Objective:To explore the correlation among ECG indexes,myocardial enzyme peak and short term cardi-ac function in patients with acute anterior ST elevation myocardial infarction (STEMI).Methods:A total of 150 pa-tients with acute anterior STEMI were selected from our hospital.According to left ventricular ejection fraction af-ter three months (3m LVEF),they were divided into cardiac dysfunction group (n=78,LVEF<50%)and normal cardiac function group (n= 72,LVEF≥ 50%).Following indexes were compared between two groups,including sum of ST elevation extent (ΣST),R wave (ΣR),Q wave (ΣQ),maximum value of ST elevation (STm)and Q wave (Qm)etc.on infarct related leads,and peak value of creatine kinase (CKm),CK isoenzyme (CK-MBm)and cardiac troponin T (cTnTm)etc.Results:Compared with normal cardiac function group,there were significant rise in ΣST,ΣQ,STm,Qm,CKm,CK-MBm,cTnTm,left ventricular end-diastolic diameter (LVEDd),3mLVEDd and significant reduction in ΣR and LVEF,3mLVEF in cardiac dysfunction group,P <0.05 or <0.01;Spearman correlation analysis indicated that ΣST,ΣQ,STm,Qm,CKm,CK-MBm and cTnTm were positively correlated with 3m LVEDd (r =0.18~0.63,P <0.05 or <0.01),and inversely correlated with 3m LVEF (r =-0.88~-0.42, P <0.01 all).ΣR was inversely correlated with LVEDd and 3m LVEDd (r =-0.46、-0.51,P <0.01 both),and positively correlated with LVEF and 3m LVEF (r =0.81,0.71,P <0.01 both).Conclusion:In patients with ante-rior STEMI,the higher ST elevation,the higher Q wave,the lower R wave,the higher myocardial enzyme peak is, the poorer short term cardiac function is.

Objective To explore the role of clinical pharmacists in nutrition support therapy in the patients with hyperemesis gravidarum. Methods The clinical pharmacist played a positive role in nutrition support care of a patient with hyperemesis gravidarum by analysising disease characteristics and adverse drug reactions, providing suggestion on the selection of fat emulsion and offering an individualized pharmaceutical care. Results The clinical pharmacist recognized the potential risk in nutrition support plan, took modifications timely, and prevented the occurrence of unfavorable clinical outcomes. Conclusion The participation of clinical pharmacists in nutrition support therapy of the patients with hyperemesis gravidarum is beneficial to improve the efficacy and safety of nutrition support and promote the rational use of drugs.

Human genne myo-inositol monophosphatase 2(IMPA2) was recently a novel and promising gen that was associated with disease,especially in mental and neuro diseases.Its locus is in chromosome 18p11 2,about 15 kb.It encodes IMPA2 enzyme.IMPA2 enzyme as a mainly and catalytic inositol plays an important role in cell signaling system.The mechanism of action of IMPA2 gene is still unclear.But in basic research on genetic structure and IMPA2 product,the biochemical functions and crystal structure have gradually been recognized;In the clinical application,the association with disease has been detected in manic depression,schizophrenia and febrile seizuers.IMPA2 even has been a susceptible gene to certain diseases.IMPA2 has increasingly been the hotspot in gene research.

BACKGROUND: Acellular vascular matrix as vascular scaffold has following advantages: acellular vascular matrix possesses complicated three-dimensional structure of natural blood vessels. Growth factor and structural domain on the surface of acellular matrix helps for cell adhesion and infiltration.OBJECTIVE: To prepare acellular vascular matrix material and to evaluate its biocompatibility in vivo and in vitro.METHODS: Trypsin and Triton X-100 were used to gradually dispose pig carotid artery and to prepare acellular vascular matrix. The biocompstibility of the material was evaluated by implantation in muscle, acute toxicity experiment and cytotoxicity test in vitro.RESULTS AND CONCLUSION: The acallular vascular matrix material possessed good chemical stability and did not release harmful factors that produced destruction and dissolution in erythrocytes, without acute hemolytic reaction or toxic effects on cell growth. The acellular vascular matrix material showed lots of inflammatory cell infiltration in eady stage of implantation, and no significant inflammatory cell infiltration in late stage of observation. Fibroblasts were visible in the acellular matrix. In addition, the acellular matrix material did not exhibit toxic effects on surrounding tissues, showing wound stage I healing. Simultaneously,histological sections demonstrated that there were good compatibility of scaffold material and surrounding tissues, without rejection. These indicated that acellular matrix material presented good biocompatibility in animals.

