Objective To explore the characteristics of TCM syndromes of acute coronary syndrome(ACS). Methods Clinical data of 127 ACS patients were collected and then a database was established.After that,the distribution of syndrome patterns was analyzed.Results The incidences of the following excess syndrome patterns were in a decreasing sequence:stasis syndrome,phlegm syndrome,cold syndrome and heat syndromes.The incidence of stasis syndrome was 90.5%,which was much higher than other excess syndromes.The incidences of the following deficiency syndrome patterns were in a decreasing sequence:heart-Qi deficiency syndrome,heart-Qi exhaustion syndrome,heart-yin deficiency syndrome,heart-Qi depletion syndrome,heart-kidney deficiency syndrome and heart-blood deficiency syndrome.The incidence of heart-Qi deficiency syndrome was 75.6%,which was much higher than other deficiency syndromes.The incidences of the stasis syndrome and cold syndrome in acute myocardial infarction(AMI)were higher than those in unstable angina(UA),and the incidences of heart-Qi deficiency syndrome and heart-Qi exhaustion syndrome in AMI were higher than those in UA(P

Objective To investigate the species distribution and the difference of virulence gene spectra of Aeromonas isolated from intestinal tract and extraintestinal body fluid,and the correlation of their pathogenicity with infection sites.Methods A total of 156 Aeromonas strains isolated from the fecal specimens of patients with acute diarrhea and extraintestinal specimens were collected during May 2013 and September 2015.Eighteen virulence genes in these strains,including hlyA,aerA,act,alt,ast,aexT,ascV,aopP,ascF-G,gcat,tapA,fla,Ser,exu,ahyB,eprCAl,lip and laf,were detected by polymerase chain reaction(PCR).Last,the differences of virulence gene spectra between intestinal and extraintestinal Aeromonas were analyzed.Results Among 156 Aeromonas strains,79 were from fecal specimens,and 77 from extraintestinal specimens.Aeromonas caviae(A.caviae,51.9％) was the most common species in the intestinal strains,while Aeromonas hydrophila(A.hydrophila,48.1％) and A.caviae(39.0％) were the main pathogens in extraintestinal infections.The most prevalent virulence genes in intestinal and extraintestinal Aeromonas were gcat,act,fla,ahyB,exu and lip (＞ 45.57 ％),while aexT,aopP,ascF-G and ascV were less frequently detected (＜ 20.78％).The detection rates of gcat,ahyB,laf,ast,exu,lip,hlyA and aerA genes in intestinal Aeromonas were significantly lower than those in extraintestinal isolates (P ＜ 0.05).The detection rates of gcat,ahyB,exu,lip,eprCAl and hlyA genes in extraintestinal A.hydrophila were significantly higher than those in intestinal A.hydrophila (P ＜ 0.05).The detection rates of lip and hlyA genes in extraintestinal A.caviae were significantly higher than those in intestinal A.caviae (P ＜ 0.05),while that of aopP gene was just the reverse.There was no significant difference in the detection rates of virulence genes between intestinal and extraintestinal Aeromonas veronii.Conclusion There are significant differences in the species distribution and virulence genes of Aeromonas isolated from intestinal and extraintestinal specimens,indicating that clinicians should treat them differentially.

Objective To analyze the clinical features and risk factors of migraine patients with white matter le-sions (WMLs). Methods One hundred ten clinically diagnosed migraine patients who underwent magnetic resonance im-aging (MRI) scans from October, 2010 to August, 2013 were enrolled in Shandong Provincial Hospital. One hundred ten migraine patients were divided into two groups:WMLs group and non-WMLs group based on the presence or absence of WMLs in MRI scans. The clinical features of the patients and location and number of WMLs were investigated. Noncondi-tional multivariate stepwise logistic regression after univariate analysis was used to analyze the data. Odds ratio (0R) and 95 confidence interval after adjustment for possible confounding variables were calculated. Results①There were 36 patients with WMLs among the 110 migraine patients. The incidence of WMLs in migraine patients was 32.7%. The WMLs in migraine patients were predominantly present in the frontal and parietal lobes (59.1%). ② Compared with non-WMLs group, there were significant increases in disease duration (5.3±3.7 vs. 7.6±4.9, P﹤0.01), frequency of head-ache attack (3.5 ± 2.3 vs. 4.6 ± 2.2, P﹤0.05), aura (18.9%vs. 36.1%, P﹤0.05) and family history of migraine (12.2%vs. 44.4%, P﹤0.01) in WMLs group.③The independent risk factors of WMLs in migraine patients were family history of mi-graine (OR=5.995), aura (OR=3.067) and long disease duration (OR=1.165). Conclusions Family history of migraine, au-ra and disease duration are the predictive risk factors of WMLs in migraineurs.

