Objective To analyze characteristics of patients with acute left ventricular failure,to explore application of non -invasive ventilator in elderly patients with acute left ventricular failure in first aid,and to provide reference for clinical practice.Methods The 84 cases of elderly patients with acute left ventricular failure were selected,in accordance with the random number table.They were divided into control group and treatment group,both groups were given conventional drugs and methods of treatment,while the treatment group was treated by using of non-invasive ventilator -assisted therapy based on the control group.The main changes in physiological indicators of treatment,clinical efficacy and prognosis of the two groups were compared.Results After treatment,in the control group,the clinical total effective rate was 61.9%,while in the treatment group was 88.1%,there were significant differences (χ2 =3.841,P <0.05).Before treatment,RR,HR,SBP,PaO2 and SaO2 of the control group were (28.70 ± 1.01)min,(133.22 ±13.20)min,(112.87 ±14.02)mmHg,(55.60 ±10.56)mmHg and (80.25 ±3.26)%respectively,while the data after treatment were (20.04 ±1.42)min,(95.83 ±14.56)min,(96.08 ±13.84)mmHg, (79.86 ±11.69)mmHg and (90.24 ±3.45)%.Before treatment,RR,HR,SBP,PaO2 and SaO2 of the treatment group were (28.87 ±1.34)min,(135.36 ±10.98)min,(110.90 ±13.65)mmHg,(57.80 ±11.35)mmHg and (81.33 ±3.34)%,while the data after treatmen was (15.86 ±1.13 )min,(84.22 ±11.82)min,(84.26 ± 10.27)mmHg,(89.31 ±12.21)mmHg and (99.35 ±3.96)%.Arterial blood gas indicators in the two groups had improved(t≥5.523,P <0.05),but the degree of improvement in the treatment group compared with the control group was significant difference (t =14.927,4.186,4.445,3.834,11.241,all P <0.05).The turnaround time of the treatment group was (12.7 ±4.1)h,which was significantly lower than that of control group[(20.8 ±5.6)h (t =7.563,P <7.563)].The length of hospital stay in treatment group was (11.8 ±3.9)d,significantly shorter than that in the control group[(18.5 ±4.9)d (t =6.933,P <0.05)].The mortality of treatment group was 2.38%,which was significantly lower than 16.67% of control group (χ2 =2.488,P <0.05).Conclusion On the basis of conven-tional treatment,the use of non -invasive ventilator -assisted therapy in elderly patients with acute left ventricular failure,can significantly improve the main physiological indicators,the effect of improving the clinical treatment and the prognosis is good.

Objective] The pathogenesis of HuangQin Tang is discussed little in six meridians syndrome differentiation, and which meridian syndrome does it belong to isn’t clear. So this article tries to discuss the belonging and pathogenesis of it. And the key point of using it in clinic will also be involved.[Method] Combining the observation of efficacy of XiaoChaiHu Tang and HuangQin Tang and the elaboration articles are related to that two prescriptions to analyze the difference of that two prescriptions in pathogenesis.[Result]It’s found that HuangQin Tang and XiaoChaiHu Tang all belong to ShaoYin in six meridian syndrome.But their pathogenesis is different. HuangQin Tang should be used in heat syndrome of ShaoYang disease which caused by heat pathogen of ShaoYang meridian and diarrhea will appear because belly is shocked. However, XiaoChaiHu Tang is used to drive cold pathogen of ShaoYang meridian. [Conclusion]Both of HuangQin Tang and XiaoChaiHu Tang belong to ShaoYang Meridian, but it’s known that HuangQin Tang is used less. And less discussion of HuangQin Tang should be blamed. The more we know on pathogenesis of HuangQin Tang, the better we use it.

?Objective:To study the influence of composite Danshen droplet pills on hemorheology in peripheral blood of patients with oral lichen planus (OLP).Methods:46 patients with OLP were treated by composite Danshen droplet pills for 8 weeks (oral administration,3 times/day,10 granules/time).The venous blood was taken and the hemorheology was studied with a LBY N6A hemorheology test machine before and after the treatment.Results:Effective results were observed in 33 patient and obvious effective results in 5,while no treating effect was found in 8 after treatment.Whole blood viscosity,blood plasm viscosity,erythrocyte aggregation indexs,thrombocyte aggregation rate,fibrinogen and ESR of the OLP patients were decreased ( P 0.05).Conclusion:The composite Danshen droplet pills may improve the hemorheology of OLP patients.

