Objective To explore the clinical significance of APACHE Ⅱ score on risk stratification in patients with acute myocardial infarction.Methods One hundred and forty-two patients with acute myocardial infarction were included in the study who were admitted to hospital consecutively from Jan.2011 to Dec.2012.High risk group and low risk group were divided by the APACHE Ⅱ score.Some clinical variables at the first 24 h after admitted to hospital and occurring during the following 1 year were recorded Results The age in high risk group was 78.9 ±8.1,significantly higher than that in low risk group (65.8 ± 10.2;t =6.835,P ＜ 0.001).The cases with Killip Ⅲ and Ⅳ in high risk group were 10(29.4％) and 2(1.8％),lower than in low risk group (6 (1.8％) and 0 (0％) ; x2 =21.950,15.777 ; P ＜ 0.005).The level of creatine kinase-MB (CK-MB) and cardiac troponin Ⅰ in high risk group were (147.7 ±21.5) U/L and (105.5 ± 17.6) U/L,higher than in low risk group((105.5 ± 17.6) U/L,(42.9 ± 6.3) U/L; t =11.541,5.785 ; P ＜ 0.001).The incidence of severe cardiac events(malignant arrhythmia,heart failure,non fatal myocardial infarction and death from any cause in high risk group were 58.8％ (20/34),47.0％ (16/34),17.6％ (6/34) and 17.6％ (6/34),higher than in low risk group (29.6％ (32/108),3.7％ (4/108),6.4％ (7/108) and 6.4％ (7/108) ; x2 =8.274,36.665,3.876 and 3.876 ; P ＜ 0.05).Conclusion APACHE Ⅱ score is likely to be a simple and practical tool for risk stratification in patients with acute myocardial infarction.

Objective To investigate the characteristics of pathogens and risk factors of the catheterassociated infection (CAI) in emergency ICU (EICU) in order to design an appropriately therapeutic strategy for the future.Methods From January 2008 to December 2010,a total of 1363 patients were enrolled for this retrospective study.Blood sample taken from the vein with indwelling catheterization and the tips of catheters cut in 5 cm after withdrawn from the veins in 1363 patients were collected for bacterial culture.Results Of 1363 catheters,pathogens were found in 147 (10.79％) after venous catheterization.The daily occurrences of CAI were 3.05 ones per 1000 catheters.Of 147 cases of infection,46.94％ pathogens were gram-negative bacilli,40.14％ gram-positive cocci,and 12.92％ fungi.Unconditional Logistic regression analysis suggested that repeated catheterization,femoral vein catheterization,the application of multi-lumen catheter and long-term indwelling catheterization were the independent risk factors responsible for CAI.Conclusions The risk factors responsible for catheter related infections should be controlled to prevent the occurrence of nosocomial infection.

Objective To explore the incidence,features and outcomes of in-hospital sudden cardiac death (SCD) in order to determine the predictors of survival. Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed.Information on genders,age,types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in-hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4％ of them.survived at discharge.The occurrence rate was higher in male than that in female (66.7％ vs.33.3％,P ＜0.01 ),whereas difference in gender did not affect the discharge rate ( P ＞ 0.05 ). Survivors from in-hospital cardiac arrest were significantly younger than non-survivors (man:62.57 ± 12.83 years vs.75.56 ± 10.55 years; women:60.36 ± 13.24years vs.69.53 ± 11.72 years,P ＜ O.01 ).From 62 ECG records of SCD patients,the incidence of nonshockable rhythms was higher than that of shockable rhythms.Compare to the non-shockable rhythms,the shockable rhythms brought a higher rate of restoration of spontaneous circulation (ROSC) (54.5％ vs.24.5％,P ＜0.05),whereas survival rates at discharge between two groups were not statistically different ( 18.2％ vs.18.4％,P ＞ 0.05 ).Conclusions Non-shockable rhythms were more common in patients suffering from in-hospital cardiac arrest.Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia,high-quality CPR and post-cardiac arrest care may play a more critical role in the outcomes of in-hospital sudden cardiac death.

The fermentation conditions of alkaline lipase producing by Pseudomonas cepacia PCL-3 were optimized.Based on the analysis of single factorial experiments,dextrin was the most suitable carbon source,peptone and urea were the suitable compound nitrogen sources among the examined materials.Three significant factors(urea,inoculum and initial pH) were selected from the eight factors related to lipase production by Plaekett-Burman method,and were further optimized with response surface analysis.And then,steepest ascent procedures were applied to define the optimal response region of the three factors.The obtained optimal conditions were urea 0.15%,inoculum 3.05% and initial pH 8.38,under which conditions,the enzyme activity was improved from 25.37 U/ml to 48.88 U/ml,enhanced 1.93 folds.Starting from the flask conditions,the highest lipase activity of 47.69U/ml was achieved by batch fermentation in a 10 L fermentor after 52 h of the cultivation.

With the economic development and the deepening of reform in China,more attention has been paid on health.Based on literature from Chinese Journal of Health Statistics in 2008,the number and ranks of practicing doctors,occupancy of hospital beds,the disease spectrums,outpatient per year were analyzed.The results hold it is better for the doctors to practice in more medical institutions.

