ObjectiveTo investigate the effects of atorvastatin on cardiomyocyte apoptosis and caspase-3 expression in acute myocardial infarction in rats.MethodsFifty SD rats were randomly divided into 3 group:sham group,control group( normal saline),atorvastatin pretreatment group ( 10mg/kg),The atorvastatin group were pretreated with atorvastatin ( 10mg/kg ) for 3 days,and those in the control group were pretreated with normal saline instead.All rats underwent coronary ligation of left anterior descending branch to establish AMI rat s model on the fourth day except the sham group,while sham group only received thoracotomy without coronary ligation.Then,The infarct size area at risk were defined by Evans blue and TTC staining,the caspase-3 mRNA expression of myocardium was measured with reverse-transcriptase polymerase chain reaction(RT-PCR) and the apoptosis index was analyzed by TUNEL staining.Results Compared with control group,the infarct size,the caspase-3 mRNA expression of myocardium,the apoptotic index were decreased significant in the atorvastatin group ( P ＜ 0.05 ).ConclusionPretreatment with atorvastatin has protective effect on the acute ischemic cardiomyocytes,which may probably be associated with the reduction of the expression of caspase-3 mRNA in the myocardium and the apoptotic index.

Objective To investigate the short-term outcomes and oncological safety of laparoscopy resection for colorectal cancer. Methods Between January 2004 and March 2009, 35 patients with colorectal cancer underwent laparoscopic-assisted surgery in our hospital, among which 32 underwent radical resection, 1 underwent laparoscopic exploration, and 2 were converted to open surgery. These patients were allocated in the laparoscopic group. Same numbers of patients who underwent conventional open surgery during the same period of time were identified and allocated in the open group. Short-term data, including surgical time, intra-operative blood loss, intra-operative blood transfusion, length of incision, histopathological data, post-operative complications and post-operative functions, were collected and compared between the two groups. Results A total of 67 patients were enrolled (32 in both laparoscopy and open groups). The other 3 cases were analyzed separately (1 underwent laparoscopic exploration and 2 converted to open surgery). The two groups were well balanced as to age, gender, and TNM staging and location of tumour. Histopathologically, the laparoscopic approach was equal to conventional approach as regard to resection margin (distal margin, 5 cm vs 5 cm, P=0.664) and lymph node yield (7 vs 8, P=0.228). This study also showed a longer surgical time (250 min vs 180 min, P=0.006), but shorter length of incision (10 cm vs 20 cm, P<0.001), less demand of intra-operative blood transfusion (1 case vs 10 cases, P=0.003), reduced use of analgesics (12 cases vs 25 cases, P=0.004), shorter post-operative stay (9.5 days vs 11 days, P=0.008) and earlier recovery of bowel function of the laparoscopic group. There was no statistical difference of intra-operative blood loss (200 mL vs 200 mL, P=0.098), incidence of post-operative complications (8 cases vs 6 cases, P=0.545) and volume of post-operative negative drainage (507.5 mL vs 669.0 mL, P=0.475) between the two groups. Conclusions Though limited by a relatively small sample size, our study showed that laparoscopy approach for colorectal cancer is equal to open approach in terms of oncological safety and short-term outcome.

Objective To investigate the expression of visfatin mRNA in abdominal omental adipose tissue and its relationship with blood lipid in type 2 diabetes mellitus.Methods 161 type 2 diabetic patients were divided into two groups according to triglyceride ( TG ),high triglyceride group ( TG ≥ 1.7mmol/L) and normal triglyceride group(TG ＜ 1.7 mmol/L).The expression of visfatin mRNA in abdominal omental adipose tissue was measured with Northern Blot.Visfatin plasma concentration,fasting plasma glucose (FPG),blood lipid profiles and other biochemical indicators were also measured.Results Comparing with normal triglyceride group,the diabetic patients in high triglyceride group had significantly increased levels of visfatin plasma concentration [ ( 129.07 ± 21.35)ng/mL vs ( 101.65 ± 15.23 ) ng/mL,t =2.295,P ＜0.05]and mRNA expression in omental adipose tissue( P ＜0.05).Visfatin plasma concentration was positively correlated with TG( β =0.592,P ＜0.05 ) and FPG( β =0.763,P ＜0.01 ).Visfatin mRNA expression in omental adipose tissue had no correlation with FPG,TG and other biochemical indicators.Conclusions The plasma visfatin level in T2DM patients may be associated with triglyceride metabolism.

