Objective To confirm the most effectively screening conditions by comparing the ARR values of different posi‐tions after saline load test .Methods After exclusion the other secondary hypertension ,the completion of saline dressing test ,84 ca‐ses diagnosed hypertensive patients under saline load test results were divided into primary aldosteronism group (pH ,52 cases) and primary hypertension group (32 cases) .Analyzed plasma aldosterone (PAC) ,renin (PRA) values of upright and decumbent body positions ,their ARR values were calculated and the urine aldosterone was tested .Results Those whose upright position ARR rati‐os higher than 240(pg/mL)/(ng · mL -1 · h-1 ) were accounted for 80 .77% (42/52) and 43 .75% (14/32) ,respectively in the both PA group and PH group;Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL were accounted for 65 .39% (34/52) and 3 .13% (1/32) ,respectively in the both PA group and ph group;The specificity of this method for PA was 96 .88% .Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h ,The specificity of this method for PA was 100 .00% .Conclusion It is an effective screening method for primary aldosteronism when ARR values of upright position higher than 240(pg/mL)/(ng · mL -1 · h-1 ) ,PAC of decumbent position higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h .

Objective To investigate the efficacy of milrinone micropump in treatment of chronic heart failure(CHF),and the influence to the level of amino-terminal B-type natriuretic peptide precursor(NT-proBNP) in serum.Methods 120 cases with CHF were selected,they were randomly divided into the observation group and the control group according to a random number table.The patients of the control group were treated with standardized anti -conventional treatment of heart failure according to their heart function,the patients of the observation group were given milrinone micropump on the basis of the standardized anti-conventional treatment of heart failure.The efficacy of clinical conditions 1 week after treatment and NT-proBNP levels in serum before and after treatment were compared between two groups.Results The clinical efficacy of the observation group was 95.00％,which was higher than 76.67％ of the control group,the difference was statistically significant(x2 =8.67,P ＜ 0.05).The serum level of NT-proBNP of the observation group was (38.9 ± 9.2) ng/L,which was significantly lower than (86.3 ± 32.4) ng/L of the control group,the difference was statistically significant (t =9.86,P ＜ 0.05).Conclusion Milrinone micro pump used in the treatment of CHF can significantly improve the clinical efficacy,and lower the serum level of NT-proBNP,improve heart function,it is safe and reliable and worth to application in the clinical.

An endogenous element-label plus exogenous element-tag strategy was proposed for inductively coupled plasma mass spectrometry ( ICP-MS) to screen and discriminate a family of ultratrace but biological important biomolecules. The feasibility of this novel idea has been demonstrated when setting seleno ( SeCys) and Se-containing ( SeMet) proteins ( peptides) as an example. Se-label naturally occurring in the biomole-cules acts an identifier for picking them up out of large amount of various coexisting proteins ( peptides) , and CH3 Hg-tag that can bind to SeCys but not SeMet fulfills the task of discriminating seleno and Se-containing ones based on the Se and Hg signals on ICP-MS. After confirmed using SeCys and GPx1, the Se-Hg dual-element labeling strategy together with ICP-MS was applied to screen and discriminate seleno and Se-contai-ning proteins ( peptides) in the water-soluble extracts of Se-enriched yeast, and seven selenoproteins ( pep-tides) were detected with both 202 Hg and 82 Se signals out of fifteen Se-containing species using RPLC/ICP-MS, providing valuable information for further identification using a high-resolution structure-selective mass spectrometer. This endogenous element-label plus exogenous element-tag dual-element approach implies that ICP-MS is not only able to quantify targeted proteins ( peptides) but also helpful to recognize targeted proteins during a discovery-based proteomic study.

