical differences(F =8.978,P <0.01).The serum IL-17 level of A group was higher than that in B group and C group,there were significant differences (F =6.096, P <0.01),the serum IL-17 level between B group and C group had no statistical difference (t =0.172,P >0.05). The serum IL-35 level of A group was lower than that of B group and C group,there were significant differences (F =8.978,P <0.01),the serum IL-35 level between B group and C group had no statistical difference (t =0.208,P >0.05).Serum IL-17 and serum IL-35 level was negatively correlated (r =-0.429,P =0.009).Conclusion High expression of IL-17 in elderly patients with heart failure,while IL-35 decreased in elderly patients with heart failure, IL-17,IL-35 are closely related to the senile congestive heart failure and the severity of illness.Serum IL-17 is nega-tively correlated with the level of serum IL-35.

This study is to investigate the effect of artesunate on transforming growth factor-beta1 (TGF-beta1) induced epithelial-mesenchymal transition (EMT) and its possible mechanism. After the in vitro cultured RLE-6TN cells were treated with TGF-beta1 then artesunate intervened on it, after 24 h, expression of the markers of mesenchymal cell was assayed using Western blotting and real-time PCR analysis. Western blotting was also used to detect the effect of TGF-beta1 on the Smad3 and Smad7 expressions of RLE-6TN cells. Morphological alterations were examined by phase-contrast microscope, and ultrastructure changes by electron microscope. Incubation of RLE-6TN cells with TGF-beta1 resulted in the up-regulation of the expression of the mesenchymal cell markers, after artesunate intervened on it, resulted in the down-regulation of the expression. Meanwhile, incubation with artesunate intervened on RLE-6TN cells could lead to the apparent down-regulation of the expression of Smad3 and up-regulation of Samd7 and the transition of RLE-6TN cells to mesenchymal-like by TGF-beta1 induction, after artesunate intervened on it, RLE-6TN cells to epithelial-like. TGF-beta1 induced epithelial-mesenchymal transition process; artesunate can inhibit TGF-beta1-induced epithelial-mesenchymal transition process, the possible mechanism is up-regulation of the expression of Smad7 and down-regulation of the expression of Smad3, meanwhile inhibits phosphorylation of Smad3.

Objective To study the change of serum lipoprotein-associated phosphorlipase A2 (Lp-PLA2) and neuron specific enolase (NSE) and its clinical significance in patients with acute cerebral infarction (ACI).Methods Fifty-two ACI patients served as ACI group and 45 subjects undergoing physical examination served as control group.The patients in ACI group were further divided into mild ACI group (n =10),moderate ACI group (n =26) and severe ACI group (n =16) according to their NIHSS score.Relationship of serum Lp-PLA2 and NSE levels with NIHSS score in ACI patients was analyzed.Results The serum Lp-PLA2 and NSE levels were significantly higher in ACI group than in control group (289.3±19.4 μg/L vs 123.4±28.4 μg/L,22.1±2.8 μg/L vs 7.2±1.9 tμg/L,P＜0.05),and in moderate and severe ACI group than in mild ACI group (P＜0.05).The serum Lp-PLA2 and NSE levels and NIHSS score were significantly higher on days 2-7 than on day 1 after treatment (P＜0.05) and significantly lower on days 6 and 7 than on day 5 after treatment (P＜0.05).Pearson correlation analysis showed that serum Lp-PLA2 and NSE level were positively related with NIHSS score in ACI group (r =0.788,P =0.035;r=0.950,P=0.001).Conclusion Lp-PLA2 and NSE play an important role in the occurrence and progression of ACI,and are closely related with the severity and outcome of ACI,which can thus provide reference for the treatment,outcome and assessment of ACI.

Objective To upgrade Oracle database to Oracle 10g Release 2 in No.1 Military Medical Project. Methods Technologies such as database upgrade assistance, manual script upgrade, exp/imp(expdp/impdp)of DBUA, transportable tablespace, materialized view and table copy were used to upgrade Oracle database respectively. Results It showed that all of these methods could upgrade Oracle database. Conclusion Although all of these methods can upgrade Oracle database, there are differences in their procedures and efficencies, so suitable methods should be chosen according to practical situation.

