0.05).After treatment,the nipple height was increased in the model group(P

Objective To investigate the effect of continued nursing on postoperative outcomes of discharged patients with chronic suppurative otitis media.Methods Toally 198 discharged patients were randomized into the control group (n=98) and the observation group (n=100).The patients in both groups received normal health education and additionally the continued nursing was used in the observation group for health education by way of phone call follow-up,on-the-spot consultation and QQ consultation.The mastery of related knowledge and skills,incidence of secondary tympanic membrane and readmission rate were compared.Results Six months after discharge,the observation group was significantly better than those the control group in the mastery of related knowledge and skills (P＜0.05).The incidence of secondary tympanic membrane perforation was not statistically significant between the groups(P＞ 0.05).The readmission rate at the second week and the third week between the two groups had no statistically significant difference (P＞ 0.05).However,the readmission rate at the first,second,third and sixth month were statistically different (P＜0.05).Conclusion Continued nursing to the postoperative discharged patients with chronic suppurative otitis media can improve the follow-up rate after discharge and self-nursing capacity,and as a result promote their recovery.

One hundred patients with acute ischemic stroke were enrolled in the study as the trial group, and 20 healthy individuals as control group. Intima-media thickness and plaque of the carotis were detected by carotid ultrasonography, cerebral infarction was detected by CT/MRI, and serum concentrations of sCD40L were measured by enzyme-linked immunosorbent assay. Neurologie impairment score was evaluated in all patients. The results showed that in patients with acute ischemic stroke the serum concentrations of sCD40L in plaques group were significantly higher than those in no plaque group. The levels of serum sCD40L of infarction group (diameter>1.5 cm) were higher than those of lacunar infarction group ( diameter<1.5 cm ) and temporary ischemic attack ( TIA ) group. The levels of serum sD40L in trial group were all higher than those in control group. In the trial group, serum concentrations of sCD40L were correlated with neurologic impairment score. The results indicate that CD40/CD40L signaling pathway may be involved in the carotid atherosclerosis formation and the rupture of plaques, and the increase of serum CD40L levels might be a risk factor for acute ischemic cerebrovascular diseases.

Objective:To investigate the relationships between matrix metalloproteinase-3 (MMP-3),high-sensitivity C-reactive protein(hs-CRP)and carotid atherosclerosis and acute cerebral infarction.Methods: Sixty-four patients with the first ever cerebral infarction and 20 normal control subjects were selected.Their serum MMP-3 levels were determined by double antibody enzyme-linked immunosorbent assays,and serum hs-CRP levels were measured by immunonephelometric assay.Their carotid intima-media thicknesses were assessed by carotid ultrasonography,and neurological deficit scores were performed in patients with acute cerebral infarction.Results:The levels of serum MMP-3 and hs-CRP in patients with acute cerebral infarction were significantly higher than those in the normal control group(P＜0.01).The levels of serum MMP-3 and hs-CRP in unstable plaque group(mixed plaque group,soft plaque group)were significantly higher than those in stable plaque group(hard plaque group)and rough intima group(P＜0.01).The levels of serum MMP-3 and hs-CRP were positively correlated with the neurological deficit scores respectively in patients with acute cerebral infarction. Conclusions:The levels of serum MMP-3 and hs-CRP in patients with acute cerebral infarction may reflect the character and stability of carotid artery plaque,and they are the important indexes in understanding the severity of cerebral infarction in clinical practice.

Objective To investigate the relationship between the matrix metalloproteinase-3(MMP-3)and the stability of carotid artery plaque,and explore MMP-3's prediction role on the attack and relapse of acute ischemic cerebrovascular events.Methods 100 patients with the first ever acute cerebral infarction,100 patients with chronic cerebral circulation insufficiency(CCCI)and 40 persons without cerebrovascular diseases were enrolled in this study.According to the carotid ultrasound examination,100 cerebral infarction patients were divided into three subgroup: unstable plaque group(45 patients,mixed plaque,soft plaque),stable plaque group(35 patients,plaque Group)and endometrial coarse group(25patients).Matrix metalloproteinase-3(MMP-3)levels of all the subjects were measured by enzyme-linked immunosorbent assay(as basal level).All the subjects were followed up for one year to observe cerebral infarction events.Serum MMP-3 levels of each group,and the basic serum MMP-3 levels were compared among patients who were attacked or relapsed cerebral ischemic with those who had not been attack cerebral ischemic during this period of time.Results 5 patients in the cerebral infarction group had relapse (5%),2 patients in the CCCI group were attacked by cerebral ischemic(2%),and no one in the normal control group was attacked by cerebral ischemic.Serum MMP-3 levels in the acute cerebral infarction group were significantly higher than CCCI group,and both groups were significantly higher than normal control group (P ＜0.05).The basic serum MMP-3 levels in all patients who were attacked by cerebral ischemic were significantly higher than those who had not been attack by cerebral ischemic during this period of time(P ＜0.05).The serum MMP-3 levels of the unstable plaque group were significantly higher than stable plaque group.And both groups were significantly higher than endometrial coarse group(P ＜0.05).Conclusions Elevated levels of matrix metalloproteinase-3(MMP-3)might have something with the stability of carotid atherosclerotic plaque,and participate the attack and the relapse of acute cerebral infarction.Determination of MMP-3 might be used to predict the attack and relapse of acute cerebral infarction.

