Objective The aim of our study was to investigate the effects and mechanisms of ghrelin on neovascularization in atherosclerosis plaque. Methods 30 male New Zealand rabbits were randomly divided into normal control group ( CON group) , atherosclerosis model group ( AS group) , and ghrelin treatment group ( ghrelin group) , and each group of 10 rabbits. The AS group and ghrelin group underwent balloon-induced arterial wall injury and then fed with high fat diet, the CON group was fed only on a regular diet. They were all fed for 3 months. Then the ghrelin group was given ghrelin 25μg·kg-1 ·d-1 , the other two groups received the same amount of sterile normal saline only. Four weeks later, body weight and blood lipids were detected. The thickness ratio of the intima to media was measured by HE staining. Degree of intra-plaque angiogenesis was evaluated by CD31+ cells immunohisto-chemistry. The vascular endothelial growth factor ( VEGF ) and vascular endothelial growth factor receptor 2 ( VEGFR2) were detected by quantitative realtime PCR and Western blot. The expressions of matrix metalloproteinase ( MMP)-2 and MMP-9 were detected by immunohistochemistry and Western blot. Results ( 1 ) No significant differences in body weight and blood lipids were found between the AS group and the ghrelin group(P>0. 05), but both items were significantly higher than those of the CON group(P<0. 05). (2)The thickness ratio of the intima to media in the ghrelin treated group was distinctly less than that in the AS group(P<0. 05). (3)Compared with the AS group, the ghrelin group showed significantly decreased microvascular density and the expressions of VEGF and VEGFR2 (P<0. 05). (4)Compared with the AS group, ghrelin dramatically inhibited the plaque contents of MMP-2 and MMP-9 ( P<0. 05 ). Conclusions Ghrelin is able to inhibit the growth of neovascularizationin in the atherosclerotic plaque and the development of plaque. And these beneficial effects derive from downregulation of VEGF, VEGFR2, MMP-2, and MMP-9 at the advanced stage of atherosclerosis in rabbits.

Objective: To explore the relationship between prevalence of atrial fibrillation (AF), iskhemia stoke and CHA2DS2-VASc score in patients≥65 years in order to provide prevention and treatment basis in clinical practice. Methods: A total of 5016 patients admitted in our hospital from 2013-10 to 2015-10 were enrolled. The patients were divided into 2 groups: AF group, n=437 and Non-AF patients, n=4579; according to age, the patients were further assigned into 4 subgroups as <65 years subgroup, (65-74) years subgroup, (75-84) years subgroup and ≥85 years subgroup. The risk factors for AF occurrence were retrospectively studied. Results: Compared with the Non-AF group, the patients in AF group had the elder age and more male gender, both P<0.001; more patients combining with hypertension, coronary artery disease (CAD), diabetes, sick sinus syndrome and rheumatic heart disease, all P<0.001. Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were the independent risk factors for AF occurrence. Compared with Non-AF group, AF group showed the higher prevalence rate of ischemic stroke and the elder onset age, both P<0.01. For non-valvular AF, the ratio of patients with CHA2DS2-VASc score≥2 was higher than those with CHA2DS2-VASc score<2 and the rate of anticoagulant therapy was decreasing by age increasing, all P<0.001. Conclusion: Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were independently related to AF occurrence. Non-valvular AF patients had the higher risk for ischemic stroke than non-AF patients, anticoagulation therapy should be conducted at the early stage.

Objective: To explore the relationship between lower extremity atherosclerosis disease (LEAD) and cardiovascular risk factors in elder people.
Methods: A total of 700 consecutive patients receive lower extremity Color Doppler ultrasound in our hospital from 2013-05 to 2014-11 were investigated. The patients were divided into 3 age groups: Young and middle group, n=83, Elder group, n=377 and Senile group, n=240. Based on ultrasound scoring system, the patients were divided into 4 groups: Normal group, n=112, Mild atherosclerosis (Mild) group, n=81, Moderate group, n=466 and Severe group, n=41. The cardiovascular risk factors among different groups were compared.
Results: Multivariate unconditional logistic regression analysis showed that age, smoking, history of diabetes, uric acid (UA), ankle-brachial index (ABI) were the independent risk factors for LEAD (B=0.144, 1.496, 0.963, 0.004, -2.510; 95% CI: 1.120-1.190, 2.257-8.824, 1.456-4.716, 1.001-1.007, 0.012-0.534;P=0.000, 0.000, 0.001, 0.006, 0.009 respectively. Ordinal logistic regression analysis indicated that age, male gender, smoking, ABI, UA, history of hypertension were related to the severity of atherosclerosis (B=0.130, 0.737, 0.592, -3.365, 0.003, 0.735; 95% CI: 0.097-0.162, 0.222-1.252, 0.052-1.132, -4.674 to -2.055, 0.001-0.005, 0.313-1.157;P=0.000, 0.005, 0.032, 0.000, 0.005, 0.001 respectively. Compared with Young and Middle groups, Elder and Senile groups had increased rates of moderate and severe arteriosclerotic lesions; compared with Elder group, Senile group presented the higher incidence of moderate and severe lesions, allP<0.01. With elevated age, the severity score of LEAD increased accordingly,P<0.01.
Conclusion: Lower extremity atherosclerosis lesions were more severe in elder patient, and it was particularly severe in senile patients.

