Cardiac rehabilitation referral service (review) / 中国康复理论与实践

@#Objective To summarize the cardiac rehabilitation referral system.Methods The literatures about the construction of cardiac rehabilitation referral systems were retrieved from the databases of CNKI, Wanfang Date, PubMed and Web of Science, and cardiac rehabilitation websites.Results For some foreign countries, the referrals of cardiac rehabilitation mainly based on electronic medical record management system, internet platform, chronic care model, and hospitals and communities. For China, referral system is trying to build based on the medical conjoined system.Conclusion Referral, as the first step, plays an important role in participating in cardiac rehabilitation for patients. The cardiac rehabilitation referral system needs to be improved in China, referred the ways of developed countries.

Voiding Dysfunction in Old Male Rats Associated With Enlarged Prostate and Irregular Afferent-Triggered Reflex Responses / 대한배뇨장애요실금학회지

Purpose@#This study was conducted to evaluate the hypothesis that an enlarged prostate in old rats may lead to complications associated with voiding dysfunction involving ionotropic P2X2/3-type purinergic receptors @*Methods@#Intact animals were divided into male young (MYR; 8–10 weeks old) and male old (MOR; 20 months old) rats. The animals underwent simultaneous detrusor electromyography (EMG) and suprapubic cystometry (CMG) under urethane anesthesia. Immunofluorescence techniques were used to evaluate prostatic autonomic innervation and P2X3R expression in bladder urothelial cells. The functional role of P2X3R was characterized by intramuscular application of AF-353, a selective P2X2/3R antagonist. @*Results@#The prostate index significantly increased in MOR, suggestive of an enlarged prostate affecting micturition patterns. Significant EMG and CMG differences were found between MYR and MOR. Higher immunoreactivity for P2X2/3R in the urothelial layer and for prostatic neurofilaments was seen in MOR. Systemic inhibition of P2X2/3R had minimal effects on MYR responsiveness, but improved voiding function in MOR with a marked decrease of intravesical pressure and bladder contractile responses. @*Conclusions@#The data support the hypothesis that an enlarged prostate in MOR may contribute to voiding dysfunction involving activation of P2X2/3R, which enhances a prostate-bladder reflex. This reflex may increase bladder afferent transmission and activation of increased prostate innervation, leading to voiding dysfunction.

Influences of Oral Undenatured Collagen Type Ⅱ on Knee Joint Range of Motion in Patients with Knee Osteoarthritis / 医用生物力学

Objective To evaluate the effects of oral undenatured collagen type Ⅱ on rehabilitation of knee osteoarthritis. Methods Sixteen patients with levelⅠand Ⅱ knee osteoarthritis (KOA) were recruited in this study. The WOMAC questionnaire was used to measure the symptoms of knee joint in patients. The KneeKG 3D evaluation system was used to measure the kinematics characteristics of the knee joints. The pair t-test was applied to analyze the differences in knee kinematics after taking undenatured collagen type Ⅱ for 3 months. Results After taking undenatured collagen type Ⅱ, the patient’s feeling of knee joint pain, stiffness, and the difficulty of daily life was reduced. In addition, the knee flexion angle increased from 51.8°±15.2° to 58.4°±10.7° (P<0.05), and the knee varus angle decreased to 2.1°±4.8°. The improvement rate of knee varus was 82%. Conclusions Taking undenatured collagen type Ⅱ for 3 months could play a role in rehabilitation for patients with early KOA. The knee range of motion was close to the level of healthy elderly people, thus improving the symptoms of knee varus.

