0.05).Incidence rate of leukopenia in the high dose DDP group was significantly higher than in the low dose DDP group(87.5% vs.71.6%)(P0.05).CONCLUSION:The therapeutic effects of high dose DDP and LD-DDP group were equivalent.The incidence rate of toxic effect was significantly higher in the HD-DDP group than in the LD-DDP group,but the rate of serious toxic effect in the two groups was similar.

BACKGROUND: Total isoflavones of pueraria (TIP) possesses estradiol-like structures and has inhibition effect on bone loss or osteopenia in ovariectomized rats. However, studies have demonstrated that the prevention and treatment effect of TIP on osteoporosis in ovariectomized rats is poor, especially in single utilization. OBJECTIVE: To investigate the combination effect of TIP and vitamin D on the treatment of osteoporosis in ovariectomized rats. METHODS: Totally 81 female sprague-drawly (SD) rats of 3-month-old were randomly assigned into 9 groups. Exception those in the sham-surgery group, all rats were prepared for ovariectomized models. Vitamin D or low-, middle- and high-dose TIP or low-, middle- and high-dose TIP combined with vitamin D were intragastric administrated in the vitamin D, TIP or combination groups, respectively. There was no drug medication in the model and sham-surgery groups. The uterus coefficient was calculated at 3 months after medication. The serum alkaline phosphatase (ALP) activity, calcium, phosphonium, bone gla protein, estradiol levels, as well as bone mineral density of femur was determined. RESULTS AND CONCLUSION: Compared with the model group, the uterus coefficient and estradiol level was obviously increased in the middle- and high-dose TIP groups and all combination groups (P < 0.05); the ALP and bone gla protein levels significant decreased (P < 0.05); and the bone mineral density of central and distal femur were notably increased (P < 0.05); in particular, the result was more manifest in the high-dose combination group. TIP and vitamin D presented with synergism in uterus coefficient, estradiol, ALP, bone gla protein levels and bone mineral density of distal femur, but the effect was not significant in the calcium and phosphonium levels in the TIP and/or vitamin D groups. The findings demonstrated that Tip combined with vitamin D can induce synergism on prevention and cure of osteporosis in ovariectomized rat.

Objective: To investigate efficacy of operation and non-operation treatment for hip fractures patients complicated with pulmonary embolism. Methods: A retrospective case control study was conducted to analyze the clinical data of 18 hip fracture patients complicated with pulmonary embolism admitted to Dongyang People's Hospital from May 2017 to January 2019. There were 11 males and seven females, aged 59 to 96 years[(80.0±9.3)years]. There were 10 patients with intertrochanteric fractures, one with femoral subtrochanteric fracture and seven with femoral neck fractures. After diagnosis of pulmonary embolism, the patients were given anticoagulant therapy with low molecular weight heparin for at least one week. The re-examination showed that pulmonary embolism absorption improved and D-dimer did not increase. Eleven patients chose surgical treatment (operation group) with intramedullary nail internal fixation or artificial hip replacement. Seven patients chose non-surgical treatment (non-operation group) with skin traction. The Harris score of hip function was compared between the two groups. Visual analogue scale (VAS) was used to evaluate hip joint pain. At the last follow-up, fracture healing, prognosis of pulmonary embolism and mortality within 3 months were recorded. Results: All the patients were followed up for 3-22 months [(11.2±6.0)months]. At last follow-up, the Harris score was (92.1±2.2)points in the operation group and (28.8±18.8)points in the non-operation group (P<0.01); the VAS was 0 point (0-1 point) in the operation group and 3 points (1-3 points) in the non-operation group (P<0.01). At the last follow-up in the operation group, five patients obtained fracture healing after internal fixation, and among the six patients receiving artificial joint replacement, five patients recovered well except for one deceased patient. At the last follow-up, pulmonary embolism was absorbed and no recurrence of pulmonary embolism was found. None of the patients died within 3 months in operation group, while 14% of the patients (1/7) in the non-operation group died within 3 months. Conclusions For hip fracture patients complicated with pulmonary embolism, compared with non-operation treatment, operation treatment is more beneficial to restore hip function and relieve pain, with lower mortality rate within 3 months. Operation treatment is feasible for patients who showed improved absorption of pulmonary embolism and no secondary increase of D-dimer after one to two weeks of full anticoagulation treatment before operation.