Objective The risk of ovarian/pelvic serous cancer can be reduced by prophylactic bilateral salpingectomy ( PBS) at the time of hysterectomy .This study was to evaluate the short-term influence of PBS plus hysterectomy on ovarian reserve in premenopausal women . Methods We retrospectively analyzed the clinical data about 60 premenopausal women treated by total lapa-roscopic hysterectomy ( TLH) for benign indications , 30 undergoing PBS at the same time ( the experimental group ) while the other 30 with the ovary preserved ( the control group ) .We compared the levels of FSH, LH, E2, and anti-Müllerian hormone ( AMH) and the inci-dence of peri-menopausal symptoms between the two groups of patients before and at 1 and 3 months after operation . Results Statistically significant differences were not observed between the two groups in the such baseline clinical characteristics as age , gravidity, parity, men-strual cycle, comorbidity, diagnosis, comorbidities, and history of abdominal surgery (P>0.05), nor in the AMH level at the baseline ([1.08±0.08] vs [1.04±0.10] ng/mL) or at 1 month ([0.86± 0.44] vs [0.81±0.48] ng/mL) or 3 months postoperatively ([0.84±0.94] vs [0.68±0.42] ng/mL) (F=0.247, P=0.746).Howev-er, the mean level of AMH was markedly reduced at 1 and 3 months after operation as compared with the baseline ( P<0.05) , though with no significant difference between 1 and 3 months ( P>0.05) .There were not any statistically significant differences in the levels FSH, LH, and E2 between the two groups before or at 1 and 3 months after surgery (P>0.05), nor in the incidence rates of peri-menopausal symptoms at 1 month (6.7%vs 3.3%, P>0.05) or 3 months postoperatively (10.0%vs 6.7%, P>0.05). Conclusion PBS at the time of total hysterectomy in premenopausal women does not affect ovarian reserve in the short term .The level of AMH has a higher sensitivity than those of FSH , LH and E2 in the assessment of postoperative ovarian function .

Objective To investigate CT features and the staging of the ovarian cystadenocarinoma.Methods The CT findings of 73 ovarian cystadenocarcinomas proved by surgery and pathology in 52 cases were analyzed.CT staging in 41 cases with whole abdominal scan was made and the CT finding was compared with operative results.Results Of 73 ovarian cystadenocarcinomas,23(31.5%) tumors were typeⅠ(mainly cystic),32(43.8%)tumors were type Ⅱ(mixed) and 18(24.7%) tumors were type Ⅲ(mainly solid).The preoperative stage accuracy for stage Ⅲ patients was 90.9%.Conclusion CT manifestations of ovarian cystadenocarcinoma are varient,the definite diagnosis can be made by typical appearance.CT scan has a high accuracy in staging of preoperative.

Objective To investigate the relationship between bone mineral density (BMD) and the changes of serum adiponectin (APN) level in elderly men.Methods A total of 240 elderly men was enrolled in this study.Measurement of BMD of lumbar spine with dual energy X-ray absorptiometry was performed.All subjects were divided into three groups (normal,osteopenia,and osteoporosis) according to the T value of BMD.Serum APN level was tested using enzyme-linked immunosorbent assay (ELISA),meanwhile were recorded as bone lurnover markers.Results (1) The level of serum APN in osteopenia group was lower than in normal group,the level of serum APN in osteoporosis group was significantly lower than in osteopenia group,while the level of serum APN in osteoporosis group was significantly lower than in normal group (all P ＜ 0.05).(2) Serum APN was positively correlated with T value of BMD (r =0.475,P ＜0.01).(3) The stepwise multiple linear regression analysis showed serum APN,25-hydroxyvitamin D,β-isomerized carboxyterminal propeptide (β-CTX),and osteocalcin could enter into the equation.Conclusions Serum APN might play an important role in pathogenesis of osteoporosis in elderly men.

Problem-based learning (PBL) is a student-centered pedagogy in which a subject is approached in the context of realistic problems.We have applied PBL into intemnal medicine of general medicine for up to three years.The results suggest that the PBL method could promote the clinical competencies and self-learning capacities of students.However there is still room for improvement.

