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In response to the major national strategic needs of "Healthy China" and "Innovation-Driven Development", Sichuan University, as a pilot university of "Excellent Doctor Education and Training Plan-Top Innovative Medical Personnel Training", has been exploring the training strategies since 2012. On the basis of the international theory of "The Third Generation of Medical Education based on Health System", we have innovatively put forward the new era of "Med+" education theory based on research-oriented hospitals (with medical/research/translational facility) and the two-level training paradigm from "cultivating professionalism" to "notch up to top" by planting three cultures. We have also developed a competency training system of "Five Integrated Curricula and Five Teaching & Learning Strategies". We have shifted from "didactic teaching" to "formative learning", edifying excellent doctors with "professionalism culture". We have initiated two kinds of top-notch plans, constructed a "1+2+3" innovation and entrepreneurship education system, explored "transformative learning" to incubate compound top-notch personnel with "innovative culture", opened up a "school-hospital unified" administrative system, built a PDCA closed-loop of quality control supported by mobile technology, and recast the "quality culture" to ensure shifting from "cultivating professionalism" to "notch up to top".
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Lung cancer is the malignancy with the highest mortality rate worldwide. Malignant pleural effusion (MPE) caused by advanced lung cancer severely affects the quality of life and prognosis of patients. Tumor-associated genetic testing is the basis for making precise treatment decisions. There are some risks of tissue biopsy, and it is difficult to sample repeatedly. Due to its non-invasive and can reflect the full profile of tumor gene characteristics, liquid biopsy is increasingly used in the diagnosis and treatment of lung cancer. Because of the extremely low DNA level of circulating tumor, the sensitivity and specificity of liquid biopsy based on blood samples are limited. Tumor cells is enriched in MPE. The detection of cell-free DNA, extracellular vesicles and microRNA in MPE will be helpful to the diagnose, treatment and assess prognosis of patients with lung cancer. This review aims to discuss the research progress of liquid biopsy based on MPE in the diagnosis and treatment of lung cancer patients. .
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Objective:Our study aims to predict acute kidney injury (AKI) in acute myocardial infarction (AMI) by establishing a random forest model.Methods:By using the clinical database from affiliated Dongyang Hospital of Wenzhou Medical University, a total of 1 363 AMI cases were included. Then, 75% of participants were analyzed as training subsets and the remaining 25% were testing subsets. The CARET package in R was used to filter variables and build random forest. The prediction ability of established model was evaluated by specificity, sensitivity, accuracy, relative operating characteristic curve (ROC curve) in testing subsets. In addition, the performance of random forest was compared with other 3 commonly used machine learning algorithms (Artificial Neural Network, Naive Bayes, and Support Vector Machine).Results:In this study, 30 variables including the demographic information, risk factors of cardiovascular disease, vital signs at admission, laboratory tests were identified and used to establish our random forest prediction model. The area under the curve of the testing subsets ROC was 0.893. The specificity and sensitivity of prediction model was 0.791 and 0.866, respectively. And the first creatinine, first blood urea nitrogen, and D-dimer after admission, age, mechanical ventilation were the top-five factors in this model. After comparing various machine learning algorithms, random forest model had a better performance.Conclusion:The random forest model would be used to predict the occurrence of AMI with AKI.
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Objective:To analyze the expression and clinical significance of human papillomavirus (HPV) 16/18E6 in lung adenocarcinoma tissues and adjacent specimens.Methods:Sixty patients with pathologically confirmed lung adenocarcinoma treated with surgical resection were included in the study. To determine the expression of HPV16/18 E6, carcinoma specimens and adjacent tissues were collected and detected using immunohistochemistry. The χ 2 test was used to analyze the relationship between HPV16/18 E6 expression and the clinical features of lung adenocarcinoma. Using the cell transfection technique, the A549 lung adenocarcinoma cell line with high HPV16/18E6 expression was established, and the differences in cisplatin resistance between the E6, control (Ctl), and A549 groups were compared using the MTT assay. Results:Of the 60 cases, 29 (48%) were male and 31 (52%) were female, with an average age of (55.5±2.4) years. In lung adenocarcinoma specimens, the positive expression rate of HPV16/18 E6 was 48% (29/60), which was higher than that observed in adjacent tissues (18%; 11/60), demonstrating a statistically significant difference (P<0.05 ); the differences between the positive expression rate of HPV16/18E6 and TNM stage, age, gender, smoking, and tumor size were not statistically significant. In the E6 A549 lung adenocarcinoma group, cisplatin resistance was higher than that in the Ctl and A549 groups, demonstrating a statistically significant difference (P<0.05 ). Finally, the half-maximal inhibitory concentration (IC 50) of cisplatin in E6 (111 mg/L)was higher than that in Ctl(75 mg/L) and A549(79 mg/L) groups, demonstrating a statistically significant difference (P<0.05 ).Conclusions:High-risk HPV16/18E6 has a higher positive expression rate in lung adenocarcinoma, independent of TNM stage, age, gender, smoking, and tumor size, and may influence resistance to chemotherapy drugs.
