OBJECTIVE:To investigate the effects and safety of fructose sodium diphosphate on cardiac function,myocardial injury markers,ischemia modified albumin (IMA) and copeptin in patients with acute myocardial infarction (AMI).METHODS:In retrospective study,102 AMI patients were collected from Nanyang Second People's Hospital during Feb.2014-Apr.2015,and then divided into observation group and control group according to therapy plan,with 51 cases in each group.Both groups received routine therapy and symptomatic therapy as intravenous dripping of urokinase+ intravenous pump of heparin+oral admin istration of aspirin.Observation group was additionally given fructose sodium diphosphate 10 g intravenously,bid.Treatment courses of 2 groups lasted for 7-10 d.The changes of cardiac function indexes (LVDd,LVSd,LVEF),myocardial injury mark ers (cTn Ⅰ,CK-MB),IMA and copeptin were recorded in 2 groups before and after treatment.The cardiac function grading,the occurrence of ADR and adverse events were also recorded in 2 groups.RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups (P＞0.05).12,24 h after treatment,LVDd and LVSd of 2 groups were shortened significantly,while LVEF and IMA levels were increased significantly,and CK-MB and copeptin levels were decreased significantly,compared to before treatment;the improvement of observation group was significantly better than control group,with statistical significance (P＜0.05).cTn Ⅰ levels of 2 groups were increased gradually compared to before treatment [there was no statistical significance in observation group between 12 h after treatment and before treatment (P＞0.05)];the increase of obser vation group was significantly smaller than that of control group,with statistical significance (P＜0.05).24 h after treatment,the proportion of cardiac function Killip grade Ⅰ-Ⅱ was 96.1％ in observation group,which significantly higher than 78.4％ in control group,with statistical significance (P＜0.05).No severe ADR was found in 2 groups,and there was no statistical significance in the incidence of ADR (P＞0.05).In respect of adverse events,the number of adverse events as severe arrhythmia,re current myocardial infarction,postinfarction angina pectoris and total incidence of ADE in observation group was significantly less or under than control group,with statistical significance (P＜0.05),besides there was no statistical significance in mortality between 2 groups (P＞0.05).CONCLUSIONS:Routine symptomatic treatment combined with sodium fructose diphosphate in the treatment of AMI can effectively increase myocardial injury markers,copeptin and IMA levels,improve cardiac function and reduce the risk of adverse events so as to improve the quality of prognosis.

Objective To investigate the efficacy of the hospital intensive treatment by auto-CPAP on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to analyse the possible factors related to the effectiveness.Methods Subjects were selected from elderly OSAHS patients over 60 years old.The eligible subjects were divided into intensive treatment group and non-intensive treatment group (non-ITG).Patients in intensive treatment group were intensively treated using auto-CPAP for 3 consecutive days,assisted with targeted health education and guidance,and making proper adjustments to parameters of the auto-CPAP according to treatment outcomes at the previous day.But those in non-intensive treatment group were just treated with auto-CPAP for only 1 day,supplemented by regular health education and guidance.The apnea-hypopnea index (AHI),minimum oxygen saturation (SaO2min),mean oxygen saturation (SaO2mean) and the time spent at SaO2 lower than 90％ (tSaO2＜90％),the occurrence of clinical symptoms and adverse effect,Epworth sleepiness scale(ESS) were compared between both groups.The correlation analyses were also conducted.Results ESS (3.58±3.76 vs.6.84 ± 3.22),AHI [(7.85±6.53) time/h vs.(10.42±7.27) time/h] and tSaO2＜90％[(5.65±15.43) min vs.(15.26±33.14) min] were lower(t=6.902,2.760,2.765,allP＜0.05),while SaO2mean [(96.57±1.53)％ vs.(94.63±1.38)％] and SaO2min [(88.24±4.43)％ vs.(83.28±5.06)％]were higher(t=-9.870,-7.740,both P＜0.05)in intensive treatment group than in non intensive treatment group.The occurrences of clinical symptoms and adverse effect (except for skin allergy) were decreased in intensive treatment group versus non-ITG (all P＜0.05).The AHI after intensive treatment was decreased in females versus males [(7.85±5.19) times /h vs.(11.27±7.78) times/h,t=2.133,P＜0.05].BMI,age,gender and the state of OSAHS were correlated to AHI,SaO2 mean,SaO2 min and tSao2＜90％ after intensive treatment (all P＜0.05).Conclusions The hospital intensive treatment can improve the clinical results and decrease the occurrences of clinical symptoms and adverse effect for elderly OSAHS patients,and is expected to improve therapy compliance,and its curative efficacy is correlated to BMI,age,gender and state of OSAHS before therapy.

