Objective To investigate use of oral antihypertensive drugs among community hypertensive patients in Shanghai and find out factors related to their unreasonable use to direct their clinical use. Methods Seven hundred and three hypertensive patients were surveyed with questionnaire by stratified cluster sampling at three neighborhoods and one village of Dahua community, Baoshan district, Shanghai during April to June 2009 to understand their use of antihypertensive agents, including kinds and forms of drugs, rationale of drug use. Results Five hundred and eighty-two (82. 8% ) of 703 hypertensive patients interviewed were using antihypertensive drugs, 271 (38. 5% ) of them used only one kind of non-compound antihypertensive drug, 182 (25.9%) used one kind of compound agent, 311 (53.4%) used two or more kinds of drugs in combination, including 117 patients ( 16. 8% ) used two kinds of agents combined and 12 patients ( 1.6% ) used three kinds of agents combined. Two hundred and sixty-six (47.5%) patients took orally calcium-channel blockers and 205 ( 35.2% ) used compound agents. Conclusions Frequency of combined use of two or more kinds of antihypertensive agents is reasonable and significantly higher than that of use of one kind of drug at Dahua community in Shanghai. Calcium channel blocker plays a predominant role in treatment for hypertension, non-long-acting compound agents are used in a higher proportion. But,guidelines for hypertension prevention and treatment are not so well complied with in local hypertensive patients. So, it is suggested that training for community physicians and management for standard use of antihypertensive agents at community should be strengthened further.

Objective To observe the effects of glucagon like peptide-1 (GLP-1) analogues liraglutide on expressions of nitric oxide synthase (NOS) and cyclo-oxygen-ase (COX)2 in renal medulla of type 2 diabetes rats, and the mechanism of its lowering blood pressure and promoting excretion of water and salt in kidney. Methods Type 2 diabetes model rats were generated by high-fat and high-sugar feeding for 8 weeks followed by intraperitoneal injection of streptozotocin (STZ). Subse?quently, eighteen type 2 diabetes rats were divided into two groups: liraglutide treatment group (DMT) and diabetes group (DM). Twelve normal rats were divided into two groups: liraglutide treatment wild type group (WTT) and wild type group (WT). DMT and WTT groups were given liraglutide (200μg/kg) by subcutaneous injection, DM and WT groups were given equivalent normal saline by the same way. The levels of blood glucose and blood pressure were detected at 0, 2, 4 and 6 weeks after treatment in groups of rats. Samples of urine were collected for detecting ion concentrations (K+, Na+and Cl-) af?ter treatment for six weeks. Rats were sacrificed and blood samples were collected for detecting ion concentrations (K+, Na+and Cl-). The expression levels of NOS and COX2 mRNA and protein in renal medulla were detected by real-time PCR and Western blot assay. Results After treating with liraglutide, the values of blood glucose (F=5.933, P<0.05) and blood pres?
sure (F=22.070, P<0.05) were gradually decreased in DMT group. After treatment with liraglutide for 6 weeks, the values of blood glucose (mmol/L:12.78 ± 3.82 vs. 18.75 ± 1.68) and blood pressure (mmHg:119.98 ± 4.43 vs. 136.42 ± 4.48) were signifi?cantly decreased (P<0.05) in DMT group than those of DM group (P<0.05). There were no significant differences in the concentrations of K+, Na+and Cl-between the two groups. There were higher levels of K+(mmol/L:46.55 ± 6.43 vs. 33.13 ± 9.71), Na+(mmol/L:56.33±8.83 vs. 41.20±7.25) and Cl-(mmol/L:159.81±25.06 vs. 71.44±12.99) in urine in DMT group than those of DM group (P<0.05). The mRNA levels and protein expressions of NOS and COX2 in renal medulla were significant?ly increased in DMT group than those of DM group (P<0.05). Conclusion GLP-1 analogues liraglutide may enhance the expression of COX2 by increasing the expression of NOS to excrete water and salt, and decrease blood pressure.

