Objective To explore the effects oflosartan on brain natriuretic peptide(BNP)and C-reactive protein(CLRP)in diabetic cardiomyopathy patients. Methods Sixty diabetics were divided into diabetic control group(30 cases)and diabetic cardiomyopathy group(30 cases), and the levels of BNP and CRP in plasma were determined. Then, diabetic cardiomyopathy group were divided into conventional treatment group(15 cases)and losartan treatment group(15 cases)by random digits table to take corresponding treatment for 12 weeks. The changes of cardiac function, the levels of BNP and CRP in plasma were detected and compared. Results The levels of BNP and CRP in diabetic cardiomyopathy group [(331.27 ±65.64)ng/L,(26.10±10.13)mg/L]were significantly higher than those in diabetic control group[(76.09±39.14)ng/L,(7.03±2.71)mg/L](P＜0.01). After treatment 12 weeks, the levels of BNP and CRP were significantly lower, left ventricular ejection fraction was significantly higher and left ventricular end-diastolic diameter was significantly lower in losartan treatment group than those in conventional treatment group(P＜0.05).Conclusions The increasing levels of BNP and CRP can reflect clinical severity of diabetic cardiomyopathy.Losartan can decrease the levels of BNP and CRP, and improve heart function, and it has better effective on diabetic cardiomyopathy.

Objective To explore the influence of Chinese Qigong--Baduanjin on mild cognitive impairment (MCI) in elderly diabetic patients.Methods A total of 78 elderly type 2 diabetic patients complicated with MCI were divided into intervention group and control group by random digits table method.The control group with 41 patients was received routine treatment and discharged guidance after discharging from hospital.The intervention group with 37 patients was received Baduanjin exercise for 12 months based on the routine treatment in control group.Montreal Cognitive Assessment (MoCA) and Activity of Daily Living (ADL) scores in two groups were compared before intervention and 1,3,6,9 and 12 months after intervention.Results In intervention group,MoCA scores were significantly increased at different times after intervention compared with those before intervention,F=72.782,the differences were statistically significant,P＜0.05.At the same time,MoCA scores were all significantly higher in intervention group than those in control group,F=2.231,2.972,4.362,5.085,5.373,the differences were statistically significant,P＜ 0.05.In intervention group,ADL scores had significantly improved since 6 months after intervention compared with those before intervention,F=93.126,the differences were statistically significant,P＜0.05,and compared with those in control group,the scores were significantly higher since 6 months after intervention,F=3.853,4.561,7.162,the differences were statistically significant,P＜0.05.Conclusion Chinese Qigong--Baduanjin in treatment of elderly diabetic patients complicated with MCI can delay the MCI progress and improve ADL of the patients.

Objective To explore the effects of modified herringbone-Trendelenburg position during gynecological laparoscopic operation of the elderly. Methods A total of 60 elderly patients undergoing gynecological laparoscopic operation under general anesthesia were recruited and assigned to the observation group (30 cases) and control group (30 cases) by random digits table method with 30 cases each according to admitting time;Patients in the control group were placed in conventional Trendelenburg position, while the patients in the observation group were positioned in modified herringbone-Trendelenburg position .Intraocular pressure (IOP) were measured in the patients at anesthesia induction (T1),5 minutes after general anesthesia in supine position (T2) , and 5 minutes after pneumoperitoneum while in the operation position (T3) , every 30 minutes (times 4 to 11), while supine at the end of pneumoperitoneum (time 12) and before awakening (time 13);Patients were followed up at 24 h and 48 h after surgery, researcher investigate and record the scores of the Operation Position Comfort Questionnaire, the situation of the pain in the shoulder and postoperative complications of the lower limbs. Results There was no statistically significant difference (t=-1.098,-0.772,-0.656, P>0.05) of the IOP at T1, T2, T13. The IOP in the observation group had statistically significant difference compared with the control group at T3 to T12 (t=6.523-19.866, P<0.01). The incidence rate of the postoperative complications of the lower limbs in the observation group was 6.7%(2/30) lower than 26.7%(8/30) of the control group (χ2=4.320, P<0.05) and the VAS scores of the patients in the two groups was statistically significant (t=2.471, P<0.05). The incidence rate of the postoperative shoulder pain in the observation group was 10.0%(3/30) lower than 43.3%(13/30) of the control group (χ2=8.523, P<0.01), and the Visual Analogue Scale scores of the patients in the two groups was statistically significant (t=3.575, P<0.05).The scores of the Operation Position Comfort Questionnaire in the observation group was higher than the control group (t=-2.319, P<0.05). Conclusions Modified herringbone- Trendelenburg position can reduce the elevation of intraocular pressure in elderly patients without affecting the operation ,and effectively improve the comfort of the operation position of the patients, reduce the incidence rate of the shoulder pain and postoperative complications of the lower limbs, is conducive to the operation safety of elderly patients.

