Objective To investigate the valuable echocardiographic parameters and to evaluate theright heart function of patients with pulmonary hypertension in ICU. Methods From March 2015 to February 2016,30 patients with pulmonary hypertension in the intensive care unit(ICU) of Dongzhimen hospital were enrolled in the experimental group,and another 33 patients without pulmonary hypertension in ICU were enrolled in the control group. All of the patients were given bedside echocardiography examination. Results Significant differences in the right atrial diameter and area ,the base diameter of the right ventricle ,the intermediate diameter portion ,the distal inner diameter of the proximal end of the right ventricular outflow tract ,the main pulmonary artery diameter ,the Tei index and the E/A were observed between the two groups. However ,no significant differences in the right ventricular free wall thickness,TAPSE,RVFAC,VREF and DT were foundbetween the two groups. Conclusion Tei index,the diameter of the right heart and the main pulmonary artery diameter are proposed to be the promising echocardiographic parameters to evaluate the right heart function of patients with pulmonary hypertension in ICU.

The bioactive identity of A Ⅱ made in China and overseas was demonstrated in different levers including receptor, organ and whole body in this report. Therefore, the A Ⅱ made in China can be used in various pharmacological researches in stead of imports.

Overweight and obesity are main risk factors for chronic metabolic diseases, and are strongly associated with the increased risk of premature death. Low carbohydrate diet (LCD) has been proven to effectively control body weight and fat mass in overweight and obese patients by short-term (≤6 months) dietary intervention studies. The mechanisms include regulation of energy metabolism, anti-inflammatory, antioxidant, alteration in expression of lipid metabolic-related genes and modulation of intestinal flora. However, the conclusions are inconsistent on whether LCD can cause durable weight loss and reduce the risk of overweight and obesity. This review summarizes the current research progress on the mechanisms, epidemiological studies, intervention studies and potential risks of LCD in controlling overweight and obesity, providing a reference for the future research and clinical application.

ObjectiveTo investigate the laws of distribution and combination of traditional Chinese medicine (TCM) syndromes of patients with diastolic heart failure (DHF); To research the relevance between TCM syndromes and DHF.Methods A four diagnostic information survey was conducted among 124 DHF patients in order to analyze their basic information and information about TCM four diagnostic methods. Statistical analysis method was used to determine the syndrome types of the DHF patients and the features of syndrome combination.ResultsMost DHF patients were in their sixties or seventies, the number of female patients was larger than that of male patients, and their heart function was in II or III grade. Qi deficiency, phlegm turbidity, Qi stagnation, blood stasis, water stagnation, Yang deficiency and Yin deficiency were the common syndromes. Two-card combination and three-card combination were more common, mainly with Qi deficiency, phlegm turbidity or blood stasis as the main patterns of manifestation. Conclusion This research could provide a clinical basis for the establishment of the standard for the TCM syndromes DHF.

Objective: To explore the effect of obesity on the treatment for femoral neck fracture in patients with SuperPATH hip replacement. Methods: Seventy patients who were treated with SuperPATH hip replacement in the Second People's Hospital of Wuxi from January 2014 to January 2017 were selected in the study.Based on their body mass index(BMI), the patients were divided into obesity group(BMI≥30kg/m²) (23 cases), overweight group(BMI: 25-30kg/m²) (22 cases), and normal group(BMI: 18.5-25kg/m²)(25 cases). The incision length, operation time, blood loss, blood transfusion rate, pain score, hip joint function score, imaging measurement results and postoperative complications were compared among the three groups. Results: All 70 patients received the operation successfully.The incision length of the obesity group was (7.4±0.2)cm, which of the overweight group was (7.2±0.1)cm, which of the normal group was (7.1±0.8)cm, the difference among the three groups was statistically significant (F=24.671, P<0.001). The patients were followed up for 9-13 months.The acetabular anteversion angle, acetabular abduction angle, pain score, mobility of hip joint, walking ability score in the obesity group were (17.8±1.2)°, (40.9±3.4)°, (1.26±0.61)points, (95.43±7.89)°, (8.10±0.27)points, respectively, which in the overweight group were (16.7±3.3)°, (42.9±2.9)°, (1.23±0.58)points, (96.78±3.22)°, (8.20±0.92) points, respectively, which in the normal group were (15.8±2.7)°, (43.9±5.1)°, (1.24±0.78)points, (97.12±6.44)°, (8.20±0.48)points, respectively.The difference of acetabular abduction angle among the three groups was statistically significant (F=9.803, P=0.002). In the obesity group, there were two cases of incision infection, two cases of deep venous thrombosis and one case of pulmonary complication, the incidence rate of complications was 5%.In the overweight group, there was one case of superficial incision infection, and one case of deep vein thrombosis, the incidence rate of complications was 2%.In the normal group, there was one case of deep venous thrombosis, the incidence rate of complications was 1%.The difference of incidence rate of complications among the three groups was statistically significant(χ²=15.31, P<0.01). Conclusion Obesity increases the surgical risk of SuperPATH total hip replacement, and more attention should be attached to perioperative and post-operative treatment for such patients.

