Objective To study the clinical effect and prognosis of lyophilized recombinant human brain natriuretic peptide at different times for acute left heart failure.Methods A total of 58 consecutive patients diagnosed as acute left heart failure from February 2013 to February 2014 were randomly divided into early group (30 patients) and late group (28 patients).The patients in early group received lyophilized recombinant human brain natriuretic peptide and other common treatment immediately after arriving at hospital,and the patients in late group received lyophilized recombinant human brain natriuretic peptide until symptoms were hard to control.Results After treatment,the NYHA class and the levels of brain natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF) in early group and late group were significant differences:(1.4 ± 0.5) grade vs.(2.6 ± 0.7) grade,(934.2 ± 52.4) ng/L vs.(1 632.5 ± 147.6) ng/L,(49.6 ± 5.4)％ vs.(31.2 ± 6.7)％,P ＜ 0.01 or ＜ 0.05.The average stay and expenses in early group were significandy less than those in control group:(11.2 ± 3.4) d vs.(19.7 ± 4.2) d,(15.8 ± 4.6) thousand Yuan vs.(27.4 ± 6.3) thousand Yuan,P ＜ 0.05.The total effective rate and survival rate in early group were significantly higher than those in late group:66.7％(20/30) vs.39.3％(11/28),P ＜ 0.05.Conclusion Earlier application of lyophilized recombinant human brain natriuretic can significantly improve the symptoms in acute left heart failure patients.

The application of information management for ethical review work help improve the quality of audit work quality and efficiency in our country , further standardize the ethical review work , also helps to protect the pri-vacy of the subjects in medical research , and establish the medical research ethics review information system in our country has certain feasibility .Therefore , can be based on the experience of the informatization construction of drug clinical trials , through the establishment of ethical review information and tracking system , to set up the electronic signature of information rights management system , building the continuing education training , establish a commu-nication platform with the principal investigator , to build and perfect the medical research ethics review information system.

Objective To compare the clinical efficacies between warm needling and Ibuprofen sustained release capsules (a nonsteroidal anti-inflammatory drug, NSAID) in treating patients with dysmenorrhea in adenomyosis. MethodSixty-five patients with dysmenorrhea induced by adenomyosis were randomized into a treatment group of 33 cases and a control group of 32 cases. The control group was intervened by oral administration of Ibuprofen sustained release capsules, while the treatment group was intervened by warm needling.The intervention lasted 3 menstrual cycles and a 3-month follow-up was studied. The Visual Analogue Scale (VAS), dysmenorrhea symptoms scores and clinical efficacy were compared between the two groups.ResultThe VAS scores after the intervention and inthe first and second months of the follow-up study were significantly different from the pre-treatment score in the two groups (P<0.01); the VAS score of the 3-month follow-up was significantly different from the score before the intervention in the treatment group (P<0.01). There were significant differences in comparing the VAS score after the intervention and in the follow-up study between the two groups (P<0.01), and the treatment group was superior to the control group. The dysmenorrhea symptoms scoresdeclined significantly after the intervention and in the first and second months of the follow-up study in both groups (P<0.01); the dysmenorrhea symptoms score of the 3-month follow-up study decreased in the treatment group and was significantly different from the pre-treatment score (P<0.01). There were significant differences in comparing the dysmenorrhea symptoms scores in the second and third months of the follow-up study between the two groups (P<0.01). The total effective rate was 93.9% in the treatment group, significantly better than 62.5% in the control group (P<0.01).ConclusionWarm needling is effective in easing pain and improving the symptoms of dysmenorrhea in adenomyosis, and can produce a consistent efficacy after the termination of thetreatment; it's superior to NSAIDs in comparing both short-term and long-term treatment efficacies.

