Objective To investigate the molecular basis for anti-ventricular arrhythmic effects by losartan through measuring alteration in mRNA and protein levels of key K+ α channel-and-β subunits (Kv4.2,Kv4.3 and KChIP2) in ventricular myocytes in spontaneously hypertensive rats (SHRs).Methods SHRs were randomly assigned to losartan[10mg·kg-1·d-1,n=12] or placebo (n= 12) with age-and weight-matched WKY rats (n = 12) as control.After 8 weeks of treatment,cardiomyocytes were isolated by enzymolysis.Action potential of cardiomyocytes Ito was recorded,mRNA and protein levels of Kv4.2,Kv4.3 and KChIP2 were assessed by reverse transcriptase polymerase chain reaction and Western blot.Results The action potential duration (APD) measured at 50% and 90% repolarization was shorter in losartan group [(16.82 ± 3.79) ms and (68.49±13.25) ms] than in SHR control group [(24.56±4.59) ms and (73.26±15.47) ms,all P<0.01].Losartan increased Ito current density associated with significant increases in the mean levels of mRNA and protein of Kv4.2 and Ky4.3,and with significant decreases in the mean levels of mRNA and protein of KChIP2 compared with those in placebo SHR (all P<0.01).Conclusions Chronic blockade of AT1 receptors with losartan reverses cardiomyocytes electrical remodeling in SHR,resulting in the shortening of APD,which is associated with increasing Ito density by increasing mRNA and protein expression of Kv4.2,Kv4.3 and by decreasing mRNA and protein expression of KChIP2.

ObjectiveTo evaluate the effect of losartan on ventricular arrhythmia in elderly patients with hypertension.Methods The 78 hypertension subjects with ventricular arrhythmia aged 65 to 89 years were randomly assigned to treatment with losartan or placebo (enalapril) for 12 months. The blood pressure, left ventricular mass index and ventricular arrhythmia were observed and analyzed.ResultsAfter 12 months treatment, the pressure lowering effect was similar in losartan versus enalapril groups, there were no differences in systolic pressure decrement and diastolic pressure decrement between the two groups (P＞0. 05). Left ventricular mass index was lower in enalapril groupthaninlosartangroup [(109.2±15. 4) g · m-2 vs. (128.5±16. 7) g · m-2, t=2.015, P＜0. 05].However, the prevalence of ventricular arrhythmia was lower in losartan group than in enalapril group [(628. 5±176.8)/24 h vs. (852.9±215.7)/24 h, t=2.417,P＜0.05]. No Pearson's correlations of reduction of ventricular arrhythmia with reduction of blood pressure (systolic: r=0. 094, P＞0. 05; diastolic: r= 0.08, P＞0. 05) and reduction of left ventricular mass index were found. in losartan group.Conclusions Initiation of antihypertensive treatment with losartan in elderly subjects appears to cause more reduction of ventricular arrhythmia than with enalapril, despite similar reduction of blood pressure.

Objective To explore the effect of hand grip ball exercise on limb function after surgery of breast cancer. Methods 69 patientsafter breast cancer operation were divided into control group (n=35) and observation group (n=34). The control group received regularrehabilitation exercise, and the observation group received nursing intervention based on hand grip ball exercise at the early stage. The effectswere compared between 2 groups 2 months after surgery. Results The patients with arm edema and shoulder function limitation wereless in the observation group than in the control group (P<0.05). Conclusion The application of grasping bounce ball during early rehabilitationstage can facilitate the recovery of breast cancer patients after operation.

