ObjectiveTo investigate the expression and clinical significance of myeloperoxidase (MPO) in patients with chronic ischemic cerebrovascular disease.Methods70 carotid atherosclerotic plaques patients with plasma MPO level in our hospital were measured and taken ultrasound examination at the same time.ResultsThere was no significant difference for those with contrast-enhanced imaging and without increase in the general information (P ＞0.05).The enhanced infarct rate was 80.5％ (33/41).The non-enhanced infarct was 44.8％ (13/29).The carotid plaque ultrasound contrast enhancement in patients with cerebral infarction group was significantly higher than non-enhanced group(P ＜ 0.01 ).In the plasma levels of MPO detection,contrast-enhanced carotid ultrasound group was significantly higher than non-enhanced group( P ＜ 0.01 ).The cerebral infarction patients was significantly higher than non-cerebral infarction group (P ＜ 0.01 ).ConclusionThe atherosclerotic plaque instability in patients with high expression level of MPO was significantly higher,which indicated high level expression of MPO in the diagnosis of chronic cerebrovascular disease had a very important role.Supplemented by the results of ultrasound imaging may had a clear diagnosis.

Objective To observe the protective effects with vascular endothelium of Danhong injection for unstable angina (UA)after percutaneous coronary intervention in patients.Methods 180 patients with UA were ran-domly divided into two groups,and patients undergoing percutaneous coronary intervention (PCI)therapy.In addi-tion,90 cases in the control group were treated with conventional western medicine treatment,90 cases in the observa-tion group were treated with conventional western medicine treatment and Danhong injection therapy.The serum super-oxide dismutase (SOD),malondialdehyde (MDA)and brachial artery flow -mediated endothelium -dependent vaso-dilation (FMD),von Willebrand factor (vWF),plasma nitric oxide (NO),endothelin -1 (ET -1)levels and other indicators before and after treatment were detected.Results The total effective rate of the observation group was 96.67%,which was significantly higher than 75.56% of the control group (χ2 =9.23,P <0.05).The endothelial function parameters NO(73.66 ±11.58)μmol/L,ET -1 (64.75 ±6.83)ng/L,vWF(114.58 ±16.24)%,FMD (6.54 ±0.88)% of the observation group after treatment were significantly improved than before treatment (t =8.04,7.90,8.44,7.67,all P <0.05),which of the control group were (62.78 ±10.42)μmol/L,(92.31 ±8.67)ng/L, (152.64 ±18.75)%,(4.18 ±0.72)%,there were significant differences(t =6.78,7.34,7.70,6.56,all P <0.05).The serum SOD (154.62 ±21.37)U /mL and MDA (4.18 ±0.79)nmol/L levels of the observation group were significantly improved than before treatment(t =7.58,8.67,all P <0.05 ),which of the control group were (132.45 ±26.89)U /mL,(5.27 ±1.16)nmol/L,there were significant differences (t =7.22,7.81,all P <0.05). Conclusion Danhong injection for the treatment of UA stasis syndrome can be widely promoted by reducing oxidative stress on vascular endothelial damage,and improving endothelial function in patients after PCI,has great clinical value.

OBJECTIVE: To explore the effects of Houttuynia Cordata on expression of human beta-defensin-2 (HBD-2) in pulmonary epithelial cells (SPC-A-1) in vitro; and to observe the correlationship between the level of HBD-2 mRNA and the concentrations or treatment times of Houttuynia Cordata. METHODS: The SPC-A-1 cells were cultured with different concentrations of Houttuynia Cordata in vitro, including 0, 12.5, 25, 50, 100 and 200 microg/ml. And then, the SPC-A-1 cells were cultured with the optimal concentration of Houttuynia Cordata in different lengths of time, including 1, 2, 4, 8, 16 and 24 hours. After the treatment, the mRNA level of HBD-2 in pulmonary epithelial cells was detected by means of semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: After being cultured with Houttuynia Cordata, the expression of HBD-2 mRNA had positive correlation with the stimulus concentrations (rs=0.829, P=0.042) and stimulus time (rs=0.914, P=0.003). The highest expression of HBD-2 mRNA was induced by 100 microg/ml Houttuynia Cordata after 8-hour treatment. In comparison with the normal control group and the interleukin-1beta group, 100 microg/ml Houttuynia Cordata could significantly up-regulate the expression of HBD-2 mRNA in SPC-A-1 cells after 8-hour treatment (P<0.01). CONCLUSION: Houttuynia Cordata can up-regulate expression of HBD-2 mRNA in SPC-A-1 cells, and the highest expression level of HBD-2 mRNA can be obtained by culture with 100 microg/ml Houttuynia Cordata for 8 hours.

