Objective To observe blood plasma matrix metalloproteinase-9 (MMP-9) of the patients with different types of carotid plaque and investigate the relationship between MMP-9 and carotid plaque vulnerability. Methods Totally 64 patients were examined by CDI, TCD, cranium CT, MRI, DSA and nerves function score (NIHSS) to judge their types of carotid plaque. Their plasma levels of MMP-9 and C-reactive protein (CRP) were detected. Results Plasma MMP-9 had direct correlation with plaque vulnerability(r=0.92,P

eticulum stress.

AIM: To investigate the effects and mechanisms of renin-angiotensin system (RAS) blockade on pancreatic islet β-cell function in rats with injection of streptozotocin (STZ) and long-term high-fat diet. METHODS: Normal male Wistar rats fed with 16 weeks-long high calorie, and high-fat diet were treated with telmisartan (TI, n=15), and injected with STZ after 24 weeks. One week later, islet function was evaluated by intravenous insulin releasing test (IVIRT). The immunoglobulin binding protein (BIP)/glucose-regulated protein (GRP78), C/EBP-homologous protein (CHOP)/growth arrest and DNA-damage-inducible gene 153 (GADD153) mRNA expression levels in the islets were detected by RT-PCR. The expression levels of insulin and Bax protein in the islets were examined by immunohistochemistry. RESULTS: The incidence of diabetes was 80%(12/15)in the high-fat diet+STZ group (HS) and 33% (5/15) in the high-fat diet+STZ+ telmisartan group (TS). Compared to HS group, maximum of insulin secretion in TS group was increased 56.9%. Early insulin secretion index (EISI) and acute insulin response (AIR) were increased by 1.98 times and 0.88 times, respectively. The expression of insulin and insulin positive cell density (PCD) were increased obviously in β-cells. The expression levels of BIP, CHOP and Bax in the islets were decreased significantly. CONCLUSION: Blockade of RAS increases the resistance to streptozotocin-induced diabetes in rats with long-term high-fat diet, and the expression of apoptosis-related molecules is downregulated in endoplasmic reticulum. The mechanism that RAS blockade improves pancreatic islets function and reduces diabetes incidence to some extent may be via attenuating endoplasmic reticulum stress.

ObjectiveTo observe the effect of early rehabilitation on the clinical neurodefect score,limb movement ability,ability of daily living(ADL)after intracerebral hematoma eliminated by neuroendoscope.Methods31 cases after intracerebral hematoma eliminated by neuroendoscope were randomly divided into two groups:rehabilitation group(16 cases) and control group(15 cases).Rehabilitation group were treated with serial rehabilitation programs after the patients' living sign had been stable over 48 hours.ResultsIn rehabilitation group, the clinical neurodefect score,amended Fugl Meyer assessment score and Bathel index score were better than that in control(P<0.05).ConclusionsEarly rehabilitation after intracerebral hematoma eliminated by neuroendoscope can reduce neurodefect degree and disability rates,improve limbs movement ability and ADL.

To investigate the effects of rennin angiotensin system blockade on the microvessel density in islets of diabetic rats and its relationship with islet function, diabetes model was created by feeding of high-caloric laboratory chow plus intraperitoneal injection of a small dose of streptozotocin (30 mg/kg). After 8 weeks intervention with perindopril (AE, n=10) or valsartan (AR, n=10), the islet function of the animals was evaluated by intravenous insulin release test (IVIRT). The pancreases were immunohistochemically stained to analyze the content of insulin and vascular endothelial growth factor (VEGF) in the islets. The microvessel density (MVD) of islets was detected by counting CD34 positive cells. The hypoxia inducible factor (HIF)-1alpha mRNA expression in the islets was detected by RT-PCR. Compared with normal control group (NC, n=10), the area under the curve for insulin from 0 to 30 min (AUCI(0-30)) of diabetes group (DM, n=8) was decreased by 66.3%; the insulin relative concentration (IRC) of betacell was decreased significantly; the relative content of VEGF was increased obviously [(-4.21+/-0.13) vs (-4.06+/-0.29)]; MVD in islets was decreased by 71.4%; the relative expression of HIF-1alpha mRNA was increased by 1.19 times (all P<0.01). Compared with DM group, the AUCI(0-30) of AE and AR group was increased by 44.6% and 34.9% respectively; IRC was also increased significantly; the relative content of VEGF was decreased by 21.2% and 21.7% respectively; MVD was increased by 62.5% and 75.0% respectively; the relative expression of HIF-1alpha was decreased by 27.2% and 29.0% respectively (all P<0.01 or P<0.05). There were no significant differences in the said indexes between group AE and AR. It is concluded that the blockade of RAS may ameliorate islets function of diabetic rats by increasing the MVD in islets.

