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 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.

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

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 investigate the expression of apolipoprotein M in rats after renal transplantation and its role and action mechanism in acute rejection (AR).Methods The kidney transplantation model in rats were established.Male SD and Wistar rats were used as donors,and Wistar rats as recipients.Three groups were designated:control group (syngeneic transplantation,n =24,recipients were treated with normal saline i.p.); AR group (allogeneic transplantation,n =24,recipients were treated with normal saline i.p.); PDTC group [allogeneic transplantation,n =24,recipients were treated with NF-κB inhibitor-pyrrolidine dithiocarbamat (PDTC) i.p.].The renal grafts were drawn at day 1,3,5 and 7 post-transplantation,and the expression levels of NF-κB P65 and apoM protein were detected by using Western blotting,and those of apoM,perforin and granzyme B mRNA were by using real-time PCR.The correlation of apoM and NF-κB,apoM and perforin,and apoM and granzyme B was respectively analyzed.Results As compared with control group,the expression levels of apoM,perforin and granzyme B mRNA in AR and PDTC groups were dramatically up-regulated at each time point (P＜0.01),and those in PDTC group were significantly lower than those in AR group (P＜0.01).The expression levels of apoM and NF-κB protein in AR group were both distinctly higher than those in control group (P＜0.01),and those in PDTC group were markedly lower than those in AR group (P＜0.01).A significantly positive correlation was found between the expression of apoM and NF-κB protein (r =0.469,P＜0.05).And the expression of apoM mRNA was positively correlated to perforin and granzyme B mRNA (r =0.731,P＜0.01 ; r =0.514,P＜0.05).Conclusion The expression of apoM is obviously up-regulated in renal grafts of rats,which may take part in the pathogenesis of AR via NF-κB.

Objective To report the experience of the arterial switch operation(ASO) for Taussig-Bing anomaly and late outcomes.Methods From January 2001 to December 2015,57 patients were underwent arterial switch operation for Taussig-Bing anomaly in Fudan university affiliated children's hospital cardiac center,Median age and weight at operation was 63(37.5-88.5)days, 4.1(3.4-5.0)kg, respectively.29 patients with Arch anomalies(50.9%), 23 patients with unusual coronaries(40.3%),according to have arch anomaly or not and surgery time, dividing the patients into two groups, group A(have, n=29)and group B(not have, n=28), earlier experience into group 1(2001-2008, n=27), later experience into group 2(2009-2015, n=30), respectively.Results The Mortality was12.3%, the mortality of group A and group B was 13.8%, 10.7%(P>0.05),group 1 and group 2 was 22.2%, 3.3%(P<0.05) respectively, follow up was complete in 47 patients with a mean follow-up of(6.2±3.5) years , three patients lost, there was no late mortality, the actual survival at 1, 5year was 87%, 87%, respectively.Reintervention was required in 10 patients(21.3%), the aorta-PA valve diameter ratio was a risk factor for reintervention(group A P=0.02, group B P=0.04) ,and 1,2,5year free of reintervention was 95.6%, 86.6%, 77.2%, respectively.Conclusion The ASO approach can be applied to Taussig-Bing anomaly with acceptable mortality , and it is the procedure of choice at our institution.One stage to repair TBA with aortic arch abnormalities did not influence outcomes.The aorta-PA valve diameter ratio<0.5 was a risk factor for reintervention.

Objective To investigate the application of 3D printing technique in the treatment of obsolete pelvic and acetabular fractures.Methods The clinical data of 23 patients with obsolete pelvic and acetabular fractures were retrospectively analyzed who had been surgically treated in our hospital from January 2006 through January 2016.3D printing technique was used in surgical planning in 11 of them,including 8 males and 3 females,with an average age of 33.8 ±4.9 years (3D group).The other 12 patients received conventional surgery without using 3D printing technique.They were 9 males and 3 females,with an average age of 34.8 ± 8.3 years (conventional group).The primary pelvic fractures in both groups were all type C according to the Tile classification system.The patients complicated with acetabular fracture in the 3D group and the conventional group were 10 and 11 cases respectively.The operative time,blood loss,blood transfusion.intraoperative fluoroscopy,visual analogue score (VAS) and Majeed score were compared between the 2 groups.Results The 2 groups were compatible in terms of preoperative general data (P ＞ 0.05).For the 3D group and the conventional group,operative time was 166.4± 24.2 min versus 222.5 ± 49.0 min.blood loss 2,063.6 ± 484.3 mL versus 2,700.0 ± 597.0 mL,blood transfusion 13.2 ± 3.2 U versus 17.6 ± 4.5 U,and intraoperative fluoroscopy 7.4 ± 1.3 times versus 11.7 ± 3.6 times.There were significant differences between the 2 groups in the above indexes (P ＜ 0.05).The 3D group and the conventional group obtained an average follow-up of 18.4 months and 21.7 months,respectively.The postoperative VAS scores were respectively 1.8 ±-0.9 points and 3.4 ± 1.0 points for the 2 groups,showing a significant between-group difference (P ＜0.05).The Majeed scores at the last follow-ups were respectively 85.7 ± 4.2 points and 84.9 ± 3.1 points for the 2 groups,showing no significant between-group difference (P ＞ 0.05).There were no such complications in the 3D group as iatrogenic nerve injury,vascular injury,nonunion or internal fixation failure.One patient in the conventional group suffered transient iatrogenic injury to the sciatic nerve.Conclusions 3D printing technique can provide helpful guidance for diagnosis and fracture classification preoperatively.It improves the patient's perioperative safety by benefiting intraoperative reduction,shortening operative time,and reducing intraoperative blood loss and intraoperative fluoroscopy.