Objective To investigate the cardiomyocyte apoptosis and protein expressions of bcl-2 and bax in adriamycin (ADM)-induced myocardial damage in rats treated with neuregulin-1? (NRG-1?).Methods Sixty male SD rats weighing 200 to 250 g were randomly divided into 3 groups:control,ADR-DCM and ADR+NRG groups.ADR-DCM group (n=20) was weekly injected 2.0 mg/kg of ADR via tail vein once a week for 8 weeks to produce cardiomyopathy.The rats of ADR+NRG group (n=20) was given an injection of NRG-1? at 10 ?g/(kg?d) via tail vein for 5 d after the establishment of cardiomyopathy by ADR injection.The animals from control group (n=20) received 2 ml/kg normal saline by injection,once a week for 8 weeks.Nine weeks later,rats were executed under anesthesia and their heart was resected.Apoptotic cardiomyocytes were detected by using the terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) method.The expressions of bcl-2 and bax protein were determined by Western blotting.Results The index of apoptotic cardiomyocytes was increased significantly in ADR-DCM group and ADR+NRG group compared with control group (P

Objective To study the adriamycin(ADR)-induced expression of ErbB4 in and apoptosis of cardiac muscle cells of rats with dilated cardiomyopathy and their intervention with neuregulin-1?.Methods Sixty male SD rats,weighing 200-250 g,were randomly divided into ADR 1 group(n=10),ADR 2 group(n=20),ADR+neuregulin-1? group(n=20),and normal control(NC) group(n=10).Rats in ADR1 and ADR2 groups were injected with 2.0 mg/kg of ADR through the tail vein,once a week for 8 and 12 weeks,respectively.Rats in ADR+neuregulin-1? group were injected with 2.0mg/kg of ADR through the tail vein,once a week for 8 weeks,followed by neuregulin-1? [10 ?g/(kg?d)],once a day for 5 d.Rats in NC group received normal saline [2 ml/(kg?d)],once a week for 8 weeks.Expression of ErbB4 was detected by Wes-tern blotting.Lesions of cardiac muscle were scored with HE staining.Apoptosis of cardiac muscle cells was detected with the TUNEL method.Results The apoptotic index of cardiac muscle cells was significantly lower in ADR+neuregulin-1? group than in ADR 1 group(P

Objective To compare the clinical efficacy of seretide (50 μg/500 μg salmeterol/fluticasone propionate) with seretide (50 μg/250 μg salmeterol/fluticasone propionate) in single inhaler in the treatment of patients with stable status moderate to severe chronic obstructive pulmonary disease (COPD)Methods Sixty patients with COPD were randomly divided into the treatment and the control groups.Baseline treatments were similar in all patients,patients in the treatment group received seretide (50 μg/500 μg) while the control group received seretide (50 μg/250 μg) inhalation once every 12 hours for 24 weeks Before and after the therapeutic course,tests for lung function in patients of the two groups were conducted and compared with each other.Clinical symptoms and physical signs were graded by questionnaire.Results There was no significant difference on indexes of lung function between the two groups at baseline (P ＞ 0.05).After treatment,the score of clinical symptoms and signs in the treatment group was lower than that in the control group ((4.0 ± 0.5) vs.(4.8 ± 0.3),t =2.63,P ＜ 0.05).Six minutes walking distance was longer in the treatment group than that in the control group ((451.6±22.9) meter vs.(401.2 ±25.4) meter,t =2.51,P ＜0.05).The levels of forced exhaled gas volume 1 (FEV1),FEV1/forced vital capacity (FVC) and FEV1/pred in the treatment group were higher than those in the control group ([FEV1:(2.18 ± 0.38) L vs.(1.78 ± 0.45) L;FEV1/pred:(63.19 ±9.08)％ vs.(57.19 ±9.25)％; FEV1/FVC％:(73.8 ±5.6)％ vs.(67.3 ± 11.5)％ ;P ＜ 0.05).Conclnsion High dosage of seretide had better effect in the treatment of stable moderate and severe COPD,and can obviously improve patients' lung function,clinical symptoms and quality of life.

At present,intravenous thrombolysis within 4.5 h is still the most effective method in treatment of acute ischemic stroke.For those who do not meet the criteria of intravenous thrombolytic therapy,do not have significant improvement after intravenous thrombolysis and even worse,endovascular interventional therapy is a safe alternative treatment method.Arterial mechanical thrombectomy devices can achieve rapid and complete recanalization and provide more treatment options for patients with acute ischemic stroke.This article reviews the related technical evolution and clinical trials of mechanical thrombectomy devices.

