Objective: To explore safety and effects of exercise rehabilitation in aged patients with chronic heart failure (CHF). Methods: A total of 83 aged CHF patients were randomly divided into exercise rehabilitation group (n=42, received exercise training based on usual care) and usual care group (n=41, received usual care). Period of treatment was eight weeks and patients were followed up for 12 months. New York heart association (NYHA) classification was used to represent cardiac function. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd) were determined by ultrasound cardiography, 6 min walking distance (6MWD) and oxygen metabolic equivalent (METs) also were determined , plasma level of brain natriuretic peptide (BNP) was examined. Minnesota living with heart failure questionnaire (MLHFQ) was used to represent quality of life. Rehospitalization rate and mortality rate within 12 months were recorded in all patients. Results: On 8 th weeks after treatment, the LVEF, LVEDd and NYHA class of two groups all significantly improved（P＜0.05 all）,compared with usual care group, there were significant improvement in LVEF [（54.7±6.2）% vs. 65.4±8.7）%], LVEDd [（49.6±8.3）mm vs.（40.2±9.3）mm] and NYHA class [（2.7±0.8）classes vs.（1.9±0.9）classes], P<0.05 all; 6MWD [(122.7±9.2) m vs. (175.6±8.7) m] and METs [(5.8±1.8) vs. (8.4±2.4)] also significantly increased (P<0.01), and plasma level of BNP [(43.4±9.8) pg/ml vs. (31.7±8.9) pg/ml, P<0.05] significantly decreased in exercise rehabilitation group. No severe adverse events occurred in exercise rehabilitation group. After 12 months, compared with usual care group, there were significant increase in MLHFQ score [(45.6±8.2) scores vs. (68.9±7.9) scores], significant decrease in rehospitalization rate caused by heart failure (24.4% vs. 9.5%) , P<0.05 all in exercise rehabilitation group. Conclusion: Exercise rehabilitation is safe and effective in aged patients with chronic heart failure, which can significantly improve cardiac function, enhance exercise capacity and increase quality of life.

Objective To evaluate the laparoscopic ovarian cystectomy of benign lesions of security,superiority.Methods Laparoscopic ovarian cystectomy of benign lesions of security,superiority.Results The operation time of laparoscopic group (40.5 ± 5.3) min,significantly shorter than the control group (60.7 ± 6.8) min (t =-14.815,P =0.000) ; Bleeding (55.1 ± 9.8)ml was significantly less than that in the control group (90.0 ±15.0) ml (t =-18.275,P =0.001) ; Anus exhaust time (13.5 ± 8.3) hour was significantly shorter than that in control group (24.5 ± 9.6) hour (t =-4.351,P =0.000).The average postoperative hospital stay was (3.5 ±1.3) days was significantly shorter than that in control group (5 ± 2) days (t =-2.158,P =0.000).Postoperative morbidity was not statistically different from controls (t =0,5,P =0.053).Postoperative pain was significantly lower than that in control group (x2 =8.525,P =0.002).Conversion to open operation in laparoscopic group:2 cases,postoperative analgesic drugs were not needed,the postoperative 12h after catheter removal started eating and ambulation,postoperative shoulder pain in 2 cases ; open operation group after all need to use analgesics,postoperative 24h after catheter removal started eating and ambulation,abdominal incision fat liquefaction and delayed healing in 4 cases.The two groups had no visceral injury,postoperative bleeding,and chemical peritonitis.Conclusion Laparoscopy in the treatment of benign ovarian tumor is safe,less bleeding,rapid recovery,fewer complications and other characteristics.

BACKGROUND: There are so many experimental and clinical researches on levels of nitrogen monoxide (NO) in serum and endothelins in plasma of patients with stroke; however, ratio and significance between them are still unclear.OBJECTIVE: To observe dynamic changes of levels of NO in serum and endothelins in plasma of patients with stroke.DESIGN: Case-controlled observation.SETTING: Neurological Department and Clinical Neurological Laboratory of the Second Hospital affiliated to Suzhou University.PARTICIPANTS: A total of 216 patients with acute cerebral infarction including 133 males and 83 females and 112 cases with cerebral hemorrhage including 68 males and 44 females were selected from Neurological Department of the Second Hospital affiliated to Suzhou University from September 1999 to December 2001. Another 106 subjects including 63males and 43 females were regarded as healthy control group.METHODS: Contents of NO in serum and endothelins in plasma were measured on 328 patients with stroke and 106 healthy subjects in the courses of 1-3 days, 1, 2, 4, 8 and 12 weeks with nitrate reductase and radio-immunity methods, respectively.MAIN OUTCOME MEASURES: Contents of NO in serum and endothelins in plasma; ratio between NO in serum and endothelins in plasma (NO/endothelins).RESULTS: ① As compared with those in the control group, content of NO in serum of patients with cerebral infarction and cerebral hemorrhage was decreased and reached the lowest value during acute period (within 1-3 days), and then increased gradually and closed to the normal level at about 4 weeks. In addition, content of endothelins in plasma was increased obviously during acute period, reached the peak at 2 weeks, and then decreased gradually. The level was still high at stage of recovery and closed to normal value within 4-8 weeks. ② As compared with that in the control group, NO/endothelins was decreased in cerebral infarction group at the courses of 1-3 days (P ＜ 0.05), reached the lowest value at 1 week (P ＜ 0.001), and increased to the normal level at 2 weeks. Moreover,NO/endothelins was remarkably decreased in cerebral hemorrhage group at the courses of 1-3 days (P ＜ 0.001), reached the lowest value at 1week (P ＜ 0.001), and increased gradually. The changes of course were great and the level reached above normal value at 8 weeks. There was significant difference of dynamic changes of NO/endothelins between cerebral hemorrhage group and cerebral infarction group (P ＜ 0.05).CONCLUSION: NO and endothelins play an important role in onset and development of ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease, and their contents are related to prognosis.

