Objective To investigate the relationship between the level of serum brain natriuretic peptide(BNP) and the severity of coronary artery disease in elderly patients with coronary heart disease(CHD).Methods We recruited 498 elderly CHD patients undergoing coronary angiography(CAG) from our hospital.Based on CAG results,patients were divided into two groups:406 patients with lesion of vessel(s)and ≥50％ vessel stenosis as the CHD group,and the other 92 patients with ＜ 50％ vessel stenosis as the negative control group.Their clinical data such as left ventricular ejection fraction(LVEF) and serum BNP was recorded.The patients was further divided into 177 single-,129 double-,100 triple-,and 92 negative vessel disease groups according to the number of vessels with significant stenosis.The patients with CHD were divided into three different age groups:(1) A group:60-69 years old,254 patients ;(2) B group:70-79 years old,112patients;(3)C group:equal or greater than 80 years old,40 patients.Serum levels of BNP were measured before CAG.The relationship between BNP and the severity of coronary disease was analyzed.Results The level of BNP was significantly elevated in the CHD group[(387.5±132.3)ng/L]than the negative control group [(58.6±22.1) ng/L](t =23.83,P ＜ 0.01).The level of BNP was significantly enhanced(F =87.42,P ＜0.01) along with the increasing number of coronary artery Stenosis,with single vessel disease group(202.2±116.6)ng/L,double vessel disease group(487.5±152.3)ng/L and triple vessel disease group(768.7±264.3) ng/L; the level of BNP significantly increased(F =57.33,P ＜ 0.01) along with increasing age,with A group(182.6±93.1)ng/L,B group(352.2±121.2)ng/L and C group(491.2±158.7) ng/L.The level ofLVEF did not change in the procedure(P ＞ 0.05).Conclusion The levels of BNP were closely associated with the severity of coronary artery disease and were a strong clinical predictor for myocardial ischemia.

Abnormal thyroid function is high risk for pregnancy.Studies from clinical observation and animal experiments have indicated that maternal sub clinical hypothyroidism during the first gestational term may lead to impairment of brain development of offspring,and early diagnosis and effective treatment may prevent the damage.Therefore,it is suggested that screening thyroid function before gestational 8 weeks in pregnant women is initiated.The changes in thyroid function during pregnancy are related to these changes in maternal thyroid physiology can lead to confusion in the diagnosis or evaluation of thyroid abnormalities.Establishment of trimester-specific reference ranges is urgently needed.Local iodine nutritional statue and testing reagent effect the measured value of thyroid function in general population,so it is recommend that all regions and hospitals should establish their own pregnancy reference ranges.

Objective To explore the effect of hyperglycemia on the survival time, duration of disease remission and complications during induction chemotherapy for acute lymphocytic leukemia(ALL). Methods The treatment-related complications in 98 adult ALL patients with or without hyperglycemia were retrospectively analyzed. Survival time and complete remission duration(CRD) were evaluated using Kaplan-Meier method. Cox regression analysis was used to examine whether hyperglycemia was an independent predictor of disease recurrence and death. Results ALL patients with hyperglycemia were found to be older, and more likely to occur thrombocytopenia. ALL patients with hyperglycemia had a shorter CRD and survival time, and were more likely to develop infection and neuropathy. Conclusion Hyperglycemia during induction chemotherapy for ALL increased the frequency of infection and the risk of disease recurrence and death.

Objective To compare the efficacy and side effect between Paracetamol and Tramadol Hydrochloride Tablet and Paracetamol and Dihydrocodeine Tartrate Tablet on chronic pain. Methods From October, 2013 to October, 2015, 84 patients with chronic pain were divided into group A (n=42) and group B (n=42), who took two Tramadol tablets or Dihydrocodeine Tartrate tablets, three times a day orally for five days. They were assessed with Numerical Rating Scale (NRS), and the incidence of satisfaction and side effect were in-vestigated. Results The score of NRS decreased in both groups after treatment (t>9.402, P<0.001), and there was no significantly difference between them (t=0.461, P=0.941). No significant difference was observed in incidence of pain relief and satisfaction between two groups (χ2=0.979, P=0.323). The incidence of constipation (χ2=5.864, P=0.006) and abdominal distention (χ2=9.946, P=0.002) were less in group A than in group B, but the incidence of nausea was more (χ2=4.934, P=0.026), while the incidence of dizziness, vomiting and tiredness was no significantly different between two groups (χ2<1.451, P>0.061). Conclusion The analgesic efficacy is similar of both drugs, but different in side effects of gastrointestine.

Objective To analyze the detection rates,species distribution and drug-resistance of urinary fungal infection in elderly patients at Beijing Hospital from 2011 to 2013,in order to provide the basis for the reasonable clinical use of anti-epiphyte medicines.Methods Totally 263 patients with an average of 79.6 years old were collected from Beijing Hospital.The urine from freshly voided midstream or bladder puncture was collected under aseptic condition for fungal culture,then the strains of epiphytes were identified by using API 20C AUX.The drug sensitivity was tested with ATB fungus3.Results 263 strains of epiphytes were isolated from the 2 983 urine samples,of which 92 were C.tropicalis,85 were C.glabrata,77 were Candida albican,and 9 were other fungus candida.The rates of drug resistance to fluconazole were 14.1 ％ (13 strains),37.6 ％ (32 strains) and 15.6％ (12 strains),and to itraconazole were 16.3％(15 strains),35.3％(30 strains) and 9.1％(7 strains),respectively.All of the 263 strains were not found to have drug resistance to amphotericin.Conclusions The isolation rate of urinary fungal infections is 8.8％ in Beijing Hospital.The majority of the tested fungal are C.glabrata,C.tropicalis and Candida albican,the former has higher resistance rate to azoles,and the two latter have better sensitivity to azole,and all of them have the sensitivity to amphotericin.

