Objective To study the changes of cytokine activation in patients with chronic congestive haert failure(CHF) as indicated by plasma levels of C-reactive protein(CRP)and its relation to adrenomedullin(ADM) and endthelin-1(ET-1).Methods The plasma levels of CRP,ADM and ET-1 of 60 decompensated haert failure(DHF) patients group and 30 essential hypertension patients with compensated cardiac function(CCF) group were tested. CRP was determined by immunoturbidometry,ET-1 and ADM were determined by radioimmunoassay.Results The plasma levels of ET-1 ,ADM and CRP of decompensated heart failure group were significantly higher than the compensated cardiac function group;In the decompensated heart failure group,the plasma levels of CRP and ADM were elevated according to worsening of heart failure(NYHA classification) ;In the decompensated heart failure group,the plasma levels of CRP were positively correlated with ADM(r=0.57).Conclusion There is extensive activation of cytokines,ADM and ET-1 in patients with chronic congestive heart failure.Cytokine activation might play a role in the synthesis of ADM,thus contribute to the hum oral regulation of heart failure,but may not be re- sponsible for the activation of ET-1.

AIM: To explore the mechanism underlying the therapeutic effects of hypoxia inhalation on asthma. METHODS: Guinea pigs were randomized into the normal group(NG), asthmatic group(AG) and the hypoxia inhalation-treated group(HITG). The model of asthma was established in the latter two groups through sensitization and induction with 10% ovalbumin(OA) and 1% OA, respectively. The animals in HITG were treated with hypoxia inhalation (13.0%?0.5% O 2/N 2 mixed gas). The content of serum cortisol, the number of eosinophils(EOS) and percentage of hypodense eosinophils(HEOS) in bronchoalveolar lavage fluid(BALF),the number of CD 4 +T-lymphocyte in peripheral blood(PB) and the tension of airway muscle were determined. RESULTS: (1)The content of serum cortisol was significantly higher in NG and HITG than in AG( P

Objective The effect of electronic cigarettes (e-cigarettes) on smoking reduction,cessation and human health remains controversial,meanwhile,studies tocused on e-cigarettes are limited.We conducted this meta-analysis in purpose of helping figuring out the controversy.Methods PubMed, Medline,Embase,Cochrane library,CNKl and Wanfang Databases were searched for articles published up to May 2014.All studies discussing the relationship between e-cigarettes and smoking reduction,smoking cessation or human health were included.The fixed or random-eftect model was used to pool the relative risk(RR).Outcome 4 articles were included based on the inclusion and exclusion criteria,there were totally 7 002 subjects.Meta-analysis indicated that there was significant difference in e-cigarettes and smoking reduction,RR=1.88,95％ CI:1.07-3.32,P=0.09.The Meta-analysis showed that e-cigarettes were available in smoking cessation.RR=1.55,95％ CI:1.24-1.95,P=0.001.Conclusion Tiffs meta-analysis indicated that e-cigarettes were helpful in smoking cessation.Nonetheless,the articles included were too few to credibly support the outcome.Hence,more high-quality,randomized blind and large sample experiments are needed to verify the results.

In order to overcome the adaptability of electrical stimulation produced by the traditional electro acu-puncture and improve the effects of electro acupuncture, a new type of music electro acupuncture instrument has been designed based on ARM. This article put forward to choose the music as prescription whose spectral density met the 1/f fluctuation law in order to make the patients more comfortable accepting electrical stimulation. What’s more, the music prescription for insomnia had been designed. At last, a total of 23 insomniacs were randomly divid-ed into three groups to verify the therapeutic effects. Clinical tests showed that the scheme in this paper was feasible and the treatment effect was significant.

