Objective: To study correlation among serum levels of lipoprotein a[Lp(a)], uric acid (UA) and cardiac function in patients with acute myocardial infarction (AMI) complicated diabetes mellitus (DM).Methods: A total of 70 AMI+DM patients were enrolled as AMI+DM group, 60 pure AMI patients were enrolled as pure AMI group, 60 pure DM patients were enrolled as pure DM group, and 60 healthy people were selected as healthy control group.According to NYHA cardiac function class, AMI+DM patients were divided into class I~II group (n=58) and class III~IV group (n=12);according to their prognosis, they were divided into no cardiovascular event group (n=54) and cardiovascular event group (n=16).Serum Lp(a) and UA levels were measured in all group, and their correlation were analyzed.Results: Serum Lp(a) and UA levels of AMI+DM group were significantly higher than those of healthy control group, pure AMI group and pure DM group, and those of pure AMI group and pure DM group were significantly higher than those of healthy control group, P<0.01 all;Pearson compared with class I~II group, there were significant rise in serum levels of Lp(a)[(183.28±19.96) mg/L vs.(335.65±22.71) mg/L]、UA[(287.45±21.82) μmol/L vs.(437.79±26.72) μmol/L]in class III~IV group (P<0.01 both);compared with no cardiovascular event group, there were significant rise in serum levels of Lp(a)[(220.75±25.72) mg/L vs.(423.97±30.81) mg/L]and UA[(308.49±21.82) μmol/L vs.(442.97±29.75)μmol/L]in cardiovascular event group, P<0.01 both;Pearson correlation analysis indicated that serum Lp(a), UA levels were significant positively correlated with cardiac function class (r=0.410, 0.412, P<0.05 both), and serum Lp(a) level was significant positively correlated with UA level (r=0.496, P=0.023) in AMI+DM patients.Conclusion: Serum Lp(a), UA levels are closely correlated with cardiac function in AMI+DM patients, which can be used as indexes diagnosing and monitoring disease progress.

Objective To investigate the relationship between gastroesophageal flap valve (GEFV) and reflux esophagitis(RE).Methods We analyzed 239 cases of RE diagnosed by endoscopy in our hospital from January 2007 to December 2009.RE was classified by Los Angeles classification system and GEFV by Hill system.The association of GEFV with RE was analyzed.Results The overall incidence of abnormal GEFV was32.9% (316/960) and that of RE was 24.9% (239/960).The incidence of severe RE ( grade C and D) in abnormal GEFV group was significantly higher than that in normal GEFV group (23.1% vs.2.4% , P = 0.000).RE grades were positively correlated with GEFV grades (r = 0.308, P = 0.000 ).The incidence of abnormal GEFV in RE patients was higher than that in non-RE (65.3% vs.22.2% ,P = 0.00 ).In terms of gender, there were more males than females in both RE group (63.6% vs.36.4% ) and abnormal GEFV group (60.1% vs.39.9% ).Additionally, incidence of RE increased with age, i.e.positively correlated with age (r=0.214,P =0.000).The incidence of abnormal GEFV also increased significantly in those over 30 years old, i.e.positively correlated ( r = 0.129, P = 0.000).Conclusion There is correlation between GEFV abnormality and RE.GEFV provides useful information for assessment and prediction of the reflux status of the patients.

Objective To study the genes of a carbapenem-resistant Klebsiella pneumoniae strain isolated from a patient. Methods The antibiotic sensitivity test of a multidrug-resistant Klebsiella pneumoniae strain was done according to K-B and MIC method. Metallo-β-lactamase was detected by Modified Hodge Test and EDTA-disk synergy test. Both nine genes encoding β-lactamases, including blaKPC, blaIMP , blaVIM , blaSME , blaCTX-M , blaSHV, blaDHA , blaACT, Class Ⅰ integrase and Class Ⅰ integron were detected by PCR. Positive products were sequenced. Results The Klebsiella pneumoniae was resistant to carbapenems, cephalosporins, cefoxitin, ampicillin and trimethoprim/sulfamethoxazole. Only susceptible to aztreonam, gentamicin, tobramycin, amikacin, ciprofloxacin and levofloxacin. The blaIMP-1 and Class Ⅰ integron were positive. The blaIMP gene was identified by PCR and DNA sequencing confirmed that the gene belong to IMP-1 type Metallo-β-lactamase gene. The strain also carried Class Ⅰ integron and IMP-1 was located in Class Ⅰ integron 5'. Conclusions It is the first detection of IMP-1 Metallo-β-lactamase in Klebsiella pneumoniae. The production of IMP-1 carbapenemase is the main mechanism of carbapenem-resistant in Klebsiella pneumoniae, and multidrug resistance is related to ClassⅠ integron.

