Rational clinical nutrition support may slow down the progress from heart insufficiency to heart failure and improve the quality of life.This article summarizes advances in nutrition support in patients with heart insufficiency in terms of nutrition and metabolic characteristics, nutritional risk screening and nutrition status evaluation, nutrient recommendations, and clinical application of nutrition support.Moreover, nutrition and metabolic support in acute heart failure is also discussed.

Objective To research the portable electron video equipment for tracheal intubatton in first aid. Methods According to the attributes of physiological bend and specialty of windpipe and gular of image, a horniness endoscopic of "C" model was designed with optical interface, CCD image transducer and small crystal display. It could quickly and visually lead tracheal intubatton through nonnasality. Results It was portable, visual, easily-operated. The rate of successful leading of tracheal intubatton is 97.8% . Conclusion It is especially suited to field battle, first aid, abrupt affairs, etc.

BACKGROUND: With the prevalence of total knee arthroplasty, periprosthetic joint infection as a serious complication has been an issue of concern.OBJECTIVE: To summarize the advances in the diagnosis and treatment of infection after total knee arthroplasty.METHODS: The first author searched the PubMed and CNKI databases for the literatures related to the diagnosis and treatment of infection after total knee arthroplasty using the keywords of total knee arthroplasty,infection in English and Chinese, respectively. The repetitive articles were excluded, and the risk factors,diagnosis, classification and treatment of infection after total knee arthroplasty were summarized.RESULTS AND CONCLUSION: (1) The infection after artificial knee replacement is closely related to the patient's preoperative condition, operation skills and postoperative status. (2) Diagnosis of infection is based on the detailed understanding of the patients' situation and complete auxiliary examinations. (3) The treatment methods include antibiotics, debridement and retention, reversion, arthrodesis, as well as amputation. (4) Periprosthetic infection is a serious complication after total knee arthroplasty, and early diagnosis and treatment are critical. Furthermore,choosing an appropriate individualized treatment scheme for different patients is important.

Objective To explore the susceptibility of Aspergillus biofilms to common antifungal drugs and molecular mechanisms of antifungal drug resistance of Aspergillus biofilms. Methods The susceptibility of planktonic spores of 22 clinical isolates of Aspergillus spp. to amphotericin B, caspofungin and voriconazole was evaluated by a standard broth microdilution method. Meanwhile, in vitro model of Aspergillus spp. biofilm was established for the 22 isolates, then the susceptibility of Aspergillus spp. biofilm to amphotericin B, caspofungin and voriconazole was evaluated by a method for antifungal susceptibility testing combined with colonmetric XTT-reduction assay. In addition, real-time reverse transcription (RT)-PCR was performed to determine the relative expressions of drug efflux pump genes and azole target enzyme genes during the formation of Aspergillus spp. biofilms. Results In terms of planktonic spores of Aspergillus spp., the- minimal inhibitory concentration (MIC) range was 0.5 to 2 mg/L for amphotericin B, 0.5 to 1 mg/L for voriconazole, and the minimal effective concentration (MEC) range was 0.125 to 0.25 mg/L for caspofungin. As far as Aspergillus spp.biofilms was concerned, the sessile minimum concentration required to inhibit the growth of 50% organisms (SMIC50) and 80% organisms (SMIC80) ranged from 2 to > 32 mg/L and from 8 to > 32 mg/L, respectively, for amphotericin B, from 32 to > 256 mg/L and from 256 to >256 mg/L respectively for caspofungin, from 4 to >256 mg/L and from 32 to > 256 mg/L, respectively for voriconazole. During the formation of Aspergillus spp.biofilms, no change was observed for the expression of any of the 7 tested drug efflux pump genes or azole target enzyme genes at 4 hours, while a significant increase was noted in the expression of AfuMDRl, CYP51B and CYP51A genes at 8 hours, as well as in the expression of AfuMDRl, AfuMDR2, AfuMDR4, CYP51A,CYP51B at 12, 16 and 24 hours. Of these genes, CYP51A showed the strongest increase in expression at the above 4 time points. The expression of AfuMDR3 and atrF experienced no significant change during the formation of Aspergillus spp. biofilms. Conclusions Compared to planktonic spores, Aspergillus spp. biofilms exhibit a decreased susceptibility to amphotericin B, caspofungin and voriconazole. After the formation of biofilms, the expression of drug efflux pump genes and azole target enzyme genes is elevated in Aspergillus spp.

