Objective To investigate whether BNP(brain natriuretic peptide) could be relatively objective index for comprehensive risk stratification of exercise rehabilitation nursing in young and middle myocardial infarction patients. Methods BNP concentration and LVEF were measured respctively in young and middle myocardial infarction patients. Then the risk stratification was administrated based these index respectively and Barther Scores and significant statistical differences were calculated according to homogeneity test for variance. Results Blood BNP concentrations in acute phase among the divided group based on EF risk stratification were significant difference,hence the standard deviation is large,which led to variance nonhomogeneity,and stracification difference between groups is not clear and across-talking. Exercise rehabilitation nursing scores based on echocardiography EF value had significant difference even veariance is nonhomogeneity,hence the differ-ence is not clear beween groups.Exercise rehabilitation nursing scores based on BNP was administrated and significance is clear beween groups. Conclusions BNP concentration and LVEF value had certain relationship and cross-talking among them.Risk stratification based on BNP concentration had objective instructions for exercise rehabili tation nursing in actue infarction myocardial pa-tients.

Objective To study efficiency and safety of fondaparinux and Enoxaparin in treatment of Chinese patients with acute coronary syndrome (ACS) having undergone percutaneous coronary intervention (PCI). Methods One thousand and sixty ACS patients (945 with unstable angina, 115 with AMI) having undergone PCI in Henan provincial hospital from July 2011 to July 2013 were randomized into two groups treated with fondaparinux or enoxaparin respectively. Apart from treatment with oral aspirin and clopidogrel, those in the former group were treated with fondaparinux (2.5 mg IH QD) and the latter with enoxaparin (60 mg IH Q12H) subcutaneously for 2 days before operation, both suspended for 12 h before the operation. All of the patients were given heparin (60 IU/kg) during the operation. After the operation, the therapies with fondaparinux (2.5 mg IH QD) and enoxaparin (60 mg IH Q12H) were resumed subcutaneously for 3 days. Perioperative observation and follow-ups were made in terms of hemorrhage, thrombosis and major adverse cardiac events (MACE) in the patients during the hospitalization period, 2 and 4 weeks after operation. Results Fondaparinux and enoxaparin are both effective on anticoagulation for the patients after PCI. There was no significant difference about the incidence of MACE between the two groups (P > 0.05). But, fondaparinux group had lower incidence of hemorrhage than enoxaparin group (P < 0.05). Conclusion Fondaparinux and enoxaparin both have good anticoagulant activity in Chinese patients with ACS undergoing PCI, but fondaparinux may lower the risk of hemorrhage compared to enoxaparin.

Objective:To explore the influence of liquid for post-operative irrigation on the effect of ESS.Method:192 cases with chronic sinusitis and/or nasal polyps of groupIIstageII who had undergone the ESS from September,1998 to June,1999 and completed a3-month follow-up were divided randomly into 3 groups to accept 3 different kinds of irrigation liquid.The evaluation of curative effect was according to the index of HaiKou ESS-97.Result:The curative effect of Herba Houttuyniae group was better than the other two.Conclusion:The post-operative care is important and the irrigation liquid can affect the effect of ESS.

Objective To evaluate the safety,local efficacy and survival rates of isolated pulmonary metastases from colorectal carcinoma treated with CT-guided radiofrequency ablation.Methods A total of 28 patients with isolated pulmonary metastases from colorectal carcinoma were performed with CT-guided radiofrequency ablation (radiofrequency ablation group).The size of the lesion was 1.2-5.0 (2.9 ± 1.0) cm.During the same time,9 patients,who did not take any treatment for isolated pulmonary metastases from colorectal carcinoma,were collected as control group.The size of the lesion was 2.0-5.0 (3.6 ± 1.0) cm.The local progression-free rates and overall survival rates were compared.Results All the cases were able to complete the radiofrequency ablation in radiofrequency ablation group.During and after the procedure,no major complications occurred.The 1-,2-,and 3-year local progression-free rates and overall survival rates in radiofrequency ablation group were significantly higher than those in control group.The local progression-free rates were 89.3％ vs.76.2％,78.6％ vs.33.9％,70.7％ vs.16.9％.The overall survival rates were 96.4％ vs.77.8％,85.7％ vs.44.4％,56.7％ vs.22.2％.The differences between two groups had statistical significance (P ＜ 0.01).Conclusion CT-guided radiofrequency ablation for isolated pulmonary metastasis from colorectal carcinoma is a safe,effective,minimally invasive treatment,and can significantly improve the local progression-free rates and overall survival rates.