OBJECTIVETo explore the effects of endoplasmic reticulum stress (ERS) related proteins and their mediated apoptosis in the formation of deep tissue injury of pressure ulcer in rats.

METHODSForty male Sprague-Dawley rats were divided into normal control group and groups A, B, C, D according to the random number table, with 8 rats in each group. Rats in group A were loaded with 22.47 kPa pressure with a special pressure apparatus for 2.0 h in the region over gracilis, and then unloaded for 0.5 h. Rats in group B were treated with the same manoeuvre as that in group A for 3 times in one day. Rats in groups C and D were treated with the same manoeuvre as that in group B for 2 and 3 days. Rats in normal control group were free from pressure loading. Rats in groups A, B, C, and D were sacrificed after pressure loading, and then the central part of pressure loaded muscular tissues were harvested for observation of histomorphological change with HE staining; apoptotic nucleoli per millimeter pressure loaded muscular tissue were counted with Hoechst 33258 staining; the levels of binding protein (BIP), protein disulfide isomerase (PDI), C/EBP homologous protein (CHOP), and caspase-12 were assessed with Western blotting (denoted as gray level ratio of target protein to GAPDH). The same parts of gracilis of rats in normal control group were harvested for determination of all the indexes as above. Data were processed with one-way analysis of variance, LSD-t test was applied for paired comparison.

RESULTS(1) Histomorphological observation. Some pathological changes, including inflammatory cell infiltration, myofibers lysis, and vacuolar degeneration, etc. were observed in pressure loaded muscular tissue of rats in groups A, B, C, and D, but not in the same parts of gracilis muscle of rats in normal control group. Compared with those in normal control group [(2.7 ± 1.4) per millimeter muscular tissue], the number of apoptotic nuclei was significantly increased in pressure loaded muscular tissue of rats in groups A, B, C, and D [(14.5 ± 4.4), (11.0 ± 2.9) , (13.8 ± 5.1), (21.3 ± 6.0) per millimeter pressure loaded muscular tissue, with t values from 4.223 to 6.000, P values all below 0.01). (2) Western blotting. The protein expressions of BIP and PDI in rats of normal control group and groups A, B, C, D were respectively 0.64 ± 0.12, 1.20 ± 0.34, 1.59 ± 0.24, 1.17 ± 0.28, 1.44 ± 0.33; 0.48 ± 0.15, 0.61 ± 0.19, 1.23 ± 0.38, 0.37 ± 0.19, 0.29 ± 0.15, and they showed significant statistical difference (with F values respectively 5.32, 7.95, P < 0.05 or P < 0.01). The protein expressions of CHOP and caspase-12 in rats of normal control group and groups A, B, C, D were respectively 0.58 ± 0.18, 1.48 ± 0.27, 1.03 ± 0.21, 0.95 ± 0.30, 1.69 ± 0.34; 0.55 ± 0.12, 1.08 ± 0.31, 0.69 ± 0.24, 1.79 ± 0.20, 2.06 ± 0.47, with significant statistical difference (with F values respectively 8.17, 15.48, P values all below 0.01).

CONCLUSIONSERS related proteins and their apoptotic pathway may play an important role in the formation of deep tissue injury of pressure ulcer in rats.

Animals ; Apoptosis ; Endoplasmic Reticulum Stress ; Male ; Pressure Ulcer ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the diagnostic value of serum angiopoietin-2 (Ang-2) level in pancreatic cancer patients.

METHODSSerum Ang-2 level was measured by enzyme-linked immunosorbent assays (ELISA) in samples from 116 patients with pancreatic cancer, 50 patients with chronic pancreatitis, and 50 normal control subjects.

RESULTSThe serum Ang-2 level in patients with pancreatic cancer [(1539.0 ± 449.3) ng/L] was significantly higher than those in patients with pancreatitis [(1044.6 ± 246.1) ng/L, P < 0.01] and normal control subjects [(1075.6 ± 228.2) ng/L, P < 0.01]. There was no significant difference of serum Ang-2 levels between patients with pancreatitis and normal controls. Pancreatic caner patients with lymph node metastasis had a significantly higher serum Ang-2 level [(1890.1 ± 354.9) ng/L] than those without metastasis [(1212.1 ± 224.2) ng/L, P < 0.01]. The area under ROC curve of serum Ang-2 level for diagnosis of pancreatic cancer was 0.819.