Objective To evaluate tumor angiogenesis and clinical significance by contrast-enhanced CT in case of non-small cell lung cancer (NSCLC). Methods 30 patients with NSCLC underwent dynamic thoracic CT, and histopathological slides were carefully prepared for VEGF immunohistochemical staining. Maxium attenuations of dynamic CT were compared with VEGF expression levels and lymph-node metastases. Results The mean peak attentation was (36.28?6.41)HU, VEGF positive expressions were in 21 patients, and negative expressions were in 9 patients. VEGF expression levels in patients with NSCLC stage II and III were higher than those in stage I , and in lymph node metastases group, the expression levels of VEGF were also higher than those in non-metastatic nodes. CT enhancement of NSCLC was positively related to VEGF expression,neoplasm stage and lymph-node metastases. Conclusion CT enhancement of NSCLC can reflect tumor angiogenesis and correlate to lymph-node metastases closely, help lung cancer diagnoses,neoplasm stage, and serve as a supplement to the present staging system for lung cancer in biological behavior.

Objective:To investigate the protective effect of rifampicin in a rat model of global cerebral ischemia /reperfusion ( GCIR) and discuss the influence of rifampicin on microglial activation.Methods:The GCIR rat model was induced via the bilateral occlusion of the common carotid arteries and systemic hypotension.Forty-two male SD (Sprague-Dawley) rats were randomly assigned to three groups:sham group ,I/R and I/R+FRP treated group.The rats in I/R+RFP group were treated with rifampicin 20 mg/kg by intra-peritoneal injection 30 min after reperfusion , while the other groups were treated with normal saline.Morris water maze test was performed for neurobehavioral test ,HE staining was detected for pathomorphology changes of neurons in CA 1 region.Microglia was im-munohistochemically stained in CA 1 region using ionized calcium adaptive molecular 1 ( IBA-1) as the marker.The protein levels of IL-1β,IL-6 and TNF-αin the hippocampal tissues of rats were also measured by enzyme-linked immunosorbent assay.Results:Rifampin improved the behavior ,shorten the escape latency of rats following GCIR obviously ( P<0.05 ) and reduced the neuron damage in hipp-ocampal CA1 region of rats after GCIR (P<0.05).Additionally,in I/R+FRP treated group the activation of microglia also showed a significantly inhibited compared with I/R group(P<0.05).Futhermore,we also found the expression of IL-1β,IL-6 and TNF-αin hipp-ocampal reduced obviously in I/R+FRP group ( P<0.05 ).Conclusion: Rifampin have obvious protective effect in the rat model of GCIR.The underlying mechanism may be associated with inhibition the activation of microglia ,reduction the expression of IL-1β,IL-6 and TNF-αand suppression the inflammatory response finally.

BACKGROUND: Chitosan is one of the most significant non-viral vector materials with the advantages of outstanding biocompatibility. Quarternary chitosan derivatives can improve transfection efficiency and solubility of chitosan in a broader range of pH values. OBJECTIVE: To synthesize a new vector of quarternary chitosan and to study its complex conditions with plasmid and transfection efficiency compared with chitosan. DESIGN, TIME AND SETTING: A contrast observational study was performed in Second Affiliated Hospital of School of Medicine of Zhejiang University between August and October 2008. MATERIALS: Quarternary chitosan was synthesized in Polymer Materials Lab of Beijing Institute of Technology. Plasmid pEGFP-C1 was presented friendly by Mr. Zheng of School of Medicine of Zhejiang University. Hela cells were provided by Miss. Cheng of School of Medicine of Zhejiang University. METHODS: Quarternary chitosan was prepared according to mass concentration of 0.2 g/L, pH value 5.5 (or 6.9, 7.6) and sodium acetate concentration of 50 mmol/L, and rapidly mixed with pEGFP-C1. The mixture was swirled for 15-30 second and stood at room temperature for 30 minutes at least. MAIN OUTCOME MEASURES: The impacts of pH values and time on complex ability of quarternary chitosan and plasmid were studied by gel retardation test. Transfection efficiency of quarternary chitosan on Hela cells was observed by inversed fluorescence microscope and also compared with chitosan. RESULTS: Quarternaty chitosan could form complex with plasmid in acidic, neutral and basic conditions. It could be used in a broader range of pH values. In an acidic condition, the combination of quarternary chitosan with plasmid was superior to chitosan. A stable complex was formed via a combination of quarternary chitosan or chitosan with plasmid within 30 minutes, and the stability lasted for 12 hours. Transfection efficiency of quarternary chitosan on Hela cells demonstrated that transfection efficiency of quarternary chitosan was superior to chitosan. CONCLUSION: Quarternary chitosan has a broader range in use and higher transfection efficiency than chitosan; however, there is no significant difference in stability between quarternary chitosan and chitosan. Additionally, transfection efficiency of quarternary chitosan on Hela cells is superior to chitosan, which needs a further research.

