The author discussed the necessitude of synchronization of cardiac interventional therapy and cardiac rehabilitation, and the methodology of cardiac rehabilitation medicine education in the article.

Objective To observe the value of myocardial performance index (Tei index) in evaluating the left ventricular function in diabetic patients with normal left ventricular ejection fraction (LVEF),and to investigate its correlation with plasma N-terminal pro-brain natriuretic peptide (NT-proBNP).Methods 96 diabetic patients with normal LVEF were selected as the observation group,50 healthy persons were selected as control group.Left ventricular Tei index was measured by color Doppler ultrasound.The plasma NT-proBNP was detected.Results The Tei index,plasma level of NT-proBNP of the observation group were (0.49 ± 0.11),(397.6 ± 39.4) ng/L,those of the control group were (0.32 ± 0.07),(101.2 ± 18.4) ng/L,the differences between the two groups were statistically significant(t =11.357,1.992,all P ＜ 0.05).There was significant positive correlation between Tei index and plasma NT-proBNP in the observation group(r =0.661,P ＜ 0.05).Conclusion Combined determination of Tei index and plasma NT-proBNP can detect early myocardial damage in patients with diabetes mellitus.

Objective To study the diagnostic value of high frequency color doppler ultrasound acute appendicitis.Methods 98 patients with symptoms of acute appendicitis were selected,the application of Logiq 9 color Doppler ultrasonic diagnostic apparatus,a frequency of 7 ～ 10.0MHz was wsed.The McBurney point as well as around the right lower quadrant tenderness of rebound pain at the obvious on the miter,slitting,transverse scanning.Combined with color Doppler flow imaging to understand the flow conditions.After diagnosis of the patients with operation of diagnosis and treatment,the histopathology of the final diagnosis with ultrasound diagnosis results were compared,and through statistical analysis,identifying all patients with the rate of misdiagnosis,missed diagnosis rate,positive rate.Results The exploration and operation pathology diagnosis results contrast,all 98 patients,diagnosed in 95 patients,the positive rate was 96.9％ ;1 cases were missed diagnosis,misdiagnosis missed diagnosis rate was 1％ ;in 2 cases,the misdiagnosis rate was 2％.Conclusion High frequency color doppler acoustic in the diagnosis of acute appendicitis diagnosis rate was high,with clinical practical value.

Neurogenic bladder is a class of diseases in the damage of normal urine and storage function that are resulted from any cause of central or peripheral nerve damage,which is also called neurogenic bladder dysfunction (neuropathic bladder dysfunction,NBSD).Children~ neurogenic bladder is a common cause of congenital spinal cord dysplasia with high morbidity,and progressive development can cause the urine impaired even life-threatening.The treatment of neurogenic bladder cannot obtain satisfactory results yet.This review summarizes the recent advances in the treatment of neurogenic bladder.

Objective To explore the expression of nitric oxide synthases including neuronal nitric oxide synthases(nNOS), inducible nitric oxide synthases(iNOS), endothelial nitric oxide synthases (eNOS) in neurogenic bladder tissues, and analyze it's producing feature and significance. Methods There were 30 cases with neurogenic bladder(18 males, 12 females). The average age was 6.3±3.1 years. All patients appeared with myelodysplasia, urinary and fecal incontinence in different degree. Twenty-six cases were manifested with hyperreflexia bladders, and all patients were treated with surgical procedures. During operation, collected bladder tissue samples including tissues of apex vesicae and tissues of bladder neck, and all tissues were enveloped with mineral wax. All tissues were detected for nNOS, iNOS, and eNOS respectively in tissues of apex vesicae and tissues of bladder neck,and with normal bladder tissues as control group (bladder tissues of hypospadia, 10 cases), and according to clinical features, to explore the expression of NOS, and to analyze the relationship among them. Results In normal apex vesicae tissues, all cases stained with nNOS, and distributed among bundles of smooth muscles, and surface of smooth muscles and interstitial tissue, histochemica;score (HS) 2.8-4.0 and 1.2-2.7. There were no stained cells in bladder tissues of iNOS, and HS was very low, HS:0-0. 4 and 0-0.1 ;eNOS mainly distributed in interstitial tissues in rarefaction manners, and mainly in vascular endothelial cell (VEC), and smooth muscles had no stainings the most expression among them was nNOS, and mainly distributed in bladder neck tissues. In neurogenic bladder tissues, the main expression of NOS type was iNOS, and nNOS decreased significantly. eNOS mainly expressed in VEC among interstitial tissues, and had no staining in smooth muscle cells and collagenoblast and rarefaction of microvessel in bladder tissues, and microvessel density decreased significantly than normal bladder tissues. Microvessal density(MVD) in bladder tisssus (6. 8± 3.2/100per square) was less than that in normal tissues (16.7±6.3/100 per square). Conclusions In normal bladder tissues, nNOS mainly distributes in bladder neck and urethra, and nitric oxide mainly derives from nNOS. Much more matrix fibers, fewer nitrogenergic nerves, and less nNOS expression are seen in neurogenic bladder interstitial tissue. There are more iNOS expressions in bladder tissues,and NO is mainly derived from iNOS, and it may play an important role in pathological bladder tissues, especially in fibrosis of bladder wall. eNOS may be considered as angiopoietic labeling, and may evaluate the blood supply of bladder.

