Objective:To study the expression of angiotensin-converting enzyme(ACE),extracellular signal-regulated kinase(ERK),and the changes of atrial fibrosis in patients with rheumatic heart disease(RHD) and atrial fibrillation(AF) treated with angiotensin-converting enzyme inhibitor(ACEI).Methods:Atrial tissues were obtained from the right appendage during open surgery in 35 patients with RHD.The mRNA of ACE and ERK2 were semi-qualified by reverse transcription-ploymerase chain reaction(RT-PCR) and normalized to the glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Western blotting analysis was employed to examine the expressions of ACE and phosphorylated ERK(pERK).Atrial collagen volume fraction(CVF) was detected by Masson's stain.Results:The mRNA of ACE and ERK2 or the protein of ACE and pERK were significantly increased,and CVF was significantly increased in patients with chronic atrial fibrillation(CAF) compared with sinus rhythm group(SR)( P 0.05).Conclusion:The expressions of ACE,ERK2 and pERK increase,and fibrosis is more severe in RHD patients with CAF as compared with those with SR.Compared with CAF patients treated without ACEI,the expressions of ERK2 and pERK significantly decrease( P 0.05)in CAF patients treated with ACEI.This suggests that the increasing expression of ERK2 and pERK resulting from local renal angiotensin-converting enzyme system activation mediates the development of atrial fibrosis,and ACEI may contribute to lesser atrial fibrosis in RHD patients with AF.

Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. PH progresses rapidly to right ventricular (RV) failure and even death without treatment. Cardiac magnetic resonance (CMR) is an accurate and reproducible tool for the assessment of RV morphology and function, which plays an important role in the prognosis of patients with PH. The aim of this study is to review the clinical application and research progress of CMR in evaluation of PH.

According to the sera aquaporin-4 antibody (AQP4), neuromyelitis optica (NMO) can be classified into two types as AQP4 antibody positive (AQP4+) and negative (AQP4-). However, the NMO patients with AQP4- are prone to delayed treatment, and may have a different pathogenesis compared to that in patients with AQP4+. Scientific researches and the clinical trials on NMO with AQP4- will deepen the understanding of NMO pathogenesis and help to make an early accurate diagnosis and rational therapy for NMO with AQP4-. This review aims to summarize the progress in clinic diagnosis for NMO patients with AQP4-.

Inflammatory bowel disease(IBD),including ulcerative colitis(UC)and Crohn’s disease(CD),is characterized by chronic non-specific inflammation of intestinal tract,which is incurable and easily relapsing. Recently,the role of gut microbiota in IBD has become a hot spot of study. This article reviewed the advances in study on intestinal microbiota in intestinal homeostasis and IBD.

Objective To explore the clinical value and the correlation of parathyroid hormone and osteocalcin in hemodialysis patients.Methods According to the dialysis duration of hemodialysis patients,they are divided into the four groups,Ⅰ (dialysis time ＜2 years),Ⅱ (dialysis time 2-5 years),Ⅲ(dialysis time ＞5-10 years),Ⅳ (dialysis time ＞ 10 years),50 cases were randomly selected from each group,50 cases of healthy people were taken as a control group,to detect the contents of PTH and N-MID in serum and analyze the results.Results The content of PTH in hemodialysis patients of Ⅰ,Ⅱ,Ⅲ,Ⅳ group were (170.9 ± 45.9) ng/L,(405.4 ± 65.3) ng/L,(717.1 ± 199.6) rng/L,(1 555.6 ± 417.8) ng/L,the content of N-MID were (79.23 ± 31.62) μg/L,(140.22 ± 50.98) μg/L,(496.11 ± 159.49)μg/L,(617.9 ± 386.18)μg/L,the content of PTH and N-MID in control group were (6.85 ± 3.74) ng/L,(16.6 ± 8.57) μg/L,PTH and N-MID levels of the four hemodialysis patients groups were significantly higher than those of normal control group,the differences had statistically significance(PTH levels of the four groups compared with the control group:group Ⅰ compared with the control group,t =25.199,P ＜0.01 ;group Ⅱ compared with the control group,t =43.091,P ＜0.01 ;group Ⅲ compared with the control group,t =25.402,P ＜0.01 ;group Ⅳ compared with the control group,t =26.211,P ＜0.01 ;N-MID levels of the four groups compared with the control group:group Ⅰ compared with the control group,t =13.518,P ＜ 0.01 ; group Ⅱ compared with the control group,t =16.909,P ＜ 0.01 ; group Ⅲ compared with the control group,t =21.229,P ＜ 0.01 ; group Ⅳ compared with the control group,t =11.007,P ＜ 0.01),the content of PTH and N-MID in Ⅰ,Ⅱ,Ⅲ,Ⅳ groups had statistically significance (four groups of PTH levels compare to each other:group Ⅰ compared with group Ⅱ,t =20.774,P ＜0.01 ;group Ⅰ compared with group Ⅲ,t =18.858,P＜0.01;group Ⅰ compared with group Ⅳ,t =23.295,P＜0.01;groupⅡ compared with group Ⅲ,t =10.495,P ＜ 0.01 ; group Ⅱ compared with group Ⅳ,t =19.233,P ＜ 0.01 ; group Ⅲ compared with group Ⅳ,t =12.805,P ＜ 0.01 ; Four groups of N-MID levels compare to each other:group Ⅰ compared with groupⅡ,t=7.189,P ＜0.01;group Ⅰ compared with group Ⅲ,t =18.130,P ＜0.01 ;group Ⅰ compared with group Ⅳ,t =9.830,P ＜ 0.01 ;group Ⅱ compared with group Ⅲ,t =15.029,P ＜ 0.01 ;group Ⅱ compared with group Ⅳ,t =8.671,P ＜ 0.01 ; group Ⅲ compared with group Ⅳ,t =2.061,P ＜ 0.05).Conclusion PTH levels were positively correlated with N-MID content in hemodialysis patients,high PTH hemodialysis patients should prevent osteoporosis early and to take appropriate treatment.

