BACKGROUND: As a multifunctional cell growth factor, vascular endothelial cell growth factor (VEGF) plays various biological roles under some physiologic and pathologic conditions. OBJECTIVE: To summarize molecular structure and biological effects of VEGF. RETRIEVAL STRATEGY: A computer-based online search of PubMed database was undertaken to identify related English articles dated from January 1989 to December 2007 with keywords"VEGF, molecular structure, biological effect, diabetes, diabetic macroangiopathy". 934 articles were firstly collected, including 38 about molecular structure and biological effects of VEGF, and 896 about diabetes and diabetic macroangiopathy. After the first trial, only articles about ①molecular structure and biological characteristics of VEGF, and ②diabetes and diabetes complicated by coronary heart disease or limb vascular disease were selected. 897 repetitive, outdated and unrelated articles were excluded. Finally, 35 articles were included. LITERATURE EVALUATION: Of 35 articles, there were 17 ones about animal trials, and in vivo, in vitro and cytological studies, 8 of review articles and comments, and 10 clinical studies. All articles were individual evaluation. DATA SYNTHESIS: Human VEGF genes consist of 8 exons and 7 introns, and are located in 6p21.3 region. VEGF encodes several isoforms with different biological characteristics. Two VEGF receptors display different biological effects. VEGF and its receptors are regulated by various factors. The receptors interact with ligand and play biological effect. In diabetic patients complicated by coronary heart disease, myocardial VEGF mRNA and protein expressions are increased but the expressions of two kinds of receptors are decreased compared with non-diabetic patients. Compared to patients with non-severe lower limb ischemia, VEGF production is more in diabetic patients complicated by severe lower limb ischemia. It is demonstrated that VEGF can restore injured neovascularization. However, VEGF therapy for diabetes still needs further study. CONCLUSION: VEGF can restore impaired neovascularization. VEGF expression shows diversity under diabetic macroangiopathy. Further study should be made focusing on the prevention value of VEGF to diabetic macroangiopathy.

The paper briefly summarizes the chief manifestations of moral degradation on the part of medical personnel and then makes a preliminary analysis of the causes. On the basis of this, it discusses at some length some major measures to be adopted in reconstructing medical personnels morality. These include: ① carrying forward traditional Chinese medical ethics and using medical codes of ethics from Western countries for reference; ②strengthening the education and training of medical personnel in ethics; ③perfecting the codes of ethics for medical personnel; ④speeding up reform in the personnel and distribution systems; ⑤reinforcing supervision and setting up corresponding evaluation mechanisms; ⑥selecting personnel combining ability with political integrity to engage in the medical profession; ⑦strengthening the construction of social morals.

Missing data represent a general problem in many scientific fields, especially in medical survival analysis. Dealing with censored data, interpolation method is one of important methods. However, most of the interpolation methods replace the censored data with the exact data, which will distort the real distribution of the censored data and reduce the probability of the real data falling into the interpolation data. In order to solve this problem, we in this paper propose a nonparametric method of estimating the survival function of right-censored and interval-censored data and compare its performance to SC (self-consistent) algorithm. Comparing to the average interpolation and the nearest neighbor interpolation method, the proposed method in this paper replaces the right-censored data with the interval-censored data, and greatly improves the probability of the real data falling into imputation interval. Then it bases on the empirical distribution theory to estimate the survival function of right-censored and interval-censored data. The results of numerical examples and a real breast cancer data set demonstrated that the proposed method had higher accuracy and better robustness for the different proportion of the censored data. This paper provides a good method to compare the clinical treatments performance with estimation of the survival data of the patients. This pro vides some help to the medical survival data analysis.
Algorithms ; Breast Neoplasms ; epidemiology ; Female ; Humans ; Probability ; Statistics, Nonparametric ; Survival Analysis

