Objective To investigate the effects of recombinant human brain natriuretic peptide and sodium nitroprusside in the treatment of acute decompensated heart failure.Methods 82 patients with acute decompensated heart failure were randomly divided into observation group and control group,41 cases in each group.The control group was given sodium nitroprusside intravenous infusion therapy on the basis of routine treatment.The observation group was given recombinant human brain natriuretic peptide infusion treatment on the basis of control group treatment.The clinical efficacy was compared between the two groups.Results The total effective rate of the observation group was 95.12％,which was significantly higher than 75.61％ of the control group (x2 =5.33,P ＜ 0.05).After treatment,the left ventricular diastolic end diameter in the observation group [(67.38 ± 6.82) mm] was significantly lower than before treatment and control group after treatment (t =4.12,3.23,all P ＜ 0.05).After treatment,the left ventricular shot ejection fraction in the observation group [(48.91 ± 7.42)％] was significantly higher than before treatment and control group after treatment (t =3.92,3.77,all P ＜ 0.05).The incidence rate of adverse reactions in the observation group was 9.76％,which of the control group was 7.32％.,the difference was not statistically significant (P ＞ 0.05).Conclusion Recombinant human brain natriuretic peptide combined with sodium nitroprusside could significantly improve the clinical curative effect of acute decompensated heart failure,improve heart function of patients,and inhibit myocardial remodeling.It had good security.

Objective To investigate the effects of dexmedetomidine (DEX) on the mRNA expression of triggering receptor expressed on myeloid cells 1 (TREM-1) in peripheral blood mononuclear cells of rats with acute obstructive suppurative cholangitis (AOSC).Methods Sixty healthy male Wistar rat models of AOSC induced by complete common bile duct ligation and injection of E.coli into the bile duct through an intubation tube were replicated successfully.After modeling,the peripheral blood was collected and mononuclear cells were isolated and cultured.According to random number table method,the mononeuclear cells were divided into model group (no drug added in culture of mononuclear cells) and low,medium and high dose DEX groups (final concentrations 0.4,0.8,1.2 μg/L DEX were in low,medium and high DEX mononuclear cell cultures,respectively).After the mononuclear cells were cultured for 24 hours,the levels of tumor necrosis factor-α (TNF-α),interleukins (IL-1 and IL-6) in the supernatant of the cultured mononuclear cells were detected by enzyme linked immunosorbent assay (ELISA).The level of C-reactive protein (CRP) was detected by immunity transmission turbidimetry.The expression of TREM-1 mRNA in the mononuclear cells was detected by reverse trantscription-polymerase chain reaction (RT-PCR).Results Compared with the model group,the levels of TNF-α,IL-1,IL-6,CRP were decreased,the TREM-1 mRNA expressions were down-regulated in the different DEX dose groups,and the degrees of descent in medium and high dose groups were more significant than those in low dose group [TNF-oα (ng/L):95.5±8.6,88.9±5.3 vs.131.1 ± 14.2;IL-1 (ng/L):53.5±8.3,48.3 ± 6.7 vs.73.7 ± 12.8;IL-6 (ng/L):266.9±26.2,252.1 ± 17.7 vs.349.9±40.4;CRP (ng/L):4.3 ± 1.1,3.9 ±0.7 vs.5.6 ± 1.7;TREM-1 mRNA (A value):0.43 ± 0.18,0.39 ± 0.16 vs.0.65 ±0.25,all P ＜ 0.05].Conclusion DEX can down-regulate the expression of TREM-1 mRNA and inhibit the formation and secretion of inflammatory factors TNF-α,IL-1,IL-6 and CRP in peripheral blood mononuclear cells of rats with ASOC.

