Animals ; Antioxidants ; metabolism ; Diabetes Mellitus, Experimental ; metabolism ; Melatonin ; metabolism ; Physical Conditioning, Animal ; Rats

Objective To explore clinical characteristics and treatment of the thrombotic microangiopathy (TMA) induced by malignant hypertension, and provide a better understanding of the disease. Methods The clinical manifestations, laboratory examinations, therapeutic methods and prognosis of 15 TMA patients induced by malignant hypertension were analyzed retrospectively. Results The clinical manifestations were characterized by microangiopathic hemolytic anemia, thrombocytopenia and kidney injury. None of the patients required plasma exchange therapy. After antihypertensive treatment, all of 15 patients were discharged with improved clinical condition, remoglobin levels and platelet count. Conclusions The TMA induced by malignant hypertension is different from the classic TMA. Improving the understanding of TMA induced by malignant hypertension will contribute to early diagnosis and targeted treatment.

Objective To evaluate the value of revised Geneva score, Daniel ECG score and age-adjusted D-dimer for predicting pulmonary embolism(PE).Methods A total of 91 cases suspected as pulmonary embolism were collected, and 52 cases were diagnosed as pulmonary embolism by computed tomographic pulmonary angiography(CTPA) results.Receiver operating characteristic(ROC) curves and diagnostic test evaluation indexes were used to evaluate the probability of PE predicted by the revised Geneva score,Daniel ECG score, age-adjusted D-dimer and combination of these two clinical scores and age-adjusted D-dimer.Results The confirmed PE was 21.4% with a low probability(revised Geneva score 0~3 points),55.4% in intermediate probability(4~10 points),85.7% in high probability(score≥11 points).The prevalence of PE was 33.3% with a low clinical probability (Daniel ECG score<2 points)and 70.7% with a high clinical probability(Daniel ECG score≥2 points).The sensitivity and specificity of age-adjusted D-dimer in predicting pulmonary embolism were 92.3%,69.2%.The area under curve of the ROC curve(AUC)in the revised Geneva score and Daniel ECG score has no significant difference(Z=0.979).The negative predictive value of the revised Geneva score, Daniel ECG score combined with D-dimer in pulmonary embolism were 100.0% and 87.5%.Conclusion All of revised Geneva score, Daniel ECG score and age-adjusted D-dimer have certain predictive value on pulmonary embolism , and the revised Geneva score combined with age-adjusted D-dimer can be more safely exclude pulmonary embolism.

BACKGROUND:Aortic root homograft has been widely used, but it stil has a high incidence of calcification and degeneration after operation.
OBJECTIVE:To investigate the alteration of biological and immunological properties of rabbit aortic root homograft treated with de-endothelialization and decellularization methods, and to find a better decellularization method.
METHODS:Aortic root homografts obtained from rabbits were randomly divided into fresh group, de-endothelialization group, and decellularization group. The morphology of homografts was evaluated by hematoxylin-eosin, Masson and VG stainings. The biological properties such as thickness, tensile strength, broken extension rate, and heat shrinkage temperature were detected. The immunological features (inflammatory cellinfiltration, calcium content and CD152 expression) were determined with immunohistochemistry and flame atomic absorption spectrometry.
RESULTS AND CONCLUSION:As demonstrated in morphological observation, protocols of de-endothelialization and decellularization methods we used attained our desired aim of decellularization perfectly. Tensile strength and broken extension rate of decellularization group were decreased significantly compared with fresh group (P<0.01), while the difference between de-endothelialization group and fresh group was not significant (P>0.05). Hematoxylin-eosin staining showed that, inflammatory reaction was the most apparent in fresh group, showing a large amount of inflammatory cells infiltration;compared with fresh group, inflammatory reaction was significantly attenuated in de-endothelialization group, the number of inflammatory cells was significantly decreased. The inflammatory reaction was the lowest in the decellularization group, only inflammatory cells infiltrated the tissue edge. Immunohistochemistry showed that, CD152 expression was significantly increased in de-endothelialization and decellularization groups compared with fresh group (P<0.05). Calcium content in de-endothelialization and decellularization groups was significantly decreased compared with fresh group (P<0.05). It could be concluded that the immunogenicity of de-endothelialized and decellularized aortic homografts is decreased significantly, and the de-endothelialization method could better maintain the tensile property.

