Objective To analyze the anti hypertensive drugs use of clinical characteristics of obstructive sleep apnea hypopnea syndrome(OSAHS) patients complicated with hypertension.Methods 233 obstructive sleep apnea hypopnea syndrome patients complicated with hypertension were enrolled,and they were theated with three different therapy methods.After the treatment,the situations of kind,effect and combined use of oral antihypertensive drugs were statistically analyzed.Results The most frequently used drugs were calcium channel blocker (CCB),especially nifedipine sustained-release tablets [75.5％ (176/233)];the combined prescription was 63.9％ (149/233) of all prescriptions,but the data reduced to 57.1％ (133/233) after OSAHS therapy.Conclusion There is a good condition regarding using oral antihypertensive drugs in Weihai.However,some antihypertensive drugs are used irrationally.

Objective To analyze the protein expression changes of retina in diabetic mice using isobaric tags for relative and absolute quantitation (iTRAQ) approach and to study proteins of apoptosis.Methods 8 diabetic mice were chosen as the diabetic model group (DM group),8diabetic mice as the normal control group.The animals were housed in wire-bottomed cages and received normal pellet chow and tap water in a constant environment.After 10 weeks,all mice were killed,and their retina were dissected.After hematoxylin and eosin(H&E) staining,the sections of retina were examined using light microscopy.The changes of protein expression in retina were studied using iTRAQ approach.Expression of apoptosis associated proteins was analyzed using ingenuity pathway analysis (IPA).Results Compared with control group,mice retina in DM group developed looser structures,tissue edema and obvious telangiectasia under light microscopy.Using iTRAQ approach,a total of 348 differential proteins were identified.Among those proteins,16 proteins were related with apoptosis,including Ataxin-10,Protein NDRG1,mucin-4,Aquaporin-1 and annexin A4,etc.There were 8 apoptosis-related proteins in retina with up-regulation,and the other 8 proteins with down-regulation in the DM group.The relationship between these proteins were analyzed and charted by IPA.Conclusions Apoptosis may be involved in the development of diabetic retinopathy.The identification of the apoptosis-related proteins will be helpful for the further study.

Objective To investigate the expression of p73 gene and its protein and their relation with clinicopathologic features in nasopharyngeal carcinoma (NPC) tissues.Methods Expression of p73 mRNA and protein in 52 NPC and 25 normal nasopharyngeal tissues was detected by real-time fluorescent quantitative PCR and immunohistochemistry.Results Expression of p73 mRNA and protein was significantly higher in NPC than that in normal nasopharyngeal tissues (mRNA:73.1％ vs 24.0 ％,protein:71.2 ％ vs 36.0 ％),there were significant statistical differences between the two groups (P ＜ 0.05),and their expression was closely related to tumor invasion depth,degree of differentiation and clinical stage (P ＜ 0.05).Expression of p73 gene and protein was not closely related to age and gender (P ＞ 0.05).Conclusion Detection expression of p73 mRNA and its protein can be helpful in the diagnosis and prognostic evaluation in NPC.

Objective To evaluate the clinical efficacy,overall survival and toxicities in the patients with advanced non-small cell lung cancer treated by liposome paclitaxel combined with nedaplatin as first-line treating.Methods 34 cases with advanced NSCLC were treated with liposome paclitaxel 150 mg/m2 on day 1 and nedaplatin 80 mg/m2 on day 1 by intravenous infusion,with 21 days as one cycle.The patients were treated with chemotherapy more than 2 cycles.Efficacy evaluation and adverse events were evaluated every 2 cycles.Results 34 patients were available for evaluation of efficacy and adverse events.The patients recieved 174 cycles of chemotherapy,and the median was 5.3 cycles.The objective response rate of liposome paclitaxel combined with nedaplatin was 32.3 ％,the disease control rate was 67.6 ％,the median overall survival was 9.5 months (95 ％ CI 6.2-10.7),1 years survival rate was 40.6 ％.The main adverse events were hematological and gastrointestinal toxicities.Frequent grade Ⅲ-Ⅳ toxicities included neutropenia (41.7 ％),anemia (17.6 ％),thrombocytopenia (8.8 ％),nausea and vomiting (8.8 ％),diarrhea (5.8 ％).Conclusions The regimen of liposome paclitaxel combined with nedaplatin is against advanced non-small cell lung cancer with high efficacy and acceptable toxicities,and it may be used as a new choice for treatment of advanced non-small cell lung cancer.

