Objective To explore the clinical efficacy of tirofiban in treatment of patients with high-risk non-ST-segment elevation of acute coronary syndrome (NSTE ACS),in order to improve the level of treatment effect. Methods 90 cases with high-risk NSTE ACS from January 2011 to April 2013 were randomly divided into control group and observation group. The control group were received treatments of conventional aspirin,clopidogrel, anticoagulation,coronary angiography (CAG)and percutaneous coronary intervention (PCI),while the observation group were added tirofiban therapy an the basis of control group. After the treatment,the differences of cardiovascular adverse events,thrombolysis in myocardial infarction (TIMI)flow grade and complications in both two group were observed and compared. Results There were significant differences in major adverse cardiovascular events in the distal vascular blockage,surgery without reflux,recurrent angina and myocardial infarction and post-PCI TIMI flow grade 2 and 3 (P<0.05),but not in bleeding complications,TIMI flow grade 0 and 1 before and after PCI treatment. Conclusion Tirofiban is safe and effective in treatment of high-risk NSTE ACS in interventional procedures. It can improve TIMI flow, increase tissue perfusion and reduce postoperative complications.

Objective To evaluate the role of myosin light chain kinase(MLCK)in the increase in the permeability of human pulmonary microvascular endothelial cells(HPMVECs)induced by mechanical stretch.Methods HPMVECs were cultured in vitro and then randomly divided into 3 groups(n = 4 each): mechanical stretch group(group S),ML9 treatment group(group M)and control group(group C).In group S,the monolayer cells and magnetic beads coated with an RGD peptide were incubated in serum-free MCDB131 medium for 2 h,the unbound beads were washed out,and then the cells were exposed to magnetic twisting stimulation(MTS)for 2 h(frequency 3 Hz,intensity 4.2 mT).In group M,the monolayer cells and magnetic beads coated with an RGD peptide were incubated for 2 h in serum-free MCDB131 medium in which MLCK inhibitor ML9(50μmol/L)was added,and the other procedures were the same as in group S.In group C,the cells after washing as in group S were incubated for 2 h without exposing to MTS.Monolayer permeability was detected with FITC-dextran flux in transwell model.The distribution of integrin αVβ3 and actin was detected using the immunofluorescence assay.Results Compared with group C,the permeability of HPMVECs was significantly increased in group S,while no significant change was found in group M.Compared with group S,the permeability of HPMVECs was significantly decreased in group M.In addition,actin polymerized to form stress fiber,and integrin αVβ3 clustered at the end of stress fiber in group S,while actin mainly distributed in the surrounding area of the cell membrane and integrin αVβ3 evenly distributed on the cell surface in group C and M.Conclusion The mechanism by which mechanical stretch induces the increase in the permeability of HPMVECs is related to MLCK activation-mediated stress fiber formation and integrin αVβ3 clustering.

Objective To investigate the clinical value of combined detection of anti-cyclic citrullinated peptide antibody(anti-CCP antibody),rheumatoid factor(RF),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in the diagnosis of rheu-matoid arthritis(RA).Methods The detection results of the four serum indicators of 290 cases of patients with RA(RA group), 286 cases of patients with non-RA autoimmune diseases(non-RA group)and 1 50 cases of healthy individuals(control group),from March 2013 to August 2014 in this hospital,were retrospectively analysed.Results The serum levels of the four indicators have significant differences among the three groups,between the RA group and non-RA group,and between the RA group and control group(P =0.000).Between non-RA group and control group,there was significant difference of serum levels of anti-CCP antibodies (P =0.013),while the other three serum indicators had no significant differences (P >0.05).The sensitivity of combined detection of anti-CCP antibody and RF,combined detection of anti-CCP antibody,RF and CRP,combined detection of anti-CCP antibody,RF and ESR,and combined detection of anti-CCP antibody,RF,CRP and ESR for RA diagnosis have statistically significant differences (P <0.05),while there was no statistically significant differences of specificity (P > 0.05 ).The area under a receiver operating characteristic (ROC) curve of anti-CCP antibody,RF,CRP and ESR were 0.873,0.893,0.678 and 0.747,respectively. Conclusion Combined detection of anti-CCP antibody and RF has good specificity and sensitivity,which could improve the clinical diagnosis of RA.Combined detection of CRP and ESR could improve the detection rate of RA.

