Objective To assess renal perfusion of chronic renal failure(CRF) at different stages in rabbits by contrast-enhanced ultrasound. Methods Fifteen rabbits were injected cationic bovine serum albumin(C-BSA) intravenously for 8 weeks to establish CRF models. Serum creatinine(Scr) and blood urea nitrogen(BUN) were determined before injection and 2,4,6,8 weeks after C-BSA injection respectively. The size of kidney was measured by two-dimensional ultrasound and contrast-enhanced ultrasound was performed on bilateral kidneys at the same time points. Renal perfusion was analyzed quantitatively with the time intensity curve. Results Renal cortical perfusion reduced started at 4weeks after injection,manifested as the peak signal intensity(PSI) of the time-intensity curve parameters decreased(P<0.05 or P <0.01). The speeds of perfusion and clearance of kidney were slower,showed as the time to peak intensity(PIT) and the time to half of peak intensity(HPT) delayed (P <0.05 or P <0.01). Compared with pre-injection, there were no differences in terms of the area under the curve(AUC) at 2,4 and 6 weeks after injection (all P> 0.05). And compared with pre-injection,2,4,6 weeks after injection, the AUC decreased at 8 weeks (P < 0.05 or P <0.01 ). The level of Scr and BUN of rabbits had increased since 6 weeks after injection (P< 0.05 or P <0.01). Two-dimensional ultrasound showed the renal volume was enlarged and the cortex was thickened from 2 weeks to 6 weeks after injection (P<0.05 or P <0.01). At 8 weeks after injection, the renal size had decreased as well (P < 0.05). These ultrasound changes were in accordance with its pathological changes. Conclusions Contrast-enhanced ultrasound in combination with time-intensity curve can quantitatively analyze the renal perfusion of CRF at different stages. The reduction of renal perfusion was earlier than the changes of routine laboratory indexes in rabbits with CRF. The haemodynamic changes of CRF rabbit were closely related with its pathological changes.

Objective To investigate the function of the left ventricular (LV) myocardial regional contractility in hyperthyroid by measuring the LV rotation and torsion using speckle tracking imaging (STI).Methods 58 patients with hyperthyroidism had accepted 131 I treatment the first time and cured and improved after treatment for 6 months were enrolled.According to the course of disease,they were divided into two groups:Group A,duration less than 6 months,28 cases;Group B,duration more than 6 months,30 cases.30 normal cases age and gender matched were enrolled as control group.LV peak rotation and torsion of endocardium and epicardium at basal and apical of levels were measured using STI in groups A and B before and after treatment,and correlation with cardiac function and structure parameters,heart rate,blood pressure,and the thyroid hormone were analyzed.Results ①Comparing group A and group B before and after treatment with control group,there was no statistically significant in the LV structure and function parameters (LVDd,LVDs,IVSd,PWd,LVEF) (P ＞0.05).②As for LV peak rotation of endocardium and epicardium at apical levels (EN PAR,EP-PAR) before treatment,group A was higher than the control group (P ＜0.05),group B was lower than the control group (P ＜0.01);After treatment,group A has improved (P ＜0.01),group B has improved only in EP-PAR (P ＜0.05),and there was no statistically significant compared with the control group (P ＞0.05).③ LV peak torsion of endocardium and epicardium (EN-Ptor,EP-Ptor) in group A was higher than the control group before treatment (P ＜0.05),group B was lower than the control group (P ＜0.01) ;After treatment,group A has improved (P ＜0.05),group B has only improved in EP-Ptor(P ＜0.05),and comparing with the control group,there was no statistically significant (P ＞0.05).④LV peak apical rotation and LV torsion were positively correlated with systolic blood pressure,heart rate,E-peak,A-peak,LVOT-V in different degree (P ＜0.01 or P ＜0.05),but no correlation with FT3,FT4,TSH (P ＞0.05).Conclusions Myocardial contractile function strengthens in early patients with hyperthyroidism and lessens with the extension of the course.Have not yet appeared heart diseases in patients with hyperthyroidism whose myocardial regional systolic function had changed,short duration can recover after treatment,but the long duration can not restore completely.Change of myocardial motion of patients with hyperthyroidism is associated with blood flow dynamics.

