OBJECTIVE: To investigate the function of activator protein-1 (AP-1) in proliferation and collagen synthesis of cardiac fibroblasts (CFs) in neonatal rats induced by tumor necrosis factor-alpha (TNF-alpha), and to explore the mechanism of Qiangxin Decoction (QXD), a compound traditional Chinese herbal medicine, in reversing cardiac fibrosis. METHODS: CFs derived from neonatal rats were cultured with enzymatic dissociation, and fibrosis of the CFs was induced by TNF-alpha. The CFs were divided into normal control group, untreated group, 5% QXD-containing serum group, 10% QXD-containing serum group and 20% QXD-containing serum group. After 24-hour culture of QXD-containing serum, AP-1 mRNA was detected by real-time fluorescent quantitative polymerase chain reaction; proliferation and collagen synthesis of CFs were assayed by thiazolyl blue assay (MTT) and measured by hydroxyproline respectively, in order to determine the effect of different dosage decoction on the proliferation and collagen synthesis of CFs. RESULTS: After 24-hour stimulation of TNF-alpha in CFs, compared with those in normal control group, the expression of AP-1 mRNA and cardiac fibroblast proliferation and collagen synthesis increased significantly (P<0.05). However, Qiangxin Decoction could reduce the expression of AP-1 mRNA and decreased the proliferation and collagen synthesis of CFs significantly (P<0.05). CONCLUSION: Qiangxin Decoction can inhibit proliferation and collagen synthesis of CFs induced by TNF-alpha, and reverse cardiac fibrosis, which may be related to its down-regulation of the expression of AP-1.

Dilated cardiomyopathy is a disease which manifests with heart enlargement, myocardial contractile dys-function and arrhythmia. The disease cause is unknown. And the disease prognosis is not good with high fatality rate. There is no specific treatment for dilated cardiomyopathy in modern medicine. Currently, a large amount of clinical researches have been conducted by traditional Chinese medicine (TCM) scholars with relatively satisfied therapeutic effects. This article made a review on the etiology, pathogenesis, treatment method (including syndrome differentiation and treatment, modern application of ancient prescription, self-made prescription, and Chinese patent medicine liq-uid) and TCM treatment progress of dilated cardiomyopathy in order to show that TCM has certain advantages in the treatment of dilated cardiomyopathy.

Objective To discuss medicine using regularity of Yan Shiyun’s treatment for arrhythmia. Methods Medical cases of arrhythmia treated by Yan Shiyun were collected. The method of frequency of SPSS19.0 was used to analyze the frequency of single herb and common prescriptions. Results Totally 112 medical cases were collected. Three different kinds of arrhythmia in totally 315 prescriptions were collected and 18 same herbs were used in the 20 highest frequently used herbs. The first two were Chuanxiong Rhizoma and Persicae Semen. Buyang Huanwu Decoction is the most commonly used prescription, followed by Zhenwu Decoction. Conclusion Most Chinese herbal medicine included in Yan Shiyun’s prescriptions can tonify qi and invigorate the circulation of blood. The medicine use is concentrated, and composition law is clear.

Objective To investigate the effects of targeted treatment of the carboplatin-Fe@C nanocage-loaded chitosan nanoparticles (C-Fe@CN-CN) combining external magnetic field on rats with transplanted liver cancer.Methods Twenty-four model rats with transplanted liver cancer were established and divided into four groups randomly (n =6).Abdominal exposure was carried out through a midline incision,and a cannula was inserted into the hepatic artery and fixed.Group A:saline water was injected as control,group B:saline water with 10 mg/kg free carboplatin was given,group C:saline water with C-Fe@CN-CN (equivalent dose of free carboplatin 10 mg/kg) was injected in absence of magnetic field,group D:saline water with C-Fe@CN-CN (equivalent dose of free carboplatin 10 mg/kg) was injected in presence of magnetic field for 30 min.All the animals were sacrificed and abdominal exposure was done again after 7 days.After tumors were reselcted,tumor weight and volume was measured,the inhibiting rate of tumor weight was calculated.Tumor and liver tissues were examined for histological changes.Results The growth of tumor was significantly inhibited after therapy with different forms of carboplatin.There was significant difference in the tumor weight of A,B,C,D groups [(0.85±0.12) g,(0.61±0.10) g,(0.48±0.09) g,(0.33±0.06) g,P ＜ 0.05,respectively].The inhibiting rates of tumor weight of B,C,D groups were 28.9 ％,43.4 ％,61.7 ％ respectively.The inhibiting rate of D group was highest which was 1.1 times higher than that of B group.There was also significant difference in the tumor volume of A,B,C,D groups [(1.06±0.24) cm3,(0.72±0.10) cm3,(0.50±0.07) cm3,(0.28±0.05) cm3,P ＜ 0.05,respectively].The tumor volume of group A was largest which was 2.8 times larger than that of group D.In group D,tumor tissues from six rats presented severe necrosis,and nanoparticles were concentrated in the necrotic tissue.In group C,five rats presented middle necrosis,one rats presented severe necrosis.There was no concentration of nanoparticles in the necrotic tissue.In group B,four rats presented middle necrosis,two rats presented mild necrosis.In group A,six rats presented mild necrosis.Conclusion C-Fe@CN-C can significantly increase the therapeutic effects of carboplatin by hepatic artery injection combining with an external magnetic field on the tumor.

