Objectives: To explore the influence of exercise training on the arterial baroreflex sensitivity （BRS）and correlation between blood pressure and BRS in spontaneously hypertensive rats (SHR). Methods: Male SHR（n=20）and normotensive Wistar rats（n=20）were randomly assigned to normality group and exercise group, n=10 in each group. Rats in two exercise groups received treadmill training at a speed of 20 m/min for 60 min/d, 6 d/w for eight weeks. Systolic blood pressure (SBP) and heart rate (HR) were measured using a tail-cuff method in a conscious state. Intravenous injections of phenylephrine (PE) and sodium nitroprusside (NP) were used to induce depressor and pressor reflex respectively. The ratio of HR over mean arterial pressure (MAP) (HR /MAP) after administration of PE or NP was regarded as an index of depressor reflex sensitivity (BRS-PE) and pressor reflex sensivity (BRS-NP). Results: After eight-week exercise training, compared with SHR normality group, there were significant reduction in resting SBP [(180±8.5) mmHg vs. (163.6±10.7) mmHg] and in HR [(368.4±13.3) beats/min vs. (345.0±9.8) beats/min] in SHR exercise group, P<0.01 both. However, there was no significant difference in resting SBP between Wistar exercise and normality groups (P>0.05), compared with Wistar normality group, there was significant reduction in HR [(362.2 ± 13.0) beats/min vs. (343.9 ± 10.2) beats/min, P <0.05] in Wistar exercise group. Compared with SHR normality group, there were significant rise in BRS [BRS-PE: (0.89 ± 0.13) bpm/mmHg vs. (1.32 ± 0.22) bpm/mmHg, BRS-NP： (0.60± 0.09) bpm/mmHg vs. (1.21± 0.26) bpm/mmHg, P<0.01] in SHR exercise group, but still lower than those of Wistar normality group [BRS-PE: (1.96±0.23) bpm/mmHg, BRS-NP: (1.32±0.17) bpm/mmHg]. Pearson linear correlation analysis indicated that MAP was significantly inversely correlated with BRS (r=-0.734, P<0.01) in SHR normality and exercise group. Conclusion: Exercise training may significantly decrease SHR blood pressure; it is related to improved baroreflex sensitivity induced by exercise, indicating that enhanced baroreflex may be an important mechanism of exercise therapy in hypertensive patients.

The paper reviewed the history and characteristics of the public hospital reform in China. Based on the theories of corporate governance, it made analysis and comments on existing roadblocks and reform attempts in such hospitals, proposing a public hospital governance model in line with the general reforms made in China's healthcare system sector.

Background and purpose: The previous work of this study has showed that the treatment of liver cancer cells with emodin could induce endoplasmic reticulum (ER) stress and apoptosis. Given the cross-talk between ER stress and autophagy, this study aimed to investigate whether blockage of autophagy, a defense mechanism against environmental stress, could improve the killing effect of emodin on liver cancer cells. Methods: The CYTO-ID auto-phagy detection kit and Western blot were used to determine autophagy in liver cancer cells. After combined treatment with chloroquine (CQ) and emodin, cancer cell survival was analyzed by ATPlite assay and clonogenic assay. Apoptosis was detected by both flow cytometry analysis and Western blot. Results: Autophagy could be induced in liver cancer cells after treatment with emodin. Inhibition of autophagy significantly increased growth-inhibitory effect of emodin on both HepG2 and Huh7 cancer cells. The combination treatment with CQ and emodin promoted remarkable apoptosis in liver cancer cells, evidenced by the increase in the percentage of cells in sub-G1 phase and the higher expression lever of cleaved caspase-3. Conclusion: Therapeutically targeting autophagy is capable of enhancing cytotoxicity of emodin in liver cancer cell lines.

Objective: To investigate the protective effects of matrine combined with glycyrrhizic acid on chronic liver injury induced by carbon tetrachloride, and explore the protective mechanism from the points of energy metabolism and CYP enzyme.Methods: The chronic hepatic injury model of rats was induced by CCl4.The changes of activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum were measured to observe the protective effect of the two drugs and their combination.The contents of glutamate dehydrogenase (GLDH) in serum and adenine nucleoside three phosphate (ATP), adenosine diphosphate (ADP) and adenine monophosphate (AMP) in liver tissue were determined to evaluate the regulation effect on hepatic energy metabolism and mitochondrial function.The levels of CYP1A2, CYP2E1 mRNA and protein in liver tissue were detected by real-time PCR and Western Blot to evaluate the two drugs and their combination on the regulation function of liver CYP enzyme.Results: Matrine (72.8 mg×kg-1)and glycyrrhizic acid(43.4 mg·kg-1)could decrease the serum activities of ALT and ALT in chronic hepatic injury model, and the combination (matrine 36.4 mg·kg-1+glycyrrhizic acid 21.7 mg·kg-1) had the most significant protective effect (P＜0.05).Matrine (72.8 mg·kg-1)and glycyrrhizic acid(43.4 mg·kg-1)could decrease GLDH in serum,and restore the content of ATP in liver (P＜0.05).Matrine (72.8 mg·kg-1) had no effect on the expression of CYP1A2 and CYP2E1mRNA, and glycyrrhizin (43.4 mg·kg-1) could inhibit the expression of CYP1A2, CYP2E1mRNA and protein (P＜0.05).Conclusion: Matrine combined with glycyrrhizin has obvious regulation effect on mitochondrial function and liver protective effect in chronic hepatic injury model.

