Objective To investigate the clinical significance of N-terminal pro-B-type natriuretic peptide(NT-proBNP) detection in evaluation of acute type A aortic dissection (AAAD) prognosis .Methods Medical records of patients with confirmed diagnosis of AAAD were retrospectively analyzed .64 patients were enrolled in accordance with the inclusion and exclusion criteria ,and were di-vided into survival group(n=56) and death group(n=8) according to prognosis .Multivariate Logistic regression analysis was em-ployed to screen the independent risk factors which would affected the prognosis .Receiver operator characteristic ,ROC) curve was used to evaluate the predictive value of NT-proBNP for AAAD prognosis .Results Differences of history of smoking ,incidence sea-son ,disturbance of consciousness ,misdiagnosis ,low density lipid-cholesterol(LDL-C) ,fasting C-peptide(FCP) ,hypersensitive C-re-active protein(hs-CRP) ,cardiac troponin I(cTnI) ,NT-proBNP ,mean arterial pressure(MAP) and prothrombin time(PT) of pa-tients between the survival group and the death group showed statistical significance (P<0 .05) .Multivariate Logistic regression a-nalysis demonstrated that smoking history ,disturbance of consciousness ,high LDL-C ,high cTnI ,high NT-proBNP and low MAP were independent risk factors for patients with poor prognosis .ROC area under the curve(AUC) of NT-proBNP prediction for peri-operative mortality risk of patients with AAAD was 0 .697(P< 0 .05 ,95% CI:0 .643~0 .733) ,and its specificity and sensitivity were 75 .85% and 70 .07% ,respectively .When NT-proBNP was 909 .69 pg/mL ,its predictive value for AAAD was the best .Set the critical value as the threshold ,the patients above were divided into the threshold above group and the threshold below group . The survival rate of patients in the threshold below group [98 .18% (54/55)] was significantly higher than that in the threshold a-bove group[22 .22% (2/9)](χ2 = 7 .211 ,P< 0 .05) .Conclusion NT-proBNP level is closely related to the prognosis of patients with AAAD and NT-proBNP detection may be conducive to predicting high risk of AAAD .

Immunology teaching course includes both basic immunology and clinical im-munology.This paper points out the problems of teaching and knowledge integration between the basic immunology and clinical immunology and suggests that teaching team should include the basic immunology and clinical immunology related content clinical experts to promote teaching quality.

Objective To evaluate clinical effects of the treatment of tibial fractures through compression reduction and osteosynthesis with common plate. Methods From March 2001 to September 2003, 48 cases of tibial fractures were treated through compression reduction and osteosynthesis with common plate. Results All the cases were followed up for 6 to 24 weeks (averaging 14 weeks). The healing time was 12 to 16 weeks (averaging 5 weeks). No delayed union, non union, infection, or ineffective internal fixation occurred. Conclusion Compression reduction and osteosynthesis with common plate to treat tibial fractures is a kind of biomechanical fixation that facilitates fracture healing.

AIM: To investigate effects of salvia miltiorrhiza injection on acute myocardial ischemia and hemorheology. METHODS: The acute myocardial ischemia model and blood stasis model were established with high dose adrenaline subcutaneous injection and being socked in ice water. The effect of salvia miltiorrhiza injection on the electrocardiogram J point and T ware of acute myocardial ischemia and the hemorheology of rat blood stasis model were observed. RESULTS: As compared with model groups, middle and high dose groups of salvia miltiorrhiza injection could obviously inhibit the rising of J point and T wave of the ischemic electrocardiogram, all dose groups of salvia miltiorrhiza injection could prevent the ascending of blood viscosity and fibrinogen and hematocrit. CONCLUSION: salvia miltiorrhiza injection can effectively decrease blood viscosity and improve circulatation of coronary artery, and protect ischemic myocardium.

