Heart fatty-acid-binding protein(H-FABP) is small molecular weight cytosolic protein that is abundant in the heart and has tissue specificity. Concentration of H-FABP changes regulation in serum after the myocardial damage. In addition it has a positive correlation with the degree of myocardial damage. It is an early diagnostic biochemical marker of acute myocardial ischemia. The advance of H-FABP in the research on physiochemical nature,and its application for myocardial injury and prospective study of sudden cardiac death in forensic science were reviews.

ObjectiveTo study the effect of the rehabilitation nursing and movement training on patients after cardiac valve surgery.Methods26 cases who accepted cardiac valve surgery were assessed with psycho-physiological and cardiac function, then make single rehabilitation nursing measures. Movement training was being done for 20 days as well as mental convalescence and health education of rehabilitation.ResultsCardiac function of all cases was promoted 1-2 grade after rehabilitation. Exercise stress was raised and movement time was prolonged than that of before rehabilitation (P<0.01). The heart rate, systolic pressure, diastolic pressure, binomial product (HR×SBP) ane the lowered S-T segment were also improved significantly after rehabilitation whether in the state at rest or motion with equal time and stress (P<0.01-0.05).ConclusionsRehabilitation nursing and movement training can reduce complications after cardiac valve surgery, raise cardiac reserve, and lower myocardial oxygen consumption. Meanwhile, it can improve myocardial ischemia and raise cardio-pulmonary function. It also can improve quantity of patients' life.

BACKGROUND:At present, the incidence rates of knee joint diseases such as knee osteoarthritis, knee joint degenerative are high. The major clinical treatment is total knee replacement in the clinic, so it is necessary to evaluate the changes in stress and bone mineral density of the regions surrounding the prosthesis after replacement. ＜br> OBJECTIVE:To explore periprosthetic stress and bone mineral density and to analyze their correlation after total knee arthroplasty. ＜br> METHODS:A total of 20 cases undergoing total knee arthroplasty were chosen.The hospital for special surgery scores were used to evaluate patients’ functional recovery at 12 months after total knee arthroplasty. The periprosthetic femur was divided into four regions of interest (ROI), respectively ROI 1-4;periprosthetic tibia was divided into three regions of interest, respectively ROI 5-7. Stress surrounding the prosthesis was analyzed using three-dimensional finite element analysis at 1, 3, 6 months, 1, 2, 3 years after replacement. Simultaneously, bone mineral density surrounding the prosthesis was measured using dual-energy X-ray absorptiometry. ＜br> RESULTS AND CONCLUSION:No patients affected infection or loosening of the prosthesis. At 12 months after replacement, the score of hospital for special surgery was (90.23±2.37), which showed significant differences as compared with before replacement (39.68±1.31) (P＜0.05). The level of stress shielding was highest in ROI 5 and lowest in ROI 3. Stress shielding rate of ROI increased with statistical difference at 6 months after operation (P＜0.05). At 1, 2, 3 years after operation, shielding rate in periprosthetic femoral stress in ROI 1 decreased. Compared with 1 month after operation, the difference was statistical y significant (P＜0.05). However, shielding rate of tibial periprosthetic stress in ROI 6 increased. Compared with 1 month after operation, the difference was statistical y significant (P＜0.05). Bone mineral density after 1 month after operation had no significant decrease (P>0.05). At 3 months after operation, bone mineral density began to decline significantly (P＜0.01). The decrease was most obviously in ROI 5 and the change was least in ROI 3. After 1 year of operation, bone mineral density did not change significantly. These data indicated that changes in bone mineral density were correlated with stress shielding after total knee arthroplasty. Monitoring two variations can provide theoretical data for preventing bone loss, which provides references for clinical rehabilitation guidance.

