Abstract:Objective To investigate the effect of dexmedetomidine combined with sevoflurane on lung injury in the patients undergoing cardiopulmonary bypass. Methods A total of 80 patients scheduled for heart valve replacement under cardiopulmonary bypass were recruited and randomly divided into 4 groups (n=20):dexmedetomidine group (D group), sevoflurane group (S group), dexmedetomidine combined with sevoflurane group (DS group) and control group. For the patients of groups D and DS, dexmedetomidine were continuously pumped into vein with the loading dose of 0.8μg/kg 10 min before introduction of general anesthesia, and then the speed was adjusted to 0.6μg/(kg·h) to the end of surgery. For those from groups S and DS, 2% sevoflurane was inhaled for 15min before and after the ascending aorta was blocked, and also before and after the ascending aorta was opened. Oxygenation index (OI), alveolar-arterial oxygen partial pressure difference [P(A-a)O₂], static compliance (Cst), and plasma levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8) and soluble intercellular adhesion molecule-1 (sICAM-1) were recorded and measured before anesthesia induction (T1), immediately after cardiopulmonary bypass (T2), after surgery (T3), and 1 d after surgery (T4). SPSS statistics 21.0 was used to perform the statistical analysis. Results The plasma levels of TNF-α, IL-8 and sICAM-1 in control group were the highest when compared with those in the other 3 groups at T2-T4 (P<0.05), and the levels was significantly lower in DS group than those of D group and S group at T2-T4 (P<0.05). At the time period, the P(A-a)O₂ was significantly higher while the OI and Cst were obviously lower in control group than in the other 3 groups (P<0.05). And the P(A-a)O₂ of DS group was significantly lower than that of the D group and S group (P<0.05), and OI and Cst were notably higher than those of the D group and S group (P<0.05). Conclusion Sevoflurane combined with dexmedetomidine can alleviate lung injury in the patients undergoing cardiopulmonary bypass, and the effect is better than the combined anesthesia of sevoflurane and dexmedetomidine alone.

Abstract:Objective To investigate the effects of Mendelssohn′s techniques and feeding training on swallowing function in the elderly Parkinson′s disease patients with dysphagia. Methods A total of 104 elderly Parkinson′s disease patients with dysphagia admitted in No. 904 Hospital from January 2016 to February 2018 were enrolled in this study. According to treatment methods, they were divided into routine intervention group (control group, n=52) and Mendelssohn′s techniques and feeding training group (observation group, n=52). Their swallowing dysfunction and comfortableness were observed and compared before and after intervention, and the incidences of aspiration pneumonia and salivation and the severity of Parkinson′s disease after intervention were compared between the 2 groups. SPSS statistics 18.0 was used to analyze the data. Results After intervention, the proportions of dysphagia grade Ⅱ, Ⅲ and Ⅳ were 53.85% (28 cases), 32.69%(17 cases) and 13.46%(7 cases) respectively in the patients of the observation group, while were 32.69%(17 cases), 36.54%(19 cases) and 30.77%(16 cases) in those of the control group. Compared with the control group, the observation group had dysphagia significantly improved (Chi-square=2.479, P=0.013). After intervention, the patients had gradeⅠ,Ⅱ, Ⅲ and Ⅳ comfortableness accounting for 42.31% (22 cases), 28.85%(15 cases), 23.08%(12 cases)[JP+1] and 5.77%(3 cases) respectively in the observation group, which were superior to those in the control group[21.15%(11 cases), 23.08%(12 cases), 34.62%(18 cases) and 21.15%(11 cases)] with significant difference (Chi-square=3.057, P=0.002). The incidences of aspiration pneumonia [5.77% (3 cases) vs 25.00% (13 cases), Chi-square=5.983, P=0.005] and salivation[7.69% (4 cases) vs 28.85% (15 cases), Chi-square=7.792, P=0.000] were significantly lower in the observation group than the control group. After intervention, the patients with Parkinson′s disease in stages 1.0,1.5,2.0,2.5,3.0 and 4.0 were 22,3, 4,2, 1 and 0 case in the observation group, which were better than those in the control group (12,5, 8,4, 2,1 cases, respectively), and the difference was statistically significant (Chi-square= 2.432, P=0.015). Conclusion Mendelssohn′s techniques and feeding training are helpful to improve swallowing function, reduce the incidences of aspiration pneumonia and salivation, and improve patient′s comfortableness in the elderly patients with Parkinson′s disease and dysphagia.

