Objective: To explore therapeutic effect of levosimendan combined dobutamine on refractory heart failure (RHF).Methods: A total of 90 RHF patients, who were treated in our hospital from Apr 2014 to Oct 2015, were selected.According to random number table, patients were randomly and equally divided into dobutamine group and combined treatment group (received dobutamine combined levosimendan).Cardiac function improvement after treatment,and adverse reactions during treatment were compared between two groups.Results: After treatment, cardiac function improvement rate of combined treatment group was significantly higher than that of dobutamine group (86.7% vs.60.0%), P=0.02.Compared with before treatment, after treatment, there was significant reduction in dyspnea score, and significant rise in LVEF and stroke votume(SV) in both groups (P<0.05 or <0.01);compared with dobutamine group after treatment, there was significant reduction in dyspnea score [(1.58±0.78) scores vs.(1.02±0.47) scores], and significant rise in LVEF [(42.61±7.10)% vs.(50.21±7.82)%] and SV [(57.62±14.63)ml vs.(64.21±15.12)ml] in combined treatment group, P<0.05 or <0.01.Hypotension, myocardial ischemia and arrhythmia etc.occurred in both groups, but there was no significant difference in incidence rate of total adverse reactions (P>0.05).Conclusion: Levosimendan combined dobutamine possess significant therapeutic effect on refractory heart failure and safety is good, which is worth extending.

The paper introduces the background of YY/T 0841 standard, and interprets the main content of this standard. It is helpful to understand and applicate the standard.
Electrical Equipment and Supplies ; standards

Objective To explore the biological function of ICAM-1and LFA-1 in tumor metastasis,we observed the expression of ICAM-1(Intercellular Adhension Molecule-1)and LFA-1(Lymphocyte function related antigen-1)in cancer tissue and normal tissue.Methods A total of the samples were obtained from hospital,it includes 60 cases of breast cancer and 60 cases of normal mammary tissues.We observed the expression of ICAM-1 and LFA-1 by SP immunohistochemistry.We analyzed the relationship between the expression of ICAM-1,LFA-1and lymphatic vessel metastasis of breast cancer.Results The expression positive rate of ICAM-1and LFA-1 in breast cancer was obviously higher than that in normal mammary tissues(P

This paper introduces the rapid & mobile first-aid unit from brigade or regiment medical aid station,especially discusses its equipment,performance,personnel structure,and working features.The rapid & mobile first-aid unit can perform emergency operation and anti-shock treatment for the serious wounded in frontier at any moment.It meets the requirements in such aspects as fast & effective first-aid,mobile & flexible treatment,high cure rate and good practicality.

Objective To evaluate the effect of group reminiscence therapy on improving the depressive symptoms of the institutionalized elderly. Methods Collecting clinical randomized controlled trials and quasi-randomized controlled trials of group reminiscence therapy for improving depressive symptoms in institutionalized elderly which published from 2000 to November 2016, by searching the Cochrane Library, PubMed, CINAHL, PsycINFO, EMbase, China Biology Medicine, China National Knowledge Infrastructure, VIP, Wanfang Database, Taiwan Academic Online Database and Airiti Library. And reviewing the quality of the studies by using the tools for assessing risk of bias. RevMan 5.3 software was used for data analysis. Results Ten studies(2 randomized controlled trials and 8 quasi-experiments), including a total of 511 cases, were included. The results showed that group reminiscence therapy significantly improved the depression, life satisfaction, and self-esteem of institutionalized elderly (95%CI-1.11--0.56, 0.41-2.05, 1.99-3.82, all P<0.01). There was no statistically significant difference between group reminiscence therapy and usual nursing in relieving loneliness (P = 0.21). Conclusions Group reminiscence therapy can improve the depression in institutionalized elderly, decrease the degree of depression, improve the level of life satisfaction and self-esteem. But in the ease of loneliness has not been confirmed. The randomized controlled trials included in this study were rare and the quality of the literature was low, and large-scale randomized controlled trials of higher quality are needed to confirm this.

Mitochondrial aldehyde dehydrogenase(ALDH2),one of the isoforms of aldehyde dehydrogenase,has multiple enzymatic functions including the activity of dehydrogenase and esterase.The metabolisms of ethanol,amino acids,biogenic amine,vitamin or steroid in the body produce various substances of aldehyde.With the help of co-factor NAD(P)+,ALDH2 can convert aldehydes into corresponding carboxylic acid,which plays a key role in reducing toxic effects of aldehydes on the body.It does not need co-factor when ALDH2 works as esterase.It can convert carboxylic ester or other acids into corresponding carboxylic acids or alcohols.Recently,it has been shown that the decrease of ALDH2 activity exacerbates multiple factors(such as ethanol,ischemia)-induced myocardial injury and accelerates the development of nitroglycerin tolerance.Therefore,the development of specific agonists of ALDH2 may provide a novel approach to the therapy and prevention of heart diseases.