Objective To study tirofiban intravenous injection,coronary artery injection of the two different methods in acute ST segment elevation myocardial infarction,the application of emergency PCI.Methods Patients underwent emergency PCI with acute ST segment elevation myocardial infarction as the research subjects,a total of 108 cases,the patients were randomly divided into the observation group and control group,54 patients in each group. In the observation group,the first dose of tirofiban was injected into the coronary artery.The control group was treated by intravenous injection.The results of the two groups were compared.Results Before treatment,TIMI level 2 and level 3 ratio,initial corrected TIMI frame count of the observation group were significantly lower than the control group (χ2 /t =4.32,4.59,5.25,all P <0.05).After treatment,MBG level 2 or level 3 ratio,post -operative corrected TIMI frame count of the observation group were significantly higher than the control group (χ2 /t =4.11,4.85,5.87, all P <0.05).1 h after PCI treatment,the number of cases of ST fully back,the added value of EF,plague index scores of observation group were 53 cases,(8.02 ±6.94)%,(0.41 ±0.28)respectively,which were significantly higher than those of the control group 36 cases,(5.87 ±6.54)%,(0.28 ±0.27)(χ2 /t =5.32,4.32,3.65,all P <0.05).Adverse events of the two groups had no significant difference (χ2 =0.52,P >0.05).Conclusion Compared with intravenous injection,tirofiban in the treatment of acute ST segment elevation myocardial infarction by intracoronary injection can improve the level of myocardial perfusion after PCI operation,promote the recovery of left ventricular function,and has high security.

Objective To evaluate the efficacy of intravenous recombinant human brain natriuretic peptide in acute anterior myocardial infarction complicated with heart failure.Methods Two hundred patients suffered from acute anterior myocardial infarction complicated with heart failure were randomly divided into two groups:rhBNP group ( n =100) and control group ( n =100 ).All patients were given conventional treatment,patients in rhBNP group were given rhBNP on the basis of conventional therapy.The clinical effectiveness including the improvement of cardiac function,cardiac ultrasound data,the incidence of hospital adverse cardiac events,and six month follow-up were compared between the two groups.Results The degree of decompensation and Killip class in rhBNP group were better than those of control group after treatment ( improved dyspnea:significantly improved:36 vs 27 ; improved:49 vs 46; no improvement:11 vs 20 ; deterioration:4 vs 7 ; Ridit value:0.4618 vs 0.5382,P =0.043) ( Killip class:significantly improved:26 vs 20; improved:56 vs 45; no improvement:14 vs 25 ; deterioration:4 vs 10; Ridit value:0.4553 vs 0.5447,P =0.017 ).After treatment for one week,The LVEF improvement in rhBNP group was more remarkable than that of control group ( [ 53.0 ± 5.2 ] ％vs.[ 50.0 ±:6.2 ] ％,P =0.014).The occurrence rate of angina ( 13.0％ vs.27.0％,P =0.013 ),heart failure ( 18.0％ vs.32.0％,P =0.022) and major adverse cardiac events(MACE) ( 17.0％ vs.30.0％,P =0.030) inrhBNP group was lower than that in control group.During 6 months follow-up period,event-free survival in rhBNP group was higher than that in control group ( 69.0％ vs.55.0％,P =0.041 ).Conclusion Transvenous injection of rhBNP combined with other routine treatment can improve cardiac function in patients with myocardial infarction in acute anterior myocardial infarction.It can also decrease adverse cardiac events during hospitalization and increase event-free survival in 6 months follow-up period.

