Objective: To explore the relationship between serum levels of carbohydrate antigen 125 (CA125) and hemodynamic changes in patients with chronic heart failure (CHF).
Methods: A total of 110 CHF patients with clear diagnosis, admitted in our hospital from 2013-01 to 2014-06 were studied. According to NYHA classiifcation, the CHF patients were divided into 3 groups: NYHA I-II group,n=40, NYHA III group,n=38 and NYHA IV group,n=32. There was a Control group including 40 subjects from healthy physical examination. The levels of CA125, B-type natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) were recorded at admission, discharge and 3 months follow-up period; the relationship between CA125, BNP and LEVF were studied in CHF patients.
Results:①In CHF patients, the levels of CA125 and BNP increased with NYHA classification by NYHA I-II group > NYHA III > group > NYHA IV group accordingly,P<0.05; while LVEF decreased with the elevated NYHA classiifcation, allP<0.05.②Correlation study indicated that CA125 positively related to BNP (r=0.64,P<0.001), LAD (r=0.28,P<0.01), LVEDD (r=0.35,P<0.001), and negatively related to LEVF (r=-0.63,P<0.001).③After treatment, the serum levels of CA125 in NYHA III group and NYHA IV group were obviously decreased,P<0.05.④There were 27 patients died at in-hospital and follow-up period, their levels of CA125 were (110.3 ± 40.2) before treatment and (67.1 ± 20.2) after treatment; for 83 survivors, their levels of CA125 were (66.7 ± 30.6) before treatment and (50.3 ± 24.5) after treatment, allP<0.05.
Conclusion: Serum level of CA125 is positively related to the severity of CHF, it might be used as a serum predictor for prognosis in CHF patients.

Objective To explore the effects of parents'participatory functional training on the prognosis of newborn babies with hypoglycemic brain injury.Methods Functional training was given to 32 parents of newborn babies with hypoglycemic brain injury and then carried out on their babies for three months.The clinical symptoms and clinical efficacy of the babies and parents'satisfaction with nursing care were then observed.Results The clinical symptoms of the babies were improved significantly after training, and the parents had significantly higher satisfaction with nursing care as compared to pretraining (p<0.01).After training, 22 babies showed significant clinical efficacy (68.75%) , 8 babies had the targeted effect (25.00%);and the total effect rate was 93.75%.Conclusion Parents'participatory functional training helps to improve the prognosis of newborn babies with hypoglycemic brain injury and reduce the incidence of neurological sequelae.

Objective: To explore early diagnostic value of combined detection of ischemia-modified albumin and other biochemical markers for acute coronary syndrome (ACS). Methods: A total of 156 patients, who received treatment within 4h because of chest pain onset, were divided into ACS group (n=112) and non-ischemic chest pain group (NICP group, n=44) according to coronary angiography (CAG). Blood sample was taken within 4h and during 4~8h after chest pain to measure cardiac biochemical markers, including ischemia-modified albumin (IMA), LDH, CK, CK-MB and cardiac troponin I (cTnI), comprehensive analysis was performed by detected results of above biochemical markers and CAG. Results: For diagnosis of ACS, within 4h after onset IMA possessed highest sensitivity (87.50%) and highest accuracy (80.77%), cTnI possessed highest specificity (95.45%); In 4～8h IMA still possessed highest sensitivity (91.07%), cTnI still possessed highest specificity（97.73%）, CK（85.90%），and IMA（85.25%）possessed highest accuracy （both CK and IMA had no significant difference）; According to comprehensive analysis, regardless of within 4h or during 4~8h after chest pain, IMA possessed highest sensitivity and highest accuracy, cTnI possessed highest specificity. Within 4h after chest pain, detection of IMA combined above-mentioned other four indexes increased sensitivity (89.28%), specificity （95.45%） and accuracy （91.02%）to highest level. Conclusion: For diagnosis of ACS, IMA possesses highest sensitivity and highest accuracy, cTnI possesses highest specificity; IMA combined above-mentioned other four indexes may increase sensitivity, specificity and accuracy to highest level.

Objective To explore the correlation of mycoplasma pneumoniae infection with frequent relapses of steroid-sensitive nephrotic syndrome (SSNS) in children.Methods 35 patients with relapse of SSNS and acute respiratory tract infection were divided into a observation group (mycoplasma pneumoniae infection) and a control group.The clinical and laboratory data including 24 h urine protein (24 h-Upro),urea nitrogen (Bun),serum creatinine (Scr),albumin (Alb) and cholesterol (Chol) were analyzed before and after treatment.Results The clinical and laboratory indexes were obviously improved after treatment,the difference was statistically significant (P ≤ 0.01).24 h-Upro decreased more significantly in the observation group than in the control group after treatment.In the observation group,15 of 18 children achieved the efficacy,9 of whom had complete response and 6 had partial response.In the control group,14 patients achieved the efficacy,6 of whom had complete response and 8 had partial response.Conclusions After treatment,most of the children with frequent relapses of steroid-sensitive nephrotic syndrome induced by cute respiratory infection are relieved.Proteinuria,hypoproteinemia,hyperlipidemia,and renal function were improved in those patients.Therapies with azithromycin achieves a more marked efficacy.

