Objective To investigate the clinical effect and safety of continuous intravenous pumping of sodium nitroprusside and dopamine on treating elderly patients with refractory heart failure. Methods Two hundred and seventy elderly patients with refractory heart failure were selected as our subjects and they were randomly divided into sodium nitroprusside group,dopamine group and the combined group( 90 cases for each group). All the patients were given the corresponding symptomatic treatment,including oxygen,diuretics, angiotensin converting enzyme inhibitors,digitalis,aldosterone receptor antagonist,etc. Patients in sodium nitroprusside group,dopamine group were treated sodium nitroprusside or dopamine respectively,and patients in combined group were given both of sodium nitroprusside and dopamine by continuous intravenous pumping. Serum brain natriuretic peptide( BNP ),left ventricular ejection fraction( LVEF ),LV end systolic volume index(LVESVI),left ventricular end diastolic volume index(LVEDVI),left ventricular diastolic early, late filling velocity ratio( E/A ),mean arterial pressure and heart rate( HR ) level were measured or recorded. Results The levels of BNP,LVEF,LVESV,LVEDV,E/A,mean arterial pressure and the level of HR among three group before treatment were no significant differences( F =4. 000,1. 434,0. 503,3. 622,3. 589, 4. 135,2. 752;P﹥0. 05). After treatment,the levels of BNP,LVEF,LVESV,LVEDV and HR in combined group were(201. 6 ±66. 8)pg/L,(45 ± 4)%,(29. 8 ± 4. 8)ml/m2,(45. 1 ± 7. 3)ml/m2,(73. 2 ± 11. 2)times/min,in sodium nitroprusside group were( 298. 6 ± 75. 3 ) pg/L,( 37 ± 4 )%,( 35. 5 ± 4. 6 ) ml/m2 ,( 51. 8 ±7.5)ml/m2,(92.9 ±11.5)times/min,and in dopamine group were(293.7 ±78.2)pg/L,(37 ±3)%, (35. 6 ± 5. 8)ml/m2,(52. 1 ± 7. 3)ml/m2,(93. 6 ± 12. 3)times/min respectively,and the differences were significant(F=41. 683,129. 400,43. 600,28. 800,328. 600;P﹤0. 05). The total effective rate in combination group was 97. 8%( 88/90 ),significantly higher than that of sodium nitroprusside group( 86. 7%,8/90 ) or dopamine group( 88. 9%,80/90 ),and the differences were statistically significant(χ2 =7. 683,P ﹤0. 05). There were 3 cases(3. 3%)with adverse reaction in combination group after treatment,including 1 cases of headache and 2 cases of nausea and vomiting. All above symptoms disappeared after stopping drugs. There was 1 cases(1. 1%)with adverse reaction in sodium nitroprusside group,1 cases(1. 1%)in dopamine group,and there was no significant differences seen among three groups(χ2 =1. 630,P﹥0. 05). Conclusion Continuous intravenous infusion of sodium nitroprusside combined with dopamine on cardiac function in elderly patients with refractory heart failure can improve clinical effect and enhance the medication security.

Objective To investigate the changes of gene expression in the cardiac outflow tract (OFT) in Cx43 knockout (Cx43-/-) mouse embryos, and to elucidate the genes involved in the myocardialization of proximal cardiae outflow tract septum. Methods The cDNA was retrotranscripted from RNA, which extracted from OFT tissues of both Cx43-/- and Cx43 wild type (Cx43+/+) mouse embryos on embryonic day (ED) 14.5. The biotin-labeled cRNA derived from the transcription of cDNA was fragmented as probes. The probes were hybridized with Affymetrix Mouse Genome 430 2.0 Array. Gene Array Scanner was used to screen the signals of hybridization, and the expression of genes was detected. Results Among the differentially expressed genes, there were 143 upregulated and 235 downregulated in Cx43 knockout OFT tissue compared with those in Cx43+/+ heart. Functions of proteins encoded by the altered genes encompassed all functional categories, with the largest percentage in genes involved in signaling pathways such as regulation of transcription, cell cycle, etc. Among the differentially expressed genes in the Cx43-/- heart, some were related with TGFβ/BMP signaling pathway, and Ssr1, Ptk2 and Bmp6 were related with conotruncal defects. These genes were verified by Real-time PCR, and the result was consistent with that of microarray (P<0.05).Conclusions Scaned by Gene Array and verified by Real-time PCR, genes related with TGFβ/BMP signaling pathway, and Ssr1, Ptk2 and Bmp6 were differentially expressed in ED 14.5 Cx43-/- OFT tissue, which may be involved in the myocardialization of proximal cardiac outflow tract septum.

