Objective To explore the characteristic and the rule of flash-visual evoked potentials (F-VEP) of SD rats after optic nerve injury in different grades. Methods By using APS-2000 multifunctional electric physiological instrument, changes in F-VEP were observed in normal optic nerve and injured optic nerve (crushed in 3 grades) in rats. The latency and amplitude of F-VEP wave, were recorded and statistically. Results The F-VEP wave was reliably displayed with characteristic curve. The L5b was(53.67?3.12)ms and A5 was(17.83?5.91)?v. The latency of F-VEP in rats with optic nerve injury in different grades showed a significant prolongation, and the amplitude showed a significant decrease compared with normal rats (P

Objective Through transmission electron microscopy we observe the ultrastructure of optic nerve to evaluate the curative effect of optic nerve incision decompression (ONID) for incomplete injury to optic nerve. Methods The optic nerve was crushed for 30s to produce incomplete injury to the optic nerve in rats, and then the rats were divided into two groups. ONID was performed 6 hours after the injury in one group, and in the other group decompression was omitted(non-ONLD). Ultrastructure of optic nerve was observed 1 month, 2 months, 3 months and 6 months later in both groups. Results After 1 month denaturalization of myelin sheaths and axons of the injured optic nerve was severe in non- ONID group, and after 3 months the optic nerve entirely lost its normal structure. On the other hand, denaturalization of myelin sheaths and axons was evidently less intense in ONID group, and the changes in structure of optic nerve were stabilized. Conclusions ONID reduced the speed of degeneration of the injured optic nerve and postpones the process of axon denaturalization, thus protects the optic nerve from secondary injuries.

ObjectiveTo study the effects and molecular mechanisms of Shuanglong Pill on angiogenesis of ischemic myocardium. Methods63 Wistar rats were ligated left anterior descending branch to be made into models of acute myocardial infarction(AMI).All rats were randomly divided into large-dosage group of Shuanglong Pill(LDG),small-dosage group of Shuanglong Pill(SDG),The control of acute MI(MIC).Other 11 rats were set as normal control(NC).Rats in every group had been treated half for 2 weeks and half for 4 weeks. New vessels' quantity in ischemic myocardium of acute MI rats were detected by immunohistochemistry double steps assay;the expressions of vessel endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) on ischemic myocardium were detected by immunohistochemistry SP assay;the expressions of VEGF mRNA and bFGF mRNA on ischemic myocardium were detected by reverse transcription polymerase chain reaction(RT-PCR) assay.ResultsThere were more new capillaries on ischemic myocardium of LDG, SDG compared with that in MIC at every stage,moreover,there was significantly increase at the end of 4 weeks compared with that at 2 weeks.At the end of 2 weeks, the expression of VEGF in LDG were significantly elevated compared with that in MIC; and the expression of bFGF in LDG were significantly elevated compared with that in SDG and MIC.Whereas the expression of VEGF in LDG were significantly decreased at the end of 4 weeks compared with 2 weeks. There were significant differences of above comparison (P<0.05-0.01).At every stage the expression of VEGF mRNA in LDG, SDG were significantly elevated compared with that in MIC; but its expression was significantly decreased at the end of 4 weeks compared with that 2 weeks. The expression of bFGF mRNA was significantly elevated in LDC at the end of 2 weeks compared with that in other groups.ConclusionsShuanglong Pill could promote angiogenesis in ischemic myocardium,application of large dose of Shuanglong Pill could significantly upregulate the expression of VEGF, bFGF, VEGF mRNA and bFGF mRNA.

