Objective To investigate the treatment of chronic heart failure in two communities in Pudong and find the deficiency of standardized treatment in community hospital.Methods A retrospective study of all the inpatient,family bed and outpatient with heart failure who visit Hudong and Lujiazui community health Service center was conducted from March 2012 to March 2015 retrospectively.General situation(gender,age,smoking history,drinking history,daily salt intake,concomitant disease),etiology and if have the acute heart failure onset in half a year and what are the incentives,drug treatment and treatment of concomitant hypertension and diabetes mellitus were analyzed by face to face follow up.Results The study included 300 patients,average age was (58 ± 10) years.Daily salt intake of 55.0％ (165/300)patients was more than 9 g.Coronary heart disease (45.7 ％,137/300),hypertension (30.7％,92/300)and cardiomyopathy (9.0％,27/300)were the chief heart failure etiology.59.3％ (178/300) patients had acute heart failure in half a year.Acute blood pressure(20.8％,37/178),transfusion too fast or too much and infection(14.6％,26/178) were the chief incentives leading to acute heart failure.83.3％ (250/300)patients used ACEI/ARB,but only 32.0％ (80/250) of them applied the target dose.53.7％ (161/300)patients used beta blockers and 98.1％ (158/161) of them could not reach the target dose.Tartaric acid metoprolol (51.6％,83/161),peso parlour (18.6％,30/161) and carvedilol (14.9％,24/161) were commonly used drug in clinic.76.6％ (230/300)patients had hypertension and blood pressure was controlled in 82.2％ (189/230) of them successfully.44.0％ (132/300) patients had diabetes mellitus and glycosylated hemoglobin (HbA1c) was controlled from 7 ％ to 8 ％ in 23.5 ％ (31/132) of them.Conclusion In the community treatment of heart failure,the drugs recommended by guidelines were low usage and achieved the target dose rarely.Treatment of concomitant diseases was not good.The knowledge of new progress was not enough.

Adolescent ; Attention ; drug effects ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; physiopathology ; Child ; Electroencephalography ; drug effects ; Female ; Follow-Up Studies ; Humans ; Male ; Psychomotor Performance ; Treatment Outcome

Objective To explore the changes of alveolar morphology and alveolar epithelial cells in rats with hyperoxia-induced chronic lung diseases (CLD). Methods CLD model in neonatal rats was established by inhalation of high concentration oxygen(85%～90% ). Eighty neonatal rats were randomly exposed to hyperoxia (model group) and to room air (control group) (n =40 each). Radical alveolar counts and the alveolar septum thickness were used to evaluate alveolar development. The site and intensity of expression of SPC,AQP5 protein were detected by immunohistochemical staining,the dynamic expression of SPC mRNA,AQP5mRNA was detected by RT-PCR on day 1,3,7,14 and 21 after exposure. Results There were no significant differences about alveolar wall thickness and RAC between experimental groups and control group on day 1～3 ( P > 0. 05 ). But there was significant difference between the model group and the control groups on day 7 and 14 (P <0. 01 ). For model group,alveolar septum thickness peaked on day 21, the difference was significant compared with control group ( 10. 62±5.01 vs 3.62±0. 88, P < 0. 001 ), but RAC decreased to the lowest level, the difference was significant compared with control group ( 3.57±1.24 vs 10. 47±0. 88,P <0. 001 ). The expression of SPC decreased on day 3 manifestedly but increased on day 7 and the levels of SPC were higher than that in the control group. Experimental group showed gradual decrease in AQP5 expression as the lung impairment devastated. Conclusion Alveolar development was delayed and alveolar epithelial cell (AEC) was damaged in the neonatal CLD rats. The changes of SPC,AQP5 expression suggested AECI was severely damaged and failed in full recovery, meanwhile the quantity of AEC Ⅱ was increased but the ability of its differentiation and transformation was decreased.

