Objective A study was performed to better define the teaching outcome of computers in teaching medical imaging. Methods 150 4rd-year students were randomly assigned to four groups and experimental group exposed to 20 radiology cases as well as to a voluntary weekly radiology lecture. Group A used computer-based cases with interactive elements; group B used computer-based cases without interactive elements; group C used paper-based cases with interactive elements; and group D was not exposed to the cases and served as a control group. Results On a multiple-choice question test,groups A,B,and C showed significant improvemen(t+10.6%,+15.7%,+13.5%,respectively),whereas group D did not(+2.7%). On an image interpretation test,group A and group B showed the most improvement (+15.8%,P

Fall is one of major causes of disability, reduced mobility, shortness of life span and increased medical costs in the elderly.There are multiple risk factors for falls in the elderly, but they can be preventable and controlled.This article reviews the evidences regarding the clinical effectiveness, practicalness and security of these fall risk assessment methods and measures of interventions by evidence-based medicine in the elderly and analyzes their research directions.

OBJECTIVE:To observe the effect of Xuezhikang on serum MCP-1 and endothelial function of brachial artery in patients with chronic heart failure but with normal cholesterol level. METHODS:Patients with chronic heart failure (NYHAⅡ-Ⅳ) were randomly allocated into two groups(n=24 each). Both groups received routine treatment in accordance with the guide of CHF treatment,additionally,the treatment group received Xuezhikang 0.6 g bid for 8 weeks. Serum levels of MCP-1 before and after treatment were measured by ELISA and endothelial function of brachial artery was detected by ultrasonography. RESULTS:In Xuezhikang-treated group compared with the control group,serum level of MCP-1 decreased significantly(P

Objective To investigate the prevalence of osteoporosis,osteopenia,fall and brittle fracture and their associated factors in men aged 80 years and over.Methods In a prospective study,184 study subjects with good self-care ability aged 80 years and over were enrolled.The questionnaire included living habits,falls,comorbidities,related symptoms and medicines.The bone mineral density,hand-grip strength,gait speed,timed up and go test(TUG),chair rising test(CRT),bone turnover markers and related hormones were measured.Binary Logistic regression model was used to analyze associated factors for osteoporosis,osteopenia,fall and brittle fracture.Results The prevalence of osteoporosis (OP)and osteopenia(OPA) were 12.5 ％ (23/184) and 45.1％ (83/184) respectively in this study.The height,weight and body mass index were lower,and serum levels of procollagen type 1 N terminal propeptide(P1NP)and C-telopeptides of type 1 collagen(s-CTx)were higher in osteoporosis group than in normal bone mass(NBM) group(P＜0.05,P＜0.01).The estradiol levels were lower in OP and OPA group than in NBM group(P＜ 0.05).The risk factors for OP and OPA included smoking(OR =3.607,P＜0.05),decreased body weight (OR=0.823,P ＜ 0.05) and elevated S-CTx level (OR =12.427,P ＜ 0.01).55.4％ (102/184) of study subjects had fall history after 80-year old.The prevalence of fragile fracture was 17.4％ (4/23),18.1 ％ (15/ 83)and 3.8％(3/78)in OP,OPA and NBM groups respectively,with total prevalence of 12.0％ (22/184).The risk factors for fragile fracture were a decreased total hip BMD(OR 0.017,P＜0.05)and fall history after 80-year-old(OR 13.126,P ＜ 0.05).Conclusions Based on associated factors of osteoporosis,osteopenia,falls and fragile fracture in male aged 80 years and over,the primary and secondary prevention of osteoporosis may need a comprehensive geriatric intervention including lifestyle adjustment,fall prevention and pharmacologic treatments.

