Objective　To study the relationship between cell apoptosis and vascular disease.Methods　The paper reviewed the concept, character, gene control and signal transduction of apoptosis associated with vascular disease.Results　Cytokine, radiation could induce apoptosis of endothelial cells, and caused vascular damage.The apoptosis of smooth muscle cells was related to the atherosclerosis and restenosis of vessels.Conclusion　Cells apoptosis is related to vascular disease significantly.

Objective To explore the relationship among plasma cytokines’ level, adhesion molecules expression and skin damage in patients with chronic venous insufficiency (CVI) of lower extremities.Methods In 32 patients with CVI and 8 normal individuals as control, blood TNF ?, IL 1? and IL 2R were assayed with ELISA method; serum endothelial cell intercellular adhesion molecule 1(EC ICAM 1), polymorphonuclear CD 18 (PMN CD 18 ) and polymorphonuclear CD 11b (PMN CD 11b ) were assayed with immunohistochemical method; and ultrastructure of diseased veins was examined by electroscope.Results The results showed that the level of plasma TNF ? and IL 1? increased remarkably in Class 2-3 compared with Class 1 and control ( P 0.05) . The index of EC ICAM 1 and PMN CD 11b positively expression increased remarkably in Class 2-3 compared with that in Class 1 and control. The index of PMN CD 18 expression in Class 2-3 and Class 1 was greatly higher than that in control ( P

Objective:To investigate the clinical effect of hydromorphone combined with ropivacaine and its effect on stress response after laparoscopic myomectomy.Methods:From March 2017 to March 2020 in Shangyu Hospital of Traditional Chinese Medicine, Zhejiang Province, 100 patients who were performed laparoscopic hysteromyoma were randomly divided into observation group (50 cases) and control group (50 cases). Both groups were treated with plane block of transverse abdominal muscle after anesthesia induction. The control group was injected with ropivacaine, and the observation group was injected with hydromorphone and ropivacaine. The changes of hemodynamics at the time of entering operation room (T 0), 1 h after operation (T 1) and after surgery (T 2) were compared between two groups. The visual analogue scale (VAS) score at postoperative 3 h, 12 h and 24 h, Ramsay sedation score during operation, and serum stress level at preoperative and postoperative 24 h were compared between two groups. Results:The levels of heart rate, systolic and diastolic blood pressure between the two groups at different times had no significant differences ( P>0.05). The VAS scores of the observation group at postoperative 3 h, 12 h and 24 h were lower than those in control group [(3.05 ± 0.32) scores vs. (3.42 ± 0.39) scores, (2.16 ± 0.38) scores vs. (2.73 ± 0.43) scores, (1.43 ± 0.29) scores vs. (2.28 ± 0.35) scores], and there were significant differences ( t = 5.186, 7.024, 13.223, P<0.05). The scores of Ramsay sedation score in observation group was higher than that in control group [(3.79 ± 0.45) scores vs. (2.54 ± 0.39) scores], and there was significant difference ( t = 14.843, P<0.05). The levels of noradrenaline, interleukin-6, and cortisol in observation group at postoperative 24 h were lower than those in control group [(254.18 ± 14.35) pmol/L vs. (328.73 ± 18.69) pmol/L, (26.89 ± 4.10) ng/L vs. (35.27 ± 5.46) ng/L, (214.30 ± 21.28) pmol/L vs. (296.53 ± 32.19) pmol/L], and there were significant differences ( t = 22.371, 8.678, 15.068, P<0.05). Conclusions:The combination of hydromorphone and ropivacaine in abdominal transverse plane block after laparoscopic myomectomy has good analgesic and sedative effects and can reduce stress response.

Objective To investigate the relationship between the serum ghrelin level and β-cell function after treatment of patients with newly diagnosed type 2 diabetes mellitus.Methods 34 patients with newly diagnosed type 2 diabetes mellitus were divided into three groups of pre-treatment(DM0),two weeks after treatment(DM1)and six months after treatment(DM2).Intravenous glucose tolerance tests(IVGTT)were performed and blood glucose,HbA1C,ghrelin,insulin were measured during the study.Insulin sensitivity was assessed by homeostasis model assessment(HOMA).Results(1)Compared with DM0 group,beta-cell function and the mean AUC of insulin were dramatically improved in groups of DM1 and DM2(all P<0.05).(2)Compared with DM1 and DM2,ghrelin levels and the mean AUC of ghrelin in DM0 groups were lower(all P<0.05).(3)Only positive correlation between ghrelin and HOMA-β(r=0.446,P<0.05),and negative correlations of ghrelin with glucose(r=-0.274,P<0.05),insulin(r=-0.35,P<0.05)and BMI(r=-0.276,P<0.05)were found after six months of treatment.Conclusions Ghrelin might play an important role in the pathogenesis and progress of type 2 diabetes mellitus.

