Objective To summarize the factors and the corresponding treatments for patients with coronary heart disease (CHD) complicated by thrombocytopenia, and provide medical advises for clinical treatment. Methods Literatures and case reports were analyzed and summarized. Results Thrombocytopenia in patient with CHD could be mainly divided into two types, one group was induced by the antithrombotic therapies for CHD, and the other group was caused by some concurrent diseases or combined non-antithrombotic medications. There were different medical decisions and prognoses according to the causes in different groups. Conclusion The treatment strategies of CHD will be considered in the CHD patients with thrombocytopenia. Identifying thrombocytopenia by monitoring the platelet counts in early stage, finding out the causes quickly and providing proper treatments are the key for the prognosis of the patients.

Objective To study the relationship of serum UA level with coronary heart disease (CHD) and cerebral stroke in elderly female essential hypertension (EH) patients. Methods Four hundred and seventy-two female EH patients admitted to our hospital from February 2014 to June 2018 were divided into normal UA group (n = 389) and hyperuricemia group (n = 83) according to their serum UA level. The clinical characteristics, blood pressure, incidence of CHD and cerebral stroke were compared between the two groups. The relationship of serum UA level with CHD and cerebral stroke was analyzed by logistic regression analysis. Results The age was significantly older, the course of hypertension was significantly longer, the SBP and BMI were significantly higher, the circumstances of lumber and buttock were significantly longer, the serum FPG,TB, UA levels and the incidence of grade 2 hypertension and grade 3 hypertension were significantly higher while the serum HDL-C level was significantly lower in hyperuricemia group than in normal UA group (P＜0.05, P＜0.01). Multivariate logistic regression analysis showed that serum UA level was positively related with CHD and cerebral stroke in elderly female EH patients after adjustment for risk factors such as age (OR = 1.003, 95％CI:1.000-1.007, P=0.045;OR = 1.006, 95％CI:1.000-1.012,P = 0.042). Conclusion Hyperuricemia is closely related with CHD and cerebral stroke in elederly EH patients.

OBJECTIVE: To investigate the inhibitory effect of genistein on activation of hepatic stellate cells (HSCs) and the role of the autophagy pathway regulated by PPAR-γ in mediating this effect. METHODS: Cultured HSC-T6 cells were exposed to different concentrations of genistein for 48 h, and HSC activation was verified by detecting the expressions of -SMA and 1(I) collagen; autophagy activation in the cells was determined by detecting the expressions of LC3-II and p62 using Western blotting. The autophagy inhibitor 3-MA was used to confirm the role of autophagy in genistein-induced inhibition of HSC activation. A PPAR-γ inhibitor was used to explore the role of PPAR-γ in activating autophagy in the HSCs. RESULTS: Genistein at concentrations of 5 and 50 μmol/L significantly inhibited the expressions of -SMA and 1(I) collagen ( < 0.05), markedly upregulated the expressions of PPAR-γ and the autophagy-related protein LC3-II ( < 0.05) and significantly down-regulated the expression of the ubiqutin-binding protein p62 ( < 0.05) in HSC-T6 cells. The cells pretreated with 3-MA prior to genistein treatment showed significantly increased protein expressions of -SMA and 1(I) collagen compared with the cells treated with genistein only ( < 0.05). Treatment with the PPAR-γ inhibitor obviously lowered the expression of LC3-II and enhanced the expression p62 in genistein-treated HSC-T6 cells, suggesting the activation of the autophagy pathway. CONCLUSIONS PPAR-γ- regulated autophagy plays an important role in mediating genistein-induced inhibition of HSC activation .
Anticarcinogenic Agents ; pharmacology ; Autophagy ; Collagen Type I ; Genistein ; pharmacology ; Hepatic Stellate Cells ; Humans ; PPAR gamma ; physiology

