Objective To investigate the relationship between heart failure with normal ejection fraction and cardiac remodeling.Methods One hundred and eighty-eight cases with chronic heart failure were collected from January 2009 to March 2012 from Department of Cardiology of Longkou People's Hospital.In strictly accordance with the diagnostic criteria,participants were divided into HFNEF(n =109) and HFREF groups (n =79).According to the NYHA classification,HFNEF and HFREF patients were further divided into three subgroups respectively (HFNEF patients:52 cardiac function Ⅱ,36 cardiac function Ⅲ,21 cardiac function Ⅳ ;HFREF patients:13 cardiac function Ⅱ,27 cardiac functionⅢ,39 cardiac functionⅣ).The measurements of the left ventricular ejection fraction (LVEF),left atrial diameter (LAD),interventricular septal thickness (IVST),left ventricular posterior wall thickness (LVPWT),right ventricular diameter (RVD) were conducted in all objects and their clinical data were statistically analyzed.Results Compared with HFREF patients,HFNEF group had older mean age ((64.59 ± 5.34) yrs vs.(58.89 ± 4.23) yrs,t =3.345,P =0.001),more female patients (58.7％ (64/109) vs.41.8％ (33/79),x2 =5.265,P =0.022),higher incidence of hypertension (81.65％ (89/109) vs.63.29％ (50/79),x2 =8.012,P =0.005).LVPWT,IVST,LAD,RVD gradually increased in HFNEF patients with the severity of cardiac function,with significant differences in LVPWT ((9.05 ± 1.89) mm vs.(11.30 ± 2.67) mm vs.(13.90 ± 2.77) mm,F =3.578,P =0.028),IVST ((9.35 ±1.75)mm vs.(11.51 ±2.48)mm vs.(12.98 ±3.01)mm,F =3.081,P =0.048),LAD ((31.23 ±5.98)mm vs.(35.55 ±7.31)mm vs.(44.81 ± 10.72)mm,F =6.711,P ＜0.001),but no difference in RVD ((18.95 ±1.02) mm vs.(19.21 ± 1.11) mm vs.(19.99 ± 0.98) mm,F =2.751,P ＞ 0.05).There was significant difference in LVPWT ((13.90 ±2.77)mm vs.(7.45 ±2.01)mm,t =11.439,P ＜0.001),IVST ((12.98 ±3.01)mm vs.(7.23 ± 1.94)mm,t =10.318,P ＜0.001),RVD ((19.99 ±0.98)mm vs.(23.51 ± 1.10)mm,t =2.838,P ＜ 0.001) between HFNEF and HFREF patients with Ⅳ level of cardiac function,while there was no statistical difference ((44.81 ± 10.72) nn vs.(46.30 ± 11.76) mm),t =1.451,P =0.151) on LAD.Conclusion Senior age,high proportions of women and essential hypertension are found in HFNEF patients.Impaired cardiac function has increasing impact on cardiac remodeling with the increase of severity but it almost has no effect on the right ventricle.Ventricular structural changes exist significantly different from HFNEF to HFREF.Therefore clinicians should have in-depth understanding of the characteristics of the HFNEF and its epidemiology,pathophysiology,diagnostic criteria and treatment principles in order to improve diagnosis and treatment of this class of patients.

Background and purpose:Resistance to antitumor agents is a major cause of treatment failure in patients with breast cancer. Research has shown that, tumor stem cell marker aldehyde dehydrogenase 1 (ALDH1) is related with some anticancer drugs (such as cyclophosphamide, cisplatin) resistance, and the content of ALDH1 in tumor cells after treatment is higher than that before treatment. Breast cancer resistance protein (BCRP) is not expressed in normal tissues, but high expressed in breast cancer of after treatment, it may be associated with the mechanism of tumor drug resistance. This study was to investigate the correlation between expression and the relationship between these two kinds of protein ALDH1, BCRP and clinical pathological characteristics. Methods:Immunohistochemistry was performed to detect the expression of ALDH1 and BCRP in breast inifltrating ductal carcinoma tissues, and whether there is a correlation between and explore their relationship with clinical pathological features and their expression. Results:The expression of ALDH1 protein and BCRP protein in breast cancer and paracarcinoma breast tissues has signiifcant difference(χ2=14.685, P=0.000;χ2=12.243, P=0.000).The expression of ALDH1 with patients age, pathologic stage, axillary lymph node metastasis, histological grading, ER, PR, and HER-2 state were not relevant(P>0.05). HER-2, BCRP protein, expression was higher in cancer tissue (χ2=5.289, P=0.021). There were no relevant with the expression of BCRP with patients age, pathologic stage, axillary lymph node metastasis and histological grading, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER-2) (P>0.05). Conclusion:ALDH1 proteins may be an independent factor compared with occur drug resistant protein, and participate breast cancer drug resistance in the chemotherapy and tumor invasion and metastasis of malignant biological behavior.

AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis.
●METHODS:Retrospective study. A total of 57 cases (57 eyes ) with complicated cataract with uveitis were involved in the study from Jan. 2015 to Dec. 2015. All cases underwent phacoemulsification and intraocular lens implantation surgery successfully. The postoperative reaction, effect, complications and so on were retrospectively analyzed after phacoemulsification and intraocular lens implantation surgery. The date of visual outcome was analyzed using Non - parametric Wilcoxon test.
●RESULTS: lris were bleed in 21 eyes ( 37%) , 4 eyes ( 7%) with posterior capsule rapture and posterior chamber intraocular lens was not implanted in 4 eyes ( 7%) . The uncorrected visual acuity ( UCVA ) was significantly increased after surgery. The UCVA of 8 eyes (14%) were 0. 1 or better before surgery, and the UCVA of 42 eyes (74%) were 0. 1 or better 3mo after surgery, the difference was statistically significant ( Z=23. 42, P<0. 001). The corneal edema (17 eyes, 30%), uveitis (2 eyes, 4%) and intraocular hypertension ( 1 eyes, 2%) were appeared in postoperative 1d. The corneal edema (3 eyes, 5%) was appeared in postoperative 1wk. The uveitis ( 1 eyes, 2%) was appeared in postoperative 1mo. The corneal edema (1 eyes, 2%), uveitis (2 eyes, 4%) , intraocular hypertension ( 1 eyes, 2%) and after-cataract ( 3 eyes, 5%) were appeared in postoperative 3mo.
● CONCLUSION: The phacoemulsification combined intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis has good effect and fewer complications.

Objective To study the expression of sex hormone-binding globulin(SHBG),insulin signaling pathway and glucose transporter in placenta of pregnant women with gestational diabetes mellitus(GDM),and to explore its role in the pathogenesis of GDM. Methods A total of 10 full-term and non-obese(BMI<25 kg/m2)pregnancy women diagnosed with GDM and 10 normal pregnant cases were recruited for the study. Placental tissues were collected respectively. The expression of protein and mRNA of SHBG and insulin signal transduction(IRS-1,ISR-2,PI3K p85α)and glucose transporter proteins(GLUT-1,GLUT-3,GLUT-4)in placental tissue were detected by real-time PCR and Western blotting. Pearson and linear regression analysis were used to evaluate the correlation among the related indicators. Results In the placental tissue of non-obese women,there existed a decrease(P<0.05)in the expression of protein and mRNA of SHBG with a concurrent a decrease(P<0.05)in the expression of protein and mRNA of GLUT-4 in GDM women compared with normal controls. Furthermore ,a decrease(P<0.05)of GLUT-3 and IRS-1 protein expression with lower(P<0.05)IRS-2 mRNA expression was also observed in placental tissue from GDM patients. No changes were found in PI3K p85α and GLUT-1 at both protein and mRNA levels(P>0.05). Results of linear correlation analysis showed that there were positive correlations between SHBG mRNA and IRS-2 mRNA(P<0.05),SHBG mRNA and PI3K p85α mRNA(P<0.05),and SHBG mRNA and GLUT-4 mRNA(P<0.05). There was also a remarkable positive correlation between IRS-2 mRNA and GLUT-4 mRNA(P<0.01). There existed negative correlations between IRS-1 mRNA and PI3K p85α mRNA(P<0.05),and IRS-1 mRNA and GLUT-3 mRNA(P<0.05). There existed a remarkable positive correlation between IRS-2 mRNA and GLUT-1 mRNA(P<0.01). Conclusion The defective receptors of insulin signaling pathway are present in GDM placental tissue. Decreased expression of SHBG may be involved in the regulation insulin signaling ,leading to a concomitant decrease expression of relevant insulin signaling components in placental tissue ,implying insulin resistance and developing GDM finally.