Objective To study the interventional effects of Candesartan Cilexetil on vascular endothelial function and expres-sions of ERK/CREB signaling pathway in rats with acute myocardial infarction.Methods 30 rats were randomized into CAN group,AMI group and Sham group.Two weeks after the treatment rats were sacrificed and blood pressure,levels of blood AngⅡ, NO and NOS,endothelial vasomotor effects of isolated thoracic aorta strips,myocardial infarctual area and the expressions of ERK mRNA and CREB mRNA in infarctual myocardium were explored.Results Blood AngⅡ levels were distinctly higher in AMI group when compared with the Sham group,while the NO and NOS level were much lower.accompanied with EDDs decreased seri-ously,and higher mRNA expressions of ERK1 and CREB in infarctual myocardium.All of the above differences were significant. After the treatment of Candesartan Cilexetil,levels of serum NO and activities of NOS were obviously higher and almost reached the similar levels to those in Sham group,additionally endothelium-dependent diastole in isolated aortic strips improved greatly.Mean-while Candesartan Cilexetil can not only increase the plasma AngⅡ,but also decrease the size of myocardial infarction and the mR-NA expressions of ERK1 and CREB in infarctual myocardium significantly.However,blood pressure in all groups was not affected. Conclusion Candesartan Cilexetil can greatly improve the disordered endothelial function developing post-AMI,decrease the size of myocardial infarction and down-regulate the mRNA expressions of ERK and CREB in myocardium of infarctual zone.And all of the above protective effects of Candesartan Cilexetil were independent on blood pressure lowering.

Objective To review the epidemiologic features of norovirus infection outbreaks in Zhejiang province during 2004-2014.Methods Epidemiological data of norovirus infection outbreaks in Zhejiang province from January 2004 to February 2014 were collected from the Emergency Public Reporting System in Zhejiang Provincial CDC.The distribution of time,area,population,route of transmission and genotype of norovirus were analyzed.Results There were 16 outbreaks of norovirus infections with 2 037 cases during 2004-2014 in Zhejiang province.Eleven outbreaks occurred during February and April,and 13 outbreaks occurred in schools.The outbreaks in schools mainly involved students aged 15-20 years,while other outbreaks took place mainly in the young and middle-aged population.The sex ratio of male to female was 1.05 ∶ 1.Among 16 outbreaks,10 were induced by norovirus G Ⅱ infections,3 were induced by norovirus G Ⅰ infections and 3 were induced by norovirus G Ⅰ and G Ⅱ infections.Fourteen outbreaks were caused by water pollution.Conclusion Outbreak of norovirus infection usually occurs in schools during winter and spring in Zhejiang province,and the epidemic of disease is mainly associated with polluted water.

OBJECTIVE:To study the mechanism of improvement effects of exenatide on mitochondrial function of H9c2 cells under hypoxia/reoxygenation (H/R) condition. METHODS:H9c2 cells were cultured in vitro and were divided into blank control group,drug control group(exenatide 200 nmol/L),model group(H/R),pretreatment group(exenatide 200 nmol/L+H/R),gluca-gon-like peptide-1 receptor (GLP-1R) inhibitor [Exendin-(9-39) 100 nmol/L+exenatide 200 nmol/L+H/R], cAMP inhibitor (Rp-cAMPS 1 μmol/L+exenatide 200 nmol/L+H/R)group and PKA inhibitor(H-895 μmol/L+exenatide 200 nmol/L+H/R)group. Except for first 2 groups,H/R model was established in other groups,and they were given exenatide 30 min before modeling and relevant inhibitor 10 min before giving exenatide. Morphology of mitochondria was observed by TEM,and mitochondrial calcium (Ca2+m)and the mitochondrial membrane potential(ΔΨm)were determined by flow cytometry. Cellular ATP content was measured by microplate reader. RESULTS:Compared with blank control group, mitochondrial cristae swelling was enhanced in model group,while density decreased,showing vacuolization;Ca2+m level increased while ΔΨm and ATP decreased (P<0.05). Com-pared with model group,mitochondrial cristae swelling relieved in pretreatment group,while density increased,showing vacuoliza-tion relieved;Ca2+m level decreased,while ΔΨm and ATP increased(P<0.05). Compared with pretreatment group,the levels of Ca2+m increased in 3 kinds of inhibitors group,while ΔΨm and ATP decreased(P<0.05). CONCLUSIONS:Exenatide attenuates H9c2 cell mitochondria Ca2+m accumulation,increases ΔΨm and ATP production. Which indicate its mechanism may be associated with activating GLP-1R/cAMP/PKA pathway.

