Objective To investigate the relationship between Tel index and the extent of coronary artery disease.Methods 100 cases who underwent quantitative coronary angiography(QCA)were enrolled in this study,Frequency spectntm of blood flow of mitral valve and aortic valve was gathered in Pulse Doppler.from which Tei index was calculated.Results 70 patients of 100 cases with coronary angiography were diagnosed coronary heart disease 70%(70/100);coronary angiography in 30 patients with negative excluded coronary heart disease;with the degree of coronary artery stenosis increased Tei index rising trend(0.39±0.03～0.48±0.06):Severe coronary artery stenosis Tei index(0.48±0.06)than the mild coronary artery stencsis(0.42±0.05)increased significantly(q=3.21,P＜0.05),but mild coronary artery stenosis(0.42±0.05)and no narrow group(0.39±0.03)there was no significant difference(q=2.21,P＞0.05);A comparison of Tei index between Gensini integral 41 to 80 cent.≥81 cent and 40 cent were significant different(q=3.28、3.31,all P＜0.05).Conclusion Tei index was postive correlated with the extent of coronary artery disease.

Objective To investigate the clinical features of glucose transporter 1 deficiency syndrome(GLUT1-DS) and summarize the characteristics of GLUT1-DS through reviewing related references.Methods The clinical data including manifestation,cerebrospinal fluid (CSF) glucose,electroencephalogram,MRI and gene mutation of a patient with GLUT1-DS was collected and the related literatures were reviewed.Results The patient was a 6 years old boy.The patient,whose seizures occurred at the age of 9 month-old and prolonged to 6 year-old,attacked before breakfast.Physical examination showed microcephaly with head circumference 47.5 cm.Laboratory tests showed that CSF glucose decreased (1.87 mmol/L) and CSF-serum ratio was 0.36.And meantime the MRI was normal and electroencephalogram showed general spike and slow wave complex paroxysm.Mutation of SLC2A1 gene,c.350_385del,was found in the patient.There were 219 cases with GLUT1-DS had been reported and the age of onset was 15.69 months.In 219 patients,159 cases (72％) suffered seizures,105 cases (47％) had motor abnormalities,61 cases (27％) suffered intellectual disability.The CSF glucose values were (1.92±0.31) mmol/L,CSF-serum ratio was 0.36±0.07.SLC2A1 gene mutations were detected in 183 patients(96％)in which missense mutation was the most mutation.Conclusion A wide range of phenotypes of GLUT1-DS include seizures,motor abnormalities,mental retardation.The diagnosis is confirmed when CSF glucose and CSF-serum ratio are continuously decreased which in the absence of meningitis.The SLC2A1 gene should be detected in suspicion of GLUTI-DS patients.Early diagnosis and treatment may improve the prognosis of those GLUTI-DS patients.

Objective To detect the expression of Survivin and hypoxia inducible factor-1α (HIF-1α) in prostatic hyperplasia and prostatic carcinoma,and investigate their roles and mutual correlations in pathogenesis and progression of prostatic carcinoma.Methods The expression of Survivin and HIF-1α in proliferative lesions of prostate (15 cases) and prostatic carcinoma (62 cases) were detected by immunohistochemistry method.The relationship between the expressions of Survivin and HIF-1α was analyzed,as well as their correlations with clinicopathological features.Results The positive expression of Survivin and HIF-1α were significantly higher in the prostatic carcinoma [71.0 ％ (44/62) and 69.4 ％ (43/62),respectively] compared with those of the prostatic proliferation [6.7 ％ (1/15) and 0] (x2 =20.56,P 0.001; x2 =23.56,P =0.001,respectively).The expression of Survivin and HIF-1α in prostate carcinoma was significantly related with the histological grading,clinical staging (x2 =10.64,5.39,7.62,6.43,all P ＜ 0.05).And there was positively correlated between Survivin and HIF-lα (rs =0.350,P =0.006).Conclusion Survivin and HIF-1α synergistically play important roles in pathogenesis and progression of prostatic carcinoma.

Objective L-selectin is an important adhesion molecule,which is the lymph cell's homing receptor specifically expressed on leukocytes.A non-lymphoma cell line-HCa-F has the high potential ability of metastasis to peripheral lymph nodes,whose character is similar to lymphoma's.We want to explore whether the HCa-F cell's metastasis mechanism is also similar to lymphoma's,that is to say,whether HCa-F cell can also express L-selectin and the expression of L-selectin bring about the lymph node metastasis character. Methods First,?-fetoprotein,CD3 and CD20's monoclonal antibodies were used to identify the origin of HCa-F cell;then we analysed whether the HCa-F cell can express L-selectin by means of flow cytometry analysis,RT-PCR,and Western blotting;finally,Stamper-Woodruff method was used to examine the L-selectin's function. Results Immunostaining showed that the HCa-F cell was ?-fetoprotein positive,CD3 and CD20 negative cell line,which suggests that it is a liver cell line.And results of flow cytometry,RT-PCR,and Western blotting showd that HCa-F cell can express L-selectin.Additionally,anti-L-selectin's antibody can inhibit the adhesion between HCa-F cells and frozen section of mouse lymph node.Conclusion L-selectin expressed on HCa-F cells is a functional molecule which can facilitate HCa-F cell's metastasis to lymph nodes.

