Objective To observe the change of the concentration of plasma B-type natriuretic peptide (BNP) before and after treadmill exercise test (TET),and to judge the accuracy of BNP changes ( ABNP)in diagnosing coronary heart disease (CHD). Methods A total of 188 patients with suspected CHD underwent TET and the levels of plasma BNP before and after TET was detected. All the patients were divided into CHD group( group A, n = 96) and non-CHD group(group B, n = 92) according to coronary ar-teriography. Meanwhile, 26 healthy volunteers were enrolled (group C). Results The levels of plasma BNP after TET increased significantly (P<0.01 ). The levels of ABNP of group A were obviously higher than those of group B and C(P<0.01 ). When the levels of △BNP was 8.5 pg/ml, the sensibility, specificity, pos-itive predictive value and negative predictive value of diagnosing CHD was 93.5%, 57.1%, 70.5% and 88.9% respectively. Area under curve (AUC) was 0.815, and 95% confidence interval was 0.768-0.896.Conclusions The levels of plasma BNP after TET increase obviously. It exists higher sensibility and speci-ficity in diagnosing CHD by △ABNP set 8.5 pg/ml.

ObjectiveTo investigate environmental factors of the relapse of alcohol dependence.MethodsOne hundred and seventeen in-patients with alcohol dependence were assessed with a home-designed questionnaire,Family Environment Scale Chinese Version (FES-CV),Clinic Institute Alcohol Withdrawal Syndrome Scale Chinese Version(CIWA-Ar) and the Scale of Personality Change Post-Traumatic Brain Injury(SPCPTBI).One hundred and five patients reassessed with alcohol dependence syndrome diagnostic criteria 1 year after hospitalization.t -test,chi-square and logistic regression were used for analysis.Results 57 of 105 were relapse and 48 of them were not relapse.The results showed that relapse group had a higher divorce or separated or remarried rate (21/36) than the no-relapse one (7/41 ) ( chi-square =6.60,P =0.010) ; a less number of years of education (5.2 ± 1.8 vs 7.2 ± 1.7,t =5.64,P =0.000) ; a bigger daily drinking ( (512 ± 186) ml vs (396 ± 109) ml,t =3.93,P =0.000) ; a higher drinking frequency in relapse group ( (2.6 ± 0.9 ) vs ( 1.8 ± 0.6) times,t =5.38,P=0.000) ;a higher rates in personality change(47/57 vs 15/48 ),brain damages (27/57 vs 13/48 ) and mood disorders (35/57 vs 17/48 ),They also showed that relapse group had more problems on intimate degree (5.66 ±1.40 vs 6.20 ± 1.20),emotional expression (4.59 ± 1.54 vs 5.41 ± 1.26,independence (3.61 ± 1.29 vs 4.64± 1.49),organization (4.26 ± 1.56 vs 5.22 ± 1.18 ),and self-controlling (4.21 ± 1.43 vs 5.12 ± 1.12 ),the differences were significant (P＜0.05) ;a higher contradiction score(4.35 ± 1.73 vs 3.64 ± 1.22,t =2.42,P =0.017).Logistic regression analysis showed that the number of daily drinking,intelligent damaged,emotional problems,arid dependence were the risk factors for the alcoholic relapse ( OR =7.44,3.99,3.92,2.96) ;Self-controlling was the protective factors for the alcoholic relapse ( OR =0.19).ConclusionProblem marital status,less education,and heavy drinking,and the number of drinking times,personality change,intellectual impairment and mood change,and poor family environment were the risk factors for the relapse of alcohol dependence.

Objective To discuss the lung protective effect of Shenfu injection on the legs' ischemia-reperfusion injury.Methods Sixty patients (6 males, 24 females, ASA grade Ⅰ or Ⅱ)with unilateral lower limb surgery, were randomly divided into Shenfu injection group (group SF, n=32) and control group (group C, n=28).All patients were treated by combined spinal epidural anesthesia, with the same dose of local anesthetic (0.75% bupivacaine 1.5 ml and the same pressure (300mm Hg) of tourniquet.Patients in group SF were given intravenous infusion of Shenfu injection with the dose of 1 ml/kg (added in normal saline 100 ml) 30 min before apply tourniquet and 1 ml/kg (added in nomal saline 50 ml) 5 min before tourniquet deflation.Patients in group C were injected with equal dose of compound sodium lactate at the same time.Recorded the hemodynamic changes before apply tourniquet (T0) and 5 min (T1), 15 min (T2) and 30 min (T3) after tourniquet deflation.Took venous blood to determine concentrations of plasma thromboxane B2 (TXB2) and malondialdehyde (MDA).Results Compared with T0, MAP in the two groups were significcantly lower at T1-T3 (P＜0.05).MAP in group SF at T2 and T3 were higher than those in group C (P＜0.05).There was no significant difference in HR between the two groups.TXB2 and MDA in group SF at T2 and T3 were significantly lower than those in group C (P＜0.05 or P＜0.01).Conclusion Shenfu injection with antioxidation has a protective effect on lower limb ischemia-reperfusion lung injury induced by tourniquet.

Objective To observe the effect of buccal needle therapy on perioperative analgesia in patients undergoing laparoscopic radical colon cancer surgery.Methods Sixty patients underwent dective laparoscopic radical of colon cancer surgery were selected,32 males and 28 females,aged 45-74 years,BMI 18.5-25.0 kg/m2 and ASA physical status Ⅱ or Ⅲ.The patients were divided into two groups using the randomized numerical table method:buccal needle group and control group,30 patients in each group.Before the induction of anesthesia,the buccal needle group was given buccal needle therapy once,and buc-cal needle therapy was performed once a day at 9 a.m.in the postoperative period,leaving the needle in place for 30 minutes each time,for 3 consecutive days of treatment,and the control group was not treated with buccal needle therapy.The amount of intraoperative propofol,remifentanil,sufentanil used in the 48 hours postoperative period and recorded.VAS pain scores were recorded at 1 hour,4,24,and 48 hours postoperatively.Venous blood was collected at the time of admission to the hand room and at 1 day,2,and 3 days postoperatively,respectively,and the concentrations of plasma C-reactive protein(CRP),interleu-kin-6(IL-6),and tumor necrosis factor-alpha(TNF-α)were measured.The occurrence of adverse reactions within 48 hours after operation was recorded.Results Compared with the control group,intraop-erative propofol,remifentanil,the amount of sufentanil used and the number of analgesic pump presses with-in 48 hours after operation in the buccal needle group were significantly reduced in the buccal needle group(P＜0.05),VAS pain scores were significantly lower at 1 hour,4,24,and 48 hours postoperatively(P＜0.05),CRP,IL-6,and TNF-α concentrations were significantly lower at 1 day,2,and 3 days postopera-tively(P＜0.05),and nausea and vomiting,incidence of laryngospasm and laryngeal discomfort were sig-nificantly reduced(P＜0.05).Conclusion The perioperative use of buccal needle therapy in patients un-dergoing laparoscopic radical colon cancer surgery can effectively reduce pain,inhibit inflammatory respon-ses,and decrease the incidence of postoperative adverse reactions.