Objective To evaluate the left atrial function and to explore its determinants in patients with hypertrophic cardiomyopathy by three-dimensional echocardiography (3DE).Methods 46 patients with HCM (obstructive HCM:25 cases,nonobstructive HCM:21 cases) and 46 healthy cases (controls) were enrolled in this study.Time-volume curve of left atrium was acquired by 3DE in all subjects.Left atrial maximal volume (LAVmax),left atrial minimal volume (LAVmin) and left atrial presystolic volume (LAVp) were acquaired.Left atrial volume index (LAVI),left atrial expansion index (LAEI),left atrium emptying fraction (LAEF),left atrium passive emptying fraction (LAPEF) and 1eft atrium active emptying fraction (LAAEF) were calculated.Comparative analysis between two groups was taken .The Spearman correlation analysis and multiple linear regression analysis between left atrial volume index (LAVI) with interventricular septal thickness (IVSd),left ventricular outflow tract peak gradient (LVOT-PG),mitral regurgitation (MI), left ventricular diastolic function (LVDF) were analyzed respectively .Results Compared to the controls LAVmax (45.67 ±11.96)ml,LAVmin (20.48 ±6.80)ml,LAVp (24.48 ±9.31)ml,LAVI 25.63 ±6.52, LAEI (1.32 ±0.49)%,LAEF (55.25 ±8.06)%,LAPEF (35.90 ±7.00)%and LAAEF (30.20 ±10.13)%, the patient with HCM had a significantly larger LAVmax (81.45 ±24.24)ml,LAVmin (44.60 ±18.96)ml, LAVp (61.00 ±21.64) ml and LAVI 45.39 ±14.17,there were significant differences among the groups (t=8.978,8.123,9.227,8.436,all P<0.01),lower LAEI(0.95 ±0.43)%,LAEF (46.15 ±11.12)%, LAPEF (25.64 ±9.09)%,there were significant differences among the groups (t=-3.865,-4.493,-6.504,all P<0.01),and slightly lower LAAEF (28.20 ±9.26)%,there were no significant differences among the groups (t=-0.656,P>0.01).There were significant positive correlation between LAVI and IVSd,LVOT-PG,MI,LVDF respectively (r=0.704,0.517,0.640,0.701,all P<0.01).Multiple linear regression analysis demonstrated that IVSd , LVOT-PG, MI and LVDF were correlated factors of LAVI (absolute standardized coeffients =0.264,0.515,0.614,0.341,all P<0.05).Conclusions 3DE could evaluate the left atrial volume and function in patients with HCM , with increased left atrial volume and decreased reservioer,conduit and booster pump function .Mitral regurgitation,obstruction of left ventricular outflow tract,left ventricular diastolic dysfunction and the thickness of left ventricular wall contributed to left atrial dysfunction at different levels ,among which mitrial regurgitation contributed the most .

Objective To investigate the dynamic changes in peripheral blood of patients with acute pancreatitis α-MSH,TNF-α,PCTS and the value of the patient assessment of disease severity.Methods Emergency surgery in the Second Affiliated Hospital of Anhui Medical University from March 2011 to March 2014 were treated 68 cases of acute pancreatitis patients,36 patients with mild,32 cases of severe group.All patients were extracted 1,3,5,7 days after admission blood,and α-MSH was measured by enzymelinked immunosorbent assay,the content of TNF-αand PCT.Results Compared with the mild group,the serum of patients with severe group of α-MSH concentrations were lower (P ＜ 0.05),while serum TNF-αand PCT levels higher than the mild group (P ＜ 0.05);in disease severity assessment,α-MSH sensitivity of 82.35％ and a specificity of 88.24％,the accuracy was 87.5％,TNF-α sensitivity of 76.47％ and a specificity of 82.35％,the accuracy was 81.25％,PCT sensitivity of 70.59％ and a specificity of 76.47％,75.00％ accuracy,PCT + TNF-α + α-MSH sensitivity of 88.24％ and a specificity of 94.12％,93.75％ accuracy;area under the PCT,TNF-α,α-MSH and the combination of the three curves 0.690,0.696,0.768 and 0.885,respectively.Conclusions Serum α-MSH,monitoring TNF-α,PCT levels have some clinical value in patients with acute pancreatitis disease severity assessment,including α-MSH in the condition assessment of the sensitivity,specificity and positive predictive value were higher than the latter two,and peripheral α-MSH in patients with a low level indicates a serious condition,poor prognosis;addition,combined detection with higher clinical value in the assessment of disease severity.

