Objective:To investigate the prevalence and its related factors of thyroid nodules in elderly residents in Tongzhou District of Beijing.Methods:This is a cross-sectional study with cluster sampling.A total of 3 639 elderly volunteers aged 60 years and over receiving annual multiphasic health checkups were enrolled in Yongshun, Tongzhou District of Beijing from June to December 2017.A uniformly designed questionnaire was used to investigate the subject's basic information and previous medical history.All volunteers received a B-ultrasound examination of the thyroid gland, and were divided into the nodular group and non-nodular group based on the results of the B-ultrasound.The differences between the two groups in blood pressure, body mass index, triglycerides, total cholesterol, fasting blood glucose, thyroid peroxidase antibodies, urine iodine and other indicators were compared so as to analyze the risk factors for thyroid nodules.Results:A total of 3 639 elderly residents were included.The prevalence of thyroid nodules was 49.68%(1 808/3 639). Univariate analysis showed that there were significant differences between nodule group and non-nodule group in the age, gender, systolic blood pressure, body mass index, urea nitrogen, uric acid, aspartate aminotransferase, triglycerides, thyroid stimulating hormone and carcinoembryonic antigen( P<0.05). Multivariate Logistic regression analysis showed that women( OR=1.577, 95% CI: 1.358-1.832), age( OR=1.025, 95% CI: 1.012-1.038), body mass index( OR=1.032, 95% CI: 1.013-1.052)were risk factors for thyroid nodules.Increasing levels of urea nitrogen( OR=0.945, 95% CI: 0.902-0.990), thyroid stimulating hormone( OR=0.925, 95% CI: 0.882-0.970)and carcinoembryonic antigen( OR=0.967, 95% CI: 0.941-0.994)were protective factors for thyroid nodules. Conclusions:Women and obesity are risk factors for thyroid nodules and increasing levels of thyroid stimulating hormone, urea nitrogen and carcinoembryonic antigen may be unique protective factors for thyroid nodules in the elderly.

Objective To investigate whether the new mechanically-activated (MA) cation channel Piezo 1 protein can cause the apoptosis of human chondrocytes under compressive loading,using a Flexercell unit by activating MAPK/ERK5 signal pathway.Methods Primary human chondrocytes were isolated,cultured,and then subjected to the static compressive loading for 2 h,12 h,24.h and 48 h,respectively.The GsMTx4,which is the special inhibitor of the Piezo1 protein and the BIX02188,which is the inhibitor of the ERK5 served as the inhibitor group.The immunofluorescence was used to locate the expression of the Piezo 1 protein.The expressions of Piezo1 and ERK5 were assessed by reverse transcription-polymerase chain reaction (RT-PCR),as well as the apoptosis gene B cell lymphoma/leukemia-2 (Bcl-2),Bcl-associated X protein (Bax) and Bcl-associated death promoter (BAD).In addition,Piezo1 inhibitor,GsMTx4,was used to block the MA cation channel Piezo1,served as the inhibitor group.AVPI was used to detect the apoptosis of the OA chondrocytes.Results The location of the Piezo1 was expressed in nucleus and cytoplasm of chondrocytes.The expression of the Piezo1,ERK5,BAD,and Bax mRNA in the OA chondrocytes is weak.The 12 h stretch force group was significant increased,and the 24 h stretch force group was the highest expression.However,the expression of the 48 h group was decreasing.The expression of the Bcl-2 in the 12 h group was decreasing,and the 12 h stretch force group was the lowest expression while the 24 h stretch force group was increasing.In the GsMTx4 group,the expression of the Piezo1,ERK5,BAD,Bax was decreasing while the Bcl-2 was increasing.In the BIX02188 group,the expression of the ERKS,BAD,Bax was increasing while the Bcl-2 was decreasing,while the expression of the Piezo1 was not change.The result of AV-PI shown that the 2 h stretch force group increased early stage of apoptosis.The 12 h stretch force group increased late stage of apoptosis,and the 24 h stretch force group's apoptotic rate was the highest.However,the apoptotic rate of the 48 h group was lower than the 24 h stretch force group.The GsMTx4 could inhibit the late stage of apoptosis.Conclusion Piezo 1 plays an important role in the apoptosis of human chondrocyte through the MAPK/ERK5 signal pathway.

[ ABSTRACT] AIM:To investigate the effect of atorvastatin on the development of heart failure after myocardial infarction and the association with sodium-calcium exchanger (NCX) expression.METHODS:The model of heart failure was established by ligation of the anterior descending coronary artery for 8 weeks.The rats were randomly divided into con-trol group, heart failure group, and atorvastatin group.Either atorvastatin (10 mg· kg-1· d-1) or vehicle was orally ad-ministered to the rats on the next day after the surgery .The left ventricular function and NCX expression were analyzed 8 weeks after ligation .Neonatal rat cardiomyocytes were cultured to investigate the effect of atorvastatin on the changes of cal -cium concentration induced by hypoxemia .RESULTS: A decrease in left ventricular diastolic dimension , an increase in left ventricular fractional shortening , and reductions of BNP level and NCX expression were observed in atorvastatin group . The hypoxemia-induced calcium overload in cultured cardiomyocytes was inhibited by atorvastatin , and it was inhibited by the inhibitor of NCX .CONCLUSION:Atorvastatin treatment improves cardiac function , which may be related to the ex-pression and function of sodium calcium exchanger in heart failure .

