Objective To clarify the mechanism of lipoprotein (a) ［Lp (a)］ metabolic disorder in patients receiving maintenance hemodialysis (MHD), and to offer theoretical basis for seeking for modus operandi of disorder control.Methods The apolipoprotein (a)［apo(a)］ isoforms were identified by high-resolution SDS-agarose gel electrophoretic method followed by immunobloting in 61 patients receiving maintenance hemodialysis (MHD group), 51 patients with end-stage renal disease (ESRD group) and 62 healthy controls (healthy control group). The influential factors for elevated serum level of lipoprotein (a) in MHD group were analyzed by applying statistical method.Results No statistical difference of Lp (a) median level was found between MHD group and ESRD group in LWM isoforms, but their level was significantly higher than that of healthy control group. In MHD group, the concentrations of serum creatine(Crea),cystatin C(CysC) and C-reactive protein(CRP) were significantly higher (P<0.05), while the concentrations of albumin(Alb) and Hb were lower than those of healthy control group (P<0.05). The concentration of LDL-C had no significant difference between MHD group and healthy control group. Compared with those of ESRD group, the levels of Crea, CRP and CysC were not significantly increased (P<0.05) in MHD group. There was no difference in the level of Lp (a) between the MHD and the ESRD patients with LMW-apo (a) isoforms (P>0.05), but compared with healthy control group, the serum levels of Lp (a) in the two groups were remarkably increased (P<0.05). The level of Lp (a) with LMW-apo (a) were significantly correlated with Alb and CysC respectively (P<0.05). The level of Lp (a) with HMW-apo (a) of MHD patients were higher than that of ESRD patients (P<0.05). The patients in the two groups had higher levels of Lp (a) as compared with those of healthy control group. The positive correlation of Lp (a) level with CRP and CysC was observed in patients with HMW-apo (a) (P<0.01). As MHD group as concerned, Lp (a) level was associated with Alb and CysC (P<0.01); regression analysis showed that apo (a) isoforms, Alb and CysC were listed in the regression equation, and the determinate coefficient (r2) was 0.348, in which the respective r2 of apo (a) isoforms, Alb and CysC was 0.121, 0.178 and 0.049.Conclusion Multiple factors may contribute to the high level of Lp (a) in MHD patients. Moreover, Lp (a) with different isoforms of apo (a) had different influencing factors. The corresponding therapeutic measure should be taken according to apo (a) isoforms in order to acquire better therapeutic efficacy for MHD patients.

Objective:To introduce our experience on extra-operating room anesthesia of children with grave congenital heart diseases during cardiac catheterization an d ventriculography. 　　Methods:Three hundred and sixty-nine children with grave congenital heart d iseases undergoing cardiac catheterization or ventriculography were selected for this study,among whom 86 are presented with left to right shunt and pulmonary a rtery hypertention,11 with pulmonic stenosis and primary pulmonary artery hypert ention,and 272 with right to left shunt.They were routinely fasted before the pr ocedure.O2 Saturation(SpO2) and electrocardiogram were monitored and blood p ressure were recorded.With oxygen inhalated by mask and venous route established ,the children were injected with scolapamine (0.02 mg/kg) and ketamine (1-2 mg /kg) for anesthesia induction.When patients lost conciousness,ketamine (6-8 mg/ kg) and droperidol (0.15-0.30 mg/kg) were given intromascularly for maintaine nce.During the procedure,ketamine (1-2 mg/kg) were given to deepen anethesia. 　　Results:The procedures were fufiled steadily.Eighteen patients presented wit h different kinds of complications such as abdomen distention,vomitting,arrhymia and refractory anoxia to defferent degrees.One patient died,and the mortality w as 0.27%. 　　Conclusions:Anesthesia of children with grave heart diseases during cardiac catheterization and ventriculography is particular.It is important for the anest hesiologists to be familiar with the pathophysiology of heart diseases,and suppl y sufficiant oxygen,keep airway open and unobstructed,avoid stomach regurgitatio n and inhalation and maintain sufficient sedation during the procedure.Oxygen sh ould be given continuously and SpO2 monitored posoperatively to avoid any comp lication.

Objective To research the relationship between anaemia and inflammatory in patients with heart failure .Methods 284 cases of patients with heart failure were enrolled and divided into 2 groups (anaemia group and non‐anaemia group) .The serum levels of of brain natriuretic peptide (BNP) ,high‐sensitivity C‐reactive protein (hs‐CRP) ,blood urine nitrogen (BUN) and creati‐nine (Crea) were measured ,and the results were analyzed .Results The levels of BNP ,hs‐CRP and Crea of anaemia group were sig‐nificantly higher than those of non‐anaemic group (P<0 .01) .The results of logistic regression demonstrated that hs‐CRP was in‐dependently associated with anaemia (P=0 .021) .Conclusion The occurrence and development of inflammation are independently associated with anaemia in the patients with heart failure .

