Objective To discuss the clinical value of using three markers including ischemia modified albu-min (IMA),N terminal brain natriuretic peptide precursor (NT -proBNP)and allergic troponin I (TnI -Ultra)in diagnosis of acute coronary syndromes (ACS).Methods 80 ACS patients diagnosed by coronary artery imaging were selected,and meanwhile 80 healthy people were chosen as the control group.The serum IMA,NT -proBNP and TnI -Ultra were recorded and compared.The changes of IMA,NT -proBNP and TnI -Ultra in all ACS patients the chest pain onset time,chest pain <3h within and between 3 -6h serum were recorded and compared;And sensitivity,specif-ic and accuracy diagnosis in ACS of the three separate tests and joint detection were compared.Results In ACS patients,serum IMA,NT -proBNP and TnI -Ultra were all significantly higher than those in the control group (t =14.62,25.08,35.77,all P <0.05).In UA,NSTEMI,STEMI patients,serum IMA,NT -proBNP and TnI -Ultra all had statistically significant differences (F =10.89,29.08,40.33,all P <0.05);And in NSTEMI,STEMI patients, serum NT -proBNP and TnI -Ultra were significantly higher than those in patients with UA (all P <0.05 );In STEMII patients,serum NT -proBNP and TnI -Ultra were significantly higher than those in the NSTEMI patients (all P <0.05).In patients chest pain less than 3h,chest pain patients'serum IMA,3 -6h NT -proBNP and TnI -Ultra were significantly higher than those in the control group (all P <0.05);In chest pain less than 3 -6h patients,serum IMA,NT -proBNP and TnI -Ultra were significantly higher than those in chest pain less than 3h patients (all P <0.05).The positive detection rate of IMA,NT -proBNP and TnI -Ultra joint detection was 95.0% (76 /80),which was significantly higher than that of the single detection (P <0.05 ).Conclusion IMA,NT -proBNP and CTnI combined detection could significantly improve the sensitivity and accuracy of the early diagnosis of ACS,which testing cycle is short and easy to operate,worthy of clinical promotion.

Objective To explore the clinical value of combined detection of D-dimer,coagulation four indices and hs-CRP in diagnosis of coronary heart disease (CHD).Methods D-Dimer,coagulation four indices and hsCPR level were detected in 67 patients with CHD[22 stable angina(SA) pectoris patients,20 unstable angina (UA) pectoris patients and 25 acute myocardial infarction (AMI) patients] and 20 healthy people(normol control group).According to the result of coronary arteriongraphy,the patients with CHD were divided into single vessel disease group (n =21),double vessel disease group (n =23) and three vessel disease group (n =23).The levels of plasma D-D,fibrinogen(FIB) and hs-CRP were detected and compared.Results Compared with UA group,SA group,control group respectively,D-D,fibrinogen and hs-CRP level of AMI group had statistical significance (P ＜ 0.01) ;Compared with SA group,control group,D-D,fibrinogen and hs-CRP level of UA group had statistical significance (P ＜ 0.05) ;Compared with control group,hs-CRP level of SA group had statistical significance (P ＜ 0.01).The comparision of PT,APTT and TT level between each two groups,there was no statistical difference (P ＞ 0.05).The levels of plasma DD and FBG in single vessel disease group,double vessel disease group and three vessel disease group were significantly higher than those in NC group(P ＜ 0.05).The levels of plasma DD and FBG in three vessel disease group were significantly higher than those in single vessel disease group and double vessel disease group(P ＜ 0.05).The levels of plasma DD and FBG in double vessel disease group were significantly higher than those in single vessel disease group (P ＜ 0.05).The comparision of PT,APTT and TT level between each two groups,there was no statistical difference (P ＞ 0.05).Conclusion The level of D-D,FIB and hs-CRP have close relationship with the severe degree of CHD and can help clinical doctor to predict the type of CHD.

