Objective In order to offer a noninvasive and objective examination method for assessing the clinical diagnosis and eurative criterion of concussion patients, the patients color three - dimensional transcranial doppler( 3D - TCD) characteristic at deferent phases, parameter and clincal manifestation were studied Method Parameter of Median Cerebral Artery(MCA), Base Artery(BA), the average peak forwand velocity of cerebral blood flow, train figure were tested by 3D - TCD within 24 hours, 3 - 6 days and at the end of treatment, respectively. The results were compared with clinical diagnoses and curative criterion. Result Among 135 patients who had clinically diagnosed concussion, agreeable diagnoses 101 cases, basically agreeable diagnooses 12 cases, disagreeable diagnosis 22 cases(16. 2%) .At the end of treatment, according to clinical determination 96 cases(71.1%) were cured, 39 cases(28.9%) were improved. Wave train character, figure and diagnoses prameter of cerebral spasm caused by concussion were suggested Conclusion To be one of the diagnostic bases and curative criterion, 3D- TC D technology is performable. Meanwhile, it is a new testing objective technique for assessing curative and determining prognosis.

Objective To study the relationship of high-sensitivity C-reactive protein (hs-CRP),homocysteine (Hcy) and blood pressure variability in elderly patients with essential hypertension.Methods As the total coefficient of variation of 24-hour systolic blood pressure variability(BPsVC),the patients with essential hypertension were divided into two groups:the high-BPsVC group(n =72 cases) and the low-BPsVC group(n =48 cases).The hs-CRP and Hcy in serum in patients were detected.Results The hs-CRP were (2.52 ± 0.78) mg/L in the high-BPsVC group and (1.59 ± 0.61) mg/L in the low-BPsVC group.There was a significant difference (t =0.2766,P ＜ 0.05).The Hcy were(15.6 ±6.2) μmol/L in the high-BPsVC group and(13.7 ± 5.9) μmol/L in the low-BPsVC group.There was a significant difference(t =0.3742,P ＜ 0.05).Condusion There was a close relationship between hsCRP,Hcy and blood pressure variability in elderly patients with essential hypertension.

Objective To study the effectiveness of valsartan on the insulin resistance and high-sensitivity C-reactive protein(hs-CRP) of patients with essential hypertension.Methods One hundred and thirty patients with essential hypertension were randomly divided into two groups,the control group (n =65 cases) and the treatment group (n =65 cases).The patients in the control group were treated through amlodipine,while the patients in the treatment group were treated valsartan.They were all treated for six months.The insulin resistance(IR) and hs-CRP were compared.Results The systolic blood pressure and diastolic blood pressure were decreased after treatment in both groups (t =6.3706,6.4418,7.0519,7.2577,all P ＜ 0.01).There wasn't a significant difference between two groups (P ＞0.05).The IR and hs-CRP were decreased in both groups (t =6.3478,1.9977,4.0581,12.0722,all P ＜ 0.01).There was a significant difference between two groups (t =7.6049,4.6893,all P ＜ 0.05).Conclusion Valsartan can improve the insulin resistance and hs-CRP,which weren't dependent on lowing blood pressure.

Objective To investigate the relation between endothelial repairing function and in-stent restenosis in patients with symptomatic middle cerebral arterial (MCA) stenosis after stent implantation.Method Sixty-six patients with symptomatic MCA stenosis underwent percutaneous stent implantation.Cranial CTA revealed that 23 patients had MCA restenosis (restenosis group) 1 year after stenting,including 14 cases with ＞50％ stenosis and 1 case with MCA occlusion,and 43 patients had no restenosis (non-restenosis group).The number of endothelial progenitor cells (EPC) was examined by flow cytometry,the adhesion function of EPC was tested by adhesion assay,the migration ability of EPC was tested by Transwell method and serum vascular endothelial growth factor (VEGF) levels were measured by ELISA.The relationship of endothelial repairing function with restenosis was analyzed.Results The MCA stent implantations were successfully performed in all patients.The EPC number (33.7 ± 4.6 vs.61.6 ± 6.4),adhesion activities (26.1 ± 7.5 vs.56.3-± 9.6),migration activities (12.0 ± 3.9 vs.21.4 ± 6.5) and serum VEGF level [(56.7 ± 14.6) vs.(89.6 ± 17.32) ng/L] in restenosis group were significantly lower than those in non-restenosis group (t =18.48,13.09,6.34 and 7.73,all P ＜ 0.05).Conclusion For patients with MCA stenosis after percutaneous stent implantation the increased risk of in-stent restenosis is associated with low level of EPCs and their migration ability,and low serum VEGF level.