Aim To study the effect of simvastatin on the production of reactive oxygen species ( ROS ) and the secretion of interleukin-1 beta ( IL-1β) in oxidized low density lipoprotein ( oxLDL )-induced macropha-ges. Methods After the murine macrophage J774A. 1 was treated with 0,50,100,200 mg·L-1 oxLDL, the contents of aggregated lipid in macrophages were ob-served and determined by oil red O staining. Then, the oxLDL-primed macrophages were treated with 0 . 5 ,1 . 0μmol·L-1 simvastatin, the production of ROS was de-termined by flow cytometry and the expressions of pro-caspase-1 , cleaved caspase-1 and mature IL-1βon pro-tein level were determined by Western blot. Results The oil red O staining results showed that oxLDL could induce obvious lipid aggregation in macrophages, and reached the saturation point with 100 mg·L-1 concen-tration. Flow cytometry results indicated that oxLDL could induce the production of ROS in macrophages, up to 167% ± 0. 47%, and ROS level decreased to 139% ± 0. 97% in a dose-dependent manner after treatment with simvastatin. Western blot indicated that simvastatin could inhibit the expression of cleaved caspase-1 and mature IL-1β in macrophages triggered by oxLDL;compared with oxLDL group, the expression of cleaved caspase-1 and mature IL-1β decreased in simvastatin treated group, and all results had statistical significance ( P<0. 05 ) . Conclusion In the lipid ag-gregation model of macrophages induced by oxLDL, simvastatin can inhibit the production of ROS, caspase-1 activation, and secretion of IL-1β in macrophages.

Objective To observe the kinetics of myocardial during isovolumic relaxation (IVR) in normal subjects during exercise stress testing,and evaluate the relationship between the recovery rate of circumferential strain during IVR and the diastolic function of the heart.Methods Echocardiography was performed in 43 healthy students at rest,at peak stress and at recovery of the exercise test.The ratio of peak early-diastolic mitral orifice flow velocity and peak early-diastolic mitral annular velocity in left ventricular posterior wall (E/e) was measured.The records of the movement in the basal,papillary muscle and apical short-axis views of the left ventricular were stored.The circumferential strain during the end systolic (ES) and the end isovolumetric relaxation (IRA) of the subendocardial and subepicardial layers in the three short axis were analyzed using X-strain software.The circumferential strain recovery rate of the subendocardial and subepicardial layers during the IVR (ENCSrec,EPCSrec) were calculated.The circumferential strain of the subendocardial and subepicardial layers in the three short-axis during ES and IRA phases in different status were compared.The relationship between the circumferential strain recovery rate during IVR and E/e were analyzed.Results The circumferential strain of the basal,papillary level in short axis during ES and IRA phases decreases at the beginning and then increased along with the exercise intensity (P ＜0.05).The circumferential strain of the subendocardial layer is greater than the subepicardial layer in the three shortaxis during ES and IRA in different exercise status (P ＜0.01).The ENCSrec and EPCSrec of the three short-axis increases at the beginning and then decreased along with the exercise intensity (P ＜0.05).The ENCSrec and EPCSrec of 3 short axis are correlated with E/e in different exercise phases (P ＜0.05).Conclusions In normal subjects,the kinetics of circumferential strain during IVR is consisted with the physiological changes of the heart during IVR in different exercise phases.The circumferential strains in different myocardial layers are different during IVR.The circumferential strain recovery rate of left ventricular myocardial during IVR may reflex the diastolic function of the heart.