How to effectively using the electronic health records (EHR) in contracted family doctors service was studied according to the new model of HER-based community medical service with community health service station as a center in combination with large hospitals,and suggestions were put forward for the solution of problems in contracted family doctor service,namely establishing and perfecting the community health service system,enlarging the scale of HER,strengthening the construction of general doctors team,and training the technically competent community health service staff.

Objective To generate recombinant Pichia pastoris for high-copy expression of human tissue factor pathway inhibitor (TFPI). Methods The cDNA encoding human TFPI was inserted into the expression vector pPIC9K and the constructed expression vector rhTFPI-pPIC9K was confirmed by restriction endonuclease analysis and DNA sequencing. The recombinant plasmids were subsequently transformed into Pichia pastoris GS115 cells, and the transformants were confirmed by PCR amplification of the genomic DNA.The recombinant Pichia pastoris with high copies of TFPI cDNA was screened by G418 selection. Western blot and TFPI ELISA Kit were employed to analyzing. The temperature, time and concentration of methanol for the induction of recombinant protein were optimized. Results PCR analysis and DNA sequencing confirmed the successful construction of the expression vector rhTFPI-pPIC9K. Real time quantitative PCR and Western blot analysis demonstrated the positive correlation between TFPI expression level and the copy number of TFPI cDNA in Pichia pastoris cells. Optimization of the induction condition significantly elevated the expression level and activity of TFPI (9.95±0.78 mg/L and 3.91±1.37 U/mL). Conclusion The Pichia pastoris strain with high copy of TFPI expression was successfully constructed, which lays a solid foundation for the further investigation on the function of TFPI and its application in the prevention and therapy of diseases.

BACKGROUND: Naloxone has a significant arousal effect on many types of comas. It is usually believed that this is because its inhibition on endogenous opioid peptides. But depth of coma is not necessarily positively correlated to endorphin (EP).OBJECTIVE: Based on existing findings on direct stimulating effect of naloxone on cerebral cortex, further studies need to be done to explore whether it is dose-dependent or not.DESIGN: Single-factor design based on cells.SETTING: Neurology department in a university hospital and the neurology department in a hospital of a military medical university of Chinese PLA.MATERIALS: This study was completed in the Laboratory Center of Tongji Medical College, Huazhong University of Science and Technology. Thirty healthy new born Wistar rats, regardless of their gender, aging 8 - 12 days and weighing 150 -250 g, were selected.METHODS: The experiment was performed at room temperature. The perfusion slot were placed on the microscope stage, and cells with smooth surfaces, triangle or pyramidal shapes, strong refraction and more than one neurites were selected for patch clamp experiment. Patch clamp whole-cell recording technique was used to measure the pyramidal cells of the frontal lobe immediately after separated from the Wistar rats, and to investigate the fluctuations of their membrane potential of cerebral cortex neurons and the frequencies of their spontaneous electric activities after administration of naloxone at different doses.MAIN OUTCOME MEASURES: The neural excitatory reaction rate, depolarization amplitude and increasing rate of spontaneous electric activities after administration of different doses of naloxone were selected as main outcome measurements.RESULTS: The excitatory reaction rates of cerebral cortex neurons immediately after separation to doses of naloxone(100, 50, 10, 1, 0. 1 μmol/L)were 83%, 67%, 86%, 71% and 33%; while the depolarization amplitude of them were 9. 8, 9.6, 8.4, 5.2 and 1. 3 mV respectively; and the corresponding spontaneous electric activity were increased by 587% , 375% ,291%, 125% and 69%.CONCLUSION: Naloxone can induce excitatory reactions in cerebral cortex neurons directly, and the reactions have proved to be dose-dependent.

