Objective:To observe the influence of long-term exercise training on carotid intima-media thickness (IMT)in patients with mild-to-moderate hypertension.Methods:A total of 92 patients with mild-to-moderate es-sential hypertension (EH)were randomly and equally divided into exercise group and routine treatment group.Exer-cise group received exercise training based on routine treatment.All patients were followed up one year.Influence of long-term exercise training on carotid artery diameter and carotid IMT was observed in EH patients.Results:Af-ter one year,there were significant reductions in systolic blood pressure (SBP),diastolic blood pressure (DBP),ca-rotid artery diameter and carotid IMT in both groups,P<0.05 all;compared with routine treatment group,there were significant reductions in SBP [(145.72±11.31)mmHg vs.(130.89±13.01)mmHg],DBP [(88.49±7.32) mmHg vs.(81.71±8.45)mmHg],carotid artery diameter [(6.34±1.23)mm vs.(6.22±1.01)mm]and carotid IMT [(0.89±0.21)mm vs.(0.84±0.11)mm]in exercise group after treatment,P<0.05 all.Conclusion:Long-term exercise training can effectively reverse early arteriosclerosis lesion of carotid wall and effectively control blood pressure.

Background Diabetic retinopathy (DR) is one of the most important microvascular complications of diabetes,which has become one of the leading causes of blindness.Neovascularization is the main pathological manifestations of DR,but its mechanism is unknown.There is a clear need to investigate its pathogenesis which can offer potential therapeutic targets.Objective The aim of this study was to investigate the expression and distribution of visfatin and vascular endothelial growth factor (VEGF) in diabetic model rats.Methods This study was approved by Animal Ethic Committee of Inner Mongolia Medical University.Sixty SPF 8-week-old male SpragueDawley rats were randomized into the diabetic group and control group.The rats were housed under a condition that alternated between 12 hours of light and darkness,with free access to rat food and water.Diabetes was induced by intraperitoneal injection of 60 mg/kg (0.60 ml/100 g) of streptozotocin (STZ) and control rats received equivalent volume of buffer.The models were regarded as successful when blood glucose was ≥ 16.7 mmol/L.Rats were sacrificed 12 weeks after the injection of STZ and retinal specimens were prepared to detect the expression of visfatin and VEGF.Total retinal protein was isolated from the retinas of experimental and control eyes,and the expression of visfatin and VEGF was assessed by Western blot.Frozen cross sections of retinas of 5 μm thickness were used to perform double immunofluorescence staining with anti-visfatin and anti-VEGF antibodies.Results Mean body weight of the diabetic rats was (189.02±11.34) g and that of the control rats was (489.57 ± 14.48) g at 12 weeks post-injection,showing a significant difference between them (t =5.236,P =0.003).Mean blood glucose level was (29.25±3.86) mmol/L in the diabetic group and (5.32±1.01) mmol/L in the control group,demonstrating a significant difference (t =11.778,P =0.000).Double immunofluorescence staining showed reduced expression of visfatin and VEGF in the retinal nerve fibrous layer and glial cells in the control rats.A stronger staining for visfatin and VEGF was found in the various layers of the retina in the diabetic rats,with an expression level of visfatin (A value) of 346.26±41.23,which was considerably higher than that of the control group (102.07±65.01) (t =8.291,P =0.000) in 12 weeks after injection.Furthermore,the expression of VEGF in the retina was elevated in the diabetic group compared with the control group (A value) (415.88±92.15 vs.113.06±32.06) (t=10.067,P=0.000).Conclusions Visfatin might contribute to the pathologic progression of diabetic retinal,neovascularization and it might play a synergistic role with VEGF in the pathophysiology of DR.

AlM:To investigate the visual function in myopia and hyperopia amblyopia whose corrected visual acuity have recovered to normal.METHODS: The visual function of children ( 50 cases ) with amblyopia eyes by binocular vision correction after treatment above 0. 9 was checked. The simultaneous perception, fusion range and distance stereopsis were measured. According to the refractive condition of the children who were divided into group A ( myopia, 20 cases ) and group B ( hyperopia, 30 cases ) . The statistically difference of simultaneous perception, fusion function and stereopsis in two groups was analyzed. RESULTS: Fifteen ( 75%) and twenty - six ( 87%) children got the simultaneous perception in group A and group B respectively, and the differences between two groups were not significant (χ2=0. 454,P>0. 05). Group A had six children ( 30%) and group B had only seven children (23%) with the normal aggregative fusion range, two groups did not show any difference (χ2 =0. 565, P>0. 05). Respectively sixteen (80%),and twenty children ( 67%) had the normal divided fusion range in group A and group B, the recovery rate did not show any significant difference (χ2=0. 740, P>0. 05). Fifteen (50%) and seven ( 35%) patients acquired the far stereoscopic vision in group B and group A respectively, the recovery rate also did not show any significant difference. Normal distance stereopsis of 50 cases had 22 cases ( 44%) , and normal near stereopsis of 50 cases had 13cases ( 26%) Seven (23%) and 6 (30%) children got the normal near stereoscopic vision in group B and group A respectively, and the recovery rate did not show any significant difference (χ2=0. 195, P>0. 05;χ2=0. 295, P>0. 05).CONCLUSlON:After amblyopia treatment, although the children got the normal visual acuity, the binocular vision still can not completely normal in the short term. Myopia and hyperopia factor will not produce significant effect on binocular vision development.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Ankle Injuries ; therapy ; Female ; Humans ; Male ; Sprains and Strains ; therapy ; Treatment Outcome ; Young Adult

