Objective To observe the efficacy and safety of arginine vasopressin receptor antagonist tolvaptan for treating hyponatremia caused by syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Methods Six patients diagnosed with SIADH were enrolled in this study.Four cases were allocated to tolvaptan group (oral tolvaptan 15-60 mg/d,the dosage was adjusted based on the level of serum sodium).Two cases were allocated to regular treatment group (liquid was limited 1 000 ml/d,intravenous drip was less than 3％ sodium chloride and/or oral salt capsule 10-15 g/d several times was adjusted based on the level of serum sodium).Data of the level of serum sodium at 4,7 d,baseline value of serum sodium,serum sodium at the first normal time,24 h urine and weight change were collected.Safety assessment was given before and after treatment,including medical history,physical examination,electrocardiogram,laboratory tests,and incidence of adverse events.Results The level of serum sodium in tolvaptan group increased from the first day of the treatment.During the period of treatment,serum sodium at 4 d increased 22,16,14,11 mmol/L compared with the baseline value respectively.No obvious change of sodium was observed in regular treatment group compared with the baseline value.For 7 d treatment,serum sodium level increased 14,13,14,13 mmol/L in tolvaptan group compared with the baseline level respectively.Only 2 cases in regular treatment group increased 4 mmol/L,and sodium level in regular treatment group did not reach the lower limit of normal level of serum sodium.In tolvaptan group,all patients urine output increased after 1 d treatment and began to stabilize in 3 d.24 h urine putouts were much more than 1 500 ml during treatment.Urine putouts 780-1 400 ml were observed in regular treatment group.There was no difference before and after treatment.Although weight dropped after treatment in the two groups,weight in tolvaptan group fell obviously.In the two groups,there was no difference in blood pressure and heart rate before and after treatment.There were no serious complications and adverse events.Conclusions Compare with regular treatment,arginine vasopressin receptor antagonist is more effective therapy because it can correct the SIADH in patients with hyponatremia and reduce water retention.It also has a good security.

A myxobacterial strain, So ce cpu-1, was isolated from a soil sample near the Huanghai beach. So ce cpu-1 had broad antimicrobial activity, active component has maxima] absorption at 210 nm. The effects of different culture conditions on the yield of the secondary metabolites were investigated. The results showed that, when cultivating the strain in the M, medium (containing 10% w/v D312 neutral absorber resin ), the air up to 70% of the whole flask volume, adding 5?L the secondary metabolites as the revulsant, at 30℃, 200r/min, for 6 days, the yield of the secondary metabolites achieved the maximum.

Objective To explore the method of 3D reconstruction of major blood vessels around the pancreas with Myrian system and its clinical significance.Methods By making use of the data from 64-slice CT of GE,the main arteries,portal vein,spleen vein,superior mesenteric vein and inferior mesenteric vein of 60 pancreases were 3D reconstructed with Myrian system.Vessel length and some other data were also recorded.Results The main arteries and veins were reconstructed.The length of portal vein was (46.37 ± 11.48)mm.The length of postpancreas trunk was (34.88±9.13)mm.The angle between portal vein and spleen vein was acute angle in 17 cases (28.33％),right angle in 11 cases (18.33％) and obtuse angle in 32 cases (53.33％).The inferior mesenteric vein fed into spleen vein in 19 cases (31.67％),superior mesenteric vein in 34 cases (56.67％) and conjunction point between spleen vein and superior mesenteric vein in 7 cases (11.67％).Conclusion Myrian system can be used to reconstruct the 3D structure of blood vessels around the pancreas with high reconstruction rates.This method can also be used in feasibility analysis of clinical operations and reduce the risk of bleeding caused by unknown distribution of blood vessels around the pancreas during operation.

