Objective To discuss the value of Duke treadmill score in the diagnosis of coronary heart disease.Methods 94 inpatients underwent treadmill test and coronary angiography,the relationship between the Duke treadmill score and the results of coronary angiography was analyzed.Results The prognostic accuracy and positive predictive value of Duke treadmill score to male and female were 88.9％,85.0％ ;those of traditional electrocardiogram ST standard were 89.6％,82.5 ％,the differences were significant (x2 =4.27,P ＜ 0.05).Conclusion The Duke treadmill score is much more significant than the traditional ST standard in the prognostic accuracy and positive predictive value of diagnosing coronary heart disease.

ObjectiveTo analyse the clinical characteristics of elderly patients with permanent cardiac pacemaker implanted. MethodsTo retrospectively analyze 41 elderly patients( ≥80 years) with permanent pacemakers implantation. Observing the clinical symptoms, bradyarrhythmia category, pacing mode, intraoperative pacing parameters,intraoperative and postoperative complications. ResultsAll patients were operated successfully. Pacing modes were,VVI 29 cases,VVIR 2 cases,DDD 9 cases and DDDR 1 case. Ventricular electrode located in right ventricular apical pacing. Atrial electrode located right heart ear. During the operateing, severe complications did not happen such as heart perforation, malignant arrhythmia. One case of postoperative dislocation electrode and one case of pocket hematocele were observed. After treatment, they were cured, no infection and pacemaker syndrome happened. 6 patients died during follow-up, postoperative from two months to 6 years. ConclusionPacing therapy in elderly patients is good. Surgical risk was not increased.

Chronic severe hepatitis is a critical disease with high mortality. Currently, effective drugs and therapy still lack. Comprehensive and supportive treatment, artificial liver and liver transplantation are the main therapies. A great number of studies on traditional Chinese medicine (TCM) in many ways combined with Western medicine treatment for chronic severe hepatitis have been reported, but the efficacy and safety still lack systematic evaluation.

0.05), but not in other brain regions. The number of GFAP-immunopositive cells of the E.coli-treated pups was markedly increased in periventricular white matter and hippocampus at P7 compared with the control group (P0.05). CONCLUSION: Intrauterine infection induces an increased expression of GFAP in the neonatal brain. [

Objective To observe the protective effect of gradual ischemic postconditioning (IP) capable of improving reperfusion on reperfusion injury in patients with ST-segment elevation acute myocardial infarction (STEAMl) undergoing primary percutaneous coronary intervention (PPCI).Methods 102 in-patients with STEAMI undergoing PPCI in the Department of Cardiology in the First People's Hospital of Kunshan City Affiliated to Jiangsu University from February 2011 to August 2014 were enrolled in this study. They were divided into three groups by a random number table: IP group (32 cases), gradual IP group (30 cases) and routine reperfusion group (40 cases). In IP group, after the opening of the infarction related blood vessel, ischemic postconditioning within the first minute of arterial reperfusion was made through three episodes of 1 minute inflation and 1 minute pressure withdrawn of an angioplasty balloon, and then persistent reperfusion was carried out. In the gradual IP group, the patients received three times of gradual angioplasty balloon inflation and denation, 1 minute/1minute, 30 seconds/30 seconds and 15 seconds/15 seconds respectively, presenting the gradual change of IP time. In the routine reperfusion group, after the opening of blocked blood vessel, the patients underwent routine PCI to persistently recover the coronary artery blood supply. The changes of related lead ST segment regression (Sum-STR), incidence of reperfusion arrhythmia, corrected thrombolysis in myocardial infarction (TIMI) franle count (CTFC), peaks of MB isoenzyme of creatine kinase (CK-MB), left ventricular ejection fraction (LVEF) and frequency of adverse events in follow-up period were compared among the three groups.Results The baseline characteristics were comparable in three groups. The incidence of ventricular premature beats was significantly lower in gradual IP group than that in routine reperfusion group [30.0% (9/30) vs. 55.0% (22/40),P < 0.05], and although theincidence of ventricular premature beats was lower in IP group than that in routine reperfusion group [34.4% (11/32) vs. 55.0% (22/40)], no statistically significant difference was found (P > 0.05). The incidence of ventricular tachycardia was significantly lower in IP and gradual IP groups than that in routine reperfusion group [15.6% (5/32), 13.3% (4/30) vs. 40.0% (16/40), bothP < 0.05]. The incidences of ventricular fibrillation, bradyarrhythmia and sinus arrest were lower in IP group and gradual IP group than those in routine reperfusion group, but no statistically significant differences were found (allP > 0.05). In IP group and gradual IP group, the Sum-STR incidence, CTFC, CK-MB peaks were lower than those of routine reperfusion group [Sum-STR: (56.7±18.3)%, (57.3±21.5)% vs. (44.6±21.6)%; CTFC: 25.47±5.37, 24.46±6.41 vs. 31.62±7.56; CK-MB peaks (U/L): 126.3±78.5, 121.6±82.5 vs. 147.4±72.5; allP < 0.05], the effect of gradual IP group being the best among the three groups. The levels of LVEF were slightly higher in IP and gradual IP groups than the level in routine reperfusion group (0.507±0.042, 0.511±0.062 vs. 0.497±0.062), but no statistically significant difference was found (bothP > 0.05). In routine reperfusion group, one patient died because the ventricular fibrillation could not be corrected and another one died of no-reflow during operation. Each group had 1 patient died during the 4 weeks of follow-up after operation, in the routine reperfusion group, one died of refractory heart failure, and the cause of death of other two patients, one in IP group and another in gradual IP group, was considered due to subacute thrombosis in stent. Major bleeding events were not found in each group.Conclusion Gradual IP can ameliorate myocardial reperfusion injury more significantly in patients with STEAMI undergoing PPCI.

