Objective To investigate the relationship between coronary heart disease patients with heart fail -ure and natriuretic peptide ( BNP) and c-reactive protein ( hs-CRP) ,and provide the clinical basis .Methods 160 cor-onary heart disease patients with heart failure were selected as the observation group ,and 200 health individuals as the control group .The BNP and hs-CRP with heart failure were analyzed .Results BNP and hs-CRP of the observation group were(481.5 ±57.8)pg/mL and(12.4 ±2.9)mg/L,which were higher than that of the control group [(41.2 ± 9.6)pg/L vs(3.8 ±1.1)mg/L],the difference was statistically significant (t=13.17,5.28,all P<0.05);Left ven-tricular ejection fraction(LVEF)of the observation group was (41.9 ±6.3)%,lower than that of the control group (60.2 ±8.4)%,the difference was statistically significant (P<0.05);BNP and hs-CRP of grade Ⅰ,Ⅱ,Ⅲ and Ⅳincreased with the grade ,the differences were statistically significant ( t=5.20,10.11,12.42,4.18,5.02,3.98,all P<0.05);By Logistic analysis,serum BNP and hs-CRP were associated with heart failure of coronary heart disease . Conclusion Coronary heart disease patients with heart failure cardiac function were associated with BNP and hs -CRP,and with grade were gradually increasing that BNP and hs-CRP increased.

BACKGROUND:Neurotrophin-3 is found in the repair of spinal cord injury in the role of the strongest neurotrophic factor.It can effectively promote axonal regeneration through the glial scar tissue in repairing spinal cord injury.OBJECTIVE:To construct recombinant lentiviral vectors for gene delivery of homo sapiens neurotrophin-3(hNT3),and to investigate the expression of hNT3 gene in Schwann cells after transfection.DESIGN,TIME AND SETTING:Observational experiment was performed from June 2007 to March 2008 at the Central Laboratory of Changhai Hospital.MATERIALS:Bilateral sciatic nerves were harvested from 3-day-old Sprague Dawley rats for culture and identification of Schwann cells.Three-plasmid lentivirus systems:pGC-E1-EGFP,pHelper 1.0 and pHelper 2.0 were gained from Shanghai Chemical Technology Co.,Ltd.METHODS:pGC-E1-hNT3-EGFP plasmid was constructed by double restriction enzyme digestion and ligation,and then the plasmid was transformed into E.coli DH5?.Purified pGC-E1-hNT3-EGFP plasmids from the positive clones was confirmed by PCR and sequencing.293T cells were cotransfected with lentiviral vector pGC-E1-hNT3-EGFP,pHelper 1.0 and pHelper 2.0 by Lipofectamine 2000 to produce lentivirus.2 mL recombinant virus complete culture solution was added according to multiplicity of infection=1,4,8,10,12.The titer of virus was tested according to the expression level of enhanced green fluorescent protein.The control groups were Schwann cells and Schwann cells transfected by no-loaded lentivirus.MAIN OUTCOME MEASURES:The lentiviruses were transduced to Schwann cells,and the transfection efficiency was examined by flow cytometry,the overexpression of hNT3 was determined by Real-time PCR and Western blotting.RESULTS:The exogenous gene sequence of the recombinant hNT3 was completely in accordance with that of its open reading frame in GeneBank.The titer of concentrated virus was 5?107 TU/L.After recombinant LV-hNT3 infection,Schwann cells gave off strikingly bright green fluorescence,and the transfection efficiency amounted to 85%(multiplicity of infection=10).Real-time RCR test showed that the hNT3 mRNA were highly expressed in hNT3-Schwann cells,while did not express in the control group.Western blotting showed the hNT3 expression in Schwann cells.CONCLUSION:Construction of hNT3 gene lentiviral vector can transfect Schwann cells leading to an efficient overexpression of hNT3.

Objective To investigate the efficacy of laboratory tests in the renal damage early diagnosis of children with Henoch-Schoalein purpura (HSP) and clinical effect of early intervention.Methods For the 143 HSP patients with normal repeated urine routine test findings,renal function biomarkers including urinary proteins ( immunoglobulin G (IgG),micro-albumin ( MA ),transferrin (TRF),a1 -microglobulin ( α1 -MG),β2-Microglobulin (β2-MG) ) and urinary enzymes ( N-acetyl-beta-D-glucosaminidase ( NAG ),γ-glutamyltransferase (y-GT) ) were detected to investigate the details of renal function changes.One hundred and thirty-one HSP patients,who had abnormal laboratory test findings of renal function biomarkers mentioned above,were randomly divided into control group ( n =65 ) and intervention group ( n =66 ),and both groups received comprehensive treatment including cimetidine,loratadine and calcium agents.However,66 patients in intervention group received low-dose heparin via micropump-based continuous intravenous infusion and regular oral diammonium glycyrrhizinate treatment.Sixty-five patients were enrolled in control group,without further treatment.Results Among the 143 patients with normal urine routine examination,131 cases (91.61％ ) had abnormal findings of renal function biomarkers.After therapy either for 2 months or 4 months,urine protein and urine enzymes were lower than before treatment,and the difference was significant (P ＜ 0.01 ).In the control group only β2-MG,NAG,γ-GT3 indexes significantly lowered at the end of 2 months ( P ＜0.01 ),and all parameters were significantly decreased at the end of 4 months ( P ＜0.01 ).Furthermore,Intervention group had lower levels of renal function biomarkers at the end of 2 months or 4 months,as compared with the control group,showing significant difference ( P ＜0.05 or P ＜0.01 ).Urinary IgG,MA,TRF,NAG recovered rapidly in the intervention group after 4 months and almost returned to the normal,but urinary α1-MG,β2-MG,γ-GT recovered slowly and still remained abnormal after 4 months due to the varying severity.After treatment for 4 months,the rate of urine testing abnormalities was higher in the control group than in the intervention group (36.92％ vs 6.10％ ),and the difference was significant (P ＜0.05).Conclusion Combined detection of renal function biomarkers is helpful for early diagnosis of renal damage in HSP patients.Early intervention with heparin and diammonium glycyrrhizinate can prevent kidney damage,delay disease progress.Early diagnosis and early intervention should be emphasized for the treatment strategy of the renal damage of children with HSP.

