Objective To investigate the efficacy of losartan on the improvement of heart function and its effect on uric acid in patients with chronic heart failure (CHF). Methods Eighty-five patients with CHF were divided into two groups randomly. Routine anti-CHF treatment included cardiotonic, diuresis, isosorbide dinitrate, beta-blockers. In losartan group(n=43), patients were given routine anti-CHF treatment and losartan. The patients in control group(n=42) were treated by routine anti-CHF treatment and Benazapril. The heart functional was evaluated. The content of serum uric acid, electrocardiogram, and Duppler ultransonography were measured before and after treatment respectively. Results The variance of heart function, left ventricle diastoic diameter (LVDD), left ventricle ejection fraction (LVEF) and cardiothotic ratio did not show statistical difference. However, they were improved sharply as compared with base-line condition in both groups after 3 months and 12 months treatment(P

Objective To put forward the prevention advice on foreign body suction,and to discuss the effica-cy,safety and application experience of flexible bronchoscopy in the diagnosis and treatment of tracheobronchial foreign bodies in children. Methods The treatment experience of 38 cases for airway foreign body removal with flexible bron-choscopy and granulation tissue proliferation in Argon plasma coagulation ( APC ) ( argon knife ) combining carbon dioxide( CO2 ) cryotherapy in Bayi Children′s Hospital Affiliated to General Hospital of Beijing Military Command from January 2013 to December 2014 were reviewed,and the clinical data including age,gender,treatment time for inhaled foreign body,clinical and X-ray manifestations,location of the foreign body,treatment with bronchoscopy with APC and cryotherapy,complications and outcomes were analyzed. Results There were 38 cases of patients including 31 male (81. 6%) and 7 female(18. 4%),aged from 10 months to 14 years old,with mean age 28. 5 months;among them there were 30 cases with definite history of foreign body,accounting for 78. 9%;the most common clinical symptom was cough among the cases,accounting for 84. 3%;X ray showed 15 cases with ipsilateral lung atelectasis,accounting for 39. 5%, emphysema in 17 cases,accounting for 44. 7%,pneumonia change in 6 cases,accounting for 15. 8%,there were 11 ca-ses who had lung computerized tomography examination when coming to the hospital,and only 1 case could be seen to have foreign body shadow;microscopic examination found that inhaled foreign body in the right bronchus accounted for 57. 9%,and peanut was the main foreign body inhalation in this group;only 4 cases(10. 5%) had definite diagnosis and foreign body removal within 24 h after foreign body aspiration,moreover,34 cases(89. 5%) with foreign body aspi-ration got the diagnosis and treatment after 24 h;crying was the primary inducement for inhaled foreign body. All the 38 cases of children with inhaled foreign body experienced removal under flexible bronchoscopy. There were 19 cases (50. 0%) who had granulation tissue proliferation around the foreign body,among which 5 cases of foreign body was wrapped by the proliferation of granulation tissue,with APC dealing with the granulation tissue of foreign body surface to remove foreign body after exposure,then giving CO2 cryotherapy. Nevertheless,there were 9 cases of foreign body who had granulation tissue but was not wrapped,receiving CO2 cryotherapy directly after the foreign body removal. One case of this group had bradycardia during the surgery,and 2 cases had postoperative bleeding,but there was no death cases with foreign bodies removal. Conclusions Education is the key to prevent foreign body aspiration in infants under 3 years old. Flexible bronchoscopy is safe to remove foreign bodies from the respiratory tract and has fewer complications, so it is one of the alternative methods in diagnosis and treatment of foreign body inhalation.

