Objective:To explore the clinical characteristics of senile degenerative valvular heart disease (SDHVD)compli-cated heart failure (HF).Methods:A total of 68 SDHVD + HF patients were enrolled as SDHVD + HF group,another 62 aged HF patients without valvular calcification in the same period were enrolled as HF control group.Characteristics of two groups were analyzed.Results:Compared with HF control group,there were significant rise in percentages of severe cardiac dysfunction (NYHA class III:19.35% vs.38.24%,NYHA class IV:35.49% vs.55.88%),incidence rates of at-rial premature (17.74% vs.38.24%),sinoatrial block (22.58% vs.50.00%),atrial fibrillation (27.42% vs.52.94%), paroxysmal atrial tachycardia (30.65% vs.48.53%),atrioventricular block (33.87% vs.52.94%)and bundle branch block (25.81% vs.48.53%)in SDHVD + HF group,P <0.05 or <0.01. Conclusion:When SDHVD patients compli-cate with HF,the HF degree aggravates and incidence rate of arrhythmia rises.

Objective To explore the clinical effect of subcutaneous negative pressure suction cosmetic suture with anti L incision in liver surgery.Methods A total of 140 patients who received liver surgery in general surgery department of our hospital from March 2015 to April 2016 were randomly selected,of which 70 cases received cosmetic suture with negative pressure drainage (observation group),the other 70 cases treated with conventional suture(control group).The repair times,the healing of the incision of two groups were observed and analyzed.Results Compared with the control group,the repair time and hospital stays of patients in observation group were significantly shorter than those of the control group,and the differences were statistically significant (P ＜ 0.01).Conclusion Cosmetic suture with negative pressure drainage is effective to shorten the repair time,reduce the incidence of incision fat liquefaction and infection,while ensuring the aesthetic level of the incision.

The sella MRIand CT of 11 patients with primary pituitary dwarfism (PPD) were evaluated in this study. The results revealed that MRI could find the aplasia of the pituitary and the abnormality of the pituitary stalk and pituitary posterior lobe, while CT only could show the disapperance of the pituitary and not the morphology of the pituitary and its posterior lobe. The CT scanning of the pituitary stalk was less clear than that of MRI. It is suggested that MRI has better tissue contrast and sensitivity, especially to the display of slight structure. Besides, the sella abnormality in MRI provides an important morphological basis for diagnosis and treatment of PPD.

Objective To compare serum potassium concentrations in type 2 diabetic and nondiabetic patients in the early phase of acute coronary syndromes (ACS). Methods Seven hundred and forty-five consecutive patients with ACS underwent cardiac catheterization from January, 1999 to March, 2003. Patients were stratified by duration of symptoms,type2diabetes,and?-receptor blocker therapy before admission. Results Serum potassium concentration was significantly higher in type 2 diabetic patients with ACS than that in nondiabetic patients with ACS 〔(4.34?0.48)mmol/L vs (4.00?0.52)mmol/L,P

BACKGROUND:Autologous split-thickness skin grafting is the main therapy for burn repair at functional sites, which has achieved certain effects, but there are stil some deficiencies, such as poor texture, stiffness and poor toughness, as wel as severer hyperplasia that is easy to result in contracture deformity and poor functional recovery. OBJECTIVE: To analyze the clinical efficacy of skin co-transplantation on burn repair at functional sites. METHODS:Sixty patients with burns at functional sites (n=84) were randomized into two groups: co-transplantation of acelular dermis and autologous split-thickness skin in experimental group and autologous split-thickness skin graft in control group. Survival rate of skin flap and rate of secondary operation were compared between two groups. At 1 month after transplantation, Vancouver Scar Scale was used to assess skin color, thickness, blood vessel distribution and flexibility, and meanwhile, the severity of scar was determined. RESULTS AND CONCLUSION:The survival rate of skin flap was significantly higher in the experimental group than the control group (93%vs. 70%,P < 0.05), and the rate of secondary operation was significantly lower in the experimental group compared with the control group (0vs. 13%,P < 0.05). At 1 month after transplantation, scores on the skin color, thickness, blood vessel distribution and flexibility were al lower in the experimental group than the control group (P < 0.05), but the incidence of mild hyperplasia in the experimental group was significantly higher than that in the control group (52% vs. 29%,P < 0.05). These findings indicate that co-transplantation of acelular alogeneic dermis and autologous split-thickness skin for burn repair at functional sites can effectively enhance the survival rate of skin flap, reduce the rate of secondary operation, contribute to wound healing and reduce the severity of hyperplasia.

Objective To investigate the mechanisms involved in cucurmosin-induced apoptosis of pancreatic cancer cell SW1990.Methods The expression of EGFR,PI3K,Akt,Bad,Caspase -9,mTOR,P70S6K-α,and 4E BP1 at the protein level were detected by western blot analysis,and RTPCR was used to determine EGFR mRNA expression.Results An increased concentration of cucurmosin showed a subsequent decrease in the expression of EGFR,PI3K,Akt,mTOR,P70S6Kα,and 4E -BP1,whereasthe expression of Bad and Caspase-9 were elevated.However,the mRNA expression of EGFR was unchanged.Conclusion Cucurmosin is shown to induce the apoptosis of pancreatic cancer cell SW1990 by down regulating the expression of EGFR and thus inactivating the PI3K/Akt/mTOR signaling pathway.

The article summarized relevant theories and successful practical experience about medical resource integration, analyzed the background of regional medical-trust in Shanghai, and discussed three different model of regional medical-trust building, and their own advantages and disadvantages. Furthermore it discussed the main framework of regional medical-trust pilot reform,including administrative and operational model, insurance-payment model and visiting-doctor model. Then, it introduced the reform strategies of regional medical-trust pilot and present progress.

