Objective To investigate hemoglobin A1c(HbA1c) and homocysteine (Hcy) in nondiabetic elder patients with coronary heart disease (CHD),and explore their clinical value.Methods Eighty-six non-diabetic elder patients with CHD [45 cases with acute coronary syndrome (ACS) and 41 cases with stable angina pectoris (SAP)] and sixty elder patients without diabetes mellitus and coronary heart disease as control group were selected.The plasma levels of HbA1c and Hcy in all groups were detected and analyzed.Results The levels of HbA1c and Hcy in CHD group were significantly higher than those in control group (P ＜0.05),and levels of HbA1c and Hcy in ACS group were both higher than SAP group (P＜0.05).The change of HbA1c and Hcy had positive correlation (r =0.34,P ＜0.05).Conclusions The levels of HbA1c and Hcy were higher in non-diabetic elder patients with CHD than those without CHD,and might correlate with atherosclerosis.HbA1c and Hcy might be markers of cardiovascular risk.

Objective: To establish a determination of bacterial endotoxin in Xiangdan Injection by kinetic-turbidimetric technique. Methods: The sample diluted times without interference was found out by adding bacterial endotoxin into sample and determining recovery ratio. Results: When the sample was diluted 40-times, the interference of sample to limulus test was eliminated efficiently. Conclusion: The method can be applied to determine the bacterial endotoxin quantitatively in Xiangdan Injection.

OBJECTIVE: To explore the relationship between the portal hemodynamics or the indices of liver fibrosis and the liver function score in patients with different traditional Chinese medical syndromes of liver cirrhosis. METHODS: One hundred and forty-seven cases of liver cirrhosis with different syndromes were included in the study. Diameters and blood flow velocities of the portal vein and splenic vein were tested by color Doppler sonarography. The indices of liver function (TBIL, ALT, AST, Alb, Glb, PTA) and the indices of hepatic fibrosis (HA, PC-III, LN, VI-C) were tested. RESULTS: The diameters of portal vein in liver cirrhosis patients with different syndromes (internal accumulation of of damp-heat, stagnation of liver-qi, superabundance of dampness due to spleen-asthenia, asthenia of liver and kidney yin, asthenia of spleen and kidney yang, blood stasis) were not significantly different. The blood flow velocities and flow volumes of portal vein in patients with the blood stasis syndrome and the internal accumulation of damp-heat syndrome were significantly different (P < 0.05). The diameter of splenic vein in patients with the internal accumulation of damp-heat syndrome was significantly different to that of the asthenia of liver and kidney yin syndrome, or the blood stasis syndrome, or the asthenia of spleen and kidney yang syndrome, respectively (P < 0.05 or P < 0.01). The blood flow velocity of splenic vein in patients with the blood stasis syndrome or the asthenia of spleen and kidney yang syndrome was significantly different to that of the internal accumulation of damp-heat syndrome, or the stagnation of liver-qi syndrome, or the asthenia of liver and kidney yin syndrome, respectively (P < 0.01). The blood flow volume of splenic vein in patients with the internal accumulation of damp-heat syndrome was significantly different to that of the asthenia of liver and kidney yin syndrome, or the asthenia of spleen and kidney yang syndrome, or the blood stasis syndrome, respectively (P < 0.01). The liver cirrhosis indices HA and PC-III in patients with the asthenia of liver and kidney yin syndrome were significantly different to those of the internal accumulation of damp-heat syndrome (P < 0.05). In Child-Pugh classification, the incidence of Child-Pugh C was the highest in the asthenia of spleen and kidney yang syndrome, while the incidence of Child-Pugh A was the highest in the stagnation of liver qi syndrome. CONCLUSION: The changes of portal vein dynamics in liver cirrhosis patients with the asthenia of liver and kidney yin syndrome, or the asthenia of spleen and kidney yang syndrome, or the blood stasis syndrome are significantly different to those of the internal accumulation of damp-heat syndrome and the stagnation of liver-qi syndrome.