Objective To detect the gene expression of PCA3 and PSA in peripheral blood and urine simultaneously to investigate whether PCA3 combining PSA gene could become new markers for diagnosis of Pca. Methods From June 2009 to December 2009,the initial urine after prostatic massage and the peripheral blood specimens were collected from 37 patients with PCa and 68 patients with BPH that were pathologically confirmed,g patients with urinary stone were used as normal control,the expression of PCA3 and PSA mRNA of mononuclear cells in urine sediments and peripheral blood were detected by fluorescence real-time quantitative PCR,with β-actin mRNA as internal control. Results The sensitivity and specificity of the expression of PCA3 mRNA in peripheral blood for diagnosis of prostate cancer were 48.6％ and 100％ respectively.ROC curve analysis was performed for the PCA3 score and the area under the ROC curve was 0.908.Using 64.6 as the cutoff,the sensitivity was 81.1％ and the specificity was 86.8％.In group with serum tPSA value ＜4 pg/L,the positive rate and negative rate of urinary PCA3 score for diagnosing prostate cancer were 80％ (4/5) and 89.4％ (20/22) respectively.In group with serum tPSA value 4 - 10 μg/L,the positive rate and negative rate of urinary PCA3 score were 66.7％ ( 2/3 ) and 84.2％(16/19) respectively.In group with serum tPSA value ＞ 10 μg/L,the positive rate and negative rate of urinary PCA3 score were 82.8％ (24/27) and 81.5％ (22/27) respectively.The sensitivity of simultaneous detection of PCA3 mRNA in peripheral blood and urinary PCA3 score was 86.5％. Conclusions The expression of PCA3 mRNA in peripheral blood was a specific marker for the diagnosis of PCa.The simultaneous detection of PCA3 mRNA in peripheral blood and urinary PCA3 score could increase the sensitivity for the diagnosis of PCa.

Objective To evaluate the value of ATP content of CD4+ T lymphocytes in the diagnosis of infection and its correlation with drug concentrations in renal transplant recipients.Methods 45 renal transplant recipients were reviewed from May 2010 to October 2011.There were 33males and 12 females,aged from 21 to 58 years old.The recipients were divided into non-infection group (n =34) and infection group (n =11) according to their clinical manifestation.11 cases of infection were diagnosed by the chest X-ray,CT imaging manifestations and etiological examination,among them 5 cases were pulmonary infection,4 cases were upper respiratory infection,1 case was urinary tract infection and 1 case was perineal abscess.23 healthy volunteers were enrolled as the control group.They were detected ATP content of CD4+T lymphocytes by Immuknow method.Thetrough concentrations of the FK506 and CsA were detected by microparticle enzyme immunoassay and fluorescence polarization immunoassay,respectively.The hs-CRP concentration was detected by immunoturbidimetry.Results The ATP content of CD4+ T lymphocytes of the control group,non infection group and the infection group were (295±74) μg/L,(35± 189) μg/L and (212± 155) μg/L respectively.The levels of ATP of infection group were obviously lower than the control group and non-infection group.There were statistically differences (P ＜0.05).24 recipients were followed up dynamicly.There were 4 cases whose ATP value was lower than the postoperative average levels in 5 infection recipients.The hs-CRP concentration of infection group were (12.4±4.8) mg/L,obviously higher than the non infection group's (3.3 ± 4.7) mg/L and the control group' s (0.5 ± 0.5) mg/L.There were statistically differences (P＜0.05).The ATP content of CD4+ T lymphocytes were no significant associated with drug trough concentrations (P＞0.05).Conclusions Low ATP level after renal transplantation is a risk factor for infection recipients.Immuknow cell function assay can make up for the inadequacy of the drug concentration monitoring,reduce the risk of infection,and guide clinical immunosuppressive adjustment.

Objective To evaluate the feasibility and effectiveness of bladder-preserving local resection combined with intra-artery chemotherapy for patients with T1G3 bladder cancer.Methods Thirty five cases with T1G3 bladder cancer were analyzed retrospectively. Patients were all treated by bladder-preserving local resection combined with intra-artery chemotherapy. Results Thirty five cases were followed up. The time of follow-up ranged from 7 to 116 months,and mean time was(66.0±18.3)months.The 5 year recurrence and bladder-preserving rate were 48.6 ％(17/35)and 68.6 ％(24/35),respectively.The overall and tumor specific survival at 5 years was 77.1％ (27/35)and 82.9 ％ (29/35).The effect of bladder-preserving local resection plus intra-artery chemotherapy was satisfactory. Moreover, intra-artery chemotherapy had no obvious side effects.Conclusion Bladder-preserving local resection combined with intra-artery chemotherapy not only can retain normal bladder function, decrease in the recurrence, but also does not reduce the survival rate. It is an effective treatment for some patients with T1G3 bladder cancer instead of cystectomy over-treatment.