ObjectiveTo study the application of magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) in brain metastases, and the relationship between DWI results and the primary tumor pathology. Methods76 cases with brain metastases were grouped according to the primary cancer pathology. The apparent diffusion coefficient (ADC) of tumor parenchyma, capsule area, edema around tumors and normal parenchyma were determined; the ratio of high signal on the DWI were calculated (namely diffusion limited) in different tumor. ResultsThe ADC was (1.1364±0.310)×10-3 mm2/s in tumor parenchyma, (2.167±0.472)×10-3 mm2/s in capsule, (1.597±0.238)×10-3 mm2/s in edema and (0.812±0.158)×10-3 mm2/s in normal parenchyma (P<0.05). 15 cases appeared diffusion limited (19.7%), in which the primary tumors were lung cancer in 10 patients (66.6%) (including 5 cases with small cell lung cancer, 5 cases with none small cell lung cancer), breast cancer in 3 cases, and the other 2 cases were colon cancer and teratocarcinoma of testis (P>0.05). The minimum ADC were (0.72±0.16)×10-3 mm2/s in tumor parenchyma with diffuse limited metastases and (0.78±0.21)×10-3 mm2/s without diffuse limited (P=0.325). ConclusionDWI can respond to brain metastases to the microstructure change, but diffusion limited may not be related with the primary histopathology.

Objective To explore the effectiveness of a respiratory function training instrument with stable chronic obstructive pulmonary disease (COPD) patients.Methods Sixty-seven COPD patients in the stable period were randomly divided into a treatment group of 36 and a control group of 31 using a random number table.Both groups were given conventional pulmonary rehabilitation,including half-closed lip respiration,abdominal respiration and upper limb training.The treatment group was additionally provided with 30 minutes of respiratory training using a respiration function training instrument 5 times per week for 6 months.Both groups were assessed for their mobility,life quality and pulmonary function using the 6-minute walk test (6 MWT),a COPD assessment test (CAT),the BODE index,forced vital capacity (FVC),forced expiratory volume in one second (FEV1) and surface electromyography (SEMG) of the respiratory muscles before and after the 6-month intervention.Results Before the treatment there were no significant differences between the two groups in terms of any of the measurements.After the treatment,significant improvement was observed in the average 6 MWT,CAT,BODE index and SEMG results in both groups,but with significantly greater improvement in the treatment group.The average FVC and FEV1 results did not improve significantly,so after the intervention there was still no significant difference between the groups.Conclusions Respiratory training using the pulmonary function training instrument can improve the mobility,life quality and the functioning of the respiratory muscles of COPD patients in the stable period.

An immunopotentiating compound has been isolated from the metabolites of Bacillus mycoides under the bioassay-guided isolation and identification for its immunopotentiating effect and chemical structure. The isolation and purification of the compound were consisted of macroporous adsorptive resins, silicagel chromatographic column and Sephadex G-200 chromatographic column. The immunopotentiating effect was assayed in every step isolation. At last, the only substance having the strongest immunopotentiating effect had been isolated and purified. Through the procedure consisiting of Ultra-Violet spectroscopy (UV), IR (Infrared Radiation), Time of Flight Mass Spectrum (TOF-MS), Nuclear Magnetic Resonance (NMR) and Element analysis, the possible structure of compound M had been identified as cyclic (Pro-Gly) dipeptide (C7H10O2N2) (Diketopiperazine). To be determined the immunopotentiating effect, the mice were treated by intraperitoneal injection of cyclic (Pro-Gly) dipeptide in the treatment group and physiologic saline in the control group. At the 14th day after the injection, the SOD activity and the phagocytosis activities reached the peak value and were significantly higher than those in control group. At the 21st day, the bactericidal activity reached peak value and was significantly higher than that in the control group. From the above results, we concluded that the main active component enhancing the immunity of mice was cyclic (Pro-Gly) dipeptide in the metabolism of Bacillus mycoides.

Objective To explore the value of peripheral blood serum levels of PCT,CRP,TNF-α and free DNA of cells in predicting the development of MODS in patients with multiple trauma.Methods Complete detail clinical data of 54 casualties with multiple trauma admitted within 24 hours after accident from January 2011 through January 2012 were collected for retrospective study.The patients were divided into MODS group and non-MODS group according the criteria set forth by the Chinese Society of Critical Care and Emergency Medicine in 1995 national conference.The data of two groups are comparable,and data of another 20 healthy subjects undertaking routine annual physical examination were taken as control.The peripheral blood levels of PCT,CRP,TNF-α and free DNA of patients of two groups were determined 1 d,2 d,3 d,and 5 days after admission.Then the results were analyzed and compared between groups.Results Compared with non MODS group,the levels of PCT,CRP,free DNA of cells in MODS group were significantly higher (P ＜ 0.05),but there was no deference in TNF-α between MODS group and non-MODS group (P ＞ 0.05).When the relative risks of increased PCT (PCT≥6 mg/L),increased CRP (CRP≥ 130 mg/L)、and increased free DNA of cells (free DNA ≥ 10 0005/L) were analyzed,the presence of these 3 biomarkers with high levels occurred at the same time was the most accurate way to predicts MODS in 6.00 relative risk (RR),and the positive predictive value was 100％.Conclusions PCT,CRP,free DNA of cells could be the predictors of MODS in patients with severe multiple trauma,and the presence of high levels of these three biomarkers appearing together had high sensitivity and specificity for prediction.

