0.05). Conclusion DSA is highly valuable for the evaluation of collateral pathways of ICA stenosis or occlusion, and it is necessary for preoperative examination. MRA is a non-invasive angiographic method and can evaluate collateral circulation in both morphology and function, and can be the preferred method for the disease.

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 investigate the correlation of the plasma homocysteine level and serum B/apolipoprolionAl(ApoB/ApoAl) radio with cerebral vascular stenosis in patients with cerebral infarction.Methods 184 patients with cerebral infarction experienced cerebral digital substraction angiography (DSA) were selected.Among them,158 patients with cerebrovascular stenesis and 26 patients without stenosis were included.Three groups were categorized by distribution of artery lesion sites:isolated intracranial artery stenesis ( n =48 ),isolated extracranial artery stenosis( n =60) co-existing of intracranial and extracranial artery stenosis( n =50).The correlation analysis was made between the levels of Hcy and ApoB/ApoAl with cerebral vascular stenosis in patients with cerebral infarction.Results ( 1 ) The proportion of subjects with high level of plasma homocysteine was significantly higher in patients with cerebrovascular stenosis than those without[( 16.9 ±8.1 ) μmol/L vs (8.6 ±4.6) μmol/L,P ＜0.001 ;40％ vs 0,P ＜0.01].The proportion of subjects with high level of ApoB and ApoB/ApoA1 ratio was significantly higher in patients with cerebrovascular stenosis than those without ApoB [( 1.02 ± 0.25 ) vs ( 0.86 ± 0.22 ) g/L,P ＜ 0.01],ApoB/ApoAl ratio [( 0.94 ± 0.50) vs ( 0.64 ± 0.21,P ＜ 0.01 )].(2) For the different groups of artery lesion sites,the proportion of subjects with high level of plasma homocysteine was not significantly different[( 16.1 ± 8.5 )mml/L、( 17.0 ± 8.9 ) mmol/L、( 16.7 ± 8.7 ) mmol/L,P ＞ 0.05],the proportion of subjects with ApoB/ApoAl ratio was not significantly different [0.98 ± 0.45,0.93 ± 0.48,0.96 + 0.50,P ＞ 0.05].(3) Based on multivariable stepwise Logistic regression model,the increased level of Hcy( OR =1.146,95％ CI:1.021 ～ 1.287 ;P =0.021 ),the increased level of ApoB/ApoAl ( OR =4.71,95 ％ CI:1.70 ～ 14.20,P =0.005 ),the increased level of ApoB ( OR =4.50,95 ％ CI 为 1.62 ～ 12.80,P =0.007),the increased level of Cho ( OR =2.406 ;95％ CI:1.145 ～ 5.055 ; P =0.023 ),the decresed level of HDL( OR =0.089,95％ CI:0.014 ～ 0.551,P =0.017 ) were all risk factors.Conclusion High level of plasma homocysteine and ApoB/ApoAl were both independent risk factors for cerebral vascular stenosis.

Objective To investigate the expression of miR-29s in the glioma stem cells,and explore how the members of miR-29s affect the bio-logical behaviors of glioma stem cells. Methods Eight patient specimens were used to culture glioma stem cells. Real-time PCR was adopted to test the expression of miR-29s. CCK-8 analysis was performed to test the proliferation ,Transwell was used to test cell migration and invasion ,and flow-cytometry analysis was carried out to test apoptosis. Results miR-29a,miR-29b and miR-29c were decreased in glioma stem cells. Over-ex-pression of miR-29s could inhibit the proliferation,cell migration and invasion,but promote apoptosis of glioma stem cells. Conclusion miR-29s acts as a cancer suppressor gene in the glioma stem cells ,and miR-29a plays the dominant functional role in the family.