Objective To evaluate the safety,feasibility and efficacy of emergency percutaneous coronary intervention(PCI)on the spot in the patients with acute myocardial infarction(AMI)in country hospitals by interventional cardiologists from higher-level hospitals(converse transport).Methods A total of 81 AMI patients received emergency PCI on the spot by interventional cardiologists from other higher-level hospitals (transported doctors)from Mar 2004 to Sep 2008 in our hospital.The mean age of patients was 68.6 ± 3.6 years (36.0-83.0 years).Forty-six patients were male and 35 were female.There were 56 cases with anterior myocardial infarction and 25 with inferior myocardial infarction(including 11 cases combined with right ventricular infarction).The average time from symptom onset to admission was 6.2 ± 1.8 hours(2.0-12.0hours).Results Three cases were transported to higher-level hospitals for CABG because of severe conditions.The other 78 cases received emergency PCI on the spot,among whom 66 cases received primary PCI.Another 12 cases received rescue PCI.Eight one stents were implanted in total into the infarcted arteries.One operation was failed because the balloon could not go through the lesion.The success.rate was 98.7％.Four patients occurred peri-operative cardiac adverse events and 2 cases died.Four cases died during the 32-86 months follow-up,of whom I was cardiac death and 3 was non-cardiac deaths.No fatal cardiovascular events occurred in the remained cases.Conclusion Emergency PCI on the spot by interventional cardiologists from other cities(converse transport PCI)in AMI is safe,feasible and effective.But it needs to be confirmed in a large-scale study in the future.

Objective To evaluate the role and technical advantages of CT in 125Ⅰseed implantation in the treatment of tumors. Methods CT-guided 125Ⅰ seed implantation in 45 cases of cancer patients treated 57 times in 51 lesions,CT were used to evaluate the progress of lesions after 125Ⅰ seed implantation 1,2,6 months. Results All procedures were once successful and the total effective rate was 74.5% without any serious complications. Fifty CT examinations immediately after implantation showed satisfactorily seeds distribution but seven cases less satisfactorily that include particles overlap,the location is too close to the lesion edge,the larger the radiation cold spots,etc. Follow-up CT reexamination in 1,2 and 6 months demonstrated that CT examinations showed satisfactorily seeds distribution but accurate seeds number,which could be solved by combined with MPR images and the positioning piece. Conclusions CT-guided 125Ⅰ seed implantation treatment of tumors was a safe,reliable and effective minimally invasive treatment. CT in the preoperative treatment of seed implants planning,precise intraoperative guidance,quality assurance and efficacy of postoperative assessment had a greater role and application advantages.