Objective To develop recruits training burnout self-reported questionnaires, and test the reliability and validity.Methods 780 recruits(360 for first test ,420 for second test) in Xinjiang were randomly assesscd with training burnout self-reported questionnaires.Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to the data, and tested the reliability and validity of recruits training burnout self-reported questionnaires.Results The questionnaires consisted of 13 items and 3 dimensions.One of the dimensions (physically and psychologically exhausted situation, training-alienation, low accomplishment) , explained 61.599％ of the total variance.Cronbach's α coefficient of the whole questionnaire was 0.837, Cronbach's α coefficient of each partial scale were between 0.775 and 0.807.Split-half reliability of the whole scale reached to 0.817, split-half reliability of each partial were between 0.758 and 0.793.The correlation coefficient among each dimensions were 0.267 to 0.569 (P＜0.01) ,and the coefficient between each dimensions and the total score were between 0.671 and 0.857(P＜0.01).Confirmatory factor analysis showed that three factor model was optimal (GFI =0.935, AGFI =0.902, NFI =0.907, CFI =0.936, IFI =0.935, RMSEA =0.050).The three dimensions and the total questionnaire had significant positive correlations with mental stress (r=-0.215--0.313, P＜ 0.01) and significant negative correlations with depression(r=0.319-0.602, P＜0.01).Conclusion The recruits training burnout self-reported questionnaires meets the requirements of psychological surveying, and could be used to text recruits training burnout.

Objective To evaluate the effect ofcytochrome P450 isoenzyme subfamily 2C19 (CYP2C19)gene polymorphism on the clopidogrel antiplatelet therapy in cirrhosis patients after receiving transjugular intrahepatic portosystemic shunt (TIPS).Methods The clinical data of 171 cirrhosis patients,who were treated with TIPS during the period from January 2013 to December 2014,were retrospectively analyzed.During operation both the portal vein and the elbow vein blood samples were collected and sent for CYP2C19 gene testing.After TIPS,clinical follow-up checkup was made once every 3 months.The gene detection results and clinical follow-up findings were comparatively analyzed.Results A total of 110 patients,who had not received blood transfusion before TIPS and who had regularly taken clopidogrel antiplatelet therapy after TIPS were enrolled in the study.The mean time to take clopidogrel was 192.4 days (31-517 days),and the gene detection results of portal vein and elbow vein were quite consistent.CYP2C19 genotype of *1/*1 was found in 49 patients (44.5％),CYP2C19 genotype of *1/*2 in 27 patients (24.6％),CYP2C19 genotype of *1/*3 in 18patients (16.4％),CYP2C19 genotype of *2/*2 in 11 patients (10.0％),CYP2C19 genotype of *2/*3 in 3patients (2.7％),and CYP2C 19 genotype of *3/*3 in 2 patients (1.8％).Following-up examinations showed that the incidence of shunt dysfunction in patients carrying slow metabolic gene was 87.5％ (14/16),which was significantly higher than that in patients carrying moderate metabolic gene (20.0％,9/45;x2=22.9,P=0.006)as well as in patients carrying fast metabolic gene (8.2％,4/49;x2=37.91,P=O.O00 1).Multivariate analysis of Cox regression model indicated that CYP2C19 slow metabolic gene variation was an important predictive factor for shunt dysfunction (95％CI:1.80-9.03,P=O.O00 7).Conclusion CYP2C19 slow metabolic gene variation,including genotype of *2/*2,*2/*3 and *3/*3,is an important factor that can influence the efficacy of clopidogrel treatment after TIPS.Preoperative CYP2C19 gene detection results can provide useful information,which is very helpful in making an effective and reliable anti-platelet treatment plan for patients after TIPS.

Objective To observe the effect and safety of low dose milrinone used in patients suffering from refractory heart failure and renal dysfunction. Methods Forty-two patients with refractory heart failure and renal dysfunction were divided into treatment group(21 cases ) and control group(21 cases )by random digits table. All the patients accepted a therapy of cardiac booster, diuretics and vasodilators, and treatment group also accepted the therapy of milrinone [0.375 μ g/( kg· min), 10 mg/d, for 7 days]. And then the symptom, signs, blood pressure, heart rate, heart function and renal function before and after the treatment were observed. Results The total effective rate in treatment group was 85.7%( 18/21 ) ,significantly higher than that in control group [57.1% (12/21)] (P ＜0.05＝. After treatment,the heart rate,systolic blood pressure,diastolic blood pressure,stroke volume,cardiac output and left ventricular ejection fraction in treatment group and control group improved significantly than those before treatment, and these index improved better in treatment group [(79.3 ± 12.4) beats/min vs. (85.4 ± 10.2) beats/min, ( 107.6 ± 15.4)mm Hg ( 1 mm Hg = 0.133 kPa) vs.( 119.1 ± 13.5 ) mm Hg, (60.8 ± 9.4) mm Hg vs. (65.8 ± 8.5 ) mm Hg,(66.3 ± 10.2 ) ml vs. (61.2 ± 9.3 ) ml, (5.3 ± 0.6 ) L/min vs. (4.8 ± 0.9) L/min, (56.6 ± 8.4 )% vs. (48.9 ±7.3)% ,P ＜ 0.05＝. In two groups,there were no statistical difference in renal function. Conclusions Low dose of milrinone can improve the heart function of the patients with refractory heart failure and renal dysfunction and has good renal safety.

