Objective: To study the influence and curative effect of carvedilol on serum matrix metalloproteinase -2, 9 and 10 (MMP-2, 9 and 10) in the patients with chronic congestive heart failure (CHF). Methods:Totally 76 patients with CHF were select-ed and randomly divided into the observation group and the control group. All the patients were given routine medical treatment, inclu-ding cardiotonic treatment ( digoxin) , diuresis ( thiadiazide) , vascular dilation ( nitrate ester) and so on. The patients in the observa-tion group were additionally given carvedilol for 6 months. The changes of serum MMP-2, 9 and 10 levels in the patients before the treatment and 6 months after the medical treatment were observed, and the curative effect and safety were studied as well. Results:Af-ter the 6-month medical treatment, the serum MMP-2, 9 and 10 levels in all the patients were obviously declined(P<0. 05), and the declining rates in the observation group were much higher than those in the control group(P<0. 05). Meanwhile, the total clinical effi-ciency of the observation group was 94. 74%, which was higher than that of the control group (78. 95%) (P<0. 05). Conclusion:Carvedilol has favorable curative effect and safety in the treatment of CIF, and the underlying mechanism may be relative to the de-crease of serum MMP-2, 9 and 10 levels.

Objective To test the reliability and validity of the Chinese version STRATIFY (St Thomas Risk Assessment Tool in Falling Elderly Inpatients) for geriatric inpatients.Methods The scale was translated and 404 geriatric inpatients were evaluated by the Chinese version STRATIFY and evaluate its reliability and validity.Results Chinese version STRATIFY was found with good feasibility.The Pearson correlation coefficient of reliability between testers was 0.951,the retest reliability was 0.885,internal consistency reliability (Cronbach's αt) was 0.523.The values of item-total correlation was over 0.3.The distinguish validity in difference of STRATIFY scores between groups with/without fall history was statistically significant.Predictive validity was moderate,the best cut-off point was determined at 2 points,and sensitivity and specificity were respectively 64.3％ and 78.2％.Conclusions Chinese version STRATIFY applied in Chinese geriatric inpatients showed good reliability between testers,retest reliability,distinguish validity and predictive validity,and it could be used to assess the fall risk of Chinese geriatric inpatients.In addition,as the internal consistency was lower,we can revise the entry of STRATIFY to provide a more accurate predicting tool.

Objective To study the effect of toothbrushing for ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods We searched Cochrane library,Pubmed,Embase,CBM,CNKI and Wanfang data.All searches were updated on April 30,2013.We also performed a manual search of the RCTs of toothbrushing for VAP.At least two reviewers independently screened the studies for eligibility,evaluated the quality,and extracted the data from the eligible literatures,with a cross-check to confirm accuracy.Different views were settled by a third party.The data had Meta-analysis by software Revman 5.0,and to those data which could not be conversed or merged,they underwent descriptive analysis.Results We identified 8 randomized clinical trials that met the inclusion.In Meta-analysis,the overall risk ratio for ventilator-associated pneumonia was decreased significantly by toothbrushing.Toothbrushing also improved the condition of oral odor and oral ulcer.But no significant differences were observed between two groups in hospital ICU mortality.Conclusions Compared the common oral care,toothbrushing can significantly decrease the overall risk ratio for ventilator-associated pneumonia,and improve the condition of oral odor,plaque index score and oral ulcer.

Objective To investigate the influence of Wnt-3a signaling on aggregative growth of dermal papilla cells.Methods Recombinant adenovirus pAdEasy-1/Wnt-3a was constructed at first,and used to transfect cultured dermal papilla cells(DPCs).Then,the growth pattem of DPCs was observed by inverse microscopy;laser confocal microscopy and Western blot were utilized to detect the expressions of Wnt-3a,β-catenin and versican in low-passage DPCs,high-passage DPCs and transfected high-passage DPCs.Results The over-expression of Wnt-3a protein could effectively induce the aggregative growth of DPCs.Laser confocal microscopy showed that the fluorescence intensity of β-catenin and versican increased from 34.16±9.62 and 18.81±9.59 in high-passage DPCs to 87.35±17.28 and 92.18±18.39 in transfected high-passage DPCs(t=11.98,17.88,both P＜0.0 1),respectively.Also,Western blot proved a significant increase of expression intensity of β-catenin(15.27±2.17 vs 60.09±7.24,t=10.10,P＜0.01)and versican(19.32±2.46 vs 58.46±2.78,t=20.63,P＜0.01)in transfected high-passage DPCs compared with untransfected high-passage DPCS.ConclusionsWnt-3a signaling plays an important role in modulating aggregative growth of DPCs,which is mainly through the classical pathway with β-catenin as the key protein.As an important downstream gene of Wnt signaling,vesican is an indispensable part for the modulation of aggregative growth of DPCs.