Objective To assess CT diagnostic value of gastric stromal tumor (GST). Methods Clinical data and spiral CT findings of 20 patients with pathologically proven GST were analyzed retrospectively. Results Twenty lesions were solitary in plain CT scan image. The malignant lesions (n=9) were larger than 5.0 cm in diameter and cystic degenerations as well as necrosis were detected within the tumors, while the underlying malignant lesions (n=11) were smaller than 5.0 cm in diameter and most of them showed homogeneous density. Calcification was detected in 2 patients. On enhanced CT scan, the substantial part of the lesions was obviously strengthened. Multiplanar reformation displayed the relationship of tumor and stomach clearly. Conclusion The CT imaging features of gastric stromal tumor are characteristic. Plain CT scan and multiplanar reformation are helpful to determine the location and nature of gastric stromal tumors.

A persistent infection model was established after human hepatoma cells infected by Japanese encephalitis viruses were subcultured for several times. Viral titers of mutant viruses in persistently infected cells were examined by plaque methods using BHK cells. Nucleotides of the E coding region of two wild and two mutant viruses were amplified by RT-PCR. PCR products were sequenced by ABI-PRSM 310 sequencing system. Compared to JaGAr-01 wild strains, four amino acids were replaced (E61Tyr --> Asp, E219His --> Tyr, E384Val --> Glu, E418Pro --> Ala) in the E sequence of JaGAr-01 persistently-infected mutant strains. Eleven amino acid replacement (E51Arg --> Ser, E61Tyr --> Asp, E83Lys --> Glu, E123Ser --> Arg, E209Arg --> Lys, E227Pro --> Ser, E276Asp --> Ser, E290Arg --> Lys, E387Lys --> Arg, E418Leu --> Pro, E454Arg --> Gly) was also noted when we compared the E sequence between persistently infected Nakayama and its wild strains. A lot of similarities of amino acid sequence between mutant strains JaGAr-01 and Nakayama were also noted. It was concluded that geno-variation existed in E region of mutant viruses and the mutant protein encoded by E region, especially the mutation of E61 (Tyr --> Asp) may contribute to the maintenance of the persistent infection of Japanese encephalitis virus.

Objective To assess whether highly cross-linked polyethylene liners are superior to conventional polyethylene liners in total hip arthroplasty (THA).Methods Randomized controlled trials (RCTs) of highly cross-linked and conventional polyethylene liners in THA were retrieved from MEDLINE,PubMed,EMBASE,Cochrane Central,CBMdisc,CBM,and VIP.Until April 2012,reference lists of the included articles and related reviews were manually searched as supplements.Meta analysis was performed with RevMan 5.1.Mean difference (MD) was used to assess the linear wear rate in highly cross-linked group versus conventional group.Odds ratio (OR) was used to estimate the osteolysis and revision incidence in the two groups.Results Meta analysis indicated that the two-dimensional linear wear rate [MD =-0.08,95％ CI (-0.1,0.06),P ＜ 0.05],three-dimensional linear wear rate [MD=-0.15,95％CI (-0.22,0.08),P＜0.05],volumetric wear rate [MD=-53.03,95％ CI (-84.39,-21.67,P＜0.05],total linear wear [MD=-0.19,95％CI (-0.23,-0.15),P＜0.05],and osteolysis incidence [OR =0.23,95％ C1 (0.13,0.39),P ＜ 0.05] were significantly reduced in highly cross-linked group than in conventional group.There were no statistical differences between the two groups concerning the creep value of the polyethylene liners and revision incidence.Conclusions Highly cross-linked polyethylene liners for primary THA present a low incidence of wear and osteolysis.As the number and quality of the included studies are limited,a long-term follow-up of more large-sample and high-quality RCTs are needed to evidence the outcome.

To investigate the enhancement of immunological activity of CpG ODN by chitosan gene carrier in mice, the effect of lymphocyte proliferation was detected in mice by using MTT, the levels of IgG and cytokines (IL-2 and IL-12) in serum were measured by ELISA and peripheral blood T lymphocyte subsets CD4(+), CD8(+) were analyzed by flow cytometry. Our results showed that spleen lymphocytes isolated from the CS-CpG ODN group of mice showed the strongest proliferation (SI=1.551), and the levels of IgG, IL-2 and IL-12 in serum were higher than those of other groups. Compared with the immunization with CpG ODN, the immunization with CS-CpG ODN gene carrier was more efficient in up-regulating the percentage of CD4(+)T cells and the ratio of CD4(+)/CD8(+) of mice. It was concluded that CS gene carrier of CpG ODN was much more effective in improving immunity of CpG ODN in mice.