OBJECTIVE:To observe the effects of different routes of administration of tranexamic acid on coagulation function and amount of bleeding in patients with one stage posterior surgery of thoracic tuberculosis. METHODS:40 patients suffered from thoracic tuberculosis in our hospital from Jan. 2011 to Dec. 2013 were randomly divided into intravenous group(5% Glucose injec-tion 100 ml+tranexamic acid 10 mg/kg,through an intravenous drip at 30 min before closing the wound) and topical application group(5% Glucose injection 10 ml and tranexamic acid 10 mg/kg,through soaking the wound before closing the wound)with 20 cases in each group. Other 15 cases suffered from the thoracic tuberculosis in our hospital from Jan. 2009 to Dec. 2010 were includ-ed in control group. 3 groups received one stage posterior surgery of thoracic tuberculosis,interbody fusion and internal fixation. The difference of hemoglobin,coagulation function and the amount of suction drainage were observed before and after surgery, and followed up. Bone graft fusion and therapeutic condition of tuberculosis were observed in the study. RESULTS:There was no statistical significance in postoperative suction drainage between intravenous group and topical application group (P>0.05),but their decrease was more significant than control group,with statistical significance(P<0.05). There was no statistically difference in fiber protease,prothrombin time or activated partial thromboplastin time among 3 groups(P>0.05). The difference value of he-moglobin in control group before and after operation was significantly higher than in intravenous group and topical application group,with statistical significance (P<0.05);there was no statistical significance between intravenous group and topical applica-tion group(P>0.05). 55 patients were all followed up and bone graft of all cases were fused,and all patients were cured and no case recurred. CONCLUSIONS:Tranexamic acid by intravenous application or topical application can reduce hemorrhage and ane-mia after operation of thoracic tuberculosis,and has no effect on blood coagulative system.

