OBJECTIVE:To observe the efficacy of lemai granule in adjunctive therapy of vertebro-basilar artery insufficiency.METHODS:186 patients with vertebro-basilar artery insufficiency were randomly divided into 2 groups,lemai granule treatment group and control group.The control group were administered with flunarizine hydrochloride capsules and xueshuan xinmaining capsules,while the treatment group underwent adjunctive therapy with lemai granules besides the same treatment as the control group,the course of medication was 4 weeks in both groups.RESULTS:The total effective rates in treatment and control group were 95.8%and 80.2%(P

Objective To observe the clinical features of abdominal aortic aneurysm(AAA)in the elderly. Methods Seventy-eight elderly cases with AAA were studied retrospectively,the effect of age and AAA size on the growth of AAA were analyzed. Results Risk factors such as smoking,hypertension,hypercholesteremia and artherosclerosis were found in most patients. Aneurysm in other side was found in 25.6%of the patients.Rupture occurred in patients with a larger in size or rapidly developing AAA.The average AAA diameter inerease was 0.1 4 cm/year and it was similar for each age grade.When the AAA diameter was wider than 5 cm,it developed faster.and the growth velocity increased to 0.46 cm/year. Conclusions Age is not a risk factor that affects the development of AAA.If the AAA diameter is≥5 cm,the AAA develops quickly,then active interventions are recommended.

Objective To observe the relationship of the red blood cell distribution width and white blood cell count with coronary heart disease and coronary artery lesions.Methods Totally 590 patients undergoing coronary angiography were selected and divided into two groups based on the results of coronary angiography:coronary heart disease group (n=383) and control group (n=207).Based on the number of coronary lesions,patients in coronary heart disease were divided into different subgroup.The Gensini scores of coronary lesions were assessed.The differences in red blood cell distribution and white blood cell count were compared among different groups,and the correlations of coronary lesions with red blood cell distribution and white blood cell count were analyzed.Results The red blood cell distribution and white blood cell count were higher in coronary heart disease group than in control group [(13.06±0.57)％ vs.(12.63±0.49)％,(6.33±1.56) 109/L vs.(5.86± 1.29) 109/L,t=9.771 and 3.728,both P=0.000].The red blood cell distribution and white blood cell count were increased along with the increasing number of coronary lesions (F=51.454 and 7.544,both P=0.000),and positively correlated with the Gensini score (r=0.414 and 0.111,P =0.000 and 0.030).The red blood cell distribution was positively correlated with white blood cell count (r=0.108,P=0.009).The receiver operating characteristic(ROC) curve for red blood cell distribution predicting coronary heart disease showed that the threshold value of red blood cell distribution was 12.75％ and the area under the ROC curve was 0.723 (95％ Cl:0.680-0.765) with a sensitivity of 67.6％ and specificity of 65.2％ for the diagnosis of coronary heart disease.Conclusions Red blood cell distribution and white blood cell count are significantly increased in patients with coronary heart disease and are independently correlated with the severity of coronary lesions.Red blood cell distribution and white blood cell count are independent predictiors for coronary artery disease.

The sera of 206 cases with hydatid disease diagnosed by B-ultrasound and X-ray in survey scene had been examined by Dot-ELISA and IHA with Qinghai cystic hydatid antigen, ELISA With Xingjiang cystic hydatid antigen and Em18-EliB with alveolar hydatid antigen. The results showed that the sero-positive rates were 90. 37％ and 91.98％ in these cases with cystic hydatid disease by Dot EliSA and IHA with Qinghai cystic hydatid antigen respectively. The sero-positive rate was 75. 94％ in same cases by ELISA with Xingjiang cystic hydatid antigen. The sero-positive rateswere 77.27％ 81. 82％ and 65. 91 ％ in those cases with the whole calcific cystic hydatid disease by above three methods respectively, and the sero-positive rates were lower in whole calcific cystic hydatid than that in other cystic hydatid disease. The sero-negative cases belonged to cystic hydatid disease which located in lungs of livers alone. The results by EM18-ELIB with alveolar hydatid antigen showed that the sero-positive rates were 73. 68％ and 5. 88％ in those cases with alveolar hydatid disease and with cystic hydatid disease diagnosed by B-ultrasound and X-ray respectively,and the sero-positive rate was 15.91 ％ in whole calcific cystic hydatid disease. The ratio of the number of positive seras to that of negative seras was 1 to 7 approximately. The value and mean of different serological methods in diagnosis and judge diagnosis for cystic and alveolar hydatid disease had been discussed.

