Objective To observe the correlation between plasma brain natriuretic peptide (BNP) level and atrial fibrillation (AF) in old patients with acute left heart failure.Methods 86 old patients with acute left heart failure were randomly divided into two groups according to AF and sinus rhythm.The plasma BNP level was compared between the twogroups.And the relationship between plasma BNP level and the results of ultrasonic cardiography was also assessed.Results Significant difference existed in BNP level between individuals with AF and sinus rhythm [(1 320.66 ± 1 546.41) pg/L vs (989.43 ± 1 042.57) pg/L,t =2.651,P ＜ 0.05] ; BNP level of the rhythm AF significantly correlated with LAD and LVEDD (r =0.723,0.645,all P ＜ 0.01).Conclusion The old patients with acute left heart failure and AF had higher BNP level than those with sinus rhythm.And BNP level of the rhythm AF significantly correlated with LAD and LVEDD.

Objective To promote the clinical practice of bone morphogenetic proteins (BMP) coated prosthesis in order to improve its biological fixation. Methods There were 12 healthy mongrels, weighted from 20 to 25 kg. They were randomly divided into 3 groups according to the scarified time. The bilateral femurs were adopted as the graft areas, and 4 kinds of implant were transplanted into each femur randomly. The transplant consisted of porous-coated anatomic(PCA group), PCA combined with BMP (BMP group), PCA combined with hydroxyapatite(Composite group), and polish PCA combined with HA (HA group). The femurs of the mongrels were retrieved at the 4th, 8th and 12th week respectively. Bone ingrowth and shear strength between the interfaces of the bone-implant were studied, using X-ray, soft X-ray, fluorescence tag, non-decalcification ground section, computer-aided image analysis, and histological examinations. Results By gross observation, the composite for the group of PCA with BMP was the most stable in all the experimental groups. All implants showed good histocompatibility, the bone ingrowth on the implant surface appeared earlier in the BMP group than any others, and so did the maturation of new bone. At 4th week, the percent of new bone formation in the BMP group was 26.58%?4.56%, which was also much higher than PCA group (18.28%?2.46%), Composite group (17.23%?2.11%), and HA group(16.89%?3.13%) through the means of non-decalcified ground section and computer aided image analysis, and the difference was of statistical significance(P0.05). Conclusion The composite of BMP to the PCA is effective and feasible procedure, which could increase biological fixation of the interfaces between the bone and implant. Furthermore, HA coating is also an effective method of prosthesis surface treatment in order to improve bone ingrowth and enhance the interface shear strength, and the technique of HA coating is an essential factor in processing the prosthesis.

Objective To investigate the characteristic of type 2 diabetes (T2DM) patients with coronary heart disease (CHD),and provide methods for prevention and treatment for patients who suffered from CHD.Methods The hospitalized patients were divided into three groups.The treatment group contains 46 cases who were T2D with CHD;The control group Ⅰ contains 30 cases who were T2DM without CHD;The control group Ⅱ contains 50 cases who were CHD without T2DM.Their ordinary circumstances were compared;the blood sugar,BP,TC,TG,HDL,LDL,HbA1c,C-P,Ins were measured.Insulin sensitive index(ISI) was calculated.Results Three groups had obvious statistical differences in BP,TC,LDL-C,ISI,HbA1 c.Diabetic patients with CHD have more common with three lesions.Conclusion In the clinical job,the composite observation should be strengthened and treatment because the factors of atherosclerosis in T2DM patients were numerous and complex.

ObjectiveTo define the high intraarterial signals on conventional MRI. Methods Review the conventional MRI data in all of the acute ischemic stroke patients in the First Affiliated Hospital,School of Medicine, Zhejiang University from January 2010 to December 2010. ResultsIn year 2010,according to the diagnostic criteria of China, there were 280 cases of acute cerebral infarction, all underwent conventional MRI. Twenty six patients (9. 29％ ) showed high intraarterial signals on conventional MRI.There were 14 cases with high signals in the anterior circulation, including 11 cases in the carotid artery, 2 cases in the anterior cerebral artery, and 1 case in the middle cerebral artery combined with the anterior cerebral artery. In the 11 patients with high signals in the carotid artery, MRA confirmed 14 internal carotid arteries stenosis, with 100％ specificity and 78.6％ sensitivity. There were 12 cases with high signals in the posterior circulation, including 5 cases in the vertebral artery, 3 cases in the basilar artery, and 4 cases in the basilar artery with vertebral artery. One patient did not undergo MRA. MRA confirmed 14 arteries with stenosis, with 100％ specificity and 78.5％ sensitivity. ConclusionsIntravascular high signals showed by conventional MR sequences have high clinical specificity, and its vascular lesions are consistent with the results of MRA.

Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia.Methods One hundred and fifty-five patients,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 20-30 kg/m2,scheduled for elective craniofacial surgery,were included in the study.Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery.The patients were divided into 2 groups according to whether or not myalgia occurred within 24.h after surgery:myalgia group and non-myalgia group.Factors including gender,age,body weight,duration of surgery,method of anesthesia,dose of succinylcholine,preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia,use of hormone (dexamethasone or methylprednisolone) and nonsteroidal analgesics (parecoxib sodium) during surgery,and consumption of fentanyl were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia.Results Forty-one patients developed postoperative myalgia,and the incidence of myalgia was 27.2％.The results of logistic analysis indicated that succinylcholine ＜ 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine.Conclusion Succinylcholine＜1.5 mg/kg and no preinjection of lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.

Objective To establish a rat model of persistent intestinal mucosal injury.Methods The rat model of persistent intestinal mucosal injury was induced by intraperitoneal injection of methotrexate.The food intake and body weight of all the rats were recorded.Pathological changes were observed using HE staining, the level of D-lactate and diam-ine oxidase in plasma, and myeloperoxidase and malondiadehyde in the intestinal tissue were measured by biochemistry. Results After modeling, the rat body weight and food intake were decreased.On day 4, the scores of mucosal damage, the levels of plasma D-lactate, DAO, MPO and MDA were significantly increased (P<0.05).On day 5, the intestinal damages of rats began to restore, and there was no significant difference among groups on day 6.The symptoms after the secondary injection were similar to those after the first injection, and the rats recovered gradually at day 12.Conclusions Intestinal mucosal injury in rats induced by 20 mg/kg MTX is an acute injury process, the course only lasts for 4-5 days. Intermittent injections twice of 10 mg/kg MTX can cause persistent intestinal mucosal injury in rats.This persistent injury model is more suitable for nutritional therapy evaluation in medium-and long-term studies of nutritional therapy.

Objective The purpose of this paper is to study the relationship between blood concentration and brain tissue drug concentration by different dose of TMX chemotherapy acute lymphoblastic leukemia in mice. Methods 4 weeks, health Kun Ming mice 80: establishment acute lymphoblastic leukemia mice model,20 mice were randomly selected to take the femur bone marrow biopsy bone marrow OK for model verification; the remaining 60 acute lymphoblastic leukemia mice were allocated randomly 6 groups of 10 mice in each group, respectively A, B, C, D, E, F groups. And collected blood 0.5 ml and brain tissue 0.4 g individually at 0.5 hour in every group. We used supernatant of centrifugation blood and brain homogenate to detected drug concentration by fluorescence polarization immunoassay. Results The mean blood concentration of MTX of six groups A, B, C, D, E, F are (39.08±5.18) μmol/L, (15.86±1.02)μmol/L, (8.67± 5.43)μmol/L, (68.29±5.19)μmol/L, (29.55±6.22)μmol/L, (13.98±1.12)μmol/L, respectively. Compared the mean blood concentration of MTX of each group there are statistical significance (P<0.05). The mean concentration of MTX of six groups in brain tissue are followed by A group (1.05±0.26)μmol/L, B group (0.61±0.25)μmol/L, C group (0.48±0.25)μmol/L, D group (2.07±0.35)μmol/L, E group (1.27±0.21)μmol/L, F group (0.59±0.69)μmol/L. Compared the mean concentration of MTX of each group in brain tissue there are statistical significance (P<0.05). MTX concentration in blood and in brain tissue of correlation coefficient followed by 0.82, 0.75, 0.19, 0.81, 0.55, 0.43. Conclusion The chemotherapy acute lymphoblastic leukemia mice of HDMTX scheme, the peak of blood concentration and brain tissue drug concentration is come after injected MTX 0.5 hour, MTX 5 g/m~2 is better permeation blood-brain barrier and more easy make brain tissue drug concentration to reach effectively therapeutic concentration than MTX 3 g/m~2.