Objective To observed the expression of matrix metalloproteinase-9 in the early onset of severe acute pancreatitis associated with acute lung injury in rats and investigate its effection in lung injury.Methods Thirty-two healthy adult male SD rats were randomly divided into two groups:Control group (n =8),Severe acute pancreatitis group(n =24).Severe acute pancreatitis model was induced by retrograde inject the 4％ sodium taurocholate sodium taurocholate into the biliopancreatic duct of rats.The severe acute pancreatitis group was detected the rate of lung water content、arterial blood gas.myeloperoxidase,matrix metalloproteinase-9,histopathology of the pancreas and lung injury score under the light microscope at 3 hours,6 hours and 12 hours.The matrix metalloproteinase-9 expression was detected by immunohistochemical and the results of immunohistochemical were analysed by the Image-Pro Plus image analysis system.Control group was detected the relevant indicators at 12 hours.Results Successfully modeling,the expression of matrix metalloproteinase-9 gradually increased beginning at 3 hours,at twelve hours up to the highest value(P ＜ 0.05).The degree of lung injury,lung water content,myeloperoxidase activity,PaCO2 gradually increased(P ＜ 0.05),PaO2 decreased significantly P ＜ 0.05).Conclusions The high expression of matrix metalloproteinase-9 is important to the pathogenesis of severe acute pancreatitis associated with acute lung injury.

Objective To evaluate of left atrial(LA) function in patients with rheumatic mitral stenosis(MS) by real time three‐dimensional echocardiography (RT‐3DE) .Methods Thirty patients with MS and 50 healthy volunteers underwent RT‐3DE . The left atrial end‐diastolic volume (LAVmax ) ,end‐systolic volume (LAVmin ) and pre‐systolic volume (LAVpre ) were measured to calculate the total ,passive and active atrial stroke volume (TASV ,PASV ,AASV) ,left atrial expansion index (LAEI) ,left atrial to‐tal ,passive ,active ejection fraction (LAEF ,LAEFpassive ,LAEFactive ) .The volume data were corrected by body surface area (BSA) to gettheleftatrialend‐diastolicvolumeindex (LAVmaxI),end‐systolicvolumeindex(LAVminI),pre‐systolicvolumeindex(LAVpreI) and the total ,passive and active atrial stroke volume index (TASVI ,PASVI ,AASVI) .The correlations between the LA volume , stroke volume ,function indices and the mitral valve area (MVA) were analyzed .Results (1)LAVmaxI ,LAVminI and LAVpreI were significantly greater in patients with MS than the controls(all P<0 .05) .(2)There was no significant difference in TASVI ,PASVI and AASVI between the two groups(all P>0 .05) .(3) LAEI ,LAEF ,LAEFpassive and LAEFactive were significantly lower in patients with MS than the controls(all P<0 .05) .(4)There was a significant correlation between the LAVmax I ,LAVmin I ,LAVpre I ,LAEF , LAEFpassive and MVA (r= -0 .432 ,-0 .421 ,-0 .440 ,0 .352 ,0 .401 ,all P<0 .05) ,there was no correlation between the TAVSI , PASVI ,AASVI ,LAEI ,LAEFactive and MVA(all P>0 .05) .Conclusion LA function in patients with mitral stenosis decreased .RT‐3DE can be used to evaluate LA function in patients with MS and sinus rhythm .

Objective: To learn the prevalence and influencing factors of dyslipidemia among the residents aged 35-75 years in Zhejiang Province, so as to provide basis for prevention and control of dyslipidemia. Methods: Based on the national high-risk early screening and comprehensive intervention program for cardiovascular disease, multi-stage stratified cluster sampling method was adopted to select 35-75 year-old permanent residents from six cities （counties or districts） in Zhejiang Province. A questionnaire survey was used to collect demographic data;physical examination and laboratory test were carried out. A multivariate logistic regression model was used to analyze the influencing factors for dyslipidemia. Results : A total of 44 440 residents were investigated and 40 751 residents responded,accounting for 91.70%. The crude prevalence rate of dyslipidemia was 36.88% （15 027 cases） and the age-standardized one was 34.58%. The crude prevalence rates of hypercholesterolemia, hypertriglyceridemia and high low density lipoprotein-cholesterol were 18.10%, 14.05%, 10.57% and 15.78%, respectively,the age-standardized ones were 16.11%, 13.76% and 14.53%, respectively.The results of multivariate logistic regression analysis showed that age （OR=1.006, 95%CI:1.004-1.008）,urban residence （OR=1.139, 95%CI: 1.087-1.194）,smoking （OR=1.099, 95%CI: 1.033-1.170）,drinking （OR=0.915,95%CI: 0.863-0.970）,underweight （OR=0.623, 95%CI: 0.528-0.735）, overweight （OR=1.624,95%CI: 1.552-1.699）, obesity （OR=2.128, 95%CI: 1.985-2.281）, diabetes （OR=1.600, 95%CI: 1.493-1.715）, hypertension （OR=1.218, 95%CI: 1.165-1.273） and hyperurcemia （OR=1.789, 95%CI: 1.679-1.905） were associated with dyslipidemia. Conclusions The age-standardized prevalence rate of dyslipidemia among the residents aged 35-75 years in Zhejiang Province was lower than that in the whole country,but the prevalence rates of hypercholesterolemia,hypertriglyceridemia and high low density lipoprotein-cholesterol were relatively high.

