Objective To develop coronary artery disease self-management scale and evaluate its reliability and validity.Methods The item pool was based on the theory of chronic disease self-management and the evidence of behavioral medical science related to coronary heart disease.Firstly,the preliminary scale was developed through specialist evaluation;then it was reviewed by 10 patients and specialists again;At last,209 patients were surveyed and based on the pilot data,a series of statistic analysis was conducted such as factor analysis,correlation analysis,etc.To deduce the items to 27 and then a comprehensive set of psychometric tests was performed on the final version.Results Psychometric tests with the application of stringent criteria confirmed the test-retest reliability(ICC=0.910),internal consistency(Cronbach's ?=0.913),criterion-related validity(r=0.271-0.573),construct validity(factor analysis confirms the hypothesis of the scale),responsiveness(t=9.011,P

Objective To investigate the major risk factors for posterior circulation stroke and the clinical and imaging features of posterior circulation stroke patients with diabetes.Methods The patients with acute cerebral infarction were enrolled.The clinical data of patients with posterior circulation and anterior circulation stroke were compared.The patients with posterior circulation stroke were further divided into either a diabetic group or a non-diabetic group,and the vascular risk factors and imaging features of both groups were compared.The patients with posterior circulation stroke were divided into proximal segment,middle segment and distal segment and mixed groups according to the distribution of vascular lesions.The correlations between diabetes and each group and the imaging features were analyzed.Results A total of 328 patients with posterior circulation stroke (male 194,the diabetic group 108) and 336 patients with anterior circulation stroke (male 214,the diabetes group 59)were enrolled.The proportions of patients with diabetes (32.9％ vs.21.7％ ; x2 =10.501,P =0.001),hyperlipidemia (60.1％ vs.47.9％ ;x2 =9.852,P =0.002),previous stroke or transient ischemic attack (TIA) (29.0％ vs.22.0％ ;x2 =4.213,P =0.040) in the posterior circulation ischemic stroke group were significantly higher than those in the anterior circulation ischemic stroke group,and the proportion of smoking patients was significantly lower than that in the anterior circulation ischemic stroke group (18.3％ vs.26.2％ ; x2 =5.977,P =0.014).The levels of total cholesterol (4.72 ±1.07 mmol/L vs.4.56 ± 0.98 mmol/L; t =2.079,P =0.038),triglycerides (1.54 ± 1.07 mmol/L vs.1.33±0.71 mmol/L; t=3.085,P=0.002) and low-density lipoprotein cholesterol (2.91±0.90 mmol/L vs.2.75 ±0.80 mmol/L; t =2.373,P =0.018) were significantly higher than those in the anterior circulation ischemic stroke group,and the level of high-density lipoprotein cholesterol was significantly lower than that in the anterior circulation ischemic stroke group (1.13 ± 0.31 mmol/L vs.1.18 ±0.32 mmol/L; t =2.045,P=0.041).Multivariate logistic regression analysis showed that diabetes (odds ratio [OR] 1.560,95％ confidence interval [CI] 1.086-2.239; P =0.016) and previous stroke or TIA history (OR 1.455,95％ CI 1.013-2.090; P =0.042) were the independent risk factors for posterior circulation ischemic stroke.In patients with posterior circulation ischemic stroke,the patient's proportions of hyperllpidemia (66.7％ vs.55.5％ ;x2 =5.069,P =0.024) and drinking (13.0％ vs.4.5％;x2 =7.568,P=0.006) in the diabetic group (n =108) were significantly higher than those in the non-diabetic group (n =220); the proportion of atrial fibrillation patients was significantly lower than that in the non-diabetic group (3.7％ vs.11.4％ ;x2 =5.274,P =0.022).The levels of triglycerides (1.70 ± 0.93 rnmol/L vs.1.45 ± 1.11 mmol/L; t =1.989,P =0.048),fasting glucose (8.46 ± 2.96) mmol/L vs.5.30± 0.96 mmol/L; t=10.706,P=0.000) and glycosylated hemoglobin (8.36％ ± 1.94％ vs.6.07％ ± 0.55％ ; t =10.576,P =0.000) in the diabetic group were significantly higher than those in the non-diabetic group.The proportion of patients with large artery atherosclerosis stroke in the diabetic group was significantly higher than that in the non-diabetic group (73.1％ vs.60.0％; x2=5.457,P=0.019); the proportion of the patients with cardioembolism was significantly lower than that of the non-diabetic group (2.8％ vs.9.1％;x2 =4.428,P =0.035).The proportion of patients with posterior circulation middle segment infarction in the diabetic group was significantly higher than that of the non-diabetic group (49.1％ vs.31.4％ ;x2 =9.726,P =0.002).The proportions of the patients with brainstem infarction (60.2％ vs.48.2％ ;x2 =4.182,P =0.041) and single brainstem infarction (55.6％ vs.30.5％ ;x2 =19.235,P =0.000) in the diabetic group were significantly higher than those in the non-diabetic group.In patients with single brainstem infarction,the proportions of the patients with pontine infarction (43.5％ vs.25.9％ ;x2 =10.374,P =0.001) and medulla oblongata infarction (7.4％ vs.1.8％ ; P =0.023) in the diabetic group were significantly higher than those in the non-diabetic group.Conclusions Diabetes and previous stroke or TIA history are the independent risk factor for posterior circulation stroke.Diabetes is closely associated with brainstem infarction,and it is more likely to result in pontine infarction.