Objective To evaluate the vascular remodeling features in the elderly hypertensives through detecting the changes of large arterial structure and function by ultrasonography. Methods High resolution ultrasound was applied to examine 52 lightly or moderate elderly hypertensives(LMEH), 52 elderly normal subjects(EN) and 25 adult normal subjects(AN). Carotid and humeral arterial intimal-medial thickness (IMT), lumen diameter(r) and IMT/r were determined as the index for the changes of arterial structure, and the humeral arterial endothelium-dependent vasodilation and cross-sectional compliance were used to reflect the changes of arterial functions. Results Carotid IMT and lumen diameter were larger in LMEH group than those in EN group(0.97?0.21)% vs. (0.82?0.12)%, (7.41?2.13)% vs. (6.38?0.45)%, all P

ObjectiveTo explore the etiology of incisional hernia of abdomianal wall.Methods98 cases with incisional hernia were analyzed retrospectively in terms of incision type, technique of suture, suture materials,infection of incision, and the time of occurrence.ResultsLongitudinal incision, improper technique of suture,infection, increase of intraabdominal pressure, and diabetes mellitus were risk factors of incisional hernia. ConclusionsTransverse incision, prevention of infection of the incision, strict aseptic manipulation and hemostasis were effective in the prevention of incisional hernia. Most hernia developed within 6 months postoperatively.

Objective To explore the value of E-flow technique in ultrasound examination of fetal pulmonary vein.Methods The pulmonary veins of 332 fetus were examined using lungs as acoustic window by two-dimensional echocardiography(2DE), color Doppler flow imaging (CDFI) and E-flow.Visualization ratios of the three methods were compared.Results The fetal pulmonary veins were displayed as following:7 cases were showed by 2DE,49 cases by CDFI and 73 cases by E-flow among 118 cases during 12 - 22 gestational weeks.The visualization ratio of E-flow was higher than that of the other two methods (P ＜0.001).Fourty-one cases were showed by 2DE, 171 cases by CDFI and 177 cases by E-flow among 214 cases during 23 - 40 gestational weeks.The visualization ratios of E-flow and CDFI were higher than that of 2DE (P ＜ 0.001).The visualization ratio of E-flow and CDFI has no distinct differrence (P ＞ 0.0167).Conclusions E-flow was sensitive to pulmonary vein blood flow and better than 2DE and CDFI in early stage of the second trimester.

Objective To investigate the efficacy and safety of intrathecal chemotherapy combined with concurrent radiotherapy in patients with leptomeningeal metastases from solid tumors.Methods The clinical and follow-up data of 29 patients with leptomeningeal metastases from malignant solid tumor who had intrathecal chemotherapy combined with concurrent radiotherapy were retrospectively analyzed.The treatment regimen was that 12.5-15.0 mg of methotrexate intrathecal injection once a week for 8 successive weeks combined with whole brain irradiation to a total dose of 40 Gy,20 fractions or with lumbosacral spinal canal irradiation to a total dose of 50 Gy,20-25 fractions.Results Nineteen patients completed the concurrent therapy and 19 patients were dead.There were 9 patients with complete remission of symptoms,11 with obvious improved symptoms,6 with alleviated symptoms,and 3 with no relief.All of the 29 patients,were followed up for 0.4-15.0 months.The median survival was 5 months.The 6-month survival rate was 48％ (11/23),excluding 4 patients with follow-up time less than 6 months and 2 patients noncancer deaths.The main toxicities were myelosuppression,methotrexate-related mucositis,chemical nerve root injuries,chemical meningitis,chronic neurotoxicity,seizures,and radiation-related mucositis.The incidence of severe toxicity was 17％ (5/29).Conclusions Combination of intrathecal methotrexate with concurrent radiotherapy can effectively alleviate the symptoms and improve the life quality of patients.The therapy with low incidence of severe toxicity and good tolerance has the trendency to prolong the median survival.