ObjectiveTo investigate the clinical efficacy and safety of solifenacin for female overactive bladder (OAB) who failed in toherodine treatment. MethodsFrom Jan 2010 to Oct 2010,48 cases of female OAB were treated with 5 mg/d solifenacin for 4 weeks after the failure of tolterodine treatment.The improvement of the perception of bladder condition as well as the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were used as objective indexes for the evaluation of therapeutic effect. ResultsAfter 4-week solifenacin treatment,the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were respectively decreased from the baselines ( 8.7 ± 1.5),(3.4 ± 2.1 ),( 2.4 ± 1.8 ),(2.1 ± 1.8 ) and (2.2 ±1.6) to be (7.2 ±2.5),(2.0 ±1.8),(1.5 ±1.2),(1.2 ±0.8) and (1.4 ±0.8).The perception of bladder condition was improved in 42 cases.The withdrawal from the treatment was seen in 3 cases due to headache and dry mouth.No severe adverse event was found in the rest 45 patients. Conclusion Solifenacin might be an effective and safe alternative agent in the treatment of female OAB who failed in tolterodine treatment.

Objective To investigate the value of low-dose MDCT in the diagnosis of breast cancer using ROC analysis. Methods Retrospectively analyze the breast images of 105 cases that had performed both 64-row CT and pathological examinations. The case number that underwent CT examination with routinedose parameters was 48; and that with low-dose was 57. Two radiologists with clinical experiences more than 5 years evaluated the breast lesions, respectively. And ROC curve was used to test the diagnostic efficacy of breast cancer between the two groups. Results Compared with the routine-dose group, the quality of CT image was high enough to disclose the breast lesions while the exposure dose was significantly decreased. The areas under the ROC curve between the routine-dose group (0.943) and the low-dose group (0.908) did not show significant difference (P >0.05). Conclusion Low-dose thin-slice MDCT with contrast enhancement can efficiently and safely diagnose breast cancer.

Aim To explore the effect of nNOS specific inhibitor 7-nitrioindazole(7-NI) on the neurogenesis after focal cerebral ischemia in the adult mice dentate gyrus.Methods Focal cerebral ischemia was induced by middle cerebral artery occlusion(MCAO).A bromodeoxyuridine(BrdU) method was used to identify the proliferated cells in hippocampal dentate gyrus.Step-down test was performed to assay the learning and memory function.Results The number of BrdU~+ cells was increased in the ipsilateral but not contralateral dentate gyrus after focal cerebral ischemia.7-NI promoted the increment in the ipsilateral dentate gyrus significantly.7-NI also improved the survival of the new-born cells,as well as the learning and memory function of ischemic mice.Conclusion Our results indicate that nNOS down-regulates the neurogenesis after focal cerebral ischemia.

Objective To observe the relationship between hemoglobin (Hb) and vascular endothelial growth factor (VEGF) in serum of the patients with cancer. Methods Enzyme linked immunosorbent assay (ELISA) was used to detect VEGF levels in serum of the patients with cancers. Results The serum level of VEGF in the cancer group are significantly higher than that in the control group. The serum level of VEGF in patients with low level of hemoglobin ( 123.5 g/L) ( P

0.05).CONCLUSIONS The rising rates of the drug-resistant Uu strains may be resulted of no-standard treatments.The treatment time will be shortened and the curative effects will be better if the treatments are based on the results of the susceptibility test.

Objective To analyze expression of miR-324-5p in plasma of CHD patients by real-time PCR and identification of early diagnosis,for CHD.Methods In 2012 June to 2013 February 76 patients and 13 normal controls who were included in the study had measurement of plasma expression levels of miR-324-5p by real-time PCR.MedCalc 13.0 software were used for statistical analysis and comprehensive evaluation of miR-324-5p in CHD disease for diagnosis.Results Analysis of re-ceiver operating curve (ROC)showed that area under the curve (AUC)was 0.731 and best diagnostic threshold was 0.116 1.The sensitivity was 64.5% and specificity of 84.6%.Conclusion Circulating miR-324-5p as a biomarker for early diagno-sis of CHD has some-extent clinical value,but needs combined with other medical indicators.

Objective The aim of this study was to investigate which inflammatory markers allow an accurate differentiation of septic and gouty arthritis.Methods In 2013 January to 2014 January 33 patients with septic arthritis and 29 patients with gouty arthritis.Detected white blood cells,C-reactive protein and uric acid of inflammatory markers in plasma and tested lac-tate,glucose,uric acid,lactate dehydrogenase and white blood cell count inflammatory markers in the synovial fluid.MedCalc 13.0 software were used for statistical analysis.Results There were no significantly different between serum C-reaction protein and WBC counts with two groups.Synovial lactate showed the greatest diagnostic potential (AUC=0.898,sensitivi-ty=96.9%,specificity=72.4%)followed by serum uric acid (AUC=0.818)and synovial uric acid (AUC=0.808).Con-clusion Lactate in the synovial fluid has excellent diagnostic potential to differ septic arthritis from gouty arthritis.Synovial lactate levers above 1.7 mmol/L almost proofed septic arthritis.