Objective To evaluate the effects of high frequency ultrasound in the assessment of vascular function during exercise in healthy subjects. Methods Forty-nine healthy subjects were enrolled in this study. The parameters of vascular function were measured at different stages (rest, exercise peak and recovery). Compliance coefficient (CC), distensibility coefficient (DC), stiffness indexα, stiffness indexβand pulse wave velocity (PWV) were measured by RF-Data technique of ultrasound vascular measurement (quantitative arterial stiffness, QAS). Endocardium-circumferential strain (EN-CS), epicardium-circumferential strain (EP-CS), endocardium-circumferential strain rate (EN-CSR) and epicardium-circumferential strain rate (EP-CSR) were collected by two-dimensional speckle tracking imaging (X-strain). The correlation between EN-CS, EN-CSR, EP-CS, EP-CSR and CC, DC, stiffness indexα, stiffness indexβand PWV were analyzed. Results At different stages (rest, exercise peak and recovery), CC were (1.436±0.448), (1.041±0.432) and (1.191±0.467) mm2/kPa DC were (0.040±0.016), (0.031±0.013) and (0.034±0.013) 1/kPa. CC and DC signiifcantly decreased at exercise peak (F=12.99 and 7.65, both P<0.01). At different stages (rest, exercise peak and recovery), PWV were (5.037±0.798), (5.845±1.165) and (5.683±1.367) m/s, stiffness indexαwere 2.298±0.633, 3.303±1.697 and 3.092±1.533, stiffness index β were 4.762±1.284, 6.794±2.515 and 6.158±3.089. PWV, stiffness index α and stiffness index β significantly increased at exercise peak (F=9.21, 13.24 and 12.33, all P<0.01). At different stages (rest, exercise peak and recovery), EN-CS were (7.825±2.445)%, (9.105±4.234)%and (6.271±2.527)%, EN-CSR were (0.831±0.276), (1.219±0.556) and (0.765±0.282) s-1, EP-CS were (6.894±2.465)%, (7.936±3.628)%and (5.489±2.306)%, EP-CSR were (0.714±0.247), (1.019±0.414) and (0.656±0.237) s-1. EN-CS, EN-CSR, EP-CS and EP-CSR signiifcantly increased at exercise peak (F=25.92, 43.76, 21.22 and 47.98, all P<0.01). EN-CS, EN-CSR, EP-CS and EP-CSR were positively correlated with PWV, stiffness indexαand stiffness indexβ(r:from 0.253 to 0.494, all P<0.05), negatively correlated with CC and DC (r:from-0.234 to-0.562, all P<0.05). Conclusions CC, DC, stiffness indexα, stiffness indexβ, PWV, EN-CS, EN-CSR, EP-CS and EP-CSR all can relfect the changes of vascular function during exercise. Properly exercise has positively direct effect on vascular elasticity.

Objective To investigate the change characteristics of the brain neurotransmitters of human with stress events by the Encephaloflucgram technology (ET) at the noninvasive condition. Methods Extract shocking informations with neurotransmitter requlation systems in EEG ( S spectral line) by ET and analyze thechange characteristics of the brain neurotransmitters of human with stress events, the clincial symptons of the patients were evaluated by the post-traumatic stress disorder-check scale (PCL-C). Results ①Compared with expected number,the activity of neurotransmitters such as γ-aminobutyric acid (GABA) were significantly decreased (4.64 ±2.88,8.45 ±0.42, P＜0. 01 ) and the activity of neurotransmitters such as dopamine( DA ) ( 17.01 ±7.41,7.59±0.55, P＜0. 01),acetylcholine(Ach) (17.01 ±7.41,14.95 ±0.65, P＜0.05) ,norepinephrine (NE ) ( 13.07 ± 4.33,11.82 ± 0.84, P ＜ 0. 05 ) were increased. ②There was a significant difference on GABA ( t =6.902, P ＜ 0. 01 ) between suspect of post-traumatic stress disorder and non-post-traumatic stress disorder. ③In PCL-C scale score, intrusion factor had negative correlation to the activity of GABA ( r = - 0.777, P ＜ 0.01 ), and positive correlation to the activity of DA ( r = 0.360, P ＜ 0.01 ), hyper-arousal factor was positive correlated with the activity of NE ( r=0.221, P＜0.05) ,escaping/numbness factor was negative correlated with the activity ofGlu( r= -0.274, P＜0.05). Conclusion In traumatic stress events GABA,Ach,DA,NE neurotransmitters aresignificantly changed ,and meybe participat stress responses.