ObjectiveTo investigate the extracorporeal clearance rate of imipenem in severe infection patients in the mode of continuous vena-venous hemofiltration (CVVH) during continuous renal replacement therapy (CRRT), in order to approach if the concentration of imipenem in plasma could achieve effective levels of anti-infection, and to explore the effect of time and anticoagulation measure on imipenem clearance during CRRT treatment.Methods A prospective observational study was conducted. All adult severe infection patients complicating acute kidney injury (AKI) in the Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University from March 2013 to September 2014, who were prescribed imipenem as part of their required medical care, and CRRT for treatment of AKI were enrolled. 0.5 g doses of imipenem was administered intravenously every 6 hours or 8 hours according to random number table, and infused over 0.5 hour. The unfractionated heparin was used for anticoagulation in the patients without contraindications, and no anticoagulation strategy was used in the patients with high risk of bleeding. At 24 hours after first time of administration, postfilter venous blood and ultrafiltrate samples were collected at 0, 0.25, 0.5, 0.75, 1, 2, 5, 6, and 8 hours after imipenem administration. The concentration of imipenem in above samples was determined with liquid chromatography-mass spectrometer/mass spectrometer (LC-MS/MS).Results A total of 25 patients were enrolled. Thirteen patients received imipenem intravenously every 6 hours, and 12 patients, every 8 hours. The anticoagulation was conducted with heparin in 13 cases, and 12 cases without anticoagulation. The intra-day precision, inter-day precision, matrix effect, and recovery rate in low, medium, and high concentration of plasma and ultrafiltrate, and the stability of samples under different conditions showed a good result, the error of accuracy was controlled in the range of±15%. With the application of Prismaflex blood filtration system and AN69-M100 filter, under the mode with CVVH, the total clearance rate of imipenem was (8.874±2.828) L/h when the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1, the total CRRT clearance rate of imipenem in vitro was (2.211±0.539) L/h, which accounting for (30.1±15.7)% of the total drug clearance. In 6 hours interval dosage regimen, the percentages of the time> 4×minimum inhibitory concentration (MIC) at specific 4×MIC of 2, 4, 6, and 8μg/mL of imipenem were more than 40% of the dosing interval. But in the 8 hours interval dosage regimen, when the level was above the 4×MIC of 4μg/mL, maintaining time would drop below 40% of the dosing interval, with significant differences compared with that in 6 hours interval dosage regimen [4×MIC = 2μg/mL: (60.84±20.25)%vs. (94.01±12.46)%,t = 4.977,P = 0.001; 4×MIC = 4μg/mL: (39.85±15.88)% vs. (68.74±9.57)%,t = 5.562, P = 0.000; 4×MIC = 6μg/mL: (27.58±13.70)% vs. (53.97±8.36)%,t = 5.867,P = 0.000; 4×MIC = 8μg/mL:(18.87±12.43)% vs. (43.48±7.83)%,t = 5.976,P = 0.000]. No significant change in sieving coefficient of imipenem was found within a short time (6 hours), which indicated that there was no effect of anticoagulation on clearance of imipenem by AN69-M100 filter, and no statistical significance was found with repeated measure analysis (F = 0.186, P> 0.05).ConclusionsThe clearance rate of imipenem is increased significantly in vitro under the mode of CVVH with the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1 in severe infective patients with severe sepsis complicating AKI, affecting the level of plasma drug concentration, need to adjust the dosage regimen. When the time of the dosing interval was shortened, the concentration of imipenem in patients' plasma could be increased significantly. In a short period of time, the sieving coefficient of imipenem through AN69 filter is not affected by anticoagulation measures and time cleaning efficiency will not decline.

Objective To evaluate the necessity and practicability of optimizing the management of type 2 diabetes mellitus in community after acquiring the peer education and the music therapy to their physical and mental issues and sleep problems. Methods Totally 179 type 2 diabetes mellitus patients who were followed up in Ruijin 2nd community health service center, the random numbers table used to randomize the patients into 2 groups:control group ( 97 cases) and experiment group ( 96 cases), the conventional treatment was used in control group. Besides the conventional treatment measures, the peer support was used by patients in the experiment group. In the second step, 45 patients were met the inclusion and the exclusion criteria, the random numbers table used to randomize the patients into 2 groups:the multiple intervention group (22 cases) and the conventional treatment group (23 cases), the multiple intervention included the music therapy, the peer support and the sleep health education, the conventional treatment included the conventional treatment and the sleep health education. The t test was used to compare the patient's HbA1c and other quantitative data in two groups of patients after the intervention. Results In the first stage of research, compared with the control group patients, the patients 'HbA1c in intervention group was significantly improvement after 6 months(7.26%±1.37%vs.7.53%±1.63%,t=2.148, P<0.05),besides, the intervention group individuals achieved significant improvement in diabetic self-management behaviors and self-efficacy after 6 months, and the improvement in self-efficacy of peer support group was significant different compared with routinely educated patients(104.09±16.40 vs.110.96± 13.86,t=2.120,P<0.05), and the PHQ-9(5.95 ± 4.02 vs.2.55 ± 1.67,t=2.630,P<0.05)between the two group had significant difference, while no improvement was found in PSQI, BMI, and WHR between intervention group and control group. Conclusions Peer support could improve the blood glucose metabolism in patients with type 2 diabetes. With the effect of yoga music and physical exercises, peer support can improve the quality of sleep and decrease depression in T2DM patients, who also have sleep disorders and mild depression.

