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 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 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 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.

Cardiovascular Diseases ; Humans ; Natriuretic Peptide, C-Type

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.

BACKGROUND: The content of type Ⅰ and Ⅲ collagen and the ratio of both are crucial factors to promote heart geometric morphology change,and ventricular systolic and diastolic myocardial performance.Matrix metalloproteinase 2 (MMP-2) and tissue inhibitor of metalloproteinase 1 (TIMP1) are primary regulatory substances of collagen metabolism.After myocardial infarction,chronic heart failure rats were subjected to bone marrow meseuchymal stem cell transplantation.What changes in MMP-2 and TIMPI would occur?OBJECTIVE: To observe the content of type Ⅰ and Ⅲcollagen and the ratio between both,as well as expression levels of MMP-2 and TIMP1 in the left ventricular tissue of rats with myocardial infarction-caused chronic heart failure following bone marrow mesenchymal stem cell (MSC) transplantation.DESIGN: A randomized controlled experiment.SETTING: Department of Senile Angiocardiopathy,General Hospital of Chinese PLA & Department of Biochemistry,Peking University Health Science Center.MATERIALS: This study was performed at the laboratory of Department of Biochemistry,Peking University Health Science Center between July 2004 and December 2005.Male Sprage Dawley rats of clean grade,aged 4 weeks old,were provided by the Laboratory Animal Center,Beijing Medical University and used for preparation of MSCs.Fourteen female rats,weighing 200-250g,were developed into models of heart failure-caused by myocardial infarction.METHODS: MSCs were isolated and,purified by gradient centrifugation and adherent cells were allowed to proliferate.Female rats underwent coronary artery ligation to induce chronic ischemic heart failure.Four weeks later,the rats were randomly divided into 2 groups: (1) experimental group (n=7),rats received transplantation of MSCs harvested from male rats [5×106 in 50 μL phosphate buffered saline(PBS)]by injection into the ischemic myocardium; (2) control group (n=7),rats received the same volume of PBS.MAIN OUTCOME MEASURES: Twenty-one days after therapy,(1) left ventricular fusion was tested by hematoxylin-eosinstaining and Masson staining; (2) Expression of MMP-2 and 1TMPI as well as contents of type I and llI collagen was analyzed by immunohistochemistry; (3) MMP-2 and TIMP1 expression levels were examined by Western blot.RESULTS: Fourteen rats were included in the final analysis.Type Ⅰ collagen expression in the scar area was much higher in theexperimental group than in the control group,while type Ⅲ collagen expression was much lower in the experimental group.MMP-2 expression was reduced and TIMPI expression was increased in the experimental group compared with the control group.Together,ventricular wall was thickened,ventricular chamber was reduced,and heart function was strengthened in the experimental group compared with the control group.CONCLUSION: MSC transplantation alleviated left ventricular remodeling in chronic ischemie heart failure,which results from dynamic regulation of MMP-2/TIMP1.

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 investigate the potential mechanism that melatonin at higher concentrations inhibits the proliferation of human MG-63 osteosarcoma cells,so as to provide a certain experimental basis for the better application of melatonin in the treatment of diseases in Department of Orthopedics. Methods MG-63 cells cultured in vitro were treated with melatonin at a concentration of 4 mmol/L . Western blotting and real-time PCR method were used to analyze the effect of melatonin on the expression of cyclins and CDKs at protein and mRNA levels ,respectively. Results Western blotting and real-time PCR analyses showed that melatonin's inhibitory effect was possibly through the downregulation of cyclin D1 and CDK4 that related to the G1 phase,and downregulation of cyclin B1 and CDK1 that related to the G2/M phase. However,there was no obvious dif-ference of cyclin E,CDK2,and cyclin A,which were related to G1/S transition and S phase. Conclusion Melatonin may significantly inhibit hu-man osteosarcoma cell proliferation by inducing cell cycle arrest in a time-dependent manner,which is related to the downregulation of cyclin D1, CDK4,cyclin B1 and CDK1.