Objective To compare the effect of carvedilol and motoprolol on high altitude chronic congestive heart failure (CHF). Methods Ninety patients with high altitude chronic CHF were divided into three groups randomly:Twenty patients in the regular treatment group treated with angiotensin-converting enzyme inhibitor (ACEI) ,diuretics and digoxin; motoprolol (50 mg twice daily) was given in the motoprolol group( 34cases) additional to regular treatment; carvedilol (25 mg twice daily) was given in the carvedilol group(36cases ) additional to regular treatment. All the patients were followed up for six months and measured the changes of cardiac function by echocardiography. Results Left ventricular end-diastolic dimension (LVEDD) was ( 57. 3 ± 6. 5 ) mm and (57.2 ± 6. 9) mm in the carvedilol group and the motoprolol group respectively, and left ventricular end-systolic dimension (LVESD) was (46. 6 ± 7.0) mm and (44. 0 ± 6. 9 ) mm in the carvedilol group and the motoprolol group respectively, which were all significantly smaller than that in the regular treatment group ([64.7 ±9. 1]mm and [53.4 ±9.8]mm for LVEDD and LVESD,respectively) (Ps ＜0.05). Left ventricular ejection fraction (LVEF) in the carvedilol group and the motoprolol group ( [47.5 ± 8. 1] % and [52. 9 ±8.5] % ,respectively) was higher than that in regular treatment group( [42. 8 ±9. 2]% ) (Ps ＜0. 05).The improvement of LVEF in the carvedilol group was better than that in the motoprolol group (P ＜ 0. 05 ). One case died in the motoprolol group and no death in the carvedilol group,4 cases died in the regular treatment group,the mortality in the motoprolol group and the carvedilol group was significantly lower than that in the regular treatment group. Conclusion Carvedilol and motoprolol significantly improved cardiac function in high latitude CHF patients,and the effect of Carvedilol is slightly better than that of motoprolol.

Child ; Child, Preschool ; Female ; Humans ; Male ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic ; Sleep Apnea, Obstructive ; genetics ; physiopathology

Female ; Humans ; Hydrocarbons, Chlorinated ; poisoning ; Male ; Middle Aged ; Occupational Diseases

Objective:To investigate the variations in ocular biometry and its influencing factors in adult Tibetans of Lhasa.Methods:A cross-sectional study was adopted.A total of 100 consecutive adult Tibetans (100 eyes) with cataract, who were treated in Tibet Autonomous Region People's Hospital from March 2017 to July 2017 were enrolled, including 51 males and 49 females, with an average age of (63.38±12.80) years.The subjects were divided into two groups, with 57 subjects (57 eyes) older than 60 years in the elder group and 43 subjects (43 eyes) younger than 60 years in the youth group.Corneal curvature, corneal astigmatism, anterior chamber depth and axial length of subjects were measured and compared with those of Beijing population which were used as standardized data of Han Chinese.The differences in ocular parameters associated with age and gender were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tibet Autonomous Region People's Hospital (No.ME-TBHP-21-KJ-005).Written informed consent was obtained from each subject prior to any examination.Results:The mean corneal curvature, corneal astigmatism, anterior chamber depth and axial length of the 100 Tibetans were (43.68±1.62)D, 0.750 (0.375, 1.000)D, (3.05±0.41)mm, (23.07±0.86)mm, respectively.The axial length of Tibetan was shorter than that of Beijing Han people and the difference was significant ( t=2.65, P<0.01).Corneal astigmatism of the elder group was higher than that of youth group and the difference was significant ( t=2.11, P<0.05).There were no significant differences in corneal curvature, anterior chamber depth and axial length between the elder group and youth group (all at P>0.05).The anterior chamber depth and axial length of males were much longer than those of females, and the differences were significant ( t=2.71, 2.25; both at P<0.05). Conclusions:In adult Tibetan population, the axial length is short, and the anterior chamber is deep.The corneal astigmatism increases with age and there is a gender difference in axial length and anterior chamber depth.

