Objective To investigate the changes and its significance of serum content of soluble CD40L(sCD40L) and C-reactive protein(CRP) in patients with acute cerebral infarction(ACI).Methods The content of serum sCD40L and CRP in 40 patients with ACI and 30 normal controls were measured by enzyme-linked immuno-sorbent assay and immunonphelometry.The content of serum sCD40L and CRP were compared in the patients of different pathogenetic condition and infarction size.The correlation between sCD40L and CRP and pathogenetic condition and infarction size were analysised.Results The contents of serum sCD40L and CRP in ACI group were significantly higher than normal control group(all P

Objective To explore the protective effect of atorvastatin on irradiated endothelium and the thrombomodulin(TM)expression.Methods Cultured human coronary artery endothelial cells(HCAEC)and human umbilical vein endothelial cells(HUVEC)were treated by atorvastatin at the final concentration of 10 μmol/ml for 10 min,and then irradiated with 2 and 25 Gy.Cell cycles status and TM expression were quantitatively measured by flow cytometry 24 hours after irradiation.Protein C activation in endothelial cells was also assessod.Results After administration with atorvastatin for 24 h,the TM expression increased by 77%,59% and 61% in normal control group,2 Gy group and 25 Gy group,respectively(t=27.395,26.420,58.065;P=0.000).The protein C levels decreased by 23% and 34% compared with the normal group post-irradiation to 2 and 25 Gy,but increased by 79% and 76% compared with the irradiated control group after administration with atorvastatin.The rates of cell apoptosis decreased by 6% and 16% in 2 Gy and 25 Gy groups,respectively after administration with atorvastatin for 24 h(t=4.178,17.863;P=0.000).Conclusions Atorva statin can protect endothelia cell from irradiation-induced apeptosis by increasing TM expression and protein C activation.

Objective To investigate the electrocardiographic(ECG) characteristics and assess the safety of radiofrequency catheter ablation (RFCA) of ventricular tachyeardia (VT), and frequent ventricular premature con- tractious(VPCs) originating from left ventricular outflow tract(LVOT). Methods Twelve-lead ECG analysis and RFCA were performed in 9 patient with VT or VPCs originating from LVOT. Results The sites to be successfully ablated were in left valsalva sinus in 6 patients,and subaortic valve in 3 patient. ECG revealed tall R wave in leads Ⅱ, Ⅲ ,aVF, V5 and V6. QS morphology in both leads aVR and aVL,QS morphology in lead Ⅰ in most cases. R wave in lead Ⅰ was relative tall, the R/S wave amplitude in lead V1 was over 0.62 ,and precordia R wave transition was irregular. All 9 patients were successfully ablated. No death or recurrenced case during follow-up. Conclusion Ventricular taehycardia and frequent ventricular premature rcontractions originating from left ventricutar outflow tract could be known by some specific ECG characteristics and could be radically treated safely by RFCA.

Objective To explore the clinical value of prenatal ultrasound on detecting fetal spleen.Methods 1850 normal cases and 34 cases of splenic abnormalities,including fetal anemia(31 cases) and intrauterine infection(3 cases),were included.All fetuses underwent standard ultrasound fetal biometry,routine fetal screening and splenic length and thickness measurement.The ultrasonic imaging and the size of fetal spleen in the two group of fetuses were compared and relevant statistical analysis was performed.Results ①In 1850 cases,the fetal spleen visual rate under prenatal ultrasound was 98.1％.②Linear regression analysis showed that there was a linear relationship between the thickness,spleen diameter and gestational age(GA) with simplified equation as follows:splenic length (mm)=GA,splenic thinckness (mm) =GA×0.5-4.③ In the 34 abnormal cases,the size of fetal spleen were significantly larger than those in normal fetuses.Conclusions It is important to detect fetal spleen by prenatal ultrasound which can provide valuable information for the diagnosis of fetal anemia and intrauterine infection.

In the progress of the new healthcare reform, China has carried out a series of reform exploration in the drug distribution system.But fluctuating markups of drugs are still the main cause of high drug price.In order to simplify the distribution procedure, the National Health and Family Planning Commission proposed to encourage the implementation of two-receipt system nationwide.As the important part of the price system of drug circulation, drug distribution system made a great impact on the implementation of two-receipt system policy.Focusing on two provinces namely Fujian and Shaanxi provinces, this paper will discuss the typical drug distribution system in china.This paper has evaluated the main body and operation pattern in the implementation of two-receipt system, and by analyzing the benefits and drawbacks, in the same provinces.It has put forward the optimized distribution mode and provided policy suggestions for strengthening the two-receipt distribution system.

Objective To study the feasibility of using fluorescent immunofiltration test based on quantum dots (QDs)for rapid and quantitative detection of C-reactive protein.Methods Based on homemade QDs and QDs-antibody bioconjugates,an immune de-tection method was established via the double antibodies sandwich technique on the immunochromatography card.The test results could be read under the irradiation of UV light,and quantitative results could be measured through the combination of a laser and fluorescent spectroscopy.Results Under UV light irradiation,the minimum detection concentration of CRP was 0.156 mg/L.U-sing the quantitative detection method,the fluorescent intensities on the cards could be established a linear relationship with the con-centration of CRP,and the linear equation was that log(Y )=0.563 log(X)+4.570,r2 =0.958.Conclusion The fluorescent quan-tum dot immunofiltration assay can be used for quantitative detection of CRP;The quantum dots immuno-labels have the potential to develop new type of immune-diagnostic reagents.

