Objective To investigate the effect and mechanism of different high concentrations glucose(Glu) on the expression of hypoxia-inducible factor 1α(HIF-1α) in cultured neonatal rat eardiomyocytes under hypoxia and non-hypoxia conditions. Methods Neonatal rat cardiomyocytes were cultured for 6 hours under different conditions and were divided into 6 groups:①Negative control group (5.5 mmol/L Glu) ; ②hypoxia mimicking cobalt chloride(Cocl_2) group(5.5 mmol/L Glu + 400 μmol/L cocl_2 ) ;③Different high concentrations Glu groups: (11.1 mmol/L, 22.2 mmol/L, 33.3 mmol/L Glu);④cocl_2 +different high concentrations Glu groups(11.1 mmol/L Glu +400 μmol/L cocl_2,22.2 mmol/L Glu +400 μmol/L cocl_2, 33.3 mmol/L Glu+400 μmol/L cocl_2);⑤High concentrations Glu + antioxidant α-tocopherol group(33.3 mmol/L Glu + 100 μmol/L α-tocopherol) ; ⑥ High concentrations Glu+antioxidant α-tocopherol+cocl_2 group(33.3 mmol/L Glu+400 μmol/L cocl_2+100 μmol/L α-tocopherol). The effect of high concentrations Glu, cocl_2 and high concentrations Glu plus cocl_2 on the expression of HIF- 1α mRNA and protein in cultured neonatal rat cardiomyocytes, as well as the effect of high concentrations Glu plus antioxidant α-tocopherol, high Glu concentrations plus cocl_2 and antioxidant α-tocopherol on the expression of HIF- 1α mRNA and protein were observed. Results 1. Compared with negative control group(5.5 mmol/L Glu), the 'expression of HIF- 1α was increased under cocl_2 mimicked hypoxia(5.5 mmol/L Glu+400 μmol/L cocl_2, 11.1 mmol/L Glu+400 μmol/L cocl_2 ,22.2 mmol/L Glu+400 μmol/L cocl_2,33.3 mmol/L Glu+400 μmol/L cocl_2). 2. The expression of HIF- 1α was increased gradually after the increasing of Glu concentrations(5.5 mmol/L, 11.1 mmol/L, 22.2 mmol/L and 33.3 mmol/L Glu).3.The expression of HIF-1α was decreased gradually after the increasing of Glu concentrations under certain cocl_2 plus different high concentrations Glu (5.5 mmol/L Glu+400 μmol/L cocl_2, 11.1 mmol/L Glu+400 μmol/L cocl_2, 22.2 mmol/L Glu+400 μmol/L cocl_2,33.3 mmol/L Glu+400 μmol/L cocl_2). 4. Under high concentration Glu plus antioxidant α-tocopherol (33.3 mmol/L Glu+100 μmol/L α-tocopherol) ,the expression of HIF- 1α was less increased than the same high Glu concentration(33.3 mmol/L Glu). 5. Under high Glu concentration plus cocl_2 (33.3 mmol/L Glu+400 μmol/L cocl_2), the expression of HIF- 1α increased less than that of the same high Glu concentration plus antioxidant α-tocopherol and cocl_2 (33.3 mmol/L Glu+400 μmol/L Cocl_2+ 100 μmol/L α-tocopherol). Conclusions High glucose increases the expression of HIF-1α under non-hypoxia, but blunts the expression of HIF-1α under hypoxia in cultured neonatal rat cardiomyocytes. Some mechanisms such as ROS (reactive oxygen species) signal transduction system and oxidative stress may be involved in it.

Objective To evaluate the short-term effect of early treatment with clopidogrel before elective coronary stenting in patients with NSTE-ACS,compared with treatment with clopidogrel at the time of the procedure. Methods Patients with NSTE-ACS undergoing elective coronary stenting were randomly divided into two groups: early treatment group (n=272) and control group (n=265). Patients in the early treatment group were given clopidogrel immediately since hospitalization (300 mg loading dose, then 75 mg once daily); while in the control group, patients were given clopidogrel (300 mg) after coronary angiography followed by 75 mg per day after PCI. The composite endpoints were death, recurrent angina pectoris, instent thrombosis, myocardial infarction and urgent target vessel revascularization within 30 days after coronary stenting. Results Differences in baseline characteristics among patients between the two groups were negligible. There were no significant difference in the target vessel lesions requiring stenting between the 2 groups. Compared with the control group, early administration of clopidogrel showed a lower rate of death, myocardial infarction, refractory ischaemia, instent thrombosis and revascularization within 30 days of PCI. Conclusion Compared with administration of clopidogrel at the time of coronary stenting, pre-treatment with clopidogrel in patients with NSTE-ACS could significantly reduce the odds of adverse cardiovascular event and improve clinical outcomes within 30 days of PCI.

