Objective:To observe the influence of erythropoietin (EPO)combined adjuvant iron treatment on cardiac function,exercise capacity and anemia in patients with diastolic heart failure (DHF)complicated anemia.Methods:A total of 94 DHF + anemia patients were randomly divided into routine treatment group (n=46)and combined treatment group (n=48,received EPO combined adjuvant iron treatment based on routine treatment).Patients re-ceived 6min walking test,levels of hemoglobin (Hb)and N-terminal pro brain natriuretic peptide (NT-proBNP), transmitral early diastolic peak velocity deceleration time (DT),early diastolic peak flow velocity (E),late diastolic peak flow velocity (A)and E/A etc.were measured and compared between two groups before and after six-month treatment.Results:Compared with before treatment,after treatment,NT-proBNP and DT significantly reduced, E/A and 6min walking distance significantly rose in both groups,P <0.05 or <0.01;compared with routine treat-ment group after treatment,there were significant reductions in NT-proBNP level [(368.4±110.7)pg/ml vs.(239 ±89.7)pg/ml]and DT [(257.5±73.4)ms vs.(208.9±59.1)ms],and significant rise in Hb level [(83.3±9.2) g/L vs.(122.1±13.6)g/L],E/A [(0.87±0.3)vs.(1.07±0.27)]and 6min walking distance [(367.54±21.08) m vs.(438.63±20.35)m]in combined treatment group,P <0.05 all.Conclusion:Erythropoietin combined iron treatment can better improve heart function and exercise capacity in patients with diastolic heart failure complicated anemia.

Objective To study the effect of sodium ferulate (SF) on the expressions of nuclear factor-?B (NF-?B) and inhibitory ?B? (I?B?) in rat brain microvascular endothelial cells (BMEC) injured by hypoxia. Methods Brain microvascular endothelial cells from Wistar rat cerebral cortex were isolated and cultured, and then cultivated in 95%N_2 and 5% CO_2 for 12 h to induce hypoxia injury. The cells were divided into normal group, hypoxia group, and SF group. BMEC activity was assayed by MTT assay. Endothelin-1(ET-1) concentration was evaluated by radioimmunoassay.The expression of NF-?B and I?B? of BMEC were assessed by immunocytochemistry. Results The content of ET-1 in BMEC media was increased after hypoxia, while sodium ferulate (100 ?g/ml) significantly decreased the content compared with hypoxia group. Immunocytochemistry indicated I?B? expression were significantly decreased in hypoxia BMEC in consistent with NF-?B expression. Conclusion Sodium ferulate may significantly reduce NF-?B of hypoxia BMEC and nuclear translocation, and increase I?B? expression and BMEC activity. It is a potent inhibitor of NF-?B in endothelial cells, which might explain its beneficial effect on injured BMEC by hypoxia.

Objective: To study diagnostic and predictive value of levels of high sensitive C reactive protein (hsCRP) and cystatin C (CysC) for acute coronary syndrome (ACS) in aged patients.Methods: A total of 60 ACS patients (ACS group) treated in our hospital and 60 healthy subjects (healthy control group) undergoing physical examination during Dec 2013 to Sep 2015 were randomly selected.Serum levels of hsCRP and CysC, and abnormal rates of hsCRP and CysC were measured and compared between two groups.Results: Compared with healthy control group, there were significant rise in serum levels of hsCRP[(3.02±1.13) mg/L vs.(7.95±2.38) mg/L]and CysC[(0.75±0.11) μg/ml vs.(1.35±0.43) μg/ml], and abnormal rates of hsCRP (0 vs.13.33%) and CysC (0 vs.11.67%) in ACS group, P<0.01 all.Conclusion: Serum hsCRP and CysC level measurements can effectively predict and assess occurrence, development and prognosis of disease in ACS patients, and provide clinical valid evidence for its diagnosis, prevention and treatment.