Objective To analyze the changes in distribution of occupational radiation cases reported from 2013 to 2017 in China and learn about the occupational health risks of radiation workers.Methods Descriptive analyses were made of regional distribution,disease category distribution,occupation category distribution and exposure mode distribution of these cases,according to the reports (2013-2017) of occupational radiation sickness from " Occupational Health of Radiation Workers Management System".Results There were 54 diagnostic radiology agencies for occupational radiation sickness in China that covered all provinces,autonomous regions and municipalities except Tibet and Production and Construction Corps of Xinjiang.A total of 106 new cases were reported from 2013 to 2017.Most of the cases were radiogenic neoplasm (43.40％),and chronic radiation sickness were from external exposure (16.98％) and radiation cataract (16.04％).Most of the cases (70.75％) were engaged in medical application and a small part of the cases (13.21％) engaged in industry application.Chronic exposure (80.19％) was the most frequent form of exposure mode,but acute exposure (5.66％) was very few.A part of cases (14.15％) were reported without exposure mode.Conclusions The morbidity of occupational radiation sickness declined generally in China and occupational health management of key workers should be strengthened continuously.

Objective To study the relationship between serum uric acid (UA) level and metabolic syndrome (MS) in elderly essential hypertensive (EH) patients.Methods Two hundred and one elderly EH patients were divided into hyperuricemia group (n=47) and normal UA group (n=154).Hyperuricemia was defined in males with their serum UA level ＞ 420 μmol/L and in females with their serum UA level ＞ 360 μmol/L.Relationship between serum UA level and MS in elderly EH patients was analyzed by Pearson correlation analysis and logistic regression analysis respectively.Results The age was significantly older,the waist circumference was significantly longer,the BMI and serum SCr,FPG,TG level and the incidence of MS,central obesity,high blood glucose and high TG were significantly higher while the serum HDL-C level was significantly lower in hyperuricemia group than in normal UA group.Pearson correlation analysis showed that waist circumference,BMI,serum FPG and TG level were positively related with serum UA level while serum HDL-C level was negatively related with serum UA level (P＜0.05,P＜0.01).Logistic regression analysis showed that waist circumference and serum TG level were the independent risk factors for elevated serum UA level in elderly EH patients (OR=1.080,95％ CI:1.035-1.127,P=0.000;OR=1.472,95％CI:1.021-2.122,P=0.038).Conclusion Serum UA level is closely related with MS and its components while waist circumference and serum TG level are the independent risk factors for hyperuricemia in elderly EH patients.

Objective To systematically evaluate the effects of albumin compared with crystalloids on fluid resuscitation for adults with severe sepsis and septic shock.Methods The six databases as follows:Cochrane Library,Pubmed,Embase,CNKI,VIP and Wanfang,were retrieved by computer,from their inception to November,2015.Randomized controlled trials(RCT) in the treatment of adult patients with severe sepsis and septic shock were included for quality assessment and Meta-analysis was performed by using RevMan5.3 software.Results A total of 4 RCTs involving 3 862 participants were included.No differences were found between albumin and crystalloids resuscitation with respect to 28-day mortality[RR=0.95,95%CI(0.86,1.05),P=0.33],90-day mortality[RR=0.95,95%CI(0.86,1.05),P=0.33],duration of stay in ICU,duration of hospital stay,duration of mechanical ventilation and renal replacement therapy.Conclusion In that meta-analysis,the effects of fluid resuscitation with albumin or crystalloids were not significantly different in adults with severe sepsis and septic shock.

The Fukushima nuclear accident happened in 2011.This article introduced the recent studies about thyroid dose estimation,incidence of thyroid nodule,thyroid cyst and thyroid cancer in the children in Fukushima prefecture after the accident.The results suggested that the incidence of thyroid nodule and thyroid cyst had no significant increase.Nevertheless,the present research noted that the incidence of thyroid cancer was obviously higher than that in other areas in Japan,but high incidence may be due to the choice of the control group or the screening effect.Meanwhile,the contribution of 132Te to the thyroid dose and the incidence of thyroid cancer might not be ignored.The continuous monitoring before and after the operation of the nuclear power plant and the health evaculation after the accident are of importance.