Objective To explore the operating methods,the effectiveness and safety for 2 cases of tracheal in-tubation related severe subglottic stenosis under laryngeal mask by using bronchoscopy in the diagnosis and interven-tional treatment. Methods Two male patients ( age at 4 and 11 months) both had difficulty breathing and weaning failure after endotracheal intubation,who were diagnosed with severe subglottic stenosis through CT and bronchoscopy examination. All parents signed their consent after being fully informed of treatment risks. Two cases were treated under bronchoscopic holmium laser combined with argon plasma coagulation and freezing treatment by using the laryngeal mask. The clinical data, complications and postoperative outcome and follow-up were analyzed. Results Two cases were operated successfully,the subglottic granulation tissue of 1 case was completely removed,2 cases of patients had subglottic narrow annular completely removed, and there was no problem for 4. 0 mm bronchoscope to get through,postoperative tracheal catheter was successfully extracted,dyspnea was significantly improved. Two cases imme-diately showed well open after treatment,7 d,30 d and 90 d through endoscopic examination. During the operation,oxy-gen saturation decreased and heart rate increased fast or slowed down,but after operation and oxygen got resumed,they immediately recovered,and there were no abnormal hemodynamic changes during and after operation. The two cases were still under follow-up. Conclusions The laryngeal mask holmium laser,argon plasma coagulation and cryotherapy can be used to remove acquired granulation tissue hyperplasia caused by subglottic stenosis,which is safe and effective, and the short-term effect was remarkable. Long-term effect still needs to be further assessed through follow-up.

Objective To investigate whether velocity vector imaging (VVI) combined with stress echocardiography could detect potential myocardial impairment of the left ventricle(LV) in diabetic rats.Methods DM rats ( n = 18,administered by STZ at 65 mg/kg) and control rats( n = 12) were performed with VVI and M-mode echocardiography both at rest and after dipyridamole stress 12 weeks later. Twodimensional echocardiographic cine loops and M-mode images of three consecutive beats were obtained from the short-axis views at the mid-LV level. The means of segmental peak systolic velocity(Vs), circumferential strain(εc) ,radial strain(εr), systolic circumferential and radial strain rate (SRc, SRr) and the percent wall thickening (WT% ,derived from M-mode) were obtained. After echocardiograms were performed,the hearts were excised and prepared for HE staining and ultrastructural observations under electron microscopy.Results At rest,only SRc in the DM group was significantly lower than that in the control group( P ＜0.05), the other parameters were statistically comparable between the two groups. After dipyridamole stress,all VVI values in the DM group were significantly lower than those in the control group ( P ＜0.05).However,there was no significant difference in WT% between the two groups either at rest or after dipyridamole stress ( P ＞0.05). Conclusions The VVI parameters combined with dipyridamole stress are more effective in evaluating potential myocardial impairment of the LV walls in diabetic rats. SRc might be more sensitive indices that can be used to detect myocardial impairment at rest.

Objective To investigate whether myocardial contrast echocardiography(MCE)combined with stress echocardiography could detect myocardial microcirculation disturbance of left ventricular(LV)in diabetic rats.Methods MCE were performed at rest and after dipyridamole infusion from parasternal shortaxis views at the papillary muscle level in DM rats(n=18,12 weeks later after STZ administration)and control rats(n=12).Regions of interest(ROI)were positioned with the anterior, lateral, posterior and septum walls.Plateau intensity(PI), initial slope of the curve(β)and time to PI(TTP)were obtained from the curve and myocardial blood flow(MBF)and myocardial flow reserve(MFR)was estimated.After the performance of MCE, myocardium was prepared for γ Well counting with ~(99m)Tc-MIBI and CD31 immunohistochemistry staining.Results There was no significant difference in MBF between the ROI of anterior, lateral, septum walls beyond posterior wall in each group at rest and after stress.MCE values from anterior wall were selected as the indexes for comparisons between the two groups.The PI., MBF and MFR in the DM group were significantly lower than those in the control group at rest and after stress(all P< 0.05).The β in the DM group was significantly lower and TTP was significantly longer after dipyridamole stress(P<0.05).The nuclide intake of myocardial tissue in different walls was similar in the DM group, but theY were all lower than those in the control group(P<0.05).The capillary density decreased significantly in the DM group compared with the control group.Conclusions The PI,β,TTP,MBF and MFR derived from MCE were all sensitive parameters in detecting the microcirculation disturbances in the earlier period of DM.

