Objective To investigate the clinical efficacy of psychological intervention combined with valsartan and Benner Pury in the treatment of congestive heart failure (CHF). Methods 100 patients with congestive heart failure treated in our hospital from January 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. Patients in the control group were treated with Benner Pury, the experimental group was given valsartan and Benner Pury combined treatment, and psychological intervention, pay attention to the psychological state of patients. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the effective rate of treatment in the experimental group was 96%, and the effective rate of the control group was 82%. The effective rate of the patients in the control group was significantly lower than that in the experimental group, with statistical difference (P<0.05). The incidence of adverse reactions in the experimental group was 8%, and the fatality rate was 10%. The incidence of adverse reactions in the control group was 10%, and the fatality rate was 12%. There was no significant difference between the experimental group and the control group in the incidence of adverse reactions and mortality, and it was not statistically significant, and could be compared. Conclusion The clinical effect of psychological intervention combined with valsartan in the treatment of congestive heart failure, Benner Pury good, can improve the treatment efficiency to a certain extent, high safety, is further applied in clinical significance.

Objective To determine the effect of ghrelin on protecting the human umbilical vein endothelial cells (HUVEC) from injury by angiotesin Ⅱ(AngⅡ) in vitro. Methods (1)HUVEC was incubated for 24 h with AngⅡ whose final concentration in the medium varied from 10-9 to 10-6mol/L or pretreated with 10-9to 10-6mol/L ghrelin for 2 h before incubation for 24 h with AngⅡwhose final concentration in the medium was 10-6mol/L. HUVECs were harvested to measure the cell vitality and cell apoptosis. The cell vitality was determined by MTT and cell apoptosis rates were measured by Annexin V-FITC apoptosis detection kit. (2)HUVECs were incubated for 3,6,12,or 24 h with 10-9,10-8,10-7,or 10-6mol/L AngⅡ, respectively. Before HUVECs were incubated with 10-6 mol/L AngⅡfor 24 h, ghrelin (10-9,10-8,10-7, and 10-6 mol/L) was used to pretreat the cells for 2 h. Growth hormone secregogue receptor 1a blocker [D-Lys3]GHRP-6 was added to the cells which were incubated for 24 h with 10-6mol/L AngⅡ and pretreated with 10-6 mol/L ghrelin for 2 h. Cell reactive oxygen species were measured by dichlorofluorescin (DCF) fluorescence probe method. (3)HUVECs were incubated for 24 h with 10-9,10-8,10-7, or 10-6mol/L AngⅡ and ghrelin, respectively,and then were incubated with 10-6mol/L of AngⅡ for 3,6,12,or 24 h. Furthermore,HUVECs were pretreated with 10-9,10-8,10-7, or 10-6mol/L ghrelin for 30 min,1 h,or 2 h, and then were incubated with the inhibitor of mitogen-activated protein kinase /extracellular regulated kinase (MAPK/ERK1/2),PD98059, the inhibitor of phosphoinositide-3-kinase/serine threonine kinase( PI3K/Akt)wortmannin, and [D-Lys3]GHRP-6 for 24 h. NO production was compared among groups. HUVECs were pretreated with ghrelin,PD98059, wortmannin, and [D-Lys3]GHRP-6 for 2 h and co-cultured with 10-6mol/L AngⅡfor 24 h,or pretreated with ghrelin plus PD98059, wortmannin, and [D-Lys3]GHRP-6 before incubation with AngⅡfor 24 h. NO was measured in the endothelial cell supernatants by Griess method. (4)HUVECs were cultivated with blank or AngⅡwith or without pretreatment with ghrelin or both ghrelin and wortmannin. The protein expression of eNOS and phospho-protein expression of Akt were measured by Western blot analysis. Results AngⅡinjuried the endothelial cell vitality,increased the cell apoptosis rates in HUVECs, and decreased NO production in HUVEC supernatants,whereas ghrelin protected HUVECs from AngⅡ injury. Ghrelin decreased the reactive oxygen species in HUVECs induced by AngⅡ. The effect could be attenuated by [D-Lys3]GHRP-6 pretreatment; PD98059 alleviated AngⅡ inhibition of NO production in HUVEC supernatants. Wortmannin and [D-Lys3]GHRP-6 could abolish protection of ghrelin from reducing NO production in HUVEC supernatants. AngⅡreduced the expression of eNOS,but ghrelin increased eNOS expression. Wortmannin could cancel this effect of ghrelin. Ghrelin increased p-Akt expression and reached the peak in 10 and 20 min. Conclusion Ghrelin may protect HUVECs from AngⅡinduced injury, which is related to decreasing oxidative stress, increasing the protein expression of eNOS, and activating PI3K/Akt signal pathway through GHSR1a receptor.

