Objective To observe the application value of cardiac troponin I (cTnI),cardiac troponin T (cTnT) and creatine kinase MB (CK MB) for the early diagnosis of acute myocardial infarction (AMI).Methods The same serum sample was measured to detect the indexes of cTnI,cTnT and CK MB levels in 60 patients with AMI and 40 patients with UA.Comparison between AMI and UA was performed and all the indexes were analysed contrastively.Results The sensitivity of cTnI and cTnT was higher than that of CK MB,and their positive rates were 63.3%,46.7% and 18.3% respectively (P0.05) and the specificity of the three indexes were almost the same without significant difference.Conclusion cTnI and cTnT,as specific markers of cardiac damage,are more sensitive and specific in the early diagnosis of AMI.As a convenient,swift and accurate measurement method,cTnI has significant clinical value.

Objective To study the effect of gastrin, motilin of chronic atrophic gastritis model in rats by acupuncturing at back-shu points. Methods 60 SD rats were randomly divided into blank control group, model control group, omeprazole group, back-shu points group, with 15 rats in each group, and to establish the model of chronic atrophic gastritis by irregular diet that given rats odd and even days. The blank control group, model control group were fed with normal saline, 2ml/time, 1 time/day. The omeprazole group was given oral gavage(Omeprazole 0.44 mg/kg, Clarithromycin 6.92 mg/kg, Metronidazole 7.6 mg/kg), 1 time/day. Back-shu points group received acupuncture at “Geshu”“Ganshu”“Pishu”“Weishu”“Shenshu”, retaining 15 min, 1 time/day. After 30 days, the content of ELSIA was used to detect the serum gastrin, motilin. Results ①GAS of model control group(54.25±5.70)pg/ml was significantly decreased compared with blank control group(66.63± 5.99)pg/ml, the difference was statistically significant (P<0.05). Compared with the model control group, GAS content of omeprazole group(62.70±8.55)pg/ml and back-shu Points group(66.27±3.79)pg/ml were higher, showed significant differences(P<0.05). ②MOT of model control group(223.60±17.83)pg/ml was significantly increased compared with the blank control group(188.45 ± 8.90)pg/ml, the difference was statistically significant(P<0.05). MOT of omeprazole group(200.16 ± 4.38)pg/ml and back-shu Points group(190.11±10.04)pg/ml were lower than those in the model control group, there was statistically significant difference(P<0.05). Conclusion Acupuncturing at back-shu acupoints can increase the content of GAS, reduce content of MOT, regulate gastrointestinal hormone in rats of chronic atrophic gastritis model.

Objective To analyze the clinical effect of brevisapine injection on high sensitivity C-reaction protein level in the treatment of acute myocardial infarction.Methods The patients were randomly divided into treatment group(n=80)and control group(n=80).Both groups were treated with routine midication,but treatment group were given intravenous drip of 100 mg brevisapine once a day.for 14 days.80 paients who came for diagnosis were selected for healthy control group.The selqlm high sensitivity C-reaction protein levels were measured at 2 d,7 d,and 14 d by ELLSA in treatment group,control group and healthy control group.Mortality,heart function status (Killip class),revaseularization and clinical adverse cardic events including postinfartion angina,new arrhythmia,reinfarction and bleeding complication at 4 weeks were observed.Results Treatment group had a significantly high level of hs-CRP compared with healthy subjects[(6.37±1.43)vs.(2.17±1.12)mmol/L,P＜0.01]at the second day.The serum hs-CRP content of treatment group was obviously lower than that of control group(3.21±1.31)and(2.25±0.34)mmol/L vs.(5.87±1.16)、(3.97±1.21)mmol/L,(P＜0.01)]on the 7th,14th days;The revascularization rate of treatment group was obviously higher than that of control group[62.50%(50/80)vs.51.25% (45/80),P ＜0.01];There was no difference between the two groups in mortality(3.75% vs.4.10%,P ＞0.05).No difference was found in the rate of bleeding between the two groups(6.25% vs.7.50%,P ＞0.05);Patients with Killip class＜Ⅱ of treatment group was obviously higher than that of control group (83.75% vs 61.25%,P ＜ 0.05 );Clinical adverse cardic events rates at 4 weeks of treatment group were obviously lower than those of control group (P ＜ 0.01 ).No obvious adverse reactions related to the treatment group were observed.Condusion The serum hs-CRP level is in close relation with acute myocardial infarction,which is the risk factor.It is effective and safe of brevisapine injection in the treatment of acute myocardial infarction.The effects of brevisapine on acute myocardial infarction might be involved in decreasing the level of hs-CRP and inhibiting the vascular inflammatory reaction.