Objective To study the association between endometrioid uterine carcinomas and metabolic syndrome (MS). Methods A retrospective study was conducted on 123 patients who were admitted in Department of Gynecology Oncology, Zhejiang Cancer Hospital (study group) and 90 healthy women (control group) with matching age from Jan. 2005 to Mar. 2009. The general conditions[including age, whether menopausal, body mass index (BMI)];the risk factors for MS [including waist circumference,fasting plasma glucose, triglycerides(TG), high-density lipoprotein (HDL) and systolic and diastolic blood pressure]were analyzed. The clinical stage, histological type, and pathology differentiated degree of study group with or without MS were also analyzed by univariate analysis and Cox proportional hazards models.Results (1) The univariate survival analysis shown that there were no significant difference with age in two groups[(54.3±0.6) vs. (54.2±0.9) years;P>0.05], while the rate of menopausal, BMI(≥25 kg/m~2), the cases coupled with MS, the size of waist circumference (> 80 cm), the level of fasting plasma glucose (≥5.6 mmol/L),TG(> 1.7 mmol/L)and abnormal systolic and diastolic blood pressure in study group were higher than those in control group (67.5% vs. 48. 9%, 45.5% vs. 23.3%, 43.9% vs.18.9%, 50.4% vs. 27.8%, 53.7% vs. 21.1%, 40.7% vs. 21.1% and 40.7% vs. 25.6%,respectively, all P <0.05). The percentage of HDL(< 1.30 mmol/L) was higher in study group than that in control granp(63. 4% vs. 32. 2%, P <0.05). (2) There were not significant difference for the clinical stage, pathological type, grades between patients with or without MS in study group (P > 0.05). (3) The Logistic multivariate survival analysis shown that central obesity, higher TG, lower HDL and abnormal plasma glucose were independent risk factors for endometrioid uterine carcinomas coupled with MS (P< 0.05). Conclusion Metabolic syndrome is marginally associated with an increased risk of endometrioid uterine carcinomas, which may be the new point to screen, prevention and treatment endometrioid uterine carcinomas.

Objectives To study the effect of bone mineral density measurement on the diagnosis and treatment of osteoporosis in patients with fragility hip fracture.Methods A retrospective analysis was conducted on 560 cases of elderly patients with fragility hip fracture in our hospital from January 2010 to December 2012.They were divided into two groups with and without the bone mineral density measurement,and compared to study the bone turnover markers detection and osteoporosis treatment.Results Among the 80 cases with the DXA bone mineral density detection,36 cases received the bone turnover markers detection(45.0%),and the rate of osteoporosis treatment in hospital was 70.0%,while the rate of osteoporosis treatment after discharge was 57.5%.Among the 480 cases without DXA bone mineral density detection,none received bone turnover markers detection,and the rate of osteoporosis treatment in hospital was 42.1%,while the rate of osteoporosis treatment after discharge was 36.7%.Conclusions The detection rate of bone mineral density and the diagnosis and treatment rate of osteoporosis are low in patients with fragility hip fracture.DXA bone mineral density measurement is helpful to improve the detection rate of bone turnover markers and the treatment rate of osteoporosis.

[ ABSTRACT] AIM:To investigate the effects of pathological products, urinary proteins and advanced glycosyla-tion end products ( AGE) produced in the progression of chronic kidney disease ( CKD) , on the structure and function of lysosomes in renal tubular epithelial cells ( TECs ) , and try to find a novel approach for preventing or delaying CKD. METHODS:The renal specimens of the untreated patients with minimal change nephrotic syndrome (MCNS), diabetic nephropathy (DN) or normal kidney were collected.The expression of lysosomal-associated membrane protein 1 (LAMP1) and cathepsin B ( CB) was studied in TECs by indirect immunofluorescent staining.Human renal tubular epithelial cell line HK-2 was incubated with 8 g/L urinary proteins or 100 mg/L AGE.The expression of LAMP1 and CB was investigated by indirect immunofluorescence and the activity of CB and cathepsin L ( CL) was measured by biochemical and enzymatic as-says.The degradation of DQ-ovalbumin was also determined.RESULTS: The lysosomal membrane permeabilization oc-curred in the TECs of MCNS and DN patients.After treatment with urinary proteins or AGE-BSA, the lysosomal membrane permeabilization of the HK-2 cells was increased.The activity of CB and CL and degradation of DQ-ovalbumin were de-creased as compared with normal control group.CONCLUSION:The digestive function of lysosome was decreased and ly-sosomal membrane permeabilization occurred in the TECs exposed to urinary proteins and AGE, which might be a key factor to induce the tubulointerstitial fibrosis.