Objective　To analyse the relationship between the psychological factors and effect of reduce blood pressure. To study the influence of the psychological factors in therapeutic effect of reduce blood pressure. Methods　While using reduce blood pressure drug, behavioral intervention and biofeedback technique were used to analyse the relationship between the psychological factors and the effect of reduce blood pressure. Results　The change values were positive correlation with the psychological factors and the reduce blood pressure. The change data of Te, E, Hy significantly affected the change data of blood pressure. Conclusion　Behavioral intervention and biofeedback technique could increase the effect of reduce blood pressure drug in aged hypertension, improve their psychological quality of life.

BACKGROUND:Bone marrow derived mesenchymal stem cells (BMSCs) will be homing to the lesions after balloon injury in the inflammatory reaction process.However,the molecular mechanism of transforming growth factor-β1 (TGF-β1) to promote BMSC into smooth muscle-like cell remains unclear.OBJECTIVE:To investigate the BMSC differentiation rate under different TGF-β1 levels after acute vascular injury.DESIGN,TIME AND SETTING:A randomized controlled animal experiment and in vitro induced cell observation were performed at the SPF Laboratory Animal Center and Laboratory of Tissue Engineering,Ninth People's Hospital of Shanghai Jiao Tong University Medical School between January 2008 and May 2009.MATERIALS:A total of 24 male SD rats were randomly divided into normal control and model groups with 12 animals in each group.In addition,6 4-weak-old male SD rats were used to prepare BMSCs.METHODS:Model of acute carotid artery injury was established in model group.Serum of normal control group and model group after 1,3,7 days of injury to detect TGF-β1 level after the vascular injury by ABC-ELISA.The BMSCs after one passage were cultured at a density of (1.0-3.0)×10~5 cells/100 mm in culture dish,and divided into two groups:in routine culture group,cells were cultured in high-glucose DMEM containing 20% fetal bovine serum;in TGF-β1 group,cells were induced by different concentrations of TGF-β1 (1,3,5 and 10 μg/L) based on routine culture for 1 week.MAIN OUTCOME MEASURES:Serum TGF-β1 level after the vascular injury;,cell morphological changes by inverted phase contrast microscopy;smooth muscle α-actin expression.RESULTS:The normal serum TGF-β1 level in rat was low,but increased rapidly after 1 day of injury,reached its peak at 3 days,and declined gradually but did not return to the basic level till day 7.After 1 week of induction,BMSCs were confluent,forming peak valley appearance.Immunocytochemistry showed that compared with routine culture,the rate differentiation of smooth muscle-like cell was significantly increased in cells stimulated by TGF-β1,especially 5 and 10 μg/L TGF-β1 (P ＜ 0.01).Real-time quantitative PCR results were similar to immunocytochemistry.CONCLUSION:Serum TGF-β1 level increased after acute vascular injury and peaked at day 3.In vitro,a similar concentration of TGF-β1 could induce cultured BMSC to differentiate into smooth muscle-like cells.

0 05). The forelimb functional tests demonstrated that, the number of food pellets eaten by PD rats with the contralateral side of 6 OHDA lesion (17 71?4 82) was significantly reduced compared with the controls (34 43?3 55)( P

