Medication guidelines for glucagon-like peptide-1 receptor agonist （2023 edition） / 中国药房

The prevalence of diabetes in China is increasing year by year， and has become a health issue of close concern to the whole society. Glucagon-like peptide-1 （GLP-1） receptor agonist （GLP-1RA）， as a new class of glucose-lowering drugs， is now widely used in the treatment of type 2 diabetes mellitus （T2DM） because of its significant glucose-lowering efficacy and low risk of hypoglycemia. As the level of evidence for its effects on improving cardiovascular system and renal protection and reducing body mass continues to improve， its status in the treatment guidelines for T2DM is gradually increasing. Currently， nine GLP-1RA drugs have been approved for the clinical treatment of T2DM in China. Although all of these drugs exert hypoglycemic effects based on the activation of GLP-1 receptors in the body， the differences in their own structures and natural GLP-1 amino acid homology lead to large differences in pharmacokinetic parameters and clinical efficacy among different analogs. In order to enable clinicians and pharmacists to have a full understanding of the characteristics and clinical evidence of these analogs and to better perform their therapeutic effects， Liaoning Provincial Pharmaceutical Society organized clinical medicine and pharmacy experts to develop a medication guide for nine GLP-1RA drugs to provide a reference for clinical medication needs and promote rational and standardized use by compiling and summarizing the pharmacological characteristics， clinical applications， adverse reactions， interactions， the medications in special populations and medication management.

Efficacy analysis of blinatumomab in treatment of relapsed/refractory B-cell acute lymphoblastic leukemia / 白血病·淋巴瘤

Objective:To explore the efficacy and safety of blinatumomab in treatment of relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL).Methods:The data of 8 patients with relapsed/refractory B-ALL treated with blinatumomab in Shanghai Zhaxin Traditional Chinese and Western Medicine Hospital from September 2020 to December 2021 were retrospectively analyzed, and their clinical characteristics, overall survival, lymphocyte subsets, cytokines, tandem transplantation and adverse reactions were analyzed.Results:The median follow-up time of 8 patients was 143 d (range: 41-534 d). Five of the 8 patients were alive; among them, 4 of 6 patients assessed to be in minimal residual disease (MRD)-negative complete remission (CR) and 1 of 2 patients assessed to be in non-remission at the time of belintuzumab discontinuation were alive. The median duration of treatment with belintuzumab was 28 d (10-56 d), and it was 23 d (10-56 d) for patients with MRD-positive at baseline and 28 d (25-31 d) for the 4 non-remission patients. Six patients achieved MRD-negative CR after treatment, of which 4 were assessed as MRD-positive at baseline and 2 were assessed as non-remission at baseline. All 4 patients with MRD-positive CR achieved MRD-negative CR after treatment with belintuzumab, including 1 patient with Philadelphia chromosome-positive (Ph +) ALL bridged to autologous hematopoietic stem cell transplantation, and 1 patient with Ph + ALL and 1 patient with Ph - ALL received sequential allogeneic hematopoietic stem cell transplantation and had persistent MRD-negative CR. Two of the 4 non-remission patients achieved MRD-negative CR after treatment with belintuzumab, including 1 patient with Ph + ALL bridged to autologous hematopoietic stem cell transplantation, and 1 patient with Ph - ALL received sequential allogeneic hematopoietic stem cell transplantation, and the 2 patients had persistent MRD-negative CR. Leukocyte counts and neutrophils decreased in both MRD-positive CR and non-remission patients after receiving belintumomab. The proportion and absolute number of CD3 + T and CD3 + CD8 + T lymphocytes in patients with MRD-positive CR were higher than those in patients without remission, and both decreased after drug administration. Median interleukin-6 (46.23, 1.42 pg/ml), interleukin-8 (17.85, 2.10 pg/ml), interleukin-10 (7.43, 1.49 pg/ml) and interferon-γ (11.82, 0.39 pg/ml) levels were elevated in MRD-positive CR and non-remission patients at week 3 of treatment. Grade 1 cytokine release syndrome occurred in 1 case with clinical manifestations of fever, which improved after drug suspension. Three cases developed infections, 2 of which were pulmonary and 1 of which was upper respiratory tract infection. No immune effector cell-associated neurotoxic syndrome was observed. Conclusions:Belintumomab is effective for MRD clearance in relapsed/refractory B-ALL with manageable adverse reactions, providing an effective therapeutic option for bridging hematopoietic stem cell transplantation to prolong the survival of patients.

