Animals ; Atherosclerosis ; etiology ; metabolism ; Gene Expression Regulation ; Humans ; Lipase ; analysis ; genetics ; physiology ; Lipoproteins ; metabolism ; Lipoproteins, HDL ; metabolism ; Lipoproteins, LDL ; metabolism ; Polymorphism, Genetic ; Tissue Distribution

Acute Disease ; Humans ; Pulmonary Embolism ; therapy

The application of MOOCs (massive open online courses) in internal medicine education is feasible with the construction of MOOCs in internal medicine, internet and mobile terminal availability, and the improvement of college student quality. We reviewed the progress of MOOCs in the medical teach-ing. The chapter of coronary heart disease was exemplified to illustrate how to apply MOOCs in internal medicine teaching. The MOOCs was carried out with the following steps: the share of MOOCs courses, self-guided learning, online question and answer section, in-class teaching and exams post MOOCs, which achieved good teaching effect, enhanced students' subjectivity, and promoted the sharing of high-quality medi-cal teaching resources. At the same time, in view of the limited nature of MOOCs in internal medicine, we need to overcome it in the development of teaching practice.

OBJECTIVE:To compare the efficacy and safety of ferrous succinate or Shengxuening in the adjuvant treatment of renal anemia in patients with diabetic nephropathy peritoneal dialysis (CAPD). METHODS:64 diatetic nephropathy CAPD pa-tients with renal anemia were randomly divided into observation group (32 cases) and control group (32 cases). All patients re-ceived subcutaneous injection of insulin for blood glucose control (adjusted the insulin dosage based on fasting blood glucose lev-els),hypertension patients actively controlled blood pressure,corrected acid-base and electrolyte balance disorders,orally received fo-lic acid and vitamin B12,ambulant CAPD,then rhEPO was subcutaneously injected with initial dose of 100-150 U/(kg·week) for 2-3 times and other conventional treatment. Based on it,observation group received 1 g of Shengxuening tablet,3 times a day;control group received 0.2 g Ferrous succinate tablet,3 times a day. The treatment course for both groups was 16 weeks. The rhEPO dose was monthly adjusted to make Hb 100-120 g/L. Clinical efficacy,serum iron,serum ferritin,total iron binding capacity,transfer-rin saturation before and after treatment,Hb,Hct,hs-CRP,rhEPO dose before treatment and after 4,8,12 and 16 weeks of treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There was no significant difference in the total effective rate between 2 groups (P>0.05). After treatment,serumiron,total iron binding capacity,transferrin saturation,Hb and Hct in 2 groups were significantly higher than before,and it gradually increased by treatment time,serum ferritin,hs-CRP was sig-nificantly lower than before,and it gradually decreased by treatment time,the differences were statistically significant(P<0.05);but there was no significant difference between 2 groups(P>0.05). The rhRPO dose in observation group 8,16 and 16 weeks af-ter treatment and in control group 8 weeks after treatment were significantly lower than 4 weeks after treatment,and 12 and 16 weeks after treatment in observation group were lower than control group,the differences were statistically significant (P<0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on conventional treatment,both ferrous succinate and Shengxuening show good ef-ficacy in the adjuvant treatment of renal anemia with diabetic nephropathy CAPD,both can improve anemia and iron metabolism, while Shengxuening is superior to ferrous succinate in terms of improving microinflammatory state and reducing rhEPO dose,with better safety.

Anemia, Aplastic ; therapy ; Child ; Female ; HLA Antigens ; genetics ; immunology ; Humans ; Mesenchymal Stem Cell Transplantation ; Peripheral Blood Stem Cell Transplantation

