Objective To observe the changes of growth hormone axis(GH axis) and to study the mechanism of acquired growth hormone resistance in aged patients with congestive heart failure (CHF). Methods Ninety-five patients with congestive heart failure were divided into three groups (Grade Ⅱ , n = 28; Grade Ⅲ , n = 36;and Grade Ⅳ , n = 31) according to New York Heart Association criterion. Another 30 healthy people were used as controls. The concentrations of plasma GH , insulin growth factor 1 (IGF-1) and insulin growth factor binding protein 3 (IGFBP-3) were measured by radioimmunoassay, and growth hormone sensitivity was assessed by log(IGF-1 /GH). Results Plasma concentration of GHC[(5. 83 ? 1. 41) mlU/L vs (1. 56 ? 0. 97) mlU/L were higher in grade Ⅳ group than those in normal subjects ( P

Objective To discuss cultivation of higher vocational nursing talents in the model of learning and working rotation during the cooperation of school and hospital. Methods Students were cultivated by two years school study, two years learning and hospital work rotation and one year hospital position practice which was adopted as an "221" mode by means of organizational leadership,agreed safeguard and co-management. Half day learning and half day practice in four learning situation which have been transformed from the real professional workplace. Results Scores of professional core courses and operation skills had been improved significantly; Students cultivated by "221" mode had more superiority on the aspects of post adaptability, hand skills, communication skills and the ability of linking theory to practice. Conclusions The model of learning and working rotation during the cooperation of school and hospital is the important way of cultivating higher vocational nursing talents.

Objective To observe the clinical therapeutic effects of radial optic neurotomy (RON) for central retinal vein occlusion (CRVO). Methods The clinical data of 12 patients (12 eyes) with CRVO who had undergone RON were retrospectively analyzed. The patients were examined by visual acuity and fundus examination, photography, fundus fluorescein angiography, and optical coherence tomography (OCT). The visual acuities of all of the 12 eyes with severe hemorrhage and retinal edema were less than 0.1. A microvitreoretinal blade or CRVO knife was penetrate into the nasal side of the optic disk, and the incision reached the cribriform plate and even the back, and then dissected at the nasal side of the cribriform plate. The postoperative follow-up period lasted 2 to 15 months with the mean of 6.5 months, and the visual acuity, the condition of visual field and ocular fundus of the eyes undergone the surgery were observed. Results In 12 eyes undergone RON successfully, the visual acuity after the surgery improved more or less in 9 (75%), and more than or up to 0.1 in 6. The results of the examinations showed that the retinal edema and hemorrhage disappeared gradually, varicosity mitigated, retinal serous detachment mitigated or disappeared, and macular cystoid edema faded; macular fovea recovered in 3 eyes, optic nerve had a hemorrhage during the operation in 3 eyes, and the dissected part of optic nerve became atrophic afterward in 4. Conclusions RON performed at the edge of the nasal side of the optic disc is safe and effective, which may improve the visual acuity of the eyes with CRVO and mitigate retinal hemorrhage and edema.

Objective To study the anti-hepatofibrotic effects of rhubarb and tetrandrine in experimental rat model, and to explore its possible mechanism. Methods The experimental hepatic fibrosis was induced by subcutaneous injection of CCl 4. The rhubarb and tetrandrine were administered through gastric tube respectively. The liver function test was performed by enzyme kinetics and the extracellular matrix (ECM) contents were determined by radioimmunoassay. The pathological changes of liver tissues were detected by HE and VG staining; meanwhile, ultra microstructural changes were observed by electron microscope in randomly selected samples. Results Both rhubarb and tetrandrine could improve the liver function in liver fibrosis, decrease the contents of ECM and reduce the degree of liver fibrosis, with the best results in rats receiving high dosage of rhubarb and low dosage of tetrandrine. Conclusions Rhubarb and tetrandrine could protect hepatocytes, inhibit the ECM synthesis, and thereby could prevent the development of liver fibrosis and cirrhosis in the experimental animal models.

