Objective To investigate the predictive value of Lp-PLA2 on the successful rate of thrombolysis in patients with a-cute myocardial infarction (AMI) .Methods Patients with AMI within 6 hours of onset were enrolled and blood samples before thrombolysis were drawn for laboratory examination .Alteplase was used for thrombolysis and 2 hours later ,successful rate and the predictive value of baseline Lp-PLA2 level on successful rate were evaluated .Results Totally 106 patients with AMI were enrolled and 48 cases were with anterior AMI ,32 cases with inferior AMI ,12 cases with lateral AMI ,and 14 cases with right ventricular and posterior AMI .Serum levels of cardiac biomarkers ,hs-CRP and Lp-PLA2 were all increased .Two hours later ,38 cases (35 .8% ) were with successful thrombolysis and 68 cases(64 .2% )were with failure ,and there were significant differences of baseline levels of hs-CRP and Lp-PLA2(P<0 .05) .hs-CRP was not correlated with successful rate of thrombolysis (r= -0 .17 ,P=0 .084) ,while Lp-PLA2 was negatively correlated with successful rate of thrombolysis(r= -0 .36 ,P=0 .013)as indicated by the Spearman rank correlation analysis .Conclusion Serum level of Lp-PLA2 can be used to predict the successful rate of thrombolysis in patients with AMI .

Objective To investigate the short-term clinical outcomes and perinatal risk factors in very low birth weight infants (VLBWI) with delayed enteral feeding (DEF).Methods Three hundred and fifty-five cases of VLBWI admitted to neonatal intensive care unit from Jan 2007 to Oct 2011 served as study objects,and the clinical data of which were analysed retrospectively.According to days to initiate enteral feeding after birth,355 VLBWI were divided into two groups:DEF group (initiate enteral feeds ≥5 days,n =55)and early feeding group (initiate enteral feeds ≤4 days,n =298).The short-term clinical outcomes were compared in 299 cases,including DEF group 44 cases and early feeding group 255 cases,in which cure or improvement were achieved and hospital stay ＞ 14 d.The perinatal risk factors were subjected to univariate and multivariate logistic regression analysis.Results The incidence of DEF was 16.05％ (57/355) in VLBWI.The time to regain birth weight in DEF group was significantly longer than early feeding group [(11.86 ± 3.86) d vs (9.76 ± 3.83) d,P ＜ 0.01],and the incidences of parenteral nutrition associated cholestasis [27.27％ (12/44)] and extrauterine growth retardation at discharge [79.55 ％ (35/44)] in DEF group were also significantly higher than early feeding group respectively [11.76％ (30/255) and 61.57％ (157/255),P ＜ 0.05].Multivariable logistic regression analysis showed that infants born to mother with placental abruption had higher risk of exposure for DEF than those without placental abruption (OR =2.74,95％ CI 1.06 ～7.05,P ＜ 0.05).Similarly,infants with mechanical ventilation had also higher odds of DEF than those with-out mechanical ventilation (OR =3.51,95 ％ CI 1.92 ～ 6.42,P ＜ 0.01).Conclusion Placental abruption and mechanical ventilation are independent risk factors for DEF in VLBWI.Improving neonatal outcome through enhancing obstetric quality and strengthening cooperation between obstetric and neonatology department is still the key to reduce DEF in VLBWI.

AIM: To explore the role of adrenomedullin (AM) in tissue factor (TF) and TFPI expression in HUVECs stimulated with oxLDL and to investigate its possible signal transduction pathway. METHODS: Using chromogenic assay and RT-PCR technique, TF and TFPI protein activity and mRNA level in cultured HUVECs were observed. The signal transduction pathway of AM action was further analyzed by applying Rp-cAMP (cAMP antagonist), PD098059 (MAPK inhibitor) and H7 (PKC inhibitor). RESULTS: AM inhibited TF protein activity and mRNA expression in HUVECs treated with oxLDL in a concentration-dependent fashion; AM alone increased TFPI protein activity and mRNA expression in concentration-dependent and time-dependent manner. Moreover, AM reversed the decrease in TFPI protein activity and mRNA level caused by oxLDL; AM-induced TFPI expression was inhibited by cAMP and MAPK inhibitors. CONCLUSION: AM can reverse the effects of oxLDL on TF and TFPI expression in HUVECs, which can help improve the state of blood coagulation in atherosclerosis and delay development of atherosclerosis.