1H-MRS detection of metabolites in posterior cingulate gyrus of Parkinson disease with cognitive impairment patients / 中国医学影像技术

Objective To investigate the value of 1H-MRS technology combined with linear combination model (LCmodel) software in diagnosis of Parkinson disease (PD) cognitive impairment.Methods Thirty-five PD patients (PD group) and 22 matched healthy subjects (control group) were collected.Patients in PD group were divided into PDN and PDMCI subgroups according to whether having cognitive impairment or not.The concentration of metabolites of posterior cingulate gyrus (PCG)was applied with 1H-MRS technology combined with LCmodel software.The differences of metabolites were compared between the two groups,and the correlations between metabolites level and cognitive status were analyzed.Results The absolute concentrations of metabolites in PDN subgroup were not significantly different from those in control group (all P＞0.05).The absolute concentrations of total creatine (tCr),N-acetyl aspartate (NAA),myo-inositol (mI) and glycerophosphocholine+ phosphocholine (tCho) in PDMCI subgroup were lower than those in control group (all P＜0.05).The absolute concentration of tCr in PDMCI subgroup was lower than that in PDN subgroup (P＜0.05).There was positive correlation among the absolute concentration of tCr (r=0.444,P=0.01),glutathione (GSH;r=0.393,P=0.024) and MMSE scores,as well as among the absolute concentration of tCr (r=0.367,P=0.035),GSH (r=0.376,P=0.031),tCho (r=0.375,P=0.031) and MoCA scores.Conclusion 1 H-MRS technology combined with LCmodel software can quantitatively analyze the changes of metabolites in PCG,therefore being helpful to evaluating PD cognitive impairment.

Risk factors for female pelvic organ prolapse and urinary incontinence / 中南大学学报(医学版)

To explore the risk factors for and the pathogenic mechanisms of pelvic organ prolapse and urinary incontinence.
 Methods: A total of 2 668 females who completed pelvic floor functional detection from July 2014 to October 2015 in the Physical Examination Center of the Third Xiangya Hospital of Central South University. The patients were divide into 4 groups: an urinary incontinence group, an organ prolapse group, an organ prolapse with urinary incontinence group, and a normal group. We compared the age, BMI, menopause, gravidity and parity, delivery pattern, the coordination of pelvic floor and abdominal muscles among the 4 groups.
 Results: There were statistical differences in age and BMI values among the 4 groups (P0.05). In the mode of delivery, there were statistical difference among the normal group and the other 3 groups (P0.05). Among the 4 groups, the normal group was the best one in coordination between pelvic floor and abdominal muscles, following by the organ prolapse group, the pelvic organ prolapse group and the urinary incontinence group.
 Conclusion: Aging, menopause, number of pregnancies and delivery, BMI, and mode of delivery all affect the occurrence of pelvic organ prolapse and urinary incontinence. Females with urinary incontinence or organ prolapse are not good in coordination between the pelvic floor and abdominal muscles.

Efficacy of physical therapy for female sexual dysfunction / 中南大学学报(医学版)

To investigate the efficacy of manipulation combined with electrical stimulation and biofeedback on the treatment of female sexual dysfunction. 
 Methods: Seventy-two female patients with sexual dysfunction were recruited from the Third Xiangya Hospital of Central South University from January 2014 to December 2015. Subjects were randomly divided into three groups (A, B, and C). Patients in group A and group B received manipulation therapy and electrical stimulation biofeedback therapy, respectively, while patients in group C received manipulation combined with biofeedback electrical stimulation treatment for 30 days. The strength and fatigue degree of the type I and the type II muscle fiber of the pelvic muscles in all groups were evaluated before and one month after the treatment for further comparison. Questionnaire survey was used to investigate the frequency of sexual life and orgasm before and after treatment.
 Results: The strength and fatigue degree of patients in group C was significantly better than those of the other two groups (P<0.05).
 Conclusion: Manipulation therapy combined with electrical stimulation and biofeedback can effectively enhance the recovery of sexual dysfunction in postpartum women and improve the quality of sexual life for patients with postpartum sexual dysfunction. It therefore can be spread in clinical practice.

