Objective To compare the changes in fibrinogen (Fib), C-reactive protein (CRP) and left atrial (LA) size between patients with atrial flatter (AFL) and those with atrial fibrillation (AF) to explore the relations among them. Methods We selected 53 AF patients (including 16 cases of paroxymal AF, 13 of persistent AF and 24 of permanent AF) and 18 patients with AFL; the control group consisted of 32 cases of sinus rhythm (SR). In all the patients, ECG or Horter and UCG were conducted; Fib and CRP were measured. The levels of the above indexes in AF group, AFL group and subgroups were compared with each other, and with those in the control group. Correlation analysis between CRP and LA size was made. Results Fib, CRP and LA size in AF group were significantly different from those in AFL and SR groups, but did not differ between the latter two groups. So did other parameters among the three groups. CRP in persistent AF and permanent AF differed significantly from that in AFL, SR and paraxymal AF. LA size in the groups of persistent AF differed from that in SR group, but there was no difference between those in persistent AF and AFL groups. LA size in permanent AF was significantly different from that in AF, AFL and SR. Positive significant linear correlations were found between CRP and LA size in AF (r=0.33). Conclusion Hypercoagulable state exists in AF; the AF. Positive correlation exists between LA size and inflammatory reaction; there is no hypercoagulable state in AFL.

Objective To explore the role of combined respiratory function combined with drug therapy in the rapid recovery of lung cancer patients, and to provide reference for clinical treatment. Methods Forty patients with early non-small cell lung cancer (NSCLC) who underwent surgical treatment from January 2012 to December 2015 were selected as subjects and were randomly divided into intervention group and control group (n=20) according to the order of admission. All patients were treated with routine chemotherapy on the basis of routine chemotherapy of lung cancer, and routine perioperative care was carried out. The intervention group received comprehensive respiratory function exercise on the basis of them. There were psychological nursing, health education, perioperative respiratory function exercise and so on. The incidence of postoperative pulmonary complications, quality of life improvement and postoperative rehabilitation were compared between the two groups. Results The incidence of pulmonary complications in the intervention group was 5％ (1/20, only one case of pneumonia), the incidence of pulmonary complications in the control group was 35％ (7/20, 4 cases of pneumonia, two cases of atelectasis, one case of hypoxemia),the incidence of postoperative pulmonary complications in the intervention group was significantly lower than that in the control group (P<0.05). The scores of SF-36 in the intervention group were higher than those in the control group, the difference was statistically significant (P<0.05). The extubation time and postoperative hospital stay in the intervention group were shorter than in the control group. The 6-minute walking test (6MWK) was longer than the control group, the difference was statistically significant (P<0.05).Conclusion Comprehensive respiratory function combined with treatment with etestin hydrochloride can reduce the early postoperative pulmonary complications in patients with early non-small cell lung cancer, improve its quality of life and promote rapid postoperative rehabilitation.

Peroxisome proliferators-activated receptors(PPARs)are ligand activated transcriptional factors and belonging to the nuclear receptor superfamily.PPARs play important roles in the regulation of lipid and glucose metabolism,energy homeostasis,cell proliferation,differentiation and reproduction.Furthermore,PPARs agonists were closely correlated to atherosclerosis and involved in delaying the formation of atherosclerosis.

Background The primary pathological basis of diabetic retinopathy (DR) is new blood formation due to anoxia and inflammation,which results in breakdown of blood-retinal barrier (BRB).Vascular endothelial growth factor (VEGF) is a key factor promoting neovascularization.Researches determined that lycium barbarum polysaccharides (LBP) can protect cells against oxidative damage.However,the study of LBP in ophthalmology is lack.Objective This study was to investigate the effects of LBP on the dynamic pathological change of retinal vessels and expression of VEGF in retina of diabetic rats.Methods One hundred and seventeen SPF male SD rats were randomly divided into the normal control group,the diabetic mellitus (DM) group and the LBP group according to random number table.Type 1 DM models were induced by intraperitoneal injection of streptozotocin (STZ,55 mg/kg) in the rats of the DM group and the LBP group,and then 250 mg/kg LBP was intragastically administered in the rats of the LBP group.The morphological change of retinal vessels was dynamically observed by retinal stretched preparation with Evans blue (EB) in 4,10 and 16 weeks after modeling.E B (45 mg/kg) was slowly injection via jugular vein,and 1％ polyoxymethylene was infused into the left ventricule.The eyeballs were extracted and retina were isolated.EB content in the retinas (mg/g) was calculated using retinal stretched preparation method at the time points mentioned above.Expressions of VEGF protein and mRNA in the retinas were detected by immunohistochemistry and real-time quantitative PCR at various time points,respectively.Results Retinal stretched preparation with EB exhibited that the abnormal degree in the shape,diameter of vessels and leakage of the retinal blood vessels were significantly slighter in the LBP group than those of the DM group in 4,10,16 weeks after modeling.At 4,10,16 weeks,EB content in the retinas was (12.17±1.55),(16.46±1.60) and (19.55±1.49) mg/g,which was significantly lower than (15.76± 1.90),(21.61 ±2.05) and (26.30±2.28) mg/g of the DM group (P＜0.05).Immunochemistry showed that the expression of VEGF protein primarily located at retinal ganglion cells (RGCs) layer.The staining intensity for VEGF protein was weaker in the LBP group than that of the DM group.The expression levels of VEGF protein (A value) in the LBP group were 0.234±0.011,0.331±0.023 and 0.536±0.031at various time points,with significant decline in comparison with 0.281±0.018,0.533±0.055 and 0.765±0.075 of the DM group (all at P＜0.05).Real-time quantitative PCR revealed that the expression levels of VEGF mRNA were 0.157±0.013,0.505 ±0.114 and 1.577±0.074 in the LBP group at various time points,which were significantly lower than 0.235±0.209,1.043±0.084 and 2.446±0.061 of the DM group (all at P＜0.05).Conclusions LBP can alleviate the DM-induced retinal vasculopathy,lessen the leakage of vessels well,and further protect the BRB.

