Objective: TO study the change of substance P(SP) level in Plasma and its relationship with ankylosing spondylitis(AS).Method: Radioimmunoassay. Results: The author observed that the level of SP in Plasma of AS is singificantly higher than that of healthy controls. SP level in AS patients during active stage is higher than in those during inactive stage. Conclusion: Increased SP may play an importantrole in the pathogenesis Of AS.

Objective To observe the effect of extracorporeal shock waves (ESW) therapy on avascular necrosis of femoral head (ANFH) of stage IV. Methods 72 hips of 44 patients with ANFH of stage IV, according to Association Research Circulation Osseous, were randomly divided into treatment group (n=37) and control group (n=35). The control group received routine therapy, while the treatment group received ESW in addition, 2.0-4.0 bar, 10 Hz, 6000 times. They were evaluated with Harris Hip Score, Manual Muscle Test (MMT) and Short Form of health survey (SF-36) before and 1 month after treatment. Results The scores of Harris Hip Score and MMT improved more in the treatment group than in the control group (P<0.05) after treatment, as well as the scores of SF-36 except physical health and vitality (P<0.05). Conclusion The ESW can obviously improve the motor function and quality of life of patients with ANFH of stage IV.

Objective To investigate effects of neuromuscular electrical stimulation (NMES) on pulmonary arterial hypertension induced by chronic hypoxic hypercapnia in rats.Methods Eighteen male Sprague-Dawley rats were randomly divided into a normal control group (the control group),a hypoxic hypercapnia group (the model group),and a hypoxic hypercapnia + NMES group (the NMES group),each of 6.The rats in both the model and NMES groups were placed in an isobaric cabin with an O2 concentration of 9％ to 11％ and a CO2 concentration of 5％ to 6％ for 8 hours a day for 4 weeks.After leaving the cabin,NMES was performed on the NMES group's bilateral calf muscles for 30 minutes every day.The heart was removed,and the right ventricle (RV) and the left ventricle plus the septum (LV+S) were dissected.An index of right ventricular hypertrophy was calculated as RVHI=RV/(LV+S).Any changes in the pulmonary vasculature were observed using an optical microscope.WT％ and WA％ were calculated.The expression of hypoxia-inducible factor-1α (HIF-1α),PDH-E1α and PDK1 in the lung tissue were determined using western blotting.The LDH activity and the concentration of PDH in the lung tissue homogenate were measured was measured by spectrophotometric method using the LDH assay kit and ELISA,respectively.Results Compared with the control group,the average RVHI,WT％ and WA％,the protein expression of HIF-lα and PDK1,and LDH activity had all increased significantly in the NMES group,while the average expression of PDH-1Eα had decreased significantly.Compared with the model group,significant decrease was observed in the average RVHI,WT％,WA％,protein expression of HIF-1α and PDK1,and LDH activity in the NMES group,but the average expression of PDH-1Eα increased significantly.No significant differences in PDH concentration were detected among the 3 groups.Conclusions NMES may alleviate pulmonary artery hypertension induced by chronic hypoxic hypercapnia,at least in rats.The mechanism may be attributed to inhibiting the expression of HIF-1α protein,which may inhibit the activity of PDH-E1α and LDH,then the aerobic metabolism into glycolysis,finally improving the remodeling of the pulmonary vascular structure.

Objective To explore the correlations between trustworthiness leadership of head nurses and work immersion. Method A questionnaire on trustworthiness leadership of head nurse and the nurses′ work immersion scale were used to have investigation among 460 nurses. Results The total score on trustworthiness leadership was (105.04 ± 13.78), which was in the middle level and the total score on work immersion was (41.28 ± 10.08), which was at a higher level. The trustworthiness leadership was positively related to their work immersion as well as its dimensions (all P<0.05). Conclusion The administrators of the hospitals and nursing managers should pay attention to head nurse′s trustworthy leadership , for the purpose of improving the integrity of the leadership behavior of head nurses.

Objective To evaluate risk factors of in-hospital mortality during extracorporeal membrane oxygenation(ECMO) support for those with refractory cardiogenic shock after aortic surgery.Methods Retrospective analyses were conducted for 35 patients using ECMO after aortic surgery at Beijing Anzhen Hospital,Capital Medical University from September 2009 to March 2016.Demographic characteristics,diagnosis,ECMO related data,including ECMO indication,operation,clinical parameters before and 24 hours during ECMO were collected to set up a database.The patients were divided into survival group and non-survival group according to the prognosis.The risk factors of mortality in hospital after ECMO were analyzed by multivariate logistic regression analysis regression.Results There were 35 adult patients who had received ECMO support with 32 male and 3female.All patients received veno-arterial ECMO (V-A ECMO).ECMO was successfully weaned in 22 patients (62.9％),and 18 patients(51.4％) survived.Multivariate logistic regression analysis revealed that high lactic acid levels at 12 hours after ECMO(OR =1.445;95％ CI:1.026-2.034) and multiple organ dysfunction syndrome(MODS,OR =10.412;95％ CI:2.246-70.798)(P ＜ 0.05) were independent risk factors of in-hospital mortality in adult patients undergoing ECMO after aortic surgery.Conclusion High lactic acid levels at 12 hours after ECMO and MODS were very important factors of patients undergoing ECMO after aortic surgery.The proper identification and management shall improve the prognosis of patients.

Objective: To explore the effect of Laminarina Japonica Polysaccharides (LJPS) on blood glucose in diabetes mice.Methods: Effect of LJPS on alloxan inducing diabetes mellitus model was investigated by applying different doses(125,250 and 500mg/kg bw).Results: The doses of LJPS were able to lower blood glucose level by 34.96%,20.70% and 26.82% respectively. They also decreased BUN level, enhanced liver glycogen, calcium in serum and insulin concentration. LJPS could restore the injury of alloxan induced pancreas islet significantly by histopathological findingConclusion: The results show that LJPS is an active component in protecting against alloxan induced pancreas injury and mediating the blood glucose level.