The present article aimed at importance of self-efficacy assessment in behavioral change ,self-management capaci-ty ,empowerment capacity and active response in patients with diabetes mellitus (DM) ,introduced research progress of dia-betes self-efficacy assessment scale in China and overseas ,and influencing factors affecting self-efficacy of DM patients , such as baseline data ,well-awareness of blood glucose control ,method and content of health education and social support etc .,in order to promote research and development of Chinese self-efficacy assessment tool .

ObjectiveTo evaluate the efficacy of fiberoptic bronchoscope( FOB )-guided tracheal intubation with laryngeal mask airway (LMA) in patients undergoing anterior cervical spine surgery.MethodsForty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-55 yr,weighing 50-75 kg,mallampatis Ⅰ or Ⅱ,scheduled for anterior cervical spine surgery under general anesthesia,were randomly divided into 2 groups( n =20 each): FOBguide tracheal intubation (group FOB) and FOB-guided tracheal intubation with LMA group (group LMA).Anesthesia was induced with mindazolam 0.04 mg/kg,fentany 3-4 μg/kg,cis-atracuriun 0.2 mg/kg and propofol 2 mg/kg.Tracheal intubation was performed at 3 min after cis-artracurium iv.Auditory evoked potential index was maintained at 10-20.The intubation time,the number of successful intubation,hypertension,tachycardia and hypoxemia were recorded.The number of successful LMA placement,LMA placement time and LMA shift after extubation were recorded.Blood stain at LMA removal and complications were also recorded.ResultsThe rate of successful LMA placement at first attempt was 90％ and placement time was ( 13 ± 3) s.The rate of successful intubation in the both groups was 100％.The intubation time was significantly shorter and the rate of successful intubation at first attempt was higher in group LMA than in group FOB ( P ＜ 0.05).Hypertension,tachycardia and hypoxemia were not found in the two groups.The number of LMA shift was 8 (40％).The number of blood stain and slight sore throat was 1 respectively in group LMA.There was no other complications in the both groups.Conclusion FOB-guided tracheal intubation with LMA can provide effective ventilation during operation,improve the success rate at first attempt and shorten the intubation time in patients undergoing cervical spine surgery.

Objective To investigate the influence of m4-1BBL on the anti-tumor effects induced by truncated human prostate specific membrane antigen (tPSMA) gene in mice. Methods A eukaryotic expression plasmid encoding tPSMA and m4-1BBL (pDC316-tPSMA-IRES-m4-1BBL), pDC316-tPSMA and pDC316 were constructed. C57BL/6 mice were vaccinated in the quadriceps femoris, respectively. The CTL activity of spleen cells from the immunized mice against prostate cancer RM-1-tPSMA was detected by CCK-8 kit in vitro. The tumor growth was then observed. Results The target cell specific cytotoxicity rate induced by pDC316-tPSMA-IRES-m4-1BBL was 42.6%, compared to 24.8% in the pDC316-tPSMA group and 10.8% in the pDC316 group. The difference was significant (P<0.05). The volume of tumor in the pDC316 group was 2657.4mm3 7 d after vaccination, compared to 1334.5 mm3 in the pDC316-tPSMA group, 9 d after vaccination. In the pDC316-tPSMA-IRES-m4-1BBL group, the tumor volume was 445.8 mm3, 12d after vaccination. The difference was significant (P<0.05). Conclusion Gene vaccines co-expressing tPSMA gene and m4-1BBL gene could significantly enhance anti-prostate cancer effects in mice.

