Dyslipidemia refers to the elevated cholesterol,triacylglyceride levels and/or the reduced high density lipoprotein level.It is the important risk factor for the occurrence of atherosclerosis,and it is alsoassociated with the onset and outcome of acute cerebrovascular disease.Therefore,the highly efficient and comprehensive lipid lowering therapy has become one of the most important and effective prevention measures for cerebrovascular disease.This article reviews the recent advances in research on dyslipidemia and lipid lowering therapy in patients with cerebrovascular disease.

Objective To observe clinical application of the apparent Shikani laryngoscope in difficult airway, so as to provide reference for basic-level hospitals to deal with difficult airway. Methods 50 patients with difficult airway were randomly divided into 2 groups:Shikani laryngoscope group (S) that direct laryngoscope group (M) . After conventional induction, patients in two groups were given endotracheal intubation with different intubation tools by the same anesthesiologist, then the intubation time and the one-time success rate of intubation were compared between two groups. The hemodynamics of patients, were observed in two groups,the HR,SBP,DBP and SPO2 at before (T0),during (T1),2 min after (T2) and 5 min after intubation (T3) were recorded. The complications including gingival and oral mucosa bleeding, sore throat, hoarseness were also recorded in two groups.Results During the process of intubation, the hemodynamic changes of patients had statistically significant difference between T0 and T1, T2,T3 subgroups ( <0.05),T2 and T3 subgroups ( <0.05) . The intubation had less influence on hemodynamics of patients in group S than M group,but the SPO2 and T0 had no significant difference between two groups ( >0.05) .Comared with M group,the one-time success rate of intubation was higher,and the intubation time was shorter in S group and there were significant differences ( <0.05) . There was no significant difference in the intubation complications between the two groups ( > 0.05), and this may be associated with small sample cases. Conclusion Compared with ordinary laryngoscope, Shikani laryngoscope has incomparable advantages in handling difficult airway and is convenient to apply,so it is worth popularizing in basic-level hospitals.

Objective To standardize the detection procedure and improve the detection ability through the capability evaluation of transfusion compatibility tests for blood transfusion departments in Dalian .Methods Both on‐site inspection and external quality assessment(EQA) were used .The items of on‐site inspection consisted of equipments ,reagents ,tests ,operating instructions and re‐cords .EQA included ABO grouping ,Rh(D) grouping ,antibody screening and crossmatching .Results 42 of 62 blood transfusion departments were qualified .Only one was unqualified in on‐site inspection because antibody screening were not carried out .The un‐qualified ratio of second‐class hospitals′ EQA was the highest (42 .3% ) .The coincidence rates of antibody screening and crossmatching were 82 .0% and 77 .4% respectively ,while those of ABO grouping and Rh(D) grouping was 100 .0% .Conclusion Relatively fixed staffing in laboratories and continual training was important for the improvement of transfusion compatibility tests .

Pulmonary circulation and gas exchange were observed during and after prostaglandin E_1-indueed hypotention in 9 adult mongrel dogs undergoing procaine balanced anesthesia. Cardiac index decreased from 12.5% to 13% (P0.05) during hypotension but the effective ratios of oxygen increased(P

AIM: To evaluate the effect of simvastatin on the left ventricular mass in patients with essential hypertension (EH). METHODS: 50 patients with hypertension without severe complication were randomly divided into two treatment groups: combination treatment group and hydragogue group, and 25 normal subjects without any treatment were taken as the control. The 25 patients in combination treatment group were given simvastatin and hydragogue for 12 weeks while the other patients in hydragogue group were given hydragogue during the same time. The left ventricular mass was examined from ultrasonography in all patients before and after treatment. RESULTS: The left ventricular mass index (LVMI) was higher in the two treatment groups of patients (133.61±31.02, 118.04±39.62 g·m-2) than that in the control group (88.79±22.73 g·m-2) before treatment (P<0.01, 0.0001, respectively) while the blood pressure was higher. There was no significantly difference in age, serum concentrations of total cholesterol or triglyceride, sugar and blood pressure between the two treatment groups and the control group (P>0.05). There was no significant difference in all variables between the two treatment groups before treatment. After treatment, the LVMI was decreased (133.61±31.02 vs 91.07±16.01 g·m-2, P<0.01) in the combination treatment group while there was no significant change in LVMI in the hydragogue group compared with the control group. The blood pressure in the two treatment groups was decreased to the normal. Compared with hydragogue group, the change of LVMI was higher in the combination group though the serum concentrations of total cholesterol, triglyceride or sugar were not significantly different. No significant change in serum concentrations of total cholesterol, triglyceride or sugar was found during treatment in the two groups. The change of LVMI did not correlate with the change of blood pressure, serum concentrations of total cholesterol , triglyceride or sugar in the combination treatment group(P>0.05). CONCLUSION: Being independent of the changes of serum concentrations of total cholesterol, triglyceride or sugar and blood pressure, simvastatin can inhibit the increase of left ventricular mass in patients with essential hypertension.

This study is to develop a therapeutic drug monitoring (TDM) network server of tacrolimus for Chinese renal transplant patients, which can facilitate doctor to manage patients' information and provide three levels of predictions. Database management system MySQL was employed to build and manage the database of patients and doctors' information, and hypertext mark-up language (HTML) and Java server pages (JSP) technology were employed to construct network server for database management. Based on the population pharmacokinetic model of tacrolimus for Chinese renal transplant patients, above program languages were used to construct the population prediction and subpopulation prediction modules. Based on Bayesian principle and maximization of the posterior probability function, an objective function was established, and minimized by an optimization algorithm to estimate patient's individual pharmacokinetic parameters. It is proved that the network server has the basic functions for database management and three levels of prediction to aid doctor to optimize the regimen of tacrolimus for Chinese renal transplant patients.