Objective Although graded nursing has been implemented in nursing homes since 2001 in China, it is not popu-lar.This research aimed to investigate factors of graded nursing implementation in nursing homes by subject analysis in order to provide a reference for the construction of graded nursing system in nursing homes . Methods We performed an analysis of data retrievals for grading nursing system in nursing homes from 2005 to 2015 based on five large databases: CNKI, Wanfang, VIP, CBM, and PubMed.Subject analysis was applied in the conclusion of retrieved literature . Results There were 993 related documents by pre-liminary selection and 21 documents were concluded for subject analysis .By document acquisition , code design , subject code search , integrated subject search and subject definition , five factors including policy , professional quality , institutional management , resource supply and individual were summarized . Conclusion These five factors give a correct and overall view of the facilitators and barriers to the implementation of graded nursing in nursing homes in China , which will contribute to its improvement .

objective:To study the growth inhibition effect of 5azaC on human salivary gland cell line HSG. Methods:HSG cells were exposed to 5-azaC at 5?10~ -6 mol/L and 10?10~ -6 mol/L respectively for 3 days. The proliferation of in vitro cultured HSG cells was studied by cell counting. The in vivo growth of HSG cells was investigated by tumor weight measurement in nude mouse models of HSG tumor induced by transplantation of the cells subcutaneously.Results:5 azaC inhibited HSG cell proliferation by 85% and 95% respectively at above mentioned doses. In the 3-week tumor growth study, the growth of the tumor induced by 5?10~ -6 mol/L 5azaC treated cell was inhibited by 74.8%.Conclusion:5azaC can inhibit the growth of HSG cells in vitro and in vivo.

Background Choroidal neovascularization (CNV) is the primary pathogenic cause of many fundus diseases.Oxidative stress injury of retinal pigment epithelial (RPE) cells plays important role in angiogenesis of choroid new blood vessels.Oxidative stress injury can active p75NTR receptor, a member of tumor necrosis factors family,resulting in the proliferation of vascular endothelial cells.However, the mechanisms of vascular endothelial cell proliferation remain unclear.Objective This study was conducted to investigate the effect of p75NTR overexpression on CNV and the relative mechanism.Methods The ARPE-19 cell line was used in this study.RPE cells were transfected with p75NTR receptor overexpressed plasmid, and untransfected cells served as the control group.The transfected results were verified by reverse transcription-PCR and Western blot assay.Viability of the cells over time was determined in the p75NTR receptor plasmid transfected group by using BrdU assay.The percentage of apoptotic cells was detected by flow cytometry using Annexin V-FITC/PI fluorescence staining.The percentage of reactive oxygen species (ROS) expression in the cells was detected by using H2 DCFDA fluorescence and flow cytometry.Mitochondrial membrane potential and cytochrome C expression were examined under the confocal microscope.The protein expressions of cleaved caspase-3, Fas and VEGF were determined by Western blot assay.Results The relative expression level of p75 NTR receptor mRNA was (6.11 ±0.77) times higher than that of the control group, and relative expression level of p75NTR receptor protein in the cells in the p75NTR receptor plasmid transfected group was (7.42±0.48) times higher than that in the control group (t=11.49 and 23.17 ,both at P＜0.01).The absorbency values of the p75NTR receptor plasmid transfected group were (93.12±0.56) ％ , (86.30±0.66) ％ , (72.53-±0.86) ％ and (60.77 ±2.81) ％ in 12,24,36 and 48 hours after plasmid transfection, which were significantly lower than 100％ in the control group, and the apoptotic percentages were evidently higher than that in the control group (all at P＜0.05).The relative fluorescence intensity of ROS fluorescence in the p75NTR receptor plasmid transfected group was 2.4 times higher than that in the control group,showing significant difference (t=16.45, P＜0.01).The positive expressing rate of mitomarker (mitochondrial membrane potentials) was 100％ in the control group and (37.30± 2.06)％ in the p75NTR receptor plasmid transfected group, with significant difference between them (t =57.71,P＜0.01).The fluorescence intensity of cytochrome C expression was elevated in the p75NTR receptor plasmid transfected group compared with the control group.Compared with the control group,the expressing levels of cleaved caspase-3 ,Fas and VEGF165 proteins in the cells were significantly raised in the p75NTR receptor plasmid transfected group (all at P＜0.01).Conclusions Overexpression of p75NTR receptors in RPE cells leads to mitochondrial damage and cellular apoptosis and the secretion of VEGF protein, which sequentially promote CNV.P75NTR receptor may be another important regulation pathway in RPE oxygen damage.

Combined with the features of neurology,this article discussed the assessing processes for quality postgraduates in neurology from four aspects: clinical skills,creative ability,ability in using English,ability of communication between doctors and patients.It also elaborated the purpose and meanings of setting the assessing goal,selecting assessing items and establishing criterion of the assessing items.