Objective To study the pattern of ultrasonic bone mineral density of calcaneus with age, height and body weight, and to establish a normal reference value of stiffness index (SI) of females in Southern China for providing scientific foundation for osteoporotic diagnosis and prevention. Methods SI for calcaneus in 2498 healthy people 10～87 years old was measured with Achilles Express ultrasound apparatus made in USA. They were divided into groups according to sex and age. One group for 10 years each and the records beyond 69 years were classified into one group, total 7 groups. Results The SI showed a characteristic mild rise-then-fall pattern with increasing age. And the peak value of SI presented in 20～29 age group. Pearson correlation analysis showed negative correlation between SI and age and a positive correlation between SI/ height and weight. The prevalence of osteoporosis gradually increase with age. Conclusion There are significant correlations in SI with age, height and weight; the values of SI will provide an important data reference to establish the normal values and diagnostic]standard of osteoporosis.

BACKGROUND:Researches about sub-health status in general community population are rare,especially in minor nationalities.OBJECTIVE:To explore the sub-health status and its risk factors with logistic regression model and negative binomial regression model in Tibetan people.DESIGN,TIME AND SETTING:A cross-sectional study was performed among subjects selected from Songpan county in the Aba Tibetan and Qiang Autonomous Prefecture of Sichuan Province on September 2007.PARTICIPANTS:A total of 1791 Tibetan subjects from were recruited from Songpan county in the Aba Tibetan and Qiang Autonomous Prefecture of Sichuan Province and were involved in this study,among which 1763 subjects completed the sub-health questionnaire.Their average age was 27 years,ranging from 10 to 80.There were 731 male subjects (41.5%)and 1032 female ones (58.5%).All subjects were informed of the survey regimen.METHODS:The sub-health rating scale framed by Chen Qingshan et al was used to assess the sub-health status of subjects with stratified and cluster sampling,including the prevalence rate of sub-health status,the number of sub-health symptoms and various dimensional prevalence.MAIN OUTCOME MEASURES:Risk factors of sub-health status with logistic regression model and negative binomial regression model.RESULTS:There were 1038 subjects suffering from one or more sub-health symptoms,and they were considered as being in the sub-health status with the prevalence of sub-health 58.9%.The split-half reliability and internal consistency of the scale were separately 0.7658 and 0.8154.Logistic regression results indicated that the seniors (P=0.0004),female (P＜0.0001),marriage status (P=0.0008),mental labor (P=0.0021)and smoking (P＜0.0001)were main contributing factors of sub-health status.However,marriage status (P=0.0689)and occupation (P=0.1398)weren't statistically significant in negative binomial regression analyses.CONCLUSION:Tibetan populations living in high altitude are also suffering from sub-health status and should be given more attention.Further more negative binomial regression model could be popularized to analyze sub-health and its influencing factors.

AIM: To explore the effect of complement on the cerebral ischemia/reperfusion injury in rat and the protection by sCR1-SCR15-18. METHODS: 75 male SD rats were randomly divided into three groups: sham operation group (SO, n=15), middle cerebral artery occlusion and reperfusion (MCAO) without treatment group (I/R, n=30); MCAO treated with sCR1-SCR15-18 group (sCR1-SCR15-18, n=30). After the MCAO for 2 h, then reperfusion for 24 h, the scores of neural behavioral functional deficits were determined. Infarction area was measured by TTC staining. Activity of MPO in cerebral cortex was detected. C3b deposition and pathological change were observed by immunohistochemial staining and HE staining, respectively. RESULTS: After reperfusion for 24 h, the neurological deficits score, infarction area and activity of MPO in sCR1-SCR15-18 group were decreased compared to I/R group. In sCR1-SCR15-18 group, C3b deposition in ischemic area was decreased and pathological injury was improved compared to I/R group. CONCLUSION: Complement plays a role in cerebral ischemia-reperfusion injury and sCR1-SCR15-18 exerts a protective effect by inhibiting the excessive activation of complement.