AIM: To investigate the role of angiopoietin-1 (Ang1) and Tie2 receptor in angiogenesis after myocardial infarction through detecting their mRNA expression in normal and infracted myocardium. METHODS: The experiment was conducted in the laboratory of Biochemistry and Molecular Biology, Medical Department of Peking University from April 2006 to April 2007. Forty male SD rats were randomly divided into acute myocardial infarction model group and sham-operation group. The myocardial infarction model was established in the rats of model group through the ligation of left anterior descending artery, while the rats in sham operation group were braided of the left anterior descending artery without ligation. Five rats in both groups were executed at 3, 7, 14, and 28 days after model establishment. RNA was extracted from the same site of left anterior wall, and the polymerase chain reaction was used to semiquantitatively analyze the Ang1 and Tie2 receptor mRNA expression with GAPDH gene as internal control; meanwhile, the immunohistochemistry was used to detect vascular density in and around infarction area. All the treatments for animals were accorded with the animal ethical standards. RESULTS: All 40 rats were included in the final analysis. Both Ang1 and Tie2 receptor were expressed in normal myocardium. In the 28 days after myocardial infarction, Ang1 expression kept at almost the same level without changing, but Tie2 receptor expression was slightly elevated at 3 days, reached peak value at 7 days, and returned to the baseline value at 14 days. The vascular density increased both infarction and peri-infarction area at 7 days after acute myocardial infarction, and did not change with time. CONCLUSION: Tie2 receptor expression is elevated and coincided with angiogenesis after myocardial infarction. It may play a role in the development and stabilization of the blood vessel after myocardial infarction.

Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rh-BNP) combined with levosimendan on acute myocardial infarction complicated by heart failure.Methods Patients who suffered from anterior wall acute myocardial infarction (AMI) with heart failure (KillipⅡ ～ Ⅲ) within 12 to 24 hours after the onset of chest pain were randomized into two groups: the control group (n=30, receiving dobutamine and/or cedilanid) and the experimental group (n=30, receiving rh-BNP combined with levosimendan).The hemodynamics, parameters of laboratory tests and adverse events were observed before and after treatment.Results The experimental group showed that the respiratory rate (RR), heart rate (HR), systolic blood pressure (SBP), arterial blood gas oxygen saturation (SaO2), cardiac index (CI), extravascular lung water index (EVLWI) were significantly different between 2 h and sequential time points after treatment and pre-treatment (allP＜0.05).The control group showed that RR, HR, SaO2, CI, EVLWI were significantly different between 6 h and sequential time points after treatment and pre-treatment (P＜0.05 for all).There were significant differences in RR, HR, SBP, SaO2, CI, EVLWI at 2 h and 6 h after treatment between the two groups (P＜0.05 for all).Parameters of RR, HR, CI, EVLWI at 72 h after treatment had differences between the experimental group and controls.Patients in the experimental group presented larger urine volume, lower level of plasma NT-pro BNP, higher left ventricular ejection fraction (LVEF) and shorter length of stay in CCU as compared with patients in the control group (P＜0.05 for all).In adverse events monitoring in hepatic parameters, electrolyte level and coagulation function before and after treatment, there was no significant difference between the two groups.Conclusions Compared with the conventional treatment, the combination therapy with rh-BNP and levosimendon can improve the hemodynamics, increase the urine volume, decrease the level of plasma NT-proBNP and elevate LVEF significantly, so as to improve the clinical symptoms and shorten the hospital stay in patients with acute myocardial infarction complicated by heart failure.

Objective: To understand the characteristics of different pulmonary function grades and comprehensive assessment groups among patients with chronic obstructive pulmonary disease (COPD) from community survey, so as to provide the evidence for the comprehensive community management of COPD. Methods: The survey data of five monitoring sites in Zhejiang Province during 2014-2015 in the COPD surveillance of Chinese residents aged 40 years and above was collected. The patients with COPD were classified by pulmonary function according to the percentage of forced expiratory volume in the first second (FEV1) in the predicted value, and by comprehensive assessment according to modified British Medical Research Council (mMRC) score, COPD Assessment Test (CAT) score and acute exacerbation in the past year. The characteristics of different pulmonary function grading and comprehensive assessment groups were compared. Results: A total of 355 patients with COPD were found, with an average age of (63.00±9.63) years. The male-to-female ratio was 3.18:1. There were 243 patients with an education level of primary school or below, accounting for 68.45%. The awareness rate of COPD related knowledge was only 1.69%. There were 257 (72.39%) patients with mild, 86 (24.23%) patients with moderate, and 12 (3.38%) patients with severe pulmonary function. The proportions of patients with childhood history of severe respiratory infection, self-reported respiratory system diseases, chronic cough, chronic sputum, acute exacerbation in the past year, CAT score ≥10 points, and inhaled medication were lower in the patients with mild pulmonary function than with moderate and severe pulmonary function; the body mass index and waist circumference were higher in the patients with mild pulmonary function than in the patients with moderate and severe pulmonary function (all P<0.05). The comprehensive assessment resulted in 158 (44.51%) patients of Group A, 134 (37.75%) patients of Group B, 1 (0.28%) patient of Group C, and 7 (1.97%) patients of Group D. The average age and systolic pressure were lower in Group A than in Group B, C and D; the proportions of patients with self-reported respiratory system diseases, family history of respiratory diseases, chronic cough, chronic sputum, dyspnea, acute exacerbation in the past year and CAT score ≥10 points were lower in Group A than in Group B, C and D (all P<0.05). Conclusion The community patients with COPD are mainly classified to mild pulmonary function and Group A in the comprehensive assessment; thus they need different levels of management.