Objective To observe the effects of brazilin on proliferation and apoptosis in T24 cells.Methods Trypan blue exclusion test was performed to detect the inhibition of brazilin on the growth of T24 cell lines in vitro cultured within different time.After exposure to different concentrations of brazilin,homogeneous bioluminescence assay was used to detect the inhibitory action of brazilin,Caspase-3 and Caspase-9 activity on T24 cells.Cellular apoptosis was measured by flow cytometry (FCM) and observed by laser scanning confocal microscope.Results Brazilin could significantly inhibit the proliferation of T24 cells after 8 hours,the inhibitory rates of the brazilin at concentration of 25,50,100,200 μg/ml against T24 cells respectively were 43.19 ％,60.73 ％,86.38 ％ and 93.89 ％ (P ＜ 0.05).After exposured to 50 μg/ml of brazilin,the inhibition ration to T24 cells increased with time prolonging (52.72 ％ in 4 h,60.73 ％ in 8 h,91.77 ％ in 24 h,96.41％ in 48 h) (P ＜ 0.05).The activity of Caspase-3 and Caspase-9 increased slightly when brazilin was at 25 μg/ml,but there was no statistical differences compared with that in the control group (P ＞ 0.05).When cells were treated with an increase of the concentration of brazilin from range of 7.5-60 μg/ml for 16 hours,the apoptosis ratio in turn showed a upward trend of 0.15 ％,1.35 ％,2.91％,34.76 ％.It could be seen by laser scanning confocal microscope that the apoptosis occurred in the cells.Conclusion Brazilin can effectively inhibit the proliferation of T24 cells and induce apoptosis in a dose and time dependent manner.

Objective To observe the level of serum hepatocyte growth factor (HGF) in patients with impaired glucose tolerance (IGT). Methods Thirty patients with IGT (IGT group), 30 patients with type 2 diabetes mellitns (T2DM) (T2DM group) and 30 healthy controls (control group) were recruited for this study. Such indexes as HGF, fasting plasma glucose (FBG), postprandial plasma glucose (2hPG), glycosylated hemoglobin A1c( GHbA1c ), fasting insulin(FINS), systolic blood pressure(SBP), diastolic blood pressure (DBP) were examined and these related factors were analyzed. Results The levels of serum HGF in IGT group and T2DM group were higher than those in control group [(413.22 ± 102.48), (422.76 ± 126.77 ), ( 120.45 ± 25.11 ) ng/L, respectively ] (P < 0.05 ). There was no significant different between IGT group and T2DM group (P> 0.05). There was positive correlation between HGF and FBG (r = 0.326, P< 0.05 ). Multiple regression analysis indicated significant correlation between HGF and DBP (r = 4.730, P< 0.05). Conclusion Higher levels of HGF are found in IGT patients, which indicates that function of vascular endothelium is abnormal in this period.

Objective To investigate the clinical value of the gated blood pool imaging phase analysis method in the evaluation of left ventricular mechanical synchronization in patients with chronic heart failure. Methods A total of 169 patients with chronic heart failure were enrolled in our study , using gated blood pool imaging phase analysis method to obtain left ventricular phase angle width ( PHB) and left ventricular phase angle standard deviation ( PSD) as evaluating left ventricular mechanical synchrony index; using tissue Doppler imaging (TDI) measurement of the standard deviation of systolic peak time(Ts-SD) of each segment by using the current prevailing 12 non-apical segments analysis method as evaluating left ventricular mechanical synchrony index, and parameters derived from both methods were compared. Results LVPHB was highly correlated with Ts-SD (r = 0. 83 ,P = 0. 000 ) . LVPSD was modestly correlated with Ts-SD ( r - 0. 69, P = 0. 000) . The ejection fraction measured by echocardiography was (42.93 ± 14. 89) % ,which was significantly higher than that measured by ERNA (39. 76 ± 17. 89)% (P <0. 01). Conclusions The evaluation of left ventricular mechanical synchrony in patients with chronic heart failure by the gated blood pool imaging can provide similar information with TDI, which can simultaneously measure two ventricular functions and get more accurate measurement of ejection fraction. Cardiac resynchronization therapy patients can be identified by combining two kinds of approaches, and cardiac resynchronization therapy responders could be improved as well. More patients with heart failure can benefit from cardiac resynchronization therapy therapy.

