Objective To analyze the effect of Shuxuetong injection on microcirculation in patients with septic shock and its therapeutic effect. Methods A prospective study was conducted. Eighty patients with septic shock treated in Department of Critical Care Medicine of Hebei Provincial Traditional Chinese Medical Hospital were randomly divided into a Shuxuetong group and a conventional therapy group according to random number table, 40 cases in each group. The conventional treatment in the two groups was energetically carried out in accord to the sepsis shock guidelines, such as positive fluid resuscitation, anti-infection, etc. In the Shuxuetong group, additionally Shuxuetong injection 6 mL in 5% glucose injection 250 mL intravenous drip was given once a day for 7 days. The levels of urine output, lactic acid (Lac), blood urea nitrogen (BUN), creatinine (Cr), aspartate aminotransferase (AST), alanine aminotransferase (ALT), left ventricular ejection fraction (LVEF), and cardiac index (CI) in the two groups were observed before and after treatment; the total dosages of dopamine, dobutamine, noradrenaline, etc. vascoactive agent used for the patients and 28-day mortality in the two groups were also recorded. Results The comparisons of levels of urine output, Lac, BUN, Cr, AST, ALT, LVEF, and CI before treatment between the two groups were of no statistical significant differences (all P>0.05). After treatment in the two groups, the urine output, LVEF, and CI were increased compared with those before treatment, whereas the Lac, BUN, Cr, AST, and ALT were significantly decreased, and the changes were more obvious in Shuxuetong group [urine output (mL/h):112.1±39.8 vs. 73.3±28.5, LVEF:0.49±0.15 vs. 0.44±0.14, CI (mL·s-1·m-2):66.2±5.7 vs. 54.2±6.2, Lac (mmol/L):3.83±1.65 vs. 4.72±2.25, BUN (mmol/L):7.1±2.7 vs. 9.3±3.5, Cr (μmol/L): 73.9±16.2 vs. 95.7±15.8, AST (U/L): 39.8±9.5 vs. 45.8±12.7, ALT (U/L):34.3±9.7 vs. 41.7±11.3, all P<0.05]. The total dosages of all kinds of vascoactive agent of Shuxuetong group were remarkably less than those in the conventional therapy group [dopamine (mg): 993.1±261.7 vs. 1 340.9±356.4, dobutamine (mg):776.2±281.0 vs. 1 049.2±364.3, noradrenaline (mg):56.4±34.6 vs. 107.6±51.3, all P<0.05]. The 28-day mortality of Shuxuetong group was obviously lower than that of conventional therapy group [40.0%(16/40) vs. 60.0%(24/40), P<0.05]. Conclusion Shuxuetong injection can improve the microcirculation perfusion in patients with septic shock and reduce their mortality.

Objective To explore the eating behaviors associated with refractory functional dyspepsia (RFD).Methods In this multicenter,prospective trial,1341 new outpatients with functional dyspepsia (FD) from three Guangdong hospitals who had been diagnosed according to the Rome Ⅲ criteria were enrolled from May to September in 2012.One hundred healthy volunteers were also enrolled as controls.A questionnaire was used to obtain data,and logistic regression analysis was used for analysis.Results ①RFD was diagnosed in 24.4％ of the FD patients.②Unhealthy eating behaviors were significantly greater in patients with RFD and non-RFD than in the normal controls.Patients with RFD skipped meals more often,ate extra meals,and preferred sweets and gasproducing foods (P ＜ 0.05).③A comparison among the non-RFD subtypes,showed that those with epigastric pain syndrome had a greater preference for spicy foods (47.5 ％ vs 35.7 ％,P ＜ 0.05),and those with postprandial distress syndrome had a greater preference for sweets(50.0％ vs 36.4％,P ＜ 0.05) and gas-producing foods (14.9％ vs 7.1％,P＜0.05).Those with both subtypes skipped more meals (30.1％ vs 17.0％,P ＜ 0.05),and ate extra meals (15.0％ vs 6.5％,P＜0.05).④Logistic regression analysis showed that meal skipping(95％ CI,1.177 ～2.272; P=0.003),eating extra meals (95％ CI,1.015 ～2.604; P =0.043),and a preference for sweets (95 ％ CI,1.040 ～ 1.757 ; P =0.024) and gas-producing foods (95 ％ CI,1.022 ～ 2.306 ; P =0.039) were risk factors for RFD.Conclusion Unhealthy eating behaviors,especially,meal skipping,eating extra meals,preferring sweets and gas-producing foods correlate with RFD and these behaviors may be the key reasons for the refractory characteristic of RFD.