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Non-alcoholic fatty liver disease (NAFLD) is characterized by increased fat depositions in the liver while the patients do not have drinking history.NAFLD has a prevalence of 10％ ～40％ in global,25％ ～26％ in Western populations.From 2004 to 2013,the numbers of new patients on the waitlist who had NASH increased by 170％ in America.The prevalence of NAFLD in China is 20％.With the decrease of HBV and HCV and the increase of diabetes mellitus type 2 and obesity,NAFLD will become the most common chronic liver disease in China over the next 20 years.NAFLD related end-stage liver disease will become the most common indication of liver transplantation.In this paper,the epidemiological features,pathogenesis,indication and prognosis of liver transplantation are reviewed.
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BACKGROUND@#Mortality of lung cancer can be decreased by early screening effectively. However, consistent and proficient standards & methods have not been established in China. This study was based on pulmonary nodules/lung cancer comprehensive management platform established by West China Hospital, Sichuan University. Early screening of pulmonary nodules was integrated into standard healthcare of lung cancer system, aiming to improve survivals of lung cancer patients.@*METHODS@#Three cohorts were established: healthy populations, pulmonary nodules cohort and lung cancer patients cohort, and related clinical data will be collected and analyzed. Preliminary plan includes verifying effect of pulmonary nodules screening module.@*RESULTS@#Pulmonary nodules screening was performed in 2,836 employers (>40 years old) of West China Hospital. Lung cancers were diagnosed in 66 participants, all receiving surgery to remove the lesions. 65 of them were with early stage diseases, 1 with lung cancer and brain metastasis.@*CONCLUSIONS@#Proficient screening, follow-up and healthcare can be achieved via pulmonary nodules/lung cancer comprehensive management mode, which will be extended all over west China region in future.
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Objective@#To evaluate the effect of dexmedetomidine on renal fibrosis in a mouse model of renal ischemia-reperfusion (I/R) and the role of serine-threonine kinase (Akt).@*Methods@#Sixty male C57BL/6 mice, aged 8 weeks, weighing 20-25 g, were divided into 5 groups (n=12 each) using a random number table method: sham operation group (S group), renal I/R group (I/R group), renal I/R plus dexmedetomidine group (I/R + D group), renal I/R plus dexmedetomidine plus Akt agonist SC79 group (I/R + D + SC group), and renal I/R plus dexmedetomidine plus normal saline group (I/R+ D+ NS group). Renal I/R injury model was established by clamping the bilateral renal pedicle for 30 min followed by reperfusion.Dexmedetomidine was intraperitoneally injected at 30 min before surgery in I/R+ D, I/R+ D+ SC and I/R+ D+ NS groups.SC79 was intraperitoneally injected as a bolus of 0.04 mg/kg at 1 min of reperfusion, followed by an intraperitoneal injection of the same dose every 24 h until day 7.The serum blood urea nitrogen (BUN) and Scr concentrations were detected at 24 h of reperfusion.Renal tissues were taken, and the damage to the renal tubules was scored.Renal tissues were removed at 14 days of reperfusion to detect the degree of renal fibrosis and expression of collagen 1 (COL1), fibronectin (FN), and α-smooth actin (α-SMA) (by immunofluorescence and Western blot). The expression of phosphorylated Akt (p-Akt) in renal tissues was determined by Western blot at 24 h and 14 day of reperfusion.@*Results@#Compared with group S, the serum BUN and Scr concentrations, renal tubule damage score and degree of renal fibrosis were significantly increased, and the expression of COL1, FN, α-SMA and p-Akt was up-regulated in group I/R (P<0.05). Compared with I/R group, the serum BUN and Scr concentrations, renal tubular damage score and degree of renal fibrosis were significantly decreased, and the expression of COL1, FN, α-SMA and p-Akt was down-regulated in I/R+ D and I/R+ D+ NS groups (P<0.05). Compared with I/R+ D group, the serum BUN and Scr concentrations, renal tubule damage score and degree of renal fibrosis were significantly increased , and the expression of COL1, FN, α-SMA and p-Akt was up-regulated in I/R+ D+ SC group (P<0.05).@*Conclusion@#Dexmedetomidine can reduce the degree of renal fibrosis in a mouse model of renal I/R and the mechanism is related to inhibiting activation of Akt.
