Objective: To measure serum testosterone level, plasma levels of interleukin-18 (IL-18) and IL-10 and explore their correlation in patients with different types of coronary heart disease (CHD), and their possible role in occurrence and development of CHD. Methods: A total of 96 male CHD patients were divided into acute myocardial infarction (AMI) group (n=35), unstable angina pectoris (UAP) group (n=32) and stable angina pectoris (SAP) group (n=29). Another 30 patients who were excluded for CHD by coronary angiography were enrolled as non CHD control group. Enzyme linked immunosorbent assay (ELISA) was used to measure serum testosterone level and plasma levels of IL-18 and IL-10 in all groups. Results: Compared with non CHD control group, there were significant decreases in serum testosterone level [(13.46±1.99) mmol/L vs. (6.89±1.35) mmol/L vs. (5.02±1.87) mmol/L, t=1.917～2.365, P<0.05 both] in UAP group and AMI group, and that of AMI group was significantly lower than that of UAP group, t=1.034, P<0.05; there were significant increases in IL-18 levels [(146.72±79.36) pg/ml vs. (209.32±80.49) pg/ml vs. (316.78±75.63) pg/ml vs. (457.78±83.21) pg/ml, t=2.016～3.167,P<0.05 all] in SAP group, UAP group and AMI group, and those of UAP group and AMI group were significantly higher than that of SAP group, t=2.173, 2.596, P<0.05; there were significant increases in IL-10 levels [(48.46±18.27) pg/ml vs. (116.45±42.76) pg/ml vs. (85.64±27.33) pg/ml vs. (70.26±18.55) pg/ml, t=2.997～2.018, P<0.05 all] in SAP group, UAP group and AMI group, and those of AMI group and UAP group were significantly lower than that of SAP group (t=2.034, 2.291, P<0.05 both). Pearson linear regression analysis indicated that serum testosterone level was negatively correlated with levels of IL-10 (r=-0.678, P<0.01) and IL-18 (r=-0.579, P<0.01) in CHD group. Conclusion: There are significant changes in serum testosterone level and plasma IL-18, IL-10 levels, and testosterone level is significantly negatively related with IL-18, IL-10 levels, and they can be regard as new indexes assessing coronary atherosclerotic lesion.

Objective To evaluate the application effect and value of four kinds of neuroendoscopic operation mode in the treat-ment of hydrocephalus .Methods The four kinds of neuroendoscopic operation mode ,including endoscopic third ventriculostomy , septostomy of the septum pellucidum ,cyst ventriculostomy and ventrideperitoneal cavity ,were selected in 58 cases of hydrocephalus according to the indications .The treatment effects were analyzed and the application value was evaluated .Results Among 58 cases of hydrocephalus ,50 cases were significantly improved after operation ,the total effective rate was 86 .21% ,2 cases appeared some complications .The four kinds of operation mode could better treat hydrocephalus .Conclusion Neuroendoscopy is an ideal method in treating hydrocephalus and has the advantages of the slight trauma and fewer complications ,which is a method deserving to be promoted in clinic .

The role of arginine vasopressin ( AVP) played in proliferation and differentiation of mouse primary osteoblast and its mechanism was investigated. 100 nmol/ L AVP was added into the medium containing primary mouse osteoblast: (1) After being cultured for 72 h, the proliferation of the cells was counted with a cell counter. (2) The media of cultured cells on 2,4,6,8,10 days were harvested and tested for the secreted ALP concentration by osteoblasts, and the cells were lysed in order to test the ALP concentration in cytosol. (3) The alizarin red staining was employed to detect the effect of AVP on calcium nodules formation on 8 th and 20 th days. (4) The osteoblast cells were incubated with AVP for 20 min, and then were lysed. Radioimmune assay was applied to test the change of cAMP in cytosol. These results showed that, compared to negative group, 100 nmol/ L AVP significantly promoted the proliferation of primary mouse osteoblast ( P<0. 01). ALP secretion was increased remarkably ( P <0. 01), and the number and area of calcium nodules were increased considerably(P<0. 01). The intracellular cAMP was increased after incubating cells with AVP for 20min ( P<0. 01). These results suggest that AVP may promote proliferation and differentiation of mouse primary osteoblasts by cAMP signal pathway.

Objective: To investigate the clinical significance of dynamic contrast-enhanced computed tomography (CT) combined with magnetic resonance imaging (MRI) in differential diagnosis of adrenal adenoma and metastasis. Methods: 120 patients with adrenal adenoma who were examined by enhanced MRI and enhanced CT before operation were collected. According to the pathological examination after operation, they were divided into adrenal adenoma group (86 cases) and adrenal metastasis group (34 cases). The difference of time-density curve between the two groups was compared, and the diagnostic criteria were evaluated by using receiver operating characteristic (ROC) curve. Results: Dynamic CT and dynamic MRI were mainly type A, followed by type C, B, D and E. Dynamic CT and dynamic MRI were mainly type B, followed by type D/E, type A and type C. There were significant differences in type A, B, C, E dynamic CT and dynamic MRI between the two groups (P<0.05); there was no significant difference in type D dynamic CT and dynamic MRI between the two groups (P>0.05). The AZ value of adrenal adenomas ranged from 0.714 to 0.825 and that of adrenal metastasis ranged from 0.872 to 0.965 at 3-30 minutes delay. Conclusions Dynamic contrast-enhanced CT combined with MRI in patients with adrenal adenoma and metastasis has a time-density difference, 5min has high discriminant value in time lapse.

