Objective:To analyze the effect of bisoprolol on the cardiopulmonary function in the patients with CHF complicated with COPD. Methods:A retrospective study was used. Totally 60 cases of patients were divided into the observation group(30 cases) and the control group(30 cases)according to the different treatment method. The patients in the control group were treated with con-ventional methods including cardiotonic drugs,vasodilators,anticoagulation,myocardial nutrition and so on,while the patients in the observation group were treated with bisoprolol additionally at the initial dose of 1. 25mg,and the dose was increased to 10mg at the rate of 1. 25 mg/1-2 weeks. The cardiopulmonary function,clinical efficacy and adverse reactions of the two groups were compared after 3-month treatment. Results:The complete response rate and effective rate of the observation group were both higher than those of the control group(P<0. 05). All indices of cardiac function were improved in the two groups after the treatment(P<0. 05),and the im-provement of the observation group was better than that of the control group(P<0. 05). There was no obvious change in the pulmonary function before and after the treatment(P>0. 05). The incidence of adverse reactions in the two groups showed no significant differ-ence(P>0. 05). Conclusion:Bisoprolol combined with conventional treatment can improve cardiac function of the patients with CHF and COPD. The adverse effect on lung function is mild. Bisoprolol is safe and effective,which is worthy of promoted application.

Objective: To observe the clinical efficacy and safety of the combination therapy of sitagliptin and irbesartan in the treatment of early diabetic nephropathy.Methods: Totally 49 cases of initial diagnosed diabetic nephropathy were randomly divided into the observation group (25 cases) and the control group (24 cases).On the basis of diabetic diet, health education and regular hypoglycemic drugs, the control group was treated with irbesartan tablets, 150 mg, po , qd, and on the basis of the control group, the observation group was treated with sitagliptin tablets 100mg, po , qd.All the patients were treated for 3 months.The fasting blood glucose (FBG), postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), urinary microalbumin (mAlb) and body massindex(BMI) were compared between the groups before and after the treatment.Results: After the treatment, FBG, PBG, HbA1c, SBP, DBP and mAlb in the observation group were significantly lower than those before the treatment (P＜0.05).Hypoglycemia occntrredin in one patient in the observation group.There were no significant changes in FBG, PBG and HbA1c in the control group (P＞0.05), and SBP, DBP and mAlb decreased significantly (P＜0.05).After the treatment, the decrease of FBG, PBG, HbA1c and mAlb in the observation group was more significant than that in the control group, and the difference was statistically significant (P＜0.05).The decrease of blood pressure between the groups was not statistically significant (P＞0.05).Hypoglycemia occnrredin in one patient in the observation group.There was no significant difference in BMI between the groups and before and after the treatment (P＞0.05).There was no significant difference in the incidence of hypoglycemia between the groups after the treatment (P＞0.05).Conclusion: The combination of sitagliptin and irbesartan in the treatment of early diabetic nephropathy can effectively decrease blood glucose, reduce mAlb excretion and delay the progression of nephropathy.