ObjectiveTo investigate the expression of CCL2 and its effects on the proliferation and adhesiveness on leukemia cells in patients with acute lymphoblastic leukemia(ALL). MethodsThe bone marrow mesenchymal cells (BMMSC) and bone marrow mononuclear cells (BMMNC) of 30 ALL patients and 30 healthy controls were studied, and CCL2 level was evaluated by ELISA. CCL2 gene mRNA level in ALL was determined by RT-PCR. The cell proliferation and adhesiveness were detected by MTT assays. The cell counts were measured by flow cytometry. ResultsThe BM plasma levels of CCL2 in patients at diagnosis were significantly higher than that in healthy controls [(780.12±129.61) pg/ml vs (120.49±25.21) pg/ml,t =4.96, P =0.00]. Supernatant levels of CCL2 in BMMSC were significantly higher than that of BMMNC [(572.38±35.39) pg/ml vs (193.85±15.45) pg/ml,t =5.37,P =0.00]in vitro.CCL2 cannot induce leukemia proliferation alone,but could induce leukemia proliferation in BMMNC and BMMSC co-culture in a dose- and time-dependent manner.CCL2 could increase the leukemia adhesive to the BMMSC compared with control (r =0.824,P =0.02).ConclusionPatients with B type ALL had higher levels of CCL2 which was secreted by BMMSC. The leukemia could induce the BMMSC to secrete CCL2. CCL2 could promote the survival and proliferation of leukemia in the presence of BMMSC and BMMNC, and enhance ALL cells adhesion toBMMSC in a dose-dependent manner.

OBJECTIVE:Taking metoprolol succinate sustained-release tablets as an example,to explore the value of speckle tracking imaging in therapeutic efficacy evaluation of CHF drugs. METHODS:68 CHF patients who had never underwent regular treatment were given Metoprolol succinate sustained-release tablets and anti-heart failure agents for 3 months. NYHA classification, resting heart rate(RHR),6 min walk distance(6MWD)and conventional echocardiographic measurements were tested before and 1 and 3 months after treatment. Dynamic image were collected in the apical 2-chamber view,apical 4-chamber view and left ven-tricular long axis plane for speckle tracking imaging offline analysis. The left ventricular global longitudinal strain (LVGLS) were measured. After 3 months of treatment,CHF patients were divided into standard group(group A,RHR 55-60 times/min)and non-standard group (group B,RHR>60 times/min) according to resting heart rate. The improvement of above indicators were com-pared between 2 groups,and that of LVGLS was also compared. RESULTS:After 1 month of treatment,RHR,LVEDd,LVEF and LVGLS of group A were improved significantly,compared with group B,with statistical significance (P<0.05). After 3 months of treatment,there was statistical significance in above indicators between 2 groups(P<0.05). In group A,RHR,6MWD and LVGLS improved significantly after 1 month of treatment,there was statistical significance,compared with before treatment (P<0.05);there was statistical significance in above indicators after 3 months of treatment,compared with before treatment and after 1 month of treatment (P<0.05). In group B,RHR and 6MWD improved significantly after one month of treatment;there was statistical significance,compared with before treatment(P<0.05);there was statistical significance in significant improvement of each indicator between after 3 months of treatment and before treatment (P<0.05);only there were statistical significance in RHR and NYHA grading,compared with after one month of treatment(P<0.05). CONCLUSIONS:Speckle tracking imaging can early reflect the left ventricular function improvement of CHF patients after anti-heart failure treatment,especially in patients with RHR control standard earlier and more significant. Speckle tracking had good clinical application value in the follow-up treatment of heart failure as routine evaluation index.

Adult ; Arsenic Poisoning ; etiology ; Female ; Humans ; Male ; Middle Aged ; Organotin Compounds ; poisoning ; Water Pollution ; Young Adult