Objective To investigate the variation of lipid profile in patients with acute myocardial infarction (AMI) of different age groups.Methods Total 1214 patients of AMI were admitted to our hospital from May 2007 to July 2011.The age of patients ranged 40-89 years,and patients were divided into 5 age groups with 10-years step.Differences in lipid levels were observed by using pair-wise comparison among different age groups.Results Pair-wise comparisons among different age groups indicated that TC levels were higher in 40-69 years age groups [(4.71 ± 1.08),(4.80 ± 1.30),(4.69 ± 1.03) mmol/L,respectively] than those in the 70-89 age groups [(4.41 ± 0.96),(4.38 ± 1.03) mmol/L],all P ＜ 0.05(t values were 2.381,2.323,4.382,3.965,3.317,3.096).TG levels among three age groups ＜ 59 years had no significant difference,which were higher than those in groups over 60 years.Among 50-89 years age groups,TG gradually reduced with increase of age.HDL levels were lower in 40-59 years age groups [(1.03 ± 0.23),(1.05 ± 0.26) mmol/L,respectively] than those in 60-89 years age groups [(1.11 ±0.28),(1.11±0.28),(1.16±0.34) mmol/L,respectively],allP＜0.05 (t values were-2.777,-2.789,-3.731,-2.543,-2.566,-3.644).Total cholesterol (TC) (r =-0.123,P ＜0.01),lowdensity lipoprotein cholesterol (LDL) (r =-0.139,P ＜ 0.01) and triglyceride (TG) (r =-0.287,P ＜0.01) were negatively but high-density lipoprotein cholesterol (HDL) (r =0.125,P ＜ 0.01) was positively correlated with age of patients.TC levels in female patients were higher than those in male patients in 50-89 years age groups; LDL levels in female patients were higher than those in male patients in 50-69 years age groups and HDL levels in female patients were higher than those in male patients in 40-79 years age groups (all P ＜ 0.05,t values were-2.878,-3.007,-3.352,-3.333).Conclusions Results show that the non-elderly AMI patients (＜60 years) have higher levels of TC,LDL and TG,and lower level of HDL than the elderly patients; the TC,LDL and HDL levels are higher in female AMI patients than those in male patients at the same age groups.

Objective To determine the optimum dose of bupivacaine for spinal anesthesia with epidural volume extension (EVE) in patients undergoing cesarean delivery.Methods A total of 100 parturients,weighing 55-100 kg,with body height of 155-170 cm,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective cesarean delivery,were included and randomized to receive bupivacaine at 5 different doses (A,B,C,D,and E groups) using a random number table,with 20 patients in each group.In A,B,C,D,and E groups,bupivacaine 6.75,7.50,8.25,9.00 and 9.75 mg were injected into the subarachnoid space,respectively,and the volume was all 1.5 ml.After successful spinal anesthesia,an epidural catheter was placed,and normal saline 10 ml was given through the catheter to perform EVE.A successful spinal block was defined as attainment of sensory block of at least T5 within 15 min after EVE along without requirement for additional local anesthetics within 60 min after EVE.The rate of successful spinal anesthesia,time to reach sensory block of T5,the maximum level of sensory block,and the first requirement for local anesthetics were recorded.The occurrence of hypotension,tachycardia,bradycardia,nausea,vomiting,chest distress,dyspnea,shivering,and referred pain and consumption of metaraminol were recorded during spinal anesthesia.Apgar scores at 1 and 5 min after birth were recorded.Results With the increasing doses of bupivacaine,the efficacy of spinal anesthesia was enhanced,and the occurrence of adverse reactions was increased.Compared with group C,the rate of successful spinal anesthesia,and the maximum level of sensory block were significantly increased,the time to reach sensory block of T5 was shortened,and the incidence of hypotension and nausea and consumption of metaraminol were increased in group E;the time to reach sensory block of T5 was significantly shortened,Apgar scores at 1 min after birth were increased (P＜0.05),and no significant change was found in the rate of successful spinal anesthesia,the first requirement for local anesthetics,the rate of time to reach sensory block ofT5≤ 15 min,and the maximum level of sensory block in group D (P＞0.05).Compared with group D,the time to reach sensory block of T5 was significantly shortened,the incidence of nausea and consumption of metaraminol were increased (P＜0.05),and no significant change was detected in the rate of successful spinal anesthesia,the first requirement for local anesthetics,the rate of time to reach sensory block of T5 ≤ 15 min,and the maximum level of sensory block in group E (P＞0.05).Conclusion The optimum dose of bupivacaine for spinal anesthesia with EVE is 9.00 mg in patients undergoing caesarean delivery.

