Objective To evaluate the safety of cardiac rehabilitation(CR)for the elderly patients with chronic heart failure(CHF). Methods All 72 patients with CHF over the age of 60 were enrolled and randomly divided into two groups: the experimental groups(n=35)and control groups(n=37). Patients in both groups were treated strictly according to the treatment guideline. On the basis of drug treatment,patients in experimental group were given a comprehensive CR program. The occurrence of all-cause death,due to deterioration of heart failure readmission and serious adverse events were compared after 12 months. ResultsCompared with the control group,the incidence of all-cause and the cases for the deterioration of heart failure readmission decreased in the experimental group after 12 months(P < 0.05). There was no statistically significant difference in the occurrence of serious adverse events between the two groups(P > 0.05). Conclusion For the elderly CHF patients,cardiac rehabilitation can effectively reduce all-cause death and deterioration of heart failure readmission in patients,but the serious adverse events had no obvious change. It is safe and effective for the elderly patients with chronic heart failure.

Objective To analyze the flow tendency of elderly patients,create a better mechanism to help guide elderly patients to form a good order in seeking medical care,and consequently improve the resource operational efficiency in medical service.Methods Analyzing the data by the descriptive,χ2 test and logistic regression of SPSS 20.0.Results Elderly patients prefer community health service centers and tertiary hospitals;of those visiting tertiary hospitals,nearly 30% seek medical advice for common chronic diseases.Main influencing factors for patient flow are medical insurance coverage and education. They tend not to embrace the two-way referral service,due to such factors of inconvenient process and defective mechanisms.Conclusion Transition from medical demand management to medical supply management.Such factors as quality cost,expense cost,time cost,and public opinion cost should be used to replace and weaken their mindset of the medical hierarchy,and embrace the concept of “seeking medical advice by grades”,thus improving the utilization of medical resources,and optimizing medical service accesibility.

Objective To investigate the diagnostic value of the combination of exercise electrocardiography test(EET) and coronary artery calcification(CAC) determined by electron beam computed tomography(EBCT) in coronary artery disease.Methods One hundred and thirty-five patients underwent coronary angiography,EET and EBCT.The value of calcium score(CS) and EET in diagnosing coronary artery disease were separately and unitedly evaluated.Results According to calcification score cut points by age and gender,the sensitivity,specificity,positive and negative predictive value of CAC for diagnosing coronary artery disease were 77%,81%,74% and 83%,respectively.The corresponding parameters of EET were 73%,76%,68% and 80%.After combining CAC and EET,the sensitivity and negative predictive value of parallel test were 93% and 92%,and the specificity and positive predictive value were 96% and 91%,respectively.Conclusions Exercise electrocardiography test combined with coronary artery calcification determined by electron beam computed tomography can significantly improve their diagnostic value for coronary artery disease.

Objective To investigate the short-term effect of PTCA on contractile function of hibernating myocardium. Methods Fifty-three patients with coronary heart disease and segmental dysfunction underwent echocardiography and radionuclide imaging. Echocardiography was repeated one week after PTCA. Results (1) Recovery of contractile function occurred in 87 revascularized segments with dysfunction (87/167, 52.1%) compared with only 2 nonrevascularized segments (2/59, 3.4%) (P

Objective To investigate the related mechanism of ligamentum flavum (LF) hypertrophy in diabetic pa-tients with lumbar spinal canal stenosis ( LSCS ) .Methods Twenty-four diabetes mellitus patients [ DM (+) ] and twenty normoglycemic patients [ DM (-) ] with LSCS were enrolled in this study .Sorbitol in LF was analyzed using D-Sorbitol/Xylitol test kit .The thickness of LF was measured by CT .The structure of LF was observed after HE and Masson's trichrome staining .The cell cycle and proliferation of fibroblastic cell NIH 3T3 line cultured in high glucose were analyzed .Sorbitol of NIH3T3 was detected under different backgrounds in vitro, normal glucose , high glucose and high glucose burdened with aldose reductase inhibitor ( ARI) , Epalrestat .The expression of inflammatory factors was detected by qPCR and Western blot under above different backgrounds .Results LF of diabetic patients exhibi-ted significantly higher level of sorbitol and pro-inflammatory cytokines , TGF-βand of CD68-positive staining than that of the normoglycemic subjects ( P<0.01 ) .The diabetic LF was significantly thicker than that of the controls , and showed evidence of degeneration .The high glucose-cultured fibroblasts exhibited significantly higher levels of sorbitol , pro-inflammatory factors , and TGF-βcompared to the low glucose-cultured cells , and these levels were dose-dependently reduced by treatment with the aldose reductase inhibitor (P<0.05).Conclusions Sorbitol level of the LF is significantly increased in the DM patients with LSCS .Increased sorbitol recruites inflammatory factors and fibrogenic-related factor TGF-βin LF of DM patients with LSCS which may contributes to the LF hypertrophy .