Accurate assessment of the degree of coronary artery stenosis is very important to guide the revascularization of patients with coronary heart disease. In recent years, functional assessment of the impact of coronary artery stenosis on the distal myocardium is changing the traditional concept of revascularization. The superiority of the fractional flow reserve(FFR) in guiding coronary interventional therapy has been widely verified in clinical practice. Due to its invasive operation, high cost, and high side effects of vasodilators during examinations, its application in my country is relatively limited. Quantitative flow ratio as a new, noninvasive, and rapid tool for assessing coronary stenosis, is being favored by researchers. This article reviews the clinical research progress of quantitative flow ratio and prospects its future clinical applications.

Objective To evaluate the effect of TEG ( thromboelastography ) in the timing choose of CABG( coronary artery bypass grafting ) surgery for patients that receiving DAPT treatment .Methods This study is prospective analysis from November 2013 to May 2014 in Wuhan Asia Heart Hospital.The study cohort consisted of 1 201 patientswith acute coronary syndrome , theage range from 43 to 79 years (61.1 ±10 years) with 134 males and 79 females.and the patients undergo DAPT ( aspirin 100 mg/d, clopidogrel 75 mg/d) which were prepare to the coronary artery bypass grafting and then randomly divided into two groups according to the ratio of 1∶1.There were 101 patients, using perioperative TEG inspection , which conduct the choose of surgery timing according to the ADP-induced platelet-fibrin clot strength ( MAADP) after 24 h of the withdraw of DAPT.Distribute the patients into≥50 mm, 35-50 mm and <35 mm groups according to the MAADPresults, and theirCABG was complete within 1 day, 3-5 days and after 5 days respectively. The other 100 patientsacceptancoronary artery bypass grafting surgery and DAPT patients but without TEG examination as the control group , which were withdrawal the DAPT for 5 -7 days by routine before operation.The primary endpoint is 24 h chest tube drainage andkey secondary endpoint is the total number of transfused red blood cells .Recorded the mean intubation time , ICU stay times , Median length of hospital stayandrethoracotomyrates, 30-day mortality, and 30-day readmission rate at the same time.Using Fisher in the variables , t-test when two groups were compared , use ANCOVA for variable factor correction and Statistical analysis was performed using chi-square test in the calculate of results .Results The average chest drainage in TEG group and the control was 438.8 ml vs 487.8 ml(t=1.063,P=0.289),and the total amount of transfused red blood cell in both groups were 493.8 ml vs 551.6 ml(t=1.228,P=0.2227), there were no significant difference between the two groups .The total waiting time in the three categories of patients in TEG group is 294 days ( an average waiting time of 3.11 days per patient ) and was reduced 38%(3.1 days to 5 days)than the guidelines recommend.Conclusions Although the perioperative bleeding and red blood cell transfusion , the occurrence and postoperative adverse events were similar in two groups , but using thrombelastographto measure platelet function before CABG surgery can help to choose the timing of surgery and reduce the waiting time before surgery .

Objective To investigate the gray matter volume differences between adult hypothyroid subjects and healthy controls using voxel-based morphometry (VBM).Methods A total of 28 untreated hypothyroid patients and 28 age and gender-matched uormal controlswere recruited.The coucentrations of their freetriiodothyronine (FT3),free theroxine (FT4),and thyroid stimulating hormone (TSH)were testedfrom their venous blood on the day they accepted MR scanning.High resolution 3D-datawereobtained using 3.0 T MRI scanner.VBM analysis was performed to detect the volume differences between the groups by using voxel-wise two sample t test.Multiple regression analysis was employed to analyze the influence exerted upon gray matter volume by serum FT3,FT4,and TSH concentrationof hypothyroid patients.Results Compared to controls,gray matter volumes in the bilateral superior frontal gyri,left precentralgyrus and bilateral cerebellum were decreased in hypothyroid patients (voxels 211-2 142,t=3.36-3.69,P＜0.01,corrected).No significant correlation between the gray matter volume in the above-mentioned brain regions and the clinical variables (serum FT3,FT4,and TSH concentration) (P＞0.05) was found in the multiple regression analysis.Conclusions VBM analysis revealed that hypothyroid patients exhibited reduced gray matter volume in multiple brain regions.It suggests that the lack of thyroid hormones can lead to the structural abnormalities in adult brain and selective gray matter atrophy in multiple brain regions.

Objective To investigate the clinical features of Crohn's disease(CD)and ulcerative colitis(UC)according to the Montreal classification.nethods The clinical data of 110 cases of CD or UC were reviewed.The age at diagnosis.location and clinical behavior were assessed with the Montreal criteria.Results CD patients diagnosed at an age younger than 16 years were rare(3.6%),the majority of the CD patients was diagnosed at 17-40 years old(65.5%).Although ileocolon lesions were most common in the patients diagnosed at 17-40 years old(37.3%),yet ileum lesions were a little more than those of other parts of digestive tract in the patients diagnosed after 40 years old(14.5%),the difference was not significant(P=0.054).Stricture frequently occurred(50.4%),especially when the lesions were located at ileum or ileocolon.Perforation rarely happened(5.3%).There was no significant difference between different location groups for clinical behaviors(P=0.096).The incidence of stricture or perforation was almost same among different age groups(P=0.984).UC patients mostly presented with mild or moderate symptoms even in the group with extensive lesion.UC patients with severe symptoms were rare(6.8%).There was no significant difference in severity between the groups with different extent of lesion (P=0.056).Conclusions The majority of CD patients was diagnosed at 17-40 years old.Stricture is much more than perforation,penetrating,occurring mostly at ileum.UC patients mostly present mild or moderate symptoms,no matter how extensive the lesion is.The extent of the lesion detected with coloscopic examination is not correlated to the severity of clinical manifestations.