Objective: To investigate the rate of post-stroke depression and psychosocial factors related to it, and to provide the direction and the basis for clinical nursing. Methods: 69 patients with stroke were assessed by Zung Self-rating Depression Scale and Type A Behavior Pattern Scale. Their sex, age, behavior type, marital condition, level of education, supportor of medical expenses were collected and analysed statistically. Results: The rate of post-stroke depression was 59.42%, and the rate in type A behavior group was higher than that in the other behavior groups(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 .

[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.

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

BACKGROUND:In recent years, there are many animal studies and osteoblast studies on the anti-osteoporotic effects of puerarin, a kind of phytoestrogen. But few of them are reported on the effects of puerarin on osteoblasts in older patients with osteoporosis. OBJECTIVE: To observe the influence of puerarin on the proliferation ofin vitro cultured osteoblasts from older female patients with osteoporosis. METHODS:The older female patients with osteoporotic femoral neck fractures who underwent artificial femoral head replacement were included in this study. The femoral neck cancelous bone removed during the operation was colected. Primary cancelous bone osteoblasts were cultured using explant culture method. The cels were sub-cultured to the required amounts. Osteoblasts from the control group were cultured with culture medium without puerarin. Osteoblasts from the 0.01, 0.1, and 1 μmol/L puerarin groups were cultured with culture medium containing the corresponding concentrations of puerarin. After in vitro co-culture with different concentrations of puerarin for 1, 3, 5 days, the proliferation of osteoblasts was observed. RESULTS AND CONCLUSION:With the increase in the concentration of puerarin, the proliferative activity of
osteoblasts constantly increased at different time points (P < 0.05). At 3 days of culture, cel absorbance value in each group reached the peak level. These results suggest that 0.01, 0.1, 1μmol/L puerarin promotes the proliferation of osteoblasts in older patients with osteoporosis in a concentration-dependent manner.

OBJECTIVE:To investigate the effects of puerarin on bone mineral density around the femoral prosthesis of el-derly women after osteoporotic fracture artificial hip joint replacement. METHODS:99 elderly women after osteoporotic fracture artificial hip joint replacement were divided into control group(49 cases)and test group(50 cases)according to random number table. Control group received conventional treatment:calcium carbonate and vitamin D3+alendronate sodium+salmon calcitonin;test group was additionally given Puerarin injection 200-400 mg dissolved in Glucose injection 500 ml intravenously,qd,on the basis of control group. A treatment course lasted for 20 d,and both groups received 2 courses of treatment. The hip joint function score and bone mineral density around the femoral prosthesis of 2 groups were observed and compared after surgery,and the oc-currence of ADR was also observed. RESULTS:3 and 2 patients withdrew from control group and test group,respectively. 18 months after surgery,the patients with hip joint function score ranged 70-79 in test group was significantly less than in control group;the rate of excellent hip joint function score in test group was significantly higher than in control group,with statistical significance (P<0.05). 15 and 18 months after surgery,bone mineral density in R1-R5 range of Gruen range in test group was slightly higher than in control group,without statistical significance(P>0.05);bone mineral density in R6-R7 range was signifi-cantly higher than control group(89.58% vs. 69.57%),with statistical significance(P<0.05). The prosthesis loosening was not found in both groups,and ADR was also not found as fever,erythra,nausea,vomiting,headache,dizziness,etc. CONCLU-SIONS:For the use of puerarin in elderly women after osteoporotic fracture artificial hip joint replacement,puerarin can increase the periprosthetic femur bone mineral density with good safety.

Objective To evaluate the clinical value of intraoperative image fusion assisted contrastenhanced ultrasound (CEUS) in real-time assessing the curative effect on radiofrequency ablation of hepatocellular carcinoma(HCC).Methods From November 2010 to August 2011,the patients with HCC which would accept radiofrequency ablation (RFA) in our hospital were divided into image fusion assisted CEUS group and conventional CEUS group.The HCC lesion in each group was named as difficult lesion if it was invisible in B-mode ultrasound,larger than 50 mm in diameter or the puncuture route was affected by lung,ribs or blood vessels.Ten minutes after RFA,two groups of patients were performed intraoperative image fusion assisted CEUS examination and conventional CEUS examination respectively.All the patients received CT/MRI one month after ablation to decide whether the HCC had been completely ablated.Difference of complete ablation rate of HCC was compared between the two groups as well as between the difficult lesions in each group.Results Forty-eight lesions in 39 patients were enrolled in image fusion assisted CEUS group including 19 difficult lesions.Sixty-eight lesions in 53 patients were enrolled in conventional CEUS group including 18 difficult lesions.No statistical difference was found between the two groups in lesion size,proportion of difficult lesions,proportion of lesions received TACE or RFA plus PEIT (P =0.052,P =0.136,P =0.185,P =1.000).Postoperation following-up results demonstrated that complete ablation rate of HCC in navigation assisted CEUS group(100 ％,48/48) was not statistically higher than that in conventional CEUS group(92.6％,63/68) (P =0.145).But the difficult lesions in navigation assisted CEUS group (100％,19/19) had statistically higher complete ablation rate than that in conventional CEUS group(72.2％,13/18) (P =0.020).Conclusions Intraoperative navigation assisted CEUS could real-time assess the curative effect on RFA of HCC,especially in the difficult lesions,and could be used as the beneficial supplement of the conventional CEUS.

