Objective To explore influencing factors of the individual entrepreneurship from as-pects of entrepreneurial intention, entrepreneurial cognition and entrepreneurship education. Methods Questionnaire of entrepreneurial cognition was conducted for 1860 students in Southern Medical Universi-ty. SPSS was used to analyze the data. Results ①Entrepreneurship intention among university students were strong.②There was a lack of awareness of college students entrepreneurship policy among college students. ③Students never receiving entrepreneurship education accounted for 65%, but 89%students held that entrepreneurial education courses was necessary. Conclusions Due to arduous professional tasks, medical students have compelling and demanding need for personalized entrepreneurship educa-tion. Initiative participation of library in integrating of entrepreneurship education information by using advantageous resources plays a important role in entrepreneurship education.

AIM: To study the time-dependent effects of diabetes mellitus (DM) on the development of cardiac remodeling in untreated streptozotocin (STZ)-induced rats with acute myocardial infarction (MI). METHODS: The left anterior descending coronary arteries were ligated 10 weeks after DM induction without any therapy. Transmission electron microscopy, echocardiography, heart weight to tibial length ratios, histological examination, microarray analysis, and real time-PCR were utilized to monitor the changes up to 56 d. RESULTS: After MI, the diabetic rats experienced lower survival rate compared to non-diabetic animals. The pathophysiologic changes indicated that DM accelerated the cardiac remodeling post-infarction. In primary examination, 164 genes related to cardiac remodeling were found to be candidates for hierarchical analysis, such as leucine-rich PPR-motif containing (interleukin-6 signaling pathway), procollagen type I and III, fibronectin-1, RT1, and TIMP-1, etc. The gene expression profile at 14 d in diabetic rats were comparably similar to both 14 d and 28 d in non-diabetic rats, while such changes at 28 d and 56 d in diabetic rats was also similar to the ones at 56 d in non-diabetic rats. CONCLUSION: The accelerated cardiac remodeling of post-infarction in STZ-induced untreated diabetic rats seems be associated with the different profile of gene expressions.

Objective: To explore the application value and safety of low-dose dobutamine stress echocardiogram (LDDSE) in patients of low-flow/low-gradient aortic stenosis combining left ventricular dysfunction with transcatheter aortic valve replacement (TAVR). Methods: A total of 5 eligible consecutive patients with contradiction of routine surgical valve replacement and going to receive TAVR in our hospital from 2013-10 to 2016-07 were enrolled. The mean aortic valvegradient, maximum flow velocity, each stroke volume and ejection fraction were recorded before and during LDDSE examination. The patients having confirmed diagnosis of true severe aortic stenosis with left ventricular contractile reserve received TAVR, for those without left ventricular contractile reserve received drug therapy or TAVR conditionally. The changes of cardiac function and NT-proBNP level were observed after TAVR. Results: All 5 patients showed positive finding in LDDSE; the mean aortic valve gradient ≥40mmHg and stroke volume≥20% implied that the patients had true severe aortic stenosis with left ventricular contractile reserve. No adverse reaction occurred during and after LDDSE. TAVR was performed in 4 patients and 1 was waiting for TAVR or balloon dilatation since temporary lacking of valve. The post-operative cardiac function was improved in all patients and NT-proBNP level was declined continuously. Conclusion: LDDSE examination could be considered in patients of aortic stenosis combining left ventricular dysfunction, low-flow and low-gradient to clarify ventricular contractile reserve and the severity of aortic stenosis. If the patients with ventricular contractile reserve, TAVR was recommended which was the effective treatment for relevant patients.

Objective: To evaluatethe efficacy of renal artery stenting combining optimal drug therapy in patients with atherosclerotic renal artery stenosis.
Methods:This is a prospective cohort study for patients who received percutaneous renal artery stenting in our hospital from 2011-09 to 2013-03. All patients had conifrmed diagnosis of atherosclerotic renal artery stenosis combing hypertension and/or renal functional damage. Thepatients received optimal drug therapy for anti-platelet and blood pressure, lipids, glucose controlling, and they were followed-up for at least 12 months to observe the improvement of blood pressure and renal function.
Results:There were 149 patients at the mean age of (61.54 ± 9.63) years and 185 renal artery stenosis with stent implantation;the average stenosis rate was (83.11±7.30)%and the success rate of operation was 99.32%(148/149). During follow-up period, the patients had increased estimated glomerular ifltration rate (GFR) compared to base line from (76.49 ± 22.50) ml/(min·1.73 m2) to (84.09 ± 28.79) ml/(min·1.73 m2), P<0.05 and decreased 24 h urinary protein from 0.1(IQR 0.02, 0.5) g to 0.04 (IQR0.01, 0.11)g, P<0.001;less type of drug therapy for hypertension from 2.22 to 1.56, P<0.05, decreased clinical and 24h dynamic systemic/diastolic blood pressure from (153.4 ± 15.6)/(83.77 ± 12.60) mmHg to (134.6 ± 14.4)/(73.57 ± 9.12) mmHg and from (143.32 ± 19.87)/(80.51 ± 11.33) mmHg to (124.44 ± 14.90)/(69.09 ± 9.49) mmHg, all P<0.05.
Conclusion:Renal artery stenting combining optimal drug therapy may improve blood pressure controlling and renal function in strictly selected patients with atherosclerotic renal artery stenosis.