OBJECTIVE:To systematically review the efficacy and safety of Calf spleen extract injection combined with chemo-therapy in the treatment of cancer,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Co-chrane Library,PubMed,Medline,EMBase,CJFD,Wanfang and VIP Database,randomized controlled trials(RCT)of the effica-cy and safety about Calf spleen extract injection combined with chemotherapy in the treatment of cancer were collected. Meta-analy-sis was performed by using Rev Man 5.0 software after data extract and quality evaluation by Cochrane 5.0. RESULTS:Totally 23 RCT were enrolled,including 1 682 patients. Results of Meta-analysis showed Calf spleen extract injection combined with chemo-therapy in the treatment of cancer can significantly improve the effective rate [OR=2.17,95%CI(1.68,2.81),P<0.001] and im-provement rate of life quality [OR=4.26,95%CI(2.47,7.32),P<0.001] and also reduce the degree rate of WBC and PLT,the inci-dence rate of nausea and emesis,the differences were statistically significant. CONCLUSIONS:Calf spleen extraction injection combined with chemotherapy has good efficacy and safety in the treatment of cancer.

Objective To investigate the role of self-made auxiliary device in pelvic tumor radiotherapy with phantom immobilization using Varian cone-beam CT (CBCT).Methods A total of 50 patients with pelvic tumor were enrolled and randomly divided into study group and control group according to the order of enrollment.The patients in the study group were immobilized with thermoplastic phantom and self-made auxiliary device,and those in the control group were immobilized with thermoplastic phantom.CBCT scan and online matching were regularly performed before radiotherapy to obtain the setup errors of the left-right (x),cranial-caudal (y),and anterior-posterior (z) directions.The independent-samples t-test was used for comparison between groups.Results The set-up errors in the x-,y-,and z-directions in the study group were 1.56± 1.00 mm,1.60± 1.29 mm,and 1.36± 1.00 mm,respectively,and those in the control group were 1.76±1.33 mm,2.76±1.69 mm,and 1.92±0.91 mm,respectively (P=0.551,0.009,and 0.043).Conclusions Self-made auxiliary device helps to eliminate the errors in the cranial-caudal direction and solve the problem of involuntary activities of the lower limbs.

Objective To study the impairment and the expression of receptor of advanced glycation endproduct (RAGE) in cultured rat glomerular mesangial cells ( GMC ) induced by constant and intermittent high glucose, and to investigate the pathogenesis of diabetic nephropathy. Methods After being cultured under constant and intermittent high glucose with different concentrations for 24 and 48 hours, the morphological changes of rat mesangial cells were observed, the proliferation of GMC was detected by MTT assay, the activity of superoxide dismutase (SOD)and the level of malondialdehyde (MDA)in supernatant were measured by spectrophotometer,and the expressions of RAGE mRNA were evaluated by RT-PCR. Results ( 1 ) Compared with the control group,the cellular morphology was changed in case of constant and intermittent high glucose. The damage of GMC with intermittent high glucose concentrations was more serious. (2)The activity of SOD was decreased and the level of MDA was raised in case of intermittent high glucose concentrations compared with the constant high glucose concentrations (P＜0.05). (3)The expression of RAGE mRNA with intermittent high glucose concentrations was significantly higher than that with constant high glucose concentrations ( P＜0. 01 ). Conclusions The damaging effects and increased expression of RAGE in cultured rat GMC induced by blood glucose fluctuation was much worse than that with constant high glucose. The blood glucose fluctuation may be one of the causes that induce diabetic nephropathy.

Objective To knockout Rag2 and IL2rg genes and construct severe combined immunodeficiency mice based on CRISPR/Cas9 technology. Method Design and synthesis of 25 bp sgRNA were made according to the Rag2 and IL2rg sequences in Genbank. After annealing, sgRNA was cloned into pX330 vector. Recombination plasmid Rag2?sgRNA, IL2rg?sgRN and Cas9 were then transcribed into RNA, these RNA were microinjected into zygotes and the zygotes were transplanted into recipient ICR mice. F0 founders were born and mutated F0 founders mated with wild type mice to obtain F1 generation heterozygous mice. Mutated F1 mice were crossed and got F2 generation homozygous mice. Genotype and phenotype of the knockout mice were identified by sequencing, flow cytometry and xenograft model. Results Rag2?sgRNA and IL2rg?sgRNA recombination plasmids were constructed and transcribed into RNA. After microinjection and mat? ing, F0 founders were born and F2 homozygous mice were obtained. The results of sequencing showed that there were two types of genotype in IL2rg gene, 10 bp or 11 bp deletion;however, there was only one genotype in Rag2 gene, which was 8 bp deletion. Compared with wild?type BALB/c mice, the number of CD3 +, B220 + and NKp46 + cells in peripheral blood of the knockout mice was reduced significantly. After inoculation of human breast cancer cell line SKBR?2HL cells, tumor size in the xenograft mouse model was increased gradually along with time extension. Conclusion CRISPR/Cas9 is an efficient way to mutate Rag2 and IL2rg gene in mice in vivo, leading to aberrant T cells, B cells and NK cells.