We retrospectively reviewed the tongue images and related clinical data of 118 AIDS patients treated in Shanghai Public Health Clinical Center Affiliated to Fudan University. The tongue images included: cyanotic and purplish tongue ( 33, 28.0% ), light-reddish tongue ( 32, 27.1% ), light-whitish tongue (21, 17.8% ) , bulgy tongue(19, 16.1% ), dark-red tongue (7, 5.9% ) and fissured tongue (6,5.1% ). There were significant differences in counts of CD4+T lymphocytes, white blood cells and red blood cells among different tongue imagine groups. The tongue image can indicate the pathogenic factors of disease as well as the functions of viscera in AIDS patients.

Objective To investigate the prevalence of vitamin D deficiency in patients in geriatric intensive care unit and the impact of vitamin D deficiency on the prognosis.Methods 213 hospitalized patients admitted into geriatric intensive care unit of Xinhua Hospital,Shanghai from June 2012 to December 2013 were included in the historical cohort study.Serum 25-hydroxyvitamin D [25 (OH)D] was examined in all the subjects.Main laboratory findings,the incidence of multiple organ dysfunction syndrome (MODS),Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and mortality rate of 30-day kept in hospital were compared among patients with different serum 25-hydroxyvitamin D level.Potential risk factors for mortality were analyzed by multivariate logistic regression analysis.Results 25(OH)D deficiency was identified in 82 patients (38.5％),25(0H)D insufficiency in 90 patients (42.3％),and 25(OH)D sufficiency in 41 patients (19.2％).Compared with 25(0H)D sufficiency group,25(0H)D deficiency group showed the increased levels of APACHE Ⅱ score,plasma lactic acid,C reactive protein (CPR),the incidence of MODS and mortality rate (21.65±-8.89 vs.17.05±8.03,1.89±0.76 mmol/L vs.1.86±1.03 mmol/L,101.08±48.23 mg/L vs.92.48±38.56 mg/L,42.7％ vs.19.5％,30.5％ vs.9.8％,all P＜0.05).Multiple logistic regression analysis suggested that 25 (OH)D deficiency was an independent risk factor for mortality.25(OH)D levels were negatively correlated with length of stay in geriatric intensive care unit (r=0.18,P＜0.05).Conclusions Vitamin D deficiency is highly prevalent among patients admitted into geriatric intensive care unit.Vitamin D deficiency is associated with disease severity and may be an independent risk factor for mortality.

Objective To explore the relationship between the level of morning blood pressure surge (MBPS) and High-sensitivity C-reactive protein( hs-CRP) in acute coronary events among old patients and to evaluate their clinical value. Methods One hundred and twenty - three patients with coronary disease were divided into two groups, each of which was old myocardial infarction(OMI, n = 55) and old myocardial infarction with acute cardiovascular syndrome (OMI + ACS, n =68). The control group includes the patients without coronary disease( n =50). The patients who have infection, malignant tumors, liver and kidney dysfunction, blood diseases, valvular heart diseases, congenital heart diseases, aortic dissection,secondary hypertension were not included. All groups were received 24 hours ambulatory blood pressure monitoring to calculate MBPS and the determination of hs-CRP in serum. Results Compared with each two groups, the levels of MBPS and hs-CRP in OMI group were significantly higher than those of the control group (0. 01 ＜ P ＜0. 05) , and had more significance in the other groups ( P ＜0.01). The levels of MBPS and hs-CRP had positive relationship in coronary events in the elderly ( r =0. 76, P ＜0. 01) . Conclusion The level of MBPS is positively correlated with serum hs-CRP which is one of key risk factors of inflammatory reactions by impairing vessels in body. The two factors both play important roles in the occurrence and the development of coronary events among old patients. They both have important clinical value in recurrent acute coronary events among old patients.

