Objective To investigate the pathological changes of cardiac collagen in the elderly patients with hypertensive left ventricular hypertrophy(LVH)and the difference of collagen among the groups of essential hypertension(EH),diabetes (T2DM) under the condition of the same stage,providing pathological foundation of clinical treatment for curing diseases and the early heart protection.Methods A retrospective study was performed in 140 cases over 65 years old of EH and normal cases as control out of 3520 consecutive autopsied cases from 1954 to 2001 in Chinese People's Liberation Army (PLA) General Hospital.The pathological changes of collagen were studied with hematoxylin and eosion(HE) staining,Sirius Red F3B (SR)and immunohistochemistry staining.Myocardial interstital collagen deposition was observed with light microscope and polarization technique.Quantitative measurements on the myocardial collagen volume fraction (CVF),CVFS of type Ⅰ and type Ⅲ,and the rate of collagen type Ⅰ to type Ⅲ (Ⅰ/Ⅲ) were determined with videodensitometry.Results The CVF(6.32％ ± 0.92％) and CVF Ⅰ (5.93％ ± 0.94％)were increased significantly in EH LVH Ⅰ group (P ＜0.01) ; but,CVF Ⅲ (2.23％ ±0.38％) and Ⅰ/Ⅲ (2.69 ±0.42) did not change significantly in EH Ⅰ group compared with the control group; The changes in the aforementioned four items were increased significantly in EH LVH Ⅱ and EH LVH Ⅲ groups (P ＜0.01)compared with the control group.The CVF and CVF-Ⅰ were decreased significantly(P ＜ 0.01) ; but CVF-Ⅲ and Ⅰ/Ⅲ did not change significantly in DM LVH-I group compared with the EH LVH-I group; the CVF(4.23％ ± 0.69％) and CVF-Ⅰ (3.92％ ±0.40％) were decreased significantly(P ＜0.01); but CVF-Ⅲ(1.79％ ±0.21％) and Ⅰ/Ⅲ (2.20 ±0.20) did not change significantly in DM LVH-Ⅰ group compared with the EH LVH-Ⅰ group.Conclusions (1)The myocardial stiffness and the reduction of cardiac diastolic function deteriorated most with the development of LVH.(2)Under the condition of the same stage,the myocardial stiffness and the reduction of cardiac diastolic function deteriorated seriously in EH groups,diabetes patients,myocardial stiffness and the reduction of cardiac diastolic function deteriorated slightly.

Objective To investigate the effectiveness and safety of applying compound lidocaine cream on tracheal mucosa as topical anesthesia to reduce the stress reaction during extubation of tracheal tube. Methods Sixty patients (aged 18-65yr,body weight 40-80kg,ASA Ⅰ-Ⅱ) scheduled for elective surgery under general anesthesia were selected,and they were randomly divided into compound lidocaine cream group (group L,n=30) and control group (group C,n=30). Orotracheal intubation was performed in all the patients. Compound lidocaine cream was uniformly smeared on the foremost third of endotracheal tubes before intubation in group L,and no drug was coated on endotracheal tubes in group C. The changes in blood pressure and heart rates during extubation,the use of hypotensive drugs,cough reflex,breath holding,sore throat and pharyngeal discomfort after extubation were compared between the two groups. Results The operation and intubation time of the two groups showed no significant difference. The blood pressure and heart rate during extubation,the rate of using hypotensive drugs,and the incidence of cough reflex and breath holding were lower in group L than in group C,while the foreign body sensation in pharynx were after extubation was more frequent in group L than in group C. The incidence of pharyngodynia was similar in the two groups,and the pharyngodynia and foreign body sensation in pharynx markedly improved one day after operation in both groups. Conclusion Topical anesthesia of tracheal mucosa using compound lidocaine cream may reduce the cough reflex and breath holding during extubation,and inhibit the stress reaction.