OBJECTIVETo investigate the effects of central oxidative stress on the baroreflex function and central mechanism responsible for the attenuated baroreflex sensitivity (BRS) in spontaneously hypertensive rats (SHR).

METHODSMale 24-week-old SHR and normal rats were anesthetized with urethane and alpha-chloralose. Intravenous injection of phenylephrine (PE) and sodium nitroprusside (NP) evoked arterial baroreflex. The ratio of change in heart rate (HR) to change in mean aortic pressure (MAP) represented the baroreflex sensitivity (BRS). Alteration in BRS was evaluated before and after intracerebroventricular administration of superoxide dismutase (SOD) mimetic tempol or SOD inhibitor diethyldithiocarbamic acid (DETC).

RESULTSBRS in hypertensive rats was significantly lower than that in normal rats (PE: P < 0.01, NP: P < 0.01). Intracerebroventricular administration of Tempol significantly improved BRS in hypertensive rats (P < 0.05), but not in normal rats. In contrast, DETC decreased BRS to a greater extent in normal group than in hypertension group (P < 0.05). MDA content in hypothalamus of hypertensive rats was higher than that of normal rats (P < 0.01), whereas total antioxidant capacity, total SOD, CuZn-SOD, catalase activity were lower in hypertensive rats than in normal rats (P < 0.05).

CONCLUSIONAttenuated baroreflex function in hypertensive rats is associated with central oxidative stress, which is linked to decreases in antioxidant enzyme activity and antioxidative capacity in the brain.

Animals ; Baroreflex ; physiology ; Central Nervous System ; metabolism ; Male ; Oxidative Stress ; Rats ; Rats, Inbred SHR

OBJECTIVETo compare the efficacy of telbivudine monotherapy and telbivudine combination therapy with adefovir in patients with nucleos(t)ide-naive chronic hepatitis B, high-level hepatitis B virus (HBV) load and hepatitis B e antigen (HBeAg)-positivity, and to explore the relationship between treatment regimen adherence and treatment outcomes.

METODSA retrospective study was performed with 123 HBeAg-positive, high-level viral load (HBV DNA≥10(7) copies/ml), nucleos(t)ide-naive chronic hepatitis B patients. Fifty-three of the patients received combination therapy with telbivudine and adefovir dipivoxil,while 70 patients received the telbivudine monotherapy. All patients were tested for rates of conversion to HBV DNA-negative status,alanine aminotransferase (ALT) normalization, HBeAg seroconversion, drug resistance, and side effects at treatment weeks 12, 24, and 48. Treatment regimen adherence was assessed through self-reporting, and interviews were used to explore the relationships to treatment outcomes. The chisquare test, t test and Fisher's exact test were used for statistical analyses.

RESULTSThe rates of HBV DNA negative conversion in the combination group at treatment weeks 12, 24 and 48 were 62.3% (33/53), 88.7% (47/53) and 94.3% (50/53) and were significantly different from those in the monotherapy group at weeks 12 and 24.The rates of ALT normalization were significantly different between the two groups at treatment week 12 (94.3% vs. 77.1%). The rate of HBeAg seroconversion in the combination group at treatment week 48 was 39.6%, and significantly different than that of the monotherapy group. The rates of drug-resistance in the combination and monotherapy groups at treatment week 48 were 3.8% and 11.4%, and the proportion of non-adherence to the treatment regimen was 53.3%, which significantly affected treatment outcome. No side effects occurred in either treatment group.

CONCLUSIONTelbivudine combination treatment with adefovir was more effective than telbivudine monotherapy and elicited a low drug resistance rate in nucleos(t)idenaive chronic hepatitis B patients with high-level HBV load and HBeAg-positivity. Adherence to the therapy regimen was a key factor influencing treatment outcomes.

