BACKGROUND: In treatment of traditional acute myocardial infarction,patients were required to lie on the bed resting for 1-4 weeks. Recently research showed that early rehabilitation exercise in myocardial infarction patients could ameliorate the reservation of cardio function, increase exercise tolerance, augment myocardial hemoperfusion, decrease myocardial ischemia and reduce the anxious and depressive emotion.OBJECTIVE: To observe the influence of early rehabilitation movement on activity of daily living, duration of hospital stay, mean hospitalized cost,incidence rate of arrhythmia and recurrence rate of myocardial infarction in two years.DESIGN: Non-randomized concurrent control analysis.SETTING: Beijing Tiantan Hospital.PARTICIPANTS: Totally 80 patients with acute myocardial infarction,who were hospitalized at Department of Circulation, Beijing Tiantan Hospital from August 2002 to October 2003, were enrolled. They were all at most 70 years old with stable pathogenetic condition. Left ventricular ejection fraction (LVEF) was over 35%. They were not combined with severe hypertension, severe pulmonary disease, nerve and disease of locomotor system.METHODS: The selected cases based on patients' will were assigned into two groups (n=40), ①early rehabilitation group: They were treated with routine drugs, absolute bed rest for 24 hours. At day 2 the head stock was rose about 30°to do passive exercise of extremity joint. At days 3-5, the patients sat on the bed, 3 times per day. At days 6-7,the patients stood at bedside, 3 times per day. At days 8-9, the patients moved joints of extremities at bedside and walked slowly in room. At days 10-14, the patients exercised walking. If there were angina pectoris attacks, serious cardiac arrhythmias or dyspneic respiration, etc., the movement should be suspended or the exercise intensity came back to that in the former stage. ②Absolute bed rest group: The patients were absolute bed rest, and only treated with routine drug without any rehabilitation training.MAIN OUTCOME MEASURES: Barthel index (full mark was 100 points, and ＜ 60 points represented unable self-care) was used to assess activity of daily living of patients. Mean duration of hospital stay, mean hospitalized cost, incidence rate of arrhythmia and recurrence rate of my ocardial infarction in two years were compared between the two groups.RESULTS: A total of 80 patients that conducted the therapy and follow up were involved in the result analysis. ①Mean duration of hospital stay and mean hospitalized cost in the early rehabilitation group were less than those in the absolute bed rest group (17.1 days vs 24.5 days; 9 021.23 yuan vs 12 383.45 yuan; P ＜ 0.05). ②Barthel index: There was insignificant difference before treatment between the two groups. It was significantly higher in the early rehabilitation group than that in the absolute bed rest group before discharge (81.43±13.57,70.68±11.48,P ＜ 0.05). ③Six and seven patients had the onset of arrhythmia in the early rehabilitation group and the absolute bed rest group, respectively. ④Follow-up observation was performed for two years. The recurrence rate of myocardial infarction in the early rehabilitation group (5% ,2/40) was obviously lower than that in the absolute bed rest group (22 %,9/40).CONCLUSION: The early rehabilitation training is of benefit to elevate activity of daily living of myocardial infarction patients, reduce mean duration of hospital stay and mean hospitalized cost and decrease recurrence rate.

Aim To establish an animal model of inflammatory pleural adhesion and to investigate the role of low-molecular-weight heparin(LMWH) in preventing encapsulation of pleural effusion.Methods Thirty New-Zealand rabbits were randomly divided into three groups:the model and the treatment group received injection of tetracycline(35 mg?kg~(-1)) in the right chest cavity,the control animals received injection of normal saline.LMWH (55 U?kg~(-1)) was injected into the right chest cavity of rabbits in the treatment group.The animals were killed on 14 d.Result In the model group,pleural effusion appeared at 2 h and reached maximum within 2～3 days.In the effusion,leukocytes accumulated and procoagulant activity increased at the same time.Fibrosis and pleural adhesion,encapsulation appeared on the fourteenth day.In the treatment group pleural effusion and procoagulant activity were reduced.No pleural adhesion was observed.Conclusion Tetracycline was successfully used to establish an animal model of pleural adhesion in rabbits.LMWH was effective in reducing pleural effusion and preventing pleural fibrosis and encapsulation.