Objective To evaluate the efficacy of imipenem-cilastin sodium as subsequent therapy on peritoneal dialysis(PD)-related peritonitis.Methods From January 2007 to December 2010,44 PD-related peritonitis patients in our hospital were enrolled in the study.These patients presented cloudy fluid after 3 days initial treatment,and bacterial culture was Gram-negative bacteria or negative.Thirteen peritonitis episodes were treated with ceftazidime,while 36 episodes with imipenem-cilastin sodium.Efficacy,outcome,pathogen and drug-resistance were analyzed retrospectively.Results The effective rates 2 d later of ceftazidime and imipenem-cilastin sodium were 23.1％ and 72.2％ respectively with significant difference (P＜0.05).Gram-negative bacteria of ceftazidime and imipenem-cilastin sodium groups were 69.4％ and 65.2％ respectively without significant difference (P＞0.05).The cure rates 3 weeks later of ceftazidime and imipenemcilastin sodium groups were 23.1％ and 72.2％ respectively with significant difference (P＜0.05).Conclusion As subsequent therapy for PD-related peritonitis,imipenem-cilastin sodium can improve the cure rate.

Objective To explore the efficacy and safety of low-dose heparin in the treament of children with primary nephrotic syndrome (PNS). Methods It was an open and comparative trial. Eightyeight children with PNS in the hypercoagulable state,on the basis of administrating with glucocorticosteroid,were administrated with low-dose heparin that infused by micro pump oriented to time ( group A). Eighty patients only treated with glucocorticosteroid were chosen as control (group B). Results Serum-albumin and activated partial thromboplastin time (APTT) increased,but fibrinogen (Fib) decreased after therapy in the group A,and they all showed significant differences (P ＜ 0. 01 ). Serum-albumin increased after therapy in the group B and there was significant difference (P＜0. 01 ). However,APTT and Fib in the group B showed no significant difference( P ＞ 0. 05 ) between post-treatment and pretherapy. Post-treatment serum-albumin and APTT in the group A were significantly higher than those in group B, and Fib was significantly lower than that in group B ( P ＜ 0. 01 ). The rate of urine protein remission in group A (82/88) was significantly higher than that in group B (63/80). Urine protein remission time and edema disappearance time were significantly shorter in group A than group B ( P ＜ 0. 01 ). APTT of group A at the peak concentration of heparin after therapy was significantly higher than that of pretherapy ( P ＜ 0. 01 ), and the ratio was 2. 38. However, there was no significant difference in APTT at the valley concentration of heparin between post-treatment and pretherapy ( P ＞ 0.05 ). Conclusion Low dose-heparin infused by micro pump oriented to time in the treatment of children with PNS has an obvious anticoagulative effect. It can improve the rate of urine protein remission and shorten edema disappearance time. Meanwhile it is safety ,requires no laboratory monitor and has few drug side effects,thus it deserves further clinical application.

Objective To study the effect of mild hypothermia on β2- microglobulin (MG) level in cerebrospinam(CSF) of traumatic brain injury (TBI) patients.Methods Thirty-six severe TBI patients were divided into two groups randomly,mild hypothermia treatment group and normathermia treatment group,and the β2- MG level and GOS score in CSF of these patients in different time- point were evaluated.Results β2-MG level increased at first,then decreased gradually,and MBP level in mild hypothermia group decreased greater than the control group( P ＜ 0.05 ),moreover,patients in mild hypothermia treatment group had better outcome than the control group( P ＜ 0.05).Conclusion Mild hypothermia may act as neuroprotection by inhibiting inflammatory response or improving immune regulation.

