Objective:To study the therapeutic value of Xueshuantong injection combined atorvastatin in patients with coronary heart disease (CHD)complicated diabetes mellitus (DM).Methods:A total of 100 CHD+DM patients, who were treated in our hospital from Jan 2012 to Jan 2014,were selected.According to random number method, they were randomly and equally divided into routine treatment group (including atorvastatin treatment)and Xue-shuantong combined atorvastatin group (combined treatment group).Clinical therapeutic effect,change of blood lipid level and safety were observed in two groups.Results:Total effective rate of combined treatment group was significantly higher than that of routine treatment group (96.0% vs.68.0%,P =0.032).Compared with routine treatment group,after treatment,there were significant reductions in levels of total cholesterol [(4.38 ± 0.50) mmol/L vs.(4.09±0.47)mmol/L],triglyceride [(2.23±0.35)mmol/L vs.(1.79±0.28)mmol/L]and low density lipoprotein cholesterol [(2.45±0.29)mmol/L vs.(2.23±0.28)mmol/L],and significant rise in level of high density lipoprotein cholesterol [(1.11 ±0.12)mmol/L vs.(1.37± 0.25)mmol/L]in combined treatment group,P <0.05 all.Incidence rate of adverse reaction was 6.0% and 4.0% in combined treatment group and rou-tine treatment group respectively,but there was no significant difference between two groups,P =0.436. Conclu-sion:Xueshuantong combined atorvastatin treatment can significantly improve blood lipid levels and raise clinical therapeutic effect in CHD+DM patients.

Objective To explore the protective effect of hydrogen-rich saline on liver ischemiareperfusion (IR) in mice and the possible mechanisms. Methods Twenty-four C57BL/6 mice were randomly divided into 3 groups: sham-operated group, control group (mice were injected with 5 ml/kg saline by tail vein just before ischemia induction) and hydrogen-rich saline group (mice were injected with 5 ml/kg hydrogen-rich saline). Six hour after reperfusion, the mice were sacrificed and the serum and liver samples undergoing IR injury were collected. The ALT and AST levels in serum were determined and liver histiological damage was also evaluated with Suziki's criteria. Malondialdehyde (MDA) contents in liver samples were measured using specific kits. The infiltration of F4/80 positive macrophage cells was detected by using immunohistochemistry and that of neutrophils with myeloperoxidase (MPO) kits. The mRNA expression of TNF-α, IL-6, ICAM-1 and IP-10 was assayed by using real-time reverse transcription PCR. The activation of transcription factor NF-κB was measured by using Western botting analysis. Results As compared with control group, at the 6th h following reperfusion, mice in hydrogen-rich saline group exhibited lower levels of ALT and AST (P＜0. 05) in serum, milder histological damage (P＜0. 01) and less MDA contents in liver samples (P＜0. 01). The infiltration of macrophages, neutrophils and the mRNA expression of TNF-α, IL-6,ICAM-1 and IP-10 in the liver tissue in hydrogen-rich saline group were reduced as compared with IR group (P＜0. 05 or P＜0. 01). The activation of NF-κB in hydrogen-rich saline group was significantly down-regulated as compared with control group. Conclusion Injection of hydrogen-rich saline via the tail vein can alleviate liver IR injury probably by inhibiting oxidant stress and inflammatory response induced by reperfusion.

0.05) in tail flick test.MPE% in group MK was always higher than group M and descended more slowly than group M,especially from the d4 to d8(P0.05). Conclusion Ketamine could block the development of morphine tolerance partly due to its inhibition effect on pCREB protein.

Objective To explore the relationship between the expression of pS2 protein and the clinicopathological parameters in breast cancer and to evaluate the value of pS2 as a prognostic factor for breast carcinoma and a predictive factor for response to endocrine therapy. Methods Expression levels of pS2 protein, estrogen receptor (ER) and progestogen receptor (PR) in tissues from 75 cases of breast cancer were detected by immunohistochemical assay. The relationship of pS2 protein expression with patient age, menopausal status, tumor size, metastasis to the axillary lymph nodes, pathological types, ER and PR was analyzed. Results pS2 protein, expressed in 33.3% of breast carcinomas, was correlated with patient age and pathological types, but was not correlated with tumor size. The positive rate of pS2 protein before menopause was higher than that after menopause, but no significant difference was found. Similarly, higher positive rate of pS2 protein was found in patients with metastasis to axillary lymph nodes than those without, but no significant difference was found. pS2 expression was correlated with ER and PR, but they were not perfectly consistent. Conclusion In breast cancer, pS2 protein expression, associated with some clinical factors and pathological features, is a good prognostic factor. pS2 expression may be a reasonable index for endocrinotherapy of breast carcinoma, but the detection of pS2 protein can not be employed in place of the detection of ER and PR.