AIM To investigate the chemical constituents from the leaves of Cucurbita moschata (Duch.ex Lam.) Duch.ex Poiret.METHODS The ethyl acetate and n-butanol fractions of 70％ ethanol extract from C.moschata leaves were isolated and purified by silica,Sephadex LH-20,ODS and preparative TLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Thirteen compounds were isolated and identified as β-amyrin (1),phytol (2),α-linolenic acid (3),α-methyl linolenate (4),palmitic acid (5),ethyl linoleate (6),ethyl palmitate (7),daucosterol (8),β-sitosterol (9),(6S,9R)-roseoside (10),soya-cerebroside Ⅰ (11),dibutyl phthalate (12),4,4'-diphenylmethane-bis (methyl) carbamates (13).CONCLUSION All the compounds are isolated from this plant for the first time.

Objective This paper investigated and analyzed medical service of clinical pathway which carries out during five tertiary hospitals from August 2010 to August 2011 in order to understand the weight of high quality nursing care in the clinical pathway and satisfaction for hospitalized patients.Methods 959 hospitalized patients were investigated by way of questionnaire survey,561 in CP wards and 398 in non-CP wards.Some influential data were statistically analyzed using SPSS17.0 statistical software.Results High quality nursing care in clinical pathway possessed a higher proportion of the actual weight.It had positive func-tion for improvement of the satisfaction degree of hospitalized patients.Conclusions It is an impor-tant way for continuous improvement of medical service by carrying out the clinical pathway combined with high quality nursing demonstration project.

Objective To study the clinical significance of liver failure staging and MELD in predicting the short term prognosis of HBV-acute-on-chronic liver failure (HBV-ACLF).Methods One hundred and ten HBV-ACLF patients admitted to our hospital from July 2013 to July 2015 were included into this study.They were divided into early stage group (n=18),middle stage group (n=48) and end stage group (n=44),the fatality rate in each group was evaluated.According to the MELD score at baseline,they were divided into four groups,MELD＜20 (n =24),20≤ MELD＜30 (n=54),30≤MELD＜40(n =28),40≤MELD (n =4).The fatality rate in each group was evaluated.In the middle stage group,they were be divided into two groups,/△MELD＜0 and △MELD＞0(△MELD=MELD1w-MELDbaseline).The fatality rate in each group was evaluated.Results The fatality rate of the 3 groups(Early,Middle and End stage group) at 3th month was 0,50％,95 ％ respectively(P＜ 0.05).The fatality rate of the 4 groups (MELD＜20,20≤MELD＜30,30≤MELD＜40,40≤MELD)was 31.58％,66.67％,85.71％ and 100％ respectively (P＜ 0.05).In the middle stage group,the fatality rate of the two groups was (△MELD＜0 and △MELD＞ 0)41.18％ and 85.71％ (P=0.001).Conclusion It can be shown that the survival probability of early stage group was high,the probability of death in end stage group and middle stage group with△MELD＞0 was high.

10.3969/j.issn.2095-4344.2013.26.005

Objective To improve self-management of diabetics with role lack.Methods A total of 121 diabetics with role lack were enrolled and received mass education and individual counseling.Serum levels of glucose and lipid profiles and body mass index (BMI) were assessed and compared before and after intervention by using paired t test.Results Knowledge on diabetes ( 79.37 ± 12.45 vs 31.69 ± 9.36,t =2.860,P ＜ 0.05) and self-management skills ( 9.21 ± 2.85 vs 4.43 ± 1.72,t =2.812,P ＜ 0.05 ) were significantly improved after receiving health education,although fasting plasma glucose [ ( 6.3 ± 1.8 ) vs (8.1 ±2.1) mmol/L,t =2.736,P ＜0.05],2-h postprandial blood glucose [(8.1 ±3.7) vs (12.8 ±4.1)mmol/L,t =3.549,P ＜ 0.05 ],glycosylated hemoglobin Alc [ (6.4 ± 2.5 ) ％ vs (7.1 ± 2.7 ) ％,t =2.603,P ＜ 0.05 ],total cholesterol [ ( 5.2 ± 2.3 ) vs ( 6.3 ± 2.4 ) mmol/L,t =2.036,P ＜ 0.05 ],triglyceride [(1.7±0.7) vs (2.4±0.8) mmol/L,t=2.368,P＜0.05] and BMI [(25.6±6.2) vs (27.3±6.5)kg/m2,t =2.546,P ＜ 0.05 ] were largely decreased.Conclusion Health education could improve selfmanagement and cure of diabetic patient with role lack.