Objective To investigate the clinical,endoscopic and pathologic features in the differential diagnosis between Crohn' s disease (CD) and intestinal tuberculosis (ITB).Methods The complete clinical data of 107 patients with CD and 69 patients with ITB in our hospital from January 2011 to January 2012 were retrospectively analyzed.The diagnostic value of the clinical and endoscopic scoring system was evaluated.Results CD occurred mainly in male.The salient features of CD included long duration of disease high incidence of colectomy.Comparing with patients with ITB,patients with CD have more cases of diarrhea,hematochezia,abdominal mass,intestinal obstruction,intestinal hemorrhage,perianal lesions,and extraintestinal manifestations (all P ＜ 0.05).It's more frequent to have positive results of anti-Saccharomyces cerevisiae antibody (ASCA),perinuclear antineutrophil cytoplasmic antibody (pANCA) and fecal occult blood in CD patients,as well as low albumin,high C-reactive protein (CRP),elevated platelet count and hematocrit (P ＜ 0.05 or P ＜ 0.01).The salient features of ITB included low fever,night sweats,active parenteral tuberculosis,increased erythrocyte sedimentation rate (ESR),chest X-ray abnormalities,the positive PPD (purified protein derivatives tuberculin) and T-SPOT (P ＜ 0.05 or P ＜0.01).Based on the imaging,CD often involved the small intestine,such as the intestinal stricture and abdominal abscess (P ＜ 0.05),while mesenteric lymphadenopathy was more common in ITB (P ＜ 0.05).The endoscopic examination showed that some patterns of disease involvement such as fissure-shape ulcer [41.12％ (44/107) vs 5.80％ (4/69)],cobblestone sign [15.89％ (17/107) vs 4.35％ (3/69)],lesions over four segment [24.30％ (26/107) vs 7.25％ (5/69)],rectum involvement [17.76％ (19/107) vs 5.80％ (4/69)],ileocecal valve stenosis [21.50％ (23/107) vs 8.70％ (6/69)] and mucosal bridge [5.61％ (6/107) vs 0(0/69)] were more frequent in CD patients than those in ITB patients(P ＜ 0.01 or P ＜0.05).However circular ulcers[37.68％ (26/69) vs 9.35％ (10/107)],rat-bite-like ulcers[24.64％ (17/69) vs 12.15％ (13/107)],persistent open ileocecal valves [39.13％ (27/69) vs 19.63％ (21/107)],tuberous and polypoid lesions [36.23％ (25/69) vs 20.56％ (22/107),37.68％ (26/69) vs 22.43％ (24/107)] were more common in ITB (P ＜ 0.01 or P ＜ 0.05).In terms of pathological findings,certain characteristic features such as transmural inflammation [5.61％ (6/107) vs 0 (0/69)],fissure-liked ulcers [14.02％ (15/107) vs 4.35％ (3/69)],non-caseous granulomas [5.61％ (6/107) vs 0(0/69)],lymphoid hyperplasia [16.82％ (18/107) vs 5.80％ (4/69)] and crypt abscess [9.35％ (10/107) vs 1.45％ (1/69)] were more common in CD than those in ITB(P ＜ 0.05).According to the clinical and endoscopic scoring system,the positive diagnostic rate of CD was 50.47 ％ (54/107)and of ITB was 66.67 ％ (46/69) (P ＜ 0.05).Conclusions The differential diagnosis between CD and ITB should be considered carefully based on clinical,endoscopic,pathological characteristics.The clinical and endoscopic scoring system may contribute to distinguish CD and ITB.

