Objective To investigate the serum lipoprotein (Lp) (a) level in patients with acute ischemic stroke and the prediction for short-term functional outcome. Methods The levels of serum Lp(a) were measured in 210 patients with acute ischemic stroke (within 24 h after onset) and 100 healthy people matched the gender and age. The patients were assessed with National Institutes of Health Stroke Scale (NIHSS) as admission, and modified Rankin Scale (mRS) as discharge. Results The median of Lp(a) was 325 mg/L (IQR: 180~545) in patients,significantly more than 148 mg/L (IQR: 69~265) in the normal controls (P<0.001). Level of serum Lp(a) was an independent variable for functional outcome (OR=1.004, 95%CI: 1.001~1.007, P<0.001) and death (OR=1.006, 95%CI: 1.001~1.008, P<0.001) in patients. In the receiver operating characteristic curve, the area under curve was more in the combined model [Lp(a) and NIHSS] than the NIHSS alone.Conclusion Serum Lp(a) increased in the in patients with acute ischemic stroke, and may predict the short-term outcome independently.

Objective To evaluate the effects of nursing intervention on the beliefs and behavior of early detection of breast cancer. Methods Four communities in Shanghai were selected by convenient sampling process. Then these four communities were randomly assigned to intervention group and control group. One hundred and eighty women who met the criteria of this study were selected from each group by convenient sampling process.Altogether 739 women were recruited. In intervention group,a one-year nursing intervention guided by health belief model was implemented,such as health education seminars,telephone follow in the third,sixth,and ninth months,and flyers of breast health care in the sixth month. Control group only received conventional education. Results After intervention women became aware of breast cancer (B=0.210,P＜0.01),perceived more benefits from attending early breast cancer detection (B=0.105,P＜0.01),and less difficulties in attending the activities of early detection of breast cancer (B=-0.086,P＜0.05). The number of women who performed breast self-examination once per month increased and more women received clinical breast examination (OR=3.0946) and mammogram after intervention (OR=2.746). Conclusion The nursing intervention,guided by health belief model,is helpful to improve women's beliefs and behaviors of breast cancer detection.

Flow cytometry (FCM) is used for multi parameter and rapid quantitative analysis of biological particles,such as all cells,microorganisms and synthetic microspheres in fast line flow state.It is also a modern cell analysis technology for the separation of specific groups.In recent years,FCM has been applied in the field of assisted reproductive medicine.FCM plays an important role in the diagnosis of immune infertility and predicting the fertilization ability of sperm.This article aims to review FCM application in peripheral immune cell surface marker detection for infertility patients,and research on the structure and function of sperm cell.

Objective To investigate the improving effects of Shenshao decoction on myocardial structure and function in diabetic cardiomyopathy,and its effect on expression of TLR4/MyD88-dependent pathway signal in diabetic cardiomyopathy.Methods Diabetes mellitus was induced in 8-week-old male Wistar rats by a single intraperitoneal injection of streptozotocin.The changes of plasma myocardial enzyme (CK, LDH) and high sensitive C reactive protein (hsCRP) were measured.Cardiac function was measured by left ventricular intubation.Hematoxylin and eosin staining and electron microscopy were used to observe the changes of myocardial morphology and ultrastructure in rats.Expression of Toll-like receptor 4(TLR4), myeloid differentiation protein 88(MyD88), and nuclear factor-κB P65(NF-κB P65) were tested by immunohistochemistry.Results After 6 weeks of treatment, the left ventricular diastolic and systolic functions were obviously improved;the degrees of myocardial fibers and mitochondrial damage were obviously relieved;the content of CK, LDH and hsCRP decreased (P< 0.05), and hsCPR was positively correlated with CK and LDH (r=0.823,r=0.819,P < 0.05).The expressions of TLR4, MyD88, NF-κB P65 were significantly decreased (P< 0.05).There was no significant difference in the above mentioned indicators between the control group and control+Shenshao decoction group (P> 0.05).Conclusions Shenshao decoction can reduce the myocardial injury in diabetic cardiomyopathy and improve cardiac diastolic and systolic functions.The mechanism may be related to attenuated inflammation by TLR4/MyD88 dependent signaling pathway.