ObjectiveTo investigate the expression of miR-21 in diffuse large B cell lymphoma (DLBCL)and normal lymph tissues and its potential relevance with clinicopathological characteristics.MethodsThe expression levels of miR-21 in 50 primary DLBCL and 12 normal lymph node tissue specimens were examined by TaqMan real-time polymerase chain reaction.The expression of bcl-2 and p53 was detected by immunohistochemistry staining. ResultsThe expression of miR-21 was significantly higher in tumor tissues than that in normal tissues, in GCB subtypes higher than in non-GCB subtypes. And it was negatively correlated with bcl-2(P=0.020),while positively correlated with p53(P=0.022). Up-regulated miR-21 expression was low in three years of survival rate. ConclusionMiR-21 may indicate a more aggressive phenotype and serve as a molecular prognostic marker in DLBCL. High-expression of miR-21 is a key feature that is correlated with cell proliferation in DLBCL.miR-21 may have some guiding significance in prognosis.bcl-2,p53 is possibly one of the targets of miR-21 in DLBCL.

Objective To explore the clinical application value of coronary angiography (CAG) combined with fractional flow re-serve(FFR) in percutaneous coronary intervention treatment of coronary artery disease (CAD) .Methods 82 cases of CAD(147 le-sions) with single hemadostenosis at least 70% -90% were randomized into the observation group and the control group .The ob-servation group(40 cases ,72 lesions) was performed the myocardial FFR detection by the pressure guide wire and the drug-eluting stents(DES) were placed in the lesions only if FFR ≤0 .80 .The patients with postoperative FFR ≤0 .80 were given the in-stent post-balloon dilatation .The control group(42 cases ,75 lesions) underwent the percutaneous coronary intervention(PCI) for conduc-ting the routine DES implantation .The general condition ,risk factors(hypertension ,diabetese ,hyperlipidemia ,smoking ,etc .) ,num-ber of lesions ,implanted stents ,hospitalization cost ,occurrence rate of major adverse cardiac events (MACE) after postoperative 6 months and the angina recurrence rate were compared between the two groups .Results The number of used stents per patient and the hospitalization cost in the observation group were significantly lower than those in the control group [(0 .88 ± 0 .88) vs .(1 .81 ± 0 .83) ,(47 200 ± 2 3000)Yuan vs .(60 000 ± 2 4100)Yuan P< 0 .05] .The two groups had no all-cause death in postoperative 6-months .The recurrent myocardial infarction rate ,revascularization rate and recurrent angina in the two groups were 2 .50% vs .0 , 2 .50% vs .2 .38% and 5 .00% vs .7 .14% respectively ,the differences had no statistical significance(P>0 .05) .Conclusion CAG combined with FFR detection can significantly reduce the number of stents and the hospitalization cost without increasing the occur-rence rates of MACE and angina within postoperative 6 months in CAD patients .

Objective:To investigate the methods and complications of ultrasound-guided percutaneous nephrostomy (PCN) for treat-ing cancer-related hydronephrosis. Methods:From June 2003 to December 2015, 289 patients (342 kidneys) with cancer-related hy-dronephrosis were treated by ultrasound-guided PCN in Fujian Provincial Hospital. Among the 97 cases of renal insufficiency, 4 pa-tients were treated with hemodialysis before PCN. Except for the anterior mid calyx of nine kidneys in nine patients, the posterior mid or lower pole calyx of all other kidneys was punctured with ultrasound guidance. With the one-step PCN technique, 8F pigtail nephros-tomy tubes were placed into six kidneys in six patients;with the Seldinger PCN technique, 14F balloon and Malecot catheters were placed into 25 kidneys in 25 patients and 311 kidneys in 258 patients, respectively. Results:No severe bleeding and injury in the intes-tine, liver, spleen, pleura, or lung occurred. Two pigtail tubes were blocked one week after PCN. Seven balloon catheters failed to drain well because of the tip and balloon of the catheters located in the proximal part of the dilated ureters. Four balloons slipped out of the collection system of the kidney because of the auto-deflation of three balloons and one case of meager renal parenchyma failing to hold the balloon after a severe hydronephrosis was emptied. All, except 1, Malecot catheter drained well, and 8/9 PCNs through anteri-or mid calyx were successful. Serum creatinine levels were significantly decreased in all the 97 patients with renal insufficiency, of which 81 cases returned to normal, and no one needed persistent hemodialysis. Conclusion:Ultrasound-guided PCN is safe and effec-tive for treating cancer-related hydronephrosis. For appropriately selected patients, puncturing the anterior mid calyx may be an op-tion without additional complications. One-step pigtail nephrostomy tubes are recommended for patients with poor systemic condi-tions. For patients with long life expectancy or suspected complicated urinary infection, large sized Malecot catheters should be consid-ered.

