Objective:To investigate the rate of anxiety after str oke and study the effect of psychological intervention.Method:206 i npatients(male 126,female 80,mean age 63?16)with stroke were divided into inte rvention group(103 cases)and control group(103 cases),which matched by sex a nd age.All subjects were tested with SAS,DNF,MMSE,LES and ADL before interventi o n,3 months,6 months and 12 months later.Results:The rate of anxiety a fter 1 month of stroke in our sample was 18.4%.The reduction rate of SAS was g re ater in intervention group than control at all follow up points.Multi-factorial analysis showed,many factors including female,younger at onset,severity of strok e,poor general physical condition,less compliance with treatment,and other psych o-social factors(heavier family burden,less income,more life events,less social support)were all associated with anxiety after stroke and less reduction rate of SAS at intake and during follow up.Conclusion:Anxiety is a common c omplication after stroke,its occurrence and maintenance were associated with a v ariety of factors including severity of illness and psychosocial factors.Suppor tive psychological intervention can reduce anxiety after stroke.

Objective To explore the relationship between the polymorphism of angiotensin converting enzyme (ACE) gene and essential hypertension complicated with left ventricular hypertrophy (LVH). Methods ACE gene I/D polymorphism in 150 healthy subjects, 80 essential hypertensive(ET)patients with LVH and 152 ET patients without LVH was detected by PCR. Left ventricular mass (LVM) was measured by echocardiography, and then left ventricular mass index (LVMI) was calculated. Results The frequencies of the ACE D allele in the ET patients with or without LVH were 0.493 and 0.514, respectively, and significantly higher than those in the healthy subjects (P

Objective To investigate the relationship between oxidative stress and cell apoptosis in the kidney of rabbit induced by high energy shock wave(HESW).Methods Forty healthy male rabbits were surgically managed to the mono-nephron models and randomized into 4 groups consisting of ten each: control group,1 000 HESW group,2 000 HESW group and allopurinol pretreated plus 2 000 HESW group.The rabbit kidney tissues were obtained.The activity of superoxide dismutase(SOD) and malondialdehyde(MDA) levels in the renal tissue were measured 24 hours after HESW application.The cell apoptosis was detected by TdT-mediated dUTP nick end labelling(TUNEL) and flow cytometry.Results Compared with the control group,the MDA level and the rate of apoptosis in the HESW groups increased,and the activity of SOD reduced significantly(P

Objectives To explore the clinical effect of coupling meglumine cyclic adenylate (MCA)and the human granulocyte colony-ostimulating factor (G-CSF)on rat with diastolic heart failure(DHF).Methods Totally 60 rats of DHF model were evenly divided into 4 groups according to random number:Control group(n=15,control),Model group(n=15,DHF model),MCA group(n =15,treated with MCA)and MCA+GCSF group(n=15,treated with MCA plus G-CSF).MCA group were administered by intragastric injection of MCA 30 mg/kg/d for 15 d,MCA+G-CSF group were administered by intragastric injection of MCA 30 mg/kg/d and plus G-CSF 100 μg/kg/d for 15 d,while Control group and Model group were given same volume of saline solution.BIOPAC SYSTEM was used to analyze the model establishment.The mRNA levels of GATA-4 and Cx43 were measured by RT-PCR.The protein expressions of GATA-4,Cx43,cTNI and c-kit were measured with western blotting.ELISA and flow cytometry were used to detect cAMP and differentiation rate of bone marrow mesenchymal stem cells (BMSCs),respectively.Results Compared with MCA group,the denaturation degree of myocardial tissues in DHF rat was significantly improved than in MCA+G-CSF group.Moreover,the level of GATA-4 (1.62 ± 0.09),Cx43 (1.02 ± 0.07),cTNI (1.42 ± 0.12),c-kit (0.65±0.02),cAMP(283.67± 18.09)nmol/L and BMSCs cell differentiation rate(38.62 ± 1.52)％ in MCA + GCSF group were significantly promoted (all P＜ 0.05)than in MCA group,GATA-4 (0.82±0.07),Cx43 (0.52±0.05),cTNI(0.86 ± 0.13),c-kit (0.48 ± 0.03),cAMP(198.83 ± 16.03) nmol/L and BMSCs cell differentiation rate (19.82 ± 0.89)％.Conclusions The combination of MCA with G-CSF is significantly improved DHF than single MAC treatment,which may regulate BMSCs differentiation though cAMP/PKA signaling pathways.