Abstract:Objective To investigate the clinical characteristics of sepsis-associated acute kidney injury (SI-AKI) patients in intensive care unit (ICU) and the impact of timing of continuous renal replacement therapy (CRRT) on 28-day prognosis in them. Methods A retrospective analysis was made on 44 SI-AKI patients hospitalized in Department of Critical Care Medicine, the First Medical Center of Chinese PLA General Hospital from June 2017 to December 2018. According to whether CRRT was performed within 48 h after the occurrence of AKI, 29 patients were assigned into the early CRRT group, and the other 15 patients into the late CRRT group. Their physiological indicators and 28-day outcomes were compared between the 2 groups. SPSS statistics 17.0 was used to perform the statistical analysis. Kaplan-Meier survival analysis was employed to analyze the 28-day prognosis of the patients. Results According to the Kidney Disease:Improving Global Outcomes (KDIGO) Clinical Practice Guideline, there were 6(13.6%) patients at AKI stage 1,8(18.2%) at stage 2, and 30(68.2%) at stage 3. The patients having transient AKI accounted for 18.2%(8/44), and persistent AKI for 81.8%(36/44). Within 28 d after AKI occurrence, 15 cases died. The early CRRT group had a higher proportion of diabetes mellitus (31.0% vs 6.7%, P=0.048), and obviously lower levels of systolic blood pressure [(114±15) vs (130±15)mmHg,P=0.005] during the process of CRRT, mean arterial pressure [(82±11) vs (91±18)mmHg, P=0.040], serum creatinine (197.0 vs 418.9μmol/L, P=0.002,), urea nitrogen (12.9 vs 35.0mmol/L, P<0.001), serum calcium (1.9 vs 2.0mmol/L, P=0.007), serum magnesium (0.7 vs 0.8mmol/L, P=0.013), elevated serum levels of hemoglobin [(96±26) vs(84±13)g/L, P=0.041] and lactic acid (3.8 vs 1.7mmol/L, P=0.009), and lower proportion of those at AKI stage 3 (58.6% vs 86.7%, P=0.041), when compared with the late CRRT group. The 28-day mortality was 31% (9/29) in the early CRRT group, and 40%(6/15) in late CRRT group, and there was no significant difference between the 2 groups (P=0.575). Conclusion Early CRRT does not improve 28-day mortality in SI-AKI patients.

Abstract:Objective To investigate the association of neutrophil-lymphocyte ratio (NLR) with grade of arteriosclerosis (AS) in the lower extremities in the patients with type 2 diabetes mellitus (T2DM). Methods A total of 556 T2DM patients admitted to our hospital from September 2017 to September 2018 were recruited in this study, and divided into 4 groups according to the results of AS grading, that is, T2DM+AS1 group (n=140, without AS), T2DM+AS2 group (n=98), T2DM+AS3 group (n=192) and T2DM+AS4 group (n=126). The clinical indices of 4 groups were collected and compared. SPSS statistics 17.0 was used for data analysis. Results Significant differences were seen in age, gender, history of smoking, course of T2DM, history of hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), neutrophil count, lymphocyte count, NLR, and levels of creatinine(Cr) and low-density lipoprotein cholesterol (LDL-C) among the 4 groups (P<0.05). Spearman correlation analysis showed that NLR was positively correlated with age, history of hypertension, SBP and Cr level in T2DM AS patients (P<0.05). Binary logistic regression analysis indicated that age (OR=1.111, 95%CI 1.076-1.147; P=0.001), LDL-C (OR=1.506,5%CI 1.011-2.243; P=0.044) and NLR (OR=1.564,5%CI 1.185-2.065; P=0.002) were the influencing factors of lower limb AS in T2DM patients. Multinomial logistic regression analysis suggested that NLR was an independent risk factor for AS grade 4 of the lower extremities in T2DM patients (OR=1.777,5%CI 1.086-2.910; P=0.022), and age was also a risk factor for different grades of AS, and the risk of AS grade 3 and 4 for male patients was 4.037 and 7.819 times higher than that of female patients, respectively; LDL-C and smoking history were risk factors for AS grade 3 in patients with T2DM. Conclusion NLR is closely related with AS in lower extremities in T2DM patients, especially closely related to AS grade 4.