Objective:To investigate the clinical efficacy of mechanical solitaire AB stents thrombectomy combined with intra-arterial thrombolysis in the treatment of patient with acute ischemic stroke.Methods:Fifteen patients with acute ischemic stroke admitted into our hospital from August 2014 to August 2016 were treated with mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis.The National Institutes of Health Stroke Scale score (NIHSS) of all patients were evaluated before and after treatment to compare the clinical efficacy.The prognosis ofpatients between two groups were compared via evaluating modified Rankin score (mRS)and gelasijia coma score (GCS).Results:After mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis treatment,14 patients achieved complete or part recanalization,and 1 patient was terminated treatment due to vital signs instability,and the rate ofrecanalization was 93.3％.The NIHSS score of patients before treatment was 12.93± 4.25,which was much higher than that after treatment (4.33± 1.45,P＜0.05).After follow-up by 3 months,the good mRS scores were obtained in all 18 patients,including 2 patients with mRS score of 2,5 patients with 1,and 8 patients with 0.Additionally,there was no patient with re-obstruction during follow-up period.Conclusion:Mechanical thrombectomy with solitaire AB stents combined with intra-arterial thrombolysis had a good capability and safety in the treatment of patients with acute ischemic stroke.

Objective To evaluate the clinical value of quantitative tissue velocity imaging (QTVI) in assessing left ventricular(LV) global and regional myocardial function in patients with mitral valve replacement(MVR).Methods Eighty patients having their implantations for more than six months were examined by echocardiography.QTVI-derived parameters such as peak systolic velocity(Sa,Sm) and early diastolic velocity(Ea,Em) of mitral annulus and LV wall were measured from the apical four-chamber,two-chamber and long axis corresponding myocardial segments in MVR groups decreased and LV ejection fraction but negative correlation between Ea' and isovolumic relaxation time(IVRT') in patients(P<0.01).Conclusions QTVI plays an important role in determining LV function of patients after MVR accurately.

Objective To study the effect of Xin Kang Injection on cardiac function of rats with adriamycin-induced myocarditis and to explore its pharmacological mechanism.Methods Seventy Wistar rats were randomly divided into seven groups:normal control group,model group,three-dosage Xin Kang Injection groups(high-,moderate-and low-dosage respectively),deslanoside group,and Huangqi group.The myocarditis rat model was established by intraperitoneal injection of adriamycin.Left ventricular end-diastolic pressure(LVEDP),left ventricular systolic pressure(LVSP),heart rate(HR),T value,and ? DP/DTmax were observed.Results LVSP,+ DP/DTmax in the treatment groups were higher and-DP/DTmax lower than those in the model group(P

Objective: To observe the effect of Tongxinluo (TXL) on homocysteine-induced rat’s cardiac micro vascular endothelial cell (RCMECs) injury and to study the oxidative stress mechanism. Methods: Primary RCMECs were cultured with tissue explants process, cell morphology was observed by inverted microscope and the cell was identiifed by CD31 immunolfuorescence method. RCMEC injury model was established by Homocysteine (Hcy) induction and the cells were divided into 5 groups: Control group, with normal cells, Hcy group, the cells were treated by Hcy at 10 mmol/L, Low-dose TXL group, Hcy treated cells were cultured with TXL at 100 mg/L, Middle-dose TXL (200 mg/L) group and high-dose TXL (400 mg/L) group. Cell survival rates were detected, supernatant levels of superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were examined, intracellular protein expressions of reactive oxygen species (ROS) and endothelial nitric oxide synthase (eNOS) were detected and mRNA expression of endothelin-1 (ET-1) was measured in different groups respectively. Results: Compared with Control group, Hcy group showed decreased cell survival rate (74.61 ± 2.88)% vs (100.00 ± 2.07)%, increased supernatant level of MDA (4.10 ± 0.18) nmol/ml vs (1.92 ± 0.10) nmol/ml, reduced SOD activity (7.55 ± 0.71) U/ml vs (20.77 ± 0.68) U/ml, elevated ROS level(38.17 ± 10.28) % vs (19.83 ± 2.97) %, up-regulated mRNA expression of ET-1 and down-regulated protein expression of eNOS. Compared with Hcy group, the above indexes were improved in each TXL group at different levels. Conclusion: TXL could decrease Hcy induced RCMECs injury, such protection was conducted by reducing the oxidative stress mechanism in cells.

