Objective To assess the relationship between fractional esterification rate of high density lipoprotein cholesterol (FERHDL) and coronary artery disease .Methods The patients were underwent coronary angiography in this hospital in the last three years were collected ,according to the results of coronary angiography ,286 patients were divided into CHD group(n=196) and non-CHD group(control group ,n=90) .And according to the number of pathological coronary artery ,the patients with coronary heart disease were divided into single-vessel subgroup(n=73) ,double vessel lesion subgroup(n=72) ,three branch lesions subgroup (n=51) .The relationship between FERHDL and coronary artery disease were analyzed .Results The FERHDL of CHD group was significantly higher than that in the control group ,the difference was statistically significant (P<0 .05) .It was a tendency that the FERHDL increased with coronary lesions increasing (P<0 .05) .The FERHDL was significant independent correlated with the low density lipoprotein cholesterol b-C(LDLb-C) ,triglycerides(TG) ,high density lipoprotein cholesterol 2-C(HDL2-C) ,high density lipoprotein cholesterol C(HDL-C) .FERHDL was positively correlated with LDLb-C(r=8 .473 ,P=0 .000) ,TG(r=0 .714 ,P=0 .002) and negatively correlated with HDL2-C(r= -0 .692 ,P=0 .024)、HDL-C(r= -0 .829 ,P=0 .008) .Conclusion The value of FERHDL was significantly increased in CHD patients and correlated with the aggravation severity of the CHD .The change of FERHDL was significant correlated with particle size of HDL and LDL particle size .

Objective To investigate the treatment effects of dahuang gancao decoction on lung Injury complicated by acute necrotizing pancreatitis and explore its mechanism. Methods 90 Wistar rats were randomly divided into 3 groups, namely sham-operated group (SO), ANP group (ANP), dahuang gancao decoction treatment group (DG). 4% sodium taurocholate was injected into the pancreatic duct to induce ANP. Dahuang gancao decoction(0.25 g/ml) 0.6 ml/100 g weight was gavaged in the DG group, the same volume of normal saline was gavaged in the SO and ANP group, which was repeated 12 h later. After 6 h, 12 h, 24 h, all rats were sacrificed, pancreas and lung tissues were harvested to observe the pathological changes and the pathological changes were scored. IL-6, IL-10, TNF-α levels of serum and lung tissue were measured,and the changes of toll-like receptor 4 (TLR4) expression in lung tissue was determined by immunohistochemical method. Results 12 h after ANP induction, the serum levels of IL-6 in SO, ANP, DG group were (14.4±4.0)pg/ml, (171.4 ±41.3)pg/ml, (156.9 ±34.7)pg/ml; the serum levels of IL-10 were (13.7 ±4.5)pg/ml, (120.5 ±23.7)pg/ml, (148.3 ±44.4)pg/ml; the serum levels of TNF-α were (22.4 ±4.7)pg/ml, (261.3 ±51.4)pg/ml, (235.3 ±45.9)pg/ml; the lung tissue levels of IL-6 were (257.3 ±55.9)pg/ml,(2578.3 ±403.0)pg/ml,(2370.0 ±491.0)pg/ml; the lung tissue levels of IL-10 were (80.8 ±20. 8)pg/g, (642.0 ± 107.3)pg/g, (695.3 ± 151.7) pg/g, the lung tissue levels of TNF-α were (207.6 ±98.6)pg/g, (1769.1 ±635.6) pg/g, (1401.1 ±450.5) pg/g; the pancreas pathological scores were 0, 7.00 ±1.33, 6.30 ± 0.95; the lung pathological scores were 0, 6.30 ± 1.42, 5.60 ± 0.97; the expressions of TLR4in lung tissue were 0.09 ± 0. 03, 0.59 ± 0. 09, 0. 52 ± 0. 08. The values in the ANP and DG groups were significantly higher than those in SO group (P < 0. 01 ); except for IL-10, all values in the DG groups were significantly lower than those in ANP group (P < 0.05); there was a positive association between lung and pancreas scores (r =0.807, P<0.01), and lung score was positively associated with the expression of TLR4(r = 0.519, P < 0.01 ). Conclusions Dahuang ganeao decoction may quickly improve lung injury complivated by ANP. The mechanism may involve inhibiting the expression of TLR4 and down-regulating the expression of IL-6, TNF-α, up-regulating the. Expression of IL-10.

