Objective To observe the changes of brain natriuretic peptide(BNP)in patients with myocardial infarction,and to assess the clinical value of BNP in the patients with myocardial infarction.Methods BNP was determined in 91 patients with myocardial infarction and in 90 normal cases,and the difference was studied between the area of myocardial infarction and the number of coronary arteries stenosis.Results BNP(ng/L)(155.03 ± 113.45,71.03 ±37.01)and LVEDd(cm)(5.11 ±0.51,4.56 ±0.43)were significantly increased in patients with myocardial infarction than that in normal cases(P＜0.01),but EF(%)(50.84 ±7.98,57.09 ±6.29)was lower than that in normal cases(P＜0.01).BNP and LVEDd were also significantly higher in patients with wide-anterior myocardial infarction than that in antero-septal,inferior and posterior wall myocardial infarction,but LVEF was lower.Conclusion The BNP level was higher in patients with myocardial infarction,especially in patients with wide-anterior myocardial infarction.BNP was a reliable bio-chemical marker which can evaluate the degree and prognosis of patients with myocardial infarction.

Objective To evaluate the efficacy of the nerve grafting and nerve transfer (neurotization) in the treatment of early obstetrical brachial plexus palsy(OBPP). Methods 48 cases with TassinⅡ-Ⅳ lesion who had no any recovery of elbow flexion, the brachial plexus were explored from 3 to 14 months after birth. The method of nerve repair depended on findings during operation. For the traumatic neuroma, it should be resected and the defect be repaired by nerve grafting with neurotization; the root avulsion was repaired by neurotization; neurolysis was only performed to those plexus that looked nearly normal and had a positive reaction of neurophysiology as tested intra-operatively. The reconstructive procedures included: C5→upper trunk, accessory →supraspinal nerve (2 cases); C5,6→the posterior and the anterior division of the upper trunk respectively, accessory →supraspinal nerve (25 cases); C5,6→the posterior and anterior divisions of the upper trunk respectively, C7→middle trunk, accessory →supraspinal nerve (4 cases); C5→posterior cord, C6→lateral cord, accessory →supraspinal nerve (5 cases); C5→anterior division of the upper trunk, C6→C8, accessory →supraspinal nerve (1 case); C5-7→the posterior, lateral and medial cords respectively, accessory →supraspinal nerve (4 cases); C5→upper trunk, C6→lower trunk (or medial cord), accessory →supraspinal nerve (2 cases); C5,6→the lateral and medial cords respectively, accessory →supraspinal nerve (3 cases); neurolysis (2 cases). Results All the patients were available at follow-up at least for 36 months, who were studied according to both of the Gilberts shoulder and elbow rating system and the Raimondis hand scale system. The score of shoulder, elbow, and hand in 13 cases with Tassin Ⅱ lesion improved from preoperative 0.54, 1.92 and 3.23 to postoperative 3.77, 4.92 and 4.31 respectively; 11 cases with Tassin Ⅲ rose from 0.46, 1.82 and 1.91 to 3.27, 4.18 and 3.64, and 24 cases with Tassin Ⅳ had an elevation from 0.25, 1.25 and 0.33 to 2.92, 3.46 and 2.83. The medial rotation contracture of the shoulder without subluxation and dislocation was found in 7 cases(14.6%) in the process of recovery. Conclusion The resection of the traumatic neuroma combined with nerve grafting and neurotization is really effective in the treatment of early OBPP.

Objective To investigate the effect of renal sympathetic denervation (RSD) on the activity of renalase in dogs with chronic heart failure (CHF).Methods After induced by abdominal aorta constriction,dogs were divided into three groups according to whether they underwent double renal artery ablation:2 dogs in control group,2 dogs in sham-operated group (no renal artery ablation),and 5 dogs in RSD group (renal artery ablation).Plasma noradrenaline (NE),B-type natriuretic peptide (BNP),and renalase were determined in 5 dogs with RSD (RSD group),2 control dogs (control group),and 2 shamoperated dogs (sham-operated group).Results NE,BNP and heart rate were significantly higher and renalase was lower in CHF group than those in control group (all P ＜ 0.05).Compared to the control dogs with CHF,the levels of renalase were significantly increased in 6 weeks after RSD [(1 948.78 ±49.19) ng/ml vs (1 847.35 ±20.72)ng/ml,P =0.029],and NE [(166.30 ±7.68)pg/ml vs (181.29 ±8.57)pg/ml],and BNP [(75.10 ± 5.58)lμg/ml vs (89.79 ± 2.04) μg/ml] were decreased in 8 weeks after RSD (all P ＜ 0.05).An decreased trend of the levels of renalase was observed in 8 weeks than in 6 weeks in CHF dogs after RSD,without significant difference (P ＞ 0.05).Conclusions The activity of renalase in dogs with CHF can be affected by RSD.