Study on the invasion of breast cancer stem cell loading miR30a in nude mice / 中华内分泌外科杂志

Objective To explore changes of invasion capability of cancer stem cells loading miR30a derived from enlarging and proliferative axillary lymph node of patients with breast cancer in nude mice.Methods MiR30a oligonucleotide fragment loaded by adenovirus vector was transfected into breast cancer stem cells isolated from enlarging and proliferative axillary lymphnodes of patients with breast cancer,MDA-MB-231 cell lines as the control.The cancer cells were injected into axillary subcutaneous fat of the nude mice for several weeks,and then,the expression of Vimentin or N-Cadherin in tumor tissues of each group of the mice was determined by immunohistochemistry and western blot.Results The average transfection rate of cancer stem cells loaded by miR30a was 62.5％,while it was 78.2％ for MDA-MB-231.The tumor volume was larger in adenovirus vector groups or in control groups of nude mice than in experimental groups induced by mir30a.Vimentin or N-cadherin in tumor tissues was significantly downexpressed in experimental groups with mir30a ((13.1±1.7)％,(15.3％±2.1)％)compared with that in adenovirus vector groups or in control groups((21.1±1.4)％,(25.3±1.6)％,P＜0.05),respectively.The difference between adenovirus vector groups and in control groups had no significant difference (P＞0.05).After inoculated for 6 weeks,except the subcutaneous plantations,no distant metastasis in nude mice was found.MDA-MB-231 cell lines groups had similar results.Conclusion The proliferative and invasive capability of cancer stem cells can be inhibited by miR30a,suggesting a new therapy for breast cancer.

Pelvic floor function in women with stress urinary incontinence / 中华物理医学与康复杂志

Objective To evaluate any changes in overall pelvic floor function among women with stress urinary incontinence ( SUI) . Methods Twenty-five female SUI patients were recruited as the SUI group and twenty-three healthy female counterparts were selected as the control group. Pelvic organ prolapse quantifica-tion ( POP-Q) was performed with both groups. Ultrasonography was used to measure the position of the bladder neck, the posterior angle of the urethra, the urethra′s inclination angle and the size of the diaphragmatic hiatus for both groups at rest, during the Valsalva maneuver, as well as during the transition from resting to the Valsal-va maneuver. The strength and fatigue of type I and type II fibers in the pelvic muscles were evaluated electro-physiologically, and anorectal manometry was also performed with both groups. The significance of any relation-ship between these measurements and SUI was determined using multivariate logistic regression analysis. Results Eleven members of the SUI group showed phase I pelvic organ prolapse. Twelve were in phase II and 2 were in phase III. All of those incidences were significantly different from the control group. There were signifi-cant differences between the two groups in the average bladder neck position, urethral inclination angle, posterior urethra angle, descending distance of the bladder neck, and urethral rotation angle during the Valsalva maneu-ver. In the transition from resting to the Valsalva maneuver, significant differences were found only in the dis-tance of the bladder neck′s descent and the rotation angle of the urethra. The severity of pelvic organ prolapse, the descending distance of the bladder neck and the urethral rotation angle, as well as the bladder neck position and urethral angle during the Valsalva maneuver were the major risk factors associated with female SUI, and the correlation was statistically significant. Conclusion The greater the mobility of the bladder neck and urethra in female SUI patients, the more serious the prolapse. Prolapse, bladder neck mobility and urethral support all af-fect the overall functionality of the pelvic floor.

Research progress of microRNA and its effect on transplantation tolerance / 国际外科学杂志

microRNAs combined with specific mRNAs are 19-25 nucleotide-long small-molecule RNA that mediate sequence-dependent post-transcriptional gene expression.Accumulating evidences indicate that microRNAs target critical signal transduction molecules of immune system,and involve in regulation of immune tolerance.Recently,microRNAs have been a potential biomarker,and are widely useded in diagnosis and prognosis of cancer,infectious disease,autoimmune disease,and transplantation.If we can further identify regulatory mechanism of microRNAs and their target genes,which makes possible the successful induction of immune tolerance and exert a huge push on organ transplantation.