Abstract:Objective To investigate the impact of individualized exercise intervention on the improvement of frailty and physical function in elderly inpatients. Methods Fifty-eight elderly patients (FRAIL score ≥1) admitted in the Zhongnan Hospital from August 2018 to February 2019 were recruited in this study. They were randomly divided into control and experimental group, with 29 cases in each. The control group received only routine nursing care and routine education during hospitalization. On the basis of these, the experimental group was given multi-component individualized exercise, including muscle strength training, aerobic training and balance training. After 12 weeks′ intervention, the frailty status, walking speed, and result of time up and go test (TUGT) were recorded and compared between the 2 groups. SPSS statistics 18.0 were used for data analysis. Results Before intervention, there was no significant difference in the composition ratio of frailty severity between the 2 groups (experimental group:16 cases in pre-frailty, 13 in frailty; control group:12 in pre-frailty and 17 in frailty; P=0.293), but after 12 weeks of intervention, obvious difference was seen in the composition ratio (experimental group:20 in the pre-frailty, 9 in frailty; control group:8 in pre-frailty and 21 frailty; P=0.002). There was notable difference in the composition ratio in the experimental group before and after the intervention (P=0.019), but no such difference was seen in control group (P=0.269). Before intervention, there were no significant differences in walking speed [(0.61±0.16) vs (0.59±0.14)m/s] and TUGT [(17.82±3.48) vs (18.25±3.32)s] between the 2 groups (P>0.05). After 12 weeks of intervention, the experimental group had remarkably better walking speed [(0.66±0.12) vs (0.57±0.11)m/s] and improved TUGT [(16.19±2.74) vs (19.84±2.35)s] than the control group (P<0.05). There were also significant differences in walking speed and TUGT in experimental group before and after treatment, so were the TUGT in control group (P<0.05). Conclusion Multi-component individualized exercise intervention can improve the frailty status and physical function in frail elderly inpatients, and is worthy of clinical promotion.

Abstract:Objective To explore the efficay of combined spinal-epidural anesthesia with light and heavy bupivacaine in the elderly undergoing hip replacement. Methods A total of 112 elderly patients undergoing hip replacement in our hospital from February 2016 to February 2018 were subjected in this study. According to the types of anesthesia, they were divided into observation group (3ml 0.25% light specific gravity bupivacaine combined spinal-epidural anesthesia) and control group (3 ml 0.50% heavy specific gravity bupivacaine combined spinal-epidural anesthesia), with 56 cases in each group. The anesthetic effect, heart rate (HR), mean arterial pressure (MAP), and arterial oxygen saturation (SpO₂) before and 5,0, 15,0 and 60min after anesthesia (T1-T5), and severity of lower extremity motor block (assessed by modified Bromage scale) and adverse events were compared between the 2 groups. SPSS statistics 17.0 was used to analyze the data. Results Compared with the control group, the observation group had significantly longer duration of anesthesia maintenance [(123.3±10.5) vs (110.2±10.3)s, P=0.031], while shorter onset times of sensory block [(35.6±7.4) vs (45.7±7.9)s, P=0.008] and of motor block [(235.7±34.7) vs (270.7±39.7)s, P=0.041]. There was no significant difference in HR between the 2 groups at T0-T3 (P>0.05), but HR was significantly lower in the observation group than the control group at T4-T5 (P<0.05). No significant difference was seen in [JP+1]MAP between the 2 groups at T0-T5 (P>0.05).SpO₂ in the observation group was significantly higher than that in the control group at T1-T4 time points (P<0.05). HR, MAP and SpO₂ levels in the observation group were slightly different at different time points from T0 to T5, but without significant differences (P>0.05). Compared with T0, HR of T1-T5 and MAP of T2-T5 in the control group changed significantly (P>0.05). Compared with pre-operation, the proportion of Bromage grade 2 in the observation group (P=0.013) and the control group (P=0.015) was increased significantly, while the proportion of grade 3 (P=0.038; P=0.021) was decreased significantly. At the same time, the proportion of grade 1 (P=0.021) and grade 2 (P=0.039) in the observation group was significantly higher than that in the control group. There was a significant difference in the incidence of adverse reactions between the 2 groups [8.9%(5/56) vs 37.5%(21/56); P=0.000]. Conclusion Light specific gravity bupivacaine combined with spinal epidural anesthesia is superior to heavy specific gravity bupivacaine in elderly patients undergoing hip replacement, because of its reducing intraoperative hemodynamic fluctuations and the occurrence of adverse events, and of high reliability and safety.

Abstract:Objective To investigate the correlation of interleukin-6 (IL-6) and prealbumin (PA) with heart failure with preserved ejection fraction (HF-PEF). Methods A total of 126 HF-PEF patients admitted in our department from June 2017 to May 2019 were recruited, and their clinical data were collected and retrospectively analyzed. According to the results of echocardiography, the patients were divided into decreased left ventricular diastolic function group and normal left ventricular diastolic function group, with 63 patients in each group. The levels of IL-6, PA, brain natriuretic peptide (BNP) and other biochemical indicators were compared between the 2 groups. Multivariate logistic regression analysis was used to identify the influencing factors of HF-PEF. SPSS statistics 22.0 was used for data analysis. Results The decreased left ventricular diastolic function group had significantly older age [(78.2±9.3) vs (70.3±8.9)years], higher body mass index [(25.2±3.4) vs (23.8±2.8)kg/m²], increased E/e′ [(13.4±5.5) vs (9.2±1.8)] and elevated levels of BNP [(115.0±128.9) vs (46.7±59.5)pg/ml] and IL-6 [(5.3±5.2) vs (3.3±3.4)pg/ml], but obviously lower levels of albumin [(38.9±3.8) vs (40.7±3.8)g/L] and PA [(21.5±4.6) vs (24.7±5.2)mg/dl] when compared with the normal left ventricular diastolic function group (P<0.05). Logistic regression analysis showed that age (OR=1.062,5%CI 1.007-1.119; P=0.026) and E/e′(OR=1.365,5%CI 1.127-1.653; P=0.002) were positively correlated with HF-PEF, while PA was negatively correlated with HF-PEF (OR=0.916,5%CI 0.842-0.997; P=0.043). Conclusion HF-PEF is related to age and PA level. Detection of PA may be helpful to early diagnosis of HF-PEF.

Abstract:Objective To investigate the effect of general anesthesia combined with continuous infusion of different doses of dexmedetomidine on elderly patients with hip fracture. Methods From January to December 2018,9 elderly patients with hip fracture admitted in our hospital were enrolled in this study. They were randomly divided into low-dose dexmedetomidine group (n=45) and high-dose group (n=44). Continuous infusion of dexmedetomidine as adjuvant anesthesia was given at 0.5μg/(kg·h) for the patients in the low-dose group, and at 1.0μg/(kg·h) for those in the high-dose group. The extubation and recovery time, mean arterial pressure (MAP) and heart rate (HR) at pre-anesthesia (T0), post-anesthesia induction (T1), after infusion of dexmedetomidine for 15min (T2) and end of operation (T3), as well as the levels of pre- and post-operative stress response indicators were compared between the 2 groups. SPSS statistics 18.0 was used for data analysis. Results The recovery time [(13.42±0.69) vs (16.91±1.08)min] and extubation time [(20.17±2.46) vs (27.63±3.02)min] were significantly shorter in the low-dose group than the high-dose group (P<0.05). Compared with the levels at T0, MAP and HR at T1, T2 and T3 time points were obviously decreased in both groups (P<0.05). There was no differences in the 2 indicators at the above time points between the 2 groups (P>0.05). The levels of cortisol [(189.24±23.76) vs (153.48±20.57)μg/L; (182.63±24.81) vs (152.88±21.72)μg/L] and aldosterone [(49.21±8.62) vs (33.76±5.80)pg/L; (47.29±4.02) vs (34.07±3.97)pg/L] at 2h after operation were notably higher than those before operation in the 2 groups (P<0.05). But no differences were found in the levels of adrenaline, cortisol, noradrenaline and aldosterone between the 2 groups before and 2h after operation (P>0.05). Conclusion Continuous infusion of high and low dose dexmedetomidine combined with general anesthesia can stabilize hemodynamic indicators in the elderly patients with hip fracture, but low dose can shorten the extubation time and recovery time.

Abstract:Objective To study whether experiential nutrition education can improve nutritional status of maintenance hemodialysis (MHD) patients. Methods From January to December 2017,0 patients undergoing MHD in the First Department of Internal Medicine, Yibin Second Hospital of Traditional Chinese Medicine were recruited, randomly divided into intervention group and control group (n=90 cases in each group), and given experiential and traditional nutrition education respectively. Six months later, nutrition knowledge-attitude-practice (KAP) score, nutrition-related biochemical indicators and physical measurement indicators were compared between the 2 groups. The overall nutritional status of patients was assessed by patient-generated subjective global assessment (PG-SGA) scale. SPSS statistics 19.0 was used for data analysis. Results There were no significant differences in age, gender, dialysis time and primary diseases between the 2 groups (P>0.05). After intervention, the intervention group had obviously higher knowledge score [(8.5±1.3) vs (6.7±2.0)], practice score [(4.1±1.0) vs (3.4±1.3)], hemoglobin level [(106.4±9.2) vs (96.1±8.7)g/L], albumin level [(38.3±5.2) vs(36.2±4.9)g/L], triceps skinfold thickness [(6.1±2.1) vs (5.4±1.9)mm], arm circumference [(26.0±4.4) vs (24.5±4.1)cm], arm muscle circumference [(24.1±2.6) vs (22.8±2.9)cm], and body fat ratio [(22.6±4.1)% vs (21.1±4.4)%] when compared with the control group (all P<0.05). There was no significant difference in PG-SGA score between the 2 groups before intervention [(6.1±2.2) vs(6.3± 2.4), P>0.05]. After intervention, the PG-SGA score was obviously lower in the intervention group than in the control group [(4.5+2.0) vs (5.6+2.1), t=3.60, P<0.05]. The nutritional status A was 27%(24/90) in the control group, and 40%(36/90) in intervention group, with significant difference between them (P<0.05). Conclusion Experiential nutrition education can improve the nutritional knowledge, attitude and practice of MHD patients, promote their dietary compliance and improve their nutritional status.

Abstract:Objective To analyze the clinical characteristics and risk factors of aspiration pneumonia (AP) in very elderly patients with pulmonary infection. Methods A retrospective study was conducted of a total of 212 elderly patients (≥80 years old) with pulmonary infection who were hospitalized in the Geriatric Department of Xijing Hospital from January 2013 to January 2016. They were divided into two groups:AP group (n=61) and non-AP group (n=151). Clinical data of the patients were collected, including gender, age, BMI, underlying diseases, medication history, etc., for the analysis of the clinical characteristics and risk factors of aspiration pneumonia in very elderly patients. SPSS statistics 18.0 was used for data analysis. Results Of the 212 elderly patients with pulmonary infection, 61(35.4%) developed aspiration pneumonia. Sputum cultures were mainly Gram-negative in both groups. The length of hospital stay in the AP group was significantly longer than that in the non-AP group [(21.4±2.1) vs (15.7±3.1)d,P=0.034], and the mortality rate was significantly higher than that in the non-AP group (24.6% vs 8.0%, P=0.002). The subjects in the observation group had more cognitive impairment, swallowing dysfunction, hypothyroidism, and a history of long-term use of angiotensin converting enzyme inhibitor/angiotensin Ⅱ receptor blocker (ACEI/ARB) antihypertensive drugs (P<0.05). Multivariate logistic regression analysis found that advanced age (OR=4.897,5%CI 3.556-7.878), cognitive impairment (OR=6.799,5%CI 2.931-9.443), swallowing dysfunction (OR=8.345,5%CI 1.062-5.133), and acid-suppressing drugs (OR=4.667,5%CI 4.283-8.343), sedatives (OR=3.886,5%CI 1.944-7.174), nitrates (OR=3.445,5%CI 2.977-6.437), calcium antagonist (OR=3.568,5%CI 4.345-7.868), ACEI/ARB (OR=6.876,5%CI 2.192-9.458) were independent risk factors for AP in elderly patients with pulmonary infection (P<0.05). Conclusion [JP+1]The incidence of AP is high in elderly patients. Advanced age,cognitive impairment, swallowing dysfunction and long-term use of ACEI/ARB antacids, sedatives, nitrates, calcium antagonists, and ACEI/ARB antihypertensive drugs are independent risk factors for the occurrence of AP in elderly people with pulmonary infection.

Abstract:Objective To compare the clinical efficacy and safety of ultrasound-guided iliac fascia block combined with lumbosacral plexus block and general anesthesia in hip arthroplasty in elderly patients. Methods A total of 90 elderly patients undergoing hip arthroplasty in Macheng People′s Hospital from October 2017 to October 2018 were enrolled in this study, and randomly divided into observation group and the control group, with 45 cases in each group. General anesthesia was used in the patients of control group, while iliac fascia combined with lumbosacral plexus block was given to those in observation group. Both groups were followed up for 30d post-operatively. The amount of intra-operative sufentanil, amount of drug in intravenous self-controlled pain (PCA), time of getting out of bed, time of discharge, scores of visual analogue scale (VAS) at 4,2 and 24h after operation, peri-operative hemodynamic parameters, cognitive function, and incidence of complications in 30 d after operation were compared between the 2 groups. SPSS statistics 17.0 was used for data analysis. Results The observation group had less intra-operative sufentanil dosage [(12.39±2.44) vs (38.02±5.28)μg], lower drug amount in PCA in postoperative 24h [(58.34±3.59) vs (81.13±4.25)ml], shorter time of getting out of bed [(4.16±0.81) vs (5.34±1.15)d] and discharge time [(7.29±0.76) vs (8.35±0.96)d] when compared with the control group (all P<0.01). But all the scores of mini-mental state examination (MMSE) were significantly higher in the former than the latter group. But the trends in VAS scores were opposite [4h:(0.83±0.15) vs (3.34±0.61); 12h:(1.52±0.31) vs (3.31±0.54); 24h:(1.76±0.35) vs (3.15±0.62), all P<0.05]. The mean arterial pressure (MAP) and heart rate (HR) in the observation group were significantly higher than those of the control group at 10 min after the completion of anesthesia, at the beginning and at the end of operation (P<0.05). After 30d of follow-up, no death occurred in the 2 groups, and the incidence of complications was significantly lower in the observation group than the control group (4.44% vs 31.11%, P<0.05). Conclusion Ultrasonic-guided iliac fascia block combined with lumbosacral plexus block can be applied in hip arthroplasty for elderly patients with high safety, good anesthesia effectiveness, and less impact on the hemodynamics and cognitive function.

Abstract:Objective To explore the effect of luteolin (Lu) on myocardial mitochondrial injury in rats with heart failure (HF) induced by isoprenaline. Methods Thirty male SD rats (6-7 weeks old) were randomly divided into control group, model group (HF) and Lu intervention group (HF+Lu), with 10 animals in each group. Rat model of HF were established by intra-peritoneal injection of 50mg/(kg·d) isoproterenol in HF and HF+Lu group, while the rats in control group were intraperitoneally injected with normal saline equally. At the same time, the rats in HF+Lu group were also given 3ml Lu 50mg/(kg·d) by gavage, while the rats in the other 2 groups were given 3ml 50g/L sodium carboxymethyl cellulose by gavage. After intervention for 10d, echocardiography was performed to detect cardiac function; on the eleventh day transmission electron microscopy was used to observe the ultrastructural changes of myocardial mitochondria; and fluorescent enzyme labeling was employed to measure mitochondrial membrane potential (MMP), and activities of succinate dehydrogenase [JP+2](SDH) and cytochrome C oxidase (COX); RT-PCR was applied to detect theexpression of apoptosis-related genes Bax, caspase3 and caspase9. SPSS statistics 19.0 was used to analyze the data. Results Echocardiography showed that compared with control group, left ventricular ejection fraction [LVEF, (68.0±3.1)% vs (86.0±4.5)%, P=0.023] and left ventricular fraction shortening [LVFS, (32.0±3.7)% vs (43.0±2.5)%, P=0.002] were decreased significantly, while left ventricular end-systolic diameter [LVEDs, (4.10±0.29) vs (3.20±0.27)mm, P=0.010] and left ventricular end-diastolic diameter [LVEDd, (7.10±0.34) vs (5.87±0.35)mm, P=0.034] were increased markedly in the HF group. After Lu intervention, LVEF [(78.0±5.8)% vs (68.0±3.1)%, P=0.028] and LVFS [(39.0±1.5)% vs (32.0±3.7)%, P=0.006] were elevated while LVEDs [(3.40±0.23) vs (4.10±0.29)mm, P=0.043] and LVEDd [(5.65±0.21) vs (7.10±0.34)mm, P=0.019] were decreased in the HF+Lu group compared with HF group. Under a transmission electron microscope, the myocardial mitochondria in control group had clear and complete structure, clear Z line, well-arranged thick and thin filaments, and mostly round or oval shaped. Myocardial mitochondria in HF group were swollen and uneven in size, with damaged membrane integrity, broken or dissolved cristae, and formed vacuoles. Compared with HF group, the damage of myocardial mitochondria in HF+Lu group was significantly reduced, cristae was clear, membrane integrity was better, and no vacuoles were found. Compared with control group, the MMP and activities of SDH and COX in HF group were significantly decreased (P<0.05), and the mRNA levels of Bax, caspase3 and caspase9 were significantly increased (P<0.05); compared with HF group, the MMP and activities of COX and SDH in HF+Lu group were significantly increased (P<0.05), while the levels of above genes were significantly decreased (P<0.05). Conclusion Lu plays a protective role in HF rats by reducing isoprenaline-induced myocardial mitochondrial damage and apoptosis.

Abstract:Objective To investigate the effect of geniposide (GE) on phenotypic transformation of neonatal rat cardiac fibroblasts (CF) as well as on collagen synthesis under the induction of high glucose (HG), and explore the underlying mechanisms. Methods Primary CF were extracted from neonatal rats, and then treated in presence or absence of 33.3mmol/L HG or GE for 24h. The mRNA levels of collagen Ⅰ (Col I), collagen Ⅲ (Col Ⅲ) and connective tissue growth factor (CTGF)were detected by reverse transcription-polymerase chain reaction (RT-PCR). The markers of oxidative stress, including superoxide dismutase (SOD), reduced nicotinamide adenine dinucleotide phosphate (NADPH) and malondialdehyde (MDA) were measured by corresponding test kits. The protein levels of transforming growth factor-beta (TGF-β), acetylated-Smad3 (ac-Smad3), α-smooth muscle actin (SMA) and silent information regulator 1 (SIRT1) were detected using Western blotting. After SIRT1 inhibitor, EX-527 was added, the expression of SIRT1 and α-SMA, activities and production of oxidative stress markers, and protein levels of ac-Smad3 signal pathway related proteins were observed and measured to further explore the protective mechanisms of GE. SPSS 22.0 statistics was used to analyze the data. Results Treatment of GE at different concentrations (1-100μmol/L) for 24h resulted in decreased mRNA levels of Col Ⅰ, Col Ⅲ and CTGF in a dose-dependent manner. Meantime, GE significantly reduced the activity of NADPH, decreased the production of MDA and enhanced the activity of SOD in the process of HG induction. Western blotting indicated that HG treatment induced up-regulation of TGF-β, ac-Smad3 and α-SMA, while GE obviously inhibited the elevations and reversed the down-regulation of SIRT1 induced by HG. Immunofluorescence assay showed that the inhibitor EX-527 could block the inhibitory effect of GE on HG-induced α-SMA and oxidative stress. Conclusion GE exerts inhibitory effect on high HG-induced phenotypic transformation of CF as well as collagen synthesis, which may be associated with TGF-β/ac-Smad3 signal pathway and oxidative stress mediated by SIRT1.

Abstract:Hepatitis B is caused by hepatitis B virus (HBV) and features inflammatory lesions of the liver, resulting in damage of multiple organs. Hepatitis B, a main cause of chronic hepatitis, cirrhosis, and liver cancer, is highly prevalent in China. The condition has become a public problem that seriously jeopardizes the health of people. This review briefly describes the five stages of the natural history of chronic HBV infection and summarizes in details the factors affecting the prognosis of HBV infection, providing reference in alleviating the damage of liver function and reducing the occurrence of adverse prognosis.

Abstract:Oxidative stress was first proposed by German scientist Sies in 1985 and its research has been continued for more than 30 years. A large number of studies across the world have confirmed that oxidative stress is involved in the occurrence and development of heart failure. Anti-oxidative stress treatment in preclinical settings has also been extensively investigated with promising results. However, most of the anti-oxidation strategies currently used in clinical practice have failed to improve the prognosis of patients with heart failure. This article summarizes the changes in oxidative stress/reduction stress in heart failure and provides new insights into the future orientations in antioxidant/reduction stress.

Abstract:Coronary CT angiography (CCTA) can be employed to assess the anatomical stenosis of the coronary artery but is unable to accurately determine whether the stenosis, especially borderline ones, can cause the myocardial ischemia. Fractional flow reserve (FFR) is a gold standard for assessing functional ischemia as a result of coronary stenosis, but it′s invasive and expensive, so it has not been widely used in clinical practice. The fractional flow reserve based on coronary CT (FFRCT), a non-invasive combination of function and anatomy, is of great significance for the diagnosis of coronary heart disease. This article reviews the value and clinical progress of FFRCT in the diagnosis of coronary heart disease.