Objective To clinically analyze the incidence of early extrapulmonary complications in premature infants with bronchopulmonary dysplasia(BPD),including periventricular intraventricular hemorrhage(PVH-IVH),white matter injury(WMI),parenteral nutrition associated cholestasis(PNAC) and metabolic bone disease(MBD),in order to direct the prevention and monitoring of these complications in BPD patients.Methods The clinical data of premature infants who were admitted to the neonatal department between September 2014 and December 2015 was retrospectively analyzed.A total of 87 premature infants diagnosed with BPD were studied as BPD group,while other 90 premature infants without BPD who were hospitalized at the same time were randomly selected as non BPD group.The occurrence of several common extrapulmonary complications was compared between two groups,including PVH-IVH,WMI,PNAC and MBD.Results The incidence of PVH-IVH in BPD group increased compared with non BPD group[(26.4%(23/87) vs 11.1%(10/90)] (P＜0.01),grade Ⅰ-Ⅱ PVH-IVH was more often seen in the BPD group too[24.1%(21/87) vs.11.1%(10/90)](P＜0.05),although the difference between two groups regarding the incidence of grade Ⅲ-Ⅳ PVH-IVH was not significant (P＞0.05).The incidence of WMI in BPD group was much higher than that in non BPD group[33.3%(29/87) vs 16.7%(15/90)] (P＜0.05),especially periventricular leukomalacia,the severe type of WMI,was more often found in BPD group than that in non BPD group[13.7%(12/87) vs 2.2%(2/90)](P＜0.05).The incidences of PNAC[22.9%(20/87) vs 5.5%(5/90)],MBD[17.2%(15/87) vs 3.3%(3/90)] and MBD with imaging changes[6.9%(6/87) vs 0] were all higher in BPD group compared with non BPD group,with significant differences between the two groups (P＜0.05).Conclusion BPD patients are more likely to have early extrapulmonary complications like PVH-IVH,WMI,PNAC and MBD than other preterm infants.It is crucial to prevent these complications reasonably and monitor them regularly for the BPD patients in order to improve the quality of life.

In the basis of a large amount of literatures, this article sumed up the characteristics and application of eggshell membrane.

Objective To study the importance of back pain-lassitude as the key symptom in the differentiation of kidney-deficiency syndrome in diabetes patients.Methods Totally 460 diabetics were divided into the pain group(154 cases)and non-pain group(306 cases).The 39 symptoms,signs and behavior were abstracted and each patient was scored according to the details of kidney deficiency scale to analyze the constitution and distribution of kidney-deficiency syndrome.Results There was a significant difference in the total symptom score of the two groups(P

AIM:To observe the influence of Lycium barbarum polysaccharide (LBP) on the PI3K/Akt/eNOS signaling pathways in ovariectomized rat myocardium .METHODS:Female SD rats (n=30) were divided into sham oper-ation group , ovariectomized group , progynova group , high-dose LBP group and low-dose LBP group .The serum levels of estradiol, lactate dehydrogenase (LDH) and creatine kinase (CK) were measured by ELISA.The myocardial contents of H2 S and oxidative stress injury-related indicators were also detected .The morphological changes of the myocardium were observed with HE staining.The expression of eNOS and PI3K/Akt pathway-related proteins in the myocardium was deter-mined by Western blot .RESULTS: Compared with sham operation group , the serum level of estradiol , the content of H2 S, the activity of GSH-Px, and the expression of eNOS and PI3K/Akt pathway-related proteins in the myocardium in ovariectomized group were all decreased , and the levels of ROS and MDA in the myocardium were increased (P<0.05). The serum levels of LDH and CK were also increased .The arrangement of the myocardial cells was disordered , and the in-tercellular space was also increased in the ovariectomized group .Compared with ovariectomized group , the serum level of estradiol, the myocardial levels of H2S and GSH-Px, and the protein levels of eNOS and phosphorylated Akt were all in-creased in high dose group, while the levels of ROS and MDA in the myocardium were decreased (P<0.05).The serum levels of LDH and CK were also decreased .The morphological changes of the rat myocardium were improved in high dose group.CONCLUSION: LBP prevents and treats postmenopausal cardiovascular lesions through regulating PI 3K/Akt/eNOS signaling pathways in ovariectomized rats .