Objective: To explore the cardiac function and outcomes in patients of aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR) within 6 months in order to provide the guidance for clinical treatment. Methods: A total of 49 consecutive severe AS patients with surgical contradiction or STS high risk score and received successful TAVR in our hospital from 2013-12 to 2015-12 were studied. Echocardiography and blood levels of NT-proBNP were examined at pre- and 1 month, 6 months after TAVR. Left ventricular ejection fraction (LVEF), aortic valve mean gradient (MG), peak gradient (PG) and peak velocity (PV) were recorded. Based on pre-operative LVEF, the patients were divided into 2 groups: Cardiac dysfunction group, LVEF<50%,n=15 (30.6%) and Normal cardiac function group, LVEF≥50%, n=34 (69.4%). Post-operative cardiac function and blood levels of NT-proBNP were compared between 2 groups. Results: In all 49 patients, the following parameters were significantly improved within 7 days after TAVR: LVEF (56.0±14.6) % vs (52.5±13.8)%, MG (11±5) mmHg vs (58±18) mmHg, PG (21.7±9.5) mmHg vs (93.0±28.6) mmHg, PV (2.3±0.5) m/s vs (4.8±0.7) m/s, blood NT-proBNP level [1831 (1098-3363)] pg/ml vs [3842 (1763-8664)] pg/ml and aortic valve area (1.57±0.43) cm2 vs (0.58±0.23) cm2 allP<0.05. Within 6 months after TAVR, LVEF was continuously increasing especially in Cardiac dysfunction group; MG, PV and NT-proBNP level were continuously decreasing, NYHA grade was continuously improving, allP<0.05. Conclusion: TAVR was an effective treatment in AS patients with surgical contradiction or STS high risk score; it may continuously improve cardiac function, especially in patients with left heart dysfunction.

To explore the safety and efficacy of levosimendan in treating the patients with severe aortic stenosis and to analyze the cardial function before and after medication in order to guide clinical treatment. Methods: A total of 20 patients admitted in our hospital from 2014-01 to 2015-12 were enrolled with the standard of echocardiography confirmed severe aortic stenosis, left ventricular ejection fraction (LVEF)≤45%, NYHA III-IV and inefficacy for conventional anti-heart failure drug therapy. The patients received intravenous infusion of levosimendan at 0.1μg/(kg·min) by persistent pumping for 24 hours. Echocardiography, LVEF, dyspnea condition, NYHA grading and plasma levels of NT-proBNP were recorded pre- and post-medication to compare the cardiac function and symptoms of levosimendan therapy. Results: After levosimendan treatment, NYHA grade was improved, P=0.025 and NT-proBNP was reduced (9101.6±7368.0) pg/mLvs (13776.5±9503.7) pg/mL, P=0.018. The following parameters were similar before and after levosimendan therapy: LVEF (31.1±7.5)% vs (33.1±8.5)%, P=0.078, the average heart rate (79.6±13.8) bmp vs (82.8±9.5)bmp, P=0.200 and systolic blood pressure (99.6±11.7) mmHg vs (97.2±12.1) mmHg, P=0.071. There were 40% (8/20) patients with obviously improved and 50% (10/20) with improved dyspnea symptoms after levosimendan treatment. Conclusion: Our preliminary study presented that levosimendan could improve NYHA grading, remit dyspnea symptom and reduce blood NT-proBNP level in patients with severe aortic stenosis and heart failure; it had safety and tolerability at certain degree in clinical practice.

OBJECTIVE: To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis. METHODS: Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model. RESULTS: Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively. CONCLUSION: Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.