To establish an HPLC method to determine osimertinib mesylate,Agilent ZORBAX Eclipse Plus C18 column (4.6 mm × 250 mm,5 μm) was used with a mobile phase consisting of methanol-buffer solution (20 mmoL/L NaH2PO4,pH 3.0 adjusted with 85％ H3PO4) (50 ∶ 50) at the flow rate of 1.0 mL/min.The detection wavelength was 210 nm,and the column temperature was kept at 35 ℃.The calibration curve was liner over the range from 50％ to 150％ of determination concentration (0.201 1-0.603 2 mg/mL,r =0.999 9).The limit of quantitation (LOQ) and limit of detection (LOD) were 0.32 μg/mL and 0.08 μg/mL,respectively.The contents of osimertinib mesylate in samples were 100.1％,99.5％ and 99.7％.Good chromatographic separation of osimertinib mesylate and its related substances,including synthetic impurities and degradation products,were obtained.The established HPLC method is specific,accurate,simple and durable,and could be used for the determination of osimertinib mesylate.

Objective To investigate the relationship between type-2 diabetes mellitus and artery atherosclerosis(AS) in the elderly. MethodsThe clinical data of 277 elders,who were admitted in hospital between April 2005 and September 2007, were retrospectively analyzed. These elders were divided into four groups: type 2 diabetes with carotid atherosclerosis (CAS) group (group A, n=119), type 2 diabetes without CAS group (group B, n= 30), non-diabetic with CAS group (group C, n=32), non-diabetic without CAS group (group D, n=96). The correlation between carotid artery plaque and related factors were studied. Results① Compared with group C,fasting blood glucose[(7.14±2.49) mmol/L vs. (5.21±0.87) mmol/L], triglycefide [(1.41±0.78) mmol/L vs. (0.95±0.39) mmol/L],left and right common carotid artery IMT [(0.85±0.11) nun vs. (0.79±0.08) mm, (0.85±0.11)mm vs. (0.78±0.09)mm] and PI [(1.37±1.16) vs. (0.50±0.80)] of group A were significantly increased, while high density lipoprotein [(1.29±0.32) mmol/L vs. (1.58±0.45) mmol/L] is significantly decreased(P=0.01). ②Compared with group B, left and right common carotid artery IMT [(0.85±0.11) mm vs. (0.80±0.11)mm,(0.85±0.11)mm vs. (0.80±0.12)mm,PI[(1.37±1.16) vs. (0.00±0.00)]and incidence of stroke 34.5% (41/119) vs. 13.3% (4/30) of group A are significantly increased (P<0.05 or P<0.01). ③Carotid artery plaque was positively correlated with history of diabetes(r=0.051, P<0.01),hypertension(r= 0.169,P<0.01),coronary heart disease (r=0.109,P<0.05),stroke(r=0.136,P<0.05),fatty liver(r= 0.340,P<0.01),FBG(r=0.339,P<0.01),TG(r=0.195,P<0.01),APOB (r=0.152,P<0.05),but negatively correlated with HDL-C (r=-0.143, P<0.05). Conclusion The risk of AS is higher in elderly patients with type 2 diabetes than that of non-diabetes. The incidence of stroke is higher in type 2 diabetes with AS than those of type 2 diabetes without AS. Carotid artery plaque is positively correlated with diabetes, hypertension, history of coronary heart disease, history of stroke, fatty liver, FBG, TG, ApoB, but negatively correlated with HDL-C.

Objective To study the relationship between the polymorphism of interleukin-12B (IL-12B)gene and coronary heart disease.Methods We recruited 256 patients with coronary heart disease admitted to our department as the study group and 256 normal subjects as the control group.The polymorphism of IL-12B gene was detected by polymerase chain reaction and single nucleotide polymorphism.Coronary artery stenosis,visfatin,high sensitive C reactive protein and cardiac function were determined.Results The difference in rs15677380 and rs14050311 allele frequencies between the study group and the control group was significant (χ2 =6.19,7.24,P=0.045,0.021).The G allele of rs15677380 and C allele of rs14050311 were risk factors for coronary heart disease (OR=1.32,1.49).Conclusion IL-12B gene is associated with the occurrence and development of carotid atherosclerosis and participates in the development of coronary heart disease.