Objective To investigate the effect of exogenous hydrogen sulfide (H 2 S) on H2 S concentration and cystathionine β-synthase (CBS) expression in hippocampus in a rat model of vascular dementia (VaD). Methods A rat model of VaD was induced by using the modified four -vessel occlusion. The rats were divided into sham operation, model, low -dose and high-dose NaHS groups using the random number table method. They were further redivided into one day, seven -day, and 30-day subgroups according to the time after modeling. After modeling respectively, NaHS 30 μmol/kg and 100 μmol/kg were injected intraperitoneally every day in the low -dose and high-dose NaHS groups. The normal saline was injected intraperitoneally every day in the sham operation group and the VaD model group. Morris water maze test was used to evaluate the learning and memory ability of the rats. The expression of CBS in hippocampus was detected by real-time fluorescent polymerase chain reaction. Western Blotting was used to detect expression of CBS protein in hippocampus. Results Morris water maze test showed that the escape latencies of the model group, low -dose and high-dose NaHS groups were prolonged significantly compared with the sham operation group (P <0.05); the times of crossing the platform were decreased significantly compared with the model group (P <0.05); and the escape latencies were shortened significantly in the low -dose and high-dose NaHS groups compared with the model group ( P <0.05). The H2 S content in hippocampus was decreased significantly in the model group, low -dose and high-dose NaHS groups compared with the sham operation group, but the low -dose and high-dose NaHS group was significantly higher than that in the model group (all P <0.05). The expression of CBS mRNA and protein in the model, low -dose and high-dose NaHS groups was significantly lower than that of the sham operation group (all P < 0.05), and there was no significant difference between the low -dose and high-dose NaHS groups and the model group. Conclusions Exogenous H2 S may improve the learning and memory ability of the VaD rats. It may be associated with the increased H2 S content in hippocampus. However, it has no effect on CBS expression.

Stroke is a class of complex diseases,and it is the result of the combined action of environmental and genetic factors.With the development of molecular biology techniques,a large number of candidate genes associated with stroke and susceptibility loci have been identified.This article reviews the recent progress in research on the genetics of different subtypes of ischemic stroke.

Objective To discuss the significance of the application of neutrophil to lymphocyte ratio (NLR)combined with prostate specific antigen (PSA)in early diagnosis of prostate carcinoma.Methods 120 cases with surgery treatment of prostate carcinoma were selected as study group,and 120 healthy people were selected as control groups.The NLR and PSA were tested to diagnose the prostate carcinoma.The critical value of NLR in diagnosing prostate carcinoma was evaluated by ROC curves,and the advantages of combination of NLR and PSA were judged. Results By using ROC curves to evaluate the NLR in diagnosis,the critical value was 2.75.The susceptibility, specificity,Youden index,correct index were 0.79,0.85,0.65,0.72.The susceptibility,specificity,positive predictive value,negative predictive value,correct index of NLR combined with PSA in diagnosing the prostate carcinoma were 0.85,0.83,5.00,0.18,0.68.Conclusion The application of NLR has higher susceptibility and specificity to diagnose prostate carcinoma.NLR combined with PSA can improve the susceptibility and specificity of early diagnosis of prostate carcinoma.

Objective To use a simple bedside technique to verify the pathophysiological mechanism of pulmonary hypertension (PH) in different races. Method The Valsalva maneuver (VM) was performed in patients referred to a specialty PH clinic. The blood pressure response of patients to VM was in different fashions. The blood pressure (BP) was measured by using cuff and stethoscope. When the cuff was inflated to 15 mmHg above the systolic pressure, sound could be heard by auscultation during VM and when the cuff was deflated the sound disappeared over 3 heart beats which was considered as abnormal BP response, and less than 3 heart beats defined as normal BP response. The right heart catheterization in patients with PH as a part of the standard evaluation. Results This study included 84 patients with a mean age of (63 ± 16) years. Those with abnormal BP response to VM had higher pulmonary artery wedge pressure (PAWP) [(22.5±6.6) vs. (11.9±4.3) mmHg, P ＜0.0001] and lower pulmonary vascular resistance [(5.8 ± 4.0) vs. (8.1 ± 4.6 ) WU, P = 0.01]. Blood pressure response to VM did not correlate with mean pulmonary artery (PA) pressure [(46.2 ± 9.9) vs. (43.4 ±10.4) mmHg, P =0.20] or cardiac index (both 2.4 ± 0.6 L/min/m2). The abnormal BP response to VM had high sensitivity (89.4%), specificity (86.1%) and accuracy (86.9%) for determining PAWP＞ 15 mmHg.Conclusions BP response to Valsalva maneuver provides important information about left heart filling pressures in patients with PH.