Objective To evaluate the efficiency of dexmedetomidine combined with flurbipro-fen axetil preventing agitation and reducing extubation reaction after general anesthesia. Methods Eighty patients,ASA Ⅰ or Ⅱ,scheduled for selective oral and maxillofacial surgery were randomly divided into four groups,20 patients in each group.30 mins before end of the operation, patients intravenously received flurbiprofen axetil 50 mg (group F),dexmedetomidine 0.5 μg/kg (group D),dexmedetomidine 0.25 μg/kg plus flurbiprofen axetil 50 mg (group DF),normal saline (group C),respectively.MAP,HR were recorded before extubation (T0 ),extubation (T1 ),5 mins after extubation (T2 ).The recovery time,extubation time,Riker sedation-agitation score(RSAS)be-fore extubation and Ramsay sedation score 5 min after extubation were observed.Results Compared with T0 ,MAP,HR at T1 ,T2 in group C and group F were significantly increased (P <0.05 or P <0.01),MAP,HR at T1 ,T2 in group D and group DF were significantly lower than those in group C (P <0.01 ).The recovery time,extubation time in group D were significantly longer than those in group C,group F and group DF(P <0.05).Ramsay scores in group D was significantly higher than other groups(P <0.05).The incidence of agitation in group D and group DF were significantly lower than those in group C(P <0.05 or P <0.01).Conclusion Dexmedetomidine 0.25 μg/kg plus flurbi-profen axetil 50 mg can effectively prevent agitation and reduce extubation cardiovascular reaction dur-ing recovery period,without the disadvantage of prolonging the recovery and extubation time.

Objective To investigate the effect of music therapy on anxiety and depression in patients with spinal cord injury. Methods Forty anxious and depressive patients with spinal cord injury were selected as the control group from December 2012 to October 2013, and another 40 anxious and depressive patients with spinal cord injury as the observation group from November 2013 to September 2014. Patients in the observation group were given the following metheds after admiting for 3 days besides psychological nursing; music therapy once a day, 1 hours one time for 4 weeks. The two groups were compared in terms of the scores by Hamilton anxiety scale (HAMA) scores and Hamilton depression scale (HAMD) before and after treatment. Results There were insignificant differences in HAMA scores and HAMD scores between the two groups before music therapy (P>0.05), but the scores by HAMA and HAMD in the observation group were both significantly lower than those in the control group. Conclusion Music therapy can alleviate anxiety and depression of patients with spinal cord injury, and promote the functional recovery.

Adolescent ; Adult ; Aged ; Child ; Endoscopy ; Female ; Humans ; Intraoperative Period ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Recovery of Function ; Smell ; Young Adult

BACKGROUND: More and more researches prove that cell apoptosis could be induced by glutamine, also there are more researches on studying the indirect and direct nervous-protective effects of insulin, but the nervous-protective effects of insulin on impairment induced by glutamine, as well as its mechanism still need further investigation.OBJECTIVE: To investigate the nervous-protective effects of insulin on impairment induced by glutamine in PC12 cells, and to explore its molecular mechanism.DESIGN: A prospective controlled study based on cells.SETTING: Department of Neurology, Zhejiang Hospital; Department of Neurology of Sun Yat-wen University Hospital.MATERIALS: The study was carried out at the Laboratory of the Third Affiliated Hospital and the Experimental Animal Center of Sun Yat-sen University from March 2002 to March 2003. PC12 cells were purchased from the same animal center.METHODS: Traumatic models were made in PC 12 cells by treated with 0.5 mmol/L glutamine for 20 minutes, and the insulin of different concentration were used for protection, after 24 hours, protective effects of insulin were assessed with MTT method, Hoechst33258 fluorescence staining, DNA agar gelatin electrophoresis, meanwhile the expression of PKB/Akt protein were also detected./Akt protein in experimental group.RESULTS: The A value of50 mU/L, 100 mU/L, 200 mU/L, 400 mU/L insulin groups were 0. 214 ±0. 062, 0. 234 ±0. 067, 0. 260 ±0. 076 and 0. 265 ± 0. 069, respectively, but the value of single glutamine group was 0. 201 ± 0. 079, statistical analysis indicated that compared with single glutamine group, there were no significant difference in 50 mU/L, 100 mU/L insulin groups( P > 0.05), but 200 mU/L, 400 mU/L insulin groups were found statistically different from single glutamine group(t=-2.398,-2. 716, P < 0.05); "DNA Ladder" could not be observed in 400 mU/L insulin group by electrophoresis;It was proved that Insulin could enhance the expression of PKB/Akt protein.CONCLUSION: Insulin has nervous-protective effects on impairment induced by glutamine in PC12 cells, furthermore it also has property of anti-apoptosis, and its protective mechanism might be associated with enhancement of the expression of PKB/Akt protein.

