Expert consensus on antiviral therapy of COVID-19 / 中华临床感染病杂志

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Cytokine storm and translating IL-6 biology into effective treatments for COVID-19 / 医学前沿

As of May 3, 2023, the Coronavirus disease 2019 (COVID-19) pandemic has resulted in more than 760 million confirmed cases and over 6.9 million deaths. Several patients have developed pneumonia, which can deteriorate into acute respiratory distress syndrome. The primary etiology may be attributed to cytokine storm, which is triggered by the excessive release of proinflammatory cytokines and subsequently leads to immune dysregulation. Considering that high levels of interleukin-6 (IL-6) have been detected in several highly pathogenic coronavirus-infected diseases, such as severe acute respiratory syndrome in 2002, the Middle East respiratory syndrome in 2012, and COVID-19, the IL-6 pathway has emerged as a key in the pathogenesis of this hyperinflammatory state. Thus, we review the history of cytokine storm and the process of targeting IL-6 signaling to elucidate the pivotal role played by tocilizumab in combating COVID-19.

Regulative effect of Rhubarb dispensing granule on autophagy and gastrointestinal motility of Cajal interstitial cells in rats with chronic transit constipation / 国际中医中药杂志

Objective:To study the regulative effect of Rhubarb dispensing granule on autophagy and gastrointestinal motility of Cajal interstitial cells in rats with chronic transit constipation (STC).Methods:A total of 75 rats were randomly divided into control group, model group, low, medium and high dose groups with 15 rats in each group. Except for the control group, the STC rat models were established by intragastric administration of compound diphenoxylate suspension. Rats in low, medium and high dose groups were given Rhubarb dispensing granule of 1, 2 and 4 g/kg by gavage respectively, while rats in control group and model group were given normal saline with the same volume by gavage, once a day for 14 consecutive days. Fecal moisture content and intestinal propulsion rate were measured. The serum levels of substance P (SP), vasoactive intestinal peptide (VIP), NO and NOS were detected by ELISA. The pathological changes of colon tissue were observed by HE staining. The c-kit level in colon tissue was detected by immunohistochemistry. The mRNA and protein levels of c-kit and Beclin1 in colon tissue were detected by PCR and Western blot.Results:Compared with the model group, the fecal moisture content, the carbon pushing distance and the intestinal pushing rate of the low, medium and high dose groups were significantly increased ( P<0.05), the serum SP level was increased ( P<0.05), the serum VIP, NO and NOS levels of the low, medium and high dose groups were decreased ( P<0.05), and the average expression score of c-kit in colon tissue of the low, medium and high dose groups was significantly increased ( P<0.05). The levels of c-kit mRNA (2.33 ± 0.35, 3.04 ± 0.17, 3.83 ± 0.23 vs. 0.61 ± 0.07) and protein (0.42 ± 0.06, 0.60 ± 0.07, 0.79 ± 0.08 vs. 0.22 ± 0.04)in colon tissue of rats in low, medium and high dose groups were increased ( P<0.05), and Beclin1 mRNA (4.17 ± 0.37, 3.35 ± 0.44, 1.05 ± 0.28 vs. 6.04 ± 0.31) and protein (0.76 ± 0.11, 0.57 ± 0.08, 0.43 ± 0.05 vs. 0.91 ± 0.06) were decreased ( P<0.05). Conclusion:Rhubarb dispensing granule could significantly increase the fecal moisture, intestinal motility rate, serum SP level and colonic tissue c-kit level, decrease serum VIP, NO, NOS level and colonic tissue Beclin1 level in rats with chronic transit constipation, and then inhibit autophagy of Cajal interstitial cells and regulate gastrointestinal motility in rats with chronic transit constipation.

Tocilizumab in patients with moderate or severe COVID-19: a randomized, controlled, open-label, multicenter trial / 医学前沿

Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12 (P = 0.0359). In moderate disease patients with bilateral pulmonary lesions, the hypoxia ameliorated earlier after tocilizumab treatment, and less patients (1/12, 8.33%) needed an increase of inhaled oxygen concentration compared with the controls (4/6, 66.67%; rate difference 95% CI-99.17% to-17.50%, P = 0.0217). No severe adverse events occurred. More mild temporary adverse events were recorded in tocilizumab recipients (20/34, 58.82%) than the controls (4/31, 12.90%). Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative. For patients with bilateral pulmonary lesions and elevated IL-6 levels, tocilizumab could be recommended to improve outcome.

