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Objective To investigate the therapeutic effect and mechanism of non-mitogenic acid fibroblast growth factor 1( NMFGF1) on diabetic cardiomyopathy ( DCM) by using PEG-modified nano-liposomes combined with ultrasound-targeted microbubble destruction technique ( UTMD ) . Methods The NMFGF1 loaded PEG-modified nano-liposomes were prepared by a water-in-water emulsion method and their quality inspections were also investigated. Type 1 diabetes animal model was induced by intraperitoneal injection of streptozotocin ( 70 mg/kg) in male SD rats. The diabetic rats were raised twelve weeks after the diabetes model was established and DCM rats were selected by ultrasonic heart function examination. After two weeks of intervention, all rats were kept for another two weeks and then underwent transthoracic echocardiography examination. The rats were sacrificed and myocardial tissue was obtained to quantify myocardial collagen fraction ( CVF ) and cardiac myocyte apoptotic index by Sirius red staining and TUNEL staining. Results NMFGF1-loaded PEG-nano-liposomes showed a good morphology and 90.3％± 1.4％ NMFGF1 encapsulation efficiency. Compared with DCM group, NMFGF1group, and NMFGF1-PEG-nano-liposomes group, NMFGF1-loaded PEG-nano-liposome plus UTMD group showed increased left ventricular end diastolic diameter (LVIDd) [(7.36±0.42) vs (5.75±0.24), (6.64±0.27), (6.72±0.24)mm, all P<0.05]and leftventricularfractionshortening(LVFS) [(50±3) vs (33±2), (44±5), (43±3)mm, all P<0.05], and decreased left ventricular posterior wall thickness (LVPW) [(1.65±0.07) vs (1.89±0.08), (1.73±0.11), (1.73 ±0.07) mm, all P<0.05], with decreased CVF and apoptotic index(all P<0.05). Conclusion PEG-nano-liposomes combining with UTMD technique has a greater translational potential in the delivery of NMFGF1 for the treatment of DCM by attenuating oxidative stress-induced injury and may provide a promising strategy for treating diabetes cardiomyopathy.
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Objective To investigate the advanced preventive effect of acid fibroblast growth factor (aFGF) on diabetic cardiomyopathy(DCM) by using heparin-modified nano-liposomes combined with ultrasoundtargeted microbubble destruction technique (UTMD).Methods aFGF-loaded nano-liposomes (aFGF-lips) were prepared by lyophilization technique.Type Ⅰ diabetes model was induced by intraperitoneal injection of streptozotocin (STZ,70 mg/kg) in male SD rats.Before and twelve weeks after intervention,all rats underwent the transthoracic echocardiography.The segmental mean peak systolic radial velocity (Vs),systolic circumferential strain (Sc),and systolic circumferential strain rate (SRc) were measured.The expression of aFGF in DCM rats was detected by western blot.The rats were sacrificed and myocardial tissue were stained with masson staining and Tunel staining to quantify myocardial collagen fraction(CVF) and cardiac myocyte apoptosis index(AI).Results aFGF-lips showed good morphology and aFGF encapsulation efficiency (89.4±1.2)％ with high stability.From the animal experiments,the echocardiographic indexes including Vs,Sc and SRc had significantly improvements over DM group (P＜0.05) and all other treatment group (P＜0.05).The Masson's trichrome staining demonstrated that CVF was significantly higher in DM group than in the control group and was significantly lower in the aFGF-loaded nano-liposome+UTMD group than other groups(all P＜0.05).The TUNEL results showed that AI was significantly higher in DM group than in the control group and was significantly lower in aFGF-loaded nano-liposome +UTMD group than other groups (all P＜0.05).Conclusion aFGF nano-liposome combining with UTMD technique can improve the functions and pathologies of the hearts in type 1 diabetes mellitus model,which might provide a novel technique for aFGF in DCM prevention.
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Objective Evaluation of efficacy and safety of combination of Yinxin Damo injection and low molecular heparin for deep venous thrombosis (DVT) in orthopedics operation.Methods Randomized controlled trials of combination of Yinxin Damo injection and low molecular heparin intervention study of DVT in orthopedics operation were searched from the Cochrane Library,clinicaltrials,gov,PubMed,EMBASE,CNKI,Wanfang database,VIP database,and Chinese biomedical database (CBM).According to the Cochrane Handbook 5.1,Meta analysis was performed by Revman 5.3 software.Results A total of 4 studies included 358 patients.The results of Meta-analysis showed that,compared with control group,incidence of DVT was significantly reduced (P =0.01),value of D-D significantly decreased (P ＜0.000 01) and value of PT increased (P =0.04),and increased value of APTT (P =0.07) in combined group.Heterogeneous sources of PT and APTT were analyzed,and the results after excluding literature 7,as compared with the control group,APTT and PT were significantly increased in combined group (P ＜ 0.000 1).Conclusion Based on the current clinical evidence,combination of Yinxin Damo injection and low molecular heparin treatment for DVT of orthopedics operation patients is effective and safe,but there is certain heterogeneity between the studies,therefore it is necessary to design a randomized controlled trial of high quality,large scale and multicenter to research.
