Objective To explore the change of serum concentrations of apolipoprotein A5(APOA5),and the relationship with levels of adiponectin and fasting insulin(FINS)in patients with coronary heart disease(CHD).Methods Blood lipids,the serum concentrations of APOA5,adiponectin and insulin were examined in 95 individuals,who were divided into two groups:51 patients with CHD and 44 healthy individuals.Results The concentrations of APOA5 and adiponectin in CHD patients were significantly lower than the healthy individuals[(230.06?115.8)?g/L and(3.03?1.85)?g/L vs(324.43?151.79)?g/L and(4.12?2.48)?g/L respectively,all P

Objective To investigate the effect of early continuous veno-venous hemofiltration (CVVH) on intra-abdominal pressure (IAP) and serum interleukin-6 (IL-6) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS).Methods 41 SAP patients with ACS were selected as treatment group and treated with CVVH as well as conventional methods in ICU.The other 12 patients with the same disease were selected as the control group and were only treated with conventional methods because of economic reasons.IAP and blood level of IL-6 in the two groups were measured daily in order to investigate their changes and the correlation between the two parameters.Results The serum IL-6 level and IAP in the two groups were higher on admission day.IAP and serum IL-6 level in the treatment group were significantly decreased on the first day after treatment,and thereafter decreased rapidly.In the control group,IAP and serum IL-6 level were significantly decreased on the 3rd day after treatment.IAP and serum IL-6 level from the 1st day to the 6th day after treatment in the treatment group were significantly lower than those of the control group at the same time point (P＜0.05).There was a significant positive correlation between blood IL-6 level and IAP in SAP patients with ACS(r=0.48,P＜0.01).IL-6 difference before and after treatment was also positively correlated with the difference of IAP(R=0.39,P＜0.05).Conclusions VVH significantly decreased the IAP and the blood level of IL-6 in ACS patients of SAP.The blood level of IL-6 is significantly correlated with IAP,suggesting that IL-6 may play an important role in the pathogenesis of ACS.Therefore early CVVH may clear the cytokines such as IL-6 and lower IAP,thus to prevent multiple organ dysfunction syndrome (MODS),which should be applied in the early stage of ACS.

Objective To investigate the effects of early estrogen replacement therapy(ERT) with different doses on aortic endothelial senescence and its possible mechanism. Methods Twenty- eight healthy New Zealand white female rabbits were randomized into four groups: group A(n=7), in sham operation;group B(n=7), ovariectomized;group C(n=7), ovariectomized and in low-dose ERT(estradiol benzoate 200 μg,im, QOD) ;and group D(n=7), ovariectomized and in high-dose ERT (estradiol benzoate 1000 μg,im,QOD). All rabbits were fed with high fat diet and the rabbits in group C and group D were given ERT from the 7th day after the operation. Blood samples taken via ear central artery before the operation and after the high fat diet for 4 and 12 weeks were used to determine the concentrations of serum estradiol(E2), total cholesterol(TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), trigtyceride (TG) and asymmetric dimethylarginine(ADMA). After 12 weeks, the aorta was separated for histopathologic analysis and the areas of senescent endothelium and atherosclerotic plaque were calculated.Results (1)After ovariectomized, the concentration of serum estradiol(E2) was significantly lower in group B than in other groups (all P<0.05). Twelve weeks later, the level of E2in was higher group D than in group A and C(both P<0. 05), but there was no significant difference between group C and group A (P< 0. 05). (2)After the high-fat diet for 4 and 12 weeks, there was a notable increase of TC, LDL-C, TG and HDL-C levels in rabbits of each group(all P<0. 01). After 12 weeks, the levels of TC and LDL- C were remarkably higher in group B than in other groups(all P<0. 01), however, the levels of TG and HDL-C were lower in group B than in other groups(all P<0. 01). The concentrations of TC and LDL-C in group C and group D were lower than those in group A (all P<0.01), but the differences of the levels of TG and HDL-C in group C and group D were not significant in comparison with group A (all P>0. 05). There were no significant differences in the lipid levels between group C and D (all P> 0. 05). (3)After 12-week high fat diet, there were a striking increases of serum ADMA level in all four groups (all P>0. 05). The level of ADMA was higher in group B than in other groups (P< 0. 05) andlower in group C and D than that in group A (both P<0. 05). There was no significant difference between group C and D (P<0. 05). (4)12 weeks later, the areas of senescent endothelium and atherosclerotic plaque in group B were significantly larger than those in other groups (all P< 0. 01), and the areas were smaller in group C and D than those in group A (all P<0. 01), there was no significant difference between group C and group D(both P>0.05). (5)Linear correlation analysis showed that there was an obvious positive correlation between the areas of senescent endothelium and atherosclerotic plaque(r=0. 962, P<0. 01), and both of them were positively correlated with the levels of serum AMDA (r=0. 812,0. 824,0. 755,0. 797,0. 749,0. 727), TC (r=0. 812,0. 824) and LDL-C(r=0. 755,0. 797) (all P<0. 01) and negatively correlated with the concentration of serum E2 (r=-0. 762,-0. 743, both P<0. 01).Conclusions Early ERT can improve serum lipid metabolism, reduce ADMA level, inhibit vascular endothelial senescence and attenuate atherogenesis. The delaying effect of estrogen on endothelial senescence may be due to its improving lipid metabolism and lowering ADMA level.

