Objective To explore the clinical application value of combined detection of serum brain natriuretic peptide (BNP),homocysteine(HCY) and blood lipids in the patients with heart failure.Methods The levels of serum BNP,HCY,TC,TG,HDL-C,LDL-C,ApoA,ApoB and Lpa were detected in 100 patients with heart failure (observation group) and contemporaneous 100 persons (control group) undergoing healthy physical examination.Then the comparative analysis was performed.Results Compared with the control group,the BNP and HCY levels in the observation group were significantly increased(P＜0.05);among 7 indicators of the blood lipid,the Lpa level in the observation group was increased compared with the control group,while the TC,HDL-C and LDL-C levels were significantly decreased(P＜0.05),and the TG,ApoA and ApoB levels had no statistical differences between the two groups(P＞0.05).Conclusion Serum BNP,HCY,TC,HDL-C,LDL-C and Lpa levels have close correlation with heart failure,especially the combined detection of BNP,HCY and Lpa,which has predictive and diagnostic value in heart failure and is worthy of clinical popularization and application.

Objective To investigate the effect of glucose-based peritoneal dialysis fluids and icodextrin-based peritoneal dial-ysis fluids on the expression of TLR2 and TLR4 on huamn peritoneal mesothelial cells .Methods Human peritoneal mesothelial cell line 5 - 10 generations(HMrSV5) was cultured in DMEM /F12 medium supplemented with 10% (v/v) fetal calf serum (FCS) .Cell viability and cell proliferation were assessed using M TT method .The experiment were divided into 5 different groups :group A (control group) ,1 .5% dextrose group ,2 .5% dextrose group ,4 .25% dextrose group and 7 .5% Lcodextrin group .Icodextrin group (aikau dextrin) ,TLR2 and TLR4 expression were detected by Western blot .Results Treatment with different concentrations of glucose-based peritoneal dialysis fluids for 24 h did not affect the expression of TLR2 and TLR4 protein .In addition ,after stimula-tion for 48 h ,1 .5% dextrose ,2 .5% dextrose ,4 .25% dextrose decreased TLR2 expression by (5 .5 ± 2 .8)% ,(31 .4 ± 7 .5)% , (54 .9 ± 1 .9)% respectively ,TLR4 expression by (32 .9 ± 17 .6)% ,(47 .7 ± 13 .5)% ,(66 .4 ± 13 .5)% respectively .Stimulation for 72 h ,decreased TLR2 expression by (29 .4 ± 14 .7)% ,(38 .9 ± 9 .9)% ,(63 .5 ± 16 .5)% respectively ,TLR4 expression by(59 .5 ± 16 .8)% ,(63 .1 ± 9 .5)% ,(79 .2 ± 14 .0)% respectively .There was no significant change in TLR2 and TLR4 protein expression on 7 .5% icodextrin group .Conclusion Glucose-based peritoneal dialysis fluids ,but not icodextrin-based peritoneal dialysis fluids downregulates expression of TLR2 and TLR4 by HM rSV5 .

This study is to investigate the inhibitory effect of lidamycin (LDM) and its combination with methotrexate (MTX) on lung metastasis of fibrosarcoma by bioluminescence imaging in athymic mice. A stable luciferase transfected HT-1080 cell line was constructed and the capability to establish experimental lung metastasis in athymic mice was confirmed. The optical imaging system was applied to evaluate the formation of lung metastasis in vivo. In addition, metastatic nodules were counted for the evaluation of inhibition rates. As shown, the fluorescent intensity of luciferase-transfected HT-1080 cells was colinear with the cell population and the minimal detected cell population was 100 cells/well. Optical imaging showed that the fluorescent intensity of treated group was apparently lower than that of the control. The inhibition rates of lung metastasis by LDM alone at 0.025 mg x kg(-1) and 0.05 mg x kg(-1) were 53.9% and 75.9%, respectively, while that of MTX alone at 0.5 mg x kg(-1) was 70.2%. The combination of LDM at 0.025 mg x kg(-1) and MTX at 0.5 mg x kg(-1) showed an inhibition rate of 88.7%. The coefficient of drug interaction (CDI) was 0.82. The results herein demonstrated that LDM alone had strong anti-metastasis effect on human fibrosarcoma HT-1080 and the inhibition efficacy is strengthened when combined with MTX.

Objective To investigate the application value of BIS monitoring and Ramsay score in the prevention of unplanned tracheal extubation in ICU patients.Methods 93 patients were enrolled in this study,they were divided into the experimental group(47 cases)and the control group(46 cases) using random number method.They received sedation regimens with BIS monitoring and Ramsay score or Ramsay score respectively.Occurrence rate of unplanned extubation was compared between the two groups.Results The occurrence rate of unplanned extubation was significantly lower in the experimental group than that of the control group.Conclusions BIS monitoring and Ramsay score is a suitable ways for the management of sedation of intubated patients.