Establishment of a candidate reference method for angiotensin Ⅱ in human plasma / 中华检验医学杂志

Objective:To establish a candidate reference method for the determination of angiotensin Ⅱ in human plasma by isotope dilution liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) and to evaluate its performance.Methods:Using [ 13C 6- 15N]-angiotensin Ⅱ as the internal standard, the plasma was accurately weighed by gravimetric method and mixed with a certain amount of internal standard. At the same time, enzyme inhibitor was added. After zinc sulfate solution protein precipitation and reversed-phase solid-phase extraction plate treatment, it was analyzed by liquid chromatography tandem mass spectrometry. The multi reaction ion monitoring mode(MRM)was selected by mass spectrometry to detect specific ion fragments of angiotensin Ⅱ and internal standard. The linearity, sensitivity, precision, recovery rate and uncertainty of the performance of the established method were evaluated according to ISO15193. Results:Angiotensin Ⅱ had good linearity in the range of 10-1 000 pg/g ( r=0.999 5), the lower limit of quantification was 7.68 pg/g, the analytical recoveries were 97.14% to 102.85%, intra-batch imprecision≤3.21%, inter-batch imprecision≤2.96%, and total imprecision≤3.67%. Conclusion:A method for the determination of plasma angiotensin Ⅱ was established by ID-LC-MS/MS. The method is accurate and reliable, and is expected to be a reference method for the determination of plasma angiotensin Ⅱ.

Application of personalized teaching mode based on Xuexitong learning platform in physiology / 中华医学教育探索杂志

Objective:To investigate the application and effect of personalized teaching mode based on Xuexitong learning platform in physiology.Methods:Four parallel classes from the nursing specialty were randomized into two groups, of which the class 1 and class 2 were taken as the experimental group, and the class 3 and class 4 were taken as the control group, with 102 students in both groups. The students number of these two groups is both 102. The experimental group adopted the personalized teaching mode based on Xuexitong learning platform, with the features of preparation before the class, the teaching in class and testing after class; while the control group adopted the traditional teaching mode. The final results of students from the two groups were compared, and questionnaires were send out. The data were processed by SPSS 22.0 software and analyzed by rank-sum test.Results:The final scores of the students from the experimental group were better than those of the control group ( P<0.001). The experimental group was significantly better than the control group in improvement of self-learning, teamwork, personality development and medical literacy ( P<0.05). And there was no significant difference in the recognition of language expression ability between the two groups ( P>0.05). Conclusion:The personalized teaching based on Xuexitong learning platform can play an important role in developing the personalities of students and improving the educational effect of teaching students in accordance with their aptitude, which has a popularization significance in the teaching of physiology.

Application of personalized teaching mode based on Xuexitong learning platform in physiology / 中华医学教育探索杂志

Objective:To investigate the application and effect of personalized teaching mode based on Xuexitong learning platform in physiology.Methods:Four parallel classes from the nursing specialty were randomized into two groups, of which the class 1 and class 2 were taken as the experimental group, and the class 3 and class 4 were taken as the control group, with 102 students in both groups. The students number of these two groups is both 102. The experimental group adopted the personalized teaching mode based on Xuexitong learning platform, with the features of preparation before the class, the teaching in class and testing after class; while the control group adopted the traditional teaching mode. The final results of students from the two groups were compared, and questionnaires were send out. The data were processed by SPSS 22.0 software and analyzed by Rank-Sum test, so as to understand the students' evaluation of individualized teaching effect.Results:The final scores of the students from the experimental group were better than those of the control group ( P<0.001). The experimental group was significantly better than the control group in improvement of self-learning, teamwork, personality development and medical literacy ( P<0.05). And there was no significant difference in the recognition of language expression ability between the two groups ( P>0.05). Conclusion:The personalized teaching based on Xuexitong learning platform can play an important role in developing the personalities of students and improving the educational effect of teaching students in accordance with their aptitude, which has a popularization significance in the teaching of physiology.