OBJECTIVE:To study the effect of paroxetine combined with low dose of olanzapine on sleep process and architec-ture of depression patients with insomnia. METHODS:84 depression patients with insomnia were randomly divided into control group and observation group. Control group was given 20 mg Paroxetine tablet,once every morning;observation group was addi-tionally given 2.5 mg Olanzapine tablet,once before going to bed. Sleep quality [Pittsburgh Sleep Quality Index(PSQI)],depres-sion scores [Hamilton Depression Scale (HAMD)],sleep process [sleep latency (SL),awakening times (AT),the actual total sleep time (TST),sleep efficiency (SE),rapid eye movement (REM) sleep latency (RL)] and sleep architecture [sleep stage 1 (S1),2(S2),3(S3)and the proportion of REM to sleep] in 2 groups before and 3,6 months after treatment and the incidence of adverse reactions(ADR)were observed. RESULTS:After treatment,PSQI and HAMD scores in 2 groups were significantly lower than before,and gradually decreased by time,and observation group was lower than control group;TST in observation group was significantly higher than before and control group,S1 in observation group was significantly lower than before,SE,S3 and REM in 2 groups were significantly higher than before,and observation group was higher than control group,SL,AT,RL and S2 were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). There were no obvious ADR in 2 groups. CONCLUSIONS:Paroxetine combined with low dose of olanzapine can sig-nificantly relieve depression,optimize sleep process and sleep architecture,then impove sleep quality.

Objective To investigate the advantage of detaining peripherally inserted central catheter through the veins of lower extremity in neonatal intensive care unit.Methods 165 cases of infants were randomized into veins of lower extremity group (first saphenous veins,then popliteal vein) and veins of upper extremity group (first basilic vein,then median cubital vein,cephalic veins) from January to December 2012.We observed the success rate of detaining,catheter tip location,and complications such as phlebitis in the two groups.Results The success rate of detaining of lower extremity group was higher than that of upper extremity group,and ectopic rate of lower extremity group was lower than that of upper extremity group.There was no significant difference in complications such as phlebitis between two groups.Conclusions Peripherally inserted central catheter through the veins of lower extremity has more advantage over through the veins of upper extremity group.

ObjectiveTo improve the diagnosis, treatment and prophylaxis of fungal infections following orthotopic liver transplantation (OLT). Methods Medical records from 175 consecutive patients who underwent 180 OLT at our centre from 1993 and 2002 were retrospectively reviewed for fungal infection. ResultsTwenty nine patients(16 6%) developed invasive fungal infection. Median posttransplantation interval was 26 days (range 3 to 96) and respiratory tract was the most common infectious site (37%). Pathogens were Candida species (24 of 43, 98%) and Aspergillus (1 of 43, 2%). Fungal infections occurred significantly more often in patients with the length of time in parenteral nutrition, antibiotic use over 3 weeks or hepatic artery complications. After treatment with Fluconazole (26 patients) and liposomal amphotericin B (8 patients with serious fungal infections), 16 patients were cured and 13 patients died. The mortality related to fungal infection was 4 0% (7/175). Conclusion Fungal infections are associated with mortality following OLT. Eliminating the various risk factors will decrease the incidence of fungal infection. Amphotericin B or liposomal amphoterin B are effective for patients with serious fungal infection.

