Objective To investigate the protective effects and mechanism of total glucosides of paeony (TGP) on the injury of neonatal rat cadiocytes induced by H2O2. Methods Cadiocytes of 3 days neonate rat was cultivated for 72 hours and divided into the model group, the TGP low (30μg/ml), medium (60 μg/ml), high (120 μg/ml) dose groups, Shuxuening injection (100 μg/ml) group and normal control group (n=8);and except the normal control group, the cells in other groups were induced by H2O2 (100μg/ml). After 6 hours, the morphology changes were observed and the survival rates were detected;the content of AST, CPK, LDH in culture medium were detected; the activity of SOD, CAT, GSH-Px and the content of MDA in cardiomyocytes were determinted;the apoptosis rates were detected. Results Compared with the model group, the survival rates of cardiomyocytes in TGP medium and high dose groups significantly improved (64.1%± 7.3%, 81.3%± 7.8%vs. 42.3%± 6.2%;P<0.05 or P<0.01);the content of AST (26.72 ± 6.03 U/ml, 23.86 ± 5.38 U/ml vs. 34.75 ± 6.91 U/ml), CPK (1.96 ± 0.35 U/ml, 1.59 ± 0.32 U/ml vs. 2.54 ± 0.40 U/ml), LDH (811.55 ± 162.32 U/L, 683.48 ± 134.14 U/L vs. 936.07 ± 140.94 U/L) in culture medium were significantly decreased (P<0.05 or P<0.01);the activity of SOD (85.34 ± 16.87 U/mg , 94.62 ± 17.75 U/mg vs. 56.45 ± 13.76 U/mg), CAT (22.76 ± 3.38 U/mg, 26.49 ± 3.72 U/mg vs. 16.13 ± 3.18 U/mg) in cardiomyocytes were significantly increased and the content of MDA (8.74 ± 2.05 nmol/mg, 6.91 ± 1.80 nmol/mg vs. 11.56 ± 2.19 nmol/mg) were significantly decreased (P<0.05 or P<0.01), the apoptosis rate (24.2% ± 5.5%, 13.4% ± 3.9% vs. 51.2% ± 9.1%) were significantly decreased (P<0.05 or P<0.01);and the activity of GSH-Px (3.54 ± 0.83 U/mg vs. 2.50 ± 0.67 U/mg) in cardiomyocytes of TGP high dose treatment group was significantly increased (P<0.05 or P<0.01). Conclusion TGP had dose-dependent protective effects on the injury of neonatal rat cadiocytes induced by H2O2, which perhaps related to its effects of improving the activity of antioxidase, inhibiting the oxidative stress, and decreasing the apoptosis rates.

Objective To study the mechanism of different forms of ST-segment elevation in acute myocardial infarction(AMI),and to investigate the distribution of its traditional Chinese medicine (TCM)syndrome types.Methods Two hundred and twelve hospitalized AMI patients with ST-segment elevation from March of 2015 to July of 2017 were divided into group A and group B.Group A had 102 cases with the elevation of concavity of STsegment,and group B had 110 cases with the elevation of arch of ST-segment.The correlation of ST-segment elevation in different forms with TCM syndrome types was analyzed.Results (1) Patients of group B were usually male,young and middle-aged,with or without short-term medical history of coronary heart disease,and coronary angiography results indicated the stenosis or occlusion of the vessels without collateral circulation.Patients in group A were usually female,aged,with medical history of coronary heart disease,and coronary angiography results indicated the existence of collateral circulation.(2) Group A was dominated by Qi-deficiency and blood-stasis syndrome,and the frequency of its syndrome types was in decreasing sequence:Qi-deficiency and blood-stasis syndrome,Qi-yin deficiency syndrome,heat-toxicity and blood-stasis syndrome,phlegm blended with bloodstasis syndrome,syndrome of cold stagnation in heart vessels.Group B was dominated by heat-toxicity and bloodstasis syndrome,and the frequency of its syndrome types was in decreasing sequence:heat-toxicity and bloodstasis syndrome,Qi-deficiency and blood-stasis syndrome,Qi-yin deficiency syndrome,syndrome of cold stagnation in heart vessels,phlegm blended with blood-stasis syndrome.The difference of the distribution of syndrome types was significant between the two groups (P ＜ 0.01).(3) In respect of the differentiation of deficiency and excess syndromes,group A was dominated by deficiency interweaved with excess syndrome,while group B was dominated by excess syndrome.The difference of the distribution of deficiency and excess syndrome was significant between the two groups (P ＜ 0.01).Conclusion AMI patients with different forms of ST-segment elevation have different TCM syndrome types.The investigation results will provide a new vision for the clinical trial of AMI treated with Chinese medicine integrated with western medicine,and will supply evidence for the syndrome differentiation and treatment of AMI patients with different forms of ST-segment elevation,which will contribute to enhancing clinical efficacy,saving life and improving prognosis.