Objective To investigate impact of abnormal slucose metabolism on major adverse cardiac event in patients after coronary artery stent implantation.Methods Two hundred and fifteen patients whose data were available were enrolled in this study,and the patients were divided into 3 groups,diabetes group(group A),abnormal glucose metabolism group(group B),normal glucose tolerance group(group C).The clinica,coronary artery lesion characteristics and major adverse cardiac event(MACE)rate during in hospital and follow up periods were compared.Resuits There was a higher occurrence of MACE in group A and group B than that in group C(P＜0.01).There was no significant difference between group A and group B.Conclusion The patients of coronary heart disease with abnormal slucose metabolism have higher MACE rate than abnormal slueese metabolism.

Objective To study the effects of protein kinase C (PKC) inhibitor staurosporine (STS) on the proliferation and apoptosis of human cholangiocarcinoma QBC-939 cells and to explore its possible mechanism. Methods CCK-8 was used to detect the effects of PKC inhibitor STS on the proliferation of human cholangiocarcinoma QBC-939 cells. The effects of STS on the ultrastructural characteristics of QBC-939 cells were observed by routine transmission electron microscopy (TEM). The apoptosis rate and the cell cycle distribution of QBC-939 cells were detected by flow cytometry. The expression of cyclin B1,Cdk1 and p-Cdk1 in QBC-939 cells was detected by Western blotting. Results STS could significantly inhibit the proliferation of QBC-939 cells in a dose-dependent manner (P <0. 05) and the half inhibitory concentration ( IC50 ) of QBC-939 cells at 24th and 48th h was 334 nmol·L-1 and 118 nmol · L-1 , respectively. TEM observed that STS could induce typical apoptotic bodies and super-microstructural changes of QBC-939 cells. By Annexin V-FITC/ PI double labeling flow cytometry,we found that the apoptotic rate of QBC-939 cells after treatment with STS for 0,12,24 and 48 h was (10. 16±4. 52)% ,(22. 35±2. 19)% ,(34. 27±2. 30)% and (59. 70±5. 97)% ,respectively. By flow cytometry,compared with the control group,STS could significantly increase apoptosis rate of QBC-939 cells,decrease the percentage of cells in G0 / G1 phase and increase the percentage of cells in G2 / M phase (P<0. 05). Western blotting proved that the expression levels of cyclin B1 and Cdk1 proteins in the STS-treated QBC-939 cells were significantly decreased (P<0. 05),while the expression level of p-Cdk1 protein in the STS-treated QBC-939 cells was significantly increased ( P < 0. 05 ). Conclusion STS can significantly inhibit cell proliferation and induce apoptosis of human cholangiocarcinoma QBC-939 cells and the mechanism may be related to cell cycle arrest at G2 / M phase.

The basic design plan of unified intelligence system with a demonstration effect was worked out using the system integration method, and its technical implementation was elaborated in aspects of enterprise service bus, database integration, platform service, and key business application from the operational point. Its extended appli-cation in clinical practice, scientific research, decision-making and hospital management was studied in order to further improve the hospital management level.

Objective To investigate the differential expression of synaptophysin(SYN)in the developing rat cochlea,to analyze the relationship between the expression of SYN and auditory functional development,and to explore the source of the adenosine triphosphate(ATP)in the cochlea.Methods The immunofluorescence was applied to observe the differential expression of SYN in the cochlea of SD rats on different days(p1,p5,p10,p14 and p28)after parturition.Results No significant stain was observed in the Kolliker organ or the Corti's organ of P1,P5 and the top turn of the cochlea in P10.The SYN expression was turned on the outer spiral bundle,the inner spiral bundle,and the medial wall of the Deiters' cell of the cochlea in P14,P28 and the second or the third turn of Corti's organ of P10.All the spiral ganglion neurons(SGN)were stained in different aged cochlea.Conclusion The expression of SYN was different during development of rat cochlea.This difference was in favor of the configuration constructed between nerve endings and target cells.It also played a key role in the formation of correct auditory coding during auditory system development.The hair cells and the supporting cells,possible the source of ATP in the cochlea,contained ATP that maybe existed in a non-vesicular form or specific staining of non-SYN.