Objective To study the expressions of cysteinyl aspartate specific proteinase 3 ( Caspase 3 ) and proliferating cell nuclear antigen ( PCNA ) in intestinal tissue of neonatal rats with necrotizing enterocolitis ( NEC ) , and the protective effect of glutamine ( Gln ) on NEC. MethodsThirty-six neonatal Sprague-Dawley ( SD) rats were randomly assigned into 3 groups at 48 h after birth (12 in each group). The control group were fed with milk replacer. The NEC group were fed with milk replacer and experiencing cold exposure after hypoxic-reoxygenation twice a day for 3 days, The Gln+NEC group were fed with milk replacer plus Gln and experiencing cold exposure after hypoxic-reoxygenation twice a day for 3 days. All the rats were sacrificed and intestinal tissues obtained at day 3 of the establishment of model. The histological changes of ileal tissues were studied using hematoxy lin-eosin ( HE ) staining. The expressions of Caspase 3 and PCNA were detected using immunohistochemical(IHC)method.Results Caspase3expressioninNECgroup(77.3±8.6)℅was significantly higher than the control group (18. 9 ± 3. 4)℅ and Gln+NEC group (50. 3 ± 6. 2)℅ ( P<0. 05). Also, Caspase 3 in Gln+NEC group was significantly higher than the control group (P<0. 05). PCNA expression in the NEC group ( 15. 0 ± 1. 9 )℅ was significantly lower than the control group (34. 2 ± 5. 8)℅ and the Gln +NEC group ( 24. 0 ± 3. 9 )℅ ( P <0. 05 ) . PCNA expression in the Gln+NEC group was significantly lower than the control group ( P<0. 05). The pathological score of the intestinal tissues was significantly correlated with Caspase 3 expression ( r = 0. 769, P = 0. 005 ), Caspase3/PCNA ratio (r=0. 835,P=0. 002) and PCNA expression (r= -0. 698, P=0. 014) in the NECgroup.Conclusions Up regulation of Cas pase3 and down regulation of PCNA might be correlated with the process of NEC. Gln might be effective in prevention and healing of NEC by inhibiting apoptosis and promoting cell proliferation.

Objectives To understand the effects of different doses of vitamin D supplementation on serum calcium,phosphorus,alkaline phosphatase and 25-hydroxyvitamin D levels in very low birth weight infants (VLBWI) and to provide guidance for early prevention of metabolic bone disease in VLBWI.Methods A total of 90 VLBWI hospitalized in the Department of Neonatology,Huzhou Maternal and Child Healthcare Hospital between January 2014 and January 2016 were enrolled and randomly divided into two groups:highdose group and low dose group.High-dose group was given vitamin D 900 U/d orally and low-dose group was given 400 U/d since the eighth day after birth.Serum calcium,phosphorus and alkaline phosphatase levels were detected at 1,7,21 and 42 days of age and serum 25-hydroxyvitamin D levels were detected at 7,21and 42 days of age.Two-sample t-test,Chi-square test,one-way analysis of variance and LSD or Dunnett's T3 test were used for statistical analysis.Results No significant differences in serum calcium,phosphorus and alkaline phosphatase levels were found between the two groups at 1 and 7 days of age,nor were found in serum 25-hydroxyvitamin D level at 7 days of age (all P＞0.05).At 21 days of age,high dose group had higher serum calcium,phosphorus and 25-hydroxyvitamin D levels than low-dose group [(2.38 ± 0.09) vs (2.04 ± 0.15) mmol/L,t=2.421;(1.80±0.50) vs (1.71 ±0.60) mmol/L,t-0.637;(45.58± 18.43) vs (42.53± 16.33) nmol/L,t=0.421],but lower alkaline phosphatase level [(505.12± 185.61) vs (588.32± 168.72) U/L,t=5.314] (all P＜0.05).The same trends were found at 42 days of age.In high-dose group,serum calcium level increased at 7,21 and 42 days of age as compared with that at 1 day of age [(2.43±0.13),(2.38±0.09),(2.39±0.08) vs (2.06±0.57) mmol/L];serum phosphorus level at 7 days of age was lower than that at 1,21 and 42 days of age [(1.31 ±0.26) vs (1.89±0.39),(1.80±0.50),(1.98±0.30) mmol/L];serum alkaline phosphatase level at 7,21 and 42 days of age was higher than that at 1 day of age [(475.18± 133.73),(505.12± 185.61),(538.43 ± 168.16) vs (296.15 ± 99.41) U/L] and a significant increase was observed at 42 days of age as compared with that at 7 days of age;serum 25 hydroxyvitamin D level at 21 days of age was higher than that at 7 days of age,and that at 42 days of age was higher than that at 7 and 21 days of age [(73.55±23.65) vs (30.63± 12.66) and (45.58 ± 18.43) nmol/L];the differences were all statistically significant (LSD or Dunnett's T3 test,all P＜0.05).Conclusions Vitamin D supplementation from the eighth day after birth can improve calcium and phosphorus metabolism in VLBWI and the dose of 900 U/d is more effective than 400 U/d.