Objective To detect the effect of a new bioactive bone screws composed of nanohydroxyapatite/polyamid 66/glass fiber (n-HA/PA66/GF) biomaterial on biological behavior of osteoblasts with a view to a later clinical application of the screws.Methods Mice osteoblasts were co-cultured with n-HA/PA66/GF biomaterial or its extract.Cell growth was detected under a microscope,cell proliferation using MTT assay,apoptosis by flow cytometry,osteocalcin by ELISA method,cell migration using Transwell invasion assay,cell adhesion and growth by scanning electron microscope,and cytoskeleton and actin filament distribution using immunofluorescene.Results Direct contact test demonstrated n-HA/PA66/GF material had no obvious cytotoxicity to osteoblasts.Extract of n-HA/PA66/GF material stimulated osteoblast proliferative activity over time with absorbance value of 0.96 ± 0.14,1.54 ± 0.15,and 2.39 ±0.27 respectively after 2,4,and 6 hours of coculture (P ＜ 0.05).The n-HA/PA66/GF material induced more osteoblasts to entering S period without obvious influence on apoptosis rate and promoted osteocalcin secretion.Migrated cells in medium supplied with n-HA/PA66/GF material or FBS was 8.73 ± 3.26 and 9.47 ± 3.29 in each visual field,but there was no significant difference (P ＞ 0.05).Osteoblasts had a regular form on the surface of n-HA/PA66/GF material,closely adhered to the surface,and reproduced and aggregated with each other to form stratified cell layers.However,nHA/PA66/GF material exhibited no obvious influence on distribution of cytoskeleton and actin filament.Conclusion The new n-HA/PA66/GF screws has excellent cytocompatibility with positive regulatory effect on cell growth,proliferation,secretion,adhesion,cycle,and osteocalcin secretion.

Objective To quantitatively analyze the correlation between stenosis ratio and cerebral perfusion in patients with solely symptomatic M1 stenosis of middle cerebral artery.Methods All the patients with solely symptomatic M1 stenosis of middle cerebral artery were selected to this study from consecutive 203 patients with elective stenting of symptomatic intracranial artery stenosis.Brain CT, CT perfusion (CTP) and DSA examinations were performed in all cases.The CTP parameters of mean transit time (MTT), cerebral blood flow (CBF) and cerebral blood volume (CBV) were measured in regions of interest (ROIs) including bilateral frontal lobe, anterior watershed, opercula of the insula (including parsopercluaris and part of insula), temporal lobe, posterior watershed and occipital lobe.Compared with the unaffected side as control, the change of CTP and their relative CTP parameters in these ROIs at affected side were analyzed.Based on DSA data, the ratio of M1 stenosis was measured manually and blindly, the source of collateral branch of compensative artery was estimated and the blood flow was graded.Correlation between the ratio of M1 stenosis and the CTP parameters including the absolute and the relative values was investigated.Results Twenty patients were selected into this study; their average M1 stenosis ration of the affected side was 70.5% ± 10.6% (53% to 91%).Compared with the unaffected side, MTT and CBF were no significant change but CBV increased in the affected frontal lobe; MTT prolonged, CBF was normal and CBV increased in the affected anterior watershed and opercula of the insula; MTT prolonged, CBF and CBV had no significant difference in the affected temporal lobe; MTT prolonged, CBF decreased and CBV had no significant difference in the affected posterior watershed; MTT, CBF and CBV were normal in occipital lobe.Tissue perfusion gradually decreased from the front to the backward in all the M1 stenosis affected cerebral regions and the posterior watershed area was the only region at hemodynamic failure stage.Leptomeningeal vessels of the anterior cerebral artery were the major sources of compensative arteries shown in the DSA in all cases.The ratio of M1 stenosis was positively correlated (r =0.66, P =0.002) with the rCBV in posterior watershed and there is no significant correlation between the ratio and any other CTP parameters in any regions.Conclusions Associated with distribution of collateral compensative artery,tissue perfusion showed obvious spatial distribution at different level in different cerebral region.M1 stenosis ratio is positively correlated with rCBV in hemodynamic failure regions, and there is no correlation with tissue perfusion in hemodynamic compromise regions.

A 44-year-old pregnant woman (G5P3) who had delivered two children with DMD was admitted and underwent prenatal diagnosis at Peking Union Medical College Hospital in 2019. (1) The karyotype of the fetus in 2019 was 47,XXY. The fluorescence in situ hybridization (FISH) result showed a nucish(CSPX×2, CSPY×1)[100] and multiplex ligation-dependent probe amplification (MLPA) suggested sex chromosome abnormality. Based on the above results, the fetus was diagnosed with Klinefelter syndrome. Fetal short tandem repeat (STR) linkage analysis and Sanger sequencing indicated a heterozygous mutation of c.9543delG(p.Trp3181CysfsTer2). (2) Sanger sequencing of the proband found a novel frameshift mutation of c.9543delG(p.Trp3181CysfsTer2 ) in exon 65 of the DMD gene. (3) The male fetus performing prenatal diagnosis in 2008 was found to have the same maternal gene markers as the proband with the same genotype. While the genotype of the fetus in 2009 obtained a different maternal gene marker from the proband and did not detect the same DMD gene mutation. This fetus was delivered at full term and was good during follow-up. (4) The elder brother and cousin of the proband had the same frameshift mutation in exon 65 of the DMD gene as the proband. The mother of the proband was a heterozygous carrier of the mutation.