Objective To explore the blood sugar controlling for elderly patients with fracture and diabetes mellitus. Methods Twenty patients with fracture complicated with diabetes were managed with mental education and diet controlling. Meanwhile nursing measures were done to prevent infections, bedsores and deep vein thrombosis (DVT). Results The fasting blood sugar levels of the 20 elderly patients were well controlled below 7.8 mmol / L. There were no related complications. Conclusion Such nursing measures as psychological counseling and diet control are helpful for a steady maintenance of blood sugar for feasibility of surgical operation, to ensure successful manipulation of the surgical operation. Prevention of infection, bedsore and DVT is critical for ensuring the success of operations.

Objective To evaluate the diagnostic value and misdiagnosis cause of echocardiography (UCG) and CT in aorto-left ventricular tunnel (ALVT). Methods UCG and CT of 5 patients who were diagnosed as ALVT by surgical operation during August 2010 to October 2014 in Wuhan Asia Heart Hospital were reviewed and analyzed. Results By UCG, 4 cases were diagnosed as ALVT. The abnormal tunnel between aortic root and left ventricle could be clearly displayed with two dimensional echocardiography. On color Doppler flow image (CDFI), it could be clearly demonstrated that the blood flow went into aorta from left ventricle in systolic period via aortic valves and ALVT, and back to left ventricle in diastolic period via ALVT. Bicuspid aortic valve (BAV) was found in 2 patients, and aortic valve reflux in 1 patient. According to Hovaquimian classification, 2/4 patients were diagnosed as ALVT of typeⅠ, and other 2 patients as ALVT of typeⅡ. One case was misdiagnosed as left coronary artery-left ventricle fistula. By CT, 2 cases were diagnosed as ALVT and 1 case was misdiagnosed as left coronary artery-left ventricle fistula. Conclusion The combination of UCG and CT is a reliable technique in the diagnosis of ALVT, which has significance in therapeutic strategy making and prognosis prediction.

Objective To investigate the value of echocardiography in monitoring the treatment of extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock (CS).Methods A total of 21 patientss were included into the present study,who were treated by ECMO due to CS in Wuhan Asia Heart Hospital from January 2013 to December 2015.The left ventricular ejection fraction (LVEF) and Tei index were measured by echocardiography before,in the middle of (flow reduced to one half)and immediately after the process of ECMO.The systolic blood pressure (SBP) and the arterial oxygen saturation (SaO2) were also recorded,and the parameters were compared.The differences of LVEF,Tei index,SBP and SaO2 among different phases of ECMO were compared by using one-way ANOVA and LSD-t test.The differences of heart beat rate,the diameters of left ventricle,diameters of inferior vena cava,subsidence rate of inferior vena cava,pulmonary capillary wedge pressure and central venous pressure among different phases of ECMO were also compared by paired-samples t test.Results Compared with the pre-ECMO level,the LVEF increased during and immediately after the ECMO (t=31.952,59.404,both P ＜ 0.01),while the Tei index decreased significantly (t=34.406,58.969,both P ＜ 0.01).Compared with the pre-ECMO level,the SBP,SaO2 and subsidence rate of inferior vena cava all increased during and immediately after the ECMO,while the diameter of left ventricle,pulmonary capillary wedge pressure and central venous pressure all decreased significantly (t=7.382,37.785,-11.286,3.294,13.923,16.971,all P ＜ 0.01 or 0.05).In contrast,there was no significant change for the parameters of heart beat rate and diameter of inferior vena cava.Conclusion When treating CS patients with ECMO,the echocardiography can monitor the cardiac function effectively,and provide important parameters for the clinical doctors to estimate the ECMO efficacy and decide the weaning time.

