Objective: To explore whether relieving effect of Ginsenosides-Rb1 (Gs-Rb1) on chronic heart failure (CHF) induced by adriamycin is related to improving levels of tumor necrosis factor (TNF) receptor (TNFR) and ligand TNF-α or not. Methods: Adriamycin-induced CHF model rats were randomly divided into adriamycin group (n=15, received adriamycin 1 μmol/L) and Gs-Rb1 group (n=17, received Gs-Rb1 70 mg•kg-1•d-1 based on adriamycin group), another 10 healthy Wistar rats were selected as normal control group. Meanwhile, cultured cardiomyocytes of neonatal rats were accordingly divided into normal control group, adriamycin group and adriamycin+Gs-Rb1 group. After intervention, echocardiography, levels of TNFR/TNF-α mRNA and protein were measured and compared among three groups. Results: 1. In vivo: Compared with normal control group TNFR-1 [protein（0.13±0.02）kDa, mRNA（0.19±0.05）bp]，TNFR-2[protein（0.24±0.01）kDa, mRNA（0.13±0.02）bp]，TNF-α [protein（0.11±0.01）kDa, mRNA（0.26±0.05）bp], the levels of TNFR-1 [protein（0.67±0.04）kDa,（0.51±0.04）kDa；mRNA（0.81±0.03）bp，（0.49±0.05）bp]，TNFR-2 [protein（0.61±0.05）kDa, （0.47±0.03）kDa，mRNA（0.28±0.03）bp，（0.18±0.04）bp] and TNF-α [protein（0.28±0.04）kDa, （0.20±0.03）kDa， mRNA（0.67±0.05）bp，（0.45±0.04）bp] significantly rose（P<0.05 or <0.01） in adriamycin group and Gs-Rb1 group; and those levels of TNFR-1, TNFR-2, TNF-α protein and mRNA of Gs-Rbl group were significant reduction than those of adriamycin group; 2. In vitro: The results were similar, those of adriamycin group and Gs-Rb1 group were also significant rise than those of normal control group（P<0.05 or <0.01），those of Gs-Rbl group were significant reduction than those of adriamycin group（P<0.05 or <0.01）. Conclusion: TNFR/TNF-α expression may play a certain role in the process of adriamycin-induced CHF; improving effect of Gs-Rb1 on adriamycin-induced CHF may be related to regulation of TNFR/TNF-α.

Objective:To explore whether ginsenosides-Rb1 (Gs-Rb1)can relieve cardiomyocyte hypertrophy induced by endothelin-1 (ET-1)via protein kinase C (PKC)system.Methods:Cardiomyocytes of neonatal rat were random-ly divided into blank control group,Gs-Rb1 group,ET-1 group,Gs-Rb1+ET-1 group,ET-1+CHE (chelerythrine, PKC blocker)group and Gs-Rb1 +ET-1 +CHE group.After 96h intervention,cardiomyocyte surface area,total protein content,PKC activity,c-fos and p-c-jun expressions were measured.Results: (1)Cardiomyocyte surface area and total protein content in Gs-Rb1+ET-1 group were significantly lower than those of ET-1 group (P <0.05~<0.001),but not significant different with those of Gs-Rb1+ET-1+CHE group,P =0.569;(2)PKC activity in Gs-Rb1+ET-1 group was significantly lower than that of ET-1 group [(9.3±0.6)pmol·min-1 ·mg-1 vs.(14.1± 0.9)pmol·min-1 ·mg-1 ],but significantly higher than that of Gs-Rb1+ET-1+CHE group [(2.7±0.2)pmol· min-1 ·mg-1 ],P <0.001 all;(3)Expressions of c-fos and p-c-jun gene and protein in ET-1 group were significant-ly higher than those of blank control group (P <0.001 all);compared with ET-1 group,there were significant re-ductions in expressions of c-fos [mRNA/protein:(0.53±0.05/0.39±0.02)vs.(0.43±0.03/0.31±0.03)]and p-c-jun [mRNA/protein:(0.64±0.04/0.44±0.02)vs.(0.33±0.05/0.37±0.03)]in Gs-Rb1+ET-1 group and ex-pressions of c-fos [mRNA/protein:0.41 ± 0.05/0.31 ± 0.02]and p-c-jun [mRNA/protein:0.31 ± 0.05/0.36 ±0.03]in ET-1+CHE group (P <0.05 or <0.001),expressions of c-fos and p-c-jun gene and protein in Gs-Rb1+ET-1+CHE group were significantly lower than those of Gs-Rb1+ET-1 group and ET-1+CHE group (P <0.05 or<0.001).Conclusion:Gs-Rb1 can significantly inhibit cardiomyocyte hypertrophy induced by ET-1 and PKC system is one of pathways mediating this biological effect.

