Objective To prospectively assess the association between cardiac resynchronization therapy (CRT )and left atrial volume .Methods Fourteen patients with chronic heart failure ,sinus rhythm and left bundle branch block were enrolled in this study and prepared for CRT implantation .Clinical and echocardiographic evaluations were performed before CRT implantation and 6 months later .Followings were parameters of the left atrial and left ventricular volume:left ventricular end-systolic volume index (LVESVi)and end-diastolic volume index(LVEDVi) ,maximal LAV index(iLAVmax) ,etc ,LAV index before atrial systole(iL-AVpre)and minimal LAV(iLAVmin) .CRT responders were defined as those whose reduction rates were more than 10% in iL-VESV in 6-month follow-up .Results Responders(71 .4% )and non-responders(28 .6% )had similar baseline ,clinical characteristics and pre-implantation LV volumes .However ,iLAVmax in the responders was remarkably lower than that in non-responders .CRT therapy significantly reduced LVESVi(P<0 .01) ,LVEDVi(P<0 .001) ,iLAVmax(P=0 .004) ,iLAVpre(P=0 .003)and iLAVpost (P<0 .01) ,but when compared with the non-responders ,iLAVmax was much lower in responders .Correlation analysis showed that there was a significant correlation of LVEDVi with iLAVmax ,iLAVpost(P<0 .05) .Conclusion CRT therapy can significant-ly improve iLAVpre and iLAVmax may be a predictor of LV reverse remodeling .

Objective To evaluated the effect of first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI)on advanced non-small cell lung cancer (NSCLC)patients with different EGFR mutation status (exon 1 9 deletion and exon 21 mutation).Methods Seventy-two advanced NSCLC patients with EGFR mutation confirmed by histopathology were enrolled.All of the patients received first-line EGFR-TKI.The relationships between EGFR mutation status and objective response rate (ORR),disease control rate (DCR),progression free survival (PFS ) and overall survival (OS ) were analyzed.Results Of the 72 patients,37 patients expressed exon 1 9 deletion,35 patients expressed exon 21 mutation,and all of them could be evaluated.The ORR and DCR of patients with exon 1 9 deletion were higher than those of patients with exon 21 mutation (75.7%vs.51 .4%,χ2 =4.583,P=0.032;89.2%vs.68.6%,χ2 =4.636,P=0.031 ).The modified median PFS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation (1 3.2 month vs.1 0.8 month,χ2 =4.700,P=0.030).The median OS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation (30.2 month vs.25.6 month,χ2 =4.686,P=0.030).The side effects were similar between the two groups.The most common adverse reaction was rash,and the incidence had no significant difference between the two groups (48.7% vs.48.6%,χ2 =0.000,P=0.995 ).Conclusion EGFR mutation status is a predictor for PFS,OS and ORR of first-line EGFR-TKI in patients with advanced NSCLC.NSCLC patients with EGFR exon 1 9 deletion are associated with longer survival time and better response rate compared with those with exon 21 mutation.

Objective To compare the differences between state-owned hospitals and private-funded hospitals in Shanghai on the introduction and application of hospital marketing conception. Methods Questionnaire and interviews were conducted to reflect understandings in marketing conception,advertisements,hospital brand,customers' sense of satisfaction,etc. Results State-owned hospitals were less concerned in marketing conception compared with their private counterparts,even less sufficient in marketing input or management. Conclusion The state-owned hospitals should update their conception and enhance their ability of marketing management.While the private hospitals need to maintain the moderation of marketing and deal with the relationship among marketing,profit and development properly.