OBJECTIVE: To evaluate the correlations between clinical symptoms and treatment efficacy in patients with rheumatoid arthritis (RA). METHODS: Four hundred and thirteen patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine-treated group with 204 cases and Chinese herbal drug-treated group with 209 cases. Eighteen clinical symptoms were evaluated before and after treatment. The Western medicine therapy included voltaren extended release tablets, methotrexate and sulfasalazine. The Chinese herbal drug therapy included glucosidorum Tripterygii totorum tablets and Yishen Juanbi Tablets combined with treatment based on syndrome differentiation. The American College of Rheumatology 20 (ACR20) was used as efficacy evaluation criteria. RESULTS: In the Chinese herbal drug-treated group, clinical symptoms such as arthralgia and tenderness of joints were positively correlated with the efficacy after 12-week treatment, while frequent urination at night was negatively correlated. In the same group, tenderness of joints and fever were positively correlated with the efficacy after 24-week treatment, while deep-colored and turbid urine was negatively correlated. In the Western medicine-treated group, tenderness of joints and thirst were positively correlated with the efficacy after 12-week treatment, while vertigo was negatively correlated. And in the same group, tenderness of joints was positively correlated with the efficacy after 24-week treatment, while heaviness of limbs was negatively correlated to the efficacy. The statistical results showed that the treatment efficacy was improved when the correlated symptoms were included in the indications. CONCLUSION: The treatment efficacy of RA is correlated with some symptoms, so further studies should proceed on these correlations in order to achieve better treatment outcome.

Objective: To explore the gender related differences of clinical symptoms and triggering factors in patients with acute myocardial infarction (AMI) in China.
Methods: A population of 14 854 AMI patients with CAMI registration from 2013-01 to 2014-03 were studied, which included 10999 (74.0%) male and 3855 (26.0%) female. The gender related differences of clinical symptoms and triggering factors were analyzed in the population.
Results: The chest pain and severe sweating were the most common symptoms of AMI patient, there were 66.4%of patients with persistent chest pain and 63.7%of patients with severe sweating. Male patients were more with chest pain (67.8%vs 62.4%) and severe sweating (65.8%vs 58.0%) than female, while female patients were more with radiating pain (36.0%vs 31.0%) and nausea/vomiting (35.6%vs 25.0%) than male, all P<0.05. There were 19.4%of patients having clear cause of AMI, and physical stress was the most frequent trigger (48.5%) for AMI. Male patients usually had clear cause than female (20.9%vs 15.1%), especially because of physical stress (49.5%vs 44.5%) and excessive recent unhealthy lifestyles (15.4%vs 8.8%), all P<0.05.
Conclusion: Chest pain and severe sweating were the most common clinical symptoms for AMI patients in China, about 1/5 of them had triggering factors and it was more in male patients.

OBJECTIVESTo compare the effects of losartan, enalapril and their combination in the prevention of left ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in the rat.

METHODSAMI model was induced in female SD rats by ligating left coronary artery. Forty-eight hours after the procedure, 83 surviving rats were randomized into one of the following 4 groups : 1) AMI control group (n = 19), 2) losartan group (n = 22, 3 mg x kg(-1) x d(-1)), 3) enalapril group (n = 20, 1 mg x kg(-1) x d(-1)), 4) losartan-enalapril combinative group (n = 22, 3 and 1 mg x kg(-1) x d(-1) respectively). 5) Sham-operated group (n = 10) and 6) normal rats group (n = 10) were selected randomly to serve as non-infarction controls. Losartan and enalapril were delivered by direct gastric gavage. After 4 weeks of medical therapy, hemodynamic studies were performed in each group, then the rat hearts were fixed with 10% formalin and pathologic analysis on them was performed. Complete experimental data was obtained in 56 rats, comprising 1) AMI controls (n = 11), 2) losartan group (n = 10), 3) enalapril group (n = 10), 4) the combination of losartan and enalapril group (n = 11), 5) sham-operated group (n = 6) and 6) normal controls (n = 8).

RESULTSThere were no significant differences among the 4 AMI groups in MI size (41.7% to approximately 43.4%, all P > 0.05). Compared with sham group, the left ventricular (LV) end diastolic pressure (LVEDP), volume (LVV), long and short axis length (L and D), as well as LV absolute and relative weight (LVAW and LVRW) in AMI group were all significantly increased (P < 0.05 to approximately 0.001); whereas the maximum left ventricular pressure rising and dropping rates (+/- dp/dt) and their corrected values by LV systolic pressure (+/- dp/dt/LVSP) were significantly reduced (all P < 0.001), indicating LVRM occurred and LV systolic and diastolic function impaired after AMI. Compared with AMI group, LVEDP, LVV, LVAW and LVRW were all significantly decreased (P < 0.05 to approximately 0.001); while +/- dp/dt/LVSP were significantly enhanced in all 3 treatment groups (P < 0.05 to approximately 0.001) except -dp/dt/LVSP in losartan group (P > 0.05). There were no significant differences in the above indices among the 3 treatment groups (all P > 0.05).

CONCLUSIONBoth losartan and enalapril can prevent from LVRM after AMI in the rat and improve LV function with equivalent effects. There seems no additive effect when the 2 drugs are used in combination.

Animals ; Antihypertensive Agents ; pharmacology ; Drug Synergism ; Enalapril ; pharmacology ; Female ; Losartan ; pharmacology ; Myocardial Infarction ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Ventricular Function, Left ; drug effects ; Ventricular Remodeling ; drug effects