We retrospectively reviewed clinical data of 150 elderly patients with serious chronic congestive heart failure who admitted in 1986, 1996 or 2006, including medication treatment, hospital stay,and admission interval. The results indicated that before 1990s, digitalis, diuretics, and blood vessel dilating agents were more often used in the treatment of chronic congestive heart failure(digitalis=100%,diuretics≥95%, blood vessel dilating agents>50%, β-blocker<10%, ACEI/ARB = 0% ). Since 1990s,the use of β-blocker, ACEI and ARB increased, which resulted in reduced hospital stay and increased admission interval(P<0.01). Our investigation suggests that evidence-based medication could be necessary in the treatment of elderly patients with chronic congestive heart failure.

Preoperative anesthetic interview is not only an important part of clinical teaching,but also a vital tache of improvement for medical treatment quality.Unlike internal medicine and surgery,interview for anesthesiology department has its own characteristics.Anesthesiology department of Changzheng hospital has put great emphasis on preoperative anesthetic interview.Some experiences about preoperative anesthetic interview were introduced in our article.

Aim To investigate the effects of heme oxygenase-1(HO-1) on brain damage due to cerebral ischemia/reperfusion.Methods 120 male mice were divided into four groups randomly and the cerebral ischemia/reperfusion(I/R) model was established through drawing out and reperfusing 40% of the whole blood volume in combination with clamping the carotid arteries for 20 min after anesthesia with 40 g?L-1chloral hydrate(400 mg?kg-1 ip).The mice were intracerebraventricularly(icv) injected with 3(l of150 ?mol?L-1 hemin,150 ?mol?L-1 ZnPPIX,or artificial cerebrospinal fluid(ACSF),respectively 16 h before the model established.Sham operation group only received anesthesia and operation without I/R and icv injection.The hippocampal HO activity and cerebral cortex xanthine oxidase(XO) activity,the levels of malonaldehyde(MDA) and reactive oxygen species(ROS),hippocampal neuron apoptosis,and hippocampal HO-1 expression were determined by spectrophotometer,TUNEL method,and Western blot,respectively.Results The increased hippocampal HO-1 expression and HO activity,decreased XO activity,MDA and ROS levels,and diminished hippocampal apoptosis were observed in the hemin group,compared with ACSF group(P0.05),but inhibited the activity of HO with the elevation of XO activity,MDA and ROS levels,as well as cellular apoptosis(vs ACSF,P

PubMed,Embase,Cochrane Library,and ISI web were searched without any limitations with regard to publication date or language,as well as the references of qualifying articles.All kinds of cohort studies comprising the risk of gastric cancer between diabetic patients and control subjects were included.We excluded studies that investigated only mortality but not incidence.25 studies met our criteria,and the qualities of these studies were evaluated using the Newcastle-Ottawa Quality Assessment Scale.Statistical analyses were carried out with STATA software version 12.0.A random-effects model meta-analysis showed an increased risk of gastric cancer in diabetic patients (RR =1.20,95 ％ CI 1.12-1.28).Subgroup analyses indicated that this result persisted in studies of both male(RR =1.15,95％ CI 1.02-1.29) and female (RR =1.29,95％ CI 1.09-1.53) subjects,in studies of European countries(RR =1.25,95％ CI 1.07-1.46) and Asia countries (RR =1.18,95％ CI 1.09-1.28).Compared with nondiabetics,the incidence of gastric cancer may be increased by approximately 20％ in diabetics.Thus diabetes may be an independent risk factor for gastric cancer.This effect tends to be more significant in type 1 and female patients.

Objective To prepare a new bioadhesive material-chitosan-thioglycolic acid conjugates from chitosan,and analysed the structure moreover.Methods Preparing chitosan-thioglycolic acid conjugates with a new synthesis method under catalytic reaction by NHS,and the contents of thiol groups in the conjugates were determined.Furthermore,elemental analysis and the IR spectrum of the polymer were determined.Results The content of thiol groups in the chitosan-thioglycolic acid conjugates was 1034?mol?g~(-1),and the structure was elucidated.Conclusion The new synthesis method was feasible,and the structure can be elucidated by IR spectrum.

Objective To observe the effects of family cognitive training on patients with vascular cognitive impairment but without dementia.Methods Sixty patients with non-dementia type vascular cognitive impairment were divided at random into a group which received family cognitive training (30 cases) and a control group (30 cases).The 2 groups all took routine drugs and exercise.The family cognitive training group received cognitive training additionally.Before treatment and after 1 and 6 months of treatment,all of the patients of both groups were assessed using the mini-mental state examination (MMSE),the Montreal cognitive assessment (MoCA) and the modified Barthel index (MBI).Results After 1 month of treatment there was no significant difference between the 2 groups in any of the assessments.After6 months the scores on each item of the MMSE,MoCA and MBI had improved significantly more in the family cognitive training group than in the control group.Conclusion Family cognitive training is effective in treating non-dementia type vascular cognitive impairment.It can delay disease progression and improve cognitive function and ability in the activities of daily living.