Objective To study the early changes of the coagulation system in type 2 diabetic nephropathy.Methods Sixty-two cases of patients with type 2 diabetic nephropathy were divided into two groups:normal albuminuria group ( N-UAlb group,UACR ＜ 30 mg/g,32 cases ),microalbuminuria group ( MUAlb group,UACR:30～300 mg/g,30 cases).Thirty healthy persons constituted a control group (NC group).Fibrinogen( FIB ),antithrombin Ⅲ ( AT-Ⅲ ),protein C ( PC ),protein S ( PS ) were measured by coagulation analyzer,while yon willebrand factor (vWF) and platelet granule membrane protein 140 (GMP-140) were detected by ELISA assay,platelet count (PLT),mean platelet volume(MPV),platelet hematocrit (PCT),platelet distribution width(PDW) by hematology analyzer.Results The level of fibrinogen,GMP-140 and vWF in the M-UAlb group were (4.20 ± 1.53 ) g/L,( 30.03 ± 7.77 ) μg/L,and ( 315.53 ± 47.24 ) ％ respectively,vwhich were significantly higher than those in the N-UAlb group [ ( 3.21 ± 0.89 ) g/L,( 18.22 ± 5.08 ) μg,/L and ( 191.88 ± 57.25 ) ％ respectively ] and the NC group [ ( 2.75 ± 0.53 ) g/L,( 14.26 ± 2.29 ) μg/L and ( 138.12 ± 61.27 ) ％ respectively ] ( F =5.42,10.42,30.44,P ＜ 0.05 or 0.01 ).The fibrinogen,vWF,GMP-140 were positively correlated with UACR ( r =0.313,P ＜ 0.05 ; r =0.620,P ＜ 0.01 ; r =0.680,P ＜ 0.01 ) and PC was negatively correlated with UACR ( r =-0.255,P ＜ 0.05 ).Conclusion Hypercoagulable state in diabetic nephropathy is associated with the high fibrinogen,endothelial dysfunction and platelet activation,and these changes have already emerged in patients without albuminuria.This might mind us that we should strengthen anticoagulant therapy on patients when they are not progressing to albuminuria.

Objective To investigate changes in the expression of prepro-orexin and orexin receptor-1 ( OX1R) following permanent middle cerebral artery occlusion ( MCAO ) with or without preconditioning through electrical stimulation of the cerebellar fastigial nucleus (FNS). Methods Wistar rats were subjected to permanent MCAO and randomly divided into 5 groups: a sham-operated control group (PO), an FNS preconditioning + shamoperated control group (FNS-PO) , an ischemia group, an FNS preconditioning + ischemia group (FNS-PI) and a cerebellar fastigial nucleus injury + FNS preconditioning + ischemia group (FNL-FNS-PI). Each group was divided into 5 subgroups according to the time at which the animals were sacrificed after the MCAO ( 1, 3, 6, 12 and 24 h).RT-PCR was used to detect expression of OX1R mRNA, and ELISA to measure the levels of orexin-A in the hypothalamus and plasma. Results The immunoreactivity of prepro-orexin decreased significantly in the PI groups, with further decreases over time. At the 12th h after MCAO, the immunoreactivity of prepro-orexin reached a minimum.There were significant differences between the rats in the PO and FNS-PO groups. On the contrary, the immunoreactivity of OX1R increased significantly in the PI groups, with further increases continuing over time, peaking at 12 h after the MCAO. There were significant differences between the PO and FNS-PO groups. In the rats with FNS preconditioning (PI-FNS) , the decrease in prepro-orexin and the increase in OX1R were significantly inhibited compared to the PI subgroups at the 6th and 12th hour. There was no significant difference between the FNL-PIFNS group and the PI group. The expression of OX1R mRNA increased significantly in the PI group, with further increases continuing over time, peaking at 24 hours. The plasma levels of orexin-A were not significantly different among the groups, but the levels of orexin-A in the hypothalamus decreased significantly in the PI and FNL-PI-FNS groups, with further decreases continuing over time. At the 12th h after the MCAO the levels were significantly different compared with the PO and PO-FNS groups. While in the rats with FNS preconditioning (PI-FNS) , the decrease in orexin-A level was reversed and there was no significant difference compared with PO and PO-FNS groups. Conclusions The orexinergic system is altered following cerebral ischaemia. FNS preconditioning may be able to regulate these changes.

Objective To observe the short-term quality of life in patients with obstructive hypertrophic cardiomyopathy (OHCM) after percutaneous transluminal septal tunnel myocardial ablation (PTSTMA). Methods The quality of life in patients with OHCM were assessed by the SF-36 before and three months after PTSTMA. Results Three months after the procedure , quality of life was markedly improved at different variances in patients with OHCM as compared with the baseline. The linear regression analysis showed the factors influencing quality of life were character, coexistence with other diseases, and 6-minute walk test. Conclusions Percutaneous transluminal septal tunnel myocardial ablation can improve the short-term quality of life in patients with OHCM. Postoperative psychological counseling and rehabilitation guidance can practically enhance quality of life.