Objective To select the calibrator for the conventional measurement system of serum a-Amylase (Amy).Methods The Amy levels of forty frozen serum samples were detected by the IFCC reference method (reference system),the conventional system A which used the Bioassay routine reagent and Randox calibrator,and was calibrated by the Roche PNPG7 method,and the conventional system B which used the Bioassay routine reagent and Randox calibrator,and was calibrated by the Rondox liquid stable PNPG7 method,respectively,and the acceptability of the two conventional systems was evaluated.Results The regression equations of the measurement values between the IFCC reference method and the conventional systems A and B were Y =0.964X +0.376 and Y =1.095X + 3.131,respectively.Among them,X and Y represented the results of the IFCC reference method and the conventional system,respectively.Compared with the IFCC reference method,the results of the conventional system A was reliable.Condusion With the guidance of the IFCC reference method,the domestic biochemical reagents matched with the suitable calibrators may provide the acceptable results.

Objective:To investigate the monitoring value of echocardiography for atrial septostomy during the treatment of extracorporeal membrane oxygenation(ECMO).Methods:Sixteen patients underwent atrial septostomy during the treatment of ECMO in Wuhan Asia Heart Hospital from Jan.2017 to Dec.2019 were included. The diameter of the ostomy, the direction of interatrial shunt, the tricuspid regurgitation degree and the pulmonary artery pressure were measured by echocardiography daily after atrial septostomy.Results:There were no significant differences in the diameter of the ostomy in 16 patients(the range of coefficient of variation 0.86%-4.77%). The direction of interatrial shunt changed gradually from right - left atrial shunt to left - right atrial shunt. Pulmonary arterial pressure decreased gradually(the range of coefficient of variation 14.70%-32.13%) as estimated by tricuspid regurgitation pressure gradient.Conclusions:Atrial septostomy is an effective measure to relieve right heart pressure and improve right heart function in patients with ECMO. The echocardiography can be helpful for the monitoring of atrial septostomy.

ObjectiveTo investigate the effect of hyperlipidemia on monophasic action potential and calcium current of heart in rabbits.Methods24 rabbits were divided into the high cholesterol group (n=12) and control group (n=12) and fed with high cholesterol forage and standard forage respectively for 10 weeks. Electrocardiograph, ventricular fibrillation threshold and the level of serum lipid were examined. Whole-cell patch clamp technique was used to record I_ Ca-L.ResultsIn high cholesterol group, the serum cholesterol level was higher than the control group ( P<0.01), ventricular fibrillation threshold (10.2±1.7 V) lower than that of the control group (13.9±1.3 V)( P<0.05), MAPD90 displayed more significant rate-dependent prolongation. At cycle lengths of 1500 ms, MAPD90 was 358±18 ms in the high cholesterol group, while it was 277±20 ms in the control group. The densities of ICa-L were larger in the high cholesterol group (14.7±0.8 pA/pF) than that in the control group (10.9±1.1 pA/pF)( P<0.01).ConclusionHypercholesterolemia can produce cardiac electrical remodeling, including increased ICa-L, prolonged repolarization and decreased ventricular fibrillation thresholds.

Bel1, a transactivator of prototype foamy virus (PFV), plays pivotal roles in the replication of PFV. Previous studies have shown that Bel1 bears a nuclear localization signal (NLS), but its amino acid sequence remains unclear and the corresponding importins have not been identified. In this report, we inserted various fragments of Bel1 into an EGFP-GST fusion protein and investigated their subcellular localization by fluorescence microscopy. We found that the 215PRQKRPR221 fragment could direct nuclear localization, which accords with the consensus sequence K(K/R)X(K/R) of monopartite NLS. Point mutation experiments revealed that K218, R219, and R221 are essential for the nuclear localization of Bel1. The results of the GST-pulldown showed that the Bel1 fragment with residues 215-223, which bears the NLS, interacts with KPNA1, KPNA6, and KPNA7. This result suggests that KPNA1, KPNA6, and KPNA7 maybe involved in Bel1 nuclear translocation.
Cell Line ; Cell Nucleus ; genetics ; metabolism ; virology ; Humans ; Nuclear Localization Signals ; genetics ; metabolism ; Protein Binding ; Protein Transport ; Retroviridae Infections ; genetics ; metabolism ; virology ; Retroviridae Proteins ; chemistry ; genetics ; metabolism ; Spumavirus ; chemistry ; genetics ; physiology ; Trans-Activators ; chemistry ; genetics ; metabolism ; alpha Karyopherins ; genetics ; metabolism

OBJECTIVETo investigate the pathogenic and clinical presentation and laboratory tests of bullous rash in hand, foot and mouth disease (HFMD) in Xi'an from January 2013 to December 2014 by retrospective analysis.