BACKGROUND:The incidence of patel ar complications is decreasing, however, the necessity of patel ar replacement remains unclear. OBJECTIVE:To investigate the incidence rate of anterior knee pain and postoperative pain score in total knee arthroplasty without the patel ar replacement and to provide a reference for the formulation of clinical operation scheme. METHODS:151 patients with 193 knees receiving total knee arthroplasty were involved in this study. Al the patients were treated with patel ar forming but not resurfacing of the patel a. The Western Ontario and McMaster University (WOMAC) Osteoarthritis Index and America Hospital for Special Surgery (HSS) score were used to evaluate patients before surgery and at 6 and 12 months after surgery. The function of knee joint, the incidence rate of anterior knee pain and visual analogous scale score before and after operation were compared. RESULTS AND CONCLUSION:After 6 and 12 months of total knee arthroplasty, WOMAC osteoarthritis index was significantly lower and HSS score was significantly higher than those before surgery (P<0.05). At 12 months post-operation, the incidence rate of anterior knee pain was 11.3%, which was significantly lower than the preoperative rate (94.5%) (P<0.05). At 12 months post-surgery, visual analogous scale scores were also significantly lower than the preoperative score (P<0.05). Total knee replacement without resurfacing of the patel a can effectively improve knee joint function in knee osteoarthritis or rheumatoid arthritis patients, ameliorate the symptoms of anterior knee pain, has a good clinical effect within short term post-operation. The middle-and long-term effects need further exploration.

Intravenous leiomyomatosis (IVL) is a rare benign neoplasm which originates from the smooth muscle cells and is usually confined to the pelvic venous system. Rarely, intracaval and intracardiac extension has been described. Death can occur as a result of intracardiac involvement. We reported 4 cases of IVL with right heart involvement (intracardiac leiomyomatosis, ICL). Three of them suffered recurrent sudden syncope, and the other one was totally asymptomatic. All of them were successfully treated through one-stage operation under extracorporeal circulation.

Objective To explore the rehabilitation effect of pelvic floor muscle training combined with traditional Chinese medicine in the treatment of mild-moderate pelvic organ prolapse.Methods A prospective ease-control study,choosing 103 patients of mild-moderate pelvic organ prolapse from October 2012 to May 2014 in Maternal and Child Health Hospital Outpatient of Hunan Province,which were randomly divided into study group (52 cases) and control group (51 cases).All of the patients underwent two courses of pelvic floor muscle training,including Kegel exercise,biofeedback,electrical stimulation therapy,the study group combined with traditional Chinese medicine (Buzhongyiqitang) at the same time.The efficacy was analyzed before and after treatment of pelvic floor muscle strength,myoelectric potential and indexing of pelvic organ prolapse quantification (POP-Q) changes.Results There werent statistically significant differences in type Ⅰ and Ⅲ muscle fiber muscle strength and myoelectric potential of two groups before treatment,while the shrinkage index improved significantly after treatment,and the study group was significantly higher with statistically significant difference (P ＜ 0.05).The effective rates of POP-Q indexing changes in two groups were 71.2％ and 56.9％,respectively.The effective rate of the study group was significantly higher than the control group(P ＜ 0.05).Conclusions The clinical efficacy of pelvic floor muscle training combined with Buzhongyiqitang in the treatment of mild-moderate pelvic organ prolapse was significant,and it had a good clinical value.

Objective: To investigate the association between inflammatory cytokines and ventricular remodeling after acute myocardial infarction (AMI) in rats, and the effects of simvastain on inflammatory cytokines and ventricular remodeling after AMI thereof. Methods: After AMI was produced in female SD rats, the animals were divided into control group,simvastain group and sham-operated group. After transthoracic echocardiography, TNF-α, IL-6 and P Ⅲ NP of the serum and cardiac muscle were measured by radioimmunology technology. The comparative heart weight and infarct sizes were calculated.Results: Compared with the control group, the LVDd and LVDs decreased significantly (P ＜ 0.05), LVEF,LVFS and posterior wall thicking increased significantly (P ＜ 0.05) in simvastain group. The values of TNF-α, IL-6 and P Ⅲ NP increased significantly in simvastain and control group compared with those of sham-operated group(P ＜ 0.05 or P ＜ 0.01 ). The values ot TNF-α, IL-6 and pⅢ NP decreased significantly in simvastain group compared with those of the control group (P ＜ 0.05). The comparative heart weight and infarct size decreased significantly in simvastain group compared with those of the control group (P ＜ 0.05). Conclusion: Simvastain can ameliorate the ventricular remodeling and improve cardiac performance after AMI by restraining the overexpression of inflammatory cytokines.

