As the real-time and dynamic ultrasound images play an important role in the distance education of ultrasound medicine, the learning system is more dependent on the technology of modern net-work information. By using the DGX protocol, we have constructed an ultrasonic distance education system composed of 5 main operating terminals, which has ensured the reliable and adaptive window transmission, and has realized the optimization of the coding and decoding technology. At the same time, we have used the system to carry out ultrasonic distance education to medical students, the staff of our ultrasound department and the ultrasound doctors in other hospitals, and have achieved good results in practical application.

Objective To investigate the correlation between the serum ghrelin levels and nutrition state in the patients with chronic obstructive pulmonary disease(COPD) ,as well as to explore the role of ghxelin in the nutri-tion metabolism. Methods Fifty-three COPD patients were observed, thirty-one of them were with malnutrition (group A), twenty-two COPD patients with normal nutrition status(group B), and twenty were healthy controls.Serum ghrelin, and nutritional parameters such as body mass index(BMI), ideal body weitht( % IBW), mid-upper arm cricumference(MAC), serum albumin(ALB), total lymphocyte counts(LYM) were determined. The correlation between ghrelin and nutritional parameters was analysed. Resuits The level of serum ghrelin in group A were sig-nificantly higher than those in group B and in healthy controls. And the serum ghrelin showed a negative correlation with BMI, % IBW, MAC, but there was no correlation between serum ghrelin level, ALB and LYM. Conclusion Ghrelin participated in the nutrition metabolism in patients with COPD, it would become much higher because of malnutrition in COPD.

OBJECTIVETo evaluate the validity, reliability, and clinical applicability of Chinese medicine syndrome diagnostic standards for coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI), which was established by expert consultation.

METHODSA total of 1 050 CHD patients after PCI were recruited from 23 hospitals. The sensitivity, specificity, accuracy, positive likelihood ratio, and area under ROC curve were used to evaluate the validity of diagnostic standards for Chinese medical syndrome types. The observable agreement rate and Kappa value were used to evaluate the reliability. Positive predictive value and negative predictive value were used to evaluate the clinical applicability.

RESULTSThe sensitivity, specificity, accuracy, positive likelihood ratio, area under ROC curve, observable agreement rate, Kappa value, positive predictive value, and negative predictive value of each Chinese medicine syndrome in CHD patients after PCI were as follows: 95.26%, 93.70%, 94.86%, 15.13, 0.924, 98.76%, 0.969, 97.76%, and 87.24% for blood stasis syndrome; 96.42%, 95.34%, 96.00%, 20.70, 0.957, 99.52%, 0.990, 97.02%, and 94.42% for qi deficiency syndrome; 88.19%, 96.46%, 94.19%, 24.89, 0.923, 96.67%, 0.915, 90.39%, and 95.58% for phlegm turbidity syndrome; 91.06%, 98.77%, 97.05%, 74.22, 0.950, 98.67%, 0.960, 95.54%, and 97.46% for cardiac blood stasis syndrome; 98.41%, 96.73%, 97.33%, 30.10, 0.976, 98.86%, 0.976, 94.40%, and 99.09% for qi deficiency blood stasis syndrome; 94.81%, 94.75%, 94.76%, 18.07, 0.948, 97.71%, 0.918, 72.73%, and 99.20% for phlegm-stasis stagnation syndrome.

CONCLUSIONThe validity, reliability, and clinical applicability of Chinese medicine syndrome diagnostic standards for CHD patients after PCI were rational and considerable in clinical practice.

Coronary Disease ; diagnosis ; etiology ; Humans ; Medicine, Chinese Traditional ; methods ; Percutaneous Coronary Intervention ; adverse effects ; Predictive Value of Tests ; Sensitivity and Specificity

Objective:To investigate the impact of nutrition supplementation (whey protein, fish oil and vitamin D) and physical exercise (resistance and aerobic exercise) on muscle mass and body fat metrics among community elderly with sarcopenia.Method:102 eligible sarcopenic participants per inclusion and exclusion criteria were randomized into the control group (routine consultation, n=34) or the groups receiving nutrition supplementation (Nutr, n=34) or nutrition supplementation combined with exercise (Nutr+Ex, n=34) for 12 weeks. Muscle and body fat related indicators were compared across groups pre- and post-intervention. Results:Analysis of covariance showed that all indicators were significantly different between groups (all P<0.05). Further pairwise comparisons showed that compared with controls, patients in Nutr group showed increased appendicular muscle mass (ASM) by 0.837 kg ( P=0.003, 95% CI: 0.301 to 1.372) and decreased fat mass by 2.876 kg ( P<0.01, 95% CI: -3.941 to -1.812), while patients in Nutr+Ex group showed increased ASM by 0.745 kg ( P=0.010, 95% CI: 0.180 to 1.311) and decreased fat mass by 2.928kg ( P<0.01, 95% CI: -4.408 to -1.808). Other muscle-related indicators also increased while fat-related indicators decreased in both Nutr and Nutr+Ex groups. However, there is no significant difference between Nutr and Nutr+Ex groups. Conclusions:Nutrition supplementation and physical exercise contribute to muscle mass and body fat improvement among sarcopenic elderly. Lifestyle intervention based on nutrition intervention is important for the community elderly with sarcopenia.

