Objective　To investigate the changes of plasma epinephrine (E) and norepinephrine (NE) in rabbits with firearm thoracic wounds. 　Methods　 A total of 24 rabbits were divided into 3 groups randomly, the simple thoracic penetrating injury group (Group A, n = 8), the pseudo-injury group (Group B, n = 8)and the normal control group ( Group C, n = 8). The pressures of carotid artery and jugular vein were recorded by eight-road physiological recorder at 5 minutes before injury. And the concentrations of plasma E and NE were detected through high-performance liquid chromatography (HPLC) and electrochemical detection (ED) at 5 minutes, 30 minutes, 1 hour, 3 hours, 6 hours, 12 hours and 24 hours after injury in all the rabbits. 　Results　The concentrations of plasma E and NE in Group A were significantly higher than those of Group C (P<0.01) and changed regularly. There was no significant difference between Group B and Group C. The pressures of carotid artery and jugular vein of Group A increased by 1.8 and 6.8 times, respectively, during 2 millisecond after injury, then decreased to normal immediately. They decreased to the minimum (0.63 and 0.25 time, respectively) in 30 minutes and 5 minutes respectively and averagely, and raised to normal slowly after 6 hours and 12 hours respectively and averagely. There was no significant difference between Group B and Group C.　Conclusions 　 The concentrations of plasma E and NE increase significantly in the rabbits with thoracic firearm wounds. Their changes have close relationship with the severity of wound and can be used as a judging criterion during the early period of wound.

Objective:To investigate the efficacy and safety of insulin glarsine combined with sitagliptin in elderly type 2 diabetic patients whose blood glucose levels were inadequately controlled by oral anti-diabetic drugs ( OAD) . Methods: In the open-labeled, randomized and parallel study, 98patients (≥60 years) were randomly divided into two groups: insulin glargine/sitagliptin combina-tion group (n=52, the observation group ) and insulin Aspart 30 injection group (n=46, the control group). The dose was adjusted according to the blood glucose. The fasting blood glucose (FBG), 2h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), the incidence of hypoglycemia and body mass index (BMI) after the 12-week treatment were compared between the two groups. Results:The fasting glucose and the incidence of hypoglycemia in the observation group were lower than those in the control group (P<0. 05). There were no significant differences in 2h postprandial blood glucose, HbA1c and BMI between the two groups (P>0. 05). Conclusion:The treatment of insulin glargine combined with sitagliptin is safe, effective and convenient in elderly type 2 diabetes patients with poor glycemic control. By diabetic education, the lower incidence of hypoglycemia treatment will be a better choice for elderly type 2 diabetic patients.

Objective To compare the diagnostic efficacy of the V/Q scan and CT pulmonary angiography (CTPA) for the detection of acute pulmonary embolism (PE) in elderly patients.Methods Fortyfour patients (age ≥60 years old) with suspected acute PE underwent V/Q scan and CTPA.The diagnosis of PE by V/Q scan was based on the criteria of prospective investigation of PE diagnosis (PIOPED) Ⅱ and the prospective investigative study of acute PE diagnosis (PISA-PED).The final diagnosis was made clinically.The sensitivities,specificities and accuracies of PIOPED Ⅱ,PISA-PED,CTPA and Wills score were calculated and compared using x2 and Fisher's exact tests.Kappa analysis was used to analyze the diagnostic accordance rate of PIOPED Ⅱ and PISA-PED.Results The sensitivities of PIOPED Ⅱ,PISA-PED and CTPA in the diagnosis of PE were 70.00％ (14/20),84.62％ (22/26) and 65.22％ (15/23),respectively (x2 =0.069-1.545,all P＞0.05).The sensitivity of Wills score was significantly lower (23.08％,3/13).The specificity of CTPA (93.75％,15/16) was significantly higher than those of PIOPED lⅡ and PISAPED (80.00％,12/15 and 61.11％,11/18,both P＜0.05).The accuracies of PIOPED Ⅱ,PISA-PED and CTPA were 74.29％ (26/35),75.00％ (33/44) and 76.92％ (30/39),respectively (x2 =0.005-0.070,all P＞0.05).The accuracy of Wills score was significantly lower (52.17％,12/23).The diagnostic accordance rate of PIOPED Ⅱ and PISA-PED criteria was 77.14％(27/35),Kappa=0.547,P＜0.05.Conclusion V/Q scan and CTPA have no significant difference for the diagnosis of PE in the elderly patients.