METHODA total of 224 specimens were collected from clinically diagnosed HFMD cases who were characterized by widespread mucocutaneous bullous reactions in Xi'an Children's Hospital from January 2013 to December 2014, the identification and subtyping of the isolates were conducted with real-time fluorescent quantitative RT-PCR. A retrospective analysis was performed to analyze the clinical presentation, laboratory tests and late follow-up problems of the HFMD.

RESULTIn the clinically diagnosed HFMD cases who were characterized by widespread mucocutaneous bullous reactions, 207 were caused by coxsackievirus A6 (CA6), accounting for 92. 4% of all cases with bullous, 4 were caused by enterovirus 71 (EV71), accounting for 1.8%, 10 were caused by coxsackievirus A16 (CA16), accounting for 4. 5%; 4 cases were negative for these viruses. In the cases positive for intestinal virus-nucleic acid, 130 were male, 90 were female; male to female ratio was 1. 44: 1, 203 were <5 years old, accounting for 92. 3%. Leukocytosis was found in 75 cases (34. 1%); high-sensitivity C-reactive protein (hsCRP) increased in 200 cases (90. 9%); elevated myocardial enzyme CK-MB was found in 35 cases (15. 9%), alanine aminotransferase increased in 15 cases (6. 8%); 187 cases had fever (85. 0%). None of the cases had serious complications such as encephalitis or myocarditis. In the course of the critical phase bullous rash or large vesicle-like changes, obvious itching, and facial rash appeared. After the fluid in the bullae was absorbed or the bullae ruptured or became ulcerated, scar formation and large areas of exfoliation occurred, with no effusion on the newly formed epithelium in the base, without significant pigmentation on later follow-up. In the late follow up process, 52 cases in CA6-positive patients (25. 1%) developed onychomadesis within 2-4 weeks after onset, 1 to 8 nails, an average of 4. 3 fell off, new nails grew, the nail bed showed no structural abnormalities and hyperplasia after falling off, the surface was smooth, had no hypertrophy, left no sequelae.

CONCLUSIONThe pathogen in HFMD characterized by widespread bullous reactions was mainly the CA6, this kind of HFMD was mainly mild type, with significant itching, later the bullae may have scar formation and skin exfoliation, in some cases onychomadesis may occur.

Child ; Enterovirus A, Human ; Enterovirus Infections ; pathology ; Exanthema ; pathology ; Female ; Fever ; Hand, Foot and Mouth Disease ; pathology ; Humans ; Male ; Pruritus ; Retrospective Studies

Objective To detect the expressions of miR-155,T helper type 17 (Thl7) cells,and Th17 cellspecific transcription factor RORγt and effector cytokine interleukin (IL)-17 in peripheral blood and skin lesions from,and to evaluate their relationship in,patients with atopic dermatitis (AD).Methods Peripheral blood was obtained from 37 patients with AD and 33 age-and sex-matched healthy controls,and biopsy specimens from the lesional and perilesional skin of five patients with severe AD as well as from the normal skin of five healthy human controls.Real-time fluorescence-based reverse transcription (RT)-PCR was employed to measure the mRNA expression levels of miR-155,RORγt and IL-17 in peripheral blood mononuclear cells (PBMCs) and skin specimens,flow cytometry to detect the percentage of Th17 cells in PBMCs,enzyme-linked immunosorbent assay (ELISA) to determine the plasma concentration of IL-17.Statistical analysis was done using independent sample's t test,one-way analysis of variance followed by the least significant difference test,and linear correlation analysis.Results Compared with the healthy controls,the patients with AD showed a significant increase in Th17 cell percentage (1.78％ ± 0.52％ vs.0.47％ ± 0.15％,P＜ 0.01),mRNA expression levels of miR-155 (5.78 ± 1.78 vs.1.82 ± 0.46,P＜ 0.01),RORγt (6.08 ± 1.04 vs.1.64 ± 0.52,P＜ 0.01) and IL-17 (7.09 ± 1.75 vs.1.71 ± 0.46,P＜ 0.01),as well as in the plasma concentration of IL-17 ((2.51 ± 6.15) pg/ml vs.(11.80 ± 2.24) pg/ml,P＜ 0.01).There was a sequential decrease in the expression levels of miR-155,RORγt and IL-17 mRNA from lesional skin,perilesional skin to normal skin (F =41.803,17.040 and 37.064 respectively,all P ＜ 0.01).The miR-155 mRNA expression level in PBMCs was positively correlated with the SCORing Atopic Dermatitis (SCORAD) index,Th17 cell percentage,RORγt and IL-17 mRNA expression levels as well as IL-17 plasma concentration (r =0.405,0.426,0.402,0.410 and 0.408 respectively,all P ＜ 0.05).Similarly,the miR-155 expression level was positively correlated with RORγt and IL-17 mRNA expression levels in lesional and paralesional specimens (r =0.428 and 0.435 respectively,both P ＜ 0.05).Conclusion The up-regulated expression of miR-155,Th17 cells and their effector cytokine IL-17 may be associated with the development of AD.