Objective To investigate the preventing and curative value of endoscopic injectim sclerotherapy underlying endoscopic variceal ligations in the treatment of the patients suffering form esophageal varix recurrence.Methods The endoscopic injection sclerotherapy was performed to the patients whose esophageal varix varnished or nearly varnished after the endoscopic variceal ligation.Results There were sinificant differences (P ＜ 0.05 ) between the group of the endoscopic variceal ligation combining more dose laurornacrogol and the group of the single endoscopic variceal ligation at the recurrence rate of bleeding.No severe complications were observed during the treatments.Conclusion The endoscopic injection clerotherapy of more amount doses lauromacrogol after the endoscopic variceal ligation can signiticantly reduce residual esophageal varix after the endoscopic variceal ligation and dday esophageal varix recurrrence.

Objective To study the clinical characteristics of epidemic Japanese encephalitis in 4 adult patients and to improve the level of diagnosis.Methods The clinical characteristics, laboratory results and MRI features of 4 adult patients with epidemic Japanese encephalitis hospitalized in our hospital between 2007 and 2008 was retrospectively reviewed and analyzed.Results All patients were sporadic.Two were female and others were male with the age from 34 to 68 years old and onset in summer and autumn.One patient had diarrhea at onset while others had fever and headache at onset.All patients had high fever and psychiatric symptoms.Two patients had respiratory failure.Obvious elevation of white cells in cerebrospinal fluid was seen in all patients and Japanese viral antibody of IgM was all positive whereas the image of MRI was abnormal only in one patient.Two patients had neurological sequelae.Conclusions The clinical manifestations of epidemic Japanese encephalitis in adults are severe and untypical and the respiratory failure is likely to occur.

BACKGROUND: Studies have shown that mild hypertension and hypothermia both offer cerebral protection against focal cerebral ischemia,and their possible synergistic effect may provide even better neuroprotective effects.OBJECTIVE: To investigate the mechanism of cerebral protection by induced hypertension combined with mild hypothermia against focal cerebral ischemia and reperfusion, through observation of the changes in the infarct volume and blood-brain barrier(BBB) in rats.DESIGN: A randomized controlled experimental study based on experimental animals.SETTING: The departments of neurology of two university hospitals and department of dermatology in a municipal hospital.MATERIALS: The study was carried out in the Laboratory of Department of Neurology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology and Laboratory of Department of Neurology, People' s Hospital of Wuhan University from March to July 2001. Sixty-four Wistar rats weighing 180 to 230 g were purchased from the Experimental Animal Center of People' s Hospital of Wuhan University.INTERVENTIONS: Sixty-four rats were randomly divided into control group, hypertension group, mild hypothermia group, and combined therapy group, each group consisting of 16 rats. Reperfusion was initiated after a 3-hour focal cerebral ischemia of the 16 rats, and at 2 hour during the ischemia, the rats in the hypertension and mild hypothermia group were treated with hypertension for 3 hours and mild hypothermia, respectively, and those in the combined therapy group received both treatment. The rats in the control group received no treatments for ischemia and reperfusion. Twenty-four hours later, all rats were killed for examination.MAIN OUTCOME MEASURES: The scores of neurological deficits, infarct volume and degree of BBB damage.RESULTS: The scores for neurological deficits, infarct size and volume of Even' s blue staining were 2. 12 ±0. 54, (17.65 ±4.78)%, and(56.63± 10.70) mm3, respectively, in hypertension group, and 2. 14 ±0.69,(16. 21 ± 3.79)%, and(53.52 ± 8.44) mm3 in mild hypothermia group,and 1.78 ±0. 61, (11, 31 ±3.64)%, and 38.45 ±5.25 mm3 in combined therapy group, which were all decreased significantly as compared with the control group[2.70 ±0. 64, (28.34 ±4. 13)%, and(94.87 ± 15.34) mm3].The combined therapy group had the smallest infarct size and volume of Even's blue staining among the three treatment groups( P ＜ 0.05).CONCLUSION: Hypertension and mild hypothermia may reduce the infarct volume and alleviate BBB damage during focal cerebral ischemia and reperfusion in rats, and the effects of combined treatment are more obvious.

