Objective To analyze and investigate dopamine combined with milrinone treatment effect on elderly patients with intractable heart failure and N-terminal B-type natriuretic peptide level and cardiac function.Methods 80 cases of elderly patients with heart failure according to the number table method randomly divided into two groups: control group and experimental group, and control group was given conventional drugs.The patients in experimental group were received dopamine +Milrinone on the basis of control group.Clinical efficacy, N-terminal pro-B-type natriuretic peptide levels ( NT proBNP ) and heart function condition between two groups are compared and analyzed.Results The total effective rate of experimental group (95.00%) was higher than that of control group (70.00%) (P<0.05).NT-proBNP(2013.31 ±295.84)ng/L、LVEDD(61.48 ± 10.11)mm、LVEF(59.69 ±8.44)% in the experimental group was significantly better than the control group(P <0.05).Conclusion Dopamine combined with milrinone in the treatment of elderly patients with intractable heart failure is remarkable, can relieve the level of NT proBNP, and promote the recovery of cardiac function.

BACKGROUND:Acute myeloid leukemia after liver transplantation is a rare complication with high mortality. OBJECTIVE:To study the clinical features of acute myeloid leukemia after liver transplantation. METHODS:One case of acute promyelocytic leukemia after liver transplantation was reported, and literatures were reviewed. RESULTS AND CONCLUSION:Case presentation was post-odontectomy bleeding with associative abnormal coagulation test at 85 months after liver transplantation. Routine blood test, bone marrow test and chromosome analysis and examination diagnosed as acute promyelocytic leukemia and promyelocytic leukemia/RARαpositive chimeric gene, and clearly diagnosed as acute promyelocytic leukemia combined with disseminated intravascular coagulation. The patient received fresh frozen plasma transfusion to correct the abnormal coagulation, and then received induction chemotherapy with retinoic acid, arsenic trioxide and daunorubicin to obtain bone marrow complete remission. The patient was treated with daunorubicin combined with cytarabine and mitoxantrone combined with cytarabine regimens after remission induction to consolidate the chemotherapy for two courses of treatment, and then subsequently subjected to arsenous acid chemotherapy, and the bone marrow was sustained for remission. During chemotherapy, the dose and type of immunosuppressive agents were adjusted, and the patient had stable liver function without serious infection or complications. The results indicate that acute myeloid leukemia is common and often occurs after liver transplantation. When the patient displays hematological abnormality, acute promyelocytic leukemia should be considered. Early diagnosis and treatment can reduce the mortality.

Dental Care ; Plasma Gases

Objective To investigate the impact of PET-CT on the target volume delineation and precise radiothera?py planning for patients with advanced non-small cell lung cancer (NSCLC). Methods PET-CT scanning was performed in 30 histologically proved NSCLC patients. The gross tumor volume (GTV) was delineated, and radiotherapy planning was es?tablished with identical parameters based on the CT image and PET-CT fused image, respectively. The differences of doses between GTV, planning target volume (PTV) and organsat rise (OAR) were compared. Results PET-CT image results changed the target volume delineation in 30 patients with 8 increased and 22 decreased. There were no differences in GTV and PTV between the VGTV and VPTV statistically, although PET-CT image changed conventional CT image size sketch of GTV and PTV. The V20 of total lung decreased in the PlanPET-CT compared with that of PlanCT (P<0.05), but no differences were found in the V30 of total lung, mean lung dose (MLD), the data of spinal cord, esophagus and heart. Conclusion PET-CT may reduce the radiation injuries in the lung and improve the target dose.