Objective To evaluate eutopic endometrial blood supply and vessels in patients with endometriosis(EMs) with contrast enhanced ultrasound (CEUS),to explore a newmethod to estimate vascularization of eutopic endometrium in EMs patients.MethodsThirty patients with EMs were enrolled and 20 patients who were diagnosed as other gynecological diseases as control.Informed consent of each case was obtained. AllcasesunderwentconventionalultrasoundexaminationandCEUSexamination.Characteristics of CEUS in each patients were observed and analyzed using off-line Qontrast software.Parameters of CEUS including peak intensity(PEAK),time to peak(TTP),regional blood volume(RBV),regional blood flow(RBF) were obtained automatically.ResultsComparing with control group,the eutopic endometrium in EMs group presented higher enhancement.The parameters of CEUS,including PEAK,TTP,RBV,RBF were (41.18 ± 3.29) dB,(29.01 ± 4.46) s,(29.07 ± 4.59) ml,(48.61 ± 5.35) ml/min in EMs group and (13.36 ± 2.34)dB,(24.59 ± 2.29)s,(26.51 ±- 3.80)ml,(48.71 ± 3.80)ml/min in controls respectively,the value of PEAK in EMs group was higher than that of controls ( P =0.000).Conclusions CEUS can be regarded as a new method which can be used to assess vascularization of eutopic endometrium in endometriosis.

Objective To discuss the value of preoperative C-reactive protein (CRP) and eryth-rocyte sedimentation rate (ESR) in predicting postoperative infections following multiple fractures. Methods A study was conducted in 78 patients with multiple fractures (complicated with pelvic frac-ture, ISS > 18) treated in our department from December 2006 to March 2009. CRP and ESR levels be-fore second damage control operation as well as postoperative infections were recorded. Meanwhile, the optimal cut-off value was determined by receiver operating characteristic curve and analyzed. Results There were 11 patients with postoperative infection. The preoperative optimal cut-off value of CRP was 50 mg/L, with a sensitivity of 0.909 and a specificity of 0.821. The preoperative optimal cut-off value of ESR was 27.5 mm/h, with a sensitivity of 0.818 and a specificity of 0.791. The combination tests showed the sensitivity and specificity of 0.875 and 0.900 respectively. Conclusion CRP (50 mg/L) can be a sensitive predictive index for postoperative infection in the multiple fractures (complicated with pelvic fractures). Combination test of CRP and ESR can benefit diagnosis of postoperative infection.

AIM: To explore the possibility that proteasome is involved in nicastrin(NCT) degradation and NCT is ubiquitinated before degradation.METHODS: Following the generation of NCT stable cell lines,the methods of Western blotting,pulse-chase metabolic labeling technique,double immunofluorescent staining,combined with proteasomal inhibition were used to investigate the NCT expression in NCT stable cell line.RESULTS: Treatment of the cells with proteasomal inhibitors significantly increased both endogenous NCT(produced by the cell itself) and exogenous NCT(produced by the gene transfection) in SH-SY5Y cells.The effect of specific proteasomal inhibitor lactacystin on NCT expression was in time-and dose-dependent manners.Pulse-chase metabolic labeling experiment showed that the turnover of newly-synthesized radio-labeled nicastrin protein was blocked by lactacystin.The results of double immunofluorescent staining showed that NCT and ubiquitin were co-located in the cells.CONCLUSION: The proteasome is involved in the degradation of NCT in neuronal cells,and NCT is ubiquitinated before degradation.

Objective To design the family support scale for adolescent patients with nephritic syndrome. Methods 192 adolescent patients with nephritic syndrome were selected in the pilot investigation, and then formed the first questionnaire. The reliability and the validity of the questionnaire were evaluated by the experts. Results The questionnaire involved 15 items and its reliability and the validity were satisfied. There was a positive correlation between the family support and the self-nursing degree. Conclusion The reliability and the validity of this questionnaire are both up to the demands, it can used to study the condition of family support for adolescent patients with nephrotic syndrome.

Objective To explore the role of insulin-like growth factor-2/insulin-like growth factor1 receptor/insulin receptor substrate-1 (IGF2/IGF1R/IRS1) signal pathway inducing the chemoresistance of epidermal growth factor receptor 2 (ErbB2) positive breast cancer cells to Herceptin.Methods Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot assay were used to determine the expression levels of IGF2,IGF1 R,and IRS1.The direct targets of miR-126 were validated by dual-luciferase reporter gene assay.In SKBR3/pool2 cells,IGF1 R activity was reduced by an inhibitor of IGF1 R,and IRS1 was knocked-down by shRNAs.Furthermore,3-(4,5-dimenthylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was performed to evaluate the sensitivity of these treated cells to Herceptin.Results IGF2,IGF1 R,and IRS1 were significantly higher expressed in SKBR3/pool2 cell compared to that in SKBR3 cell.Western blot assay showed that IGF2/IGF1R/IRS1 was activated in SKBR3/pool2 cells.Bioinformatics analysis combined with luciferase activity suggested that miR-126 directly targeted IRS1.MTS results demonstrated that the chemosensitivity to Herceptin of SKBR3/ pool2 cells with inhibitor of IGF1R or shRNAs targeting IRS1 or overexpressing miR-126 was significantly reduced.Conclusions IGF2/IGF1R/IRS1 signal pathway confers to the chemoresistance of ErbB2 positive breast cancer cells to Herceptin.