ObjectiveTo evaluate analytical performance of NT-proBNP on Electro-Chemiluminescence Immunoassay system.MethodsThe precision,accuracy,limit of blank ( LoB ),limit of detection (LoD),functional sensitivity (FS),analytical measure range (AMR),maximal dilution rate,clinical reportable range(CRR) and the analytical anti-interference ability of NT-proBNP were evaluated according to EP documents issued by CLSI and related references.The analytical performance data were compared to quality standards declared by the manusfacturers.According to CLSI C28-A2,80 healthy volunteers,aged from 18 to 74, were chosen and divided into 4 groups on average for biological reference intervals verification.Results The within-run CV and total CV were 1.1％ -2.2％and 1.5％ -2.9％ respectively.The deviations from controls distributed by National Center for Clinical Laboratory and affiliated calibrators were 2.7％ -5.9％ and 2.7％ -7.5％,respectively.The results of LoB,LoD and FS were 2.5,7.8 and 8.8 pg/ml,respectively.AMR was 8 -35 126 pg/ml,and the most suitable dilution rate was 1∶ 2,so the CRR was 9 -70 252 pg/ml.428 μmol/L bilirubin,2 g/L haematoglobin and 2 200 FIU chyle didn't interfere with the NT-proBNP assay.Moreover,almost all the data from different age groups were in the range of biological reference intervals declared by the manusfacturers, except one test data (167 pg/ml).Conclusions The analyticalperformance of NT-proBNP analyzed on Roche Cobas E601electrochemiluminescence immunoassay systemisconsistentwiththestandarlswhichmanufacturershas proclaimed.The establishment of LoD,FS,maximal dilution and CRR for NT-proBNP assay could provide the quality assurance for clinical use and the biological reference intervals declared by manusfacturers could meet the clinical needs.

Objective To observe the effect of acupuncture on ghrelin,estradiol (E2) and bone mineral density (BMD) in postmenopausal osteoporosis rats.Methods According to the random number table method,60 female Sprague-Dawley rats aged 3 months,were randomly divided into surgery group (40 rats) and sham group (20 rats).The osteoporosis model was established by bilateral ovariectomy.Three months after the operation,a significant decrease in BMD of lumbar vertebrae and femur of the model rats as measured by dual energy X-ray absorptionmetry against the sham group indicated successful establishment of the osteoporosis model.Then surgery group was randomly divided into a model subgroup,a acupuncture subgroup and an estrogen subgroup,with 10 rats in each subgroup.The acupuncture subgroup was treated with electroacupuncture,estrogen subgroup with subcutaneous injection of estradiol benzoate,sham group and model subgroup without any treatment.After 3 months of intervention all the rats were sacrificed,BMD of the lumbar vertebrae and femur was measured,ghrelin and E2 were determined.Results Serum ghrelin in acupuncture subgroup (399 pg/ml) and estrogen subgroup (276 pg/ml) were significantly lower (P ＜ 0.01) than that in model subgroup (546 pg/ml); serum E2 in acupuncture subgroup (128.02 pg/ml) and estrogen subgroup (182.89 pg/ml) increased significantly (P ＜ 0.05) than that in model subgroup (72.10 pg/ml) ;lumbar vertebrae BMD in acupuncture subgroup (0.212 g/cm2) and estrogen subgroup (0.231 g/cm2) increased significantly (P ＜ 0.05) than that in model subgroup (0.191 g/cm2),but in acupuncture subgroup the effect on improving the level of E2,ghrelin and lumbar vertebrae BMD was less than that in estrogen subgroup (P ＜ 0.05).Conclusions Acupuncture intervention can improve lumbar vertebrae BMD and serum E2 level of postmenopausal osteoporosis rat model,down regulate serum ghrelin level,but the overall effect of acupuncture is less than estrogen.

Objective To observe the effect of electroacupuncture (EA) on intestinal vitamin D receptor (VDR) mRNA and protein expression in ovariectomized rat model,and to explore the possible mechanism of acupuncture treatment for postmenopausal osteoporosis.Methods Sixty 3-month-old female SD rats were randomly divided into operation group and sham group.3 months after osteoporosis model was successfully produced,rats in operation group were randomly divided into model group,EA sham group,EA group and drug group.12 weeks after intervention,bone mineral density (BMD) of lumbar spine and femur were detected,then rats were all sacrificed to extract the small intestinal mucosa.VDR mRNA and protein expressions were determined by real-time quantitative PCR and Western blotting.Results The model of postmenopausal osteoporosis was successfully established.The bone mineral density was significantly improved in EA group and drug group as compared with the model group at 12 weeks after intervention.Western blotting and realtime quantitative PCR showed that small intestinal VDR mRNA and protein expressions were increased in EA group and drug group,but the increment of VDR mRNA expression was less in EA group than in drug group.Conclusions One of the mechanisms of acupuncture treatment for postmenopausal osteoporosis may be related with increasing the intestinal VDR mRNA and protein expression levels and enhancing the bioactivity of vitamin D.

Rheumatoid arthritis (RA) is a kind of chronic autoimmune disease and osteoporosis is one of its complications.