A questionnaire survey on chronic heart failure management was conducted in 110 physicians from Xindu,Supo,Jiajiang and Xinhua community hospital in Chengdu from January 2007 to June 2010.Results showed that 77.3％ (85/110) of community physicians lacked knowledge about prevention,diagnosis and treatment of chronic heart failure,and the diagnostic accuracy rate was only 51.3％ (40/78) in these community hospitals.There was lack of awareness of the guideline of chronic heart failure:the rate of β blockers use was 15.0％ (6/40) and only 5.0％ (2/40) used the target dose; the rate of angiotensin converting enzyme inhibitor use was 17.5％ (7/40) and only 7.50％ (3/40) used the target dose.In addition,90％ (99/110) of community doctors lacked the education and management for patients with heart failure.The survey suggests that the current situation of chronic heart failure management in community physicians in Chengdu is unsatisfactory.It is necessary to strengthen the training of community physicians.

Objective To explore the culturing strategies,curiculum provision,courses conferring methods,teaching effects as well as the associated managerial evaluations on the basis of Sino-French cooperation on medical education with the hope of summarizing helpful suggestions to Sino-Foreign cooperation on medical education. Methods The achievements of our Sino-French cooperation on medical education were analyzed and compared in the teaching models,culturing strategies along with courses conferring processes among seven-year medical students from both English-teaching and French-teaching classes. Results Our Sino-French cooperation on medical education was featured in its distinct culturing purposes and effective teaching model.Its scientifically formulated culturing strategy found its full expression in French-teaching atmosphere.The Sino-French cooperation on medical education was consistently welcomed and favorably recommended by both faculties and students. Conclusion The Sino-French cooperation on medical education has not only gained precious experience in culturing the cutting-edge medical talents with the international visions but also conduced to fulfill the goal to establish a modernized and internationalized medical school.

Objective To evaluate the diagnostic value of gray scale contrast-enhanced ultrasonography(CEUS) in the diagnosis of active hemorrhage of the kidney.Methods Forty-six active hemorrhage animal models were created within the kidney of 23 New Zealand rabbits heparinized under general anesthesia,rabbit kidneys were examined by routine two dimensional ultrasonography and CEUS.Results Routine ultrasonography showed 26 traumas with irregular and poorly defined margins.CEUS showed all active bleeding sites,contrast agents overflowed from injured blood vessel and formed irregular remarkable enhanced parts.After average 85s for contrast agent was injected,the intensity of the enhanced regions in the kidneys were significantly higher than those of normal renal parenchyma.Conclusions CEUS could clearly demonstrate the active hemorrhage in traumatic kidney and could significantly improve the diagnostic level of ultrasonography.

Objective To investigate the effect of extracorporeal membrane oxygenation (ECMO) combined with ultrafiltration in treatment of kidney injury induced by serious hemorrhagic shock in rabbits.Methods Models of pressure-controlled hemorrhagic shock was developed in 24 New Zealand white rabbits which were divided into unresuscitation group (n =8),ECMO combined with ultrafiltration group (combined resuscitation group,n =8),and fluid resuscitation group (n =8) according to the random number table.Heart rate was monitored via electrocardiograph and arterial pressure via fermoral artery catheter.Blood samples were collected pre-and post-shock and after resuscitation to measure levels of lactic acid,serum creatinine,IL-6,and TNF-α.Kidney samples were collected for measurement of histopathological changes via HE staining,expression of heat shock protein 70 (HSP70) via immunohistochemical staining.Results Arterial pressure was (53.1 ± 11.4) mmHg in combined resuscitation group,higher than (41.3 ± 11.1) mmHg in fluid resuscitation group and (25.9 ± 10.5) mmHg in unresuscitation group (F =41.425,P ＜ 0.05).Hemorrhagic shock induced significant up-regulation of lactic acid,serum creatinine,IL-6,and TNF-α(P ＜ 0.05),but all were lowered after resuscitation,especially in combined resuscitation group (P ＜ 0.05).HE staining showed the degree of kidney tissue necrosis and inflammatory cytokine infiltration in combined resuscitation group alleviated notably compared with fluid resuscitation group.Median and interquartile values of HSP70 were 17 828.960 0 (15 779.865 0-21 751.980 0) in unresuscitation group,2 714.270 0 (1 339.215 0-7 616.950 0) in fluid resuscitation group,and 262.930 0 (198.820 0-538.195 0) in combine resuscitation group,with statistical differences among groups(P ＜ 0.05).Conclusion ECMO combined with ultrafiltration is superior to conventional fluid resuscitation in improving hypoxia tissue injury and inflammatory reaction after hemorrhagic shock and is beneficial to attenuating kidney injury.