ObjectiveTo investigate the independent risk factors of 30-day mortality of nontraumatic acute chest pain in emergency department so as to get non - traumatic acute chest pain risk score,MethodsThe clinical data of 532 patients with non - traumatic acute chest pain were reviewed.The independent risk factors of 30 - day mortality were identified after analysis of medical history,symptom and sign,laboratory findings by uuivariate analysis and logistic regression.Non- traumatic acute chest pain risk score was made as per the odds ratios of these risk factors. ResultsThe average age of the patients was (55.7 + 12.7 ) years,and 45 patients ( 8.4％ ) died after 30 days.In patients with non - traumatic acute chest pain,history of hypertension (OR:4.28; 95％ CI:1.59-11.55 ),prolonged chest pain (OR:1.1; 95％ CI:1.05-1.15),dyspnea (OR:6.61; 95％CI:2.40-18.10) and tachycardia (OR:1.02; 95％CI:1.00-1.04),high leucocyte count (OR:1.18; 95％CI:1.06-1.31) and D - Dimer ( OR:1.002; 95％ CI:1.001-1.002 ) predicted 30 - day mortality independently,whereas chest pain relieved by medicine (OR:0. 15; 95％ CI:0.04-0.65),high blood oxygen saturation (SaO2) (OR:0.89; 95％CI:0.83-0.98) and normal hematocrit (OR:0.92; 95％CI:0.86-0.99) were good markers to predict optimistic prognosis.Non - traumatic acute chest pain risk score was higher in 30 - day dead group than those in survival group significantly ( P ＜ 0.01 ),and mortality was significantly different between groups with various risk stratification (P ＜ 0. 01 ).Conclusions Clinical physician can predict 30 - day mortality and evaluate prognosis in patients with acute chest pain by using non - traumatic acute chest pain risk score quickly and effectively.

Objective ToinvestigatetherelationshipbetweenmuscleRASoncogenehomolog (MRAS)genepolymorphismandyoungpatientswithischemicstroke.Methods Atotalof243young patients with ischemic stroke from Nanjing Stroke Registry Program from December 2009 to October 2012 were enrolled retrospectively. At the same time,512 age-and sex-matched healthy controls were selected. The polymorphisms of MRAS genes rs3755751 and rs9289559 loci were analyzed by the modified multiplex PCR-ligase detection reaction assay. The genotype of each locus and the allele frequencies were analyzed and compared. Results (1)The frequencies of AA,AG and GG genotypes for rs3755751 in the stroke group (n=243)were 7. 4%(n=18),37. 0%(n=90),and 55. 6%(n=135),respectively. There were no significant differences compared with those (6. 4%[n=18],36. 9%[n=189]and 56. 6%[n=190]) in the control group (n=512)(P>0. 05). The frequencies of AA,AG and GG genotypes for rs9289559 in stroke group were 7. 0 (n=17)%,42. 0%(n=102),and 51. 0%(n=124),respectively. There were no significant differences compared with 6. 1%,(n=31)37. 9%(n=194),and 56. 1%(n=287)in the control group (P>0. 05). (2)Further construction of an effect model (AA vs. AG+GG and GG vs. AG+AA),there was no significant difference between the stroke group and the control group (P >0. 05 ). Analyzing the effects of different genotypes on plasma lipid levels showed that the high-density lipoprotein cholesterol level of the GG genotype subgroup in the young ischemic stroke group was significantly higher than that rs3755751 of the AG +AA genotype subgroup (OR,6. 80,95%CI 2.18-21.27, P=0. 001 ). Conclusions MRAS gene polymorphism may have no significant correlation with the genetic susceptibility in young patients with ischemic stroke. Polymorphism of rs3755751 may be correlated with the level of serum high-density lipoprotein cholesterol.

Objective To explore the therapeutic effect of erythropoietin (EPO)combined oral iron in patients with chronic congestive heart failure( CHF)accompanied by anemia. MethodsNinety six patients with CHF accompanied by anemia, whom were consecutively hospitalized from January 2007 to December 2009, were enrolled into this study. They were randomly divided into treatment group accepted routine anti-heart failure therapy combined EPO and oral iron, and control group solely accepted routine anti-heart failure therapy. After 6 months follow up, the changes of hemoglobin ( Hb ), cardiac function classification, left ventricular ejection fraction(LVEF) ,6-minute walking distance,readmission rate of CHF and cardiac death were compared between two groups. ResultsCompared with those before therapy, we found significant improvements of hemoglobin level ( [ 120. 12 ± 10. 42 ] g/L vs [ 86.40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2. 65 ± 0. 67 vs 3. 13 ±0. 61, P ＜ 0. 01 ), LVEF ( [ 37.21 ± 4. 96 ]％ vs [ 33. 92 ± 7. 28 ]％, P ＜ 0. 01 ), 6-minute walking distance ( [ 443.52 ± 97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in treatment group after EPO combined oral iron administration. After 6 months follow up, we also found significant improvements of Hb level ( [ 120. 12 ±10. 42 ] g/L vs [ 86. 40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2.65 ± 0. 67 vs 2. 98 ± 0. 81,P＜0.01),LVEF([37.21 ± 4.96]％ vs [34.67 ±4.10]％,P ＜ 0. 01),6-minute walking distance ( [443.52 ±97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in the comparison between treatment and control group. The readmission rate of CHF fell significantly in treatment group compared to control (20. 83％ vs 39. 58％ ,P ＜ 0. 05 ). However, we found no significant difference in cardiac death rate ( 0％ vs 4. 17％, P ＞0. 05). ConclusionTreatment of EPO combined oral iron could significantly improve the cardiac function,increase exercise tolerance,lower the readmission rate of CHF in patients with chronic congestive heart failure (CHF)accompanied by anemia.