Objective To evaluate clinical efficacy of multiple regimen combination in treatment of osteoporosis of perimenopausal or postmenopausal women. Methods From Jul. 2008 to Dec. 2009, 109 women with low bone mineral density (BMD) or osteoporosis treated in Department of Obstetrics and Gynecology, Affiliated Second Hospital, Wenzhou Medical College were enrolled randomly into 3 group,including 36 women in Group A managed by osteoform 1000 mg/d + alfacalcidol 0. 25 μg/bid orally, 40 women in group B managed by osteoform 1000 mg/d + alfacalcidol 0. 25 μg/bid + tibolone 1.25 mg/d orally and 33 women in group C managed by ostcoform 1000 mg/d + alfacalcidol 0. 25 μg/bid +bisphosphonates 70 mg/w orally. After 48 weeks BMD on lumbar 1 -4 (L1-4) and left femur were detected by X-ray. Bone alkaline phosphatase(BALP) ,cross linked clelopeptide of type Ⅰ collagen(CTX) and 25-hydroxychole calciferol [25 (OH) D3] was measured by enzyme linked immunosorbent assay (ELISA).Result Seven women (6. 4%, 7/109) were withdrawed form this study, including 2 cases losing follow up in group A, 3 cases stopping treatment in group B, 2 cases giving up treatment due to severe adverse effect (burning in upper abdomen) in group C. (1) Pain relieve: after 48 weeks treatment, women in 3 groups improved symptom of pain significantly, the rates of pain relieve were 85% (29/34)in group A, 92% (34/37) in group B and 94% (29/31) in group C. (2) BMD: BMD was improved significantly in women in 3 groups after treatment. BMD of L1-4 were (0.88±0.15) g/cm2 in group A,(0.89±0.18) g/cm2 in group B and (0.87±0.10) g/cm2 in group C before treatment, and converted to (0.90±0.01) g/cm2 in group A, (0.93±0.09) g/cm2 in group B and (0.91±0.11) g/cm2 in group C after treatment. BMD of left femur were (0.87±0.07) g/cm2 in group A, (0.87±0.07) g/cm2 in group B and (0.85±0. 12) g/cm2 in group C before treatment and converted to (0.90± 0.03) g/cm2 in group A, (0.91±0.08) g/cm2 in group B and (0.89 ±0.12) g/cm2 in group C after treatment. It was shown significantly different BMD between group B or C and group A (P < 0. 01), however, there was no significant different BMD between group B and C (P >0. 05). (3) Index of bone metabolism: BALP were (26±6) μg/L in group A, (26±9) μg/L in group B and (28±7) μg/L in group C before treatment and converted to (22±5) μg/L in group A, (20±9)μg/L in group B and (22±8)μg/L in group C after treatment, which showed statistical difference (P < 0.05). CTX were (0.85±0.20) ng/L in group A, (0.84±0.47) ng/L in group B, and (0. 88 ±0. 11) ng/L in group C before treatment and converted to (0. 81 ±0. 19) ng/L in group A, (0. 77±0.33) ng/L in group B, and (0.82 ±0. 14) ng/L in group C after treatment, which showed statistical difference (P < 0. 05). Conclusions Those 3 regimens combination could be used in treatment of osteoporosis by decreasing bone conversion, increasing bone density, decreasing bone absorption. Regimen A was only suitable for basic therapy,the other two regimens could provide better treatment.

Objective To summarize complications and early clinical effect of less invasive stabilization system and the femoral condylar support plates in treatment of AO type C distal femoral fractures. Methods We reviewed 46 patients who had internal fixation of AO type C distal femoral fractures. Of all 46 patients, 25 were with less invasive stabilization sys-tem and 21 were with femoral condylar support plates fixation. Comparative analysis was performed using intraoperative in-dex, postoperative complications and the Evanich score at follow-up. Results All 46 patients were followed up with a mean time of 19.6 months after surgery. The difference in incision length, blood loss, fracture healing time was significant between the 2 groups(P＜0.05)but not in the duration of operations and hospital stays(P>0.05). The statistical signifi-cance was also found in the total incidence of postoperative complications and the Evanich score at the last follow-up(P＜0.05). Conclusion Patients with less invasive stabilization system fixation had the characteristics of less trauma, shorter fracture healing time, less postoperative complications and better functional recovery compared with femoral condylar sup-port plates. Less invasive stabilization system had became an ideal internal fixation in treatment of AO type C distal femoral fractures.