Objective To explore the effect of modified Seldinger technology in PICC intubation for chemotherapy . Methods Forty patients with chemotherapy during January to December 2014 were assigned as the control group, where the traditional PICC intubation was used, and another forty patients during January to December 2014 as the observation group, where modified Seldinger technology was used. The two groups were compared in terms of post-intubation comfort, puncture success rate, bleeding rate and complications. Results The post-intubation comfort degree of the observational group was significantly higher than that of the control group (P<0.05). The total puncture success rate and one-time success rate were both statistically significantly higher than those of the control group, and the rates of obstruction and infection were significantly lower than those of the control one (P<0.05). Conclusion Modified Seldinger technology used for intubation for chemotherapy can help improve comfort degree and safety and reduce the rate of complications.

Objective: To explore the relationship between serum level of high-sensitivity cardiac troponin T (hs-cTnT) and atrial ifbrillation (AF) occurrence in patients with stable coronary artery disease (CAD).
Methods: A total of 1011 patients with stable CAD treated in our hospital from 2013-01 to 2015-09 were retrospectively studied. According to quartiles of hs-cTnT, the patients were divided into 4 groups: Group① the patients with hs-cTnT≤7ng/L, n=283, Group② hs-cTnT 7-10ng/L,n=238, Group③ hs-cTnT 10-15ng/L,n=272 and Group④ hs-cTnT>15ng/L,n=218. The relationship between hs-cTnT level and AF occurrence rate was studied; the risk factors for AF occurrence were explored by multi stepwise Logistic regression analysis.
Results: There were 127/1011 (12.6%) patients combining AF and 884 (87.4%) with simple type stable CAD. AF patients had the higher serum level of hs-cTnT than non-AF patients 17.0 (12.0, 25.0) ng/L vs 10.0 (7.0, 13.0) ng/L,P<0.01. With baseline hs-cTnT level increasing, AF occurrence rates were elevated from group① to Group④ as 4.6% (13/283), 4.6% (11/238), 11.0% (30/272) and 33.5% (73/218), Ptrend<0.05. Multi stepwise Logistic regression analysis revealed that with adjusted common risk factors of age and gender, the risk for stable CAD patients suffering from AF in Group④ was 5.324 times higher than group① (95% CI 2.285-12.405,P<0.01).
Conclusion: Increased serum level of hs-cTnT was closely related to AF occurrence in patients with stable CAD.

Objective:To compare the dosimetric differences between volumetric modulated arc radiotherapy with RapidArc and fixed-field intensity modulation radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC), and identify the techniques from which patients of different T stages can gain the maximum benefit. Methods:Sixty non-metastatic patients with NPC were randomly selected. According to the T staging of 2008 Chinese Classification, T1-T2 stage cases were observed in 20 of the 60 patients, whereas T3 and T4 stage cases were seen with 20 patients each. RapidArc and IMRT treatment plans were managed by the Eclipse treatment planning sys-tem of Varian Co., US. The dosimetry of the target volume coverage, organs at risk (OARs), monitor unit (MU) per second, and deliv-ery time were evaluated. Results:Both techniques reached the requirement of clinical treatment. The coverages of planning target vol-ume, conformity index, and homogeneity index were similar. However, the stratified analysis of T staging indicated that RapidArc plans led to an increased dose to the tumor target (P<0.05) and an improved homogeneity index (P=0.059) in the T4 stage cases. RapidArc al-lowed a statistical dose reduction to the OARs, including optic nerves, lens, temporal lobe, V20 of the parotids, larynx, and temporo-mandibular joint (P<0.05). In the T-stage stratified analysis, the D1%and Dmax of brain stem in T1-T3 stages were similar but statistical-ly low in T4 stage in the RapidArc group (P<0.05). Compared with those in IMRT group, the MUs and the delivery time in RapidArc group were reduced by 65%and 63%, respectively. Conclusion:Both RapidArc and IMRT attained the clinical requirement for NPC. RapidArc technique showed improvements in the OARs and reduction in MUs and delivery time. The target volume coverages were similar for T1-T3 stage. However, RapidArc delivered an increased dose to the tumor target in T4 stage cases, and the dose to OARs was reduced.

