Objective Previous studies showed that hypoxia preconditioning could protect cardiac function against subsequent myo-cardial infarction injury. However, the effect of hypoxia on left ventricular after myocardial infarction is still unclear. This study therefore aims to investigate the effects of hypoxia training on left ventricular remodeling in rabbits post myocardial infarction. Methods Adult male rabbits were randomly divided into three groups: group SO (sham operated), group MI (myocardial infarc-tion only) and group MI-HT (myocardial infarction plus hypoxia training). Myocardial infarction was induced by left ventricular branch ligation. Hypoxia training was performed in a hypobaric chamber (having equivalent condition at an altitude of 4000 m, FiO214.9%) for 1 h/day, 5 days/week for four weeks. At the endpoints, vascular endothelial growth factor (VEGF) in the plasma was measured. Infarct size and capillary density were detected by histology. Left ventricular remodeling and function were as-sessed by echocardiography.Results After the 4-week experiment, compared with the group SO, plasma VEGF levels in groups MI (130.27 ± 18.58 pg/mL,P< 0.01) and MI-HT (181.93 ± 20.29 pg/mL,P< 0.01) were significantly increased. Infarct size in Group MI-HT (29.67% ± 7.73%) was deceased remarkably, while its capillary density (816.0 ± 122.2/mm2) was significantly increased. For both groups MI and MI-HT, left ventricular end-diastolic and end-systolic dimensions were increased whereas left ventricular ejection fraction was decreased. However, compared with group MI, group MI-HT diminished left ventricular end-diastolic (15.86 ± 1.09 mm,P< 0.05) and end-systolic dimensions (12.10 ± 1.20 mm,P< 0.01) significantly and im-proved left ventricular ejection fraction (54.39 ± 12.74 mm,P< 0.05).ConclusionHypoxia training may improve left ven-tricular function and reduce remodeling via angiogenesis in rabbits with MI.

Objective: To investigate the prevalence and risk factors of dyslipidemia among residents in Haining City, Zhejiang Province, so as to provide into the management of dyslipidemia. Methods: Totally 1 953 residents at ages of 15 to 69 years were recruited using a multi-stage stratified cluster sampling method in 5 townships (streets) of Hainan City. Subjects' demographic features, smoking status, alcohol consumption, family history of diseases and development of chronic diseases were collected. The height, body weight, waist circumstance and blood pressure were measured, and the fasting blood glucose, serum uric acid and blood lipid levels were determined. The prevalence of dyslipidemia was analyzed and standardized by the 7th population census data. The factors affecting dyslipidemia were identified using a multivariable logistic regression model. Results: Totally 1 893 valid questionnaires were recovered. The respondents included 949 males (50.13%) and 944 females (49.87%), and had a mean age of (47.90±14.34) years. A total of 513 participants were detected with dyslipidemia, and the prevalence and standardized prevalence of dyslipidemia were 27.10% and 27.01%, respectively. The prevalence of hypertriglyceridemia, hypercholesterolemia, hyperlipoproteinemia and hypolipoproteinemia was 16.53%, 3.22%, 1.74% and 15.27%, respectively. Multivariate logistic regression analysis showed that male (OR=1.571, 95%CI: 1.268-1.947), family history of stroke (OR=1.645, 95%CI: 1.192-2.270), hyperuricemia (OR=1.809, 95%CI: 1.370-2.388), central obesity (OR=1.423, 95%CI: 1.066-1.900), obesity (OR=1.736, 95%CI: 1.335-2.257), underweight (OR=0.171, 95%CI: 0.049-0.593) significantly correlated with dyslipidemia. Conclusions The prevalence of dyslipidemia is lower than the national level among residents at ages of 15 to 69 years in Haining City, and hypertriglyceridemia and hypolipoproteinemia are predominant types of dyslipidemia. Male, obesity, family history of stroke and hyperuricemia are risk factors of dyslipidemia.

OBJECTIVEParticulate samples from the atmosphere in an electronic waste dismantling area were collected to investigate the levels and sources of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs).

METHODSParticulate samples including total suspended particulates (TSP) and particulate matter <2.5 μm diameter (PM(2.5)) were collected on selected non-rainy days in summer (Jul 10-12, 2006) and winter (Jan 11-13, 2007) from Fengjiang (FJ), an electronic waste (e-waste) dismantling area in eastern China, and an adjacent area Luqiao (LQ). The samples were analyzed by isotope dilution - high resolution gas chromatography / high resolution mass spectrometry (HRGC/HRMS).