AIM: To study the changes of plasma atrial natriuretic peptide(ANP), endothelin-1 (ET-1) and serum cardiac troponin I(cTnI) levels and the effects of ANP and ET-1 on myocardium in crush injury rats. METHODS: Crush injury was produced in SD rats,the serum levels of cardiac enzyme and cardiac troponin I,plasma levels of ANP and ET-1 were studied by automated biochemical analyzer,automated chemiluminescence assay and radioimmunoassay. RESULTS: The plasma ET-1 level was much lower ,the levels of plasma ANP and serum cardiac enzyme and cTnI were much higher after crush injury than those of the control group( P

Objective To study the right ventricular function of patients with pulmonary thromboembolism by using color Doppler ultrasound.Methods 31 patients with acute pulmonary thromboembolism,compared with 31 vohnteers,were enrolled in this study.The right ventricular anterior wall movement,right ventricular end diastolic volume,right ventricular ejection fraction,and myocardial performance index were observed by echocardiography.Resuits The right atrium diameter,right ventricles diameter,right ventrieular end diastolic volume and pulmonary artery inner diameter in study group were much larger than that in control group (P<0.01),and the right ventricular anterior wall movement and right ventrieular ejection fraction decreased in study group (P<0.01).Tricuspidal annular E peak velocity tended to be decreased,isovolumie relaxation time and isovolumic contraction time were prolonged and myocardial performance index was increased (P<0.01).Right ventricular myocardial performance index showed significant correlation with right ventrieular ejection fraction (r=0.78,P<0.01),isovolumic relaxation time and isovolumic contraction time(rl=0.88,r2=0.57,P<0.01).Conclusion The right ventricular function in patients with pulmonary thromboembelism is decreased and myocardial performance index is a sensitive index which can be used to reflect right ventricular function in pulmonary thromboembolism.

Objective To analyze the composing experience of Menghe physician Ma Peizhi for cough by TCM inheritance support system. Methods The prescriptions for cough of Ma Peizhi were collected, frequency and association of drugs were analyzed by using data mining methods such as revised mutual information, complex system entropy cluster and unsupervised hierarchical cluster. Results Based on the analysis of 57 prescriptions, the frequency of each herb and association rules among the herbs were computed, 18 core combinations and 9 new prescriptions were mined from the database. Conclusion Menghe physicians Ma Peizhi is well experienced in expelling wind and opening the inhibited lung, dissolving phlegm and relieving cough. TCM inheritance support system can be used to analyze clinical experience of old TCM doctor.

ABSTRACT:Objective To evaluate the expressions of cell adhesion molecules CD146 and transferrin receptor 1 (TfR1)in ovarian epithelial cancer and investigate their relationship with clinical pathological features of patients with ovarian epithelial cancer (OEC ) so as to further explore the pathogenesis of OEC. Methods Immunohistochemistry was employed to determine the expressions of CD146 and TfR1 in normal,benign and ovarian cancer tissues.Results The immunohistochemical results showed that the positive expressions of CD146 and TfR1 gradually increased with the changes of normal,benign and malignant tissues in OEC.There were significant differences between all the groups (P<0.05).The advanced the clinical stage,the higher the expression rate (P<0 .0 5 ).The lower the histopathological differentiation,the higher the expression rate (P<0 .0 5 ).The expressions of CD146 and TfR1 were not correlated with age or pathological patterns (P>0.05).There was a significant correlation between expressions of CD146 and TfR1 in OEC (P<0.05,rs=0.532).Combined detection sensitivity and specificity were 82.4% and 75.0%.Conclusion The high expressions of CD146 and TfR1 may play a key role in the occurrance,progression and metastasis of OEC.They may be used as potential markers for diagnosis,postoperative follow-up and targeted therapy.

Objective To investigate the effects of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia (VAP) in critical patients. Methods About 56 patients treated with mechanical ventilation from January 2015 to December were grouped by ward numbers:32 patients in the south ward were in the experiment group and 24 in the north ward were in the control group. The two groups were given the same routine care, e.g., mechanical ventilation by endotracheal intubation. In the experiment group, the cuff pressure was controlled to 30cm H2O every six hours and the control group was every 4h. The two groups were compared in terms of the incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation and mortality. Result The incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation, and mortality showed no significant differences between the two groups (P>0.05). Conclusions For mechanically ventilated patients, the cuff pressure controlled to 30cm H2O every 6h can not increase the incidence of VAP, duration of mechanical ventilation and mortality. It can reduce the nursing workload.

Objective To investigate the expression and clinical significance of tumor-associated carbohydrate anti-gen sTn in endometrium from patients with atypical hyperplasia of endometrium, endometrial carcinoma and benign the uter-ine lesion. And to analyze the association between sTn and the pathologic stage and grade of endometrial carcinoma. Meth-ods sTn was detected by immunohistochemistry in 193 patient samples, including 93 subjects with endometrial carcinoma, 50 subjects with atypical hyperplasia of endometrium and 50 subjects with benign uterine lesions. Results The positive sTn rate in endometrial carcinoma group was 73.1%,which was significantly different from that in atypical hyperplasia endo-metrium group (32%) and that in benign uterine lesion group (14%), (P＜0.017). sTn positive rate in patients with endometri-al carcinoma was 78.8%which is higher than that in patients with other diseases (P＜0.008 ). The positive rate of sTn in pa-tients with poorly differentiated endometrial carcinoma was significantly higher than that in patients with highly differentiat-ed endometrial carcinoma (P＜0.017). The positive rate of sTn in tissues of tumor infiltration with depth of more than half of myometrial was significantly higher than in tissues of tumor infiltration with depth of equal or less than half of myometrial (P＜0.05). But there was no significant difference in sTn positive rate between the endometrial carcinoma groups with and without lymph node metastasis (P>0.05). Conclusion sTn may play a role in the tumorigenesis and development of endo-metrial carcinoma.