OBJECTIVE: To investigate the effects of total flavones of Ampelopsis(TFAG) on blood glucose and its antioxidant capacity. METHODS: The TFAG were extracted by ultrasonic assisted extraction and purified by D-101 macroporous resin. The effect of TFAG on the activities of α-glucosidase and α-amylase were determined in vitro. Diabetes mellitus(DM)mouse models were established by induction of streptozotocin(STZ). And the mice were daily treated by different dose of TFAG (100, 200, 400 mg·kg-1) for 15 d. In order to determine the blood glucose, blood was collected every 3 d. After administration of drug for 16 d, the blood was collected from the eyes and serum insulin and other biochemical indicator were measured. Hematoxylin and eosin stain will be used for histological analysis after collection of pancreatic tissues. Meanwhile, the amount of SOD, CAT and MDA in liver were measured. RESULTS: TFAG could significantly inhibit the activity of α-glucosidase and α-amylase, and that TFAG had a better inhibitory activity on α-glucosidase than α-amylase. The results of in vivo assay showed that TFAG could significantly reduce the levels of blood glucose, LDL, TC and TG, and increase the concentration of insulin and HDL in diabetic mice. HE staining showed that TFAG had some repair effects on pancreatic islet in diabetic mice. It was found that TFAG significantly decreased the levels of MDA, but instead it significantly increased the activities of SOD and CAT in liver of diabetic mice. CONCLUSION: The TFAG has significant effect on the hypoglycemic and antioxidant activity, and promote repair of pancreatic islets. Collectively, TFAG are valuable raw material with medicinal and edible properties and high development value.

Prone position ventilation has become an important part of lung protective ventilation in acute respiratory distress syndrome (ARDS) patients. Timely and appropriate implementation can improve the mortality of such patients. The same is true for patients with critical coronavirus disease 2019 (COVID-19) patients, but safety assessment, control of implementation details and prevention of complications still need to be further standardized during the practical procedure of prone position ventilation. The purpose of this paper is to explain the specific requirements and key points of prone position ventilation in critical COVID-19 patients, in order to promote the application of prone position ventilation in the treatment of patients with critical COVID-19 and reduce the occurrence of related complications.

Objective: To observe the clinical efficacy of heat-sensitive moxibustion for adjuvant treatment of depression in Parkinson disease and explore its mechanism. Methods: A total of 80 patients with Parkinson disease coupled with depression were randomized into an observation group and a control group, with 40 cases in each group. The control group was treated with levodopa and benserazide hydrochloride tablets and paroxetine tablets, while the observation group was treated with heat-sensitive moxibustion on the basis of the medications in the control group. The treatment course was 2 months. The Hamilton depression scale-17 (HAMD-17), unified Parkinson's disease rating scale (UPDRS) and Parkinson's disease quality of life questionnaire-39 (PDQ-39) were scored before and after the treatment, and the efficacy was evaluated after treatment. Levels of patients' serum dopamine (DA), 5-hydroxytryptamine (5-HT), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected before and after the treatment. Results: After treatment, the total effective rate of the observation group was higher than that of the control group (P<0.05). The HAMD-17 scores in the two groups decreased significantly after treatment (both P<0.05), and the score in the observation group was obviously lower than that in the control group (P<0.05). The component scores and total scores of UPDRS in both groups decreased significantly (all P<0.05), and the scores in the observation group were lower than those in the control group (all P<0.05). The score of PDQ-39 in the observation group decreased significantly (P<0.05), and was lower than that in the control group (P<0.05). After treatment, the serum DA and 5-HT levels in the observation group increased significantly (both P<0.05) and the TNF-α and IL-6 levels decreased significantly (both P<0.05), which were statistically different from those in the control group (all P<0.05). Conclusion: Heat-sensitive moxibustion has certain auxiliary effect in treating depression in Parkinson disease, significantly improving clinical symptoms and the quality of life, which may be related to the up-regulation of DA and 5-HT levels and down-regulation of TNF-α and IL-6 levels.

OBJECTIVE: To analyze the general and forensic pathological characteristics of death due to fat embolism syndrome (FES) and to provide reference data for forensic identification. METHODS: Twenty autopsy cases due to FES were selected from the forensic center of a medical college from 1999 to 2012. The general and forensic pathological characteristics such as the ways and types of injuries, clinical manifestation and the pathological changes were summarized. RESULTS: Fat embolism mainly occurred after long bone fracture or a large area of soft tissue injury with the majority of cases being fat embolism of lung and occasional cases being combined embolisms of lung and brain as well. The onset of symptoms appeared shortly after the injury or surgery. Lipid droplets could be observed within small pulmonary vessels and verified by special staining. CONCLUSION There are particular characteristics in death due to FES in concern with types of injuries, onset of symptoms and pathological findings. In order to find out the direct evidence of FES, special staining (oil red O staining) can be used in the forensic identification.
Autopsy ; Cause of Death ; Death ; Embolism, Fat/mortality* ; Forensic Pathology ; Fractures, Bone/complications* ; Humans ; Male ; Middle Aged ; Pulmonary Embolism/etiology* ; Soft Tissue Injuries/complications*

