Aim To study the receptor mechanism of carvedilol(CAR) on heart failure.Methods Established rat model of heart failure was induced by abdominal aortic coarctation.With modified Langendorff model of rat,isoproterenol(ISO),carvedilol,propranolol(PRL) and the specific ?3 adrenergic receptor(?3AR) blocker SR59230A were given perfusion on heart failure and normal rats' hearts.Then the cardiac function was investigated.At the same time,plasma norepinephrine in normal and heart failure group was measured.Results ① The ?dp/dtmax of heart failure group were significantly reduced compared with those of the normal group,and the norepinephrine level was remarkably higher than that of the normal group.② In heart failure group,perfused PRL on the basis of ISO,the maximum rate of left ventricular pressure rise(+dp/dtmax) decreased by 40.37%? 2.52%,the maximum rate of left ventricular pressure decrease(-dp/dtmax) reduced by 41.36%?1.10%;perfused CAR on the basis of ISO,+dp/dtmax decreased by 24.73%? 3.60%,-dp/dtmax reduced by 22.05%?1.27%.There were differences between these two groups,and the cardiac function perfused CAR was better than PRL.③ Perfused CAR in heart failure group,+dp/dtmax increased by 41.57%?14.98%,-dp/dtmax increased by 33.39%?6.41%;perfused ?3AR specific blocker SR59230A,+dp/dtmax increase by 45.75% ?2.64%,-dp/dtmax increased by 42.81% ?9.62%.There were no differences between these two groups.Conclusion Another receptor mechanism of CAR in heart failure model was probably blocked by ?3AR.

Liver plays a central role in regulation of nutrition.Due to metabolic abnormalities,patients with end-stage liver disease often demonstrate undernutrition,which has a close relationship with the prognosis of the patients.Correct nutritional assessment and nutrition support is therefore very important.Dietary intake alone could not meet the nutritional needs of patients with end-stage liver disease.In recent years,the use of enteral and parenteral nutrition formulation has significantly improved the nutritional status of such patients,but there still lacks a gold standard. How to develop appropriate nutrition support regimens is a challenge for clinicians.This paper summarizes nutrition-related issues in patients with end-stage liver disease,aiming to provide a reference for individualized nutritional intervention for patients with end-stage liver disease.

Objective To investigate the effect of urotensin Ⅱ on myocardial fibrosis in rats.Methods The pressure overload animal model was established in rats by abdominal aorta coarctation.The rats were divided into sham operation group,modeled for 4,8 and 12 weeks group.The expression of U Ⅱ,GPR14,col-Ⅰ,col-Ⅲ,and PKA in cardiac tissues was detected by Western blot.Isolated and cultured cardiac myofibroblasts (CFs) from new-born SD rats were treated with U Ⅱ,KT5720 or SB-611812,and then the proliferation of CFs was observed by micro scope and CKK-8.Results The expression of U Ⅱ,GPR14,col-Ⅰ,col-Ⅲand PKA increased markedly in cardiac tissues of model rat,which were time-dependent.U Ⅱ promoted the proliferation of CFs (P＜0.05),which could be inhibited by KT5720 or SB-611812.Conclusions U Ⅱ/UT system promotes the occurring and development of myocardial fibrosis.

Objective To summarize our experience in the management of extensive small bowel necrosis from acute superior mesenteric arterial (SMA) embolism. MethodsSeven cases with extensive small bowel necrosis from acute SMA embolism were treated from 1991 to 1999. Results In this group small bowel of 28～ 30 cm and 70～90 cm were remained respectively in 3 and 4 cases after surgery. Two patients died of septic shock while the other 5 developed short or ultra short bowel syndrome and were finally cured by means of combined intravenous nutrition and oral feeding. 5 patients were followed up for 18～36 months, all are in good health. Conclusions Timely diagnosis and prompt operation are important to elevated survival rate. SMA embolectomy helps in preserving living intestine. For patients with short or ultra short bowel syndrome, comprehensive measures of intravenous nutrition and stepwise oral feeding in combination can quickly restore digestive and absorptive function of the residual intestine.

AIM　To study the effects of Phe-Met-Arg-Phe-NH2 (FMRFa) on Na+/Ca2+ exchange and its specificity for Na+/Ca2+ exchange in rat ventricular myocytes. METHODS　Na+/Ca2+ exchange current and other currents of ion channels were measured using whole cell voltage clamp techniques. RESULTS　A dose-related inhibition of tetrapeptide FMRFa on Na+/Ca2+ exchange was observed in rat ventricular myocytes. Inward and outward INa+/Ca2+ were inhibited by 60.1% and 56.5%, respectively, at highest concentration (100 μmol*L-1) and its IC50 were 20 μmol*L-1 and 34 μmol*L-1 in inward and outward INa+/Ca2+, respectively. Inward and outward INa+/Ca2+ were inhibited 38.7% and 34.9%, respectively, at FMRFa 5 μmol*L-1. FMRFa 5 μmol*L-1 and 20 μmol*L-1 did not affect L-type calcium current, sodium current, transient outward current and inward rectifier potassium current. CONCLUSION　These data indicate that FMRFa is a specific inhibitor of Na+/Ca2+ exchange in intact rat ventricular myocytes.