Objective To investigate the relationship of polymorphisms at codons 333 and 637 of TAP-1 allele gene to recurrent condyloma acuminatum (CA) in a Chinese population. Methods Amplificatory refraction mutation system-PCR (ARMS-PCR) was performed to detect TAP1 polymorphic residues at codon 333 in 88 patients with recurrent CA and 81 age- and sampling date-matched controls and at codon 637 in 60 patients with recurrent CA and 60 age- and sampling date-matched controls. Results The frequencies of AA,GG and AG genotypes at codon 333 of TAP-1 gene were 86.36%, 0, 13.64%, respectively, in patients with recurrent CA, 79.01%, 0 and 20.99%, respectively, in the controls, and no significant difference was observed between the two groups (χ2 = 1.604, P ＞ 0.05). However, a significant difference was observed in the frequencies of AA, GG and AG genotypes at codon 637 of TAP-1 gene between the patients and controls (3.33% vs 10.0%, 95.00% vs 60.00%, 1.67% vs 30.00%, χ2 = 21.551, P ＜ 0.01 ). Conclusions The recurrence of CA may be associated with the polymorphism at codon 637, but not with that at codon 333, of TAP-1 gene.

Objective To assess the efficacy of laryngeal mask airway Supreme (LMA Supreme) used in patients undergoing laparoscopic surgery. Methods One hundred and twenty ASA I or Ⅱ patients of both sexes aged 35-60 yr weighing 48-85 kg undergoing elective laparoscopic surgery were randomized to 2 groups ( n = 60 each): LMA Supreme group (group S) and tracheal intubation group (group T). Mallampati test was performed before operation in both groups. The patients were classified as I - Ⅲ . In group S the LMA Supreme was inserted after induction of anesthesia with sufentanil 0.2 fig/kg, propofol 2-3 mg/kg and vecuronium 0.1 mg/kg. A gastric tube was inserted through the drain tube of the LMA Supreme. In group T the patients were intubated under direct laryngoscopy. The success rate, LMA placement/intubation time, success rate of gastric tube placement, airway seal pressure, SpO2, PETCO2 , peak airway pressure and complications (hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents) were recorded. The duration of surgery, anesthesia time, extubation time and emergence time were also recorded. Results There was no significant difference in the success rate between the two groups. The placement and removal time and recovery time were significantly shorter in group S than in group T. The airway seal pressure was (25 ±4) cm H2O in group S. SpO2, PETCO2 and peak pressure were within normal range in both groups. The incidence of postoperative hypoxemia, choking and sore throat were significantly lower in group S than in group T. Conclusion LMA Supreme can provide adequate ventilation during operation with less complications and can be used effectively for laparoscopic surgery.

Objective To investigate the effects of inhalation of different concentrations of sevoflurane on pulmonary inflammatory response in rats. Methods One hundred and twenty adult Wistar rats of both sexes weighing 200-250 g were randomly divided into 4 groups: Ⅰ control group breathing room air (group C, n = 12);Ⅱ oxygen group breathing 40% O2(group O, n = 36);Ⅲ and Ⅳ sevoflurane groups breathing 1.5% and 3.0% sevoflurane in 40% O2 respectively (group S1, S2, n = 36). Group Ⅱ was further divided into 3 subgroups according to the duration of 40% O2 inhalation 4 h, 8 h and 10 h. Group Ⅲ and Ⅳ were further divided into 3 subgroups ( n = 12 each) breathing sevoflurane for 4 h, 8 h and 8 h followed by 2 h O2 (40%) inhalation. The animals were sacrificed at the end of O2 or/and sevoflurane inhalation. Broncho-alveolar lavage was performed in 6 animals in each subgroup. The TNF-α concentration in broncho-alveolar lavage fluid was determined. The TNF-α mRNA expression and MPO activity in the lung tissue were measured in the other 6 animals in each subgroup. Results Inhalation of 1.5% or 3.0% sevoflurane for 4 or 8 h did not induce inflammatory response in the lung as compared with animals breathing room air or 40% O2 . Conclusion Exposure to sevoflurane does not induce pulmonary inflammatory response in rats breathing spontaneously.