Therapeutic effect of extracorporeal shock wave combined with orthopaedic insole on plantar fasciitis / 中南大学学报(医学版)

Objective: To observe the therapeutic effect of extracorporeal shock wave combined with orthopaedic insole on plantar fasciitis. Methods: A total of 153 plantar with plantar fasciitis were randomly divided into a combined group (n=51), an extracorporeal shock wave group (n=53) and an orthopaedic group (n=49). The combined group received treatment of both extracorporeal shock wave and orthopaedic insole while the extracorporeal shock wave or the orthopaedic group only received the treatment of extracorporeal shock wave or orthopaedic insole. The therapeutic parameters such as visual analogue scale (VAS) scores, continued walking time and thickness of the plantar fascia were monitored before and atf er the treatment for 2 weeks, 1 month and 3 months, respectively. Results: The VAS scores in the 3 groups were all reduced after the treatment compared with the corresponding scores before the therapy (P<0.05). hTe VAS score in the extracorporeal shock wave group was greater than that in the orthopedic group atfer the treatment for 2 weeks. hTe VAS score in the combined group was smaller than that in the orthopedic group atfer the treatment for 2 weeks and 3 months (P<0.05). hTe VAS scores in the orthopedic group and the combined group were smaller than those in the extracorporeal shock wave group after the treatment for 1 month or 3 months (P<0.05). The continued walking time and thickness of the plantar fascia was improved after the treatment (P<0.05). hTe cure rate and total effective rate in the combination group were obviously greater than those in the two other groups. hTe cure rate in the orthopedic group was greater than that in the extracorporeal shock wave group (P<0.05). Conclusion: Extracorporeal shock wave combined with orthopaedic insole therapy is an effective method to treat plantar fasciitis. It is recommended to spread in clinic.

Effect of home-based rehabilitation on functional independence measures in patients with heroin-associated encephalopathy / 中南大学学报(医学版)

OBJECTIVE@#To investigate effect of home-based rehabilitation on performance in a functional independence measure (FIM) in patients with heroin-associated encephalopathy (HE).@*METHODS@#A total of 56 patients with HE were divided into a family rehabilitation management group (treatment group, n=30) and a control group (n=26). The patients in the home-based rehabilitation management group were put on a rehabilitation program and then followed-up; those in the control group were only followed-up. Both groups were evaluated with FIM at discharge and 3, 6, and 12 months after discharge.@*RESULTS@#FIM in the treatment group was remarkably better than that in the control group at 3, 6, 12 months after discharge (79.5±16.3 vs 62.3± 14.6, 88.2±20.0 vs 65.5±13.4, 99.6±21.2 vs 68.7±15.8; all P< 0.05). In the rehabilitation group, FIM of the patients receiving 3, 6, and 12 months of rehabilitation therapy was significantly higher than that at the time of discharge (P<0.01).@*CONCLUSION@#Home-based rehabilitation management has significant effect on the FIM in patients with HE.

Clinical observation of long-term combined drug therapy for benign prostatic hyperplasia / 中华老年医学杂志

ObjectiveTo observe the curative effect of finasteride combined with terazosin on benign prostatic hyperplasia (BPH).Methods53 elderly patients with BPH continuously received finasteride (5 mg daily) and terazosin (2 mg daily) in our hospital from June 2002 to December 2010.The rating of international prostate symtom score (IPSS),nocturia,prostate volume and bladder residual urine were recorded before and 2 and 5 years after treatment.ResultsThe IPSS,nocturia,prostate volume,and bladder residual urine were better after treatment than before treatment (P＜ 0.05).The rating of IPSS,nocturia and prostate volume after 5 years of treatment also improved than after 2 years treatment (P＜0.05),but there was no difference in bladder residual urine between 5 years and 2 years of treatment.ConclusionsLong-term use finasteride combined with terazosin for treatment of BPH is effective with little side effects.

In vitro lipofectamine mediated NF-κB decoy oligodeoxynucleotides transfection of Kupffer cells / 中华普通外科杂志