OBJECTIVE:To observe the effect of atorvastatin combined with methylprednisolone on the liver function of ne-phrotic syndrome patients. METHODS:The data of 93 patients with primary nephritic syndrome were retrospectively analyzed and divided into atorvastatin group,methylprednisolone group and combination group by different medication. Atorvastatin group was orally given atorvastatin 20 mg at bedtime,once a day+aspirin;methylprednisolone group was orally given methylprednisolone 0.8 mg/kg in the early morning,once a day+aspirin;combination group was given atorvastatin+methylprednisolone+aspirin(the same usage and dosage with the above-mentioned groups). The course was 4 weeks. The clinic data was observed,including ALT,AST, GGT,TB and DB before and after treatment,the incidence of patients with drug-induced liver disease and prognosis of patients with drug-induced liver disease. RESULTS:After treatment,the ALT,AST and GGT in atorvastatin group and combination group were significantly higher than before,with significant difference(P<0.05);compared with other parameters and all indexes in methylprednisolone group before and after treatment,there were no significant differences(P>0.05). There was no significant dif-ference in the elevated rate of ALT among groups(P>0.05);the incidence of drug-induced liver disease in combination group was significantly higher than atorvastatin group and methylprednisolone group,with significant difference(P<0.05). ALT in combina-tion group was significantly decreased and returned to pretreatment levels after atorvastatin withdrawal and 2 weeks of hepatoprotec-tants treatment for 7 patients with drug-induced liver disease. CONCLUSIONS:Atorvastatin combined with methylprednisolone has high risk on liver function in the treatment of nephrotic syndrome. Pretreatment levels can be recovered by both drug withdrawal and symptomatic treatment.

To investigate the gene expression profiles in acute allograft rejection of renal transplantation, and identify the markers for the early diagnosis of acute rejection, heterotopic kidney transplantation was performed by using F344 or Lewis donors and Lewis recipients. No immunosuppressant was used. Renal grafts were harvested on days 3, 7, and 14. A commercial microarray was used to measure gene expression levels in day-7 grafts. The expression levels of 48 genes were up-regulated in the allograft in comparison with the isograft control, and interferon-gamma-induced GTPase gene was most significantly up-regulated in allografts. It is concluded that a variety of pathways are involved in organ transplant rejection which is dynamic and non-balanced. IFN-inducible genes, such as IGTP, may play an important role in the rejection. A lot of important factors involved in acute rejection are unnecessary but sufficient conditions for the rejection. We are led to conclude that it is virtually impossible to make an early diagnosis based on a single gene marker, but it could be achieved on the basis of a set of markers.
Gene Expression Profiling ; Gene Expression Regulation ; Graft Rejection/*genetics ; Graft Rejection/metabolism ; Kidney/*metabolism ; Kidney Transplantation ; MAP Kinase Signaling System ; Oligonucleotide Array Sequence Analysis ; Rats, Inbred F344 ; Rats, Inbred Lew ; Signal Transduction ; Species Specificity ; Time Factors ; Transplantation, Homologous

Objective To explore the effect of electroporation mediated gene therapy on angiogene-sis of the distraction area during early mandibular distraction osteogenesis (DO). Methods Thirty-two New-Zeland rabbits were randomly divided into 4 groups: group A: recombinant plasmid pIRES-VEGF165-EGFP and electroporation; group B: recombinant plasmid pIRES-VEGF165-EGFP; group C: normal saline (NS) and electroporation and group D: control group. The rabbits were sacrificed at 1d, 3d, 7d and 14d after injection, respectively. The distraction area tissue was removed for histological examination and electron microscopy, and immunohistochemical stain for CD34 was performed to detect the microvessel density. Results Generation of vascular endothelial cells (VEC) in the group A and group B were active, and majority of VEC in groups C and D took on early change of cataplasia and apoptosis. The immunohistochemical stain for CD34 showed that it expressed weakly at the first day after transfection, and at 3,7,14 days after transfection, CD34 of VECs in the distraction area expressed positively. CD34 expression was the strongest in group A (P<0. 05), and there was significant difference among three groups and different time, respectively.Compared to each other, CD34 of VECs expressed positively with a tendency to rise in the groups A and B. But it fluctuated at the level of the expression at the first day in the groups C and D. Conclusion Electroporation-mediated transfecting recombinant plasmid could promote angiogenesis during early stage of mandibular DO. It could promote local vascular proliferation and penetration, increase the blood flow of broken ends in fractured bone. It indicates that electroporation-mediated transfecting recombinant plasmid play an important role in regulating and promoting growth and reparative process of the bone.

