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

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 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

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 analyze the utilization of drugs in children with ventricular septal defect(VSD) undergoing operation.METHODS:The medical orders of 120 VSD children patients in our hospital in 2005 were analyzed retrospectively.RESULTS:The per capita drug cost was(3 067.20? 325.04) yuan,accounting for 9.52% of the total medical cost.Circulatory system drugs and antibiotics were the chief categories.Leading the first 3 places in terms of DDDs were cefuroxime,vecuronium bromide and furosemide,respectively.CONCUSION:The drug cost for VSD children patients was relatively low and reasonable.

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 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.

Critical care medicine has the characteristics of complex,a wide range of knowledge,and interdisciplinary,so standardized training is difficult.Intensive Care Unit explored a standardized training mode and evaluation system suitable for standardized training residents in the Intensive Care Unit,including generalizing training target,developing step by step teaching plans,establishment of entrance education,basic theory,basic skills,scientific thinking and doctor-patient communication training with diversity of teaching methods,including lecture-based learning,problem-based and casebased learning,implement the flexible and strict evaluation system.

Accidents, Occupational ; prevention & control ; Emergency Medical Services ; organization & administration ; Humans ; Occupational Exposure ; prevention & control ; Occupational Health ; Poisoning ; prevention & control ; Risk Assessment