Objective To systematically evaluate the efficacy and safety of injected hemocoagulase Agkistrodon for intraoperative bleeding.Methods We electronically searched several Chinese database till May 2014 to identify randomized controlled trials (RCTs) about injected hemocoagulase Agkistrodon for operative hemorrhage.The methodological quality of included RCTs was assessed,and the data were extracted by two reviewers independently according to the Cochrane Handbook.The homogeneous RCTs were pooled using RevMan software (Version 5.1.0).Results 2 358 articles were searched initially,and 12 RCTs involving 1 031 patients met the inclusion criteria.The results of Meta-analyses showed that:in the study groups,the average haemostatic time of the wound is shorter [OR =-40.29,95％ CI(-71.13,-9.44),P =0.01],the hemorrhagic volume of the wound [OR =-1.38,95％ CI(-1.90,-0.87),P ＜ 0.000 01],hemorrhagic volume per unit area of the wound [OR =-0.05,95％ CI(-0.06,-0.03),P ＜ 0.00001],introperative hemorrhagic volume and drainage volume on POD1 [OR =-18.52,95％ CI (-25.50,-11.53),P ＜ 0.000 01] are lower than the placebo groups.In all studies,no difference was found in the variation of hemostatic function,liver and renal function and drug-induced adverse events.Conclusions The injection of hemocoagulase Agkistrodon can significantly reduce the average haemostatic time of the wound,the hemorrhagic volume of the wound,overall introperative hemorrhagic volume and drainage volume on POD1,and does not affect the hemostatic function,liver and renal function and not increase the incidence of adverse effects or postoperative complications.

Objective To investigate the relationship between tumor metastasis-related Rac1 mRNA expression levels and gastric carcinomas metastasis, and to investigate the significance of Rac1 as a tumor marker for the evaluation of gastric carcinomas metastasis and distinguish between benign and malignant lesions. Methods This experiment used fluorescence quantitative RT-PCR TaqMan probe technology, chose Rac1 target gene fragment, which was cloned into the pET-20b (+) vector, constructed recombinant plasmid, and established the Rac1 mRNA fluorescence quantitative RT-PCR standard curve. And then the Rac1 mRNA levels were detected in 52 cases of gastric carcinoma tissues,52 cases of para-carcinoma tissues and 12 cases of benign gastric disease tissues. Its association with the metastasis of gastric carcinomas was analyzed. Results The positive rates and levels (median, P25-P75) of Rac1 mRNA were 100. 0% ,7.41 ×105 (3. 50 × 105-4. 36 × 106) copies/μl in gastric carcinomas, 46. 2% ,0(0-1.73 × 104) copies/μl in parscarcinoma tissues, 33. 3%, 0(0-3.55 × 103) copies/μl in benign tissues. The positive rates and leves(x2 =43.16,x2Xk-w = 64. 19, P ＜0. 01)among the three groups were significantly different. When the critical value of Rac1 mRNA level was 1.73 × 104 copies/μl determined by ROC, the sensitivity and specificity were 88. 5% and 100% respectively. When the critical value of Rac1 level was 7.49 × 105 copies/μl, the sensitivity and specificity were 57.9% and 78. 6% respectively. ConclusionThe Rac1 mRNA level detected with fluorescence quantitative RT-PCR has reference value to distinguish between benign and malignant lesions and evaluate gastric carcinoma metastasis.

Objective To investigate the clinical efficacy of drug-eluting stent( DES) combined with clopi-dogrel therapy in patients with coronary heart disease. Methods 123 patients underwent percutaneous coronary intervention (PCI) were randomly divided into observation group (DES) of 60 cases and the control group ( bare-metal stent,BMS) of 63 cases. The observation group was given the treatment of DES combined clopidogrel, the control group was given the treatment of BMS combined clopidogrel. The stent implantation and the follow-up two-year MACE were observed. Results (1) The average implanted stent length of the observation group was longer than that of the control group(P<(0.05) ,the angiography in vascular disease and complexity between the two groups had no significant difference ( P > 0. 05 ) ; the success rate of surgery in the two groups was 100% , after operation the TIMI flow reached grade 3. (2) The incidence of angina pectoris and revascularization rate of the observation group was significantly lower than that of the control group (P < 0.05); the rate of coronary angiography, recurrent myocardial infarction and the incidence of cardiac death between the two groups had no significant difference ( P > 0.05). Conclusion DES combined with clopidogrel maintenance therapy for a year in patients with coronary heart disease had a good long-term efficacy.