Objective To study the effects of allopurinol in different dose on the cardiac function of chronic heart failure rats induced by adrimycin. To explore dose-dependency of allopurinol in improving blood vessel endothe-lium function and cardiac ventricle remodeling of the rats heart, as to supply evidence and new sight in clinical treat-ment of congestive heart failure. Methods 40 Sprague-Dawley male rats were randomly divided into four groups: normal control group (group A)、model control group (group B)、low-dose allopurinol group (group C)、high-dose allopurinol group (group D). The heart failure model was made by administering adriamycin to rats. After the model myocardial pathological changes were detected. Results Compared with the normal control group, the weight and heart weight of rats in model control group and allopurinol groups were obviously lessen (group A=(300.10± 9.85)g,group B=(200.67±9.91)g, group C=(233.14±9.42)g,group D=(248.25±13.34) g;group A= (828.30±50.97) nag, group B=(681.50±16.97) mg, group C=(743.00±17.20) nag, group D=(784.88± 36.83) mg,P<0.05). Heart weight indexes were all incerased ( group A=(2.76±0.15) mg/g, group B=(3.41± 0.17) mg/g, group C=(3.26±0.76) mg/g, group D=(3.11±0.65) mg/g, P<0.05). The hemedynamics resuh showed that myocardial contractile force were enhanced in drug groups. The level of NO, SOD were increased in the allopurinol groups compared with the model control group (group B: NO=(41.55±6.28) μmol/L, group C: NO= (52.47±5.59) μmoL/L,group D:NO=(61.04±4.26) μmoL/L; group B:SOD=(63.83±6.40) U/ml,group C: SOD=(76.29±7.99) U/ml, group D: SOD=(100.13±7.43) U/ml, P<0.05) and MDA levels were obviously decreased (group B: MDA=(9.70±1.08) μmol/L, group C: MDA=(6.64±0.34) μmol/L, group D: MDA= (5.72±0.71)p.moVL,P<0.05). The level of NO, SOD were obviously increased in the allopurinol of high-dose group compared with low-dose allopurinol group(P<0.05). MDA levels were obviously decreased(P<0.05). The myocardial pathological changes were relieved obviously in the allopufinol groups. Conclusion Allopurinol improves blood vessel endothelium function dose-dependently. High-dese allopurinol obviously decreases MDA, improve NO, SOD, thereby can improve the cardiac function of heart failure.

OBJECTIVE:To establish a method for the simultaneous determination of chlorogenic acid and vitexin in Lophather-um gracile. METHODS:HPLC was performed on the column was Waters Atlantis C18 with mobile phases of acetonitrile- water (gradient elution)at a flow rate of 1.0 ml/min,detection wavelength was 280 nm,column temperature was 35 ℃,and the injec-tion volume was 10 μl. RESULTS:The linear range was 0.041 0-1.228 8 μg for chlorogenic acid(r=0.999 8)and 0.264 0-7.920 0μg for vitexin(r=0.999 9);RSDs of precision, stability and reproducibility tests were lower than 2%;recoveries were 97.6%-102.3%(RSD=1.85%,n=9) and 97.1%-101.3%(RSD=1.19%,n=9),respectively. CONCLUSIONS:The method is simple,stable and reproducible,and can be used for the simultaneous determination of chlorogenic acid and vitexin in L. gracile.

Objective To highlight the characteristics of pulmonary sequestration (PS) with combination of practical experience and review of literature. Methods One patient with PS confirmed by biopsy was described and the relevant literatures of 279 cases were reviewed. Results PS can be divided into two types: intralobar type and extralobar type. The percentage of intralobar type is about 78.5%, intralobar type is 13.3%, other unreported is 8.2%. Clinically, PS was often combined by repeated pulmonary infection. The mis-diagnose rate is 72.8%. Etrograde arteriography or enhanced CT scan could find the abnormal artery, from which we can make correct diagnosis. The diagnose rate is 100%. Conclusion For patients with above clinical and X-ray symptoms, PS should be considered. Enhanced CT or retropgrade arteriography examination should be done as soon as possible. Timely diagnosis and surgery treatment are important for curing this kind of disease.