Objective To evaluate the reliability and validity of a medication dependence questionnaire in mi?graineurs of the Chinese version. Methods One hundred fifteen migraine patients with drug dependence syndrome were included and their clinical data were then collected. All the subjects were interviewed with the medication dependence questionnaire in migraineurs of the Chinese version. The reliability and validity of the questionnaire were evaluated ac?cording to test-retest reliability and internal consistency reliability, and the content validity and construct validity respec?tively. Results The test-retest reliability of the questionnaire items was 0.725~1.000 except item 11 (0.558) and item16 (0.443). The internal consistency coefficient of the questionnaire was 0.820, internal consistency coefficient of each di?mension was above 0.7. Every item score was positively correlated with corresponding dimension score (r=0.595~0.962). Seven factors with latent roots greater than 1 could explain 76.3%of total variance, and these factors were relatively pow?erful in related items. Conclusions The medication dependence questionnaire in migraineurs of the Chinese version shows preferable reliability and validity. Thus, this is a promising assessment tool to evaluate the medication dependence in Chinese migraineurs in future clinical practice.

Therapeutic approaches to brain metastases from non-small cell lung cancer ( NSCLC ) include corticosteroids, anticonvulsants, surgery, radiotherapy and chemotherapy. In recent years, molecular targeted therapy such as the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) has become a new option. This article discussed the roles of surgery, brain radiation, chemotherapy, targeted therapy , and other new directions in the treatment of patients with brain metastases from NSCLC.

Background Diabetic retinopathy (DR) is a common complication of diabetic mellitus,but its pathogenesis is still unclear.Adiponectin may restrain inflammatory reaction and reduce adhesion of vascular endothelial cell to influence diabetic microangiopathy.Relation between adiponectin and nitric oxide synthase (NOS)is less reported.Objective This study was to observe the effect of adiponectin on the expression of NOS in the retinas of diabetic rats.Methods Forty 8-10 weeks Sprague-Dawley (SD) female rats were collected.The rats were randomized into the normal control group (10 rats),adiponectin group (15 rats) and diabetic model control group (15 rats) using the random number table method.Tetraoxypyrimidine was intraperitoneally injected to establish the diabetic model in the rats of the adiponectin group and diabetic model control group,and 10 μg/kg of adiponectin was then injected into the rats of the adiponectin group.Western blot was used to detect the expression of the adiponectin protein in the rat retinas,and the expression of NOS in rat retina was located by immunochemistry.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The relative amount of adiponectin (adiponectin/β-actin)in the retinas was 0.85 ± 0.21,0.79 ± 0.17 and 0.42 ± 0.08,respectively,in the normal control group,adiponectin group and diabetic model control group,with significant differences among the 3 groups (F =4.236,P =0.000).The adiponectin/β-actin ratio in the retinas of the diabetic model control group was significantly declined in comparison with the normal control group and adiponectin group (q =6.615,P =0.000 ; q =6.026,P =0.000).The NOS levels (A value) in the retinas were 0.244 ± 0.035,0.262 ± 0.032 and 0.367 ± 0.066,respectively,in the normal control group,adiponectin group and diabetic model control group,showing a significant difference among them (F =3.752,P =0.001).The A value of NOS in the diabetic model control group was significantly increased in comparison with the normal control group and adiponectin group (q =3.488,P =0.002 ; q =3.079,P =0.005).NOS expression was localized to the inner nuclear layer and retinal ganglion cell layer.Conclusions Adiponectin reduces NO content in diabetic rat retinas by regulating NOS expression.