Objective: To observe the acute toxicity of Ke'erxing Capsules (KC) in mice and its long-period toxicity in rats. Methods: The maximal tolerance dose was tested by gastric infusion of single oral dose of KC. Three groups of rats (in high, moderate and low dosage of KC) were administered with repeated gastric infusion of KC for 8 weeks. Body weight, hematological and hematobiochemical parameters, coefficient and histomorphological figure of organs (the heart, liver, spleen, lungs, kidneys, adrenals, testes, prostate, pancreas, uterus, brain, thymus) were examined in 8 weeks and 2 weeks after the cessation of KC. Results: The oral maximal tolerance dose of KC in mice was more than 4000 mg/kg (equal to 600 times of clinical dose). General conditions were changed and the body weight was increased slowly in high-dosage group. The coefficient of prostate was increased in high-dosage group and moderate-dosage group and recovered to normal 2 weeks after stopping the drug. Conclusion: KC has a certain effect on mice and rats but the effect was reversible.

Objective To investigate the effects of continuous stellate ganglion block (SGB) on serum thyroid hormone and cortisol levels in patients with severe brain injury.Methods Eighty ASA Ⅱ or Ⅲ patients with severe brain injury aged 22-61 yr undergoing emergency craniotomy were randomly divided into 2 groups ( n = 40 each): control group (group C) received routine treatment only and continuous SGB group (group SGB) received continuous SGB with 0.2% ropivacaine besides routine treatment. SGB was performed on the operated side after induction of general anesthesia and tracheal intubation. An epidural catheter was placed. A bolus of 0.2% ropivacaine 7 ml was followed by continuous infusion of 0.2% ropivacaine at a rate of 2 ml/h. Continuous SGB was maintained for 48 h. Successful SGB was confirmed by increase in skin temperature by ≥1.5℃ behind earlobe on the operated side.Venous blood samples were obtained at 30 min before and 3 and 7 day after operation for determination of serum thyroid stimulating hormone (TSH), triiodothyronine (T3) ,thyroxine (T4) , reverse triiodothyronine(rT3) and cortisol concentrations. Glasgow prognosis score was used to evaluate the clinical results at 3 months after operation. Results Serum T4 , rT3 , TSH and cortisol concentrations were significantly lower while the serum T3 concentration was higher in the SGB group than in group C at 3 and 7 d after operation. The clinical results were significant better in SGB group than in group C according to Glasgow prognosis scores at 3 months after operation. Conclusion Continuous SGB can inhibit the stress response, and improve hypothalamus-pituitary-thyroid gland axis function and is helpful to patient's recovery from injury.

Pancreatic cancer is a malignant with very poor prognosis.Although methods and technologies of diagnosis and treatment in connection with pancreatic cancer have made great progresses,the prognoses of patients with pancreatic cancer still have not a significant upgrade,which are closely related with the degree of malignancy of pancreatic cancer cells.Earlier studies have shown that normal pancreatic cells need to have a total of six capabilities,which are intimate connection with the degree of malignancy of pancreatic cancer cells,during the process of deterioration.A variety of immunohistochemical markers that correlate with prognosis of pancreatic cancer involve in the process of pancreatic cells obtaining these six capabilities.

Objective To compare the effect of laminar flow bed in the prevention of hospital infections in patients with leukemia after chemotherapy. Method The Meta-analyses were done on Meta RevMan5.0 by retrieving the domestic databases from January 1999 to January 2014 to look into and compare the hospital infections in leukemic patients using laminar flow beds and common beds, including of the rate of hospital infection, duration of fever, days for antibiotic use, hospital stay. Results A total of 16 papers were included. The Meta analyses showed that the rate of hospital infection in the wards with laminar flow beds was significantly lower than that in the wards with common beds (RR=0.54,95%CI (0.47, 0.62), P<0.01). The fever duration, time for antibiotics use and hospital stay in patients in the wards with laminar flow beds were all significantly shorter than those in the patients in the wards with common beds [WMD=-3.64, 95%CI (-4.83,-2.46);WMD=-4.13, 95%CI (-5.95,-2.32)];WMD=-5.36, 95%CI (-7.52,-3.20);P<0.01,respectively)]. Conclusion Laminar flow beds are effective in preventing hospital infections among acute leukemic patients having undergone chemotherapy.

Because of its unique advantages , zebrafish has been more and more widely used in drug screening and safety assessment , environmental protection , developmental biology and other fields . But the standardization of environments, feed, and water environment of zebrafish are prominent problems and weakness which hindered their application .This paper probes into the standardization of environment and feed of zebrafish in Zhejiang , in order to promote its standardization construction .