Objective:To explore whether the effect relieving chronic heart failure (CHF) induced by Adriamycin of Ginsenoside-Rbl (Gs-Rbl ) is related to inhibiting Toll-like receptor (TLR ) . Methods :Adriamycin-induced CHF model rats were randomly divided into Adriamycin group (n=15) and Gs-Rb1 group (70 mg/kg d ,n=17);another 10 normal rats were regard as control group .Neonate rat cardiomyocytes were also randomly divided into control group ,Adriamycin group (1 μmol/L) and Gs-Rb1 group (1 μmol/L Adriamycin + 200 μmol/L Gs-Rbl) .After the intervention being performed ,echocardiography and expressions of TLR2/TLR4 gene and protein were assessed in all groups .Results:(1) Both studies in vivo and in vitro indicated that expressions of TLR 2 protein and mRNA in Adriamycin group were significantly higher than those of control group ,compared with Adriamycin group ,there were significant reductions in expressions of TLR2 protein [ (0.975 ± 0.022/0.564 ± 0.031) vs .(0.593 ± 0.018/0.344 ± 0.024)] and mRNA [ (0.576 ± 0.029/0.853 ± 0.043) vs .(0.349 ± 0.015/0.401 ± 0.021)] in Gs-Rbl group ,P<0.01 both ;(2) No matter study in vivo or in vitro ,expressions of TLR4 protein and mRNA in Adriamy-cin group were significantly higher than those of control group ,compared with Adriamycin group ,there were signif-icant reductions in expressions of TRL4 protein [ (0.654 ± 0.032/0.519 ± 0.013 ) vs . (0.371 ± 0.013/0.254 ± 0.027)] and mRNA [ (1.602 ± 0.013/0.838 ± 0.021) vs .(1.140 ± 0.021/0.503 ± 0.022)] in Gs-Rbl group , P<0.01 both .Conclusion:Adriamycin may trigger the process of CHF through increasing TLR 2 and TLR4. The effect of Gs-Rbl improving adriamycin-induced CHF may be related to inhibition of TLR 2 and TLR4 .

Objective To provide clinical experience in treatment of cook′s fungus infection of evidence‐based medical evidence , separation of medical environment of cook′s bacteria identification and antimicrobial susceptibility test .Methods Collected in the hospital infection of hygiene monitoring ,collection and medical staff hands ,skin and mucous membrane ,air and object surface sam‐ples from 86 strains of cook ,application ATB Expression semi‐automatic bacteria identification of susceptibility analyzer supporting article try ID32 Staph identification and drug susceptibility test Staph 5 ,strain identification and drug sensitive test .Results 86 strains bacteria identification cook 62 strains bacteria ,mutation detection rose cook bacteria strains of 16 ,cook eight strains of bac‐teria .Cook bacterium of norfloxacin(16 .3% ) ,and with nitrofurantoin low because of the sensitive rate(20 .9% ) ,of erythromycin (69 .3% ) and gentamycin(67 .4% ) ,the sensitive rate at nearly 70 .0% ,sensitivity to penicillin and other 12 kinds of antimicrobial a‐gents more than 80 .0% ,even 100 .0% .Conclusion Cook for most still sensitive ,clinicians and microorganism inspection personnel should strengthen the cook .

Objective To investigate the ultrasonic image characteristics of Zenker diverticulum(ZD).Methods The ultrasonographic features were summarized using the analysis confirmed by surgery pathology or X-ray imaging of the ZD in six eases.Results The diverticulum of Zenker located behind the thyroid gland in all the six cases,with five cases to the left and one to the right.The internal hyperechoic foci caused by air was found for all the six cases.The diverticulum wall appeared to be semicircular,narrow-band and acoustic halo low echo with an average thinckness of 0.53 mm.The Doppler sonogram of the six diverticulums showed no vascular signal.Conclusions The ZD had several unique characterisitics for identification by ultrasonic diagnosis,which included hyperechoic foci caused by air,internal changes of echo after drinking water and the special layered structure of the five-layer ZD wall.

Objective To stuay the serum levels of sCD40L,hsCRP,ICAM-1 and VCAM-1,and the expression of CD40L of the CD4+T cells in patients withacute coronary syndrome(ACS),and to explore the relationship between CD40L and inflammatory factors and the effects of CD40/CD40L on ACS.Method Thirty-two coronary heart disease patients without history of other discernible systemic disease and medicine of steroids or immunosuppressants taken were divided into acute myocardial infarction group(AMI,n=11),unstable angina pectoris group(USP,n=14)and stable angina pectoris group(SAP,n=7).The control group was composed of eight healthy volunteers(CON group).Theexpression of CD40L Was determined by flow cytometry(FCM).Serum sCD40L.ICAM-1 and VCAM-1 were determined by using ELISA.The serum hsCRP was assayed by using immunoturbidimetry.Data were analyzed with SPSS 11.0 software for windows.Results The expression percentage(%)of CD40L of the CD4+T cells,and the serum levels of sCD40L,hsCRP,ICAM-1 and VCAM-1were sifnificantly higher in patients of AMI group than those in patients of other groups(P＜0.05 or P＜0.01).Similarly,those biomarkers in patients of UAP group were usually higher than those in patients of CON or SAP groups(P＜0.05).There Was a positive correlation between the expression of CD40L and the serum level of VCAM-1 in paients of AMI group(P＜0.05),and likewise,a positive correlation also existed between the serum level of sCD40L and other factors,hsCRP,ICAM-1 as well as VCAM-1,in patients of AMI group(P＜0.05).Conclusions The enhanced expression of CD40L of the CD4+T cells and high serum level of sCD40L are present in patients with acute coronary syndrome.The hsCRP,ICAM-1 and VCAM-1 play roles in the pathogenesis of ACS,and they have correlation with enhanced expression of CD40L and high serum level of sCD40L.Therefore,CD40L and sCD40L may be used as indicators of risk in coronary heart disease.