Objective To investigate the relationship between angiotensin 1-converting enzyme(ACE)inserting/defaulting(I/D)gene polymorphisms and the carotid intima-media thickness(CCA-IMT)in patients with type 2 diabetes(T2DM).Methods The polymorphisms of ACE(I/D)was determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)method and the CCA-IMT was assessed using non-invasive high resolution B-mode ultrasonography in 120 T2DM in Han's population of Dongguan city.The data were analyzed by Logistic regression to explore the independent and significant risk factors for CCA-IMT increase in type 2 diabetic patients.Results The DD genotype were significantly more common in diabetic patients with CCA-IMT increase than in those without it(F=10.164,P=0.006);Logistic regression analysis showed that DD genotype,age,male gender and essential hypertension contributed significantly to the CCA-IMT increase in type 2 diabetic patients(OR=3.689,1.054,1.562,respectively,P

Objective To explore the relationship of professional stress,social support and somatic symptoms of sub-health status of Ningbo normal senior school teachers. Methods 128 normal senior school teachers were selected and investigated by professional stress scale,social support scale and somatic symptoms of sub-health status scale, and canonical correlation analysis was used. Results The canonical correlation coefficient were 0.563, 0.471( P <0.01) with the existence of social support variable. The somatic symptoms of sub-health status would be greater with the rise of their professional stress and the decline of their social support. The canonical correlation coefficient was 0.497( P <0.01) with the elimination of social support variable. The factor loading of "examination pressure","professional burden" and "career expectation" in canonical variable ξ add to 0.801,0.855,0.726 respectively. The factor loading of "feeling of fatigue","sleep disorders" in canonical variable η add to 0.774,0.859 respectively. Conclusion The social support have adjustment function between the professional stress and somatic symptoms of sub-health status.

BACKGROUND:Except for mechanical properties and physical and chemical properties, corrosion resistance testing is necessary for a variety of biomedical materials applied in the oral environment to ensure the biocompatibility of materials. OBJECTIVE:To explore the corrosion resistance of titanium abutment and different titanium aloysin vitro. METHODS:Corrosion environment byin vitroartificial saliva was constructed with pH=6.0 at (37±0.5)℃. Potentiodynamic polarization technique, scanning electron microscope and X-ray diffraction methods were employed to assess the corrosion resistance of titanium aloy, gold aloy, nickel-chromium aloy, and titanium abutment immersed in the artificial saliva for 24 hours. RESULTS AND CONCLUSION:Different aloys had different steady-state potentials, and the range of passivation region was the largest for gold aloy, folowed by titanium abutments and titanium aloys, and the smalest for nickel-chromium aloy. After 24 hours of immersion in the artificial saliva, passivation films appeared on the surface of different materials. under the scanning electron microscope, the nickel-chromium aloy surface showed obvious traces of corrosion and there were a large number of large-diameter deep pits, but no corrosion occurred on the surface of the remaining three kinds of aloys; on the surface of nickel-chromium aloy, the contents of chromium, molybdenum and aluminum were decreased, and the contents of nickel and oxygen were increased, but there were stil no changes on the surface of the remaining aloys. Cr2O3 was found on the surfaceof nickel-chromium aloy, TiO2 was generated on the surface of titanium abutment and titanium aloy, but Au and Pt stil existed in a single phase on the surface of gold aloy. These findings indicate that titanium aloy and titanium abutment have similar corrosion resistance that is inferior to the gold aloy, but better than the nickel-chromium aloy.