A 57-year-old man was admitted to the hospital for a 7-year progressively spreading plaques involving the entire body surface, and multiple irregularly sized red nodules and infiltrated patches on the face, trunk and limbs. Histopathological examination showed pleomorphic tumor cells diffusely dis-persed throughout the dennis, giving an appearance of low proliferation. Some cells with cytoplasmic pro-cesses appeared multiangular in shape, lmmunohistochemically, tumor cells were negative for CDla or S-100, but positive for CD45, FXIIIa, CDl4, MHC- Ⅱ, CD68 and lysozyme with extracellular interstitial expression. Ultrastructurally, the cells exhibited cytoplasmic processes and irregularly sized nuclei; no Birbeck granules were observed. Vesicules of low electron-density were seen diffusely in cytoplasm and extracellular matrix. The case is herein diagnosed as cutaneous non-Langerhans cell histiocytosis, which presents with a chronically invasive clinical course. These cells may develop from immature dermal dendritic cells.

Objective To probe into the relation of expressions of HIF-1α, VEGF and EGFR in esophageal squamous cell carcinoma with radiation therapy efficacy. Methods 73 of the patients with carcinoma of oesophagus from January , 2011 to May , 2014 in the General Hospital of Ningxia Medical University , were involved in this research , their clinical data reviewed and analyzed. Before radiotherapy , immunohistochemical SP was used to test expressions of HIF-1α, VEGF and EGFR in the cancer tissues. Relationships between the expressions and the efficiency of radiotherapy were analyzed. Results The positive expressions of HIF-1α, VEGF and EGFR were 70.0%, 84.9% and 80.8%, respectively. In terms of the single factor analysis related to recent curative effects, HIF-1α expression had significant correlation with recent curative effects (P=0.03). Conversely , multiplicity indicated that HIF-1α and EGFR expressions were notably associated with recent curative effects (P=0.007, 0.045, respectively). Conclusions The positive expressions of HIF-1α,VEGF and EGFR in the esophageal carcinoma may account for a largest proportion of the total. HIF-1α and EGFR expressions are associated with the short-term outcomes.

A 53-year-old woman presented with arthralgia and dyspepsia on exertion.Symmetrical joint swelling and pain of bilateral hands with pigmentation sedimentation in the articular surfaces,dry cough and short of breath were the main clinical manifestations.Elevated levels of erythrocyte sedimentation rate (89 mm/1 h),C-reactive protein (64.45 mg/L),IgG (31.22 g/L) and IgA (5.44 g/L).Rheumatoid factor was positive and anti-cyclic citrullinated peptide antibody was negative.Chest high-resolution computed tomography scan found that diffusely distributed lung nodules,round cysts with varying sizes and patchy ground glass opacities.A significant plasma cell infiltration and amyloid deposition were seen in lung tissue.The patient was finally diagnosed as rheumatoid arthritis,interstitial lung disease and pulmonary nodules.Combination therapy of prednisone 7.5 mg qodpo,thalidomide 50 mg qdpo,tocilizumab 560 mg iv once per month for 1 month.Chest computed tomography showed stable lung nodules,however,pulmonary interstitial lesions gradually aggravated.

Objective To assess differential expression profiles of microRNAs(miRNAs) in HaCaT human keratinocytes before and after p53 gene silencing,and to make a functional analysis of target genes.Methods Lentivirus-mediated RNA interference (RNAi) was used to silence p53 gene in HaCaT cells.Total RNA was extracted using Trizol reagent.Then,miRNAs were isolated by polyethylene glycol (PEG) and subjected to fluorescent labeling using T4RNA ligase followed by hybridization to a mammalian miRNA chip.Microarrays were scanned by a GenePix 4000B microarray scanner and fluorescence ratios were determined with the GenePix Pro 6.0 software.The TargetScan software was used to predict target genes of differentially expressed miRNAs (＞2-fold difference in expression level),and the top 20 target genes with the highest enrichment score were selected for each miRNA and subjected to functional analysis and pathway analysis through the KEGG signaling database.Results Totally,53 differentially expressed miRNAs,including 12 down-regulated and 41 up-regulated miRNAs,were identified in HaCaT cells after p53 silencing as compared to those before p53 silencing.Of these 53 differentially expressed miRNAs,5 (hsa-miR-141-3p,hsa-miR-15a-5p,hsa-miR-27a-3p,hsa-miR-130b-3p,hsa-miR-19a-3p) showed a more than 200-fold increase in expression,and 4 (hiv1-miR-TAR-3p,hsa-miR-630,hsa-miR-1246,hsa-miR-1275) experienced a more than 4-fold decrease in expression in HaCaT cells after p53 silencing.Functional analysis and pathway analysis revealed that some target genes of these differentially expressed miRNAs were involved in the mitogen-activated protein kinase (MAPK) signaling pathway,metabolic pathways,and tumor invasion.Conclusion Nine miRNAs,including hsa-miR-141-3p,may be involved in p53-mediated molecular regulation.

This paper focuses on the quality risk control and management of Chinese medicine (CM) injections. The most important technological requirements are analyzed, and a strategy for integrated pharmacology to study CM mechanism is proposed. A key technology system for quality risk control and management was further constructed. The strategy and technology system was finally applied to Shengmai injection for quality risk control and management.
Drugs, Chinese Herbal ; pharmacology ; standards ; Humans ; Injections ; Medicine, Chinese Traditional ; Quality Control ; Risk ; Technology