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Ischemia-reperfusion injury is one of the main causes of complications related to liver transplantation, hepatectomy, trauma and hemorrhagic shock. The cells of ischemia and hypoxic injury release of injury-related molecular patterns, lead to the activation of immune cells and cytokine, which further aggravates the inflammatory response and enlarges the injury. It’s indicated that injury-related molecular patterns, liver resident immune cells and cytokines play a key role in promoting inflammation and liver ischemia-reperfusion injury. However, recent studies suggested that the ischemia cells and cytokines played acomplex role in this process. Relevant progresses were reviewed in this article.
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Ischemia-reperfusion injury is one of the main causes of complications related to liver transplantation, hepatectomy, trauma and hemorrhagic shock. The cells of ischemia and hypoxic injury release of injury-related molecular patterns, lead to the activation of immune cells and cytokine, which further aggravates the inflammatory response and enlarges the injury. It ' s indicated that injury-related molecular patterns, liver resident immune cells and cytokines play a key role in promoting inflammation and liver ischemia-reperfusion injury. However, recent studies suggested that the ischemia cells and cytokines played acomplex role in this process. Relevant progresses were reviewed in this article.
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Objective To evaluate the effect of dexmedetomidine on renal fibrosis in a mouse model of renal ischemia-reperfusion (I/R) and the role of serine-threonine kinase (Akt).Methods Sixty male C57BL/6 mice,aged 8 weeks,weighing 20-25 g,were divided into 5 groups (n=12 each) using a random number table method:sham operation group (S group),renal I/R group (I/R group),renal I/R plus dexmedetomidine group (I/R + D group),renal I/R plus dexmedetomidine plus Akt agonist SC79 group (I/R + D + SC group),and renal I/R plus dexmedetomidine plus normal saline group (I/R+D+NS group).Renal I/R injury model was established by clamping the bilateral renal pedicle for 30 min followed by reperfusion.Dexmedetomidine was intraperitoneally injected at 30 rmin before surgery in I/R+D,I/R+D+SC and I/R+D+NS groups.SC79 was intraperitoneally injected as a bolus of 0.04 mg/kg at 1 min of reperfusion,followed by an intraperitoneal injection of the same dose every 24 h until day 7.The serum blood urea nitrogen (BUN) and Scr concentrations were detected at 24 h of reperfusion.Renal tissues were taken,and the damage to the renal tubules was scored.Renal tissues were removed at 14 days of reperfusion to detect the degree of renal fibrosis and expression of collagen 1 (COL1),fibronectin (FN),and α-smooth actin (α-SMA) (by immunofluorescence and Western blot).The expression of phosphorylated Akt (p-Akt) in renal tissues was determined by Western blot at 24 h and 14 day of reperfusion.Results Compared with group S,the serum BUN and Scr concentrations,renal tubule damage score and degree of renal fibrosis were significantly increased,and the expression of COL1,FN,α-SMA and p-Akt was up-regulated in group I/R (P＜0.05).Compared with I/R group,the serum BUN and Scr concentrations,renal tubular damage score and degree of renal fibrosis were significantly decreased,and the expression of COL1,FN,α-SMA and pAkt was down-regulated in I/R+D and I/R+D+NS groups (P＜0.05).Compared with I/R+D group,the serum BUN and Scr concentrations,renal tubule damage score and degree of renal fibrosis were significantly increased,and the expression of COL1,FN,α-SMA and p-Akt was up-regulated in I/R+D+SC group (P＜0.05).Conclusion Dexmedetomidine can reduce the degree of renal fibrosis in a mouse model of renal I/R and the mechanism is related to inhibiting activation of Akt.
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In order to strengthen the cultivation of core competence of undergraduate clinical medi-cine interns and improve the quality and efficiency of practice, Dongyang People's Hospital has constructed an integrated training system of practice teaching with objectives, contents, methods and assessment. The system is guided by "actual nursing capacity" and "medical professional knowledge and skills". By setting goals, improving teaching content, improving teaching methods, and strengthening assessment and evalua-tion, the quality of interns' practice has been improved, and the excellent rate of interns' medical history collection and assessment and skill operation assessment has also been improved. According to assessment tests of theory and technical operation, and the passing rate of examination of doctor qualification of the new employees in the past 2 years, the results shows that the scores of new employees who used to practice in the hospital are significantly higher than those in other hospitals.