Objective To explore the evaluation value of serum Ghrelin and pleural effusion in patients with acute pancreatitis . Methods Eighty patients with acute pancreatitis treated in our hospital from February 2011 to February 2014 were divided into mild case group (31 patients) and severe case group (49 patients) according to the severity of the disease .Venous blood samples were collected at time point including :admission ,48h after admission and after discharge at empty stomach in the morning ,and CRP level ,WBC ,PCT level of patients were checked .The concentration of serum Ghrelin of patients were mensurated by enzyme linked immunosorbent assay and pleural effusion were diagnosed by sternum .Results Compared with the patients in the mild case group , serum Ghrelin ,CRP level ,APACHE score ,CT score and Ranson score were higher in the severe case group and the hospital day of patients in the severe case group was longer(P<0 .01) .The area under the curve of CRP level ,pleural effusion ,Ghrelin ,Ghrelin combined with pleural effusion of ROC were 0 .708 3 ,0 .749 6 ,0 .852 4 and 0 .910 8 .Ghrelin combined with pleural effusion has the best evaluation effect on the patients with acute pancreatitis .The sensibility ,specificity ,accuracy of CRP were 93 .6% ,69 .4% and 73 .7% ;the sensibility ,specificity ,accuracy of pleural effusion were 75 .2% ,88 .7% and 76 .8% ;the sensibility ,specificity ,accuracy of Ghrelin were 86 .9% ,88 .2% and 85 .3% ;the sensibility ,specificity ,accuracy of Ghrelin combined with pleural effusion were 90 .1% ,92 .6% and 91 .4% .Conclusion Serum Ghrelin and pleural effusion have high sensibility ,specificity and accuracy in pa‐tients with acute pancreatitis and has high clinical value .

BACKGROUND:In total hip arthroplasty, the accurate placement of the acetabulum is needed to guarantee the survival rate of the prosthesis and improve the prognosis. In order to ensure the accurate placement of the acetabulum, the accurate measurement of the abduction angle and the anteversion angle of the acetabulum is needed. OBJECTIVE:To investigate the application value of C-arm X-ray displacement measurement of acetabular anteversion angle and abduction angle in total hip arthroplasty. METHODS:Total y 63 cases undergoing total hip arthroplasty were divided into two groups according to their wil . Patients in the control group (n=30) were implanted with traditional acetabular prosthesis locator. Patients in the observation group (n=33) were implanted with acetabular prosthesis after C-arm X-ray displacement measurement. Acetabular anteversion angle, abduction angle and pelvic inclination were measured before, during and after arthroplasty. Acetabular anteversion angle and abduction angle were measured in both groups after arthroplasty. Pain score and hip function Harris score were recorded in both groups at different time points. RESULTS AND CONCLUSION:(1) No significant difference in acetabular anteversion angle, abduction angle and pelvic inclination was detected before, during and after arthroplasty (al P>0.05). (2) No significant difference in abduction angle was determined between the two groups after arthroplasty (P>0.05), but acetabular anteversion angle was significantly smal er in the observation group than in the control group (P<0.05). (3) At 7 days after arthroplasty, Visual Analog Scale scores were less in the observation group than in the control group (P<0.05). (4) Compared with that before arthroplasty, Harris score was significantly higher after arthroplasty in both groups (P<0.05). Harris score was higher in the observation group than in the control group at 3 and 12 months after arthroplasty (P<0.05). (5) Results indicated that during total hip arthroplasty, C-arm X-ray machine can measure acetabular anteversion angle and abduction angle, and effectively correct pelvic inclination, internal and external rotation, abduction and adduction, improve the accuracy of acetabular cup placement and the quality of replacement surgery, and improve the prognosis of the patients.

Objective:To investigate the effects of estradiol on ~(60)Co?-ray induced apoptosis of bone marrow hematopoietic cells of mice,and to discuss the related anti-irradiation mechanism.Methods:KM mice were randomly divided into 3 groups(15 mice/each group):control group(without radiation),pure radiation group and estradiol+radiation group(ER group).The pure radiation group was irradiated by 4.0 Gy?-ray at a dose rate of 1.15Gy/min;the ER group was administered with 0.1 mg estradiol(IM)at 10 days before 4.0 Gy?-ray radiation;and the control group received no special treatment.The apoptotic DNA segments of bone marrow hematopoietic cells were analyzed by DNA agarose gel electrophoresis;flow cytometry was used to examine the apoptosis rate of cells and expression of Fas and Bcl-2 at 4 h,8 h,and 12 h after irradiation.Results:Eight hours after radiation,the apoptotic DNA segments were obviously increased and apoptotic DNA ladder appeared,which was not seen in the other 2 groups.The apoptosis rate of bone marrow hematopoietic cells in ER group was significantly lower than that in the pure radiation group at 4,8,and 12 h after irradiation(P

0.05).There were more polycystic ovary (PCO) and (or) polycystic ovarian syndrome (PCOS) patients,more basal antra] follicles,longer duration of Gn stimulation (range 16-33 days),higher Gn dose,lower serum peak estradiol (E_2) level,fewer oocytes,fewer embryos transferred,in group 1 compared with group 2 (P