Effect of electric stimulation combined with Ai salt bag on shoulder-hand syndrome after cerebral infarction / 中国基层医药

Objective To study the effect of electric stimulation combined with Ai salt bag on shoulderhand syndrome after cerebral infarction.Methods A total of 188 patients with shoulder-hand syndrome after cerebral infarction admitted to Taizhou Central Hospital from September 2015 to August 2018 were enrolled in the study,they were randomly divided into study group (n =94) and control group (n =94) according to the random number table method.The control group was given uplink electrical stimulation treatment based on the conventional treatment for cerebral infarction and rehabilitation training,the study group was given Ai salt bag treatment on the basis of the control group.The clinical treatment effect,pain and edema VAS score,Fugl-Meyer motor function score and ADL score were observed and compared between the two groups.Results After 28 days of treatment,the total effective rate was 88.30％ (83/94) in the study group and 76.60％ (72/94) in the control group,the difference between the two groups was statistically significant (x2 =4.447,P ＜ 0.05).The VAS score of edema degree and pain degree in the study group decreased from (4.13 ± 1.40) points,(3.43 ± 2.20) points to (1.70 ± 1.36) points,(1.52 ±1.22) points,which in the control group decreased from (4.10 ± 1.46) points,(3.40 ± 2.17) points to (2.79 ±1.58) points,(2.52 ± 1.18) points,there were statistically significant differences between the two groups after treatment (t1 =5.712,t2 =5.069,all P ＜ 0.05).The Fugl-Meyer motor function score and ADL score of the study group increased from (19.91 ± 13.32) points,(42.34 ± 15.57)points to (54.21 ± 11.71) points,(86.02 ±16.62)points,which in the control group increased from (20.74 ± 11.30) points,(45.84 ± 14.44) points to(45.44 ± 12.61) points,(78.84 ± 17.79)points,there were statistically significant differences between the two groups after treatment (t1 =4.941,t2 =2.859,all P ＜ 0.05).Conclusion Electrical stimulation combined with Ai salt bag in the treatment of shoulder-hand syndrome after cerebral infarction has significant clinical effect,which can effectively alleviate the pain symptoms and swelling of the affected limb,promote the activities of daily living and improve the function of the affected limb,and is worthy of clinical application.

Screening and intervention of resistant hypertension in the community / 中华全科医师杂志

Objective To assess the screening and intervention techniques for resistant hypertension in the community.Methods Random sampling method was used to recruit 1 171 hypertensive patients from two communities in Hangzhou and Zhuji cities of Zhejiang province form October 2015 to september 2016.Among them,97 patients with resistant hypertension were identified with the Three-steps-flow screening method and the individualized intervention was given.The standardized treatment and lifestyle changes were compared before and after intervention.Results Among 97 patients with resistant hypertension,7 cases of pseudo resistant hypertension were detected;there were 2 cases with thyroid disease history,48 cases with snoring history and 1 case with sleep apnea syndrome.The life style intervention and standardized medication guidance were given to 90 patients with resistant hypertension according to the individual risk factors.After one year of intervention,the results showed that the rate of normalized blood pressure was 83.5％ (75/90) and the rate of standardized medication increased from 14.4％(13/90) to 90.0％ (81/90),the rate of medication compliance increased from 46.7％(42/90) to 95.6％(86/90),the blood pressure control rate increased from 12.2％(11/90) to 77.8％(70/90),and the average systolic blood pressure and diastolic blood pressure levels were decreased by 20.4 mmHg (1 mmHg=0.133 kPa) and 15.5 mmHg.The life style of patients with resistant hypertension was remarkably changed,56.7％(51/90) of patients took exercise regularly,high salt/high calorie diet decreased from 37.8％(34/90) to 11.1％(10/90),the proportion of the obese went down to 16.7％(15/90).Conclusion With the application of resistant hypertension screening and intervention,there are remarkable improvement in blood pressure control and life style changes for patients with resistant hypertension in the community.