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Objective To analyze the effect of air quality index (AQI) on the incidence of tuberculosis (TB) in Beijing,and to provide evidence for setting up a better program regarding prevention and control of tuberculosis.Methods Generalized additive model (GAM) was used to analyze the association between AQI and the incidence of tuberculosis in Beijing,from January 1,2014 to November 9,2016.Confounding factors as meteorological conditions and time trends were under control.Results In Beijing,a total of 14 533 TB cases with definite dates of onset were collected during the study period,with 36 children excluded from the study.Finally,14 497 cases were included in the study,including 9 513 men and 4 984 women,with 11 290 adults (15-59 years old) and 3 207 elderly (≥60 years old).Data from the optimal single-day lag effect of GAM showed that,with every 1 0 increase of AQI,the percent of increase on the onsets of overall,male,female and adult;tuberculosis cases were 0.85％ (95％CI:0.26％-1.44％),0.83％ (95％CI:0.24％-1.42％),0.93％ (95％CI:0.24％-1.62％) and 0.88％ (95％CI:0.29％-1.46％),respectively.The optimal lag time of the single-day effects were 15 days (lagl5),but 16 days (lag16) for male.The optimal cumulative lag effect showed that with every 10 AQI increase,the percent of increase on the onsets of overall,male,female and adult tuberculosis cases were 1.92％ (95％CI:0.23％-3.16％),1.94％ (95％CI:0.15％-3.72％),2.04％ (95％CI:0.10％-3.97％) and 2.00％ (95％CI:0.30％-3.69％),respectively,with the optimal lag time of cumulative delayed effects as 17 days (lag0_17),18 days (lag0_18),16 days (lag0_16) and 17 days (lag0_17),respectively.However,there were no statistical significances noticed in the elderly cases.Conclusion There was a positive correlation between AQI and the number of TB cases in Beijing,and the effects of AQI on the number of TB cases in different genders and age groups were different.
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Objective To analyze the effect of air quality index (AQI) on the incidence of tuberculosis (TB) in Beijing,and to provide evidence for setting up a better program regarding prevention and control of tuberculosis.Methods Generalized additive model (GAM) was used to analyze the association between AQI and the incidence of tuberculosis in Beijing,from January 1,2014 to November 9,2016.Confounding factors as meteorological conditions and time trends were under control.Results In Beijing,a total of 14 533 TB cases with definite dates of onset were collected during the study period,with 36 children excluded from the study.Finally,14 497 cases were included in the study,including 9 513 men and 4 984 women,with 11 290 adults (15-59 years old) and 3 207 elderly (≥60 years old).Data from the optimal single-day lag effect of GAM showed that,with every 1 0 increase of AQI,the percent of increase on the onsets of overall,male,female and adult;tuberculosis cases were 0.85％ (95％CI:0.26％-1.44％),0.83％ (95％CI:0.24％-1.42％),0.93％ (95％CI:0.24％-1.62％) and 0.88％ (95％CI:0.29％-1.46％),respectively.The optimal lag time of the single-day effects were 15 days (lagl5),but 16 days (lag16) for male.The optimal cumulative lag effect showed that with every 10 AQI increase,the percent of increase on the onsets of overall,male,female and adult tuberculosis cases were 1.92％ (95％CI:0.23％-3.16％),1.94％ (95％CI:0.15％-3.72％),2.04％ (95％CI:0.10％-3.97％) and 2.00％ (95％CI:0.30％-3.69％),respectively,with the optimal lag time of cumulative delayed effects as 17 days (lag0_17),18 days (lag0_18),16 days (lag0_16) and 17 days (lag0_17),respectively.However,there were no statistical significances noticed in the elderly cases.Conclusion There was a positive correlation between AQI and the number of TB cases in Beijing,and the effects of AQI on the number of TB cases in different genders and age groups were different.
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With the continuous development of endovascular surgery, thoracic endovascular aortic repair (TEVAR) has gradually replaced traditional open surgery and has become the preferred treatment strategy for Stanford type B aortic dissection. However, the disadvantage of the short proximal landing zone greatly limited the indication of TEVAR surgery and affected the prognosis. In recent years, many strategies such as hybrid surgery, in vitro fenestrated and branched aortic endo-graft, chimney technique, in-situ fenestration technique, etc., have been developed, which greatly broadens the TEVAR indication and improved the prognosis.
