Objective To analyze the influence of atrial fibrillation(AF) on N‐terminal pro‐brain natriuretic peptide(NT‐proB‐NP) for the assist diagnosis of acute heart failure(AHF) .Methods Totally 457 inpatients with suspected AHF due to acute dysp‐nea and conducting blood NT‐proBNP detection and electrocardiogram(ECG) within 24 h of admission were collected and devided into groups according to whether AHF was diagnosed and complicated with AF identified by ECG on admission ,that was AHF +AF group ,AHF + non AF group ,non AHF + AF group ,non AHF + non AF group .The receiver operating characteristic (ROC) curve was adopted to evaluate the value of NT‐proBNP for diagnosing AHF .Results Among 457 cases ,194 cases (42 .5% ) were diagnosed as AHF and 140 cases (42 .5% ) as AF .The NT‐proBNP level in the AF group was significantly higher than that in the non AF group (4 482 .0 pg/mL vs .1 302 .0 pg/mL ,P < 0 .01) .The NT‐proBNP level had no statistical difference between the AHF + AF group and the AHF + non AF group AF(6 580 .0 pg/mL vs .6 769 .0 pg/mL ,P> 0 .05) .The NT‐proBNP level in the non AHF + AF group was significantly increased compared with the non AHF + non AF group (403 .3 pg/mL vs .2 892 .0 pg/mL ,P< 0 .01) .The area under the curve(AUC) of NT‐proBNP for diagnosing AHF in the AF group and the non AF group was 0 .759(95% CI :0 .677 - 0 .841 ,P < 0 .01) and 0 .931(95% CI :0 .903 - 0 .985 ,P < 0 .01) .Conclusion The NT‐proBNP level in AF patients without AHF is significantly increased ,which might affect the value of NT‐proBNP in the diagnosis of AHF .In the clinical applica‐tion ,whether the patient has AF cardiac rhythm should be paid attention to for better interpretating the detection result of NT‐proBNP .

Six compounds were isolated from Glycyrrhiza yunnattettsis. on the basis of physico-chemical properties and spectroscopic analysis, their structures were identified as homopterocarpiu (Ⅰ ), medicarpin (Ⅱ ), formononetin (Ⅲ ), 4' -methoxy-4-hydroxy challone (Ⅳ ), glyyunnansapogeuin B (Ⅴ ) and ?-sitosterol (Ⅵ ). Ⅰ~Ⅴ are fouud for the first time in this species,

Objective To analyze the effects of different doses of naloxone on resuscitation of patients with quality of dezocine anesthesia.Methods 84 patients with dezocine anesthesia surgery were selected and divided into three groups in accordance with the use of naloxone plus volume,28 cases in each group.All patients were treated with vein injection of propofol,fentanyl and Shun type atracurium for induction of anesthesia,endotracheal intubation and mechanical ventilation were given dezocine infusion to maintain anesthesia.After the operation,the high dose group was given 14μg/kg naloxone,the low dose group was given 7μg/kg naloxone,and the control group only received intravenous infusion of the corresponding measurement.Mean arterial pressure (map),heart rate (HR)before anes-thesia,recovery,extubation and intubation after 10min of three groups were observed.Pain and sedation situation score of the patients regained consciousness after 1min,1h,2h were received by visual analogue scale (VAS),sedation/restlessness score (SAS).At the same time,the incidence of complications and adverse reactions of the three groups were recorded.Results There were no significant differences in MAP and HR indexes among the three groups before anesthesia.At resuscitation and extubation there were no differences in MAP and HR between the low dose group and the control group (all P >0.05).However,resuscitation,extubation,MAP and HR were significantly lower in the low dose group than those in the high dose group (all P <0.05).The difference of VAS,SAS score had no statistical sig-nificance between the low dose group waken up each time and control group,but the VAS,SAS score in the high dose group waken up each time were significantly higher than those in the control group and low dose group(all P <0.05). The respiratory inhibition in the high dose group and low dose group were significantly lower than those of the control group(0,3.57% and 10.71%;χ2 =4.169,1.077,all P <0.05),but nausea and vomiting in the high dose group were higher than those in the control group and low dose group(all P <0.05).Conclusion Different doses of nalox-one could be used for patients using dezocine anesthesia according to patients after operation,to reduce respiratory inhibi-tion,and help patients relieve pain and agitation,and the recommend dose of naloxone is 7μg/kg.

ObjectiveTo investigate the nursing key points to 8 end-stage ovarian cancer patients with totally implantable venous access ports.Method The totally implantable venous access ports were used in the 8 patients and nursing was carried out to them.Result There were no occurrences of infection,leakage,seepage,pipe obstruction and the needlepoint shift.Conclusions The ovarian cancer patients in the end-stage had very low resistance and high risk of infection.Individualized nursing care to them may ensure the use of the ports in a safe way.

