Objective To evaluate the effect of trimetazidine in ischemic cardiomyopathy patients with impaired systolic function. Methods There were 90 cases in total, and were divided into two groups randomly: 42patients took conventional therapy,and 48 patients took trimetazidine additionally. Plasma levels of brain natriuretic peptide (BNP), left ventricular ejection fraction(LVEF) and left ventricular end-diastolic dimension(LVEDD) were measured before and after trimetazidine therapy at 6 months, 12 months. Results Compared to conventional therapy group, LVEF, LVEDD and BNP were significantly improved in the trimetazidine group (P ＜ 0.01 ). Conclusions Trimetazidine additional to conventional therapy might improve heart function and reverse ventricles reconstitution in ischemic cardiomyopathy patients with impaired systolic function.

Objective To explore the difference of plasma pentraxin 3 (PTX3) levels in acute coronary syndrome (ACS) patients,and to evaluate the correlation between plasma PTX3 levels and ACS as well as hypersensitive C-reaction protein (hs-CRP), through detecting the plasma levels of PTX3 and serum levels of hs-CRP in ACS patients, stable angina pectoris (SAP) patients and normal controls. Methods According to coronary angiography results,78 subjects were divided into control group (n = 20), stable angina pectoris (SAP) group (n = 22), and acute coronary syndrome (ACS) group (n = 36). The plasma levels of PTX3 and serum hs-CRP as well as routine blood biochemical markers were detected on the second day after admission. SPSS10.0 was used for one-factor analysis of variance and Logistic regression analysis. Results The logarithm level of plasma PTX3 in ACS group was significantly higher than that of the other two groups (P <0.05). The difference between the SAP group and the control group was not statistically significant (P > 0.05). Logistic regression analysis revealed that the estimated value of the plasma PTX3 logarithm level was 2.32 (P < 0.05), that of the serum hs-CRP was 0.447 (P > 0.05). Conclusion The plasma PTX3 level in ACS group is significantly higher than that of the SAP group and the control group. The correlation between plasma FTX3 levels and the ACS is stronger than that of the serum hs-CRP levels.

Purpose To explore the relationship of Tei index and the concentration of plasma brain natriuretic peptide (BNP) in patients with dilated cardiomyopathy. Materials and Methods Fifty healthy individuals (control group) and fifty dilated cardiomyopathy patients (study group) were recruited in this study. BNP level was measured by enzyme-linked immunosorbent assay (ELISA). Color Doppler echocardiography were performed to measure the cardiac indices including left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic diameter (LVESd), interventricular septal thickness at diastole (IVSd), left ventricular ejection fraction (LVEF). Tei index was then calculated. The indices between the two groups were compared and correlation of Tei index and BNP with cardiac indices was analyzed. Results LVEDd, LVESd, Tei index, and BNP were significantly higher in study group than those in control group (t=14.4, 23.4, 21.9 and 22.3, P<0.01). IVSd and LVEF were significant lower in the study group (t=12.4 and 12.5, P<0.01). BNP was negatively correlated with LVEF (r= -0.266, P<0.05), and positively correlated with Tei index and LVEDd (r=0.401 and 0.326, P<0.05). Tei index was negatively correlated with LVEF and E/A (r= -0.480 and - 0.241, P<0.05), and positively correlated with LVEDd (r=0.375, P<0.05). Multiple stepwise regression analysis showed that the variates of BNP stepwise regression equation were Tei index, LVEF and LVEDd (t=5.984, -2.477 and 2.326, P<0.05); after correcting LVEF, the stepwise regression analysis showed closer relationship between Tei index and BNP (t=2.728, P<0.05). Conclusion There is correlation between Tei index and BNP. Tei index may be a good index for accurately estimating global ventricular function.