Validation and optimization of the indicator system of risk assessment for mechanical cuts / 中华劳动卫生职业病杂志

Objective@#To validation and optimization the indicator system of risk assessment for mechanical cuts.@*Methods@#The risk assessment index system of mechanical cutting injury established earlier was used to assess the risk of mechanical cutting injury in 40 cases of mechanical cutting injury registered from January 2015 to December 2017 and 40 similar positions without accidents in the same period. The multiple stepwise regression analysis was used to screen the indicator system, and to adjust the weight coefficient of each index. The total coincidence rate and Kappa value were compared between before and after optimization respectively.@*Results@#The new index system has 3 first-class indicators, 10 second-class indicators and 14 three-class indicators, fewer than the old index system which has 3 first-class indicators, 10 second-class indicators, 34 three-class indicators. There three indicators have revamped in the first-class. The total of coincidence rates of the new and old indicator systems were 67.50% and 90.00%, the difference was statistically significant (P<0.01). The Kappa value were 0.35 and 0.80, respectively.@*Conclusion@#The evaluation results with new indicator systems is more consistent with the actual hazard detection the the old indicator systems, and scientific, reasonable and practical, and the indicator system of risk assessment for mechanical cuts can be used for the risk assessment of mechanical cutting injuries.

Outcomes of reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation for 10 patients with myelofibrosis / 中华血液学杂志

Objective@#To evaluate the efficacy of reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation (RIC-allo-HSCT) for patients with myelofibrosis (MF).@*Methods@#The clinical data of 10 patients with myelofibrosis (MF) who underwent RIC-allo-HSCT.@*Results@#Of all 10 patients, 6 were male and 4 women, with a median age of 28.5 (22-54). Using fludarabine/busulfan plus total body irradiation (FB+TBI) pretreatment scheme based. Hematopoiesis reconstitution was achieved in 9 patients (90%). The median time of neutrophil and platelet engraftment was 13.5 (10-22) day and 16.5 (13-40) day, respectively. Acute GVHD occurred in 4 cases while chronic GVHD in 5 cases. The prospective OS for 3 years was (90.0±8.5)% after a median follow-up time of 17 months. Transplant related mortality was 1 case.@*Conclusion@#RIC-HSCT with FB+TBI is a feasible and effective alternative for MF patients.

The effect of participatory training on occupational health intervention in polishing workers / 中国职业医学

OBJECTIVE: To study the intervention effects of participatory training on the occupational health in polishing workers. METHODS: By the stratified random sampling method,930 front-line polishing workers were selected from 50 manufacturing enterprises in Guangzhou,467 workers in the intervention group and 463 workers in the control group. The intervention group adopted participatory training and the control group adopted the traditional training. We evaluated the changes of occupational health knowledge,attitude and practice( KAP) in workers of these two groups using the questionnaire table of occupational health KAP for polishing workers. Data of before intervention,immediately after intervention and 3 months after intervention were collected. RESULTS: The workers 'knowledge,attitude and practice scores at the time point of immediately after intervention were higher than those before intervention in the same group( P <0. 05). The workers' knowledge and practice scores of 3 months after intervention in intervention group were higher than those before intervention( P < 0. 05). The knowledge and practice scores of 3 months after intervention in the intervention group were higher than that in the control group( P < 0. 05). The evaluation scores on protection measure and warning signs of workers in the intervention group were lower than those in workers of control group 3 months after the intervention( P < 0. 05). Three months after the intervention,the workers in intervention group believed that the training was more effective than that in the control group in the following 6 aspects: improving the knowledge of occupational health,improving the ability of identifying risk factors, learning to use the personal protective equipment, helping other workmates,having confidence to make suggestions and introducing other workmates to participate in training( P < 0. 05).CONCLUSION: The participatory training is an effective intervention model in improving the workers ' awareness of occupational health KAP.

