Objective To investigate the changes and significance of the serum myeloperoxidase (MPO) and lipoxin (LXA4) in patients with coronary heart disease (CHD). Methods From December 2010 to February 2011,143 patients with CHD (CHD group) and 44 patients without CHD (control group) were selected. The serum high sensitive C-reactive protein (hs-CRP), MPO and LXA4 levels were assessed, and the ratio of MPO and LXA4 (M/L) was calculated. These indexes were compared between 2 groups. The influencing factors of MPO, LXA4 and M/L levels were analyzed by multifactor Logistic regression analysis. Results The serum levels of hs-CRP, LXA4, MPO, and M/L in CHD group were significantly higher than those in control group: 3.25 mg/L vs. 0.99 mg/L, 229.88 ng/L vs. 178.63 ng/L, 422.58 U/L vs. 186.85 U/L and (1.78 ± 0.52) U/ng vs. (1.02 ± 0.17) U/ng, and there were statistical differences (P<0.05). Multifactor Logistic regression analysis result showed: LXA4 level, unstable angina, acute myocardial infarction and severe elevation of white blood cell count were the impact factors for the elevation of MPO (P<0.01 or<0.05);there were no correlations between MPO level and stable angina, mild and midrange elevation of white blood cell count (P>0.05). MPO was the impact factor for the increase of LXA4 (P<0.01), and stable angina was the impact factor for the decline of LXA4 (P =0.019);there were no correlations between LXA4 level and unstable angina, acute myocardial infarction and other factors (P>0.05). Stable angina, unstable angina and acute myocardial infarction were the impact factors for the elevation of M/L (P<0.01); there were no correlations between M/L and other factors (P>0.05). Conclusions The inflammatory response in patients with CHD is accompanied by the presence of inflammation and resolution imbalance.

Objective To investigate the computer tomography (CT) and magnetic res-onance imaging (MRI) features of posterior reversible encephalopathy syndrome (PRES) caused by pregnancy-indueed hypertension (PIH). Methods CT scan and MRI scan + diffusion-weighted imaging (DWI) were used in 31 patients with PIH. Results CT scan found low density lesions in parietal-occipital lobe of watershed regions in 31 patients with PIH. CT value was 19 to 23Hu. Among them, MRI showed slight hypointensity lesions on T1-weighted images and slight hyperintensity lesions on T2-weight images in 11 patients, fluid-attenuated inversion recovery (FLAIR) sequence showed hyperintensity lesions, DWI revealed isointense, and apparent diffusion coefficient- did not decrease. The recovery time of clinical symptoms was earlier than that of MRI. Conclusions The lesion sites on cr and MRI had certain characteristics in PIH occurred PRES at late pregnancy, combining clinical history a clear diagnosis could be made.