Objective To learn the recent development and regional distribution of clinics in China.Methods Based on statistics and a nationwide survey of clinics in the country,a simple linear regression was made to find factors determining clinics regional distribution.Results Clinics in China were found to have grown sizably from 134 000 in 2008 to 155 000 in 2014;medical technology workers to 2.31 per clinic in 2014;and the total revenue of these clinics accounted for only 0.724% of all medical institutions,while there are more clinics in the east than the west regions in China.Conclusions The role of clinics in attracting high quality medical resources to primary care should be further enhanced for development of the hierarchical medical system in China.

Objective To analyze the clinical features of 27 Chinese patients with Kennedy's disease(KD), a sex-linked inheritance disorder. Methods We collected the clinical data of 27 KD patients whose diagnosis were confirmed by gene examination to analyze their clinical features, as well as their serum levels of sex hormones and biochemical indicators. Results Patients with spinal and bulhar muscular atrophy tend to have an adult onset, exhibiting a slow progression of lower motor neuronal weakness and atrophy involving limbs and bulbar zones. Part of the invalids presented signs of androgen insensitivity such as gynecomastia or reduced sexual function, even though their degrees of sex hormones were normal. There was mild motor functional lesion which correlated with the course of the disease ( r = 0. 77, P = 0. 000). The degrees of creatine kinase ( ( 920. 10 ± 495.54 ) U/L ) and triglyceride ( ( 3.27 ± 2. 78) mmool/L) increased mildly and was significantly different from the levels of healthy ones (107.20 U/L,t =7.517,P =0.000;1.40 mmol/L, t =2.687,P =0.017). Conclusions Basically, Chinese KD patients present the same clinical features as the literature reports, however they have distinctive aspects such as elevated degree of triglyceride. The present research can help us to understand the features of Chinese KD more particularly.

Objective To search the feasibility of mutation,RdxA gene was analyzed by the metronidazole induction experiment.Method The non-multiple,sensitive H.pylori strains,were selected and subjected to metronidazole induction experiment,which made H.pylori strains transform susceptibility to resistance.Extracted DNA of metronidazole sensitive and resistant pairs of H.pylori strains before and after induced,amplified by PCR and sequenced rdxA gene.Result 4 of 12 H.pylori strains were induced successfully with metronidazole whose MICs increased by 16~64 times.Strains were transferred three times on metronidazole-free medium and the MICs redetermined were the same as those after induced.There was 0.2～0.8% difference between pairs of metronidazole sensitive and resistant H.pylori strains.There was 2.2～2.7% difference between unrelated H.pylori strains.Conclusion The metronidazole induction experiment could make H.pylori acquire stable resistance to metronidazole in a short period and exclude that the natural polymorphism of rdxA gene influenced on mutation analysis.There was good hope that the experiment would become a good method to research metronidazole resistance mechanism