RESULTSIn FJ, the mean PCDD/F concentrations (mean TEQ values) were 280.6 pg Nm(-3) (3.432 pg WHO-TEQ Nm(-3)) for the TSP samples and 223.3 pg Nm(-3) (3.180 pg WHO-TEQ Nm(-3)) for the PM(2.5) samples. The total PCDD/F concentrations and TEQs in the PM(2.5) samples were about 66.8%-108.0% of the TSP samples, indicating that the fine particles contained higher levels of PCDD/Fs than coarse particles. The PCDD/F levels in FJ were much higher than those detected in common urban areas around the world, suggesting that the study area was heavily polluted by PCDD/Fs. Furthermore, the total average daily PCDD/F intake in FJ was estimated at 62.11 pg WHO-TEQ kg(-1)·day(-1) for adults and 110.11 pg WHO-TEQ kg(-1)·day(-1) for children, which greatly exceeds the WHO (1998) tolerable daily intake of 1-4 pg of WHO-TEQ kg(-1)·day(-1).

CONCLUSIONThe PCDD/F homologues and congener profiles confirmed that the PCDD/Fs in FJ originated from crude e-waste recycling activities. The severe dioxin pollution present in FJ has also substantially influenced the adjacent area of LQ through atmospheric transport. Open burning of medical waste was another source of PCDD/Fs identified in LQ.

Air Pollutants ; chemistry ; Atmosphere ; Benzofurans ; chemistry ; China ; Dibenzofurans, Polychlorinated ; Electronic Waste ; Environmental Exposure ; Humans ; Inhalation Exposure ; Occupational Exposure ; Particulate Matter ; chemistry ; Polychlorinated Dibenzodioxins ; analogs & derivatives ; chemistry ; Refuse Disposal ; methods ; Seasons

ObjectiveTo investigate the clinical value of color Doppler ultrasound examination in the diagonosis of acute and chronic artery occlusion of the extremities.MethodsA review was made on 129 extremetiy artery occlusion patients at Anzhen Hospital during 2006 -2010. 85 cases were male, and 44 cases were female. Age was from 17 to 94 years (average: 62 ±9 years). We analyzed two-dimensional and color Doppler flow imagings of 39 acute occlusion arteries and 97 chronic occlusion arteries. We compared factors including the echoes of artery lumens, the vessel wall structures, hemodynamic parameters of inlet and outlet at the occlusion, and collaterals between groups.ResultsThe factors of depths of vessel wall,internal diameters of ccclusion arteries, proximal resistant index and collaterals were significantly different between groups ( P ＜ 0. 05 ). The internal diameters of acute occlusion arteries were wider than chronic occlusion arteries. The depths of vessel wall, proximal resistant index and collaterals were thinner, smaller,and less than chronic occlusion arteries. The total accurate rate of differential diagnosis for acute and chronic artery occlusion by color Doppler ultrasound was 95.6％.ConclusionsColor Doppler ultrasound is an effective method for the differential diagnosis of acute and chronic artery occlusion of the extremities.

Objective To compare the efficacy and safety ofetanercept injection 50 mg once weeklycombined with methotrexate (MTX) therapy for patients withactive rheumatoid arthritis.Methods This studyconsists of 2 parts：a 12-week double-blind treatmentperiod (part A) followed by a 12-week open-labelsafety study period (part B).The randomization oftreatments in double-blind treatment period was completedthrough the clinical operations randomization environment(CORE) system.During part A,the subjects wererandomly assigned to the etanercept 50 mg or placebo group. The dosage regimen for etanercept was 50 mgadministered subcutaneously once weekly while MTX wasadministered orally.All subjects who completed partA received 50 mg etanercept once weekly and MTX1 during theopen-label treatment.The primary endpointwas ACR 20 response at week 12.Secondary endpoint variablesincluded physician／patient global assessmentsof disease activities,duration of morning stiffness,painvisual analog scale (VAS),health assessment questi onnaire (HAQ),CRP level and tender and swollen joint counts .The results of safety between the two groupswere compared.The primary endpoint and other secondarybinary endpoints were analyzed using the Fisher’sexact test.For continuous endpoints.the change frombaseline was analyzed with analysis of covariance.Results One hundred and fifty six subjects satisfiedmodified intent-to-treat (mITT) population were enrolled during part A,of which 77 subjects were in theetanercept+MTX group,and 79 subjects were in theplacebo+MTX group respectively.A total of 149 subjectscompleted part A.As early as week 4.the ACR 20response achieved 39％ (30,77) in the etanerceptgroup,which was significantly higher than that of theplacebogroup [16％(13／79),P<0.001].At week 12,the ACR 20respouse achieved 62％(48,77)in the etanercept group and 23％(18／79) in the placebo group (P<0.01).Fromweek 4,other study endpoints including physician global assessment,patient globalassessment,duration of morning stiffness,painVAS,HAQ,CRPlevel,tender joint counts,swollen joint counts were alsocompared.The results showed that all above efficacyendpoints in the etanercept+MTX group were better than thoseof the placebo+MTX group(P<0.01).Butthere Was no significant difference in the total adverseeriects between the two groups.ConclusionEtanercept 50 mg once weekly + MTX treatment for 24 weeks iswell tolerated.During the first 12-weektreatment period,the etanercept group has shown a rapidefficacy onset and a significantly better therapeuticeffect compared to that of the placebo group.

