Aim To investigate the effect of racemic-doxazosin(rac-DOX),S-doxazosin(S-DOX) and R-doxazosin(R-DOX) on the proliferation of vascular smooth muscle cells(VSMCs) of the rat aorta.Methods VSMCs of the rat aorta were cultured,MTT assay was used to determine the cell proliferation and the morphological changes in VSMCs were analyzed using Giemsa's staining.Results The treatment with rac-DOX,S-DOX or R-DOX at 3~30 ?mol?L-1 for 96 h inhibited the proliferation of VSMCs significantly.However,the inhibitory effect of S-DOX on cell proliferation was more potent than that of R-DOX at the same concentration(P

Objective To explore the changes of etiology and mortality of upper gastrointestinal bleeding (UGIB) in the last 20 years in Guangdong region. Methods A total of 3140 UGIB cases diagnosed in Guangdong General Hospital from January 1990 to October 2009 were analyzed with retrospective analysis. Groups were divided according to admission chronological order and age to analyze the causes of UGIB to get the trend of changes and influencing factors. Results UGIB occurred more in men than in women, the gender ratio was 2. 5∶1. There was no significant change in gender composition between the first and later 10 years. Peptic ulcer bleeding (PUB) was the main cause of UGIB in young and middle-age patients (age<60 years), especially duodenal ulcer (DU)bleeding (45. 0%) , and secondary was acute gastric mucosal lesion ( AGML) (16. 6%). While in elder patients group (age≥60 years), the main cause of UGIB was AGML (40. 5%), the frequency was significantly higher compared with the young and middle-age group (40. 5% vs 16. 6%,P<0. 01).Compared the first 10 years with the later 10 years, the occurrence rate of PUB was overall in downward trend (57. 4% vs 42. 8%, P<0.01), of which DU and compound ulcer(CU) bleeding reduced significantly (DU: 43.8% vs 27.7%, P<0. 01 and CU: 7.7% to 5.5%, P<0. 05). While the incidence of gastric ulcer (GU) (7.4% vs 8. 1% ,P>0. 05) and esophagogastric variceal bleeding (EVB) (11. 7% vs 12. 9%, P>0.05) remained stable. The occurrence of AGML bleeding significantly increased than before (32. 4% vs 18. 8%,P<0. 01), and became one of the most important causes of UGIB. Conclusions PUB is still the most important cause of UGIB in Guangdong region. AGML becomes another important cause of UGIB in elder patients, which may relate to the increasing use of non-steroidal anti-inflammatory drugs (NSAIDs), anti-platelet and antineoplastic medicine.

Objective To assess the characteristics and satisfaction of outpatients in walk-in clinic of a grade A tertiary hospital.Methods A total of 1 100 outpatients visiting walk-in clinic of the Second Hospital of Hebei Medical University during March 2016 and June 2016 were randomly selected for the questionnaire survey.The self-designed questionnaire included the general information of patients,the satisfaction degree to the walk-in clinic,to special clinics of the hospital or to community clinics and related reasons,and suggestions for further improvement.Results Total 947 valid questionnaires were received with a retrieval rate of 86.09％.Most of participants had one chronic disease (594,62.72％).The satisfaction degree of walk-in clinic (1.78) was higher than that of hospital special clinics (1.93) (P =0.010),in turn the latter(2.33)was higher than that of conmmnity clinics (P ＜ 0.001).The reasons for patient to choose the walk-in clinic were wide range of medications (389,41.08％),reliable quality (285,27.98％),short waiting time (249,26.29％) and so on.Suggestions for improvement of the walk-in clinic were further reducing the waiting time (428,45.20％),need specialists for chronic disease management (210,22.18％),raising reimbursement rate (172,18.16％) and so on.The reasons for patients to choose special clinic were need readjusting prescription (587,61.99％),special disease or drug (427,45.09％).The reasons of dissatisfaction with special clinic were long waiting time (476,50.26％),frequent transfer to multiple departments (221,23.34％),high registration fee (221,23.34％).The reasons for patients to choose community clinic were short distance (350,36.96％),better environment (350,36.96％),short waiting time (184,19.43％).The reason of dissatisfaction with community clinic were low qualification of medical staff (405,42.77％),insufficient medications (392,42.39％);distrusting the quality of drugs (263,27.77％).Suggestions for improvement of the community clinics were upgrading the qualification of medical staff (317,33.47％),enlarging drug variety (298,31.47％),improving medical environment (94,9.93％) and so on.Conclusion Most outpatients visiting walk-in clinic of grade A tertiary hospital are highly satisfied the clinic.To meet the patients' needs the primary medical unit should further improve their overall service.