Objective To investigate the effect of Xinmailong injection on patients with heart failure after emergency PCI and its effect on cardiac function. Methods 80 patients with heart failure after PCI in our hospital from December2015 to December 2016 were enrolled. All patients were divided into Xinmailong treatment group and conventional treatment group according to the random number table method, with 40 cases in each group. After emergency PCI, both groups were given conventional anti-platelet aggregation therapy, oral statin lipid-lowering drugs, ACEI, β-receptor antagonists, nitrates, etc. The Xinmailong treatment group was given 0.9％ sodium chloride injection 100 mL+Xinmailong injection 6 m L (ivgtt, 2 times/d). And the conventional treatment group was given 0.9％ sodium chloride injection 100 mL (ivgtt, 2 times/day). The two groups were treated continuously for 4 weeks. The clinical efficacy after treatment, as well as the changes of serum NT-proBNP levels before and after 1 week and 1 month of treatment, the LVEF and LVEDd before and after treatment of the two groups. Results The total effective rate of the patients in Xinmailong treatment group was 95.00％, which was significantly higher than that of the conventional treatment group, and the difference was significant (P<0.05). After treatment, serum NT-proBNP levels in the Xinmailong treatment group were significantly lower than those in the conventional treatment group at 1 week and 1 month after treatment, respectively, and the difference was significant (P<0.05). After treatment, the LVEF of the Xinmailong treatment group was significantly higher than that of the conventional treatment group, and the LVEDd of the Xinmailong treatment group was significantly lower than that of the conventional treatment group, and the difference was significant (P<0.05). Conclusion Xinmailong injection on the basis of routine treatment has exact curative effect on patients with heart failure after emergency PCI, which can significantly improve the heart function and improve the prognosis of patients. It is worthy of clinical promotion and application.

Objective:To develop a recombinant protein vaccine based on KPC-2, a drug resistance target in Klebsiella pneumoniae, and evaluate its immunogenicity, protective efficacy and mechanism in a mouse model of pneumonia. Methods:KPC-2 was expressed in Escherichia coli and purified using GST affinity chromatography. A recombinant protein vaccine was prepared with KPC-2 and used to immunize New Zealand rabbits through subcutaneous injection. Serum samples were isolated from cardiac blood and Protein G chromatography was used to purify polyclonal antibodies against KPC-2. Opsonophagocytic killing assay was used to assess the bactericidal activity of the polyclonal antibodies in vitro. Female BALB/c mice were immunized three times with the recombinant protein vaccine, and the titers of specific IgG antibodies in serum were measured by indirect ELISA. One week after the last vaccination, the mice were infected with Klebsiella pneumoniae strain SRT through tracheal intubation, and received a single intravenous dose of meropenem (0.1 mg) 1 h later. The protective efficacy of the KPC-2 recombinant protein vaccine was evaluated by comparing the survival rates, bacterial colonization and histopathological changes between vaccine group and adjuvant group as well as the survival rates between meropenem group and normal saline group. Moreover, the protective efficacy of polyclonal antibodies against KPC-2 was evaluated through passive immunization. Results:The level of specific IgG antibodies in serum was significantly higher in the vaccine group than in the adjuvant group ( t=4.325, P<0.05). The survival rate in the vaccine group was also higher than that of the adjuvant group [70% (7/10) vs 10% (1/10), P<0.05]. Furthermore, lung inflammation was less severe and bacterial burden was reduced in the vaccine group as compared with those of the control group ( t=3.127, P<0.05). Both active and passive vaccination strategies demonstrated strong protective efficacy against Klebsiella pneumoniae infection, and had a synergistic effect when used in combination with antibiotic therapy. The polyclonal antibodies against KPC-2 had bactericidal activity in vitro ( t=5.427, P<0.05). Conclusions:The prepared KPC-2 vaccine has better immunogenicity and protective efficacy. It can induce strong humoral immune responses. This study suggest that drug resistance target may be used as a candidate antigen for future vaccine development.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Myocardial fibrosis （MF） is a common pathological manifestation of various heart diseases. Due to the non-renewable nature of myocardial cells， the occurrence of MF represents irreversible damage to the myocardium. Previous studies have suggested that fibroblast-mediated collagen deposition is the main mechanism of MF. Recent studies have found that there is an immune regulation mechanism in the heart itself， and macrophage activation/polarization plays an important role in MF. With the deepening of traditional Chinese medicine research， scholars have found that traditional Chinese medicine can interfere with MF by regulating the renin-angiotensin-aldosterone system （RAAS） system and the inflammatory process， repairing the extracellular matrix， managing oxidative stress， and maintaining the balance of autophagy. This process is closely related to the activation and M1/M2 polarization of macrophages. Throughout the MF process， macrophage activation is beneficial， but excessive activation will be harmful. In the early stage of MF， appropriate M1 macrophage polarization is conducive to activating immunity and removing harmful substances. In the middle and late stages of MF， appropriate M2 macrophage polarization is conducive to remodeling the damaged myocardium. If macrophage activation is excessive/insufficient， or the balance of M1/M2 macrophage polarization is broken， the effect changes from improvement to destruction. Traditional Chinese medicines that regulate the activation/polarization of macrophages have the effects of replenishing Qi and nourishing Yin， as well as regulating Qi and activating blood， but there are also some heat-clearing， dampness-drying， and detoxification products. Therefore， the occurrence of MF may be caused by Qi and Yin deficiency， damp heat accumulation， and Qi stagnation and blood stasis. By summarizing the biological processes involved in macrophage activation/polarization in MF， this paper expounded on the research progress of traditional Chinese medicine in regulating macrophage activation and M1/M2 polarization from different angles to improve MF， so as to provide a reference for the treatment of MF with traditional Chinese medicine.