Objective To investigate the effect of sevoflurane preconditioning on the expression of Toll-like receptor 4(TLR4) during myocardial ischemia reperfusion(IR) in rats.Methods Thirty male SD rats weighing 250-300 g were randomly divided into 3 groups (n=10 each):sham operation group (S group) , IR group and sevoflurane preconditioning group(SP group).Myocardial ischemia was produced by temporary ligation of anterior descending branch of left coronary artery for 30 min followed by 2 h reperfusion. In SP group, the animals inhaled 2.5% sevoflurane for 30 min followed by 15 min washout before ischemia. The rats were sacrificed at 2 h of reperfusion, hearts removed and myocardial tissues obtained for microscopic examination.The expression of TLR4, NF-κB and TNF-α was detected using Western blot. Results The expression of TLR4, NF-κB and TNF-α was significantly up-regulated in IR and SP groups compared with group S (P＜0.05).The expression of TLR4, NF-κB and TNF-α was significantly down-regulated in group SP compared with group IR (P＜0.05).The myocardial injury was attenuated in group SP.Conclusion Sevoflurane preconditioning can attenuate myocardial IR injury by inhibiting the up-regulation of TLR4 expression and reducing the inflammatory response.

Objective To investigate the relationship of self-management skills and the quality of life among solitary elderly patients with hypertension.Methods 110 cases of solitary elderly patients with hypertension were measured with self-designed Self-management of Hypertension Scale and Short Form Health Survey (SF-36) and the correlation of them was analyzed.Results The levels of self-management skills of elderly hypertensive patients was at a middle level,and the mean score of self-management skills was (78.6 ± 5.2) points.The total score of SF-36 of patients with good self-management skills was higher than those with bad self-management skills.The therapy management,catering management,psychosocial management,sports management and overall quality of self-management of elderly patients with hypertension were positively correlated with survival quality.The factors influencing self-management ability of patients incuded education,gender,social resource utilization,psychological conditions.Conclusions Community health nurses should pay attention to self-management skills such as diet,exercise,therapy,social and psychological aspects in elderly hypertensive patients in order to improve their quality of life.Furthermore community nurses should strengthen intervention for solitary eldedy males with lower education level,poor utilization of social resources to improve their self-management skills.

Apoptosis ; Brain ; growth & development ; metabolism ; pathology ; Fetal Growth Retardation ; Humans ; Organ Size

Objective To study astragalus polysaccharide′s synergistic enhancement on Carvedilol′s improvement effects on dilated cardiomyopathy′s heart function.Methods SD rat model of dilated cardiomyopathy was established and divided into CON group (no treatment),CAR group (only Carvedilol treatment),APS group (only astragalus polysaccharide treatment) and C+A group (Carvedilol and astragalus polysaccharide treatment) according to their treatment methods.The left ventricular ejection fraction (LVEF),Tei index,high sensitive C reactive protein (hs-CRP),tumor necrosis factor (TNF)-α,interleukin (IL)-1,IL-6,IL-8,CD3+,CD4+ and CD8+ T lymphocyte subsets in four groups were detected and compared.Results The LVEF in C+A group and CAR group were significantly higher than those in CON group and APS group respectively (P<0.05,respectively),while Tei index in C+A group and CAR group were significantly lower than those in CON group and APS group respectively (P<0.05,respectively).The LVEF in C+A group was significantly higher than that in CAR group (P<0.05),while Tei index in C+A group was significantly lower than that in CAR group (P<0.05).The hs-CRP,TNF-α,IL-1,IL-6 and IL-8 in C+A group and APS group were significantly lower than those in CON group and CAR group respectively (P<0.05,respectively),while CD3+,CD4+ and CD8+ T lymphocyte subsets in C+A group and APS group were significantly higher than those in CON group and CAR group respectively (P<0.05,respectively).The hs-CRP,TNF-α,IL-1,IL-6 and IL-8 in C+A group were significantly lower than those in APS group respectively (P<0.05,respectively),while CD3+,CD4+ and CD8+ T lymphocyte subsets in C+A group were significantly higher than those in APS group respectively (P<0.05,respectively).Conclusion Astragalus polysaccharide has significant synergistic enhancement on Carvedilol′s improvement effects on dilated cardiomyopathy′s heart function,which may be related to the enhancement of T lymphocyte immunity and the decreasing of inflammatory reaction.

The effectiveness and efficiency of university educational management would have a direct impact on universities' teaching performance.Moreover,it is important to undertake a further reformation for the educational management system of university and college and establish such a standardized,high efficient educational management system.Since they would be the milestones that improve universities'teaching performance constantly and ensure there is a persistent evolution in universities as well.

Neoadjuvant chemotherapy is one of the common means in multidisciplinary treatment of locally advanced breast cancer,with anthracyclines and taxanes as main chemotherapeutic drugs.In recent years,molecular target agents have significantly improved the efficacy of chemotherapy,as well as have provided more choices and ideas for clinical treatment.Currently,the widely studied molecular targeted drugs include trastuzumab,lapatinib,pertuzumab,T-DM1 and bevacizumab.