OBJECTIVE:To explore clinical efficacy of levoearnitine combined with trimetazidine in the treatment of ischemic cardiomyopathy(ICM) heart failure in elderly patients.METHODS:64 ICM elderly patients with heart failure were randomly divided into control group and observation group(n=32).Both group were given therapy of regulating blood lipid,antiplatelet,anti ischemia and conventional anti-heart failure therapy.Observation group were additionally intravenously injected with levoearnitine and given oral dose of trimetazidine for 2 weeks.Cardiac function classification,left ventricular end-diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF) of patients were determined before and after treatment.RESULTS:The cardiac function and the level of LVEDD,LVESD and LVEF in observation group were all significantly better than in control group.There were statistical significance in difference between two groups(P

Objective To investigate the role of A2B adenosine receptor(A2BAR)in 6% HES 130/0.4-induced reduction of pulmonary capillary permeability in a rat model of sepsis.Methods Fifty male SD rats weighing 250-300 g were randomly divided into 5 groups(n = 10 each): group Ⅰ sham operation(group S);group Ⅱ sepsis(group CLP);group Ⅲ ,Ⅳ,Ⅴ low,medium,high dose HES(group H1,2,3).The animals were anesthetized with intraperitoneal pentobarbital sodium 50 mg/kg.Left carotid artery and left femoral vein were cannulated for MAP and HR monitoring and fluid and drug administration.Sepsis was induced by cecal ligation and puncture (CLP).6% HES 130/0.4 7.5,15.0 and 30.0 ml/kg were infused iv over 2 h in group H1,2,3 respectively at 4 h after CLP.The animals were sacrificed at 6 h after CLP.The lungs were isolated for determination of pulmonary capillary permeability(by iv Evans blue injection),the expression of A2BAR and the contents of cAMP,protein kinase A(PKA),TNF-α,IL-6 and IL-10 in the lung tissue.Results CLP significantly increased pulmonary capillary permeability,A2BAR expression and cAMP,IL-6 and TNF-α contents in the lung tissue in group Ⅱ as compared with group S.0.6% HES 130/0.4 significantly reduced pulmonary capillary permeability,increased A2BAR expression,cAMP,PKA and IL-10 and decreased IL-6 and TNF-αcontents in the lung tissue in group H1,2,3 as compared with group CLP.6% HES 130/0.4 decreased pulmonary capillary permeability and up-regulated A2BAR expression in a dose-dependent manner.6% HES 130/0.4 15.0 ml/kg was most effective in increasing cAMP and PKA contents in the lung and depressing inflammatory response.Conclusion 6% HES 130/0.4 decreases pulmonary capillary permeability in a rat model of sepsis by up-regulating A2BAR expression in lung tissue.

Objectlve To assess the clinical effects and safety of intravitreal injection of conbercept and macular photocoagulation for non-ischemic macular edema secondary to branch retinal vein occlusion (BRVO).Methods A total of 50 patients (50 eyes) with non-ischemic macular edema following BRVO were retrospectively analyzed.Patients were divided into 2 groups:ICI group (26 eyes) received intravitreal injection of conbercept,laser group (24 eyes) received standard-of-care grid laser for macular edema.The best-corrected visual acuity (BCVA) and central macular thickness (CMT) were observed before and 1 week,1 month,2 months and 3 months after treatment.Then,the changes in pre-treatment and post-treatment were compared,and the related complications were recorded.Results The difference of BCVA before treatment was not significant between two groups (P ＞ 0.05).BCVA at 1 week,1 month,2 months and 3 months after treatment in two groups were all improved,the differences were statistically significant compared with before treatment (all P ＜ 0.05),and the differences were statistically significant between two groups after treatment (all P ＜0.05).At 3 months after treatment,BCVA of 18 patients (69.23％) in ICI group and 8 patients (33.33％) in ICI group improved 2 lines.The difference of CMT before treatment was not significant between two groups (P ＞ 0.05),CMT at 1 week,1 month,2 months and 3 months after treatment in two groups were all decreased,the differences were statistically significant compared with before treatment (all P ＜ 0.05),and the differences were statistically significant between two groups after treatment (all P ＜0.05).13 eyes received repeat intravitreal injection in ICI group,including 2 eyes at 1 month,7 eyes at 2 months with CMT ＞250 μm,and 3 eyes at 3 months.No severe side effect related with drug and intravitreal injection occurred in the two groups.Conclusion Mean BCVA change and CMT change are significantly greater in the intravitreal injection of conbercept than the standard-of-care grid laser group for the macuiar edema secondary to non-ischemic BRVO.