Objective To explore characteristics of sleep structure and the correlation with cognitive function in cerebral infarction combined with obstructive sleep apnea hypopnea syndrome (CI-OSAHS).Methods The patients with CI-OSAHS and OSAHS in Department of Neurology and Breathing Sleep Monitoring Room of Tianjin Medical University General Hospital from December 2009 till March 2011 were collected All the patients completed polysomography(PSG).Sixty patients were selected and divided into 3 groups based on PSG.These 3 groups were combined group 20 persons (CI-OSAHS),OSAHS group 20persons (OSAHS) and control group 20 persons (without cerebral infarction obstructive sleep apnea hypopnea syndrome).All the patients completed image examinations ( CT and MRI ) evaluation of the cognitive function by Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA).Results Sleep structure:the awake time,non-rapid eye movement sleep (NREM) 1,NREM 2 and NREM periods in combined group and OSAHS group were significantly longer,the NREM3 + 4 and rapid eye movement(REM) periods were shorter than the control group.The NREM and NREM 1 periods in combined group were longer,the NREM 3 +4 and REM periods were shorter than the OSAHS group.The correlation analysis of cognitive function and breathing disorders and low oxygen related index:there was negative correlation between the total scores of cognitive function (MMSE and MoCA)and apnea hyponea index,oxygen desaturation index (ODI) ( MMSE r =-0.450,-0.671,MoCA r =-0.486,- 0.494,all P ＜0.05) while,was positive correlation between them and noctumal average hypoxemia and minimum hypoxemia ( MMSE r =0.477,0.485,MoCA r =0.507,0.482,all P ＜0.05) in the OSAHS group.There was negative correlation between ODI,arousal index and the total scores of MoCA in the combined group (MoCA r=-0.463,0.480,both P＜0.05),there was correlation between the total scores of MMSE and the other sleep parameters,but,there was no difference in statistics.The correlation analysis of cognitive function and sleep stages:There was positive correlation between the total scores of cognitive function ( MMSE and MoCA) and the NREM 3 + 4 periods ( r =0.521,0.474,both P ＜ 0.05 ) while,there was negative correlation between the total scores of MMSE and the N REM 1 + 2 periods (r =-0.458,P ＜ 0.05 )in the OSAHS group.There was positive correlation between the REM period and the total scores of MoCA (r =0.472,P ＜ 0.05 ).There was correlation between the total scores of MMSE and the sleep structure,but,there was no difference in statistics in combined group.Conclusions Patients with OSAHS have obvious sleep structure disorder.The awake time and light sleep periods are significantly longer than the control group,while,the deep sleep and REM periods are significantly shorter than the control group.The NREM 1 of the patients with CI-OSAHS is longer than the patients with OSAHS.The higher the AHI,the lower the night blood oxygen,the more obvious cognitive dysfunction The longer the awake time,the longer the light sleep,the shorter the deep sleep and REM periods,the more serious cognitive dysfunction.The correlation between the cognitive impairment and low oxygen is more apparent than sleep structure.There is apparent correlation among the total scores of MoCA,the degree of hypoxia and sleep structure in the patients with CI-OSAHS.The total scores of MoCA are more sensitivity than MMSE in mild vascular cognitive impairment.

Objective To investigate the prevalence of malnutrition and nutritional support and interventions in geriatric inpatients.Methods The elderly patients (aged ≥ 65 years)from the geriatric demonstration ward were consecutively enrolled from July 2010 to January 2012.MiniNutritional Assessment-short form (MNA-SF) was performed after admission,and data of nutritional support were collected.Results A total of 179 patients were enrolled in this study.According to MNA-SF,42 cases (23.5％)were rated as malnutrition,and 55 cases (30.7％) were rated as at risk of malnutrition.Totally,45 patients received nutritional support.50.0％ (21/42) patients with malnutrition,and 29.1％ (16/55) patients at risk of malnutrition received nutritional support.As to the route of nutrition therapy,the ratio of the enteral to parenteral to combination of enteral and parental nutrition was 4.4 ∶ 1.0 ∶ 1.0.Conclusions The incidence of malnutrition is high in the geriatric inpatients,and routine nutritional risk screening and assessment are essential for the elderly patients.Nutritional support and other comprehensive treatment are in great need,and the enteral nutrition is appropriate and preferred.