Objective To investigate the effect of Supplementing Qi and activating blood and tonifying kidney therapy on the function and quality of life in patients with prolapse of lumbar intervertebral disc after operation.Methods92 cases of lumbar disc herniation treated in Fuyang Hangzhou Hospital of traditional Chinese Medicine hospital from November 2015 to October 2016 were selected,divided into observation group and control group, there were 46 cases in each group, the observation group were treated with Supplementing Qi and activating blood and tonifying kidney therapy,the control group were given conventional western medicine treatment, the improvement of VAS score, JOA score and WHQOL-BREF score were compared between the two groups after treatment, and the clinical effects were compared between the two groups after treatment and the incidence of adverse reaction.ResultsAfter treatment,the VAS scores of the two groups were decreased, the observation group (1.85±0.43) is lower than the control group (2.97±0.69), the difference between the two groups was statistically significant(P<0.05);After treatment, patients withthe JOA scores of the two groups were increased, the observation group (25.78±5.89) higher than the control group (20.45±4.82), the difference between the two groups was statistically significant(P<0.05);After treatment, the total efficiency of observation group was 93.48% higher than 76.09% in the control group, the difference between the two groups was statistically significant(P<0.05);There was no significant difference in WHOQOL-BREF scores between the two groups before treatment;After treatment, the WHOQOL-BREF scores of the two groups were increased, the observation group was higher than the control group, the difference between the two groups was statistically significant(P<0.05), there was no significant difference in the incidence rate of complications between the two groups after treatment.ConclusionThe patients with lumbar disc herniation after operation to give Supplementing Qi and activating blood and tonifying kidney therapy,can effectively helpe patients to recover, improve the pain of patients, improve the patient's functional activities and quality of life, the effect is significant.

Objective To explore the change of serum vascular endothelial growth factor(VEGF)、nitric oxide(NO)levers in patients with Kawasaki disease(KD) and their Clinical significance.Methods Serum VEGF and NO were detected by the double antibody sandwich ELISA and the method of nitratase respectively in 38 patients with KD at their acute and remission stages,and compared with anther 30 normal children.Results The lever of serum VEGF、 NO at the acute stage in KD group were significantly higher than those at the remission stage and the normal control group(P

In order to study the status of cell apoptosis in psoriatic epidermis, we have investigated the changes of the lesions in various stages in patients with psoriasis vulgaris by using terminal deoxynueleotidyl transferase-mediation dUTP-biotin nick end labelling (TUNEL). The results showed that the highest frequency of apoptotic keratinocytes was observed in the early scaling papular lesions, and the frequency was reduced in the progressive maculo-papular lesions and the coalescent plaques successively. The frequency of hyperproliferation of epidermis was in the reverse order in comparison with the above results. These results suggest that increased apoptosis of keratinocytes is the initial change of psoriatic epidermis, then hyperproliferation of keratinoeytes follows.

Objective To explore ways of enhancing the therapeutic level of the neurology department and reducing the economic burdens of patients. Methods Relevant materials were collected by means of evidence based medicine to optimize therapeutic schedules, with cerebral infarction being the pitching in point. Results Prior to the adoption of evidence based medicine, the average length of stay, the effective rate of treatment and the expenses for single entity diseases were respectively 17.83?13.44, 89.91% and 4 550.70 yuan, whereas after the adoption of evidence based medicine, they were respectively 15.38?11.37, 94.16% and 3 942.88 yuan. Conclusion Evidence based management is a means of scientific management. Its application in the department of neurology has produced a marked effect and it is worthy to be spread.

Defecography was performed in 110 patients without any anorectal symptoms which included 57 male and 53 female with an average age of 43. 15. Normal defecography was found in 82 cases and abnormal one in 28. The normal features of defecography in 82 patients were as follows;1.There was an increase of anorectal angle during defecation. The increase was 21. 27 degrees measured-with precise axis method and 36. 72 degrees with approximate axis method.2. Reduction or obliteration of the impression of the puborectal muscle.3. There was a shortening of the anal canal by 1. 20 cm and a widening of the caliber of the anal canal to an average of 2. 23 cm.4. The resistance of the pelvic floor was good and the decending of the perineum was smaller than 3 cm during straining. The rectovaginal septum of female subjects was not deformed during straining.5. The barium paste in the distal rectum was largely or totally evacuated with an average e-vacuation rate of 90. 55%.