BACKGROUND:Previous studies have shown that chitosan can promote the repair of peripheral nerve injury and methylprednisolone can improve the microenvironment around nerve injuries, which are commonly used in clinical treatment of acute central nervous system injury.
OBJECTIVE:To observe the effects of modified chitosan and methylprednisolone combination on repair of sciatic nerve injury in rats.
METHODS:The rat sciatic nerve was transected and microscopical y anastomosed immediately. Then, modified chitosan, methylprednisolone, methylprednisolone+modified chitosan, and saline were injected respectively around the anastomosis site, compared with the sham surgery group.
RESULTS AND CONCLUSION:Compared with other groups, the combination group showed shorter claw extending reflex recovery time (P<0.05). Significant differences were found between the combination group and other groups in nerve conduction velocity, the remnant rate of gastrocnemius wet weight, the diameter and section area of gastrocnemius cells (P<0.05). The nerve fibers through the anastomotic site were significantly increased, with consistent thickness and arrangement and less neurodegeneration when observed 12 weeks after operation. In conclusion, the modified chitosan combined with methylprednisolone could significantly promote the sciatic nerve repair.

Objective To investigate the myocardium protective effect of immunoinflammatory response induced by preinfarction angina. Methods Eighty-eight patients of acute myocardial infarction were divided into preinfarction angina group (48 subjects) and sudden onset group (40 subjects). The incidence of severe arrhythmia,heart failure,cardiac shock and in-hospital mortality were assessed in the two groups. The myocardial infarction size,ventricular function,coronary angiography were compared between the two groups. Some immunoinflammatory markers levels were detected. Results In preinfarction angina group,the incidences of severe arrhythmia,heart failure,and in-hospital mortality were lower (P

Using the method of stratified random cluster sampling,8 996 elderly hypertensive patients in community were selected in the study.Patients entered the community-based hypertension program receiving stratified management,individualized treatment and health education.After 3 years of intervention,the disease awareness rate,treatment compliance rate and hypertensive control rate were increased from 68.30％,55.40％ and 38.60％ to 98.90％,86.70％ and 77.80％,respectively (P ＜0.05).The systolic and diastolic pressure,body mass index,triglyceride levels and other hypertensionrelated indicators were improved significantly,the number of individuals with obesity/overweight,smoking and drinking were decreased and those with regular exercise increased (all P ＜ 0.05).The results indicate that community-based comprehensive hypertension management is effective for hypertension control for elderly patients in community.

Objective From October 2010 to explore the current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou,Jiaxing and Shaoxing in Zhejiang province.Methods To April 2011,10 644 geriatric patients aged 60 years and over were included,and related questionnaire survey,physical examination and laboratory examination were carried out.The situation of hypertension control and influencing factors were analyzed.Results The control rate of hypertension was 38.6％,and its standardized rate was 27.6％.It showed that female,inhabited city,high level of education degree and regular exercise were positively correlated with hypertension control,while age,smoking,high salt diet and abdominal obesity were negatively correlated with hypertension control,and standardized treatment had a close relationship with hypertension control.Conclusions The situations of hypertensive control among geriatric patients in Hangzhou,Jiaxing,Shaoxing in Zhejiang province are still unsatisfactory.Strengthening standardization management measures for improving the control rate of hypertension is needed and has actual value.

Objective: To evaluate the influence of recombinant human brain natriuretic peptide(rhBNP)on ventricular remodeling and ventricular systolic synchrony in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods: A total of 48 patients with AMI after PCI were randomized into two groups: rhBNP Group (n=25) and Routine treatment Group (n=23).Two dimension echocardiography was used to measure the index of left ventricular end-diastolic volume (LVEDVI), the index of left ventricular end-systolic volume (LVESVI), left ventricular ejection fraction (LVEF), the index of left ventricular mass (LVMI), the movement index of infarcted regional wall (RWMI) at 1 week, 4 weeks and 24 weeks after the treatment procedure.And at 1 week and 24 weeks period, equilibrium radionuclide angiography was performed respectively to evaluate the ventricular systolic synchrony.Results: ①1 week after PCI, LVESVI in rhBNP group was decreased and LVEF was increased than that in Routine treatment group (P<0.05, respectively).4 and 24 weeks after PCI, LVEDVI, LVESVI, LVEF were significantly different in rhBNP group than those in Routine treatment group (P<0.05,respectively).24 weeks after PCI, RWMI and LVMI were significantly decreased in rhBNP group than those in Routine treatment group(P<0.05,respectively).②24 weeks after PCI, phase shift, full width at half maximum and peak phase standard deviation were significantly improved in rhBNP group than those in Routine treatment group (P<0.05, respectively).Conclusion: Intravenous injection of rhBNP could inhibit left ventricular remodeling and improve left ventricular function.

Objective To evaluate the method of ultrasonic imaging to confirm endotracheal tube location in adult patients.Methods A certified sonographer identified the location of the trachea tube with ultrasound machine and then put it to optimum place.Correct trachea tube location confirmed by fiberoptic bronchoscopy (FOB) was used to evaluate the accuracy of ultrasonography for detecting endotracheal tube location.Results Several relevant structures,including anterior wall of trachea,the edge of balloon and the superior edge of the aorta (DGA) would be successfully visualized by sonographic examination.Among 48patients underwent ultrasound-guided tracheal intubation,there were 44 successful cases.2 intubatedmalposition cases and 2 failed-to-guide cases.The locating accuracy rate was 91.7％.Conclusions Ultrasound examination can identify the position of trachea tube in adult patients accurately,and it is a noninvasive,convenient and radiation free method for patients undergoing airway management.