BACKGROUND: Previous studies demonstrated that adventitia fibroblasts exhibit important role in the hyperplasia of newly born endomembrane after blood vessel injury. However, the mechanism regarding phenotypic transition of adventitia fibroblasts in vitro remains unclear. OBJECTIVE: To observe effect of peroxisome proliferators-activated receptor ?agonist (PPAR ?) on phenotypic transition of adventitia fibroblasts induced by transforming growth factor ?1 (TGF-?1) in vitro, as well as the expression of collagen protein Ⅰ. DESIGN, TIME AND SETTING: A randomized grouping control experiment was performed at the Tissue Engineering Laboratory of Ninth Affiliated Hospital of Shanghai Jiao Tong Medical College between July 2007 and October 2008. MATERIALS: The aorta thoracica's adventitial fibroblasts were cultured from Sprague Dawley rats, with 2-month-old, weighing 120 g. The TGF-?1 was supplied by American GenWay Biotech Company. The rosiglitazone power was purchased from Beijing Comens Chemical Co., Ltd. METHODS: The experiment was divided into 3 groups: In the TGF-?1 group, fibroblasts was induced with TGF-?1 with different concentrations (3, 5, 10, 15 ?g/L) for 48 hours; in the rosiglitazone group, fibroblasts was induced with rosiglitazone (5, 10, 30, 50 ?mol/L) for 45 minutes followed by co-culture with 10 ?g/L TGF-?1 for 48 hours. There was no intervention measure in the control group. MAIN OUTCOME MEASURES: The phenotypic transition of fibroblasts was measured by ?-smooth muscle actin, the expression of smooth muscle ? 2-actin, as well as collagen type Ⅰ was determined by protein immunoblotting. RESULTS: Compared with the control group, 5 ?g/L TGF-?1 could significantly stimulate the changes of phenotypic transition of fibroblasts as well as the expression of smooth muscle ?2-actin and collagen type Ⅰ, which reach a peak level when treated with 10 ?g/L TGF-?1 (P 0.05). Compared with control group, 30 ?mol/L rosiglitazone could significantly inhibit changes of phenotypic transition of fibroblasts as well as the expression of smooth muscle ? 2-actin and collagen type Ⅰ(P

OBJECTIVE: To investigate the potential protective role of Cistanche extracts on 1-methyl-4-phenylpyridinium ion (MPP(+))-induced Parkinson's disease (PD) cellular model, and to find out whether this effect is achieved through the regulation of growth arrest- and DNA damage-induced gene 153 (GADD153). METHODS: MPP(+))-induced cellular injury and the protective effect of Cistanche extracts on the SH-SY5Y cell line viability treated by MPP(+)) were investigated by using methyl thiazolyl tetrazolium (MTT) assay. The mRNA of GADD153 in SH-SY5Y cell line treated by MPP(+)) and Cistanche extracts were evaluated by reverse transcriptase-polymerase chain reaction (RT-PCR). The protein level of GADD153 in SH-SY5Y was assessed by Western blotting. RESULTS: Cistanche extracts (100 mug/ml) increased the cell viability (P<0.01). And the mRNA of GADD153 in the Cistanche extracts pretreatment group was much less than that in the MPP(+)) group (P<0.01). The result of Western blotting showed that GADD153 had a lower level in the Cistanche extracts pretreatment group, compared with MPP(+)) group, especially in the 100 microg/ml group (P<0.01). CONCLUSION: Cistanche extracts pretreatment has a protective effect on the MPP(+))-treated SH-SY5Y cell line, and its down-regulation of GADD153 may contribute to the effect.

Objective To investigate the coagulant function of Thrombomodulin-Protein C-EPCR System in rats with hemorrhagic shock in virto study.Methods In this study,30 rats were divided into three groups,with each group 10 rats:control group,the sham shock group,hemorrhagic shock group.Hemorrhagic shock model was subjected to computer-controlled arterial hemorrhage to 40 mm Hg for 60 min The rat blood serum samples were obtained from rats in sham shock group and shock group after maintaining 3 hours,and fetal bovine serum (FBS) was used as control group.Then medium contained fore-mentioned serums cultured with SV40-transformed aortic rat endothelial cells for 6 hours,12 hours and 18hours.The messenger RNA (mRNA) expression of thrombmodulin (TM),Endothelial cell protein C receptor in the SV40-transformed aortic rat endothelial cells which were treated with serums were detected by reverse-transcription polymerase chain reaction.Results Compared to control group,SVARECs were incubated for 6hrs with shock serum,the mRNA expression of TF,TM and t-PA was significantly higher,and continued elevating at the time of 18 hours (P ＜ 0.01).Conclusions Serums from hemorrhagic shock rats upregulate TMmRNA EPCRmRNA expression on the endothelial cells surface.It is suggested that Thrombomodulin-Protein C-EPCR System pay a key role of anticoagulation,the protection of endothelial function.