Objective To observe the impact of ginkgo biloba extract in rats with chronic cerebral ischemia on the expression of PSD-95 protein and the content of amino acid neurotransmitter.Methods A total of 42 SD rats were divided into the sham group (n=12), the model group (n=14) and the ginkgo biloba extract group (n=14) by random number table method. Cerebral ischemia rats were produced by permanent ligation of bilateral common carotid arteries . The rats in the ginkgo biloba group were intrgastric administrated with ginkgo biloba extract suspension 28 mg/kg daily for 40 days, since 2 hours later after the surgery. The rats in the sham and model groups were intragastric administrated with equal-Volume nomal saline daily for 40 days, since 2 hours later after the surgery. The expression of PSD-95 protein was detected by immunohistochemistry techniques with image analysis. The content of Glu and GABA in the thalamus was determinated by OPA-pre-column derivatization and HPLC fluorescence detection method.Results The expression of PSD-95 protein (cortex was 212.58 ± 45.02vs.244.20 ± 34.28, thalamus was 132.33 ± 28.32 vs.272.00 ± 62.14) were significantly lower in the cortex and thalamus of the model group than those of the sham group (P<0.01). The content of GABA (6 081.46 ± 2 388.91 mmol/Lvs.8 280.45 ± 3 388.49 mmol/L) in the thalamus of the model group rats was significantly lower than the sham group (P<0.05). Ginkgo biloba extract could significantly improve the expression of PSD-95 protein (cortex was 237.89 ± 34.41 vs.212.58 ± 45.02, thalamus was 226.18 ± 75.80 vs. 132.33 ± 28.32) in the cortex and thalamus of chronic cerebral ischemia rats (P<0.01), and significantly improve the content of Glu and GABA (Glu was 10 523.78 ± 3 639.72 mmol/L vs.6 081.46 ± 2 388.91 mmol/L, and GABA was 18 440.93 ± 7 476.88 mmol/Lvs.11 239.83 ± 4 411.79 mmol/L) in thalamus with chronic cerebral ischemic rats compared with the model group rats (P<0.01).Conclusion Ginkgo biloba extract could regulate the levels of Glu, GABA and selectly regulate the PSD-95 experssion in the cortex and thalamus of cerebral ischemia rats.

Objective To observe the phenomenon of apoptosis and expression of related proteins in injured muscle tissue during the formation of pressure injury, and to explore its mechanism of action on the pressure injury. Methods Forty male Sprague-Dawley (SD) rats were divided into normal control group, 3, 5, 7 and 9 compression groups according to the random number table, with 8 rats in each group. The pressure injury models on the gracilis muscle of hind limbs were reproduced by using a way of cycle compression of ischemia/reperfusion (I/R) magnet. One cycle consisted of 12-hour compression, and followed by 12-hour release. The 5, 7, 9 compression groups were cut through after receiving 3 cycles. The normal control group did not receive any treatment. Muscle tissue specimens were harvested in the pressurized center at the end of the experiment (the same site for the normal control group), then the rats were sacrificed. The hematoxylin-eosin (HE) staining was used to examine the changes of muscle tissue morphology. The Hoechst 33258 staining was used to evaluate the apoptosis of muscle tissue. Western Blot was used to detect the expressions of heat shock protein 70 (HSP70), B-cell lymphoma-2 protein (Bcl-2) and Bcl-2 associated X protein (Bax). Results ① HE staining showed that the compressed tissues appeared different degrees of pathological degradation, and the change of tissue morphology was more serious with the increase of the compression cycle.② Hoechst 33258 staining showed that the nuclei of compressed tissue showed condensed, compact morphology and granular fluorescence, and the number of apoptotic cells increased with the increase of the compression cycle.③ Western Blot showed that with the increase of the compression cycle the protein expressions of HSP70 and Bax were gradually increased, and the protein expression of Bcl-2 was gradually decreased. Compared with the normal control group, the protein expression of HSP70 in the 9 compression group was increased with statistically significant differences (HSP70/GAPDH: 1.78±0.21 vs. 0.55±0.17, P < 0.01). The protein expression of Bax in the 7 and 9 compression groups were increased with statistically significant differences (Bax/GAPDH: 0.96±0.09, 0.98±0.02 vs. 0.67±0.07, both P < 0.01). The protein expression of Bcl-2 in the 3, 5, 7 and 9 compression groups were significantly decreased (Bcl-2/GAPDH: 0.17±0.03, 0.13±0.03, 0.14±0.03, 0.10±0.02 vs. 0.36±0.04, all P < 0.05). Conclusions Apoptosis can be induced by I/R in pressure injury tissues. Apoptosis induced by HSP70 and apoptosis factors Bcl-2 and Bax may be involved in the formation of pressure injury.