Rhei Radix et Rhizoma, as a commonly used traditional Chinese medicine, has been widely applied in clinic. Its major purgative constituent is anthraquinones, which are believed to be a toxic ingredient. Glycyrrhizae Radix et Rhizoma has been reputed as the best alexipharmic to moderate medicine natures. In this paper, the effect of Glycyrrhizae Radix et Rhizoma in relieving purgative activity of Rhei Radix et Rhizoma was studied in two aspects--the boiling process and intestinal metabolism; Studies on combined administration of Glycyrrhizae Radix et Rhizoma and Rhei Radix et Rhizoma in recent years were summarized according to chemical constituent, intestinal flora, I/II phase metabolism and drug transport. However, the material basis and mechanism for their compatibility remain unclear, further studies will be made in the future.
Animals ; Cathartics ; adverse effects ; analysis ; pharmacology ; Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; adverse effects ; analysis ; pharmacology ; Glycyrrhiza ; chemistry ; Humans ; Rheum ; adverse effects ; chemistry ; Rhizome ; chemistry

With the development of management in NICU,nosocomial infection increases gradually.Nosocomial infection monitoring is very important for improving the survival rate of the newborn and crutial for updating the management of NICU.This article discussed the risk factors and prevention strategies of nosocomial infection in NICU.

AIM:Todetecttheeffectofspironolactoneonhyperthyroxine-inducedatrialremodeling.METH-ODS:New Zealand rabbits were divided into control group ( C ) , hyperthyroxine group ( H ) and spironolactone group ( S) .Thyroxin was given to the rabbits in group H and group S by intraperitoneal injection for 4 weeks , and then spirono-lactone was given in group S by gavage for 2 weeks.Atrial fibrillation (AF) was induced by burststimulation after ad-ministration.The inducing rate of AF and atrial effective refractory period ( AERP) were tested by intra-cardiac electro-physiologic instrument.The expression of AF-related Ca2+channel (Cav1.2), K+channels (Kv1.5 and Kv4.3) and con-nexins (Cx40 and Cx43) at mRNA and protein levels was detected by real-time PCR, immunohistochemistry and Western blot.RESULTS:Spironolactone reduced the inducing rate of AF .No significant difference of AERP between group H and group S was observed (P>0.05).Compared with group H, the protein expression of Cav1.2 was significant increased in group S (P<0.05).The expression of Kv1.5 at mRNA and protein levels in group S was significantly lower than that in group H (P<0.05), while the protein expression of Kv4.3 in group S was significantly decreased compared with group H (P<0.05).The mRNA expression of Cx43 in group S was significantly decreased compared with group H (P<0.01), whereas the protein expression of Cx 40 in group H was significantly higher than that in group S ( P<0.05 ) .CONCLU-SION:Spironolactone attenuates the hyperthyroxine-induced atrial remodeling in rabbits , and reduces the susceptibility of the myocardium to AF .

Objective Protection afforded by ischemic preconditioning (IPC) against myocardial ischemia in adult heart has been investigated. This study was designed to examine the effects of IPC on myocardial tolerance to ischemia in immature hearts.Methods The aorta of isolated immature rabbit heart (14-21d old) was connected to Langendorff preparation within 30 s after excision. The hearts were perfused with oxygenated (95%O 2:5%CO 2) Krebs-Henseleit buffer(KHB) at 60 cmH 2O. 16 immature rabbit hearts were equally divided into 2 groups: control group and IPC group. In IPC group the hearts were first subjected to IPC stimulus consisting of 5 min global ischemia followed by 10 min reperfusion. The hearts in both groups were made globally ischemic for 30 min(no perfusion) followed by 40 min reperfusion. At the end of 40 min reperfusion the hearts were harvested for ATP analysis. The coronary flow(C), HR, left ventricle developed pressure(LVDP) and ?dp/dt were monitored and recorded before ischemia and at 5,10,20,30 and 40 min of reperfusion, and calculated as % of pre-ischemia levels. Coronary flow was collected before and after reperfusion for CK-MB determination.Results There were no statistically significant differences in the four parameters between the two groups. Arrhythmia scores were also comparable betweeen the two groups. The CK-MB leakage in IPC group was increased but not significantly different from that in control group. The ATP levels of myocardium at the end of reperfusion was significantly lower than that in the control group [(123.85?17.42)?g/g versus (167.21?16.53)?g/g].Conclusions IPC can not protect immature rabbit hearts from ischemia-reperfusion injury. On the contrary it may lead to myocardial injury due to more energy consumption.