CONCLUSIONThe serum Ang-2 level can be a useful indicator for diagnosis of pancreatic cancer.

Adult ; Aged ; Angiopoietin-2 ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms ; blood ; diagnosis ; pathology ; Pancreatitis ; blood ; ROC Curve ; Retrospective Studies

Objective To apply iTRAQ technology to observe changes in protein expression group in the process of inducing C2C12 cells differentiation towards osteoblast by BMP-2.Methods The myoblast C2C12 cells were seeded in BMP-2 induced differentiation system for differentiation induction.In the 7th day,differentiation protein was extracted and labeled with iTRAQ reagent.Then,mass spectrometric detection,data analysis of differentially expressed proteins,and analysis of biological information were carried out.Results 23 significantly differentially expressed protein spots were screened by BMP-2-induced myoblast C2C12 differentiated cell protein expression profile analysis,where the protein was labeled with iTRAQ reagent.8 protein points were up-regulated,and 15 protein points were down-regulated.Trend classification found that the above differential protein had differential expression in each period of C2C12 cell osteogenic differentiation (1-7 days).Part of up-regulated protein in the early differentiation period showed high expression level;part of up-regulated protein in the late differentiation period showed high expression level;similarly,part of down-regulated protein in the early differentiation period presented low expression level;part of down-regulated protein in the late differentiation period showed low expression level.Preliminary identification showed SERCA3,Cytochrome bS,S100A4,ATPase inhibitor and ATPIF1 presented dynamic changes,which suggests that these proteins may be related to inducing osteogenic differentiation mechanism.Conclusion The results of differential protein expression trend show the necessity of full monitoring of C2C 12 cells osteogenic differentiation and indicate that iTRAQ technology is an effective method of studying protein changes of cellular molecule.Five proteins including SERCA3,Cytochrome b5,S100A4,ATPase inhibitor and ATPIF1 can be used as candidate targets for osteogenic differentiation mechanism research.

OBJECTIVE:To investigate the feasibility,safety and efficacy of domestic small waist big edge-type occluder for patients with multiple outlets sac-type membranous ventricular septal defection (VSD),and summarize its technical problems and the choice of treatment strategies.METHODS:A total of 20 patients with sac-type membranous VSD,underwent left ventricular angiography at left anterior oblique 45°-60° plus CAOD 20°-25°;the left ventricular entrance diameters were 7-21 (10.9±5.2) mm,more than 2 outlets in the right ventricular surfaces,and the largest outlet diameters were 3-10 (4.8±2.9) mm.According to the result from transthoracic echocardiography (TTE) and angiography,the sac-bag size,shape,location,extent of tissue adhesion,and stability were determined.Different types of small waist big edge-type occluder were implanted,and the occluder diameter was 5-14 (4.6±2.8) mm.Following 15 minutes of blocking,the immediate effects of occlusion were observed through repeating left ventricuiar angiography and TTE.All patients rechecked ultrasonic cardiography and electrocardiogram at 5-7 days of hospital stay,and 1,3,6 and 12 months following surgery.All patients took aspirin tablets for 6 months.RESULTS:Of 20 patients,17 cases underwent domestic small waist big edge occluder,blocked successfully through left ventricular entrance,2 cases were successful using symmetry block,and 1 case was failed.Intraoperative occlusion did not affect the aortic valve and tricuspid valve function.There were 1 case with left bundle branch block and 1 case with right bundle branch block during the operation,and all recovered within a week by using hormone therapy.After 6 months,the cardiac sizes were reduced to different degrees.CONCLUSION:It is safe and effective to treat multiple outlets sac-shaped membranous VSD with domestic small waist big edge-type occluder.The key technology,according to the sac size,shape,firmness,outlet orientation,import size,and the size of aortic stump,is to determine the block site and to select a suitable occluder.