Objective Alterations in vascular structure and function and impairment of associated endothelial cells with aging are one of the independent risk factors in the process of atherosclerotic vascular diseases.The study of age-related endothelial dysfunction plays a critical role in preventing as well as treating heart and cerebral vascular diseases in the elderly.Methods The healthy male rats were divided into the young group (3-month-old),the adult group (9-month-old) and the middle-aged group (15-monthold).The indicators associated with vascular endothelial function,including plasma NO,eNOS,iNOS,ET-1 and aortic NO,eNOS,iNOS,were quantified to evaluate the endothelium-dependent and non-endothelium-dependent vasodilating function of isolated aortic rings.These morphological changes of rat aorta helped to find out the group in which endothelial function changed in the early stage.Results Plasma NO,eNOS,iNOS and aortic NOS activity in the young group,the adult group and the middle-aged group gradually decreased with increasing age (P ＜ 0.05).NO,eNOS and iNOS respectively displayed a negative correlation to age.ET-1 gradually increased with aging (P ＜ 0.05) and showed a predominantly positive correlation to age.Acetylcholine-induced greatest vasodilation of aortic rings lessened with increasing age (P ＜ 0.05).Vasodilation in each group reacted generally consistently with nitroprusside sodium (P ＞0.05).Aortic morphology,including intima media thickness (T),diameter (D) and intima media thickness / inner diameter (T / D),gradually enhanced with aging (P ＜ 0.05).T,D was positively correlated with age.NO,eNOS,iNOS,ET-1 of the adult group showed maximum slope (P ＜0.05 respectively) according to group regression analysis,suggesting that vascular endothelial function changed in this group.Meanwhile,T and D of the middle-aged group showed maximum slope (P ＜ 0.05 respectively),suggesting that age-related vascular structural changes predominantly occurred in this period and vascular function changed earlier than the structure.Conclusion Our study demonstrated vascular endothelial dysfunction with aging.Early evident changes of endothelial function occurred in the adult group,which impaired endothelium-dependent vasodilating function.Vascular function changed earlier than the structure.

ObjectiveTo study the liver and kidney function and muscle effects of rosuvastatin in rats.MethodsIn this study,twenty healthy male rats (9-month-old) were randomly divided into two groups:normal control group and rosuvastatin treatment group.The first treated group was given conventional feed; The second treated group was given conventional feed and oral rosuvastatin [5mg/( kg · d)] of 12 weeks.The level of liver and kidney function and creatine kinase,histological changes of liver and muscle were examined before and after the treatment.ResultsOur findings demonstrate that the level of liver and kidney function and creatine kinase was no significant difference among the two experimental groups,also no difference before and after treatment( P ＞0.05).At the same time,liver and muscle showed no abnormal pathology.Conclusion These findings collectively indicate that rosuvastatin shows no significant side effects in the liver and kidney function and muscle pathology compared with control group.

Objective To investigate the prevalence of vitamin D deficiency in patients in geriatric intensive care unit and the impact of vitamin D deficiency on the prognosis.Methods 213 hospitalized patients admitted into geriatric intensive care unit of Xinhua Hospital,Shanghai from June 2012 to December 2013 were included in the historical cohort study.Serum 25-hydroxyvitamin D [25 (OH)D] was examined in all the subjects.Main laboratory findings,the incidence of multiple organ dysfunction syndrome (MODS),Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and mortality rate of 30-day kept in hospital were compared among patients with different serum 25-hydroxyvitamin D level.Potential risk factors for mortality were analyzed by multivariate logistic regression analysis.Results 25(OH)D deficiency was identified in 82 patients (38.5％),25(0H)D insufficiency in 90 patients (42.3％),and 25(OH)D sufficiency in 41 patients (19.2％).Compared with 25(0H)D sufficiency group,25(0H)D deficiency group showed the increased levels of APACHE Ⅱ score,plasma lactic acid,C reactive protein (CPR),the incidence of MODS and mortality rate (21.65±-8.89 vs.17.05±8.03,1.89±0.76 mmol/L vs.1.86±1.03 mmol/L,101.08±48.23 mg/L vs.92.48±38.56 mg/L,42.7％ vs.19.5％,30.5％ vs.9.8％,all P＜0.05).Multiple logistic regression analysis suggested that 25 (OH)D deficiency was an independent risk factor for mortality.25(OH)D levels were negatively correlated with length of stay in geriatric intensive care unit (r=0.18,P＜0.05).Conclusions Vitamin D deficiency is highly prevalent among patients admitted into geriatric intensive care unit.Vitamin D deficiency is associated with disease severity and may be an independent risk factor for mortality.