BACKGROUND: The effective therapy of artificial liver for severe hepatitis needs an absorbing material which possesses strong adsorptive property, high adsorption rate and good blood compatibility.OBJECTIVE: To study the adsorptive property of eight novel adsorbents for plasma bilirubin and cytokines in severe hepatitis patients. DESIGN: A controlled observation.SETTINGS: Graduate School of Tianjin Medical University, Tianjin Haihe Hospital, Tianjin Third Central Hospital and the Institute of Polymer Chemistry in Nankai University.PARTICIPANTS: All plasma was collected from 30 severe hepatitis patients hospitalized in Tianjin Third Central Hospital from November 2004 to November 2005. Informed consent was obtained from each patients. This experiment was approved by the hospital ethical committee. All the patients were divided into two groups at random: group 1 (n=10) and group 2 (n=20). The level of total bilirubin (TBiL) before therapy in two groups was (377.3±147.5) μmol/L and (327.6±140.1) μmol/L, respectively.METHODS: ①Adsorbents: Chitosan (Qingdao Lizhong Chitosan Factory, Shandong) with relative molecular weight 97 000 and de-acetyl grade 85%; Adsorbents No.1-3 were prepared by using 1%, 3%, 5% polyethyleneglycol (relative molecular weight 600) as porogenic agent. Adsorbent No.4 was aminated crosslinked chitosan microspheres; Adsorbent No.5 was divinyl-benzene crosslinked macroporous polystyrene microspheres; Adsorbent No.6 was post-crosslinked macroporous divinyl-benzene styrene copolymer microspheres; Adsorbents No.7 and 8 were chitosan wrapped adsorbent No.5 and 6.②Detection: Step 1: 3 mL plasma collected from each severe hepatitis patient in group 1 was absorbed with 1 mL of 8 kinds of adsorbents. Levels of plasma TBiL, direct bilirubin (DBiL) and indirect bilirubin (IBiL) before and after adsorption were determined by using the vanadate oxidation method to analyze the average adsorption capacity so as to screen the adsorbents with the better adsorptive properties. Step 2: 3 mL plasma collected from each severe hepatitis patient in group 2 was absorbed with 1 mL of two adsorbents selected from the step 1. The levels of bilirubin, interleukin-6 and tumor necrosis factor-α before and after the adsorption were analyzed by ELISA method.MAIN OUTCOME MEASURES: The levels of bilirubin and cytokines before and after the adsorption were determined.RESULTS: ①The data in the first step experiment showed that after No.4 and No.5 adsorbents were used, the level of plasma TBiL, DBiL and IBiL were significantly decreased (P < 0.01); no differences were found for other six kinds of adsorbents (P > 0.05).②The data in the second step experiment showed that the average levels of plasma TBiL, DBiL, IBiL, interleukin-6 and tumor necrosis factor-α were remarkably reduced after using adsorbents No.4 and No.5 (P < 0.01). Compared with adsorbent No.5, there were significant decrements for adsorbents No.4 (P < 0.01).CONCLUSION: Aminated chitosan microsphere has significant effects on adsorbing bilirubin and cytokines in plasma of severe hepatitis patients in vitro.

Objective To analyze the impact of medical insurance reimbursement mechanism on the income of urban community health centers run by various entities. Methods The data of the baseline survey of community health centers in 28 cities made in 2007 were called into play. These data were used to compare the percentage of the annual medical insurance income from outpatient clinics of three types of community health centers in their gross annual income and their annual outpatient clinic income. Results For 929 community health centers with income from medical insurance reimbursement, the average percentage of their annual income from outpatient clinic accounts for 24% of their gross annual income and 26. 09% of their annual outpatient income;In respect of the reimbursement rates of medical insurance at outpatient clinics, the highest come from those run by enterprises, secondly those by the government,and the least those run by social organizations or individuals. Conclusion The mechanism of medical insurance reimbursement has already affected the income of the third type of community health centers. It is recommended to raise the coverage rate of medical insurance of such type of centers and their reimbursement rates of medical insurance. This may further consolidate the policies of medical insurance reimbursement.

Objective To evaluate the efficacy of myringotomy with grommet insertion in the treatment of tympanic membrane atelectasis .Methods From July 2011 to July 2013 ,62 patient with tympanic membrane atelecta-sis were treated with myringotomy with grommet insertion in our hospital ,we evaluated 54 patients(56 ears)whose follow -up period was 1 year or more .Of the 54 patients included in this study ,28 (30 ears))were female and 26(26 ears)were male .The age of the patients ranged from 8 to 54 ,with a mean age of 25 .8 ± 6 .6 years old ,and 18 pa-tients (32% ) were under the age of 16 .The air -bone gap(ABG)was compared at pre -operation and 1 year after post-operation .Results The average ABG of pre-operation and post -operation ,including all patients ,were 27 . 07 ± 5 .03 dB and 15 .52 ± 5 .73 dB ,respectively (P<0 .05) ,and the difference was statistically significant .All the 3 groups ,the ABG of pre- and post-operation ,the difference of each group was statistically significant .Conclusion Myringotomy with grommet insertion was effective in treating tympanic membrane atelectasis .