This study was performed to explore the effect of flagellin+rapamycin on the growth and metastasis of 4T1 breast cancer in tumor-bearing mice,and their regulatory effect on several immunocytes.4T1 cell line was applied to establish an breast cancer model in Balb/c mice,which then injected with flagellin+rapamycin,and the volume and inhibition rate of tumor were recorded.MTT assay was used to detect the inhibitory effect of flagellin+rapamycin against 4T1 cells.Data showed that the combination of flagellin and rapamycin had the best inhibition effect on 4T1 cells,and the same results were found in animal model experiments.Flow cytometry result indicated that flagellin+rapamycin significantly down-regulated the levels of CD11b+Gr-1+myeloid-derived suppressor cells(MDSCs)and CD11b+F4/80+tumor-associated macrophages(TAMs)of tumor-bearing mice.Furthermore,flagellin+rapamycin alleviates the metastasis of 4T1 cancer cells into liver and lung.Taken together,flagellin+rapamycin can inhibit proliferation and metastasis of 4T1 cells,thus exert antitumor effects in mice,which may related with its regulatory effects on immunocytes in tumor microenvironment.

A cDNA fragment locating at the putative envelop protein 2(E2) region of GBV-C/HGV fused with Schistosoma japonicum, glutathione S-transferase(GST) was amplified with PCR from plasmid pGEX-E2. The amplified DNA fragment was inserted into plasmid pGEX-5X-1, at the downstream of the coding sequences of GST, in the same reading frame with the gene of GST. The fusion gene fragment of GST-E2 was amplified with PCR, using the recombinant plasmid pGEX-5X-1-E2 as the template. The amplified 1324 bp DNA fragment of GST-E2 was inserted into Pichia pastoris expression vector pPIC9K in reading frame with alpha-factor secreting signal peptide. The plasmid pPIC9K-GST-E2 was transformed into Pichia pastoris GS115 with electroporation. The transformants (His+ Muts) were selected and induced to express the 54kD GST-E2 fusion protein, which could be specially recognized by both the antisera directed against E2 and against GST. The GST-E2 fusion protein was purified with Sepharose 4B glutathione affinity chromatography to a purity of 95%. The expression was optimized to achieve the highest expression level of GST-E2 fusion protein which was accumulated up to 50% of total proteins in the culture supernatant. The GST-E2 protein derived from the recombinant Pichia pastoris was proved possessing antigenicity and high specificity by ELISA, probed with sera from the patients infected by GBV-C/HGV.
Animals ; Antigens, Viral ; genetics ; immunology ; isolation & purification ; GB virus C ; genetics ; immunology ; Gene Expression ; Genetic Engineering ; Glutathione Transferase ; genetics ; Hepatitis Antibodies ; blood ; immunology ; Humans ; Pichia ; Recombinant Fusion Proteins ; genetics ; immunology ; isolation & purification ; Schistosoma japonicum ; enzymology ; Viral Envelope Proteins ; genetics ; immunology ; isolation & purification

Nicotinamide adenine dinucleotide phosphate oxidases (NOXs) are the major enzymatic source of reactive oxygen species (ROS). NOX2 and NOX4 are expressed in the heart but its role in hypoxia-induced atrial natriuretic peptide (ANP) secretion is unclear. This study investigated the effect of NOX on ANP secretion induced by hypoxia in isolated beating rat atria. The results showed that hypoxia significantly upregulated NOX4 but not NOX2 expression, which was completely abolished by endothelin-1 (ET-1) type A and B receptor antagonists BQ123 (0.3 µM) and BQ788 (0.3 µM). ET-1-upregulated NOX4 expression was also blocked by antagonists of secreted phospholipase A2 (sPLA2; varespladib, 5.0 µM) and cytosolic PLA2 (cPLA2; CAY10650, 120.0 nM), and ET-1-induced cPLA2 expression was inhibited by varespladib under normoxia. Moreover, hypoxia-increased ANP secretion was evidently attenuated by the NOX4 antagonist GLX351322 (35.0 µM) and inhibitor of ROS N-Acetyl-D-cysteine (NAC, 15.0 mM), and hypoxia-increased production of ROS was blocked by GLX351322. In addition, hypoxia markedly upregulated Src expression, which was blocked by ET receptors, NOX4, and ROS antagonists. ET-1-increased Src expression was also inhibited by NAC under normoxia. Furthermore, hypoxiaactivated extracellular signal-regulated kinase 1/2 (ERK1/2) and protein kinase B (Akt) were completely abolished by Src inhibitor 1 (1.0 µM), and hypoxia-increased GATA4 was inhibited by the ERK1/2 and Akt antagonists PD98059 (10.0 µM) and LY294002 (10.0 µM), respectively. However, hypoxia-induced ANP secretion was substantially inhibited by Src inhibitor. These results indicate that NOX4/Src modulated by ET-1 regulates ANP secretion by activating ERK1/2 and Akt/GATA4 signaling in isolated beating rat hypoxic atria.

