LAD(OR=1.209). Conclusion Left atrial diameter was independent risk factor for ischemic stroke in hypertensive patients.

Educational narrative is the application of narratology in the field of education.This paper introduced the definition of educational narrative and its characteristics of life,situationality and reflexivity,and then discussed the applicableness of the application of educational narrative in the medical ethics education.Based on this,it proposed the effectiveness means,namely that to improve theory quality and enhance the ability of narration,clarify the narrative theme and select material carefully,take care of medical students' growth and listen to their voice.

Screening of CHD of infants (11 178) born from May 1st 2012 to April 30th 2013.92 infants were screening positive,68 were diagnosed.The detectable rate of CHD was 6.08‰,while boys were 3.31‰,girls were 2.77‰.68 CHD patients,the top three were VSD(2.14‰),PDA(1.34‰) and ASD (0.89‰).In these infants,detectable cardiac souffle were 61,abnormal pulse oximetry were 40.The detectable rate of CHD among infants was identical compare the average level of whole country,but the distributional characteristics was disparity.The screening of CHD was feasible,and cardiac souffle and pulse oximetry were recommended.

Objective To explore the effect of listening zhidiao tone in the five elements music together with language training on the rehabilitation of stroke patients with aphasia.Methods 57 subjects of stroke patients with aphasia were randomly divided into three groups,one was zhidiao music group,another was west music group,and the third was the control group.Four weeks later,using the scale called the Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) and the Stroke Aphasic Depression Questionnaire Hospital Version(SADQ-H) to see the variance of scores of language function,and depression in the three groups before and after intervention.Results After the intervention,depressed mood scores of three groups decreased significantly,zhidiao music group experienced less depressed mood compared with the control group.According the Ridit analysis,the clinical curative effect was significantly better in the zhidiao music group than in the western music group or the control group.Conclusion Zhidiao music combined with language training can improve the patients’ depression status,and improve compliance and enthusiasm of language training,so as to promote the reha-bilitation of the language function.Listening to zhidiao music had a positive role in language rehabilitation in stroke patients with aphasia,and worthy of further promotion and application.

AIM:To observe the effect of micronised fenofibrate(lipanthyl)on lipotoxicity and insulin sensitivity(IS)in spontaneously hypertensive rats(SHR)with high-fat diet.METHODS:Twenty-seven SHR were randomly divided into three groups:normal chow group(n=9),high-fat diet group(n=9)and micronised fenofibrate treatment group(n=9).Micronised fenofibrate 100 mg?kg-1?d-1 was given orally to SHR,which diet on high-fat diet for three months.Intramuscular lipids were observed and lipids accumulation index(LAI)was calculated.Nonesterified fatty acid,glucose and insulin were determined in all rats.RESULTS:(1)Compared to SHR in normal chow diet group,body weight and the level of serum TG and TC increased significantly and the level of HDL-C decreased significantly in SHR fed with high-fat diet(P

Objective To establish a system of the screening, evaluation and intervention of congenital heart disease (CHD) in China. Methods All infants (16070) born in Changzhou Maternal and Child Health Hospital from May 1st 2011 to April 30th 2013 were screened for CHD. The infants with CHD were followed up till 1 year of age. Results One hundred and three infants were diagnosed with CHD, and the incidence rate was 0.641%. The top three CHD types in incidences were VSD (0.205%), PDA (0.174%) and ASD (0.10%), respectively. In these infants, 94 cases were followed-up and 9 cases were lost. The incidence of small gapped VSD, ASD and premature PDA were high. Some infants with serious CHD were subjected to surgery, and others were still followed up. Conclusions The incidence of CHD in Changzhou is comparable with that in the whole country. The follow-up can improve the life quality of CHD infants.