Adenine ; analogs & derivatives ; Alanine Transaminase ; Drug Therapy, Combination ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Organophosphonates ; Retrospective Studies ; Thymidine ; analogs & derivatives ; Treatment Outcome ; Viral Load

BACKGROUNDStatins improve arterial stiffness in patients with coronary artery disease (CAD). Hypertension is a predominant contributor of arterial stiffening. However, the influence of hypertension on the effect of statins for improving arterial stiffness in CAD patients has seldom been investigated. Therefore, in this study, we investigated the relationships between statin use and arterial stiffness in normotensive and hypertensive CAD patients.

METHODSBrachial-ankle pulse wave velocity (ba-PWV) was measured in 437 patients, including 220 hypertensive CAD patients (121 used statins, 99 did not) and 217 normotensive CAD patients (105 used statins, 112 did not). The normotensive and hypertensive CAD patients were matched according to age, sex, and body mass index (BMI).

RESULTSIn the normotensive and hypertensive CAD patients, lipid profiles were significantly improved in the statin group compared with the non-statin group. No significant differences in the administered statins (i.e., atorvastatin, simvastatin, rosuvastatin, and pravastatin) and statin therapy duration were found between normotensive and hypertensive CAD patients (all P > 0.05). No significant correlation of ba-PWV and statin therapy duration was found in all CAD patients, normotensive CAD patients, or hypertensive CAD patients (all P > 0.05). ba-PWV in the statin group was significantly lower than that in the non-statin group in normotensive CAD patients ((1331.68 ± 167.52) cm/s vs. (1468.61 ± 244.54) cm/s, P = 0.002) but not in hypertensive CAD patients (P > 0.05). In multiple linear regression analyses, statin therapy was significantly associated with ba-PWV after adjusting for confounding variables in normotensive CAD patients (P = 0.018) but not in hypertensive CAD patients (P > 0.05).

CONCLUSIONSStatins may significantly improve arterial stiffness in CAD patients, and hypertension may probably influence the effectiveness of statin therapy in improving arterial stiffness in this population. Further studies are required to investigate the effect of statins on arterial stiffness in normotensive and hypertensive CAD patients.

Aged ; Ankle Brachial Index ; Coronary Artery Disease ; physiopathology ; Cross-Sectional Studies ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; pharmacology ; Hypertension ; physiopathology ; Male ; Middle Aged ; Pulse Wave Analysis ; Vascular Stiffness ; drug effects ; physiology

BACKGROUNDBreast cancer remains the most important cancer among women worldwide. The disease itself and treatment may have a profound impact on the patients' psychological well being and quality of life. Depression is common in breast cancer patients and affects the therapeutic effects as well as prolongs the duration of hospital stay. However, few studies reported the effectiveness of music therapy on depression and duration of hospital stay of female patients with breast cancer after radical mastectomy.

METHODSOne hundred and twenty subjects were recruited to this clinical trial and randomly allocated to two groups. The experimental group (n = 60) received music therapy on the basis of routine nursing care, whereas the control group (n = 60) only received the routine nursing care. The whole intervention time was from the first day after radical mastectomy to the third time of admission to hospital for chemotherapy. Data of demographic characteristics and depression were collected by using the General Questionnaire and Chinese version of Zung Self-rating Depression Scale (ZSDS) respectively. One pre-test (the day before radical mastectomy) and three post-tests (the day before discharge from hospital, the second and third admission to hospital for chemotherapy) were utilized. Duration of hospital stay was calculated from the first day after radical mastectomy to the day of discharged from hospital.

RESULTSThe mean depression score of all subjects was 37.19 ± 6.30. Thirty-six cases (30%) suffered from depression symptoms, with 26 (72.2%) mild depression cases, 9 (25.0%) moderate depression cases, and 1 (2.8%) severe depression case. After music therapy, depression scores of the experimental group were lower than that of the control group in the three post-tests, with significant differences (F = 39.13, P < 0.001; F = 82.09, P < 0.001). Duration of hospital stay after radical mastectomy of the experimental group ((13.62 ± 2.04) days) was shorter than that of the control group ((15.53 ± 2.75) days) with significant difference (t = -4.34, P < 0.001).

CONCLUSIONSMusic therapy has positive effects on improving depression of female patients with breast cancer, and duration of hospital stay after radical mastectomy can be reduced. It is worthy of applying music therapy as an alternative way of nursing intervention in clinical nursing process of caring female patients with breast cancer.