Cardiovascular Diseases ; Humans ; Natriuretic Peptide, C-Type

Objective To understand the schedule and effectiveness of water-improving defluoridation projects comprehensively of control of fluorosis in drinking-water-borne endemic fluorosis areas in Shandong Province,and to provide a scientific basis for making strategies for prevention and control of the disease.Methods In accordance with the requirements of Shandong Provincial Survey Scheme for Implementation of Prevention and Control Measures of Endemic Fluorosis,the progress of water-improving defluoridation projects was investigated in Shandong Province.The types of water source,scale and operating conditions for water-improving defluoridation projects in 17 cities of the province were investigated.Water fluoride contents of the normal operating projects were detected by F-ion selective electrode.Results ① By the end of 2012,a total of 3 539 water-improving defluoridation projects were built that covered 9 856 fluorosis villages,113 counties,17 cities in the province,and the water-improving rate was 91.01％ (9 856/10 830).The type of water source of water-improving project was mainly groundwater,accounted for 93.78％ (3 319/3 539) of the total projects.As for the scale of the water-improving projects,small centralized water supply projects were the main projects,accounted for 92.96％(3 290/3 539) of the total projects.\)Of all the water-improving defluoridation projects,normal operating projects accounted for 89.12％(3 154/3 539),intermittent and scrapped projects accounted for 3.25％(115/3 539) and 7.63％ (270/3 539),respectively.③Among normal operating projects,the number of projects with water fluoride content ≤ 1.20 mg/L was 1 925,accounted for 72.40％(1 925/2 659).The number of projects with water fluoride content ＞ 1.20 mg/L was 734,accounted for 27.60％ (734/2 659); among them water fluoride contents between 2.01-4.00 mg/L and ＞ 4.00 mg/L were 233 and 65,respectively,and the highest water fluoride value was 9.71 mg/L.Conclusions The progress of water-improving projects in some cities (counties) of Shandong Province is still slow.Some of the water-improving projects can not be operated normally or have been scrapped,and water fluoride content has exceeded the standard seriously.So the prevention and control measures need to be further strengthened,funding should be increased,and the operating conditions and water quality of the water-improving defluoridation projects in Shandong need to be further improved.

Objective To evaluate the efficacy of lung volum ereduction surgery(LVRS) on severe chronic obstrutive pulmonary emphysema (COPE).Methods Fifteen patients with COPE with LVRS were retrospectively analyzed.The lung volume was reduced with GIA by a degree of 20％-30％.The activity and the lung function indexes of patients before LVRS,half a year and 1 year after LVRS were analyzed.Results Fifteen patients recovered and were discharged in 8-54 (14.7 ± 8.8) days after LVRS.The forced expiratory volume in one second (FEV1),total lung capacity (TLC),residual volume (RV),and 6-minute walk distance (6MWD) of patients with LVRS were significantly improved after operation (P ＜ 0.05).Conclusion The lung volume reduction surgery provides a quite new and effective treatment for some cases of severe chronic obstructive pulmonary disease.

Objective To investigate the expression of connexin43 (Cx43) protein and mRNA in human adenocarcinoma of lung and its clinical significance.Methods One hundred and forty-eight human adenocarcinoma of lung tissues were detected by immunohistochemistry for Cx43 expression and fluorescence in situ hybridization for mRNA.The relationship between Cx43 expression and clinicopathologcal factors was analyzed.Results The positive rates of Cx43 expression in well/moderately differentiated and poorlydifferemiated/indififerentiated lung cancer tissues were 48.7 ％ (38/78) and 30.0 ％ (21/70),respectively (P ＜ 0.05).The positive rates of Cx43 expression in negative lymph node metastasis and positive lymphnode metastasis lung cancer tissues were 56.3 ％ (18/32) and 34.5 ％ (40/116),respectively (P ＜ 0.05).The positive rates of Cx43 expression in stage Ⅰ-Ⅱ and Ⅲ-Ⅳ lung cancer tissues were 51.5 ％ (49/95) and 34.0 ％(18/53),respectively (P ＜ 0.05).The positive rates of Cx43 mRNA expression in adenocarcinoma of lung adenocarcinoma and normal lung tissues were 32.4 ％ (48/148) and 60.0 ％ (12/20) (P ＜ 0.05).Conclusion The expression of Cx43 is closely related with well differentiation,invasion,status of lymphnode,clinical stage and prognosis of human lung adenocarcinoma.It may participate in the development and progression of human lung adenocarcinoma,and may be used to predict the prognosis of human lung adenocarcinoma.