Objective To investigate the expressions of apoptosis stimulating protein of P53 (ASPP)family in colorectal carcinoma tissue and to explore their relationship with the clinicopathological characteristics of colorectal carcinoma,and to clarify the effect of ASPP family in the development of colorectal carcinoma.Methods 45 cases of colorectal carcinoma tissue and 20 cases of healthy controls were selected. Among 45 cases of colorectal carcinoma tissue, there were 1 1 cases of well differentiated colorectal carcinoma, 2 1 cases of moderately differentiated colorectal carcinoma,and 13 cases of poorly differentiated colorectal carcinoma;7 cases of T1 stage colorectal carcinoma,8 cases of T2 stage colorectal carcinoma,25 cases of T3 stage colorectal carcinoma,and 5 cases of T4 stage colorectal carcinoma;19 cases of N1 stage with lymph node metastasis,26 cases of N0 stage without lymph node metatasis.The expressions of ASPP1,ASPP2,and iASPP in 45 cases of colorectal carcinoma tissue and 20 cases of normal colon tissue were detected by immunohitochemistry SP method,and the correlations between the expressions of ASPP family and the pathologic typing,infiltrative depth,and lymph node metastasis of colorectal carcinoma were analyzed. Results ①The immunohitochemical staining results showed that the ASPP family members expressed in colorectal carcinoma tissue and normal colon tissue, and there were no significant differences in ASPP1 and ASPP2 positive rates between colorectal carcinoma tissue and normal colon tissue (P>0.05);the positive expression rate of iASPP in colon cancer tissue was higher than that in normal colon tissue (P<0.01).② The expression of ASPP1 in colon caner tissue had no correlation with the differentiation degree of tumor cells (rs=0.163,P>0.05);the expression of ASPP2 positive rate was decreased when the differentiation degree of tumor cells reduced,they had positive correlation (rs=0.454,P=0.002);the expression of iASPP in colon cancer tissue had no correlation with the differentiation degree of tumor cells (rs=-0.171,P>0.05).③ The expression of ASPP1 in colon caner tissue had no correlation with the infiltrative depth of tumor (rs=-0.268,P>0.05);the expression of ASPP2 positive rate was decreased when the tumor infiltrative depth increased,they had negative correlation (rs=-0.348,P<0.05);the expression of iASPP in colonic carcinoma caner tissue had no correlation with the infiltrative depth of tumor (rs=0.231,P>0.05).④The expressions of ASPP1,ASPP2, and iASPP in colon caner tissue had no correlation with lymph node metastasis (rs=0.089,rs=0.044,rs=0.210, P>0.05).Conclusion The expression levels of iASPP in colon cancer and normal colon tissues are different,it may be useful for the diagnosis, differential diagnosis and evaluation in benign and malignant colorectal diseases. The expression of iASPP is negatively correlated with the pathologic typing and neoplasm staging of colorectal carcinoma,it indicates that iASPP can be used as a indicator in judging the prognosis of colorectal carcinoma.

Objective To evaluate the diagnostic value of velocity parameters of Tardus-Parvus for the detection of renal artery stenosis ( RAS) ( diameter reduction ≥50%) and to determine the useful cutoffs for these parameters .Methods A study group was composed of 221 renal arteries that were detected Tardus-Parvus by color Doppler flow imaging and were referred to abdomino-aorto-re-nal arteriography afterwards .Five Doppler parameters including the peak systolic velocity ( PSV ) , end-diastolic minimum velocity (EDV), resistance index (RI), acceleration time (AT), and accelerated velocity (AC) from each location including renal aorta ( MRA) , segmental artery ( SRA) , interlobar artery ( IRA) , and arcuate artery ( ARA) were archived and compared among the differ-ent groups .Renal artery angiography showed arterial canon reduced 50% or higher RAS .Arteries were considered stenosed on renal arteriography if there was a diameter reduction of greater than 50%.Statistical analysis to determine the best parameter for predicting a RAS was performed with the receiver operating characteristic ( ROC) curves.The sensitivity, specificity, and negative and positive predicting values at various cutoffs were calculated .Results Renal artery stenosis degree was less than 50% in 16 cases, 50%~99%in 197 cases, completely occluded in 2 cases, and no stenosis in 6 case by renal arteriography .For RAS with inner diameter re-duction of 50%or more, the ROC curve analysis showed renal artery flow velocity had a good sensitivity and specificity , 50%~99%of the RAS had optimal threshold value in PSV 20 cm/s, EDV 10 cm/s, RI 0.50, AT 0.09 s, and AC 1.5 m/s2.Conclusions Tardus-Parvus had high specificity and sensitivity for diagnosis of stenosis rate in more than 50% of the RAS, low sensitivity for the narrow degree in 0~49%, and no clinical value for the renal artery occlusion .