Objective To study characters of TCM syndrome and pathological changes of coronary artery in patients of coronary artery disease combined with diabetes(CAD-DIA).Method By epidemiological way,patients with CAD-DIA were collected and compared with CAD without DIA,including clinical characters,characters of pathological changes of coronary artery,characters of syndrome.Result Compared with CAD without DIA group,history of hypertension and blood vessel rebuilt in CAD-DIA group had significant difference(P

Objective To research the effects and mechanism of gastrodin against migraine and on single amine neurotransmitter. Methods The model of nitroglycerin migraine was made after rat treated by gastrodin for 5 days, the time points of ear rubescence and the times of scratch head were observed to take as evaluation index of pharmacodynamic action, the concentration of 5-HT, NE and DA were measured in the brain with HPLC. Results Gastrodin could obviously prevent the attack of migraine and increase the concentration of 5-HT, DA and NE in the brain. Conclusions The effects of gastrodin against migraine is related with the concentration of 5-HT, DA and NE in the brain, gastrodin can regulate neurosystematic functions and enhance the secretion and metabolism of neurotransmitters.

Objective To investigate the effects of treatment of proximal humeral fracture in the elderly with anatomical plate internal fixation.Methods Twenty-seven cases of proximal humeral fractures received operative treatment with anatomical plate.According to Neer classification,there were 18 patients with three-part fractures of the bone,there were 9 patients with four-part fractures of the bone.Results Twenty-seven patients were followed up for 6-24 months.According to the evaluation of Herscovici scales,the result were excellent in 17 cases,and good in 8,92.6％ (25/27) of all reductions were excellent or good.The excellent and good rate of Constant-Murley score was 88.9％(24/27 ).Conclusion It is an ideal way to treat the displaced proximal humeral fracture with anatomical plate,which can provide rigid fixation,it allows early functional treating.

Objective To investigate the effects of goal-oriented scheme for continuous mild sedation on patients with mechanical ventilation.Methods A total of 78 patients undergoing mechanical ventilation were enrolled via simple random number sampling method from January,2013 to December,2015,and divided into the experimental group(n=38)and the control group(n=40).The experimental group received goal-oriented scheme for continuous mild sedation designed by our department,and the control group received routine sedation protocol.Total sedative dosage,duration of mechanical ventilation,length of ICU stay,fatality rate in ICU,ventilator-associated pneumonia,pneumothorax,accidental extubation,tracheotomy were recorded.Results Duration of mechanical ventilation,length of ICU stay and total sedative dosage,incidence of ventilator-associated pneumonia and rate of tracheotomy in the experimental group were significantly lower than those in the control group and the differences were statistically significant(P＜0.05).There were no significant differences in accidental extubation,reintubation and barotrauma between two groups (P＞0.05).Conclusion Goal-oriented scheme for continuous mild sedation can reduce total sedative dosage,length of ICU stay,duration of mechanical ventilation,rates of ventilator-associated pneumonia and tracheotomy.It is safer and more effective which can improve the prognosis of mechanically ventilated patients.

Objective To investigate the effect of salbutamol aerosol combined with magnesium sulfate on IL-2, IL-4, IL-5, IFN-γand T lymphocyte subsets in pediatric asthma patients.Methods 38 pediatric asthma patients were selected and randomly divided into control group and experimental group.Control group was treated by clinical routine method.Experimental group was treated by salbutamol aerosol combined with magnesium sulfate.The IL-2, IL-4, IL-5, IFN-γ, T lymphocyte subsets, blood pressure, heart rate, respiratory and clinical effects were observed and compared.ResuIts Compared with control group, the serum levels of IL-2 and IFN-γwere higher(P<0.05).The IL-5, IL-4 level were lower(P<0.05).The CD3 +, CD4 +, CD4 +/CD8 +level were higher(P<0.05).The serum CD8 +were lower(P<0.05).The total efficiency were higher(P<0.05).ConcIusion Salbutamol aerosol combined with magnesium sulfate can effectively regulate T lymphocyte subsets proportion and cytokine levels in asthmatic children, enhance immunity, and improve the clinical symptoms.