Objective To investigate the effectiveness of Ender nail fixation in the management of pediatric femoral shaft fractures. Methods A total of 24 children with femoral shaft fracture underwent small incision Ender nail internal fixation followed by 4 weeks of monolateral hip spica-cast immobilization. Results Follow-up observations for 6~24 months revealed no non-union or delayed union. The affected limbs were found within 1 cm shorter or longer than the contralateral in 4 cases. None became lame, and the functions of lower limbs were completely recovered. Conclusions So far as indications and contra-indications of Ender nail fixation are strictly followed, this treatment for femoral shaft fractures in children of age 5~10 years gives characters of small incision, anatomic reduction, unimpaired periosteum, short hospital stay, and quick functional recovery.

BACKGROUND:The mesenchymal stem calls (MSCs) have multiple-direction differentiation potential.How to induce human mesenchymal stem cells (hMSCs) into chondrogenic in vitro is an advanced researching direction.OBJECTIVE: Experimental study on chondrogenic differentiation of mesenchymal stem cells from human bone marrow in study culture medium so as to observe the characteristic of the cells in the continuous progressive process,such as culture of the primary generation and passage culture.DESIGN: A single sample and open study.SETTING : Department of Orthopaedics, Children's Hospital Affiliated to Soochow University.MATERIALS:A total of 5 children with single bone cyst were selected from Children's Hospital Affiliated to Soochow University from August 2002 to September 2003,including 3 boys and 2 girls aged from 3 to 12 years.All of them donated 5 Ml bone marrow, which was added with 1 Ml (20 U/Ml) heparinization, from which MSCs was obtained. Main reagents were detailed as follows: F-12 (Gibco, USA), fetal calf serum (Sijiqing Bioengineering Company, Hangzhou), trypsin (Sigma, USA), transforming growth factor-β1 (TGF-β1) (Sigma, USA) and vitamin C (the Third Medical Company,Nanjing; batch number: 021017).METHODS:① Standard culture medium:0.1 volume fraction of fetal calf serum,100 U/Ml penicillin,100 U/Ml streptomycin, 5.8 g/L Hepes, 2 g/L NaHCO3 and 0.3 g/L glutamine were added into F-12 culture medium (Ph 7.2-7.4). ②Study culture medium: 50 μg/L vitamin C and 1 μg/L TGF-β1 were added into standard culture medium (Ph 7.2-7.4). ③Cell culture of the primary generation: 12 Ml Hanks which contained 1 Ml of heparinization (20 μ/Ml) and 5 Ml bone marrow was centrifugated. Then the cells which had nucleolus were rinsed. Then cells were cultured in a 50 Ml plastic culture bottle at the density of 3×109 L-1 and were cultured in 6-well culture plate at the density of 1×109 L-1. One bottle and 3 well was used study culture medium,the other bottle and 3 well was used standard culture medium.The cells were cultured in incubator containing 0.05 volume fraction of CO2 and saturated tumidity at 37℃. The medium was changed every 48 hours. The cells were observed under inverted microscope. ④ Passage culture: When the primary generation cells had been cultured with standard culture medium for 10-14 days, we would find that the cells covered 80％ of the bottle bottom. Then 2.5 g/L of trypsin containing 0.2 g/L of EDTA was used to digestion and passage. The third generation cells were separated at the ratio of 1:1, and were cultured in two bottles. One bottle used standard culture medium, the other used study culture medium. At the same time, the cells in 6-well plate which contains coverslip were deal with in the same way. 3-wells used standard culture medium, and the others used study culture medium. Culture time was7 days.The cells were observed under inverted microscope.⑤ Index detection:Alcian blue staining was used to show the expression of the glycosaminoglycan of the primary generation and the third generation. Type- Ⅱ collagen immunohistochemical staining was used to show the express of the type- Ⅱ collagen of the primary generation and thethird generation.MAIN OUTCOME MEASUREMENTS:① Morphological observation; ② secretion of glycosaminoglycan; ③ expression of type- Ⅱ collagen.RESULTS: ① Observation under inverted microscope: Most of the hMSCs in primary culture were spindle; a few of them were wide, flat and polygon. After passage, the cells were found in a uniform spindle shape. The cells, which were induced in TGF-β1 and vitamin C, became round or oval shape. ② The positive rate of primary generation was 82.4％, the 3rd generation which were cultured in study culture medium was 76.3％ (x2 =1.14,P＞ 0.05), and the 6th generation was 68.5％(x2 =5.22, P ＜ 0.05). The cells, which were culturedinstandardculturemedium, were negative. ③ The 3rd generation and 6th generation cells which were cultured in study culture medium, were found that brown-yellow granules distributed in cytoplast. It was the positive reaction. The cells, which were cultured in standard culture medium, were negative.CONCLUSION:MSCs derived from human bone marrow may be inducedinto hondrocytes under study culture medium which contained TGF-β1 and vitamin C in vitro.The express of the glycosaminoglycan and type Ⅱ collagen show the characteristic of chondrocyte.