Objective Hepatocellular carcinoma with bile duct tumor thrombus (BDTT) is rare,and surgical treatment is currently considered as the most effective treatment.Whether resectional surgery should be carried out on these patients remains controversial.Therefore,this Meta-analysis aimed to find out the long-term survival after resectional surgical treatment.Methods We conducted a literature search on PubMed,Embase and Web of Science from inception to September 2016.11 studies were included which involved 5295 patients.Each study was evaluated using the Newcastle-Ottawa Scale.The pooled effect was calculated and the associations between BDTT and overall survival (OS) or disease-free survival (DFS)were reevaluated using Meta-analysis with hazard ratio (HR) and 95％ confidence interval (CI).Results The HR for OS and DFS was 2.34 and 1.81,the 95％ CI were 1.26 ～ 4.36 and 1.17 ～ 2.78,respectively.Conclusion HCC patients with BDTT had a bad prognosis after hepatic resection or liver transplantation.

In this paper, the action of suet oil in the preparation of self-assembled micelles of the active flavonoids in Epimedium in the simulated human environment was researched. Twelve suet oil samples were collected from different growing areas and different positions of sheep or goat to simulate the formation of micelles. Then the effects of the fatty acids in suet oil on the preparation of self-assembled micelles were studied furthermore. The results showed that the micelles had a dispersed state and spherical smooth surface. To compare the diameter, potential, encapsulation efficiency and drug loading of the 12 batches micelles, the micelles prepared by the suet oil from Qinghai were more stable and had a higher encapsulation efficiency. The fatty acids in suet oil could promote the formation of self-assembled micelles, but the whole suet oil had a better effect. Above all the study, we confirmed that the suet oil promoted the formation of self-assembled micelles of the flavonoids in Epimedium, it laid foundation for further research about increasing the efficacy of Epimedium and improved the absorption of the active flavonoids in Epimedium.
Animals ; Chemistry, Pharmaceutical ; methods ; China ; Drug Carriers ; chemistry ; Electric Conductivity ; Epimedium ; chemistry ; growth & development ; Fatty Acids ; chemistry ; Flavonoids ; chemistry ; Geography ; Goats ; Humans ; Micelles ; Oils ; chemistry ; Sheep

OBJECTIVETo observe the effect of Qianliean Pill (QP) on inflammatory factors such as IL-1β, IL-10, and tumor necrosis factor α (TNF-α) in chronic nonbacterial prostatitis (CNP) model rats, and to explore its therapeutic mechanism.

METHODSCNP rat model was established by castration and estradiol benzoate injection. Totally 50 rats were randomly divided into 5 groups, i.e., the model group, the positive medicine group, the high dose QP group, the medium dose QP group, and the low dose QP group, 10 in each group. Besides, 10 normal rats were recruited as a normal control group. Since the 8th day of castration, Pulean Tablet (PT) at 10. 80 g/kg was administered to rats in the positive medicine group by gastrogavage. QP at 11.00, 5.50, and 2.75 g/kg was administered to rats in high, medium, and low dose QP groups by gastrogavage. Distilled water at 2 mL/100 g was administered to rats in the model group and the normal control group by gastrogavage, once daily for 30 successive days. After 30 days of medication all rats were sacrificed and their prostate tissues were extracted. The prostatic index was calculated. Pathological changes of rat prostate were observed under light microscope. Meanwhile, levels of IL-1β, IL-10, and TNF-α were detected using enzyme linked immunosorbent assay.

RESULTSCompared with the normal control group, the prostate index obviously decreased, levels of IL-1β, TNF-α, and IL-10 in the prostate tissue significantly increased in the model group (P < 0.01). Compared with the model group, the prostate index obviously decreased in high and medium dose QP groups, and the positive medicine group (P < 0.01); levels of IL-1β, TNF-α, and IL-10 obviously decreased in each QP group and the positive medicine group (P < 0.01). Compared with the positive medicine group, the TNF-α level decreased more obviously in the high dose QP group (P < 0.05). Compared with the normal control group, inflammatory reactions occurred obviously in rats' prostate of the model group. Compared with the model group, inflammatory reactions were milder in rats' prostate of each QP group and the positive medicine group, and their degrees were improved to some extent.