Objective To explore the impact of hyperglycemia on Hypersensitive C-reaction protein (hsCRP),B-type natriuretic peptide(BNP) and ventricular remodeling in elder patients with acute myocardial infarction(AMI).Methods One hundred and twenty elder patients with AMI are divided into hyperglycemia group(blood sugar in admission ＞ 7.8 mmol/L) and non-glycemia group(blood sugar in admission ≤7.8 mmol/L).The levels of blood sugar in admission,hsCRP,BNP were detected.LVEF,LVEDD,LVESD,WMS were observed by cardiac echo in admission and two weeks after therapy.Results The blood sugar in admission,hsCRP and BNP of the patients in hyperglycemia group were (9.6 ± 0.6) mmol/L,(1 750.6 ±677.1) ng/L,(56.1 ±38.6) ng/L,higher than those in non-glycemia group (t =38.679 and P =0.000; t =11.941 and P =0.000; t =3.288 and P ＜0.01,respectively).LVEF,LVEDD,LVESD and WMS of patients in hyperglycemia group didn't show statistical significance before and after therapy.However,there were significant in hyperglycemia group (t =2.049 and P =0.043,t =2.836 and P =0.005,t =3.814 and P =0.000,t =2.086 and P =0.039,respectively).Conclusion Hyperglycemia can reduce the increase of hsCRP and BNP,which has an impact on hsCRP,BNP and ventricular remodeling in elder patients with acute myocardial infarction,but the mechanism need to further research.

Objective: To detect the systolic and diastolic velocity in patients with idiopathic premature ventricular beat(PVB)by pulsed wave-tissue Doppler imaging (PW-TDI) techniques.Methods: There were two groups involved in this study. PVB group,n=30,patients with idiopathic PVB,and Control group,n=30,of healthy subjects. The changes of cardiac function were measured and compared between two groups by the index of myocardial motion velocity using PW-TDI techniques.Results: A total of 7 sites were studied,there were no significant differences in systolic peak velocities (Sm),time velocity integral (TVI),peak velocity of the early relaxation wave (Em),peak velocity of the later relaxation wave (Am) and Em/Am ratio (Em/Am) between the Control group and PVB group in the normal sinus beat (P＞0.05).Compared with the normal sinus beat,Sm,TVI,Em and Em/Am were significantly lower in PVB (P<0.01),while Sm,TVI,Em in the post-PVB sinus beat were significantly higher than that in normal sinus beat (P<0.01). However,there were no significant differences of Am in each site among the normal sinus beat,PVB and the post-PVB sinus beat. Conclusion: PVB and PVB-induced compensational interval could significantly influence the systolic and diastolic function of the ventricle.

AIM: To investigate the potassium channel gene expression of myocardial sleeves of pulmonary vein and effects of amiodarone on rabbits with rapid atrial pacing.METHODS: Rabbits were divided into three groups(n=10),(1) the control group with sham operation and placebo;(2) the right atrial pacing(RAP) group at 600 beats/min with the placebo;(3) the amiodarone group treated for seven days with oral amiodarone at 100 mg ? kg-1 ? d-1.Based on RAP simultaneously,the messenger ribonucleic acid(mRNA) of specimen was measured by reverse transcription-polymerase chain reaction.RESULTS: Compared with the control group,Kv4.3(transient outward K+ current,Ito1) mRNA expression in RAP group was reduced by 51%(P

Objective To analyze the causes of death for 89 HIV/AIDS patients,and the association of CD4+ T lymphocyte counts with the mortality.Methods Data were collected from 89 deceasedpatients who were admitted to Shanghai Public Health Clinical Center from Jan 1996 to Sep 2007,and wereretrospectively analyzed with t-test.Results Heterosexual,blood transfusion and blood products were themajor transmission routs for 89 deceased HIV/AIDS patients.The primary causes of death varied with different levels of CD4+ T lymphocyte counts.With higher CD4+T lymphocyte counts,patients were more likelyto die from non-AIDS-related opportunistic infections such as upper digestive tract hemorrhage.Serious pulmonary infection induced by various etiologies was the primary cause of death.Co-infections of multiple etiologics were often seen in these death cases.Conclusion Opportunistic infection is the primary cause of death for HIV/AIDS patients.Appropriate therapies should be based on CD4+ T lymphocyte counts and patients' specific conditions to reduce the mortality.