BACKGROUND: The role of mechanical stress in the functional regulation of osteoblasts becomes an emphasis in osseous biomechanical researches recently. There are few reports on whether fluid shear stress can induce the expression of core-binding factor α1 (Cbfα1) or not and what is its rule.OBJECTIVE: To investigate the effects of fluid shear stress (FSS) on the gene expression of Cbfα1 in human osteosarcoma cells.DESIGN: A controlled observation experiment.SETTING: Department of Aerospace Biodynamics, Faculty of Aerospace Medicine, Fourth Military Medical University of Chinese PLA.MATERIALS: Subjects were human osteosarcoma cells (MG-63) METHODS: This study was carried out at the Department of Aerospace Biodynamics, Faculty of Aerospace Medicine, Fourth Military Medical University of Chinese PLA from November 2004 to April 2005. ①After cultured for 60 hours, MG-63 were treated with 0.5 Pa (0.5 Pa stress treated group ) or 1.5 Pa (1.5 Pa stress treated group ) FSS in a flow chamber for 15, 30, 60minutes, respectively. Cover glass was put in the Petri dish containing culture medium at the same time, serving as the control group of FSS treated group. ②The total RNA in cells was isolated. Reverse transcription polymerase chain reaction analysis was made to examine the gene expression of Cbfα1 mRNA. The ratio of Cbfα1 mRNA and GAPDH mRNA was calculated.MAIN OUTCOME MEASURES: The mRNA expressions of Cbfα1 at different FSS and different time.RESULTS: ① Compared with control group, Cbfα1 mRNA expression increased significantly at 30 and 60 minutes with the treatment of FSS.Within certain time range (15 to 60 minutes), Cbfα1 mRNA expression was strengthened with the elongation of time and the increase of stress level. ②The Cbfα1 mRNA expression at 30 and 60 minutes were significantly increased in 1.5 Pa stress treated group in comparison with 0.5 Pa stress treated group (P＜0.01).CONCLUSION: FSS can significantly increase the gene expression of Cbfα1 in human osteosarcoma cells.

Objective To investigate the relationship between the plasma levels of ET-1,TAT,and hs-CRP and slow coronary flow syndrome (SCFS),and explore effects of coronary endothelial function,coagulation function,and inflammatory reaction on blood flow of coronary artery.Methods A total of 400 cases with normal blood flow of coronary artery by coronary angiogram was randomly selected.The coronary flow patterns were determined by corrected thrombolysis in myocardial infarction frame count method (cT-FC).Among them,45 cases whose average cTFC more than 27 were assigned as SCFS group,the other 45 cases no SCFS.Plasma levels of ET-1,TAT and hs-CRPwere examined with enzyme-linked immunosorbent assay (ELISA),and were compared between two groups.Moreover,multivariate analysis evaluating predictors of SCFS was performed with regression test.Results No statistical difference was found between two groups concerning the gender,history of hypertension,diabetes mellitus,and cigarette alcohol percentage..The plasma level of HDL in SCFS group was lower than that of no SCFS [(1.22 ± 0.42) mmol/L vs (1.44±0.34) mmol/L,t =-2.731,P ＜0.01],but the plasma level of glucose in the former was higher than that of the latter [(5.68 ±0.62) mmol/L vs (5.10 ±0.84) mmol/L,t =3.727,P ＜0.01].However,Plasma levels of ET-1,TAT and hs-CRP in SCFS were higher than that of no SCFS [(94.3 ± 16.78) ng/Lvs (83.5±12.53) ng/L,t =3.051,P ＜0.01;(12.96±3.24)μg/Lvs (8.76 ±2.64)μg/L,t =5.945,P ＜ 0.01 ; (2.48 ± 0.35) μg/L vs (1.38 ± 0.46) μg/L,t =11.259,P ＜ 0.01].Furthermore,Logistic regression analysis showed that ET-1,TAT and hs-CRP were risk factors for SCFS (OR ＞ 1.22).Conclusions Due to coronary endothelial dysfunction,endothelial inflammatory reaction,and activated coagulation function,slow coronary flow of coronary artery occurs.