Objective To evaluate accurately the cardiac output, an early post-operative indicator for the cardiac function, after cardiac surgery in the neonates with congenital heart diseases and assess the risk factors for surgery, with an aim at exploring the early strategy for decressing the mortality. Methods From January 2007 to November 2007, forty-seven consec-utive neonates with complex congenital heart diseases underwent surgical correction at Shanghai Children's medical center.There were 38 boys and 9 girls with age from 3 days to 29 days [mean age (21.98 +8.15) days] and weight from 2.6 kg to 4.2 kg [ mean (3.49±0.51 ) kg]. 15 patients had delayed sternal clousure. The operations were performed with hypothermia, deep hypothermia low flow, or deep hypothermia circulatory arrest techniques. Cardiac index (CI) was derived from pulse contour analysis and calculated with the PiCCO plus system. Meanwhile, serum cardiac troponin I ( cTnl), mixed venous oxygen saturation ( SvO_2 ) and cardiopulmonary bypass (CPB) time were measured. Finally, the risk factors for surgical treatment in survivors and that associated with an increased mortality were analyzed. The association between post-operative cardiac output and the death after surgery was examined. Results Four neonates died after surgery, with a surgical mortality of 8.5%. CIvalue in the neonates [ (2.0±0.3 ) liters per minute per square meter of body surface was less than normal 2.5±0. 3. CI was associated inversely with CPB time but had a positive correlation with SvO_2. No significant difference association between CI and cTnI was observed. The value of cTnl was associated with the type of surgical procedures. Cases for which DHCA and low flow cerebral pefusion technique were used were free from neurological complications, ischemia in the lower extremities and oli-guria. The duration of cardiopulmonary bypass, urgent state of the operation and the abnormal coronary artery were associated with high mortality in the neonates after cardiac surgery. Conclusion The cardiac output of the neonates in whom cardiac pro-cedures were performed is adequate for the the oxygen supply required by the whole body though it is slightly lower than nomad after cardiac surgery. Higher mortality in the neonates during early postoperative period may be due to the complexity of the primary diseases, prolonged cardiopulmonary bypass time, residual abnormalities and severe acidosis before operation. Various techniques for CPB and that for the myocardial protection are safe and can provide an appropriate operative field.

ObjectiveTo study the role of chemokines and their receptors in peripheral blood in the pathogenesis of breast cancer in elderly patients.MethodsSerum levels of regulated on activation normal T-cell expressed and secreted(RANTES),macrophage inflammatory protein-3 α (MIP-3α ) and stromal cell derived factor-1(SDF-1) were determined by double-antibody sandwich enzyme-linked immunosorbent assay(ELISA) in 30 elderly patients with breast cancer(breast cancer group) and 30 normal controls (control group).Meanwhile,chemokine receptors,CC chemokine receptor(CCR)5,CCR6 and CXC chemokine receptor(CXCR) 4 on peripheral blood CD3+ T-cell in two groups were analyzed by flow cytometry.ResultsSerum levels of RANTES,MIP-3 α and SDF-1 in breast cancer group were significantly higher than those in control group [ (27.9 ± 16.6) μ g/L vs.( 12.6 ± 4.2) μ g/L,( 10.9 ± 7.1 ) μ g/L vs.(5.4 ± 3.5 )μg/L,(339.4 ±94.6) ng/L vs. (195.0 ±70.8) ng/L,P ＜0.01].There was no significant difference in expressions of CCR5,CCR6 and CXCR4 on peripheral blood CD3+ T-cell between two groups(P ＞ 0.05).ConclusionThe abnormal increase of serum levels of RANTES,MIP-3 α and SDF-1 in peripheral blood may play role in the carcinogenesis and progress of breast cancer in elderly patients.