Objective To analyze the risk factors for hypertension in patients with chronic kidney disease stage 5(CKD5) . Methods The basic information of 390 CKD5 patients complicated with hypertension was collected for univariate analysis ,in‐cluding gender ,age ,primary disease ,dialysis method ,body mass index(BMI) ,complications(hyperlipidemia ,high uric acid ,car‐diac insufficiency) ,level of education ,parathyroid hormone(PTH)level.Univariate variables that showed statistical significance were then subjected to the multivariate analysis(Logistic regression)to identify the risk factors for hypertension in CKD5 pa‐tients.The defined daily dose(DDD)that satisfied the criteria interms of different stages was evaluated.Results Overall hyper‐tension control rate was 22.8%.Univariate analysis showed that the following variables were significantly associated with hy‐pertension in CKD5 patients :>40 years old ,male ,diabetic nephropathy ,hypertensive nephropathy ,hemodialysis ,hyperlipemia , high uric acid level ,and high PTH level(P<0.05).Logistic multivariate analysis showed that diabetic nephropathy ,hyperlipi‐demia ,high PT H level were the independent risk factors for hypertension in patients with CKD5.In hypertension segmented standard ,there was no difference in the DDD between stage 0 and 1(P>0.05) ,and DDD at stage 2 and 3 was increased signifi‐cantly when compared with that at 0 and 1 standard(P<0.05).Conclusion Overall hypertension control rate is very low in pa‐tients with CKD5.Diabetics ,hyperlipidemia ,high PTH level are independent risk factors for hypertension in patients with CKD5.

Objective To observe the effect of restrictive transfusion in colon cancer surgery in elderly patients on postoperative VAP (ventilator-associated pneumonia). Methods Forty cases of elderly patients with colon cancer intending to undertake surgery were randomly divided into restrictive transfusion group (group R) and standard transfusion group (group S) with 20 cases in each group. In group R, patients were administered one third of accumulative fluid loss in the first 60 minute, then the infusion rate were 4 mL/(kg·h) and central venous pressure was maintained at 5 ~ 7 cmH2O. In group S, rate of fluid administration = CVE + deficit +maintenance + loss + third space. Blood gas index including lactic acid and volumes of fluid administered, blood loss, urine volume and thoracic fluid count (TFC) were recorded in the operation. Clinical pulmonary infection score(CPIS) was recorded respectively before operation, 1 day, 3 day, 7 day after operation to evaluate the risk of VAP. Results Compare with those in group S, there were significantly less TFC and intraoperative volumes of fluid administration in group R. The CPIS was significant lower at day1, day3, day7 after operation in group R. There was no significant difference in MAP, HR, CO and urine volume between two groups. Conclusions In colon cancer surgery for elderly patients, restrictive transfusion can maintain hemodynamic stability, ensure the tissue oxygenation, reduce conjunction edema, shorten the recovery and hospital stay and reduce the incidence of VAP.

Anthracosis ; diagnosis ; Diagnostic Errors ; Humans ; Lung Diseases ; diagnosis ; Male ; Middle Aged ; Pulmonary Artery

Objective To compare the predictive power of model for end-stage liver disease(MELD) and Child-Turcotte-Pugh(CTP) on the cirrhotic patients who underwent transjugular intrahepatic portosystemic shunt(TIPS).Methods A total of 110 patients(98 males and 12 females) undergoing TIPS from January 2004 to March 2008 in our hospital were analyzed.Data of all patients were analyzed retrospectively.The main statistical tests included: Kaplan-Merier analysis to compare survival respectively,and the area of receiver operating characteristics(ROC) to compare the performance of the 2 models for predicting 3-month,1-year,and 2-year mortality.Results The survival rate rate of the patients whose MELD score under 15 showed significantly higher than the patients above MELD score 15.The area of ROC that predicting survival was 0.866 and 0.863 at 3 months,0.755 and 0.739 at 1-year,0.729 and 0.750 at 2-years respectively for the MELD and the CTP score.Conclusion Both MELD and CTP score can predict short-term survival accuracy,but poor in long-term.However,the MELD has overcome the shortcomings of CTP,and may be worth using in clinical.