Objective To probe into the social support, coping styles, and mental health status of medical staff in a tertiary hospital in Beijing, for identifying potential mental problems. Methods Such means as the Social Support Rating Sheet (SSRS), Simple Coping Style Questionnaire (SCSQ), Symptom Checklist (SCL-90), and demographic characteristics questionnaire were called into play, to study 2460 medical staff in five tertiary hospitals in Beijing. Results Differences were identified among medical staff of different demographic characteristics, in terms of positive coping style and support dimensions. Analysis of the survey data indicates that the total SCL scores, total symptom problem index, positive symptom pain level, total average score of the factors, are positively related to passive coping style, as P<0. 01; and are negatively related to subjective/objective support, support utilization, and total support scores, as P<0. 01. Conclusions Hospital administration is expected to implement focused intervention to such medical staff as those under 40 years old, women, widows or divorcees, those with education lower than university degree, those with junior academic title or lower, those without titles, those in emergency departments and emergency intensive care units, doctors and nurses, frequent night-shift workers, those of excessively low self evaluation, and medical staff with chronic diseases. The purpose of this practice is to alleviate their mental stress.

Objective To evaluate the preliminary screening effect of the ESS、SAQLI and QOLOSAHS for OSAHS,and find out the most effective preliminary screening method.Methods The scores of ESS、SAQLI、QOL-OSAHS of the 93 participants were analyzed.The predictive values of the three scales for OSAHS were determined by receiver operator curve and discriminatory analysis.Results The sensitivity and specificity of ESS(ESS≥9 points) were 0.486 and 0.870.The sensitivity and specificity of SAQLI (≤246 points) were 0.914 and 0.522.The sensitivity and specificity of QOL-OSAHS (≤161 points) were 0.886 and 0.522.Conclusions ESS、SAQLI、QOL-OSAHS have moderate predictive value for OSAHS.SAQLI is better to drinker than ESS for diagnosis of OSAHS.

Objective:To construct recombinant lentiviral vectors harboring interference RNA ( RNAi ) targetting murine TNF-αgene,so as to lay the foundation on the RNAi gene therapy.Methods: Three small interfering RNA ( siRNA) sequences targeting murine TNF-αgene ( siRNA1,siRNA2,siRNA3) and negative-control siRNA were designed and synthesized.The inhibition effects of siRNAs on TNF-α,IL-1βand IL-6 secretion of LPS-stimulated RAW264.7 macrophages were observed using real-time PCR and ELISA methods.DNA oligo was designed and synthesized according to the most effective siRNA 2 sequence.The recombinant lentiviral shuttle plasmid expressing short hairpin RNA ( shRNA) was constructed and sequenced.The lentiviral shuttle plasmids with packaging plasmids were transfected into 293T cells to produce lentiviral particles.Results: ①The TNF-αmRNA relative expression levels of siRNA1, siRNA2 and siRNA3 were 0.24±0.01,0.16±0.02,0.19±0.01 respectively,significantly lower than that of negative control (0.95± 0.02) (F=531.3,P<0.001).The inhibition rates at mRNA level were 74.26%,83.09%,79.93%,respectively comparing with negative control.No significance was observed in IL-1βor IL-6 mRNA relative expression change after TNF-αsiRNA transfection ( P>0.05).②The TNF-αprotein expression levels of siRNA1,siRNA2 and siRNA3 were (23.95±1.21),(17.27±1.46),(19.07± 1.57)ng/ml respectively,significantly lower than that of negative control (35.37±2.93)ng/ml (F=18.1,P=0.000 6<0.001).The inhibition rates of protein expression were 32.29%, 51.16%, 46.08%, respectively comparing with negative control.③The PCR product electrophoresis showed that recombinant vectors yielded 343 bp fragments,non-constructed vectors yielded 306 bp fragments.DNA sequencing partially showed insertion sequence.④Lentiviral particles were obtained by transfecting 293T cells with recombinant lentiviral shuttle plasmids and lentiviral packaging plasmids.Cells grew well during virus production with strong fluorescence expression.The titer of concentrated virus was 2×106 TU/μl.Conclusion:The lentiviral vector harboring RNAi targeting murine TNF-αgene has been successfully constructed.