[ Objective ] To investigate the therapeutic effect of Chinese herbal medicines, which have the actions of dispersing stagnated liver-Qi and promoting bile secretion, clearing heat and removing damp, activating blood and removing blood-stasis, in the treatment of the third-level or above intrahepatic biliary duct stone. [Methods] After the routine surgical treatment including cholecystectomy, choledochotomy with T-tube drainage and choledochoscope lithotomy, 42 cases of third-level or above intrahepatic biliary duct stone received Dandao Paishi Mixture (DPM, mainly composed of Herba Lysimachiae, Radix Clematidis, Herba Artemisiae Scopariae, Radix Aucklandiae, Rhizoma Curcumae Longae, Radix Curcumae, etc.) for oral use. The effects of DPM on the intrahepatic biliary duct stone were evaluated after treatment. [Results] Before the treatment of DPM, the stones in third-level or above intrahepatic biliary ducts cannot be taken out; after the treatment of DPM, T-tube reverse biliary contrast examination showed that stones were removed in 39 (92.9%) cases, stones still existed in the common bile duct in 3 cases and then were removed by lithotomy through T-tube sinus of the common bile duct with Olympus fiber choledochoscope 8 weeks later. [Conclusion] DPM has good lytholytic and lithagogue effects for the treatment of third-level or above intrahepatic biliary duct stone and for intrahepatic biliary duct incarcerated stone. It can also reduce the postoperative residue of stone and recurrence rate.

Objective To evaluate the relationship between carotid plaque instability and coronary heart disease by contrast-enhanced ultrasound. Methods Thirty-five patients with acute coronary syndrome (ACS) and 32 patients with stable coronary artery disease(sCAD) were included. Inclusion criteria were at least 1 carotid atherosclerotic plaque with thickness larger than 2.0 mm. Contrast-agent enhancement in the plaque was evaluated by visual interpretation and quantitative analysis. Results The percentage of soft plaque in ACS group was significantly higher than that in sCAD group ( P ＜0.001 ). The proportion of contrast-agent enhancement in patients with ACS was significantly than that in patients with sCAD( P =0. 037). The enhanced intensity in the plaque and the ratio of enhanced intensity in the plaque to that in the carotid artery lumen in patients with ACS were significantly larger than those in patients with sCAD ( P ＜0.001, P = 0.026, respectively). Sensitivity and specificity of prediction ACS were 74% and 60%,respectively,for enhanced intensity in the plaque and 86% and 67%, respectively, for ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery. Conclusions The subjects with ACS had more intense contrast-agent enhancement than the subjects with sCAD. Contrast-enhanced ultrasound can be used to evaluate the relationship between carotid plaque instability and coronary heart disease.

Objective To observe the clinical effects of tibial locking multidirectional interlocking intramedullary nail (TLMIIN) for tibial plateau fractures. Methods 38 cases with closed tibial plateau fractures treated by TLMIIN from October 2008 to May 2012 were retrospectively analyzed. There were 22 males and 16 females, with an average age of 48.7 years (range, 28-67 years). There were 24 fractures on the left side while the other 14 factures were on the right side, which were all fresh frac?tures. According to AO/OTA classification of tibial plateau fractures, there were 4 cases of B1, 1 case of B2, 14 cases of B3, 8 cas?es of C1, 5 cases of C2 and 6 cases of C3. Close reduction were performed on 4 cases (10.5%of all cases). Open reduction were performed on the other 34 cases. The limited incision was decided by the distribution of the fragments and fracture line. Hohl?Luck evaluation system was applied for the follow?up. Results The mean follow?up period was 18.1 months (range, 11-23 months). All fractures were healed at an average period of 87.4 days (range, 48-131 days). The average time from operation to full weight?bearing was 108.9 days (range, 80-128 days). Hohl?Luck evaluation system was used in the final follow?up. The excellent and good rate of functional score was 94.7%(36/38), including 28 cases excellent, 8 cases good and 2 cases fair from functional as?pect. The excellent and good rate of radiological score was 84.2%(32/38), including 23 cases excellent, 9 cases good and 6 cases fair from radiological aspect. No complications such as infection, breakage and loosening of the screw, malunion, nonunion oc?curred at the time of the latest follow?up. 6 cases with serious swelling of the knee joint and the soft tissue of crus were cured by an?ticoagulation, dehydration and physiotherapy treatments after operation. The 2 cases with a little exudates and incrustation was bacterial cultured negative and healed after 16 days and 18 days on the incision. 1 case had lost of reduction due to weight?bearing 1 week after operation, who had 25 degree of varus deformity, which was left dispose, and the bone healing and joint function were unaffected. Conclusion The intramedullary support, restrictive and non?restrictive multidirectional tridimensional fixation of TLMIIN technology had satisfactory effects in treating plateau fractures. It can supply a new therapeutic method, with little dam?age of soft tissues when taking out the internal fixation and reduce some postoperative complications.