Objective To treat scalp lacerations by using the hair apposition technique (HAT) and to compare the HAT with standard suturing in a controlled prospective trial. Method Fifty patients with scalp lacerations were treated either by HAT or by standard suturing. Two groups were evaluated in consumed times for operation, pain sores, and complications. Results There were 30 HAT patients and 20 patients treated with suturing. The took shorter operation time consumed[(3.33 vs. (6.05 t = 4.85.P < 0.01], and HAT produced significantly lower pain score [(1.73vs. (3.20t = 4.01,P < 0.01]. There was a trend that more and more patients were willing to have HAT performed. Conclusions The advantages of HAT include a shorter time consumed for operation, less pain, satisfactory wound healing, and high acceptance by patients. HAT is acceptable for treating scalp lacerations in emergency room.

Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) in Zhejiang and to analysis factors associated with outcomes for providing evidence on improving the success rate of cardiopulmonary resuscitation (CPR). Methods Clinical data of 493 patients with OHCA collected from the emergency department (ED) of Zhejiang Provincial People's Hospital, Ningbo Emergency Medical Service Center and Shaoxing Emergency Medical Service Center from January 2012 to August 2016 were analyzed retrospectively. All the data were recorded following the Utstein style included causes of arrest, location of arrest, first arrest rhythm, witnessed by bystanders, bystander CPR, pre-hospital defibrillation, pre-hospital intubation, pre-hospital epinephrine administration, emergency medical services (EMS) response time, return of spontaneous circulation (ROSC) at scene/enroute, ROSC at ED, admission to hospital, survival to hospital discharge and neurological outcomes at discharge. Factors associated with 30 days survival rate of patients with OHCA were analyzed. Results 493 patients were enrolled, of whom 342 were male and 151 were female. The average age was (58.8±21.4) years. The causes of arrests consisted of cardiac etiology (219 cases), trauma (155 cases), respiratory disease (22 cases), drowning (19 cases), electrocution (8 cases) and others (70 cases). Most of the events occurred at home (65.1%) and public places (22.7%). 55.2% patients were witnessed by bystanders while bystander CPR was performed in only 2.6% cases. Asystole was the predominant rhythm (78.7%) observed by the ambulance crew at the arrest site while only 5.5% first arrest rhythms were ventricular fibrillation/ventricular tachycardia (VF/VT). Only 6.9% patients underwent pre-hospital defibrillation. Pre-hospital intubations were attempted in 16.4% patients. Epinephrine was administered in 56.4% patients at scene or in ambulances. EMS response time was (13.6±8.0) minutes. 4.5% patients had ROSC at scene/enroute and 7.7% had ROSC at ED. Only 9.7% patients were admitted to hospital and 1.2% discharged alive. 0.8% patients were still in hospital on 30th day. The 30-day survival rate was 2.0% (10/493) and only 0.8% patients had neurologically favorable survivals [with the cerebral performance category (CPC) score of 1 or 2]. Witnessed by bystanders (3.31% vs. 0.45%), VF/VT as the first arrest rhythm (7.41% vs. 1.72%), bystander CPR (15.38% vs. 1.67%), pre-hospital defibrillation (8.82% vs. 1.53%) and EMS response time < 10 minutes (3.57% vs. 0.74%) could improve 30-day survival rate of OHCA significantly (all P < 0.05). Conclusion Resuscitation survival of OHCA in Zhejiang province was unsatisfactory. Improvements are required in series aspects of OHCA survival chain.