Objective: To evaluate the effects of office blood pressure(OBP)combined with ambulatory blood pressure monitoring(ABPM)on the diagnosis of hypertension. Methods: The residents aged 35-79 years without hypertension history,whose casual OBP were 120~159 mm Hg/80~99 mm Hg,were enrolled from 4 communities of Hangzhou and Zhuji from 2015 to 2018. They were performed OBP measurements on other two days in 4 weeks and ABPM in a week. There were 2 criteria of OBP as elevated OBP on the first day or in 3 different days,and 4 criteria of ABPM as elevated mean BP in 24 hours, daytime, nighttime and either of the above time. Receiver operating characteristic(ROC)curve was employed to evaluate the effects of different OBP criteria combined with ABPM criteria on the diagnosis of masked hypertension(MH)and white-coat hypertension(WCH). Results: Taking 3-day-OBP as a golden standard,the 1-day-OBP with 4 ABPM criteria had the areas under the ROC curve(AUC)of 0.79-0.81,sensitivity of 57.58%-62.77% and specificity of 100.00% in MH;had the AUC of 0.95-0.98,sensitivity of 100.00% and specificity of 88.96%-96.80% in WCH. The Kappa values were all less than 0.6,known as low consistency. Taking either time of ABPM as a golden standard,24 hours,daytime and nighttime ABPM criteria with OBP had the AUC of 0.90-0.92,sensitivity of 79.17%-83.90% and specificity of 100.00% in MH(all Kappa>0.6),when with 1-day-OBP,the Kappa values were all more than 0.8,known as high consistency;had the AUC of 0.95-1.00,sensitivity of 100.00% and specificity of 89.54%-99.37% in WCH,the Kappa values of daytime ABPM were all more than 0.6,known as high consistency. Conclusions If limited by options, 1-day-OBP could be used instead of 3-day-OBP for detection of WCH or exclusion of MH yet with less accuracy; 24 hours or daytime ABPM instead of either time of ABPM was reliable.

Objective To investigate the effects of cryptotanshinone and tanshinone Ⅱ A,two major monomer components of tanshinone,on the proliferation,differentiation and lipid synthesis of rat meibomian gland epithelial cells in vitro.Methods The eyelid meibomian gland tissue was isolated from 2-month-old SD rats and co-cultured with 3T3 trophoblasts for 5 days.Cryptotanshinone and tanshinone Ⅱ A were prepared with DMSO into different concentrations.The cells were grouped to 0.125 μmol/L,0.250 μmol/L,0.500 μmol/L,1.250 μmol/L and 2.500 μmol/L drug groups and treated for 48 hours,respectively.Only dimethyl sulfoxide (DMSO) was added in medium in the DMSO control group.The expressions of keratin 14 (K14) and p63 in frozen sections of meibomian gland tissue and clones of meibomian gland cells were detected by immunofluorescence.Real-time fluorescence quantitative PCR was used to assay the relative expression of K16,cell proliferation related antigen 67 (Ki67) and CCAAT enhancer binding protein α (C/EBPcα) in meibomian gland cell clones.Crystal violet staining and oil red staining were used to evaluate the colony formation rate and lipid synthesis of meibomian gland epithelial cells.Results Primary cultured meibomian gland cells were cloned on day 4-5 in vivo,and the cloning area was increased on day 7 after culture,p63 and K14 were positively expressed in clones.Compared with the DMSO control group,the relative expression levels of Ki67 mRNA were significantly elevated in the 0.500 μmol/L,1.250 μmol/L and 2.500 μmol/L cryptotanshinone groups (all at P ＜ 0.05).The relative expressions of Ki67 mRNA in the 0.500 μmol/L and 1.250 μmol/L tanshinone Ⅱ A groups were significantly higher than those in the DMSO control group (all at P＜0.05).No significant difference was found in the relative expression of K16 and C/EBPα mRNA among different concentrations of cryptotanshinone or tanshinone Ⅱ A group (all at P＞0.05).No lipid drop was found in the tarsal gland cell clones;however,the accumulation of lipid was seen in the cell clusters at the margin of the clones by oil red O staining.The average clone formation rate of tarsal gland cells in the 1.250 μ mol/L cryptotanshinone group was (2.55±0.20)％,which was significantly higher than (2.05±0.13)％ in the DMSO control group (t =4.379,P＜0.05).The average clone formation rate of tarsal gland cells in the 1.250 μmol/L tanshinone Ⅱ A group was (2.25±0.20)％,there was no significant difference between 1.250 μmol/L tanshinone Ⅱ A group and DMSO control group (t=1.616,P＞0.05).Conclusions Cryptotanshinone and tanshinone Ⅱ A promote the proliferation of meibomian gland epithelia cells,but play less impacts to lipid synthesis of meibomian gland epithelia cells in vitro.cryptotanshinone promote the clone tormation of meibomian gland epithelia cells.