CONCLUSIONQP could treat CNP, which might be achieved by regulating local immune state of the prostate, relieving inflammatory reactions of the prostate, and lowering levels of IL-β, TNF-α, and IL-10 in the prostate tissue.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Interleukin-10 ; metabolism ; Interleukin-1beta ; metabolism ; Male ; Prostatitis ; drug therapy ; metabolism ; Rats ; Tumor Necrosis Factor-alpha ; metabolism

Objective To analyze the distribution of class 1,2 and 3 integrons and their gene cassettes,and to explore its relationship with drug resistance in Shigella.Methods Antimicrobial susceptibility was detected by minimal inhibitory concentration (MIC) method.All the genes of integrons and gene cassettes were amplified by polymerase chain reaction (PCR).The amplicons were identified by amplified fragment length polymorphism (AFLP) and sequencing.Results Fifty seven multi-drug resistant strains were identified from a total of 62 Shigella strains (91.9％).Among multi drug resistant strains,52 strains carried integrons of class 1 (91.2 ％) and 55 strains carried integrons of class 2 (96.5％).Only 2 strains carried class 1 integrons alone,5 strains carried class 2 integrons alone and 50 strains had both class 1 and class 2 integrons.Class 3 integrons were not detected.The gene cassettes of typical class 1 integrons,dfrV and dfrA17-aadA5,were detected in 6 strains and 2 strains,respectively.Atypical class 1 integrons with gene cassettes blaOxA30 aadA1 were detected in 44 strains.The typical and atypical class 1 integrons coexisted in 6 Shigella flexneri strains.Gene cassettes for class 2 integrons were dfrA1 sat1-aadA1.Conclusions The multi-drug resistant Shigella strains are widely distributed in Ji'nan,and the atypical class 1 integrons and class 2 integrons are common in these strains.Coexistence of the two integrons is observed in some of the strains.

BACKGROUND:Accumulating studies have confirmed the excellent effectiveness of local infiltration analgesia, but the literature analysis is mainly limited to within 1 day after total knee arthroplasty or shorter period.
OBJECTIVE:To study the effectiveness of local infiltration analgesia (LIA) at low concentration after total knee arthroplasty, and to observe the analgesic effect at rest and movement states.
METHODS:Thirty patients undergoing total knee arthroplasty were randomly al ocated to control group and LIA group, receiving oral non-steroidal anti nflammatory drug (celebrex) and low concentration of ropivacaine (0.1%) for epidural analgesia. Control group was injected with 0.9%saline 150 mL, while LIA group was injected with equal volume of solution include ropivacaine 300 mg, morphine 5 mg and epinephrine 10μg. The rest pain and motion pain of patients in two groups were evaluated at 6, 12, 24, 36, 48 hours after operation by using visual analogue scale. The incidence rate and degree of nausea, vomiting, numbness and muscle weakness of the legs were observed after operation. The incision healing was also recorded.
RESULTS AND CONCLUSION:Visual analogue scale pain scores in the LIA group were significantly lower than the control group at 6, 12, 24 and 36 hours at rest (P<0.05), at 6, 12, 24, 36, 48 hours on movement (P<0.05). At 6 and 12 hours, there was no difference in the rest and motion pains in the LIA groups (P>0.05). No patient appeared drowsiness, nausea, and vomiting in both groups. Two patients in each group complained of slight numbness in legs. No case influenced function exercise because of muscle weakness. Al the wounds healed and there were no incision infections in two groups. Combined with oral non-steroidal anti-inflammatory drug and low concentration of ropivacaine for epidural analgesia, the local infiltration analgesia technique in total knee arthroplasty is effective in early post-operative pain management, and produces no analgesia related adverse reactions.

Objective To investigate the operative methods and their efficacy of the modified decompressive craniectomy in combination with indirect revascularization for the treatment of massive cerebral infarction. Methods The clinical data of 15 patients with massive cerebral infarction who underwent modified decompressive craniectomy in combination with encephaloduroarteriomyosynangiosis were analyzed retrospectively. The clinical efficacy was assessed according to the mortality, Barthel Index and modified Rankin scale. Results All the patients were followed up, and 12 patients survived 3 months after operation, of those, 4 had a good functional outcome; 11 patients survived 6 month after operation, of those, 7 had a good functional outcome. Conclusions The modified decompressive craniectomy in combination with indirect revascularization for the treatment of massive cerebral infarction could effectively treat massive cerebral infarction and increase the survival rate and life quality of patients, however, the surgical timing, surgical indications and surgical skills are needed to master accurately.