Objective To infect human pulmonary artery smooth muscle cells with different HIV-based vectors, and introduce foreign genes into the cells with HIV-based lentivirus vectors.MethodsThe human pulmonary artery smooth muscle cells, U87.CD4.CCR5 and U87.CD4.CXCR4, were infected with ADA/Luc, HXB2/Luc, VSV-G/Luc and VSV-G/GFP.ResultsU87.CD4 with corresponding coreceptors could be infected by ADA/Luc and HXB2/Luc, however, the human pulmonary artery smooth muscle cells could not be infected by ADA/Luc and HXB2/Luc, even pseudotypes. VSV-G/Luc and VSV-G/GFP could be transfered into the human pulmonary artery smooth muscle cells. After 3 days post-infection, the relative proportion of positive cells of human pulmonary artery smooth muscle cells expressing VSV-G/GFP was 18%.ConclusionHIV-based lentivirus vectors can introduce foreign genes into the human pulmonary artery smooth muscle cells.

Objective To analyze the level of Th17 and Treg cells in the peripheral blood of patients with rheumatoid arthritis(RA),and to investigate its role in the pathogenesis of RA and the clinical significance.Methods Flow cytometry(FCM)was used to analyze the ratio of interleukin(IL)-17+CD4+T (Thl7)cells and Foxp3+CD25+CD4+T(Treg)cells in CD4+T cells from the peripheral blood of 57 RA patients and 32 normal controls.T-test and Chi-square test were used for inter-group comparison and Pearson's linear analysis was used for correlation analysis.Resuits Compared with normal controls.the level of both IL-17+CD4+T cells and the ratio of Th17/Treg in RA patients increased significantly.while the level of Foxp3+CD4+CD25+T cells decreased markedly[(4.2±2.2)%vs(2.3±1.4)%,P=0.000;1.15±0.62 I)5 0.34±0.17,P=0.000;(3.9±1.6)%vs(7.0±2.2)%,P=0.000].Compared with early RA(persistent for 2 years or less)patients,the levels of Th17,Treg and the ratio of Th17/Treg in chronic RA(duration for more than 2 years)patients didn't markedly changed(P>0.05).The level of Th17 cells and the ratio of Th17/Treg was directlycorrelated with disease activity parameter (including tender ioint counts,visual analog seale of patients,disease activitv score in 28 joints,etc).Regression analysis discovered that risk factors of bone erosion were the level of Th17 cells,the ratio of Th17/Treg,disease activity score in 28 joints and disease duration.Antirheumatic drugs could decreascthe ratio of Th 17/Treg.Conclusions Treg cells is decreased in RA patients while Th7 cells is increased in patients with RA.Th17/Treg ratio goes up significantly as well.Change of T celt subsets,especially Th17 and Treg cells are important for the pathogenesis of RA.Th17 and Treg cells could aggrevate disease activity and bone destruction throughout the whole disease process.Anti-rheumatic medications is effective by regulating Th17/Treg subset balance.