PEG-rhG-CSF for peripheral blood stem cell mobilization in patients with relapsed or refractory malignant lymphoma / 中国肿瘤临床

Objective:To compare the efficacy and costs of pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) and granulocyte colony stimulating factor (G-CSF) for hematopoietic stem cell mobilization and hematopoietic recovery after transplantation in patients with relapsed or refractory malignant lymphoma. Methods:From July 2014 to October 2016, 15 patients with malignant lymphoma using peripheral blood stem cell mobilization (PBSCM) for autologous peripheral stem cell transplantation (APBSCT) were treated in our institution and enrolled in the PEG-rhG-CSF group (experimental group). We analyzed data from other 15 patients with malignant lymphoma mobilized with G-CSF who were treated in our institution from January 2013 to August 2015 (control group). Results:Patients in both groups were successfully mobilized. The median amounts of CD34+cells collected in the experimental and control groups were 16.2×106/kg and 8.9×106/kg, respectively (P=0.414), and the median amount of mononuclear cell (MNC) was 12.4×108/kg and 9.9× 108/kg, respectively (P=0.519). In the experimental and control groups, the mean durations of mobilization were 10.66±1.45 and 9.33±1.83 days (P=0.234), the mean durations of neutropenia during mobilization were 4.20±2.17 and 3.80±2.04 days (P=0.608), the mean durations of absolute neutrophil count recovery after APBSCT were 10.14±1.29 and 10.93±2.69 days (P=0.327), and the mean durations of platelet recovery were 10.36±2.27 and 12.27±3.38 days (P=0.121). Mobilization and hematopoietic recovery after APBSCT were not significantly different between the two groups. The cost was lower in the experimental group than that in the control group (RMB 3,960 yuan versus RMB 11,479.3±2,401.3 yuan). Conclusion:High-dose chemotherapy combined with PEG-rhG-CSF is a promising, effective, and low-cost mobilization regimen for patients with relapsed or refractory malignant lymphoma.

Emodin reduces FFAs-induced fatty degeneration in HepG2 cells via the AMPK/SREBP-1 pathway / 中国医师杂志

Objective To investigate the effects of emodin on the triglyceride metabolism and oxidative stress in steatosis in HepG2 cells and possible underlying mechanisms.Methods The appropriate concentration of emodin on HepG2 cells were detected by methyl thiazolyl tetrazolium (MTT) assay.HepG2 cells were induced to fat overaccumulation by 1 mmol/L free fatty acids (FFA) (oleate∶ palmitate =2∶1).The model group exposed to 10 μmol/L,20 μmol/L,40 μmol/L emodin.The intracellular lipid accumulation was documented by Oil Red O staining and the content of triglyceride and total cholesterol was observed.Reactive oxygen species (ROS) was determined by flow cytometry.Western blotting was performed to analyze the protein levels of adenosine monophosphate-activated protein kinase (AMPK),phosphorylated AMPK,and sterol regulatory element-binding protein 1 (SREBP-1).Results Emodin reduced lipid accumulation and triglycerides (TG) content (P ＜ 0.05).At the same time,it significantly reduced ROS production (P ＜ 0.05).Moreover,the levels of AMPK and p-AMPK protein were significantly upregulated,and SREBP-1 protein was significantly downregulated with the treatment of emodin (P ＜ 0.01).Conclusions This study has demonstrated that emodin can reduce fatty degeneration induced by FFAs in hepatocytes,and this effect may be partially mediated by the AMPK/SREBP-1 pathway.

