Objective: To explore the correlation among plasma fibrinogen (Fg), serum uric acid (SUA) level, severity of premature coronary heart disease (PCHD) and major adverse cardiovascular events (MACE).Methods:A total of 195 PCHD patients diagnosed by coronary angiography (CAG) were selected, including 72 cases with stable angina pectoris (SAP), 67 cases with unstable angina pectoris (UAP) and 56 cases with acute myocardial infarction (AMI).Another 75 healthy subjects were enrolled as normal control group.Plasma Fg and serum urea acid(SUA)levels were compared among four groups, and their relationship with coronary disease severity and incidence of MACE during six-month follow-up were analyzed.Then ROC curve was used to assess predictive value of plasma Fg and SUA levels for PCHD.Results: Compared with normal control group and SAP group, there were significant rise in levels of plasma Fg[(2.80±0.26) g/L, (2.85±0.32) g/L vs.(3.44±0.32) g/L, (4.25±0.35) g/L]and SUA[(306.56±15.55) μmol/L, (308.81±16.77) μmol/L vs.(349.48±15.59) μmol/L, (368.86±20.72) μmol/L]in UAP group and AMI group (P<0.05 or <0.01), and those of AMI group were significantly higher than those of UAP group (P<0.05 both);Spearman correlation analysis indicated that plasma Fg and SUA levels were significant positively correlated with Gensini score (r=0.750, 0.743, P<0.01 both);levels of plasma Fg and SUA in those suffering from MACE during follow-up were significantly higher than those of patients without MACE, P<0.05 or <0.01.Meanwhile, ROC curve suggested that plasma Fg and SUA possessed certain diagnostic value for PCHD[area under the curve (AUC) =0.867, 0.736].Conclusion: Plasma fibrinogen and serum uric acid detection can provide certain evidence for diagnosing PCHD and determining disease severity.

Objective To investigate the variation and clinical significance of serum levels of inflammatory cyto-kines after percutaneous coronary intervention (PCI)treatment in acute myocardial infarction (AMI)patients. Methods 118 incipient AMI patients with successful underwent PCI (Defined as treatment group,blood samples were collected from pre-operation,12 h after operation,24 h after operation,48 h after operation and 90 d postop-erative follow-up period)and 52 AMI patients with diagnostic coronary angiography (CAG)(Defined as control group,blood samples were collected prior to CAG,12 h after CAG,24 h after CAG,48 h after CAG and 90 d fol-low-up period)were enrolled in this study.Serum levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were detec-ted in all the subjects by enzyme-linked immune sorbent assay(ELISA)and major adverse cardiac events(MACE) occurrence rate was analyzed in 90 days followed-up cases.Results No significant differences in baseline levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were found in the two study groups(P >0.05).No significant differences of levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were found after CAG in control group (P >0.05).The serum levels of IL-6,IL-18,hs-CRP and TNF-αafter PCI were significantly increased (P <0.01 )while no significant differences were found in level of MMP-9 (P >0.05)in PCI group.There were significant differences of levels of IL-6,IL-18,hs-CRP and TNF-αbetween MACE group and without MACE group after PCI.The multivariable lo-gistic analysis showed that IL-6,IL-18,hs-CRP and TNF-αwere risk factors of MACE after 90 days follow-up. Conclusion The concentrations of serum IL-6,IL-18,hs-CRP and TNF-αare significantly increased in AMI pa-tients treated with PCI.PCI operation may induce inflammatory reaction.High serum levels of peripheral inflamma-tory cytokines IL-6,IL-18,hs-CRP and TNF-αhave an important role in major adverse cardiac events(MACE)and short-term prognosis in the first AMI patients treated with successful primary PCI.