Objective To formulate an evidence-based nursing scheme of a pin site nursing method to reduce the incidence of pin site infection among patients with bone pin surgery. Methods Under the principle of PICO, the issue was put forward aiming directly at patient′s clinical manifestations. By some database retrieval and evaluate the retrieval of literature evidence, the optimal evidence will be applied to the patients and the curative effect were observed. Results A total of 1 systematic review, 1 cohort study and 9 randomized controlled trials (RCTs) were included. According to the available evidence mentioned herein and patient′s conditions, they developed a new pin site nursing method and applied to patients. Seven days later, the two pin sites with infection symptoms obviously improved, with decreasing secretion, without skin redness and pain, and the temperature of skin was normal. The other six pin sites without infection did not occur infection. Conclusions The patients with pin sites using based iodine disinfection and sterile gauze strip winding better than the conventional alcohol drop pin site in reducing infection.

Objective: To observe the clinical effect of Guishao Liujunzi decoction combined with entecavir tablets in the treatment of liver cirrhosis with hepatitis B, and to provide reference for the clinical treatment. Methods: From May 2012 to January 2015, 80 patients with hepatitis B-induced liver cirrhosis treated in Dongyang Guangfu Hospital were selected, and they were divided into control group(n=40) and observation group(n=40) according to the different method.The control group was given entecavir tablets, while the observation group was given Guishao Liujunzi decoction on this basis.The TCM symptom scores and levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), gamma glutamyl transferase(GGT), total bilirubin(TBil), prothrombin time(PT), hepatitis B virus deoxyribonucleic acid(HBV-DNA) of the two groups before treatment and 3 months, 6 months and 12 months after treatment were compared. Results: The TCM symptom scores of the control group at 3 months, 6 months and 12 months after treatment were (12.68±1.82)points, (12.07±1.74)points, (11.38±1.63)points, respectively, which were higher than that before treatment[(14.30±1.48)points, t=4.368, 6.174, 8.388, all P<0.05]. The TCM symptom scores of the observation group at 3 months, 6 months and 12 months after treatment were (11.25±1.63)points, (10.40±1.82)points, (9.81±1.47)points, respectively, which were higher than before treatment[(14.59±1.61)points, t=9.137, 10.828, 13.780, all P<0.05]. The TCM symptom scores of the observation group at 3 months, 6 months and 12 months after treatment were significantly lower than those of the control group(t=3.589, 4.220, 4.359, all P<0.05). After treatment, the levels of ALT, AST, GGT and TBil in the observation group were (39.24±28.37)U/L, (45.18±34.35)U/L, (41.63±10.55)U/L, (20.94±9.15)μmol/L, respectively, which were lower than (85.18±27.22)U/L, (109.25±37.09)U/L, (50.71±9.62)U/L, (33.97±10.11)μmol/L in the control group(t=7.184, 7.818, 3.905, 5.898, all P<0.05). The levels of HBV-DNA in the control group at 6 months and 12 months after treatment were (3.18±1.13) copies/mL and (2.25±0.51) copies/mL, respectively, which were significantly lower than (3.65±1.19)copies/mL before treatment(t=1.811, 6.839; all P<0.05). The levels of HBV-DNA in the observation group at 6 months and 12 months after treatment were (2.96±0.97)copies/mL and (2.07±0.81)copies/mL, respectively, which were significantly lower than (3.70±1.13)copies/mL before treatment(t=3.143, 7.415, all P<0.05). Conclusion Guishao Liujunzi decoction combined with entecavir tablets in the treatment of liver cirrhosis with hepatitis B not only can significantly improve the clinical symptoms of patients, but also can help to strengthen the antiviral effect, improve the liver function of patients, which has important significance to the prognosis.

Objective: To understand the relationship between school environment and campus bullying behavior of junior high school students, and to provide scientific basis for the intervention of campus bullying behavior. Methods: Based on the data of "China Education Panel Survey" from 2014 to 2015, the school environment and self reported campus bullying behaviors of 9 300 junior high school students were analyzed. Results: The two level mixed effect linear regression model showed that the frequency of boys campus bullying behavior was higher than girls( B =0.356, P <0.01). Junior high school students in the school with higher student teacher ratio and school average class status had higher frequency of campus bullying behavior( B =-0.007, -0.004, P < 0.05 ). The negative correlation between school average class status and the frequency of bullying behavior of boys was greater than girls( B = -0.006 , P <0.01). Conclusion Prevention and treatment of junior high school students campus bullying not only needs to start from the individual students, families and peer groups, but also needs to pay attention to the school environment, reduce the school socioeconomic segregation, and pay more attention to boys campus bullying behavior.