Objective To discuss the effects of electroacupuncture intervention in different acupoints of rats models with diarrhea type irritable bowel syndrome (D-IBS).Methods The rat models were established with acute and chronic stimulation. The rats were divided into the normal control group, model group, “Taichong” (LR3) + “Zusanli” (ST36) group, and “Tianshu” (ST25) + “Zusanli” (ST36) group. Electroacupuncture was applied to bilateral corresponding acupoints for 20 minutes, every other day for 7 times. The physical signs of each rat were observed. The contents of 5-HT, NE and CGRP in the rats’ plasma were detected by sandwich ELISA. Results Compared with the normal group, the contents of 5-HT and NE in the model group were obviously higher and the content of CGRP decreased (P<0.05). Compared with the model group, the contents of 5-HT and NE in all treatment groups were lower and the content of CGRP increased (P<0.05). There was no difference between the “Taichong” (LR3) + “Zusanli” (ST36) and “Tianshu” (ST25) + “Zusanli” (ST36) groups.Conclusion The mechanism of electroacupuncture may be realized through lowering the contents of 5-HT and NE in the model rats and increasing the content of CGRP to treat D-IBS.

Objective To explore the clinical effect of transvaginal repair of cesarean scar diverticulum (CSD). Methods Totally 64 patients of CSD in the First Maternity and Infant Hospital, Tongji University between Mar. 2013 and Sept. 2014 underwent transvaginal repair of CSD were reviewed retrospectively and followed. Result All the patients had a prolonged period, and the duration was (14.8± 3.5) days; all the patients were received the transvaginal repair of CSD, there was no intra-operative complications, the procedures were successfully performed in all patients. The mean operation time was (67± 12) minutes, the mean blood loss was (53±32) ml, and the mean length of hospital stay was (4.0±1.1) days. All patients were followed after the operation, the duration of menstruation was (8.1 ± 3.5) days shorter in average, which was statistically significant (P<0.01);the operation effective rate was 94%(60/64) to assess the clinic syptoms, the operation effective rate was 95%(61/64) for anatomic assessment. The distance of the CSD from the serosa became thicker after surgery significantly, the distance was thicker (3.4 ± 0.4) mm compared with preoperation (P<0.01). Conclusions Transvaginal repair of CSD offers minimal invasiveness, good exposure and accurate resection. It is worth to be popularized in the treatment of patients with CSD.

Objective:To evaluate the efficacy and safety of capecitabine or S-1 combined with oxaliplatin or cisplatin in the treat-ment of advanced gastric cancer. Methods:Six databases including Cochrane Library, Pubmed, Embase, CNKI, VIP and WanFang were retrieved. Randomized controlled trials ( RCT) in the treatment of advanced gastric cancer were involved for the quality assess-ment and Meta-analysis. Results:A total of 14 RCT involving 1 051 patients were included. There were no significant differences in the total effective rate, complete remission rate and partial remission rate between the two groups(P>0. 05). In the safety evaluation, the incidence of hand-foot syndrome was higher in capecitabine-based regimens than that in S-1-based regimens[RR=2. 59,95%CI (1. 61,4. 17),P<0. 000 1], while the incidence of stomatitis was lower in capecitabine-based regimens[RR=0. 64,95%CI(0. 50, 0. 82),P=0. 000 4]. The other adverse reactions such as nausea and vomiting, diarrhea,neuropathy,dysfunction of liver and kidney, anemia, leukopenia, neutropenia and thrombocytopenia exhibited no significant differences between the two groups(P>0. 05). Con-clusion:Capecitabine combined with oxaliplatin or cisplatin has similar efficacy with S-1 combined with oxaliplatin or cisplatin in the treatment of advanced gastric cancer, and the incidence of hand-foot syndrome is higher in capecitabine-based regimens and the inci-dence of stomatitis is higher in S-1-based regimens.