In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography (RT-MCE), intravenous RT-MCE was performed on 20 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification=1; partial or reduced opaciflcation or subendocardial contrast defect=2; constrast defect=3. Myocardial perfusion score index (MPSI) was calculated by dividing the total sum of contrast score by the total number of segments with abnormal wall motion. Twenty patients were classified into 2 groups according to the MPSI: MPSI1.5 as poor myocardial perfusion. To assess the left ventricular remodeling, the following comparisons were carried out: (1) Comparisons of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) before and 3 months after revascularization in two groups; (2) Comparisons of LVEF, LVESV and LVEDV pre-revascularization between two groups and comparisons of these 3 months post-revascularization between two groups; (3) Comparisons of the differences in LVEF, LVESV and LVEDV between 3 months post-and pre-revascularization (DeltaLVEF, DeltaLVESV and DeltaLVEDV) between two groups; (4) The linear regression analysis between DeltaLVEF, DeltaLVESV, DeltaLVEDV and MPSI. The results showed that the LVEF obtained 3 months after revascularization in patients with MPSI>1.5 was obviously lower than that in those with MPSI1.5 was obviously larger than that in those with MPSI1.5 and those with MPSI Echocardiography/*methods ; Infusions, Intravenous ; Myocardial Infarction/*diagnosis ; Myocardial Infarction/pathology ; Myocardial Infarction/*ultrasonography ; Myocardial Reperfusion ; Myocardium/*pathology ; Perfusion ; Regression Analysis ; Time Factors ; Ventricular Remodeling

The clinically applied value of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery using real-time myocardial contrast echocardiography (RT-MCE) combined with two-dimensional strain echocardiography was assessed. Twenty patients underwent intravenous RT-MCE by intravenous injections of SonoVue before and after coronary artery bypass surgery. Two-dimensional images were recorded from the left ventricular four-chamber view, two-chamber view and the apical view before, and two weeks and three months after coronary artery bypass surgery, and the peak systolic longitudinal strain was measured. The results showed that myocardial perfusion was significantly increased after coronary artery bypass surgery in about 71.6% segments. In the group that myocardial perfusion was improved, the peak systolic longitudinal strain three months after bypass surgery was significantly higher than that before operation [(-15.78+/-5.91)% vs (-10.45+/-8.31)%, P<0.05]. However, the parameters did not change in the group without myocardial perfusion improvement [(-10.33+/-6.53)% vs (-9.41+/-6.09)%, P>0.05]. It was concluded that whether or not the improvement of myocardial perfusion can mirror the recovery trend of regional systolic function, two-dimensional strain echocardiography can observe dynamic change of regional systolic function. The combination of myocardial perfusion with two-dimensional strain echocardiography can more accurately assess the curative effectiveness of coronary artery bypass surgery.

This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography. Fifty patients with carotid atherosclerotic plaques were enrolled and examined with contrast-enhanced ultrasonography. The correlation of contrast agent enhancement of the carotid atherosclerotic plaques and the clinical symptoms was analyzed. The results showed that among the 50 patients, plaques were enhanced in the 23 patients with obvious clinical symptoms. In 27 patients without apparent clinical symptoms, plaques were enhanced sparsely in 15 patients and not enhanced in 12 patients. It was suggested that contrast-enhanced ultrasonography could be used for the examination of the microcirculation in carotid atherosclerotic plaques on real-time basis and serve as a new noninvasive approach for the assessment of stability of carotid atherosclerotic plaques.
Carotid Artery Diseases/*ultrasonography ; Contrast Media ; Image Enhancement/*methods ; Phospholipids/*diagnostic use ; Sensitivity and Specificity ; Sulfur Hexafluoride/*diagnostic use