To explore the impact of middle and low dose atorvastatin on peripheral endothelial progenitor cells (EPCs) in patients with acute myocardial ischemia injury via investigating EPC proliferation, migration, differentiation and secretion of cytokines. Method: A total of 80 patients with acute ST-segment elevation myocardial infarction (STEMI) were randomly divided into 2 groups: Observation group, the patients received atorvastatin 40 mg and Control group, the patients received atorvastatin 20 mg. n=40 in each group. The number of circulating EPC, EPC proliferation ability and the secretion of cytokines before and at different time points after drug therapy were examined by means of MTT, flow cytometry and ELISA. Results: The number of EPC was obviously increased with greatly changed migration ability within 2 weeks atorvastatin treatment in both groups. The secretion of cytokines presented that the contents of VEGF, bFGF, CXCR were elevating first followed by reducing thereafter, while the content of SIRT1was continuously increasing during the period of treating. The above parameters were similar between 2 groups. Conclusion: Middle and low dose atorvastatin could effectively improve EPC proliferation and migration, increase the expressions of CXCR4, VEGF, bFGF and SIRT1 in STEMI patients.

Objective:To systematically evaluate the effect of dietary intervention on blood glucose during intestinal preparation for colonoscopy.Methods:Randomized controlled trials (RCTs) on the effects of different interventions on blood glucose during bowel preparation in colonoscopy patients were retrieved on PubMed, CNKI, and WanFang, and RevMan 5.3 software was applied for meta-analysis based on the intervention groups.Results:A total of 10 RCTs in 8 papers, including 3 345 patients, 1 603 patients in the control group and 1 742 patients in the intervention group, were reviewed. Meta-analysis results showed that 10 studies reported incidence of hypoglycemia and interventions during intestinal preparation, and heterogeneity among researches was statistical ( P<0.000 01, I2=80%). Under random effects model combined with effect quantity, compared with the control group, dietary intervention could significantly reduce the incidence of hypoglycemia during bowel preparation, the difference was significant ( OR=0.19, 95% CI: 0.09-0.40, P<0.05). Conclusion:Dietary intervention during intestinal preparation for colonoscopy can prevent the occurrence of hypoglycemia and avoid relative adverse reactions and parasympathetic nerve activity. However, due to the limited number and quality of included researches, the above conclusion need to be verified by more high-quality RCTs.

AIM:Nitroxyl ( HNO) increases myofilament Ca 2+responsiveness relative to increases in intracel-lular Ca2+in cardiac muscle.In this study, we further investigated this effect of HNO on trabecular muscles from phospho-lamban knockout ( PLB-KO) and wide-type ( WT ) mice using a novel HNO donor , 1-nitrosocyclohexyl acetate ( NCA ) . METHODS:Trabecular muscles were dissected from the right ventricles of the rat hearts and mounted between a force transducer and a motor arm.The muscles were superfused with K-H solution (pH 7.4) at room temperature.Fura-2 was loaded into the trabecular muscles via electrophoresis .The length of the sarcomere was set to 2.2~2.3μm.During stead-y-state activations, the maximal Ca2+-activated force and Ca2+required for 50% activation were measured.RESULTS:The intracellular Ca 2+transients and force of the PLB-KO muscles at baseline were higher than those of the WT muscles and exhibited a negative force-frequency relationship (FFR).NCA (2.5μmol/L) increased systolic force in both PLB-KO group and WT group at any given [Ca2+]o.However, there was more dramatic increase in the force development due to moderate increases in the intracellular Ca 2+transients in the WT muscles when external Ca 2+increased from 1.5 to 4.5 mmol/L under NCA.NCA did not affect the negative FFR in PLB-KO muscle.Steady-state force-Ca2+relations obtained from skinned muscles were not different between the 2 groups, while NCA increased Ca2+responsiveness in skinned mus-cles from both PLB-KO and WT mice.CONCLUSION:HNO increases force development in both PLB-KO and WT mus-cles as a result of increases in myofilament Ca 2+responsiveness .The increased intracellular Ca 2+transients are accompa-nied by greater force development in WT mice , suggesting that HNO improves Ca 2+activation and establishes HNO as a positive inotropic agent with novel mechanisms .

