Autophagy is a ubiquitous physiological process that occurs in all eukaryotic cells.It can be induced by starvation,ischemia/reperfusion injury and heart failure.Rational autophagy in cardiac cells during ischemia/reperfusion helps to keep cellular homeostasis,and inhibit the cell loss.However,inappropriate activation of autophagy leads to cell death.

Objective To explore the curative effect and safety of of Entecavir ( ETV) combined Liuweiwul-ing Pian in the treatment of chronic hepatitis B patients with HBeAg +.Methods 124 patients according to the ran-dom number table were divided into the two groups ,which respectively used ETV combined Liuweiwuling Pian treat-ment and ETV.The liver function and index of viral replication of the two groups were compared .Results The effec-tiveness of the observation group was 91.94%,which of the control group was 82.26%,the difference between the two groups had statistical significance(Ridit=32.251,P=0.000);Since 24 week treatment,HBV DNA of the observa-tion group was lower than the control group,the difference was statistically significant (t =2.365,4.595,all P<0.05);After treatment,ALT,AST of the observation group decreasing degree was higher than the control group ,the difference was statistically significant (t=78.512,62.145,all P<0.05);after treatment,the ALT rate,effective rate and bounce rate in the two groups was statistically significant differences (χ2 =25.621,46.241,11.512, all P<0.05);After treatment,the HBV DNA and HBeAg positive in two groups was below cut-off test cases,differences was statistically significant(χ2 =17.265,21.264,all P<0.05).Conclusion Entecavir combined Liuweiwuling Pian in the treatment of chronic hepatitis B patients with HBeAg +can reduce liver fibrosis , and has obvious detoxification and anti-viral.

Objective To evaluate the effects of limited fluid resuscitation on septic shock caused by myocardial injury . Methods 60 severe traumatic sepsis and septic shock patients were randomly divided into study group and control group ,with 30 cases in each group ,the control group was given active fluid resuscitation ,maintain the mean arterial pressure (MAP) in 70 mm Hg ;the study group were treated with limited fluid resuscitation ,namely when MAP rose to a slow infusion rate 50-60 mm Hg ,we restrict the amount of fluid ,maintain MAP at about 50 mm Hg ,observe and record the two groups of patients hemodynam-ics index ,APACHE Ⅱ score and heart function index ,and compared serum cTnI ,NT proBNP and CRP in the two groups .Results (1)In study group the infusion volume before admission was (258 ± 105)mL ,preoperative was (558 ± 226)mL ;in the control group that of before admission was (816 ± 422)mL ,preoperative was (1 668 ± 780) mL (P<0 .05) .The mortality rate in study group was 13 .3% ,the mortality in control group rate was 26 .7% (P<0 .05) .(2) the HR and blood lactic acid levels in two groups decreased significantly after treatment ,MAP and CVP increased significantly (P<0 .05);there were no significant differences in hemodynamic parameters (P>0 .05) .(3)After the treatment APACHEⅡscore of the two groups was significantly decreased ,car-diac output ,stroke volume and left ventricular ejection fraction significantly increased in control group ,the study group were better than control group (P<0 .05) .(4) The plasma cTnI ,NT proBNP ,CRP levels of the two groups significantly decreased after treat-ment (P<0 .05) ,plasma cTnI ,NT proBNP and CRP levels of research group were significantly lower than that of control group (P<0 .05) .Conclusion Limited fluid resuscitation can maintain hemodynamic ,reduce the interference on the internal environment ,re-duce myocardial injury ,and improve the success rate of treatment .

E-health is a new kind of health care model, which raises medical efficiency, brings happiness and hope to the therapy of severe disease, and stands for the future of health care. However, it is faced with many issues and challenges, such as the safety of information storing, privacy protection and the distribution of health resources.Therefore, research & development in e-health should observe some criterion. The author holds that the development of e-health should observe ethical principles such as inform-concent, safety, justice, risk-benefit and developing step by step, and puts forward regulating recommendations in many aspects.