Objective To investigate the relationship between abnormalities of maternal serum markers in Down syndrome screening in second trimester and adverse pregnancy outcome.Methods Totally,1935 pregnant women were screened for Down syndrome with maternal serum tri marker with time-resolved fluorescence assay,including alpha fetoprotein (AFP),free β-human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3),between 15 and 20+6 gestational weeks at Peking Union Hospital from January 1,2009 to January 31,2011,and were followed up till delivery.The relationship between incidence of adverse pregnancy outcomes and women with normal or abnormal levels of serum markers in Down syndrome screening was investigated.T-test or Chi-square test were applied for statistical comparison.Results (1) Among the 1935 pregnant women,normal levels of serum markers were found in 1255(normal group) and 680 were abnormal(abnormal group),in which 577 with only one abnormal serum marker,89 with two and 14 with three abnormal serum markers.According to the serum marker level,the 577 women with one abnormal serum marker were further divided into five groups,including high AFP group (n=17),low AFP group (n=114),high β-hCG group (n=242),low β-hCG group (n=139) and low uE3 group (n=65).The birth weight of infants in lower AFP group and the gestational age at delivery in low β-hCG group were greater than those in normal group [(61.3±9.1) kg vs (59.5±8.3) kg,(272.6±11.8) d vs (274.4±10.1) d,t=2.21 and 1.99,both P＜0.01].(2) The incidence of adverse pregnancy outcome in normal group was 42.8％(537/1255),while comparing with the abnormal group(43.7％,297/680),no statistical significance was shown (RR =1.02,P =0.71).While comparing with the normal group,the incidences of placenta previa [25.5％ (32/1255) vs 2/17,RR=4.61,P＜0.05] and abnormal placental morphology were higher in high AFP group [4.1％ (51/1255) vs 5/17,RR=7.24,P＜ 0.05],the incidence of gestational diabetes mellitus (GDM) was higher in low AFP group [8.1％ (101/1255) vs 14.4％(16/114),RR=1.74,P＜0.05],the incidence of placenta and membrane retention was higher in high β-hCG group [3.5％ (44/1255) vs 6.2％(15/242),RR=1.77,P＜0.05],the incidence of pre-eclampsia was higher in low β-hCG group [1.7％ (21/1255) vs 6.5％ (9/ 139),RR=3.87,P＜0.05].(3) There were 89 women with two abnormal serum markers.Comparing with the normal group,the incidences of small for gestional age (SGA) infants,oligohydramnios,abruptio placenta were higher in women with low AFP but high β-hCG [SGA infants:6.9％(2/29) vs 1.8％(22/1255),RR=3.94; oligohydramnios:20.7％(6/29) vs 6.4％(80/ 1255),RR=3.24; both P＜0.05],the incidences of oligohydramnios was higher in women with both low AFP and low uE3[3/14 vs 6.4％(80/1255),RR=3.36,P＜0.05],the incidence of premature birth and GDM were higher in women with both low β-hCG and low uE3 [premature birth:2/6 vs 4.3％(54/1255),RR=7.75; GDM:3/6 vs 8.0％ (101/1255),RR=6.21; both P＜0.05].(4) There were 14 women with three abnormal serum markers.The relationship between adverse outcome and abnormal serum markers did not show any statistical significance.Conclusions The abnormality of serum markers of Down syndrome screening is closely related to adverse pregnancy outcomes,and women with abnormal serum markers should be carefully monitored during pregnancy.

Objective To calculate the incidence of chromosomal abnormalities at second trimester in women who were 35 or older at their expected date of birth.Methods The amniocentesis and karyotyping results in Peking Union Medical College Hospital from January 1st,2001 to June 30th,2011 were retrospectively analyzed.The only indication for amniocentesis in these group of woman was advanced maternal age.A total of 6584 cases Were included in this study and were divided into two groups according to maternal age,ie.35-39 and ≥40 year old group.The incidences of fetal 47,+ 21,47,+ 18 and sex aneuploidies were calculated and compared between two groups by Chi-square test.Results Altogether,121 cases were diagnosed to be abnormal chromosome,and the overall incidence was 18.38‰ (121/6584).The abnormal karyotypes included 111 cases of aneuploidies (mosaicism included) and 10 cases of structural abnormalities.The aneuploidies included 59 cases of 47,+21 (8.96‰,59/6584),25 cases of 47,+18 (3.80‰,25/6584),2 cases of 47,+13 (0.30‰,2/6584) and 25 cases of sex aneuploidies (3.80‰,25/6584).Fetal 47,+21 was the most frequent chromosomal abnormality,accounting for 53.15％ (59/111) of all aneuploidies.The incidence of fetal 47,+21 was significantly higher in ≥40 year-old group than that of 35-39 year old group[13.99‰(16/1144) vs 7.90‰(43/5440),x2=3.937,P=0.047].There were no statistical differences of the incidences of fetal 47,+ 18 and sex aneuploidies between the two groups.Conclusions The main fetal chromosomal abnormalities in women aged 35 and older are the aneuploidies of chromosome 21,18,13 and sex chromosomes.The incidence of fetal 47,+21 is significantly increased in the women aged 40 years and older.So prenatal screening should be provided first to women at 35-39 years of age and amniocentesis should be the first choice of prenatal diagnosis for women over 40 years old.