BACKGROUND:Phytohemagglutinin (PHA) can stimulate the peripheral blood mononuclear cells (PBMCs) into cellcycle, and cause their immune activation, which is a common immune proliferation model. However, the role of non-PBMC ingredient of peripheral blood is unclear, as wel as the expression of endothelial cells related cytokines. OBJECTIVE:To study the effect of whole blood culture and PBMCs alone culture with PHA on the PBMC proliferation and apoptosis, expression of inflammatory cytokine and endothelial cellsecreted cytokine markers. METHODS:Morphological changes of PBMCs separated from normal karyotype human peripheral blood individual y cultured with or without PHA were observed. The PBMCs were col ected by whole blood culture or PBMC separated culture. mRNA was extracted for the fluorescence quantitative RT-PCR, which was applied to detect the cellproliferation, apoptosis, and expression of inflammatory cytokine and endothelial cellsecreted cytokines. The statistic analysis was used for the significance explication. RESULTS AND CONCLUSION:PBMCs alone cultured ere different from those undergoing whole blood culture. The PHA could up-regulate the gene expression of Ki67, proliferating cellnuclear antigen, Caspase 3, interferon-γ, tumor necrosis factor-βand interleukin-6, but down-regulate Protein C. This indicted that PHA could promote the proliferation and apoptosis of PBMCs and up-regulate the expression of inflammatory cytokines, but down-regulate the expression of endothelial cells secreted coagulation cytokines.

To investigate the effect of naringenin on ovariectomy-induced postmenopausal osteoporosis comprehensively and systemically, thirty-two virgin Sprague-Dawley rats about 3-month-old were used and randomly divided into 4 groups: sham control group (Sham), OVX control group (OVX), naringenin treatment group and 17β-estradiol (E2) treatment group. After 12 weeks treatment with different drugs, 24 h urine were collected, organs were weighed and the organ indies were computed. Uterine pathological changes were observed by making paraffin section. Biochemical parameters and bone turnover markers: serum osteocalcin (BGP) and urine deoxypyridinoline (DPD) were analyzed with automatic biochemical analyzer or ELISA assay. Bone mineral density (BMD) and bone mineral content (BMC) were analyzed by DEXA, bone biomechanical properties was measured by three point bending test and the trabecular bone microarchitecture was evaluated by Micro CT. From the results, we can see that: the gaining of weight and the increasing of bone turnover markers such as serum BGP and urinary DPD could be inhibited by naringenin. The treatment could also enhance the bone strength and prevent the deterioration of trabecular microarchitecture, increase the bone volume, trabecular number and thickness, and decrease the trabecular space. The effects mentioned above were not accompanied with stimulating effects on uterus. Long-term using of naringenin had no obvious influence on other organs and the liver and kidney functions. The study suggests that naringenin had obvious antiosteoporotic effect on ovariectomized rats and it had the potential value for the treatment of postmenopausal osteoporosis.

Rhubarb is a traditional Chinese medicines which possess laxative, lipid-lowering, and weight-loss activities, but the active compounds of lipid-lowering and underlying molecular mechanisms are not yet clear. This study aims to explore the effects of chrysophanol on the mRNA expressions of sterol regulatory element-binding proteins (SREBPs) and lipid metabolism in human liver carcinoma Huh-7 cells, which is one of the active compounds obtained from Rhubarb. A reporter gene assay was used to test the transcription of SREBP. The intracellular triglyceride and total cholesterol contents were measured by using commercially available test kits. The SREBPs target genes expressions were measured by Quantitative Real-Time PCR. Cell viability was evaluated by Cell Counting Kit-8. As the results shown, chrysophanol (40 μmol · L(-1), 16 h) could notably inhibited human SRE promoter activity in a dose-dependent manner and decrease intracellular cholesterol and triglyceride levels. Furthermore, the mRNA expressions of SREBPs target genes were significantly downregulated by chrysophanol treatment. However there are no significant differences on cell viability when compared with the control group. These results suggested that chrysophanol might improve lipid metabolism through suppressing the mRNA expressions of SREBPs target genes to attenuate intracellular lipid accumulation.