OBJECTIVE:To study the effect and its possible mechanism of Xuezhiping capsule on blood lipid levels of high blood lipid model golden hamsters. METHODS:Golden hamsters were randomly divided into normal control group,model group, atorvastatin group (3 mg/kg),combination group (Xuezhiping capsule 1.3 g/kg+atorvastatin 1.5 mg/kg),Xuezhiping capsule low-dose,medium-dose,high-dose groups(Xuezhiping capsule 1.3,2.6,5.2 g/kg),10 in each group. Hamsters in normal control group received normal diet,the other groups were given high-fat diet to establish high blood lipid model. Then relevant drugs were intragastrically given 2 weeks later. Normal control group and model group were intragastrically given equal volume of distilled wa-ter,once a day,for 4 weeks. After last administration,blood lipid indexes(TG,TC,HDL-C,LDL-C,FFA),mRNA and protein expressions of lipid metabolism related genes (PPAR-α,CYP7A1,ACOX,SREBP-1c,ACC1) were detected. RESULTS:Com-pared with normal control group,serum contents of TC,TG,LDL-C,FFA in model group increased,HDL-C content decreased;PPAR-α,CYP7A1,ACOX mRNA and protein expressions were weakened,SREBP-1c,ACC1 mRNA and protein expressions were enhanced(P<0.05). Compared with model group,above-mentioned indexes were obviously improved in Xuezhiping capsule high-dose group,atorvastatin group and combination group (except for HDL-C in Xuezhiping capsule high-dose group)(P<0.05);TC,TG,FFA contents,and PPAR-α,CYP7A1,ACOX,ACC1 mRNA,and CYP7A1,SREBP-1c,ACC1 protein were obviously improved in Xuezhiping capsule medium-dose group(P<0.05);TC,TG contents,and PPAR-α mRNA,and CYP7A1, SREBP-1c protein were obviously improved in Xuezhiping capsule low-dose group (P<0.05). CONCLUSIONS:Xuezhiping cap-sule has a promising effect of lowering blood lipid,the mechanism may be related to activating PPAR-α and inhibiting SREBP-lc signaling pathway.

Objective:To identify the signature of tumor-infiltrating lymphocyte (TIL) subtypes that may affect cytokine expres-sion between different outcomes of hepatocellular carcinoma (HCC) patients by analyzing the CD molecular expression profiles of non-cancerous hepatic tissues. Methods:Surface markers of TIL in noncancerous hepatic tissues from 146 HCC patients were determined by using immunohistochemical method and flow cytometry. Univariate and multivariate Cox proportional hazards models and Kaplan-Meier method were used to analyze the association of their expression levels with tumor recurrence and survival. Results:More than 86.4%of TILs in patients were quiescent, as measured via CD4+or Foxp3 expression. Meanwhile, more than 90%of CD3+T cells ex-pressed CD8+. The proportion of T cells was low compared with CD8+T cells. The proportion of CD19 and CD20 in distant nontumor tissues almost was zero. The proportion of T cell subgroups isolated from HCC circulating whole blood did not show a significant shift compared with the normal control, as follows:CD4+T/CD8+T=1.167 ± 1.04, CD8+T/CD3+T=0.288 ± 0.116, and CD4+T/CD3+T=0.429 ± 0.178. The proportion of CD8+T cells in noncancerous hepatic tissues was higher than that in blood (P<0.001).Conclusion:TILs in HCC noncancerous hepatic tissues are increased and contain a subpopulation of CD3+CD8+T cells. CD8+T cells in cancerous tissues, rather than noncancerous tissues, show significant differences between different prognostic groups.

Objective To study the CT manifestations and diagnostic value of stromal tumor.Methods CT documentation of 25 stromal tumor cases confirmed by surgery and pathology were analyzed retrospectively,all cases underwent 64 row or 256 row spiral CT plain scan and enhanced scan.Results Within 25 cases,1 7 cases were gastrointestinal,of which,10 cases were found in stom-ach,1 case in duodenum,3 cases in jejunum and 3 cases in ileum;and 8 cases were extra-gastrointestinal,of which,6 cases were found in enterocoelia,1 cases in inguinal region,1 case in abdominal wall;the ratio was 2.1 ︰ 1.In 25 cases,highly malignant dan-ger level were 1 1 cases,7 cases of moderate and 7 cases of low malignant danger;Transfer occurred in 7 cases and 3 cases of postop-erative recurrence.Conclusion The volume CT has great advantages in displaying information in lesion,and has high value in loca-ting the lesion and qualitative diagnosis of disease.

