To investigate plasma N-terminal pro-brain natriuretic peptide (NT-BNP) levels and to assess their clinical significance in elderly patients with isolated diastolic dysfunction. Methods Plasma NT-BNP level were measured by electrochemiluminescence immunoassay in 34 symptomatic patients (Group 1), 34 asymptomatic patients (Group 2) with isolated diastolic dysfunction, and in 16elderly healthy subjects (control group, Group 3), serving controls. Colored Doppler echocardiography was performed to evaluate the patients' cardiac structures and functions. Results The plasma NT-BNP level in Group 1 was significantly higher than those in Group 2 and Group 3 and increased with the severity of heart failure. There was no significant difference of plasma NT-BNP levels between Group 2 and Group 3 (p＞0.05). A NT-BNP value of 102.75 pg/mL showed a sensitivity of 88.2%, a specificity of 87.5%, and an accuracy of 88.1% for diagnosing diastolic dysfunction. Patients with restrictive filling pattern on echocardiography had higher NTBNP levels than those of impaired relaxation pattern (1961.2±304.9 versus 460. 1±92.7pg/mL, p＜0.001). Conclusion The elevation of plasma NT-BNP level in elderly patients with isolated diastolic dysfunction correlates with the severity of their diastolic abnormalities.The level of plasma NT-BNP has an important clinical value in the diagnosis of elderly patients with isolated diastolic dysfunction.

Objective To develop the scale of volume-management for peritoneal dialysis(PD) patients.Methods The item pool was formulated based on literature review and in-depth interviews.An initial scale was constructed through two rounds of Delphi expert consultation and preliminary test.Totally 125 PD patients from Jiangsu-Zhejiang-Shanghai area were investigated to test the reliability and validity of the scale.Results 2 factors were extracted by exploratory factor analysis,which contained 8 items and could explain 66.07％ of the total variance.The content validity index was 1.0,the Cronbach α was 0.870,and test-retest reliability was 0.930.Conclusions The scale is proved to be a reliable and valid tool for the volume-management assessment of PD patients.

China ; History, 20th Century ; History, 21st Century ; Pathology ; Periodicals as Topic ; history

Basic life support ( BLS ) is a very important clinical skill for medical students. However,current BLS education is lack of proper BLS skills evaluation protocol to give educational feedback both to instructors and students. This article is aimed to discuss the necessity of protocol of skills evaluation in basic life support education for medical students prior to their internship.

OBJECTIVETo explore the repair of Xiangsha Liujunzi Decoction (XSLJZD) on interstitial cells of Cajal (ICC) and gap junction (GJ) in the gastric muscular layer of rats of Pi-qi deficiency syn- drome (PQDS).

METHODSPQDS was established using purgative method with bitter and cold drugs in 30 healthy Wistar rats. After successful modeling they were randomly divided into the treatment group and the model group, 15 in each group. Another 15 healthy Wistar rats were recruited as the healthy control group. Rats in the treatment group were gastric administered with XSLJZD at 2 mL/100 g body weight, once daily for 14 successive days. Equal volume of normal saline was gastrically administered to those in the healthy control group and the model group. The gastric muscle tissues were taken out before modeling, before intervention, and after intervention, respectively. Ultrastructural changes of ICC and GJ were observed using transmission electron microscope (TEM). The number and distribution of Connexin43 (Cx43) were detected using immunohistochemistry.

RESULTSResults of TEM indicated that compared with the healthy control group, both ICC and GJ in the model group showed obvious injury. ICC and GJ were apparently repaired after intervention in the treatment group. Compared with the same group before modeling, the integrated optical density (IOD) of the Cx43 expression significantly decreased in the model group before and after intervention (P <0.05). Compared with before intervention, the IOD of the Cx43 expression significantly increased in the treatment group (P <0.05). Compared with the healthy control group, the IOD of the Cx43 expression significantly decreased in the model group before and after intervention (P <0.05). Compared with the model group, the IOD of the Cx43 expression significantly increased in the treatment group (P <0.05).

CONCLUSIONSUltrastructures of ICC and GJ in the gastric muscular layer of rats of PQDS were obviously damaged. XSLJZD could repair the structural damage of ICC and GJ in the gastric muscle tissues of rats of PQDS.

Animals ; Connexin 43 ; Drugs, Chinese Herbal ; pharmacology ; Gap Junctions ; Interstitial Cells of Cajal ; drug effects ; Leydig Cells ; Male ; Muscle, Smooth ; Qi ; Rats, Wistar ; Syndrome