Objective To evaluate the short-term clinical efficacy and safety of administration of levosimendan or milrinone added to conventional therapy in patients with decompensated heart failure.Methods A total of 180 patients admitted due to heart failure [NYHA (New York Heart Association) class Ⅲ or Ⅳ] were randomly (random number) divided into control group,milrinone group and levosimendan group (n =60,each group).A continuous infusion of milrinone added to conventional therapy was administered for 72 hours in milrinone group,while administration of levosimendan for 24 hours in levosimendan group.The changes in left ventricular ejection fraction (LVEF),left ventricle end-diastolic diameter (LVDD) and B-type natriuretic peptide (BNP) plasma level were compared between before and after treatment,respectively,and comparisons of improvement in cardiac function (NYHA class) and hospital mortality were carried out among three groups.Patients were further followed up at 3 months after treatment.Results The LVEF in levosimendan group after treatment had significantly more increased than that in control group [(32.0±6.3)％ vs.(30.6 ±5.5)％,P =0.007].Compared BNP before treatment,the sums of BNP deducted were 444.0 (-74.0,1068.0) pg/mL,469.0 (141.5,1151.5) pg/mL and 936.5 (437.8,1566.8) pg/mL in control group,milrinone group and levosimendan group,respectively after treatment (all P ＜ 0.01).Moreover,the deduction in BNP was more dramatic in levosimendan group compared with control or milrinone group (t =3.256 or 2.665,P =0.004 or 0.026).After treatment for 5 days,the probability at least of achieving more effectively better improvement in NYHA class (cardiac function) in levosimendan group was 2.036 times that of control group (95％ CI:1.030-4.028,P =0.041).The incidence of combined end point events (death or readmission) in levosimendan group was significantly lower than that in milrinone group (50％ vs.70％,HR =0.573,95％ CI:0.358-0.917,P=0.020),while in hospital mortality,readmission or 3-month mortality incidence was similar among 3 groups (P ＞ 0.05).Conclusions The short-term clinical efficacy of levosimendan is superior to that of milrinone or conventional therapy in patients with decompensated heart failure.

Objective To investigate the short-term clinical efficacy of levosimendan on treating patients with decompensated cardiac insufficiency.Methods One hundred and twenty patients with heart failure (NYHA Ⅲ-Ⅳ or Killip Ⅲ) were randomly divided into levosimendan group(n =60) and control group(n =60).The patients in levosimendan group were given intravenous levosimendan for 24 hours beside conventional heart failure medications.The patients in control group were given the conventional heart failure medications.The left ventricular ejection fraction (LVEF) was recorded and B-type natriuretic peptide (BNP) were measured before and after treatment.NYHA grade and mortality also were recorded.All patients were followed up for 3 months.Results The LVEF in the levosimendan group after the treatment was (35.6 ± 13.3)％,significantly higher than that in the control group ((31.4 ± 6.7) ％,F =8.952,P =0.002).The BNP in two groups after treatment were lower compared with before treatment(P ＜0.05).And it was more remarkable after treatment in levosimendan group compared with control group (441.0 (212.5,1050.0) ng/L vs.870.0 (435.0,1267.0) ng/L,P =0.014).The change of NYHA grade in levosimendan group was better than that in control group after 5 d.The recovery rate and ineffective or deterioration rate in levosimendan group were 45.0％ (27/60),26.7％ (16/30) and 43.3％ (26/60) respectively,higher than that of control group (28.3％ (17/60),20.0％ (12/60),36.7％ (22/60)) (OR =2.280,95％ CI 1.163-4.468,P =0.016).There was no significant difference in term of mortality between in hospital and 3 months follow-up in the levosimendan and the control group (20％ (12/60) vs.25％ (15/60),28.3％ (17/30) vs.41.7％ (25/60),x2 =1.543,P =0.214 and x2 =2.590,P =0.108).There was a decreasing trend regarding of readmission rate during 3 months in levosimendan group compared with that of the control group (21.7％ (13/60) vs.33.3％ (20/60),x2 =3.591,P =0.058),but mortality or readmission rate was lower than that in the control group (46.7 ％ (28/60)vs.66.7％ (40/60),x2 =4.835,P =0.028).Conclusion The short-term clinical efficacy of levosimendan on treating patients with decompensated cardiac insufficiency is remarkable better than the traditional treatment.