Objective To investigate the prevalence of plasmid-mediated quinolone resistance ( PMQR ) determinants [ qnr,aac ( 6' ) -Ib-cr and qepA ]and mutations in quinolone resistance-determining regions (QRDRs) of gyrA and parC and their association with fluoroquinolone susceptibility in clinical isolates of Serratia marcescens in Anhui.Methods The minimum inhibition concentration ( MIC ) of 104 strains of S.rnarcescens collected from various clinical specimens from 34 hospitals during 2005 to 2010 were determined by agar dilution method.The qnr,aac (6')-Ib,qepA,gyrA and parC genes were screened by polymerase chain reaction (PCR) in 31 strains resistant to ciprofloxacin,and positive results were subsequently confirmed by sequencing.The conjugation experiments were performed for qnr and aac(6')-Ib-cr positive strains.The MIC of S.marcescens isolates,recipient strains and conjugants were tested by agar dilution method for quinolones and other antimicrobial agents.Results Six strains of the 31 S.marcescens isolates harboured qnr and/or aac(6')-Ib-cr genes.Among those 6 strains,2 strains harboured a qnrB6 gene,1 harboured a qnrS2 gene,and 4 harboured aac( 6' ) -Ib-cr,whereas no qnrA-,qnrC- or qnrD-positive isolate was detected.None of the 31 isolates carried the qepA gene.Mutations in the QRDR of gyrA and parC genes were detected in 9 and 7 isolates,respectively.The conjugation experiments were successfully carried out in 5 isolates of 6 PMQR determinants-postive strains.The MIC of conjugants for quinolones were increased evidently compared to recipient strains.Conclusions Chromosome and plasmid-mediated resistance determinants play an important role in quinolone resistance in clinical isolates of S.marcescens.And more important is that the PMQR determinants can be horizontal transmitted.It is necessary to continuously survey and watch for the spread of PMQR in S.marcescens in public health control program.

ObjectiveTo analyze the clinical distribution and antimicrobial resistance profile of Serratia marcescens(S. marcescens), and to provide the scientific evidence supporting clinical diagnosis and treatment.MethodsThe antimicrobial susceptibility test was performed in 104 strains of S. marcescens by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute (CLSI) 2010.The data were analyzed by chi square test. Results The majority of S. marcescens were isolated from sputum specimens,accounting for 59.6％ (62/104). The bacteria were most frequently isolated from department of respiratory (33.7％,35/104),followed by intensive care unit (23.1％,24/104),department of gerontology (16.3％, 17/104). The results of antimicrobial susceptibility test showed that the resistance rates of S.marcescens against ampicillin,gentamicin and cephazolin were high,which were 90.4％,86.5％ and 79.8％,respectively; those against the 3rd generation of cephalosporins were 24.0％-43.3％. No imipenem and meropenem resistant strains were identified. Compared with cefoxitin-resistant strains,the resistance rates of non-cefoxitin resistant strains against piperacillin (82.9％ vs 28.6％),ceftazidime (63.4％ vs 9.5％),aztreonam (68.3％ vs 9.5％),amikacin (68.3％ vs 20.6％),ciprofloxacin (48.8％ vs 19.1％) and chloramphenicol (90.3％ vs 58.7％) were all lower (all P ＜ 0.05 ). Conclusions S. marcescens is one of the most common conditional pathogenic bacteria leading to nosocomial infections,which is resistant to many kinds of antimicrobial agents.The surveillance of antimicrobial resistance in S. marcescens should be strengthened for purpose of preventing the transmission of multidrug resistant strains.

Objective To investigate the difference between Asia-Pacific Colorectal Screening (APCS) scoring system and colorectal cancer sequential screening criteria issued by the Health Ministry of China (China sequential criteria) in the evaluation of high-risk colorectal neoplasm in patients undergoing coronary artery angiography (CAG) examination.Methods The data of 870 patients aged from 40 to 74 who underwent CAG examination were retrospectively analyzed.The measurement data were analyzed by t test and the count data were aralyzed by x2 test.Results There were 72 patients aged from 40 to 49 years old.Among them,eight patients were stratified as high-risk population according to the Chinese sequential criteria; however there was no high-risk population by APCS.There were 798 patients aged from 50 to 74 years old.There were 460 patients stratified as high-risk population by APCS.The percentage of CAG negative group (34.7％) was significantly lower than that of the coronary artery disease (CAD) group (68.0％,x2 =77.74,P＜0.01).According to the Chinese sequential criteria,and there were 134 patients stratified as high-risk population,and there was no significant difference between the CAG negative group (17.7 ％) and the CAD group (16.4％,P＞0.05).Among the patients aged from 50 to 74 years old without family history of colorectal cancer in first-degree relatives,72 cases (29.0％) of the CAG negative group and 316 cases (57.5％) of the CAD group were stratified as high-risk according to APCS,however not stratified as high-risk by the Chinese sequential criteria.About 90.5 ％ (351/388) of them were male smokers.According to APCS,30 cases (12.1％) of the CAG negative group and 32 cases (5.8％) of the CAD group were stratified as middle-risk population,however stratified as high-risk population by the Chinese sequential criteria.About 75.8％ (47/62) of them were female non-smokers.Conclusions The percentage of patients stratified as high-risk population by APCS was higher than that by the Chinese sequential criteria.In patients aged from over 50 to 74 years old and without family history of colorectal cancer in first-degree relative,APCS maybe overestimated the risk degree of colorectal neoplasm in male smokers and underestimated the risk degree in female non-smokers.