In order to affirm the cardioactive components in Fuzi, we identified a group of aminoalcohol- diterpenoid alkaloids in Fuzi using ultra high-performance liquid chromatography coupled with electrospray ionization mass spectrometer (UPLC-ESI-MS) method. Among a total of forty-one isolated ingredients, thirteen major aminoalcohol-diterpenoid alkaloids were identified by comparing their retention times and MS spectra with those of the reference substances. Moreover, Fuzi samples from different places of origin and with different processing methods were examined and their components displayed a pattern of high similarity, though the relative abundance varies probably due to their different processing methods. Furthermore, the cardiac effect of each identified alkaloid was individually evaluated using the isolated bullfrog heart perfusion experiment. Among the thirteen aminoalcohol diterpenoid alkaloids tested, six of them significantly enhanced the amplitude rates. Taken together, we affirm that the cardioactive components in Fuzi are aminoalcohol-diterpenoid alkaloids, shedding light on future studies of the mechanisms and development of these cardioactive compounds.

Various new ophthalmic formulations have been prepared to enhance ocular bioavailability,while lots of irritant sub-stances are applied,including surfactants,polymers and other cationic materials. Therefore,safety of the preparations has been paid more and more attention besides the efficacy. Since in vitro experiments lack of associated enzymes and integral reaction of organiza-tion,the reasonability and correlation of the results extrapolated to the animal experiments still need to be further proved. The in vivo common eye irritation methods( winking,histopathological slices,Draize score and confocal microscopy test etc)were reviewed,eval-uated and analyzed in the paper.

Objectives: To investigate whether the protective actions of ginsenoside Rb1 (Rb1) on astrocytes are mediated through the Gs-type G-protein-coupled receptor (GPCR-Gs). Methods: Primary astrocyte cultures derived from neonatal mouse brain were used. Astrocyte injury was induced via oxygen-glucose deprivation/re-oxygenation (OGD/R). Cell morphology, viability, lactate dehydrogenase (LDH) leakage, apoptosis, glutamate uptake, and brain-derived neurotrophic factor (BDNF) secretion were assessed to gauge cell survival and functionality. Western blot was used to investigate the cyclic adenosine monophosphate (cAMP) and protein kinase B (Akt) signaling pathways. GPCR-Gs-specific inhibitors and molecular docking were used to identify target receptors. Results: Rb1 at concentrations ranging from 0.8 to 5 μM did not significantly affect the viability, glutamate uptake, or BDNF secretion in normal astrocytes. OGD/R reduced astrocyte viability, increasing their LDH leakage and apoptosis rate. It also decreased glutamate uptake and BDNF secretion by these cells. Rb1 had protective effects of astrocytes challenged by OGD/R, by improving viability, reducing apoptosis, and enhancing glutamate uptake and BDNF secretion. Additionally, Rb1 activated the cAMP and Akt pathways in these cells. When the GPCR-Gs inhibitor NF449 was introduced, the protective effects of Rb1 completely disappeared, and its activation of cAMP and Akt signaling pathways was significantly inhibited. Conclusion Rb1 protects against astrocytes from OGD/R-induced injury through GPCR-Gs mediation.

