Objective To investigate the associations between the left ventricular geometry and the insulin resistance (IR) in elderly patients with essential hypertension (EH) and the effect of the IR on the left ventricular geometry. Methods According to left ventricular mass index (LVMI)and relative wall thickness(RWT),72 EH patients were divided into normal geometry group (34 cases ),concentric remodeling group (18 cases ),concentric hypertrophy group (11 cases ),and eccentric hypertrophy group (9 cases ).The oral glucose tolerance test and insulin release test were performed in all patients and 35 healthy subjects as control.The area under curve of glucose tolerance (AG), area under curve of insulin release (AI), fasting serum insulin /fasting serum glucose (FIS/FSG) ratio, AI/AG ratio and insulin sensitivity index (ISI) were calculated.Correlation between RWT,LVMI and 7 insulin-sensitivity parameters were respectively obtained using linear regression analysis,and the stepwise regression analysis was used to assess the independent effect of each parameter. Results RWT was positively correlated with AG、 AI(r=0.160、0.227, respectively, all P0.05). Only ISI was independently correlated with RWT (r2=0.071,P

Objective To study the influence of multidrug resistance gene (MDR)1 C3435T genetic polymorphism on the eradication of gastric ulcer with Helicobacter pylori (Hp) infection.Methods A total of 106 gastric ulcer patients with positive Hp were randomly divided into two groups by lot with 53 cases each.One group was assigned with 20 mg esomeprazole,0.5 g clarithromycin,1.0 g amoxicillin twice one day(EAC group),and the other group was assigned with 20 mg omerprazole,0.5 g clarithromycin,1.0 g amoxicillin twice one day (OAC group).The therapy of two groups was one week.Hp was detected at least 4 weeks after the end of treatment.MDR1 C3435T genetic polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism assay.The influence of MDR1 C3435T genetic polymorphism on the eradication of Hp was recorded and analyzed.Results The Hp eradication rate was 84.9％ (45/53) and 77.4％ (41/53) in EAC group and OAC group,and there was no significant difference between two groups (P ＞ 0.05).There was no significant difference in the Hp eradication rate in patients with different MDR1 C3435T genotypes in two groups (P ＞ 0.05).The Hp eradication rate was 66.7％(16/24),86.3％(44/51),83.9％(26/31) in TT,CT,CC genotype,and there was significant difference(P＜ 0.05).The Hp eradication rate in patients with TT genotype was lower than that in patients with CT,CC genotype,and there was significant difference (P＜ 0.05).Conclusion There is significant relationship between the effect of gastric ulcer with Hp eradication and MDR1 C3435T genetic polymorphism,and the Hp eradication rates of patients with TT genotype are more lower.

Objective To discuss the teaching effects of PBL teaching approach applied in clinical practice of medical oncology.Methods Throush clinical practice of medical onclolgy with the PBL teaching approach and the traditional one.A contrast between two teaching modes was made.And the teaching results were investigated based on the questionaic.Results The PBL teaching approach is superior to the traditional one.Conclusion The PBL teaching approach has an obvious advantage in the teaching of clinical practice of medical oncology and can improve the teaching quality

AIM: To observe the effects of shock lymph on apoptosis relative gene expressions of pulmonary micro-vascular endothelial cells(PMVECs),and explore its mechanism.METHODS: The model of severe hemorrhagic shock was established by maintaining the blood pressure of rats in the condition of sepsis,mesentery lymph and shock portal vein blood was taken out.As control,mesentery lymph,portal vein blood of normal rats was taken out.The primary PMVECs of passages 3 were treated by different treatment factors,respectively.The apoptosis rate was analyzed by flow cytometry,and the expressions of relative genes of apoptosis such as fas,fas L,bcl-2 and bax were detected by RT-PCR.RESULTS: The apoptosis rate of PMVECs was 9.86%?3.24% after exposed to shock lymph at the final concentration of 4% for 4 hours and significantly higher than that in control(P

Objective To clone and express the thioredoxin(Trx)from RH strain tachyzoites of Toxoplasma gondii,estab?lish the prokaryotic expression vector and purify the recombinant protein,then produce the polyclonal anti?Trx antibody in rab?bits. Methods Trx fragment was amplified by PCR and cloned into the pET?28a(+)vector,and the recombinant protein was in?duced with IPTG and purified by Ni?NTA affinity chromatography. The polyclonal antibody specificity was detected by Western blotting. Results The trx gene was amplified from T. gondii cDNA by PCR. The recombinant plasmid trx/pET?28a(+)was use?fully constructed,and the recombinant TRX protein was expressed and purified. The TRX polyclonal antibody was also ob?tained. The specific band of TRX was detected by Western blotting. Conclusion Western blotting can detect the specificity of polyclonal anti?Trx antibody,which will facilitate the biological functions of Trx.