BACKGROUND: Compared with the traditional organic fluorescent dyes, quantum dots present good biomarker characteristics. Especially, quantum dots for cell labeling and targeted bioimaging present unique optical properties.OBJECTIVE: To investigate the biocompatibility of CdSe/ZnS quantum dots with mononuclear macrophages.METHODS: The macrophages RAW264.7 were inoculated into 96-well plates containing 0, 50, 100 mg/L CdSe/ZnS quantum dots for 1 or 2 hours. Then, the fluorescent signal was detected by flow cytometry. After 0-24 hours of culture,the fluorescence signal intensity of the macrophages cultured with 50 mg/L CdSe/ZnS quantum dots was detected by flow cytometry. After 18 hours of culture, quantitative PCR was used to detect the levels of tumor necrosis factor α and interleukin 1β in macrophages, and macrophage proliferation cell apoptosis were detected by MTT and flow cytometry,respectively.RESULTS AND CONCLUSION: The fluorescence signal intensity was positively correlated with the mass concentration of CdSe/ZnS quantum dots, and the intensity of the fluorescent signal was increased with the labeling time. After labeling using 50 mg/L CdSe/ZnS quantum dots, the fluorescence signal of macrophages increased continuously with time, and reached the peak at 18 hours. Compared with 0 mg/L quantum dot group, 50, 100mg/L quantum dot groups could significantly promote the expression of tumor necrosis factor α and interleukin 1β in macrophages (P < 0.01 or P < 0.05).The level of tumor necrosis factor α in the 100 mg/L quantum dot group was higher than that in the 50 mg/L quantum dot group (P < 0.01). The expression of interleukin-1β showed no difference between 50 and 100 mg/L quantum dot groups.The cell proliferation in the 50 and 100 mg/L CdSe/ZnS quantum dot groups was significantly higher than that in the 0 mg/L quantum dot group (P < 0.05), but there was no difference between the former two groups. In addition, 50 and 100 mg/L CdSe/ZnS quantum dots had no significant effect on apoptosis of macrophages. To conclude, CdSe/ZnS quantum dots could activate macrophages and promote their proliferation and secretion of inflammatory factors, but did not affect their apoptosis.

Objective To determine the effect and safety of metallic stents in the treatment of acute malignant colorectal obstruction.Methods From May,2000 to June,2003, self-expanding metallic stents were implanted in 15 patients with acute left colonic obstruction caused by malignancies. The postoperative remission and complications were observed.Results Stents were implanted successfully in 12 cases(80.0%,12/15).Of the 12 cases,the obstruction were all disappeared within 24h. No death or colonic perforation happened in this series. Stent migration and anal pain developed each in one case after stent implantation. Elective radical resection was performed on 8 cases after bowel preparation and supportive therapy; and stents reserved permanently in other 4 cases. Conclusions The implantation of self-expanding metallic stents is a safe and effective method for the temporary remission or permanent treatment of acute left-colonic or rectal obstruction caused by malignancies,it can instead of colostomy.

Objective To construct clinical nursing pathway for patients with laparoscopic cholecystectomy surgery in acute cholecystitis stage, and to provide standardized nursing service. Methods With case record and literature review as theoretical basis, Omaha System as frame, clinical nursing pathway with patient centered was developed through analysis of main nursing problem and intervention. Results Omaha System oriented clinical nursing pathway was constructed in different stages of Laparoscopic cholecystectomy surgery with acute calculous cholecystitis. Conclusions Combined standardized nursing language and nursing process, clinical nursing pathway based on Omaha system provide practicability nursing plan in different stage regarding time as the coordinate axle. It contains assessment, problem, intervention and outcome evaluation indexed, which is beneficial to improve nursing quality.

Objective To investigate the awareness of osteoporosis and its influential factors in middle-aged and older people. Methods By using self-designed questionnaire, 354 middle-aged and old people were investigated as to their awarness of osteoporosis in Chajiao street community in Guangzhou. Among them, 58 people were measured the bone density in the calcaneal bone by Ultrasound. Results The average score of the questionnaire was 9.46 ± 5.13, and the accuracy was 39.4%. In the diagnosis and treatment, the accuracy was just 17.8%. The diet (the accuracy in 54%) and sport (the accuracy in 50.3%) were good. The statistical analyses showed the linear relationship between the T value of bone density and the age (P = 0.021), between the T value and the score (P = 0.047). Wilcoxon rank sum test found that the T value between female and male was significantly different (Z = -3.749, P < 0.000). With multiple linear regression analysis, the T value had a linear correlation with the score (F = 4.224, P = 0.045) positively. Conclusions Currently, the awareness of osteoporosis in the middle-aged and old people was inadequate. To better prevent osteoporosis, the propogation of knowledge and guidance provided by clinicians in osteoporosis should be improved necessarily and emergently.