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Objective@#The therapeutic effect of acid fibroblast growth factor 1(FGF1) on rats with diabetic cardiomyopathy (DCM) was evaluated by using nano-liposomes combined with ultrasound-targeted microbubble destruction technique (UTMD).@*Methods@#The FGF1-loaded nano-liposomes were prepared by water-in-water emulsion method combined with lyophilization technique.TypeⅠdiabetes model was induced by intraperitoneal injection of streptozotocin (STZ, 70 mg/kg) in 60 male SD rats.Sixteen weeks later, diabetic rats were randomly divided into: placebo group (saline treatment), FGF1 group, FGF1-loaded nano-liposomes group, and FGF1-loaded nano-liposomes plus UTMD group (n=15 each). After two weeks of intervention followed by 2 weeks intervention stop, all rats underwent cardiac catheterization, and the left ventricular end-systolic pressure (LVESP), left ventricular end-diastolic pressure (LVEDP) and the maximal increase/decrease rate of left ventricular pressure (LV±dp/dtmax) were measured.Then, the rats were sacrificed and myocardial tissue were obtained for Masson trichrome staining, TUNEL apoptotic staining and CD31 immunohistochemistry staining to quantify myocardial collagen fraction (CVF), cardiac myocyte apoptotic index and myocardial microvascular density (MVD).@*Results@#(1)Scanning electron microscope results revealed good morphology and FGF1 encapsulation efficiency (84.3±2.8)% with high stability and dispensability of FGF1 loaded nano-liposomes.(2)The hemodynamic evaluation showed that LVESP, LV + dp/dtmax and LV -dp/dtmax were all significantly higher, while LVEDP was significantly lower in the FGF1-loaded nano-liposome+ UTMD group than in DCM group, FGF1 solution group, and FGF1 nano-liposome group(all P<0.05). (3)The Masson trichrome staining demonstrated that CVF was significantly higher in all DCM groups than in control group and was significantly lower in the FGF1-loaded nano-liposome+ UTMD group than in DCM group, FGF1 solution group, and FGF1 nano-liposome group (all P<0.05). (4)The CD31 immunohistochemical staining results showed that MVD was significantly lower in all DCM groups than in control group and was significantly higher in the FGF1-loaded nano-liposome+ UTMD group than in DCM group, FGF1 solution group, and FGF1 nano-liposome group (all P<0.05). (5)The TUNEL results showed that apoptotic index was significantly higher in all DCM groups than in control group and was significantly lower in the FGF1-loaded nano-liposome + UTMD group than in DCM group, FGF1 solution group, and FGF1 nano-liposome group (all P<0.05).@*Conclusion@#FGF1 nano-liposomes combining with UTMD technique can significantly improve cardiac functions and attenuate myocardial CVF and apoptosis and enhance myocardial MVD in DCM rats.
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Objective To regulate standardized ICD-10 case classification name and coding,and common clinical diagnosis name or expression of mapping rules,to systematically improve the quality of DRGs key data,and to assess the impact of medical diagnostic data quality on DRGs and the indicators based on the DRGs.Methods Extension of the glossaries of clinical diagnosis synonyms or near-synonyms,and establishment of a standardized maintenance procedure of ICD-10 dictionary.Adjustment of the impact extent of DRGs disease makeup on case classification,comparison of the consistency of principal diagnosis classification,and the consistency of DRGs grouping,as well as changes of such indicators as DRGs grouping reduction in variance (RIV) and case mix index (CMI).Results Data of the obstetrics,gynecology and pediatrics disciplines of a maternity and children hospital from 2012 to 2013 (72 005 cases)and 2014 to 2015 (77 705 cases) were chosen for prior-after comparison.The encoding consistency rate was 59.60％ before the improvement,with the improved standardized consistency rate rising to 66.38％afterwards;beforehand the DRGs grouping consistency rate was 69.30％,with the improved standardized consistency rate rising to 88.00％ afterwards;beforehand the cost RIV was 0.515,with the cost RIV rising to 0.576 afterwards;the CMI variations of individual campuses of healthcare institutions appear more reasonable.Conclusions Diagnostic quality control and improvement project can improve the data accuracy of coding.This empowers the RIV and CMI indexes calculated on such basis to better describe the complexity of clinical settings,conducive to establishing a value-oriented prepayment system which is more transparent,fair and reasonable.