Objective:To investigate dermoscopic features of molluscum contagiosum.Methods:A total of 82 outpatients with molluscum contagiosum were collected from Dalian Dermatosis Hospital between August 2019 and January 2020, and the dermoscopic features of 227 skin lesions were analyzed retrospectively.Results:Of the 227 skin lesions, hilar depression and orifices were observed in 120 (52.86%) by naked eyes and 198 (87.22%) by dermoscopy, and blood vessels were observed in 20 (8.81%) by naked eyes and 214 (94.27%) by dermoscopy. Different vascular patterns were identified by dermoscopy, including crown-shaped vessels (132 lesions, 58.15%) , punctate vessels (34 lesions, 15.00%) , and a mixed pattern (48 lesions, 21.15%) . The proportion of punctate vessels was significantly higher in lesions with inflammation or exfoliation (86.00%) than in those without (22.03%, χ2=81.685, P < 0.001) , and significantly higher in lesions with eczematous changes (50.00%) than in those without (33.85%, χ2=17.784, P < 0.001) . The most frequently observed structures were round, white-yellow, amorphous structures (40.53%) , followed by four-leaf clover-like pattern (33.48%) , polylobular pattern (20.26%) and nonspecific pattern (5.73%) . Conclusion:Orifices, vascular structures and white-yellow amorphous structures can be observed in molluscum contagiosum by dermoscopy, and the most common vascular pattern is the crown-shaped vessel.

LU’s acupuncture therapy is one of the representatives of Shanghai schools of traditional Chinese medicine, and has been indexed by Shanghai Intangible Cultural Heritage List and National Intangible Cultural Heritage List, making a profound influence. From the perspectives of its origin, main academic theories, and inheriting study basements of LU’s acupuncture school, this article elucidated and studied LU’s acupuncture therapy, for further promoting LU’s acupuncture school and reviving acupuncture schools of Shanghai region.

Objective To analyze the influencing factors of surgical management for neonatal complicated congenital heart disease(CCHD),sumarize the clinical experience and improve the surgical effect.Methods The clinical data of 154 neonates with complicated congenital heart disease who were undergone surgical management from August 2008 to August 2013 were retrospectively analysed.Results There were 14 cases of death with a mortality rate of 9.1％ (14/154),including 4 cases of preoperative death.The operative motality is 6.7％ (10/150),including 3 cases of single malformations(D-TGA/VSD,PA/VSD,IAA),and 7 cases of multiple malformation(HRHS/PS in 2,D-TGA/COA in 1,D-TAG/PS in 1,COA/SV in 1,SV/PA/IVS in 1 and D-TGA/COA/SV in 1).140 cases accepted regular follow-up after hospital discharge from 3 months to 5 years,8 of them underwent secondary surgery and all survived.Conclusion Timely diagnosis,actively improvement for preoperative internal environment,fine operative technique,individual cardiopulmonary bypass and intensive postoperative care are all important influencing factors of surgical effect for neonatal severe complicated congenital heart disease.

Objective:To explore the influence of chronic cobalt chloride (CoCl2 ) treatment on blood glucose and car-diomyocyte apoptosis in diabetic rats .Methods:In vivo MI model of rat was established using male GK diabetic rats and male Wistar rats (all weighing 200g~250g) .Blood glucose level was measured before model establishment .Af-ter successful operation ,rats were divided into six groups:Wistar sham operation group ,Wistar MI group ,Wistar MI + CoCl2 group ,GK sham operation group ,GK MI group and GK MI + CoCl2 group ,six rats survived in each group at least .After three weeks ,blood glucose level was measured and heart was excised ,expression of Caspase-3 apoptosis gene in ischemic necrosis area was measured .Results:(1) Compared with GK sham operation group and GK MI group on three weeks after operation ,there was significant reduction in blood glucose level [ (27.73 ± 2.58) mmol/L ,(27.87 ± 3.18) mmol/L vs .(16.3 ± 2.15) mmol/L] in GK MI + CoCl2 group ,P<0.05 both;(2) Compared with GK MI group ,there were significant reductions in optical density [ (0.84 ± 0.03) vs .(0.70 ± 0.03)] and mRNA ex-pression [ (0.64 ± 0.03) vs .(0.52 ± 0.03)] of Caspase-3 in GK MI + CoCl2 group ,P<0.05 both;(3) There were no significant difference in blood glucose level ,optical density and mRNA expression of Caspase-3 in Wistar MI group and Wistar MI + CoCl2 group , P>0.05 all .Conclusion:Chronic cobalt chloride treatment can decrease blood glucose level and reduce expression of Caspase-3 apoptosis gene in ischemic necrosis area in diabetic rats .

