Objective To explore the clinical significance of APACHE Ⅱ score on risk stratification in patients with acute myocardial infarction.Methods One hundred and forty-two patients with acute myocardial infarction were included in the study who were admitted to hospital consecutively from Jan.2011 to Dec.2012.High risk group and low risk group were divided by the APACHE Ⅱ score.Some clinical variables at the first 24 h after admitted to hospital and occurring during the following 1 year were recorded Results The age in high risk group was 78.9 ±8.1,significantly higher than that in low risk group (65.8 ± 10.2;t =6.835,P ＜ 0.001).The cases with Killip Ⅲ and Ⅳ in high risk group were 10(29.4％) and 2(1.8％),lower than in low risk group (6 (1.8％) and 0 (0％) ; x2 =21.950,15.777 ; P ＜ 0.005).The level of creatine kinase-MB (CK-MB) and cardiac troponin Ⅰ in high risk group were (147.7 ±21.5) U/L and (105.5 ± 17.6) U/L,higher than in low risk group((105.5 ± 17.6) U/L,(42.9 ± 6.3) U/L; t =11.541,5.785 ; P ＜ 0.001).The incidence of severe cardiac events(malignant arrhythmia,heart failure,non fatal myocardial infarction and death from any cause in high risk group were 58.8％ (20/34),47.0％ (16/34),17.6％ (6/34) and 17.6％ (6/34),higher than in low risk group (29.6％ (32/108),3.7％ (4/108),6.4％ (7/108) and 6.4％ (7/108) ; x2 =8.274,36.665,3.876 and 3.876 ; P ＜ 0.05).Conclusion APACHE Ⅱ score is likely to be a simple and practical tool for risk stratification in patients with acute myocardial infarction.

Objective To explore the complication and its cause and treatment of pace markers implantation in older patient.Methods Among 205 older patients aged 70 to 90 years,103 were male,the others were female.Of these patients,162 were implanted with single chamber pace marker,43 with dual chamber pace markers.Results 21 patients happened complication(10.2%),the common complications related to operation were blood effusion and hematoma formation in pocket 12 cases,lead dislodgement 4 cases and infection with or without pocket rapture 2 cases.Occurrence of blood effusion was related to aspirin administration,lead dislodgement and infection with or without pocket rapture were related to operation.Conclusion To pay attention to ample preparation,close operation and strict observation can decrease the complication rate when pace marker is implanted.The serious result will be avoided by timely and effective treatment.The older patient with pace markers implantation is safe.

Objective To evaluate the effect of intrathecal resveratrol on activation of Ca2+/ calmodulin-dependent protein kinase Ⅱ (CaMK Ⅱ) in spinal dorsal horn neurons of rats with bone cancer pain.Methods Thirty-two adult female Sprague-Dawley rats,weighing 180-220 g,were equally randomized into 4 groups using a random number table:sham operation group (group S),bone cancer pain group (B group),and bone cancer pain + solvent control group (BD group).Walker 256 mammary gland cancer cell suspension (4× 105 cells/ml) 5 μl was injected into the medullary cavity of the right tibia in B,BR and BD groups.Normal saline 5 μl was given in group S.On 12,13 and 14 days after injection of mammary gland cancer cells,resveratrol 200 μg/10 μl was injected intrathecally once a day in group BR,and 1％ dimethyl sulfoxide 10 μl was intrathecally injected once a day in group BD.Before injection of mammary gland cancer cells (T0) and on 3,5,7,10,12 and 14 days after injection of mammary gland cancer cells (T1-6),mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured.The rats were then sacrificed and L4,5 segments of the spinal cord were removed for confirmation of the location of phosphorylated CaMK Ⅱ (p-CaMK Ⅱ) in spinal dorsal horn neurons (by immunofluorescence) and for detection of p-CaMK lⅡ expression (using Western blot).Results Compared with group S,MWT and TWL were significantly decreased at T2-6,and p-CaMK Ⅱ expression was upregulated at T6,and p-CaMK Ⅱ was mainly co-expressed with neurons in B,BR and BD groups.Compared with group B,MWT and TWL were significantly increased at T5,6,and p-CaMK Ⅱ expression was down-regulated at T6 in group BR.There was no significant difference in MWT,TWL,and p-CaMK Ⅱ expression at each time point between group B and group BD.Conclusion Resveratrol can alleviate hyperalgesia in rats with bone cancer pain and inhibited activation of CaMK Ⅱ in spinal dorsal horn neurons may be involved in the mechanism.