Objective To study telomerase activity in cervical cancer and it′s precursor lesion Methods Thirty six cervical cancer and 16 cervical intraepithelial neoplasia (CIN) specimens were measured for telomerase activity using TRAP ELISA, and 11 normal cervix, 6 chronic cervicitis and 8 adjacent normal tissue specimens as controls Results Mean telomerase activity in CIN, cervical cancer, and controls were 0 398?0 293, 1 580?0 819, 0 050?0 012 There was statistically significant difference among three groups ( P

Objective:To analyze the clinical manifestations, skeletal muscle pathology, electromyography, skeletal muscle magnetic resonance imaging and gene mutations of a family with distant-onset DnaJ (heat-shock protein 40) homolog subfamily B member 6 (DNAJB6) myopathy.Methods:A total of three generations with three cases of the disease in a family, inherited by autosomal dominant inheritance, were collected. The examination of muscle enzymes, left biceps biopsy, skeletal muscle magnetic resonance imaging (MRI) and electromyography, etc,were performed for the family 's proband. Whole-exon sequencing was performed to screen the proband for pathogenic genes, and Sanger sequencing technology was performed to verify mutation sites of the proband′s family members. Results:The proband is a 30-year-old male who began to show weakness in the distal muscles as a teenager, and then gradually developed to the proximal muscles, accompanied by muscle atrophy of the limbs, mainly affecting small muscles in the hands and distal muscles of the lower limbs. Muscle enzymes of the proband were slightly elevated. Skeletal muscle MRI indicated muscle atrophy and fatty degeneration in the proximal and distal extremities, which in the distal extremities were more severe, mainly affecting the muscle groups of the posterior group. Electromyography indicated chronic myopathic damage. Muscle pathology suggested chronic muscle fiber damage and rimmed vacuoles could be found. The proband was found a heterozygous mutation [c.298T>G(p.F100V)] in DNAJB6 gene by all-exon sequencing. Sanger sequencing confirmed that his brother (similar medical history) and the second daughter also had the same mutation, and the eldest daughter was not detected the mutation at the above site. The second daughter is not ill and is a carrier of the mutation. The father of the proband died of pancreatic cancer and had similar symptoms during his lifetime.Conclusions:The above mutation of DNAJB6 gene is the pathogenic gene of this family. The clinical features are adolescence-onset muscle weakness and atrophy in distal extremities. This is the first family report of distal-onset DNAJB6 myopathy caused by mutations at this site in China.

AIM: To access the difference of the efficacy between terbinafine and itraconazole in the treatment of dermatophyte onychomycosis. METHODS: The Medline, Science Direct On Site (SDOS), and Springer database were searched in detail on the data of the mycological cure rates of the two antifungal agents for treatment of dermaphyte onychomycosis occourring in patients aged from 18 a to 60 a with the published double blind randomized clinical trials and then pooled. The odds ratio (OR) and its 95 % confidence interval (CI) were calculated. RESULTS: Six treatises of double blind randomized clinical trials were selected for this analysis according to the screening criteria. The mycological cure rate of continuous terbinafine 250 mg per day was higher than that of either therapeutic effect of itraconazole pulse 400 mg per day (OR = 5.01, 95 % CI (3.42 - 7.33)) or continuous itraconazole 200 mg per day (OR = 2.58, 95 % CI (1.91 - 3.49)) . CONCLUSION: Terbinafine is more effective than itraconazole in the treatment of dermatophyte onychomycosis.

