Objective To evalute the efficacy and safety of primary percutaneous coronary intervention (PCI) therapy and facilitated PCI therapy (thrombolysis plus PCI) for acute myocardial infarction (AMI). Methods Sixty four patients with ST elevation myocardial infarction (STEMI) were divided randomly into two groups including the facilitated PCI group and the primary PCI group. The patency rate of infarct-related artery (IRA) before intervention, the incidence of bleeding complications and acute ischemic events during hospitalization as well as the left ventricular ejection fraction (LVEF) measured by echocardiography before discharge were compared. The thrombolysis in myocardial infarction (TIMI) flow grade (TFG), TIMI myocardial perfusion grade (TMPG) and angiographic perfusion score (APS) in all patients were measured before and after PCI and the extent of ST segment elevation resolution was analyzed 90 minutes after reperfusion therapy. The relationship between APS and percentage of complete ST resolution was analysed by linear regression. Results The IRA patency rate and TMPG in the faciliated PCI group were significantly higher than that in the primary PCI group before PCI (P

Objective To assess the performance of the methylation‐sensitive high‐resolution melting curve analysis (MS‐HRM analysis) on the detection of the methylation in stool DNA for colorectal cancer screening .Methods Eighty‐two qualified stool samples were collected from 27 patients with colorectal cancer patients (CRC group) ,25 patients with advanced adenomas (AA group) ,and 30 healthy people (control group) .The methylation status of vimentin gene in all of the stool samples was detected by the MS‐HRM analysis on the LightCycler 480 platform .The fecal occult blood test (FOBT) was also used for the same samples . Results The positive rates of the MS‐HRM assay in the CRC group ,AA group ,and control group were 81 .5% (22/27) ,80 .0%(20/25) ,and 6 .7% (2/30) respectively .The positive rates of FOBT in the three groups were 37 .0% (10/27) ,12 .0% (3/25) and 3 .3% (1/30) respectively .The diagnostic sensitivity of the MS‐HRM assay for colorectal cancer and advanced adenomas (80 .8% , 42/52) was significantly higher than that of FOBT (25 .0% ,13/52)(P<0 .05) .No significant difference was found in the diagnos‐tic specificity between the MS‐HRM assay (93 .3% ,28/30) and the FOBT (96 .7% ,29/30) (P>0 .05) .Conclusion MS‐HRM performs better than FOBT and has great application potential in the detection of stool DNA methylation for colorectal cancer screening .

Objective To detect the change of serum cystatine C ( cys C ) level in Parkinson ’ s disease ( PD ) patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS ) and explore its influencing factors .Methods Fifty-six PD patients with polysomnography examination from July 2011 to December 2013 in the Department of Neurology , the Second Affiliated Hospital of Soochow University were collected.Eighteen healthy controls who took the polysomnography examination during the same period were included.According to the apnea-hypopnea index ( AHI) , PD patients were further divided into two groups:PD with OSAHS group ( n=26 ) , and PD group ( n=30 ).The general conditions , movement function , biochemistry parameters , and sleep parameters were assessed.Statistical analysis was performed using SPSS ver 17.0 software.Results The mean serum levels of cys C in PD with OSAHS group , PD group and control group were (1.05 ±0.17) mg/L, (0.96 ±0.12) mg/L and (0.84 ±0.20) mg/L, respectively.Statistical analysis showed that there was significant difference in the three groups (F=9.184,P<0.05), and the mean serum level of cys C in PD with OSAHS group was the highest.In PD with OSAHS group , Spearman correlation analysis showed a positive and significant correlation between cys C levels and creatinine levels (r=0.459,P =0.018), urea levels (r =0.405,P =0.040), AHI (r =0.482,P =0.013), the oxygen desaturation index (r=0.408,P=0.038), the arousal index (r=0.392,P=0.047) as well as Hoehn and Yahr (H-Y) stage (r=0.467,P=0.016).Correlation was not observed between cys C levels and other clinical parameters (P>0.05).Multivariate analysis showed that creatinine levels (B=0.007,P=0.005), AHI (B=0.004,P=0.013) , H-Y stage (B=0.102,P=0.026) may be influencing factors of cys C levels in PD patients (P<0.05).Conclusions Cys C level is elevated in PD patients, especially in PD patients with OSAHS.The degree of hypoxia and severity of PD is related to the level of cys C in PD patients with OSAHS .