Objective To evaluate the correlation between plasma high sensitivity C reactive protein (hs-CRP) level and global registry of acute coronary events (GRACE) scores,and its predictive value for long-term (5 years) cardiovascular events in middle-aged and elderly patients with acute coronary syndrome (ACS).Methods 138 middle aged and elderly patients with ACS were divided into three groups according to GRACE scores:low risk group,middle risk group,high risk group.And based on quartiles of hs-CRP levels,subjects were segregated into 4 groups (Q1 to Q4).All subjects were followed up for about 5 years and adverse cardiovascular disease events were recorded.Results The hs-CRP level was gradually increased along with increasing risk according to GRACE risk stratification (hs-CRP low risk group,0.09 ± 0.22 ; middle risk group,0.21 ± 0.04 ;high risk group,0.43±0.23,P＜0.001).Meantime,GRACE risk scores were gradually increased along with increasing hs-CRP levels from Q1 to Q4 (Q1:133.0 ± 43.6; Q2:161.9 ± 60.2; Q3:169.3±52.6; Q4:188.4±47.5; all P＜0.001).Regression analysis showed that hs-CRP level was positively correlated with GRACE risk scores (r=0.576,P＜0.001).During a follow-up period of about 5 years,96 cardiovascular events were recorded.Receiver operating characteristic(ROC) curve analysis showed that area under the ROC curve (AUC) of hs-CRP was 0.821 (95 ％CI:0.749-0.892,P＜0.001) and AUC of GRACE risk score was 0.869 (95％CI:0.801 0.938,P＜0.001) in the evaluation of the long-term risk of incident cardiovascular events.The differences in prediction of long-term cardiovascular events in middle-aged and elderly patients with ACS were not significant (P =0.237) between GRACE risk score and hs CRP level.Conclusions Plasma hs-CRP level is positively associated with GRACE score.Both of them can predict long-term adverse cardiovascular events in middle-aged and elderly patients with acute coronary syndrome.

Objective To investigate the changes of serum high sensitive C-reactive protein(hs-CRP) level in patients with acute cerebral infarction(ACI),and the relationship between serum hs-CRP level and ACI severity as well as subtypes according to Chinese Ischemic Stroke Subclassification(CISS)criteria. Methods The serum hs-CRP level in 256 patients with ACI and 196 normal controls were measured. The degree of nervous function defect in patients with ACI was assessed by the United States National Institutes of Health Stroke Scale ( NIHSS ) score. All patients were classified into five major ischemic stroke subtypes based on CISS criteria. Logistic regression analysis was applied to analyze the risk factors of ACI. Results The serum hs-CRP level in patients with ACI and control group were(4. 69 ± 2. 58)mmol/ L and(2. 13 ± 1. 79)mmol/ L,and the difference between groups was significant(t = 12. 439,P = 0. 000). The hs-CRP in patients with severity ACI (147 cases)were(5. 89 ± 4. 15)mmol/ L,significantly higher than that in patients with mild ACI,and the difference between groups was significant((2. 11 ± 1. 45)mmol/ L,t = 10. 230,P = 0. 000)). As for subtype ACI,the case of the large artery atherosclerosis subtypes was 106( 41. 57% ),highest than any other subtypes. The hs-CRP level of large artery atherosclerosis was(7. 01 ± 3. 12)mmol/ L,higher than that of control group( P = 0. 000). The logistic regression analysis showed that many factors were related to ACI including total cholesterol,homocysteine and high sensitive C-reactive protein( OR = 0. 324,0. 749,0. 809;P< 0. 05). Conclusion The serum hs-CRP level in patients with ACI increase significantly,and relate to the degree of neural function defect. The level of hs-CRP of large artery atherosclerotic stroke is the highest. The change of serum hs-CRP is very valuable to estimate the severity of ACI.

Objective To study the effect the edaravone on the expressions of ICAM-1,TNF-α after focal cerebral ischemia reperfusion in male rats.Methods 45 male SD rats were selected and randomly assigned into 3 groups:sham operation group(SO),ischemia reperfusion group(I/R),and edaravone treatment group(ED),each group had 15 rats.The expression of ICAM-1,TNF-α were checked by immunohistochemistry.All data in the groups were analyzed with t test.Results The expression of ICAM-1 and TNF-α in the I/R group and ED group were higher than the SO group(t=21.919,27.758,26.576,17.395,32.821,43.021,14.195,31.828,21.201,10.195,25.768,17.900,all P＜0.05)at reperfusion 3 hours,6 hours,and 12 hours.The expression of ICAM-1 and TNF-α in the I/R group were higher than the ED group(t=9.623,13.845,7.201,11.313,all P＜0.05)at reperfusion 3 hours and 6 hours.Conclusion Edaravone may exert the neuroprotective effect against the cerebral ischemia in rats by decreasing the expression of ICAM-1 and inhibiting the activation of TNF-α.This process could inhibit free radical generation.

