Objective To investigate the relationship between the levels of circulating pregnancy-associated plasma protein A(PAPP-A,a novel marker of atherosclerotic plaque activity) and myocardial perfusion before or after percutaneous coronary intervention(PCI) in patients with non-ST elevation acute coronary syndrome(NSTEACS).Methods Forty-four patients with high-risk NSTEACS were examined for serum PAPP-A levels,cardiac troponin T and the brachial artery flow-mediated vasodilation(FMD) before PCI.The angiographic data was analyzed before and after PCI in terms of TIMI myocardial perfusion grade(TMPG) in the area of culprit vessels.Results Before PCI,twenty patients with TMPG 1-2 had higher PAPP-A levels(30.41?21.33 mIu/L vs.23.55?18.61 mIu/L,P=0.036) and lower FMD(2.95%?1.71% vs.3.54%?1.58%,P=0.027) companed with the patients with TMPG 2-3.After PCI,twelve patients with TMPG 1-2 had higher PAPP-A levels(35.64?20.58 mIu/L vs.21.87?19.30 mIu/L,P=0.009) and lower FMD(2.26%?1.83% vs.3.95%?1.43%,P=0.018) than those with TMPG 2-3.Conclusion The PAPP-A level and the degree of endothelial dysfunction play roles in myocardial perfusion in patients with high-risk NSTEACS.

OBJECTIVE: To evaluate the efficacy and safety of Pravastatin versus Simvastatin in downregulating low density lipoprotein cholesterol(LDL-C) and upregulating high density lipoprotein cholesterol(HDL-C).METHODS: A total of 66 patients with hypercholesterolemia were enrolled: 33 were randomly assigned to receive Pravastatin(40 mg) for 6 weeks,and another 33 to receive Simvastatin(40 mg) for 6 weeks.Serum lipid levels at baseline and 6 weeks after medication were measured.The primary effective indicator was LDL-C as compared with baseline value and the secondary effective indicator was HDL-C.Safety was evaluated based on laboratory data and clinical adverse reactions.RESULTS: Both Pravastatin and Simvastatin significantly decreased LDL-C level,showing significant differences as compared with before medication(P0.05).Less adverse drug reactions were noted in both groups.CONCLUSION: Pravastatin and Simvastatin were equivalent in lipid-regulatory effect and both were well-tolerated.

The construction of a medication safety culture is important for medication safety management and rational drug use.The construction of medication safety culture standards is formulated based on relevant national policies and regulations,accreditation standards for hospitals,expert opinions,the current situation,and the development trend of the healthcare industry.With scientificity,general applicability,instructive guidance,and practicality,they standardized basic requirements,management processes,and improvement of the construction of medication safety culture.To facilitate understanding and the implementation of the standards,we describe the process of standards formulation and explain the key points of the standards.

Objective:To recheck the Histoplasma capsulatum and Coccidioides sp. strains of the past by molecular identification and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS). Methods:The phylogenetic relationships among the ten Histoplasma capsulatum isolates and reference strains were analyzed by multilocus sequence typing (MLST). Based on the Coi region, Coccidioides posadasii was distinguished from Coccidioides immitis accurately. MALDI-TOF MS was used to set up the MALDI-TOF MS database of Histoplasma capsulatum and Coccidioides sp. for rapid identification. In addition, hierarchical clustering of spectra was compared with MLST. Results:An unrooted dendrogram constructed with MLST showed that ten individuals of Histoplasma capsulatum were divided into three clades: Eurasia clade, Australia clade and North American class 2 clade, in agreement with the establishment by MALDI-TOF MS cluster analysis. All individuals of Coccidioides sp. were identified as Coccidioides posadasii with Coi region primers. The in-house MALDI-TOF MS database of Histoplasma capsulatum and Coccidioides posadasii was expanded and reached an identified accuracy of 100%. Conclusions:We improve the recognition of Histoplasma capsulatum and Coccidioides posadasii by molecular pathways which shows the major species or clades in Chinese mainland. The in-house MALDI-TOF MS database of Histoplasma capsulatum and Coccidioides posadasii can provide a new efficient way to identify those pathogens rapidly.