Objective To study the value of echocardiogram in preoperative examination for the diagnosis of silent myocardial is-chemia in patients before surgery .Methods 172 patients with surgical preoperative suspected diagnosis of coronary heart disease , were divided into heart valve surgery group (72 cases) and non heart valve surgery group (100 cases) .All of the patients had echo-cardiography and coronary angiography before 2 weeks of operation .We drew a series of analysis to assess the sensitivity、specialty and accuracy of diagnosis of silent myocardial ischemia with regional wall motion abnormality (RWMA) and wall motion score in-dex (WMSI) .Results Coronary angiography as the gold standard of coronary heart disease diagnosis .The sensitivity of RWMA for the diagnosis of silent myocardial ischemia in patients undergoing heart valve surgery group and non heart valve surgery group was 85 .7% and 100 .0% ,while the specificity of RWMA was 100 .0% and 80 .0% ,respectively ,the differences between the two groups had no statistical significance (P>0 .05) .We also drew the ROC curve of WMSI for the diagnosis of silent myocardial ische-mia ,maximum area under the ROC curve of WMSI were 2 .20 and 2 .05 .In patients undergoing cardiac surgery and non-cardiac sur-gery ,the curves indicated that the sensitivity were 79 .7% and 75 .9% ,the specificity were 83 .0% and 67 .7% ,respectively .Area under the ROC curve was 0 .832 and 0 .702 ,but the difference was not statistically significant (P>0 .05) .Conclusion Using RW-MA and WMSI as reference indicators ,surgical preoperative echocardiography in the diagnosis of patients with silent myocardial is-chemia has good sensitivity ,specific ,and accurate ,there is no statistically significant difference between heart valve surgery and non heart valve surgery .

OBJECTIVETo observe the prevention effects of patients with lung exudation and pulmonary fibrosis induced by paraquat poisoning in sodium bicarbonate (SB) with gastric lavage, atomization inhalation and intravenous injection.

METHODSTo collect 38 patients with paraquat poisoning in hospital, after poison immediately with gastric lavage of 1.5% SB, and atomization inhalation of 5% SB 10~15 ml twice daily and intravenous injection of 5% SB twice a day, continuous application of 5~7 days. and the HRCT score and liver and kidney function was performed on patients with lung after treatment. And the extraction of 38 SB patients with previously untreated with SB for comparison.

RESULTSLung HRCT average score in 72 h, 7 d, 30 d on patients with paraquat poisoning untreated with SB reached 2.87, 3.12, 2.13, HRCT display shows that the appearance of the wear glass shadow, grid shadow, honeycomb shadow, and other signs of fibrosis. Average HRCT reached 1.95, 2.20, 1.67 on patients treated with SB,signs of lung exudation and fibrosis was significantly reduced,compare two groups,there was statistically significance (P<0.01). And compared to the control group, activity of serum alanine aminotransferase (ALT) and aspartic acid transaminase (AST) decreased significantly in group of paraquat poisoning with triple application of SB, the level of serum urea nitrogen (BUN) and creatinine (Cr) significantly decreased, the difference is statistically significant (P<0.01).

CONCLUSIONThe triple application of SB can reduced the pulmonary fibrosis and effusion induced by paraquat poisoning,and protective effect on the function of liver and kidney is obvious, suggesting that the method for treatment of paraquat poisoning, prevention of paraquat lung and improve survival rate has the exact effect.

Blood Urea Nitrogen ; Creatinine ; blood ; Gastric Lavage ; Humans ; Injections, Intravenous ; Lung ; pathology ; Paraquat ; poisoning ; Pulmonary Fibrosis ; chemically induced ; therapy ; Sodium Bicarbonate ; therapeutic use ; Survival Rate

Objective To investigate whether the spleen diameter,serum albumin and periphefial blood cells might be as non-invasive predictive indicators for the presence of esophageal varices(EV)in patients with liver cirrhosis.The predictive values of these parameters to the large esophageal varices were evaluated.Methods OBe hundred and sixty-seven patients with liver cirrhosis underwent endoscopic examination.Among them,127 patients(mild in 41,medium in 38,severe in 48)were found with EV and 40 patients without(NEV).The diameters of portal vein and spleen vein,the sizes of spleen and the ratio of platelet count/spleen size were examined by Doppler ultrasound.The platelet count and the level of albumin were calculated.Results The average of age,diameter of portal vein and spleen vein,and sizes of spleen were higher in EV group than those in NEV group,while the platelet count,the level of albumin and the ratio of platelet count/spleen size in EV groups were lower than those in NEV group.Multifactor analysis revealed that the index related to serious EV were the blood platelet count(＜70×109/L),the ratio of platelet count/spleen size(＜1.0)and albumin level (＜35 g/L).Conclusions The degree of EV in patients with liver cirrhosis were paralleled with the degree of portal hypertension.The patients who present with platelet count＜70×109/L,or platelet count/spleen size＜1.0 or albumin＜35 g/L should be considered as EV,and endoscopic examination is needed.