Tibetan medicineLiu-Wei Mu-Xiang(LWMX) pill, a traditional compound medicine, has special therapeutic effects in the treatment of gastrointestinal anabrosis, especially chronic gastric ulcer. It has been widely applied in the clinics in Tibetan region. Nevertheless, the current standards for quality control are insufficient and incomplete, which makes it difficult to ensure its quality. This review focused on two closely related perspectives, which were the effective material basis and quality control, to summarize and review the recent advancement in relevant studies. This review also pointed out that the burning questions for Tibetan medicine standards were the origin confusion and“different medicines with the same name”. It offered meaningful suggestions for the consideration to improve its quality standards.

Objective To explore the experience of self-perceived burden in patients with chronic obstructive pulmonary disease (COPD) and provide evidence for clinical nursing interventions.Methods Indepth interviews were conducted among 17 patients with COPD using phenomenological method of qualitative research.Data were analyzed with the Colaizzi's method.Results 3 themes was identified:self-accusation and guilt,loss of dignity and powerlessness,concern and insecurity.Conclusions Nurses should take the experience of SPB in patients with COPD seriously and take the influence of SPB into account during the process of nursing interventions and evaluation.

Objective: To explore the protective roll of ifbroblast growth factor 21 (FGF21) in endoplasmic reticulum stress (ERS) induced rat's H9c2 cardiomyocyte apoptosis with its mechanism. Methods: pcDNA4 was used as gene vector, pcDNA4-FGF21 plasmid was constructed and transfected into rat's H9c2 myocardiocytes for 48 h. ERS model was established by 10 μM tunicamycin (TM) induction for 24 h. The experiment was conducted in 4 groups:①Control group,②TM group, the cells were treated by TM,③pcDNA4-FGF21+TM group,④pcDNA4+TM group. The expressions of FGF21, protein kinase R-like ER kinase (PERK) and c-Jun N-terminal kinases (JNK) mediated apoptosis pathway related protein were measured by Western blot analysis; cell survival rate was examined by CCK-8 method and apoptosis rate was detected by TUNEL technique. Results: pcDNA4-FGF21 vector was successfully constructed and overexpressed in H9c2 myocardiocytes. Compared with Control group, TM group and pcDNA4+TM group had up-regulated endogenous FGF21 expression, increased PERK and JNK mediated apoptosis pathway related protein expression; reduced cell survival rate and elevated apoptosis rate. Compared with TM group and pcDNA4+TM group, pcDNA4-FGF21+TM group had down-regulated PERK and JNK mediated apoptosis pathway related protein expression; increased cell survival rate and decreased apoptosis rate. Conclusion: FGF21 overexpression can reduce ERS induced apoptosis rat's H9c2 myocardiocytes which might be partly related for inhibiting PERK and JNK mediated signal transduction of apoptosis pathway.

Aerenchyrna formation has been described in depth in a number of species at a histological level. But large gaps remain in our understanding of its regulation as a developmental process. It is attempted to analyse essential mineral elements like K, Mg, Cu, Zn, Ca and P in the cell wall of aerenchyma cells in petioles ofS. trifolia at five different developmental stages by CSEM-EDX technique. At early stage, K and Cl concentrations in cell wall were high up to 36% and 4.3% of dry weight, respectively. It supported the hypotheses that aerenchyma spaces are filled with liquid at early developmental stages of aerenchyma in S. trifolia petiole. Mg concentration was high at stage 2, up to 0.86% of dry weight. Zinc and Cu were detected only at rapid expansion stages, during which the concentrations were up to 1.5% and 2.5%, respectively. Calcium was detected in the cell wall only at mature stages, the concentration was high up to 1.3% of dry weight at stages 4 and 5. These results confirmed that the element concentration of aerenehyma cell wall undergoes dynamic changes during different developmental stages, and a low Ca with high Zn and Cu concentration are needed for cell expansion. Copper and Zn deposition in the cell wall showed a significant positive linear correlation, suggesting that these two elements share same or similar uptake and transport mechanism in plants.