Objective To study the effects of ischemia postconditioning(IPC) in reducing ischemia-reperfusion injury(IRI) in acute limp ischemia(ALI) and investigate the mechanism.Methods 45 New Zealand rabbits were treated with the method that combined high lipid diets and femoral intima injury by balloon inflation to build up limp atherosclerotic stenosis model,then they were randomly divided into three groups( each group 15 rabbits):control group;IR group and IPC group.Serum creatine phosphate kinase(CK),malondialehyde(MDA),superoxide dismutase (SOD) in three groups were measured before occlusion and 2 hours after sustaining reperfusion.The histological changes of limp skeletal muscle of experimental rabbits were analyzed and TUNEL method was used to access apoptosis of skeletal muscle cells.Results The levels of CK,M DA in IPC group were lower than IR group [ (7.49 ± 0.84)vs (8.19 ± 1.06),P＜0.05],[ (3.67 ±0.36) vs (4.06 ±0.55),P ＜0.05] while SOD level was higher than IR group [ (420.40 ± 30.94 ) vs ( 384.73 ± 44.12),P ＜ 0.05 ] ; The injury of skeletal muscles in I PC group was lighter than IR group and the apoptosis index of skeletal muscle cells was significantly decreased compared with that in IR group[(12.27+2.11)％ vs (16.62 ± 1.44)％,P＜0.01].Conclusion Applying IPC in acute limp ischemia could alleviate IRI and protect skeletal muscles.The mechanism was associated with oxidation resistance enhancing and the effects in reducing apoptosis of skeletal muscles induced by IRI.

Objective To investigate the relationship between renal sympathetic nerve activity and the severity of heart failure in dogs with chronic heart failure ( CHF) .Methods CHF were induced by ab-dominal aorta constriction.Plasma renin activity ( PRA) , adrenaline ( E) , and noradrenaline ( NE) were determined in 9 dogs with CHF (CHF group) and 3 sham-operated dogs (control group).Results E, NE, PRA, and B-type natriuretic peptide ( BNP) were significantly higher in CHF group than those in con-trol group (all P <0.01).Compared to 10-week post-operation, PRA [(2.08 ±0.08)ng/(ml? h) vs (2.26 ±0.16)ng/(ml? h)], NE [(184.01 ±11.76)pg/ml vs (202.99 ±16.54)pg/ml] and BNP [(85.87 ±11.41)μg/ml vs (100.41 ±9.24)μg/ml] were significantly increased in the 12-week post-op-eration (all P <0.01).PRA [10 weeks post-operation:(2.13 ±0.08)ng/(ml? h) vs (2.02 ±0.05)ng/(ml? h);12 weeks post-operation:(2.38 ±0.09)ng/(ml? h) vs (2.11 ±0.07)ng/(ml? h)] and NE [10 weeks post-operation: (191.75 ±8.40) pg/ml vs (174.33 ±7.08) pg/ml;12 weeks post-operation:(215.69 ±6.26)pg/ml vs (186.36 ±7.98)pg/ml] were higher in high BNP group than those in low BNP group both in 10 and 12 weeks post-operation ( P =0.013, P =0.013, P =0.002, respectively).Con-clusions PRA was increased in dogs with CHF and associated with the severity of CHF.

