Objective:To explore clinical therapeutic effect and safety of diltiazem treating coronary artery spasm. Methods:A total of 100 patients with coronary artery spasm were selected in our hospital.According to number ta-ble method,they were randomly and equally divided into routine treatment group (n=50,received,lipid regulation and expanding coronory artery etc.)and diltiazem group (n=50,received diltiazem pumping based on routine treat-ment).Clinical and ECG therapeutic effect,changes of blood lipids,nitric oxide (NO)and endothelin-1 (ET-1) levels before and after treatment and safety were compared between two groups.Results:(1 )Compared with rou-tine treatment group,there were significant increase in total effective rates of clinical effect (60.00% vs.94.00%) and ECG (62.00% vs.92.00%)in diltiazem group,P<0.01 both;(2)Compared with before treatment,there were significant improvements in all ECG indexes,heart rate and blood pressure in two groups after treatment,and those of diltiazem group were significantly better than those of routine treatment group (P<0.05 all);(3)Com-pared with before treatment and routine treatment group,there were significant improvements in blood lipid levels in diltiazem group after treatment (P<0.05 all);(4)Compared with before treatment and routine treatment group,there was significant rise in NO level [(95.17±19.99)μmol/L,(95.17±21.22)μmol/L vs.(106.71± 22.38)μmol/L]and significant reduction in ET-1 level [(64.09±16.29)ng/L,(59.98±14.28)ng/L vs.(44.91± 6.38)ng/L]in diltiazem group after treatment (P<0.05 all);(6)During treatment,there were no adverse reac-tion in both groups.Conclusion:Diltiazem based on routine medication possess significant therapeutic effect and high safety for treating coronary artery spasm,which is worth extension in clinic.

Objective To investigate whether immunization mice with an immune tolerogenic vac-cine could inhibit the occurrence of allergic asthma through regulating the inflammatory T cells . Methods The BALB/c mice were randomly divided into 5 groups, with 10 mice per group.The mice in different groups were treated with different immunization strategies , which were 100 μl of phosphate buffer ( PBS) for the negative control , 10 μg of ovalbumin for the unrelated antigen control , 10 μg of dexametha-sone for group 3, 10μg of ovalbumin protein and 10μg dexamethasone for group 4 and 100 μg of ovalbumin protein and 100 μg of dexamethasone for group 5.The mice were immunized subcutaneously on days 1, 4, 7, and 14.Seven days after the last immunization , all mice were used for the induction of allergic asthma . The incidences of asthma in mice from different groups were evaluated 24 hours after the induction .The eval-uation indicators included pathological changes in lung tissues , infiltration of inflammatory cells in bronchial alveolar lavage fluid , antibody in serum samples and allergic responses .Results Immunization mice with the immune tolerogenic vaccine significantly reduced the infiltration of inflammatory cells in lung tissues , de-creased the levels of IgE and IgG 1 antibodies in serum samples and alleviated the injuries and pathological changes in lung tissues.However, the percentages of CD4+CD25+Foxp3+regulatory T cells to CD4+T popu-lations were significantly increased .Moreover, immunization mice with the tolerogenic vaccine could inhibit the expression of Th2 type cytokines .Conclusion Immunization mice with the tolerogenic vaccine could in-duce high levels of regulatory T cells , reduce the infiltration of inflammatory T cells in lung tissues and in-hibit the expression of Th2 cytokines, resulting in the inhibited occurrence of asthma in the murine model .

Objective To explore the insertion of the teaching contents of nursing in rural doctors'higher education,so as to increase their understanding of medical knowledge and improve their medical skills.Method 90 rural doctors of Grade 2014 were chosen as the research object,and according to their willingness to participate,they were divided into control group and observation group.The students in the control group were mainly taught by the relevant knowledge of clinical medicine,while nursing teaching content was inserted in the teaching of observation group.In the teaching process,firstly,the teaching contents of nursing were reorganized,and then the teaching content of clinical medicine was taken as the main line,according to the development of teaching content,flexibly inserting nursing teaching part.The results of the final examination of the internal medicine of the two groups were compared and the specific learning experience of rural doctors was investigated.SPSS 20.0 was used to analyze the data,the count data was expressed as percentage,and chi square test was performed.Results The number of students in the control group and the observation group whose subjective score was more than 40 was 17.65％ and 48.72％ respectively.The number of students scoring ＜30 points accounted for 23.53％ and 5.13％ of the total number of students,and there was a statistically significant difference between the two groups(P＜0.05).The observation group had a better learning experience,and had little influence on the learning of clinical medical knowledge.Conclusion In the stage of education for rural doctors,inserting the teaching contents of nursing can improve the teaching effect.