Objective To investigate the polymorphism of Brucella melitensis biovar 3 ( B.melitensis biovar 3) strains isolated from Guangdong province .Methods PCR assays followed by agar-ose gel electrophoresis and capillary electrophoresis based on the multiple locus variable number of tandem repeats (VNTR) analysis (MLVA) were performed to analyze 43 clinic isolates of B.melitensis biovar 3 strains isolated from clinical patients in Guangdong province .Results MLVA typing showed that the simi-larities of the analyzed locus among 43 strains of Brucella ranged from 68.2%to 100%.32 genotypes identi-fied among the isolates were identical (100%similarity).27 out of 43 strains (62.8%) were single geno-types, while the other 16 strains (37.2%) belonged to 5 other genotypes with 2 to 5 strains in each of them . Conclusion B.melitensis biovar 3 isolates showed polymorphism distribution in Guangdong province as in-dicated by MLVA typing analysis .Single-genotype isolates accounted for 62.8% of all studied strains.No predominant genotype was found among all isolates .

OBJECTIVE:To investigate the efficacy and safety of carvedilol in patients with chronic heart failure(CHF). METHODS:46patients with CHF were randomly divided into carvedilol group(n=26)and control group(n=20),thareinto,standard therapeutic scheme is used in control group,standard therapeutic scheme+carvedilol is used in carve diol greup.The treatment courses were6months in both groups.RESULTS:Left ventricular end-diastolic diameter(LVEDD)reduced and left ventricular ejection fraction(LVEF)increased in carvedilol group with significant difference comparing with control group(P

Objective:To investigate the ethical significance of the extracorporeal circulation membrane oxy-genation ( ECMO) in the donation organ transplantation .Methods: Analyzing the data of ECMO protected to the organ in 13 donors after brain death , Accounting the rising costs which caused by ECMO and make the interview to the patients and family members .Results:In the period of ECMO flow , the hemodynamic of the DBD donors be-come stable gradually , the medications reduced significantly or stop , the function of organs was restored .There were 38 organs can be used for the transplantation which were proven by the pathological biopsy .Twenty six kid-neys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed .Medical cost of this patients increase 5.3%, all of the family members and patients can accept the intervention of ECMO .Conclusion:ECMO is an effective method to protect and improve the utili-zation rate of the organ .the improvement of the related technical standards , legal, laws and ethics of staff will pro-mote to the development of organ transplantation .

Objective To investigate neuroimaging and its correlation with clinical aspects of cerebral palsy (CP).Methods A retrospective study of 295 children with CP was conducted.Magnetic resonance imaging (MRI),the gross motor function classification system (GMFCS) and intelligence testing were administered,and any correlations among these measures was analysed.Results Among the 295 cases,257 presented abnormal MRIs (87.1％) due to brain maldevelopment (n =11),periventricular leukomalacia (PVL) (n =173),cortical/subcortical lesions (n =17),basal ganglia lesions (n =26),cerebellar maldevelopment (n =11) or others lesions (n =19).Thirty-nine presented with normal MRIs.About 26％ were rated at GMFCS level 1,18％ at level 2,17％ at level 3,19％ at level 4 and 20％ at level 5.Almost 82％ of the children presented with brain maldevelopment and 84.4％ with PVL-induced spastic bilateral paralysis.In 41％ of the children with cortical or subcortical lesions,induced spastic hemiplegia was observed,whereas 47％ had induced spastic bilateral paralysis.In 77％ of the children with basal ganglia lesions induced involuntary movement was observed,and all of those with maldevelopment of the cerebellum were ataxic.Most of those with spastic hemiplegic,bilateral paralysis,involuntary movement and ataxia were on GMFCS levels 1 or 2,with only 3.7％,33.5％,64.1％ and 46.2％ respectively on GMFCS level 4 or 5.Among those in whom the MRI revealed brain maldevelopment,9.1％ were on GMFCS level 1 or 2.The corresponding percentage for PVL was 43.9％,for cortical or subcortical lesions 58.8％,for basal ganglia lesions 19.2％ and for cerebellar maldevelopment 27.3％.The balance in each category were on GMFCS level 4 or 5.Epilepsy was most common in the children with brain maldevelopment (36.4％) or cortical or subcortical lesions (41.2％).Mental retardation was most common in cases of brain maldevelopment (45.5％),cortical or subcortical lesions (41.2％) or cerebellum maldevelopment (36.4％).The incidence of epilepsy and mental retardation was higher among the children on levels 4 and 5 than on levels 1 and 2.Conclusions Neuroimaging correlates significantly with the type of CP and GMFCS level.Epilepsy and mental retardation are most common in children with brain maldevelopment or lesions.The incidence of epilepsy and mental retardation is higher among children rated at GMFCS level 4 or 5 than among those on levels 1and 2.