Objective:To establish an HPLC method for the simultaneous determination of rutin, salvianolic acid B and ginsen-oside Rb1 in Xinning tablets. Methods:The samples were separated on a CAPCELL PAK MG(250 mm × 4. 6 mm,5μm)column with gradient elution using acetonitrile(A) and 0. 1％ phosphoric acid(B) as the mobile phase at a flow rate of 1. 0 ml·min-1. The col-umn temperature was set at 35℃. The wavelengths were set on 354nm, 286nm and 203 nm (in a wavelength switching mode). Re-sults:The linear range of rutin was 0. 0273-1. 3600 mg·ml-1(r =1. 0000), that of salvianolic acid B was 0. 0244-1. 2200 mg· ml-1(r=1.0000),and that of ginsenoside Rb1 was 0.0186-0.9310 mg·ml-1(r=0.9999), and the average recovery (n=6) was 102.3％ (RSD=1.1％),98.7％ (RSD=0.8％) and 101.7％ (RSD=1.8％)(n=6), respectively. Conclusion: A rapid, simple, accurate HPLC method is successfully established for the simultaneous determination of 3 effective components in Xinning tab-lets, which is helpful to the quality control of Xinning tablets.

【Objective】 The effect of pretreatment with Buyang Huanwu Decoction(BHD) on L-type calcium channels of cortical neurons in rats with global cerebral ischemia was observed,thus to explore the molecular therapeutic mechanism of BHD for cerebral ischemia as well as the pathogenic mechanism of Ca2+ message in ischemic injury of neurons.【Methods】SD rats were randomized into pseudo-operation group,model groups and BHD groups.And the model groups and BHD groups were divided into six groups according to the time points after reperfusion(2nd,12th,24th,48th and 72nd hour after reperfusion respectively).BHD groups received 0.64g/kg BHD by gastric infusion,bid,for 5 continuous days.Except the rats in pseudo-operation groups,the rats in other groups were induced global cerebral ischemia by modified Pulsinelli's four-vessel occlusion.Cerebral cortical neurons in rats were isolated promptly in 2nd,12th,24th,48th and 72nd hour after reperfusion.The recorded single-channel current was amplified by the EPC-9 patch-clamping amplifier,and then input into the computer by Pulse+Pulsefit.The analytical software TAC was used to detect the opening time and opening probability of the L-type Ca2+ channels in rats at different time points after reperfusion.【Results】In the model groups,the opening time of the L-type Ca2+ channels was prolonged after reperfusion as compared with that in the pseudo-operation group,and the opening probability of the L-type Ca2+ channels arrived at the peaks in 2nd and 24th hour after reperfusion.In BHD groups,the opening time in 72nd hour after reperfusion was decreased(P

AIM:To investigate the effect of resveratrol on the lipids ( CHOL, TG, LDL-C and HDL-C) , ni-tric oxide ( NO) , peroxynitrite anion ( ONOO-) and the expression of inducible nitric oxide synthase ( iNOS) in the artery of the mice with ovariotomy ( OVX) .METHODS:The lipid levels and NO level in the serum were measured .The chan-ges of atherosclerosis were evaluated with Oil Red O staining .The expression of iNOS was measured by DAB staining and Western blot .The ONOO-production was measured by DAB staining .RESULTS:Compared with sham group , the levels of the lipids and NO production in OVX +high fat (HF) group were increased (P<0.05).Compared with OVX+HF group, the levels of the lipids and NO production in resveratrol group were decreased (P<0.05).Fourteen weeks later, the atherosclerosis model was successfully established .Compared with OVX +HF group, the iNOS expression and the ONOO-production in resveratrol group were decreased ( P<0.05 ) , while those in sham group were increased ( P <0.05).CONCLUSION:Resveratrol prevents and treats atherosclerosis by inhibiting the iNOS expression in C 57BL/6J mice.