ObjectiveTo investigate the preventive strategy of early post-operative complications of closed spinal dysraphisms in children.MethodsOne hundred and nine children with closed spinal dysraphisms underwent surgery from January 2004 to December 2008,were enrolled in this study.After dural closure,the wound was washed completely with saline to clear the tissue debris to prevent postoperative infection. We routinely made a horizontal incision to prevent postoperative infection. Results After operation,all patients were recovered and were discharged from hospitalNo post-operative complications,including cerebrospinal fluid leakage, wound infection and flap necrosis, were encountered. ConclusionThe sophisticated microsurgical technique and the delicate surgical manipulation is the prerequisite for the prevention of early operational complication of closed spinal dysraphisms in children.

Objective Electronic portal imaging devices (EPIDs) are widely used as a replacement of portal films for patient position verification, but the image quality is not always optimal. Because of very low density resolution, the portal imaging is difficult to be used clinically. In this study, several transforming models and the optimization exposure or acquisition conditions were studied for optimization portal imaging, which based on DicomRT platform built by ourselves. Methods 6 MV X-ray from Varian 21EX linac was used to generate portal images by Portal Vision aSiS00 amorphous silicon detector image acquisition system. The density resolution study was based on the number of the lines which could be seen in the image of a special Las Vegas image quality test board. The optimization calculating models were focused on equalization after stretch transforming discrete wavelet transform (DWT) and Butterworth high pass filters. The calculation was performed in Matlab language. Results The optimal numbers of MU, average frames and reset number were 4 - 5,3 - 4 and 2 - 3, respectively. The density resolution of optimized imaging via equalization after stretch transforming, DWT and Butterworth high pass filter transforming was markedly improved. The bone structure could be definitely distinguished. The number of lines distinguished in Las Vegas image via equalization after stretch transforming, DWT and Betterworth high pass filter transforming was 3, 4 and 5, respectivly. Conclusions The proposed transforming systems, including DWT edge detection and Butterworth high pass filter transform, are suitable for improving density resolving power of MV X-ray portal image.

Objective To investigate the clinical and angiographic characteristics of no reflow phenomenon after primary percutaneous coronary intervention (PCI) with acute myocardial infarction (AMI).Methods A total of 319 patients with AMI undergoing primary-PCI was divided into no-reflow and normal reflow groups.The incidence of no-reflow phenomenon,the clinical date,angiography findings,and surgical date were compared between two groups.Results No-reflow phenomenon occurred in forty(13.4％)of the patients after primary PCI.There was dramatic difference in combined hyperlipidemia,angina pectoris history before AMI,heart function ≥2 grades on admission,the length of the vascular lesions,vascular stenosis degree,blood clot load level,coronary artery opening time,and the expansion of the balloon between no-reflow and normal blood flow groups.Multiple logistic regression analysis identified that angina pectoris history before AMI,heart function classification on admission,high thrombus burden,the expansion of the balloon,and coronary artery opening time on angiography as independent predictors of no-reflow phenomenon.Conclusions The occurrence of no-reflow phenomenon after primary PCI was associated with high cholesterol history,no history of pre-infarction angina,heart function classification on admission,long vascular lesions,narrow degree of heavy,blood clots in the high load,coronary artery opened long time,and the expansion of the balloon more frequently.

Objective To analyze the VP1-VP4 genetic region of enterovirus 71 ( EV71 ) strains isolated from children with severe or mild hand, foot and mouth disease ( HFMD) in Shenzhen in 2012. Methods EV71 strains were isolated from five children with mild HFMD and five children with severe HFMD in Shenzhen in 2012.Reverse transcription-polymerase chain reaction ( RT-PCR) method was used to amplify the sequence of VP1-VP4 genes of EV71 strains.The sequences of the amplified products were analyzed by comparing with those of the EV71 reference strains ( A, B and C genotypes) published in Gen-Bank using nucleotide alignment, amino acid alignment and phylogenetic tree analysis.Results The homo-geneity between the EV71 strains isolated from severe and mild cases was 95.1%-98.2% in nucleotides and 99.2%-100% in amino acids.The VP1-VP4 nucleotide sequences of 5 strains isolated from severe cases and 5 strains from mild cases in Shenzhen shared 87.9%-97.8% homologies in nucleotides and 97.3%-99.9% homologies in amino acids with the genotype C EV71 reference strain.The EV71 strains isolated from children in Shenzhen were highly similar with the EV71 strain (FJ439769) isolated in Fuyang in 2008 and the one isolated in Jingdezhen in 2011 (JQ806378, C4a subtype) in nucleotide sequences.Mutations at the residue 31 in the VP1 region ( N→D ) were detected in 3 strains isolated from children with severe HFMD.Conclusion All of the 10 EV71 strains isolated in Shenzhen in 2012 belonged to the sub-genotype C4a.The mutation ( aa31 N→D) in the VP1 region of EV71 might be related to the different clinical mani-festations of HFMD cases in Shenzhen area.