Objective To evaluate the accuracy of prediction equations in calculating energy expenditure in elderly patients with type 2 diabetes mellitus (T2DM).Methods In 75 elderly T2DM patients hospitalized in our hospital between August 2014 and August 2015,the resting energy expenditure (REE)measured with indirect calorimetry was compared with those calculated with six different prediction equations.Statistical analysis was performed with paired t-test,the percentage of individual coincidence,and BlandAltman method.Results The measured REE of the patients was (1 513.2 ± 240.6) kcal/d.There were statistically significant differences between the measured REE and the values predicted with Harris-Benedict,Owen,Mifflin,and Liu equations (all P ＜ 0.05),while no statistically significant differences were observed between the measured REE and the values predicted with FAO/WHO/UNU and Schofield equations (both P ＞0.05).FAO/WHO/UNU equation showed the smallest average difference from the measured value (-18.9 kcal/d),but the 95％ consistency limit (-363.3 kcal/d,325.5 kcal/d) was still beyond the acceptable clinical range.Conclusion The accuracy of prediction equations in estimating REE in elderly patients with T2DM may be dissatisfactory.

Protein post-translational modifications are important ways to regulate protein function and cell behavior, and oxidative stress directly influences protein post-translational modifications. P53 protein has various post-translational modifications, which can be quickly regulated under stress conditions to activate a series of downstream target genes and facilitate the p53 function diversity. The effects of oxidative stress on p53 post-translational modifications of phosphorylation, ubiquitination, sumoylation, acetylation and methylation are introduced in this paper.

BACKGROUND:Vascular endothelial growth factor(VEGF)can promote vascular endothelial regeneration,inhibit thrombosis,and attenuate neonatal intimal thickness and luminal stenosis degree.OBJECTIVE:The present study established atherosclerosis models in rabbits and observed the effects of local transfection of VEGF gene on restenosis after angioplasty.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed at the Laboratory of Microorganism,Tongji Medical College,Huazhong University of Science and Technology between November 2004 and December 2006.MATERIALS:Rabbits were daily raised with high-fat diet to create atherosclerosis models.Twenty successful rabbit models were randomly and evenly divided into a control group and a gene treatment group.METHODS:The DcNDA 3.0 recombinant human VEGF165(hVEGF 165)was trimsferred to the ventral aorta through the use of Foley's catheters.and the pcDNA3.0 was transfefred in the controls.MAIN OUTCOME MEASURES:At 1,2,and 4 weeks after surgery,luminal area of left renal artery opening was measured by MRI.At 2 and 4 weeks after surgery,the ratio for intimal to medial area was obtained through the use of HMIAS-2000 high definition color medical image analysis software.Simultaneously,vascular endothelial cell regeneration was observed by immunohistochemistry of factor Ⅷ related antigen.RESULTS:The pcDNA3.0/hVEGF 165 could be successfully transferred through the use of Foley's catheters.At 2 and 4 weeks after surgery,luminal area was larger in the gene treatment group than in the control group(P<0.01);simultaneously, the ratio of intimal to medial area was significantly smaller in the gene treatment group than in the control group(P<0.05).In the gene treatment group,expanded vascular endothelial cell regeneration was accomplished at 2 weeks after surgery,while in the control group,it took 4 weeks.CONCLUSION:pcDNA3.0/hVEGF 165 gene transduction can promote local vascular endotllelialization and apparently attenuate restenosis degree and intiaml thickening.