Objective To examine outcomes of superficial vein stripping for vein varicosis caused by combination of superficial and deep venous reflux and the effect on deep vein reflux. Methods From January 2004 to December 2006, twenty patients (22 lower extremities) with combined superficial and deep venous reflux were enrolled for evaluation, patients with superficial venous reflux alone worked as controls.All patients underwent superficial vein stripping and followed up for 2 years. Venous clinic severity score (VCSS) and color duplex ultrasound test were used to evaluate the change of clinic symptoms and valve reflux of deep veins. Results Preoperative VCSS of superficial and deep vein reflux group and superficial vein reflux group was 7.1 ± 2. 9 and 6. 6 ± 2. 0 respectively (P = 0. 44). At two years after operation the VCSS was 2. 3 ± 1.2 and 1.8 ± 0. 8 respectively without significant statistic differences, whereas comparing postoperative VCSS with individual preoperative parameters there was a significant decrease (P <0. 01). In combined superficial and deep vein group, deep venous reflux reduced in 7 limbs, progressed in 4 limbs, no change in 12 limbs. While in superficial reflux alone group, deep venous reflux occurred in 4 limbs.Conclusions Superficial vein stripping effectively improves symptoms of great saphenous vein varicosis of lower extremity caused by combination of superficial and deep vein reflux without a significant effect on the stares of deep vein reflux.

Objective To study relationship between preprocedural white blood cell count(WBC) and long-term patency of stent implanted in the subelavian artery.Methods Data of 113 cases with stents implanted in the atherosclerotic SUbclavian arteries in Anzhen Hospital,Beijing during January 2005 to January 2008 were analyzed.Student t-test was used to compare the difierence in WBC count between those with patency and those with stenosis after the procedure and chi-square test was used to compare the difference in stent pateney between those with higher and lower WBC counts.Results There Was significant difference in WBC counts between 102 cases with patency and 11 cases with stenosis of the stents after implantation(t=-5.051.P<0.001).Percentage of patency ofthe stents in 36 cases witll higher WBC count(>7.195×109/L)was significantly higher than that in 77 cases with lower WBC count(≤7.195× 109/L)before the procedure(P=0.001).Among 113 cases with stents implanted,109 cases(96.5%) could keep their stents patent one year after implantation,and 60 cases(89.6%)could keep stents patent three yeats after implantation.Conclusions In addition to those traditional factors associated with long-term patency of stents after their implantation,inereased WBC count alSO associated with stenosis or occlusion of the stents after the procedure.

Objective To explore the effect of predictively nursing care for children with congenital large-sized nevus.Methods 142 cases of children with congenital large-sized nevus were treated by surgical resection,based on the principle of voluntary and informed patients,and order of children admitted to hospital were randomly divided into control group and observation group,and the two groups of children were 71 cases.Children in the control group received routine care;children in the observation group received nursing care support.Comparison of the two groups of children with treatment compliance and the satisfaction of paediatric patients' family,postoperative recovery and complicatians were observed.Results Observation group of patients treatment compliance was significantly higher;the difference was significant (P＜0.05).Observation group of children family satisfaction was significantly higher [97.2 ％ (63/71) vs 88.7 ％ (63/71)],the difference was significant (P ＜ 0.05).1,3,6,and 9-month postoperative follow-up was observed in children with recovery of the observation group were better than the control group;the difference was significant (P＜0.05).After nine months the two groups of children were cured.Group of children were observed without serious complications;redness developed in 1 patient in the control group and skin graft necrosis developed in 2 patients.Conclusions Pediatric patients with congenital large-sized nevus with predictively nursing care measures have better clinical efficacy,worthy of promoting.

Objective To investigate the characteristics of cognitive impairment in patients with type 2 diabetes mellitus (T2DM),and to analyze the correlation of T2DM with its risk factors and serum insulin like growth factor-1 (IGF-1) levels Methods A total of 78 hospitalized patients with T2DM at our hospital from November 2011 to March 2012 were divided into the cognitive impairment group (n=39) and the non-cognitive impairment group (n=39) according to Montreal Cognitive Assessment (MoCA) scores,and general clinical data were collected.Levels of blood lipids,glycosylated hemoglobin (HbAlc),fasting blood glucose (FBG),fasting blood insulin (FBI) and other biochemical indicators were detected,insulin resistance index (HOMA-IR) scores were calculated,and serum IGF-1 levels were determined by the enzyme-linked immunosorbent assay (ELISA).Results The education levle was (8.94±4.13) years for the cognitive impairment group and (12.65[2.50) years for the non-cognitive impairment group,and there was a statistically significant difference between the two groups (P=0.004).HbAlc levels were (9.69 ± 1.25) and (7.96 ± 1.31) for the cognitive impairment group and the non-cognitive impairment group,respectively,and were statistically difference between the two groups (P =0.001).Serum IGF-1 levels were (122.60±11.56) mmol/L and (139.32±9.57) mmol/L in the cognitive impairment group and the non-cognitive impairment group,respectively,and had a statistically significant difference between the two groups (P =0.037).Additionally,compared with the non-cognitive impairment group,scores on visuospatial ability,naming,language,abstraction,delayed recall and orientation were lower in the cognitive impairment group (P＜[0.05 or 0.01).Moreover,MoCA scores were negatively correlated with TC,LDL-C,TG,HbAlc,FBI levels and HOMA IR (r=0.498,-0.411,0.414,-0.452,-0.449,-0.539,respectively,P＜0.05 for all),and positively correlated with education lcvcl and IGF 1 level (r=0.579 and 0.491,respectively,P＜0.05 for both) Conclusions Cognitive impairment caused by T2DM is prominent in visuospatial ability,language,memory and executive functions,and is closely related to poor education,poor glycemic control,dyslipidemia and insulin resistance.Furthermore,decreased serum IGF-1 levels might be a risk factor for diabetic cognitive impairment.