Objective To evaluate clinical significance of the grade of ischemia by QRS complex on the admission electrocardiogram(ECG)to predict severe arrithmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Patients with acute ST-segment elevation myocardial infarction(STEMI)admitted to emergency department from July 2003 to April 2008 were enrolled.A total of 223 patients met the criteria(ischemic chest pain ≥ 30 min,2 or more adjacent leads of ST segment elevation and onset time within 12 h).Exclusion criteria were bundle branch block and left ventricular hypertrophy.All enrolled patients were divided into two groups based on the enrollment electrocardiogram:grade 2 ischemia(ST elevation without terminal QRS distortion; n =134)and grade 3 ischemia(ST elevation with terminal QRS distortion; n =89).Patients of the two groups had comparable genderproportion,average age and coronary heart disease risk factors etc.All patients received thrombolytic therapy.The incidence rate of ST segment resolution(STR)and severe arrithmia in hospital stay were observed.Numerical variables were expressed mean ± standard deviation and compared by unpaired Student't test,Categorical variables were expressed percentage and compared by chi square test.Multiple logistic regression analysis was used to determine independent predictors of severe arrithmia.Results Patients with grade 3 ischemia had greater Σ ST on admission and 2 h after thrombolysis ECGs(P ＜ 0.01),the incidence rate of STR in patients with grade 3 ischemia was lower than that in patients with grade 2 ischemia(P ＜0.01).The peak creatine kinase MB fraction was higher in patients with grade 3 ischemia than that in patients with grade 2 ischemia(P ＜ 0.01).There was no significant difference of the incidence of severe arrithmia,such as ventricular premature beat,ventricular tachycardia or fibrillation,second-degree or third-degree atrioventricular block,and sinus arrest between the two groups(P ＞ 0.05),but there was a trend of higher incidence of severe arrithmia in patients with grade 3 ischemia compared with that in patients with grade 2 ischemia.Multiple logistic regression analysis demonstrated that the independent predictors of severe arrithmia were duration from symptom to thrombolysis and initial.Σ ST,whereas grade 3 ischemia remained a strong predictor of severe arrithmia.Conclusions Grade 3 ischemia on admission is associated with lower incidence of STR in patients with ST-segment elevation myocardial infarction(STEMI)after thrombolysis and a strong predictor of severe arrithmia.

Objective To investigate the effects of (?)doxazosin [(?)DOX] and its enantiomers on the myocardial morphology,cell cycle and cell apoptosis in rabbits fed with high fat diet. Methods Male New Zealand white rabbits were fed with high fat diet for 4 weeks. Forty such rabbits with hyperlipemia were then divided into atherogenic diet group (model),model + (-)doxazosin [(-)DOX] group,model + (+)doxazosin [(+)DOX] group and model + (?)DOX group (10 each). Another 10 rabbits were included as normal control group. In those drug-treated groups,1.0mg/kg of doxazosin or its enantiomers were intraperitoneally administered for 9 weeks; rabbits in normal control group and atherogenic diet group were given sterile distilled water. Percentages of myocardial cells in G0/G1 phase and in S phase,proliferation index (PI) and apoptotic rate of myocardial cells were compared among the groups,and the effects of doxazosin and its enantiomers were evaluated. Results Of the animals in atherogenic diet group,the proportion of myocardial cells in G0/G1 phase increased significantly (P0.05). No histomorphological alterations were observed in myocardial cells of the rabbits in normal control group. Pathological changes in myocardial cells were observed in the rabbits of atherogenic diet group,such as vacuolar degeneration,fatty degeneration,focal myocardial necrosis,myocardial fibrosis and focal lymphocyte infiltration. The pathological changes in myocardial cells were significantly ameliorated in the animals in (-)DOX and (?)DOX group,but aggravated in the rabbits of (+)DOX group. Conclusions A long term treatment with (-)DOX in the rabbits may improve the histopathological changes in myocardial cells caused by high fat diet. (-)DOX and (+)DOX may have a optical selective effect.