Objective To analyze the characteristic of some important clinical indicators, including carotid artery intima-middle thickness ( IMT) , peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 con-centrations of acute coronary syndrome ( ACS) patients. On the other hand, to investigate the correlation among those indicators and major adverse cardiac events ( MACE) , and further to evaluate the value of those indicators in early prediction and prognosis judgement of ACS patients with diabetes( DM) in clinic. Methods This study en-rolled 120 ACS patients who had received coronary arteriography( CAG) examination. Among them, 60 cases had DM. Meanwhile, 60 cases who had DM were selected as DM group,60 cases of healthy people who received physi-cal health examination were selected as the control group. Carotid artery IMT was determined by color doppler ultra-sonography. The levels of Fib in peripheral blood were detected by solidification method. Immune turbidimetric method and ELISA were used to measure the concentrations of serum IL-18 and MMP-9 respectively. The CAG re-sults, complications and in-hospital mortality of ACS patients were also collected and analyzed. Results Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS pa-tients were significantly increased compared with healthy control(P<0. 01). A comparison of those clinical indica-tors of ACS patients between with DM group and without 2 diabetes group showed a significant increase in ACS pa-tients with DM group. Carotid artery IMT, plasma Fib, serum IL-18, MMP-9 and Gensini score in ACS patients were positively correlated. The incidence of multi-vessel diseases of coronary artery was more frequent in ACS pa-tients with DM versus without DM ( 61. 7%) , while one or two vessel diseases of coronary artery was much more common in ACS patients without DM (61. 7%) . The Gensini score of ACS patients with DM group was much high-er than that of ACS patients without DM group ( P<0. 01 );severe and extremely severe lesions occurred more fre-quently in ACS patients with DM group (73. 3%) ,while mild-to-moderate lesions occurred more frequently in ACS patients without DM group (56. 7%) . Peripheral blood Fib levels, serum IL-18 and MMP-9 concentrations were significantly higher in ACS patients with MACEs compared to ACS patients without MACEs. Peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS diabetes mellitus extended the down-ward trend with the treatment time after standardized treatment show time-effect relationship. Conclusion Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentration and serum MMP-9 concentrations have great po-tential to become effective clinical indicators, which could be used to quantitatively predict coronary atherosclero-sis,and further to determine the risk degree and short-term prognosis of ACS patients with DM.

Objective To evaluate the role of polymorphonuclear (PMN) in patients with acute myocardial infarction (AMI).The preventive effects of Vitamin C-a potent free radical scavenger,on parameters of PMN oxygen free radicals (OFR) production in patients with AMI were also studied.Methods 60 patients with AMI were randomized to receive either conventional treatment only (group Ⅰ,n=30) or conventional treatment supplemented with vitamin C infusion,3.0 g/d,for 7 days (group Ⅱ,n=30).Parameters of PMN OFR production were assayed by a method named as polymorphonuclear chemiluminescence (PMN-CL) on the 1st,3rd,7th and 10th day after been hospitalized.62 healthy controls of similar age,sex were also studied.Results Parameters of PMN-CL increased significantly in patients with AMI compared with that in the healthy controls.Parameters of PMN-CL decreased significantly in group Ⅱ on the 3rd,7th and 10th day compared with that in group Ⅰ(P<0.05,0.01,0.001,respectively).ST segment score was significantly higher in group Ⅱ than that in group Ⅰ on the 3rd,7th and 10th day.Conclusion These results indicate that the PMN act as a potential contributor to extension of tissue injury induced by OFR.Supplementation with vitamin C may suppress PMN OFR production and could be beneficial in preventing myocardial necrosis.

PurposeTo establish sensitive and reliable serum marker on liver fibrosis for early clinical diagnosis. MethodsSerum hyaluronate acid,type Ⅲ procollagen and type Ⅳ procogen of 48 patients with viral hepatitis were analyzed by radioimmunoassay and ELISA respectively. ResultsThe serum HA, PCⅢ and PCⅣ level increased gradually with the progress of the disease. Their levels were correlated distinctly with the index of hepatic activity of inflammation and that of fibrosis.ConclusionsThe value of serum HA,PCⅢ and PCⅣ in predicting liver fibrosis will be enhanced ff the effect of inflammation could be excluded.