Objective To study the transfection effects of nuclear factor-KappaB(NF-κB)decoy oligodeoxynucleotides(ODN) to Kupffer cells (KCs) mediated by lipofectamine,and investigate it's suppression effects on KCs activation. Methods Twenty-four Wistar rats were divided into three groups (n=8).(1)Control group,in which the normal KCs were isolated.(2)LPS group,in which 1 ms/L LPs was added to the culture system.(3)NF-κB decoy ODN group,in which KCs were transduced with NF-κB decoy ODN (4μg×105KCs)prior to LPS stimulation.The transfection efficiency Was assayed,and the phagocytosis function,NF-κB(P65) translocation,CD40 mRNA expression of KCs were also detected respectively. Results Kupffer cells were obviously activated after LPS stimulation.the phagocytosis function was reinforced.the activity of NF-κB transloeated from cytoplasm into nucleus was obviosly increaced.The co-stimulatory molecules expression(CD40 mRNA)significantly increased compared with control group(t=4.01,P<0.01).NF-κB decoy oligodeoxynucleotides can efficiently transfected into KCs mediated by lipofectamine,which can obviously suppress KCs activation,and downregulate the expression of downstream gene(compared with LPS group,t=4.89,P<0.01). Condusion NF-κB decoy ODN can efficiently transfect into KCs and inhibit it's activation.

Prospective Controlled Study of Interventional Therapy for Acute Severe Pancreatitis: Report of 35 Cases / 中国微创外科杂志

Objective To investigate the effect of interventional therapy for acute severe pancreatitis.Methods A total of 70 patients with acute severe pancreatitis were randomly divided into Control(common medication) and Interventional Therapy groups(common medication plus interventional therapy) with 35 cases in each.The curative effect was compared between the two groups.Results Compared with the Control Group,the patients in the Interventional Therapy Group had a significantly lower mortality [25.7%(9/35) vs 5.7%(2/35);?2=5.285,P=0.022],lower incidence of ARDS [37.1%(13/35) vs 14.3%(5/35);?2=4.786,P=0.029],decreased incidence of pancreatic encephalopathy[34.3%(12/35) vs 11.4%(4/35);?2=5.185,P=0.023],shorter recovery time of serum amylase[(7.6?2.1) d vs(3.4?1.5) d;t=-9.628,P=0.000],and shorter hospital stay[(34.0?6.4) d vs.(23.5?8.9) d;t=-5.667,P=0.000].In the Interventional Group,the symptoms and signs disappeared at(10.0?2.4)d after the treatment,which was significantly earlier than that in the Control Group(18.0?2.6)d(t=-13.376,P=0.000).Conclusions Interventional therapy can effectively control acute severe pancreatitis and shorten the course of the disease.

Role of IRAK-4 activity in inhibitory effects of lipopolysaccharide pretreatment on hepatic ischemia/reperfusion injury / 中国病理生理杂志

AIM: To observe the changes of interleukin1 receptor associated kinase-4(IRAK-4) in ischemia/reperfusion(I/R) liver pretreated with lipopolysaccharide(LPS) and to explore the protective mechanisms of LPS pretreatment against hepatic I/R injury.METHODS: Male Sprague-Dawley rats,weighing 240-280 g,were divided into three groups: control,ischemia/reperfusion group(I/R group) and LPS-pretreated group(LPS group).On the first day,LPS group received 0.1 mg/kg LPS via the tail vein,followed by 0.5 mg/kg on the 2nd,3rd,4th and 5th day.I/R group received the equivalent volumes(0.5 mL) of sterile PBS.Experiments of I/R injury was induced by temporary ischemia of the left lateral liver lobe for 90 min followed by 3 h reperfusion on 2 days after the last LPS treatment.At 0 min,60 min and 180 min after reperfusion,the expression of IRAK-4 gene and protein level were determined by RT-PCR and Western blotting.The activity of NF-?B and the serum TNF-? level were also detected by ELISA.RESULTS: Although the level of IRAK-4 gene and protein were higher in the LPS group than that in I/R group and control group(P0.05) at 0 min after reperfusion.However,all those indexes were evidently lower in the LPS group than those in I/R group(P