Objective To investigate the effect of sitagliptin in the treatment of elderly patients with type 2 diabetes mellitus complicated with coronary heart disease and its influence on Hcy,irisin and chemerin.Methods From January 2015 to June 2016,600 elderly patients with type 2 diabetes mellitus complicated with coronary heart disease in the Sixth People's Hospital of Cixi were selected and divided into observation group and control group,with 300 cases in each group.The control group received metformin treatment,the observation group was given sitagliptin combined with metformin.Before and after treatment,the blood FBG,HbA1c and BMI,Hcy,irisin and chemerin levels were detected.Results After treatment,the FBG,HbA1 c and BMI levels in the observation group were significantly lower than those in the control group [(6.28 ± 1.43) mmol/L vs.(7.03 ± 1.04) mmol/L,t =5.256;(6.17 ± 1.02) ％ vs.(7.02 ± 0.98) ％,t =7.446;(21.03 ± 2.04) kg/m2 vs.(23.02 ± 1.23) kg/m2,t =14.469] (all P ＜ 0.05).The level of Hcy in the observation group after treatment was significantly lower than that in the control group [(7.48 ± 1.03) μmol/L vs.(10.38 ± 1.74) μmol/L,t =17.868,P ＜ 0.05].After treatment,the blood irisin level in the observation group was significantly higher than that in the control group [(3.28 ± 0.89) μg/mL vs.(2.43 ± 0.38)μg/mL,t =15.213,P ＜ 0.05].After treatment,the chemerin level in the observation group was significantly lower than that in the control group [(210.38 ± 9.84)ng/mL vs.(231.38 ± 10.03)ng/mL,t =24.379,P ＜ 0.05].Conclusion Sitagliptin in the treatment of elderly patients with type 2 diabetes mellitus complicated with coronary heart disease can effectively regulate the levels of Hcy,irisin and chemerin,and improve the curative effect.

Objective To rapidly isolate and culture sweat gland epithelial cells in vitro and to observe the characteristics of the cells. Methods The secretory coils of sweat glands were dissected and picked out under an anatomical microscope, then digested by collagenase. The harvested epithelial cells of sweat gland were observed for their growth characteristics and identified by immunohistochemistry. Results The cultured epithelial cells grew very well. About 3 weeks later, a distinctive cobblestone appearance was observed in the culture. The antibody-staining showed the cells were positive for epithelial membrane antigen and cytokeratin, but negative for actin, which confirmed that the cells were sweat gland epithelial cells. Conclusion A method is established for rapid isolation and culure of sweat gland epithelial cells in vitro.

Objective To evaluate antibacterial and antifungal effect of the composite chitosan artificial skin in vitro. Methods The standard strains were used in the experiment, including Staphylococcus aureus (ATCC25923), Escherichia coli (ATCC25922), Pseudomonas aeruginosa (ATCC27853) and Candida albicans (ATCC10231). Twelve agar plates were prepared for each standard strain, which were equally divided into the trial and the control groups. In the trial groups, 50 ?L composite chitosan dermal substitute was added to each prepared agar plate, two samples for each plate. In the control groups, composite collagen-gelatin dermal substitute was used. After the plates were incubated at 35 ℃ for 18 ~ 24 h, the antibacterial or antifungal rings of every sample were measured. Results The composite chitosan dermal substitute showed the antibacterial effect on Staphylococcus aureus (ATCC25923), Escherichia coli (ATCC25922), and Pseudomonas aeruginosa (ATCC27853) (P