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Objective To observe the effect of aerobics exercise on myocardial fibrosis after acute myocardial infarction (AMI) in rat.Methods Twenty-four AMI Sprague Dawley (SD) rats were randomly assigned to sham-operated group (Sham),AMI group and aerobics exercise treatment group (ET).Except Sham,other groups of rats were underwent anterior wall myocardial infarction.After ten weeks,the myocardial mRNA level of connective tissue growth factor (CTGF),collagen Ⅰ (COL1 a1),collagen Ⅲ (COL3a1) detected by real time-quantitative polymerase chain reaction (PCR) analysis and myocardial collagen volume fraction (CVF) was determined on Masson stained sections.Results Campared to Sham-operated group,AMI group the level of CTGF,COL1a1,COL3a1,and CVF were increased (P ＜0.05,P ＜ 0.01).Campared to AMI and ET groups,the levels of CTGF,COL1a1,COL3a1,and CVF were decreased (P ＜ 0.05,P ＜ 0.01).Conclusions Aerobics exercise can reduced the myocardial fibrosis after AMI in rat.
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We discussed the function of four pairs of genes in the toxin-antitoxin system of Mycobacterium tuberculosis,providing theoretical foundation and scientific basis for studying the transmission mechanism of Mycobacterium tuberculosis.Four pairs of genes which belong to VapBC family,including four VapC genes (Rv1720c,Rv2103c,Rv2494,Rv3408) and four VapB genes (Rv1721c,Rv2104c,Rv2493,Rv3407) were chosen.We constructed a serial of arabinose-induced hybrid plasmid system in Escherichia coli and a serial of acetamide-induced hybrid plasmid system in Mycobacterium smegmatis respectively,in order to observe the potential inhibition effect of VapC and the release inhibition of homologous VapB.Results showed that only one toxin gene(Rv2103c) showed the function of bacteriostasis in both E.coli and M.smegmatis and the homologous antitoxin gene(Rv2104c) could release the inhibition of growth.We built the inducible systems of VapBC family in both E.coli and M.smegmatis respectively and found only a pair of toxin and antitoxin genes(Rv2103c,Rv2104c) had the function of inhibition and release for the growth of bacteria.And two pairs of toxin genes(Rv1720c,Rv2494) did not have the function of inhibition for the growth of both E.coli and M.smegmatis.Whereas,another toxin gene VapC47(Rv3408) also did not have the bacteriostastic activity,only this result was not consistent with the existing literature.We speculated that the reason for this kind of difference may be the different inducible systems we used.Cause the other three results were consistent with all existing literature and the doubtful result also appeared in other reports,so our protocol could be confirmed as reliable,and we would use it to build inducible systems and make further functional identification of certain toxin and antitoxin genes that we are interested in.
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Objective To investigate the value of echocardiography for assessing the right ventricular function before and af ter treatment in the patients with pulmonary embolism.Methods Ninety-six patients with pulmonary embolism in our hospital from June 2014 to December 2015 were selected as the research subjects and divided into low-risk group,intermediate-risk group and high-risk group according to the disease severity.The echocardiographic examination was performed before and after treatment in all cases.Results The pulmonary artery systolic pressure after treatment in the low-risk group was lower than that before treatment (P＜0.05).The transverse diameter of right ventricle,transverse diameter of right ventricle and pulmonary artery systolic pressure after treatment in the intermediate-risk group and high-risk group were lower than those before treatment (P＜0.05).The Tei index after treatment in the low-risk group,intermediate-risk group and high-risk group was lower than that before treatment (P＜ 0.05).The right ventricle ejection fraction (RVEF),right ventricular end-systolic volume (RVESV) and right ventricular end-dias tolic volume (RVEDV) in the low-risk group had no statistically significant difference between before and after treatment.RVEF after treatment in the intermediate-risk group and high-risk group was higher than that before treatment(P＜0.05),while RVESV and RVEDV after treatment were lower than those before treatment (P＜0.05).Conclusion Echocardiography can objectively re flect the change situation of right heart function before and after treatment in the patients with pulmonary embolism,and can be used as an evaluation method for the effect of pulmonary embolism treatment.