Objective To investigate the relationship between regular exercise habit and coronary collaterals of patients with acute coronary syndrome (ACS).Methods TWo hundred and thirty-night patients diagnosed ACS and operated coronary angiography (CAG) showing severe coronary stenosis were enrolled hospitalized from May 2012 to October 2012.They were divided into regular exercise group (n =102) and irregular exercise group(n =137) according to the exercise frequency.The information of the general data,the information of CAG and other relevant index were collected.The coronary artery score was recorded according to the Censini and the coronary collateral class was made according to the Rentrop.Other characters in clinical and laboratory were recorded.Multi-factor regression analysis was used to analysis the influence factors of coronary collateral.Results The proportion of coronary collaterals (41.2％ (42/102)) in the regular exercise group was higher than that in the irregular exercise group (24.1％ (33/137)),and the difference was statistically significant(x2 =7.929,P =0.005).Lg(Gensini score) was (1.89 ± 0.18) the and (1.94 ± 0.19) in the regular exercise group,The left ventricular ejection fraction was 57.0％ (52.0％,60.0％) in the regular exercise group and 50.0％ (45.0％,57.0％) in the irregular exercise group,and the difference was statistically significant (Z =-5.152,P =0.000).Multi-factor regression analysis showed that regular exercise (OR =3.423,95％ CI:1.790-4.578),diabetes mellitus (OR =0.451,95％ CI:0.212-0.962),B-type natriuretic peptide (OR =2.412,95 ％ CI:1.271-4.578),non-ST-segment elevation ACS (OR =2.383,95％ CI:1.185-4.791),chest pain history (OR =2.207,95％ CI:1.175-4.145),Gensini score (OR =1.538,95％ CI:1.141-2.073) were independent influence factors of coronary collateral(P ＜ 0.05).After adjusting other factors,the patients with regular exercise had better coronary collaterals than that with irregular exercise (OR=3.423,95％CI:1.790-6.548,P ＜0.001).Conclusion The regular exercise can promote coronary collateral emergence for the patients with ACS.

Objective To evaluate the improvement effect of levosimendan by vein injection on short term cardiac function of patients with decompensated heart failure.Methods One hundred and sixty patients admitted due to heart failure were randomly divided into levosimendan group and control group (80 subjects for each group).Patients in control group were given a regular therapy including diuretics,vasodilators (including the recombinant human brain natriuretic peptide),angiotensin converting enzyme inhibitor(ACEI) or angiotensin Ⅱ receptorantagonists(ARB),β blockers,spironolactone and stain.Patients in levosimendan were administered levosimendan for 24 hours plus regular therapy.The improvements of dyspnoea in 9 days and cardiac function classification in 30 days after therapy were assessed.Mortality of 1 month and 3 month in two group were calculated and compared during follow-up.Results The dyspnoea improvement rate was superior than that of control group during 9 days (OR =1.956,95％ CI:1.156-3.310,P =0.013).The improvements in the levosimendan group were better than in the control group at 1 st day (OR =2.261,95 ％ CI:1.280-3.999,P =0.005),at 3rd (OR =2.002,95 ％ CI:1.111-3.607,P =0.021) and 5th day (OR =1.846,95 ％ CI:1.009 -3.377,P =0.047).However,there was no significant difference in term of improving dyspnoea between the levosimendan group and the control group at 9th day (P =0.126).Similarly,the improvement of cardiac function classification in the levosimendan group was superior than the control group during 30 days (OR =1.933,95％ CI:1.229-3.040,P =0.004).Although no significant difference was seen regarding of improving cardiac function classification between the two groups at 30th day after treatment (P =0.115),the improvements in the levosimendan group were better than in the control group at 3rd (OR =1.986,95％ CI:1.195-3.300,P =0.008),5th (OR =2.268,95 ％ CI:1.329-3.873,P =0.003),9th (OR =2.627,95 ％ CI:1.419-4.860,P =0.002) and 14th day(OR =2.212,95％ CI:1.189-4.112,P =0.012).Moreover,there was a nonsignificant reduction in terms of mortality in levosimendan group during 1-month and 3-month follow-up compared with control group (P ＞ 0.05).Condusion Levosimendan can effectively improve the short-term cardiac function in patients with decompensated heart failure.