BACKGROUND: Congestive heart failure (CHF) is the clinical syndrome of all kinds of heart disease on the serious or final stage. About half of patients with organic heart disease will have heart failure that has a high incidence rate and mortality. The survival of heart failure was inferior to that of malignant tumor.OBJECTIVE: To confirm the clinical effect of Lujiao prescription on CHF and elucidate its possible mechanism.DESIGN: A control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 60 patients with CHF were selected from the department of cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. There were 31 male and 29 female. Included criteria: ①All of patients were consistent with Framinham diagnostic criteria. ② Above Ⅲ degree by New York Heart Association(NYHA). ③ Three months case history. ④Accept quantity sufficient diuretic and vasodilating agent (exclude angiotensin converting enzyme inhibitor ). ⑤ Left ventricle hypertrophy was proved by echocardiogram or chest X-ray. ⑥ Differentiation of symptoms and signs of Traditional Chinese Medicine refers to asthenia syndrome of differentiation of symptoms and signs of Traditional Chinese Medicine (1986, Researching Association of Chinese integrated medicine) General state of health and basic disease of the patients in the two groups were not significant deviation.METHODS: 60 patient s of CHF were randomly divided into Lujiao prescription group(n=40) and Digoxin group (n=20) at the rate of 2:1. Lujiao prescription group: Orally liquid decoction of Lujiao Prescription 35 mL (1 mL contain crude drug 1.6 g) Bid. po. Course of treatment: 4 weeks. Digoxin group: Digoxin tablet, 0.125-0.25 mg, qd. po. course of treatment: 4 weeks.After 4-week treatment, the patients' clinical effect, integrals of the symptoms of renal deficiency, classification of function capacity of the NYHA,Lee's heart failure score, heart rate(HR), myocardium oxygen consumption (MOC), proportion of heart to chest, echocardiogram, measurement of plasma angitention Ⅱ (Ang Ⅱ ) and plasma atrial natriuretic factor (ANF) were observed.MAIN OUTCOME MEASURES: ① The total clinic effective rate. ②Integrals of the symptoms of renal deficiency. ③ Classification of function capacity of the NYHA. ④ Lee's heart failure score. ⑤HR and MOC. ⑥The proportion of heart to chest. ⑦ Ejection fraction(EF), cardic output (CO), interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) through echocardiogram. ⑧The measurement of plasma Ang Ⅱ and plasma ANF.RESULTS:Totauy 60 patients entered the final analysis. ① The total clinical effective rate of the Lujiao prescription group was 90 %, which showed no significant difference from the Digoxin group (90 %, P ＞ 0.05).② Improvement was significantly observed in the integrals of the symptom of renal deficiency of the patients in the Lujiao prescription group after treatment (P ＜ 0.01), but which was not significant in the Digoxin group(P＞ 0.05). ③ It was found that classification of functional capacity of NYHA between Lujiao prescription group and Digoxin group after treatment was obviously decreased (P ＜ 0.01). ④ Lee's heart failure score of patients in Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01). ⑤Myocardium oxygen consumption and HR of the patients in the Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01). ⑥ The proportion of heart to chest between Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01).⑦ EF and CO were increased by Lujiao prescription and by Digoxin (P＜ 0.01,vs pretreatment, respectively). IVST, PWT, LVMI of Lujiao prescription group after treatment were obviously decreased (P ＜ 0.01), while those of the Digoxin group were not obviously decreased (P ＞ 0.05). ⑧ Thlevel of plasma Ang Ⅱ of the patients in the Lujiao prescription group after treatment were obviously decreased (P ＜ 0.01), while that of the Digoxin group were not obviously decreased (P ＞ 0.05). The level of plasma ANF was decreased by Lujiao prescription and by digoxin(P ＜ 0.01, vs pretreatment, respectively).CONCLUSION: There is increasing cardiac constriction power and regressing left ventricular hypertrophy of patients with CHF by Lujiao prescription. The therapeutical effect of Lujiao prescription for CHF is better than that of Digoxin. The effect may be related to the regulation of circular or local endocrine(plasma Ang Ⅱ and ANF) disorder.