ObjectiveTo investigate the influence of the number of T-junctions between central venous catheter and pressure transducer on measurement of central venous pressure (CVP) in patients.Methods A prospective controlled study was conducted. The patients with CVP monitoring in Department of Critical Care Medicine of the Fifth Center Hospital in Tianjin from February to October in 2014 were enrolled. The patients were divided into three groups according to the number of T-junction between central venous catheter and pressure transducer: without T-junction control group and 1, 2, 3 T-junctions groups. In each patient, corresponding CVP values with different number of T-junctions placed between the central venous catheter and pressure sensors were determined within a certain period, and a square-wave graphic was obtained and preserved on the monitor. The own frequency (fn) and the attenuation coefficient (D) of the system of pressure measurement were calculated after measurement of the shock wave following a square-wave to obtain the distance between two vibrations and the amplitude of the shock wave. The difference in CVP, fn and D were compared among the groups.Results A total of 20 cases were enrolled, and 150 groups of data were collected.① With the increase in the number of T-junction, CVP showed a tendency of gradual reduction. The CVP of the groups of control and 1, 2, 3 T-junctions was (7.00±1.60), (7.00±3.00), (5.00±2.00), and (4.00±1.00) mmHg (1 mmHg = 0.133 kPa), respectively. The CVP of 3 T-junctions group was significantly lower than that of the control group (F = 9.333,P = 0.015).② With an increase in the number of T-junction, fn showed a tendency of gradual increase. The fn of groups control and 1, 2, 3 T-junctions was (12.30±0.79), (16.00±0.91),(18.10±1.75), (20.90±2.69) Hz, respectively. The fn of 1, 2, 3 T-junctions group was significantly higher than that of the control group (F1 = 45.962,F2 = 45.414,F3 = 46.830, allP = 0.000); the fn of groups 2 and 3 T-junctions was significantly higher than that of 1 T-junction group (F1 = 5.827,P1 = 0.042;F2 = 15.038,P2 = 0.004), but there was no significant difference between the groups of 2 T-junctions and 3 T-junctions (F = 3.800,P = 0.087).③ With an increase of the number of T-junction, D also showed a tendency of gradual increase. The D of 1, 2, 3 T-junction group was 1.62±0.27, 1.60±0.22, 1.82±0.25, and 2.15±0.58, respectively. There were no differences among four groups.ConclusionAfter the application of T-junctions between central venous catheter and pressure transducer, CVP values will be underestimated, the reason of which is considered to be the increase in length and thinner lumen of the T-junctions.

Paraquat (PQ) poisoning has become one of the common pesticide poisoning in China. PQ is extremely toxic to human beings. The fatality rate of oral PQ poisoning is more than 90%. So far, there is no specific antidote. Seek effective treatment measures for PQ poisoning has become the focus of clinical medical research. In November 2017, a patient with acute severe PQ poisoning was treated in the intensive care unit (ICU) of Shouguang People's Hospital Affiliated to Weifang Medical College. The patient refused blood purification therapy and was rescued successfully only by continuous fluid therapy, diuresis, catharsis and routine treatment. By reviewing the treatment process of this case, new treatment ideas for the clinical treatment of PQ poisoning in primary hospitals were provided. Patients with acute PQ poisoning should be rescued by immediate administration of emetic, gastric lavage, catharsis and oral montmorillonite powder. For those without dysfunction of heart, lung and and kidney, a large amount of fluid treatment and diuresis should be given immediately to promote the excretion of poison. The key to improve the success rate of rescue of acute PQ poisoning is to eliminate PQ from the body as soon as possible.