Objective To explore the efficacy and safety of low dose dopamine combined with phentolamine in the treatment of primary nephrotic syndrome (PNS) with edema. Methods Retrospective control studies were performed in 155 patients of PNS with edema, who received comprehensive treatment with small dose dopamine combined with phentolamine (group A). Patients treated with furosemide infusion were recruited as control (group B). Results The urinary output, urinary sodium increased after therapy in group A, showing significant differences (P ＜ 0. 01). But urinary potassium excretion, serum sodium and potassium showed no significant difference after therapy in group A. The urinary output, urinary sodium and potassium excretion increased and the serum sodium and potassium decreased after therapy in group B, all showing significant differences between before and after treatment (P ＜0. 01). The edema relief rate,urinary output, urinary sodium excretion, serum sodium and potassium in group A was significantly higher whereas urinary potassium excretion were significantly lower than those of group B(P ＜0. 01). The rate of drug adverse reaction in group A was significantly lower than that of group B. Conclusion Low dose dopamine combined with phentolamine in PNS with edema is safe and effective,which may be a substitute of diuretic like furosemide in the treatment of edema of patients with different blood volume.

Objective To study the effect of mild hypothermia on MBP level in the CSF of TBI patients.Methods We investigated 36 patients with severe traumatic brain injury and randomized them into two groups,mild hypothermia treatment group and normathermia treatment group.The MBP levels in CSF and ICP and GOS scores in different time-points were evaluated.Results There was no significant difference between the two groups in the MBP level on the 1st day after treatment(P ＞ 0.05).The MBP levels in mild hypothermia group decreased greater than that in the control group on the 7th and 14th day after treatment(P ＜ 0.05).ICP decreased more in mild hypothermia group than in the control group(P ＜ 0.05)on the 7th and 14th day after treatment.Moreover,patients in mild hypothermia treatment group have better outcome than those in the control group(P ＜ 0.05),but there was no significant difference in the death rate between the two groups.Conclusion Mild hypothermia may provide neuroprotection by reducing MBP degradation and stabilizing medullary sheath,thus improving the prognosis of TBI patients.

Objective To study the effect of different dose fractionation on overall survival in patients with limited-stage small cell lung cancer (LS-SCLC). Methods LS-SCLC patients treated with radical combined chemotherapy and radiotherapy (RT) between January 2001 and Dec 2007 were analyzed retrospectively. According to the dose fractionation schemes, patients were divided into three groups:conventional fractionated RT (1. 8 -2.0 Gy,once daily), hyperfractionated RT (1.4 Gy, twice daily) and hypofractionated RT (2. 5 Gy,once daily). Overall survival, disease free survival and pattern of failures of the three groups were compared. A total of 177 patients were enrolled, including 63 patients in conventional fractionated RT group, 79 in hyperfractionated RT group and 35 in hypofractionated RT group. Results The overall follow-up rate was 96. 6%. The patient numbers with follow-up of more than 2 and 5 years were 153 and 92, respectively. The median survival time of the entire group was 22. 4 months, and the 2-and 5-year survival rates were 43.4% and 23. 5%, respectively. The 2-year survival rates for three groups were 31%, 46% and 59% (x2 =7.94,P=0.019), respectively. The 2-year disease free survival for three groups were 20%, 31% and 40% ( x2 = 4. 86, P = 0. 088 ), respectively. In the pairwise comparisons,patients in hypofractionated RT group have better survival than those in conventional fractionated RT group ( x2 = 7. 81, P = 0. 005 ), the effect of hyperfractionated RT group lies between the hypo-and the conventional fractionated RT groups, but no significant differences were detected ( x2 = 2. 31, P = 0. 128; x2 = 2. 95, P =0. 086). The mildest side effect was found in the hypofractionated RT group. No statistically significant differences were found in the patterns of first failure. Conclusion The hypofractionated RT scheme showed potential survival benefits for patients with LS-SCLC and should be considered in the setting of randomized clinical trials.

Objective To compare the difference in radiotherapy dose caused by different ways of adding bolus.Methods A total of 20 patients who needed to receive postmastectomy chest wall irradiation from October to December on 2014 were selected.Each patient underwent two CT scans;CT-1 was to perform CT scan directly without bolus, and CT-2 was to perform CT scan after adding bolus to the body surface.An equivalent bolus was added for CT-1 in the radiotherapy planning system, and Plan-1, which met the clinical requirements, was performed.Then Plan-1 was put on CT-2 through image fusion and plan verification to develop Plan-2, which was to develop plans with equivalent boluses at other times and perform radiotherapy with a bolus added to the surface of the body.At last, CT-2 was used to perform radiotherapy Plan-3, which met the clinical requirements.The paired t-test was used for comparison of clinical data between any two plans with SPSS 19.0.Results The V20 of the whole lung, V20 of the diseased lung, V30 of the heart, and Dmax of the healthy breast showed no significant differences across the three plans (P=0.074-0.871).The V50 , V55 , conformity index, and homogeneity index of the planning target showed significant differences across the three plans, and the total number of monitor units showed a significant difference between Plan-1 and Plan-2(P=0.002-0.049).The dose distribution in the target volume and the number of monitor units in each radiation field also showed significant differences.Conclusions When the equivalent bolus is added to the body surface before CT scan, such a plan can accurately reflect the dose distribution of the planning target and the dose to organs at risk.