Objective To study the relationship between morning blood pressure surge with carotid artery intima-media thickness in good controlled elderly hypertensive patients.Methods A total of 151well controlled elderly hypertensive patients was selected in this study.Through the ABPM examination,the morning blood pressure peak was calculated,and then these patients were divided into two groups according to the morning blood pressure peak.The patients whose morning blood pressure peak ≤30 mmHg were divided into non-morning blood pressure surge group (NMS group),and the patients whose morning blood pressure peak ＞ 30 mmHg were divided into morning blood pressure surge group (MS group).The carotid IMT of these patients was measured with ultrasonic detection.The hypertension-related factors with blood pressure and morning peak phenomenon and the impact of IMT were analyzed,and the relationship between the morning blood pressure peak and IMT was analyzed with linear regression analysis.Results Two groups of 151 cases were well-controlled hypertension,76 patients with morning blood pressure showed peak phenomenon,accounting for 50.3％.Age,gender,body mass index,blood lipids,blood glucose,the maximum systolic blood pressure,average systolic blood pressure,minimum systolic blood pressure,maximum diastolic blood pressure,average diastolic blood pressure and minimum diastolic blood pressure had no difference between the two groups ( P ＞ 0.05 ).However,the morning blood pressure peak in patients with MS group [ (42.34 ± 7.10)mmHg] and IMT [ (0.89 ± 0.13 )mm] was higher than the NMS group [ (21.16 ±5.23) mmHg,(0.84 ±0.14) mm,P ＜0.01 orP ＜0.05],and carotid IMT and peak morning blood pressure was positively correlated ( r =0.56,P ＜0.01 ).Conclusions Good controlled elderly hypertensive patients remained the phenomenon of the morning blood pressure surge,the morning blood pressure peak might lead to carotid atherosclerosis.

Objective To investigate the predictive value of combined analysis on single nucleotide polymorphisms (SNPs) of X-ray cross-complementing1 ( XRCC1 ) gene 194 and 399 codon,xeroderma pigmentosum group D (XPD) gene 312 codon and glutathione S-transferase P1 (GSTP1) gene 105 codon in platinum based chemotherapy.Methods Direct sequencing was performed to detect XRCC1,XPD and GSTP1 genotypes in peripheral blood from 50 cancer patients receiving platinum-based chemotherapy.Genetic polymorphisms of these genes related to sensitivity of platinum were reviewed.Results Favorable genotypes were Arg/Trp and Trp/Trp in XRCC1 194 codon,Arg/Arg in XRCC1 399 codon,Asn/Asn in XPD 312 codon and Val/Val in GSTP1 105 codon.The response rate to chemotherapy was 57.1％,75.0％,60.9％,85.7％ and 87.5％,respectively.The response rate for patients possessing ≥2 favorable genotypes and those possessing 1 or 0 favorable genotype was 78.9％,36.4％ and 0,respectively.Patients possessing ≥2 favorable genotypes demonstrated higher sensitivity to platinum based chemotherapy,compared with those possessing 1 or 0 favorable genotype ( x2 =25.79,P ＜ 0.01 ).Conclusions Combination analysis of genomic polymorphisms of XRCC1,XPD and GSTP1 may be useful in predicting sensitivity of platinum based chemotherapy.

Objective To investigate the relationship between the expression of DEK and Hpa infection in uterine cervical carcinogenisis.Methods Formalin-fixed,paraffin-embedded samples including 45 cases of squamous cell carcinomas,25 cases of cervical intraepithelial neoplasia CINⅢ,and 20 cases of CINI-Ⅱ,10 cases of normal cervical tissues were studied using polymer detection system for immunohistochemical technique to examine the expression of DEK and Hpa.Results The positive ratios of DEK in cancer tissues,normal cervical intraepithelial lesions,normal cervical tissues positive rates were 88.9％,24.4％,10.0％,respectively.The positive ratio of expressions of DEK in cervical carcinomas was significantly higher than CIN and normal cervical tissues (x2 =38.054,P ＜0.01 ;x2 =5.774,P ＜0.05).The positive ratios of expressions of Hpa in normal cervical tissues,CIN and cervical cancers were 75.6％,24.4％ and 10.0％,respectively.The positive ratio of expressions of Hpa in cervical carcinomas was significantly higher than CIN and normal cervical tissues ( x2 =31.69,P ＜ 0.01 ; x2 =12.94,P ＜ 0.01 ).The expression of DEK and Hpa in cervical lesions was highly related in the cervical cancer tissues( r =0.617,P =0.001 ).Conclusions DEK and Hpa possibly played an important role in the development of cervical cancer.Cervical intraepithelial lesions and cervical carcinoma might be associated with changes in the expression of DEK and Hpa,and interact together to influence the development of CIN and cervical cancer.