Implication of canonical transient receptor potential in cardiovascular disease / 国际药学研究杂志

The canonical transient receptor potential(TRPC)regulating non-voltage-gated cation entry in plasma-membrane is widely expressed in cardiovascular system. Cytosolic Ca2+takes charge of multifunctional biogenic activities and its stabilization is criti?cal for physiological function. Almost all TRPC channels are non-selectively permeable for Ca2+. Overexpression or transgenation of TRPC leading to the change of Ca2+may contribute to fundamental malfunctions and engage in the physiological and pathophysiological processes of some diseases. Evidence suggests that regulation of TRPC channels plays important roles in the development of hyperten?sion,pulmonary arterial hypertension,cardiac hypertrophy,atherosclerosis,and arrhythmia. This review gives an overview of the functional properties of mammalian TRPC channels,describes their roles in cardiovascular diseases and discusses their potential as drug targets for therapeutic intervention.

Association of genetic polymorphism in the advanced glycation endproduct gene with genetic susceptibility to ischemic stroke / 中华老年医学杂志

Objective To investigate the association of genetic polymorphism in the advanced glycation endproduct (RAGE) gene with genetic susceptibility to ischemic stroke.Methods A case-control study was conducted with 124 ischemic stroke patients serving as the stroke group and 125 healthy volunteers serving as the control group.Three common polymorphisms in the RAGE gene,82G/S (rs2070600),-429T/C (rs1800625) and-374T/A (rs1800624),were genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP) method.The association between the three polymorphisms and genetic susceptibility to ischemic stroke was further analyzed by logistic regression analysis.Results The body mass index (BMI),diastolic blood pressure,blood lipids levels,and the percentage of smokers were significantly higher in the stroke group than in the control group (each P＜0.05).At the 82 position,the frequencies of the genotypes GG,GS and SS were 10％,48％ and 42％,respectively.At the 429 position,the frequencies of the genotypes TT,TC and CC were 15％,44％ and 41％,respectively.At the 374 position,the frequencies of the genotypes TT,TA and AA were 8％,41％ and 50％,respectively.After adjusting for confounding factors including age,gender,smoking and blood pressure,the genotype frequencies of SS and S alleles at 82G/S of the RAGE gene were higher in the stroke group than in control group (SS:OR=2.14,95％ CI:1.37-3.51;S:OR=1.96,95％ CI:1.24-3.34),while no significant differences of genotype frequencies of the 429T/C and-374T/T polymorphisms were observed between the stroke group and the control group (each P＞0.05).Conclusions The 82G/S gene polymorphism of the RAGE gene has correlations with ischemic stroke in the Henan Han population,with the S allele as the risk factor for ischemic stroke.However,no clear association between the 429T/C or-374T/A polymorphisms of the RAGE gene and ischemic stroke is identified in the Han population.

Establishment and validation of an indicator system of risk assessment for mechanical cuts / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish an indicator system of risk assessment for mechanical cuts, and to validate the system using examples.</p><p><b>METHODS</b>An indicator system was proposed by the expert investigation method. The index weight, expert authority coefficient, and degree of coordination were determined. The reasonability and stability of the expert questionnaire were evaluated by the reliability analysis. Some on-site examples were given to validate the indicator system.</p><p><b>RESULTS</b>An indicator system containing 3 first-class indicators, 10 second-class indicators, and 34 third-class indicators was obtained by screening indicators using the boundary value method and the assignment transformation method. The average expert authority coefficient was 0.79. The average expert coordination coefficient was 0.47. The overall reliability coefficient was 0.884. The scores obtained using the indicator system were significantly correlated with the actual injury results in six workplaces (r=0.866, P<0.01).</p><p><b>CONCLUSION</b>The indicator system of risk assessment for mechanical cuts proposed in this study is reasonable and highly consistent with the actual injury results. However, this indicator system still needs further validation and optimization.</p>

Significance of thyroid hormone level change in patients with acute ST elevation myocardial infarction / 心血管康复医学杂志