Objective To evaluate the effect of infiltration anesthesia at Calot's triangle on postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.Methods One hundred and forty patients,aged 18-64 yr,with 18 kg/m2 ≤ body mass index ≤ 31 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,were randomly divided into 2 groups (n =70 each):control group (group A) and infiltration anesthesia at Calot's triangle group (group B).In group B,1％ ropivacaine 10 ml was injected into Calot's triangle before dissection of the gallbladder,while the equal volume of normal saline was injected into Calot's triangle in group A.The patients in both groups received patient-controlled intravenous analgesia (PCIA) for 48 h starting from 10 min before the end of surgery.The VAS score was maintained below 4 during PCIA.When VAS score ≥ 4,lasting for more than 30 min,tramadol 1.5 mg/kg was injected intravenously.The consumption of physic liquor for PCIA,and requirement for tramadol were recorded.The incidence of puncture-related damage to Calot's triangle and local anesthetic intoxication and adverse effects such as nausea and vomiting within 48 h after surgery were also recorded.The first postoperative flatus time was recorded.Results Compared with group A,the consumption of physic liquor for PCIA,requirement for tramadol,and consumption of tramadol were significantly reduced,and no significant change was found in the incidence of nausea and vomiting and the first postoperative flatus time in group B.No puncture-related damage to Calot's triangle occurred in A and B groups.There was no local anesthetic intoxication in group B.Conclusion Infiltration anesthesia at Calot's triangle can optimize postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.

Objective To investigate the value of application of magnetic resonance imaging (MRI) in diagnosis and treatment of leptomeningeal metastases from malignant solid tumors.Methods A retrospective analysis was conducted depend on the radiological data of 63 patients who had been diagnosed as leptomeningcal metastasis of malignant solid tumors.Results All patients received brain MRI examination.26 patients underwent cervical or lumbar spine MRI examination.The MRI images showed nodular enhancement in the gyri and sulci,leptomeningeal linear enhancement,dura mater thickening and enhancement,ependymal enhancement,intraventricular metastasis,intraspinal metastatic nodules,communicating hydrocephalus,subdural hydroma and negative imaging.Ncuroimages of ependymal enhancenent,intraventricular metastasis and intraspinal implantation metastasis appeared in 5,7 and 9 patients with small cell carcinoma,respectively,which were higher than that of the other pathological types (P =0.002,P =0.009,P ＜ 0.000 1).Seizure occurred in 7 patients after intrathecal chemotherapy,of which 5 patients had pia mater linear enhancement.Among 33 patients treated with radiotherapy combined with intrathecal chemotherapy,3 patients had poor prognosis,of which 2 patients had negative imaging findings.The conditions of 25 patients were improved obviously after treatment,of which 21 patients showed different imaging remission in MRI re-examination.Conclusions The contrast MRI has an important assistant effect in diagnosis of leptomeningeal metastasis of malignant solid tumors.The MRI findings and clinical features are related with the pathological types.The pia mater linear enhancement indicates a high possibility of seizures after inthathecal chemotherapy,and it suggests that the preventive treatment should be given for such patients.MRI is not applicable to evaluate severity,prognosis and curative effect of the disease.

As an income redistribution mechanism, the design of Urban Resident Basic Medical Insurance ( URBMI) should reflect the inclination to take care of vulnerable populations, such as people with chronic diseases and low incomes. Therefore, whether the healthcare services of vulnerable populations have been improved, is the most important indicator to determine the effectiveness of the URBMI. Using the DID model, this paper analyzes healthcare service utilization of invulnerable and vulnerable populations before and after the establishment of URBMI ( including both outpatient and inpatient) , based on the idea that these two populations have different socio-economic and health status. Then, based on the gap between the healthcare service utilization changes of different groups, we can measure the equity in URBMI. The results show that the establishment and implementation of URBMI has indeed narrowed the gap of invulnerable and vulnerable populations with different socio-economic and health status; health-care service utilization of vulnerable populations has increased significantly, and health status has significantly im-proved. From vertical and horizontal perspectives, the results prove that the establishment of URBMI has improved the equity of healthcare service utilization among different populations across China.