Objective To learn the status of health care personnel construction of primary health institutions in Jiangsu province. Methods In July 2015, cluster sampling method was adopted in which 14 areas from Jiangsu province were selected, then one or more township health centers from each area were selected , and a total of 23 hospitals were selected. Personal interview were applied to administrators, the medical staff and residents respectively. A self-made questionnaire was performed in medical personnel from different departments. The method of descriptive statistics was used to collect data of rural health care personnel in primary health institutions. Results A total of 521 questionnaires were collected. In the town hospitals, the average age of the health professional staff was 37 years old. 68.33% (356 people) of the staff had college diploma or technical secondary school diploma and 35.12%(183 people) of them had junior title. There were 10.94%(57 people) and 14.01%(73 people) of the staff had no title and no physician practice qualification respectively. Conclusion Grass-roots health personnel construction task is still formidable. Further efforts are needed to improve the educa-tional system of health talents. And the incentive mechanism should be improved to strengthen the at-traction and stability of grass-roots health personnel. Strengthening education and training for the exist-ing staff is also needed to intensify the ability to primary health care.

Objective:To inquiry the variety difference of upper airway caliber OSAHS sufferer and normal person in quiet respiration Method:Twenty OSAHS sufferer who were viewed by PSG and 16 normal adults who hadve no chief complaint of sleeping disease were selected.The curves of the subjects in a respiratory cycle were recorded by respiratory monitoring system in PSG,while the morphological changes in the harynx of all subjects were observed by fiberscope in a calm respiratory cycle,and then both of the two processes simultaneously were recorded on the same computer.According to the different stages of respiratory cycle by analyzing respiratory curve the video had been edited into pictures about the various anatomical areas in the upper airway,he cross section area and the dimension of palate and lingua and root of the tongue region upper irway wereas studied by the image tools in computer,and the changes of areas and dimensions at palate,and lingua and root of the tongue region upper airway were calculated.Result:It was found that there wasis a morphological change f the upper airway with the respiratory movement in the both groups.The upper airway caliber decrease with inspiration begin and reach the most narrowing at the end of inspiration,then upper airway caliber enlarges with the expiration begin and reach the most widening at the end of expiration.No matter the normal group or the OSAHS roup has the obvious changes in the palate and lingua region on the diameter,the cross section area and the dimension in respiration.The changes in the palate and lingua region on the diameter,the cross section area and the dimension of OSAHS group were greater than normal group.No matter OSAHS group or normal group on the diameter nd cross section area change in the palate was obviously more than the tongue area and the root of tongue area.The changes of OSAHS group on the dimension in the palate were greater than the tongue area and the root of tongue area.Conclusion:There are periodically changes of upper airway during respiration cycle in normal adults and SAHS patients.The effects of respiration on upper airway caliber of OSAHS patients are more obviously than normal adults.and the increasing effects in OSAHS patients is one of OSAHS etiology.

Objective: To investigate the inlfuence of different blood pressure (BP) circadian rhythm on cardiac function in hypertensive patients.
Methods: A total of 180 hypertensive patients with well controlled day-time blood pressure were divided into 3 groups. Dipper group, n=30, Non-dipper group, n=99 and Reverse dipper group, n=51. The relationship between cardiac function, relevant clinical index and blood pressure circadian rhythm were analyzed.
Results: The mean systolic and diastolic BP, BP classiifcation and the antihypertensive medication were similar among 3 groups.①The ratio of peak mitral E wave to peak mitral annulus E' wave (E/E') increased accordingly from Dipper group, Non-dipper group and Reverse-dipper group as (8.1 ± 2.4), (8.6 ± 2.5) and (9.6 ± 3.2), P<0.05. ②Left atrial volume index (LAVi) in Reverse-dipper and Non-dipper groups were higher than that in Dipper group as (43.8 ± 11.8) ml/m2, (40.7 ± 9.8) ml/m2 and (36.6 ± 8.5) ml/m2, P<0.05 or P<0.01. ③E/E' was positively related to nocturnal systolic BP and age, negatively related to nocturnal BP decline rate (nocturnal BPR); E/E' was independently related to age and BPR. LAVi was positively related to nocturnal systolic BP, pulse pressure, age and hypertension course, negatively related to the mean diastolic BP, day-time diastolic BP and BPR; LAVi was independently related to BPR, pulse pressure and hypertension course. Left ventricular ejection fraction had no statistic differences among 3 groups.
Conclusion: Abnormal blood pressure circadian rhythm was associated with the cardiac injury in hypertensive patients. The cardiac injury increased accordingly from Non-dipper group to Reverse-dipper group and the main damage was in diastolic function.