ObjectiveTo investigate the effect of Glutamine (Gln) on the expression of PCNA in intestinal tissue of neo-natal rats with necrotizing enterocolitis (NEC), and to explore the protective mechanism of Gln in intestinal mucosa.Methods Forty-eight neonatal rats at the age of 48 hours were selected, and divided into 4 groups, control group, Gln group, NEC group, NECGln group. Each group had 12 rats. Control group were fed mice milk substitutes; Gln group were fed mice milk substitutes mixed with Gln; NEC group were fed mice milk substitutes and had cold/ hypoxia exposure twice a day for 3 days; NECGln group were exposed to cold stress, hypoxia and treated with Gln mixed in the milk. The expression of PCNA was detected using immunohistochemical method.Results Compared with control group were and Gln group, the general condition was worse, and the weight was decreased in NEC and NECGln group. The inifltrated inlfammatory cells, congestion, edema, intrinsic layer separation were observed in intestinal mucosa in NEC and NECGln group. The intestinal villus was lost in severe in NEC and NECGln group. The PCNA index was 34.17±5.78, 34.42±5.38, 15.00±1.94, 30.67±3.14 in control, Gln, NEC and NECGln group respectively, with signiifcant difference between each groups (H=24.32,P=0.000). The expression of PCNA in NEC group was lower than that in normal, Gln, and NECGln group (P<0.008). The expression of PCNA had no signiifcant difference among normal, Gln, and NECGln group (P>0.008).Conclusions The expression of PCNA in intestinal mucosa was decreased in NEC rats. Gln supplement could raise the expression of PCNA in intestinal mucosa of NEC rats, and accelerate the speed of intestinal mucosa repair.

Objective To investigate the clinical features and antimicrobial susceptibility of neonatal Listeria septicemia.Methods Eleven cases of neonatal Listeria septicemia that were treated in the Huzhou Maternity and Children Health Hospital from March 2013 to March 2017 were enrolled in this study.Clinical data including the results of bacterial culture,antimicrobial susceptibility test and antibiotic treatment were collected and retrospectively analyzed.Moreover,maternal history of Listeria monocytogenes (LM) infection before delivery was retrieved.Results All of the 11 mothers had fever before delivery and nine of them showed different grades of amniotic fluid contamination during delivery.Clinical symptoms of the 11 neonates included dyspnea (11 cases),fever (ten cases),apnea (nine cases),slow response and feeding difficulty (nine cases),convulsion (six cases),vomiting and abdominal distension (two cases),pulmonary hemorrhage (one case),progressive jaundice (one case) and systemic skin bleeding point (one case).All cases showed abnormal results of blood routine test and increased calcitonin and C-reactive protein.Ten cases received cercbrospinal fluid examination,seven of which were abnormal.Altogether 17 strains of LM were isolated from various specimens.These strains were all sensitive to piperacillin-tazobactam,ampicillin-sulbactam,meropenem,vancomycin,cotrimoxazole,ciprofloxacin and gentamycin,but resistant to oxacillin.Strains those were sensitive to penicillin,ampicillin,erythromycin and clindamycin accounted for 10/17,11/17,9/17 and 8/17,respectively.The 11 neonates were treated with piperacillin-tazobactam,meropenem or vancomycin.All of them improved (11/11)and ten were cured (10/11).All cases were followed up through phone calls at one week and one month after discharge.Two were lost to follow-up,while thc others were all in good condition.Conclusions Neonatal Listeria septicemia is usually a severe disease characterized by rapid progression and mainly presented with dyspnea and fever,besides there is a high possibility of purulent meningitis.Some LM strains are resistant to single-agent penicillin antibiotics.However,antibiotics such as piperacillin-tazobactam,meropenem and vancomycin are effective in the treatment of neonatal Listeria septicemia.