Immunotoxicity of absorbable silk fibroin biofilm on rats / 中国组织工程研究

BACKGROUND: Silk fibroin, the main component of silk fibroin biofilm, is a natural protein, but it is still a heterologous protein to the body. Its immunogenicity/toxicity is an important factor in determining the development prospects. OBJECTIVE: To evaluate the toxicity of absorbable silk fibroin biofilm and its degradation products on the rat immune system by muscle implantation experiments in rats. METHODS: Ten Wistar rats from Beijing Weitong Lihua Experimental Animal Technology Co., Ltd. were implanted with a long strip of 1 mm× 10 mm in the right gluteal muscle to observe the implant absorption and determine the implantation cycle. Seventy-two Wistar rats were assigned into control and experimental groups (n=36/group, 18 in either sexes) . A long strip of 1 mm×10 mm was implanted into the rat right gluteal muscle in the experimental group, and the control group received no implantation. Some of the rats were taken for histological examination and calculate the organ/weight ratio, at 26 weeks postoperatively. The spleen lymphocyte proliferation ability, NK cell activity, cell classification of T lymphocytes, and levels of interleukin 2 and tumor necrosis factor α were detected. Another part of the animals was taken for macrophage phagocytosis of erythrocytes cell capacity and antibody producing cell count. RESULTS AND CONCLUSION: (1) Silk fibroin biofilm was completely absorbed after implanted into the rat muscle for 26 weeks. (2) In female or male Wistar rats, the immune organs in the experimental group showed no significant changes in the appearance, weight and histological examination. There were no significant differences in the hematological indexes (hemoglobin, red blood cell count, hematocrit, blood platelet count and white blood cell count and classification) , spleen lymphocyte proliferation, NK cell activity, the ratio of T lymphocytes and their subpopulations, and the levels of interleukin 2 and tumor necrosis factor α had no significant differences between two groups (P> 0.05) . (3) In female or male Wistar rats, the macrophage phagocytosis of chicken erythrocytes cell capacity and antibody producing cell count showed no significant differences between two groups (P> 0.05) . (4) These results indicate that silk fibroin biofilm causes no immunosuppression or immunostimulation on immune organs, immune cells and immune molecules (cytokines) of rats.

Final report of a prospective randomized study on thoracic radiotherapy target volumes for limited-stage small cell lung cancer / 中华放射肿瘤学杂志

Objective In view of the controversy over radiotherapy target volume for patients with limited-stage small cell lung cancer ( SCLC), a prospective randomized controlled trial was conducted to compare the impact of different radiotherapy target volumes on prognosis. Methods After 2 cycles of EP chemotherapy,patients without progressive disease were randomly assigned to receive thoracic radiotherapy (TRT) to either the post-or pre-chemotherapy primary tumour extent as study arm or control. Involved field radiotherapy (IFRT) to the entire metastatic lymph node regions was applied for both arms. TRT consisted of 45 Gy/30Fx/19 d administered concurrently with cycle 3 chemotherapy. Prophylactic cranial irradiation was administered to patients achieved complete or partial remission. Kaplan-Meier method was used for survival analysis. Results Between June 2002 and December 2017,159 and 150 patients were randomly assigned to study arm and control respectively. The 1-,2-,and 5-year local/regional control rates were 79. 4%,61. 5% and 60. 1% respectively in the study arm versus 79. 8%,66. 5%,and 57. 3% in the control arm (P=0. 73). The median OS time was 22. 1 months in the study arm (95%CI,18. 2-26. 0 months) and 26. 9 months (95%CI,23. 5-30. 3 months) in the control arm,the 1-,3-,5-,and 7-year OS rates were 81. 1%,31. 6%, 23. 9% and 22. 2% respectively in the study arm versus 85. 3%,36. 6%,26. 1% and 20. 0% in the control arm (P=0. 51).Grade 2-3 acute esophagitis was developed in 32. 9% and 43. 2% of patients respectively in study arm and control arm (P=0. 01),while grade 2-3 pulmonary fibrosis was observed in 2. 0% and 10. 9% of patients ( P= 0. 01 ) respectively. Conclusions For patients with limited-stage SCLC who received induction chemotherapy,thoracic radiotherapy can be limited to post-chemotherapy tumour extent and IFRT can be routinely applied.