AIM: To explore the effects of exendin-4 (EX-4) on endoplasmic reticulum stress (ERS)-mediated insulin resistance in the 3T3-L1 adipocytes.METHODS: In vitro 3T3-L1 pre-adipocytes were differentiated into adipocytes, and the cells were treated with tunicamycin (TM), tauroursodeoxycholic acid (TUDCA) or EX-4, respectively.The cell viability was measured by MTT assay.The glucose consumption was determined by glucose oxidase assay to evaluate insulin sensitivity of the 3T3-L1 adipocytes with different interventions.The protein levels of p-Akt, Akt and endoplasmic reticulum stress markers, including inositol requiring enzyme-1 (IRE1), p-IRE1, JNK, p-JNK, protein kinase R-like endoplasmic reticulum kinase (PERK), p-PERK, eukaryotic initation factor 2 alpha (eIF2a), p-eIF2a, activating transcription factor-6(ATF-6) were detected by Western blot.RESULTS: The insulin-stimulated glucose consumption and the protein level of p-Akt were inhibited by TM at 5 mg/L for 5 h (P<0.05), while they were increased when the cells were treated with TUDCA at 1 mmol/L or EX-4 at 100 nmol/L for 24 h (P<0.05).The effects above induced by TM (5 mg/L for 5 h) were also blunted by pretreating with TUDCA at 1 mmol/L or EX-4 at 100 nmol/L for 24 h (P<0.05).The protein levels of ERS markers such as p-IRE1, p-JNK, p-PERK, p-eIF2a and ATF-6 were significantly increased by treating with TM at 5 mg/L for 5 h, whereas 24 h pre-treatment with TUDCA or Ex-4 alleviated the ERS of the 3T3-L1 adipocytes induced by TM.The expression of total IRE1, JNK, PERK and eIF2a was not changed in different groups.CONCLUSION: Exendin-4 improves endoplasmic reticulum stress mediated insulin resistance in 3T3-L1 adipocytes.

Objective To observe the effect of catechol-O-methyltransferase inhibitor (COMTI) tolcapone on levodopa-treated patients with Parkinson's disease (PD) and on the motor function fluctuation, and safety taking this drug.Methods50 PD patients treated with levodopa were divided into the trial group and control group with 25 cases in each group. The patients in the trial group were given tolcapone 100 mg three times per day. The cases in the control group were given placebo with the same dose. The hepatic function of the patients was examined every month after administration. The time variety of patients' motor function fluctuation was recorded by the diary. The time of clinical observation was 6 months.ResultsThe UPDRS scores of the trial group in the first and second months after taking tolcapone were not significantly different from that of the control group ( P>0.05), but scores of the third to sixth months were significantly different from that of the control group ( P<0.05～0.01). There was a significant difference between UPDRS scores of the trial group before and after treatment ( P<0.01～0.001). The Honhe-Yahr scores of the trial group in the first and second months after treatment were not significantly different from that before treatment ( P>0.05), but scores of the third to sixth months were significantly different from that before treatment ( P<0.05). The motor function fluctuation of the patients in the trial group improved significantly after treatment ( P<0.05). The numbers of the cases had dry mouth, nausea and astriction were 3 respectively; those had acratia, insomnia and diarrhea were 2 respectively; those had muscular soreness, abdominal distention, hidrosis and fidget were 1 respectively. All adverse effects had a little influence to administration. The hepatic function of all patients had no significant change.ConclusionTolcapone can increase the curative effect of PD patients treated with levodopa and improve the motor function fluctuation, and is safety after taken.

Objective:To determine the prevalence and risk factors for age-related macular degeneration (AMD) in Tibetan of plateau area, and to establish a nomogram prediction model.Methods:A cross-sectional study was carried out.The 40-year-old and older Tibetan subjects were enrolled by cluster random sampling from Xinghai County and Tongde County with an average altitude of 3 000 meters in Qinghai Province.Questionnaire survey, routine ophthalmic examinations, direct fundus photography and health education were carried out among the subjects.The questionnaire items included age, gender, smoking, drinking, living duration in plateau region, daily sunshine duration, diabetes, hypertension and hyperlipidemia.A χ2 test was used to screen significantly factors, and risk factors for AMD were analyzed by logistic regression analysis.The nomogram plot was drawn by R software to establish a predicting model.The study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Qinghai Provincial People's Hospital (No.2017-21). Written informed consent was obtained from each subject prior to any medical examination. Results:A total of 1 223 subjects were enrolled, and AMD were detected in 190 subjects with an prevalence of 15.54%.The risk factors for AMD were old age, living duration in plateau region, sunshine duration, smoking, hypertension and hyperlipidemia.Age was the first one of risk factors for AMD ( OR: 20.183, 95% CI: 9.536-29.805, P<0.001), followed by sunshine duration ( OR: 3.785, 95% CI: 1.581-8.721, P<0.001). The nomogram prediction model showed that when the questionnaire score was >150, the probability of suffering AMD was 50%.The decision curve showed that when the threshold probability was >25%, the predicted probability of AMD was the same as the actual probability. Conclusions:Pathogesis of AMD in Tibet is associated with old age, living duration in plateau area, sunshine duration, smoking, hypertension and hyperlipidemia.