Objective To explore effect of different postures for PICC intubation through basilic vein in very low birth weight infants. Methods Eighty infants from Oct. 2013 to Sep. 2014 with PICC via basilic vein were set as the control group in which traditional method of preventing catheter displacement was applied, another 80 cases from Oct. 2014 to Sep. 2015 were divided to the observation group. And improved method was applied in the experiment group besides the traditional method. The ectopic occurrence rates of the two groups were compared. Result The ectopic rate of PICC catheters in the observation group was significantly lower than that of the control group (P<0.05). Conclusion When the catheter tip reaches the shoulder of the very low birth weight infants, the method of raising their upper limbs slightly to the head can reduce the ectopic incidence of catheters and thereby improve the success rate of PICC intubation.

[ ABSTRACT ] AIM: To investigate the molecular mechanisms of cytotoxicity induced by dihydroartemisinin ( DHA) in non-small cell lung cancer ( NSCLC) cells.METHODS:NSCLC cell lines A549 and NCI-H1650 were treated with various concentrations of DHA for indicated time.Subsequently, the effects of DHA on the cell activity, colony forma-tion ability and apoptosis were determined by MTT assay, colony formation assay, Annexin V-FITC/PI staining and flow cy-tometry, respectively.At the same time, the effects of DHA on glucose, ATP and lactate levels were assessed, and the PI3K pathway activation and glucose transporter 2 ( GLUT2) expression were detected by Western blot in the A549 cells and NCI-H1650 cells.Overexpression of GLUT2 and Rheb was established in A549 and NCI-H1650 cells by transfection with GST-GLUT2 and GST-Rheb plasmids, respectively, and the effects of DHA on cell activity, apoptosis, glucose level, ATP content and PI3K pathway activation were analyzed in A549 cells and NCI-H1650 cells.The effect of glucose depriva-tion on the cytotoxicity triggered by DHA in NSCLC cells was also determined.RESULTS:Compared with control group, DHA significantly inhibited cell activity and colony formation ability, and induced remarkable cell apoptosis in the A549 cells and NCI-H1650 cells.At the same time, DHA reduced ATP and lactate contents, and hindered glucose uptake in a time-and dose-dependent manner in A549 cells and NCI-H1650 cells.The activity of PI3K pathway and GLUT2 expression were downregulated, while upregulated GLUT2 expression and activated PI3K pathway reduced the cytotoxicity induced by DHA in NSCLC cells.Glucose deprivation increased DHA-mediated cytotoxicity in NSCLC cells.On the contrary, high levels of glucose inhibited DHA-mediated cytotoxicity in NSCLC cells.CONCLUSION: DHA restrains cell activity and colony formation, and induces apoptosis.DHA induces cytotoxicity via inhibiting PI3K pathway activation and GLUT2 ex-pression, leading to inhibit glycolytic metabolism in NSCLC cells.

Objective To evaluate the safety and efficacy of low-dose platelet glycoprotein Ⅱb/Ⅲa antagonist tirofiban on preventing reocclusion during mechanical thrombectomy (MT) for in situ thrombosis(IST).Methods It is a retrospective cohort study, and 112 patients treated with MT, from the Nanjing Prospective Stroke Registration, were enrolled from February 2014 to October 2014. During MT, if angiography after a successful recanalization(defined as Thrombolysis In Cerebral Infarction(TICI) 2b/3) showed residual stenosis at the site of occlusion, additional angiographies were made every 10 min for 30 min.Then, if angiography displayed reocclusion in the corresponding vessels, a repeat recanalization was operated, followed by a low dose intra-arterial tirofiban infusion. MRA or CT angiography (CTA) was implemented to identify intracranial atherosclerosis (ICAS) 5-7 days after the procedure. The patients with confirmed ICAS were enrolled in the IST group. The rest were enrolled in the non-in situ thrombosis (NIST) group.Results A total of 80 patients with acute cerebral infarction were enrolled in the study. IST rate was 32.5%(26/80).All IST patients were confirmed ICAS by follow-up vascular imaging. Instant reocclusion after successful recanalization was significantly more common in the IST group(57.7%(15/26) vs 3.7%(2/54);χ2=30.568, P=0.000) than in the NIST group.In the case of the efficacy and safety of low-dose intra-arterial tirofiban infusion, 82.6%(19/23) of the reocclusion patients eventually accomplished TICI 2b/3, the rest 17.4%(4/23) of the cases were intractable to the procedure and needed rescue stent implantation.The modified Rankin Scale scores in patients infusing tirofiban were superior to the unused patients in 90 days. There was no patient with symptomatic intracranial hemorrhage after the procedure. Conclusions Patients with IST have higher cerebrovascular reocclusion rate during MT. After MT, low-dose intra-arterial tirofiban infusion may prevent reocclusion, and the prognosis is better.