Objective To compare the efficacy of the streamlined liner of the pharynx airway (SLIPA) and the proseal laryngeal mask airway (PLMA) in airway management in elderly patients undergoing laparoscopic cholecystectomy.Methods One hundred and twenty patients aged 60-75 years with American Society of Anesthesiologists (ASA) grade] or Ⅱ undergoing laparoscopic cholecystectomy were randomly divided into three groups:the endotracheal intubation group (Group T,n=40),the SLIPAgroup (GroupS,n=40) and the PLMA group (GroupP,n=40).Endotracheal intubation and laryngeal mask airway insertion were conducted after induction of anesthesia.All the patients were ventilated with intermittent positive pressure ventilation.Mean arterial pressure and heart rate were recorded at before induction (T0),successful insertion (T1),ten minutes after pneumoperitoneum (T2),successful extubation (T3),and ten minutes after extubation (T4).The rate of successful placement at first attempt,time taken for placement,airway sealing pressure,and side effects were recorded.The incidences of post-extubation cough,backflow,aspiration,larynogospasm,bleeding,gastric distension and sore throat within 2 days after intubation were also recorded.Results The successful rates of insertion were 92.5 ％,92.5 ％,95.0 ％,respectively,at first attempt and 100.0％ at second attempt in the three groups (x2 =0.268,P＜0.05).Changes in hemodynamic parameters were significantly different between Group T and Group S or P after induction (t=4.076,P＜0.05).Time taken for placement was shorter in Group S than in Groups T and P,meaning that the placement of SLIPA was easier than that of endotracheal intubation or PLMA (t=43.561,P＜0.05).The airway sealing pressure was higher in Group P than in Group S,but had no statistically significant difference between the two groups (t=0.363,P＞0.05).There was no significant difference in post extubation complications,including backflow,aspiration,laryngospasm and gastric distension (t=0.321,P＞0.05),among the three groups,but incidences of postextubation cough and pharyngalgia were higher in Group T than in Group S and Group P (x2 =26.674,10.568,P＜0.05).Conclusions SLIPA and PLMA can both provide adequate ventilation during operation,with few complications.SLIPA placement is the easiest,while PLMA has good airway sealing and thus is more suitable for elderly patients undergoing laparoscopic cholecystectomy.

Objective: To establish a method for the determination of the related substances in pantoprazole sodium capsules. Methods:A Kromasil C18 column (250 mm × 4. 6 mm, 5 μm) was used. 0. 01 mol·L-1 monopotassium phosphate solution (adjus-ting pH to 7. 0 with phosphoric acid)-acetonitrile was adopted as the mobile phase with gradient elution. The detection wavelength was 289 nm and the column temperature was 40℃. The injection volume was 20μl and the flow rate was 1. 0 ml·min-1 . Results:Panto-prazole sodium and its degradation substances could be well separated. The limit of detection and quantification of pantoprazole sodium was 0. 16 ng and 0. 48 ng, respectively. Conclusion:The method is simple, specific and sensitive, and can be applied to determine the related substances in pantoprazole sodium.

Objective:To explore the influence of psychological and to identify determinants for patients using position immobility by thermoplastic sheet in the course of radiotherapy. Methods:55 patients who received radiotherapy using position immobility by thermoplastic sheet were investigated with questionnaires. Results:There are 34.5%(19/55) patients admit under psychological stress during the treatment, which were affected by the tension from doctors’ consultation and the chemotherapy experience. Conclusion:Some patients were under psychological stress caused by the position immobility with thermoplastic sheet. Nursing intervention is necessary to improve, especially to the patients who show stress when consultation with doctors and who had chemotherapy experience.

Objective To evaluate the effect and safety of ultrasound-guided pereutaneous thrombin injection for the treatment of iatrogenic femoral arterial pseudoaneurysm.Methods Thirty patients [6 male,24 female,age range 45-82 years,mean (63 ± 10) years] were found to have pseudoaneurysms confirmed by ultrasound between 1 and 7 days following femoral arterial puncture from July 2011 through July 2014.Results All patient had pseudoaneurysm thrombosis after the first procedure.Thrombin 200-1000 U (50 U/mL)was injected into the pseudoaneurysm under ultrasound-guidance,performed.One patient showed acute allergy 5 min after thrombin injection,which was relieved by anti-allergic therapy.No thromboembolic complications or infections occurred.Conclusions Ultrasound-guided pereutaneous thrombin injection is a safe and effective noninvasive method for the treatment of iatrogenic femoral pseudoaneurysm and should be considered as first-line therapy.

Objective To explore the effect of aerobic exercise and progressive relaxation training on cancer-related fatigue in lung cancer patients during chemotherapy. Methods Sixty lung cancer patients undergoing chemotherapy were randomly assigned to an experiment group (n=30) and control group (n=30). The patients in the study group received regular nursing plus 6 weeks aerobic exercise intervention and progressive relaxation training, while the patients in the control group only received regular nursing care. The effect of intervention was evaluated by the Piper fatigue scale (PFS). Results Before the intervention, three were no difference in the PFS scores and all dimentions scores between the two group. After the intervention, the total score of the cancer-related fatigue and the score on every dimension of PFS were significantly lower than those of the control group (P<0.01). For the control group, the total score and the score on the dimension had insignificant difference between pre-and post-intervention (P<0.01), except the dimensions of emotion and feeling which showed significant differences between pre- and post-intervention (P < 0.05). Conclusion Aerobic exercise and progressive relaxation training can decrease the cancer-related fatigue and improve the quality of life.