Adult ; Aged ; Breast Neoplasms ; surgery ; Depression ; therapy ; Female ; Humans ; Mastectomy, Radical ; psychology ; Middle Aged ; Music Therapy ; methods

Objective To evaluate the effect of calf pulmonary surfactant (Kelisu) combined nasal continuous positive airway pressure (NCPAP) in the treatment of neonatal respiratory failure (NRF).Methods Forty-eight NRF in our hospital were selected,and divided into the control group (n =24) and the treatment group (n =24) according to random number table.Control group were given NCPAP therapy,treatment group were treated with Kelisu 70-100 mg · kg-1 combined NCPAP.After using Kelisu 0,6,12,24 h,the results of arterial blood gas analysis,respiratory function indexes,clinical effects and incidence of complications in the two groups were compared.The adverse drugs reaction (ADR)were investigated.Results After 12 h treatment,the level of PaO2 in treatment group with (75.7 ± 1.6) mmHg was higher than the control group with (70.8 ± 1.8) mmHg.The level of PaCO2 in treatment group with (51.2 ± 1.7) mmHg was lower than the control group with (53.8 ± 0.7) mmHg.The time of the oxygen curein in treatment group with(180.65 ± 21.64)h was shorter than the control group with (217.52 ±19.58)h.The incidence of ADR in treatment group with 16.7％ (4 cases/24 cases) was lower than the control group with 45.8％ (11 cases/24 cases).Camparison between control group and the treatment group on the factors,the differences were statistically significant(all P ＜ 0.05).Conclusion Endotracheal dripping of calf pulmonary surfactant combined with NCPAP is an effective treatment for NRF,and had good safety.

Objective:To investigate the diagnostic value and imaging characteristics of MRI combined with 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/CT in focal cortical dysplasia (FCD) complicated with refractory epilepsy. Methods:A retrospective analysis was performed on 42 patients with FCD complicated with refractory epilepsy who were admitted to the Affiliated Hospital of Jining Medical University from January 2017 to December 2022. All patients underwent preoperative MRI and 18F-FDG PET/CT, and PET/MRI fusion was performed on the images. Chi-square test and Kappa consistency test were used to compare the localization diagnostic efficacy of PET/CT, MRI and PET/MRI fusion for epileptic foci. The patients were categorized based on gender, lesion location, pathological type, seizure type, and efficacy. Independent sample t-test and analysis of variance were used to compare maximum standardized uptake (SUVmax) values and asymmetry index (AI) of the patients between different groups. Results:Among the 42 patients, the positive rates of MRI, PET/CT, PET/MRI fusion examinations were 85.7%(36/42), 95.2%(40/42), 100.0%(42/42), the lateral localization rates were 71.4%(30/42), 92.9%(39/42), 95.2%(40/42), and the localization rates were 57.1%(24/42), 81.0%(34/42), 88.1%(37/42), respectively. There were significant differences in the lateral localization rates and localization rates of epileptogenic foci between MRI and PET/CT (χ 2=6.574, P=0.010; χ 2=5.570, P=0.018). There were significant differences in the positive rates of lesions, the lateral localization rates and the localization rates of epileptogenic foci between MRI and PET/MRI fusion (χ 2=6.385, P=0.012; χ 2=8.571, P=0.003; χ 2=10.118, P=0.001). There were no significant differences in the positive rates of lesions between MRI and PET/CT, and in the positive rates of lesions, the lateral localization rates and localization rates of epileptogenic foci between PET/CT and PET/MRI fusion (χ 2=2.184, P=0.139; χ 2=2.024, P=0.155; χ 2=0.210, P=0.647; χ 2=0.819, P=0.365). The Kappa consistency test of PET/CT and PET/MRI fusion imaging was performed for the location of epileptogenic foci, and the Kappa=0.721 was obtained, indicating that they were consistent in the location of epileptogenic foci. The SUVmax values of patients with temporal lobe epilepsy were lower, and the AI values were higher than that of patients with extra temporal lobe epilepsy (7.4±1.3 vs 9.6±1.6, 15.5±2.6 vs 12.9±2.4; t=5.154, 6.083; P=0.001, 0.001). The SUVmax values of patients with good efficacy (according to the Engel efficacy grading system, grades Ⅰ-Ⅱ indicating good efficacy) were higher, and the AI values were lower than that of patients with poor efficacy (according to the Engel efficacy grading system, grades Ⅲ-Ⅳ indicating poor efficacy; 9.5±1.9 vs 7.9±2.1, 13.5±3.3 vs 14.8±3.0; t=2.789, 3.722; P=0.042, 0.029). There were no significant differences in SUVmax and AI values among different genders, pathological types and seizure types (all P>0.05). Conclusions:The imaging characteristics of patients with different types of FCD complicated with refractory epilepsy are different. PET/MRI fusion is better than MRI in the diagnosis of FCD complicated with refractory epilepsy, and is consistent with PET/CT in the location of epileptogenic foci.