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.

Cardiac arrhythmia is one of the most common cardiovascular diseases,with high morbidity and mortality,which threatens human health and lives. With the development of medicine, natural products are revealing ever-greater anti-arrhythmic benefits and potential. However,their targets have not been fully clarified. In the recent ten years ,scientists have been studying the molecular mechanisms of natural products that have been found to inhibit INa,ICa-L,Ito,IK1,IKr,IKM3,HERG channel current and steady state K+ current,promote IKs and IKATP,inhibit microRNA-1 expression and change cardiac microRNA expression profile,affect Na+-K+-ATPase and superoxide dismutase activity,inhibitβ receptor and angiotensinⅡ receptor,and regulate lipid metabolism,thus affecting cardiac rhythm and exerting anti-arrhythmic effect. This paper revies the research advances in the antiarrhythmic tar?gets of natural products.

Objective To evaluate the effect of different sevoflurane postconditioning on myocardial injury in patients undergoing coronary artery bypass grafting (CABG ) with cardiopulmonary bypass (CPB ) .Methods Seventy-five NYHA class Ⅰ or Ⅱ patients ,aged 46-72 yr ,weighing 57-90 kg ,scheduled for elective CABG with CPB ,were randomly divided into 5 groups ( n=15 each) using a random number table :control group (groupⅠ) , postconditioning with continuous administration of 1.7% sevoflurane group (groupⅡ a ) , postconditioning with continuous administration of 3.4% sevoflurane group (group Ⅲa) ,postconditioning with interrupted administration of 1.7% sevoflurane group (Ⅱb) and postconditioning with interrupted administration of 3.4% sevoflurane group (group Ⅲb) .Sevoflurane was not given in group Ⅰ .In Ⅱa group ,after the anastomotic stomas of the internal mammary artery to anterior descending artery were released ,the patients continuously inhaled 1.7% sevoflurane for 15 min .In Ⅱb group ,after the anastomotic stomas were released .In Ⅲa group ,after the anastomotic stomas were released , the patients continuously inhaled 3.4% sevoflurane for 15 min , the patients inhaled 1.7%sevoflurane for 5 min first ,inhalation was interrupted for 5 min ,and then inhalation was recovered lasting for 5 min ,and it was 15 min in total .In Ⅲb group ,after the anastomotic stomas were released ,the patients inhaled 3.4% sevoflurane for 5 min first ,inhalation was interrupted for 5 min ,and then inhalation was recovered lasting for 5 min ,and it was 15 min in total .Venous blood samples were taken for determination of the plasma creatine kinase ,creatine kinase isoenzyme-MB , lactic dehydrogenase , and cardiac troponin I concentrations before CPB and at 6 and 24 h after operation .Myocardial specimens were obtained from the right auricle before CPB and after termination of CPB for microscopic examination of the ultrastructure .Results Compared with group Ⅰ , the concentration of cardiac troponin Ⅰ was significantly decreased at 6 and 24 h after operation ( P<0.05) ,and no significant changes were found in the other parameters in Ⅱb group ( P>0.05 ) .The pathological changes were significantly attenuated in sevoflurane postconditioning groups as compared with group Ⅰ ,especially in Ⅱb group . Conclusion Postconditioning with continuous administration of 3.4% sevoflurane for 15 min can attenuate myocardial damage in patients undergoing CABG with CPB .

Objective To analyze the characteristic of auditory brainstem responses (ABR) evoked by chirp in normal hearing subjects .Methods Fifteen cases (30 ears) with normal hearing young people were recorded ABR by stimulation with two kinds of sounds :chirp and click .The data were compared .Results The response threshold of chirp-ABR were lower than that of click -ABR .The average difference was 8 .59 dB .At 90 dB nHL ,the wave V amplitude yield no significant difference between chirp -ABR and click-ABR .The wave V amplitude had a signifi-cant difference between chirp -ABR and click-ABR at 60 dB nHL .At 90 and 60 dB nHL ,the wave V amplitude of chirp-ABR had not a significant difference .The occurence rate was 40% for the wave I of chirp -ABR ,obvi-ously less than that of click -ABR .At 90 dB nHL ,the wave V latency of chirp -ABR was shorter than that of click-ABR .Conclusion The wave V response threshold of chirp -ABR is less than that of the click -ABR .The chirp-ABR is more advantageous than the click -ABR for assessing hearing threshold .

