Objective: To assess trends of β-blocker use within 24h of admission in ideal candidates with acute myocardial infarction (AMI) in eastern urban China from 2001 to 2011. Method: A 2-stage random sampling design was performed. In the first stage, a simple random-sampling was used to identify participating hospitals. In the second stage, a systematic sampling was conducted in 2001, 2006 and 2011 to select cases from the participating hospitals. Data was obtained by central medical record abstraction. 10-year trend and predictors of early β-blocker application were assessed with weighted calculation for each year to represent the overall situation of eastern urban China. Results: 35 hospitals were sampled and 32 of them were finally participated. With necessary exclusion, 1399 ideal candidates were included in this analysis. The early weighted β-blocker application rates in 2001, 2006 and 2011 were 64.7%, 69.7%, and 60.9% respectively, P=0.0447 for trend. Patients with chest pain at admission (OR=2.22, 95% CI 1.19-4.13), higher systolic blood pressure (OR=1.40, 95% CI 1.11-1.77) or faster heart rate (OR=2.01, 95% CI 1.58-2.55) were more likely to use β-blocker; in contrast, compared with NSTEMI patients, STEMI patients seemed less likely to receive such treatment (OR=0.55, 95% CI 0.37-0.81). Conclusion: The early β-blocker therapy in eastern urban China is suboptimal for ideal AMI patients who could benefit from it. The application pattern has not been changed from 2001 to 2011 which might be related to physicians' misunderstanding of relevant evidence or guidelines. Our study may help to create an important target to improve the quality of AMI care.

ObjectiveTo understand the pathological and physiological roles of Presenilin 1 (PS1) in Alzheimer's disease (AD) recurrence, and the interaction between PSI and carhoxyl terminus of Hsc70 interacting protein (CHIP). MethodsThe yeast two-hybrid system was applied to identify a novel PS1 interacting protein as CHIP. After pGBKT7-PS1-C203 bait plasmid and full fragement CHIP of pACT2-CHIP expression vector were constructed, the interaction between PSI and CHIP was tested by β-galactosidase assay, pGBKT7-PS1-C203 was co-transfected with pACT2-CHIP into 293T cells and the interaction between PS1 and CHIP was tested by co-immunoprecipitation and Western blot. ResultsSpecificity of the interaction between PS1 and CHIP was identified by β-galactosidase assay and co- immunoprecipitation. ConclusionsCHIP is able to modulate chaperone functions and the pathway of protein ubiquitination/degradation. CHIP may regulate a proper assembly of the γ-secretase complex through its interaction with PSI, which is helpful to elucidate the mechanism of AD pathology.

AIM: To explore the role of PI3K/Akt/nNOS in Zhouluotong extract resisting diabetic peripheral neuropathy.METHODS:The Schwann cells were divided into normal group ( D-glucose 25 mmol/L) , model group ( D-glucose 100 mmol/L) , Zhouluotong extract Z-6 +high glucose group, Zhouluotong +high glucose group, mecobalamine+high glucose group.The viability, nitric oxide content and the Ca2+-ATPase activity in Schwann cells were determined by Cell Counting Kit-8 , nitric oxide assay kit and Ca2+-ATPase assay kit, respectively.The apoptosis of Schwann cells were analyzed by flow cytometry.The expression of Bcl-2, Bcl-xL, Bax, Bak and caspase-3, and the phosphorylation levels of nNOS and Akt were determined by Western blotting.The signal pathway of PI3K/Akt was explored by dominant negative PI3K and Akt (δp85 and DN-Akt) transient transfection assay.RESULTS:Under high-glucose culture, the cell viability, nitric oxide content in culture supernatant, the expression of Bcl-2 and Bcl-xL, and the phosphorylation levels of Akt and nNOS in the Schwann cells were significantly increased.The cell apoptosis, the expression of Bax, Bak and caspase 3 in the Schwann cells were significantly decreased by Zhouluotong extract Z-6, compared with model group.In-creased nitric oxide content and the up-regulation of nNOS were observed.However, the effects of blocking PI3K/Akt, the upstream pathway of nNOS , by transfection with DN-δp85 on Akt phosphorylation in the Schwann cells was still unclear. CONCLUSION:Zhouluotong extract Z-6 changes the phosphorylation of nNOS, and the expression of anti-apoptotic fac-tors , caspase-3 and pro-apoptotic factors in Schwann cells under high-glucose culture, thus reducing apoptosis and elevating viability.The relationship to PI3K/Akt/nNOS pathway needs further investigation.

BACKGROUNDThe results of recent experimental studies have suggested that frequently continuous administration of certain cytotoxic agents at low doses (a tenth to a third of the maximum tolerated dose), known as 'anti-angiogenic chemotherapy', can increase the efficacy by targeting the tumor microvasculature. Ginsenoside Rg3 has also been proven to have certain anti-angiogenic effects. The aim of this study is to investigate the inhibitory effects of administration of low-dose gemcitabine combined with ginsenoside Rg3 on angiogenesis of mouse Lewis lung carcinoma and the influence of administration on quality of life of mouse.