Objective:To study the chemical constituents of Aconitum straminiflorum. Methods:The air-dried roots of A. stra-miniflorum were powdered and extracted three times with 90% ethonal under reflux. After the removal of the solvent under reduced pressure,the crude extract was dissolved in 1. 5% HCl solution(7 L). The acidic solution was basified to pH 9. 0 with ammonia (25%)and extracted with CHCl3 to obtain crude extract of total alkaloids after the removal of CHCl3 . The compounds were isolated and purified by column chromatography and identified based on spectral analysis( MS,1 H-üMR and 13 C-üMR). Results:Totally 7 compounds were isolated from A. straminiflorum,and characterized as aconosine(1),13-deoxyludaconitine(2),dolaconine(3), ezochasmanine(4),talatisamine(5),scopaline(6)and cammaconine(7),respectively. Conclusion:Seven diterpenoid alkaloids are isolated from A. Straminiflorum for the first time.

Objective: To study the chemical constituents in the roots of Aconitum iochanicum Ulbr.Methods: The air-dried roots of A.iochanicum were powdered and extracted by methanol with a percolation method.After removing the solvent under reduced pressure, the crude extract was dissolved in1.5% HCl solution, and then extracted by ecetic ether.The acidic solution was basified to pH 9.0 by NaOH (5%) and extracted with ethyl acetate to obtain crude alkaloidal extract after the removal of ethyl acetate.The compounds were isolated and purified by column chromatography and identified based on spectral analysis (1H-NMR, 13C-NMR and MS).Results: Totally 18 compounds were isolated from A.iochanicum and characterized as 14-O-acetylsachaconitine (1), franchetine (2), crassicaudine (3), indaconoitine (4), 14-benzoyl chasmanine (5), 14-O-acetyltalatisamine (6), talatisamine (7), chasmannine (8), crassicauline A (9), bikhaconine (10), 13,15-dideoxyaconitine (11), crassicautine (12), kongboensine (13), liljestrandisine (14), ludaconitine (15), 8-deacetyl-yunaconitine (16), yunaconitine (17) and ouvrardiantine (18).Conclusion: It''s the first time to study the chemical constituents of A.iochanicum, and 18 diterpenoid alkaloids are isolated.

Objective:To study the chemical constituents in the roots of Aconitum transsectum. Methods:The compounds were i-solated and purified by column chromatography on the columns of silica gel, Al2 O3 and Sephadex LH-20, and their structures were elu-cidated on the basis of spectroscopic evidence ( MS and NMR) . Results:Totally 12 compounds were isolated from A. transsectum, and characterized as yunaconitine (1), indaconitine (2), crassialine A (3), 8-deacetylyunaconitine (4), talatisamine (5), chasma-conitine (6), 14-acetyltalatisamine (7), vilmoraconitine (8), sachaconitine (9), 14-acetylsachaconitine (10), acoforestinine (11) and vilmorrianine C (12). Conclusion:Compounds 8-11 are obtained from A. transsectum for the first time.

Objective To investigate the effect of enteral nutrition support via naso-jejunal tube in esopha-geal carcinoma patients treated with radiotheraphy.Methods 36 esophageal carcinoma patients were randomly assigned into enteral nutrition(EN)group,while 38 patients assigned to control group.All patients underwent defini-tion IMRT combined with weekly concurrent chemotherapy of paclitaxel-nedaplatin.The naso -jejunal tubes were bedside inserted by hand in EN group.Enteral nutrition support began the day after the tube insertion.The control group took food orally.Nutrition was assessed through body weight,BMI,lymphocyte,albumin,pre -albumin and hemoglobin.Treatment induced complications were recorded.Results The degree of nutritional reduction was lower in EN group and significantly different with the control group.The EN group underwent (4.5 ±1 .1 )cycles concurrent chemotherapy,the control group underwent (3.1 ±2.3)cycles concurrent chemotherapy(t=6.21,P=0.027).The hematotoxicity induced by chemoradiotherapy(CRT)was statistically severe in the control group(χ2 =24.64,P<0.01),while radiation esophagitis was similar between the two groups.Conclusion EN support via naso -jejunal tube in esophageal carcinoma patients treated with radiotheraphy may improve the nutritional status,alleviate CRT induced hematotoxicity,increase tolerance of CRT.