Studies on the Acute Toxicity in Mice and Cytotoxicity of the Impurity in Ornithine / 中国药师

Objective:To study the acute toxicity in mice and cytotoxicity of the impuritiy(3-amino-2-piperidinone hydrochloride) in ornithine. Methods:The mice were given the impurity by intravenous injection.The acute toxicity was observed and LD50in mice was calculated by Bliss method. According to the result of LD50,the mice were given the impurity respectively at high,medium and low dose. The changes of general condition and body weight were recorded,and the blood biochemical indices and histomorphology of organs and tissues were observed after 14 days. The cytotoxicity was measured on fibroblasts(L929) cells. Results:The LD50and 95% con-fidence limit of the impurity (intragastric administration) was 758.49-848.08 mg·kg-1.All the detected indices of the three groups (660,330 and 170 mg·kg-1) including general condition,weight change,biochemical indices,organ morphological and histological change were all within the normal ranges. The impurity significantly decreased the viability of L929 cells. The NOAEL value was 660 mg·kg-1in mice. Conclusion:The impurity has certain toxicity to mice and cells. The data can provide experimental basis for the quality standard establishment for ornithine and the safety improvement in clinic use.

Determination of Copper Ion in Rabbit with Implantation of Copper Intrauterine Device / 医药导报

Objective To develop a method for determination of serumal copper ion in rabbit with implantation of copper intrauterine device.Methods At different time points after implantation,the serumal copper ion concentrations were determined by microwave digestion-inductively coupled plasma mass spectrometry(ICP-MS) using scandium(Sc) and indium(In) as internal standards to compensate sample matrix effects,and the pharmacokinetics parameters were calculated in order to reflect copper ion release and metabolic rule.Results The serumal copper ion concentrations were kept at a low and stable level.The recoveries were in the range of 98.7%-113.3%,with the relative standard deviations of less than 5.0%.Conclusion The analytical method is simple,fast,and can be used for the determination of serumal copper ion in rabbit.

The relationship and mechanism between accessory renal artery and essential hypertension by CTA / 实用放射学杂志

Objective To explore the relationship between accessory renal artery(ARA)and essential hypertension,and the possible mechanism using CT angiography(CTA).Methods The patients who underwent CTA examination on renal artery were reviewed retrospectively in our hospital.A variety of CTA reconstruction techniques were used to observe the type and number of ARA,as well as the diameter of ARA and the main renal artery.Results A total of 126 ARA(66 left ARA and 60 right ARA)were found in 253 patients. 10% of the patients had more than two ARAs.In 164 patients with essential hypertension,ARA detection rate was 40.2%(66/164).In the non-hypertension patients,the proportion of ARA was 31.5%(28/89).There was higher proportion of young(P=0.002)and male (P=0.022)patients in ARA hypertension group compared with ARA non-hypertension group.There were no significant differences on the prevalence of type(P=0.826)and number of ARA(P=0.501)between these two groups.In all of the patients with single ARA,no significant differences were detected on the ratios of diameter of ARA and main renal artery between the two groups(P=0.32). However,in ARA hypertension group,the diameter of main renal artery on the ARA side was significantly smaller than that on the opposite side(P=0.01).In non-hypertension ARA group,no statistical difference was found between the diameter of bilateral main renal arteries(P=0.06).Conclusion ARA is more prevalent in essential hypertensive patients,especially in young male.The decrease of the diameter of main renal artery in the ARA side may be a possible mechanism for essential hypertension.