Background Dyslipidemia is one of the major causes of age-related macular degeneration (AMD).At present,the study of the preventive and treating methods of A MD is still a hot spot.Objective The purpose of this study was to observe the effect of tonifying the spleen and promoting blood circulation on the retina and Bruch membrane in apolipoprotein E-deficient (ApoE-/-) mice with dyslipidemia.Methods Thirty-six ApoE-/-mice aged 2 months were randomly divided into the normal diet group,high fat diet group and medicine group.A diet with a higher content of fat was given for 5 consecutive months to the mice of the high fat diet group and medicine group,and in the last month,a concoction that tonifies the spleen and promotes blood circulation was gavagely administered in the medicine group,and an equivalent volumes of normal saline solution was administered in the same way in the normal diet group and high fat diet group.Total plasma cholesterol (TC),low density lipoprotein (LDL)and triglyceride (TG) were detected by (ELISA? Name of assay?) using the 7170 Hitachi automatic biochemical analyzer,and morphological changes of the retina and Bruch membrane were examined by light microscopy and transmission electron microscopy.The number of outer nuclear layer (ONL) cells,retinal pigment epithelial (RPE) cells and the thickness of the Bruch membrane were examined by semi-quantitative histopathology with the Mias 2000 Imaging Analyzer System.Results The concentrations of TC,LDL and TG were (6.47 ±0.49) mmol/L,(1.46 ±0.10)mmol/L and (0.62 ±0.21) mmol/L,respectively,in 7-month-old mice of the medicine group,showing a significant reduction in comparison with (10.53 ±0.30) mmol/L,(1.90±0.13) mmol/L,(1.15±0.29) mmol/L of the high fat diet group,and (9.63 ± 0.18) mmol/L,(1.12 ± 0.15) mmol/L,(0.88 ± 0.21) mmol/L in the normal diet group (P＜0.05-0.01).The disorder and atrophy of ONL and RPE cells,divergence of fiber of the Bruch membranes were found in both the high fat diet group and normal diet control group under the light microscope,and drusen formed in some of the mice in the high fat diet group.However,ONL and RPE were well organized in the medicine group.The cell numbers in the ONL and RPE layer in the 7-month-old mice were (23 124.00±755.18) and (10.75±0.59),respectively,in the medicine group,(19 107.00 ± 1436.82) and (8.55 ± 1.11),respectively,in the high fat diet group,(21 663.00± 1073.27) and (9.75 ±0.58),respectively,in the normal diet group,with significant differences among them (P＜0.05-0.001).Thickness of the Bruch membrane in the medicine group extensively reduced in high fat diet group and normal diet control group (P＜0.01).The ultrastructures of the RPE and Bruch membrane were much more improved in the mdedicine group.Conclusions Tonifying the spleen and promoting blood circulation can attenuate hyperlipemia in ApoE-/-mouse;furthermore,it lessens the pathological abnormalities in the ONL,RPE and Bruch membrane.