Objective: To explore the relationship between non-dipper pattern of blood pressure circadian rhythm and homocysteine (Hcy), carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 240 T2DM patients including 139 male and 101 female were enrolled. According tonocturnal blood pressure falling rates, the patients were divided into 2 groups: Dipper group,n=80 and Non-dipper group,n=160; based on CAS condition, the patients were divided into another set of 2 groups: CAS group,n=119 and Non-CAS group,n=121. Blood levels of Hcy, carotid intima media thickness (CIMT) and 24hSBP, dSBP, nSBP, 24hDBP, dDBP, nDBP were compared between 2 groups in each set; the risk factors of CAS were analyzed. Results: The following indexes were higher in Non-dipper group than Dipper group: Hcy by μmol/L (16.41.0±8.08 vs 12.55±4.07), CIMT by mm (1.00±0.59 vs 0.80±0.30), 24 hSBP by mmHg (138.7±19.2 vs 127.5±15.6), dSBP (139.4±19.2 vs 132.0±16.2), nSBP (136.4±20.0 vs 113.8±15.0), nDBP (74.0±12.0 vs 64.9±9.8), allP<0.01. Multi linear regression analysis indicated that Hcy (β=0.011,P<0.01), nSBP (β=0.021,P<0.01), nDBP (β=0.018,P<0.01) could affect blood pressure circadian rhythm. The following indexes were higher in CAS group than Non-CAS group: CIMT (1.18±0.65 vs 0.69±0.72), age by years (62.33±12.02 vs 59.17±10.80), 24 hSBP (138.2±18.2 vs 131.9±18.9), dSBP (139.5±18.4 vs 134.4±18.5), nSBP (133.9±20.7 vs 123.9±20.9) nDBP (73.3±12.8 vs 68.6±11.0),P<0.05 orP<0.01; while 2 indicators in CAS group were lower than Non-CAS group: SBPF (4.00±7.89 vs 7.66±7.36), DBPF (5.95±8.44 vs 10.19±8.67),P<0.01. Logistic regression analysis showed that age (OR=2.204,P<0.05), nDBP (OR=2.357,P<0.05), SBPF (OR=2.562,P<0.01) were the risk factors for carotid atherosclerosis. Spearman correlation analysis presented that CIMT was positively related to age (0.195,P<0.05) and negatively related to SBPF (r=-0.191,P<0.01). Conclusion: T2DM patients with non-dipper pattern of blood pressure circadian rhythm were usually combining high blood level of Hcy, non-dipper pattern was the independent risk factor for CAS. Restoring blood pressure circadian rhythm is important to prevent atherosclerosis.

Objective To discuss the feasibility and effect of the new look-up table method in the diet health management of type 2 diabetes patients. Methods 200 patients with type 2 diabetes in department of endocrinology in our hospital were divided into experimental group and control group according to the random number table method and 100 cases in each group. The new look-up table method and food exchange method were used respectively to intervene. Before the intervention and 6 months after the intervention, the clinical related metabolic indexes and diet self-management scores of patients in two groups were monitored, meanwhile, the time for nurses to guide patient to learn self-catering arrangements was calculated. Results Fasting blood glucose, postprandial 2 hours blood glucose, glycosylated hemoglobin of patients in experimental group were respectively (9.64±4.62) mmol/L, (12.37±4.88) mmol/L, (9.26 ± 2.56) % before intervention and were respectively (6.74 ± 3.87) mmol/L, (9.16 ± 4.76) mmol/L, (7.21 ± 3.21) % at 6 months after intervention, the difference was statistically significant (t=4.81, 4.71, 4.99, P < 0.01). However, fasting blood glucose, postprandial 2 hours blood glucose, glycosylated hemoglobin of patients in control group were respectively (9.14 ± 5.28) mmol/L, (12.95 ± 4.65) mmol/L, (9.12±3.31)%before intervention and were respectively (7.29±4.98) mmol/L, (10.01±5.56) mmol/L, (7.36± 2.86)%at 6 months after intervention, the difference was statistically significant (t=2.55, 4.06, 4.02, P<0.05 or 0.01). The diet self-management scores of patients were significantly improved in two groups, the scores of experimental group were (9.52±5.45) points before intervention and (13.70±7.11) points after 6 months intervention, the difference was statistically significant (t= 4.44, P < 0.01). The scores of control group were (9.18±6.32) points before intervention and (11.27±6.38) points after 6 months intervention, the difference was statistically significant (t=2.33, P<0.05). Meanwhile, the difference between two groups was statistically significant (t=2.54, P<0.05). The time needed for the education of experimental group was less than that of control group, (22.47 ± 5.84) min in experimental group and (32.23 ± 7.66) min in control group respectively, the difference was statistically significant (t=10.13, P < 0.01). Conclusions The new look-up table method is more convenient and can improve diet self-management ability for patients. It can also improve the work efficiency of clinical nurses and has the feasibility and applicability in the diet management of diabetes patients.