Objective To build up one bonus shares method of improvi ng nursing quality in order to simulate nurse′s the inner enthusiasm.Methods The competence model and assessment system were established for one important weight for bonus sharing of competence qualified of nursing staff,competence coefficient and performance assessment.Results The implementation of performance assessment improved nurse′s satisfaction from 76.3% to 89.2%,while the parent′s satisfaction increased from 84.3% to 93.0%(χ2 =1 3.070,9.766;P <0.05).Conclusions The bonus shares method is scientific and reasonable,which can dig out the potential of nursing staff and is worthy of promotion.

BACKGROUND:As lumbar spine biomechanics research is unceasingly thorough and the constant development of related fusion and dynamic fixation device, the spine fusion technique which is represented by artificial disc replacement is a new choice to the spine surgeons. Therefore, it is particularly important to design reasonable artificial intervertebral disc. OBJECTIVE:To establish the finite element model of the new artificial disc replacement of the lumbar motion segment for further biomechanical study. METHODS:The L3-4 thin-section CT images of a healthy male volunteer was selected, combined with human anatomy data and applied the reverse engineering technology to rebuild the lumbar spine model with medical image software Mimics and tool software Geomagic Studio. The three-dimensional model of the silicone artificial disc was converted into a finite element model through software ANSYS12.0. RESULTS AND CONCLUSION:Through CT scanning, digital image processing and computer-aided design, the three-dimensional model of the lumbar motion segment and the finite element model of artificial disc replacement were successful y established. The finite element model contained 691 085 units and 1 008 913 nodes which could be applied constraint and load and could be used for spinal biomechanics and the further research of the new artificial intervertebral disc.

Objectives To evaluate the effectiveness of bedside noninvasive scoring system in diagnosis of coronary heart disease (CAD).MethodsSix hundred and twelve patients with suspected CAD in our hospital were enrolled (343 males and 269 females) from September 2008 to October 2010,with an average age of 55 ± 7 y.The detailed history was taken; physical examination,resting electrocardiogram,blood biochemistry,treadmill exercise test and/or 12 lead Holter monitoring,64 or 256 rows CT coronary artery imaging and coronary artery angiography were performed in all patients.The risk factors for CAD were screened by multiple questionnaire surveys with Delphi method.The risk factors were stratified according to the results of expert survey: heavy smoking,diabetes mellitus,typical angina,positive treadmill exercise test and positive Holter monitoring electrocardiogram were included in the highest risk factors with an integrated scores of 8 ; dyslipidemia of 3 items,hypertension complicated with left ventricular hypertrophy were high risk factors with an integrated scores of 6; males≥40 y,medium smoking,dyslipidemia of 2 items,pathoglycemia,heavy drinking,positive ECG and post-menopause females were moderate risk factors with integrated scores of 4; Low risk factors contain moderate drinking and dyslipidemia of item,were classified as low risk factors with an integrated scores of 2. The bedside noninvasive scoring system was evaluated in all patients and the results were compared with those from multi-slice spiral CT or coronary angiography.ResultsWhen integrated score ≥ 24 was set as the cut-off level for diagnosis of CAD,thesensitivity,specificity,positive predictive value and accuracy were 89.95％,85.63％,94.03％and 88.73％ respectively.When integrated score≤ 14 was set as the exclusion criteria of CAD,the sensitivity,specificity,positive predictive value and accuracy were of 93.10％,82.86％,98.09％ and 84.80％ respectively.The accuracy was lower than that of multi-slice spiral CT or coronary angiography( P ＜0.05 ).ConclusionsThe bedside noninvasive scoring system is effective for preliminary diagnose of CAD,but need to be further improved.