AIM:To observe the effects of astragaloside IV (AS-IV) on myocardial fibrosis in chronic heart failure ( CHF) rats and to explore the underlying mechanism preliminarily .METHODS:Chronic heart failure model rats established by abdominal aorta constriction (AAC) were divided into CHF group, valsartan group and AS-IV group.Sham operation group was also established .The rats in valsartan group and AS-IV group received valsartan and AS-IV at 2 and 30 mg· kg-1 · d-1 , respectively.The rats in sham operation group and CHF group received normal saline .After 8 weeks of treatment, the cardiac structure and the hemodynamic parameters were measured .The morphologic changes of myocardial tissue were observed after staining .The expression of long-chain acyl-CoA dehydrogenase ( LCAD) and 6-phosphofructoki-nase-1 (PFK1) at mRNA and protein levels was determined by RT-qPCR and Western blot.RESULTS:Compared with sham operation group , left ventricular mass index ( LVMI) , collagen volume fraction ( CVF) , left ventricular posterior wall depth (LVPWD), and the mRNA and protein of PFK1 in CHF group were increased (P<0.05), while the mRNA and protein levels of LCAD were decreased (P<0.05).Compared with CHF group, the LVMI, CVF, LVPWD, and the mRNA and protein levels of PFK1 in valsartan group and AS-IV group were decreased (P<0.05), while the mRNA and protein levels of LCAD were increased (P<0.05).CONCLUSION:AS-IV inhibits myocardial fibrosis in the CHF rats , the mechanism of which might be associated with up-regulating the expression of LCAD , down-regulating the expression of PFK1 and normalizing the myocardial energy metabolism .

Objective: To study the impact of astragaloside on ventricular remodeling and peroxisome proliferator activated receptor a (PPARa) expression in pressure-overload rats and to preliminarily explore its mechanism. Methods: Pressure-overload rat's model was established by abdominal aorta constriction (AAC) in 8-week old SD rats and the result was conifrmed by echocardiography at 6 weeks later. Pressure-overload rats were divided into 4 groups with different intragastric treatment: Model control (normal saline) group, Benazepril hydrochloride [10mg/(kg.d)] group, Low-dose astragaloside [40mg/(kg·d)] group and High-dose astragaloside [80mg/(kg.d)] group; in addition, Sham operation group, the rats received intragastricnormal normal saline.n=20 in each group and all animals were treated for 8 weeks. Rat's cardiac structure and function indexes were assessed by echocardiography, hemodynamic parameter was examined by left ventricular intubation, myocardium and blood levels of free fatty acid (FFA) were determined, morphological changes of myocardial tissue was observed by HE and Masson staining, mRNA and protein expressions of PPARa were measured by qRT-PCR and Western blot analysis. Results: Compared with Sham operation group, Model control group showed increased left ventricular mass index(LVMI), collagen volume fraction (CVF) and FFA level, allP<0.05, while decreased mRNA and protein expressions of PPARa, bothP<0.05. Compared with Model control group, Low-dose and High-dose astragaloside groups presented reduced LVMI, CVF and FFA level, allP<0.05-0.01, while elevated mRNA and protein expressions of PPARa, bothP<0.01. Conclusion:Astragaloside IV mayinhibit myocardial remodeling in pressure-overload rats, which might be via up-regulating mRNA and protein expressions of PPARa, enhance myocardiumFFA utilization, and therefore improve myocardial energy metabolism.