Objective:To establish a Mongolian gerbils model by long-term infection of Helicobacter py-lori (Hp) with highly-expressed thioredoxin-1 (Trx1 ) gene and to investigate the histopathological findings of gastric mucosa in Mongolian gerbils.Methods:In this study,75 healthy male Mongolian ger-bils were randomly divided into 3 groups:Hp with highly-expressed Trx1 gene group (n =30),Hp with lowly-expressed Trx1 gene group (n =30),and control group (n =15).The animals underwent gastric perfusion of Hp suspension once a week for 5 weeks.The animals were sacrificed at the end of 4,20, 34,48,70,and 90 weeks after inoculation for detecting Hp colonization by rapid urease test and War-thin-Starry silver staining and histological examination,respectively.Results:(1)The Mongolian gerbil model of long-term infection of Hp with highly-expressed Trx1 gene and lowly-expressed Trx1 gene were successfully established.(2)The macroscopic mucosal lesions,including erythema,uneven,erosion, nodules,etc.could be observed in experimental groups.The severity of lesions and the time when lesions occurred in Hp with highly-expressed Trx1 gene group were heavier/earlier than that in Hp with lowly-ex-pressed Trx1 gene group.(3)Histopathologically,the gastric mucosa of Hp with highly-expressed Trx1 gene group showed the mild dysplastic hyperplasia of epithelial cells 34 weeks after the Hp inoculation, and the time was in the 48th week in Hp with lowly-expressed Trx1 gene group.At the end of the 90th week after Hp inoculation,the gastric adenocarcinoma could be detected in the two experimental groups (71.4% vs.42.8%).The difference between the two experimental groups did not reach statistical sig-nificance (P =0.592),which might be due to the small sample capacity and /or short observation time. In addition,there were 2 cases with severe epithelial dysplastic hyperplasia in Hp with highly-expressed Trx1 gene group,and only 3 cases with moderate epithelial dysplastic hyperplasia in Hp with lowly-ex-pressed Trx1 gene group.The uninfected control animals showed no abnormal findings throughout the en-tire observation period.Conclusion:Hp with highly-expressed /lowly-expressed Trx1 gene colonizes stab-ly in the glandular gastric mucosa of Mongolian gerbils.The histological changes after infection are similar to those of the Hp infected human being,and Hp with highly-expressed Trx1 gene cause the injury of gas-tric mucosa and the occurrence of gastric adenocarcinoma.Trx1 maybe the virulence factor that partici-pates in the pathogenesis of gastric cancer and Hp expressing high levels of Trx1 should be highly toxic for gastric diseases in China.

ObjectiveTo investigate the methods and clinical significance of detecting PLAC4 and COL6A1 gene on fetal chromosome 21 from maternal peripheral blood. Methods From Oct. 2008 to Nov. 2009 30 normal pregnancies in Weifang People's Hospital were selected as pregnant group, and 9 nonpregnant women were selected as control group. Quantitative real-time PCR was used to determine transcript levels of the target genes ( PLAC4 and COL6A1 ) in blood samples. Correlation between the expression level and gestational age was analyzed. Results ( 1 ) PLAG4 mRNA was detected in peripheral blood of all pregnant women. Its maximum level was 12. 760 × 103 copies/ml, whereas the minimum was 2. 105 × 103 copies/ml, and the average value is 6. 612 × 103 copies/ml. In control group the PLAC4 mRNA could not be detected. There was statistically significant difference ( P ＜ 0. 01 ) between the two groups. ( 2 ) COL6A1 mRNA is detected in pregnant group and control group, and the concentration was 6. 847 × 103 copies/ml and 7. 322 × 103 copies/ml respectively, with no statistically significant difference ( P ＞ 0. 05 ). ( 3 ) Correlation analysis: there was no relationship between the level of PLAC4, COL6A1 mRNA and the gestational age, the correlation coefficients (r) were 0. 29 and 0. 31, and the P values were 0. 121 and 0. 168 respectively. Conclusions COL6A1 mRNA can be detected in both pregnant group and control group, so it is not specific for pregnancy. PLAC4 mRNA can be detected only in pregnant women, so it has specificity in pregnancy and can be a discriminative marker gene for prenatal dignosis of trisomy 21 fetuses.