· AIM: To observe the inhibitory effect of triamcinolone acetonide (TA) on the proliferation of monkey choroidretinal endothelial cells (RF/6A) in hypoxia or normal conditions.retinal endothelial cells of rhesus monkey (RF/6A). The effect of TA on the cellular activity was observed by MTT,the effect on cellular proliferation and apoptosis was detected by flow cytometry (FCM).cycle were reduced and the proportion of cells in G2-M phase was increased under the hypoxia condition .TA had a great effect on the cell cycle of choroid-retinal endothelial cells of rhesus monkey and it induced apoptosis of endothelial cells. It relatively increased the S-phase cells and reduced G2-M phase cells under both normal and hypoxia conditions, which indicates its role in blocking cell cycle from s-phase to G2-M phase and reducing mitosis.RF/6A cells while TA has the opposite effect in both normal and hypoxia conditions. TA can also induce apoptosis of endothelial cells.

Objective To study the mutations of Env sequence of SIVmac239 after infection of Chinese rhesus monkeys, and compare the differences and characteristics of Gp120 sequences of enterotropic and neurotropic SIV strains. Methods Six strains of simian immunodeficiency virus were analyzed in this study: four separated from peripheral blood mononuclear cells of SIVmac239-infected monkeys and two neurotropic SIVmac251 strains.Isolated and cultured monoclonal virus was obtained by limiting dilution assay.Gp120 sequences were amplified after the RNA extraction and phylogenetic analysis was processed thereafter.So did the Gp120 amino acid sequence and N-glycosylation sites analysis of the enterotropic and neurotropic strains.Results SIVmac239 had different mutations in four rhesus monkeys.The diversity in amino acid sequences of the enterotropic and neurotropic strains concentrated in the V1 and V4 regions of Gp120.The enterotropic strains had an addition of glycosylation site in V4 but the glycosylation site changes of neurotropic strains were located in the conservative regions of C1, C2 and C3.Conclusions The addition of one glycosylation site in V4 region of GP120 and loss of one glycosylation site in C1 region are associated with enhanced enterotropism and neurotropism.The differences between the enterotropic and neurotropic strains are not dipicted in Gp120 V3 region which is closely related with the tropism of strains.

Objective To investigate the changes of serum apolipoprotein A-I and its clinical significance to acute respiratory infection.Method Totally 44 patients with acute respiratory infection were divided into three groups according to various concentration of Serum apolipoprotein A-I.They were procaleitonin(PCT)＜0.5 ng/ml group,0.5 ng/ml≤PCT＜2 ng/ml group and PCT≥2 ng/ml group.We measured apolipoprotein A-I,C-reactive protein,procalcitonin and albumin within 24 hours after admission.Results With the increase of serumPCT,the production of ApoA-I and albumin were down-regulated,while CRP up-regulated.Conclusions Apolipoprotein A-I has a sound relationship with the acute respiratory infection.It can be used as one of the diagnostic criteria in severe infection patients who have disorders of lipometabolism.

Objective: To compare the long term prognosis between revascularization (REV) and medical therapy (MP) in patients with three-vessel disease (3VD) with or without left main (LM) lesion.
Methods: A total of 4,875 consecutive patients with elective coronary angiography (CAG) diagnosed 3VD with or without LM lesion treated in our hospital from 2007-01 to 2008-12 were retrospectively studied. The patients were divided into 2 groups: MT group,n=705 (14.5%) and REV group,n=4170 (85.5%). The all cause mortality and the rate of revascularization during follow-up period were compared between 2 groups by inverse-probability-weighting approach with propensity score.
Results: There were 3962/4875 (81.3%) patients with simple 3VD (right, left anterior descending and left circumlfex coronary arteries) and 913 (18.7%) with 3VD+LM lesion. The in-hospital mortality was similar between 2 groups (OR=0.7, 95% CI 0.3-1.4,P=0.30). With the longest 2-year follow-up study, the adjusted all cause mortality and the rate of revascularization in MT group were both higher than those in REV group (HR=8.3, 95% CI 6.7-11.1,P<0.001) and (HR=1.4, 95% CI 1.1-1.6,P<0.001). No matter the patients with simple 3VD or 3VD+LM lesion, compared with REV group, MT group had the higher all cause mortality, for 3VD+LM lesion (HR=10.4, 95% CI 7.1-15.4,P<0.001) and for simple 3VD (HR=7.1, 95% CI 5.3-10.0,P<0.001).
Conclusion: In real world, the long term prognosis by revascularization treatment was superior to medical treatment in patients with either simple 3 vessel coronary disease or 3 vessel combining LM disease.