Objective To investigate the characteristics of coronary vessel re-endothelialization after placement of drug-eluting stents (DES), and to provide clinical evidence for the double anti-platelet treatment. Methods Optical coherence tomography (OCT) was performed in 43 patients in 1 year after DES implantation. Characteristics of re-endothelialization and percentage of neointimal coverage of stent struts were evaluated by OCT. Results The rate of stent struts intimal coverage was 90.70%, and the remain was lack of endothelial coverage; The ratio of neointimal thickness (NIT) between 0-99, 100-199 and above 200 microns was 19.92%, 37.55% and 42.53%, respectively. The rate of neointimal coverage was higher and the degree of neointimal hy-perplasia was more extensive in patients with DM and in patients with ACS than those of patients without DM and of patients with stable angina pectoris. Conclusion One year after stent placement, most of the stent struts were covered with neointima and few struts obtained poor coverage of endothelial. DM and ACS may be impact factors for the progress of re-endothelialization after DES placement.

Objective To investigate the mechanism and prevention of syncope on patients with hypertrophic cardiomyopathy (HCM). Methods Seventy-six cases of HOCM (obstruction group) were successfully operated by PTSMA and oral ACEI/ARB. After six months , they were treated with β-receptor blocker. Another 29 patients (control group) with LVOTPG < 50 mmHg or < 70 mmHg after pharmacologic stress test (PST), have being treated with β-receptor blocker. The results was observed as follow: (1) the difference of between syncope incidence and positive incidence induced by PST in control group; (2) the difference of syncope incidence at half year, a year and admission in control group; (3) the difference of syncope incidence in obstruction group before and after operation; (4) the difference of syncope incidence after six months between two groups at same period; (5) the difference of syncope incidence one year between two groups. Results In control group, the syncope positive incidence induced PST was 55.5%. Treating with medications for half a year , syncope incidence significantly dropped than that on admission (P < 0.05); Obstruction group syncope incidence in the history obviously lower than the control group syncope positive induced PST (P < 0.05), and half a year after takingβ-receptor blocker syncope incidence was significantly dropped than before (P < 0.01). Conclusions The mechanism of syncope with HOCM is not only obstruction but also neuronal reflex. PST is an very useful inspection item for screening the ablation indication, analysis syncope mechanism, and guiding clinical medication.β-receptor blocker is an effective drug on treating and preventing syncope with HCM.

With the increasing incidence and mortality of coronary heart disease (CHD) in China, the prevention and treatment of CHD is no time to delay. Since Professor Gruentzig completed the first human case of percutaneous transluminal coronary angioplasty (PTCA) in 1977, percutaneous coronary intervention (PCI) had reached to a new page. After three decades of development and change, PCI has been improved and matured gradually from the early PTCA to the current stent era. With the advent of stents, the rate of restenosis after PCI was significantly reduced from 30%-50% to 10%-20%. But stent restenosis was still with no total cure. The issue of how to prevent the stent restenosis has become a long-term major issue for the exploration in both clinical and preclinical medicine. Therefore, this paper reviewed the etiology, pathology, related risk factors, latest diagnosis methods, prevention and treatment of stent restenosis by integrative medicine.

This study was aimed to observe the safety and effectiveness ofShugan Jieyu Capsules in the treatment of vasovagal syncope (VVS) with mild-to-moderate depression and anxiety, and to compare the effect with Flupentixol and Melitracen Tablets. A total of 89 VVS cases with mild-to-moderate depression and anxiety were randomly divided into 3 groups, which were group A (Shugan Jieyu Capsules group), group B (Flupentixol and Melitracen Tablets) and group C (control group). Based on the conventional therapy of VVS treatment, treatments were given to all three groups for 8 weeks. And the negative conversion ratio of VVS in each group was observed. Hamilton Depression Scale (HAMD 24 items) and Hamilton Anxiety Scale (HAMA) were evaluated for the calculation of reductive rate. Treatment emergent symptoms scale (TESS) was used in the evaluation of adverse reactions of both medications during the treatment. In the 12-month follow-up after treatment, the recurrence rate of syncope was observed in each group. The results showed that compared with pretreatment, HAMD-24 and HAMA scores of group A and group B after treatment were significantly reduced (P < 0.05). Compared with group C, the heat-up tilt testing-negative rate, HAMD-24 and HAMA reductive rate of group A and group B after treatment were significantly increased (P < 0.05). Compared with group B, the negative rate, HAMD-24 and HAMA reductive rate of group A were more significant (P < 0.05). After treatment, scores for TESS of group A was significantly lower than group B (P< 0.05). In the 24-month follow-up, the recurrence rate of syncope of group A and group B was significantly lower than group C (P < 0.05); and group A was obviously better than group B (P < 0.05). It was concluded thatShugan Jieyu Capsules can be used in the treatment of VVS with mild-to-moderate depression and anxiety. Its effectiveness and safety may be better than Flupentixol and Melitracen Tablets.