Objective:To analyze the relationship among smoking, levels of homocysteine (Hcy), cystatin C (CysC), C reactive protein (CRP) and coronary heart disease (CHD) onset in young people.Methods:A total of 152 patients, who received selective coronary angiography because of chest pain in our hospital, were enrolled, and all subjects were <45 years old.According to examination results, they were divided into CHD group (n=100) and non-CHD group (n=52).Clinical data were analyzed in both groups, and Logistic multi-factor regression analysis was used to analyze independent risk factors for CHD in young people.Results:Compared with non-CHD group, there were significant rise in percentages of men (30.8% vs.65.0%), smoking (46.1% vs.68.0%) and hypertension (34.6% vs.51.0%), levels of CysC[(0.85±0.16) mg/L vs.(1.34±0.28) mg/L], CRP [(1.26±0.85) mg/L vs.(6.93±0.85) mg/L] and Hcy[(7.16±1.16) mol/L vs.(20.85±2.16) mol/L],P<0.05 or <0.01;multi-factor Logistic regression analysis indicated that male, hypertension, smoking, Hcy, CysC and CRP were risk factors for CHD in young people (OR=1.34~3.42, P<0.05 or <0.01).Conclusion:Male, smoking, total cholesterol, homocysteine, Cys C and C reactive protein are risk factors for CHD in young people.Therefore, these risk factors should be eliminated, or its risk should be reduced.

Objective:To explore effect of early rehabilitation therapy on improving prognosis and quality of life (QOL) in patients with acute myocardial infarction (AMI) .Methods :A total of 120 AMI patients treated in our hospital were selected .According to random number table ,they were randomly and equally divided into routine treatment group (n=60 ,received routine treatment) and rehabilitation group (n=60 ,received routine treatment combined rehabilitation therapy ) .Clinical symptoms ,myocardial enzymes ,cardiac function indexes ,complications , QOL ,length of hospital stay and hospitalization cost were statistically analyzed and compared between two groups . Results :Compared with routine treatment group after treatment ,there were significant reductions in incidence rates of dizziness ,low back pain ,leg weakness ,constipation ,palpitations (P<0.05~ <0.01) ,abdominal distension and complications (36.7% vs .5.0% );significant rise in Barthel index [ (61.9 ± 8.7) scores vs .(86.4 ± 6.9) scores] , significant reductions in length of hospital stay [(13.8 ± 3.2) d vs .(5.9 ± 2.6) d] and hospitalization cost [(13600 ± 1450) RMB vs .(8600 ± 1240) RMB] in rehabilitation group ,P<0.05~ <0.01 .Conclusion:Early rehabilitation therapy can significantly improve prognosis and quality of life ,shorten length of hospital stay , lower hospitalization cost in patients with acute myocardial infarction ,which is worth clinical extending .

OBJECTIVE To investigate the distribution and the resistance rate of Shigella in Anhui Province to guide the choice of antibacterials. METHODS Ninety one strains of Shigella were cultured in Sep 2005.The groups were identified by biochemical and serologic tests.Susceptibility of 91 strains of Shigella in Anhui to various antibiotics was tested using standardized custom dilution MIC panels according to CLSI(2005) guidelines. RESULTS There were 57 strains of Shigella flexneri,31 strains of S.sonnei and 2 strains ofS.boydii among 91 strains of Shigella.The resistance rates of Shigella to cefoperazone/sulbactam and piperacillin/tazobactam were remarkably lower than to other third generation cephalosporins.The susceptible rates to carbopenems were 100%.The resistance rates to ciprofloxacin lactate and pazufloxacin mesilate were 27.47% and 32.97%,respectively. CONCLUSIONS There is a certain resistance rate of the Shigella to fluoroquinolones and the third generation cephalosporins.More attention should be paid to the surveillance and control of such resistance.

With the improvement of people's living standards, the degree of aging is increasing, so the health demands is increasing greatly. In China, General Medicine attracts more and more attention, and the training of general practitioner is important and urgent. First of all ,“providing good service for the patients” should be the central concept in the GP training. Secondly, based on the national conditions, we should learn the modern medicine theories and absorb the essence of“Preventive Treatment of Dis-ease”in traditional Chinese medicine. In the actual implementation process we should pay attention to the integration of western philosophy and modern technology. Finally , we shoulduse the example of Xuanwu Hospital's general practitioner standardization training to conduct empirical research tothe above prelimi-nary understanding of the situation.