The ginsenoside-Ro is sensitive to be hydrolyzed in an alkaline medium. This paper investigated the hydrolysis kinetics of ginsenoside-Ro under different pH and temperature values. The results showed ginsenoside-Ro in alkaline solution followed pseudo-first-order reaction. Hydrolysis kinetics of ginsenoside-Ro has not been reported previously. The hydrolysis rate was independent of initial concentration. On the basis of UFLC-MS/MS, NMR, as well as chemical evidence,the structure of hydrolyzate was assigned as 3-O- [beta-D-glucuronopyranosyl- (1 --> 2) -beta-D-glucopyranosyl] -oleanolic acid.
Drugs, Chinese Herbal ; chemistry ; Ginsenosides ; chemistry ; Hydrogen-Ion Concentration ; Hydrolysis ; Kinetics ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

Objective To study the effect of nursing teaching competition to improve nurses' teaching ability.Methods Totals of 120 clinical teaching nurses from department of internal medicine and department of surgery were randomly divided into the control group and the observation group,each with 60 cases.Both groups received regular teaching training and the observation group received teaching competition once a month in addition.Teaching effect was evaluated by both teaching nurses and student nurses at the end of internship.Results Student nurses' satisfaction rates of teachers' knowledge level,professional quality,teaching methods,communication ability and teaching attitude were respectively 92.7％,95.3％,94.0％,93.3％ and 94.7％,all higher than 80.0％,86.7％,80.0％,84.0％ and 78.7％ in the control group,and the differences were statistically significant (x2 =10.198 7,6.878 3,12.997 4,6.501 5,16.615 4,respectively; P ＜ 0.01).Charge nurses' evaluation of student nurses' communication ability,quality of carefulness while alone,health education ability,professional dedication and ability to handle emergency were higher in the observation group than in the control group,and the differences were statistically significant (x2 =5.555 6,16.770 2,27.272 7,0.724 6,12.000 0,respectively; P ＜ 0.01).Conclusions Nursing teaching competition can greatly improve nurses' ability of clinical teaching,which plays a decisive role to improve student nurses' comprehensive quality.

OBJECTIVETo study the factors affecting extracellular glycerol (Gly) in patients with severe traumatic brain injury (STBI).

METHODSPerilesional extracellular Gly and cerebral blood flow (CBF) in 53 patients with STBI were consecutively monitored. Simultaneously, the intracranial pressure (ICP) and cerebral perfusion pressure (CCP) were monitored. The hourly minimum of CCP and CBF and the hourly maximum of ICP levels were matched with the hourly Gly. Gly values were divided into several groups according to regional ICP (less than 15 mm Hg or larger than 15 mm Hg), CCP (less than 70 mm Hg or larger than 70 mm Hg), CBF (less than 50 AU or 50-150 AU) and the outcomes (death or persistent vegetative state group, severe or moderate disability group, and good recovery group).

RESULTSIn comparison with the severe or moderate disability group, the Gly concentration of the death or persistent vegetative state group increased significantly, but CBF and CCP decreased significantly. In comparison with the good recovery group, the Gly concentration of the severe or moderate disability group increased significantly, but CBF and CCP decreased significantly. The Gly concentrations in patients with ICP larger than 15 mm Hg, CCP less than 70 mm Hg and CBF less than 50 AU were respectively higher than those of patients with ICP less than 15 mm Hg, CCP larger than 70 mm Hg and 50 AU less than CBF less than 150 AU. In patients with diffuse axial injury, the mean Gly concentration was (201.17+/-55.00) micromol/L, which was significantly higher than that of the patients with epidural hematoma (n equal to 7, 73.26+/-8.37, P less than 0.05) or subdural hematoma (n equal to 9, 114.67+/-62.88, P less than 0.05), but it did not increase significantly when compared with those in patients with contusion(n equal to 24, 167.48+/-52.63).