AIM: To explore the effect of Snail1 siRNA on high-glucose induced tubular epithelial-to-mesenchymal transition (TEMT). METHODS: Subconfluent renal tubular epithelial cells were incubated in serum-free DMEM for 24 h to arrest and synchronize the cell growth. Then cells were treated with normal glucose (5.5 mmol/L D-glucose) or high glucose (25 mmol/L D-glucose) for 72 h. Meanwhile 19.5 mmol/L D-manntiol was used as high osmotic control. Snail1 siRNA was transfected into tubular epithelial cells. In parallel, cells were transfected with non-specific siRNA which served as the control data sets. Cells were then treated with 25 mmol/L D-glucose for 72 h. RNA and cell lysates were collected to determine the protein and mRNA levels of Snail1, TGF-β_1, α-SMA, vimentin and E-cadherin. RESULTS: Transfection caused the decreases in Snail1 at mRNA and protein levels by 62% and 68% respectively as compared to those in untransfected cells cultured in high glucose medium. Western blotting exhibited that Snail1 siRNA transfection restored E-cadherin protein expression by 61% compared to that in high-glucose-treatment cells, whereas it inhibited high-glucose-induced induction of α-SMA protein by 58%. Similarly, RT-PCR revealed that Snail1 siRNA transfection dramatically suppressed the high-glucose-induced mRNA expressions of α-SMA and vimentin by 72% and 61%, respectively, while E-cadherin mRNA increased by 53%. CONCLUSION: Our study provides direct evidence that Snail1 is able to control TEMT.

Objective To investigate a suitable model for the teaching of medical statistics in postgraduates in general medicine. Methods A total of 225 postgraduates who majored in general medicine in the class of 2017 in Xi'an Medical College were enrolled and randomly divided into study group with 130 postgraduates and control group with 95 postgraduates. The postgraduates in the study group received blending learning (with the application of Wenjuanxing and Duifenyi), and those in the control group received traditional teaching. The two groups were compared in terms of teaching efficiency and degree of satisfaction. Results Compared with the control group, the study group had significantly higher score of objective questions (t=11.2, P<0.01), score of SPSS analysis (t=5.44, P<0.01), total score of exams (t=26.3, P<0.01), and degree of satisfaction (Z=-3.853, P<0.01). Conclusion Blending learning may have a better overall effect than traditional teaching and can help students to achieve stronger abilities of data analysis and SPSS operation. This is an important attempt to change the teaching mode of medical statistics in postgraduates and provides a feasible method for the training of general medical talents with innovative and scientific thinking.

Objective: To observe the effect of ticagrelor for non-ST-segment elevation acute coronary syndrome after percutaneous coronary intervention (PCI). Methods: A total of 200 patients with non-ST-segment elevation acute coronary syndrome after PCI were enrolled in this study.And the patients were randomly divided into the observation group (18 months treatment group, 100 cases) and control group (12 months treatment group, 100 cases) according to the digital table.The control group was given dual antiplatelet therapy (DAPT) for 12 months, and then, suspended the usage of ticagrelor.The observation group was treated by DAPT for 18 months.The major adverse cardiovascular events (MACCE) and the secondary end point events were observed. Results: The incidence rate of MACCE between the two groups had no statistically significant difference (χ²=0.298, P=0.862). And there was no statisticallysignificant difference in the incidence of the secondary end point events between the two groups (χ²=1.963, P=0.375). Conclusion The usage of DAPT beyond or equal 12 months doesn't reduce the incidence of MACC and it will not increase the blooding rate.The use of DAPT (aspirin and ticagrelor) should be used less than 12 months.

Objective: To understand the awareness of sexual knowledge among primary and secondary school students, as well as their attitudes towards school sex education and to provide a reference for school-based sex education. Methods: A total of 5 531 primary and secondary school students were selected from Beijing, Chongqing, Heilongjiang (Harbin and Jiamusi) and Hubei (Wuhan and Xiaogan) by stratified cluster sampling and were investigated with self-reported questionnaire. Results: Sex-related knowledge scored 62.33±19.35, with a pass rate of 61.9%, and the excellent rate 17.5%. Sexual knowledge of junior high school students scored 64.30±19.07, with the pass rate of 64.7%, and the excellent rate 22.0%. A large proportion of primary students reported unaware of pubertal growth and HIV/AIDS-related knowledge, and a large proportion of junior high students unaware of reproductive physiology. Multivariate Logistic regression analysis showed region, grade, gender, and suburban areas were related to the level of sexual knowledge(P<0.05). More than 76.0% primary students and 85.9% middle school students agreed on the importance of school sexuality education. 59.7% of primary school students and 73.3% of junior high school students hoped to include school sexuality education in compulsory education courses; 59.8% of primary school students and 68.3% of junior high school students felt that school sexuality education should be equipped with specialized teachers. Conclusion Chinese primary and secondary school students are lack of sexual knowledge. As students have strong wills to get more information on sexual knowledge, schools should provide them with more comprehensive and effective sex education through appropriate courses and activities.