Objective To investigate the effect of early application of aldosterone receptor blockade-spironolactone on cardiac remodeling in patients with acute myocardial infarction.Methods A total of 616 patients were enrolled in this prospective study,who were admitted to the CCU Division of the First Affiliated Hospital of Harbin Medical University from January 2008 to January 2010.Inclusive criteria were as follows:First-onset STEMI according to the diagnostic criteria in ST-segment elevation acutemyocardial infarction diagnosis and treatment guidelines and admitted within 24 hours from onset.Exclusive criteria were as follows:Non-STEMI,only right ventricular infarction and old myocardial infarction; cardiac function Killip Class Ⅳ or hypotensive state; renal dysfunction(serum creatinine ＞ 221 μmol / L); serum potassium ＞5.0 mmol / L; longer than 24 hours from onset and older than 75 years of age.All the patients were randomly divided into a control group of standard therapy and a treatment group of standard therapy combined with spironolactone 20 mg per day.Totally 528 patients were observed completely,including 266 patients in the control group and 262 patients in the treatment group.There was no statistical difference of clinical characteristics between the two groups,including age,gender,past medical history,admission situation,and treatment(P ＞ 0.05).The effect of spironolactone on cardiac remodeling、left ventricular function、renal function and blood levels of potassium were evaluated by detecting echocardiography,serum potassium and serum creatinine at one month and one year follow-up.Results Compared with the control group,the echocardiography indicators such as LVESD,LVEDD,LVEF,LAD-ML and LAD-SI were significantly improved in treatment group at one year(P ＜ 0.05).In treatment group,LVESD,LVEDD,LVPWT,LVEF,LAD-ML and LAD-SI were significantly improved at one year than one month(P ＜ 0.05,and P =0.007 to LVEF),and LVEF was significantly improved at one year than one month in control group(P =0.0277).There were no statistical differences of serum potassium and serum creatinine between the two groups.Conclusions On the basis of conventional treatment,the early combination of low dose spironolactone(20 mg/d)could inhibit cardiac remodeling at late stage and prevent heart failure.

Nascent polypeptide associated complex (NAC) and its two isolated subunits, αNAC and βNAC, play important roles in nascent peptide targeting. We determined a 1.9 Å resolution crystal structure of the interaction core of NAC heterodimer and a 2.4 Å resolution crystal structure of αNAC NAC domain homodimer. These structures provide detailed information of NAC heterodimerization and αNAC homodimerization. We found that the NAC domains of αNAC and βNAC share very similar folding despite of their relative low identity of amino acid sequences. Furthermore, different electric charge distributions of the two subunits at the NAC interface provide an explanation to the observation that the heterodimer of NAC complex is more stable than the single subunit homodimer. In addition, we successfully built a βNAC NAC domain homodimer model based on homologous modeling, suggesting that NAC domain dimerization is a general property of the NAC family. These 3D structures allow further studies on structure-function relationship of NAC.
Amino Acid Sequence ; Dimerization ; Humans ; Molecular Chaperones ; chemistry ; Peptides ; metabolism ; Protein Multimerization

Objective To determine the prevalence and prognostic implication of hypocalcemia in the set-ring of acute myocardial infarction. Method The study consisted of 1274 consecutive patients presenting with a-cute myocardial infarction. Plasma calcium concentrations were obtained on the 1st day, 2nd day, 3rd day after admission. According to the plasma calcium concentrations, 1274 patients with AMI were designed into four groups:group A (Ca2+≥2.20 mmol/L),gronp B (2.00～2.19 mmol/L), group C (1.90～1.99 mmol/L),group D (Ca2<1.9 mmol/L). Echocardiographic examination was performed on day 2 or 3 of hospitalization.Results There were 606 patients (47.6%) having hypocalcemia, defined as a plasma calcium level <2.2mmol/L. Among them, there were 476 patients(37.4%) in group B(2.00～2.19 mmol/L), 73 patients(5.7 %)in group C (1.90～1.99 hanoi/L) and 45 patients(3.5%)in group D(Ca2+< 1.90 retooL/L). The mortality of group A was 2.5 %, on the contrary, the mortality of the other groups was 7.8 %, 20.5 %, 17.8 %. The difference was significant. In multivariate logistic regression analysis, hypocalcemia was independently associated with 30-day mortality. Conclusions Hypocalcemia in patients with acute myocardial infarction is an independent predictor of 30-day mortality.

Objective To investigate the correlation between myocardial microcirculation and inflammation in acute myocardial infarction(AMI)by myocardial contrast echocardiography(MCE).Methods Eighty-one AMI patients(AMI group)and 30 healthy adults(normal control group)were enrolled.White blood cell(WBC),hypersensitive C reactive protein(hsCRP)and neutrophilic gtanulocyte percentage(G%)were measured in patients and healthy adults.According to different count of WBC,AMI group was devided into A group(n=40,WBC≥10×109/L)and B group(n=41,WBC＜10×109/L).Myocardial contrast intensity(A),blood flow rate(β)and myocardial blood volume(MBF=A×β)of each segment were measured by MCE during 5-7 days of hospitalization.Results Compared with control group.WBC,hsCRP in A group and hsCRP in B group were significantly elevated(P＜0.05).A,β and MBF in A group were significantly lower than those in B group(P＜0.05).WBC and hsCRP in A group had significant negative correlations with β respectively(BWBC=-0.67,P＜0.05;BhsCRP=-0.5 1,P＜0.05).Conclusions The level of plasma inflammatory factors were remarkably increased after AMI,which had a positive correlation with low microcirculation perfusion.