Objective To detect the Yersinia pestis plasmid and molecular weight along the Qinghai-Tibet Railway.Methods Yersinia pestis plasmids molecular weight detected and analyzed using alkaline lysis,phenol-chloroform extraction of Yersinia pestis plasmid by agarose gel electrophoresis.Results The 18 Yersinia pestis strains of Qinghai-Tibet Railway contained 6×106,45×106,52×106,65×106,92×106plasmid,varing in the range of the 52×106-92×106.Conclusions The Yersinia pestis of Qinghai-Tibet Railway has a standardplasmid graphics,with the biggest Yersinia pestis plasmid changing in a certain regular degree,which providessignificance in the study of plague natural foci of the spatial structure and the genetic.characteristics of Yersiniapestis.

Objective To investigate the effects of fluoxetine and pyrrolidine dithidarbamate (PDTC) on the lipopolysaccharide(LPS)-induced interleukine-6(IL-6) release in cultured rat astrocytes.Methods The purified astrocytes were cultured in 48-well tissue culture plate and classified into control group,LPS group,fiuoxetine group and PDTC group.Control group and LPS group were cultured as usual,and fluoxetine group and PDTC group were cultured with fluoxetine or PDTC at different concentrations for 48 hours,and then LPS group,Fluoxetine group and PDTC group were incubated with 1 ug/ml LPS for 24 hours.Finally,the levels of IL-6 in the cell supernatant were detected by enzymatic linked immunosorbent assay (ELISA) method.Results The level of IL-6 in LPS group ((1975.46 ± 171.54) pg/ml) was significantly higher than that in control group((10633 ± 782.15)pg/ml) (P ＜ 0.01).The levels of IL-6 were (6198.6 ± 379.4) pg/ml,(4973.6 ± 132.5) pg/ml and (4747.9 ±473.9) pg/ml respectively when the concentrations of fluoxetine were 10 μM,20 μM and 40 μM,and (4821.6 ±180.8) pg/ml,(4735.7 ±620.0)pg/ml and (3525.9 ± 240.0)pg/ml respectively when the concentrations of PDTC were 100 μM,150 μM and 200 μM.There was significant difference in the levels of IL-6 between LPS group and fluoxetine group (P ＜ 0.05),as well as between LPS group and fluoxetine group (P ＜ 0.05).Conclusion LPS can induce IL-6 release from astrocytes,while fluoxetine or PDTC at some concentrations can suppress LPS-induced IL-6 release.

Objective To explore the polymorphism of nef gene and conservation level of functionally important domains of nef as well as their influences on HIV-1 disease progression of HIV-1 B'infected individuals in northern China.Methods 30 long term nonprogressors(LTNPs)and 42 typical progressors (TPs)were selected.Provirus DNA was extracted from whole blood sample.The full nef gene was amplified by nested-PCR.PCR product was sequenced directly after purification.Phylogenetic analysis and amino acid sequence mutation was applied on nef sequences to explore the differences between LTNPs and TPs.Results At position 15,the S15R/K/N substitution was detected.The frequency of TPs(64.29%)wsa higher than LTNPs(33.33%,P<0.01,0R=3.60);R21K/E/H/I.Q,TPs and LTNPs mutation frequency was 59.52%and 93.33%(P<0.005,OR=0.11);At position 39,K39R/E/N was only detected in TPs(23.81%,P<0.005).Conclusion No significant deletion or defect associated with disease progression wsa detected in nef gene of HIV-1 B'.But it suggested that K/E/H/I/Q mutation at 21 st amino acid of nef associated the disease nonprogression.R/K/N at 15 th amino acid of nef and R/E/N mutation at 39th amino acid of nef associated the disease progression in.HIV-1 B'.All domaias of nef amino acids sequences were comparatively conservative.