Objective To investigate the effect of intrathecal morphine preconditioning (ITMP) on the excitability of substantia gelatinosa (SG) neurons in the dorsal horn of the spinal cord in a rat model of myocardial ischemia-reperfusion (I/R).Methods Thirty-six adult male Sprague-Dawley rats,weighing 200-300 g,in which intrathecal catheters were successfully placed without complications,were randomly divided into 3 groups (n =12 each) using a random number table:sham operation group (group S),group I/R,and group ITMP.Myocardial I/R injury was produced by occlusion of the left anterior descending branch of the coronary artery for 30 min followed by 120 min reperfusion.In group ITMP,the rats received intrathecal morphine 3 μg/kg (10 μl) by three cycles of 5 min infusions interspersed with 5 min infusion-free periods starting from 30 min before ischemia,and the equal volume of normal saline was given instead of morphine in group I/R.At 10 min of reperfusion,6 rats randomly selected in each group were sacrificed,and the T2-6 segments of the spinal cords were acutely isolated to prepare spinal cord slices.The resting potential,threshold of action potential (APT),peak of action potential (APP) and action potential duration in SG neurons in the dorsal horn of spinal cord slices were determined using the whole-cell patch-clamp technique,and the number of action potentials evoked by currents of 40,60,80 and 100 pA was recorded.At 120 min of reperfusion,6 rats randomly selected in each group were sacrificed,and myocardial specimens were obtained for determination of myocardial infarct size (IS) and area at risk (AAR),and IS/AAR ratio was calculated.The expression of c-fos in the T2-5 dorsal horns of the spinal cords was detected by Western blot.Results Compared with group S,the IS/AAR ratio was significantly increased,the expression of c-fos was up-regulated,the number of action potentials in SG neurons in dorsal horns of spinal cord was increased,APT was decreased,and APP was increased in group I/R (P＜0.05).Compared with group I/R,the IS/AAR ratio was significantly decreased,the expression of c-fos was down-regulated,the number of action potentials in SG neurons in dorsal horns of spinal cord was decreased,APT was increased,and APP was decreased in group ITMP (P＜0.05).Conclusion The mechanism by which ITMP attenuates myocardial I/R injury is related to decrease in the excitability of SG neurons in the dorsal horn of the spinal cord and reduction of responses to nociceptive stimuli in rats.

Objective To discuss the efficacy of the flexible ureteroscopy combined with Holmium laser lithotripsy for kidney calculi with HIV positive patients.Methods From May 2015 to May 2016,47 cases of patients with renal calculi were treated by the flexible ureteroscopy combined with Holmium laser lithotripsy in our hospital.There were 29 cases male,18 cases female,aged from 22 to 56 years old,average 39 years.There were 38 cases with single stone,9 cases with multiple stones.There were 9 cases with stones on both sides.Flexible ureteroscopy channel sheath was used in surgery.Stones were fragmented by Holmium laser.During one-month follow-up after surgery,stone removal and stone free rate were recorded.Residual stones were re-treated with a secondary lithotripsy or ESWL.Results The flexible ureteroscopy channel sheath was indwelled successfully in all the cases.All stones were detected.The average operation time was 63min (range,42-141min) and the median postoperative stay was 4.5days (range,2-16 d).Among the 47 patients,41 patients underwent first-stage lithotripsy,6 patients underwent second-stage ESWL after lithotripsy,and 1 patient underwent third-stage lithotripsy.The one-month stone free rate was 87.2％ (41/47).The total stone free rate was 97.9％ (46/47) after second-stage lithotripsy.Postoperative fever occurred in 4 cases after lithotripsy.No blood transfusion,systemic infection,ureteral perforation,or ureteral avulsion occurred.The total complication rate was 8.5％ (4/47).The mean number of CD4 +T lymphocytes before lithotripsy was 402/μl,and was 410/μl 3 days after lithotripsy.There was no Statistical differences between them.Conclusions Flexible ureteroscopy combined Holmium laserlithotripsy could be a safe and effective treatment for kidney calculi patients with HIV/AIDS positive.