The professional competency of medical informatics graduates from China Medical University in 1992-2011 was investigated, the requirements of employers for their professional competency were analyzed, and the current medical informatics curriculum system was evaluated with suggestions put forward for the reform of medical informatics curriculum system, including revision of its training target, measures for curriculum system reform, and improvement of confidence.

Objective To investigate the association between plasma Klotho protein level and lacunar cerebral infarction in the elderly.Methods Eighty eight patients with lacunar cerebral infarction aged over 60 years were selected as the observation group,and 90 age-and gender-matched elderly patients without lacunar infarction as the control group.The protein level of Klotho was tested by enzyme linked immunosorbent assay (ELISA).Klotho protein level was compared between the observation and control groups.The correlation between plasma Klotho level and lacunar infarction in elderly patients was analyzed.Results Compared with the control group,lacunar infarction group showed that Klotho protein level was decreased [(689.4±40.8) ng/L vs.(848.5±38.7) ng/L,P=0.009],and the proportion of patients with hypertension was increased (83.0％ vs.66.7％,P=0.04).There was no significant difference in age,gender,body mass index (BMI),dyslipidemia,diabetes mellitus and coronary heart disease between the two groups.The multivariate logistic regression analysis showed that the low plasma level of Klotho protein and hypertension were identified as the independent risk factors for Lacunar infarction (OR=3.325 and 2.413,P=0.003 and 0.021,respectively).Conclusions Klotho protein level may be associated with lacunar cerebral infarction in elderly people.Monitoring plasma Klotho protein level has an important clinical significance in the prevention,diagnosis and prognosis of lacunar cerebral infarction.

Objective:To investigate the effect of Superfine Cordyceps militarisv Powder on the immune functions of the mice,and to provide basis for improving the utilizable ratio of Cordyceps militaris.Methods:A total of 40 mice were randomly divided into negative control group,low dose (0.166 5 g·kg-1),middle dose (0.333 3 g·kg-1),and high dose (0.999 9 g·kg-1) of Superfine Cordyceps militaris Powder groups,and there were 10 mice in each group.The mice in different doses of Superfine Cordyceps militaris Powder groups were administered with the Superfine Cordyceps militaris Powder for 30 d by intragastric infusion respectively,whereas,the mice in negative control group were administered with the same volume of water for 30 d by intragastric infusion.The body weights,the spleen indexes and thymus indexes of the mice in various groups were measured;the lymphocyte transformation abilities of the mice in various groups were observed by lymphocyte transformation experiment;the levels of delayed-type hypersensitivity reaction of the mice were examined with toe incrassation;the number of antibody forming cells,phagocytic rate and phagocytic index of chicken erythrocytes phagocytized by peritoneal macrophages of the mice were detected.Results:Compared with negative control group,the body weights,the spleen indexes a nd thymus indexes of the mice in different doses of Superfine Cordyceps militaris Powder groups had no significant differences (P>0.05).The lymphocyte transformation abilities of the mice in middle and high doses of Superfine Cordyceps militarisPowder groups were higher than that in negative control group(P<0.05).The levels of delayed-type hypersensitivity reaction of the mice in middle and high doses of Superfine Cordyceps militaris Powder groups were higher than those in low dose of Superfine Cordyceps militaris powder group and negative control group(P<0.05).The numbers of antibody forming cells of the mice in low,middle and high doses of Superfine Cordyceps militaris Powder groups were higher than that in negative control group(P<0.05).The phagocytic rates and phagocytic indexes of chicken erythrocytes phagocytized by peritoneal macrophage of the mice in low,middle and high doses of Superfine Cordyceps militaris Powder groups were higher than that in negative control group(P<0.05).Conclusion:Superfine Cordyceps militaris Powder can strengthen the immune functions of the mice,and the recommended doses are 0.333 3 and 0.999 9 g·kg-1.