Background To optimize the culture method of human retinal microvascular endothelial cells is very important for the study of retinal angiogenesis disease.Human retinal microvascular endothelial cells have been successfully cultured in previous studies,but further improvement of the culture method to harvest higher yields and purity cells is still needed.Objective This study was to design a modified method to isolate and purify human retinal microvascular endothelial cells much easily and quickly,and to compare the expression of specific markers of vascular endothelial cells,factor Ⅷ and CD31/CD34 in the cells.Methods The use of human donor eyeballs was approved by the Ethic Commission of Zhongshan Ophthalmic Center of Sun Yat-sen University.The retina tissue from healthy donor was isolated and digested by the two-step digestion method with 2％ trypsin and 0.133％ collagenase Ⅳ.Human retinal microvascular endothelial cells were collected and plated in 60 mm dishes coated by 0.1％ fibronectin and cultured in endothelial cell-specialized medium supplemented with 10％ fetal bovine serum,0.3 mg/L β-endothelial cell growth factor (ECGF) and 100 ng/L sodium heparin.During the culturing,the growth situation of the cells was monitored by morphological observation,and immunohistochemical staining was performed to probe vascular endothelial cell-specific membrane protein CD31,CD34 and factor Ⅷ for identification of the cell purity.Results Human retinal microvascular endothelial cells were isolated successfully from the retina by the twostep digestion method.The primary cultured cells adhered to well 72 hours later and achieved confluence with the typical cobblestone appearance 9 to 10 days after cultured.The cells exhibited the blue nuclei and reddish cytoplasm by regular haematoxylin and eosin stain and showed a strong positive response for CD31,CD34 and factor Ⅷ by immunohistochemistry.The positive dye of CD31 and CD34 was lower than Ⅷ factor in both endothelial cells.Conclusions Modified culture method of human retinal microvascular endothelial cells can improve cell culture result and purify target cells.

Objective To determine the changes of interleukin-12(IL-12) and IL-12 mRNA in gastric mucosa of children with helicobacer pylori (Hp) infection,and to study the effects of Hp infection on the expression levels of IL-12 and IL-12 mRNA,and to evaluate its possible roles in the pathogenesis of gastric mucosal inflammation in Hp related gastroduodenal diseases.Methods Biopsy specimens were taken from the antral mucosa on endoscopy in patients with or without Hp infection, which were diagnosed by urease test and Giemsa staining. The expression levels of IL-12 and IL-12 mRNA in gastric mucosa were determined by ELISA and RT-PCR.Results Inflammation of gastric antral mucosa was more severe in Hp-positive mucosa .The expression levels of IL-12 and IL-12 mRNA in Hp-positive mucosa were (66.42?15.15) ng/g and (59.21?15.03)%,which were more than those in (Hp-negative )(22.22?8.79) ng/g and (17.94?7.39)%(P

OBJECTIVETo study the clinical effects of three different root canal preparations on endodontic interappointment pain (EIAP) among the elderly.

METHODSIn this study, 292 teeth with acute or chronic pulpitis or apical periodontitis were collected from 265 individuals. The samples were divided randomly into three groups. Three root canal preparations were utilized for groups M, G, and H. Modified single length technique with Mtwo instrument was utilized in group M. Modified step-back technique with Gates-Glidden bur was employed in group G, and step-back technique with stainless steel H-files was employed in group H. The EIAP rates were observed and compared.

RESULTSThe rates of EIAP for groups M, G, and H were 5.81%, 6.38%, and 19.64%, respectively. A significant difference was observed between groups M and H (P < 0.012 5) as well as between groups G and H. However, no significant differences were observed between groups M and G (P > 0.012 5).

CONCLUSIONModified single length technique with Mtwo instrument and modified step-back technique with Gates-Glidden bur can reduce EIAP in the elderly.

Aged ; Dental Pulp Cavity ; Humans ; Pain ; Root Canal Preparation ; Stainless Steel

OBJECTIVETo verify the pharmacological hypothesis of prescriptions by studying the targeted distribution of major components in stewed rhubarb in the rat model with acute pancreatitis (AP).

METHODNormal SD rats (control group, n = 5) and the AP model induced with intraperitoneal cerulein (model group, n = 5) were taken as the experimental objects. Rats of the two groups were orally administered with stewed rhubarb granules (20 g x kg(-1)). Their heart, liver, spleen, lung, kidney and pancreas were collected two hours after the administration. Such constituents as emodin, chrysophanol, physcion, rhein and aloe-emodin and their concentrations in each tissue homogenate were detected by high performance liquid chromatography-mass-mass.