Objective To investigate the clinical value of percentage of pulmonary perfusion defect score ( PPDs％ ) for risk stratification and prognosis evaluation in patients with acute pulmonary embolism (APE).Methods A retrospective study was carried out on PPDs％ data of patients( n =21 ) with confirmed APE from January 2001 to December 2008.The patients were divided into three levels,low( n =10),medial( n =7) and high risk groups( n =4),according to 2008 ESC APE diagnosis and treatment guidelines.The reference index in predicting risk stratification by PPDs％ was ascertained.34 patients with confirmed APE were divided into three levels ( mild,moderate and severe risk levels) according to the standard of PPDS％ diagnosis from January 2009 to June 2011.A prospective study on the incidence rate of the clinical adverse events was performed.Results The PPDs％ of low,medial and high risk levels according to 2008 ESC guidelines were (25.94 ± 3.95 ) ％,(45.63 ± 4.38 ) ％ and ( 58.42 ± 4.96 ) ％ respectively,with a significant difference ( t ≥4.755,P ＜ 0.01 ).The standard of PPDS％ diagnosis for risk stratification was confirmed in APE:low risk levels:PPDs％ ＜ 30％,moderate:30％ ≤ PPDs％ ＜50％,and high:PPDs％ ≥50％.The mild,moderate and severe risk patients with APE were 17cases,11cases and 6cases respectively,according to the standard of PPDs％ diagnosis,or 15cases,13cases and 6cases respectiveldy,according to the standard of 2008 ESC guidelines.The uniform rate was 94.11％ for two methods; the uniform rate was 100.00％ in which high risk of APE.The mild,moderate and severe risk patients with APE according to the standard of PPDs％ standard with clinical adverse events for were 1case (5.89％ ),3cases (27.27％ ) and 4cases (66.67％ ) respectively,with a significant difference ( x2 =9.23,P ＜0.01 ).Conclusions PPDs％ could be used as an important reference index for risk stratification of diagnosis,selecting therapeutic programs,evaluating therapeutic efficiency and predicting the prognosis in patients with APE.

Objective To detect the expression of Cytokeratin 19 (CK19) mRNA in the peripheral blood of cervical carcinoma patients and evaluate its clinical significance.Methods The expression of CK19 mRNA was evaluated by fluorescent quantitative reverse transcription polymerase chain reaction ( FQRT-PCR ) in the peripheral blood of 138 patients with cervical carcinoma and 36 patients with benign gynecological tumors.In 138 patients,possible correlations between clinical pathological factors were analyzed.Results The positive expression rates of CK19 mRNA was 69.6％ in 138 cervical carcinomas in comparison with 13.9％ in benign gynecological tumors,and 57.9％ in patients with FIGO Stage Ⅰ A to Ⅱ A cervical carcinoma in comparison with 80.6％ in patients with FIGO Stage Ⅱb to Ⅳ cervical carcinoma.The expression of CK19 mRNA in patients with FIGO Stage Ⅰ A to Ⅱ A cervical carcinoma were significantly correlated with stage,differentiation and lymph vascular space involvement,but was not associated with prognostic factors including age,bully tumor size,pathological types,deep stromal invasion and lymph node metastasis.In multivariate survival analysis,lymph vascular space involvement was an independent risk factor of CK19mRNA expression in patients with cervical carcinoma.Conclusions Fluorescent quantitative RTPCR can be used to detect the expression of CK19 in the peripheral blood of cervical carcinoma patients,and it is a sensitive and specific technique.CK19 mRNA in peripheral blood may be a potential biomarker for detecting micrometastasis in cervical carcinoma.The results suggest a possible use of this approach for evaluating prognosis.