By analyzing the clinical data of 216 cases of acute cerebral infarction (ACI) from 2012 January to 2013 June retrospectively,we found that the serum levels of high sensitive C-reactive protein (hs-CRP) in patients were significantly higher than those in 186 controls (P ＜0.01).The degree of neural function defect in ACI patients was assessed by the National Institutes of Health Stroke Scale (NIHSS) score.The hs-CRP level of the patients with NIHSS score ＞ 8 were higher than that in those with NIHSS score ≤8 (P ＜ 0.05).The hs-CRP level of patients of large artery atherosclerosis were (6.32 ± 4.12) mg/L and the positive rate of hs-CRP was 85.7％ (84/98).All were respectively higher than those in patients of penetrating artery disease [(1.97 ±0.86) mg/L,7/71],cardiogenic stroke [(3.70 ± 2.76) mg/L,14/24],undetermined etiology [(3.43 ± 3.52) mg/L,5/11] and other etiologies [(3.41 ± 3.25) mg/L,5/12] (all P ＜ 0.05).Logistic regression analysis was performed for the risk factors of ACI.The correlative factors of ACI included hypertension,diabetes mellitus,atrial fibrillation,smoking,total cholesterol,homocysteine and high sensitive C-reactive protein (OR =1.56,1.19,1.23,1.17,3.08,1.34,1.25,all P ＜ 0.01).The serum levels of hs-CRP increased significantly in ACI patients and were correlated with the degree of neural function defect.

Objective To verify the clinical applicability of the published standard intervals of routine clinical chemistry (WS/T404 .1‐2012 ,WS/T404 .2‐2012) based on the health examination results of Han and Uygur populations in Urumqi .Methods This was a retrospective study .The results of serum TP ,ALB ,ALT ,AST ,ALP ,GGT from healthy examination individuals of Han and Uygur populations (from 2013 August to 2015 January) were collected and the healthy cases (age range:20 -79 years old) were chosen to calculate the 2 .5% and 97 .5% percentiles ,excluding the significant abnormal results according to the Medical Deciding Level 2 recommended by Staland .The percents of health cases not falling in the published standard interval were calculated to meet the judgment criterion of verification (<10% ) .Results The test of normality revealed that the Han and Uygur's results of all veri‐fied items were skewed distributions .The 2 .5% and 97 .5% percentiles of the results of two populations were as follows ,TP(Han 65 -81 g/L ;Uygur 64-81 g/L) ,ALB(Han 41-53 g/L ;Uygur 40-52 g/L) ,ALT(Han:male 9-51 U/L and female 7-42 U/L ;Uygur:male 9-53 U/L and female 6-43 U/L) ,AST(Han:male 14-42 U/L and female 12-37 U/L ,Uygur:male 12-42 U/L and female 12-38 U/L) ,ALP(Han:male 45-119 U/L ;Uygur:male 47-122 U/L) ,ALP(female 20-49 years old:Han 35-95 U/L and Uygur 40-104 U/L) ,ALP(female 50-79 years old:Han 43-131 U/L and Uygur 51-132 U/L) ,GGT(Han:male 11-71 U/L and female 8-54 U/L ;Uygur :male 11 -73 U/L and female 7 -55 U/L ) .The percents of AST results for Han's male , Uygur's male and Uygur's female not falling in the published standard reference interval were slightly over 10% ,but AST results o‐ver 10% were mainly under the lower limit of the published standard reference interval .The health case percents for the other veri‐fied items of Han and Uygur populations not falling in the published standard reference interval were under 10% .Conclusion The published standard reference intervals of routine clinical chemistry (WS/T404 .1‐2012 ,WS/T404 .2‐2012) are applicable in our la‐boratory for the detection of Han and Uygur population .

Overt gastrointestinal bleeding (GIB) is one of the noncardiac complications in patients with acute myocardial infarction (AMI).Identification of patients at increased risk of overt GIB could aid in targeting more aggressive treatment,and lead to improved outcomes.The aim of this study is to determine the frequency,risk factors,and prognostic significance of overt GIB in patients with AMI.Methods A retrospective review of the medical records of 1443 patients admitted to the Chinese PLA General Hospital with AMI was conducted.Charts were reviewed for clinical characteristics,possible precipitating factors and complications.Patients were categorized as having or not having overt GIB(GIB associated with hemodynamic changes or the need for transfusions).Results Twenty nine (2.0%) patients developed overt GIB within 30 days after AMI.Patients with overt GIB had higher 30-day mortality rate than those without (44.8% vs.9.9%,P ＜ 0.001).Multivariate logistic regression analysis showed major determinants of in-hospital overt GIB secondary to AMI were gender of female (odds ratio 2.41,95% confidence interval [CI] 1.08 to 5.37),age=75 years (odds ratio 1.58,95% CI 1.13 to 2.20),prior history of AMI (odds ratio 2.28,95% CI 1.17 to 4.88),pneumonia (odds ratio 3.47,95% CI 1.50 to 8.03) and anemia at admission (odds ratio 2.37,95% CI 1.04 to 5.37).Conclusions In patients with AMI,overt GIB is associated with higher in-hospital mortality,and female sex,older age,prior AMI,pneumonia and anemia at admission are predictors of overt GIB during hospitalization.(J Geriatr Cardiol 2008;5:195-198)