Objective To evaluate the efficacy of fiberoptic bronchoscope(FOB)-guided orotracheal intubation with Glidescope videolaryngoscopy in elderly patients.Methods Forty ASA Ⅰ or Ⅱ patients,agaed 65-77yr,weighing 43-82 kg,scheduled for abdominal surgery under general anesthesia with trcheal intubation,were randomly divided into 2 groups ( n =20 each):group FOB and FOB-guided tracheal intubation with Glidescope videolaryngoscopy(group Glidescope).Anesthesia was induced with mideazolam 0.04 mg/kg,cis-atracutium 0.2 mg/kg,fentany 2-3 μg/kg and propofol 1.5 mg/kg,orotracheal intubation was performed 3 min after intravenous cis-artracurium.The intubation time,success rate of orotracheal intubation and hypoxemia were recorded.The number of glottic exposure,epiglottic exposure with Glidescope videolargngoscopy were recorded in group Glidescope.Results The intubation time was shorter and success rate of orotracheal intubation at first attempt was higher in group Glidescope than in group FOB ( P ＜ 0.05).The number of glottic exposure with Glideseope videolaryngoscopy was 15 patients(75％ ) and epiglottic exposure was 5 patients(25％ ) in group Glidescope.Hypoxemia was not found in the two groups.Conclusion FOB-guided orotracheal intubation with Glidescope videolaryngoscopy shorten the intubation time and higher success rate,and can be used effectively in the elderly patients.

Objective To evaluate the efficacy of dexmedetomidine and dezocine used to supplement awake tracheal intubation assisted by fiberoptic bronchoscope (FOB) in elderly patients.Methods Sixty elderly patients aged 65-77 yr,of ASA physical status Ⅱ or Ⅲ (Mallampati grade Ⅰ or Ⅱ),scheduled for elective surgery under general anesthesia,were randomly divided into 3 groups (n =20 each) using a random number table:dezocine group (group DEZ),dexmedetomidine group (group DEX) and dezocine combined with dexmedetomidine group (group DEZ+DEX).Dezocine 0.1 mg/kg was injected intravenously in group DEZ.Dexmedetomidine 0.4 μg/kg was infused intravenously over 10-15 min in group DEX.In group DEZ+DEX,dexmedetomidine 0.4 μg/kg was infused intravenously over 10-15 min,and dezocine 0.1 mg/kg was injected simultaneously.Laryngeal mucous membrane was sprayed with 2％ lidocaine for topical anesthesia during infusion in all the three groups.In addition,1％ tetracaine 3 ml was injected into trachea through cricothyroid membrane.Awake tracheal intubation was performed and assisted by FOB after the end of administration in all the three groups.Cardiovascular response (MAP or HR＞30％ of baseline values) and respiratory depression (SpO2＜90％ and RR＜8 bpm) were recorded during the period between induction of anesthesia and 3 min after intubation was completed.The intubation time was recorded.The tolerance of tracheal tube was assessed in the patients.At the time of topical anesthesia,when epiglottis came into view,immediately after tracheal tube was successfully inserted into trachea,and at 3 min after successful intubation,perfusion index and Ramsay sedation score,and patients' satisfaction with the sedation (Ramsay sedation score 2-4) were recorded.Results Compared with group DEZ or DEX,the tolerance of tracheal tube was significantly enhanced,intubation time was shortened,the rate of satisfactory sedation was increased,perfusion index and the incidence of cardiovascular response were decreased in DEZ+DEX group.There was no significant difference in respiratory depression among the three groups.Conclusion Dexmedetomidine and dezocine can provide better condition for awake tracheal intubation assisted by FOB than dexmedetomidine or dezocine alone in elderly patients.

Objective: To quantitatively evaluate the abnormal tense of parasympathetic nerve via measuring the heart rate deceleration capacity (DC) and heart rate variability (HRV) in patients with vasovagal syncope (VVS).
Methods: Our research included 2 groups: VVS group,n=28 patients with positive head-up tilt test treated in our hospital from 2013-06 to 2014-08 and Control group,n=30 patients without cardiovascular disorders. The DC and HRV were examined and compared between 2 groups.
Results:① The overall deceleration capacity (ODC) (9.4 ± 2.9) ms and daytime deceleration capacity (DDC) (8.9 ± 2.9) ms in VVS group were higher than those in Control group (7.5 ± 2.5) ms and (7.5 ± 2.5) ms respectively,P<0.05.② More patients in VVS group presented daytime-to-nighttime deceleration capacity ratio (DNratio) >1 than those in Control group (9/28, 32.1% vs 2/30, 6.7%),P=0.019.③ The SDNN (139.8 ± 34.0) ms, SDSD (29.9 ± 15.7) ms and rMSSD (40.9 ± 18.8) ms in VVS group were higher than those in Control group, (115.5 ± 29.4) ms, (21.8 ± 6.6) ms and (28.9 ± 8.4) ms respectively,P<0.05.④ Multivariate Logistic regression analysis indicated that ODC was positively related to vasovagal syncope occurrence (OR=2.045, 95% CI: 1.100-3.801,P=0.024).
Conclusion: VVS patients have abnormally increased indexes of DC and HRV, HDC is the predictor for vasovagal syncope occurrence.