BACKGROUND:Active surgical treatments are preferred for elderly hip fractures. Individual fixation method is chosen according to fracture site, type, age and whether there are basic diseases in internal medicine, which plays an important role in the successful treatment of elderly hip fractures.
OBJECTIVE:To explore the effects of optimized surgical treatment on osteoporotic hip fracture in the elderly.
METHODS: Totally 176 patients with osteoporotic hip fracture were treated by different methods between January 2000 and January 2012, including 63 males and 113 females, with a mean age of (76.7±6.3) years. Out of the 84 cases of interchanteric fracture, seven cases were treated with conservative methods, 34 cases were treated with dynamic hip screw internal fixation, 18 cases were treated with cannulated screw internal fixation, seven cases were treated with anatomical plate internal fixation, 12 cases were treated with bipolar femoral placement, and six cases were treated with total hip arthroplasty. Out of the 92 cases with femoral neck fractures, 40 cases were treated with bipolar femoral placement, 37 cases were treated with total hip arthroplasty and 15 cases were treated with cannulated screw internal fixation. Modified Harris hip function scores were used to evaluate the therapeutic effects of different treatment methods. Complications were observed.
RESULTS AND CONCLUSION:Seventy-six cases of interchanteric fractures and 85 cases of femoral neck fractures were fol owed-up for 8-26 months with an average of (5.7±1.3) months. Three cases suffered from post-operative infection, and one case died due to cardio-pulmonary failure in 10 days after operation. Both intraoperation and postoperative complications included femoral head cutting, intraoperative fracture, internal fixation and prosthetic loosening, postoperative fracture, avascular necrosis of femoral head, coxa vara, legs shorten, and delayed fracture healing. The incidence rates of complications in patients undergoing bipolar femoral placement and total hip arthroplasty were significantly lower than those treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P<0.05). The outcomes of the treatment according to Harris scoring criterion were better in patients treated with bipolar femoral placement and total hip arthroplasty than in patients treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P<0.05). No significant differences were found in the incidence rate of complications and Harris scores among patients treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P>0.05). No significant differences were found in the incidence rate of complications and Harris scores between patients treated with bipolar femoral placement and total hip arthroplasty (P>0.05). These findings indicate that the treatment of osteoporotic hip fracture in the elderly can achieve satisfactory results if the comprehensive therapies are given. Bipolar femoral placement and total hip arthroplasty are preferred for elderly femoral neck fractures.

Objective To explore the efficient method of managing team leaders in clinical nursing practice. Methods By cluster sampling, we utilized competition recruitment method to select 32 team leaders out of the 340 interns in July 2013 as observation team;by designated method, we chose 27 team leaders out of the 333 interns in July 2012 as comparison team. Then we compared both teams′ degree of satisfaction from teachers and interns and comprehensive evaluation on the quality of clinical practice. Results In terms of the practice team leaders′ role modeling contribution from teachers, duty fulfillment, communication and coordination ability, team cohesion, the overall degree of satisfaction from the teachers for the observation team were 92. 7%, 93. 8%, 86. 5%, 90. 6%, 92. 7%, which were apparently higher than those of the comparison team (χ2 =19. 238,5. 256,17. 079,17. 904,34. 122;P<0. 05). In terms of the practice team leaders′ role modeling contribution form interns, duty fulfillment, concerns for team members′study and life, problem solving skill, the overall degree of satisfaction from the interns of the observation team (91. 0%, 98. 2%, 87. 0%, 81. 6%, 94. 3%)was apparently higher than the comparison team as well (χ2 =81. 993, 170. 152, 100. 410, 104. 635, 130. 974;P<0. 05). With regard to the comprehensive evaluation on the quality of clinical practice, the observation team was better than the comparison team (P < 0. 05). Conclusions The competition recruitment of team leader in the clinical nursing practice can make full use of outstanding student resources, and it has an upside for cultivating the interns′competition consciousness and mobilizing their learning initiative. It has also improved the comprehensive quality of clinical practice.