BACKGROUND: Critical closing pressure (CCP) is recently thought to play a key role in cerebral blood flow autoregulation as an effective downstream pressure of cerebral circulation and can objectively reflect the cerebrovascular tone, namely the vascular smooth muscle contraction and diastole, which is subjected to dynamic modulation.OBJECTIVE: To dynamically assess the hypertension-induced damage of the contraction function of cerebral microvascular smooth muscles and its correlation with morphological changes based on CCP evaluation.DESIGN: Randomized controlled experiment.SETTING: Institute of Neural Science of Second Hospital Affiliated to Guangzhou Medical College and Department of Neurology, First Hospital Affiliated to Sun Yet-san University.MATERIALS: The experiment was carried out at the Laboratory of Physiological Science of Sun Yet-san University between July 2002 and August 2003. Totally 160 health male SD rats were randomized into control group and hypertension group with 80 rats in each group. METHODS: Stroke-prone renovas cular hyp ortonsive rats were established in rats of the hypertension group by bilateral renal artery occlusion with two clips. The rats in the control group were not subjected to the occlusion with other treatments identical to those of the hypertension group. At the time points of 2, 4, 6, 8, 10, 12, 14 and 16 weeks after operation, respectively, 10 rats were randomly selected from each of the two groups for determination of arterial pressure and CCP. After the measurements the frontal-parietal lobe was obtained from the anaesthetized rats and cut into slices for quantitative analysis of the morphological changes in cerebral microvessels.different postoperative time points.mean arterial pressure in hypertension group obviously increased from the 6th postoperative week with significant difference from that of the control after operation to a level significantly higher than that of the control group at postoperative 14 and 16 weeks [(63.75±7.43) vs (37.28±3.68) mm Hg and (67.37±15.57) vs (38.39t7.41) mm Hg, respectively, P ＜ 0.05].significance from that of the control group at the 8th postoperative week (Paverage arterial pressure and cerebral arteriole tunica media (r=0.906 93,0.811 36, respectively, P ＜ 0.05). The changes in CCP was more obvious in the early and advanced stages of blood pressure elevation, but not so manifest during obvious blood pressure increment, displaying an inverted S-shaped curve of changes (R2=0.996 2, P ＜ 0.05).CONCLUSION: Contraction of the cerebrovascular smooth muscles is enhanced with the dynamic increment of arterial pressure after the development of hypertension. Vascular tone increase is more manifest during the early and advanced stages of hypertension.

Objective To evaluate the effects of different concentrations of remifentanil on the expression and distribution of gap junction protein connexin 43 (Cx43) in the cardiomyocytes of rabbits.Methods Healthy adult rabbits of both sexes,weighing 2.0-2.5 kg,were anesthetized with pentobarbital sodium.Their hearts were rapidly excised and retrogradely perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃.After 15 min of stabilization with K-H solution,the 24 isolated hearts were randomly divided into 4 groups (n =6 each) using a random number table:control group (group C),and low,medium and high concentrations of remifentanil groups (R1-3 groups).The hearts were continuously perfused with K-H solution at 37 ℃ in group C.The hearts were perfused for 60 min with K-H solution containing remifentanil 12,25 and 50 ng/ml in R1-3 groups,respectively.The myocardial specimens were then obtained from the anterior wall of the left ventricle for detection of the expression and distribution of Cx43 by Western blot and immunohistochemistry,respectively.Results The expression of Cx43 was gradually down-regulated in C and R1-3 groups in turn (P＜0.05).Compared with group C,there was a tendency for the proteins localized at end-to-end contact sites of ventricular cardiomyocytes to localize at side-to-side contact sites in R1-3 groups,and the distribution was messy in R1-3 groups.Conclusion Remifentanil dose-dependently down-regulates the expression of Cx43 and changes the distribution of Cx43,which may be one of the mechanisms of remifentanil-induced arrhythmia in rabbits.