Objective To construct an eukaryotic expression vector pEGFP-N1-CKB and establish a stably transfected NCI-H520 cell line.Methods Human CKB gene was amplified by PCR with human CKB cDNA library as the template and the fragment was combined with plasmid pEGFP-N1.The recombinant expression vector,pEGFP-N1-CKB,was transfected to NCI-H520 using Lipofectamin.The stably transfected cell line was established after G418 selection and the expression level of CKB gene before and after transfection was detected by Western blot.Results After identification by restriction enzyme digestion and sequencing,the eukaryotic expression vector,pEGFP-N1-CKB,was successfully constructed.The expression level of CKB in NCI-H520 transfected by pEGFP-N1-CKB was significantly higher than that in control.CKB gene had a stable transfection in NCI-H520 cells.Conclusions An eukaryotic plasmid encoding CKB (pEGFP-N1-CKB) has been constructed and a cell line expressed CKB stably has been successfully prepared.

Objective To evaluate the effectives of high-frequency oscillatory ventilation (HFOV)in the treatment of severe NRDS.Methods The severe NRDS who failed to response to conventional mechanical ventilation (CMV) were changed to HFOV treatment.Ventilator parameters and blood gas analysis were compared before and after treatment.Results Among thirty patients,19 cases were significantly improved and 11 cases were failed,the success rate was 63％.Nineteen patients with HFOV,the main ventilator parameters and blood gas results such as FiO2 ( 0 h:0.87 ± 0.09 vs 3 h:0.67 ± 0.10,6 h:0.54 ±0.08,12h:0.44 ±0.08),MAP[0 h:(14.47 ±1.17) mbar vs 3 h:(13.79 ± 1.03) mbar,6 h:(13.26 ±1.05) mbar,12 h:( 12.37 ±0.83) mbar],f[0 h:(7.26 ±0.56) Hz vs 3 h:(7.89 ±0.57) Hz,6 h:(8.42±0.51 ) Hz,12 h:(9.26 ±0.45) Hz] and PaCO2 [0 h:(9.69 ±0.86) kPa vs 3 h:(6.00 ±0.55) kPa,6 h:(5.62 ± 1.03)kPa,12 h:(5.47 ±0.55)kPa] were decreased while pH(0 h:7.21 ±0.06 vs 3 h:7.35 ±0.07,6 h:7.39 ±0.07,12 h:7.40 ±0.06) and PaO2[0 h:(5.46 ±0.82)kPa vs 3 h:(7.92 ± 1.13)kPa,6 h:(9.25 ± 0.99)kPa,12 h:(9.20 ± 0.96)kPa] were significantly increased compared with before treatment ( P ＜ 0.05).Conclusions The patients of severe NRDS who failed to response to CMV were treated with HFOV,some patients received a significant effect with HFOV treatment.

Objective To investigate the.expression and significance of peritoneal fluid (PF) erythropoietin (EPO) and neutrophils activation peptide-78 (ENA-78)in patients with endometriosis.Methods The levels of EPO and ENA-78 in peritoneal fluid (PF) were measured by means of enzymelinked immunosobent assay (ELISA) in 30 women with endometriosis (9 in Ⅰ ～ Ⅱ stage,21 in Ⅲ～ Ⅳ stage)and 30 without endometriosis.And the relationship between the PF levels of EPO and ENA-78 in patients with endometriosis was analyzed.Results The PF levels of EPO and ENA-78 in women with endometriosis [ (9.272 ± 2.284 ) IU/L,( 2.068 ± 0.794 ) ng/ml ] were significantly higher than those in control group [ (5.759 ±0.502) IU/L,(0.886 ±0.145 ) ng/ml,P ＜0.05].There were no significant differences in the PF levels of EPO between stage Ⅰ ～ Ⅱ [ (9.549 ± 1.996) IU/L] and Ⅲ ～ Ⅳ [ (9.181 ± 1.897) IU/L,P ＞0.05].The ENA-78 concentrations of PF in stage Ⅲ～ Ⅳ [ (2.517 ± 0.518 )ng/ml] were significantly higher than those in stage Ⅰ ～ Ⅱ[ ( 1.137 ±0.169)ng/ml,P ＜0.05].There were no obvious correlations in PF EPO and ENA-78 in patients with endometriosis.Conclusions The excessive expression of EPO and ENA-78 in the PF of women with endometriosis suggests that EPO and ENA-78 may be an important role in the pathogenesis of endometriosis.