Objective To study the risk factors of periventricular-intraventricular hemorrhage (PIVH) in extremely low birth weight infants(ELBWI). Methods A retrospective study was performed in 41 ELBWI hospitalized between January 2001 and August 2008. Univariate analysis and Logistic regression analysis were performed to detect the risk factors of PIVH. Results Of 41ELBWI, twenty-three suffered from PIVH with the incidence of 56.1%. Univariate analysis revealed that,in PIVH group,gestational age,mean blood pressure and the minimum values of blood pressure were lower than non-PIVH group[ ( 27.1 ± 1.9 ) weeks vs ( 28. 7 ± 1.6) weeks, t = 2. 834, P ＜ 0. 05 ;(28.9±4.8) mm Hg vs (33.1±4.9) mm Hg, t=-2.747,P＜0. 05; (24.4±4.3) mm Hg vs (31.4 ± 6.6) mm Hg,t= -3. 863, P＜0. 05], while blood pressure fluctuation and the highest values of PaCO2 during the first week of life were higher[(19.0 ± 5.2) mm Hg vs (13.7 ± 4. 8) mm Hg;(60. 2± 19. 4) mm Hg vs (49.5±12.1) mm Hg] (t= 3. 310 and 2. 166, P＜0. 05), the incidence of administration of pulmonary surfactant, neonatal respiratory distress syndrome, shock, hypotension before 4 days of age, hyperglycemia and mechanical ventilation therapy were higher[73. 9 % (17/23) vs 27. 8%(5/18), 60. 9%(14/23) vs 27.8%(5/18),52. 2%(12/23) vs 5.5%(1/18),73. 9%(17/23) vs 33.3%(6/18) ,78. 3%(18/23) vs 44. 5%(8/18),87. 0% (20/23) vs 44. 5% (8/18)]( all P＜0.05).Multivariate Logistic analysis revealed that blood pressure fluctuation (OR = 1. 260, 95% CI: 1. 009-1. 572, P = 0. 041 ) and lowest mean blood pressure(OR = 0. 805,95 % CI: 0. 672-0. 965, P = 0. 019)were risk factors of PIVH. Among twenty-eight ELBWI received mechanical ventilation, only peakinspiratory pressure(OR=- 2. 086,95% CI: 1. 140-3. 819, P= 0. 017) was the risk factor of PIVH by Logistic analysis. Conclusions Low blood pressure and blood pressure fluctuation may be risk factors of PIVH in ELBWI. The high values of peak inspiratory pressure is a risk factor of ELBWI with mechanical ventilation.

Purpose To explore the three-dimensional display and parameter features of 3.0T MR diffusion tensor imaging (DTI) in the imaging of normal female pelvic floor muscle fiber bundles, and to provide a reference standard for the application of DTI in patients with pelvic organ prolapse. Materials and Methods Fifty cases of females who had not given birth or had given birth by cesarean delivery were divided into four groups:20 to 29 years (15 cases), 30 to 39 years (15 cases), 40 to 49 years (12 cases) and 50 to 54 years (8 cases). First, the conventional sagittal, axial, coronal T2WI and axial T1WI images were acquired with a 3.0T MRI scanner;then a dynamic sagittal fiesta sequence was executed to exclude pelvic organ prolapse; at last, the transverse two-dimensional diffusion-weighted spin echo-echo planar imaging (SE-EPI) pulse sequence was executed to acquire pelvic floor DTI data, through the post-processing of the data, normal female pelvic floor muscle fiber bundle images can be obtained and apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value were calculated. Results Content three-dimensional muscle fiber bundle images and corresponding ADC and FA values of the pubic visceral muscles in pelvic wall and obturator muscles in pelvic wall were acquired in all subjects;there was no statistically significant difference (P>0.05) for the ADC and FA values between the left and right side of the pubic visceral muscles and obturator muscles within the same age group;and the difference of ADC and FA values of pubic visceral muscles and obturator muscles among different age groups were not statistically significant (P>0.05), either. Conclusion 3.0T MR DTI fiber tracking imaging can be applied for the three-dimensional observation of the complicated muscle fiber bundle structures in female pelvic floor, through the measurement of ADC and FA value changes, functional abnormity can be suggested before the anatomy structure changes of the pelvic muscles occurs, thus provides an important new approach for further study of pelvic organ prolapse.

Objective To analyze the serum calcium , phosphate and alkaline phosphatase level among apparently healthy school children and adolescents in Heilongjiang Province and establish the reference intervals in different gender and different age groups .Methods Random sample of 2 101 primary and secondary school students from 9 to 18-year-old was collected from different district of Heilongjiang Province including Harbin and Mudanjiang from July 2008 to June 2009 .The fasting venous blood was collected and serum calcium , phosphate and alkaline phos-phatase concentration was measured as soon as possible .After screening outlier individual , a total of 2 091 subjects were enrolled.The reference intervals of serum calcium , phosphate and alkaline phosphatase for healthy school children and adolescents were established by gender and age ( P2.5 to P97.5 ) .Results The change tendency of serum calcium, phosphate and alkaline phosphatase with age and sex were presented .All these parameters had shown inverse relationship with age and were significantly higher in boys than girls (P<0.001).Serum calcium, phosphate of both sexes and serum alkaline phosphatase of girls declined progressively with age .However , the highest alkaline phosphatase level was seen at 13 years in boys.Alkaline phosphatase showed a positive correlation with age before 13 years of age , but after that alkaline phosphatase started to decline .Conclusions Reference in-tervals of serum calcium , phosphate and alkaline phosphatase for healthy school children and adolescents in Hei -longjiang Province in the age group of 9-18 years were presented , which supply good reference value for clinicians especially pediatricians to interpret the results of school children and adolescents and make decision .