Objective To investigate the expression and clinical significance of proapoptotic genes HtraA2 in acute myeloid leukemia.Methods 78 cases of AML patients were divided into newly diagnosed AML group,complete remission group and hard flag group,and another 25 cases treated at the same period were set as the control group.The boue marrow and peripheral blood samples were collected from all the groups for total RNA extraction and detection of expressed HtrA2.The HtrA2 expressions were compared among thc groups.Finally 17 patients were followed up for 1～56 months.Results The HtrA2 expression levels of 3 groups were significantly different (x2 =35.13,P ＜ 0.05),with the ratio of maximum to minimum values up to 68.76.There were no statistically significant differences in the relative expression of gcnes HtrA2 among the FAB type (F =0.004,P ＞ 0.05).HtrA2 gene expression after treatment was significantly higher than before treatment in the patients followed up (P ＞ 0.05).HtrA2 gene might affect the survival time of patients (Wald =4.979,P ＜ 0.05),but age and gender had no influence on survival states (Wald =2.426 and 0.833,P ＞ 0.05).Survival curve analysis showed that the median smvival time was 34.50 months in the patients followed up.Conclusion The expression level of HtrA2 can be beneficial for the diagnosis,treatment and prognostic evaluation of AML.

Objective To explore the risk factors for acute kidney injury (AKI)in patients with acute myocardial infarction (AMI).Method The medical data of hospitalized patients with AMI admitted from October 2013 to May 2014 were reviewed.All patients were divided into AKI group and non-AKI group.The univariate comparison analysis were performed to obtain the AKI risk factors.Results A total of 565 patients were enrolled.The incidence of AKI (n =91 )was 16.1% and there were 474 non-AKI patients.The mortality of AKI group was 19.8% and mortality of non-AKI group was 0.4% (P <0.01). Univariate analysis demonstrated that the risk factors of AKI were age,hypertension,previous myocardial infarction,heart failure history,chronic kidney disease,cerebral infarction history,peripheral vascular disease;ventricular fibrillation,heart rate,Killip grade ≥3 stage,left ventricular ejection fraction,serum creatinine,eGFR,hemoglobin,blood urea nitrogen,troponin I,B-type natriuretic peptide and C-reactive protein,fasting glucose,albumin,maximum daily dose of furosemide,non-use of ACEI /ARB and statins, the use of intra-aortic balloon pump, temporary pacemaker and pulmonary mechanical ventilation, implementation of PCI and coronary artery bypass graft surgery.Conclusions These risk factors for AKI after AMI were found to identify high-risk patients,helping the clinicians to make decision for preventive intervention.

Objective To study Tephroseris Kirilowii Turez.Houlub extract on cell cycle and apoptosis marker AnnexinV/PI of U266 in vitro..Methods U266 cells were cultured together with Tephroseris Kirilowii Turez.Houlub extract.Cell cycle and apoptosis marker AnnexinV/PI were detected by flow cytometry(FCM).Results After exposure of U266 cells to Tephroseris Kirilowii Turez.Houlub extract.the cell cycle distribution was changed.There Was a decrease of cells in the G0/G1 phase with an increase of cells in the S phase and G2/M phase and apoptosis.FCM with staining of Annexix V FITC/PI showed a dependence of apoptotic cells with the dosage of Tephroseris Kirilowii Turez.Houlub extract.Conclusion Tephroseris Kirilowii Turez extract has strong cell apoptosis effect on U266 cells.