Objective To compare the importance of heart murmurs and transcutaneous oxygen saturation (SpO2)in screening neonatal congenital heart diseases(CHD),and to explore a reliable and easy-to-use method for the screening of CHD. Methods All infants (16 070 cases) born in Changzhou Maternal and Child Health Hospital from May 1 st 2011 to April 30 th 2013 were screened of CHD for heart murmurs and SpO2 . The screen-positive infants were divided into 3 groups:heart murmurs group,abnormal SpO2 group and mixed group. All screen-positive infants re-ceived cardiac color ultrasound to make a definite diagnosis of CHD,so as to compare the values of heart murmurs and SpO2 . Results Eight thousand seven hundred and ninety-nine boys and 7 271 girls were screened,in which the ratio was 1. 21:1. 00. One hundred and eighteen infants were screened positive,including 76 murmurs of which 45 were confirmed as CHD,28 with abnormal SpO2 of which 18 were confirmed and 14 mixed of which 13 were confirmed,so the confirmation rates were 59. 21%,64. 29% and 92. 86%,respectively. The diagnostic rate of CHD in mixed group was higher than other 2 groups,which had statistical significance(P=0. 045). The top three formation types of CHD were ventricular septal defect (VSD) (29/76 cases,38. 16%),patent ductus arteriosus (PDA) (13/76 cases, 17. 11%) and atrial septal defect (ASD) (11/76 cases,14. 48%). Conclusions The combination of heart murmurs and SpO2 was useful in increasing detection and decreasing misdiagnosis of CHD.

Objective To explore metabolic characteristics of and risk factors for newly diagnosed type 2 diabetes mellitus(T2DM) combined with non-alcoholic fatty liver disease (NAFLD).Methods One hundred and forty-two cases of newly diagnosed T2DM were divided into two groups according to whether they have comorbid NAFLD:group A (without NAFLD,n =79) and group B (combined with NAFLD,n =63).Data collected included body height,body weight,blood pressure,fasting plasma glucose (FPG),blood lipid,serum uric acid (UA),HbA1c and fasting insulin,body mass index and insulin resistance index with homeostasis model(HOMA-IR) were calculated to compare the clinical and biochemical parameters between groups A and B.Results (1) The difference of age and blood pressure between groups A and B were not statistical different (P ＞ 0.05).Compared with group A,BMI ((26.79 ± 1.93) kg/m2 vs (24.61 ± 2.46) kg/m2,t =5.76),FINS((15.49±2.44) mU/L vs (13.20±2.17) mU/L),t =5.91),HOMA-IR((6.74± 1.32) vs (5.65 ±1.10),t =5.37),glycerin trimyristate (TG) ((2.94 ± 0.65) mmol/L vs (1.74 ± 0.46) mmol/L),t =12.86),low density lipoprotein cholesterin (LDL-C) ((3.46 ±0.73) mmol/L vs (2.78 ±0.86) mmol/L,t =5.07) and UA((342.41 ±71.49) mmol/L vs (312.98 ±66.24) mmol/L,t =2.54) were significantly higherand hight density lipoprotein cholesterin (HDL-C) ((0.99 ± 0.17) mmol/L vs (1.21 ± 0.29) mmol/L,t =5.33) was significantly lower in group B (P ＜ 0.05).(2) Using whether to combined with NAFLD as dependent variable,and BMI,FINS,HOMA-IR,TG,LDL-C,HDL-C and UA as independent variable,logistics regression analysis showed that BMI,HOMA-IR and TG were risk factors for NAFLD(OR =2.838,19.241,and 2.019 respectively,P ＜ 0.05).Conclusion Newly diagnosed type 2 diabetes mellitus combined with NAFLD have more obvious dyslipidemia and insulin resistance.Obesity,insulin resistance,hyper-triglyceridemia are risk factors for newly diagnosed type 2 diabetes mellitus combined with NAFLD.

Objective In order to know the effect of rehabilitation of pelvic organs by pelvic floor muscle training and electrical stimulation. Methods Divided 330 pregnant women into the integrated group(120 cases),the experimental group(100 cases) and the control group(100 cases) randomly. Rou-tine nursing cares was used in the control group, pelvic floor muscle training and electrical stimulation were used in the integrated group in addition, pelvic floor muscle training was used in the experimental group. Evaluated the rehabilitation condition of pelvic organs in the 42nd day after delivery among the three groups. Results All the indexes which can indicated the rehabilitation condition of pelvic or-gans in the integrated group and the experimental group were significant better than those of in the con-trol group, while there was no significant differences about the above indexes between the integrated group and the experimental group. Conclusions Pelvic floor muscle training combined with electrical stimulation can effective promote the rehabilitation of function of pelvic organs, and then prevent the in-cidence of related diseases.