Objective To evaluate the therapeutic efficacy and safety of micro-invasive craniopuncture scavenging technique (MPST) for treatment of intracranial hematoma in patients with hypertensive cerebral hemorrhage (HICH).Methods All the clinical randomized controlled trial (RCT) studies published on MPST and internal medicine conservative treatment of HICH were searched via computer screening of databases including Cochrane clinical trials database, the Chinese biomedical literature database (CBM), Chinese periodical network full-text special topic database, Chinese science and technology periodical database and electronic periodicals database of Wanfang from January 2006 to January 2017. The study group was given the MPST plus basic treatment, and the control group was given conservative treatment. The studies collected meeting the eligible criteria were sorted and analyzed by the software RevMan 5.0, the differences in therapeutic effect and mortality were compared between the two groups, and a funnel chart was plotted to analyze the potential publication bias.Results A total of 13 RCTs published studies consistent with the eligible criteria were found, including1556 patients. The Meta-analysis showed that the effective rate in the study group was significantly higher than that in the control group [odds ratio (OR) = 4.29, 95% confidence interval (95%CI) 3.33 - 5.53,P < 0.01]; the fatality rate was markedly lower than that of the control group (OR = 0.25, 95%CI 0.19 - 0.35,P < 0.01). The funnel graph showed that each study had asymmetrical scatter plot of the variable quantity of research results, indicating a publication bias being present, which might be related to the subjectivity of the researchers in publishing their results.Conclusions Using MPST to treat HICH can significantly improve the therapeutic efficiency and reduce deterioration rate. However, due to the low quality of clinical research, it is necessary to carry out rigorous andmulti-center randomized controlled studies to further confirm the results.

BACKGROUND:During fracture healing, in addition to the need for appropriate biomechanical environment, the role of cytokines is also increasingly attracted attention.
OBJECTIVE:To study the effect of nerve growth factor and alpha-lipoic acid on fracture healing in rat models of femoral fracture.
METHODS:Sprague-Dawley rat models of femoral fracture were established. Seventy-two rats were randomly divided into three groups. In the control group, rats were intramuscularly injected with physiological saline. In the nerve growth factor group, rats were intramuscularly injected with nerve growth factor 200 ng/kg, once a day. In the combined therapy group, rats were intramuscularly injected with nerve growth factor 200 ng/kg and oral y taken alpha-lipoic acid 25 mg/kg, once a day. At 1, 2 and 3 weeks after administration, bony cal us volume was measured. Enzyme linked immunosorbent assay was used to measure serum bone morphogenetic protein-2 levels. Western blot assay was utilized to detect bone morphogenetic protein-2 protein expression at the broken end of fracture. Semi-quantitative RT-PCR was applied to examine vascular endothelial growth factor mRNA expression.
RESULTS AND CONCLUSION:(1) At 1 week after administration, no significant difference in bony cal us volume was detected among the three groups. Serum bone morphogenetic protein-2 level, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA expression were significantly higher in the nerve growth factor group and combined therapy group compared with the control group (P<0.05), but no significant difference was found between the two groups. (2) At 2 weeks after administration, the amount of cal us, serum bone morphogenetic protein-2 levels, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA levels were significantly higher in the nerve growth factor group and combined therapy group compared with the control group (P<0.05). Above expression levels were higher in the combined therapy group than in the nerve growth factor group (P<0.05). (3) At 3 weeks after administration, serum bone morphogenetic protein-2 levels, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA levels were significantly decreased in the nerve growth factor group. However, above expression levels were stil high in the combined therapy group, and significantly higher than in the nerve growth factor group (P<0.05). (4) These results indicate that nerve growth factor combined with alpha-lipoic acid had better effects on the fracture healing compared with the nerve growth factor alone.

Objective To investigate the serum levels of heat shock protein 70 (HSP70) in uremic patients with different dialysis ages.Methods Ninety-two maintenance haemodialysis patients were divided into short-term group(from three months to 2 years,n =32),median-term group(from 2 to 5 years,n =37) and longterm group(more than 5 years,n =23) according to different dialysis ages.Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of HSP70 before and after haemodialysis in each group.Results The semm levels of HSP70 had significant difference both in median-term group and long-term group before and after haemodialysis(median-term group:(54.94 + 39.21) μg/L vs (69.72 + 39.90) μg/L,t =-2.068,P =0.047 ;long-term group:(46.17 +34.63) μg/L vs (74.07 ±41.11) μg/L,t =-2.814,P =0.010).But there was no statistics difference on the serum levels of HSP70 before and after haemodialysis in the short-term group((70.42 ±38.30) μg/L vs (62.89 ±43.01) μg/L,t =0.870,P =0.390).Conclnsion Haemodialysis patients with more stress protection ability are likely to obtain long term survival.