Objective To observe expression of resistin gene in adipose tissue of SD rats fed with high-fat diet and its correlation to insulin resistance, diabetes mellitus and leptin. Methods Using RT-PCR to mRNA from adipose tissue, the products were obtained, purified, constructed and squenced. Once its squence was verified, semi-quantitative RT-PCR and Northern Blot were employed to study its expressions in adipose tissues of rats with different diets. Oral glucose tolerance test and insulin release test were performed in 2 groups of rats. Results (1) The resistin gene was successfully constructed and sequenced, which was in accordance with the data of genbank. (2) Compared with the control, the expression of resistin in adipose tissue of high-fat diet rats was significantly enhanced, and blood glucose, serum insulin and leptin levels were also elevated in high-fat diet rats (P

Objective To observe the effect of berberine on glucose transport in 3T3-L1 adipocytes and to investigate its mechanism. Methods The glucose consumption of the cells was determined by the glucose oxidase method. The glucose transportation rate of the cells was assayed by the uptake of 2-deoxy-〔 3H〕-D-glucose. Protein kinase B (Akt) activity was detected by immunoprecipitation and Western blot. The gene expression of c-Cbl-associated protein (CAP) was detected by Northern blot. Results 0.1～200 ?mol/L berberine significantly increased glucose consumption in 3T3-L1 adipocytes with a dose-dependent effect, which was independent of insulin. The glucose transportation was significantly increased in adipocytes incubated with 0.1～10 ?mol/L berberine; the action began at 2 h and reached a peak value at 12 h. The results of immunoprecipitation and Western blot showed that berberine did not enhance Akt activity. The result of Northern blot indicated that berberine significantly decreased CAP mRNA expression. Conclusion Adipocytes are the important target cells of berberine. Berberine significantly increases glucose transportation and consumption in adipocytes, the action appeares to be independent of insulin signal pathway.

Objective To observe the clinical safety of dual axis rotational coronary angiography (DARCA) in the diagnosis of coronary artery disease in Chinese population.Methods From March to December in 2010,74 patients undergoing diagnostic DARCA were enrolled.The improved isocentering technique was adopted in 34 of the patients at the end of the study during DARCA.Blood pressure,heart rate and symptoms were recorded immediately before-and-after contrast injections.Contrast dose,radiation exposure and procedure time for DARCA were recorded.Continuous variable data were analyzed using Student＇s t test,if normality assumption was violated,rank sum test would be used.Categorical variables were analyzed using x2 test.Results ( 1 ) Clinical safety:There was no chest pain documented during or immediately post-injection for all patients.Only 1 patient ( 1 ％ ) had an attack of ventricular tachycardia immediately after the contrast injection and then relieved automatically.Pre and post-injection systolic blood pressure values of left coronary artery were statistically different [ ( 116 ± 20 ) mm Hg vs.( 111 + 18) mm Hg( 1 mm Hg =0.133 kPa),t =3.303,P =0.001 ],and heart rates differed,too [ 73 ( 65- 84)bpm vs.71(64-78) bpm,Z =-4.789,P =0.001 ],but that imposed no clinical significance.(2)Contrast dose,radiation dose and procedure time:The mean contrast utilization,radiation dose and procedure time for DARCA were 28 (25-34) ml,8979 ( 6733-12 363 ) mGycm2 and 200 (164-270) s.Compared with conventional DARCA,improved isocentering technique during DARCA had less radiation exposure and procedure time in left coronary artery angiography and the whole coronary artery angiography [ left coronary artery angiographic radiation exposure:4004 (2932-5772) mGycm2 vs.5808 (4798- 8838) mGycm2,Z =-3.471,P =0.001 ;total radiation exposure:(8116 +2493) mGycm2 vs.( 11 371 ±4122) mGycm2,t =-4.176,P =0.001 ; left coronary artery angiographic procedure time:120 ( 80-180)s vs.150(126-214) s,Z =- 2.836,P =0.005; total procedure time:180 (139-240) s vs.220( 186-308 )s,Z =-3.004,P =0.003 ],but there was no statistically difference in contrast utilization [30(25-35) ml vs.27(25-34)ml,Z=-0.906,P=0.365].Conclusion This study demonstrates clinical safety of DARCA in the diagnosis of coronary artery disease in Chinese population.Compared with conventional isocentering technique of DARCA,improved isocentering technique can significantly reduce radiation exposure and procedure time on the basis of simplified operation,and replace the conventional isocentering technique,but randomized double-blind controlled studies should be conducted.