Objective To investigate the clinical value of the echocardiography in the diagnosis of congenital mitral valve malformation and summarize its occurrence and type associated with other cardiac malformations.Methods The echocardiographic image data of 101 patients with congenital mitral valve malformation were retrospectively analyzed,the characteristics of different types were summarized and compared with operation results,CT,cardiac catheterization,transesophageal echocardiography,as well as the data of echocardiographic follow-up.Results Among 101 patients with echocardiographic examination showed mitral valve congenital malformation,63 cases were isolated valve set malformation (62.4％),and multiple valve set malformation were found in 38 cases (32.7％).In another side,39 cases were of single mitral valve malformation (38.6％),while 62 patients combined with other type cardiac malformations (61.4％).No significant difference of dynamic change was shown between patients with solitary and multiple malformation of mitral valve (P ＞0.05).Conclusions Echocardiography can display congenital mitral valve malformation in a fast,robust,real-time way.It has an important clinical value in the diagnosis of congenital mitral valve malformation.

Objective To investigate the effect of growth inhibition and apoptosis induction of sunitinib-liposome-loaded microbubbles on renal carcinoma cell strain.Methods GRC-1 cell strain was cultured in vitro,and was divided into 6 groups:blank control group,pure microbubbles group,pure lipsomes group,sunitinib group,sunitinib-liposome-loaded microbubbles without ultrasound treat group,sunitinib liposome-loaded microbubbles with ultrasound treat group.Growth inhibition in different groups was observed at different time with MTT assay,apoptosis induction with Sigma-FlTC technology and transmission electron microscope.Results The growth inhibition and apoptosis promotion of GRC-1 cell were significantly increased in sunitinib-liposome-loaded microbubbles with ultrasound treat group compared to the other groups.Conclusions Microbubble guided sunitinih delivery can increase the effect of the growth inhibition and apoptosis induction of GRC-1 cells,which may provide an more effective approach for cancer treatment.

Objective To explore the therapeutic value of modified endoscopic submucosal dissection with ligation (ESD-L) for small tumors originated from gastric muscularis propria.Methods Total of 60 patients with tumors originated from gastric muscularis propria,which was confirmed by endoscopic ultrasonography and smaller than 12 mm and were recruited to the present study.The conventional ESD technique was used to dissect the tumor to the depth of muscularis propria.Then the bottom of the tumor and the beneath muscularis propria were ligated fully with a nylon loop.Further dissection was applied till the whole tumor was isolated.Results All 60 lesions were dissected completely with perforation occurred in 10 cases,which were managed successfully with metal hemoclip.Pathologic diagnosis was obtained in all lesions,and no recurrence was found during the follow-up.Conclusion Modified technique of ESD-L is effective for complete resection of small tumors originated from gastric muscularis propria,which can also decrease the risk of stomach perforation.

Objective To evaluate the effect of stellate ganglion block (SGB) on cellular immune function in diabetic rats.Methods Healthy male Sprague-Dawley rats,aged 3 months,weighing 240-280 g,were used in this study.Diabetes mellitus was induced by intraperitoneal 1％ streptozotocin 60 mg/kg and confirmed by blood glucose ≥ 16.7 mmol/L 3 days later.Forty-eight rats with diabetes mellitus were randomly divided into 2 groups (n=24 each) using a random number table:diabetes mellitus group (group DM) and group SGB.Another 24 healthy rats,aged 3 months,were selected and served as control group (group C).At 1 week after successful establishment of the model,unilateral transection of cervical sympathetic trunk (TCST) was performed in group SGB,while the right cervical sympathetic trunk was only exposed in C and DM groups.Before TCST (T0) and on 1,3,7 days after TCST (T1-3),6 rats were randomly selected from each group,and blood samples were collected from the inferior vena cava for determination of the blood glucose,plasma norepinephrine (NE) concentrations (by enzyme-linked immunosorbent assay),and levels of T lymphocyte subsets CD3+,CD4+ and CD8+ in whole blood (using FACSCalibur flow cytometer).C D4+/CD8+ratio was calculated.The rats were weighed before sacrifice,and the rats were sacrificed to obtain the thymus which was weighed.The thymus index (thymus weight/body weight) was calculated.Results Compared with group C,the blood glucose was significantly increased,and the levels of CD3+ and CD4+ in whole blood,CD4+/CD8+ ratio,and thymus index were significantly decreased at T0-3 (P＜0.05),and no significant change was found in CD8+ levels in DM and SGB groups (P＞0.05),the plasma NE concentrations were significantly decreased at T1-3 in group SGB (P＜0.05),and no significant change was found in plasma NE concentrations in group DM (P＞0.05).Compared with group DM,the blood glucose and plasma NE concentrations were significantly decreased,and the levels of CD3+ and CD4+ in whole blood,CD4+/CD8+ ratio,and thymus index were significantly increased at T1-3 (P＜0.05),and no significant change was found in CD8+ levels in group SGB (P＞0.05).Conclusion SGB can improve the cellular immune function in diabetic rats.