Objective To explore properties of emotion memory circuits in late-life depression,and differences in functional connectivity of emotional memory network between late-life depression and healthy controls who were investigated by resting-state fMRI.Methods Eighteen late life depression patients and twenty four healthy controls were involved in our study.Resting-state functional MRI data were acquired via 3.0T MRI scanner.Functional MRI data were analyzed.Behavioral data were acquired during retrieval.The independent samples t-test of functional MRI data and ANOVA of behavioral performance were performed with AFNI and SPSS 13.0 statistical software,respectively.Results Decreased connectivities had been shown in depression,including amygdala-thalamus,amygdala-left inferior frontal gyrus,supramarginal gyrus-dorsomedial prefrontal cortex/anterior cingulate cortex (ACC),middle temporal gyrus-middle frontal gyrus and thalamus-inferior frontal gyros/left frontal eye fields (FEF) connectivity;while increased connectivities included hippocampus-middle temporal gyrus,hippocampusventromedial prefrontal cortex/middle temporal gyrus/ACC/FEF,middle temporal gyrus-fusiform gyrus/FEF,insula-middle temporal gyrus/FEF and thalamus-caudate connectivity (P＜0.05).For depression,global hubs included left amygdale,right hippocampus,right middle frontal gyrus,and right insula.For healthy group,global hubs included bilateral amygdale and middle frontal gyrus,right anterior inferior parietal lobe and right insula.Conclusion There are common and different characters in functional connectivity of emotional memory network between depression and healthy control.Global hub function decreases in the right amygdale and left inferior frontal gyrus,while right hippocampus shows compensatory increase.

Objective To explore the brain function changes in cirrhotic patients with normal blood ammonia and high in direct bilirubin with regional homogeneity (ReHo) of resting-state functional MRI (rs-fMRI).Methods Fifty-three cirrhotic patients with normal blood ammonia and high indirect bilirubin (cirrhosis group) and 60 healthy volunteers (control group) performed rs-fMRI scans.ReHo values in different brain areas of the two groups were acquired and compared.The correlation between the ReHo values of different brain regions in both groups and the indirect bilirubin concentrations was analyzed.Results Compared with control group,cirrhosis group showed that ReHo values increased in left dorsal-lateral frontal gyrus,left orbital superior frontal gyrus,left top edge of angular gyrus,left precentral gyrus,right caudate,right putamen,right insula,right olfactory cortex (all P＜0.001),and decreased in left superior occipital gyrus,left middle occipital gyrus,left cuneus,left orbital inferior frontal gyrus,right paracentral lobule,right precuneus,right middle occipital gyrus,bilateral lingual gyrus and bilateral cerebellum (all P＜0.001).ReHo values in right insula and right putamen in cirrhotic patients positively correlated with indirect bilirubin (r=0.32,P=0.021).Conclusion The resting state brain function increases and decreases in some brain regions of cirrhotic patients with normal blood ammonia and high indirect bilirubin.Indirect bilirubin level correlates with function of some brain regions,which has certain effect on brain function of adult.

Objective To investigate the diagnostic efficacy of fecal calprotectin(FC) on assessing endoscopic disease activity in colonic or ileo-colonic Crohn disease (CD) and CD-related surgery patients .Methods Totally 56 colonic or ileo-colonic CD pa-tients ,25 CD-related surgery patients and 25 irritable bowel syndrome (IBS) patients with previously confirmed diagnosis of CD and IBS were enrolled into this study .Fecal samples were collected from 1 to 3 day before bowel preparation and FC was measured by ELISA .Endoscopic activity was determined for colonic or ileo-colonic CD with Simple Endoscopic Score for Crohn′s Disease (SES-CD) and CD-related surgery patients with the Rutgeerts′ score .Results Among colonic or ileo-colonic CD patients ,the levels of FC in endoscopic active patients had significantly higher than that of endoscopic remission patients and IBS patients(P < 0 .01) ,there was significant correlation between levels of FC and the SES-CD (r= 0 .802 ,P< 0 .01) .FC threshold of 250 μg/g was tested to in-dicated active endoscopic disease with 97 .1% sensitivity and 71 .4% specificity .Among CD-related surgery patients ,FC level in IBS patients were significantly lower than that of endoscopic remission patients and endoscopic active patients ,but the FC in endoscopic remission patients and endoscopic active patients had no statistic difference(P> 0 .05) ,FC cutoff level of 250 μg /g gave a sensitivity and specificity of 50 .0% ,66 .7% ,respectively .Conclusion FC is a surrogate marker for the evaluation of colonic or ileo-colonic CD endoscopic disease activity .The FC ,however ,can not distinct remission period and active period after CD surgery .