Highly conjugated linear molecular wires are one of the basic elements for constructing molecular electronic devices. Among these conjugated compounds, ferrocene-terminated compounds as well as their derivatives have been widely studied because of their ideal electrochemical activity. Based on these, a new ferrocene-terminated phenylethynyaniline ( Fc-NH2 ) was synthesized by Sonogashira cross coupling reaction. The structure of the target compound was identified by infrared ( IR) , nuclear magnetic resonance ( NMR) , mass spectra ( MS) and cyclic voltammetry ( CV) . Combined the graphene-chitosan ( GH-CS) and Fc-NH2 , a new composite of GH-CS/Fc-NH2 was prepared and then used for immobilization of Cytc to prepare the GH-CS/Fc-NH2/Cytc/GCE. It was found from the CV result that a pair of peaks near-0. 2 V appeared which can be attributed to Cytc. The GH-CS/Fc-NH2/Cytc modified GCE showed good catalysis towards NaNO2 , and good linear relationship was found in the range of 1 ×10-7-1. 5 ×10-4 mol/L,and the determination limit was bellow 4×10-8 mol/L. Therefore, cytochrome c (Cytc) can be immobilized on the GH-CS/Fc-NH2 and the direct electron transfer can be realized between the electrode and solution and shows good prospect for detection of NaNO2 .

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

Background and purpose:Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for MR imaging systemic examination, especially the lymph node and bone diseases can be clear, and the imaging result is similar with PET. The aim of this study was to compare the value of clinical application in the diagnosis of malignant metastatic osteopathic between DWIBS and bone scintigraphy mapping. Methods:Thirty-six specimens conifrmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods. Results:Thirty (165 positions in all) of 36 malignant tumor patients were conifrmed as having bone metastasis, compared that 26 patients (143 positions) with DWIBS method and 23 patients (132 positions) with bone scintigraphy mapping were detected, but there was no statistical signiifcance between this two imaging methods (χ2=1.002, P=0.506). The sensitivity, positive predictive value (PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with 86.7%, 96.3%, 86.1%and 76.7%, 88.5%, 72.2%, respectively;but the speciifcity and negative predictive value (NPV) in DWIBS (83.3%and 55.6%) was higher than that of in bone scintigraphy (50.0%and 30.0%). The detection rates of different bone metastasis with DWIBS and bone scintigraphy were 86.7%(143/165) and 80.0%(132/165), and it was no signiifcant difference (χ2=2.640, P=0.104);DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different signiifcant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is ifne consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.

Objective To explore the effect of immune senescence on lung cancer metastasis and reveal the mechanism of Fuzheng traditional Chinese medicine Jinfukang in the prevention and treatment of the metastasis. Methods A lung metastasis model of Lewis lung cancer cells was established in C57BL/6 mice with different ages (15 months, 6 months, and 2 months). Mice in the 6-month-old group were given Jinfukang intragastrically for 42 days. Pulmonary metastasis was analyzed by in vivo imaging, anatomical microscopic observation, and HE staining. The proportion of memory T cells and NK cells in peripheral blood was detected by flow cytometry. Results The lung metastatic tumor formation rate of 15-month-old and 6-month-old mice was significantly higher than that of 2-month-old mice (all P < 0.05). Abundance of CD4+T cells in peripheral blood was positively correlated with age (2-month-old vs. 6-month-old, P=0.041; 2-month-old vs.15-month-old, P=0.041; 6-month-old vs.15-month-old, P=0.953). The abundance of NK cells was negatively correlated with age (2-month-old vs. 6-month-old, P=0.009; 2-month-old vs.15-month-old, P=0.009; 6-month-old vs. 15-month-old, P=0.574). However, the survival time of mice in the Jinfukang group was longer (P > 0.05) and the level of NK cells in peripheral blood was significantly higher (P=0.029) than those in the normal saline group. Conclusion Immune senescence can promote the metastasis of lung cancer. The prolongation of the survival time of mice administered with Jinfukang may be related to delaying immune senescence and increasing the number of NK cells.

Immunosenescence is the decline in the structure and function of the body's immune system that involves organs, cells, im-mune factors, and regulatory networks. Decreased immunity and immune clearance, caused by immunosenescence, are key contribu-tors to tumorigenesis. This article begins by introducing the concept of immunosenescence and provides a comprehensive description of the relationship between immunosenescence and tumorigenesis. We also discuss the influence of the various components of the immune system on tumor incidence. Finally, the article provides ideas for immunosenescence intervention aimed at the prevention and treatment of cancer.

Pertussis toxin (PT) is one of the major virulence factors of Borrelia pertussis and also an essential component of pertussis vaccines. Before using it in vaccine production, detoxification is necessa-ry because of its biological activity. This paper summarized the structure and detoxification process of PT as well as the safety and immunogenicity of pertussis vaccines prepared with detoxified PT.