Objective:To establish a quantitative evaluation system for medical equipment procurement and to explore its application value in the allocation and management of hospital assets.Methods:Based on theoretical research and on-site evaluation,an evaluation index system was developed from four levels of clinical demand,technical level,procurement process and service capabilities.The quantitative evaluation of the procurement process was conducted by using covariance-analytic hierarchy process(Cov-AHP),and a"6-stage"optimization process of medical equipment procurement was developed.A total of 257 sets of medical equipment purchased by Beijing Shunyi Hospital from August 2019 to July 2023 were selected,and the expert demonstration model(126 units)and the quantitative evaluation model(131 units)were used for medical equipment asset allocation management.The standardization of the medical equipment procurement process,effectiveness of performance objectives and satisfaction of clinical services of medical equipment procurement under different management methods were compared.Results:The standardization degrees of the procurement process of the medical equipment in the quantitative evaluation model in terms of startup,demonstration,implementation,installation and use stages were(98.42±2.83)%,(98.97±2.45)%,(96.24±3.87)%,(96.42±2.54)% and(94.82±5.31)%,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=3.741,4.385,6.551,7.620,4.563,P<0.05).The achievement rates of quality index,progress index,social benefit index and cost-benefit index of medical equipment procurement in the quantitative evaluation model were(96.15±4.08)%,(96.41±2.37)%,(92.77±3.89)% and(93.06±4.33)%,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=4.156,4.562,5.014,4.069,P<0.05).The clinical satisfaction scores of medical equipment users of medical equipment in the quantitative evaluation model for large medical equipment,life support and first aid equipment,laboratory testing equipment,surgical treatment equipment and other medical equipment were(90.24±1.89)points,(93.45±2.64)points,(95.67±3.64)points and(93.82±2.55)points and(97.25±3.89)points,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=3.678,4.079,2.845,3.628,5.023,P<0.05).Conclusion:The quantitative evaluation system can standardize the procurement process of medical equipment,improve the achievement rate of the performance target of medical equipment procurement,and improve the clinical service level of medical equipment.

OBJECTIVE:To evaluate the effectiveness and safety of bromocriptine by vaginal delivery in the treatment of hyperprolactinemia in Chinese female patients,and to provide evidence-based reference for clinic.METHODS:Retrieved from PubMed,The Cochrane Liabmry,Excerpta Medica Database,Chinese Journal Full-text Database,Wanfang Database and China Bxdxiology Medicine disc,randomized controlled trials (RCTs) about bromocriptine oral tablets by vaginal delivery (trial group) vs.bromocriptine by oral administration (control group) in the treatment of bromocriptine in Chinese female patients were collected.After data extraction,quality evaluation of included studies with Cochrane system evaluator manual 5.1.0,Meta-analysis of serum level of Prolactin levels,the rate of menstruation improvement,the rate of pregnancy recovery,the rate of galactorrhea disappearance,the incidence of ADR in digestive tract and the incidence of ADR in nervous system was conducted by using Rev Man 5.1 statistical software.RESULTS:A total of 16 RCTs were included,involving 1 175 patients.The results of Meta-analysis showed that the incidence of ADR in digestive tract [OR=0.14,95％CI(0.09,0.23),P＜0.001] and ADR in nervous system [OR=0.32,95％CI(0.11,0.90),P=0.03] in trial group were significantly lower than control group,with statistical significance.There was no statistical significance in serum level of PRL [MD=0.24,95％ CI (-0.94,1.41),P=0.69],the rate of menstruation improvement [RD=0.04,95％CI (-0.04,0.11),P=0.32],the rate of pregnancy recovery [RD=0.01,95％CI (-0.08,0.10),P=0.84] or the rate of galactorrhea disappearance [RD=0.05,95％ CI (-0.03,0.13),P=0.20] between 2 groups.CONCLUSIONS:Compared with oral administration,bromocriptine by vaginal delivery has no significant difference in therapeutic efficacy but has obvious advantages in the incidence of ADR in digestive tract and in nervous system and better safety.It is suggested to development the special vaginal delivery preparation of bromocriptine.