Objective To investigate the aging features of pure leukoaraiosis (LA) in nondemented outpatients. Methods The outpatients with age older than 40 years, without taking cholesterol lowering and B vitamin medications and with mini-mental state examination more than 24 scores were selected from July 2008 to December. 2009 in Beijing Tiantan Hospital. LA was defined with MRI. Patients were classified into two groups i. e. LA group consisting of 138 patients with leukoaraiosis but without lacunar lesions and cortical infarcts and a control group consisting of 124 patients without any lesion in brain. Age and other vascular risk factors were also investigated. Results Age of the patients in the LA group was significantly higher than that in the control group (P< 0.001). Multivariable logistic regression analysis showed that age was independently associated with pure LA ( OR 1.080, 95% CI 1.042-1.120), after adjusting sex, vascular risk factors and presence of atherosclerosis in cervical arteries. If age-stratification was further considered, logistic regression analysis showed that OR (95% CI) for LA was 2.693 (95% CI 1.103-6.575) in a 60-69 year group and 13. 527(95%CI 3.319-55.131) in a≥70 year group as compared with a 40-49 year group. Conclusion Age is a determining risk factor for pure LA and patients with age older than 60 years are at high risk of LA.

Objective To investigate the clinical applicated value of simple transumbilical single-tunnel laparoscopic renal cyst decortication.Methods 7 patients with renal cysts were treated with simple single-tunnel laparoscopic renal cyst decortication.Results The operations of 7 patients were succeed.The mean operative time was 37 (28 ～ 90) min,and the mean time of pulling the drain tube out was 2 (1 ～ 4) d,and the mean int aoperative blood loss was 30 (25 ～ 80) ml,and the mean bed stay was 1.5 (1 ～ 3) d,and the mean hospital stay was 4 (3 ～ 8) d.In 7 patients,no recurrence of the cyst occurred during a follow-up of 1 ～ 6 months by color-ultrasonography,CT after operation.Conclusion The simple transumbilical single-tunnel laparoscopic renal cyst decortication has advantages of economic,minimal trauma,hairdressing,rapid recovery and better effect,therefore it maybe an ideal treatment choice for renal cysts.

Objective To investigate the relationship between fragmented QRS (fQRS) complexes and the severity of coronary artery lesions in elder patients with complex coronary artery lesions.Methods Two-hundred and one elder patients with complex coronary lesions undergone coronary angiography in Beijing Anzhen Hospital from January 2013 to July 2016 were enrolled.Based on the coronary lesions,patients were divided into the complex coronary lesions group and the simple coronary lesions group.The clinical features and coronary scores were compared between groups.Logistic regression analysis was used to evaluate the risk factors of complex coronary lesions.Results Compared with simple coronary lesions group,the complex coronary lesions group was associated with higher rate of fQRS (31.3％ vs.17.2％,x2 =9.68,P＜0.01),more number of fQRS leads [(1.0±1.5) vs.(0.5±0.8),t=-4.04,P＜0.01],longer duration of QRS [(87.2±10.7) ms vs.(84.1±8.9) ms,t=-3.09,P＜0.01].Moreover,patients with fQRS had a lower level of high density lipoprotein cholesterol (HDL-C) [M(Q25,Q75),0.9 (0.8,1.1) mmol/L vs.1.0 (0.9,1.2) mmol/L,t=-2.84,P＜0.01] and a higher Gensini score [40 (8-76) vs.22 (16-2),t=8.63,P＜0.01] compared with those without fQRS.Furthermore,Logistic regression analysis showed that HDL C (OR=0.346,95％CI:0.163 0.674,P＜0.05),fQRS (OR=2.215,95％ CI:1.381-3.725,P＜0.05) and the number of fQRS leads (OR=4.613,95％ CI:2.412-9.578,P＜0.05) were independent risk factors for patients with high Gensini score,and there was a positive correlation between fQRS and Gensini scores (=0.624,P＜0.01).Conclusions fQRS might be a noninvasive indicator of severity of coronary artery lesions for elder patients with complex coronary lesions.