Objective To evaluate the different arteriographic manifestations of acute renal arterial hemorrhage,and the treatment effects of emergency interventional embolization.Methods 87 patients with renal arterial hemorrhage who were failed to conservative treatment underwent the renal arteriography to confirm the position and degree of lesion.According to the arteriographic manifesta-tions,appropriate embolic agents such as spring coil,acrylic acid microspheres and the like were used to embolize the targeted vessel. The arteriographic manifestations and embolization efficacy were retrospectively analyzed.Results Contrast medium leakage was showed by renal angiography in 43 patients,13 of whom had arterio-venous fistula (AVF)and 1 5 of whom had renal pseudoaneu-rysms (RAP).Among this 1 5 patients,there were 5 patients with arteriovenous fistula and one patiernt with artery-calyces fistula. Hemorrhage of tumor vessel was shown in 1 5 patients and renal arteriovenous malformation (RAVM)in 1.47 patients underwent renal artery CT arteriography before emergency interventional embolization.The hematuresis was completely stopped or significantly relieved in 82 of all patients.Only 3 patients with renal trauma and 2 patients with percutaneous nephroscope were still had haematu-ria.All patients were followed up for 2 years.The total effective rate of emergency interventional embolization treatment was 94.25%(82/87),and no serious complications were observed.Conclusion As a safe,effective and micro-invasive treatment,emergency in-terventional embolization therapy can be used to treat the acute renal hemorrhage effectively.It can keep the maximum renal func-tion.Though acute renal hemorrhage angiography may have different manifestations,the choice of embolic agents is the key to stop the symptom.Renal artery CTA before embolotherapy is important for the diagnosis and therapy of acute renal hemorrhage.

Objective To investigate whether myocardial dysfunction and perfusion impairment had happened in diabetes mellitus(DM)rats,and to assess the relationship between them by using myocardial contrast echocardiography(MCE)and velocity vector imaging(VVI).Methods MCE and VVI were performed from the short-axis views of the mid-left ventricular level both at rest and after dipyridamole stress in control rats and DM rafs(12 weeks after induction with streptozotocin).MCE-derived myocardial blood flow(MBF)and myocardial flow reserve(MFR)and VVI-derived circumferential strain rate(SRc)and SRc reserve were obtained.Results SRc(absolute value)and MBF in the DM group were significantly lower than those in the control group at rest(P =0.03 for SRc and P =0.005 for MBF).SRc reserve and MFR in the DM group were significantly lower than those in the control group after dipyridamole stress (P =0.000 for SRc reserve and P =0.014 for MFR).There was no significant correlation between SRc and MBF at rest in the DM group(r =0.189,P =0.453).However,significant negative correlation existed between SRc reserve and MFR(r =-0.658,P =0.003).Conclusions Both myocardial systolic function and perfusion are impaired in DM rats.The decrease of MBF might not be the predominant determinant of myocardial systolic dysfunction at rest.However,the impairment of MFR could be an important contributor to the decrease of myocardial contractile reserve.

OBJECTIVETo study the chemical constituents from the seeds of Notopterygium franchetii.

METHODEthanol extracts of seeds N. franchetii were separated and purified by such methods as normal and reversed phase column chromatographies and thin-layer chromatography and structurally elucidated by MS and NMR evidences.

RESULTTwenty nine compounds were separated, they were isoimperatorin (1), [3-sitosterol (2), phellopterin (3), bergapten (4), N-tetra, hexa, octacosanoylanthranilic acid (5-7), daucosterol (8), oxypeucedanin hydrate (9), umbelliferone (10), demethylfuropinnarin (11), (2S, 3S, 4R, 8E)-2-[(2'R)- 2'-hydroxydoco, trico, tetraco, entaco, hexaco sanosylamino] -octadecene-1, 3, 4-triol (12-16), (-)-oxypeucedanin (17), diosmetin (18), bergaptol-O-beta-D-glucopyranoside (19), nodakenin (20), 1'-O-beta-D-glucopyranosyl-(2R, 3S)-3-hydroxynodakenetin (21), uracil (22), decuroside V (23), 8-O-beta-D-glucopyranosyl-5-hydroxypsoralen (24), 8-O-beta-D-glucopyranosyl-5-methoxylpsoralen (25), diosmin (26), alaschanioside C (27), kynurenic acid (28) and mannitol (29).