Object:The paper aims to analyze Taiwanese experience in pharmaceutical procurement, pharma-ceutical benefits and reimbursement schedule, and make references for the Mainland China. Methods:Through read-ing and analyzing the Taiwanese government policy and the literature published to find out the pharmaceutical pro-curement measures, different medicines’ pricing strategy and its reimbursement mode compared with the Mainland China. Results: Hospitals can purchase medicines based on their own needs, and the purchase price was formed through negotiating with providers and buyers. It has been found that Taiwan only controls the medicines reimburse-ment prices. The international reference pricing is adopted for new medicines, and the originators, bioequivalence/bioavailability generic medicines and general generics reimbursement prices are very high at international reference prices, and need to be weakened in order to fit the requirements. Moreover, the medicine quality is one of the stand-ards considered in case of making decisions on the reimbursement prices. In addition, the reimbursement price is as-sociated with procurement price. When the spread is larger than 30%, the government will adjust the reimbursement to fill the gap. Conclusions: Through the system design and adjustment, the Taiwanese Government have set up a better procurement and reimbursement co-ordination in the pharmaceutical segment, and formed the reasonable prices for the case. The Taiwanese experience can be taken as a reference for the mainland China to refine its procurement reforms and reimbursement policy.

BACKGROUND:With more and more elderly patients suffering lumbar degenerative disease undergoing internal fixation, infection after spinal internal fixation is a common complication in orthopedic surgeries, but its treatment strategy remains controversial.OBJECTIVE: To explore the curative efficacy of incision infection after internal fixation in the elderly with lumbar degenerative disease.METHODS: 197 patients with lumbar degenerative disease undergoing internal fixation and followed up for more than 2 years admitted in Department of Orthopedics, Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2012 to January 2015, were analyzed retrospectively. The follow-up time was 2-4.9 years. There were 97 cases of lumbar stenosis, 29 cases of lumbar disc herniation, 33 cases of lumbar spondylolisthesis, 17 cases of degenerative scoliosis and 21 cases of lumbar compression fractures.RESULTS AND CONCLUSION: (1) Eleven patients experienced incision infection, including ten acute, and one delayed infection. (2) Among acute infected cases, three were superficial infection in three cases and seven had deep infection,who characterized as exudation (10/10), local pain (8/10) and fever (9/10). Acute infected cases received bacterial culture, drug sensitive test, antibiotic therapy, and debridement of the infected wound, and leaving all internal fixators in situ in all but one case. (3) For delayed infection, one patient had local pain, incision exudation, and intermittent fever,and then the internal fixators were removed. (4) Pseudarthrosis was not founded during 2-year follow-up in all patients.(5) These results suggest that for the elderly patients suffering lumbar degenerative disease with infection after internal fixation, intravenous antibiotics, debridement plus drainage are recommended, but without internal fixator removal, and repetitive debridement and drainage is a rational choice if necessary.

OBJECTIVE: To explore the prevalence, clinical feature and levels of protein carbonyl (PCO) in serum of type 2 diabetes mellitus combining obstrucitive sleep apnea syndrome (OSAHS). METHOD: Two hundred and three patients with type 2 diabetes were taken multi lead sleep detection and their AHI, age, height, body mass index (BMI),waistline, duration of diabetes, fast blood glucose, HbA1c level and level of PCO in serum were recorded. RESULT: The prevalence of OSAHS was 79.2% in 203 patients, serious apnea 30.4%, moderate apnea 45.4%, mild apnea 24.2%. BMI, waistline, fast blood glucose, HbA1c level and level of PCO in serum were higher in patients complicated with OSAHS (P < 0.01). HbA1c was independently and positively correlated with patients with OSAHS risk (P < 0.05, OR 6.11). The independent correlation factors of AHI included HbA1c level,BMI, waistline, duration of diabetes and level of PCO in serum,with HbA1c as the predominant factor (P < 0.05). CONCLUSION The prevalence of OSAHS was higher in patients of type 2 diabetes mellitus combining (OSAHS). Moreover, in these patients poor glucose control and aggravated protein oxidative injury were observed.
Body Mass Index ; Diabetes Mellitus, Type 2 ; blood ; complications ; Humans ; Prevalence ; Protein Carbonylation ; Risk Factors ; Sleep Apnea, Obstructive ; blood ; complications

