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 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.

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 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 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.

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.

Recent studies have found that endoplasmic reticulum stress (ERS) is a common feature of the pathogenesis of organ fibrosis. However, the functional alteration of ERS and its potential role in the process of liver fibrosis is still unclear. This review summarizes the potential function of ERS and ERS-mediated apoptosis in liver fibrosis, suggesting that ERS is a cellular self-protection mechanism, but excessive ERS could cause irreversible cell damage and even induce apoptosis. However, the mechanism of ERS-mediated apoptosis involved in liver fibrosis has not been well understood and merits further exploration. With the further thorough research on the association between liver diseases and ERS, the treatments for liver diseases will be more apposite in the future.

Objective To evaluate the method of detecting antibodies to Bacillus anthracis by enzymelinked immunosorbent assay(ELISA)using crude antigen.Methods The anti-Bacillus anthracis antibody levels in sera of 42 healthy people and 42 patients were detected by indirect ELISA.Standard curve was plotted using the data from positive controls,based on which the relative content of each serum was calculated and compared with the result of rLF.Results The median of antibody's relative content in patient group and healthy people group are 1.19 and 0.24,the differences being statistically significant(uc=7.643,P＜0.05).The result of crude antigen is in concordance with rLF(but not parallel absolutely).Conclusions Crude antigen can distinguish most of patients with healthy population effectively.The results suggested that crude antigen is applicable in anti-Bacillus anthracis antibody surveillance.

This study was aimed to discuss the relations between relieving depression and benefit findings for advanced cancer patients.A total of 80 advanced cancer patients with the anxiety / depression assessment of more than 7 points and less than 15 points,were randomly divided into the intervention group and the control group,in comprehensive hospitals.Finally,76 cases were included with 39 cases in the intervention group,and 37 cases in the control group.The progressive muscle relaxation training (PMRT) was used in the control group.Traditional Chinese medicine (TCM) special technique (i.e.,TCM five-element musicotherapy plus PMRT) was used in the intervention group.The reduced fraction of the Benefit Finding Scale (BFS) and the Hospital Anxiety and Depression Scale (HADS) were used in the effect evaluation after 8-week intervention.The results showed that after 8-week treatment,the reduced fractions of BFS and HADS in the intervention group were obviously higher than the control group with statistical significance.The variation tendencies of BFS and HADS in the intervention group were obviously higher than the control group with statistical significance.There were 8 individual values in BFS of the intervention group were higher than the control group with statistical significance.It was concluded that the benefit findings for advanced cancer patients were related to the application of TCM special techniques,can improve the levels of benefit findings among advanced cancer patients.It enriched and perfected the depression regulation plan of cancer patients by TCM special techniques.

OBJECTIVETo explore the effect of drug-containing serum of Chinese herbal compounds [Xiongshao Capsule (XS, for activating blood) and Huanglian Capsule (HL, for dispelling toxin)] on tumor necrosis factor-alpha (TNF-alpha)-induced adherence between human umbilical vein endothelial cells (HUVECs) and polymorphonuclear neutrophils (PMN), inflammatory reaction and expression of related proteins in mitogen-activated protein kinase (MAPK) pathway.

METHODSThirty-two rats were randomly divided into four groups (8 in each group) using random digit table: the blank control group treated with distilled water, the test group I treated with Chinese herbal compound of XS (0.135 g/kg), the test group II treated with Chinese herbal compound of HL (0.135 g/kg), and the test group Ill treated with Chinese herbal compound of XS (0.135 g/kg) and HL (0.135 g/kg). All medication was given by gastrogavage once a day for a week. Rats' blood serum was harvested 1 h after the last administration to prepare drug-containing serum. HUVECs were exposed to TNF-alpha (100 ng/mL) to induce cell injury model and incubated with corresponding drug-containing serum (10%) for 24 h. Normal rats' serum was given to cells in the blank control group and the model group, while XC + HL containing serum was given to cells in the rest 3 groups. The adherence of HUVECs and PMN cells was detected by using rose bengal strain. Levels of E-selectin, intercellular adhesion molecule-1 (ICAM-1), and interleukin-1beta (IL-1P) in the supernatant of cultured HU-VECs were determined by ELISA. Protein expressions of mitogen-activated protein kinases p38 (p38MAPK) and extracellular signal-regulated kinase 1/2 (ERK 12) were determined by Western blot.

RESULTSCompared with the blank control group, HUVECs were seriously injured; PMN adherence amount significantly increased; levels of E-selectin, ICAM-1, and IL-1beta increased; expression levels of p-p38MAPK and p-ERK 1/2 in the supernatant of HUVECs significantly increased in the model group (all P < 0.01). Compared with the model group, HUVECs-PMN adherence amount decreased (P < 0.05); levels of E-selectin, ICAM-1, and IL-1 beta in the supernatant of HUVECs decreased (P < 0.01, P < 0.05); expression levels of p-p38MAPK and p-ERK 1/2 of endothelial cells decreased in the test group I, II, and III (P < 0.01).

CONCLUSIONSDrug-containing serums of activating blood, activating blood and dispelling toxin could attenuate TNF-alpha induced injury of HUVECs, inhibit HUVECs-PMN adherence and the release of adhesion factors. Its mechanism might be involved with protein phosphorylation of p38MAPK and ERK 1/2 in the MAPK pathway.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; E-Selectin ; Endothelial Cells ; physiology ; Human Umbilical Vein Endothelial Cells ; Humans ; Inflammation ; Intercellular Adhesion Molecule-1 ; metabolism ; Interleukin-1beta ; Mitogen-Activated Protein Kinase 3 ; Neutrophils ; Rats ; Serum ; Tumor Necrosis Factor-alpha ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism