Objective To investigate the effect of Tongxinluo capsule combined with metoprolol on elderly patients with coronary heart disease and angina pectoris and its influence on hemorheology and inflammatory factors.Methods 135 elderly patients with angina pectoris of coronary heart disease were selected,and they were randomly divided into treatment group (68 cases) and control group (67 cases).The treatment group was treated with Tongxinluo capsule combined with metoprolol,while the control group was treated with metoprolol.The two groups were treated for 8 weeks.The curative effect of the two groups was compared,the number and duration of angina pectoris,the changes of hemorheology and inflammatory factors before and after treatment were compared.Results The total effective rate of the treatment group (94.12％) was higher than 76.12％ of the control group (P ＜ 0.05).After treatment,the frequency and duration of angina pectoris in the treatment group were (6.03 ± 1.21) times/week and (3.02 ± 0.76) min/time,respectively,which were significantly lower than those in the control group [(9.87 ± 1.46) times/week and (4.86 ± 0.98) min/time] (t =16.649,12.201,all P ＜ 0.05).After treatment,the whole blood viscosity at high shear rate [(3.76 ± 0.41) mPa/s],whole blood viscosity in low shear [(8.13 ± 0.76) mPa/s],plasma viscosity [(1.23 ± 0.08) mPa/s],erythrocyte aggregation index [(2.06 ± 0.27)],fibrinogen [(2.46 ± 0.41) g/L] in the treatment group were lower than those in the control group[(4.53 ± 0.52) mPa/s,(9.61 ± 0.89) mPa/s,(2.09 ± 0.27) mPa/s,(2.63 ± 0.35),(3.53 ± 0.62) g/L] (t =9.562,10.396,25.170,10.604,11.844,all P ＜ 0.05).After treatment,the interleukin-6 (IL-6) [(8.49 ± 1.76) pg/mL],intercellular adhesion molecule-1 (ICAM-1)[(85.25 ± 8.92) pg/mL],C reactive protein (CRP) [(8.74 ± 1.76) mg/L] in the treatment group were lower than those in the control group[IL-6 (11.32 ± 2.10) pg/mL,ICAM-1 (103.42 ± 10.72) pg/mL,CRP (14.98 ± 2.24)mg/L] (t =8.491,10.712,18.012,all P＜0.05).Conclusion Tongxinluo capsule combined with metoprolol in the treatment of elderly patients with coronary heart disease angina pectoris has obvious curative effect,and can improve the patients'blood rheology and inflammatory reaction.

Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune syndrome of central nervous system.The main clinical manifestations include psychiatric symptoms,movement disorders and seizures.It is often misdiagnosed as viral encephalitis.Tumors,especially the ovarian teratoma,play an important role in the disease.The prevalence in children is beyond imagination.Anti-NMDAR antibodies are specific diagnostic tests.Immune suppression is the main treatment.The first-line treatments include corticosteroids,intravenous immunoglobulin,and plasmapheresis.The second-line treatments include biological agents and cytotoxic drugs.Early diagnosis and treatment are essential for neurologic recovery.Overall prognosis is good.

ObjectiveTo investigate the relationship between carotid atherosclerosis and progressing stroke.Methods103 patients with acute cerebral infarction within the first 24 hours from onset were tested with carotid color doppler ultrasonography during the first week from admission. Univariate and multiple logistic regression analyses were performed to examine the relationship between carotid intima media thickness (IMT), plaque structure, the degree of artery stenosis and the early deterioration of cerebral infarction.ResultsPrevalence of carotid plaque and thickness of IMT in patients with progressing stroke were higher than that in non progressing patients. In logistic regression, presence of carotid plaque was independent predictors of progressing stroke. Plaque size, extent of artery stenosis and IMT were not included in the regression model.ConclusionPlaque structure and its chemical feature may be the cause of progressing stroke.

MicroRNA(miRNA)is a kind of 22 nt endogenous small non-coding single strand RNA and is universally present in animals and plants.It can suppress the expression of target genes at post-transcription al level by complementary biding to the 3'UTR of target mRNAs.Recent studies indicate that microRNA is closely associated with tumorigenesis,differentiation,metastasis and relapse.MicroRNA might act as a new biomarker of tumor diagnosis and a new target of tumor gene therapy.

Objective To evaluate the clinical practical value of the heart rate viability test in the patients with malignant tumor during their therapies. Methods Totally 187 cases were analyzed and were divided into three different groups, which included 90 malignant tumor patients before therapy, 45 patients with chemotherapy and 52 non-malignant tumor cases (control group). We compared four HRV indexes(ASDNN5,SDANNS, SDNN and RMSSD) of the patients between the different groups as well as inside each group. Results There were statistical significances in the indexes of ASDNN5, SDANN5 and SDNN of patients at different stages before therapy, the three indexes of the stage Ⅲ group were lower than those of the stage Ⅰ group and the control group as well. The three indexes of the stage Ⅳ group compared with the stage Ⅰ group or the control group (P<0.05) were lower either. There was also statistical significances in SDNN between the stage Ⅲ and the stage Ⅱ of the before-therapy group (P< 0. 05). The indexes of SDANN5 and SDNN of the stage Ⅳ in the chemotherapy group were lower than those of the same stage in the before-therapy group(P<0.05). Conclusions The later the stage of malignant tumor patients is, the more the index of HRV declines. Chemotherapy may affect autonomic nerve function of stage Ⅳ patients with malignant tumor and decrease their HRV.