Objective To study the clinical characteristics and HBeAg status in HBV liver cirrhosis patients with different HBV DNA levels, Method Three hundred and thirty-seven patients with liver cirrhosis caused by chronic HBV infection were investigated. HBV DNA levels were detected by PCR, and HBV markers were detected by MEIA. The ratio of patients with HBeAg positive or negative in groups with different HBV DNA levels was compared, and the clinical characteristics in patients with different HBV DNA levels and HBeAg status were evaluated. Results The positive ratio of HBV DNA and HBeAg were 80.4% (271/337) and 31.5% (106/337). The negative ratio of HBeAg was 68.5% (231/337). The proportion of patients with Child-Pugh grade A, B or C and hepatocellular carcinoma (HCC) in different groups of HBV DNA levels and in different HBeAg status showed no significant difference, but the ratio of HCC in patients with HBV DNA 3-4 lg copies/ml was higher than that in patients with HBV DNA <3 lg copies/ml (P=0.014) and ≥7 lg eopies/ml (P =0.009). No significant difference of HBV DNA levels was found in different age groups, but the negative ratio of HBeAg increased with the increasing of the age. Conclusions More than 80% of patients with liver cirrhosis caused by chronic HBV infection axe HBV DNA positive, and 2/3 of them are HBeAg negative. Suppressing HBV replication may improve the prognosis of HBV related cirrhosis and HCC.

Objective To investigate the protective effect of curcumin on apoptosis of human umbilical vein endothelial cells (HUVECs) induced by oxidized low density lipoprotein (ox-LDL) and its possible mechanism.Methods Cultivated HUVECs were divided into six groups: control group, ox-LDL group, ox-LDL plus endoplasmic reticulum stress(ERS) inhibitor PBA group,curcumin group, ox-LDL plus curcumin group,ox-LDL plus curcumin plus PI3K inhibitor LY294002 group.Cell viabilities were evaluated by CCK-8 assays.The proportions of apoptotic cells were assessed by flow cytometry.The translocation of activating transcription factor 6 (ATF6) observed by laser confocal microscopy.Western blot was used to determine the expression of the ERS associated proteins:glucose-regulated protein 78(GRP78), protein kinase-like ER kinase(PERK), inositol-requiring kinase1(IRE-1) and the related pathways protein: LOX-1, AKT and phophorylated AKT.Results Compared with control group,increasedthe proportions of apoptotic cells(P<0.01),enhanced the expressions of ERS related proteins(P<0.01),promoted the transfer of ATF6 into the nucleus,as well as increased the expression of LOX-1(P<0.01)and decreased the expression of p-AKT(P<0.01) in the ox-LDL group;Compared with ox-LDL group,PBA inhibited ox-LDL-induced HUVECs apoptosis(P<0.01),curcumin inhibited ox-LDL-induced the expression of ERS associated protein and LOX-1(P<0.01), the nuclear translocation of ATF6, the apoptosis of HUVECs (P<0.01), and it also increased ox-LDL-induced down-regulation of p-AKT expression (P<0.01);LY294002 partially attenuated the inhibitory effect of curcumin on ERstress-related protein expression induced by ox-LDL(P<0.05).ConclusionsCurcumin can reduce ox-LDL induced apoptosis of HUVECs, its mechanism may be through the inhibition of LOX-1 expression and activation of AKT pathway to reduce ERS in cell.

Objective: To analyze mutations of RUNX2 gene in a Chinese family with CCD. Methods: The proband and her parents were investigated in the present study. Radiological examination regarding osseous malformations was carried out over the entire body. Genomic DNA was extracted from whole blood, and the RUNX2 gene was amplified by PCR from genomic DNA. 100 healthy people were also included. DNA sequences were analyzed by using BLASTN (BLAST nucleotide) program. Results: Both the proband and her mother have typical CCD clinical characteristics, different from her healthy father. After BLASTN analysis, one novel mutation was identified in the proband and her mother, a heterozygous A to G transition mutation at nucleotide 478 in exon 2, which converted asparagines to aspartic acid at codon 160 (478 A>G,N160D). Conclusion: The N160D mutation is identified as a novel heterozygous mutation, which supplements the data of RUNX2 gene mutation research.