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Objective To investigate the influence of Trisialoganglioside-GTlb combined with Edaravone Injection on clinical effect and serum related indicators in patients with acute cerebral infarction.Methods A total of 126 cases of patients with acute cerebral infarction in our hospital from October 2010 to May 2016 were selected and divided into observation group and control group,63 cases in each group.Patients in the control group were treated with regular treatment and Edaravone Injection,and patients in the observation group were treated with regular treatment,Edaravone Injection and Trisialoganglioside-GTlb.The clinical effect,NIHSS scores,Barthel index scores,serum level of neuron specific enolase (NSE),S100β protein,superoxyde dismutase (SOD),advanced oxidation protein products (AOPP) and malondiadehyde (MDA) were compared.Results The total effective rate of the observation group (90.48％) was significantly higher than that of the control group (76.19％),the difference between the two groups was statistically significant (P ＜ 0.05).After two weeks of treatment,two groups of NIHSS and Barthel index scores were significantly lower than before treatment,the difference was statistically significant (P ＜ 0.05);and the NIHSS and Barthel index scores of observation group were significantly lower than that of control group,the difference was statistically significant (P ＜ 0.05).NIHSS scores,Barthel index scores of the observation group were significantly better than that of the control group (P ＜ 0.05);The serum level of NSE,S100,AOPP,MDA of two groups after treatment were significantly lower than that before treatment,the difference was statistically significant (P ＜ 0.05);and the above indexes of the observation group was significantly lower than the control group,the difference was statistically significant (P ＜ 0.05);SOD levels of two groups were significantly increased than before treatment,the difference was statistically significant (P ＜ 0.05);and the SOD levels of observation group was significantly higher than that of control group,the difference was statistically significant (P ＜ 0.05).Conclusion Trisialoganglioside-GT1b can synergy improve the clinical effect of Edaravone Injection in patients with acute cerebral infarction,and be good to recovery the neurologic function and ability of daily living,and these may be related to the change of the serum level of NSE,S100β protein,SOD,AOPP and MDA.
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AIM To study the influence of Huangqi Powder (Puerariae lobatae Radix,Astragali Radix,Mori Cortex) on femur and tibia in rats with glucocorticoid-induced osteoporosis (GIOP).METHODS Thirty one-month-old male SD rats were divided into three groups by randomized block design,which were control group (normal saline),prednisone group (3.5 mg/kg prednisone acetate),Huangqi Powder group (clinical adult dosage).Experimental test was maintained for one hundred and twenty days.Double fluorochrome labeling with calcein was performed before necropsy;bone resorption and bone formation index were determined by using blood serum;the femur structural and material mechanics were analyzed by using bone biomechanics method.The cancellous bone of proximal tibial and the cortical bone of tibial shaft static parameter and dynamic parameter were analyzed by bone histomorphometry method.RESULTS Huangqi Powder had no obvious improving effects on bone biomechanics and bone static parameter,but could increas the area,width and number of the proximal tibia bone trabecular.Mark perimeter percentage and mineralization rate of deposition could be increased.CONCLUSION Huangqi Powder can significantly increase proximal tibia cancellous bone mass and enhance bone trabecula structure of glucocorticoid-induced osteoporosis rats.
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Objective:To investigate reperfusion and secondary preventive drug therapy for ST-segment elevation myocardial infarction (STEMI) patients in provincial, city and county levels hospitals of China. Methods:A total of 18,967 STEMI patients within 7 days of symptom onset from 2013-01-01 to 2014-09-30 were enrolled by China acute myocardial infarction (CAMI) registry study group from 107 hospitals covering 31 provinces/autonomous regions, cities and counties in China;223 patients were excluded for key information missing. Demographic data, reperfusion as primary percutaneous coronary intervention (pPCI), thrombolytic therapy (TT) and secondary preventive drug therapy as aspirin, P2Y12 inhibitors, statins,β-blockers, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor antagonist (ARB) were analyzed and compared among 3 levels of hospitals. Results:There were 9,885/18,744 (52.7%) patients received reperfusion including 8,038 (42.9%) pPCI and 1,847 (9.9%) TT. Reperfusion rate in provincial hospital (61.8%, 4041/6537) was higher than city hospital (49.1%, 4728/9625) and county hospital (43.2%, 1116/2582), P Conclusion:In CAMI Registry, 70.8%arrived hospital within12 h of symptom onset had been treated by reperfusion therapy in China; the reperfusion rate in county hospital was obviously lower. The secondary preventive drug therapy condition was similar among 3 levels of hospitals.