Objective To investigate whether human bone marrow mesenchymal stem cells (hBC-MSCs) have the immune-suppression ability on the proliferation of peripheral blood mononuclear cells (PBMCs) and their pro-inflammatory cytokine production in rats,to explore what kinds of human cytokines are required for the induction of hBM-MSCs to become immune-suppressive,and to observe the effect of intravenous delivery of hBM-MSCs on tumor necrosis factor (TNF)-α transcription and expression in the core infarct areas of rats after cerebral ischemia.Methods The fetal-originated hBC-MSCs and rat PBMCs were extracted;the rat PBMCs were activated by adding 10 μg/mL concanavalin A (ConA).(1) The first experiment was divided into hBM-MSCs+PBMCs group,hBM-MSCs+PBMCs+ConA group,PBMCs group and hBM-MSCs group;CCK-8 assay was employed to detect the proliferation of these cells.(2) The second experiment was divided into hBM-MSCs+PBMCs+ConA group,PBMCs+ConA group;ELISA was used to detect the TNF-α,interferon-γ (IFN-γ) and intedeukin (IL)-10 expressions.(3) The third experiment was divided into hBM-MSCs+PBMCs (IFN-γ+IL-1α) group,hBM-MSCs+PBMCs (IFN-γ+IL-1β) group,hBM-MSCs+PBMCs (IFN-γ+TNF-α) group and hBM-MSCs+PBMCs group;CCK-8 assay was used to detect the proliferation of these cells.(4) Thirty SD rats were randomly divided sham-operated group,control group (giving normal saline after ischemia) and hBM-MSCs group (giving hBM-MSCs after ischemia,n=10);on the third d of ischemia,the TNF-α mRNA and protein expressions at the infarct areas was detected by real time PCR and Western blotting,respectively.Results (1) The optical density (OD) in the hBM-MSCs+PBMCs group was significantly increased as compared with that in the PBMCs group and hBM-MSCs group (P＜0.05);OD in the hBM-MSCs+PBMCs group was significantly increased as compared with that in the hBM-MSCs+PBMCs+ConA group (P＜0.05).(2) The TNF-α,IFN-γand IL-10 levels in the PBMCs+ConA group were (1030±196) pg/mL,(2880±250) pg/mL and (330±45) pg/mL;the TNF-α and IFN-γlevels in hBM-MSCs+PBMCs+ConA group were (160±10) pg/mL and (240±55) pg/mL,which were significantly lower than those in the PBMCs+ConA group (P＜0.05);the IL-10 level in hBM-MSCs+PBMCs+ConA group was (750±110) pg/mL,which was significantly higher than that in the PBMCs+ConA group (P＜0.05).(3) The OD in the hBM-MSCs+PBMCs(IFN-γ+IL-1α)group,hBM-MSCs+PBMCs (IFN-γ+IL-1 β) group and hBM-MSCs+PBMCs (IFN-γ+TNF-α) group was significantly decreased as compared with that in the hBM-MSCs+PBMCs group (P＜0.05).(4) The TNF-α mRNA expression in the sham-operated group,control group and hBM-MSCs group was 0.490±0.128,2.369±0.788 and 1.002±0.408;the TNF-α protein expression in the sham-operated group,control group and hBM-MSCs group was 0.144±0.028,0.314±0.029,0.240±0.029;the TNF-α protein and mRNA expressions in the hBM-MSCs group were significantly decreased as compared with those in the control group (P＜0.05).Conclusions The allogeneic transplantation of hBC-MSCs is competent in suppressing the inflammation of rats in vitro and in vivo.Furthermore,this immune-suppression ability is not innate,but cytokine stimulation dependent.The immune-suppression ability of hBM-MSCs on rat PBMCs are at least partly responsible for the therapeutic effect of hBM-MSCs transplantation into the rat models,such as ischemia stroke.

Objective:To evaluate the effect of different blood pressure control levels on myocardial work by left ventricular pressure-strain loop (LVPSL) in elderly hypertensive patients.Methods:Retrospectively, 158 elderly patients with hypertension in Shanxi Bethune Hospital from January to June 2017 were randomly divided into standard anti-hypertensive group ( n=75) and intensive anti-hypertensive group ( n=83). Another 48 cases of age and sex matched elderly without cardiovascular and cerebrovascular diseases and other diseases affecting cardiac function were selected as control group. All patients with hypertension underwent echocardiography at baseline, 12 and 24 months after antihypertensive treatment. The parameters of myocardial work, including global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE), were obtained by LVPSL. The changes of myocardial work parameters were compared between the standard group and the intensive group after 12 and 24 months of antihypertensive treatment. Results:①At baseline, GWI, GCW, GWW of the standard group and the intensive group were significantly higher than those of the control group (all P<0.05). ②After 12 and 24 months of antihypertensive treatment, GWI, GCW and GWW in standard and intensive antihypertensive groups decreased continuously ( P<0.05). ③The GWI, GCW and GWW of the intensive antihypertensive group were lower than those of the standard antihypertensive group at 12 and 24 months after antihypertensive treatment ( P<0.05). ④After 12 months of antihypertensive treatment, the reductions of GWI, GCW and GWW in standard and intensive antihypertensive groups were greater than those in 24 and 12 months of antihypertensive treatment (all P<0.05), and the reductions of GWI, GCW and GWW in intensive antihypertensive group were greater than those in standard antihypertensive group (all P<0.05). Conclusions:Left ventricular systolic function decreases and myocardial work increases in elderly hypertensive patients. Left ventricular systolic function improves after antihypertensive treatment, and the improvement of intensive antihypertensive is more obvious than that of standard antihypertensive treatment.