This study aims to investigate the effect of total flavones of Fructus Chorspondiatis (TFFC) on the mRNA and protein expression of collagen type I and III of rat cardiac fibroblasts (CFs) induced by angiotensin II (Ang II), and explore its anti-myocardial fibrosis molecular mechanism. Neonatal rat CFs were prepared from Sprague-Dawley rats (1-3 d after birth). The expression of collagen type I and III mRNA and protein were measured by RT-PCR and Western blotting, respectively. The study showed that stimulation of neonatal rat CFs with 100 nmol.L-1 of Ang II for 72 h resulted in a significant increase of the expression of collagen type I and III mRNA and protein. The changes on the expression level were blocked by TFFC. The results demonstrated that TFFC can inhibit myocardial fibrosis induced by Ang II in rats, which is probably associated with the collagen type I and III mRNA and protein levels up-regulated by Ang II, and TFFC was shown to decrease the expression levels of collagen type I and III mRNA and protein.

Objective To learn the present efficiency of medical equipments at public hospitals in Liaoning province, and provide scientific basis for rational distribution of such resources, and for control of medical expenses.Methods Data envelop analysis (DEA) was used to appraise the deployment efficiency of 2 784 such equipments worth over 100 000 yuan per unit, with equipments randomly sampled from 31 public hospitals in the province.Results The equipment deployment at public hospitals in Liaoning was found at a low level.9.7% of the hospitals were found as relatively efficient, 3.2% of them as in relatively weak efficiency, while 87.1% of them relatively inefficient.Gaps were found between urban hospitals and tertiary hospitals, and rural hospitals and secondary hospitals in their deployment efficiency, as evidenced in overinvestment of equipments and insufficiency of competent operators.Conclusions Hospitals should strengthen their scientific management of the equipments, and emphasize human resource investment, thus elevating the efficiency of equipment deployment.

Background Light-induced retinal damage models vary as many influence factors,herein the modeling method is difficult to copy.It is necessary to establish the grading standardization of retinal damage after retinal light exposure.Objective This study was to improve the modeling method and establish a grading standardization for light-induced retinal damage in rat.Methods Twenty-four SPF 8-10 week-old male SD rats were randomly divided into 4 groups and 6 eyes for each group.The rats were exposed to light intense of 5000 lx for 1,2,3 hours respectively in 3 groups,and other 6 rats served as the normal group.Full-field light exposure experiment was performed for each individual rat separately,and an annular illumination box was used tO ensure the experimental rat moving in a single direction and exposing the right eye in 5000 lx light surrounding during experimental duration.Ganzfeid electroretinogram(ERG)was recorded from the experimental rats at the fifth day after light exposure,and the animals were then sacrificed for histopathology observation to evaluate the retinal thickness change.All procedures which involved animals adhered to the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research.Results After exposing to intensity light for 1,2,3 hours,the b-wave amplitudes of rod response,maximal mixed response,oscillatory potential in scotopic ERG as well as cone response,20 Hz flicker response of photopic ERG were significant declined as lapse of light exposure time(F=71.690,P=0.000；F=56.250,P=0.000；F=23.610,P=0.000：F=27.130,P=0.000；F=27.030,P=0.000)and lowed by 26.2％,52.5％,70.7％,24.4％,39.3％,58.1％respectively at the end of experiment.Meanwhile,the b-wave latencies of rod response,maximal mixed response in scotopic ERG as well as cone response of photopic ERG were evidently different among different groups (F=1.370,P=0.282；F：0.800,P=0.508；F=11.840,P=0.000；F=2.080,P=0.136).Light induced retinal damage located mainly at the temporal retina area.After intensity light exposure for 1,2,3 hours,the thickness of outer nuclear layer at the superior temporal retina attenuated by 11.3％,25.6％and 72.5％,respectively(P<0.05).A significant difference was seen in mean thickness of outer nuclear layer at superior temporal retina among different groups(F=410.27,P=0.000). Conclusion A standardized grading method for light-induced retinal damage is recommended.The continuous illumination in a intensity of 5000 Ix for 1,2,3 hours can induce the mild,moderate or severe retinal damage respectively at temporal retina.