Objective To investigate the clinical effect of early use of enteral nutrition therapy in elderly diabetic patients suffering from severe lower respiratory tract infection.Methods A prospective,randomized,open,controlled trial was conducted.Patients aged ≥ 60 years old with diabetes mellitus complicated by severe lower respiratory tract infection admitted to Department of Geriatrics of the Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from July 2013 to June 2015 were enrolled,and they were divided into the observation group (nasogastric tube infusion of fresubin) and control group (ordinary liquid diet) according to the random number table method,with 60 patients in each group.Nutritional status,inflammation state and immunological indexes before treatment (0 day) and 4,7,14 days after treatment,the outcome of the disease and the nutrition related complications were compared between two groups.Results After treatment,serum albumin (ALB),pro-albumin (PA),immunoglobulin A and G (IgA,IgG) were significantly increased compared with those before treatment in both groups [at 7 days,ALB (g/L):28.37 ± 0.40 vs.26.72 ± 0.37 in control group,29.12 ± 0.25 vs.26.86 ± 0.26 in observation group;PA (mg/L):53.80 ± 6.28 vs.43.76 ± 6.93 in control group,58.46 ± 8.70 vs.44.68 ± 7.33 in observation group;IgG (g/L):11.62±4.72 vs.9.98±3.71 in control group,13.36±4.58 vs.9.88±3.27 in observation group;IgA (g/L):2.31 ±0.35 vs.1.50±0.39 in control group,3.07±0.48 vs.1.37±0.29 in observation group;all P ＜ 0.05].Compared with the control group,the level of PA in observation group was significantly increased from 7 days on (mg/L:58.46 ± 8.70 vs.53.80 ± 6.28,P ＜ 0.05),while ALB,IgG,IgA levels in observation group increased at 14 days [ALB (g/L):33.24 ± 0.45 vs.30.76±0.79,IgG (g/L):15.03 ±3.73 vs.11.45 ±2.83,IgA (g/L):3.56±0.32 vs.2.50±0.16,all P ＜ 0.05].The levels of C-reactive protein (CRP) and procalcitonin (PCT) in both groups gradually lowered,but they were significantly lower in observation group than those in the control group from 4 days on [CRP (mg/L):17.72±4.23 vs.20.96±5.83,PCT (ng/L):123±37 vs.257±88,both P ＜ 0.05],up to 14 days.The hospital mortality rate of the observation group was lowered compared with that of the control group (6.67％ vs.8.89％),and the duration of mechanical ventilation was significantly shortened (hours:145.00±19.39 vs.193.00± 18.97,P ＜ 0.05),insulin dosage was also significantly decreased (U:33.52 ± 5.74 vs.49.71 ± 6.99,P ＜ 0.05).There was no significant difference in the incidence of abdominal distension,diarrhea and reflux of gastric contents between the two groups,and they were relieved after treatment and had no influence on further enteral nutrition therapy.Conclusion Early administration of the complicated enteral nutrition in elderly diabetic patients with severe lower respiratory tract infection cannot only decrease the levels of pro-inflammatory factors in patients,but also shorten the duration of mechanical ventilation,enhance immunity,improve the curative effect with little influence on the blood glucose level.

Since the United States released the first AHA CPR guidelines in 1966 since,CPR tech-nology in the world successfully rescued tens of thousands of cardiac arrest patients.After 50 years of devel-opment,CPR technology has become one of the dying patient in cardiac arrest and basic rescue techniques, have a significant impact on emergency aid,particularly released in 2000 CPR and ECC guidelines:evi-dence based medicine and global experts The recommendations become a strong support for the clinical treat-ment regimen.Thus,with the progress of the study to update the guidelines every five years,the medical profession has become concerned about the release point.October 2015 AHA in 《Circulation》journal re-leased new CPR guidelines,the new guidelines more streamlined processes,promote rapid response.The chain of survival outside the hospital and into the hospital,so that treatment mechanism more flexible.Con-firmed the single rescue operation sequence,sure the high quality of the BLS is the solid foundation of ACLS,and further stressed the importance of ACLS team.The purpose of this combined edition 2010 CPR Guidelines 2015 on the basis of new guidelines for comparative analysis,familiar with and master the new CPR guidelines change,so that medical staff better grasp CPR techniques,more scientific and effective res-cue cardiac arrest patients,improve Cardiopulmonary resuscitation success rate.