AIM:To explore the protective effect of ischemic preconditioning on myocardial capillary bed. METHODS: Anesthetized open-chest dogs in ischemic preconditioning (IP) group ( n =6) were subjected to 5 min ischemia and 5 min reperfusion for 4 times in left descending coronary artery (LDA) while the dogs in sham-operated (SO) group ( n =6) were observed for 40 min without any stimulating. Myocardial contrast echocardiography (MCE) was performed before the surgery, at the end of the first and the fourth ischemia and reperfusion period, respectively. Myocardial samples in ischemic area were obtained for capillaries ultrastructure examination and their quantitative analysis was conducted by corresponding imagine analyzing system, then compared within group and between control group. RESULTS: (1) Comparing fourth 5 min ischemia with first one, the percents of area defect in minimum (AD min%) by MCE decreased from 32.6%?5.7% to 21.8%?5.2%( P

Objective:To study the effect of Fuzheng Qufeng prescription （FZQP） on transforming growth factor-β₁ （TGF-β₁）/Smad signaling pathway and epithelial-mesenchymal transition of podocyte in membranous nephropathy （MN） rats and to explore its molecular mechanism for podocyte protection. Method:The rats were randomly divided into normal control group （NC） and modeling group. Rats in modeling group induced by bovine serum albumin （C-BSA） were randomly divided into model group （MN）， losartan potassium group （LP， 0.05g·kg^-1）， and FZQP high dose （FZQPH， 41 g·kg^-1）， medium dose （FZQPM， 20.5 g·kg^-1）， and low dose （FZQPL， 10.25 g·kg^-1） groups. The administration lasted for 4 weeks. In week 0， 2， and 4 of administration， the levels of 24 hours urine protein （24 h-Upro） were tested. At the end of 4th week， the levels of blood urea nitrogen （BUN） and serum creatinine （SCr） were detected， and the rats in each group were sacrificed and the renal pathological morphology changes were observed by light microscope with hematoxylin-eosin （HE）， Masson and periodic acid-silver metheramine （PASM） staining. The deposition of immune complex， the thickening of glomerular basement membrane （GBM） and podocyte foot process were observed by transmission electron microscope （TEM）. The distribution and expression intensity of Desmin in renal tissues were detected by immunohistochemistry （IHC）. The mRNA and protein expression levels of TGF-β₁， Smad2/3， phospho（p）-Smad2/3， Smad7 and Desmin in renal tissues were respectively detected by Western blot （WB） and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. Result:Compared with NC group， the levels of 24 h-Upro， BUN and SCr significantly increased in model group （P<0.01）， with increased deposition of immune complex， significantly thickened GBM and fusion of foot processes， significantly increased Desmin mRNA and protein expression （P<0.01） and increased TGF-β₁， Smad2， and Smad3 mRNA and protein expression （P<0.05）， and decreased Smad7 mRNA and protein expression （P<0.05，P<0.01）. Compared with model group， 24 h-Upro and BUN decreased in FZQP groups and LP group （P<0.05）， levels of serum SCr in FZQPM group decreased （P<0.05）， deposition of immune complex， thickening of GBM and fusion of foot process were all alleviated in FZQP groups and LP group. Distribution of Desmin along GBM decreased in FZQPH group， FZQPM group and LP group （P<0.05）. Both mRNA and protein expression levels of TGF-β₁ and p-Smad2/Smad2 in FZQPM group decreased， while mRNA and protein expression levels of Smad7 increased （P<0.05）. Both mRNA and protein expression levels of p-Smad3/Smad3 in FZQPH group decreased （P<0.05）. Both mRNA and protein expression levels of Desmin in podocyte in FZQPH group， FZQPM group and LP group decreased （P<0.05）. Conclusion:FZQP might realize podocyte protection effect in MN via suppressing EMT mediated by overactivated TGF-β₁/Smad signaling pathway.

OBJECTIVETo observe the relationship of Chinese medicine (CM) syndrome pattern with heart function detected by ultrasonic cardiography and brain natriuretic peptide (BNP) level in patients with heart failure (HF).

METHODSOne hundred and sixteen inpatients of HF hospitalized in Dongfang Hospital from January, 2007 to January, 2009 were assigned to three groups according to their CM syndrome pattern differentiated, the qi-yin deficiency group (QYD), the qi-deficiency and blood-stasis group (QDBS) and the yang-deficiency with water overflowing group (YDWO). Ultrasonic cardiographic (USCG) parameters, including left ventricular end-systolic diameter (LVEDs), left ventricular end-diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) were detected, and blood level of BNP was measured.