Objective To investigate the clinical value of GFR, microalbuminuria (mAlb), serum β2-microglobulin (MG) and cystatin C (CysC) for the evaluation of renal function in patients with DN.Methods A total of 150 patients with type 2 DM diagnosed by WHO standard (1999) from December 2012 to December 2015 were retrospectively analyzed.Thirty-three kidney transplantation donors during the same time were chosen as the control group.The urine mAlb, Cr, albumin/Cr ratio(ACR) and SCr, serum β2-MG, CysC, urea, uric acid(UA), fasting blood glucose (FBG), hemoglobin A lc (HbA1c) and C-reactive protein (CRP) were measured.99Tcm-DTPA renal dynamic imaging was performed.The Gates method was used to calculate GFR, and the modification of diet in renal disease (MDRD) method was used to calculate the estimated GFR (eGFR).The relative equation between GFR and eGFR was studied.The clinical stages of renal function in type 2 DM patients were evaluated by Mogenesen standard method.Two-sample t test was used for data analysis.ROC curve analysis was performed to study the diagnostic value of GFR in DN.Results The patients were divided into merely type 2 DM group, early stage DN (Ⅰ, Ⅱ, Ⅲ), and clinical DN(Ⅳ) groups by Mogenesen standard method.GFR and eGFR in the DNⅠstage were higher than those of the merely type 2 DM group (t values:-7.502,-3.629, both P<0.01), and GFR and eGFR decreased with the increased stage of DN.However, serum UA, CRP, FBG and HbA1c, SCr, urea, β2-MG, CysC, mAlb and ACR increased when the stage of DN was higher.GFR and eGFR showed a linear correlation, with the regression equation of y=0.957x+6.823.AUC of ROC in patients with DN Ⅰ was 0.989.With the cutoff value of 125.09 ml/min, the sensitivity and specificity was 96.2%(25/26) and 98.4%(122/124) respectively in diagnosis of DNⅠ.Between high UA and normal UA groups, FBG and HbA1c were not significantly different (t values:-1.010,-1.034, both P>0.05), but the renal function indicators were different (t values:-5.090-2.209, all P<0.01).Compared with the normal CRP group, the FBG, HbA1c and renal function indicators were statistically different in high CRP group (t values:-6.114-7.386, all P<0.01).Conclusions GFR and eGFR show a linear relationship in type 2 DM.GFR is a sensitive, specific diagnostic index in DN Ⅰ period.β2-MG, CysC, mAlb and ACR are conducive to the early diagnosis of DN.High UA is an independent risk factor for the onset of DN, and high CRP is an inflammatory damage factor in DN.

Objective To investigate the effect of long-term cardiac rehabilitation on risk factors with doctor supervision after percutaneous coronary intervention(PCI). Methods One hundred and twelve patients after PCI were divided into the cardiac rehabilitation group(56 cases) and the control group (56 cases). All of the patients were given medication and health education, meanwhile the cardiac rehabilitation group received 4～6 weeks hospitalized cardiac rehabilitation program and one year ambulatory cardiac rehabilitation with doctor supervision. Risk factors were assessed six mouths and twelve mouths after the treatment. Results The risk factors except diastolic blood pressure and body weight index improved more significantly in the cardiac rehabilitation group than in the control group. Clinical event in the cardiac rehabilitation group is lower than in the control group. Conclusion Long-term cardiac rehabilitation with doctor supervision is safe, efficiency and good compliance to improve risk factors of coronary heart disease after PCI except diastolic blood pressure and weight management.

Objective To investigate the serum lipids levels of Chinese men with chronic paraplegia.Methods A total of 650 male paraplegics admitted to the China Rehabilitation Research Center (CRRC) for rehabilitation therapy from Jan 2004-Dec 2008 were investigated. The inclusion criteria were a definite paraplegic history (T2-L5 spinal cord injury); complete data; age 18-60 years; and no history of stroke. TG, TC, LDL and HDL serum lipid profiles were studied. Results These male paraplegics showed significantly higher mean TG and TC levels and lower mean HDL levels than the nation-wide averages for similar males ( TG 1.72 mmol/L vs. 1.36 mmol/L; TC4.42 mmol/L vs. 4.30 mmoL/L; HDL 0.99 mmol/L vs. 1.18 mmol/L). No difference in average LDL levels was found. TG, TC and LDL levels were correlated positively with age, but HDL was not. Duration of paraplegia correlated positively with HDL levels, but negatively with LDL. The prevalence of dyslipidemia was 67% , and the prevalence of low HDL was 64%. Conclusions The serum lipid profiles of the young male paraplegics showed a high prevalence of dislipidemia, significantly low HDL levels with a high prevalence of low HDL, and no correlation with age. TG, TC and LDL levels increased with age. The duration of paraplegia was correlated positively with HDL but negatively with LDL, probably due to increased exercise of the upper limbs.