Sepsis-associated encephalopathy (SAE) is the most common neurological complication of sepsis, with an incidence of up to 70% in sepsis, and contributes to the increased mortality and disability in sepsis. To date, the exact pathogenesis of SAE is not clear. Most of current researches indicated that blood-brain barrier (BBB) dysfunction, active neuroinflammation, glial cell over activation as well as cerebral microcirculation dysfunction contributed to the pathophysiology of SAE. BBB, as a complex cellular structure between the central nervous system and the peripheral system, strictly controls the entrance and discharge of substances and plays an important role in maintaining the balance between biochemical system and immune system of central system. During the progress of sepsis, inflammatory cytokines and reactive oxygen species resulting from peripheral system directly or indirectly resulted in the damage to the integrity and structure of BBB, which helped above species easily enter into the central system. Above these damages caused glial cell activation (microglia and astrocyte), the imbalance of neurotransmitters, mitochondrial dysfunction and neural apoptosis, which also reversely contributed to the damage to the integrity and permeability of BBB via decreasing the expression of tight junctional protein between cells. Therefore, this review focuses on the structural and functional changes of BBB in SAE, and how these changes lead to the development of SAE, in order to seek a BBB-targeted therapy for SAE.

Objective To investigate the effect of Buyang-Huanwu decoction on left ventricular diastolic function in DHF rats.Methods Thirty male Sprague-Dawley rats were randomly divided into the normal group (n=10),the Chinese medicine group (n=6),the western medicine group (n=6) and the model group (n=6).Except for the normal group,the other groups got abdominal aorta stenosis.After 12 weeks,The Chinese medicine group was given Buyang-Huanwu decoction 12.72 g/(kg·d),and the western medicine group was given metoprolo 1 0.004 5 g/(kg·d),and the normal group and the model control group were given water.After once daily for 8 weeks,echocardiography was used to measure EF,E/A ratio and e/a ratio.The heart rate,left ventricular diastolic pressure,left ventricular end-diastolic pressure,tension and maximal change in pressure of left ventricular were measured by Langendorff.Results Compared with the model group,the e/a value (1.11 ± 0.28 vs.0.67 ± 0.20) of the Chinese medicine group significantly increased (P＜0.05),and the ventricular muscle tension (0.86 ± 0.64 g vs.1.01 ± 0.33 g) significantly decreased (P＜0.05).Conclusions Buyang-Huanwu decoction could improve cardiac relaxation by reducing ventricular muscle tension,thus improving diastolic function of diastolic heart failure rats.

Objective: To observe the integration frequency of aadA2 resistance cassette at attI site of the integron under different concentration of streptomycin. Methods: Class 1 integron with known gene sequence was cloned into plasmid pACYC184 to produce recombinant plasmid pACIDA, meanwhile the integrase gene was cloned into plasmid pET28a to construct recombinant plasmid pETINT. These two recombinant plasmids were consecutively transformed into E. coli BL(DE3). These transformed bacteria was cultured in the LB medium at 37 ℃ overnight with addition of different concentration of streptomycin. The copy number of total integrons and the copy number of integrated aadA2 at attI site of integrons were determined by using real-time PCR. and the integration frequency is the result of the former divided by the latter. Results: The resulting frequencies were (1.97±0.24)×10^-3, (3.23±1.77)×10^-3, (3.27±0.67)×10^-3, 0.45±0.13 and 1.32±0.11, with respective streptomycin concentrations of 0, 20, 30, 40 and 50 μg/ml. The background frequency of integration without integrase overexpression was less than (1.75±0.33)×10^-7. Conclusion These findings indicate that antibiotic concentration significantly increase recombination frequency of aadA2 resistance cassette at attI site of the integron, catalyzed by integron integrase.(Chin J Lab Med, 2018, 41: 531-535)

Objective To explore the effects of protection motivation theory on fall risk caused by senile osteoporotic spinal fracture, fall incidence and self-efficacy.Methods A total of 94 cases of senile osteoporotic spinal fracture in Wuxi Second People's Hospital from February 2015 to August 2016 were selected and divided into the control group (46 cases) and the observation group (48 cases) according to the random number table. Patients in the control group used routine nursing care, while patients in the observation group received additional protection motivation intervention. The fall risk assessment questionnaire (FRAQ) and osteoporosis self-efficacy scale (OSES) were used to compare the fall risk score, self-efficacy and the incidence of fall of the two groups before and after the intervention.Results At 6 months after the intervention, the incidence of fall was 2.08%(1/48) in the observation group and 13.04%(6/46) in the control group. The difference between two groups was statistically significant (χ2=4.094,P<0.05). The fall risk score in the observation group was (36.46±3.08) %, which was significantly lower than that in the control group; calcium uptake efficiency score (44.98±2.84) and exercise self-efficacy scale score (48.54±2.85) in the observation group were significantly higher than those in the control group (t=3.817, 4.946, 8.186;P<0.05).Conclusions Application of protection motivation theory intervention can effectively reduce the risk and the incidence of fall in patients with osteoporotic vertebral fracture and improve the calcium uptake efficiency and exercise self-efficacy. It is worthy of promotion.