Background Pupillary light reflex has been widely used in the diagnosis and evaluation of visual system and nervous system diseases.However,in animal experiments,functional evaluation of the visual system and nervous system needs more advanced technology and are affected by many factors.Objective This study was to explore the use of the dynamic pupillometer in evaluating pupillary light reflex and to discuss the influence of brightness of stimulate on relevant curve parameters in C57BL/6 mouse.Methods Ten healthy SPF male C57BL/6 mice were collected in this experiment.White light of five luminance levels (2,8,32,128,256 cd/m2) was used to stimulate the mice following a 2-hour dark adaptation.The stimulation was given at the 60-second intervals,for a duration of 100 ms at every stimulation.An infrared camera and video capture card were used to capture digital images during the measuring process in a scotopic environment,at a speed of 60 frames per second.Measuring outcome was saved in the*.AVI format.A software that was developed by our group was used to determine pupil diameter and output pupillary light reflex curve offline.Pupil initial diameter (R1),constriction amplitude (CA),constriction velocity (CV),latency (T1),time for maximum velocity (T2),time for maximum constriction (T3),time for maximun con-striction to 10.1％ R1 re-dilation (RT)and re-dilation velocity (RV)were assessed,and the correlations between luminosity and measuring parameters were analyzed using the Spearman rank correlation.The use of animals followed the Regulations for thd Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results R1 values showed no statistically significant difference among the 5 different luminosity groups(F=1.117,P=0.361).A positive linear correlation was found between stimulating luminosity and CA(r=0.508,P＜ 0.01),but negative correlations were seen between stimulating luminosity and CV or RV (r=-0.625,-0.609,P＜0.01).T1 and T2 values in the 5 different luminosity groups were not statistically significant (F =0.202,P =0.936 ; F =1.584,P =0.195).The different levels of stimulating luminosity showed positive linear correlations with T3 and RT values (r =0.791,0.609,P＜ 0.01).Conclusions The dynamic pupillometer can quantitatively measure the pupillary light reflex of C57BL/6 mice.The pupillary light reflex dynamic curve parameters of mouse were affected by stimulus luminosity levels.These outcomes offer a basis for the application of the dynamic pupillometer system for measuring pupillary light reflex in animal models.

This paper introduces the nursing care of two children with type 1 diabetes during continuous glucose monitoring. In addition to psychological care,diet instruction and insulin therapy,the nurses actively communicated with the children and their parents,introduced the principle and advantages of continuous glucose monitoring system (CGMS) to promote the children and parents to cooperate with the medical staff. Moreover,the insert site of CGMS was changed from inferior abdomen to up-per lateral buttock according to the physiological character of children. As a result,the CGMS was completed successfully in the 2 eases,which provided reliable reference for the regulation of treatment plan.

Objective To investigate clinical characteristics,quality of life,and psychological factors in functional dyspepsia (FD) patients with weight loss.Methods A multi-center and prospective investigation was conducted (Clinical trial registration number:ChiCTR-TRC-12001968) which recruited 1341 consecutive FD outpatients from three Guangdong hospitals according to Rome Ⅲ criteria between June and September in 2012.Of these,1057 patients with complete information were divided into group A as having weight loss more than 5％ (n =207) and group B as having weight loss less than 5％ (n =850).Nepean Dyspepsia Index-symptom checklist,appetite,Hamilton Rating Scale of Anxiety/Depression (HAMA/HAMD),Pittsburgh Sleep Quality Index (PSQI),Nepean Dyspepsia Index-quality of life,direct medical costs were used to compare the differences between the two groups.Results There were no significant differences in total scores of NDI-symptom checklist,the severity or bothersome items between two groups (t =-1.301、-0.918、0.138,P =0.193、0.359、0.890),but significant differences were observed in the frequence item and the rating of appetite as poor or very poor between two groups (t =-2.122,P =0.035 ;x2 =35.448,P =0.000 ;x2 =35.274,P =0.000).Significant differences were observed in the incidence of anxiety and depression and total scores of PSQI between the two groups (x2 =73.939,P =0.000;x2 =47.046,P =0.000 ; t =-4.904,P =0.000).Subscales scores of NDI-quality of life in group B were all significantly higher than those in group A (t =5.348、2.569、5.809、4.704,P =0.000、0.010、0.000、0.000).There were significant differences in the frequency of care-seeking and direct medical costs between the two groups (t =-4.860、-3.011,P =0.000、0.003).The frequency of gastroscopic examinations in group A was slightly higher than that in group B (t =-1.505,P =0.133).Conclusion FD patients with weight loss is not rare,and most of them have psychological disorders,loss of appetite and sleep disturbance.Moreover,care-seeking are more frequent,direct medical costs are more expensive,and impairment as assessed by NDI-QOL is more severe.Therefore,we should pay more attention to FD with weight loss in clinical setting.