Background:The incidence of ulcerative colitis (UC)in developed countries is higher than that in developing countries,which may be related with westernized lifestyle,especially high animal protein and low complex carbohydrate diet. With the increased high fat and meat intake,synthesis and secretion of bile acid in liver is also increased,which may have an impact on the occurrence of UC. Aims:To investigate the expressions of farnesoid X receptor (FXR)and G protein-coupled bile acid receptor 5 (TGR5)in patients with UC. Methods:Thirty patients with active UC from January 2013 to June 2016 at the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled,and 30 healthy subjects were served as controls. Expressions of FXR and TGR5 were determined by immunohistochemistry. Results:Compared with control group,expression of FXR was significantly decreased in UC patients (4. 63 ± 2. 07 vs. 6. 91 ± 2. 62,P =0. 00),however,no significant difference in expression of TGR5 was found between the two groups (6. 70 ± 2. 90 vs. 6. 11 ± 2. 44,P = 0. 40). Expression of FXR was significantly increased in right hemicolon colitis than in left hemicolon colitis (P < 0. 05). Conclusions:There is a significant decrease in FXR in active UC patients,indicating that FXR may have some role in the pathogenesis of UC,however,TGR5 may have no obvious effect in the pathogenesis of UC.

OBJECTIVE: To evaluate the safety and efficacy of FK506-based dual therapy and CsA-based triple therapy for immunosuppression after liver transplantation. METHODS: The literature about the randomized controlled trials (RCT) on FK506 and CsA for immunosuppression after liver transplantation was retrieved for analysis using RevMan 5.0 software. RESULTS: A total of 7 RCTs were included; 3 were considered as high quality of RCT, 4 as moderate quality. The results of Meta-analysis of FK506-based dual therapy indicated the patients’ survival rate (RR=1.06, 95%CI=0.77～1.45,P=0.72), grafts’ survival rate (RR=0.99, 95%CI=0.76～1.29,P=0.92), infection rate(RR=0.98, 95%CI=0.60～1.58,P=0.93)and incidence of neurotoxicity (RR=0.59, 95%CI=0.32～1.07,P=0.08)was not significantly different. The incidence of acute rejection in CsA group was lower than in FK506 group (RR=1.57, 95%CI=1.23～2.01,P=0.000 3). CONCLUSION: The curative efficacy of FK506 group is not different from that of CsA group in respect of rate of patient/graft, infection but increase the incidence of acute rejection. Because CsA can increase incidence of neurotoxicity, it is suggestion to treat patients of nervous systerm disease with FK506.

Objective To compare the results of the three grades pictures affiliated With the Synotophore and to choose the opti- mal pictures for the clinician.Design Retrospective case series.Participants 41 normal persons and 44 cases of intermittent exotropia. Methods All participants were separately examined the three grades function with different kinds and degrees pictures affiliated with the Synotophore.The average radian measured with four sorts of pictures of the first grade function and the average measured with the three sorts of pictures of the second grade function were analysed,the stereoacuity of third grade function was measured with qualitative picture and random dot quantitative picture.Comparison was made between two groups of the people who possessed with stereoacuity. Main Outcome Measures Radians and seconds gained from the pictures affiliated with the Synotophone,Results Synotophore of the superposition of the first grade function:the outcome of using four sorts of pictures to examine the normal persons were 1.47+1.68, 1.21?1.21,1.68?1.60,1.32?1.27,F=0.595,P=0.619;the intermittent exotropias were 8.41?4.30,8.73?4.26,8.45?3.86,8.73?4.28,F= 0.070,P=0.987;the difference was not prominent.The fusion range of the second grade of Synotophore,using three different pictures to examine the normal persons were 26.03?6.17,21.11?6.87,17.21?5.40,F=17.260,P=0.000,the result of the fusion range has direct proportion with the degrees of the pictures,the bigger the picture was,the larger the fusion range,the difference was statistically signif- icant.And there was no significant differences for the intermittent exotropias when examined with the same pictures(21.74?7.43,21.31?7.82,20.32?7.53),F=0.590,P=0.556.The stereoaeuity of the third grade of Synotophore,in the normal person group 85.4% and 100%, X~2=4.877,P=0.027,the results were statistically significant between the qualitative picture and the random dot quantitative picture. About the intermittent exotropia group,no statistically significant differences were detected(72.73% and 59.10%),X~2=1.821,P=0.177. Condusion Choose pictures randomly when examine the first grade function of Synotophore;for the second grade function of Syno- tophore in both groups may choose intergraded degree pictures;the stereoacuity of the third grade of Synotophore,normal group should choose quantitative pictures,while strabismic patients may choose both of them.(Ophthalmol CHN,2008,17:120-122)