This paper summarizes the 10 cases weaning from mechanical ventilation with proportional pressure support(PPS).The nursing care focus on dynamic monitoring of PPS,asphyxia ventilation,system airtight care,etc.Ten patients were successfully remove the respirator.

Objective To evaluate the effect of the traditional Chinese medicine (TCM) knowledge and skills training on non TCM community physicians in Shanghai, and provide important basis and feedback for future adjustments and training improvement.Methods The current situation of the TCM knowledge and skills training on non TCM community physicians in Shanghai was reviewed. The community physicians participated in the training courses in 2014 in Jiading district were randomly selected for investigation. The TCM theory and skills scores of all the 65 trainees were compared before and after training, a self-made questionnaire survey on assessment of training was conducted after training, and the influencing factors of training effect were analyzed. Results After training,test results of TCM theory and skills were significantly higher than before(P<0.01). According to the survey of trainees after TCM training, 84.6% thought the training was necessary,95.4% liked the teaching form, 93.9% accredited training content difficulty level,92.3% thought the training was practical, 98.5% were willing to provide Chinese medicine services for community residents, 60.0% thought training to promote the general medical work was very helpful. The existing problems were short training periods(43.1%), only 10.8% could skilled TCM appropriate technologies and 60.0% were basically master. Conclusion The TCM knowledge and skills training on non TCM community physicians in Shanghai had achieved better effect. There still were some deficiencies, which require further exploration in order to better carry out future training.

Objective To investigate the safety and clinical efficacy of recombinant human endostatin injection (endostar) continuous pumping combine with chemotherapy injection in the treatment of advanced malignancies . Methods 156 patients with advanced cancer were divided into the chemotherapy group (78 cases) and the chemotherapy combined with endostar group (78 cases). The two groups were similar in the tumor types, the neoplasm staging, the KPS and the chemotherapy agents. After two cycles chemotherapy, the efficacy was evaluated according to RECIST criteria and the quality of life (QOL) was assessed by KPS scores. Results The objective response rate (RR) of the chemotherapy combined with endostar group was 39.74%(31/78). The RR of the chemotherapy group was 17.95%(14/78). There was statistics significance in the RRs of the two groups (P<0.05). The QOL of 42 cases (53.8%) were improved, 26 cases (33.3%) were in stable and 10 cases (12.8%) were decreased in the chemotherapy combined with endostar group. The QOL were improved in 30 cases (38.5 %), stabled in 17 cases (21.8 %) and decreased in 31 cases (39.7 %) in the chemotherapy group. There were significant difference between the two groups (P< 0.05). The main adverse reactions were myelosuppression and digestive tract reaction in both groups (P>0.05), and all patients can tolerate. Conclusion The QOL of patients with advanced malignant tumors are improved by endostar combined with chemotherapy which is safe and effective. It is worthy further clinical observation.

Objective To investigate the effect of hydrogen on radiation-induced acute injury in rat brain.Methods Forty-five mature Sprague-Dawley rats were randomly divided into three groups:saline therapy group,hydrogen therapy group and healthy control group.The whole brain of SD rat was irradiated with single dose of 20 Gy by 4 MeV electrons.Rats in therapy group were injected with hydrogen-rich saline after irradiation and were sacrificed at 1,3,7,14 d post-irradiation.The changes of malonaldehyde (MDA),superoxidase dismutase (SOD) and 8-hydroxydeoxygunosine (8-OHdG) in brain homogenate and the pathological changes in brain hippocampus were observed.Results The brain water content (t=3.78,3.18,P＜0.05) and the contents of 8-OHdG (t=2.33,2.71,2.33,P＜0.05) in the therapy group was lower than the control group at 7 d and 14 d post-irradiation.The contents of SOD were significantly higher(t =2.41-2.92,P ＜ 0.05) from 1 to 7 day,while the contents of MDA were significantly lower in therapy group than those in the control group from 1 to 14 day post-irradiation (t =4.01-6.20,P ＜ 0.05).Moreover,the damage degree in the nerve cells of hippocampus was less compared to the control group.Conclusions The hydrogen-rich saline could have protection role in irradiation-induced acute brain injury in rats.