BACKGROUND: Valsartan is an antagonist of angiotensin Ⅱ (Ang Ⅱ ) receptor. Many researches have proved that it can protect heart tissue. Val-PREST suggests that valsartan with a long-term administration can decrease restenosis rate in stent; however, effect of valsartan on restenosis rate of Chinese population is still unclear presently.OBJECTIVE: To evaluate the effect of oral valsartan for 6 months on patients with coronary heart disease (CHD) who undertook successful intervention therapy.DESIGN: Multicenter, double blind, randomized, and controlled evaluation and prospective design.SETTING: Beijing Friendship Hospital Affiliated to Capital Medical University; Beijing Anzhen Hospital Affiliated to Capital Medical University; Peking Union Hospital; People's Hospital of Peking University; Beijing Tongren Hospital Affiliated to Capital Medical University; Beijing Shijingshan Hospital; Beijing Fuxing Hospital Affiliated to Capital Medical University;Beijing Chuiyangliu Hospital.PARTICIPANTS: Eight three-grade A hospitals in Beijing participated in the study. Since December 2002 to October 2003, a total of 200 patients who underwent bare mental stent implantation were consented, but 196 patients were recruited in the end. All 196 patients were randomized into valsartan group (100 cases) and control group (96 cases).METHODS: Basic medicines in the two group included aspirin, clopidogrel, nitrides, statins, β-receptor antagonists, calcium channel antagonists, etc. Additionally, Patients in valsartan group were also given valsartan (Beijing Nuohua Pharmaceutical Co. Ltd., batch number: SD 34004) in a dosage of 80 mg a day. Both groups were followed-up once a month for total 6 months.MAIN OUTCOME MEASURES: ① Major adverse cardiac events within 6 months on clinics (death, non-fatal myocardial infarction, hospitalisation once more due to recurrent myocardial ischemia, and target vessel revascularization); ② Results of duplicated coronary angiography or exercise treadmill test (ETT) of partial patients within 6 months.RESULTS: ① Two patients (2%) in valsartan group were excluded in this study because of intolerance, so 194 patients were involved in the final analysis. ② No significant differences of baseline characteristics in terms of lesion type, the number of diseased vessels and the cardiac function were found between the two groups (P ＜ 0.05). ③ During the period of 6-month follow-up, one case died in control group. One acute myocardial infarction occurred in each group, whilst one case undertook target vessel revascularization in valsartan group. It was found that the proportion of recurrent cardiac events was lower in valsartan group than that in control group (11.2% vs. 15.6%). However, this difference did not reach the statistic significance. ④ During the period of 6-month duplicated contrast examination, one case had restenosis of in-stent in valsartan group. ⑤ The positive rate of exercise treadmill test (ETT) was lower in valsartan group (25.7%) than that in control group (36.4%), but there was no statistic difference.CONCLUSION: Six-month oral valsartan on patients with coronary heart disease who undertook successful intervention therapy can decrease the trend of recurrent cardiac events and positive rate of ETT.

Objective To analyze the risk factors of retinopathy and nephropathy in hospitalized patients with type 2 diabetics. Methods 24 h-urinary albumin was measured in 2 338 patients with type 2 diabetic hospitalized from July, 2002 to Sep, 2008 in our hospital. All the subjects were divided into normalbuminuria group (NA) and diabetic nephropathy group (DN), the latter consisted of microalbuminuria group (MAU) and macroalbuminuria group (CAU). All the patients were divided into normal retina group (NR) and diabetic retinopathy group (DR), the latter consisted of background diabetic retinopathy group (BDR) and proliferative diabetic retinopathy group (PDR) according to fundus photography. Results (1) The percentages of DR and DN of this cohort were 28.8% and 28.7%, respectively.The percentage of DR and DN had no statistical difference between male and female (27.8% vs 30.0%;29.6% vs 27.6%, P>0.05). (2) The percentage of DR was 23.1%, 37.7% and 56.6% in NA, MAU and CAU group, respectively. There was significant difference among different albuminuria group (P<0.01). (3) The percentage of DN was 23.1%, 41.1% and 59.3% in NR, BDR and PDR group, respectively. There was significant difference among different DR group (P<0.01). (4) Combined with DN, diabetes duration, systolic pressure, hemoglobin A1C, triglyceride were independently associated with DR by Logistic regression analysis. Meanwhile, combined with DR, systolic pressure, hemoglobin A1C, and triglyceride were all independently associated with DN. Conclusions The onset and progression of microvascular complications in type 2 diabetic patiens are correlated with hemoglobin A1C and systolic pressure. Diabetic retinopathy is closely correlated with diabetic nephropathy.