Objective To study the effects of Yizhichan moxibustion on chronic fatigue syndrome (CFS) athletes.Methods 143 patients of CFS were blind randomly devided into3 groups, which were moxibustion of Yizhichan (56 cases) group, general moxibustion group (42 cases), and normal group (45 cases).The normal group was treated by passive massage for relaxation, the moxibustion of Yizhichan group was treated by specific acupoints application of moxibustion of Yizhichan in addition to passive massage;and the general moxibustion groupwas treated by general moxibustion in addition to passive massage.All sample were treated once a day for 6 days in a week.3 weeks was a period of treatment, and the total time of treatment was 15 weeks.Results After treatment, the sleep quality (1.73 ± 0.73, 1.54 ± 0.85 vs.0.83 ± 0.52, F=14.130), time for sleep (1.57 ± 0.60, 1.35 ± 0.60 vs.1.03 ± 0.54, F=5.386), sleep time (1.78 ± 0.71, 1.77 ± 0.61 vs.0.67 ± 0.65, F=19.811), daytime dysfunction (0.78 ± 0.83, 1.64 ± 0.83 vs.1.03 ± 0.83, F=4.798) in the control group, moxibustion of Yizhichan group and a general moxibustion group were statistically significant(P＜0.05).The total effective rate of the moxibustion of Yizhichan group was better than the control group and the general moxibustion group (83.8％, 42.2％ vs.63.6％;x2=13.973, P=0.001).Conclusion Specific acupoints moxibustion of Yizhichan is a beneficial exploration of moxibustion methods of traditional Chinese medicine, and can improve CFS athletes level of physical health, attention and sleep quality.

Objective To determine the accuracy of femoral components sizing predicted by standardized digital templating in total knee arthroplasty (TKA).Methods Fifty consecutive patients (50 knees),who underwent primary TKAs for endstage osteoarthritis,were prospectively studied.The intra-operative and radiographic data were collected.All operations were performed by the same surgical techniques with PS type,open box Vanguard Complete Knee System.All patients underwent lateral and AP radiography of the involved knee under fluoroscopy before and after surgery.The distal femoral anteroposterior dimension (DFAP) were measured and the femoral components size were predicted on preoperative radiographs by two different methods:measurement of DFAP did not include (group A) the cartilage thickness of the medial posterior condyle or included that (group B).Cutting errors were corrected gradually,and DFAP was measured consequently.The most appropriate size was chose after each step respectively based on postoperative radiographs.The accuracy of femoral size predicted under different conditions was compared within two groups.Results During correction of cutting errors,the correct rate ranged from 18％ to 44％ in group A and from 26％ to 34％ in group B,the accuracy within one size ranged from 54％ to 84％ in group A and from 58％ to 84％ in group B.The cartilage thickness of medial posterior condylar,external rotation of femoral component,under-resected of anterior condylar,flexion of femoral component,and over-resected of posterior condylar can change the DFAP by 1.97±0.85 mm,1.56±2.06 mm,1.15±1.31 mm,-2.86±1.52 mm,and-0.87±0.77 mm,respectively.Conclusion Variation of intraoperative cutting errors and the cartilage thickness of medial posterior condyles can influence the accuracy of templating to some extent.Standardized digital radiography templating cannot predict femoral sizes accurately.

Objective To investigate the effects and mechanism of glucagon-like peptide-1 ( GLP-1 ) receptor agonist liraglutide on the proliferation and apoptosis of human pancreatic cancer cells. Methods The human pancreatic cancer cell line MIA PaCa-2 was incubated for 24 h with liraglutide at various concentrations (10-1 000 nmol/ L), or with 100 nmol/ L liraglutide for various durations (0-72 h). Cell proliferation was determined by Cell Counting Kit-8 (CCK-8) analysis. RT-PCR and Western blot were used to detect the mRNA and protein expression levels of related genes. Results GLP-1 receptor was expressed in the MIA PaCa-2 cells. Liraglutide suppressed cell proliferation, up-regulated the expression levels of pro-apoptotic protein Bax and down-regulated the expression levels of anti-apoptotic protein Bcl2 in human pancreatic cancer cells in a dose- and time-dependent manner. Meanwhile, liraglutide down-regulated the expression levels of insulin receptor (INSR) and insulin-like growth factor-1 receptor (IGF-1R), and the phosphorylation levels of their downstream signaling proteins Erk1 / 2 and Akt, in a dose- and time-dependent way. Conclusion Liraglutide inhibits proliferation and promotes apoptosis of human pancreatic cancer cells; the process may be mediated via suppressing the expression of INSR and IGF-1R and inhibiting activation of the downstream MEK/ Erk1 / 2 and PI3k/ Akt pathways.