Objective: To explore the influence of adverse childhood experiences (ACEs) on pubertal development of boys and girls and to provide a reference for the development of intervention measures. Methods: A stratified cluster sampling method was used to select a total of 1 156 students in grades three and four in the boarding school system and public primary schools in Huangshan City and surrounding towns in September 2018, using the Childhood Trauma Questionnaire (CTQ) and the Pubertal Development Scale (PDS). For the baseline self-assessment survey, according to different dimensions, abuse children score no exposure groups. Children were divided into an exposure group and a high exposure level group, according to their childhood experiences. PDS self-report questionnaire was administered two years later, and an analysis of ACE type and severity of the continuous impact of youth development was conducted. Results: In the baseline survey, there were 53 girls (11.32%) and 51 boys (7.41%) who developed earlier. The rate of early development in girls was higher than that of boys, and the difference was statistically significant(χ 2=5.21, P<0.05). Univariate analysis showed gender differences in the effects of type and severity of ACEs and abuse on adolescent development at both baseline and follow-up. There were gender differences in the rate of early development between boys and girls at baseline and at follow-up between the exposure groups. Regression analysis showed that the higher the degree of emotional abuse, emotional neglect, and sexual abuse in girls, the higher the PDS score(B=0.22, 0.15, 0.08, P<0.05). In boys, the more severe the emotional abuse experienced, the higher the PDS score, and the more severe the physical abuse experienced, the lower the PDS score(B=0.20, 0.04, P<0.05). Conclusion Attention should be paid to the influence of ACEs and gender differences during youth development among male and female students, and more longterm studies should also be carried out.

Objective To evaluate the effect of "5As" (ask,advice,assess,assist,arrange) model based on the "two-in-one team" management (integrated hospital and community health service center management team) on the self-management behavior in stroke high-risk population.Method A stroke risk screening was conducted among 1 196 residents aged ≥40 years selected by cluster sampling in a community of Shijiazhuang city from March 2016 to March 2017,and 218 high-risk individuals were identified.The high risk individuals were randomly divided into intervention group and control group.The control group received routine health instruction,the intervention group was managed by "two-in-one team" with 5As model.Stroke prevention knowledge questionnaire and self-evaluation scale were applied for evaluation before and after intervention.Results Before intervention,scores of the stroke prevention knowledge and self-management behavior in the intervention group and the control group were (21.6 ±4.7) and (130.8 ± 6.4) points,(20.4±5.0) and (131.4 ±6.3) points,respectively (t =1.79,P =0.08;t =0.67,P =0.50).After intervention,the scores of prevention knowledge and self-management behavior in the intervention group were higher than those in the control group [(30.5 ± 5.1) vs.(21.7 ± 6.0) points,t =16.83,P=0.00;(158.3±19.0) vs.(135.6±20.0)points,t=7.85,P=0.00].Conclusion The 5As intervention model based on the two-in-one team management can improve stroke prevention knowledge and self-management behavior among stroke high-risk individuals in the community.