Objective:To explore the current situation of knowledge, attitude and practice in the prevention and treatment of lymphedema after tumor treatment among nurses in cancer hospitals, and analyze its influencing factors.Methods:This study is a cross-sectional study. From October to November 2021, convenience sampling was used to survey 478 nurses from Hunan Cancer Hospital using the self-made Lymphedema Prevention and Treatment Knowledge, Attitude and Practice Questionnaire, which included 41 items from three dimensions of knowledge, attitudes and practice. The influencing factors of nurses' knowledge, attitude and behaviors related to lymphedema were studied using univariate analysis and multiple linear regression analysis.Results:The knowledge, attitude and practice scores and the total score of nurses in the cancer hospital regarding the prevention and treatment of lymphedema after tumor treatment were (17.05±9.81) , (49.96±6.03) , (30.51±11.03) , and (97.53±21.52) , respectively. The score rate of knowledge dimension was the lowest at 42.63%, while the score rate of attitude dimension was the highest at 90.84%. Multiple linear regression showed that working with lymphedema patients, participation in lymphedema training, training forms (on-the-job continuing education, school studies, self-study) , and the nurses' department being the breast or gynecological oncology department were the influencing factors for the nurses' knowledge, attitude, and practice in the prevention and treatment of lymphedema ( F=15.801, P<0.01) . Conclusions:Nurses in the cancer hospital generally have a moderate level of knowledge, attitude and practice in the prevention and treatment of lymphedema after tumor treatment. They have poor knowledge mastery and need to improve their behavioral, but their attitude is relatively positive. Nursing managers in cancer hospitals should strengthen training on lymphedema related knowledge among nurses from departments other than breast and gynecological oncology, strengthen nurses' knowledge and behavior in the prevention and treatment of lymphedema, and cultivate lymphedema therapists and specialized nurses. At the national level, policies should be introduced to establish a complete lymphedema rehabilitation training system, and improve nurses' ability to prevent and treat lymphedema in clinical practice.

OBJECTIVE To explore the role of runt-related transcription factor 3(RUNX3) in the tumorgenesis and progression of cervical carcinoma. METHODS The immunohistochemical staining technique was used to detect the expression of RUNX3 protein in 25 cases of normal cervix, 34 intraepithelia neoplasia (CIN), and 48 cervical carcinomas. SYBR Green I chimeric fluorescence Real-time PCR was applied to detect the expression of RUNX3 mRNA in 10 cases of normal cervix, 24 CIN, and 30 cervical carcinomas. RESULTS The expressions of RUNX3 protein and mRNA in normal cervix, CINI,CINII-III, and cervical carcinoma tissues tended to be down-regulated. There was significant difference among these groups (P<0.05). The expressions of RUNX3 protein and mRNA in the cervical carcinoma tissues were correlated with the histological differentiation, clinical stage, and lymphatic metastasis (P<0.05), but had no relationship with the age, high-risk human papillomavirus infection, and histological classification (P> 0.05). CONCLUSION RUNX3 may function as a tumor suppressor gene in the occurrence and progression of cervical carcinoma.
Adult ; Carcinoma, Squamous Cell ; genetics ; metabolism ; Cervical Intraepithelial Neoplasia ; genetics ; metabolism ; Core Binding Factor Alpha 3 Subunit ; genetics ; metabolism ; Disease Progression ; Female ; Humans ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Uterine Cervical Neoplasms ; genetics ; metabolism

Objective To evaluate the correlation between cerebral blood flow perfusion and memory impairment in patients with severe stenosis of vertebral basilar artery (VBA).Methods 62 cases of patients with VBA stenosis diagnosed by digital subtraction angiography(DSA) in Beijing Tiantan Hospital from September 2016 to March 2017 were enrolled.Mental State Examination (MMSE),Clinical Memory Scale (CMS) test and CT perfusion(CTP) was performed.All patients were divided into memory normal group(n=24,including 1 excellent case,6 above normal cases,and 14 normal cases) and memory impairment group(n =38,including 18 below normal cases,12 periphery cases,8 impaired cases) according to CMS.The ratios of side-to-side period were compared between bilateral mesial temporal lobe and anterior circulation area.The relative time to peak (rTTP),relative mean transit time(rMTY),relative cerebral blood flow(rCBF) and relative cerebral blood volume (rCBV) were calculate.Results The incidence of CTP decompensation in the medial temporal lobe was higher than that in the patients with memory impairment(P＜0.05).The difference of rTTP and rMTT value between the two groups in the bilateral medial temporal lobes was statistically significant (rTFP:(1.131 ±0.037),(1.437±0.139),t=10.520,P＜ 0.05);rMTT:(1.081 ±0.059),(1.281 ±0.174),t=5.423,P＜0.05).Conclusion The patients with VBA severe stenosis are more likely to get memory impairment due to cerebral hypoperfusion.