Objective:To evaluate the techniques and short-term outcomes of pericardial autologous angioplasty for the reconstruction of mediastinal large vessels in the treatment of locally advanced malignant thymoma.Methods:We retrospectively analyzed the clinical data of 6 patients with locally advanced malignant thymoma who received autologous pericardial transplantation for mediastinal great vascular reconstruction in the same treatment group of Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University from April 2017 to October 2018.Results:The operative time of malignant thymoma patients receiving autologous pericardial vascular reconstruction was(192.3±32.5)min, intraoperative blood loss was(105.0±27.5)ml, thoracic drainage time was(4.5±1.5)days, and postoperative hospital stay was(5.3±2.5)days. The postoperative quality of life of the patients was satisfactory. Angiography showed that the reconstructed vessels of the left inus vein were occluded in 1 patient 10 months after the operation, and the reconstructed vessels were unobstructed in the other patients. The average follow-up time of the patients was 34.3 months after surgery. One patient developed chest wall metastasis 23 months after surgery, and his condition was stable after receiving local radiotherapy. The other 5 patients did not occur local recurrence or distant metastasis.Conclusion:The application of autologous pericardium for the reconstruction of mediastinal great vessels in the treatment of malignant thymoma is a safe and effective method, and its clinical application prospect is worth expecting.

Objective:To explore the application effect of case-based learning (CBL) and lecture-based learning (LBL) in the teaching of image post-processing course in the standardized training system of medical imaging technology.Methods:A total of 34 trainees in the standardized training of imaging technology of Batch 2018 in West China Hospital of Sichuan University were divided into the experimental group and the control group according to their student numbers, with 17 students in each group. CBL teaching was carried out in the experimental group, and LBL teaching was carried out in the control group. According to the standardized training course design, after one year of image post-processing course teaching, the teaching effect was evaluated through closed-book examination, questionnaire survey and post-processing test. SPSS 20.0 was used for t-test and Mann-Whitney U test. Results:The scores of closed-book examinations (74.42±6.10) and post-processing test (73.47±6.03) in the experimental group were higher than those in the control group [(69.11±3.70) and (69.08±6.51)], and the difference was statistically significant ( P<0.05). The questionnaire survey showed that the students in the experimental group recognized CBL teaching in terms of learning interests stimulation, classroom atmosphere mobilization, clinical thinking cultivation, self-study ability training, and analysis of difficult and rare cases, etc. Conclusion:In the image post-processing course of standardized training of medical imaging technology, the rational application of CBL teaching mode is helpful to improve students' learning enthusiasm, self-learning ability, comprehensive analysis of clinical ability, practical ability, innovation consciousness and so on.

ObjectiveTo systematically review the effects of psychosocial support-related activities on mental health of older adults. MethodsRandomized controlled trails (RCTs) on mental health benefits for older adults were retrieved from PubMed, Web of Science, EBSCO and CNKI, until August, 2022. A systematic review was conducted. ResultsSeven RCTs were included, from Spain, Chile, Canada, Finland, the United Kingdom, South Korea and the United States, mainly from psychiatry, mental health of the elderly and other journals, published after 2017. The subjects aged 60 to 80 years, accounting to 1 258 cases. Psychosocial interventions included Pilates, mindfulness, behavioral activation, cognitive stimulation, daily difficult problem solving training, pain and depression symptom management, health education and guidance, nursing coordination, group exercise (such as circuit training, pedal training or rubber band training), and water sports, etc. The frequency of intervention was 30 to 120 minutes a time, one to nine times a week, and the intensity of the intervention was low to high intensity for four to 64 weeks. Intervention sites included sports venues, community health centres, ageing services, and intervention staff included sports therapists (yoga), psychologists, health professionals, community health services, and health care workers. All interventions were carried out under supervision. The benefits of psychosocial intervention on the mental health of the older adults mainly reflected in the improving cognitive function and self-efficacy, reducing anxiety and depression, improving depressed mood or loneliness, improving sleep quality, increasing sense of social integration and relieving pain and other problems. ConclusionMental health interventions (psychological interventions or support, social interventions or support, psychosocial interventions) and mental health-related interventions (physical activity interventions) benefit older people's mental health, including improving cognitive function, alleviating anxiety and depression, improving sleep quality, and improving quality of life and well-being.