Objective To evaluate the effects of glutamine on immune function in elderly patients with malnutrition.Methods Twenty-four elderly patients with malnutrition were equally randomized divided into glutamine group and control group.Patients in both two groups were administered with enteral nutrition containing equal nitrogen and calorics for consecutively 7 days.In the glutamine group,patients were also supplied with oral glutamine (7.5g tid).Changes of plasma IgG,IgA,and IgM levels,percentages of T-lymphocyte subsets (CD3,CD4,CD8),and CD4/CD8 ratio were determined before and after treatment.Results Plasma IgG and IgA lev-els,percentages of CD3 and CD4,and CD4/CD8 ratio were significantly higher in glutamine group than in control group (P<0.05 or P<0.01).Conclusion Glutamine can improve the immune function in elderly patients with malnutritiop and promote their recovery.

Objective: To investigate the effect and mechanism of rapamycin inhibiting mammalian target of RAPA (mTOR) on heart valve cell calciifcation in experimental rats. Methods: The rat’s valvular interstitial cells were isolated and the cells were cultured in 4 groups:①Normal control group,②Calciifcation group,③Rapamycin group and ④Calciifcation + rapamycin group. The apoptosis rates of valvular interstitial cells were detected by flow cytometry, calcium deposition was observed by Alizarin S staining, the calcified nodules were counted and the protein expressions of bmp-2, osteocalcin, osteopontin, smad-1 and caspase-3 were examined by Western blot analysis. Results: The rat's valvular interstitial cells were suceessfully isolated; the cell apoptosis rates were similar among different groups,P>0.05. The calciifed nodule in Calciifcation group (0.471 ± 0.091) was more than Normal control group (0.104 ± 0.023), while the nodule in Calciifcation + rapamycin group (0.237 ± 0.039) was less than Calciifcation group, allP<0.05. Compared with Normal control group, the protein expression levels of bmp-2, osteopontin and smad-1 were obviously increased in Calciifcation group,P<0.05, and compared with Calciifcation group, the above indexes were obviously lower in Calciifcation + rapamycin group, P<0.05. The protein expression levels of caspase-3 were similar among 3 experimental groups,P>0.05. Conclusion: Rapamycin may down-regulate the targeting protein expressions of bmp-2, osteopontin and smad-1 via inhibiting mTOR, therefore, reducing the valvular interstitial cell calcification which might be related to mTOR pathway suppression in experimental rats.

Objective:To explore the judging value of brain natriuretic peptide (BNP) on patient's condition of male patients with senile degenerated heart valvular disease (SDHVD) complicated heart failure (HF) .Methods :A total of 67 SDHVD + HF male patients were regarded as SHDVD group ,another 43 male HF patients ,who accepted treatment during the same period with corresponding age and without valvular heart disease ,were enrolled as pure HF group .Cardiac function indexes and plasma BNP level were measured and compared between two groups ,the correlation between BNP and left ventricular end -diastolic dimension (LVEDd) was analyzed ,and the cutoff point of BNP level for judging severity of SDHVD + HF was also calculated .Results:Compared with pure HF group , there were significant rise in LVEDd [ (49.79 ± 4.31) mm vs .(53.04 ± 7.10) mm] and plasma BNP level [ (214.43 ± 237.71) pg/ml vs . (682.06 ± 981.15 ) pg/ml ] , and significant reduction in left ventricular ejection fraction [LVEF ,(64.84 ± 5.83)% vs .(58.24 ± 7.99)% ] , P<0.05 or <0.01;percentage of moderate -severe heart dys‐function (NYHA class Ⅲ + Ⅳ) in SDHVD group was significantly higher than that of pure HF group (56.72% vs . 37.21% ) ,χ2 =3.988 , P=0.046. Spearman correlation analysis indicated that BNP level was positively correlated with LVEDd (r=0.588 ,P= 0.001) .The area under ROC (AUC) of BNP was 0.975 ,and the critical point of BNP level judging severity of male SDHVD complicated HF was 312 pg/ml ,and its sensitivity and specificity was 86.8% and 96.6% respectively .Conclusion:The SDHVD patient's condition is more severe compared with patients without valvular heart disease ,and BNP level is help to judging patient's condition .

Objective There is little research focusing on the expression and function of bradykinin 1 receptor ( B1R ) and bradykinin 2 receptor ( B2R) after cerebral ischemia/reperfusion on the basis of diabetes .The aim of this study was to compare the ex-pression difference and function change of B 1R and B2R in non-dia-betic and diabetic rats . Methods The cerebral ischemia/reperfu-sion model was established on 41 non-diabetic and type 2 diabetic rats, the weight and the biochemical index were measured on these two types of rats .8 non-diabetic rats and 8 diabetic rats were respec-
tively assigned to two groups according to random number tables:control group and I/R 24 h group, 4 in each group.Real-time PCR was performed to observe the expressions of two receptors at 24 h after reperfusion .Then, 33 non-diabetic rats and 33 diabetic rats were randomly divided into 4 groups respectively, including sham group (n=6), saline group (n=9), B1R antagonist group (n=9) and B2R antagonist group (n=9).At 24 hours after cerebral I/R, neurological deficiency was evaluated by neurological severity scores ( NSS);infarct volume was observed by TTC staining;cell apoptosis was determined by TUNEL staining;neuron degeneration was de-tected by Fluoro-Jade C staining. Results Glucoses of diabetics at 3, 7, 14 d after model establishment [(23.45 ±5.01), (23.71 ±4.87), (22.72 ±4.11) mmol/L] were obviously elevated compared with non-diabetics [(5.77 ±0.75), (6.05 ±0.69), (7.15 ±1.09) mmol/L];blood cholesterin [(4.59 ±3.43) mmol/L] and insulin [(67.26 ±12.02) pmol/L] at 14 d after model establishment were evidently incresaed in comparison to those in non-diabetics [(1.58 ±0.37) mmol/L, (25.34 ±4.88) pmol/L] (P<0.05), while no significant difference was found in the blood triglyceride of diabetics between them (P>0.05).Compared with non-diabetics, diabetics suffered from more apparent up-regulation of B1R mRNA (P<0.01) but relatively less B2R mRNA (P<0.05) at 24 h after I/R.NSS score, infarction volume, damaged and apoptotic cells in B2R antagonis-treated non-diabetic rats at 24 h after I/R conspicuously decreased compared with saline-treated non-daibetic rats.Those indicators in B1R antagonis-treated diabeics were strikingly lessened compared with saline-treated daibetics . Conclusion I/R induced distinct up-regulation of B2R mRNA in non-diabetics and inhibiton of B 2R effectively ameliorated the infarct volume and cell injury after I/R in non-diabetics; I/R induced more notable up-regulation of B1R mRNA in diabetics and B1R antagonist exerted neuroprotective effects instead of B 2R antagonist af-ter I/R in diabetics.