Objective To discuss CT and MRI features of aggressive fibromatosis (AF), especially the characteristic signs of MRI, and to evaluate the value of MRI in diagnosing the disease. Methods The CT and MRI studies in 9 cases with pathologically proven AF were retrospectively analyzed. Results Among 9 cases with AF, one cases could not be discovered by CT and all cases could be discovered by MRI. Appearances of lesion were infiltrating in 7 cases and mass-like in 2 cases. All cases were without calcification and lipo-tissue in the lesion and without edema on adjacent muscle structures. A homogeneous density and high density was seen on CT plain scans and high density on contrast enhanced scans. On MRI scans, variable signal intensity was demonstrated on T 1WI, and high signal intensity on T 2WI, as well as increased signal intensity after contrast enhancement. The signal characteristics primarily reflected the underlying histologic composition of the lesions. Conclusion MRI is more excellent than CT in delineating the site, shape, and extent of these lesions. MRI is valuable in detecting and differentiating AF.

Object To study on the structure of sapogenins from pod of Gleditsia sinensis Lam Methods Pod of G. sinensis was extracted with solvents and the constituents in the extraction isolated, after hydrolised completely, with the aid of flash chromatography to obtain 2 gledgenins Results The structures of the 2 gledgenins were proved to be 3 hydroxy 12 oleanen 28 oic acid and 3, 16 dihydroxy 12 oleanen 28 oic acid respectively as shown by IR, NMR, MS and crystallographic data The structures were further verified by acylation, methylation and followed by reaction with 3, 5 dinitro benzoyl chloride Conclusion New crystalline derivatives were obtained to provide further evidence of their structures

Objective To evaluate the therapeutic effect of spironolactone on schistosomal pulmonary arterial hypertension(SPAH). Methods A total of 62 patients suffered from hepatosplenic schistosomiasis with pulmonary arterial hypertension were divided into the spironolactone group(n=31) and control group (n=31). All the patients underwent serial echocardiography and the clinical effect before and after the treatment was evaluated by assessing the mean pulmonary arterial pressure (mPAP) and pulmonary arterial diameter (PAD). At the same time, the varieties of the clinical symptoms, signs and the distance of the 6-minute walking test (6-MWT) were investigated. Results In spironolactone group, mPAP(-x±s) decreased from (31.8±7.1) mmHg to (21.2±2.1) mmHg, PAD(-x±s) decreased from (28.0±5.0) mm to (20.0±3.5) mm before and after the treatment respectively(P<0.01). There were significant differences in mPAP, PAD, the distance of 6-MWT and the heart function before and after the treatment in the spironolactone group. However, the data did not show the significant difference in the control group. Conclusion The therapeutic effect of spironolactone in the treatment of SPAH is satisfactory.