Action Potentials ; Animals ; Ear, Inner ; blood supply ; Facial Nerve ; physiopathology ; Hearing Loss, Sensorineural ; etiology ; Rabbits

Objective To investigate the infiltration and prognostic significance of tumor-infiltrating mast cells (TIMs) in nasopharyngeal carcinoma (NPC).Methods Immunohistochemistry for tryptase was performed on 154 NPC specimens.The median value of TIM density was used as a cutoff point to separate the patient cohort into two groups with either low or high TIM infiltration.The associations between TIM and clinicopathological factors were analyzed by Mann-Whitney U text.Survival curves were plotted according to the Kaplan-Meier method.Univariate and multivariate analyses were performed using the Log-rank test and the Cox proportional hazard models,respectively.P ＜ 0.05 was considered statistically significant.All statistical analyses were conducted using SPSS 13.0.Results TIM was mainly in the stroma of NPC and detected in all specimens.The median value of TIM density (25.60/high power field) was used as a cutoff point to separate the patient cohort into two groups with either low or high TIM infiltration.The density of TIM was positively correlated with N stage (Z =-2.193,P ＜ 0.05) and clinical stage (Z =-2.551,P ＜ 0.05).The 3-year overall survival (OS) and progression-free survival (PFS) of patients were 64.4％ and 55.7％ in the high TIM density group;78.3％ and 77.0％ in the low TIM density group.For survival evaluation,high density of TIM was associated with worse OS and PFS (P ＜ 0.05).Multivariate Cox regression model analysis showed TIM infiltration was an independent risk factor for both OS and PFS.Conclusions The density of TIM in NPC increased with tumor stage.High TIM infiltration was associated with poor overall survival and progression-free survival.

Objective To explore the status, characteristics and factors in relation to occupational stress for medical staffs in tertiary general hospitals. Methods A total of 2460 medical staff were sampled in five tertiary general hospitals in Beijing, with their occupational stress levels evaluated with the Occupational Stress Inventory. Results The top ten stressors as found ranked as heavy duty, high risk exposure, high workload, low wages, setbacks in the health care management system, insufficient staffing, excessively frequent inspections and examinations, strained doctor-patient relationship, price inflation, frequent overtime, and pressure from continuous learning. Occupational stress is seen as moderate and above by 95.2% of the surveyed. Differences in age, gender, marital status, professional title, education, work experience, as well as those of different organizations, departments, professions, and duty were found to be statistically significant in regard of professional stress. Conclusions Stress management should be in place targeting demographic and stress characteristics. Effective measures are recommended to alleviate the pressure on medical staff, in order to maintain their physical and mental health, hence improving their work efficiency and organizational cohesion.

Objective To investigate the clinical features of aortic dissection (AD) and emergency treatments. Methods Data from 784 patients with aortic dissection were collected in the Department of Emergency from January 2000 through December 2009. A retrospective analysis was carried out to determine the survival rate, mortality rate and treatment efficiency. Results Pain was the most common onset symptom (77.7% , 609/784). The majority of patients (86.5%) had essential hypertension (678/784). All the patients with preoperative diagnosis of aortic dissection underwent emergency medical intervention by internists resulting in 81.5% survival rate (639/784) and 18.5% mortality rate (145/784). There were 157 patients without improvement (20.0% ) and the total efficiency rate was (83. 1% ). The efficiency rate of conventional treatment was 76.4% , while the efficiency rate of triple four-procedure treatment was 89. 8% (P<0.05). Of them, 139 patients (17. 7% ) died in the hospital. Among them,. 26 patients died within 24 hours (18.4% ) and 47 cases died within 48 hours (33. 8% ) and 66 patients died within 72 hours (47.2% ). There were 92 patients who refused treatments after diagnosis, and among them, 81 patients died within 72 hours (88.04% ). The difference in mortality rate between two groups was significant (P<0.05). Conclusions The diagnosis of aortic dissection depends on detailed history, physical examination and CT or MRI imaging. Analgesia, sedation and control of blood pressure are essential for emergency treatments. Early diagnosis and effective emergency treatments are the critical strategy for the early surgical intervention and time window for further treatment to improve the survival rate of AD.