Objective:To evaluate clinical significance of change of serum thyroid hormone level in patients with ST elevation myocardial infarction (STEMI) and old myocardial infarction (OMI) .Methods :Clinical data of 52 STE‐MI patients (STEMI group) and 48 OMI patients (OMI group) hospitalized in our department of cardiology were retrospectively analyzed .Automatic chemiluminescent analyzer was used to quantitatively measure thyroid hormone levels in two groups .Results:Compared with OMI group ,there were significant reductions in serum levels of free triiodothyronine [FT3 ,(4.45 ± 1.09) pmol/L vs .(3.03 ± 0.14) pmol/L] ,free thyroxine [FT4 ,(18.53 ± 3.89) pmol/L vs .(11.83 ± 0.53) pmol/L] and thyrotropic‐stimulating hormone [TSH ,(1.85 ± 1.04)μIU/L vs .(0.26 ± 0.13)μIU/L] in STEMI group ,P<0.01 all .Conclusion:Thyroid hormone levels of STEMI patients are significant‐ly higher than those of OMI patients , serum thyroid hormone levels may reflect severity of coronary vessel lesions in patients with myocardial infarction.

Chlamydia pneumoniae infection,inflammatory factor and blood lipid level in patients with coronary heart disease / 心血管康复医学杂志

Objective:To explore the Chlamydia pneumoniae (Cpn) immunoglobulin (Ig) G positive rate , inflamma‐tory factors and blood lipid levels in patients with coronary heart disease (CHD) .Methods :A total of 50 CHD patients hospitalized in our hospital were selected as CHD group ,and 33 non‐CHD patients visited to outpatient clinic in same period were regarded as non‐CHD control group .Blood lipid ,inflammatory factor levels ,and positive rate of Cpn IgG were compared between two groups .Results :Compared with non‐CHD control group ,there were significant rise in levels of TC [ (3.96 ± 1.07) mmol/L vs .(4.75 ± 1.33) mmol/L] ,TG [ (1.05 ± 0.42) mmol/L vs .(1.67 ± 0.82) mmol/L] and LDL‐C [ (2.12 ± 0.47) mmol/L vs .(2.88 ± 0.86) mmol/L] , P < 0.05 all ;significant rise in levels of inflammatory factor :C reactive protein [CRP ,(3.85 ± 0.87) mg/L vs .(5.80 ± 1.60) mg/L] ,interleukin‐ 6 [IL‐6 ,(6.50 ± 1.53) mg/L vs .(15.80 ± 7.62) mg/L] and tumor necrosis factor‐α [TNF‐α ,(5.50 ± 1.60) mg/L vs .(16.10 ± 2.20) mg/L] in CHD group , P < 0.05 all ;positive rate of serum Cpn IgG in CHD group was significantly higher than that of non‐CHD control group (78.0% vs .21.2% ,P < 0.05) .Conclusion : In present study ,positive rate of serum Cpn IgG ,inflammatory factor and blood lipid levels significantly rise in CHD patients ; Chlamydia pneumoniae infection and dyslipidemia may have a synergistic effect ,cause occurrence and development of CHD in common .

Epidemiological characteristics of burn workers in Hunan Province / 中南大学学报(医学版)

OBJECTIVE@#To understand the epidemiological characteristics of workers who are burn patients, and to provide basis for prevention and treatment of burn at work.@*METHODS@#We investigated 4 078 burn workers in 9 cities in Hunan provincial enterprises, and different trades managed by municipal government from January 1st, 2005 to December 31st, 2010.@*RESULTS@#The incidence rate of employment injury was 94.84 per 10 thousand workers each year in Hunan. That of the enterprises directly managed by Hunan Medical Insurance Bureau was 93.71 per 10 thousand workers each year, and that of the enterprises managed by Medical Insurance Bureaus of cities or districts was 95.02 per 10 thousand workers each year. The burn incidence accounted for 2.00% of the total work injury in Hunan Province (7.35% in the enterprises directly managed by Hunan Medical Insurance Bureau and 1.39% in districts and industries). There were 4 078 burn patients from the sorted units [1 823 out-patients and 2 255 in-patients; 3 498 males (85.78%) and 580 females (14.22%) with age of (38.64±11.56) years]. The ratio between males and females was 6.03:1. Among the 4 078 patients, 2 979 were from the rural area (71.78%), with 1 100 out-patients and 1 379 in-patients. The burn was mostly mild and moderate (64.66%), and mainly occurred on the face, head, arms, and legs (61.55%). The main causes of burn were heating power (74.1%), chemical stuff (14.37%), and electric power (10.78%). The death rate was 1.42%. The burn accidents often happened between July and September. The average time from being burned to be in the hospital for treatment was 3.91 hours.@*CONCLUSION@#Burn accidents, especially mild and moderate burn, occur mainly in young, married and poorly educated males from rural areas. Heating power, chemical stuff, and electric power are the key causes for burn. Work injury prevention measures should be improved in high risk enterprises.