Objective To study protective effect and mechanism of caffeic acid phenethyl ester ( CAPE ) in rats with doxorubicin-induced myocardial injury.Methods Sixty male SD rats were randomly divided into control group, model group and CAPE ( 12、24、48 mg/kg ) groups.The models of doxorubicin-induced myocardial injury were established by injection of 2.5 mg/kg doxorubicin every other day for 6 times.After the last injection, model group was given distilled water and CAPE ( 12、24、48 mg/kg ) groups were fed with CAPE, one time a day for 8 weeks.After consecutive 8 weeks, serum creatine kinase, lactate dehydrogenase and BNP were assessed , NO concentration, MDA,GSH,SOD,NOS,LPO and CAT contents in the heart were determined and histopathological changes were detected.Results serum creatine kinase、lactate dehydrogenase and BNP of CAPE 48 mg/kg group decreased significantly(P<0.05), while the activity of NO,NOS,GSH,CAT and SOD increased in the CAPE 48 mg/kg group significantly ( P<0.05 ) .Histopathology showed caffeic acid phenethyl ester could improve the doxorubicin-induced myocardium injury. Conclusion caffeic acid phenethylester has the protective effects in rats with doxorubicin-induced myocardial injury.Protective effect may be related to improve myocardial against oxidative stress damage.

BACKGROUND: The differentiation of neural stem cells (NSCs) is an important for NSCs to be applied in clinical treatment. And whether the neurons differentiated from NSCs can be connected with other neurons or not comes into being a critical problem. OBJECTIVE: To observe the effect of nerve growth factor (NGF) on the growth and differentiation of in vitro cultured NSCs, and on the formation and growth of axons. DESIGN, TIME AND SETTING: The cytology in vitro experiment was performed at the Equipment Center of China Medical University from June 2007 to December 2008. MATERIALS: Three 2-3 day male Sprague Dawley rats were used in this study. NGF was purchased from Peprotech. METHODS: NSCs were isolated from neonatal rats by enzyme digestion and mechanical separation. At the fourth passage, cell clone masses received nestin immunocytochemistry. Remaining cells were dispersed by mechanical separation. Monoclone NSCs were incubated by limiting dilution assay, and made into 108 L-1 monoplast suspension in complete medium. NSCs were assigned into 2 groups. NSCs in the control group were incubated in 10% fetal bovine serum (FBS). NSCs in the induction group were incubated in the 10% FBS+50 ?g/L NGF for 5-7 days. The five isolated neurons with positive expression of neuron specific enolase (NSE) were observed. The number of axons was measured through concentric circles (37.5 ?m and 75 ?m diameter) circling neurons to detect the length of long axon. MAIN OUTCOME MEASURES: Cultured cells were identified by nestin, NSE and glial fibrillary acidic protein (GFAP) immunohistochemistry to test the number of neurons, number and length of axons. RESULTS: Neurospheres were Nestin-positive and could differentiate into the NSE-positive or GFAP-positive cells. At day 6, the numbers of neurons and axons were significantly more, and the length of longest axons was significantly longer in the induction group than in the control group (t=3.301, 2.982, 4.012, P