Objective To evaluate the educational effectiveness of feedback debriefing in clinical training.Methods Forty medical students and fifteen teachers were enrolled in the 2015 after-internship clinical training,which was newly designed to obtain the debriefing part.The test scores and single technical practices were collected and analyzed,before and after the training.DASH scoring system was used to evaluate the effect of debriefing in the team simulation.Results were statistically analyzed by SAS 9.2(SAS institute Inc).Quantitative data were described by x ± s,while qualitative data were described by number and/or constituent ratio.Student's t test and Wilcoxon rank sum test were applied as needed.A P-value ＜ 0.05 was considered to be significant.Results The scores of the students before and after the assessment were (41.88 ± 8.54) vs.(65.06 ± 13.83),and the difference was statistically significant(P=0.000).Individual skills before and after the course had a different degree of improvement.The average DASH-scores evaluated by the students,teachers and supervisors were (39.3 ± 2.12) (very good),(35.1 ± 4.18) (good) and (37.2 ± 3.03)(very good),separately.Conclusions Potent debriefing helps to improve the effectiveness of simulationbased clinical training.

Diagnostic whole body scan (Dx-WBS) with 131I and serum Tg level are the main parameters to evaluate the effectiveness of thyroid remnant ablation in patients with DTC.Undetectable Tg and positive radioiodine uptake in the thyroid bed (Tg-/Dx-WBS+) may be found in some patients.However,the clinical significance is uncertain.A small amount of thyroidal remnant,a small DTC lesion,increased expression of NIS gene and autoimmune inflammation may all result in Tg-/Dx-WBS+.A wait-and-watch approach without rushing for high-dose radioiodine treatment might be a more reasonable approach for these patients.

Objective To investigate CT and MRI features of abdominal huge liposarcoma,and improve the preoperative diagnostic accuracy. Methods The CT and MRI findings of 1 7 cases with abdominal huge liposarcoma proved by operation and pathology were analyzed and correlated with pathologic subtypes retrospectively.Results In 17 cases,16 cases were located in retroperitoneal,1 case was located in the abdominal cavity.The average maximal diameter of the lesions was 17 cm.In all cases,main components of well differentiated liposarcomata (n=7) were fat density on CT and MRI,and enhanced slightly,3 cases were multiple lesions,1 case of sclerosing liposarcoma contained massive patchy calcification,1 case was fatless.Myxoid liposarcoma (n=5)were similar to cystic on CT and MRI features,enhanced with latticed or cloudy components slightly to moderately .Dedifferentiated liposarcoma (n=2)has both fat and soft tissue inside and the dividing line was clear.The soft tissue mass unevenly obviously enhanced.Mixed liposarcoma (n=3)had the imaging characteristics above different types,2 cases contained no fat composition.Conclusion Liposarcoma pathological subtype has diversity,and various subtypes have certain characteristic on CT and MRI imaging features.

AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential ( P-VEP) game.
METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group ( 66 eyes of 49 patients ): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group (72 eyes of 52 patients):conventional methods mentioned above with P - VEP games.
RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94. 4% in the experimental group and 83. 3% in the control group. There was a statistically significant difference between them (P<0. 05).
CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.

Objective To observe the effect of sodium acetate Ringer solution on serum levels of electrolytes, blood glucose (Glu) and lactic acid (Lac) in peri-operational stage of children undergoing neurosurgery. Methods Forty cases of children prepared to undergo neurosurgery admitted into Hunan Children's Hospital from December 2018 to April 2019 were enrolled, and according to the criteria of American Society of Anesthesiologists (ASA), they were classified into Ⅰ-Ⅱ grade. They were divided into a sodium acetate Ringer solution group and a sodium lactate Ringer solution group by random number table method, 20 cases in each group. Sodium acetate Ringer solution group was given the sodium acetate Ringer solution; sodium lactate Ringer solution group was given the sodium lactate Ringer solution, and both groups used intravenous infusion of their own respective solution at a rate of 10 mL·kg-1·h-1. Arterial blood gas detections were measured after anesthesia induction (T1), 1 hour after administration (T2), 2 hours after administration (T3) and at the end of surgery (T4); the changes in serum levels of electrolyte concentrations, blood Glu and Lac were observed in the patients of two groups. Results With the prolonged operation time, the levels of Glu and Lac in the two groups showed an increasing trend, compared with the levels at T1 and T2 , the levels were increased at T3 and T4 [the sodium lactate ringer solution group: Glu (mmol/L) were 5.85±1.02, 6.95±1.21 vs. 5.28±0.72, 5.20±0.62, and Lac (mmol/L) were 1.53±0.74, 1.91±1.41 vs. 1.23±0.71, 1.38±0.69; sodium acetate ringer solution group: Glu (mmol/L) was 5.44±0.86, 5.85±1.12 vs. 5.05±0.85, 5.14±0.74, Lac (mmol/L) were 1.58±1.31, 1.61±1.23 vs. 1.14±0.65, 1.28±0.95, all P < 0.05], the Lac and Glu levels at T4 in sodium acetate Ringer solution group were significantly lower than those in sodium lactate Ringer solution group (both P < 0.05). There were no statistically significant differences in pH value, Na+, K+ and residual base (BE) levels between the two groups at different time points (all P > 0.05). Conclusion Sodium acetate Ringer solution used in pediatric neurosurgery for more than 2 hours can reduce the blood lactic acid level without rising blood glucoselevel. Therefore, it is more suitable for infusion during pediatric neurosurgery.