BACKGROUND: Left ventricular hypertrophy (LVH) is an important ring-joint of congestive heart failure (CHF). It is also considered to be independent risk factor of cardiovascular disease, so how to reverse or relieve LVH is valuable to cure CHF.OBJECTIVE: To observe the effect of Lujiao prescription on degree of LVH in patients with CHF.DESIGN: A random-control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 20 patients with CHF were selected from the Special Clinic and Department of Cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. All of them were consistent with the Framirham diagnostic criteria and following standardizations: ①above Ⅲ degree of cardiac functional grading by New York Heart Association (NYHA);②over 3 months case history;③accepted basic treatment of quantity sufficient diuretic and vasodilating agent excluding angiotensin converting enzyme inhibitor (ACEI);LVH was proved by echocardiogram or chest X-ray. They were informed of treatment items and consented.METHODS: According to random lot, the patients were divided into Lujiao prescription group and Digoxin group, each containing 10 patients.①Oral administrations of Lujiao prescription (35 mL, two times per day, produced by Shanghai Shuguang Hospital) and Digoxin (0.125-0.25 mg per tablet, batch number: 970757, once daily) were given in the corresponding groups, and the treatment duration was 3 months. After treatment, all the patients were detected in①NYHA cardiac functional grading; ②interventricular septal thickness (IVST) and posterior wall thickness (PWT) in diastolic phase through echocardiogram, myocardium weight of left ventricular by Devereux formula, left ventricular mass index (LVMI) corrected by bodysurface area, and degree of LVH;③the level of plasma angiotensin Ⅱ (Ang Ⅱ ) by radioactive immunoassay.MAIN OUTCOME MEASURES: NYHA cardiac functional grading, e-chocardiogram (IVST, PWT, LVMI, degree of LVH), the level of plasma Ang Ⅱ.RFSULTS: All 20 adopted patients entered the result analysis.①The classification of NYHA cardiac functional grading ( Ⅰ , Ⅱ ,Ⅲ,Ⅳ) were respectively 2, 5, 3, 0 case in Lujiao prescription group and 2, 4, 4, 0 case in Digoxin group after treatment, and difference was significant compared with those before treatment (0, 0, 7, 3, P ＜ 0.05).②IVST, PWT and LVMI of Lujiao prescription group were obviously decreased after treatment [(11.20±0.42), (12.10±0.32) mm, P ＜ 0.01; (10.60±0.84), (11.40±1.10) mm,P ＜ 0.01; (139.4±12.4), (155.3±15.4) g/m2, P ＜ 0.01], while those of the Digoxin group were untouched (P ＞ 0.05). The degree of LVH of Lujiao prescription group after treatment was obviously decreased [normal, mild,moderate, sever: 2, 6, 2, 0; 0, 3, 4, 3, P ＜ 0.01], while that of the Digoxin group was not obviously decreased (P ＞ 0.05).③)The level of plasma Ang Ⅱin the Lujiao prescription group was obviously decreased [(97.7±19.5),(144.0±18.5) ng/L, P ＜ 0.01], while that of the Digoxin group was not obviously increased (P ＞ 0.05).CONCLUSION: Lujiao prescription can reverse or relieve the degree of LVH in patients with CHF.

Objective:To summarize the main issues, analyze the causes and offer a strategy for AIDS preven-tion and control for all types of healthcare facilities in the health care system. Methods:184 leaders and experts of tertiary-level healthcare facilities ( provinces, cities and counties) from 30 provinces who had been engaged in AIDS prevention and control for more than five years were studied through a questionnaire including the issues and causes in AIDS prevention and control. Results: According to the results of the respondents and experts’ demonstration, the main issues were identified, including a lack of human resources in the system of disease control facilities, a lack of relevant agencies involved in AIDS response, the difficulty for AIDS patients to receive surgery and follow-up, poor detection of HIV, shortcomings in medical insurance, and so on. Conclusion: Based on the analysis of issues and causes, the paper offers strategic solutions: Clearly define the responsibilities of various health institutions in AIDS prevention and control;promote the participation of primary health institutions in AIDS prevention and control; im-prove the medical service system for AIDS patients;improve AIDS medical security policies;reform the management system of antiretroviral therapy drugs;and strengthen technical support from disease control facilities.

AIM:Tostudywhe ther theangiotens in-(1-7)[Ang-(1-7)]/Mas receptor axis protects cardio-myocytes against high glucose (HG)-induced injury by inhibiting nuclear factor-κB (NF-κB) pathway.METHODS:The cell viability was measured by CCK-8 assay.The intracellular levels of reactive oxygen species ( ROS) were detected by DCFH-DA staining .The number of apoptotic cells was tested by Hoechst 33258 nuclear staining .Mitochondrial membrane potential ( MMP) was examined by JC-1 staining.The levels of NF-κB p65 subunit and cleaved caspase-3 protein were de-termined by Western blotting.RESULTS: Treatment of H9c2 cardiac cells with 35 mmol/L glucose (HG) for 30, 60, 90, 120 and 150 min significantly enhanced the levels of phosphorated ( p) NF-κB p65, peaking at 60 min.Co-treatment of the cells with 1 μmol/L Ang-(1-7) and HG for 60 min attenuated the up-regulation of p-NF-κB p65 induced by HG. Co-treatment of the cells with Ang-(1-7) at concentrations of 0.1~30μmol/L and HG for 24 h inhibited HG-induced cy-totoxicity, evidenced by an increase in cell viability .On the other hand, 1 μmol/L Ang-(1-7) ameliorated HG-induced apoptosis, oxidative stress and mitochondrial damage , indicated by decreases in the number of apoptotic cells , cleaved caspase-3 level, ROS generation and MMP loss .However, the above cardioprotective effects of Ang-(1-7) were markedly blocked by A-779, an antagonist of Ang-(1-7) receptor (Mas receptor).Similarly, co-treatment of H9c2 cardiac cells with 100 μmol/L PDTC ( an inhibitor of NF-κB) and HG for 24 h also obviously reduced the above injuries induced by HG.CONCLUSION:Ang-(1-7)/Mas receptor axis prevents the cardiomyocytes from the HG-induced injury by inhibiting NF-κB pathway .