Objective To evaluate the safety, efficacy and local control effect of CT- guided radiofrequency ablation (RFA) in treating non-small-cell lung cancer (NSCLC) that is inoperable or the surgical treatment is refused by the patient. Methods Between March 2007 and March 2010 at authors’ hospital, a total of 68 procedures of CT-guided RFA were carried out in 60 patients with early stage NSCLC. The patients included 37 males and 23 females with a mean age of 68.5 years. Pathologically, the lesions included squamous cell carcinoma (n=23, 38.3%), adenocarcinoma (n=31, 51.7%), large cell carcinoma (n=2, 3.3%) and adeno-squamous carcinoma (n=4, 6.7%). The mean diameter of the lesions was 3.8 cm (1.8-6.8 cm). The overall survival rate, cancer-specific survival rate and local progression-free survival rate were evaluated. Results RFA procedure was well tolerated by all patients with an average ablation time of 35 min (18-63 min). The main intraprocedural complication was pneumothorax (n=17, 28.3%). No death occurred during perioperative period. The median local progression-free survival time was 28 months, the median survival time was 32 months, and the one-, 2- and 3-year local progression-free survival rate were 94.6%, 83.1%and 73.6%, respectively. Conclusion For patients with inoperable NSCLC and patients with NSCLC who refuse to receive surgery, CT-guided RFA is a safe and effective treatment. This therapy can significantly improve the local progression-free survival rate.

Plaque rupture,platelet aggregation,and thrombogenesis are the main mechanisms of acute coronary syndrome (ACS),and inflammation factors play key roles in plaque unstability.Psychological stress promotes acute inflammatory response,leading to increased circulating levels of C-reactive protein (CRP),IL-6,and serum intercellular adhesion molecule (sICAM)-1.But it is not clear that whether psychological stress has a direct effect on atherosclerotic plaque stability.The purpose of this study was to investigate effects of chronic psychological stress on inflammatory marker (ICAM-1 ) in atherosclerotic plaque,and inflammatory markers in peripheral blood.Materials and methods Sixty male rabbits were randomized into 2 groups:the control group (n =10) and the atherosclerotic group (n =50).The latter were fed on high fatty diet and were given a large dose of vitamin D3 (3 600 000IU/kg) via intraperitoneal injection.After 8 weeks,the atherosclerotic model was estaslished.Then the 50 atherosclerotic model rabbits were divided into 3 subgroups:no-stress subgroup (n = 16),physiological stress subgroup (n = 16) and psychological stress subgroup (n =18).In physiological stress subgroup and psychological stress subgroup,drinking was cut from twice a day to once a day.At the same time,psychological stress subgroup was given empty bottle stress,and this process lasted for 2 weeks.One hour after the last stress,the blood samples were collected and the serum levels of CRP,IL-6 amd ICAM-1 were tested by radioimmunoassay or enzyme linked immunosorbent assay.The aorta and heart were extracted for pathology examination,and the express of ICAM-1 was tested by immunohistochemical examination.Results (1) After effective atherosclerotic animal model construction,the expression of ICAM-1 in aorta was higher in atherosclerotic group than that in control group (P＜0.01),and was notably higher in psychological stress subgroup than that in no-stress subgroup or in physiological stress subgroup (2.18±0.17 vs 1.58±0.22,1.22±0.15,P＜0.001,respectively).The expression in physiological stress subgroup was higher than that in no-stress subgroup (584±0.22 vs 1.22±0.15,P=0.001).(2) The serum level of IL-6 (51.80±4.60 pg/ml vs 27.60±4.19 pg/ml,8.01±1.39 pg/ml,7.83±1.37 pg/ml),sICAM-1 ( 1.24±0.25 vs 0.85±0.09,0.62±0.17,0.57±0.11),CRP ( 1.004±0.37 vs 0.90±0.29,1.01±0.22,0.71±0.13) in psychological stress group were significantly higher than that in other groups (All P＜0.05).There was a positive relationship between the serum level of CRP,IL-6 and ICAM-1 and the expression of ICAM-1 in aorta wall ( r =0.59,r =0.75,r =0.87,P＜0.01,respectively).Conclusions Psychological stress induces an increased expression of ICAM-1 in aortic atherosclerotic plaque,a higher serum level of CRP,IL-6,and sICAM-1 expression.Psychologial stress has a direct effect on the transition from stability to unstability through in-plaque and out-plaque inflammation.The serum level of CRP,IL-6 and ICAM-1 can reflex the inflammatory degree in atherosclerotic plaque.(J Geriatr Cardiol 2008;5:235-242)