Serotonin is one of the most important neurotransmitters influencing mental health and, thus, is a potential target for pharmaco-logical treatments. Functional neuroimaging techniques, such as positron-emission tomography (PET) and single photon emission computed tomography (SPECT), could provide persuasive evidence for the association between mental disorders and serotonin. In this concise review, we focus on evidence of the links between serotonin and major depressive disorders, as well as other mood disorders, anxiety disorders, schizophrenia, addiction, attention deficit hyperactivity disorder (ADHD), and autism.
Anxiety Disorders ; Attention Deficit Disorder with Hyperactivity ; Autistic Disorder ; Depressive Disorder, Major ; Functional Neuroimaging ; Mental Disorders* ; Mental Health ; Mood Disorders ; Neuroimaging* ; Neurotransmitter Agents ; Positron-Emission Tomography ; Schizophrenia ; Serotonin* ; Tomography, Emission-Computed, Single-Photon

OBJECTIVETo observe the effect of Cornus Officinalis total glycosides (COTG) and Cornus polysaccharides (CP) on myocardial mitochondria and expression levels of glycogen synthase kinase-3β (GSK-3β) of acute myocardial infarction (AMI) rats.

METHODSThe AMI rat model was established by ligating the left anterior descending branch of coronary artery. Rats were divided into 5 groups according to random digit table, i.e., the sham-operation group, the model group, the COTG prevention group, the CP treatment group, the COTG treatment group, 12 in each group. Normal saline was administered to rats in the normal control group and the model group by gastrogavage. Corresponding medication was respectively administered to rats in the rest 3 groups by gastrogavage. The cardiac function was detected by echocardiography and hemodynamics. The infarct size was determined by Masson trichrome staining. The expression of mitochondrial biogenesis genes such as a subunit of peroxisome proliferators-activated receptor-γ coactivator-1 (PGC-1α), PGC-1β, nuclear respiratory factor-1 (NRF-1), and GSK-3P mRNA were detected by Real-time PCR.

RESULTSCompared with the sham-operation group, the myocardial infarction size increased, cardiac function decreased, the expression of PGC-1α, PGC-1β, and NRF-1 mRNA decreased, and the expression of GSK-3β mRNA increased (all P <0. 05). Compared with the model group, myocardial infarction sizes were reduced, cardiac function was improved, the expression of NRF-1 mRNA was elevated in the COTG prevention group, the CP treatment group, the COTG treatment group; the expression of the PGC-1α and PGC-1β mRNA was elevated in the COTG prevention group and the CP treatment group; the expression of GSK-3β mRNA was reduced in the CP treatment group (all P <0. 05). Compared with the CP prevention group, fractional shortening (FS) and aortic systolic blood pressure (SBP) increased in the CP treatment group; ejection fraction (EF) decreased in the CP treatment group; the expression of PGC-1α, PGC-1β, NRF-1 mRNA were reduced in the the CP treatment group and the COTG treatment group; the expression of GSK-3β mRNA decreased in the CP treatment group (all P <0. 05). Compared with the COTG treatment group, FS, EF, left ventricular end systolic pressure (LVESP), SBP, and the expression of GSK-3β mRNA were reduced in the CP treatment group (P <0. 05).

CONCLUSIONSCOTG and CP could improve cardiac function, reduce the myocardial infarction area, and promote biogenesis of myocardial mitochondria. Their protective effects on the mitochondria of cadiocytes might be achieved by GSK-3β signalina pathway.

Animals ; Cornus ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Glycogen Synthase Kinase 3 ; Glycogen Synthase Kinase 3 beta ; Glycosides ; Heat-Shock Proteins ; Mitochondria, Heart ; physiology ; Myocardial Infarction ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; Polysaccharides ; Protective Agents ; pharmacology ; therapeutic use ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Transcription Factors

OBJECTIVETo separate and identify cyclopeptides of tubers of Rubia schumanniana.

METHODThe 70% methanol extracts from tubers of Rubia schumanniana were separated and purified by silica gel, RP-18, Sephedax LH-20 and HPLC. Their structures were identified by spectral analysis.

RESULTNine cyclopeptides were separated and identified as RA- II (1), RA-V (2), RA-VIII (3), rubiyunnanin C (4), RA-X (5), RY-II (6), RA- I (7), RA-XIII (8) and RA-XIII-OMe (9), respectively.

CONCLUSIONAll of nine cyclopeptides were separated from R. schumanniana for the first time.

Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Peptides, Cyclic ; analysis ; isolation & purification ; Rubia ; chemistry