Objective To study the causes of emergency department (ED) overcrowding and access block in Beijing.Methods This was a multi-center cross sectional study.The studied cohort of patients included all ED visiting patients from 18 municipal teaching hospital EDs in Beijing from 2012 to 2013.Patient' s characteristics and medical care settings were analyzed.Results The urgent care cases accounted for only 4.6 ％ (71 224/1 554 387) of the emergency annual visits in 2012 and 5.5 ％ (88 190/1 615 571) in 2013.The total number of observation patients in EDs was 185 277 and 211 900 in 2012 and 2013 respectively,with an increase of 14.4 ％ (P ＜ 0.01).The total ED-admission inpatients only accounted for 2.97％ and 2.89 ％ of total annual visits in 2012 and 2013 respectively.The average time of ED-admission took 37.1 hours and 36.2 hours in 2012 and 2013 respectively.The average time of ED stay for observation was 4.9 days and 5.4 days in 2012 and 2013 respectively.Upper respiratory tract infection was the leading illness in annual visits.The leading cause of ED stay for observation was bedridden with pneumonia.Conclusions The ED settings in Beijing are different from other countries.The EDs actually assume the task of the clinic and ED service for 24 hours thereby made EDs terribly overcrowded.The main causes are large number of non-emergency patients visiting the ED and patients in the ED are difficulty to be hospitalized.Patients with end-stage disease and multiple organ failure stayed in the ED due to nursing home shortage.

Objective: To observe the effect of needling Hegu (LI 4) on functions of the prefrontal cortex using the functional near infrared spectroscopy (fNIRS). Methods: A total of 12 healthy volunteers were randomly assigned to an acupuncture group (n=6) and a control group (n=6). The control group received no intervention. The acupuncture group received needling Hegu (LI 4) on the right side. The real-time concentration changes of oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (d-Hb) and total hemoglobin (t-Hb) in the prefrontal cortex were recorded using the fNIRS, allowing for effect analysis of needling Hegu (LI 4) on the functions of the prefrontal cortex. Results: Compared with the control group, the HbO2 and t-Hb concentrations were increased in the acupuncture group and there were between-group statistical significances (bothP<0.05). There was no between-group statistical significance in d-Hb concentration (P>0.05). Conclusion: Needling Hegu (LI 4) can extensively activate the prefrontal cortex and therefore has significant effect on the functions of the brain's prefrontal cortex.

Objective To investigate the efficacy and safety of modified endoscopic submucosal dissection (ESD) and rubber band ligation assisted endoscopic dissection for treatment of small gastric submucosal tumors (SMT) originating from the muscularis propria layer. Methods A total of ninety-two patients diagnosed as gastric SMT (6 mm≤diameter≤13 mm) originating from the muscularis propria layer by EUS in our hospital were enrolled in this study. With intravenous anesthesia and tracheal intubation in all patients, modified ESD was performed firstly to stripe the small tumors. After being exposed to a certain extent, the tumors were ligated by rubber band and snared for endoscopic dissection. The situation of bleeding, perforation in both intraoperative and postoperative, the integrity and size of the resected specimens were observed and recorded. The resected specimens were identified with histopathological detection and immunohistochemistry assay. At the 6-month and 12-month after the operation, all patients were reviewed by gastroscopy and EUS in our hospital. Results All the 92 tumors were resected completely and successfully. The mean operating time was (19.2±2.3) min and the mean blood loss in operation was (2.6±0.5) mL. Perforation after resection occurred in 3 cases, which were closed with metal hemostatic clips and nylon ropes. No delayed bleeding and perforation occurred in one week after the operation. The tumor sizes ranged from 6 mm × 5 mm to 13 mm × 12 mm. Seventy-three gastric stromal tumors (risk classification:all were very low risk), 18 gastric leiomyomas and 1 gastric neurofibroma were identified. There were no residue or recurrence in all cases during the 12-month follow-up period. Conclusion The modified ESD and rubber band ligation assisted endoscopic dissection are effective and safe for treatment of small gastric submucosal tumors originating from the muscularis propria layer. The tumors are resected completely and successfully, showing certain significance to assess the nature, degree of malignancy of the tumor and prognosis of the patients.