Objective To diagnose limb-girdle muscular dystrophy type 2A(LGMD2A)using Western blot with micro-sample.nethods Skeletal muscle specimens of 73 cases of progressive muscular dystrophy with prominent proximal muscle involvement were obtained by open biopsy,and underwent histochemical,immunohistochemical stains with anti-dystrophin-N,C,R,α,β,γ,δ-sarcoglycan,dysferlin,caveolin-3 monoclonal antibodies.Twenty-nine cases were excluded with deficiency of dystrophin,sarcoglycans,dysferlin and caveolin-3,then Western blot and immunoreaction were performed with anti-calpain-3,caveolin-3 monoclonal antibodies.Results Ten cases with LGMD2A were diagnosed,all presenting muscle weakness of the proximal limb and elevated creatine kinase in vacant levels.and electromyography showed myogenic change.Histochemical stains showed variation in fiber size,different extent of degeneration,regeneration and necrosis,increased connective tissue elements,while lobulated fibers presented in 6 cases.Immunohistochemical stains identified dystrophin,sarcoglycans,dysferlin and caveolin-3 expressed normal in muscle fibers.Western blot,compared with the control,confirmed that the bands at 94 000 were absent(8 cases)or partly(2 cases)deficient:The additional bands at 30 000expressed weakly;The bands at 22 000 were normal.Conclusion Western blot analysis with microspecimen of skeletal muscle is an effective modality to diagnose LGMD2A,and is suitable to diagnose the sub-type of LGMD in clinic.

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.

Objective To observe the clinical effect of patients in the department of neurosurgeryoperation combined with autologous blood transfusion. Methods A retrospective analysis of 113 cases of operation patients in department of neurosurgery. All the patients were under general anesthesia using autologous blood transfusion. Thepreoperative , the first dayand the third day postoperative blood routine indexes , coagulation function examination and the electrolyte were analyzed. Resuits Theblood transfusion volume was (262.53 ± 163.41)mL. Hemoglobin , hematocrit and platelet count after 1 days and 3 days after operation were significantly lower than preoperative. The potassium ionsthat first day postoperation was significantly higher than preoperation , postoperative 1 day and the 3 day after the operation of sodium ions and chloride ions were significantly increased. Conclusion Patients in the department of neurosurgery of autologous blood transfusion is safe and effective, which can save the blood and reduce the risk of allogeneic blood transfusion.

OBJECTIVE:This article discusses the development of a new commodity flow pattern,acting delivery,in Chi?nese pharmaceutical circulation.METHODS:Using comparative method to analyze the reasons,the operating framework and the present strategies on developing acting delivery.RESULTS&CONCLUSION:The new pattern of acting delivery is con?ducive to reduce pharmaceutical circulation cost,to strengthen enterprises'competitiveness and to use social resources more rationally.That is an inevitable development tendency for Chinese pharmaceutical circulation market and for following inter?national practice.

OBJECTIVE:To provide reference material for standardization of lice ns ed pharmacist's consultation service METHODS:From the angle of The Law of Pro tecting Consumer's Rights and Interests,the legal relation between pharmacist and customer,rights and duties of the two parties and fair-honest dealings wer e analysed RESULTS & CONCLUSION:In the new pharmaceutical service,the licens ed pharmacists should take public health as the focus of work,carry out consult ation service according to law,so as to promote the development of social healt h undertaking

OBJECTIVE:To discuss the risk in clinical pharmacy service in order to provide reference for Chinese hospitals in both guarding against and reducing risk.METHODS:This study adopted a classified method to set forth the tactics on re?ducing risk of both organization and individual person in clinical pharmacy practice after analyzing the risk factors.RESULTS&CONCLUSION:It is important for the working personnel who engage in clinical pharmacy work to heighten their con?sciousness of risk and to strengthen managing it.

OBJECTIVE:To provide some suggestions for reference in establishment of clinical pharmacist institution in China.METHODS:Through analysing the present policy,mechanism,education,social psychology and law,the difficulties confronting us in establishment of clinical pharmacist institution were discussed.RESULTS&CONCLUSION:It needs to improve the mechanism in many aspects and to intensify the reform continuously in the process of establishing clinical phar-macist institution.