[ABSTRACT]AIM:ToexploretheeffectofretinoidXreceptor(RXR)agonistbexarotene(Bex)andvitaminD receptor (VDR) agonist calcitriol (Cal) on the expression of nuclear factor-kappa B (NF-κB) and the development of atherosclerosis in streptozotocin-induced diabetic apolipoprotein E knockout ( STZ-ApoE-/-) mice.METHODS: Male mice were treated for 12 weeks as follows:(1) C57+vehicle;(2) ApoE-/-+vehicle;(3) STZ-ApoE-/-+vehicle;(4) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1);(5) STZ-ApoE-/-+Cal (10 μg/kg, twice a week);(6) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1) +Cal (10 μg/kg, twice a week).Intraperitoneal injection of STZ was performed to establish the diabetic animal model .Western blotting and immunohistochemical method was used to detect NF-κB level in the thorac-ic aorta.Plaque area in the thoracic aorta was measured using HE staining .RESULTS:Compared with the C57 mice, the fasting blood glucose in the ApoE-/-mice was not remarkably changed .The levels of total cholesterol ( TC) and low-densi-ty lipoprotein ( LDL) were greatly increased .The fasting blood glucose and lipid levels in STZ-ApoE-/-group were much higher than those in ApoE-/-group.Compared with STZ-ApoE-/-group, the fasting blood glucose and lipid levels in Bex group and Cal group were not significantly changed .Compared with the C57 mice, the protein expression of NF-κB in the ApoE-/-mice and the STZ-ApoE-/-mice was remarkably increased .Compared with STZ-ApoE-/-group, the levels of NF-κB in Bex group, Cal group and combination group were greatly decreased .Compared with STZ-ApoE-/-group, the thoracic artery plaque areas in Bex group and Cal group were inhibited (both P<0.05).Compared with Bex group, the plaque area of the thoracic artery in combination group was significantly decreased (P<0.05).CONCLUSION:Bexaro-tene or calcitriol decreases the development of atherosclerosis in streptozotocin -induced diabetic ApoE-/-mice.Bexarotene combined with calcitriol affords greater protection than monotherapy .The mechanism may be involved in down-regulating the expression of NF-κB.

Background Whether serum uric acid are related with ischemic stroke in essential hypertension (EH) is controversial. Objective To delineate the relationship between serum uric acid and ischemic stroke in EH. Methods A retrospective study was conducted in a cohort of 729 EH patients. Patients were classified into four groups according to serum uric acid level. The odds ratio for ischemic stroke was calculated with the lowest quartile as the reference. Results The prevalence of ischemic stroke in EH with quartile 4 of uric acid was higher than that in EH with quartile 1(37.9% vs 17.6%,P

Objective To investigate the effect of metabolic syndrome(MS) on the atrial fibrillation(AF) in patients with essential hypertension(EH).Methods A cross-sectional study was conducted in a cohort of 1810 hospitalization essential hypertension patients,which were divided into EH+non MS group(n=1155) and EH+MS group(n=655) according to MS criteria.Results Incidence of AF in EH+MS group was higher than that in EH+non MS group(14.4% vs 8.3%,P

AIM:To investigate the effect of activation of retinoid X receptor (RXR) on transforming growth factor β1 (TGF-β1) induced collagen synthesis under hypoxic environment in rat cardiac fibroblasts (CFs) and underlying molecular mechanisms .METHODS: CFs were cultured using myocardial tissue with dry method .Hypoxic environment was established for CFs by continuous nitrogen supplement .Type I and type III collagens in supernatants were detected by ELISA.Nuclear and cytoplasmic extractions were prepared using NE-PER nuclear and cytoplasmic extraction reagents .The protein levels of Smad2 and p-Smad2 were determined by Western blot and immunocytochemical staining .RESULTS:Un-der hypoxic condition , TGF-β1 (0.01~10 μg/L) increased the synthesis of type I and type III collagens in a dose-de-pendent manner in the CFs .At the concentration of 5μg/L, the synthesis of collagen I and III was significantly increased as compared with control group (P<0.01).RXR agonist 9-cis-retinoic acid (9-cis-RA;10 -9 ~10 -6 mol/L) decreased TGF-β1 (5μg/L)-induced synthesis of type I and III collagens in a dose-dependent manner in the CFs under hypoxic con-dition.The synthesis of type I and type III collagens was significantly inhibited by 9-cis-RA (P<0.01).Smad2 inhibitor ( 20 nmol/L) showed similar inhibitory effect on the synthesis of type I and III collagens induced by TGF -β1 under hypoxic condition.Compared with TGF-β1 intervention group, the cytoplasmic level of p-Smad2 in the CFs was significantly in-creased in TGF-β1+9-cis-RA group, but the nuclear p-Smad2 level was significantly decreased (P<0.05).CONCLU-SION:Retinoid X receptor agonist 9-cis-RA inhibits TGF-β1-induced synthesis of type I and type III collagens in the CFs by repressing p-Smad2 nuclear translocation under hypoxic condition .