Objective: To evaluate the effects of office blood pressure(OBP)combined with ambulatory blood pressure monitoring(ABPM)on the diagnosis of hypertension. Methods: The residents aged 35-79 years without hypertension history,whose casual OBP were 120~159 mm Hg/80~99 mm Hg,were enrolled from 4 communities of Hangzhou and Zhuji from 2015 to 2018. They were performed OBP measurements on other two days in 4 weeks and ABPM in a week. There were 2 criteria of OBP as elevated OBP on the first day or in 3 different days,and 4 criteria of ABPM as elevated mean BP in 24 hours, daytime, nighttime and either of the above time. Receiver operating characteristic(ROC)curve was employed to evaluate the effects of different OBP criteria combined with ABPM criteria on the diagnosis of masked hypertension(MH)and white-coat hypertension(WCH). Results: Taking 3-day-OBP as a golden standard,the 1-day-OBP with 4 ABPM criteria had the areas under the ROC curve(AUC)of 0.79-0.81,sensitivity of 57.58%-62.77% and specificity of 100.00% in MH;had the AUC of 0.95-0.98,sensitivity of 100.00% and specificity of 88.96%-96.80% in WCH. The Kappa values were all less than 0.6,known as low consistency. Taking either time of ABPM as a golden standard,24 hours,daytime and nighttime ABPM criteria with OBP had the AUC of 0.90-0.92,sensitivity of 79.17%-83.90% and specificity of 100.00% in MH(all Kappa>0.6),when with 1-day-OBP,the Kappa values were all more than 0.8,known as high consistency;had the AUC of 0.95-1.00,sensitivity of 100.00% and specificity of 89.54%-99.37% in WCH,the Kappa values of daytime ABPM were all more than 0.6,known as high consistency. Conclusions If limited by options, 1-day-OBP could be used instead of 3-day-OBP for detection of WCH or exclusion of MH yet with less accuracy; 24 hours or daytime ABPM instead of either time of ABPM was reliable.

were no significant differences in the detection rate of recto-sigmoid colon,mid colon,right colon and total detection of polyps among the 3 groups (P >0.05).Conclusion 4-L split-dose PEG is better than the oth-er 2 regimens in the colon cleansing quality,so it can better reach the intestinal cleaning standards before enteroscopy,which is a more suitable regimen for bowel preparation.

Objective To assess the screening and intervention techniques for resistant hypertension in the community.Methods Random sampling method was used to recruit 1 171 hypertensive patients from two communities in Hangzhou and Zhuji cities of Zhejiang province form October 2015 to september 2016.Among them,97 patients with resistant hypertension were identified with the Three-steps-flow screening method and the individualized intervention was given.The standardized treatment and lifestyle changes were compared before and after intervention.Results Among 97 patients with resistant hypertension,7 cases of pseudo resistant hypertension were detected;there were 2 cases with thyroid disease history,48 cases with snoring history and 1 case with sleep apnea syndrome.The life style intervention and standardized medication guidance were given to 90 patients with resistant hypertension according to the individual risk factors.After one year of intervention,the results showed that the rate of normalized blood pressure was 83.5％ (75/90) and the rate of standardized medication increased from 14.4％(13/90) to 90.0％ (81/90),the rate of medication compliance increased from 46.7％(42/90) to 95.6％(86/90),the blood pressure control rate increased from 12.2％(11/90) to 77.8％(70/90),and the average systolic blood pressure and diastolic blood pressure levels were decreased by 20.4 mmHg (1 mmHg=0.133 kPa) and 15.5 mmHg.The life style of patients with resistant hypertension was remarkably changed,56.7％(51/90) of patients took exercise regularly,high salt/high calorie diet decreased from 37.8％(34/90) to 11.1％(10/90),the proportion of the obese went down to 16.7％(15/90).Conclusion With the application of resistant hypertension screening and intervention,there are remarkable improvement in blood pressure control and life style changes for patients with resistant hypertension in the community.