OBJECTIVE To explore pathogens and drug resistance in ventilator-associated pneumonia caused by Acinetobacter baumannii,and to provide the corresponding clinical prevention strategies.METHODS The clinical resords and the bacterial susceptibility results of sputum cultivation in 62 cases with VAP caused by A.baumannii between from 2003 and 2006 in ICU of our hospital were reviewed.RESULTS All of the patients suffered from severe underlying diseases,the aged accounted for 77.4%.At least one kind of antibiotic was used in all cases before occurrence of VAP.30.6% of the cases had mixed infection.VAP caused by A.baumannii had the rise trend year by year.The results of bacterial susceptibility showed that A.baumannii had multiple drug resistance,but was lowly resistant to cefoperazone/sulbactam and imipenem.CONCLUSIONS The reasonable choice for antibiotic of VAP caused by A.baumannii should be based on the latest local surveillance on etiology and drug resistance.

Objective:To observe the nutritional status and respiratory function of the patients with mechanical ventilation in Intensive Care Unit after high fat and low carbohydrate enteral nutrition treatment.Methods:271 patients with mechanical ventilation in Intensive Care Unit were randomly divided into two groups:study group and control group.The study group was given high fat and low carbohydrate enteral nutrition treatment,while the control group with Enteral Nutritional Suspension.Thealbumin,prealbumin,blood gas analysis(PaC02,Pa0) and RQ,VC02,V02,IgG,CD4,CD4/CD8 were observed.Results:After nutritional support,nutritional status of two groups were improved,but there was no significant difference regarding the serum albumin and prealbumin.The PaO2,VO2,VCO2,RQ,IgG,CD4,CD4/CD8 and the total time of mechanical ventilation were improved,and the study group was superior to the control group.Conclusion:High fat and low carbohydrate enteral nutrition improves the nutritional status and respiratory function of the patients with mechanical ventilation in Intensive Care Unit,and decreases the total time of mechanical ventilation and total medical expenses.

Objective To explore the application of case-based discussion combined with translational medicine teaching method in clinical teaching of gastrointestinal surgery.Methods Totally 100 undergraduates of clinical medicine in grade 2007 and 100 undergraduates in grade 2008 from the second military medical university were divided into experimental class (50 students,25 in discussion class and 25 in comprehensive class) and control class (50 students).Method of case-based discussion was applied in discussion class; method of case-based discussion combined with translational medicine was employed in comprehensive class and traditional method was used in control class.Results Scores in experimental class were superior to those in control class ; questionnaire survey showed that 90％ students thought the new model was better than the traditional model; the interests of students in exploring clinical problem in experimental class were increased (90％ vs.50％ ) ;the sense of mission and responsibility was Strengthened (86％ vs.64％ ) ;the scientific research thinking was more active (80％ vs.48％ ) ; the individual ability and quality were enhanced (76％ vs.50％ ),the depth and width of study were markedly increased (80％ vs.52％ ),the consciousness of independent study and thinking was strengthened (88％ vs.54％ ).Comprehensive class had more obvious improvements in scientific research thinking,individual ability and quality,depth and width of study,independent study and thinking.Conclusions The new teaching model which combined translational medicine with case discussion breaks through the traditional model and adapts to the requirements of modem medicine,it can enhance the teaching effect and worth promoting in educational reform.

Objective To explore the prognostic value for cardiovascular events of elevated NT-proBNP in coronary heart disease(CHD) patients with metabolic syndrome(MS).Methods The level of NT-proBNP was measured in 165 CHD patients with MS diagnosed by coronary angiography.After 2 years follow-up,we recorded the corresponding cardiovascular events in those patients.Results The NT-proBNP level was much higher in ACS group than that in SCHD group( P ＜ 0.01 ).There were totally 45 events after 2 years.After adjustment of traditional risk factors including hypertension,diabetes,smoking history and high sensitivity C reactive protein( hs-CRP),Cox proportional hazard analysis indicated that high NT-proBNP level( ＞ 111.58ng/L)was an independent risk factor for future events (relative risk 2.67,P ＜0.01 ).Conclusion Elevated NT-proBNP level might be one of the independent risk factor for cardiovascular events in CHD patiens with MS.