Objective Through the correlation study of fibroblast growth factor 23 (FGF-23) and chronic heart failure to investigate the pathogenesis of chronic heart failure and provide a new method for chronic heart failure diagnosis.Methods One hundred and twenty-eight chronic heart failure patients (chronic heart failure group) were involved in this study.According to the level of left ventricular ejection fraction (LVEF),they were divided into LVEF slightly lowing group (LVEF 40％-50％,50 patients),LVEF moderately lowing group (LVEF 30％-39％,35 patients),LVEF severely lowing group (LVEF ＜30％,43 patients).Fifty healthy people was as control group.The level of FGF-23,parathyroid hormone (PTH),creatinine (Cr),urea nitrogen (BUN),blood calcium,blood phosphorus,N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The patients in two groups were performed color Doppler ultrasonography.Results The level of FGF-23,blood phosphorus,PTH,left ventricular mass index (LVMI),NT-proBNP in chronic heart failure group were significantly higher than those in control group [68.44(55.85-94.73) ng/L,34.18(30.57-38.87) ng/L,(1.13 ± 0.13) mmol/L vs.(1.02± 0.12) mmol/L,(15.51 ± 3.99) ng/L vs.(9.97 ± 0.89) ng/L,(112.27 ± 52.02) g/m2 vs.(71.37 ± 12.95) g/m2,(6 265.3 ± 15 991.6) ng/L vs.(76.12 ± 51.80) ng/L](P ＜ 0.01).The level of blood calcium,glomerular filtration rate (GFR) in chronic heart failure group were significantly lower than those in control group [(2.28 ±0.16) mmol/L vs.(2.48 ±0.13) mmol/L,(78.28 ± 14.20) ml/ (min ·1.73 m2) vs.(85.03 ± 14.44)ml/ (min·1.73 m2)] (P ＜ 0.01).Spearman correlation analysis showed that FGF-23 had positive correlation with age (r =0.256,P ＜0.01),blood phosphorus (r =0.326,P ＜0.01),PTH (r =0.584,P ＜0.01),NT-proBNP (r =0.799,P ＜ 0.01),LVMI (r =0.540,P ＜ 0.01),and had negative correlation with blood calcium (r =-0.308,P ＜ 0.01),GFR(r =-0.527,P ＜ 0.01).The level of FGF-23 was increased when LVEF reduced.Conclusions It has significant correlation between the level of FGF-23 and the degree of chronic heart failure.It suggests that the level of FGF-23 can evaluate the myocardial systolic function and ventricular remodeling.

Objective To investigate the relationship between serum uric acid level and atrial fibrillation in patients with coronary heart disease.Methods Two hundred and forty-seven inpatients with coronary heart disease were selected.All the patients were divided into simple coronary heart disease group (90 cases),coronary heart disease with paroxysmal atrial fibrillation group (85 cases) and coronary heart disease with continuous/permanent atrial fibrillation group (72 cases).The age,history of cardiovascular events,uric acid,echocardiographic characteristics and drug-taking history were carefully recorded.The risk factors of atrial fibrillation in patients with coronary heart disease were analyzed by Logistic regression.Results The level of history of smoking,diastolic blood pressure,body mass index,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,creatinine,fasting plasma glucose,postprandial 2 h plasma glucose,interventricular septal thickness,carotid intima-media thickness and drug-taking history among the 3 groups showed no statistical differences (P ＞ 0.05).The age,systolic blood pressure,uric acid,left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD) in coronary heart disease with paroxysmal atrial fibrillation group and coronary heart disease with continuous/permanent atrial fibrillation group were significantly higher than those in simple coronary heart disease group,the left ventricular ejection fraction (LVEF) was significantly lower than that in simple coronary heart disease group,and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The result of Logistic regression analysis showed high uric acid,high age,expanded LAD and LVEDD were the independent risk factors of atrial fibrillation in patients with coronary heart disease,and uric acid showed the most significant correlation (P =0.001,OR =1.061,95％ CI 1.026-1.096).Conclusion High serum uric acid level maybe a risk factor of atrial fibrillation in patients with coronary heart disease.

Objective To investigate the correlation of uric acid(UA) level and the circadian rhythm of blood pressure in hypertensive patients. Methods Among the individuals who presented to the cardiology clinic, 70 patients who had hypertension and were diagnozed with non- dipper hypertension (non-dipper hypertension group) by 24 h ambulatory blood pressure monitoring (ABPM), 70 patients with dipper hypertension patients (dipper hypertension group), and 52 normotensive individuals (control group) were enrolled in this study. Peripheral venous blood samples were collected from all the patients in order to evaluate the hematological and biochemical parameters. All the assessed parameters were compared among three groups. Results The level of UA in non-dipper hypertension group was the highest, in dipper hypertension group was higher and in contrl group was the lowerst:(393.57 ± 53.52), (280.57 ± 41.64), (267.66 ± 59.38) μmol/L, and there were significant differences (P<0.01). Multivariate Logistic regression analysis revealed that the level of UA was an independent risk factor for non-dipper circadian rhythm of blood pressure (P = 0.003, OR = 2.26, 95% CI: 1.34- 3.89). Conclusions The higher level of UA may be a risk factor for non-dipper circadian rhythm of blood pressure in hypertension patients.