Objective To evaluate the effect of neuromuscular block on the airway sealing pressure of laryngeal mask airway (LMA) i-gel in patients undergoing general anesthesia.Methods Sixty patients scheduled for elective surgery under general anesthesia with LMA i-gel were randomly allocated to one of three groups (n =20 each):control group (group C),rocuronium 0.3 mg/kg group (group R1) and rocuronium 0.6 mg/kg group (group R2).Anesthesia was induced with target-controlled infusion of propofol and remifentanil.The target plasma concentration of propofol was 3.5 μg/ml,and the target effect-site concentration of remifentanil was 3.0 ng/ml.When the patients lost consciousness and after the target plasma and effect-site concentrations were balanced,LMA i-gel was inserted to perform mechanical ventilation.After insertion of LMA i-gel,rocuronium 0.3 and 0.6 mg/kg were injected in R1 and R2 groups,respectively.The airway sealing pressure of LMA i-gel was detected immediately after insertion of LMA i-gel and at 1 min after administration of rocuronium.Results There was no significant difference in the airway sealing pressure of LMA i-gel between groups and within groups(P ＞ 0.05).Conclusion Neuromuscular block has no significant effect on the airway sealing pressure of LMA i-gel in patients undergoing general anesthesia.

ObjectiveTo investigate the relationship between the polymorphisms of the promoter of a disintegrin and metalloproteinase 10(ADAM10) gene and sporadic Alzheimer's disease (SAD).Methods The promoter of ADAM10 gene in 10 controls and 10 SAD patients was sequenced.Three variations were found,then these variations in 298 SAD patients (SAD group) and 315 healthy controls (control group)were genotyped by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).ResultsThree polymorphisms were found in the promoter of ADAM10 gene: -279G/A (rs653765),- 630G/T( rs514049 ) and - 921GAGA/- ( rs33926666 ).For - 921GAGA/-,there were significant differences in genotype ( GAGA/GAGA:138 (46.3％ ),GAGA/-:155(52.0％),-/-:5(1.7％))and allele frequencies (GAGA:431 (73.6％),-:165 (27.7％) ) between SAD and control (genotype:x2 =34.130,P =0.000; allele:x2 =25.972,P =0.000). For - 279G/A,there were significant differences in genotype and allele frequencies between SAD and control in the subjects without ApoEε4 allele (genotype:x2 =8.734,P=0.013; allele:x2 =5.129,P=0.024). -279G and -921GAGA were relatively protective allele types for SAD,and they were not in linkage disequilibrium.ConclusionThe polymorphisms - 279G/A and - 921GAGA/- of ADAM10 are associated with SAD.Allele G or genotype G/G of -279G/A and the GAGA/GAGA genotype or the GAGA allele of -921GAGA/- might have a protective effect on SAD.