Objective To investigate the surgical technique and the curative effect of the intact ectocystectomy for renal hydatid cyst.Method Totally 7 cases of renal echinococcosis patients treated by the intact ectocystectomy of renal hydatid complete at Urology,the First Affiliated Hospital of Xinjiang Medical University from Mar 2007 to Dec 2015 were analyzed by retrospective analysis,the surgical procedure,postoperative pathologic results and efficacy were summarized.Results Visible in the operation of renal parenchyma and hydatid cysts,along a detachable gap between the gaps,renal hydatid capsule could be completely removed.The renal wound was smooth grossly,without much blood,hydatid ectocyst was removed completely,with smooth wall,pathology inspection for the attached results confirmed the capsule wall collagen fiber tissue,a small amount of renal parenchyma.Totally 7 cases of surgical success,with no liquid capsule rupture overflow,and they were followed up for 1-36 months,no recurrence and residual cavity formation and other complications occurred.Conclusion The results have indicated that the intact ectocystectomy is a radical therapy for renal echinococcosis and retain renal parenchyma.

Objective To discuss the management and selection of donor and recipient veins in the transfer of vascularied autogeneous submandibular gland (SMG).Methods The SMGs of 48 patients with severe keratoconjunctivitis were transfered to the temporal region by microsurgery from June,2002 to June,2013.The secreted saliva was used as the substitute of tear.Donor and accepting-site vessels,vessels crisis and managements,survival of grafts were retrospectively analysed.Results Transplantation succeeded in 45 patients and failed in 3.For donor veins,39 were facial veins,12 were venae comitantes of facial artery,1 was vein near the duct.For revipient veins,41 were superficial temporary veins,6 were deep temporary veins and 5 were veins in the upper neck.For revipient artery,except superficial temporary artery,deep temporary artery was also a good selection.After surgery,2/5 venous crisis cases were rescued by reanastomosising veins.TC99m examination suggested that the 49 TSMGs were survived,and the ducts were unobstructed.Follow up lasted for 6 months to 10 years,the symptoms of photophobia and anemophobia were alleviated,the symptoms of corneal xerosis disappeared.Good clinical efficacy was obtained after transplantion.Conclusion During SMGs transplantion,facial veins,venae comitantes of facial artery or vein near the duct can be used for donor vein.For recipient veins,except the superficial temporary veins as major,deep temporary veins or veins in the upper neck is also a secection.Correct selection and microsurgical management of donor and revipient veins are keys to successful SMGs transplantion.

Objective To study the clinical efficacy of acupuncture combined with medication plus joint mobilization in the treatment of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis.MethodsTotally 66 cases of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis were collected randomly and divided into treatment group (34 cases) and control group (32 cases). The control group was given treatment of simple acupuncture and TCM medication, while the treatment group was given joint mobilization treatment besides acupuncture and TCM medication. Functions of lumbar vertebra were evaluated by ODI scale and the degrees of pain were evaluated by VAS. The clinical efficacy in the two groups was compared. Results ODI in both groups were significantly improved after treatment compared with that before treatment. However, the changing range of the ODI of the treatment group was more significant than that in control group (P<0.01). After treatment, VAS scores were relieved (P<0.05) in both groups, and treatment group was more significant than that in control group (P<0.05). The total clinical efficacy was 97.06% (33/34) in the treatment group, and 84.38% (27/32) in the control group, with statistical significance (P<0.05).Conclusion Acupuncture combined with medication plus joint mobilization in the treatment of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis has good efficacy.

The impacts of humanistic quality development for medical students include various factors such as family,society and school education,in which family influence plays a direct role,social environment plays a decisive role,and school education plays a leading role.We must pay attention to and coordinate various factors,give full play to the leading role of school education,improve humanistic education,guide and promote humanistic quality development effectively for medical students.