[Summary] A 32 year-old woman in the third trimester of pregnancy was admitted for severe acute pancreatitis due to hypertriglyceridemia . During hospitalization she developed multiorgan dysfunction , infected pancreatic necrosis , abdominal compartment syndrome and intrauterine fetal death . She was successfully treated by multidisciplinary team including department of emergency medicine , ICU, gastroenterology, obstetrics, endocrinology, ultrasonography, radiology, infectious disease, nutrition and surgery.

This study aims to save cost of sampling for estimating the area under the amlodipine plasma concentration versus time curve in 24 hours (AUC(0-24 h)). Limited sampling strategy (LSS) models was developed and validated by mutiple regression model within 4 or fewer amlodipine concentration values. Absolute prediction error (APE), root of mean square error (RMSE) and visual predict check were used as criterion. The results of Jackknife validation showed that fifteen (9.4%) of the 160 LSS based on regression analysis were not within an APE of 15% by using one concentration-time point. 156 (97.5%), 159 (99.4%) and 160 (100%) of the 160 LSS model were capable of predicting within an APE 15% by using 2, 3, 4 points, separately. Limited sampling strategies have been developed and validated for estimating AUC(0-24 h) of amlodipine. The present study indicated that the implemention of both 5 mg and 10 mg dosage could enable accurate predictions of AUC(0-24 h) by the same LSS model. This study shows that 12, 4, 24, 2 h after administration are key sampling time points. The combination of (12, 4), (12, 4, 24) or (12, 4, 24, 2 h) might be chosen as sampling hours for predicting AUC(0-24 h) in practical application according to requirement.

Objective The brain volume and behavioral performance of emotional memory were measured by combining voxel-hased morphometry (VBM) and behavior to explore the morphological characters of brain regions related to the emotional enhancement effect of memory.Methods A total of 32 healthy young subjects participated in the study.The experimental processes included MR scan and behavioral performance of emotional memory the latter of which involved two phases-encoding and retrieval.Behavioral performance was recorded and the whole-brain 3D MRI data were acquired via 3.0T MR.3D MRI data were segmented by VBM5,and the wholebrain volumes of gray matter,white matter and CSF were produced.SPM5 and SPSS13.0 were used for statistical analysis of the 3D MRI data and behavioral data,respectively.Results Retrieval accuracy of the emotional pictures was higher than that of the neutral pictures ( t =5.08,P＜0.001 ),the emotional enhancement effect was significant ( Δ Pr =0.12 ± 0.01 ).Brain regions related to emotional enhancement effect included bilateral amygdala,dorsolateral prefrontal cortex,middle frontal gyrus,dorsomedial prefrontal cortex,fusiform gyms,right parahippocampus,left orbitofrontal cortex and middle cingulate gyms.Volume ratio of bilateral amygdala were related to emotion enhancement effect evidently (left:r=0.564,P＜0.01 ; right:r=0.541,P＜0.01 ).Conclusion This study morphologically confirms that brain regions,such as amygdale and prefrontal cortex,are critical structures for the enhancement of emotional memory,and further extends the findings of previous functional imaging studies.

With development of medical imaging,especial the wide application of CT,MRI and so on,traditional education method can not meet the needs of the intern-clinical students.Fairly satisfying teaching effects has been achieved for the effective combination of traditional teaching methods with net-work educational method.