One hundred and thirty seven pafients diagnosed by coronary angiography were recruited in the study and divided into coronary heart disease group(CAD)and control group.Relationship between serum apolipoprotein M levels and the severity of stenosis of coronary arteries was analyzed.In covariate analysis,serum apolipoprotein M levels were significantly lower in CAD group than those in control group adjusted for sex,age,body mass index(BMI)(P＜0.05).By stepwise muhiple regression,serum levels of apolipoprotein M were correlated positively with BMI(r=0.65,P＜0.01),and correlated negatively with total cholesterol(TC)(r=-0.53,P＜0.01)and low density lipoproteins(LDL-C)(r=-0.42,P＜0.01).Serum levels of apolipoprotein M were correlated negatively with the score of coronary stenosis(r=-0.62,P＜0.01).The results suggest that apolipoprotein M might be related to the development of coronary artery disease.

Objective To determine the correlation between the risk factors of cerebral palsy and gestational age of live born infants. MethodsThe gestational age, the risk factors of cerebral palsy and clinical features of 478 children with cerebral palsy were analyzed retrospectively. ResultsFetal distress, threatened abortion, non-infectious diseases during pregnancy, hypoxic-ischemic encephalopathy, neonatal convulsion, infection of newborn, intracranial hemorrhage and haemolysis did not correlated with the gestational age of children with cerebral palsy (P>0.05). Brain malformation, maternal infection, aspiration pneumonia, neonatal asphyxia and hyperbilirubinemia negatively correlated with the gestational age (P<0.05). The incidence of spasmo-diplegia was significantly different between preterm and term infant (P<0.05). ConclusionThe morbidity of cerebral palsy associated with the merging development malformation, maternal infection, aspiration pneumonia, neonatal asphyxia or hyperbilirubinemia increased as the gestational age declined. The spasmo-diplegia more happened in the preterm infants than in the term ones.

Objective To evaluate the early diagnostic value of circulating microRNA-1 (miR-1) on acute myocardial infarction (AMI). Methods A prospective cohort study was conducted. The patients with chest pain admitted to the Second People's Hospital of Wuxi from November 2012 to June 2015 were enrolled. According to AMI diagnostic criteria, the patients were divided into AMI group and non-AMI group, and healthy individuals during the same period were served as heath controls. The venous samples of the onset patients were collected within 3 hours after admission. The plasma miR-1 was determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR), and the levels of plasma cardiac troponin I (cTnI) and MB isoenzyme of creatine kinase (CK-MB) were measured by electrochemiluminescence. The correlation between plasma miR-1 and cTnI as well as CK-MB was performed by Spearman analysis. The early diagnostic performance of plasma miR-1, cTnI, and CK-MB for AMI was estimated by receiver operating characteristic (ROC) curve analysis. Results There were 127 patients in AMI group, and 107 in non-AMI group, including 82 patients with angina pectoris, 2 with pulmonary embolism, 3 with aortic dissection, 2 with acute pericarditis, 3 with myocarditis, 13 with acute heart failure, and 2 with peptic ulcer. Ninety volunteers were served as healthy controls. There was no difference in clinical characteristics including gender and hyperlipidemia between AMI group and non-AMI group. The expressions of plasma miR-1, cTnI and CK-MB were significantly increased in AMI patients as compared with those of the healthy controls [miR-1 (2-ΔΔCt): 4.32±2.60 vs. 1.44±0.75 and 0.98±0.18, cTnI (μg/L): 3.23 (0.63, 10.70) vs. 0.02 (0.00, 0.17) and 0.00 (0.00, 0.00), CK-MB (U/L): 32.40 (14.20, 95.40) vs. 14.40 (11.20, 17.10) and 8.90 (8.28, 9.50), all P < 0.01]. The expression of plasma miR-1 had a significantly positive correlation with cTnI and CK-MB in AMI patients (r1 = 0.395, r2 = 0.490, both P < 0.000). It was demonstrated by ROC curve analysis that the area under ROC curve (AUC) for the diagnostic value of miR-1 on AMI was 0.905 [95% confidence interval (95%CI) = 0.860-0.950, P = 0.000], the sensitivity was 86.6%, and the specificity was 95.4%; the AUC for cTnI was 0.908 (95%CI = 0.870-0.946, P = 0.000), the sensitivity was 81.9%, and the specificity was 95.9%; the AUC for CK-MB was 0.795 (95%CI = 0.736-0.854, P = 0.000), the sensitivity was 63.0%, and the specificity was 92.9%. Conclusions Plasma miR-1 has the capacity in early diagnosis of AMI, superior to CK-MB, and equal to cTnI. It can provide additional diagnostic information beyond cTnI. The diagnostic accuracy for early AMI can be improved with the combination of plasma miR-1 and cTnI.