Objective To investigate the current infection situation of Chlamydia trachomatis (CT) and Ureaplasma urealyticum (Uu) in patients with cervical erosion .Methods CT and Uu were detected in cervical secretions of 562 cases of cervical erosion pa‐tients (observation group) and 218 healthy controls (control group) .Drug susceptibility testing was performed for the patients with Uu infection .Results Positive rate of CT ,Uu and mixed infection was 20 .11% ,42 .35% and 9 .61% ,higher than those of control group (P<0 .05) .The difference of the positive rate between moderate cervical erosion and severe cervical erosion was not signifi‐cant (P>0 .05) ,while the positive rate of CT ,Uu and mixed infection was significantly different between the two groups and mild cervical erosion (P<0 .05) .The highest susceptibility rate of Uu to antimicrobial agents was josamycin (91 .78% ) ,followed by pristinamycin (84 .25% ) .The highest resistant rate of Uu was to ciprofloxacin (85 .96% ) ,followed by ofloxacin(73 .29% ) .Conclu‐sion The infection of CT and Uu could be intimate correlated with cervical erosion and the extent of erosion .Varying degrees of drug resistance of Uu could be found ,and the sensitive and effective antibiotics should be chosen to treat cervical erosion infection of Uu .

Objective To investigate the effects of high dose atovastatin administration on platelet activity and ventricular remodeling of patients with ST-Segment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PCI).Methods A total of 260 STEMI patients who hospitalized in our Department of Cardiology from June 2012 to December 2013 was enrolled and randomly divided into two groups:controlled group (n =140) and high dose atorvastatin group (n =120).Indicators of platelet activities including mean platelet volume (MPV),platelet large cell ratio (P-LCR),blood CD62p,and glucose protein Ⅱ b/Ⅲa (PAC-1) were measured before and 48 hours after PCI.TIMI myocardial perfusion grade (TMPG) after PCI was recorded and patients accepted ultrasound cardiogram (UCG) examinations 5 ～7 days after PCI and 6 months after discharge.After PCI,Patients were followed up for 6 months,statin-associated liver impairment,myopath and major adverse cardiac events (MACE) happened during follow-up periods were recorded.Results MPV,P-LCR,CD62p,and PAC-1 in patients of high dose atorvastatin group were less than controlled group and TMPG were better than controlled group [(12.96±1.73)fl vs (14.18 ± 1.86)fl,P ＜0.05;(29.12 ±5.83)％ vs (30.66 ±6.12)％,P ＜ 0.05;(45.36±5.24)％ vs (48.44±4.75)％,P ＜0.01;(74.61 ±5.57)％ vs (78.55±5.78)％,P ＜0.01].Six months after PCI,UCG examination showed that Left ventricular end-diastolic volume (LV-EDV),left ventricular end-systolic volume (LVESV) and left ventricular mass index (LVMI) in high dose group were less than controlled group while the left ventricular ejection fraction (LVEF) was higher than controlled group [(110.46 ±8.86)ml vs (112.61 ±8.5)ml,P ＜0.01;(60.16 ±6.13)ml vs (63.52 ± 5.54)ml,P ＜0.01;(1O1.69±4.35)g/m2 vs (103.96 ±4.17)g/m2,P ＜0.05;(50.08 ±3.78)％ vs (48.47 ± 4.12) ％,P ＜ 0.05].After 6 months of follow-up,the incidence rate of statin-associated liver impairment and myopathe had no significant difference between two groups and Kaplan-Meier survival analysis showed patients of two groups had significantly different cumulative non-events survival rates (91.7％ vs 82.4％,Log rank =4.409,P =O.036).Conclusions Loading dose atorvastatin before PCI combined high maintenance dose after PCI can inhibit platelet activation and improve myocardial perfusion levels of patients with STEMI underwent primary PCI.It also can reduce Left ventricular remodeling and improve patient's prognosis without increasing side effects.

