Objective To study the clinical efficacy of intensive insulin therapy (IIT) on patients with severe heart failure,pulmonary infection and hyperglycemia.Methods A retrospective analysis was studied on 104 patients with severe heart failure,pulmonary infection and hyperglycemia from January 2009 to August 2012,and 48 cases were treated by insulin conventional treatment (control group),while 56 cases were treated by IIT treatment (observation group).The blood glucose changes at each time and time of antibiotic using,pulmonary infection control situation and mortality rate between the two groups were observed and compared.Results The blood glucose before treatment in observation group and control group were (15.8 ± 4.3) and (15.3 ± 5.1) mmol/L,and there was no statistical difference (P ＞ 0.05).The blood glucose levels at 24,48,72 h and 1 week after treatment in observation group were (8.3 ± 2.1),(8.0 ± 1.2),(7.9 ± 1.3) and (7.9 ± 1.1) mmol/L,in control group were (12.5 ± 3.2),(11.7 ± 2.1),(11.3 ± 1.5) and (11.2 ± 1.7) mmol/L.The blood glucose levels after treatment in the two groups were significantly lower than those before treatment,but in observation group were significantly lower than those in control group,and there were statistical differences (P ＜0.01).The time of antibiotic using in observation group was significantly shorter than that in control group [(14.3 ± 2.5) d vs.(20.1 ± 3.2) d],and there was statistical difference(t =10.368,P ＜ 0.01).The total effective rate of pulmonary infection in observation group was significantly higher than that in control group [87.5％(49/56) vs.68.8％(33/48)],and there was statistical difference (x2 =5.448,P ＜ 0.05).The mortality rate in observation group was significantly lower than that in control group [8.9％ (5/56) vs.22.9％ (11/48)],and there was statistical difference (x2 =6.423,P ＜ 0.05).Conclusion The IIT used in the treatment of patients with severe heart failure,pulmonary infection and hyperglycemia can significantly improve the prognosis of patients and reduce mortality rate,which is worthy of clinical application.

Adult ; Dimethylformamide ; adverse effects ; Glutathione ; blood ; Humans ; Male ; Methanol ; adverse effects ; Nitric Oxide ; blood ; Occupational Exposure ; Oxygen ; metabolism ; Superoxide Dismutase ; blood ; Surveys and Questionnaires ; Toluene ; adverse effects

Objective To explore how attachment and pain belief mediate the relationship among coping strategies and adjustment to chronic pain in elderly community residents.Methods The demographic questionnaire,the Chinese version of Brief Pain Inventory,Coping Strategies Questionnaire-Revised,Experiences in Close Relationship-Revised,Pain Beliefs and Perceptions Inventory were used to investigate 242 patients in chronic pain.Results Attachment avoidance mediate the relationship between brace face,between bad feeling,between ignorance of pain and adjustment to chronic pain,with the mediation effects being 0.047,0.031 and 0.017 respectively,accounting for 27.99％,6.28％ and 7.28％ of total effect.The belief of continuing pain mediates the relationship between bad feeling and adjustment to chronic pain,with the mediation effect being 0.043,accounting for 9.54％ of total effect.The belief that pain can not be relieved mediates the relationship between bad feeling and adjustment to chronic pain,with the mediation effect being 0.022,accounting for 4.89％ of total effect.Conclusions Attachment avoidance,belief of continuing pain and belief that pain can not be relived play mediation roles between coping strategies and adjustment to chronic pain,attachment avoidance accounts for a more important role in all.