Objective To explore the therapeutic effect, mechanism and safety of Qingrehuashi recipe in treating chronic superficial gastritis with erosion pertaining to spleen-stomach damp-heat syndrome. Methods 84 cases of chronic superficial gastritis with erosion were recruited into a control group and a treatment group randomly, with each groups containing 42 cases. The treatment group was treated with Qingrehuashi recipe, while the control group was treated with Qingweizhitong granule. Both groups were treated for 8 weeks. The clinical manifestations and signs, gastroscopic results and pathological effects were observed before and after the treatment. Results The total effective rate and curative rate in the treatment group were superior to those in the control group (P<0.05) . Conclusion Qingre Huashi recipe is effective and safe in in treating chronic superficial gastritis with erosion pertaining to spleen-stomach damp-heat syndrome. The mechanism might be related to its effects of anti-inflammation, anti-oxidation, eradicating Hp, promoting gastric motility and enhancing gastric mucosal barrier.

Cajanin preparation could significantly reduce the mouse pinna inflammation iuduced by croton oil. The higher the dose, the stronger the effect .It also inhibited the infiltration increase of intraperitoneal blood capillary of mice led by acetic acid.In addition, the preparation had an analgesic effect. These experimental results indicated that cajanin may be hopefully developed to a new drug for the treatment of scald trauma, and infection.

Objective To evaluate the effect of high-frequency oscillatory ventilation (HFOV) on lung injury in the piglets with acute respiratory distress syndrome (ARDS).Methods Twelve male piglets,aged 6-8 weeks,weighing 14-16 kg,were randomly divided into 2 groups (n=6 each) using a random number table:conventional mechanical ventilation with low tidal volume group (CMV group) and HFOV group.ARDS was induced by bilateral pulmonary lavages with isotonic saline (38 ℃),repeated every 10 min until the oxygenation index＜200 mmHg.After successful establishment of the model,CMV group was ventilated using conventional mechanical ventilation with low tidal volumes.After successful establishment of the model,HFOV group was ventilated using HFOV,lung recruitment was performed,the airway pressure was set at 25 cmH2O and maintained at this level for 30 s,and the airway pressure was then adjusted 5 cmH2O higher than that after successful establishment of the model,with bias flow 25 L/min,inspiratory time ratio 33％,frequency 8 Hz,amplitude 40-80 cmH2O,and inspiratory oxygen fraction 1.0.In both groups,carbon dioxide partial pressure was maintained between 35 and 50 mmHg.Before establishment of the model (baseline),after successful establishment of the model (T1),and at 0.5,1.0,2.0 and 4.0 h after beginning of mechanical ventilation (T2-5),blood samples were collected from the femoral artery and central vein for blood gas analysis,arterial oxygen partial pressure and carbon dioxide partial pressure were recorded,oxygen delivery index,oxygen consumption index,oxygenation index and intrapulmonary shunt were calculated,and the improvement in pulmonary function (oxygenation index ≥ 200 mmHg) was recorded.At T0,T1 and T5,venous blood samples were collected for determination of the concentrations of serum Clara cell secretory protein 16,soluble intercellular adhesion molecule-1,and high-mobility group box 1.Results Compared with CMV group,the arterial oxygen partial pressure at T35 and oxygenation index at T4.5 were significantly increased (P ＜ 0.05),and no significant change was found in the other parameters in HFOV group (P＞0.05).Conclusion Compared with conventional mechanical ventilation with low tidal volumes,although HFOV improves lung oxygenation,the degree is small in the piglets with ARDS.