Objective To explore the characteristics and its clinical significance of troponin I(cTnI),myo-cardial enzymes and intraoperative hemodynamic changes in the pediatric patients undergoing living donor liver trans-plantation. Methods Liver transplantation was performed in 50 congenital biliary atresia children who were ranged from grade Ⅲ or Ⅳ in Tianjin First Central Hospital from January 2013 to December 2014 according to the American Society of Anesthesiologists(ASA),meanwhile,the method of the combined intravenous - inhalation anesthesia was ap-plied during operation. Blood samples were drawn from central vein before skin incision(T0 baseline),at 30 min of an-hepatic phase(T1),30 min of neohepatic phase(T2),and 12 h,36 h after operation(T3,T4). Levels of cTnI,crea-tine kinase(CK),lactate dehydrogenase(LDH)and α - hydroxy butyric acid dehydrogenase(α - HBDH)were mear-sured,respectively. Furthermore,heart rate(HR),mean arterial blood pressure(MAP),central venous pressure(CVP) and arterial blood gas analysis[pH value,pa(O2 ),pa(CO2 ),and base excess(BE)]were monitored at the moment of T0,T1,T2 as well as the end of surgery. Results The levels of cTnI,CK,LDH and α - HBDH in T1 - T3 were in-creased,and there was a peak at the T2 compared with the baseline at T0(all P ﹤ 0. 05). At T3 and T4,cTnI,CK, LDH and α - HBDH levels significantly decreased compared with those at T2(all P ﹤ 0. 05),the levels of cTnI were (0. 06 ± 0. 02)μg/ L,(0. 37 ± 0. 52)μg/ L,(0. 05 ± 0. 02)μg/ L,CK levels were(344. 6 ± 209. 5)U/ L,(466. 1 ± 116. 4)U/ L,(219. 3 ± 111. 5)U/ L,LDH levels were(552. 3 ± 414. 9)U/ L,(966. 4 ± 454. 1)U/ L,(322. 8 ± 108. 8) U/ L,and α - HBDH levels were(301. 6 ± 124. 0)U/ L,(456. 4 ± 168. 4)U/ L,(146. 2 ± 80. 2)U/ L,respectively. The levels of hemodynamics significantly changed in anhepatic phase and neohepatic phase. Compared with T0:T1,HR ac-celerated,MAP,CVP decreased,BE value increased,and the differences were statistically significant(all P ﹤ 0. 05);T2,open vena cava and back to the blood volume surge,CVP,MAP increased,HR decreased but still higher than T0, BE value further increased,and the differences were statistically significant(all P ﹤ 0. 05). After the surgery,various hemodynamic indexes fell to preoperative levels,the levels of HR were(103. 1 ± 5. 9)times/ min,(128. 8 ± 8. 5) times/ min,(115. 1 ± 0. 3)times/ min,(103. 5 ± 5. 9)times/ min,MAP levels were(59. 7 ± 9. 1)kPa,(48. 7 ± 5. 4) kPa,(58. 6 ± 7. 1)kPa,(59. 1 ± 8. 6)kPa,CVP levels were(7. 5 ± 4. 3)kPa,(3. 9 ± 4. 6)kPa,(5. 8 ± 3. 5)kPa, (7. 2 ± 4. 1)kPa,BE levels were( - 1. 5 ± 5. 0)mmol/ L,( - 0. 4 ± 5. 7)mmol/ L,(1. 0 ± 3. 8)mmol/ L,(2. 4 ± 2. 2)mmol/ L,respectively. Conclusions The myocardial injury may appear during the perioperation of pediatric living donor liver transplantation and gradually aggravated during the anhepatic phase. The worst injury peaks at 12h and it gradually returns to the preoperative level 36 h postoperativelly.

Objective To evaluate the effect of dexmedetomidine on postoperative brain injury in pediatric patients undergoing living-related liver transplantation.Methods Forty American Society of Anesthesiologists physical status Ⅲ or Ⅳ pediatric patients of both sexes,aged 5-12 months,weighing 5-10 kg,were divided into dexmedetomidine group (group D,n =20) and control group (group C,n =20) using a random number table.After induction of anesthesia,dexmedetomidine was infused in a loading dose of 1 μg/kg for 10 min followed by a continuous infusion of 0.3 μg · kg-1 · h-1 in group D.The equal volume of normal saline was given instead in group C.Immediately before skin incision (T1),at 30 min of anhepatic phase (T2),at 1 h of neohepatic phase (T3),immediately after peritoneum closure (T4) and at 24 h after operation (T5),the blood samples were collected from the central vein to detect the concentrations of neuron-specific enolase (NSE) and S-100β protein in serum by enzyme-linked immunosorbent assay.Postoperative delirium was assessed at 1 day after surgery using Pediatric Anesthesia Emergence Delirium scale.At 1 day before surgery and 1 week after surgery,the Mental Development Index (MDI) and Psychomotor Development Index were recorded using Bayley Scale of Infant Development Ⅱ.Results The concentrations of serum NSE and S-100β protein were significantly higher at T2-5 than at T1 in the two groups (P＜0.05).Compared with group C,the concentrations of serum NSE and S-100β protein were significantly decreased at T2.5,and the Pediatric Anesthesia Emergence Delirium scale score and incidence of delirium were decreased after surgery in group D (P＜0.05).The MDI and Psychomotor Development Index were significantly lower at 1 week after surgery than at l day before surgery in the two groups (P＜0.05).The MDI was significantly higher at 1 week after surgery in group D than in group C (P＜ 0.05).Conclusion Dexmedetomidine can reduce postoperative brain injury in pediatric patients undergoing living-related liver transplantation.