Objective To observe the expression changes of peripheral endothelial progenitor cells (EPCs) and Ang-1/Tie2 in patients with pulmonary arterial hypertension (PAH).Methods From Jun 2011 to Dec 2012,45 patients with PAH charged in Affiliated Hospital of Hangzhou Normal University were divided into 3 groups according to mean pulmonary arterial blood pressure (15 per group):mild(Group L),moderate(Group M),and severe(Group S),with another 15 normal people as control group(Group C).The EPCs were isolated from peripheral blood of every patient,number counting using fluorescence activated cell sorter (FACS),function test using cell culture in vitro.Expression of Ang-1 and Tie2 in the peripheral EPCs were measured by RT-PCR or Western-blot.Non normal data was analyzed by non parametric statistical test.Results The statistical discrepancy existed among Group L,M,S and the control in the number of EPCs [32.0 (27.0,37.0),26.0 (19.0,31.0),24.0 (22.0,26.0) vs 40.0 (37.0,51.0),P ＜ 0.05].The ability of migration [32.1 (26.5,37.5),26.8 (22.4,35.4),21.0 (17.8,34.0) vs 39.0 (33.3,42.4),P＜0.05] and adhesion of the EPCs [57.1(50.9,61.8),51.8(45.2,58.7),46.0 (37.2,55.1) vs 64.1 (56.2,75.0),P ＜ 0.05] among study groups and control group was different in statistic,the same with the proliferation activity of EPCs in different groups [0.6 (0.5,0.7),0.5 (0.4,0.6),0.4(0.3,0.5) vs 0.7(0.6,0.8),P ＜0.05].The mRNA expression of Ang-1 and Tie2 in Group M & S were significantly reduced compared with control [4.33 (2.49,4.62) and 2.89 (2.39,3.44) vs 5.31(3.78,6.22),P＜0.05],Tie2 mRNA[1.32(1.23,1.34)and 1.23(1.08,1.42)vs 1.49(1.25,1.66),P ＜ 0.05],and the protein expression of the phosphorylated Tie 2 in Group M &S were decreased [0.16 (0.15,0.24) and 0.12 (0.08,0.18) vs 0.22 (0.19,0.28),P ＜ 0.05].No significant difference of Ang-1 and Tie2 expression was observed between Group L and control [5.42 (4.72,5.95),1.54 (1.43,1.66) and0.23(0.19,0.33),P=0.674,0.867 and 0.674].Conelusion With the severity of PAH,the number and function of circulating EPCs decreased,as consistent with Ang-1 and Tie2 expression changes,suggesting that function decrease of EPCs in patients with PAH may be associated with the decrease of Ang-1/Tie2 expression.

OBJECTIVEThis study aimed to explore the effect of the up-regulation of Notch1 on osteoclastogenesis induced to osteoclasts by receptor activator for nuclear factor-kappaB ligand (RANKL) and macrophage colony-stimulating factors (MCSF) in vitro.

METHODSThe bone marrow stem cells (BMSCs) of Rosa(-notch1) mice were cultured and induced to osteoclasts by RANKL and MCSF. The BMSCs were transfected with the Ad-Cre-green fluorescent protein (GFP) virus or Ad-GFP virus. Total RNA from cells was extracted, and the gene expression levels of Notch1, Notch2, Notch3, Notch4, Deltal, Delta3, Delta4, Jagged1, Hes1, and tartrate resistant acid phosphatase (TRAP) were detected at the defined stage by reverse transcription-polymerase chain reaction (RT-PCR). Osteoclast formation was analyzed by TRAP assay.

RESULTSThe number of TRAP-positive multinuclear cells of the experimental group significantly decreased compared with that of the control group. The mRNA expression levels of Notch1, Notch3, Jagged1, Delta3, and Hesl of the experimental group were significantly higher than those of the control group, whereas the TRAP mRNA expression of the experimental group was significantly lower than that of the control group (P<0.05).

CONCLUSIONUp-regulation of Notch1 inhibit osteoclastogenesis of BMSCs induced by RANKL and MCSF in vitro.