AIM: To detect whether N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) inhibits epithelial-mes-enchymal transition in A549 cells induced by TGF-β1 through suppressing the expression of heat shock protein 27 (HSP27) and zinc finger proteins Snail (including SNAI1and SNAI2) which ultimately inhibited the deposition of type I and type III collagens.METHODS:The colocalizations of HSP27 and SNAI1/SNAI2 respectively on A549 alveolar epi-thelial cells induced by TGF-β1 were measured by confocal microscopy .The expression of HSP27, SNAI1 and SNAI2 at mRNA level was detected by real-time PCR.Western blotting analysis was used to detect the expression of HSP 27, SNAI1 and SNAI2 on epithelial-mesenchymal transition in A549 cells induced by TGF-β1 and also the deposition of type I and type III collagens in A549 cells transfected with HSP27shRNA prior to TGF-β1 stimulation.RESULTS: Compared with control group, TGF-β1 increased the expression of HSP27, SNAI1, SNAI2, type I and type III collagen, which decreased significantly followed by Ac-SDKP intervention.The expression of SNAI1, type I and type III collagen decreased signifi-cantly after transfected with HSP27shRNA in A549 cells, which had the similar effect on Ac-SDKP intervention.CON-CLUSION:Ac-SDKP inhibits the transition of cultured A 549 cells to myofibroblasts and attenuates collagen synthesis by suppressing the expression of HSP 27 and zinc finger proteins SNAI 1 and SNAI2.

Objective To investigate the effects of astragalus polysaccharides on radio-pulmonary lesion.Methods 48 Wistar rats were divided into normal group, model group, astragalus polysaccharides treated group and dexamethasone treated group, each had 12 rats.Models of radio-pulmonary lesion of rats in later three groups were established by whole-thorax irradiation 20 Gy, then normal group was pretending to irradiation.Rats in normal group and model group were given 0.9% NaCl, astragalus polysaccharides treated group and dexamethasone treated group were given astragalus polysaccharides(8mg/mL) and dexamethasone(0.05mg/mL), accordingly.All rats were with 8 weeks, at 2 w and 8 w post-injury, 6 rats in each group were selected randomly and anesthesia to death.The erythrocytes and leukocytes in blood and bronchoalveolar lavage fluid ( BALF) in each group were detected and histological examination of lung tissues were performed by Haematoxylin and Eosin staining to study general morphology.Results Radiation-induced lung injury rat model were successfully constructed, general observation showed that irradiated rats gradually appear listlessness, reduce the volume of activities, arched, hair removal and other symptoms, astragalus polysaccharide (APS) and dexamethasone treated rats had gradual improvement than model group.Compared with control group, erythrocytes and leukocytes counts in serum of model group at 2 w and 8 w post-injury were significantly decreased(P <0.05), the numbers of erythrocytes and leukocytes in BALF were significantly increased(P <0.05). Compared with model group group, the leukocytes, erythrocytes and neutrophils counts in serum of astragalus polysaccharides treated group and dexamethasone treated group were all increased(P <0.05), respectively, and the number of leukocytes and erythrocytes in BLAF were significantly decreased(P<0.05).All the indexes between two groups had no significant difference.The pathological changes of lung tissues showed that rats in model group had rupture alveolar wall, widened alveolar interval, pulmonary interstitial hyperplasia, and the alveolar space and interstitial lung stroma had a large number of inflammatory cells exudation.The symptoms in astragalus polysaccharides treated group and dexamethasone treated group were all alleviated, and there was no significant difference between the two groups.Conclusion Astragalus polysaccharides have therapeutic effect on radio-pulmonary lesion in rats, and the therapeutic effects of astragalus polysaccharides are roughly similar to dexamethasone.Further research is needed to elucidate the mechanism behind the effects of astragalus polysaccharides in order to develop appropriate treatment.