Application of TMS in quantitative assessment of full term neonatal brain maturation with HIE / 实用放射学杂志

Objective To investigate the applications of total maturation scores (TMS) in assessment of the hypoxic ischemic encephalopathy (HIE) group and matched group with MRI and to find which patterns of HIE can delay the brain maturation in neonate.Methods MRI were performed on 43 full term neonates (28 HIE newborns and 15 matched controls) who were further divided into three groups,including 37-39 weeks postmenstrualage (PMA) (13 cases),39-41 weeks PMA (16 cases),and 41-44 weeks PMA (14 cases).MRI features and TMS scores were evaluated simulataneously.Results TMS gradually increased with PMA at each stage.While TMS,cortical folding and germinal matrix were all higher in matched group (P＜0.05),myelination and glial cell migration item were lower in HIE group (P＞0.05).Conclusion TMS can reflect brain development in the full term neonates.HIE may delay the brain maturation due to injury of the cortical myelin and neurons.TMS can evaluate the neonatal brain development and injury easily,quantitatively and effectively.

Prospective cohort study on the value of high-risk human papillomavirus viral load and subtype tests in predicting cervical intraepithelial neoplasia / 中国肿瘤临床

Objective:To evaluate high-risk human papillomavirus (hrHPV) genotyping and viral load in predicting CIN (cervical intraepi-thelial neoplasia (CIN) grade 2 or worse in a Chinese rural area population with limited health resources. Methods:We performed a population-based prospective study and enrolled 2,257 women aged 35 to 64 years from three rural screening sites of Jiangxi prov-ince. We conducted a hybrid capture (HC-2) assay to predict viral load. A HC-2 relative light unit (RLU) threshold of 10 was set to differ-entiate samples between low (<10) and high (≥10) viral loads. We also carried out a HybriMax test to detect different hrHPV geno-types in the samples. Women exhibiting positive HC-2 or HybriMax results underwent colposcopy and colposcopically directed biopsy. Women with negative or positive hrHPV test results but with normal biopsy or CIN1 were followed-up for 24 months without interven-tion (n=2,211). We used histopathological findings as outcome. Results:Of the 2,211 women, 1,636 provided complete follow-up data. Of the 132 women with a high viral load, 4 (3.03%) developed CIN2+in the same period. The relative risk (RR) of CIN2+for HC-2 posi-tivity at baseline was 42.24 (95%CI=4.76-375.2). Of the 159 women who were positive for HPV16 or HPV18 upon screening, 4 (2.52%) progressed to CIN2+(RR=33.06, 95%CI=3.72-293.9). The 2-year cumulative incidence rates of CIN2+did not significantly differ be-tween the high viral load group and the HPV16/18 group. Conclusion:The risks of CIN2+progression were higher among women with a high viral load or HPV16/18 positivity than among women with negative hrHPV. Increasing the HC-2 cut-off value to 10 RLU or using HPV16/18 positivity may be similarly used to triage hrHPV-positive women for immediate colposcopy and comprehensive follow-up.Both approaches were equally predictive of the CIN2+risk in rural area. Increasing the HC-2 cut-off value to 10 RLU may also help allo-cate health resources effectively.

The analysis of current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou, Jiaxing and Shaoxing in Zhejiang province / 中华老年医学杂志

Objective From October 2010 to explore the current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou,Jiaxing and Shaoxing in Zhejiang province.Methods To April 2011,10 644 geriatric patients aged 60 years and over were included,and related questionnaire survey,physical examination and laboratory examination were carried out.The situation of hypertension control and influencing factors were analyzed.Results The control rate of hypertension was 38.6％,and its standardized rate was 27.6％.It showed that female,inhabited city,high level of education degree and regular exercise were positively correlated with hypertension control,while age,smoking,high salt diet and abdominal obesity were negatively correlated with hypertension control,and standardized treatment had a close relationship with hypertension control.Conclusions The situations of hypertensive control among geriatric patients in Hangzhou,Jiaxing,Shaoxing in Zhejiang province are still unsatisfactory.Strengthening standardization management measures for improving the control rate of hypertension is needed and has actual value.