BACKGROUND: Fructose-1,6-diphosphate (FDP) of certain dosage plays a protective role in the pancreatic islets damaged by interleukin-1 beta (IL-1β), and there are different effects of FDP of low and high dosages.OBJECTIVE: To investigate the effects of FDP of low and high dosages on the islet cells damaged by IL-1β.DESIGN: A grouped design and controlled animal experiment.SETTING: Department of Physiology, North Sichuan Medical College.MATERIALS: The experiments were carried out in the Tumor Laboratory and Central Laboratory of Rheumatology and Immunology, Department of Surgery, North Sichuan Medical College between July 2004 and February 2006. Twenty Wistar rats within 1-3 days after birth were selected.METHODS: The pancreases of the rats were removed to collect islet cells, and then the cells were divided into normal control group, IL-1β damaged group, IL-1β+1, 25, 50 mmol/L FDP groups. The cellular activity was detected with methyl-thiazol-tetrazolium (MTT) assay, basic amount of insulin secretion and that stimulated by high glucose with radioimmunoassay, content of nitric oxide and activity of nitric oxide synthase (NOS) with nitric oxide and NOS kits, and the with [Ca2+]i with Fura-2fluorescent assay.MAIN OUTCOME MEASURES: Activity of islet cells; basic amount of insulin secretion and that stimulated by high glucose; content of nitric oxide and activity of NOS; [Ca2+]i.RESULTS: ① The activities (A values) of the islet cells in the IL-1β damaged group, IL-1β+1, 25, 50 mmol/L FDP groups were obviously lower than that in the normal control group (0.116±0.012, 0.129±0.008, 0.125±0.015, 0.120±0.016, 0.252±0.020, P ＜ 0.01). The activities (A values) of the islet cellswere not significantly different from that in the IL-1β damaged group (P ＞ 0.05) when the FDP dosage was too low (1 mmol/L) or too high (25 mmol/L). ② The basic amount of insulin secretion and that stimulated by glucose were significantly lower in the IL-1β damaged group, IL-1β+1, 25, 50 mmol/L FDP groups than in the normal control group [(237.00±22.21), (230.83±11.58), (225.16±12.46), (220.50±15.63),(425.67 ±16.85) mIU/L; (90.17 ±6.11), (96.62 ±8.64), (87.66-±8.24),(85.46±9.59), (204.50±10.78) mIU/L, P ＜ 0.01], and there were no significant differences between the FDP groups of Iow and high dosages and the IL-1β damaged group (P ＞ 0.05). ③ The NOS activity and content of nitric oxide in the supernatant were obviously higher in the IL-1β damaged group than in the normal control group [(332.07±25.34), (144.86±12.17) μkat/L;(457.64±19.29), (84.67±10.23) μmol/L, P ＜ 0.01], and those in the IL-1β+1, 25, 50 mmol/L FDP groups were not significantly different from those in the IL-1β damaged group. ④ The [Ca2+]i concentration in islet cells was obviously higher in the IL-1β damaged group than in the norrmal control group [(328.50±26.28), (73.42±1.79) nmol/L, P ＜ 0.01], but obviously lower in the IL-1β+1, 25, 50 mmol/L FDP groups than in the IL-1β damaged group [(152.72± 11.86), (216.39±15.32), (233.61±21.76),(328.50±26.28) nmol/L, P ＜ 0.01].CONCLUSION: FDP of low and high dosages can not protect the islet cells damaged by IL-1β.

Objective To investigate the preliminary value of mitral annular displacement (MAD) with two-dimensional speckle tracking in evaluating left ventricular systolic function. Methods Forty-nine patients with dilated cardiomyopathy, aged 51±14 years (DCM group), and 43 age-matched (46±14 years) normal subjects (control group) were enrolled in this study. Two-dimensional and real-time three-dimensional (RT3D) imaging were obtained all at the apical four-chamber view. The parameters of MAD and RT3D-LVEF were obtained using off-line QLAB software. Results Compared with control group, MAD reduced significantly in DCM group (P＜0.01). The parameters of MAD correlated positively with LVEF (P＜0.01). The intra- and inter-observer variabilities for measurement of MAD were low. When one point was placed at the chest wall, the ratio of long axis shortening correlated best with LVEF among all the data of MAD. Conclusion Based on two-dimensional speckle tracking imaging, MAD is a rapid and reproducible method of determining LV global systolic function, may even replace LVEF in the future.

OBJECTIVE: To investigate the signal transduction mechanism of curcumin in inhibiting the proliferation of bovine lens epithelial cell (LEC) induced by recombinant human epidermal growth factor (rhEGF). METHODS: There were three groups in this experiment, which were normal control group, untreated group and curcumin-treated group. Proliferation of LEC was induced by rhEGF (50 microg/L). The concentration of intracellular Ca(2+) ([Ca(2+)](i)) in LEC was measured with Fura-2/AM by spectrofluorimetry. The contents of intracellular cAMP and cGMP were assayed by radioimmunoassay. RESULTS: The [Ca(2+)]i in LEC was obviously increased in the untrated group as compared with that in the normal control group (P<0.01), and the [Ca(2+)](i) in LEC in the curcumin-treated group was highest among three groups (P<0.01). The content of intracellular cAMP in LEC was decreased while the content of intracellular cGMP was obviously increased in the untreated group as compared with those in the normal control group (P<0.01). The content of intracellular cAMP in LEC was higher in the curcumin-treated group than that in the untreated group, while the content of intracellular cGMP was lower than that in the untreated group (P<0.01). CONCLUSION: The antiproliferation effects of curcumin on LEC may relate to the regulations of multiple processes of signal transduction.

Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Tyrosinemias ; diagnosis ; therapy

Objective To determine the usefulness of tricuspid annular displacement(TAD),based on twodimensional speckle tracking imaging, for assessment of right ventricular(RV)systolic function.Methods Eighteen patientswith dilated cardiomyopathy and 20 age-matched healthy volunteers were in volved. Twodimensional and real-time three-dimensional(RT3D)imaging were obtained in all patients at apical four-chamber view.The parameters of TAD were derived from off-line QLAB software.RT3D-RV ejection fraction(RVEF)was calculated by using 4D RV function software.Results TAD data were acquired in all 38 cases, while RT3D-RVEF was done in 30 out of 38.The parameters of TAD correlated well with RVEF(P<0.01).The parameters of TAD in dilated cardiomyopathy group were significantly lower than the corresponding values in healthy subjects (P<0.01).The intra-and interobserver variabilities for measurement of TAD were(0.49±2.69)mm and(0.21± 0.60)mm, respectively.Conclusions TAD,based on two-dimensional speckle tracking imaging,proved to be a rapid and reproducible method in determining RV global systolic function.