Objective To study the effect of artemether (Art) on total antioxidant capacity (T-AOC) in adult Schistosoma japonicum. Methods In vitro, the T-AOC was determined in five-week old worms incubated without or with Art and/or hemin for 24 h, and the worms were continuously incubated for 96 h, then worm survival was assessed. In vivo, T-AOC was determined in worms freshly recovered from mice 6 - 24 h after treatment with Art 300 mg/kg. Results Throughout 96 h incubation no worms were killed by 50 μmol/L Art or 50 μmol/L hemin alone, but approximatdy 80% of them were killed by Art plus hemin. Addition of reduced glutathione and vitamin E could significantly block the cidal action of the combined treatment. No effect on T-AOC was seen in the worms exposed to Art or heroin alone for 24 h, but the combined treatment led to a pronounced T-AOC reduction in female worms in vitro. Such a drug effect on female worms was demonstrated in vivo. After female worms were exposed to Art for 6 - 24 h in vivo, their T-AOC was significantly reduced by 40% - 64%. However, no drug effect on male worms' T-AOC was observed in vivo and in vitro exposed to Art plus hemin. Conclusion Art-induced T-AOC reduction in female worms may sensitize them to lethal damages of endogenous and exogenous oxygen radicals.

Objective To separate the side population cells(SP) from breast cancer MCF-7 cell line,and observe its biological characteristics.Methods Flow cytometry and Hcechst 33342 dye efflux assay were used to isolate SP cells and non-SP cells from the MCF-7 cell line of human breast cancer.Tumorigenicity of the two subpopulations was observed by a soft agar cloning method.Results The results of FACS analysis indicated that (6.5 ± 0.4 ) ％of the MCF-7 cells were SP cells;The vitro colony formation rate of SP cells was(38.5 ±9.4)％,and higher than that of non-SP cells ( 8.4 ± 2.6 ) ％ ( t =5.34,P ＜ 0,05 ).Concluslon The SP cells sorted from MCF-7 cell line enriched tunor stem cells,which exhibited high tumorigenicity.It indicated that SP cells should play a principal role in breast cancer.

Objective: To study the chemical constituents of Artemisia integrifolia. Methods: Solvent extraction, silica gel column chromatography, and HPLC were used for isolation and purification. The structure was identified by NMR spectrum analysis. Anti-oxidant activity tests were performed using DPPH. Results: A total of 21 monomeric compounds were isolated from A. integrifolia and identified as 2R-(2Z-pentenoic acid methyl ester)-3S-(methyl acetate) cyclopentanone (1), methyl-4S-6α-hydroxy-3- oxoeudesma-1,11 (13)-dien-12-oate (2), methyl caffeate (3), dextrin inositol (4), monobutyl fumarate (5), caffeic acid (6), monobutyl malonate (7), 6,8-dimethoxycoumarin-7-O-β-D-glucoside (8), 3,5-O-di-caffeoyl quinic acid butyl ester (9), 3,4-O-dicaffeoyl quinic acid butyl ester (10), 4,5-O-dicaffeoyl quinic acid butyl ester (11), 3,5-O-dicaffeoyl quinic acid methyl ester (12), 4,5-O- dicaffeoylquinic acid (13), 1,5-O-dicaffeoylquinic acid (14) 3,5-O-dicaffeoylquinic acid (15), o-hydroxycinnamic acid glucoside (16), 1,3-O-dicaffeoyl quinic acid (17), chlorogenic acid (18), 3,4-O-dicaffeoylquinic acid (19), methyl 3,4-O-dicaffeoylquinate (20), and o-hydroxycinnamate methyl glucoside (21). Conclusion: Compound 1 is a new natural product. Compounds 2, 5, 7-11, 14, 16, and 21 are isolated from Artemisia for the first time, and the rest are isolated from A. integrifolia for the first time. Both caffeoyl quinic acid compounds had strong anti-oxidant capacity, and the activity is basically equivalent to Vc.