RESULTAloe-emodin and physcion in stewed rhubarb whose concentrations in liver and kidney of normal rats were higher than that in pancreatic tissues, while the distribution spectrums and concentrations of the remaining components in pancreatic tissues had no significant difference with that of other organs. The concentrations of emodin, aloe-emodin, rhein and chrysophanol in stewed rhubarb in pancreatic tissues of the AP model group were higher than that in other tissues and organs, while their concentrations in pancreatic, renal and splenic tissues were notably higher than that in the normal group.

CONCLUSIONIn the conditions of AP, effective components in stewed rhubarb show a targeted distribution feature in pancreas, which provides experimental basis for the pharmacological hypothesis of prescriptions.

Acute Disease ; Animals ; Anthraquinones ; pharmacokinetics ; pharmacology ; therapeutic use ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacokinetics ; pharmacology ; therapeutic use ; Male ; Organ Specificity ; Pancreatitis ; drug therapy ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rheum ; chemistry

Objective To investigate clinical characteristics of relapsing polychondritis(RP)and to improve early recognition for it.Methods Clinical and laboratory data of 56 patients with RP were analyzed retrospectively.Results Ratio of number of male patients to female ones was 1.2.Age at onset was(46?11)years(ranging from 27 to 71)and average interval between onset and diagnosis was(21? 35)months,(8?6),(16?31)and(29?37)months for patients initial onset with auricle,respiratory tract and joints involved,respectively.Site involved included airway in 40 patients(71.4%),auricle in 32 (57.1%),joints in 32(57.1%),eyes in 27(48.2%),nasal chondritis in 25(44.6%)and inner ear in 13(23.2%).At initial stage of the course,17 patients were misdiagnosed as respiratory infection (30.4%),nine as perichondritis(16.1%),six as pulmonary tuberculosis(10.7%),five as rheumatoid arthritis(8.9%).Seven of 40 patients with airway involvement received metallic stents for their tracheobronchial stenosis.Four patients whose condition never improved after regular therapy all had respiratory involvement.Conclusions Patients of RP with initial onset at non-auricle,non-nasal sites tended to be misdiagnosed.Prevalence of airway involvement was not so low with a poor prognosis in patients of RP.

Objective To investigate the expression and clinical significance of plasma miR-150,squamous cell carcinoma anti gen (SCCA) and carbohydrate antigen 125 (CA125) in human papillomavirus (HPV) positive cervical cancer patients.Methods RT PCR was detected in 108 cases of HPV patients with positive cervical cancer (cervical cancer group) and 40 cases of HPV positive CIN patients (CIN group) and 40 cases of HPV with positive/HPV positive uterine benign lesions (control group),plasma miR-150,SCCA and CA125 levels.Analyzed the relation between miR 150 expression and clinicopathological features of cervical cancer.ROC curve was used to evaluate the early diagnostic value of miR-150,SCCA and CA125 in patients with HPV positive cervical cancer.Multivariate Logistic regression model was used to analyze the rela tionship between three indicators and HPV positive cervical cancer.Results The levels of miR-150,SCCA and CA125 in the cervical cancer group were significantly higher than those in the CIN group and the control group [miR-150(2-△△Ct):10.28 ±4.16 vs 4.72± 1.18 and 1.83±0.64.SCCA(ng/ml):9.86±2.14 vs 3.18±0.85 and 1.35±0.3t.CA125 (U/ml):46.26 ±11.58 vs 19.14±7.05 and 16.42±5.83,F=16.427,13.205,8.719,all P＜0.01].The expression of plasma miR 150 in HPV positive cervical cancer correlated with clinical stage,lymph node metastasis and depth of invasion (P＜0.05).The optimal cut-off values of plasma miR-150 for diagnosis of HPV positive cervical cancer and CIN were 8.25 and 3.46,and the sensitivity and specificity were 87.0 ％ and 84.3 ％,81.0 ％ and 80.2 ％,respectively.Logistic regression analysis showed that elevated plasma miR 150 and SCCA levels were independent risk factors for HPV positive cervical cancer [OR(95 ％ CI)=2.107(1.915～2.814),OR(95％CI)=1.583(1.327～2.036)].Conclusion Plasma miR 150 was significantly up regulated in patients with HPV positive cervical cancer,which can be used as a biological marker for the early diagnosis of HPV positive cervical cancer and the differential diagnosis of CIN.