Objective To explore the best plan of perioperative individualized fluid therapy in the elderly patients with coronary heart disease undergoing gastrointestinal surgery.Methods Eighty elderly patients with coronary heart disease undergoing gastrointestinal surgery were divided into experimental group and control group by random digits table method with 40 cases each.Conventional capcity treatment was given during surgery and postoperative period in control group.Individualized fluid therapy was used during surgery and postoperative period in intensive care unit of 24 h in experimental group,which was determined based on target controlled fluid therapy according to the cardiac index,stroke volume,and stroke volume variation.Traditional fluid therapy was used in control group in the intraoperative and postoperative period.The two groups were compared in terms of postoperative hemodynamic parameters,total fluid volume,incidence of adverse cardiac events,and recovery of gastrointestinal function.Results The mean arterial pressure at the beginning of the operation,the cardiac index at operation begining 1 h and at the end of operation were (80.4 ± 6.4) mmHg (1 mmHg =0.133 kPa),(4.0 ± 0.6) L/(min ·m2),(4.1 ± 0.8) L/(min ·m2) in experimental group and (76.9 ± 8.0) mmHg,(3.5 ± 0.4) L/(min· m2),(3.6 ± 0.3) L/(min · mè) in control group,and there were significant differences between two groups (P ＜ 0.05).During surgery and 24±hour stay in intensive care unit,the total fluid volume,crystal usage,urine and colloid usage were (2 915 ± 650),(2 715 ± 415),(1 515 ± 315),(1 225 ± 385),(419 ± 233),(619 ± 285),(1 015 ± 220),(1 535 ± 455) ml in experimental group and (3 645 ±770),(3 355 ±750),(2 315 ±320),(1 855 ±325),(602 ±31),(875 ±423),(805 ±250),(1 135 ± 205) ml in control group,and there were significant differences between two groups (P ＜ 0.05).The perioperative adverse cardiac events rate was 30％ (12/40) in experimental group,lower than 45％ (18/40) in control group,but the difference was no statistically significance (P ＞ 0.05).Conclusion In the elderly patients with coronary artery disease undergoing gastrointestinal surgery,individualized fluid therapy can effectively decrease adverse cardiac events,improve postoperative gastrointestinal function,and reduce length of hospital stay.

Mercury is one of the ubiquitous environmental neurotoxins which causes adverse effects on the development of children's neural system.Considering the severe neurotoxicity of mercury,finding and minimizing the sources of mercury exposure is essential for children's health.Amongst the mercury compounds,the toxicity of organic mercury is the most severe.Methyl mercury (MeHg) is the most detrimental and represents a major source of human exposure of mercury.Recent studies on molecular mechanisms of MeHg neurotoxicity points out that MeHg mainly mediates its toxic effects through the impairment of intraceilular calcium homeostasis,alteration of glutamate homeostasis,and oxidative stress.These concepts provide the biochemical interpreting of MeHg neurotoxicity.This review provides the current information on mercury,including environmental sources,neurotoxicity,and molecular mechanisms of MeHg-induced neurotoxicity.It will be helpful to find some effective ways of interfering children mercury exposure.

Objective To evaluate the effect of dexmedetomidine sedation on acute lung injury induced by trauma and endotoxemia two-hit in rats.Methods Twenty-four adult male Sprague-Dawley rats,aged 6-8 weeks,weighing 150-200 g,were randomized into 3 groups (n =8 each) using a random number table:control group (group C),two-hit group (group T) and dexmedetomidine group (group D).Bilateral middle femoral shaft fractures were produced using hemostatic forceps.In group D,dexmedetomidine 2.5 tμg· kg-1· h-1 was infused via the caudal vein immediately after fractures,while the equal volume of normal saline was infused for 8 h in C and T groups.Lipopolysaccharide 2.5 mg/kg was injected via the caudal vein at 4 h after fractures in T and D groups.All the animals were monitored for 24 h with a continuous glucose monitoring system.Blood glucose concentrations were recorded within 24 h after fractures,and mean amplitude of glucose excursions (MAGE) was calculated.The arterial blood samples were collected at 24 h after fractures for blood gas analysis.The lungs were then harvested for determination of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) contents in lung tissues and for microscopic examination of pathological changes which were scored.Results Compared with group C,MAGE,PaCO2,TNF-α and IL-6 contents and pathological scores were significantly increased,and pH value and PaO2 were decreased in T and D groups.Compared with group T,MAGE,TNF-α and IL-6 contents and pathological scores were significantly decreased,and pH value and PaO2 were increased,and no significant change was found in PaCO2 in D group.Conclusion Dexmedetomidine sedation can mitigate acute lung injury induced by trauma and endotoxemia two-hit,and the mechanism is related to reduced stress and inflammatory responses in rats.

Stromal cell-derived factor-1(SDF-1)is an early cell growth factor which belongs to a subfamily of chemokines.The CXCR4 is SDF-1 receptor.The SDF-1 interacting with CXCR4 plays important roles in physiological and pathological processes such as hematopiesis, stem cell homing,angiogenesis and leukemic cells infiltrating.To study the expression of CXCR4 in leukemia and the relationship between CXCR4 and leukemic cells infiltration can add indicators for leukemic MIC diagnosis of immunology indexes and have great significance to take molecule targeted therapy for preventing leukemia from infiltration or relapse as well.