Objective To study the incidence of low triiodothyronine (T3) syndrome in critical patients,and compare the prognosis evaluation value between low T3 syndrome and acute physiology and chronic health evaluation (APACHE) Ⅱ score.Methods A total of 160 critical patients were enrolled.APACHE Ⅱ score of patients were recorded at admission,and thyroid hormone levels were measured on the first and the third day after admission.The patients who were low T3 level were enrolled into observation group,and the patients who were normal T3 level were as control group.The patients were followed up for 28 d,then were divided into death group and survival group according to the prognosis.The prognosis evaluation value was compared between T3 and APACHE Ⅱ score by receiver operating characteristic (ROC) curve.Results The incidence rate of low T3 syndrome was 25.6％ (41/160).During the follow-up phase,the fatality rate in observation group was 41.5％(17/41),and in control group was 29.4％ (35/119),there was statistical difference (P ＜ 0.05).The ROC area under curve of T3 was 0.657 (95％ CI:0.712-0.846),APACHE Ⅱ score was 0.672 (95％ CI:0.721-0.857),and there was no statistical difference (P ＞ 0.05).Best cut-off value of T3 was 0.41 μ g/L resulting in 76.9％(40/52) sensitivity and 78.7％(85/108) specificity.Conclusion Critical patients complicated with low T3 syndrome has poor prognosis,and T3 may be a predictive marker in evaluating the prognosis of critical patients.

Objective To analyze the clinical characteristics of suspected acute aortic dissection with ST-segment elevation detected by inferior leads in order to avoid the misdiagnosis of acute aortic dissection facilitating an appropriate treatment strategy carried out in time.Methods A total of 14 patients with suspected acute aortic dissection with ST-segment elevation detected by inferior leads were enrolled.Their clinical presentation,ECG features,imaging findings,laboratory testing,coronary angiography results, treatment and outcome were retrospectively analyzed.Results Clinical characteristics of suspected acute aortic dissection with ST-segment elevation detected by inferior leads suggested that hypertension as a single risk factor accounted for 79%.The patients with normal blood pressure or high blood pressure in emergency visits accounted for 86%.The amplitude of ST elevation in lead Ⅲ was greater than that in lead Ⅱ,and lead Ⅲ accompanied with ST elevation in lead V1 or V4R accounted for 86%.Significantly elevated D-dimer >2 000 ng/mL was found in those patients.Coronary angiography showed that the opening of coronary artery not seen,normal coronary arteries or a simple right coronary artery proximal lesion.Transesophageal echocardiography and computed tomography angiography were used to identify the diagnosis with 100%accuracy.The mortality rate of this group was 50%.Conclusions Patients with acute aortic dissection evidenced by ST-segment elevation detected by inferior leads are in critical setting of high mortality. Emergency surgical treatment can significantly improve the survival rate of patients.

Objective To investigate the effects of β1-adrenergic receptor autoantibodies (β1-AA) on the proliferation of different subtypes of T lymphocytes in patients with heart failure .Methods β1-AA-positive IgG antibodies isolated from patients with heart failure were purified by using affinity chromatog -raphy.CD3 +CD4 +T and CD3 +CD8 +T lymphocytes were sorted by flow cytometry analysis .The prolifera-tion of different subtypes of T lymphocytes was tested by using CCK-8 kit.Tests for lactate dehydrogenase ( LDH) level and cell apoptosis were performed to evaluate T lymphocytes damage .Results The prolifera-tion of activated lymphocytes was inhibited by β1-AA isolated from the serum of patients with heart failure in a concentration dependent manner , but it could be blocked by β1 receptor blocker .The damage of lympho-cytes induced by β1-AA was increased.Moreover, β1-AA promoted the necrosis and apoptosis of CD 3 +CD4 +T and CD3 +CD8 +T lymphocytes and thus inhibited the proliferation of them .Conclusion β1-AA isolated from the serum of patients with heart failure inhibited the proliferation of CD 3 +CD4 +T and CD3 +CD8 +T lymphocytes through increasing the necrosis and apoptosis of them .This study suggests that β1-AA might induce immune disorders in addition to causing pathological changes in heart tissues .