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Objective To analyze the clinical application of detecting anti Mullerian hormone (AMH) in the patients with polycystic ovary syndrome (PCOS).Methods A total of 480 cases with PCOS and 500 cases of healthy females were selected in the study.The levels of AMH in the patients with PCOS were compared between the two groups.Results The levels of AMH,luteinizing hormone (LH),testosterone (T) in patients with PCOS were significantly higher than those in the healthy control group (P＜0.05).Differences of the levels of estradiol (E2) and follicle-stimulating hormone (FSH) in patients with PCOS and thosein healthy control group had no statistical significance(P＞0.05).As the age increased,the level of AM H obviously declined.Conclusion The level of AMH in patients with PCOS is obviously higher than that in the healthy ones,it declines with the age increasing.
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Objective To investigate the effect of acupuncture at Zusanli, Sanyinjiao and Danzhong on mammary estrogen receptor (ER) and progesterone receptor (PR) expressions in rats with dimethylbenzanthracine (DMBA)-induced mammary cancer. Methods One hundred and twenty female SD rats aged 6-8 weeks were randomized into a model group of 60 rats and a blank group of 30 rats. The model group received an oral gavage of DMBA for model making. The blank group received an oral gavage of equal volume of sesame oil. At 15 weeks after model making, the model group of rats was randomized into treatment and control groups. The treatment group received acupuncture at Zusanli, Sanyinjiao and Danzhong, and the control and blank groups, only the same grasp and release. After the completion of acupuncture treatment (twenty-seventh week), abdominal venous blood was taken and serum tumor markers were determined by electrochemiluminescence immunoassay. Tumor masses were counted and their shapes were recorded. The mass was taken and its height, maximum diameter and vertical diameter were measured using a 1 mm precision vernier caliper. Pathological changes in tumor tissues, and ER and PR positive areas and mean optical densities were observed under an Olympus optical microscope.Results There were statistically significant post-treatment differences in the average number and volume of mammary tumors between the treatment group and the control or blank group (P<0.01,P<0.05) and between the control and blank groups (P<0.01). There were statistically significant post-treatment differences in the concentrations of various tumor markers (CA724, CA125, CA199, AEP, CA15-3, CEA and CA50) between the treatment or control group and the blank group (P<0.01,P<0.05) and between the control and blank groups (P<0.01). There was a statistically significant post-treatment difference in CA15-3 concentration between the treatment and control groups (P<0.01). There were statistically significant post-treatment differences in ER and PR positive areas and mean optical densities between the treatment group and the control or blank group (P<0.01) and between the control and blank groups (P<0.01).Conclusions Acupuncture can reduce the occurrence of rat DMBA-induced mammary tumor (including the number and volumes of the tumors). The mechanism of its action may be related to decreasing the concentrations of tumor markers CA724, CA125, CA199, CA15-3, AEP, CEA and CA50 and especially to decreasing CA15-3 concentration, and ER and PR positive areas and mean optical densities.
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Objective To explore the clinical significance of application of trans-abdominal Heller combined with Dor fundoplication for esophageal achalasia in the elderly.Methods Clinical data of 9 patients with esophageal achalasia undergoing trans-abdominal Heller combined with Dor fundoplication from Oct.2009 to Dec.2013 were collected.The postoperative effects and complications were analyzed.Results The operations were successful in the 9 patients with no conversion to open operation and no complications.The maximum esophageal diameter was reduced to (1.94 ± 0.76) cm from (3.69 ±-1.34) cm (P＜ 0.05).Rest lower esophageal sphincter pressure declined by 12.18 mmHg in average (1 mmHg=0.133 kPa,P＜0.05).Dysphagia score fell to 2.49 points from 7.88 points (P＜0.05).There were no retrosternal pain and dysphagia,stenosis and food retention in the lower esophagus and cardia place,and obvious expansion in esophageal.There were statistically significant differences in the above indexes.Conclusions The trans-abdominal Heller combined with Dor fundoplication can significantly improve the symptoms of esophageal achalasia in elderly patients,and effectively prevent postoperative gastroesophageal reflux,and has the characteristics being minimally invasive and fast,and fewer complications.
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We injected collagenase into the lumbor disc(20 cases)or outside the lumbar disc(230 cases)for treating the patients with lumbar disc herniation from December 1994 to August 1996.200 cases had been followed up.The results were excellent or good in 91%.The authers in- troduced the operative method and its indications in detail,and suggested that chemonucleolysis is sate,good and easy to be operated with littlecomp lieation.Herniation more than 10mm in with cal- cification,lateral recess stenosis or recumance after the laminectomy are not the absolute contraindi- cations.