Objective: To explore the correlation between glycosylated hemoglobin (HbA1c) level and severity of coronary artery disease in patients with coronary heart disease (CHD). Methods: Clinical data of 515 patients, who hospitalized in department of cardiology and received coronary angiography (CAG) examination, were analyzed. According to CAG results, they were divided into CHD group (n=370) and normal CAG group (n=145); according to HbA1c level, CHD patients were further divided into HbA1c<7% group (n=282) and HbA1c≥7% group (n=88), according to SYNTAX score, they were divided into SYNTAX score low risk group (n=181, 1~22 scores), intermediate risk group (n=125, 23~32 scores) and high risk group (n=64, ≥33 scores). HbA1c level was compared and analyzed among all groups. Results: Coronary SYNTAX score of HbA1c≥7% group was significantly higher than that of HbA1c<7% group [(25.6±9.97) scores vs. (20.92±10.26) scores, P<0.01]. HbA1c levels in high risk and intermediate risk groups were significantly higher than those of normal CAG group and low risk group [(8.74±0.83) scores, (7.74±0.62) scores vs. (5.12±0.49) scores vs. (5.68±0.59) scores], P<0.01 all, and that of low risk group was significantly higher than that of normal CAG group, , P<0.01 all. Pearson correlation analysis indicated that HbA1c level was positively correlated with coronary SYNTAX score (r=0.764, P<0.01). Conclusion: Glycosylated hemoglobin level is positively correlated with severity of coronary artery disease. Its level in those with higher SYNTAX score is significantly higher than those with low SYNTAX score.

Objective:To explore the feasibility and safty of robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy in treatment of Ⅳa grade tumor thrombus without cardiopulmonary bypass and thoracotomy.Methods:The clinical data of 4 patients with renal cell carcinoma and Ⅳa grade tumor thrombus by robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy from January 2013 to June 2019 were retrospectively analyzed. The median age was 53.5 (53-70) years. The average body mass index was 23.25 (20.7-26.3) kg/m 2. The tumors were located on the right side in 2 cases. The average maximum diameter of the tumor was 8.1 (3.6-11.2) cm.Preoperative tumor thrombus of all patients was classified as Ⅳa. The average preoperative length of tumor thrombus in vena cava was 12.3 (11.8-18.0) cm. All the operations were performed under multidisciplinary cooperation of urology, hepatobiliary, cardiovascular, ultrasound and anesthesiologist team. Surgical procedure: Robot assisted liver mobilization was used to expose the inferior vena cava. Under the guidance of intraoperative ultrasound, the central tendon and pericardium of diaphragm were dissected until the inferior vena cava and right atrium in the superior pericardium were exposed. The first porta hepatis and inferior vena cava were blocked in turn.The vena cava thrombectomy and inferior vena cava reconstruction were performed. Results:All the operations were completed without conversion. The median operation time was 553.5 (338-642) minutes, and the median time of the first porta hepatis occlusion was 18.1 (14-32)minutes. The median blood loss was 1 900(1 000-2 600)ml. All patients were transferred to ICU after operation. The median length of stay in ICU was 7(4-8) days, and the median time of indwelling drainage tube was 8(4-12) days. The average postoperative hospital stay was 13(11-20) days. There were 1 case of grade Ⅱ and 3 cases of grade Ⅲ complications (Clavien classification). One case had paroxysmal supraventricular tachycardia, one case had lymphatic fistula, one case had pleural effusion with atelectasis, and one case had hepatic and renal insufficiency and lymphatic fistula. The complications were improved after treatment. There was no perioperative death.Conclusions:Robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy is an alternative method for the treatment of Ⅳa grade inferior vena cava tumor thrombus. Using this method, Ⅳa grade tumor thrombus can be treated without cardiopulmonary bypass and thoracotomy, with controllable complications and zero perioperative mortality.