Nicotinamide adenine dinucleotide phosphate oxidases (NOXs) are the major enzymatic source of reactive oxygen species (ROS). NOX2 and NOX4 are expressed in the heart but its role in hypoxia-induced atrial natriuretic peptide (ANP) secretion is unclear. This study investigated the effect of NOX on ANP secretion induced by hypoxia in isolated beating rat atria. The results showed that hypoxia significantly upregulated NOX4 but not NOX2 expression, which was completely abolished by endothelin-1 (ET-1) type A and B receptor antagonists BQ123 (0.3 µM) and BQ788 (0.3 µM). ET-1-upregulated NOX4 expression was also blocked by antagonists of secreted phospholipase A2 (sPLA2; varespladib, 5.0 µM) and cytosolic PLA2 (cPLA2; CAY10650, 120.0 nM), and ET-1-induced cPLA2 expression was inhibited by varespladib under normoxia. Moreover, hypoxia-increased ANP secretion was evidently attenuated by the NOX4 antagonist GLX351322 (35.0 µM) and inhibitor of ROS N-Acetyl-D-cysteine (NAC, 15.0 mM), and hypoxia-increased production of ROS was blocked by GLX351322. In addition, hypoxia markedly upregulated Src expression, which was blocked by ET receptors, NOX4, and ROS antagonists. ET-1-increased Src expression was also inhibited by NAC under normoxia. Furthermore, hypoxiaactivated extracellular signal-regulated kinase 1/2 (ERK1/2) and protein kinase B (Akt) were completely abolished by Src inhibitor 1 (1.0 µM), and hypoxia-increased GATA4 was inhibited by the ERK1/2 and Akt antagonists PD98059 (10.0 µM) and LY294002 (10.0 µM), respectively. However, hypoxia-induced ANP secretion was substantially inhibited by Src inhibitor. These results indicate that NOX4/Src modulated by ET-1 regulates ANP secretion by activating ERK1/2 and Akt/GATA4 signaling in isolated beating rat hypoxic atria.

Objective To investigate the MRI characteristics of different pathologic types of patients with focal cortical dysplasia (FCD). Methods The postoperative clinical data of 23 patients with FCD were retrospectively analyzed and they were divided into patient groups of 4 types according to Palmini' s classification. The MRI characteristics of different pathologic types of patients with FCD were concluded. Results Among these 23 patients, 2 were diagnosed as having FCD ⅠA, 6 as having FCD IB, 8 as having FCD ⅡA and 7 as having FCD IE. As compared with that in patients with FCD Ⅰ, obviously increased signal of Flair images in patients with FCD Ⅱ was more prevalent (2:11,P=0.039). Increased signal in T2 images and tapering of abnormal white matter signals to ventricles were more prevalent in patients with FCD Ⅱ as compared with those in patients with FCD Ⅰ, but no significant differences were noted (P= 0.074, 0.058). As compared with patients with other 3 types of FCD, blurring of the gray matter-white matter junction, increased signal in T2 images, deep sulcus, thickening of the cortex and tapering of abnormal white matter signals to ventricles in patients with FCD ⅡB were more prevalent (P<0.05). Conclusion Different MRI characteristics in each type of FCD are noted, especially in patients with FCDⅡB. These different MRI characteristics are helpful to make preoperative diagnosis and planning of FCD.

Objective To analyze the prevalence,disease burden,and trends of diabetes in China from 1999 to 2019,providing reference for diabetes prevention and control as well as health resource allocation to alleviate the disease burden.Methods Data on the disease burden of diabetes in China from 1999 to 2019 were collected from the Global Burden of Disease(GBD)2019 database.Indicators such as incidence rate,prevalence rate,mortality rate,disability-adjusted life years(DALYs),years of life lost due to premature mortality(YLLs)and years lived with disability(YLDs)were used to analyze the diabetes burden in China by gender,age and year.The estimated annual percentage change(EAPC)was used to measure the temporal trend of standardized rates over a specified period,and the rank sum test was used to assess the gender differences in disease burden.Results In 2019,3.78×106 cases of diabetes and 1.73×105 deaths were reported in China.Compared with 1999,the standardized rates of incidence and prevalence increased by 5.80%and 17.12%,respectively,while the standardized mortality rate decreased by 2.82%.Compared with 1999,the standardized rates of DALYs and YLDs increased by 2.86%and 16.06%,respectively,while the standardized YLL rate decreased by 14.39%.The EAPC for diabetes incidence,prevalence,YLDs,and DALYs in the 20-40 age group all exceed 0,indicating an annually upward trend in disease burden of diabetes.Additionally,the disease burden in males was significantly higher than that in females(P＜0.05),and the gap is continuously widening.Conclusions The disease burden of diabetes in China is severe,particularly in term of life loss due to disability.The population with diabetes onset is becoming increasingly younger.Males constitute a high-risk population for diabetes-related morbidity and mortality.Diabetes prevention and control efforts should continue to enhance behavioral interventions,appropriately tilt health resource allocation towards high-risk population,and focus on improving the rehabilitation capabilities and promoting rehabilitation technology at grass-roots unit.