Objective To study the effect of black granule capsules(BGCs) on growth of transplanted mouse hepatocarcinoma cells, cell proliferation cycle and apoptosis.Methods KM mouse were subcutaneously inoculated with Hepatocarcinoma cells (H22) and randomly divided into the model control group, the positive control group, the low, medium and high does of BGC group after 24h. The positive control group received intraperitoneal injection with 30 mg/kg cyclophosphamide. Mice of BGC groups were intragastricaly with different dosage of BGC (400, 800, 1 600 mg/kg). The model control group received intragastricaly with normal saline. The drugs were administrated once a day for seven days. The tumor inhibition rate was calculated at 24 h after the last administration. Flow cytometry was used to detect changes of cell cycle and apoptosis in harvested H22 tumor cells.Results The group of high does showed significant inhibitory effect on the growth of transplanted H22 tumor cells withthe inhibitory rate 38.78% (male) and 43.57% (female). Compared with model control group, groups of different dosages decreased time of G0-G1 phase (58.06% ± 9.65%, 55.10% ± 5.89%, 61.36% ± 15.95%vs. 74.47% ± 2.63%), increased tiem of Sphase (33.96% ± 11.90%, 32.67% ± 4.04%, 33.89% ± 9.82%vs. 14.37% ± 4.92%), and increased the apoptosis rate (31.12% ± 1.85%, 31.89% ± 2.16%, 40.64% ± 0.55%vs.21.75% ± 2.64%).Conclusion BGC has antitumor effect on mouse hepatocarcinoma H22 tumor cells, and its mechanism was to regulate cell proliferation cycle and induce the apoptosis.

OBJECTIVETo explore the effect of the Hsp90 inhibitor anacardic acid on cell proliferation, invasion and migration of breast cancer MDA-MB-231 cells.

METHODSThe inhibitory effect of anacardic acid on Hsp90 was assessed with in vitro ATPase inhibition assay and ATP-sepharose binding assay. MTT assay was used to detect the growth inhibition induced by anacardic acid in MDA-MB-231 cells. Transwell assays were used to evaluate MDA-MB-231 cell invasion and migration. Western blotting was performed to assess the effect of anacardic acid in triggering the degradation of MMP-9, TIMP-1, Hsp90, and Hsp70.

RESULTSAnacardic acid exhibited a modest activity of ATPase inhibition with an IC50 value of 82.5 µmol/L. Anacardic acid significantly suppressed the proliferation of MDA-MB-231 cells in a dose-dependent manner (IC50 value of 29.3 µmol/L). Treatment with 12.5, 25, and 50 µmol/L anacardic acid for 36 h caused inhibition of cell invasion by 23.6%, 56.6%, and 67.0% in MDA-MB-231 cells, respectively (P<0.05), and anacardic acid treatment for 24 h inhibited the cell migration by 30.0%, 45.5%, and 77.5%, respectively (P<0.05). Anacardic acid dose-dependently induced MMP-9 degradation, but did not obviously affect Hsp90 or Hsp70 expressions.

CONCLUSIONAnacardic acid can significantly inhibit the proliferation, invasion, and migration of MDA-MB-231 cells, the mechanism of which may involve the inhibition of Hsp90 ATPse activity and down-regulation of MMP-9 expression.

Anacardic Acids ; pharmacology ; Breast Neoplasms ; pathology ; Cell Line, Tumor ; drug effects ; Cell Movement ; Cell Proliferation ; Down-Regulation ; HSP90 Heat-Shock Proteins ; antagonists & inhibitors ; metabolism ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism

OBJECTIVETo improve the water solubility and biological activity of neoligans (magnolol and honokiol) and test the antitumor activity of the modified compounds.

METHODSThe glycosylated products of magnolol and honokiol were obtained by enzymatic synthesis using a UDP-glycosyltransferase (YjiC) from Bacillus. The products were characterized by high-performance liquid chromatography (HPLC), liquid chromatography-mass spectrometry (LC-MS), and nuclear magnetic resonance (NMR) analysis. MTT assay was used to detect the growth inhibition of 4 human cancer cell lines induced by the compounds.

RESULTSWe obtained two glucosides of neolignans (magnolol and honokiol) for the first time by enzymatic synthesis using a UDP-glycosyltransferase. Based on the spectroscopic data, the glucosides were identified as magnolol-2- O-β-D-glucopyranoside (1) and honokiol-4'-O-β-D-glucopyranoside (2). Compounds 1-4 exhibited moderate anti-proliferative activities against the 4 human cancer cell lines, with IC50 values ranging from 9.41 to 111.21 µmol/L.

CONCLUSIONThe glycoslated products show enhanced water solubility and drug sensitivity against SMMC7721 cells, suggesting their value as potential therapeutic drugs.

Antineoplastic Agents, Phytogenic ; chemistry ; Biphenyl Compounds ; chemistry ; Cell Line, Tumor ; Chromatography, High Pressure Liquid ; Glucosides ; chemistry ; Glycosylation ; Humans ; Lignans ; chemistry ; Magnetic Resonance Spectroscopy ; Mass Spectrometry