Objective To explore the effect of endothelial progenitor cells (EPCs) on the development of collateral formation in stable angina patients with serious coronary artery disease.Methods The subjects were patients ( n =92) who underwent coronary angiography (CAG) and had chronic total occlusion (CTO) in one major coronary artery.They were divided into two groups,patients without collaterals (coil-,n =50) and patients with collaterals (coll +,n =42).EPCs were isolated from peripheral blood samples and cultured.The numbers of colony-forming units (CFUs) and the vasculargenesis capacity in vitro was assayed respectively.The plasma level of SDF-1α was determined by enzyme linked immunosorbent assay.Results The number of colony-forming units ( CFUs ) [ ( 22.10 ± 4.69 ) CFUs/106 EPCs vs ( 16.90 ± 3.66) CFUs/106 EPCs ],vasculogenesis capacity in vitro (25.3 ± 3.2 vs 17.4 ± 2.6) and plasma level of SDF-1 α[ (243.7 ± 19.2 ) ng/ml vs ( 203.1 ± 17.8) ng/ml,P ＜ 0.01 ] in coll + group were higher than that of coll group.It had a positive correlation between the level of collateral circulation and the numbers of CFUs,vascular genesis activity of circulating EPCs and plasma level of SDF-1αt( r =0.74,0.69,0.82,0.81,0.64,P ＜ 0.01 ).Conclusions The number of CFUs and vasculargenesis activity of EPC in coll + group with serious coronary artery disease is significantly higher than that in coll- group.These changes may be related to the increase of plasma SDF-1 α.The method improving the numbers and function of EPCs,increasing the activity of SDF-1 α may benefit the patients with coronary artery disease.

Objective To observe the effect of total intravenous anesthesia (TIVA) on intrapulmonary shunt fraction and arterial oxygenation during one-lung ventilation (OLV) for thoracoscope surgery.Methods Forty patients scheduled for thoracoscope surgery were randomly assigned to two groups ( n =20),group of TIVA (A) and group of intravenous anesthesia combined with inhalational anesthesia(B).After inducing and intubating,patients were assigned to maintenance of anesthesia with propofol ( group A)or with sevoflurane ( group B) in order to maintain a BIS between 40 and 60.Mean arterial pressure (MAP),heart rate (HR),SpO2 and Paw were measured in four phases,always in the lateral position,10min after beginning two-lung ventilation (TLV),15 min after beginning OLV (OLV + 15 ),30 rain after beginning OLV ( OLV + 30) and 60 min after beginning OLV ( OLV + 60).Blood samples were drawn simultaneously and analyzed within 5 min.The Qs/Qt at each phase was calculated.Adverse events including hypotension,bradycardia,hypoxemia,delayed emergence and restlessness in recovery period were recorded.Results In all patients,a decrease in PaO2 and an increase in the Qs/Qt occurred during OLV were observed.But PaO2 values in group A were significantly higher than those in group B ( 177 ±88 vs 125 ±63;150 ±65 vs 110 ±67;188 ±69 vs 128 ±52) ( P ＜0.05).The Qs/Qt in group B was significantly higher than those in group A (34.2 ±5 vs 28.8 ±2;38.4 ±8 vs 32.1 ±6;37.1 ±2 vs 29.5 ±2,P ＜0.05).MAP values in group A were significantly lower than those in group B at the phase:OLV + 15 and OLV +30(72 ± 10 vs 88 ± 14;74 ± 12 vs 89 ± 10) ( P ＜ 0.05 ).The incidence of hypotension and delayed emergence in group A was higher than those in group B ( 10 case vs 4 case;9 case vs 2 case).The incidence of restlessness in recovery period in group B was more than those in group A (9 case vs 3 case).The differences between two groups were significant ( P ＜ 0.05).Conclusions Compared with sevoflurane-sufentanyl combined anesthesia,TIVA with propofol can efficiently decrease intrapulmonary shunt fraction and improve arterial oxygenation during OLV for thoracoscope surgery,which is good for the prevention of hypoxemia.