Objective:To observe the effects of different moxibustion times on proteins of transient receptor potential vanilloid 3 (TRPV3) ion channel protein and synovial cell apoptosis in rats with rheumatoid arthritis (RA), to provide a new basis for the anti-inflammatory mechanism of moxibustion. Methods:A total of 50 Sprague-Dawley (SD) rats were divided into a normal group, a model group, moxibustion groupⅠ, moxibustion groupⅡ and moxibustion groupⅢ by complete randomization, with 10 rats in each group. Rats in the normal group were bred routinely, and rats in the model group were also bred routinely after successful modeling. After successful modeling, rats in moxibustion groupⅠ,Ⅱ andⅢ accepted consecutive moxibustion at Zusanli (ST 36) and Shenshu (BL 23) for 15 d, once a day, respectively 5 min, 20 min and 30 min for each session. The degree of paw edema was observed and recorded. Immunohistochemical assay was used to detect the protein expression of TRPV3 ion channel in dorsal root ganglia and spinal cord dorsal horn. Terminal-deoxynucleoitidyl transferase-mediated nick end labeling (TUNEL) was used to detect apoptotic synovial cell number. Results: At the end of treatment, paw circumference of rats in moxibustion groupⅡ andⅢ were significantly reduced as compared with that in the model group (P<0.05). TRPV3 ion channel protein expression of dorsal root ganglia and spinal cord dorsal horn was higher in the model group than that in the normal group (P<0.05); the TRPV3 ion channel protein expressions of dorsal root ganglia and spinal cord dorsal horn in moxibustion groupⅡ andⅢ were higher than that in moxibustion groupⅠ (P<0.05); apoptotic synovial cell number in the model group was larger than that in the normal group (P<0.05), and apoptotic synovial cell numbers in moxibustion groupⅡ andⅢ were significantly higher than that in the model group (P<0.05). Conclusion:Moxibustion of appropriate time could induce TRPV3 expression, and promote synovial cell apoptosis.

Objective To verify whether the periodic or continuous exposure to high glucose may have different effects on human umbilical vein endothelial cell (HUVEC)apoptosis, and to explore the effect of NF-κB pathway on apoptosis of HUVEC induced by high glucose using the RNAi adenovirus vector. Methods RNAi combinant adenovirus vector which targeted 1566 site of NF-κB p65 mRNA was constructed and the effect of p65 gene knockdown in HUVEC was detected by Western blot analysis. Then, the RNAi adenovirus was transducted to explore the role of NF-κB pathway on the regulation of apoptosis in HUVEC induced by high glucose. The apoptosis of HUVEC was tested by flow cytometry and TUNEL assay. Results High glucose could induce apoptosis of HUVEC. p65 protein expression of nuclear extracts was significantly increased in high glucose culture as compared to control group, but only slightly increased in NF-κB-specific knockdown group, which maintained at basal state. Compared with normal glucose group, the number of TUNEL-positive cells in high glucose group was significantly increased (25.81%±1.77% vs 8.20%±0.63%, P<0.05). The number of TUNEL-positive cells was decreased in 30.5 rmnol/L glucose plus Ad-1566 than that in 30.5 mmol/L glucose plus Ad-DEST (11.49%±0.92% vs 26.10%±0.98%, P<0.01). Flow cytometry and TUNEL assay showed that the apoptosis of human umbilical vein endothelial cells induced by high glucose was inhibited by the RNAi adenovirus. Conclusion High glucose induces apoptosis of HUVEC. Knockdown of NF-κB p65 may protect HUVEC from apoptosis by preventing high glucose-induced NF-κB nuclear translocation.

OBJECTIVETo assess the predictive value of hemoglobin (HGB) levels for non-alcoholic fatty liver disease (NAFLD) by performing a prospective cohort study of NAFLD incidence in a healthy population.