Objective To assess the roles of renalase and renal sympathetic nerve activity in patients with chronic heart failure (CHF). Methods Plasma renin activity (PRA), angiotensinⅠ (AngⅠ), angiotensin Ⅱ(AngⅡ),adrenaline (E), noradrenaline (NE) and renalase were determined in 60 patients with CHF (CHF group) and in 42 healthy cases (control group). Data were compared between patients with mild and serious CHF. Results PRA, E, NE and AngⅠincreased and renalase decreased in CHF group than those in control group. Compared with mild CHF, renalase and left ventricular ejection fraction decreased (P < 0.01, 0.034), while N-terminal pro-B-type natriuretic peptide (NT-proBNP) and PRA significantly increased (P<0.01). Linear correlation analysis showed that renalase was inversely correlated with Log NT-proBNP (r = -0.400, P = 0.002) and Log NE (r=-0.314, P = 0.014). Logistic regression analysis showed that NT-proBNP (OR = 6.963, 95%CI = 1.223 to 39.638), PRA (OR = 3.736, 95%CI = 1.031 to 13.540) and renalase (OR = 0.253, 95%CI = 0.069 to 0.927) were associated with increased NYHA classes. Conclusions PRA would increase while renalase would decrease in patients with CHF. PRA and renalase were correlated to the severity of CHF.

Objective To investigate the predictive value of serum aldosterone and Plasminogen activator inhibitor-1 ( PAI-1 ) levels to the severity of coronary artery lesions and the recent prognosis in acute coronary syndrome (ACS) patients underwent percutaneous coronary intervention(PCI). Methods The study included 160 consecutive patients admitted. All the patients received coronary angiography and were divided into two groups:control group and ACS group. The patients' blood samples were abtained at the root of aortic artery to measure the serum aldosterone and PAI-1 levels. We analyzed their relationship with the severity of coronary artery lesions. The patients were also divided into three groups( high-score group, moderate-score group,low-score group)according to Gensini accumulated points,we analyzed the difference of aldosterone and PAI-1 levels in three groups. The predictive values of aldosterone and PAI-1 to the recent pronosis of ACS patients underwent PCIwere assessed. Results ( 1 )The patients' serum aldosteeone and PAI-1 levels in ACS group were significantly higher than control group( all P <0. 05 ) ;(2)The aldosterone and PAI-1 levels in high-score group were higher than moderate-score group, and moderate-score group was higher than low-score group. (3)The serum aldosterone level in ACS patients was positively correlated with the PAI-1 level ( r = 0.213, all P < 0. 05 ). ( 4 ) Multiple factor Logistic regression analysis indicated that aldosterone, PAI-1 levels were srtong independent predictors for the recent prognosis of ACS patients underwent PCI. Conclusion The aldosterone ,PAI-1 levels in ACS patients were correlated with the severity of coronary artery lesions. Both of them were strong predictors for the recent prognosis of ACS patients underwent PCI.

Objective:To investivate the relationship of serum estradiol and oxidative stress with microcirculation resistance in women with syndrome X.Methods:A total of 120 patients with syndrome X who were hospitalized in the Department of Cardiology in Guangzhou First People's Hospital from January 2015 to January 2019 were enrolled. All patients underwent coronary angiography and pressure wire examination and were divided into two groups according to the index of microcirculation resistance (IMR). Forty healthy people in the medical examination center were used as controls in the same period. The level of serum estradiol, interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD) were measured among three groups.Results:The rate of diabetes mellitus in high IMR group was higher than that in control group and low IMR group ( P<0.05). There was no significant difference between low IMR group and control group ( P>0.05). The levels of serum estradiol and SOD were significantly lower in high IMR group than those in low IMR group and control group. The levels of IL-1 and TNF-α were significantly higher in high IMR group than those in low IMR group and control group ( P<0.05). These indexes have the same relationship between low-IMR group and control group ( P<0.05). The level of serum estradiol was negatively correlated with the levels of IL-1 and TNF-α in high and low IMR groups and positively correlated with the level of SOD in these groups. Multivariate logistic regression analysis showed that diabetes, low serum estradiol level, low SOD level, high IL-1 level, high TNF-α level were the independent risk factors for microcirculation resistance in women with syndrome X ( P<0.05). Conclusions:The decreased serum estradiol is an important factor for coronary microcirculation disorders in women with syndrome X. The decrease of serum estradiol level leads to the loss of the corresponding antagonistic effect in oxidative stress state, which may be one of the important mechanisms of the formation and progress of coronary microcirculation disorder.