Objective:To compare the prediction efficiency of traditional linear regression model and four machine learning models on the learning behavior of clinical medical postgraduates, and to explore the pros and cons and applicability of different prediction models.Methods:A total of 6,922 clinical medical postgraduates were surveyed, their comprehensive learning behavior scores were obtained through the learning behavior scale. In the training set, Lasso linear regression and artificial neural network, decision tree, Bootstrap random forest, and lifting tree were used to build prediction models respectively. The above models were used to predict the validation set data and compare the prediction efficiency.Results:The comprehensive learning behavior score of clinical medical postgraduates was (3.31±0.54) points, and the overall compliance rate was 74.02%. In the linear regression model, the influence of age, school level, degree type, learning interest, pressure and satisfaction on learning behavior were statistically significant. In the prediction of validation set, the sensitivity, specificity, and accuracy of the linear regression model were 0.484, 0.914, and 0.801, respectively. The indexes of the four machine learning models were higher than those of the traditional linear regression model, and the Bootstrap random forest had the highest elevation.Conclusion:The linear regression model has a good prediction effect on learning behavior, and machine learning is superior to linear regression model in terms of accuracy of prediction. However, traditional linear regression models are superior to machine learning models in computational efficiency and interpretability.

Objective To evaluate the prognostic value of ~(99m)Tc-MIBI myocardial perfusion single-photon emission computed tomography (MPS) with adenosine triphosphate in patients aged 80 years or older. Methods A total of 265 patients [ mean age (84. 2 ±3.6) years old ] who underwent adenosine triphosphate and rest ~(99m)Tc-MIBI myocardial SPECT imaging were followed-up for (36. 7 ± 22. 8 ) months. Results During the period of follow-up, 57 patients (20. 4% ) suffered from cardiac events, including 20 major events: 5 cardiac death and 15 acule non-fatal myocardial infarction, 14 unstable angina pectoris,7 heart failure and 16 cases undergoing PCI. The cardiac event rate in patients with fixed or mixed perfusion defects (n = 54) was 50%, which was significantly higher lhan that in patients with reversible perfusion defects(n=67, 31. 3% ,P<0. 05) and normal perfusion imaging( n = 144, 6. 2% ,P <0. 01 ) . The major cardiac event rate in patients with fixed or mixed perfusion defects was 27. 8% , which was significantly higher than that in those with reversible perfusion defects ( 6. 0% , P < 0. 05) and normal perfusion imaging (0.7%, P < 0. 01 ) . Cox multivariate analysis revealed that an abnormal MPS was the most important independent predictor of major or total cardiac events. Conclusions ~(99m) Tc-MIBI MPS with ATP is demonstrated to be a powerful tool for the prognostic evaluation in octogenarian population. Octogenarians with a normal MPS have a low risk of major or total cardiac events, but when an abnormal MPS is present, the risk is significantly higher, being highest in patients with fixed or mixed perfusion defects.

ObjectiveTo study the effect of different renal functions on the prognosis of elderly patients with coronary neart disease (CHD). MethodsAll 383 patients with CHD were divided into elderly group and non-elderly group. Then patients in the elderly group were assigned to 4 groups according to the quartile of the estimated glomerular filtration rate (eGFR): GFR1 group (eGFR:1.73 m-2). All patients were followed up for 2 years, and the cumulative death rate of cardiovascular diseases and the relative risk for cardiovascular death were analyzed. Results(1)The cumulative death rate of cardiovascular diseases in elderly group was higher than that in non-elderly group (9.4vs. 1.3%, P=0. 019). (2)The cumulative death rate of cardiovascular diseases in GFR1,GFR2,GFR3 group were 6.8% ,6.3% ,4.6%, respectively, and there were no statistical differences among the three groups (P>0. 05). The cumulative death rate of cardiovascular diseases was 19.4% in GFR4 group, which was higher than that in other three groups (19.4% vs. 6.8%, P=0.038;19.4% vs. 6.3%, P=0.025 ;19.4% vs. 4.6%, P=0.009) . (3)Multivariate regression analysis revealed that eGFR was an independent prognosis factor for elderly patients with CHD, and the hazard ratio for cardiovascular death was 0. 965(95% CI: 0. 946～0. 985, P=0. 001). ConclusionseGFR is an important predictor for cardiovascular death in elderly patients with CHD.