A primary report on modified trabeculectomy for primary open angle glaucoma / 眼科

Objective To introduce an anti-glaucoma filtering surgery, modified trabeculectomy, which may have a continuous drainage of the aqueous. Design Retrospective, comparative case series. Participants 41 patients (51eyes) with primary open angle glaucoma. Methods Remove a perpendicular scleral flap along with the trabecular meshwork and followed with a peripheral iridectomy and tenonnectomy. The excision of a portion of Tenon's capsule ensures that the superior end of the tunnel remains open. Patients were followed over one year period. The therapeutic efficacy of the modified operation versus traditional operation were compared. Main Outcome Measures Pre-and post-operative intraocular pressure(IOP), un-corrected visual acuity(UCVA), best-corrected visual acuity (BCVA), postoperative bleb formation and postoperative complications. Results A total of 41 patients (51eyes) were included in this study. Chronic open angle glaucoma was the most common type of glaucoma. During the one year follow-up, 97.2% (25/26) of the mod ified operation treated eyes achieved IOP below 20mmHg and 76.0% (19/25) of traditional operative procedure, below 21mmHg. The postoperative BCVA in both groups did not show significant changes. Conclusion In the modified surgery, a perpendicular sclera strip with trabecular meshwork was excised. Postoperative IOP was reduced and visual acuity remained stable. IOP may be controlled for a long term in modified trap procedure, which seems to be a safer and more effective treatment for open angle glaucoma.

Construction of recombinant adenovirus vector expressing EGFP gene specifically in AFP producing liver cancer cells / 中国病理生理杂志

AIM: To construct a recombinant adenovirus vector carrying AFP promoter to specifically express a targeting gene in hepatocellular carcinoma HepG2 cells. METHODS: Based on the Adeno-X~TM Expression system, the CMV promoter was replaced by a 300 bp a-fetoprotein promoter. The EGFP(enhanced green fluorescent protein) gene as a report gene was inserted to the multiple-cloning site(MCS). The normal liver LO2 cells, hepatocellular carcinoma HepG2 cells and HeLa cells were infected by the recombinant adenovirus, respectively. Northern blotting and fluorescence microscope were used to detect the transcription level of EGFP gene and its protein expression, respectively. RESULTS: Northern blotting showed that the target gene was markedly transcribed in HepG2 cells, but slightly in LO2 and HeLa cells. Under the fluorescence microscope, strong EGFP expression was seen in HepG2 cells but very weakly in HeLa and LO2 cells. CONCLUSION: Under the control of the 300 bp human AFP promoter, the target gene carried by the recombinant adenovirus was expressed in the AFP-producing HepG2 cells at a very high level, but not or very weakly in AFP negative cells. This adenovirus system can be used as a new, potent and specific approach for the gene-targeting therapy for the AFP producing primary hepatoma. [

Clinical study on using anti-HBV therapeutic vaccine in the treatment of chronic HBV carriers / 解放军医学杂志

Objective To evaluate prove the clinical efficacy of anti HBV therapeutic vaccine in the treatment of chronic HBV carriers. Methods 600 patients diagnosed as chronic HBV carrier based on the criteria formulated by the National Conference of Viral Hepatitis in 1997 were enrolled for the study. The patients were randomly assigned into 2 groups. In the first group, 300 patients were given anti HBV therapeutic vaccine subcutaneously once a month, tagether with vitamin C 500mg p o. once a day for 12 months. Patients in the second group received normal saline 2 ml/month by subcutaneous injection and vitamin C 500mg/day p o. for 12months. There were no significant deferences in the age, sex, duration of the illness and the positive rate of serum HBV markers between the 2 groups. At the week 12, 24 and 48 after treatment, the patients were reexamined in the hospital. Serum HBsAg, HBeAg, HBV DNA, anti HBe, anti HBs and ALT were assayed before the treatment and at week 12, 24 and 48 during the course of the therapy. The efficacy of the treatment was evaluated on basis of the results of the assessment of parameters described above at week 48. After completion of the treatment, 208 patients in the treatment group and 196 cases in the control group were followed up for 12 months, and serum HBV markers were checked at the 12th month. The changes in HBV markers during the follow up study were analysed to evaluate the sustained effect after the therapy was ceased. Results The seronegative rates of serum HBsAg, HBeAg and HBV DNA in the treatment group were 14 7%, 32 0% and 37 3%, respectively, and they were significantly higher compared with the control group ( P