Objective: To study the relationship between insulin resistance (IR) and coronary collateral circulation in patients with impaired glucose tolerance (IGT). Methods: A total of 227 patients with coronary angiography (CAG) were studied. There were 131 patients with male gender and the average patient’s age was (53.2 ± 11.0) years. IR (HOMA2-IR) index was measured by HOMA2 method, the severity level of coronary stenosis was assessed by Gensini scoring system, collateral circulation condition was determined by Rentrop classiifcation. 187 IGT patients were divided into 4 groups: Rentrop 0 group,n=55, Rentrop 1 group,n=42, Rentrop 2 group,n=39 and Rentrop 3 group,n=51; in addition, Control group,n=40 patients with normal glucose tolerance and coronary stenosis<50%. Results: Compared with Control group, all patients in 4 Rentrop groups had increased 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while decreased fasting insulin (FINS), allP<0.05. Compared with Rentrop 3 group and Rentrop 2 group, the patients in Rentrop 1 group and Rentrop 0 group had elevated 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while Rentrop 0 group had reduced FINS, allP<0.05. Multivariable regression analysis showed that HOMA2-IR index (R=0.518,P<0.05), HbA1c (R=1.916, P<0.05), 2h-PBG (R=2.130,P<0.05) and FINS (R=1.547,P<0.05) might be related to the severity of coronary stenosis. Binary regression analysis indicated that poor collateral circulation (the patients in Rentrop 0 group and Rentrop 1 group) was related to HOMA2-IR index (OR=1.679, 95% CI 1.101-2.558,P=0.016). Conclusion: HOMA2-IR index could be signiifcantly higher in patients with IGT combining chronic coronary occlusion. IR was the independent risk factor for the severity of coronary stenosis and coronary collateral formation.

Objective:To study the biotransformation rule of the chemical components of total ginsenosides from ginseng stems and leaves tranformed by submerged fermentation of ganoderma lucidum,and to lay the foundation for further development and research of the medicinal fungus of ginseng stems and leaves.Methods:The total ginsenosides from ginseng stems and leaves were fermented by ganoderma lucidum,the changes of chemical components before and after fermentation were measured by thin-layer chromatography;the levels of total ginsenosides from ginseng stems and leaves before and after fermentation were detected by ultraviolet spectrophotometry;the levels of ginsenoside Rb1,Rg3,Rd,CK,Re,Rg,and Rh1 before and after fermentation were measured by high performance liquid chromatography.The human hepatocellular carcinoma SMMC-7721 cells were divided into blank control group,low,medium and high doses of total ginsenosides from ginseng stems and leaves groups and medicinal fungus of ginseng stems and leaves groups.The dosages of total ginsenosides from ginseng stems and leaves and medicinal fungus of ginseng stems and leaves were 5,10 and 20 mg·L-1,respectively.The inhibitory rate(IR) of the cells was determined by MTT assay.Results:The results of thin-layer chromatography showed that the saponins before and after fermentation occured mutual transformation;the levels of total ginsenosides from ginseng stems and leaves before and after fermentation were 749.98 and 602.26 mg·g-1,respectively;the levels of panaxadiol saponins Rb1,Rg3,Rd and CK before fermentation were 24.54,2.21,87.22 and 0 mg·g-1,and the levels of panaxatriol saponins Re,Rg and Rh1 were 151.34,77.02,and 3.06 mg·g-1.After fermentation,the level of Rb1 was decreased by 61.45%,the levels of Rg3,Rd and CK were increased by 238.91%,34.43% and 268.00%.The levels of Re and Rg1 were decreased by 63.75% and 64.41%,and the level of Rh1 was increased by 408.88%;the IR of the SMMC-7721 cells in medium dose of medicinal fungus of ginseng stems and leaves group was higher than that in medium dose of total ginsenosides from ginseng stems and leaves group(P<0.05);the IR of the SMMC-7721 cells in high dose of medicinal fungus of ginseng stems and leaves group was higher than that in high dose of total ginsenosides from ginseng stems and leaves group(P<0.01).Conclusion:The total ginsenosides from ginseng stems and leaves transformed by the submerged fermentation of ganoderma lucidum can significantly change its chemical components,which have stronger anti-proliferation activity in the SMMC-7721 cells.

'Social beings' model of standardized training program for residents in Shanghai is one of the important measures in the health care reform. According to the requirements of the standardized training of residents in thoracic surgery, the article preliminarily explored the standardized training model for residents from four aspects such as individualized treatment of different professional backgrounds, focus-ing on the training needs of residents with different starting point of social beings, developing training programs for different training time and combining the master's degree graduate education. And based on the characteristics of thoracic surgery, it also summed up the past experience and explored the clinical practice teaching.