Objective To analyze the expression of miRNA-29a in U937 macrophages infected with Mycobacterium tuberculosis and its regulation of target genes.Methods The target genes of miRNA-29a were predicted with softwares miRnada,RNAhybrid and targetscan.The differentiation of U937 macrophages was induced by phorbol ester(PMA), the induced U937 cells were infected with bacilli calmette guerin (BCG).The expression levels of miRNA-29a and its target genes in U937 cells were detected with real-time fluorescence quantitative PCR(RT-fqPCR).The miRNA-29a over-and low-expression U937 macrophage cell lines were constructed and the levels of miRNA-29a and its garget genes were detected.The SPSS 18.0 software was used to analyze the data.Results As predicted by relevant softwares,the miRNA-29a regulate the expression of VEGFA,NFATC3 and TSC22D3 genes.After BCG infection,the expression of miRNA-29a increased to 1.33 fold(P <0.05), and the expression levels of VEGFA, NFATC3 and TSC22D3 were increased to 5.34,99.25 and 2.12 fold,respectively(P<0.01).In the miRNA-29a over-expressing U937 macrophages,the expression levels of VEGFA,NFATC3 and TSC22D3 were up-regulated to 1.35,1.29 and 3.38 fold,respectively(P<0.05 or <0.01).While in the U937 macrophages with miRNA-29a knock-down,the expression levels of VEGFA, NFATC3 and TSC22D3 were down-regulated to 0.07, 0.08 and 0.55 fold, respectively(P <0.01).Conclusion The results suggest that Mycobacterium tuberculosis infection can increase the expression of miRNA-29a in U937 macrophages,further targeting the regulation of VEGFA, NFATC3 and TSC22D3 gene expression, which may participate in the pathogenesis and development of tuberculosis.

Objective:To evaluate the efficacy of dual-tuberosity locking plate for the treatment of proximal humeral fractures.Methods:This study retrospectively analyzed data of patients with proximal humeral fractures treated with a new locking plate from July 2017 to July 2019. Finally, 19 eligible patients were included, including 12 females and 7 males, with an average age of 64.0±12.8 years (range, 32-85 years). According to the Neer classification of proximal humeral fractures, 1 case was two-part fractures, 9 cases three-part fractures and 9 cases four-part fractures. Among them, 9 cases combined with greater and lesser tuberosities fractures and 10 cases with isolated greater tuberosity fractures. Constant-Murley and disabilities of the arm shoulder and hand (DASH) scores, the change of neck-shaft angle, the change of humeral head height, tuberosity consolidation and other complications were recorded at the latest follow-up.Results:The mean follow-up time was 16.1 months (range, 12-18 months). All fractures were healed within follow-up period. Mean Constant-Murley score was 84.2±11.0 (range, 55-98), DASH score was 19.4±11.6 (range, 2.3-47.8) and VAS was 1.6±1.3 (range, 0-4) at the latest follow-up. As for the radiographic results, 19 patients had a mean neck-stem angle of 141.9°±9.8° (range, 132.17°-162.66°) on the first day after surgery, and a mean humeral head height of 18.0±5.9 mm (range, 7.45-27.12 mm). The mean neck-stem angle was 148.6°±7.5° (range, 132.70°-159.39°) and the mean humeral head height was 17.4± 5.5 mm (range, 5.02-27.31 mm) at the latest follow-up. The average change of neck-stem angle was 3.29° (range, 0.68°-33.10°), and mean change of humeral head height was 0.68 mm (range, 1.32-6.56 mm). No fractures developed greater or lesser tuberosity absorption or malunion, but 4 cases suffered loss of fixation and 1 developed primary intra-articular screw penetration as well as wound infection.Conclusion:In the open reduction and internal fixation of the proximal humeral fractures, the new locking plate can fix greater and lesser tuberosity fractures simultaneously, which helps reduce their displacement and deformity of tuberosities. By given that, satisfactory radiographic outcomes and shoulder functions can be obtained.