Study on Antimicrobial Effectiveness of Zhenzhu Mingmu Eye Drops / 中国药师

Objective:To evaluate the antimicrobial effectiveness of Zhenzhu Mingmu eye drops according to the requirements de-scribed in Chinese pharmacopoeia (2010 edition). Methods:Totally 7 batches of Zhenzhu Mingmu eye drops from 7 enterprises were evaluated. All the samples were tested according to the requirements described in Chinese pharmacopoeia, and the testing points of 6h and 24h were added. Results:As for bacteria, the reduction value of staphylococcus aureus in 7 days treated with Zhenzhu Mingmu eye drops from enterprise e was 0. 61g, and that in 14 days was 1. 01g. That in 7 days treated with the eye drops from the other enter-prises was all above 1. 01g, that in 14 days was above 3. 01g, and that in 14-28 days kept stable. As for fungi, the number was stable from the beginning with the treatment of the eye drops from the seven enterprises. Conclusion:Although the type and content of bacte-riostatic agent in domastic Zhenzhu Mingmu eye drops are the same, there is difference in the antimicrobial effectiveness of the product from different enterprise. The eye drops from one enterprise can't meet the requirements for type I product described in Chinese pharma-copoeia,and the others meet the requirements.

Preparation and bioactivity evaluation of streptavidin-tagged human interferon- inducible T cell alpha chemoattractant bifunctional fusion protein / 南方医科大学学报

<p><b>OBJECTIVE</b>To prepare streptavidin-tagged human interferon-inducible T cell alpha chemoattractant bifunctional fusion proteins (SA/hI-TAC) and evaluate its biological activity.</p><p><b>METHODS</b>pET24a-SA-hI-TAC/pET21a-hI-TAC-SA plasmids were constructed and expressed in BL21. SA-hI-TAC and hI-TAC-SA fusion proteins were purified by Ni-NTA affinity chromatography, refolded by dialysis and identified by Western blotting. The bifunctionality of the fusion proteins (biotin-binding function and hI-TAC activity) was analyzed by flow cytometry and lymphocyte chemotaxis experiment, respectively.</p><p><b>RESULTS</b>SA-hI-TAC/hI-TAC-SA fusion proteins were expressed at about 12% and 25% of the total bacterial protein, respectively. The two fusion proteins had a purity of about 85% and 90% after purification, and their purity reached 98% after purification with S-100 gel filtration chromatography. Both of the fusion proteins were efficiently immobilized on the surface of biotinylated mouse bladder cancer MB49 cells (91.3% for SA-hI-TAC and 98.8% for hI-TAC-SA). SA/hI-TAC induced lymphocyte chemotaxis in a dose-dependent manner, and hI-TAC-SA showed a stronger chemotactic effect than SA-hI-TAC.</p><p><b>CONCLUSIONS</b>We successfully obtained SA/hI-TAC bifunctional fusion proteins, which may potentially be used in local treatment of tumor and as a tumor vaccine.</p>

The smoking cessation effect on pulmonary function of chronic obstructive pulmonary disease and its mechanism / 安徽医科大学学报

Objective To explore the smoking cessation intervention impact on lung with genetic polymorphism of SOD3. The aim is to further reveal the importance of smoking cessation intervention on early COPD patients. Meth-ods 60 COPD patients with smoking cessation intervention and 40 COPD patients without intervention ( the control group) were enrolled in this study. Limosis peripheral blood was taken and whole blood corpuscle genomic DNA was extracted. The genetic polymorphism of SOD3 genes was determined by ligase detection reaction and polymerase chain reaction ( LDR-PCR) and serum SOD3 concentration was measured using ELISA. Lung function between the two groups before and after intervention were detected by microspirometry. Results ①The FEV1% and the FEV1/FVC% were increased after 3 and 6 months intervention in smoking cessation group(P0.05). ③The serum of SOD3 concentration of COPD intervention group and the control have no significance after intervention ( P>0.05 ) . ④ The serum of SOD3 concentration a-bout CC and CG/GG genotype in COPD intervention group have no significance after 3 and 6 months intervention ( P>0.05 ) . Conclusion Smoking cessation interventions for patients with COPD pulmonary function improves significance in short-term. But different SOD3 genotypes have no effect on lung function after intervention. Smoking cessation intervention has no effect on in serum SOD3 concentration of COPD patients, and has no relationship be-tween the expression of SOD3 genetype.