Animals ; Cell Differentiation ; Cell Line ; In Vitro Techniques ; Macrophage Colony-Stimulating Factor ; Mice ; Osteoclasts ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B ; Receptor, Notch1 ; metabolism ; Receptor, Notch2 ; Up-Regulation ; physiology

ObjectiveTo observe the efficacy of acupuncture plus acupoint injection in improving the depression state and quality of life (QOL) in patients with depression after ischemic stroke (syndrome differentiated as blood stagnation obstructing collaterals).MethodAccording to the inclusion and exclusion criteria, the eligible subjects were enrolled and randomized into a treatment group and a control group. The treatment group was intervened by acupuncture plus acupoint injection, while the control group was by oral administration of Fluoxetine. They were evaluated by using the Hamilton Depression Scale (HAMD) and Barthel Index (BI) before treatment and after 2-month treatment.ResultAfter 2-month treatment, there was no significant difference in comparing the anti-depressionefficacy between the two groups (P>0.05). The BI score of the treatment group was significantly better than that of the control group after 2-month treatment (P<0.05).ConclusionAcupuncture plus acupoint injection is effective in improving the depression state in the patients with depression after ischemic stroke (syndrome differentiated as blood stagnation obstructing collaterals); after 2-month treatment, it can produce an equivalent therapeutic efficacy compared with oral administration of Fluoxetine.Acupuncture plus acupoint injection is superior to the control in improving the QOL of the patients.

Objective To investigate the clinical curative effect of absorbable screw in the treatment of Limbs joint fracture. Methods From May 2009 to May 2011, 86 patients of Limbs joint fracture in our hospital were randomly divided into the observation group and the control group. The observation group were treated with absorbable screw while the control group were given conventional treatment methods of fracture treatment, and the clinical effect of the two groups were observed after treatment. Results The excellent rate was 56. 3% in control group and 96. 3% in observation group. The excellent rate of the clinical treatment in the observation group was significantly better than the control group with a statistically significant difference (P<0. 05). Conclusion The clinical efficacy of absorbable screw for limbs joint frac-ture is significant, and its operation safety is higher. It improves the life quality of patients and it is worth of clinical promotion.

Objective To discuss the 3D printing modeling used to assist minimally invasive fixation with hollow screws for unstable pelvic fractures.Methods From January 2014 to January 2016,137 patients with unstable pelvic fracture received minimally invasive fixation with hollow screws and obtained complete follow-up at our department.In 65 of them,the fixation was assisted by 3D printing modeling;they were 37 men and 28 women,with an average age of 33.1 ± 4.9 years.In the other 72 cases,conventional fixation was performed without assistance of 3D printing modeling;they were 45 men and 27 women,with an average age of 32.6 ±4.7 years.The 2 groups were compared in terms of operation time,frequency of intraoperative fluoroscopy,reduction quality and curative effect.Results This cohort were followed up for 6 to 15 months (average,9 months).The 3D printing modeling group needed significantly less operation time (58.6 ± 13.4 min) and intraoperative fluoroscopy (29.3 ± 3.6 frequencies) than the conventional group (72.4 ± 12.4 min and 36.6 ± 2.8 frequencies) (P ＜ 0.05).According to the Matta scoring criteria,the quality of pelvic reduction was evaluated as excellent in 21 cases,as good in 30 cases,as fair in 13 cases and as poor in one in the 3D printing group,yielding an excellent and good rate of 78.5％ while as excellent in 22 cases,as good in 36 cases,as fair in 12 cases and as poor in 2 cases in the conventional group,yielding an excellent and good rate of 80.6％.According to the Majeed scoring criteria,the curative effect was evaluated at the last follow-up as excellent in 27 cases,as good in 26 cases,as fair in 11 cases and poor in one in the 3D printing group,giving an excellent and good rate of 81.5％ while as excellent in 30 cases,as good in 28 cases,as fair in 13 cases and as poor in one in the conventional group,giving an excellent and good rate of 80.6％.There were no statistically significant differences between the 2 groups in reduction quality or curative effect (P ＞ 0.05).No nonunion or iatrogenic neurovascular lesions happened during the follow-up period.Conclusion 3D-printing modeling is helpful for a good reduction and minimally invasive fixation with hollow screws for unstable pelvic fractures by reducing operation time and intraoperative fluoroscopy.