Ventricularization of the proximal cardiac outflow tract contributes to trabeculated right ventricle in mouse embryo / 解剖学报

Objective To explore the mechanism underlying the rapid shortening of outflow tract and the formation of the right ventricle of the embryonic mouse heart .Methods Serial sections of embryonic mouse hearts from embryonic day 9 (E9) to E12(3 to 5 embryos for each stage)were stained with antibodies against α-sarcomeric actin (SCA), α-smooth muscle actin (SMA), GATA-4, myosin heavy chain (MHC), proliferating cell nuclear antigen (PCNA) or active caspase-3 (CAS-3).Results At E11, the aortic sac and the distal border of cardiac outflow tract had regressed towards the ventricle into the pericardial cavity , while GATA-4、SCA and SMA staining showed that precursors from the second heart field were differentiating into cardiomyocytes adding to the arterial pole of the heart to lengthen the outflow tract .The length of outflow tract rapidly shortened at E12.Before and during its shortening , no CAS-3 positive cell was detected in the entire outflow tract.During E10-12, the cardiomyocytes in the right ventricle and proximal outflow tract wall proliferated inward to form trabeculae, with some trabeculae extending into the ridges .Proximal extremities of the outflow tract ridges were gradually myocardialized remodeling into the trabeullar right ventricle wall .At E12, scattered SCA and SMA staining cells and SCA and SMA weak positive mesenchymal cell clusters , which were continuous with the outflow tract myocardium were detected in the mesenchymal proximal outflow tract ridges .These results suggested that the proximal outflow tract was remodeled into the right ventricle by trabecularization , during which mesenchymal ridges were trabecularlly myocardialized . Conclusion Ventricularization of the proximal outflow tract contributes to the trabecular right ventricle and resultes in the vapid shortening of outflow tract in the mouse embryonic heart .Cardiomyocyte appoptosis and transdifferentiation are found to play a more limited contribution during this process .

The effects of pioglitazone on the Kupffer cells of nonalcoholic fatty liver disease in rats / 中国医师杂志

Objective To explore the preventive effect and mechanism of pioglitazone on nonalcoholic fatty liver disease in rats.Methods Thirty six male Sprague-Dawley ( SD) rats were randomly divided into normal control group , high-fat diet group , and pioglitazone intervention group , with 12 rats in each group .Normal control group fed with standard diet for eight weeks , and the rest two groups fed with high fat diet .Pioglitazone intervention group fed with pioglitazone in the four to eight weeks , the rest two groups in the same period fed with distilled water .Fasting serum alanine aminotransferase , aspartate aminotransferase , total cholesterol , triglyc-erides, fasting glucose , and fasting blood insulin levels were determined .The fasting insulin resistance index was calculated .Routine histological features of hepatic section were observed by hematoxylin eosin (HE) staining.The shape change of Kupffer cells in the liv-er was detected .The levels of tumor necrosis factor ( TNF)-αand nitric oxide ( NO) secreted by Kupffer cells were measured .Results The fasting insulin resistance index , triglycerides , and total cholesterol in rats of high-fat diet group were significantly higher than in normal control group ( P <0.05 ) .Histopathological examination showed hepatocellular macrove sicular steatosis , lobular inflammatory cell infiltration, and inflammatory cell infiltration .Hepatic Kupffer cell morphology change , its produced TNF, NO and liver tissue pa-thology changes were positively correlated ( P <0.05 ) .The fasting insulin resistance index , triglycerides , total cholesterol was signifi-cantly lower in rats of pioglitazone intervention group than the high-fat diet group ( P <0.05 ) .The liver tissue structure was obviously improved pioglitazone intervention group rats , morphology and function of liver Kupffer cells were normal .Conclusions Pioglitazone can prevent the nonalcoholic fatty liver disease induced by high fat diet .The mechanism may be related to improve insulin resistance , reduce blood fat , and regulate function of Kupffer cells .