Objective To evaluate the efficacy and safety of ureteral stenting after transurethral resection ( TUR) of bladder tumors involving the ureteral orifice.Methods From March 2009 to November 2015,34 cases of non-muscle invasive bladder tumor including 28 male and 6 female aged from 26 to 79 years( mean 51 years) were treated by TUR.14 cases had single tumor and 20 had multiple tumors,and 29 were primary and 5 were recurrent.All the patients had tumors involving the ureteral orifice without preoperative hydronephrosis revealed by IVU or CTU examination.The tumors were resected into the deep muscle layer and the involved ureteral orifices were resected during the procedure,and after that a double-J ureteral stent was placed in 18 cases.All patients received one immediate intravesical instillation of 50mg epirubicin after TUR, and further scheme of adjuvant intravesical chemotherapy instillations were made according to the pathological diagnosis.Ureteral stents were removed 10-12 weeks after TUR,and cystoscopy and urinary tract ultrasound examinations were performed every 3 months for 1-2 years postoperatively. Results The operations were successful without complications.No serious adverse reaction occurred in immediate and further adjuvant intravesical chemotherapy.During the follow-up period of 3-71 months, no ureteral stricture, hydronephrosis or tumor recurrence in the upper urinary tract occurred in all the 18 patients with ureteral stent, and the resected ureteral orifices recovered well with normal appearance and ejecting urine.Hydronephrosis was observed in 3 of 16 patients without ureteral stent including 2 cases of nontumoral stenosis at the ureterovesical junction requiring ureteral reimplantation and 1 case of lower ureteral tumor on the involved side requiring nephroureterectomy and bladder cuff excision.No patient complained of symptoms secondary to vesicoureteral reflux or continuous unrelievable lower urinary tract symptoms.2 cases of bladder tumor recurred out of the resected area.Conclusions Ureteral stenting after TUR of bladder tumors involving the ureteral orifice can prevent stricture at the ureterovesical junction without increasing the risk of tumor cell seeding along the upper urinary tract.The existence of a double-J ureteral stent does not increase complications of adjuvant intravesical chemotherapy, and also won't cause intolerable lower urinary tract symptoms.

OBJECTIVETo develop a novel vaccine by immobilizing interleukin-21 (IL-21) on the surface of MB49 cells and evaluate its effect in inducing specific cytotoxic T lymphocytes (CTLs) and antitumor immunity in a mouse model of subcutaneous metastatic bladder cancer.

METHODSSA-IL-21 was immobilized on the surface of 30% ethanol-fixed MB49 cells to prepare the cell vaccine. C57BL/6 mice with subcutaneous implantation of MB49 bladder cancer cells were randomized into 5 groups to receive treatments with IL-21/MB49 vaccine, soluble IL-21, GFP surface-modified MB49 cells, ethanol-fixed MB49 cells, or PBS. The tumor growth and CTL were examined to assess the antitumor efficacy of the vaccine.

RESULTSIL-21 surface-modified MB49 cell vaccine significantly inhibited the tumor growth and generated a long-lasting memory response (P<0.05). At the same effector-target (E:T) ratio, the specific CTLs induced by IL-21/MB49 vaccine showed the most potent cytotoxicity against MB49 cells (P<0.05).

CONCLUSIONWith the protein-anchor technique, IL-21 can be efficiently immobilized on the surface of MB49 cells to prepare IL-21/MB49 cells vaccine. The novel vaccine can maintain its biological activity and significantly enhance the cytotoxicity of CTLs against bladder cancer cells.

Amino Acid Motifs ; Animals ; Cancer Vaccines ; therapeutic use ; Cell Line, Tumor ; Female ; Immunotherapy ; Interleukins ; immunology ; Lymphocyte Activation ; Mice ; Mice, Inbred C57BL ; Neoplasm Metastasis ; Neoplasms, Experimental ; therapy ; T-Lymphocytes, Cytotoxic ; immunology ; Urinary Bladder Neoplasms ; therapy

Objective: To evaluate the comprehensive workplace health promotion intervention effects on workplace health promotion in 10 government agencies. Methods: A prospective self-controlled design was employed. Baseline evaluation and effectiveness evaluation were both conducted by questionnaire investigation. Results: The intervention results showed that most effectiveness indicators were significantly improved including health behaviors, psychosocial work environment, and health status. After the intervention, the prevalence of passive smoking and physical inactivity decreased from 70.3% and 38.7% to 44.1% and 30.5%, respectively. The scores of job control and social support at work increased by 0.30 and 0.05, respectively. The prevalence of good self-rated health and good mental health raised from 68.3% and 68.8% to 75.6% and 85.6%, respectively. However, the scores of job demand increased by 0.4. Furthermore, the prevalence of occupational stress increased significantly from 45.8% to 65.5%. Conclusion After implementing workplace health promotion, the physical and mental health of the staff have been promoted. However, the occupational stress of government officials still need to be improved.