CONCLUSIONAll of these compounds were separated from the seeds of N. franchetii for the first time. Of them, 18, 22, 26 and 29 were firstly obtained from genus Notopterygium.

Apiaceae ; chemistry ; Chromatography, Thin Layer ; Coumarins ; chemistry ; Diosmin ; chemistry ; Flavonoids ; chemistry ; Furocoumarins ; chemistry ; Glucosides ; chemistry ; Kynurenic Acid ; chemistry ; Magnetic Resonance Spectroscopy ; Mannitol ; chemistry ; Methoxsalen ; analogs & derivatives ; chemistry ; Seeds ; chemistry ; Sitosterols ; chemistry ; Uracil ; chemistry

Objective To investigate the specpfic electric fiberobronchoscopic manifestations of refractory Mycoplasma pneumoniae pneumonia(RMPP) and explore the level of IL-17,IL-18,PTX3 in bronchoalveolar lavage fluid(BALF) and their clinical sigfinance.Methods To select patients who were diagnosed as MPP and examined by fiberobronchoscopy in acute stage.Dividing them into groups:(1) RMPP group (60cases):dividing RMPP patients into three groups according to if they were treated by systemic corticosteroids or immunoglobulin before the examination of fiberbronchoscope,① RMPP-A group:both are not used.②RMPP-B group:use systemic corticosteroids.③ RMPP-C:both are used.(2)general MPP group(35 cases).15 children with foreign body in bronchus were enrolled as control group.Firstly,to analysis the electric fiberobronchoscopic manifestations of all the cases.Secondly,the cases who had BALF samples in all group were selected,the levels of IL-17,IL-18 and PTX3 are detected by ELISA.Results Under electric fiberobronchoscopy,that the proportions of RMPP group with mucosal erosion,necrotic mucous membrane peeling,sputum bolt blockage in bronchial lumen or moulding are higher than general MPP group.The levels of IL-17,IL-18 and PTX3 in BALF of all MPP cases are higher than control group (P ＜ 0.05),but only the difference of IL-18 between RMPP group and general MPP group has statistical significance (P ＜ 0.05).The levels of IL-17,IL-18 and PTX3 in BALF of RMPP-B group are all higher than RMPP-A group (P ＜ 0.05).Conclusion Mucosal erosion,necrotic mucosa peeling and sputum bolt,moulding are the characteristic manifestations of RMPP,and can help identify RMPP.IL-17,IL-l8 and PTX3 all participated in the pathogenesis of RMPP.Only the level of IL-18 in BALF can be the predictive marker of RMPP.Systemic corticosteroids may inhibit the levels of IL-17,IL-18 and PTX3 of RMPP patients.

Objective: To investigate the relationship between occupational stress and working ability of workers in a petroleum processing enterprise in a high altitude area. Methods: A total of 728 workers in a petroleum processing enterprise at an altitude of 2850 m were subjected to a survey using Occupational Stress Inventory (OSI) , Work Ability Index (WAI) Scale, Occupational Role Questionnaire (ORQ) , Personal Strain Questionnaire (PSQ) , and Personal Resource Questionnaire (PRQ) from May 2014 to August 2016. Results: Of the 728 workers, 55 (7.6%) had a poor working ability, moderate in 262 (35.9%) , and good in 411 (56.5%). There were significant differences in WAI between the workers with different types of work, sexes, ages, and working years (P<0.05). There was a significant difference in WAI between different occupational stress groups (P<0.05). WAI was negatively correlated with ORQ score and PSQ score (r_s=-0.387, P<0.05; r_s=-0.467, P<0.05) and positively correlated with PRQ score (r_s=0.343, P<0.05). The multiple linear regression analysis showed that high ORQ score and PSQ score were the inhibitory factors for high WAI (B=-0.058; B=-0.082) and high PRQ score was a contributing factor for high WAI (B=0.029) . Conclusion Occupational stress is an influencing factor for the working ability of workers in the petroleum processing enterprise in the high altitude area. Hypoxia in high altitude area may further reduce the working ability. In order to reduce occupational stress and improve work ability, it should be considered to strengthen skills training, improve the working environment, and pay attention to mental health.