Objective To explore the predictive value of Tei index and plasma brain natriuretic peptide(BNP) on major adverse cardiovascular events(MACE) during long term follow up in the patients with anteriormyocardial infarction(MI).Methods A total of 238 patients with anterior MI were selected and divided into four groups according to the median of Tei index and BNP:G1 group(Tei≤0.66,BNP≤532.60 ng/mL,n=70),G2 group(Tei≤0.66,BNP＞532.60 ng/mL,n=51),G3 group(Tei＞0.66,BNP≤532.60 ng/mL,n=50) and G4 group(Tei＞0.66,BNP＞532.60 ng/mL,n=67).The follow up end was the MACE occurrence.Results There was a significant positive correlation between the Tei index and BNP(r=0.582,P=0.000).Tei entered the BNP regression equation(β=0.658,P＜0.05).The MACE-free survival rate had no statistical difference among 4 groups(x2 =9.975,P=0.019).The Cox regression analysis showed that Tei index and BNP were the independent predictive factors for MACE.Tei combined with BNP had stronger predictive value to MACE(AUC=0.781,95CI:0.721-0.841,P=0.000),its sensitivity was 72.52％ and specificity was 76.89％.Conclusion Tei combined with BNP has stronger predictive value for anterior MI during long term follow up.

Objective:To explore the use of anterior cervical corpectomy and fusion (ACCF) combined with anterior cervical discectomy and fusion (ACDF) in patients with multilevel cervical spondylopathy myelopathy (CSM).Methods:The clinical data of 83 patients with multi-segment CSM admitted to the Department of Spinal Surgery of Hubei Liuqi2 Orthopaedic Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to January 2021 were retrospectively analyzed. According to the different surgical methods used in their treatment, they were divided into group A and group B. In group A, 44 patients were treated with anterior cervical ACCF combined with ACDF, and 39 patients in group B were treated with posterior single-door laminoplasty. The general clinical indexes such as operation time, perioperative bleeding volume and hospitalization time were collected.The neurological function and cervical dysfunction improvement effect of the patients before and 6 months after operation were evaluated by using the Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) scale. The cervical curvature of the patients before and 6 months after operation was compared, The complications of the two groups were observed 6 months after operation. The patients were divided into improved group (72 cases) and non improved group (11 cases). Comparison between count data groups χ 2 inspection. Independent sample t-test was used for comparison between measurement data groups conforming to normal distribution. According to the results of univariate analysis, the meaningful factors were included in the binary Logistic regression to analyze the influencing factors related to the surgical efficacy. Result:The perioperative blood loss ((153.36±10.68) mL) and hospital stay ((10.11±2.30) d) in group A were lower than those in group B ((171.47±11.32) mL, (15.58±3.76) d). There were significant differences between the two groups ( t values were 7.50 and 8.10; both P<0.001). Six months after operation, the JOA score (13.70±1.49, 12.94±1.63) and cervical curvature (22.10±3.23, 13.38±3.12) of patients in groups A and B were all higher than those before operation (9.40±1.32, 9.36±1.51; 11.16±2.60, 11.23±2.71), and group A was higher than group B, the difference was statistically significant (JOA scores before and after operation: t values were 14.33 and 10.07, respectively; cervical curvature: t values were 17.50 and 3.25, respectively; t values between groups were 2.22 and 12.47, respectively, and the P values were <0.001, <0.001, <0.001, 0.002, 0.029 and <0.001, respectively). Six months after the operation, the NDI indexes of groups A and B (11.38±4.76, 14.79±4.85) were lower than those before the operation (39.56±9.43, 39.74±9.51), and those in group A were lower than in group B, and the difference was statistically significant ( t values were 17.70, 14.60, and 3.23; all P<0.001). Binary Logistic regression showed that the duration of disease ≥6 months ( OR=59.045, 95% CI: 6.485-537.629), the presence of cervical spinal cord MRI signal changes ( OR=0.031, 95% CI: 0.002-0.587), the surgical approach (posterior approach single-door laminoplasty) ( OR=6.300, 95% CI: 1.269-31.273) was an independent risk factor affecting the surgical outcome ( P values were <0.001, 0.021, and 0.024, respectively). Conclusion:Anterior cervical ACCF combined with ACDF has an ideal surgical effect in the treatment of patients with multi-segment CSM, which can significantly improve the cervical spinal nerve function and cervical curvature, shorten the operation time and reduce the perioperative blood loss. It isstill necessary to pay attention to the patient's disease course, MRI signals changes of cervical spinal cord and the effect of surgical methods on their surgical outcomes.