Pig copper zinc superoxide dismutase (CuZnSOD) is an important antioxidant enzyme. Some studies focused on the function of CuZnSOD gene, but the transcriptional regulation of the CuZnSOD gene is not yet fully elucidated. Therefore, the aims of the study were to determine the core promoter region and to explore its mechanism of transcriptional regulation. The 853 bp DNA sequence of 5'-flanking promoter was amplified by performing PCR. A series of CuZnSOD promoter fragments with gradually truncated 5'-end were produced by nested PCR and inserted into pGL3-Basic vector. The activities of the promoters were measured by the dual-luciferase assay system after transient transfection into the NIH/3T3 cells. The results demonstrated that there were 2 potential transcription start sites in the regions from initiation codon to -87 bp and -266 bp, respectively. The region from -383 bp to +67 bp in CuZnSOD gene promoter showed higher activity than other regions, and further deletion analysis demonstrated that the region from -75 bp to -32 bp contained an essential promoter sequence for pig CuZnSOD gene transcription. In addition, several potential transcription factor binding sites were predicted with bioinformatics method. These results suggest that these transcription factor binding sites may be involved in the transcriptional regulation of CuZnSOD gene.
Animals ; Cloning, Molecular ; Gene Expression Regulation ; Genetic Vectors ; Mice ; NIH 3T3 Cells ; Promoter Regions, Genetic ; Superoxide Dismutase ; genetics ; Swine ; Transfection

Objective To evaluate the feasibility of assessing osteoarthritis (OA) in hip dysplasia using 3D delayed gadolinium-enhanced MRI of cartilage (dGEMRIC).Methods Thirty-five hips in 20 patients with radiographic evidence of hip dysplasia underwent 3D-dGEMRIC scanning.Clinical symptoms were assessed with the Western Ontario and McMaster Universities Osteoarthritis ( WOMAC ) questionnaire.Radiographic measurement of lateral center-edge angle and T(o)nnis grading were performed on the X-rays.Hips of T(o)nnis grade 1were included in the group of hips with early OA,while the hips with no evidence of OA and without pain symptom were included in the group of hips with normal morphology.The 3D-dGEMRC scans were completed on a 1.5 T MR scanner.The data of 3D-dGEMRIC was reconstructed radically.The dGEMRIC indices were measured on six sites of periphery zones of hip cartilage on reconstructed images.The dGEMRIC indices among different groups were analyzed by non-parametric tests.The differences of dGEMRIC indices among six sites in the group of early OA or the group of normal morphology were analyzed by Wilcoxon test.Results The mean dGEMRIC indices of six sites were lower in group of T(o)nnis grade 1than in group of T(o)nnis grade 0 ( Z =- 2.149,P =0.032 ),and lower in group of T(o)nnis grade 2 than in group of T(o)nnis grade 1( Z =- 1.990,P =0.047 ).The dGEMRIC indices of the anterior site,anterosuperior site,superior-anterior site,and superior site were significantly different between the group of hips with early OA and the group of hips with normal morphology (Z =-2.333--2.041,all of the P values were lower than 0.05).In the group of hips with normal morphology,the dGEMRIC indices of superior-anterior site of hip were lower than superior site(P =0.028).In the group of hips with early OA,the dGEMRIC indices of superior-anterior site were lower than the other sites except for anterior-superior site ( Z =- 3.041- - 2.277,all of the P values were lower than 0.05 ).Conclusions 3 D-dGEMRIC might be a sensitive technique for detection of glycosaminoglycans alteration in early OA and staging of OA in hip dysplasia.Radial reconstruction could provide an accurate assessment of OA,and the results demonstrated that early cartilage alteration could be detected in the anterior to superior sites of hips,and the earliest cartilage alteration may occur in the superior-anterior site of hips.