CONCLUSIONGly can be taken as a marker for degradation of membrane phospholipids and ischemia, which reflects the severity of primary or secondary insult.

Adolescent ; Adult ; Biomarkers ; analysis ; Brain Chemistry ; Brain Injuries ; diagnostic imaging ; metabolism ; Extracellular Space ; chemistry ; Female ; Glycerol ; analysis ; Humans ; Male ; Microdialysis ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo study the effect of mild hypothermia on glucose metabolism and glycerol of brain tissue in patients with severe traumatic brain injury (STBI) using clinical microdialysis.

METHODSThirty-one patients with STBI(GCS less than or equal to 8) were randomly divided into hypothermic group(Group A) and control group(Group B). Microdialysis catheters were inserted into the cerebral cortex of perilesional and normal brain tissue. All samples were analyzed using CMA microdialysis analyzer.

RESULTSIn comparison with the control group, lactate/glucose ratio(L/G), lactate/pyruvate ratio(L/P) and glycerol(Gly) in perilensional tissue were significantly decreased; L/P in normal brain tissue was significantly decreased. In control group, L/G, L/P and Gly in perilensional tissue were higher than that in normal brain tissue. In the hypothermic group, L/P in perilensional tissue was higher than that in relative normal brain.

CONCLUSIONSMild hypothermia protects brain tissues by decreasing L/G, L/P and Gly in perilensional tissue and L/P in "normal brain" tissues. The energy crisis and membrane phospholipid degradation in perilensional tissue are easier to happen after traumatic brain injury, and mild hypothermia protects brain better in perilensional tissue than in normal brain tissue.

Adolescent ; Adult ; Brain ; metabolism ; Brain Injuries ; metabolism ; therapy ; Glucose ; metabolism ; Glycerol ; analysis ; Humans ; Hypothermia, Induced ; methods ; Microdialysis ; Middle Aged

OBJECTIVETo develop a reliable assay for simultaneous sequence-based typing (SBT) of HLA-DPA1 and HLA-DPB1, and to apply it for the study of allelic polymorphisms in southern Chinese Han population.

METHODSBased on full-length HLA-DPA1 and HLA-DPB1 allelic sequences, locus-specific PCR primers were designed and applied to amplify the target sequence encompassing the entire exon 2 of HLA-DPA1 and HLA-DPB1. PCR products were purified with magnetic beads, and run through an ABI 3730 DNA sequencer. Genotypes were assigned with an Assign 3.5 SBT software.

RESULTSThe target sequences of HLA-DPA1 and HLA-DPB1 were both amplified with the PCR procedure. Little background and noise was observed in the derived sequences. Among 176 non-related healthy individuals, 4 HLA-DPA1 alleles with the frequencies of DPA1*02:02 (0.589) > DPA1*01:03 (0.284) > DPA1*02:01 (0.096) > DPA1*04:01 (0.031) were identified. In addition, 14 HLA-DPB1 alleles, including 4 common alleles (with a frequency of more than 5%, namely DPB1*05:01, DPB1*02:01, DPB1*04:01 and DPB1*02:02), 7 alleles with a frequency ranging from 1%-5% and 3 alleles with a frequency of less than 1% were identified. The results of HLA-DPB1 genotyping were all in accordance with the typing results derived from an Atria AlleleSEQR HLA-DPB1 kit.

CONCLUSIONA reliable technique has been established for simultaneous genotyping of HLA-DPA1 and HLA-DPB1, which may have a broad application in population and disease association studies.

Alleles ; Base Sequence ; DNA Fingerprinting ; methods ; Gene Frequency ; Genotype ; HLA-DP alpha-Chains ; genetics ; HLA-DP beta-Chains ; genetics ; High-Throughput Nucleotide Sequencing ; methods ; Humans ; Molecular Sequence Data ; Polymorphism, Genetic

Candida albicans ; immunology ; Candidiasis ; diagnosis ; Epitopes ; Humans ; Peptide Library ; Serologic Tests