Expression of Periostin and VEGF in the tissue of esophageal carcinoma and their signifi-cance / 临床与实验病理学杂志

Purpose To investigate the expression of Periostin and VEGF protein in esophageal squamous cell carcinoma tissue and their significance. Methods Immunohistochemical staining (SP method) was used to detect Periostin and VEGF expression in 130 cases of esophageal squamous cell carcinoma and 130 cases of normal esophageal mucosa tissues. Results There was a significantly difference between esophageal squamous cell carcinoma and normal esophageal mucoma ( P<0. 05 ) . The expression of Periostin was related to the depth of invasion and the metastasis of lymph node (P<0. 05). A dramatic correlation has been found in the expression of VEGF to the degrees of differentiation, the depth of invasion and the metastasis of lymph node (P<0. 05). The expression of Peri-ostin was also positively correlated with the expression of VEGF (P<0. 05). Follow-up data was available in 66 cases with a range of 1 to 48 months. Kaplan-Meier survival curve showed survival rate of Periostin-positive group was significantly lower than that of Perios-tin-negative group (P<0. 05). The survival rate of VEGF-positive group was significantly lower than that of VEGF-negative group (P<0. 05). Conclusion The expression of Periostin has a close relationship with VEGF in the carcinogenesis, combined detection of both Periostin and VEGF can become an objective target to evaluate Potentials of invasion and lymph node metastasis of esophageal squamous cell carcinoma, which has a great significance to the judgment of prognosis in esophageal squamous cell carcinoma.

Community-based hypertension management for elderly patients / 中华全科医师杂志

Using the method of stratified random cluster sampling,8 996 elderly hypertensive patients in community were selected in the study.Patients entered the community-based hypertension program receiving stratified management,individualized treatment and health education.After 3 years of intervention,the disease awareness rate,treatment compliance rate and hypertensive control rate were increased from 68.30％,55.40％ and 38.60％ to 98.90％,86.70％ and 77.80％,respectively (P ＜0.05).The systolic and diastolic pressure,body mass index,triglyceride levels and other hypertensionrelated indicators were improved significantly,the number of individuals with obesity/overweight,smoking and drinking were decreased and those with regular exercise increased (all P ＜ 0.05).The results indicate that community-based comprehensive hypertension management is effective for hypertension control for elderly patients in community.

Survey on knowledge of home blood pressure monitoring in community physicians of Zhejiang province / 中华全科医师杂志

Objective To survey on knowledge of home blood pressure monitoring (HBPM) in community physicians of Zhejiang province.Methods One hundred and thirty eight community physicians from Xiacheng District of Hangzhou Municipality were assigned in intervention group (n =70) or control group (n =68).The knowledge of home blood pressure monitoring was surveyed by using the China HBPM questionnaire in both groups.Results Total 132 valid questionnaires were returned,including 70 from intervention group and 62 from control group.The results showed that 80.0％ (61/70) physicians in intervention group and 62.9％ in control group frequently suggested hypertensive patients to have HBPM in out-patient clinics (P ＜ 0.05).Physicians who correctly instructed patients to use upper arm electronic sphygmomanometer,to measure blood pressure in morning and night,to repeat 2-3 times each time,to record result 3 times,and to take ≥ 135/85 mmHg(1 mmHg =0.133 kPa) as criteria of hypertension in intervention and control groups were 67.1％ (47/70) versus 32.3％ (20/62),5.7％ (39/70) versus 29.0％ (18/62),92.9％ (65/70)versus 66.7％ (40/62),38.6％ (27/70)versus 6.4％ (4/62)and 57.1％ (40/70) versus 38.7％ (24/62),respectively,and the differences between two groups were all statistically significant (P ＜ 0.05).As for measuring frequency,92.9％ (65/70) physicians in intervention group and 67.7％ (42/62) in control group considered that blood pressure should be measured every day for poorly controlled patients ; 81.4％ (61/70) versus 14.5 ％ (9/62) considered that blood pressure should be measured every week for well-controlled patients; 87.1％ versus 35.5％ (22/62) considered that blood pressure should be measured every year at least for people with normal blood pressure; there were significantly differences between two groups (P ＜ 0.05).The community physicians generally considered that HBPM can be used to improve the awareness of hypertension for patients and to increase the blood pressure control rate in community.