Objective To explore the clinical effect of double M-shaped cartilage used in nasal tip cosmetic plasty.Methods From December 2016 to May 2017,nasal fip plasty was performed in 39 patients in Hangzhou Huashan Luyeme Medical Cosmetology Hospital.With the Goodman's incision in the columella and nasal vestibule,a big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum.Ear cartilage was trimmed into two strips and sutured with nasal septum cartilage graft.Meanwhile,the sandwich cartilage graft was inserted between the lower lateral cartilages to form the first "M" shape stent when fixing part of it on the nasal septum.Then the ear cartilage was turned over and fixed with lateral crus of the lower lateral cartilages to form the second "M" shape stent.Willow-shaped prosthesis was placed into the nasal dorsum.Results A total of 39 cases of nasal tip surgery were performed,including 1 male and 38 females.Ages ranged from 21 to 48 years in this group.The follow-up period was from 1 month to 5 months.36 patients were satisfied with the efficacy while 2 patients were suffered from the deviation of nasal tip,one patient was suffered from nasal septum deviation.Conclusions The application of double M-shaped cartilage in nasal tip cosmetic plasty is one of ideal rhinoplasty approaches with less wound,simple procedure and good clinical effects.

Objective:To assess the applying value of Chinese shorter version of the Visual Function Index questionnaire (VF-11R-CN) for presenting low-vision cataract pre-operation and post-operation by using minimal clinically important difference (MCID) determined by combination of distribution-based with anchor-based methods, and to compare the improvement rate of vision-related quality of life (VRQol).Methods:A cross-sectional study was performed in this study.Ninety-eight patients with presenting low vision cataract were enrolled at Eye Hospital of Wenzhou Medical University from May 2018 to June 2019.All the patients received a phacoemulsification with intraocular lens implantation.A questionnaire survey was carried out with VF-11R-CN Scale before surgery and 1 month-3 months after surgery, and a complement anchor item was added during the questionnaire after surgery.The applicability of the scale was assessed by floor or ceiling effects, and score difference of the VF-11R-CN over time and effective size was determined.Distribution-based MCID was calculated using 0.5 standard deviation (SD) of score difference and 1.96 standard error of measurement (SEM). Anchor-based MCID was calculated using the slope of the linear regression analysis.In responder analysis, sensitivity and specificity of MCID was reported.The differences of postoperative VRQol improvement rate based-on MCID were compared between male and female, single eye disease and multiple eye diseases, pre-operative and post-operative scores.This study protocol was approved by the Ethics Committee of Eye Hospital of Wenzhou Medical University, and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results:A total of 85 patients completed the following up.The mean score difference was 399.51±234.92, and that of the presenting visual acuity (PVA) was 0.65±0.36.Both the minor floor and ceiling effects were 1.18% before surgery, and the ceiling effects were 22.35% after surgery.The score before surgery was significantly higher than that after surgery ( t=15.68, P<0.001). The effective size for the surgery was 1.63.The MCID was 122.23 and 123.10 according to 0.5 SD and 1.96 SEM.The linearity regression analysis showed that score difference reduced 106.17 if anchor item option increased 1.The average MCID estimate was 117.17.A total of 76 patients (89.41%) reported an improvement of VRQol.The sensitivity of MCID for the assessment of VRQol was 96.67% and specificity was 46.67%.No significant differences were found in VRQol improvement rate between gender, single cataract and multiple eye diseases or PVA (LogMAR 1.3 as cutoff value) ( P=0.73, 0.88, 0.27). Conclusions:VF-11R-CN scale is available for Chinese presenting low vision cataract patients undergoing surgery.The MCID value for the cataract surgery is 117.17 scores, with a high sensitivity and a relatively low specificity.