Objective To investigate the effects of "two-classroom" teaching mode of basic life support (BLS) training on medical staffs. Methods One hundred and ninety-nine medical staffs trained in BLS curriculum education from May to August 2018 were selected as the research subjects. They were divided into two groups according to random number table: "two-classroom" teaching mode group (102) and traditional teaching mode group (97). The medical staffs in the traditional teaching mode group were trained by the traditional mode, while those in the"two-classroom" teaching mode group were trained by the "two-classroom" teaching mode, including the first and second classes; the first class is in-class teaching, using the Chinese version of the original American Heart Association (AHA) textbook, whose contents included basic life support operation video observation, practical operation, scene simulation and other teaching modes to carry out classroom teaching, and the second class was mainly in the extracurricular scene simulation. After the training, the differences in teaching effects regarding theoretical knowledge test scores and operational skills test scores and the degrees of satisfaction between the two groups were compared. Results The theoretical and operational scores of the "two-classroom" teaching mode group were significantly higher than those of the traditional teaching mode group (theoretical scores: 92.10±2.40 vs. 83.4±2.5, operational scores: 91.10±2.20 vs. 82.23±2.13, both P < 0.05). The degree of satisfaction with the BLS training (including 5 parts: controllable learning time, good interaction, cooperative communication, autonomous learning ability, achieving teaching goals) in the medical staffs in the "two-classroom" teaching mode group were higher than those in the traditional teaching mode group (controllable learning time: 98.04±6.35 vs. 83.51±5.27, good interaction: 97.06±6.12 vs. 83.51±5.33, cooperative communication: 96.08±6.07 vs. 73.20±4.96, autonomous learning ability: 96.08±6.15 vs. 73.20±4.28 and achieving teaching goals: 98.04±6.27 vs. 79.38±4.62, all P < 0.05). Conclusion The "two-classroom" teaching mode is a scientific, practical, simple and convenient teaching method, which can improve the theoretical and operational performance grades of trainees, and the medical staffs are well satisfied with the "two-classroom" teaching mode of BLS.

Objective To observe the effect of S-adenosyl-L-methionine(SAMe) in treatment of jaundice in newborns and its mechanism.Methods Two hundred and two newborn infants with jaundice were treated with SAMe,76 cases in control group treated with phototherapy and liver enzyme induction elixir;SAMe 30-60 mg/(kg?d) were added to 202 cases intravenously in treatment group.The total biliorubin(T-BILI),direct bilinrubin(D-BILI) and indirect bilinrubin(I-BILI) were dynamically detected.Results Six days after treatment,the skin jaundice index in treatment group decreased remarkably.T-BILI,D-BILI and I-BILI decreased significantly.The curing effectiveness was higher in treatment group than that in control group.The number of applicating blood products and albumin,and blood produets/albumin were decreased in treatment group than those in control group.In those who used glucose to dissolve the SAMe 2.68% had blood-vessel phlebitis.Conclusions SAMe can efficiently quicken the retrogression of jaundice in newborns.It can reduce the use of blood products.It is a reliable and safe drug to treat jaundice in newborns.

Aim To investigate the expression of stro-mal interaction molecule 1 (STIM1) in rat pulmonary arterial hypertension ( PAH ) tissues and effects of STIM1 on arterial muscle cells proliferation. Methods PAH was induced by a single intraperitoneal injec-tion of MCT at a dose of 60 mg·kg - 1 . The mRNA or protein expressions of STIM1 in monocrotaline-induced pulmonary hypertensive rats were measured by real-time PCR or Western blot, respectively. The arterial smooth muscle cells A7R5 were transiently transfected with STIM1 plasmids to prepare STIM1 overexpressed cells. Cell proliferations were detected by using CCK-8 kits. The expressions of Akt/ mTOR pathway molecules of A7R5 were measured by Western blot. Results The right ventricular systolic blood pressure ( RVSP) and right ventricular mass index ( RVMI ) were markedly elevated in MCT-treated rats (P < 0. 01) in comparison to control rats. The mRNA and protein ex-pression levels of STIM1 in monocrotaline-induced pul-monary hypertensive rats were 2. 19 and 1. 66 folds of control rats, respectively. STIM1 were transiently over-expressed in cultured A7R5. Cells transfected with STIM1 grew more quickly than non-transfected control. Overexpression of STIM1 significantly increased the phosphorylation of Akt, mTOR, p70-S6K, and 4E-BP1, but did not change their protein expression lev-els. Conclusion STIM1 are over-expressed in rat PAH tissues. Overexpression of STIM1 can promote ar-terial smooth muscle cells proliferation by regulating Akt/ mTOR pathway.

ObjectiveTo observe the curative effect of galvanoiontophoresis combined with ultrashort wave therapy on cervical vertebrae disease-derived arrhythmia.Methods112 patients with cervical vertebrae disease-derived arrhythmia were randomly divided into the treatment group and control group with 56 cases in each group. All patients of two groups were treated with antiarrhythmia drug, Sibelium and traditional Chinese medicine. While, the patients of the treatment group were added with galvanoiontophoresis combined with ultrashort wave therapy to eliminate the aseptic inflammation.ResultsThe cure rate and total effective rate of the treatment group were 51.8% and 94.6%. Those of the control group were 16.1% and 76.8%. The effect of the treatment group was better than that of the control group significantly ( P<0.01).ConclusionThe galvanoiontophoresis combined with ultrashort wave therapy has a better effect on cervical vertebrae disease-derived arrhythmia.

Objective　To study the occurence, development and regulation of reactive gliosis with astrocyte (Ast) in vitro. Methods　Ast was isolated and cultured in vitro and its model of reactive gliosis was established by scratching the cultured astrocytes. The reactivity and rules of Ast to injury was studied by morphological changes, RT-PCR, immunocytochemistry, in situ hybridization and imaging analysis. Results　After scratching, the astrocytes showed typical features of reactive gliosis, with the hypertrophic cell body, thickened and lengtheded processes, and enhanced glial fibrillary acidic protein (GFAP) staining. In situ hybridization and RT-PCR analysis confirmed that the expression of GFAP mRNA was markedly increased. These changes occurred 1 d after scratching and reached the peak 5 to 7 d after injuring. Conclusion　A model of reactive astrogliosis was successfully established in vitro which showed an active reaction to injury. The characteristics of reactive gliosis parallel that seen in vivo.