Objective To investigate the effect of nifedipine on renal ischemia-reperfusion injury (I/R) in rats and the possible mechanism. Methods Forty-two male SD rats weighing 220-250 g were randomly divided into 3 groups with 14 animals in each group: sham operation group (group S); I/R group and I/R + nifedipine group (group N). The renal ischemia was induced by occlusion of bilateral renal arteries and veins for 45 min followed by reperfusion. In group S the renal arteries and veins were only exposed but not occluded. In group N, nifedipine 0.1 mg/kg was injected via the tail vein 15 min before ischemia and 15 min before reperfusion, while the equal volume of solvent was given in group I/R. The urine was collected to detect the N-acetyl-β-D-glucosaminide (NAG) activities at 6 and 24 h of reperfusion. Arterial blood samples were taken at 6 and 24 h reperfusion for determination of concentrations of serum creatinine (Cr), malondialdehyde (MDA) and NO. The rats were then sacrificed and the kidney was removed to detect the apoptotic cells in renal cortex and expression of heat shock protein 70 (HSP70) and endothelin- 1 (ET-1). Results The concentrations of serum Cr and MDA, NAG activity, expression of HSP70 and ET-1 and apoptosis rate were significantly increased in group I/R compared with group S (P ＜0.05). The concentrations of serum Cr and MDA, NAG activity, ET-1 expression and apoptosis rate were significantly decreased, while the serum NO concentration was significantly increased in group N compared with group I/R (P ＜ 0.05). Conclusion Nifedipine can attenuate renal I/R injury and the underlying mechanism may be related to the inhibition of ET-1 expression.

Objective To observe the depressive symptoms in patients with burn injury of middle and small area at different periods.Methods65 patients with burn injury of middle and small area (<39%) were assessed with Hamilton Depression Scale (HAMD) at acute stage and convalescence respectively, and the results were compared with those of 41 normal subjects (control group).ResultsThe factor scores and total score of HAMD in the patients with burn injury at acute stage and remission were obviously higher than those in the control group ( P<0.05～0.01). For the patients with burn injury, the scores of depressive symptoms, difficulty in falling asleep, early wake-up, psychiatric anxiety, somatic anxiety, constitutional symptoms, sexual symptom, doubt of disease, circadian change, dispersonalization, feeling of despair, decline in ability feeling, and inferiority feeling at convalescence were obviously higher than acute stage ( P<0.05～0.01), but the scores of superficial sleep, excitation, gastrointestinal symptoms, reduce in body mass, paranoid ideation and obsession-compulsion were markedly lower than acute stage ( P<0.05～0.01).ConclusionThe depressive symptoms are totally different in patients with burn injury of middle and small area at different periods, and psychological interventions should be in pertinence.

Objective To construct a recombinant lentivirus vector containing the human NIS gene and HIF-1α with the myosin light chain-2v(MLC-2v) as a promoter and to investigate the specific expression and feasibility of NIS as a reporter gene in cardiomyocytes.Methods The target gene HIF-1α and NIS were subcloned into the lentivirus (Lv)-elongation factor (EF)1-HIF-1α-internal ribosome entry site (IRES)-NIS and Lv-MLC-HIF-1α-IRES-NIS lentivirus vectors.The recombinated vectors were transfected into Hela cells by lipofectamine 2000.The expression of HIF-1α and NIS in the transfected Hela cells was detected by indirect immunofluorescence and Western blot.The H9C2 cells were exposed to different multiplicities of infection (MOI; 5,10,20,40) with packaged virus particles.The infection efficiency was detected by Western blot.MOI 20 was used for H9C2,NIH-3T3 and L6 cell lines and the specificity of the MLC-2v promoter was detected by the count of NIS protein in the 3 different cell lines with Western blot.The function and features of NIS protein were evaluated by dynamic iodine uptake and NaClO4 iodine uptake inhibition tests in vitro.Two-sample t test was used to analyze the data.Results The two recombinant lentivirus vectors were constructed successfully.The HIF-1α protein was expressed in the cytoplasm and the NIS protein was expressed on the cell membrane in Hela cells.The grey levels of NIS and HIF-1α proteins in the positive control were 69.8 and 71.9,respectively,which were 109.4 and 92.7 after being prompted by EF1,and 141.9 and 132.4 by MLC-2v.The expression of these proteins was much higher by EF1 promoter than that by MLC-2v promoter.The optimal MOI for the Lv-MLC-HIF-1α-IRES-NIS virus to infect H9C2 cells was 20.With the MOI of 20,the grey levels of NIS protein promoted by EF1 were 23.4,29.8 and 28.6 for H9C2,NIH-3T3 and L6 cells infected with Lv-EF1-HIF-1α-IRES-NIS virus,respectively.The expression of NIS protein promoted by MLC-2v was much higher in H9C2 cells than the other two cell lines.The grey level of NIS protein was 157.9 in H9C2 cells,178.8 in L6 cells and 217.3 in NIH-3T3 cells.The NIS protein expressed in infected H9C2 cells showed high radioiodine uptake.The peak of iodine uptake was 4 287.2 counts · min-1 at 40 min which was 16.85 times of the control group (254.4 counts · min-1) (t=5.34,P＜ 0.01).The inhibition rate of iodine uptake was up to 85.5％ (3 666.4/4 287.2,t=21.3,P＜0.01) by NaClO4.Conclusions MLC-2v promoter allows specific expression of the external gene HIF-1α and NIS in myocardium.The cardiomyocytes transfected with NIS gene acquires the function of iodine uptake.Therefore,NIS may have a potential to be the reporter gene to monitor the external gene therapy in ischemic cardiomyopathy.