Objective To investigate the correlation between serum HCY (Homocysteine) and carotid artery stenosis,plaque stability in patients with ischemic cerebrovascular disease.Methods 154 patients with ischemic cerebrovascular disease in Tangdu Hospital were enrolled in the study from June to December 2016.The serum levels of HCY were detected.CT angiography (CTA) was uesd for patients with neck vascular scanning.According to the difference of serum HCY level,patients were divided into 80 cases of high HCY group (observation group) and 74 cases of normal HCY group (control group).The degree of carotid artery stenosis,number and stability of plaque were compared between the two groups and the correlation between serum HCY level and degree of carotid artery stenosis and plaque stability were analyzed.Results The total stenosis rate in the observation group was significantly higher than that in the control group,the moderate stenosis rate and severe stenosis rate in the observation group were significantly higher than those in the control group,with the statistically significant differences (x2 =5.594～ 22.506,all P＜0.05).The levels of serum HCY in mild,moderate and severe stenosis group were 13.16 ± 6.73,15.19± 5.93 and 26.13 ±11.18 μmol/L respectively.The levels of H CY in moderate stenosis group and severe stenosis group were significantly higher than that in mild stenosis group,and the levels of HCY in severe stenosis group was significantly higher than that in moderate stenosis group,with the statistically significant differences (t=2.684～ 5.270,all P＜0.01).The rate of carotid plaque in the observation group was significantly higher than that in the control group,and the differences statistically significant (x2 =25.053,P＜0.01).The rate of unstable plaque and mixed plaque in the observation group was significantly higher than that in the control group,and the rate of stable plaque was significantly lower than that in the control group (x2 =4.067～ 14.95,all P＜0.05).The levels of serum HCY in stable plaque group,mixed plaque group and unstable plaque group were 16.14±5.49,21.91 ± 6.32 and 26.74 ± 10.59 μmol/L respectively.The levels of HCY in mixed plaque group and unstable plaque group were significantly higher than that in stable plaque group,and the differences were statistically significant (t=4.370,4.628,all P＜0.01).The level of HCY in unstable plaque group was significantly higher than that in mixed plaque group,and the difference was statistically significant (t =2.249,P＜ 0.05).Conclusion Serum HCY levels were closely related to carotid artery stenosis and plaque stability.Hyperhomocysteinemia can increase the incidence and degree of carotid artery stenosis as well as the number of carotid plaques and unstable plaques.

Objective To determine the relationship between neuronuscular block induced by cisatracurium for tracheal intubation during anesthesia induction and types of myasthenia gravis (MG).Methods Sixty-five patients of both sexes with MG,aged 20-75 yr,weighing 53-92 kg,with body height of 155-185 cm,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective videoassisted thoracoscopic thymectomy,were enrolled in the study.Among the 65 patients,there were 8 patients with ocular MG (type Ⅰ),19 patients with mild generalized MG (type]Ⅱ a),33 patients with subacute generalized MG (type Ⅱ b),2 patients with acute MG (type Ⅲ) and 3 patients with late severe MG (type Ⅳ).Neuromuscular monitoring was initiated when the patients lost consciousness after induction of anesthesia.Cisatracurium was administrated with the initial dose of 0.05 mg/kg,and if T1 depression was less than 95％ within 6 min,cisatracurium 0.015 mg/kg was intravenously injected until T1 depression was more than 95％.The patients were then tracheally intubated.The amount of cisatracurium consumed for intubation,onset time (from the beginning of cisatracurium injection to T1 depression ＞95％) and recovery time (recovery of T4/T1 to 25％ of control height) of neuromuscular block were recorded.T1 depression ＞ 95％ within 6 min after administration of 1-fold ED95 cistracuriun was defined as sensitivity to muscle relaxants.The requirement for cistracurium ＞ 1-fold ED95 when T1 depression ＞ 95％ was defined as insensitivity to muscle relaxants.The proportion of sensitivity/insensitivity was calculated.Results There was no significant difference in the amount of cisatracurium consumed for intubation and onset time and recovery time of neuromuscular block between patients with type Ⅰ and those with type Ⅱ a (P＞0.05).Compared with patients with type Ⅰ and type]Ⅱ a,the amount of cisatracurium consumed for intubation was significantly decreased,the proportion of sensitivity/insensitivity was increased,the onset time was shortened,and the recovery time was prolonged in patients with type Ⅱ b (P＜0.05).Conclusion With the severity of MG,the consumption of cisatracurium is gradually decreased when used for tracheal intubation during anesthesia induction,and the sensitivity is gradually increased in the patients with MG.