RESULTSLVEF was decreased while BNP was increased in patients with syndrome patterns in the order of QYD --> QDBS --> YDWO, and showed significant difference between groups (P < 0.01); CM syndrome patterns was related with all the USCG parameters and BNP level, especially the BNP (r = 0.71, P < 0.05) and LVEF (r = -0.34, P < 0.05).

CONCLUSIONLVEF and BNP can reflect the severity of heart failure, and they could be taken as the beneficial objective and quantitative indices for syndrome pattern differentiation.

Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Heart Failure ; diagnostic imaging ; metabolism ; physiopathology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Stroke Volume ; physiology ; Ultrasonography ; Ventricular Function ; physiology ; Young Adult

Objective To explore the effect of reduced alpha - cardiac actin 1(ACTC1)gene expression on the rat embryonic cardiomyocytes H9C2 cell apoptosis and its mechanism. Methods The rat embryonic cardiomyocytes H9C2 cell was cultivated;the rat embryonic cardiomyocytes H9C2 cell was transfected with ACTC1 - small interfering RNA(siRNA),and at 24 h,48 h,72 h after transfection,the cells were collected for extraction and purification of RNA, the real - time quantitative PCR(qPCR)method was used to detect the expression level of ACTC1 gene;and the termi-nal deoxynucleotidyl transferase - mediated dUTP - biotin nick end labeling assay(TUNEL)method was used to ex-plore the effect of reduced ACTC1 gene expression on the rat embryonic cardiomyocytes H9C2 cell apoptosis. Western blot was used to detect the expression of Cyto C,cysteine - containing aspartate - specific proteases(Caspase)- 3, Caspase - 8,Caspase - 9,Bcl - 2 and Bax. Results The expression of ACTC1 mRNA detected by qPCR decreased compared with that of the scramble siRNA group in 24 h,48 h,72 h(0. 80 vs. 1. 00,0. 20 vs. 1. 00,0. 25 vs. 1. 00),and in the ACTC1 - siRNA group decreased significantly at 48 h,72 h,and the difference was statistically significant(t =4. 245,P < 0. 05);TUNEL positive cells rate significantly increased in the ACTC1 - siRNA group(80％)compared with that in the scramble siRNA group(20％),and the difference was statistically significant(P < 0. 05);Western blot also confirmed that the expression of Caspase - 3,Caspase - 9,Cyto C and Bax/ Bcl - 2 were accordingly increased (0. 91 ± 0. 12 vs. 0. 59 ± 0. 01,0. 48 ± 0. 09 vs. 0. 24 ± 0. 03,0. 92 ± 0. 03 vs. 0. 45 ± 0. 01,2. 25 ± 0. 26 vs. 1. 16 ± 0. 12),and the differences were statistically significant(t = 2. 821,7. 336,2. 420,0. 798,all P < 0. 05);but the expre-ssion of Caspase - 8 had no obvious change,and the difference was not statistically significant (P > 0. 05 ). Conclusions Reduced ACTC1 gene expression can induce the rat embryonic cardiomyocytes H9C2 cell apoptosis perhaps mainly through endogenous mitochondrial signal transduction pathways.

OBJECTIVETo evaluate the efficacy and safety of Chinese medicine (CM) intervention in the treatment of nonalcoholic steatohepatitis (NASH) from liver enzyme (ALT), imaging (the liver/spleen CT ratio) and syndrome scores, and to establish standard methods for diagnosis and therapeutic efficacy evaluation with characteristics of CM.

METHODSA multi-center, stratified randomized, parallel controlled, blindness-method evaluated, superiority trial was performed. Totally 204 patients were randomly allocated into two groups, 102 patients in the experimental group (treated with CM) and 102 patients in the control group [treated with Western medicine (WM)]. The alanine aminotransferase (ALT), liver/spleen CT ratio, and clinical symptoms were observed in both groups.

RESULTSOf the randomly allocated 204 cases from 4 hospitals, 3 patients were rejected, and 25 were lost. Totally 176 cases con- formed to the plan with complete follow-ups. After 3 months of treatment, syndrome scores and the improvement of partial clinical symptoms (fatigue and sallow complexion) were superior in the experimental group to those in the control group (P < 0.05). After 3 months of follow-up, the syndrome scores and improvement of partial clinical symptoms (fatigue and sallow complexion) were superior in the experimental group to those in the control group (P < 0.05). There was no statistical difference in improving liver enzymes or the liver/spleen CT ratio between the two groups (P > 0.05). There were 4 adverse reactions/adverse events in the two groups in the process of treatment, mainly covering drug-induced liver injury, diarrhea, and epigastric distension. Adverse reactions had nothing to do with CM treatment.

CONCLUSIONSJianpi Shugan Recipe had obvious efficacy in treatment of NASH. It could remove the liver fat and play a role in anti-inflammation and liver protection. It also could improve the indices of liver enzymes and the liver/spleen CT ratio effectively, which was superior to Polyene Phosphatidylcholine Capsule (PPC) in improving clinical symptoms, especially for such symptoms as fatigue and sallow complexion.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; drug therapy ; Phytotherapy