Objective:To investigate the prevalence and associated risk factors of pre-hypertension and hypertension in young and middle-aged population in Nanjing.Methods:Subjects of the study were those who underwent physical examination in the physical examination center of Nanjing Drum Tower Hospital from 2009 to 2016. The prevalence and risk factors of pre-hypertension and hypertension in young (aged 18-44 years old) and middle-aged people (aged 45-59 years old) were analyzed.Results:A total of 142 857 participants aged 18-59 years old were analyzed. Among them, 64 220 cases in the pre-hypertension group and 13 912 cases in the hypertension group. The prevalence of hypertension was 9.74% (12.51% in males and 5.82% in females). The prevalence of pre-hypertension was 44.95% (53.31% in males and 33.15% in females). In the middle-aged group, the prevalence of pre-hypertension and hypertension were 51.68% and 15.13%, respectively, which was higher than that in the young group (37.95% and 4.13%, respectively). The prevalence of pre-hypertension and hypertension in 2013-2016 was 45.37% and 10.65%, respectively, which was higher than that in 2009-2012(44.52% and 8.78%). In addition, the prevalence of abnormal blood glucose metabolism, abnormal blood lipid metabolism and abnormal glucose and lipid metabolism in the pre-hypertension group was higher than that in the normal blood pressure group, but lower than that in the hypertension group ( P<0.001). A logistic regression analysis indicated that age, overweight or obesity, hyperglycemia, hypertriglyceridemia and hypercholesterolemia were risk factors of pre-hypertension in male. Age, overweight or obesity, hyperglycemia, hypertriglyceridemia, hypercholesterolemia and hyper-low density cholesterolemia were associated with hypertension in male and with pre-hypertension and hypertension in female. Conclusions:Middle age, overweight/obesity, elevated fasting plasma glucose, elevated triglyceride and elevated total cholesterol were risk factors of pre-hypertension and hypertension in both men and women. Intervention on the related risk factors should be conducted as early as possible.

Objective To investigate the difference of two models of respiratory failure in preterm infants with nasal continuous positive airway pressure(nCPAP)and nasal biphasic positive airway pressure (nBiPAP).Methods Comparative analysis of 81cases of premature infants with respiratory failure requi-ring respiratory support was needed.They were applied nCPAP and nBiPAP ventilation mode treatment.The use of breathing machine and total oxygen inhalation time,the number of treatment failures,the PEEP param-eters of the ventilator,the total number of recent complications and secondary infections were compared.Re-sults In the nBiPAP treatment group,the average time of noninvasive ventilation was(96.34±31.5)h,the total time of oxygen inhalation was(10.11 ±9.39)d,3cases of treatment failure,the incidence of severe complications was 5.56%(2/36),PEEP (4.08±0.73)cmH2O (1cmH2O =0.098kPa ).In the nCPAP group,the average time of noninvasive ventilation was(114.14±41.69)h,the total time of oxygen inhalation was(17.53±15.96)d,15cases were failed,the incidence of severe complications was 15.56%(7/45), PEEP(5.11±1.01)cmH2O.There were significant differences between the two groups(P﹤0.05).But there were no significant differences in infection control and patent ductus arteriosus (P ﹥0.05).Conclusion nBiPAP as one of the first choice treatment for premature infants with respiratory failure significantly better than nCPAP,as soon as the proper use can avoid invasive ventilation.

Objective To study cytotoxic and antineoplastic effect in vitro of tephroseris kirilowii turez, houlub extract on U266 multiple myeloma cell line. Methods U266 cells were cocultured with the tephroseris kirilowii turez, houlub extract. Cytotoxicity assay was used by CCK-8 detection kit. Cell cycle and apoptosis were determined using flow cytometry(FCM) analysis. Results Extract of tephroseris kirilowii turez, houlub showed strong cytotoxicity against U266 cells.The IC50 was about 3.2 mg/L. After exposure of U266 cells to the drug, the distribution of cell cycle was changed compared with that of the controls. When the durg concentration was 1.25, 2.5, 5 and 10 mg/L. respectively, the pencentages of cells in the G0/G1 phase were decreased with (34.12±0.49) %, (38.06 ± 0.63) % , (27.46±0.61) %, (15.91±0.32) %, respectively, while those in the S phase were increased with (4.98± 0.50) %, (4.01±0.22) %, (4.16±0.15) % and (5.04±0.12) % in G2/ M phase were increased with (50.05 ±1.12) %, (51.27±0.71) %, (51.84±0.73) % and (55.11±0.25) %, respectively, and apoptosis cells were increased. Apoptosis of U266 cells inadose-depadeut manner could be deteted with staining of Annexix V FITC/PI testing through FCM. Conclusion Tephroseris kirilowii turez extract showed strong cytotoxic effect on U266 cells. The antineoplsastic mechanism of the drug can be partly due to its induced apoptotic effect.