Objective To learn the correlation between thyroid function and arteriosclerosis in elderly popu-lation,and to provide research data for early clinical intervention.Methods 7 1 elderly patients with hypothyroidism were selected as A group,76 elderly patients with subclinical hypothyroidism were selected as B group,70 healthy elderly cases were selected as C group.Triiodothyronine (FT3 ),tetraiodothyronine (FT4 ),thyrotrophin (TSH ), triglyceride (TG),total cholesterol (TC ),low density lipoprotein cholesterol (LDL -C ),high density lipoprotein cholesterol (HDL-C),C reactive protein (CRP)levels of the three groups were detected.Carotid artery intima media thickness (CIMT)was examined by color Doppler ultrasonography.Results FT4 levels of A group,B group were (5.25 ±4.17)pmol/L,(10.74 ±5.02)pmol/L respectively,which were lower than (18.53 ±6.38)pmol/L of C group.TSH levels of A group,B group were (16.45 ±6.96)mU/L,(6.25 ±3.84)mU/L respectively,which were higher than (3.37 ±1.13)mU/L of C group (t=14.650,8.232,15.522,6.037,all P<0.05).FT4 level of A group was lower than that of B group,TSH level of A group was higher than B group (t=7.185,11.097,P<0.05).TC, LDL-C levels of A group,B group were (5.96 ±1.01)mmol/L,(4.15 ±1.69)mmol/L,(5.64 ±0.94)mmol/L, (3.64 ±1.17)mmol/L respectively,which were higher than those of C group [(5.17 ±1.12)mmol/L,(3.20 ± 1.06)mmol/L](t=4.400,2.754,3.992,2.374,all P<0.05).TC,LDL-C levels of A group were higher than B group (t=1.990,2.139,all P<0.05).CIMT,CRP levels of A group,B group were (0.90 ±0.23)mm,(6.20 ± 1.31)mg/L,(0.79 ±0.17)mm,(4.55 ±1.05)mg/L respectively,which were higher than those of C group [(0.68 ±0.11)mm,(3.12 ±0.88)mg/L](t=7.229,4.599,16.364,8.878,all P<0.05).CIMT,CRP levels of A group were higher than B group (t=3.312,8.453,all P<0.05 ).CIMT and TSH,LDL -C,CRP levels were positively correlated (r=0.789,0.647,0.583,all P<0.05),CIMT and FT4 levels were negatively correlated (r=-0.636,P<0.05 ).Conclusion Hypothyroidism,subclinical hypothyroidism are associated with atherosclerosis in elderly population,and elderly patients with hypothyroidism,subclinical hypothyroidism are at high risk of atherosclerosis.

Objective Aims To investigate the dynamic changes of multi-organ functional indices in esophageal carcinoma patients during peri-operation period at flatland and moderate high altitude. Methods 44 cases of esophageal carcinoma scheduled to receive gastroesophagostomy were categorized semi-randomly into three groups: Flatland control group (FCG, n=8), moderate altitude lung protection group (MPG, n=16), moderate altitude control group (MCG, n=20). The cases in FCG and MCG underwent routine pulmonary function examination and respiratory tract preparation peri-operatively. Besides the above routine treatment, the cases in MTG received administration of Rahdiola compound capsules preoperatively, with 2 pills a day. Blood-gas and biochemical indices of multi-organs were recorded in the three groups preoperatively and at 1, 3, and 5 days postoperatively respectively. The patients' systematic reaction, the changing trend of the indices reflecting organs function and the postoperative complication were observed. Results The blood-gas parameters were different significantly both preoperatively and postoperatively between the three groups. While other indices reflecting the organs function were not different significantly between the three groups before the operation, but at 1, 3, 5 days postoperatively, the indices in MCG and MPG were significantly different with that in FCG (P

Objective To investigate the role of gastric acid in the esophageal adenocarcinogenesis induced by duodenal juice reflux in the rats. Methods Eight week old male Sprague Dawley rats, 125 in all, weighing approximately 200 g each, were used. Three types of surgical procedures were performed to produce gastroesophageal reflux (GER), duodenoesophageal reflux (DER) and duodenogastroesophageal reflux (DGER), and a group of sham operation (SO). The animals were fed with a standard diet. Esophageal mucosal pathological changes were examined 20 weeks after surgery. Results No pathological changes were found in the 15 SO rats animals. Significant esophagitis were observed in three reflux groups. In 35 DER and 32 DGER animals, the incidence of Barrett's esophagus (BE) was 91.4%, 84.4% respectively and the incidence of esophageal adenocarcinoma (EAC) was 25.7%, 53.1% respectively, significantly higher than those in the 24 GER animals ( P