Objective To observe the effect of intermediate care on recurrence factors and recurrence rate of elderly patients with cerebral infarction.Methods Five Hundred and ninety-eight cases of acute cerebral stroke were divided into two groups,301 cases in the experimental group and 297 cases in the control group.After the acute stage,patients in the experimental group was included into the intermediate care unit.The experimental group was given comprehensive evaluation and multidisciplinary management,including the combination of traditional Chinese and Western medicine treatment,rehabilitation training and physical therapy,medication guidance,nursing and health education.After the acute stage of the disease,the control group patients were in the general ward.The course of treatment was 2 weeks.At baseline(t0),second weeks(t1),sixth months(t2)and twelfth months(t3),the blood pressure(SBP,DBP),fasting blood-glucose(FBG),blood lipid(TC,TG,LDL),serum homocysteine(Hcy)level and the recurrence rate of cerebral infarction in all two groups were observed.Results SBP at t1,t2 and t3 was lower than that at t0 in the experimental group,and the difference was statistically significant(P＜0.05).SBP in the experimental group at t2 and t3 was lower than that in the control group.There was significant difference between the experimental group and the control group(P＜0.05).DBP at t2 and t3 was lower than that at t0 in the experimental group,and the difference was statistically significant(P＜0.05).DP in the experimental group at t2 and t3 was lower than that in the control group.There was significant difference between the experimental group and the control group(P＜0.05).FBG at t1((5.34±0.76)mmol/L),t2(5.86±1.05)mmol/L)and t3(5.62±0.89)mmol/L)were lower than that at t0((7.27±2.34)mmol/L),and the difference was statistically significant(P＜0.05).FBG in the experimental group at t2 and t3 were lower than that in the control group((6.85±0.92)mmol/L,(6.36±1.03)mmol/L).There was significant difference between two groups(P＜0.05).TC at t1((4.86±0.85)mmol/L),t2((4.21±0.76)mmol/L)and t3((3.95±0.64)mmol/L)were lower than that at t0((5.56±1.06)mmol/L),and the difference was statistically significant(P＜0.05).TC in the experimental group at t2 and t3 was lower than that in the control group((5.06±0.93)mmol/L,(4.84±0.76)mmol/L).There was significant difference between two groups(P＜0.05).TG at t3((1.48±0.26)mmol/L)was lower than that at t0((1.86±1.31)mmol/L),and the difference was statistically significant(P＜0.05).TG in the experimental group at t3 was lower than that in the control group((1.71±0.66)mmol/L).There was significant difference between two groups(P＜0.05).LDL at t1((3.76±0.92)mmol/L),t2((3.09±0.62)mmol/L)and t3((2.59±0.51)mmol/L)were lower than that at t0((4.59±1.45)mmol/L),and the difference was statistically significant(P＜0.05).LDL in the experimental group at t2and t3 was lower than that in the control group((4.09±0.75)mmol/L,(4.12±0.64)mmol/L).There was significant difference between two groups(P＜0.05).Hcy at t1((14.16±3.17)μmol/L),t2((10.37±2.59)μmol/L)and t3((10.10±1.86)μmol/L)were lower than that at t0((23.62±5.62)μmol/L),and the difference was statistically significant(P＜0.05).Hcy in the experimental group at t2and t3 was lower than that in the control group((18.52±3.64)μmol/L,(16.37±2.75)μmol/L).There was significant difference between two groups(P＜0.05).The recurrence rate of cerebral infarction within 1 years was 4.7％(14/301)and 7.1％(21/297)in the experimental group and the control group.There was a decreasing tendency,but no statistical significance(P=0.208).Conclusion The intermediate care may affect the blood pressure,FBG,blood lipids,serum Hcy levels in elderly patients with cerebral infarction,so as to reduce the recurrence rate of cerebral infarction.

Objective To summarize the experience of clinical application of combining double suture fixation and resection of partial fat retro-orbicularis oculus in some specially difficult blepharoplasty.Methods During upper blepharoplasty,patients with heaviness and bulkiness in the both upper eyelid and lateral upper orbital region,we combined double suture fixation and resection partial fat retro-orbicularis oculus.First,partial pretarsal bulky fat was resected,and to form skin-orbicularisoculi composite below incision line.And then,some thickened fat retro-orbicularis oculus was resected,which was also named preseptal and retro-orbicularis oculus fat (ROOF).Double suture fixation techniques were applied to form dynamic and physiological double eyelid.Results 146 cases had satisfactory effectiveness,except for 2 cases with secondary operation because of some superficial double eyelid creases,and 1 case had hematoma,and 3 had transient numbness in the lateral supraorbital nerve region.They were satisfied with healthy eyelid skins,concealed incision and non-serious complications followed at 3-24 months postoperatively.Conclusions Combining double suture fixation and resection of partial fat retro-orbicularis oculus would appear to be a useful adjunct to standard blepharoplasty techniques in selected patients.