BACKGROUND: Traditional repair for Achilles tendon rupture has disadvantages of long cast immobilization times, poor outcomes and many complications.OBJECTIVE: To explore the safety and efficacy of early isokinetic rehabilitation training for patients after repair of Achilles tendon ruptures.METHODS: A total of 11 patients with Achilles tendon ruptures received treatments at the Department of Orthopedics, East District of Qingdao Municipal Hospital, from September 2007 to September 2009, were included. Nine of them underwent 8-week isokinetic exercises by using lsomed-2000 at 4 weeks after tendon repair. The evaluative indicators included Arner-Lindholm score, the ankle range of motion, and extensor-flexor peak torque.RESULTS AND CONCLUSION: The follow-up averaged 6 months, ranging from 3 to 12 months. The excellent and good rate of Arner-Lindholm score was 88.9%. The results showed a significant improvement in the ankle range of motion and extensor-flexor peak torque (P < 0.05). There were no infection or re-rupture cases. It is indicated that early isokinetic rehabilitation is safe and effective for patients with Achilles tendon ruptures at 4 weeks postoperatively. It provides evidence for early rehabilitation in patients with Achilles tendon ruptures.

Objective To investigate the value of bone marrow imprint in the diagnosis of plasma cell myeloma and the remission rate after chemotherapy.Methods Bone marrow aspiration,bone marrow imprint,and bone marrow biopsy of plasma cell myeloma with 128 patients were collected.The bone marrow biopsy was used as the standard.Bone marrow imprint was compared to bone marrow aspiration in bone marrow nucleated cells quantity,infiltration degree,and diagnostic coincidence rate.Sensitivity,specificity,positive predictive value,and Youden index were evaluated.Results The results of bone marrow imprint showed that the number of nucleated cells was better than that of bone marrow aspiration (P ＜ 0.05),and was similar to that of bone marrow biopsy (P ＞ 0.05).Bone marrow biopsy combined with CD38 (+) showed the degree of infiltration of bone marrow as the standard,and the bone marrow imprint was better than that of bone marrow aspiration (P ＜ 0.05),and was similar to that of bone marrow biopsy (P ＞0.05).To evaluate the compliance rate of bone marrow infiltration in bone marrow imprint:In phase Ⅰ,the compliance rate of bone marrow aspiration was 95.83％ (23/24) and bone marrow imprint of 91.67％ (22/24),the difference was not statistically significant (P ＞ 0.05);In phase Ⅱ,bone marrow imprint coincidence rate was 92.86％ (65/70),which was significantly higher than that of bone marrow aspiration in 65.71％ (46/70) (P ＜0.05);In phase Ⅲ,bone marrow imprint coincidence rate was 79.41％ (27/34),which was significantly higher than that of bone marrow aspiration in 44.12％ (15/34) (P ＜ 0.05).The other parameters,such as sensitivity,specificity,positive predictive value,and Youden index were better than those of bone marrow aspiration.Conclusions Bone marrow imprint has characteristics that both bone marrow aspiration and bone marrow biopsy have.It has obvious advantages in diagnosis of plasma cell myeloma and monitoring the remission after chemotherapy.

Objective To investigate the clinical effect of angioplasty for symptomatic intracranial atherosclerotic stenosis. Methods Eighty-two patients with symptomatic intracranial atherosclerotic stenosis whom underwent angioplasty after the failure of standard medical therapy were enrolled from Nan-jing Stroke Registry Program from September 2010 to June 2013.Nine of them underwent routine balloon angioplasty alone and 73 underwent intracranial stenting.The median time from onset to surgery was 24.5 days.The occurrence of endpoint events (any stroke ≤30 d after procedure,death and ischemic stroke >30 d in guilty vessels or original stenosis had restenosis and needed to be treated again)was assessed. The incidence of restenosis was followed up with imaging (CTA or DSA). Results (1)In the 82 patients, the success rate of operation was 92.7%(n=72 ),and 78 (95.1%)received follow-up,4 were lost to follow-up.The median follow-up time was 22.5 months (range 9 to 29 months ).Ten patients had an endpoint event,7 of them were ischemic stroke,1 was cerebral hemorrhage,and two were severe asymptomatic restenosis who underwent stenting again.The endpoint events of 3 patients occurred at day 30 after procedure (at ≤24 h after procedure).Kaplan-Meier curves showed that the incidences of cumulative endpoint events at 1,6,12,and 24 months were 3.7%,8.6%,11%,and 13%,respectively.(2)60 patients (73.2%)received imaging examination (11 CTA and 49 DSA ).Restenosis occurred in 17 patients (28.3%),among them the incidence of symptomatic restenosis was 5%(n =3 ),and asymptomatic restenosis was 23.3%(n=14). Conclusion After a comprehensive assessment and a rigorous screening, the safety is high and the mid- and long-term efficacy are satisfactory in patients with symptomatic intracranial arterial stenosis who are treated with angioplasty when their medical treatment is invalid.