METHODSA novel mouse model was developed by inoculating Lewis lung carcinoma cells directly into C57B1/6 mice. The mice were treated with low-dose gemcitabine, ginsenoside Rg3, or both agents together respectively. Then angiogenesis and growth of tumor were observed by color Doppler flow imaging (CDFI) and immunohistochemistry.

RESULTSRemarkably, the combined therapy of gemcitabine and ginsenoside Rg3 resulted in better quality of life of mice than either single agent administration. CDFI and immunohistochemistry showed that there were significantly higher tumor necrosis rate and stronger anti-angiogenic effects in combined therapy group than single agent group.

CONCLUSIONSThe combined therapy of low-dose gemcitabine and ginsenoside Rg3 may cooperatively inhibit neovascularization and growth of mouse Lewis lung carcinoma, and it can keep good quality of life of mouse. It may provide a new strategy for cancer therapy.

Objective: To explore the role of a customized 3D printing guide in total hip arthroplasty (THA). Methods: A retrospective analysis was performed of the 60 patients who had been treated by THA for avascular necrosis of the femoral head at Department of Orthopaedics and Traumatology, Foshan Hospital of Traditional Chinese Medicine from January 2018 to May 2019. Half of them used the personalized 3D printing guide in THA and half did not. In the guide group there were 17 men and 13 women with an age of 53.4±8.9 years while in the conventional group 19 men and 11 women with an age of 54.7±9.4 years. The acetabular cups were orientated at an abduction angle of 40° and an anteversion angle of 15°. The intraoperative blood loss, operation time and acetabular abduction angle were compared between the 2 groups. Results: The 2 groups were comparable due to insignificant differences between them in gender, age, body mass, cause of disease or staging of avascular necrosis of the femoral head (P>0.05). The guide group had significantly less intraoperative blood loss (286.7±150.8 mL) and operation time (90.5±34.4 min) than the conventional group did (438.3±292.6 mL and 115.6±58.6 min) (P< 0.05). The acetabular cup abduction was 38.9°±4.2° in the guide group and 37.2°±5.5° in the conventional group, showing no significant difference(t=1.315, P=0.194). Conclusion Use of a personalized 3D printing guide in THA can shorten the time for installation of an acetabular prosthesis and reduce the amount of intraoperative blood loss, but it leads to insignificant difference in the postoperative acetabular cup abduction compared with no use of the guide.

Objective:To assess the predictive values of bioelectrical impedance analysis(BIA)-measured body fat indices to abnormal lipid profiles, and to preliminary propose optimal cut-off values of body fat in children and adolescents.Methods:Children and adolescents, aged 6-16 years, were selected from 30 schools (8 primary schools, 21 middle schools and one 12-year education school) in Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by adopting a stratified cluster sampling method from November 2017 to January 2018.Questionnaire survey, body mass index(BMI), body fat mass index (FMI), fat mass percentage (FMP) and four lipid profiles were conducted.Results:A total of 14 309 participants, aged (11.0±3.3) years, were enrolled in the analysis, with 49.9% boys.In boys and girls, the percentile values ( P60- P95) fitted by FMI and FMP with K-median-coefficient of variation(LMS) method were taken as the cutting points, and P75 values were selected as the cut-off points of excessive body fat for their better sensitivity, specificity, predictive value and area under curve (AUC) for identification of abnormal lipid profiles.Boys with FMI above P75 accounted for 28% of the total population, and controlling boys with FMI below P75 could prevent dyslipidemia of 8%-57%.FMI in girl population occupied about 26% of the above, and controlling FMI in girl population below this cut-off point may prevent dyslipidemia from 8%-42%.FMP observed similar results to FMI.Assessed by FMI or FMP with P75 cut-off values, adiposity performed better than BMI for recognizing abnormal lipid profiles in boys (AUC: 52.4%-69.6% vs.50.2%-67.1%, P<0.05) rather than in girls ( P>0.05). In addition, when FMI or FMP beyond P90, the specificity of each abnormal lipid profiles was around 90%. Conclusions:The recommend cut-off points for body fat may be to assess children′s adiposity, and can be applied in preventive activities.