Objective To observe the effect of shock lymph drainage on multiple organ injury of rats with traumatic hemorrhagic shock (THS) and discuss the relating mechanism. Methods Male Wistar rats were divided into control group, lymph drainage group and lymph return group. The THS model was established in lymph drainage group and lymph return group, when the shock mesenteric lymph was drained in lymph drainage group. The change of the mean arterial pressure ( MAP), the biochemical indices of liver, kidney, myocardium and acid-base, the morphology, ATP contents and ATPase activities of lung, kidney, liver and myocardium were observed. Results The MAP at multiple time points after 80 minutes of infusion, the ATP contents and ATPase activities of multiple organs in lymph drainage group were higher than those in lymph return group. Multiple biochemical indices in lymph drainage group were superior to those in lymph return group, with statistical difference. The inflammation, congestion, degeneration and necrosis were found in organs of lymph return group, but only mild lesions could be seen in lymph drainage group. Conclusions The shock lymph drainage can alleviate multiple organ injury of THS rats, mechanism of which is correlated with improvement of the energy metabolism and maintenance of MAP and acid-base status.

[Objective] To evaluate the clinical efficacy and safety of propranolol in treating infantile hemangiomas.[Methods] Ninety children with hemangioma collected from July 2010 to November 2011 were recruited in this study.Oral propranolol was given at a dose of 1.5-2.0 mg/kg per day,and the dose was adjusted according to the growth of body weight.Patients were revisited every month for the observation of appearance of hemangioma.The following parameters,including blood glucose,alanine transarninase,aspartate aminotransferase,urea nitrogen,creatinine,creatine kinase,heart rate,blood pressure,electrocardiogram and ultrasound image of hemangioma,were monitored before and after the administration of propranolol.[Results] A rapid halt in haemangioma proliferation was seen in 91.1％ (82/91) of the patients within 24-48 hours after the administration of popranolol.After 1-10 months of treatment,haemangioma shrunk by 0-25％ with a lightening of lesional color in 8.0％ (7/88) of the patients,by 26％-50％ with an obvious lightening of lesional color in 39.8％ (35/88),by 51％-75％ with a marked lightening of lesional color in 26.1％ (23/88),and 26.1％ (23/88)of the patients achieved a shrinkage of more than 75％ or fading of lesional color.The 7-8 months of treatment leaded to the best outcome,followed by 5-6 months,3-4 months,and 1-2 months,of treatrnent.No rebound was observed in patients who stopped the treatment at 10 months to l year and 4 months of age.Usually during early stage of the therapy,some of the patients suffered from reduced diastolic blood pressure,sleep disorder,loose stools,hypoglycemia,cold extremities,bronchial hyperreactivity,elevated alanine transaminase/aspartate aminotransferase or creatine kinase isoenzyme,most of which were tolerable and relieved with or without symptomatic treatment.[Conclusion]s Propranolol can suppress the growth and accelerate the regression of hemangiomas in proliferative phase,and also can promote the subsidence of hemangiomas in regressive phase.The side effects of propranolol are usually mild,but still need close monitoring.

Objective Investigate the effect of valsartan combined with statins on coronary heart disease and its effect on BNP and CRP.Methods 92cases of patients with coronary heart disease were selected, which were treated in hospital from March 2015to March 2017, and were divided into the study group (46cases) and control group (46cases) .The patients of all two groups were treated with conventional treatment.The patients of control group were treated with valsartan (40mg/d, oral;if no hypotension after 3days of treatment, the dose increased to 80mg/d) , and on the basis of control group, the patients of study group were treated with atorvastatin calcium capsules (20mg/d, in 0.5hafter dinner) .The patients of two groups were all treated for 6months in a row.Compare the adverse reactions and changes of the levels of blood lipids, coronary plaques, BNP, CRP and LVEF of two groups.Results After the appropriate treatment, the TG, TC, LDL-C levels of the study group were significantly lower than those of the control group, and the HDL-C, LVEF levels of the study group were significantly higher than those of the control group (P<0.05);the lipid plaque, fibrous plaque, calcified plaque, mixed plaque levels of the study group were significantly lower than those of the control group (P<0.05);The BNP, CRP levels of the study group were significantly lower than those of the control group (P<0.05);There were acute myocardial infarction, unstable angina, heart failure and other adverse events occurred in both two groups, and the difference was statistically significant between the two groups (P<0.05) .Conclusion Valsartan combined with statins in the treatment of patients with coronary heart disease can improve blood lipid levels, reduce coronal plaque area, inhibit inflammatory response, which makes it worthy of clinical promotion.