Objective To explore the distribution of parvovirus B19 (HPVB19) infection in patients with leukopenia.Methods Patients who visited the Affiliated Hospital of Hangzhou Normal University from January 2015 to June 2016 were analyzed.Patients with peripheral leucocytes count less than 3.5×109/L were included in experiment group and healthy people were included in control group.HPVB19 IgG and IgM were detected by enzyme-linked immunosorbent assay, and HPVB19 DNA was detected by quantitative polymerase chain reaction.Differences in continuous data between two groups were compared with two-sample t test and those in categorical data were compared with Chi-square test.Results A total of 79 patients were included in experiment group, including 32 males and 47 females.Ages ranged from 24 to 62 years old.And 126 healthy individuals were included in control group, including 55 males and 71 females.Ages ranged from 28 to 67 years old.The positive rates of HPVB19 IgG, IgM and DNA in experiment group were 34.2%, 5.1% and 3.8%, respectively, while those in control group were 36.5%, 0 and 0, respectively.The detection rates of HPVB19 IgM and DNA between two groups were significantly different (χ2=6.507, P=0.011 and χ2=4.856, P=0.028, respectively).Sequence analysis for 3 of the HPVB19 DNA positive samples showed that there were two single nucleotide polymorphisms in VP1/VP2 sequence from one patient, which contributed to the 153rd (L/H) and 219th (N/Y) amino acids mutations, respectively.Phylogenetic analysis found that two strains belong to genotype 1a and one strain belongs to genotype 1b.Conclusions Detection rate of parvovirus HPVB19 infection (positive rates of HPVB19 IgM and DNA) in leukopenic patients is significantly higher than healthy controls.HPVB19 should be detected before considering transfusion in leukopenic patients in clinical practice.

Objective To investigate the distribution of ompA gnne in 15 Chinese reference standard strains belonging to 15 serogroups of Leptospira interrogate, and to express recombinant OmpA ( rOmpA ) and to identify immunogenicity and immunoprotection of rOmpA. Methods Genomic DNAs from different leptospiral strains were extracted by phenol-chloroform method. Entire ompA gene fragments from the strains were amplified by PCR and then sequenced after T-A cloning. A prokaryotic expression system of ompA gene from L. interrogans strain 56601 was constructed, and the expression and yield of rOmpA were determined by SOS-PAGE plus Bio-Rad Agarose Image Analyser. Rabbits were immunized with rOmpA for obtaining antiserum, and immunodiffusion test was used to measure the antiserum's titer. Western blot assay was performed to determine the immunoreaetivity of rOmpA with the antiserum against rOmpA and antiserum against whole cell of L. interrogans strain 56601, while mi-croscopic agglutination test (MAT) was applied to detect the cross agglutination to the 15 L. interrogans strains. A leptospire adhering cell model and a leptospire infecting guinea pigs model were used to determine the adhesion-bloc-king effect of rOmpA antiserum and immunoprotection of rOmpA. Results All the 15 L. interrogans strains, but not L. biflexa strain Patoe Ⅰ , had sequence conserved ompA genes. The yield of rOmpA was approximate 20% of the total bacterial proteins, rOmpA could induce rabbits to produce antibody and immunodiffusion titer of the anti-serum was 1:4. Both antisera against rOmpA and against whole cell of L. interrogans strain 56601 were able to pro-duce positive Western blot signs to rOmpA, and the former offered 1 : 20-1 : 320 MAT titers to the 15 L. interrogans strains. 1: 10-1:160 dilutions of rOmpA antiserum could efficiently block L. interrogans strain 56601 adhering to J774A. 1 cells, and 100 μg and 200 μg rOmpA displayed 50.0% and 75.0% immunoprotective rates in the infee-ted guinea pigs. Conclusion ompA gene only exists in genomes of different pathogenic L. interrogans serogroups. rOmpA has relatively stronger antigenicity, cross immunoreactivity and certain immunoprotection, implying that this recombinant protein may be used as a candidate antigen for developing universal genetic engineering vaccine of L. interrogans.