Objective To study the effect of levosimendan on cardiac function and hemodynamics in patients with acute myocardial infarction and cardiogenic shock.Methods Totally 118 patients with acute myocardial infarction complicated with cardiogenic shock admitted to 363 Hospital were randomly assigned to control group or observation group,with 59 cases in each group.All the patients in both groups received routine treatment,and the observation group was given levosimendan additionally.The cardiac function indexes such as stroke volume(SV),cardiac index(CI),left ventricular ejection fraction(LVEF),and longitudinal peak systolic strain rate(SRs),the myocardial funtion indexes such as troponin I(cTnI),creatine kinase isoenzyme(CK-MB),vasopressin(AVP)and angiotensin(AngⅡ),hemodynamic parameters such as central venous pressure(CVP),pulmonary capillary wedge pressure(PCWP),mean arterial pressure(MAP),and left ventricular end-diastolic volume(LVEDV)were compared between the two groups before treatment and on day 3 after treatment.Shock duration,drug dose,time staying in intensive care unit(ICU),use of intra-aortic balloon counterpulsation(IABP),and incidence of malignant arrhythmia were also compared.Results There were no significant differences in all indexes between the two groups before treatment(P>0.05).On day 3 after treatment,SV,LEVF,CI,SRs,and MAP in the observation group were significantly higher than those in the control group(P<0.05),while AVP,AngⅡ,cTnI,CK-MB,CVP,PCWP,and LVEDV in the observation group were significantly lower than those in the control group(P<0.05).The duration of shock,the dosage of drugs,ICU time,and IABP time in the observation group were significantly lower than those in the control group(P<0.05).The incidence of malignant arrhythmia in the observation group was significantly lower than that in the control group(13.56%vs 28.81%,P<0.05).Conclusion Levosimendan can improve the hemodynamics of patients with acute myocardial infarction and cardiogenic shock.It has clinical application value.

For lack of cognitive screening standard system and controversy over the value of imaging for cerebrovascular diseases in China, the research group of Alzheimer′s Disease Chinese (ADC) studied the knowledge of neuropsychology, neuroimaging and clinical neurology, systematically reviewed the diagnostic techniques such as memory, language, visuospatial, executive, function, and magnetic resonance imaging (MRI) of cerebrovascular diseases, and their optimal threshold and diagnostic value for vascular dementia. Via a consensus meeting, the diagnostic guidelines and practical screening process are combined to construct a framework in Chinese population, which is based on the objective evidence of medical history and clinical evaluation. The diagnosis of vascular dementia is supported by imaging evidence of cerebrovascular diseases and differentiates from other causes of dementia or comorbidities. This consensus is applicable to medical units in China, and is of great significance for early detection, early diagnosis and early treatment of vascular dementia.

Criteria for diagnosis of Alzheimer's disease (AD) is not available in China.The international criteria is not a proper choice due to issues such as translation and lead to low diagnostic rate and high rate of missed diagnosis.The research group of Alzheimer's Disease Chinese (ADC) reviewed knowledge and techniques in neuropsychology,neuroimaging,molecular biology,and clinical neurology,and systematically studied the detection techniques such as memory,language,visuospatial,executive function,and medial temporal lobe visual scores on MRI,and their optimal threshold and diagnostic value for the diagnosis of AD.Through a systematic review and consensus meeting,a diagnostic framework for screeningAD in the Chinese population was established.Among these methods,an operational standard for clinical pathology models increased the diagnostic sensitivity by 15％.The sensitivity and specificity of screening memory impairment increased by 18.1％ and 11.6％,respectively.The sensitivity of screening medialtemporal lobe atrophy increased by 24.5％ and missed diagnosis was decreased by 34.5％.An operational standard for clinical biology models,incorporating the latest molecular imaging and molecular biology techniques,has enabled the early diagnosis of AD in China.The framework combines a principled diagnostic guideline with an operational screening protocol,which is applicable to all clinical settings and of great significance for the early detection,early diagnosis and early treatment of AD.

Objective: To investigate the inhibitory effect of dehydroandrographolide (DA) on the hepatocyte apoptosis induced by carbon tetrachloride (CC14) in the hepatic fibrosis model mice, and to elucidate its possible mechanism. Methods: A total of 30 male C57BL/6J mice aged 6-8 weeks were randomly divided into control group, model group and treatment group; there were 10 mice in each group. Except the normal control group, the mice in other two groups were intraperitoneally injected with 20%CC14 2. 0 mL · kg-1, three times a week; the hepatic fibrosis models were establised. The mice in control group were given the same volume of olive oil. The mice in treatment group were intragastrically given 100 mg · kg-1 DA, three times a week; while the mice in control group and model group were given the equal volume of normal saline. Four weeks later, 24 h after the last administration, the eyeball blood was taken, the marrow was broken, and the liver was taken. The activities of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of the mice in various groups were detected; the activities of superoxide dismutase (SOD) and the levels of malondialdehyde (MDA) in liver tissue of the mice in various groups were detected. The pathological performance of liver tissue of the mice in various groups were observed by HE staining and Sirius red staining. Western blotting method was used to detect the levels of 8-oxoguanine DNA glycosylase 1 (Oggl), Caspase-3, Bcl-2-associated X protein (Bax), and B-cell lymphoma-2 (Bcl-2) proteins in liver tissue of the mice in various groups. The expression levels of transforming growth factor-β1 (TGF-β1) and α-smooth muscle actin (α-SMA) proteins in liver tissue of the mice in various groups were observed by immunohistochemistry. Results: Compared with control group, the activities of serum ALT and AST and the level of MDA in liver tissue of the mice in model group were significantly increased (P<0. 05), and the activity of SOD in liver tissue was significantly decreased (P<0. 05). Compared with model group, the activities of ALT and AST in serum and the level of MDA in liver tissue of the mice in treatment group were significantly decreased (P< 0. 05), and the activity of SOD in liver tissue was significantly increased (P<0. 05). The HE staining and Sirius red staining results showed that compared with model group, the inflammatory cell infiltration and collagen deposition in liver tissue of the mice in treatment group were significantly improved. Compared with control group, the expression levels of Oggl, Caspase-3, Bax, TGF-β1, α-SMA and Bcl-2 proteins in liver tissue of the mice in treatment group were significantly increased (P<0. 05); compared with model group, the expression levels of Oggl, Caspase-3, Bax, TGF-β1 and a-SMA proteins in liver tissue of the mice in treatment group were significantly decreased (P< 0.05), and the expression level of Bcl-2 protein was significantly increased (P<0. 05). Conclusion: DA has a protective effect in the mice with hepatic fibrosis induced by CCL, which might be related to reducing oxidative stress injury, inhibiting hepatocyte apoptosis and reducing hepatic stellate cell activation.

There are no standard diagnostic criteria for Alzheimer′s disease (AD) in China. The copied international criteria has led to a high rate of missed diagnosis due to issues such as translation and cultural discrepancy. Under the principles of semantic equivalence, content equivalence and performance equivalence, the research group of Alzheimer′s Disease Chinese (ADC) adopted several effective methods, such as two-way translation, content conversion, performance evaluation, etc. to systematically study the cognitive, behavioral, functional, and general assessment techniques in dementia screening and diagnosis, as well as their screening thresholds and diagnostic values. We also established a dementia screening and assessment framework in clinical practice through systematic reviews and group consensus. It has improved the early diagnosis rate of dementia in China, been accepted by home and abroad academic institutions, which is of great significance for early diagnosis and treatment of dementia.