Comparison of therapeutic effect and safety between atorvastatin and simvastatin in patients with angi-na pectoris of coronary heart disease / 心血管康复医学杂志

Objective:To compare therapeutic effect and safety between atorvastatin and simvastatin treating angina pectoris of coronary heart disease (CHD).Methods:A total of 150 patients with chronic stable angina pectoris (SAP)of CHD were selected and randomly and equally divided into atorvastatin group and simvastatin group accord-ing to number table method.Changes of angina pectoris attack frequency,duration,degree of pain,nitroglycerin dosage and blood lipids were compared between two groups before and after treatment.All patients were followed up six months.Results:Compared with before treatment,there were significant reductions in angina pectoris attack frequency,duration,pain degree and nitroglycerin dosage after treatment 12 weeks in two groups,P0.05 all). Compared with before treatment,there were significant reductions in serum levels of total cholesterol [ (5.62 ± 0.54)mmol/L vs.(3.68±0.41)mmol/L,(5.78±0.56)mmol/L vs.(3.33±0.43)mmol/L],triglyceride [(2.30 ±0.42)mmol/L vs.(1.62±0.34)mmol/L,(2.35±0.41)mmol/L vs.(1.68±0.69)mmol/L]and low density lipoprotein cholesterol [(3.56±1.22)mmol/L vs.(2.76±0.83)mmol/L,(3.48±1.21)mmol/L vs.(2.43± 0.72)mmol/L],and significant increase in level of high density lipoprotein cholesterol [(1.32±0.35)mmol/L vs. (1.58±0.34)mmol/L,(1.30±0.46)mmol/L vs.(1.60±0.45)mmol/L]in atorvastatin group and simvastatin group after treatment (P0.05);there was no significant difference in incidence rate of cardiovascular events (28.00% vs.25.33%,P>0.05)between two groups during follow-up.Conclusion:Both atorvastatin and simvasta-tin can effectively regulate the state of high blood lipid,and possess good effect and safety for angina pectoris of coronary heart disease.

The cost-effectiveness of early rehabilitation of burns patients / 中华物理医学与康复杂志

Objective To compare the cost-effectiveness of intervention protocols with or without rehabilitation approaches for burn patients.To explore the pros and cons of the two treatment programs,especially in terms of efficacy.Methods Data on 164 burn patients hospitalized in four hospitals in Hunan Province were collected and compared in terms of the therapeutic interventions employed,the direct medical costs and the effects obtained at the end of the first two months of hospitalization.The patients were divided into an early rehabilitation therapy group and a control group,based on the interventions they received.Results The average total direct medical cost of the early rehabilitation group was significantly lower than that of the control group [((￥)59 380.80 ±196.87) versus ((￥)67 471.62 ±217.23)].The average Vancouver scar scale (VSS) results in the early rehabilitation group were significantly better than those of the controls,but their Zung's Self-rating Anxiety Scale and Barthel index scores were not.The average cost-effectiveness ratio (C/E) of the early rehabilitation group as judged by these scores was lower than that of the control group.Conclusion Early rehabilitation can improve the therapy of burns patients and reduce subsequent expenditures.It is a cost-effective approach to treating burns patients.