Objective:To study the effect of seeding cells of tissue-engineered skins,keratinocytes and fibroblasts,on the phenotypes of langerhans cells (LC).Methods:Peripheral blood mononuclear cells were induced by cytokines,granulocyte macrophage-colony stimulating factor (GM-CSF),interleukin 4 (IL-4),transforming growth factor β1 (TGF-β1) to generate LCs,which were subsequently cocultured with allogenic keratinocytes or fibroblasts.Then the phenotypes of langerhans cells was detected by flow cytometer (FCM),and the degree of proliferation of autogeneic lymphocytes was assessed after stimulation with LCs.Results:Cultured LCs had low level expression of HLA-DR,CD80,CD86 and no expression of CD83.Cocultured with allogenic keratinocytes or fibroblasts,phenotypes of LCs did not change significantly.Simultaneously,LCs could not stimulate autogeneic lymphocytes proliferation.Conclusion:These data indicate that LCs cocultured with seeding cells of tissue-engineered skins remain immature state.It is suggested that seeding cells of tissue-engineered skins have low immunogenicity and are unable to induce significant immunological rejection of host after transplantation.

Objective To investigate the effect of hepatocyte growth factor (HGF) on migration and apoptosis of,as well as phosphorylated-Akt (p-Akt) expression in cultured human eccrine sweat gland epithehal cells (hESGc).Methods The first generation of hESGc were cultured in keratinocyte serum free medium (KSFM) and treated with various concentrations (2,20,40μg/L) of HGF for different durations.Then,cell scratch test was performed to detect cell migration,a double staining flow cytometry assay using annexin VFITC/propidium iodide to detect cell apoptosis.and Western blot to measure the expression of p-Akt.Results HGF of 2μg/L had no effect on the migration of hESGc,while that of 20 μg/L and 40μg/L could promote the migration of hESGc by 33.2% and 228.2%.respectively.The average number of cells migrating into the scrach zone was significantly lower in untreated cell group than that in 20 and 40μg/L HGF-treated cell group (17.3±5.5 vs 23.0±6.3 and 56.7±7.9,t=2.653, 15.858,P<0.05,0.01, respectively).The apoptosis rate was 14.76% in untreated cells,14.16%,13.5% and 8.87% in cells treated with HGF of 2,20 and 40μ/L, respectively;there was a significant difference between untreated cells and 40μg/L HGF-treated cells (t=7.852,P<0.01).HGF could activate the phosphorylation of Akt protein and increase the expression of p-Akt.Conclusion HGF could promote the migration of,inhibit the apoptosis of,and stimulate the p-Akt expression in.hESGc.

Objective To investigate the clinical outcomes of surgical excision combined with recom binant interferon aipha-2b in the treatment of acral malignant melanoma (MM). Methods Fifteen patients with acral MM admitted to the department since 2004 were recruited into this study. The tumors varied from 1.8 mm to 3.9 mm in invasion depth. Thin tumors with an invasion depth of 1.8 - 2.0 mm were excised with a margin of lcm beyond the tumors, and those with an invasion depth of 2.0 - 3.9 mm were excised with a margin of 2 cm beyond the tumors. After excision, 4 cases of minor excision were sutured directly, 10 cases of large excision were repaired with adjacent skin grafts and flaps, 1 patient with the involvement of the first metatarsophalangeal joint underwent toe amputation followed by the repair of planta wound surface with the remaining skin on the dorsa of toes. Patients received intramuscular recombinant interferon alpha-2b for 3 months (3 million units daily for the first 3 days and 6 million units for the remaining days) following operation. Results There were 6 cases of MM in situ and 9 cases of invasive MM in this study. All the skin grafts and flaps survived. Within the 3-year follow up, relapse was observed only in 1 patient with invasive MM. Recovery was achieved in the functions of feet in all patients. Conclusion The excision of tumors with a margin determined by tumor thickness plus intramuscular interferon alpha-2h may improve the survival of patients with cutaneous MM in planta pedis with avoidance of amputation.