Objective To know the prevalence of chronic obstructive pulmonary disease(COPD) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) in Kunming Yunnan Province, and the clinical symptom of OS.Methods Retrospective study of 4 636 cases of patients with snoring, excluding COPD in addition to chronic respiratory disease and assess the patient`s condition.The test included AHI, BMI, Epworth sleepiness scale, lung function.The index of OS was confirmed by AHI>5 times/h and FEV1/FVC<70%.Results During the period of 2006 to 2012, he prevalence of COPD in patients with OSAHS was 10.1% [95% confidence interval (CI) 9.1%-11.1%] in Kunming Yunnan Province.And male`s OS prevalence rate is higher than the female(male 10.2%;female 9.7%).The OS patients` average age was 56.9±14.1, the mean AHI was (47.46±26.79) times/h, and the average FEV1/FVC was 60.09%±23.57%.Polysomnographyresults show that patients suffered obvious hypoxiaat night in both OSAHS group and OS group, but it was more significant in OS group.Pulmonary function test showed that OS patients have more serious chronic obstructive pulmonary disease.Conclusions The prevalence of COPD in OSAHS patients was high in Kunming, Yunnan Province, and the prevalence rate in old group reached more than 24%.In addition, the sympotms of patients with OS were more severe than those with only OSAHS or COPD in lung function and hyoxemia.

Objective To dynamically monitor the base excess(BE) in traumatic brain injury(TBI) patients within 3 d after admission,and to assess the impact of the early BE on prognosis.Methods Blood BE was monitored for 3 d in 56 TBI patients.Patients were classified into mild group(15 patients),moderate group (22 patients) and severe group (19 patients) according to the scores of Glasgow coma scale(GCS).Patients were classified into survival group(42 patients) and dead group(14 patients) according to prognosis.Patients were classified into high BE group (35 patients,BE≥-8 mmol/L) and low BE group (21 patients,BE ＜-8 mmol/L).The relations among BE,degree of injury and prognosis were analyzed.Results The level of BE in mild group,moderate group and severe group was increased after treatment for 1,2,3 d than that before treatment.The level of BE was consistent with the degree of injury [mild group:(-3.02 ± 0.21)mmol/L; moderate group:(-8.49 ± 1.44) mmol/L;severe group:(-9.64 ± 1.19) mmol/L].The level of BE in mild group and severe group had significant difference than that in moderate group (P＜ 0.01).The level of BE in dead group before treatment and after treatment for 1,2,3 d was significantly lower than that in survival group [(-11.97 ±2.13) mmol/L vs.(-6.29 ± 1.16) mmol/L,(-9.84 ± 1.33) mmol/L vs.(-4.89 ± 1.78)mmol/L,(-8.78 ± 2.01) mmol/L vs.(-3.61 ± 1.43) mmol/L,(-7.84 ± 1.42) mmol/L vs.(-3.10 ±0.98)mmol/L] (P ＜0.01).The scores of APACHE Ⅱ before treatment and fatality rate in low BE group were significantly higher than those in high BE group [(24.84 ± 3.68) scores vs.(16.27 ± 2.21) scores,52.4％ (11/21) vs.8.6％(3/35)] (P ＜ 0.01).The scores of GCS before treatment in low BE group was significantly higher than that in high BE group [(7.56 ± 3.09) scores vs.(10.51 ± 2.43) scores](P ＜ 0.01).Conclusion The level of early BE is a good factor on evaluating the condition and prognosis in TBI patients.

Objective To investigate the expression and clinical significance of IL-27 and TGF-β1 in patients with pulmonary fibrosis. Methods The expression levels of IL-27 and LTB4 were determined by ELISA method in 20 cases of pulmonary fibrosis patients and 15 cases of healthy control group. Results(1)The levels of IL-27 and TGF-β1 in pul-monary fibrosis patients were higher than the control group;IL-27 and TGF-β1 levels were gradually increased from the control group, pulmonary fibrosis mild hypoxia group, moderate hypoxia group, severe hypoxia group, the differences were statistically significant (F=21.58, P<0.001; F=18.75, P<0.001);(2)The serum IL-27 and TGF-β1 levels were significantly reduced with the increase of PaO2, the linear correlation was found between the two groups and PaO2 were negatively correlated(r=-0.754,P<0.05;r=-0.793,P<0.05);It was positively correlated between IL-27 and TGF-β1(r=0.854,P<0.05). Conclusion IL-27 and TGF-β1 were being involved in the pathogenesis of pulmonary fibrosis, detec-tion simultaneously, there were important significances for pulmonary fibrosis clinic diagnosis and therapy.