Aim To observe the improved effects of Shuangshen Ningxin capsule on ventricular remodeling and wall motion in myocardial ischemic miniature swine induced by thrombus.Methods Myocardial ischemic model miniature swine induced by self-thrombus via cardiac catheter in left anterior descending coronary artery(LAD)were administrated Shuangshen Ningxin capsule for 6 days.The changes of cardiac form,left heart systolic and diastolic function,left ventricular wall motion were observed by the technology of conventional ultrasound and Doppler tissue imaging.Results 6 days after myocardial ischemia and administration,miniature swine of model group showed ventricular wall thinning,chambers heart dilating,ventricle remodeling and wall motion weak,but Shuangshen Ningxin capsule obviously lowered left ventricular internal diameter at end-diastole(LVIDd),left ventricular internal diameter at end-systole(LVIDs),end-systolic volume(ESV),end-diastolic volume(EDV)and isovolumic relaxation time(IVRT),and increased ejection fraction(EF),tissue velocity and tissue trace of left ventricle anterior wall cardiac apex segment.Conclusion Shuangshen Ningxin capsule has anti-myocardial ischemia effect by improving left ventricular remodeling,increasing left cardiac work,improving left heart systolic and diastolic function and increasing left ventricular wall motion.

Aim To study the protective effects of hydroxysafflor yellow A(HSYA) on acute myocardial ischemia in dogs.Methods The acute ischemia models were prepared by ligation of left anterior descending(LAD) artery.The myocardial blood flow(MBF) was determined by ultrasonic doppler,the oxygen metabolism was recorded using blood-oxygen analysis,and the ET was measured with radioimmunological assay.The experiments adopted epicardiogram mapping to measure the scope and the degree of myocardial ischemia,and used quantitative histological assay to determine the size of myocardial infarction.Results HSYA was showed to obviously increase the MBF and the oxygen volume in coronary vein sinus.And the treatment could inhibit the ET release from the injured microvessels.Furthermore,HSYA could alleviate the degree of myocardial ischemia(?-ST),the scope of myocardial ischemia((N-ST),) and narrow the ischemic(area.) Conclusion HSYA was showed to inhibit the ET release,increase the MBF,improve the cardiac oxygen metabolism,and then inhibit the myocardial ischemia damage.

Objective To evaluate the clinical effect and safety of transurethral enucleation of prostate with the bipolar plasma kinetic technique(PKEP)in the treatment of benign prostate hyperplasia (BPH)more than 80 mL.Methods The data from the 116 patients who underwent the PKEP were analyzed retrospectively.The clinical parameters include operation time,blood loss, postoperative catheter retention time,postoperative complication rates,the differences of the clinical parameters pre-and postopera-tively were compared,include maximum urine flow rate(Qmax),residual urine(RU),international prostate symptoms score(IPSS), and quality of life(QOL).Results Mean operation time was (87.46±25.01)min,Mean blood loss was (129.15±44.35)mL.Mean resected tissue weight was (77.67±19.56)g.No patient had the transurethral resection syndrome(TURS),All cases were followed up for 3 to 6 months,the clinical parameters pre-and postoperatively was respectively:Qmax(6.04±2.37)mL/s vs.(17.85±2.55) mL/s;RU(116.25±53.18)mL vs.(8.85±7.66)mL;IPSS(25.06±4.23)vs.(5.90± 1.91);QOL(4.85 ±0.65)vs.(1.71± 0.54).Conclusion The transurethral enucleation of prostate with the bipolar PKEP resects the proliferated prostate cleanly,had lesser bleeding and complication rates,had advantages of high safety,and satisfactory efficacy for the treatment of BPH more than 80 mL.