METHODSA total of 2840 individuals in the Xinjiang province were enrolled in the study from 2008 to 2011, based on liver ultrasound showing no evidence of fatty liver disease and the discovery of no major risk factors upon interview. All participants completed an epidemiological questionnaire survey, a physical examination, an abdominal ultrasonography, and gave blood for biochemistry testing. The hazard ratios of NAFLD were compared when the participants were grouped according to HGB level (g/L in quintiles): Q1, less than or equal to 145 for males and less than or equal to 123 for females; Q2, > 145 to less than or equal to 151 for males and > 123 to less than or equal to 129 for females; Q3, > 151 to less than or equal to 155 for males and >129 to less than or equal to 134 for females; Q4, > 155 to less than or equal to 161 for males and > 134 to less than or equal to 139 for females; Q5, > 161 for males and > 139 for females. Between-group comparison of measurement data was carried out by t-test and of percentage or count data by chi-square test. Between group comparison of the HGB level was carried out by one-way ANOVA. The prospective association between HGB levels and NAFLD was assessed by conditioned logistic regression analysis.

RESULTSThe values of body mass index, blood pressure, and triglyceride level were significantly higher in the participants with elevated serum uric acid quartiles. Within the 3-year study period, NAFLD was newly diagnosed in 19.6% of the male participants and 10.1% of the female participants; the difference between males and females reached the threshold of statistical significance (X2 = 51.043, P less than 0.01). The incidence of NAFLD in the quintile groups was 6.10% in Q1, 10.50% in Q2, 13.13% in Q3, 16.95% in Q4, and 22.03% in Q5 (X2 = 70.495, P less than 0.01), and the increasing trend with elevated HGB quartiles was significant (P less than 0.01). In multivariate logistic regression analysis, with adjustment for sex, age, race, metabolic syndrome and its components, the hazard ratios for incidence of fatty liver comparing Q2 to Q5 of HGB concentration to Q1 were 1.125, 1.325, 1.516 and 1.982.

CONCLUSIONElevated HGB concentration is predictive of NAFLD in otherwise healthy subjects and may be used for screening during a routine health check-up.

Adult ; Early Diagnosis ; Female ; Hemoglobins ; analysis ; Humans ; Logistic Models ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; blood ; diagnosis ; Predictive Value of Tests ; Prospective Studies ; Surveys and Questionnaires

Objective To explore the anatomic basis of the thinning of the free posterior tibial artery perforator flaps and the clinical effect of repairing wound on hand or foot due to trauma.Methods From November,2016 to December,2017,10 cases of lower extremity cadaver specimens perfused with red ralex were dissected,which were perfused through the amputated femoral artery.Five of them were left and the rest were right.All cases were males.The number,diameter,branches and distribution of the perforator was observed.From September,2012 to September,2017,there were 13 cases of clinical application,which were 5 cases of hand wound and 8 cases of foot wound.The size of the wound was 3.0 cm × 2.0 cm to 6.0 cm × 4.0 cm,and the flap area was 3.5 cm × 2.2 cm to 6.5 cm × 4.5 cm.The repairing procedure was suitable for the wound associated with tendon,bone,joint capsule exposure.Results The number of posterior tibial artery perforating branches that more than 0.50 mm in diameter was 4 to 6,and the mean diameter was (0.87±0.26) mm.The perforating branch penetrated into the fat layer and was divided into 3 layers of vascular network:deep fat vascular network,superficial fat vascular network and subdermal vascular network.The perforating branch was located according to the positional relationship from deep to shallow,and vessel diameter become smaller step by step.The perforating branch trunk gave off branches to the deep vascular network,and the superficial vascular network had the same origin or shared with the deep blood vessels.The subdermal vascular network issued from the superficial vascular network or directly from the perforating branch trunk.There was no or few communicating branch between the deep vascular network and superficial ones,besides the vessel pedicle.So trimming deep fat layer will not affect the blood supply of superficial vascular network and neither will affect the flap blood supply.Most of the deep fat tissue was trimmed in 13 cases.The superficial and subdermal fat vascular network was preserved,and the same to the trunk and branches of the pedicle.All the flaps survived.Of which,1 appeared arterial crisis on the 2nd day after operation,and relieved by the local injection of papaverine.There was 1 case of venous crisis on the 3rd day,and improved by stitches,local release of congestion.Followed-up time was ranged from 2 to 12 months.All flaps were soft with good blood supply and good appearance,and did not need a second thinning surgery.Flaps restored the protective feeling 6 months later.Conclusion The microdissection of perforator flap of posterior tibial artery provides a theoretical basis for the perforator flap thinning,and the thinning of perforator flap is a good method to repair the appearance and function of the wound after foot and hand injuries.