AIM: To observe the different changes of neuroendocrine systems between the state of sport fatigue and poverty of movement. METHODS: 60 male Wistar rats were randomly divided into three groups: normal control group, sport fatigue model group and poverty of movement model group (20 rats in each group). The sport fatigue model was established by the method of combining basal diet and loaded swimming during 2 weeks, whereas the method of restricted activities was used to establish the poverty of movement model with total experimental time of 10 weeks. By the end of experiment, the climbing pole time was determined. The contents of hypothalamus thyrotropin releasing hormone (TRH), and serum norepinephrine (NE) and epinephrine (E) in rats with different treatments were determined by ELISA. In addition, the changes of hypothalamus corticotropin release hormone (CRH), pituitary adrenocorticotropic hormone (ACTH) and thyroid stimulating hormone (TSH), and serum corticosterone (CORT), triiodothyronine (T_3), tetraiodothyronine (T_4) were determined by radioimmunoassay to evaluate the functions of adrenergic nerve-adrenomedullin system, hypothalamo-pituitary-adrenal (HPA) axis and hypothalamo-pituitary-thyroid (HPT) axis. RESULTS: Compared to control group, the climbing pole time of the animals was obviously decreased in two model group. The adrenergic nerve-adrenomedullin system and HPA axis were inhibited in sport fatigue model rats, but HPT axis was unchanged. Interestingly, the HPA axis was hyperfunctional and HPT axis was inhibited in poverty of movement model rats. However, no change in the adrenergic nerve-adrenomedullin system was observed. CONCLUSION: Sport fatigue and poverty of movement all affect neuroendocrine system and lead to the adjustment mechanism imbalance, but the target and tendency are different.

Bone Neoplasms ; diagnosis ; Humans ; Osteosarcoma ; diagnosis ; Prognosis

AIM: To discuss the tongxinluo supermicropowder's interventional effect on aorta endodermis of rabbits which are fed with fatty forage plants.METHODS: Thirty-two healthy male New Zealand rabbits were divided into 4 groups randomly: control group,model group,atorvastatin treatment group,and tongxinluo treatment group.The control group was fed with common feedstuff,and all the other groups were fed with fatty feedstuff.The atorvastatin treatment group and the tongxinluo treatment group were given suspension of atorvastatin(3 g?kg-1?d-1) and tongxinluo supermicropowder(0.31 g?kg-1?d-1) by intragastric administration on the basis of fatty feedstuff.All the groups were fed with medicine for 6 weeks.At the end of 6 weeks,blood lipid levels were observed by enzymic method,the levels of blood serum NO and MDA and the activity of SOD were observed by chromatometry,the expression of nuclear factor-kappaB(NF-?B),intercellular adhesion molecule-1(ICAM-1) was detected,and VCAM-1mRNA expression in the aortic tissue was examined by reverse transcription polymerase chain reaction(RT-PCR).RESULTS: The levels of blood serum TC,TG,LDL-C,HDL-C,and MDA were increased significantly compared with the control group(P

Objective:To evaluate the effect of gender on dose-effect relationship of remimazolam combined with alfentanil in painless gastroscopy.Methods:Subjects who planned to undergo elective painless gastroscopy,aged 18-60 years old,body mass index 19-24 kg/m2,American Society of Anesthesiologists physical status Ⅰ or Ⅱ,were enrolled.They were divided into male group and female group.The first subject in both groups received afentanil 5 μg/kg and remimazolam 0.2 mg/kg,and was implanted into a gastroscope 2 minutes later.Positive reactions were defined as body movement,coughing,swallowing and frowning during gastroscopy placement and examination.Remimazolam 0.05 mg/kg was used as a dose gradient by using modified Dixon's up-and-down method.The dose of the next subject was adjusted according to whether the subject had a positive reaction.If there was a positive reaction,the dose of the next subject was increased by one level of gradient,otherwise,the dose was decreased by one level of gradient,and so on.The process was terminated at the seventh intersection point of positive-negative reaction.And 50% effective dose(ED50),95% effective dose(ED95)and 95% confidence interval(CI)of remimazolam for inhibiting gastroscopic implantation reaction was calculated by Probit method.Results:A total of 46 subjects were included,with 23 subjects in each group.There was no significant difference in general data between the two groups.The ED50 of afentanil combined with remimazolam was 0.193 mg/kg(95% CI:0.145-0.286),and the ED95 was 0.293 mg/kg(95% CI:0.237-0.903)in male group.The ED50 of afentanil combined with remimazolam was 0.215 mg/kg(95% CI:0.155-0.293),and the ED95 was 0.316 mg/kg(95% CI:0.261-0.968)in female group.The ED50 and ED95(P＜0.05).Conclusion:When combined with 5 μg/kg of afentanil,remimazolam is more effective in inhibiting responses to gastroscopy inserting in male subjects than in female subjects.