OBJECTIVE To evaluate the curative effect of acute cerebral stroke influenced by lower respiratory tract infection. METHODS To adopt previous way to compare one group included 178 cases with lower respiratory tract infection with the other group included 172 cases which had not been infected,and the relationship between the contact of lower respiratory tract infection and curative effect of acute cerebral stroke. RESULTS The neural function defects′score of the infected group was higher than the noninfected group(P

Decades researches of molecular oncology have found some moleculars which can promote tumor growth and help cancer surrive.This brings new hope for the treatment of tumors.Epidermal growth factor receptor (EGFR) is the first important molecular to inhibit tumor growth.Fifty percent triple negative breast cancer (TNBC) and inflammatory breast cancer (IBC) overexpress EGFR.EGFR and its downstream pathway can regulate epithelial-mesenchymal transition,promote tumor cell migration.EGFR therapy can improve the chemosensitivity of TNBC cells,apoptotic signal transduction occur.These studies suggest that the EGFR targeted therapy may have an important role in the treatment of TNBC and IBC.

Objective Renal tumor and gynecological tumor invading into inferior vena cava and extending to the right cardiac cavities is quite uncommon,we report the experience of diagnosis and surgical treatment of intravenous tumor embolus extending through inferior vena cava into the right cardiac cavities.Methods From Junuary 2001 to May 2008,4 patients with intravenous tumor embolus extending through inferior vena cava into right cardiac cavity were treated in PUMC Hospital.Three cases were leiomyomatosis.Two patients' operation was performed by stages,firstly removed tumer in the right cardiac cavities using cardiopulmonary bypass under mid-hypothermia,and,postoperatively 3～4 weeks,total abdominal hysterectomy with bilateral salpingo-oophorectomy including the tumor mass was performed.The other patient's tumor was resected at one time.One case is renal clear cell carcinoma,The urologist performed abdominal nephrectomy and then cardiac surgeon resected tumor embolus using cardiopulmonary bypass under deep hypothermic total circulatory.Results The four patients were uneventful recovery,there was no death or any serious perioperative complications.Following up of 3 months to 4 years showed no tumor recurrence after the operation.Conclusion Confirmed diagnosis,the tumor embolus extending through inferior vena cava into the right cardiac cavities should be suspected among patients with renal cell carcinoma and multiple hysteromyoma are all critical for the treatment.Successful therapy for intravenous tumor embolus is dependent on totalone or two-stage surgical excision of the tumor and multi-department cooperation and combined therapy.

Objective To investigate the correlation between age and the prognosis of thrombolytic therapy in acute ischemic stroke (AIS).Methods One hundred and fourteen patients with AIS were divided into ≤60 years group,61-70 years group and ≥71 years group according to age.Thrombolysis and post-thrombolysis treatment was done in accordance with 2010 version of Chinese Acute Ischemic Stroke Treatment Guidelines standard.The United States National Institutes of Health Stroke Scale (NIHSS) score was done in patient immediately after treatment,24 h after thrombolysis and 7 d after thrombolysis,and modified Rankin scale (mRS) score was assessed 3 months after thrombolysis The spontaneous intracranial hemorrhage (sICH) and the death of 2 weeks was recorded.Results ≤ 60 years group had 22 males and 10 females;61-70 years group had 26 males and 10 females; ≥71 years group had 20 males and 26 females.In ≥ 71 years group,women accounted for 56.52％ (26/46),which was higher than that in the other 2 groups,and there was significant difference (x2 =0.685,P =0.015).The NIHSS score immediately after treatment,24 h after thrombolysis and 7 d after thrombolysis among 3 groups had no significant difference (P ＞ 0.05).The mRS score at the 3 months after thrombolysis among 3 groups was (1 ± 3),(2 ± 5) and (2 ± 3) scores,respectively,and there was significant difference(P =0.040).Mortality and incidence of sICH in 2 weeks also had significant difference (P =0.049,0.017).Conclusions Despite the differences in the mortality and incidence of sICE among different ages,thrombolytic therapy with recombinant tissue-type plasminogen activator can significantly improve the neurological deficit after 3 months in AIS patients of different ages.