Nowadays,surgery is a comprehensive approach for the treatment of hepatic carcinoma as the first choice,but there are still many limitations in surgical therapy,such as the location,boundary and metastasis of hepatic carcinoma.Currently,the indocyanine green fluorescence imaging-guided hepatectomy is widely used at home and abroad as a new progress and hotspot in hepatobiliary surgery,which makes hepatobiliary surgery more convenient and makes up for some deficiencies in hepatectomy.Thus,we summarized the experience of indocyanine green fluorescence imaging-guided hepatectomy in the People's Hospital of Hunan Province and discussed its value of application.

Objective To evaluate the perioperative and long-term effects of endovascular aneurysm repair(EVAR) of infrarenal abdominal aortic aneurysm (AAA).Methods Clinical data of 131 AAA cases undergoing EVAR were retrospectively evaluated for the safety and long-term efficacy.Results The operative time was (137 ±29) min,blood loss was (142 ±20) ml,blood transfusion was (46 ± 26) ml,ICU staying time was (17 ± 4) h.Major perioperative complications were severe heart failure in 8 cases,myocardial infarction in 2 cases,pulmonary complications in 5 cases,internal leakage in 4 cases.During the period of up to 60 months there were15 cases of endoleak including 8 cases of type Ⅰ,5 cases of type Ⅱ,1 each case of type Ⅲ and Ⅳ and 2 deaths.By Kaplan-Meier survival analysis there were complications developing after 60 months and up to 40％ of them needing reintervention.Conclusions Endovascular repair is the safe treatment for AAA,but discharged patients need close long-term follow-up.Complications that ensued need intensive management.

Objective:To investigate the changes of T-lymphocyte subsets, T-cell immunoglobulin and mucin domain molecule-1 (TIM-1) and TIM-3 levels, and cytokines in the peripheral blood of patients with active tuberculosis.Methods:From December 2017 to December 2018, 50 tuberculosis patients and 50 cured tuberculosis patients in Zhejiang Hospital of Integrated Chinese and Western Medicine were selected as the tuberculosis group and cured tuberculosis group, respectively. Fifty healthy individuals in the same period were selected as the control group. Flow cytometry was used to detect the T-lymphocyte subsets in the peripheral blood. The mRNA levels of TIM-1, TIM-3, interferon(IFN)-γ and interleukin(IL)-4 in peripheral blood mononuclear cells (PBMC) were detected by quantitative real-time polymerase chain reacticn (PCR). T test was used for statistical analysis. Results:The ratio of CD4 + /CD8 + T lymphocytes in the tuberculosis group (1.21±0.50) decreased significantly, comparing with those in the cured tuberculosis group (1.88±0.62) and the control group (1.92±0.82). The differences were statistically significant ( t=2.148 and 2.207, respectively, both P<0.05). The mRNA levels of TIM-1, TIM-3 and IL-4 in PBMC in the tuberculosis group were 2.16±0.37, 1.59±0.36 and 1.52±0.69, respectively, which were all higher than those in the cured tuberculosis group (1.60±1.23, 1.01±0.52 and 0.91±0.36, respectively) and the healthy control group (1.40±0.27, 0.92±0.34 and 0.79±0.42, respectively). All of these differences were statistically significant ( t=14.120, 11.440, 17.130, 12.090, 12.050 and 17.030, respectively, all P<0.05). However, the IFN-γ mRNA level (0.43±0.11) was lower than that in the cured tuberculosis group (1.74±0.72) and the control group (1.82±1.17), and the differences were both statistically significant ( t=13.880 and 11.430, respectively, both P<0.05). Conclusion:The immune dysfunction in patients with active tuberculosis may be related to the low ratio of CD4 + /CD8 + T lymphocytes, the increased expressions of TIM-1 and TIM-3, and the imbalance of helper T lymphocyte (Th)1/Th2 cytokines.