Objective To investigate the outcome after ventriculoperitoneal (V-P)shunt for post-traumatic hydrocephalus (PTH). Methods A retrospective study investigated the outcome of 51 patients after head injury, who had undergone V-P shunt due to PTH.The Glasgow outcome scale (GOS),age and intracerebral pressure(ICP) were analyzed. Results Twenty-two of 33 patients with COS 3 or less than 3 scores had clear-cut benefit from V-P shunt,while only 6 of 18 patients with GOS 4 scores did.Tbe GOS before V-P shunt had correlated with the GOS 6 months after operation. The patients with GOS 3 or less than 3 scores had good outcome than patients with COS 4 scores (P<0.05). Patients' age and ICP before the V-P shunt did not influence the outcome (P>0.05 ). Conclusion V-P shunt has much benefit for the patients with PTH, GOS before operation is a best predictive parameter for outcome after V-P shunt.

Objective To know the state of endemic fluorosis,running state of water improvement project in Jiangsu Province,and to provide a scientific basis for adjusting control measures against the disease.Methods Nine key counties were selected from the endemic fluorosis areas as survey spots in Jiangsu in 2012.Three villages in each spot were selected as survey villages.To known the progress and running conditions of water facilities,water samples were collected to determine the fluorosis level.All children aged 8 to 12 were tested for dental fluorosis at the survey villages.The fluorine content in water was determined with F-selective electrode (WS/T 106-1999).Dental fluorosis was diagnosed byased on the Dean method.Results Twenty-seven villages were investigated,the number of villages that had water quality improved was 26,the rate was 96.30％ (26/27);the number of villages that did not have water quality improved was 1,the rate was 3.70％ (1/27).Among the 26 facilities,21 improved-water facilities ran normally,the rate was 80.77％ (21/26);2 facilities ran with intermittently water supply,the rate was 8.70％ (2/26);3 facilities were scraped,the rate was 11.54％ (3/26).In the villages with normal improved-water facilities and qualified water fluorosis,the total rate of dental fluorosis of children aged 8 to 12 was 22.74％ (380/1 761),the index of dental fluorosis was 0.45.In the villages with abnormal improved-water facilities and excessive water fluorosis,the total rate of dental fluorosis of children aged 8 to 12 was 66.51％ (143/215),the index of dental fluorosis was 1.45.The total rate of dental fluorosis of children aged 8 to 12 was 42.86％ (12/28) in the villages which had not changed water source,the index of dental fluorosis was 0.86.Conclusion Improvement of water decreasing fluorine project in Jiangsu Province has a certain effect on children's dental fluorosis,but some of the water fluorosis projects are scrapped,and excess fluorine water should be taken seriously.

Objective To evaluate the efficacy and safety of the bundles of treatment protocol for patients with acute brain injury (ABI) complicated by acute lung injury (ALl)/acute respiratory distress syndrome (ARDS).Methods A total of 83 patients with acute brain injury complicated by ALI/ARDS were randomly divided into experimental group (n =41) and control group (n =42).The control group was treated with the routine bundle protocol while the experimental group was treated with an intensive bundle protocolin addition to the routine bundle protocol.The data was collected,and the effectiveness and safety of the two bundles of treatment protocol were evaluated.Results The results of heart rate (HR),SpO2,and PO2/FiO2 in the two groups showed significant differences before and after treatment.The improvement of PO2/FiO2 in the experimental group occurred earlier and was more significant compared tothe control group,24 hours after treatment.The mechanical ventilation time,ICU stay time,and total hospitalization time for the experimental group were significantly different (P ＜ 0.05) from the control group.The 28-day mortality and morbidity of ventilator-associated pneumonia showed no significant difference (P ＞ 0.05) between the two groups.Conclusion The treatment of acute brain injury complicated by ALI/ARDS by the two bundles of treatment protocol is effective.Compared to the conventional treatment bundles,the intensive treatment bundles can significantly improve oxygenation,and shorten the mechanical ventilation time required,as well as ICU and total hospital stay.