ObjectiveTo assess myocardial perfusion by the end-systolic and end-diastolic replenishment parameters of real-time myocardial contrast echocardiography (MCE).MethodsTwenty-one patients with myocardial infarction(MI) and normal control group of 6 cases underwent intravenous realtime myocardial contrast echocardiography via slow and homogeneous venous injections of SonoVue.MCE images were obtained from the apical 4-chamber,2-chamber,and long-axis views.According to the exponential function:y(t) =A [1 - e-kt] + B,the time intensity curves were obtained.By an off-line ECG triggering and curve fitting,the replenishment parameters A value,k value,A × k value were obtained separately from end-systolic and end-diastolic images.ResultsIn normal control group,the end-systolic replenishment parameters A value,k value,A × k value were all lower than that of the end-diastolic replenishment parameters[(6.21 ± 2.69)dB vs (7.93 ± 3.66)dB,P ＜0.05；0.36 ± 0.15 vs 0.42 ± 0.19,P ＜ 0.01 ;2.88 ± 1.29 vs 3.39 ± 1.61,P ＜0.05,respectively].The end-diastolic replenishment parameters were found significantly greater variability than the end-systolic values (variation coefficient CV:A value 46.2％ vs 43.3％,k value 45.2％ vs 41.4％,A× k value 47.5％ vs 44.8％,all P ＜0.05).In 21 patients,the end-systolic replenishment parameters in myocardial segments supplied by infarct-related coronary artery were significantly lower than that in myocardial segments supplied by non - infarct - related coronary artery.ConclusionsThe end-systolic and end-diastolic replenishment parameters of real time myocardial contrast echocardiography can assess myocardial perfusion.The variability of the end-systolic replenishment parameters is smaller than that of the end diastolic parameters.Significant variability in k-value suggests that this parameter is best suited for before-after study in the same patient.

Objective To evaluate the microcirculation abnormalities in the patients with hypertrophic cardiomyopathy(HCM). Methods Twenty patients with HCM and 20 healthy volunteers were included in the study. Two-dimensional images on the apical four-chamber, two-chamber and long-axis views, including 5 cardiac cycles before 'flash' and 15 cardiac cycles after 'flash', were reeorded and stored for off-line analysis in EchoPAC workstation. Then,contrast time-intensity curves were obtained for each available left ventrieular segment. Results There were significant differences in the A,k and the product A×k between the hypertrophic wall segments (P = 0.01, P<0.001, P = 0.036,respectively) and nonhypertrophic wall segments (P<0.001,respectively) and healthy subjects. A,k and the product A×k in hypertrophic wall segments were significantly different from those in nonhypertrophic wall segments in patients with HCM (P = 0.021, P = 0.016, P = 0. 001,respectively). Accordingly,the normalized value of A and the product A × k were lower in hypertrophied wall segments (P = 0.031, P<0.001, respectively) and nonhypertrophied wall segments(P = 0.002, P<0.001,respectively) in patients with HCM than those in normal segments of healthy controls. The normalized value of A and the product A × k were lower in hypertrophic wall segments than nonhypertrophic wall segments in patients with HCM(P = 0.045, P = 0.021,respectively). Conclusions Myocardial contrast echocardiography is a useful method to investigate myocardial perfusion abnormalities in patients with HCM.

Objective To study the effect of Tongxinluo on the plasma C-reactive protein(CRP)and endothelin-1(ET-1)in acute coronary syndrome(ACS) patients.Methods 100 patients with ACS were randomly divided into conventional therapy group and treatment group(conventional therapy+Tongxinluo gelatin capsule).The changes of CRP and ET-1 in the first day,7th and 14th day were observed.Results In the treatment group,CRP and ET-1 were significantly decreased in the 7th and 14th day(P＜0.05,P＜0.01),and there was significant decrease only in the 14th day(P＜0.05)in the conventional therapy group.CRP and ET-1 levels in the treatment group were significantly different as compared with conventional thereapy group(P＜0.01).Conclusion Tongxinluo capsule may protect blood vessel endothelium through inhibiting CRP and ET-1 to decrease the inflammatory response of endangium.

Objective To evaluate the relationship between carotid plaque instability and coronary heart disease by contrast-enhanced ultrasound. Methods Thirty-five patients with acute coronary syndrome (ACS) and 32 patients with stable coronary artery disease(sCAD) were included. Inclusion criteria were at least 1 carotid atherosclerotic plaque with thickness larger than 2.0 mm. Contrast-agent enhancement in the plaque was evaluated by visual interpretation and quantitative analysis. Results The percentage of soft plaque in ACS group was significantly higher than that in sCAD group ( P ＜0.001 ). The proportion of contrast-agent enhancement in patients with ACS was significantly than that in patients with sCAD( P =0. 037). The enhanced intensity in the plaque and the ratio of enhanced intensity in the plaque to that in the carotid artery lumen in patients with ACS were significantly larger than those in patients with sCAD ( P ＜0.001, P = 0.026, respectively). Sensitivity and specificity of prediction ACS were 74% and 60%,respectively,for enhanced intensity in the plaque and 86% and 67%, respectively, for ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery. Conclusions The subjects with ACS had more intense contrast-agent enhancement than the subjects with sCAD. Contrast-enhanced ultrasound can be used to evaluate the relationship between carotid plaque instability and coronary heart disease.