Objective To investigate the correlation between two single nucleotide polymorphisms of the leukotriene A4 hydrolase (LTA4H) gene (rs2660845 and rs2540493) and risk of ischemic stroke in population of southern Zhejiang Province.Methods A total of 300 ischemic stroke patients and 300 healthy controls,recruited from the Department of Neurology,Third Affiliated Hospital of Wenzhou Medical University between September 2010 and June 2013,were enrolled in this study.Two single nucleotide polymorphisms of the LTA4H gene (rs2660845 and rs2540493) were analyzed by polymerase chain reaction and matrix-assisted laser desorption/ionization time of flight,respectively.Sixty-seven patients and thirty controls were randomly selected (complete randomization) and detected the serum leukotriene B4 (LTB4)concentration by ELISA method.Results There was no evidence of association between the two variants of LTA4H gene and the risk of ischemic stroke or its TOAST (Trial of Org 10 172 in acute stroke treatment)subtypes (P ＞ 0.05).Analysis of LTB4 levels revealed that there was no statistically significant difference in serum LTB4 concentration between patients (n =67) and controls (n =30; 0.991 ± 0.305 vs 1.035 ± 0.498 ; P =0.692),and no statistically significant difference in LTB4 concentration was found among the three genotypes of rs2660845 as well (AG genotype vs AA genotype vs GG genotype:0.938 ± 0.269 vs 1.038 ± 0.268 vs 1.043 ± 0.383 ; P =0.401).Conclusion The present study suggests that there is no association between the two polymorphisms in the LTA4H gene and risk of ischemic stroke in population of southern Zhejiang Province.

Objective: To explore change of hemoglobin (Hb) concentration, the relationship between anemia and left ventricular function and the influence of anemia on prognosis in patients with diastolic heart failure (DHF). Methods: According to NYHA classification, a total of 176 DHF patients were divided into class Ⅱ group (n=78), class Ⅲ group (n=50) and class Ⅳ group (n=48), then Hb level and morbidity rate of anemia were analyzed in each group. According to diagnostic standard of anemia, patients were divided into anemia group (n=58, , occupied 33.0%) and non anemia group (n=118, occupied 67.0% ). Left ventricular diastolic function, mortality rate and rehospitalization rate during follow-up were compared and analyzed between two groups. Results: Along with cardiac function class rose (from class Ⅱ to class Ⅳ), Hb level showed a decreasing trend [(130±6) g/L vs. (108±4) g/L vs. (96±12) g/L], while morbidity rate of anemia gradually rose (8.97% vs. 36.0% vs. 68.8%), P<0.05 all in anemia group；Compared with non-anemia group, there were significant rise in percentages of patients with coronary heart disease (55.1% vs. 65.5%), levels of creatinine [(87.6±39.2) μmol/L vs. (113.7±59.8) μmol/L] and N terminal pro B type natriuretic peptide [NT-proBNP, (578.0±136.7) pg/ml vs. (886.0±174.8) pg/ml], and early-diastolic peak velocity deceleration time [(137±15)ms vs. (196±13)ms], and significant reduction in mitral early/late diastolic peak flow velocity [E/A, (0.87±0.32) vs. (0.62±0.29)], P<0.05 all. Compared with non-anemia group, there were significant rise in mortality rate (9.3% vs. 20.7%) and rehospitalization rate (18.6% vs. 32.8%) in anemia group during follow-up, P<0.05 all. Conclusion: DHF patients often complicate with anemia. Along with heart failure aggravates, their morbidity rate of anemia rises, and anemia may aggravate cardiac diastolic dysfunction. Mortality rate and rehospitalization rate rise in DHF patients complicated with anemia.

Objective: To explore the entry points and monitoring points of individualized treatment for fracture surgery patients with ARDS.Methods: Clinical pharmacists comprehensively assessed the patient's conditions and looked up lots of literatures.Some suggestions on the anti-infection treatment efforts, glucocorticoid use dispute and rational use of ambroxol were offered.The efficacy and adverse reactions of drugs in the treatment process were monitored using some subjective and objective indicators.Results: The consensus about the pros and cons, dosages, as well as the possible dosage decrease of glucocorticoid therapy, the dosages of antimicrobial agents, and the dosages and treatment course of ambroxol was achieved between clinical pharmacists and doctors.As a result, the maximum benefits were obtained for the patient.Conclusion: Clinical pharmacists can explore the treatment and monitoring for specific diseases and find out intervention entry points of clinicians and patients to play a certain role in clinics, and accumulate treatment experience gradually.