Objective To analyze and compare reflectance confocal microscopy (RCM) features between Paget's disease and eczema on the scrotum.Methods RCM was performed to image scrotal lesions of 5 male patients with suspected Paget's disease and 5 male patients with eczema.Then,the scrotal lesions were resected and subjected to histopathological examination,and a comparison was conducted between the confocal microscopic and pathological findings.Results RCM imaging for the 5 cases of Paget's disease showed disorganized epidermal structure,absence of normal honeycomb structures,single or clustered pagetoid cells in the prickle cell layer.RCM imaging for the 5 cases of eczema showed intercellular edema in the prickle cell layer,reticular degeneration of blisters in all the cases,and pustule formation in some cases.Conclusion RCM features are obviously different between Paget's disease of the scrotum and scrotal eczema,so RCM imaging can facilitate the early diagnosis of Paget's disease.

AIM: To investigate expression and function of CD40 ligand by peripheral blood mononuclear cells (PBMCs) in patients with systemic lupus erythematosus (SLE). METHODS: Expression of CD40 ligand by PBMCs in patients with SLE and control were examined by flow cytometric analysis before and after stimulated by phytohemagglutinin(PHA)and depressed by Dexamethasone(Dex). The correlation between expression of CD40 ligand and SLE activity index(SLEDAI) was analysed in patients with SLE. RESULTS: The expression of CD40 ligand by PBMCs in patients with active SLE was higher than that in patients with inactive SLE and control. Though the expression of CD40 ligang by PBMCs could be stimulated by PHA in three groups, it was the highest in patients with active SLE. Dex depressed the expression of CD40 ligand by PBMCs significantly in patients with SLE , but not in control. There was high positive correlation between expression of CD40 ligand and SLEDAI in patients with active and inactive SLE. CONCLUSION: Increased expression of CD40L by PBMCs in patients with SLE may play an important role in pathogenesis of SLE.

Objective To investigate the clinical and reflectance confocal microscopy (RCM) characteristics of hypopigmentation induced by local glucocorticoid injection.Methods A retrospective study was carried out on 26 cases of hypopigmentation induced by local glucocorticoid injection.The clinical manifestations,RCM characteristics and treatment outcomes of hypopigmentation induced by local glucocorticoid injection were analyzed in these cases.Results Of the 26 patients,22 were female and 4 were male.Lesions were round or oval,pale white or white patches with obscure boundaries.Different degrees of localized skin atrophy occurred in 15 patients,and subcutaneous venous networks were observed in 8 of the 15 patients.RCM imaging of lesions in the 26 cases showed different degrees of epidermal thinning in the areas of hypopigmentation,shortening or disappearance of trochanterellus,and decreased number or disappearance of chromocytes in the basal layer,which were totally different from RCM characteristics of vitiligo lesions.Conclusion Hypopigmentation induced by local glucocorticoid injection is a kind of depigmentation disease complicated by skin atrophy with definite inducements,and RCM is of great value to its diagnosis.

Objective To investigate the levels of literacy and numeracy in type 2 diabetes patients with poor glycemic status in communities of Shanghai,China,and to evaluate their associations with blood glucose level.Methods A total of 800 type 2 diabetes patients with recent HbA1c≥7.5％ or fasting plasma glucose level ≥10 mmol/L were recruited from 8 communities in Minhang district and Changning district of Shanghai,China,and were interviewed using a structured questionnaire during February 2015 and March 2016.Literacy and numeracy levels of all patients were evaluated using the validated Health Literacy Management Scale (HeLMS) and the 5-item version Diabetes Numeracy Test (DNT-5),respectively.Results The patients included in this study were observed to have higher levels of health literacy,with a median score of HeLMS being 116 [interquartile range (IQR),108-120] and a median correct rate of DNT-5 of 80％ (IQR,60％-100％).Age,educational level and occupation were significantly related with health literacy levels and numeracy.Sex and income were closely related with health literacy levels.HeLMS score was not significantly associated with HbA1c level (P =0.383),while the lower correct rate of DNT-5 was linked with a higher level of HbA1c.The median HbA1c level was 8.3％ (IQR 7.7％-9.4％) in the patients with the lowest tertile of DNT-5 correct rate,significantly higher than 8.2％ (IQR:7.5％-9.2％) in the medium and 8.0％ (IQR:7.5 ％-8.8 ％) in the highest tertile group (P =0.009).Conclusions Diabetes patients with poor glycemic status in communities of Shanghai have high levels of health literacy,which was significantly related with age,sex,educational level,occupation and income.Ability in numeracy may be a more important influence factor than health literacy for glycemic status of diabetes patients.