Objective To examine whether the increase of carbon monoxide (CO) induced by oral methylene chloride (MC) administration in recipients before heart transplantation would protect heart grafts against isehemia/reperfusion (I/R) injury associated with transplantation and to explore the possible mechanism.Methods Inbred male Balb/c mice were used as donors and recipients to establish cervical heart transplantation model Recipients were treated with either MC (100 mg/kg or 500 mg/kg,per os)(group MC 100 mg,n=10;group MC 500 mg,n=12) or olive oil(0.15 ml,per os.group olive,n=10) 3 h prior to anesthesia.Age-matched norwlal mice served as controls (group N,n=5).The serum COHb and the CO content of myocardial tissue were measured at 0,1,3,6,12,24 h after oral MC administration.Half of recipients were killed at 3 and 24h after transplantation for senum or cardiac graft samples.The serum cTnI levels,the mRNA levels of TNF-α,IL-10,Bcl-2,Bax.the protein levels of NF-κB and the ultrastructures of myocardium were examined.Results As tompared with group olive.the serum COHb and tissue CO were increased significantly and peaked within 3 h in group MC 100 mg and group MC 500 mg.The serum cTnI levels in group MC 100 mg and group MC 500 mg were significantly decreased (P<0. 01 ), especially in group MC 500 mg. The increase of CO in recipients of group MC100 mg and group MC 500 mg significantly inhibited the proinflammatory gene expression of TNF-α mRNA and the pro-apoptotic gene expression of Bax mRNA (P<0. 01), and increased the anti-apoptotic gene expression of Bcl-2 mRNA (P<0. 01), but did not increase the anti-inflammatory gene expression of IL-10 mRNA (P>0. 05) in the heart grafts. As compared with group N, the myocardial NF-κB activation was increased significantly in group olive,group MC 100 mg and group MC 500 mg (P<0. 01 ), but there was no significant difference among the later three groups (P>0. 05). The myocardial ultrastructure was also alleviated significantly in group MC 100 mg and group MC 500 mg as compared with group N. Conclusion The increase of CO induced by MC in recipients suppresses pro-inflammatory and pro-apoptotic gene expression and efficiently ameliorates transplant-induced heart I/R injury. The possible mechanism does not seem to be associated with down-regulation of the NF-κB signaling pathway.

OBJECTIVE: To study the role of nuclear factor-kappa B (NF-kappaB) and cycloxygenase-2 (COX-2) in the onset of phlegm obstruction due to lung-deficiency in rats and the therapeutic mechanism of Huatan Recipe. METHODS: Twenty-four SD rats were randomly divided into normal group, model group and treatment group, with 8 rats in each group. The rats in the model group and treatment group were exposed to sulfur dioxide and cold wind to establish the rat model of phlegm obstruction due to lung-deficiency, and the rats in the treatment group were also treated with Huatan Recipe, a compound traditional Chinese medicine. The expression of NF-kappaB in the bronchial epithelial cells of the rats was tested with the method of immunohistochemistry, and the COX-2 mRNA in the lung tissues of the rats was measured by using reverse transcription-polymerase chain reaction. RESULTS: The expressions of NF-kappaB and COX-2 mRNA in rats of the model group were higher than those of the normal group (P<0.01), and the expressions of NF-kappaB and COX-2 mRNA in rats of the treatment group were obviously lower than those of the model group (P<0.01). CONCLUSION: The NF-kappaB and COX-2 play an important role in the onset of phlegm obstruction in rats. Huatan Recipe may prevent the development of phlegm obstruction by down-regulating the expressions of NF-kappaB and COX-2 mRNA.