Background and objective Invasive mucinous adenocarcinoma(IMA)was a rare and specific type of lung adenocarcinoma,which was often characterized by fewer lymphatic metastases.Therefore,it was difficult to evaluate the prognosis of these tumors based on the existing tumor-node-metastasis(TNM)staging.So,this study aimed to develop Nomo-grams to predict outcomes of patients with pathologic N0 in resected IMA.Methods According to the inclusion criteria and exclusion criteria,IMA patients with pathologic N0 in The Affiliated Lihuili Hospital of Ningbo University(training cohort,n=78)and Ningbo No.2 Hospital(validation cohort,n=66)were reviewed between July 2012 and May 2017.The prognostic value of the clinicopathological features in the training cohort was analyzed and prognostic prediction models were established,and the performances of models were evaluated.Finally,the validation cohort data was put in for external validation.Results Univariate analysis showed that pneumonic type,larger tumor size,mixed mucinous/non-mucinous component,and higher overall stage were significant influence factors of 5-year progression-free survival(PFS)and overall survival(OS).Multivariate analysis further indicated that type of imaging,tumor size,mucinous component were the independent prognostic factors for poor 5-year PFS and OS.Moreover,the 5-year PFS and OS rates were 62.82％and 75.64％,respectively.In subgroups,the sur-vival analysis also showed that the pneumonic type and mixed mucinous/non-mucinous patients had significantly poorer 5-year PFS and OS compared with solitary type and pure mucinous patients,respectively.The C-index of Nomograms with 5-year PFS and OS were 0.815(95％CI:0.741-0.889)and 0.767(95％CI:0.669-0.865).The calibration curve and decision curve analysis(DCA)of both models showed good predictive performances in both cohorts.Conclusion The Nomograms based on clinicopathological characteristics in a certain extent,can be used as an effective prognostic tool for patients with pathologic N0 after IMA resection.

Objective: To analyze the correlation between physical activity and physical fitness index of children and adolescents in China, so as to provide reference for physical activity and physical fitness promtion of children and adolescents. Methods: In September 12,2018, 4 269 students were selected by cluster sampling in east, northwest, north, central, southwest and South China, the test of standing long jump, grip strength, 50 m running, improved seat forward bend, 30 s sit ups, 20 s cross repeatedly, 20 m round trip running was completed. Results: In comparing the physical fitness index of children and adolescents with different levels of physical activity, the PFI values of the middle and high intensity physical activity (MVPA) groups of boys aged 10-12 and 16-18 years old were (0.46±3.58) (0.75±3.0), the value of PFI of the MVPA group were (-0.69±3.64) (-0.61±2.87), the difference was statistically significant ( t =0.04, 0.57, P >0.05). There was no significant difference in the values of PFI between the four age groups of the girls ( P <0.05). In comparison of physical activity status of children and adolescents in different physical ability grades, the time of MPA, VPA and physical exercise in healthy physical ability group was higher than that in unhealthy physical ability group ( Z =-2.04, -4.93, -7.09, P <0.05). Linear regression analysis showed that there was a positive correlation between daily MVPA, physical exercise and physical fitness index ( P <0.05). Conclusion Moderate and high intensity physical activity, that is, physical exercise, is positively correlated with physical fitness index. Therefore, it is particularly important for children and adolescents to engage in sufficient moderate and vigorous intensity physical activities.

Objective To observe the clinical effects of Yiweining Capsules combined with rebamipide tablet in the treatment of spleen-stomach qi deficiency syndrome in chronic atrophic gastritis(CAG).Methods Totally 80 patients with CAG were divided into the study group and the control group by using the random number table method,with 40 cases in each group.Both groups were given rebamipide tablet,0.1 g/time,3 times a day,orally;on this basis,the study group added Yiweining Capsules 2 g/time,3 times a day,orally.Both groups were treated continuously for 12 weeks.The TCM efficacy,the efficacy of gastroscopy and the efficacy of histopathology in the two groups were observed.The TCM symptom score before and after treatment in two groups were observed.The adverse reactions were recorded.Results No cases fell off in both groups.The total effective rate was 92.5%(37/40)in the study group and 70.0%(28/40)in the control group,and the clinical efficacy of the study group was better than that of the control group(P<0.01).Compared with before treatment,the total TCM symptom scores in the two groups after treatment decreased(P<0.01);Compared with after treatment,the total scores of TCM symptom in the study group were lower than those in the control group(P<0.05,P<0.01).The total effective rate of gastroscopy in the study group(82.5%)was better than that in the control group(67.5%),with statistical significance(P<0.05).The overall efficacy rate of histopathdogy in the study group(87.5%)was better than that of the control group(70.0%),with statistical significance(P<0.01).There were no adverse reactions in both groups.Conclusion Yiweining Capsules combined with rebamipide tablet can effectively improve the clinical symptoms,gastroscopic manifestations and the degree of mucosal lesions in patients with CAG,with remarkable efficacy.