Objective To evaluate the effect of mefformin on the human keratinocyte line HaCaT,and to explore its molecular mechanism.Methods HaCaT cells were divided into several groups to be treated with mefformin at different concentrations of 1,2,5,10,20,50 mmol/L for 24,48 and 72 hours.Cell counting kit-8 (CCK-8) assay was performed to evaluate the effect of metformin on the survival rate of HaCaT cells.After 48-hour treatment with metformin at concentrations of 0 (control group),0.5,1,2,5,10 mmol/L,flow cytometry was conducted to evaluate the effect of metformin on cell cycle and apoptosis.Western blot analysis was performed to determine the expression of cell proliferation-and differentiation-related proteins (keratin-16 [K16],K17,K1,involucrin),apoptosis-related proteins (Bax,Bcl-2) and AKT/mTOR/STAT3 pathway proteins.Enzyme-linked immunosorbent assay (ELISA) was conducted to detect the levels of interleukin (IL)-8,tumor necrosis factor (TNF)-α and IL-23 (inflammatory factors) in the culture supernatant of HaCaT cells.Statistical analysis was carried out with SPSS19.0 software using one-way analysis of variance for comparison of the above indices among the 0.5-,1-,2-,5-,10-mmol/L metformin groups and control group,repeated measures analysis of variance for comparisons among different time points or different metformin groups,least significant difference (LSD)-t test for multiple comparisons.Results CCK-8 assay showed that mefformin had inhibitory effects on the proliferation of HaCaT cells (F =116.87,P ＜ 0.05),and the cell survival rates gradually decreased along with the increase in the concentrations of mefformin.After 48-hour treatment with mefformin at concentrations of 0,0.5,1,2,5,10mmol/L,the proportion of HaCaT cells in G2/M phase gradually increased (5.55％ ± 1.03％,6.37％ ±0.93％,8.57％ ± 1.18％,10.05％ ± 0.60％,10.76％ ± 0.87％,13.63％ ± 1.41％,respectively,F =24.98,P ＜0.05),and the early apoptosis rate also gradually increased (0.78％ ± 0.71％,19.18％ ± 1.41％,25.67％ ±1.34％,28.45％ ± 0.92％,34.97％ ± 2.12％,40.41％ ± 1.49％,respectively,F =296.08,P ＜ 0.05).Along with the increase in the concentrations of metformin,there were increasing trends in the expression of K1 and the pro-apoptotic protein Bax (F =8.86,5.38 respectively,both P ＜ 0.05),while there were decreasing trends in the expression of K16,K17 and the apoptotic protein Bcl-2 (F =8.02,4.82,12.10 respectively,all P ＜ 0.05).There was no significant difference in the expression of involucrin among different metformin groups (F =0.57,P ＞ 0.05).After 48-hour treatment with mefformin at different concentrations,the levels of IL-8 and TNF-α in HaCaT cells significantly decreased (F =33.89,14.99 respectively,both P ＜0.05),while there was no significant change in the IL-23 level (F =2.12,P ＞ 0.05).Along with the increase in the concentrations of metformin,the expression of p-AKT,p-mTOR and p-STAT3 significantly decreased (F =11.38,0.35,4.38 respectively,all P ＜ 0.05),but there were no significant changes in the protein expression of AKT,mTOR and STAT3 (F =0.66,0.35,4.24 respectively,all P ＞ 0.05).Conclusion Metformin can inhibit the proliferation,promote the differentiation and apoptosis of HaCaT cells,and inhibit the secretion of inflammatory factors by regulating the AKT/mTOR/STAT3 signaling pathway.

Objective To investigate the efficacy and safety of ultrapulsed fractional CO2 laser in the treatment of porokeratosis in children.Methods Clinical data were collected from 9 children with porokeratosis in the Department of Dermatology of Beijing Children's Hospital from January 2014 to December 2015,and analyzed retrospectively.These patients were all treated with ultrapulsed fractional CO2 laser in a dynamic superficial stripping (Active FX) mode.The initial energies were 100,200 and 300 mJ/cm2,and the frequencies ranged from 100 to 300 Hz.Before and after the treatment,as well as during the follow-up,confocal laser scanning microscopy was used to evaluate the severity and recovery of skin lesions.Results Of the 9 patients,7 were male,and 2 were female.Their average age was 4.19 ± 3.97 years.After the treatment with ultrapulsed fractional CO2 laser,all of the patients were considered to be cured based on the clinical standard.Some adverse reactions such as erythema,edema and erosion occurred in the 9 patients immediately after the treatment,but all completely regressed within 3-7 days.At 3,6 and 12 months after the treatment,no scars or skin discoloration was observed.The average duration of follow-up was 1 year,and the longest duration of follow-up was 2 year and 4 months.No relapse occurred during the follow-up.Conclusion Ultrapulsed fractional CO2 laser is effective and safe for the treatment of porokeratosis in children.