Objective To investigate whether ischemic preconditioning( IPC) could protect against ischemia-reperfusion injury in immature rabbit heart and the role of KATP channel in the mechanism of myocardial protection. Methods New Zealand rabbits aged 14-21 days weighing 220-280g were used. The animals were anesthetized and heparinized. Chest was opened and heart was quickly removed and aorta was connected to Langendorff preparation within 30 s. The hearts were perfused with Krebs-Henseleit buffer balanced with gas mixture(O2: CO2 = 95% : 5% ) at 60cmH2O2(perfusion pressure) . IPC consisted of 5 mm global ischimia plus 10 mm reperfusion. Glibenclamide was used as KATP channel blocker. Cardiac arrest was induced with cold(4℃ ) St Thomas Ⅱ cardioplegic solution and heart was made globally ischemic by withholding perfusion for 45 mm followed by 40 mm reperfusion. Thirty immature rabbit hearts were randomly divided into four groups: group Ⅰ( n= 9 control) was subjected to ischemia-reperfusion only; groupⅡ(n= 9 IPC + ischemia-reperfusion); group Ⅲ(n = 6 glibenclamide + ischemia-reperfusion) and group Ⅳ( n= 6 glibenclamide + IPC + ischemia-reperfusion) . Coronary flow(CF), HR, left ventricle developed pressure( LVDP) and ? dP/dt max were monitored before ischemia/IPC/glibenclamide( baseline value) and 5, 10, 20 and 40 mm after reperfusion and were expressed as percentage of their baseline values. Arrhythmia scores were recorded. Coronary effluent was collected at 10 miii after reperfusion was started for determination of CK-MB level. At the end of reperfusion 200mg myocardium was taken from apex for determination of ATP content. Results The group Ⅱ(IPC group) showed best results. The recovery of CF, HR, LVDP and ?dp/dt max, was best among the four groups. The incidence of arrhythmia was low and less CK-MB leaked out. Myocardial ATP content was better preserved. Pretreatment with glibenclamide completely abolished the myocardial protection provided by IPC but did not affect ischemiareperfusion injury. Conclusions IPC can protect against ischemia-reperfusion injury in immature rabbit bean. Activation of KATh channel is involved in the mechanism of myocardial protection of IPC.

Objective To explore whether antibiotic prophylaxis is beneficial in tension-free in-guinal hernia repair Method A perspectiverandomized controlled study was conducted which included 1 28 patients who underwent tension-free inguinal hernia repair from July 201 1 to August 201 3.In the anti-biotic prophylaxis group,antibiotic was intravenously administrated within 30 minutes before surgery.In the control group,no preoperative antibiotic wasadministrated.The incidence of incision infection was com-pared between groups.Result Incision infectiondeveloped in onepatient of the antibiotic prophylaxis group and two patientsin the placebo group,indicating no significant difference between the groups(P >0.05).Conclusion Before tension-free repair,there is no real need to apply prophylactic antibiotics reg-ularlyfor inguinal hernia without high risk factors.

Objective To explore changes of risk factors between premenopausal and postmenopausal female patients with coronary heart disease (CHD). Methods A total of 283 female patients were divided into CHD group (n=154) and con?trol group (n=129) according to whether they suffered from CHD or not. Patients were further stratified into two groups accord?ing to menopausal situation:premenopausal group (n=78, including premenopausal CHD group of 34 cases and premenopaus?al control group of 44 cases) and postmenopausal group (n=205, including postmenopausal CHD group of 120 cases and post?menopausal control group of 85 cases). Clinical data of age, body mass index (BMI), medical history and menses situation were recorded. The levels of cholesterol (CHO), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipo?protein cholesterol (LDL-C), very low density lipoprotein cholesterol (vLDL-C), apolipoprotein AI (ApoAI), apolipoprotein B (apoB), lipoprotein a (Lpa), homocysteine (HCY) and high-sensitive C-reactive protein (hsCRP) were also detected. Results There were significantly higher levels of age, CHO, TG, LDL-C, vLDL-C, Lpa, ApoB, hsCRP, and the ratio of hypertension history, diabetic history, coronary heart disease family history in CHD group than those of control group. The level of HDLc was significantly lower in CHD group than that of control group. The ratio of hypertension history, diabetic history and levels of CHO, TG, LDL-C, vLDL-C, Lpa, ApoB, hsCRP were significantly higher in both premenopausal and postmenopausal CHD groups than those of their control groups. The level of HDL-C was significantly lower in postmenopausal CHD group than that of postmenopausal control group (P<0.05). Hypertension history, diabetic history and LDL-C were the independent risk fac?tors of premenopausal CHD. Hypertension history, diabetic history and CHO were the independent risk factors of postmeno?pausal CHD, and HDL-C was the protecting factor of CHD. The ratio of hypertension history, the level of CHO and LDL-C were significantly higher in postmenopausal CHD group than those of premonopausal CHD group. Conclusion The abnor?mal blood pressure level and dyslipidemia are more prevalent in postmenopausal female patients with CHD than premeno?pausal female patients. We should control these risk factors to improve the prognosis.