Objective:To investigate the effects of long-term ionizing radiation on peripheral blood cells of nuclear power workers.Methods:In March 2019, a total of 530 radiation exposed workers in the nuclear power industry who underwent in-service radiation occupational health examination in Guangzhou occupational disease prevention and control hospital in 2018 and with service age ≥1 year were selected as the radiation group. At the same time, 545 workers in nuclear power industry were selected as control group. According to the methods and requirements of GBZ 235-2011 ＂technical specification for occupational health monitoring of radiation workers＂ and GBZ 98-2017 ＂health requirements for radiation workers＂, the occupational health monitoring data were collected, and the change rules of peripheral blood cells in the two groups were analyzed.Results:Compared with the control group, the total number of WBC, NEUT, LYMP, Hb, MCV and MCHC in radiation group were lower than those in control group ( P<0.05) , and the difference was statistically significant ( P<0.05) . The MPV increased significantly ( P<0.05) . Compared with the control group, the abnormal rate of WBC and Hb in the radiation group was higher than that in the control group ( P<0.01) , but there was no significant difference in the abnormal rate of RBC and PLT ( P>0.05) . Conclusion:Low dose ionizing radiation has a certain cumulative damage effect on peripheral blood cells of radiation workers in nuclear power industry. The change rules of different cell subtypes are different, and the changes of WBC and PLT appear earlier.

Objective To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of typing idiopathic sudden sensorineural hearing loss (ISSNHL).Methods Total of 438 patients with ISSNHL,including 76 with hearing loss in low-middle frequencies,43 in middle-high frequencies,162 in all frequencies and 157 in total deafness,were randomly divided into two groups,the systemic application group:dexamethasone (DEX) was applied by intravenous injection in dose of 10 mg × 3 d followed by 5 mg ×4 d,and the topical injection group:methylprednisolone sodium succinate of 40 mg was injected into cortical bone of mastoid region every three days.According to the results of puretone threshold audiometry,the curative effect among ISSNHL with low-middle frequencies,middle-high frequencies,all frequencies hearing loss,and total deafness were evaluated.SPSS 18.0 software was used to analyze the data.Results Among 220 patients with systemic application of DEX,66 subjects (30.0％) cases were recovery,51 (23.2％) were excellent better,39 (17.7％) better,64 (29.1％) were poor,and the total effective rate was 70.9％ (156/220).There was no statistical difference in total effective rate of four typing subgroups (x2 =1.60,P ＞ 0.05).And the recovery rate in total deafness subgroup was significant lower than that in low-middle and all frequencies subgroups (x2 =10.63 and 15.94 respectively,both P ＜ 0.05).In the topical injection group,the recovery rate was 30.3％ (66 cases),excellent better 18.8％ (41),better 15.6％ (34),poor 35.3％ (77),and the total effective rate was 64.7％ (141/220).There were statistical differences of total effective rate in low-middle frequencies in comparison with that in all frequencies(x2 =8.38) and total deafness (x2 =7.28) subgroups (both P ＜ 0.05).Regarding recovery rate,there were significant differences between each two typing subgroups,except middle-high frequencies subgroup vs.all frequencies (x2 =1.60) and total deafness (x2 =2.29) subgroups (both P ＜ 0.05).In 76 ISSNHL with hearing loss in low-middle frequencies,the recovery rate in cases with local corticosteroids injection(65.0％) was significantly increased in comparison with that with systemic application (41.7％),x2 =4.15,P ＜ 0.05.There were increasing tendencies of curative effect in other three typing groups by systemic corticosteroids application when compared with local injection,but no statistical significances (all P ＞ 0.05).Conclusions For low-middle frequencies ISSNHL,the corticosteroids administration of local injection should be the optimization.Systemic application would be applied for middle-high frequencies,all frequencies and total deafness.

Objective:To evaluate the sedative efficacy of remimazolam in outpatients undergoing curettage.Methods:Eighty outpatients, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, aged ≥18 yr, undergoing curettage, were divided into 2 groups according to the random number table method: remimazolam group (group R, n=41) and propofol group (group P, n=39). Anesthesia was induced with alfentanil 10 μg/kg injected intravenously in two groups, and in addition remimazolam 7 mg was intravenously injected in group R, and propofol 1.5 mg/kg was intravenously injected in group P. If the Modified Observer′s Assessment of Alertness/Sedation score ≥3 or the patient could not tolerate the surgical procedure, remimazolam 2.5 mg was given for rescue sedation in group R and propofol 0.5 mg/kg was given for rescue sedation in group P, and alfentanil 1 μg/kg was given as rescue analgesic.The onset time of sedatives, time to eye opening, emergence time and time to discharge were recorded.The success of sedation, intraoperative BIS value, requirement for rescue medications, and occurrence of adverse reactions were recorded. Results:The intraoperative BIS values were maintained at 61-72 and 40-64 in group R and group P, respectively.The success rate of sedation was 95% in group R and 100% in group P, and there was no significant difference between the two groups ( P>0.05). Compared with group P, the rate of rescue sedative agents used and rate of rescue alfentanil given were significantly increased, the onset time of sedative agents was significantly prolonged, the incidence of postoperative nausea and vomiting was increased, and the incidence of respiratory depression and injection pain was decreased in group R ( P<0.05 ). Conclusion:Remimazolam (given according to the instructions) is safer when used for outpatient curettage, but it can only maintain a light sedation status, and the sedative efficacy is inferior to propofol.