Objective:To understand the characteristics and practice of standardized training for resident in psychiatric department,providing a reference for other hospitals in the similar situation.Methods:Using qualitative method,in-depth interview and focus group interview were carried out with clinical teaching and teaching management experts of a tertiary hospital,to understand the characteristics,practice,and deficiencies of resident doctors standardized training for psychiatrists.Results:Focusing on clinical operation,psychotherapy,and communication capability were the major characteristics of resident doctors' standardized training for psychiatrists in this hospital.Though this hospital did positive trials on guarantee system improvement,outpatient and inpatient training combination,and training content expansion,it was not perfect enough in united training and training pattern.Conclusions:The psychiatry resident's standardized training for psychiatrists should establish complete standards of performance for united training,strengthen training mechanism and training mode,and make full use of modem distance education resources to further improve quality of the psychiatric residency training.

C8orf32 is a gene which has not been functionally characterized,the mRNA level of this gene is significantly higher in breast cancer tissues than that in normal breast tissues.The amplified cDNA fragment was inserted into the pGEX-6P1 vector fused with the upstream GST gene.The expression vector was transformed into the E.coli BL21(DE3) strain and expression of GST-C8orf32 fusion protein was induced by IPTG..After removal of GST tag by site-specific protease,the C8orf32 protein fused with an eight amino acid peptide tag was obtained.The purity of recombinant C8orf32 protein was about 95%.The identity of the purified protein was confirmed by N-terminal sequencing and tandem mass spectrometry.The polyclonal antibody was prepared by immunizing the New Zealand white rabbits with C8orf32 protein.The polyclonal antibody was proved to recognize the C8orf32 protein correctly.The purified C8orf32 protein can be used for structural and functional studies and the polyclonal antibody can be used for tissue specific protein expression profiling.

OBJECTIVETo observe the efficacy and safety of modified Shengma Biejia Decoction (MSBD) combined with CAG program in treating elderly acute myeloid leukemia (AML) patients with yin deficiency toxin stasis syndrome (YDTSS).

METHODSTotally 46 elderly AML patients were assigned to the treatment group (24 cases; treated with MSBD + CAG) and the control group (22 cases; treated with CAG + placebos of Chinese medicine) according to random digit table. The therapeutic course of CM placebo or MSBD was 21 days. The clinical efficacy and adverse reactions were observed. Meanwhile, physical state (ECOG Score), transfusion dependency, and TCM syndrome score were compared before and after treatment.

RESULTS(1) The complete remission rate was 54% (13/24) and the objective response rate (ORR) was 71% (17/24) in the treatment group, obviously higher than those of the control group [36% (8/22); 54% (13/24)], with statistical difference (P = 0.036, 0.042). When comparing the efficacy based on risk level, the moderate and poor ORR was 71% (10/14) and 67% (6/9) in the treatment group, and 57% (8/14) and 33% (2/6) in the control group, with statistical difference between the two groups (P = 0.048; P = 0.010). (2) Compared with before treatment in the same group, the ECOG score significantly decreased, the average infusion time of red cells and platelets were markedly prolonged in the treatment group after treatment (P < 0.05). ECOG score, the average infusion time of red cells and platelets were significantly better in the treatment group than in the control group after treatment (P < 0.05). (3) Compared with before treatment in the same group, scores of fever, hemorrhage, and bone pain were markedly reduced in the control group (P < 0.05); scores of fever, fatigue, hemorrhage, dry mouth, and bone pain were markedly reduced in the treatment group (P < 0.05). Better effect in relief of fever, fatigue, hemorrhage, dry mouth, and so on was obtained in the treatment group than in the control group (P < 0.05). (4) In aspect of hematotoxicity, the incidence of neutropenia, anemia, thrombocytopenia was obviously lower in the treatment group than in the control group [29.2% (7/24) vs 54.5% (12/22); 16.7% (4/ 24) vs 45.5% (10/22); 33.3% (8/24) vs 63.6% (14/22); P < 0.05]. The incidence of fatigue and anorexia was obviously lower in the treatment group than in the control group [37.5% (9/24) vs 63.6% (14/22), 37.5% (9/24) vs 81.8% (18/22); P < 0.05].

CONCLUSIONMSBD combined with CAG program in treating elderly AML patients with YDTSS, with efficacy enhancing toxicity reducing effect, had distinct advantages in improving physical condition and clinical symptoms, and reducing transfusion dependency.

Aclarubicin ; therapeutic use ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Medicine, Chinese Traditional ; Phytotherapy ; Yin Deficiency ; drug therapy