Objective To investigate the efficiency of ring butterfly sewing in lower uterine segment aided with tourniquet in treating pernicious placenta previa combined with placenta percreta. Methods Twelve pregnant women diagnosed with pernicious placenta previa combined with placenta percreta by prenatal ultrasound in Peking University First Hospital from April 1, 2012 to November 30, 2014, were enrolled. All of them received elective cesarean delivery using ring butterfly sewing in lower uterine segment aided with tourniquet. The efficiency of this novel technique, in term of blood loss and vital signs during operation, blood transfusion, and postoperative recovery, was analyzed. Results Twelve cases were diagnosed with placenta percreta during operation, with placenta invading the perimetrium in seven cases and urinary bladder being involved in one case. Ring butterfly sewing in lower uterine segment aided with tourniquet during elective cesarean delivery was all successful in the 12 cases. The median amount of blood loss was 1 000(400-2 000) ml during operation and the amount of blood loss was lower than 1 000 ml in three cases. Two cases received no blood transfusion, and the median blood transfusion in the other 10 cases were 400(400-1 200) ml. The mean operation time was (75±22) min (43-131) min. Eleven cases had normal lochia and temperature after operation and the other one had placenta invading urinary bladder and partial placenta in situ, and developed fever at day 3 after operation, but recovered after antibiotic treatment, and no placenta tissue was seen by ultrasound at day 59 after operation. Conclusions The ring butterfly sewing in lower uterine segment aided with tourniquet is highly effective for the pernicious placenta previa combined with placenta percreta, and it is a simple, fast and fertility sparing technique with low blood loss and without usage of special equipment.

Objective To investigate the outcomes of increased gestational diabetes mellitus (GDM) and the influencing factors after the implementation of the new GDM diagnostic criteria.Methods A total of 1 439 GDM women who delivered in the Peking University First Hospital between May 1,2011 and December 31,2012 were studied and divided into two groups.Group Ⅰ included the women who met the new GDM diagnostic criteria (fasting plasma glucose and 1 or 2 h plasma glucose levels for 75-g oral glucose tolerance test performed between 24 and 28 weeks of gestation were no less than 5.1,10.0 and 8.5 mmol/L),but did not meet the National Diabetes Data Group (NDDG) criteria;and Group Ⅱ included the women who met the NDDG criteria only.Women in Group Ⅰ were further divided into two subgroups according to whether attending the one-day GDM outpatient visit.Follow-up rate and detecting rate of abnormal glucose metabolism at 6-12 weeks after delivery were analyzed.Chi-square test,t test and multivariate Logistic analysis were used for statistical analysis.Results There were 849 GDM women in Group Ⅰ (59.0％,849/1 439) and 590 (41.0％,590/1 439) in Group Ⅱ.The follow-up rate in group Ⅰ was lower than in group Ⅱ [25.9％(220/849) vs 32.0％(189/590),x2=6.112,P=0.013].There were five cases of impaired fasting glucose and 34 impaired glucose tolerance in Group Ⅰ;and four cases of impaired fasting glucose,56 impaired glucose tolerance,eight impaired fasting glucose tolerance with impaired glucose tolerance and five diabetes mellitus in Group Ⅱ;there were significant differences [17.7％(39/220) vs 38.6％(73/189),x2=33.810,P=0.000].(2) In Group Ⅰ,the increased glucose level at 2 h in oral glucose tolerance test during pregnancy (OR=1.547,95％CI:1.038-2.306,P=0.032) and family history of diabetes mellitus (OR=1.879,95％CI:1.066-3.313,P=0.020) were risk factors for postpartum abnormal glucose metabolism,while breast-feeding was a protective factor (OR=0.290,95％CI:0.092-0.914,P=0.035).(3) In group Ⅰ,the follow-up rate in those who attended the one-day GDM outpatient visit was higher than those who did not [30.7％(185/603) vs 14.2％(35/246),x2=23.780,P=0.000],but the detecting rate of postpartum abnormal glucose metabolism were similar in women attending the one-day GDM outpatient visit and those not attending [17.8％(33/185) vs 17.1％(6/35),x2=0.020,P=0.887].Conclusions Increased GDM women still have glucose metabolism abnormality after delivery,especially those who have higher glucose level at 2 h after glucose intake in 75 g oral glucose tolerance test during pregnancy and who have a family history of diabetes mellitus.The one day GDM outpatient visit may improve the follow-up rate for these women.