Objective To understand the differences in killing ability and mechanism of human mononuclear macrophages and neutrophils against Leptospira interrogans.Methods Human THP-1 and HL-60 cell lines were respectively pretreated with PMA (phorbol 12-myristate 13-acetate) and ATRA (all-trans retinoic acid) to induce their differentiation into macrophages and neutrophils.Confocal microscopy was used to detect the changes in total ROS (reactive oxygen species) and NO (nitric oxide) levels as well as free Ca2+ concentration ([Ca2+]i) in THP-1 monocyte-derived macrophages and HL-60 cell-derived neutrophils after infection with Leptospira interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai.Fluorospectrophotometry was applied to analyze the differences in killing ability between THP-1 monocyte-derived macrophages and HL-60 cell-derived neutrophils against intracellular leptospires before and after treatment with total ROS and NO inhibitors and intracellular free Ca2+ chelator.Results The total ROS and NO levels and [Ca2+]i in THP-1 monocyte-derived macrophages and HL-60 cell-derived neutrophils were significantly increased after infection with the spirochete (P<0.05).Moreover,the total ROS and NO levels and [Ca2+]i in the former were significantly higher than those in the latter (P<0.05).The THP-1 monocyte-derived macrophages had stronger killing ability against intracellular leptospires than the HL-60 cell-derived neutrophils (P<0.05).Inhibiting total intracellular ROS,NO or free Ca2+ could result in decreased killing ability of THP-1 monocyte-derived macrophages against intracellular leptospires,but not affect the killing ability of HL-60 cell-derived neutrophils.Conclusion Mononuclear macrophages rather than neutrophils act as the main phagocytes eliminating Leptospira interrogans.High levels of total intracellular ROS,NO and free Ca2+ are closely associated with the ability of mononuclear macrophages to kill Leptospira interrogans.

Objective To investigate the direct and indirect MRI manifestations of anterior cruciate ligament(ACL)tears and discuss its mechanism and diagnostic value.Methods The study involved 40 patients with ACL tears including 37 males and three females at age range of 16-49 years(mean age of 33 years).Arthroscopy and operation confirmed 28 patients at acute phase of ACL tears,12 at chronic phase of ACL tears,35 with complete ACL tears and five with partial ACL tears.All patients were examined on 1.5T Siemens MRI scanner,with SE,TSE or Medic sequence in multiple directions.The direct and indirect MRI manifestations of ACL tears were retrospectively and statistically analyzed by employing three experienced doctors.Results Among 28 patients with acute tears,the direct MRI signs included signal interruption or non-consecutive(86%),uneven signal(64%)and swelling and thickening ligament(36%).While in 12 patients with chronic teats,the MRI signs manifested swelling ligament(92%),signal interruption or non-consecutive(75%)and uneven signal(58%).The sign of thickening ligament was mainly seen at chronic phase of ACL tears(P ＜0.01).Of 35 patients with complete ACL tears,80% occurred in the middle part of ACL,with low incidence of upper and lower parts.All five patients with partial ACL tears occurred in the anteriomedialis bundle.The indirect MRI signs of ACL tears included 7-shaped deformity of posterior cruciate ligament(PCL)(34 patients,85%),meniscus exposure(26 patients)including 16 with lateral meniscus exposure(62%),bone injury(15 patients)including segond fracture(8 patients,53%),widened joint space(9 patients)including 78% at chronic phase,and tibia antelocation(23 patients,57%).Among 40 patients,37 patients were diagnosed correctly preoperatively,with accuracy rate of 92%.While three patients with partial ACL tears were missed diagnosis preoperatively,with inaccuracy rate of 8%.Conclusion ACL tear is relatively easy to identify preoperatively according to direct and indirect MRI signs in combination with trauma history.

Objective To evaluate the value of contrast-enhanced ultrasound in superficial lymphadenopathy. Methods Ninty-four superficial enlarged lymph nodes were studied by 2-dimensional, color Doppler ultrasound, and contrast-enhanced ultrasound. Then the contrast-enhanced images were analyzed by Philips Q-LAB software. All the results were compared with pathological diagnosis. Results For the 94 superficial lymph nodes examined,44 were benign,33 were metastases and 17 were lymphomas. The sensitivity, specificity,and accuracy of contrast-enhanced images were 84% ,74% and 790//oo respectively. Contrast-enhanced ultrasound examination showed intense homogeneous enhancement in 39 of 44 benign lymph nodes; high or low homogeneous enhancement in 25 of 33 and 7 of 33 in metastases respectively;intense homogeneous, and scarce enhancement in 6 of 17 and 9 of 17 in lymphomas respectively. Time-intensity curves showed that compared with metastasis lymph nodes and lymphomas, benign lymph nodes had higher peak intensity and larger area under the curve (P<0.01). Conclusions The diagnosis accuracy was significant increased when contrast-enhanced ultrasound was test against conventional ultrasound. The character of contrast agent enhancement and Q-LAB time-intensity curves provide valuable diagnosis information for differential diagnosis of benign,metastasis lymph nodes and lymphomas.