Objective To investigate the role of autophagy and synaptophysin (SYP) in cognitive impairment in de?pressed rats receiving electroconvulsive shock (ECS). Methods Clean and healthy adult male Sprague-Dawley rats were acclimatized to a standard laboratory environment for 7 days. The chronic unpredictable mild stress (CUMS) was used to establish the rat model of depression. Behavior tests were conducted before and after CUMS to evaluate the depression and cognition level of rats. After establishment of the model, 24 rats were randomly divided into ESC group (group E) and depression group (group D) with 12 rats in each group. The rats in group E were administered 80 mg/kg of propofol (10 mg/mL) by intraperitoneal injection, followed by ECS treatment. The rats in group D were administered propofol by intra?peritoneal injection, followed by sham-ECS treatments. The above interventions were conducted daily for 7 consecutive days. After the interventions, rats underwent behavior tests as before. Subsequently, rats were killed and specimens were collected for measurements. Immunohistochemistry was performed to examine autophagy markers such as Beclin 1 and LC3Ⅱand ELISA was used to detect SYP in the hippocampus. Results Group E after ECS significantly increased the percentage of sucrose preference (68.2%±8.7%), rearing times (7.0±1.9), total horizontal distance [(569.5±70.0) cm], es? cape latency [(21.9±5.3)s] and space exploration time [(20.5±3.9)s] compared with group D or group E before ECS. There was no significant difference in these index between groups before ECS or in group E between before and after ECS(P>0.05). Compared with group D, group E had upregulated protein expression levels of Beclin 1 and LC3Ⅱin CA1, CA3, DG as well as the area near the hippocampus and increased SYP contents (P<0.05). Conclusions Cognitive impairment in depression rats following ECS correlates with activated autophagy and increased SYP by ECS.

In-vitro assay methods were established to evaluate transactivation and binding activity of compounds on peroxisome proliferator-activated receptor y (PPARγ). Firstly, plasmids were constructed for transactivation assay of PPARγ response element (PPRE) triggered reporter gene expression, and for cell-based binding activity assay of the chimeric receptor, which was fused with PPARγ ligand binding domain (LBD) and yeast transcriptional activator Gal4. Secondly, by using PPARy competitive binding assay based on time resolved-fluorescence resonance energy transfer (TR-FRET), affinities of compounds and drugs to PPARγ were evaluated. In application of these above methods, the PPARγ activating potency and characteristics of different compounds were evaluated, and a novel benzeneselfonamide derivative, ZLJ01, was found to have comparable binding activity and affinity with the well-known PPARy agonist, but lack of PPRE mediated transactivation activity. In preliminary study on in-vitro hypoglycemic activity, ZLJ1 was found to promote insulin-stimulated glucose uptake by liver cells. Therefore, we believe that combining transactivation and binding activity as well as affinity evaluation, the system could be used to screen non-agonist PPARγ ligand as anovel PPARγ modulator
Genes, Reporter ; Hepatocytes ; Hypoglycemic Agents ; chemistry ; Ligands ; PPAR gamma ; agonists ; chemistry ; Plasmids ; Response Elements ; Sulfonamides ; chemistry ; Transcriptional Activation

In-vitro assay methods were established to evaluate transactivation and binding activity of compounds on peroxisome proliferator-activated receptor y (PPARγ). Firstly, plasmids were constructed for transactivation assay of PPARγ response element (PPRE) triggered reporter gene expression, and for cell-based binding activity assay of the chimeric receptor, which was fused with PPARγ ligand binding domain (LBD) and yeast transcriptional activator Gal4. Secondly, by using PPARy competitive binding assay based on time resolved-fluorescence resonance energy transfer (TR-FRET), affinities of compounds and drugs to PPARγ were evaluated. In application of these above methods, the PPARγ activating potency and characteristics of different compounds were evaluated, and a novel benzeneselfonamide derivative, ZLJ01, was found to have comparable binding activity and affinity with the well-known PPARy agonist, but lack of PPRE mediated transactivation activity. In preliminary study on in-vitro hypoglycemic activity, ZLJ1 was found to promote insulin-stimulated glucose uptake by liver cells. Therefore, we believe that combining transactivation and binding activity as well as affinity evaluation, the system could be used to screen non-agonist PPARγ ligand as anovel PPARγ modulator

Objective To study the changes in the level of serum IMA in patients with cardiac arrest followed by CPR,and explore the value of serum IMA in predicting prognosis of these patients after CPR.Methods (1) A total of 36 patients (25 men and 11 women) after CPR following cardiac arrest were recruited into experimental group (group C).Of them,15 cases (11 men and 4 women) and 21 cases (14men and 7 women) were assigned into resuscitation group (group R) and non resuscitation group (group NR),respectively,according to the presence or absence of ROSC.Meanwhile,another 60 healthy subjects (39 men and 21 women) matched for age and gender were recruited into healthy control group (group H).(2) The determination of the serum IMA level and comparisons of changes in serum IMA levels among groups were carried out.Results (1) The level of serum IMA in group C was higher than that in group H (P ＜ 0.05) ; The serum IMA level in group R was lower than that in group NR and higher than that in group H (P ＜0.05 for both).(2) The area under the ROC curve for serum IMA in predicting the prognosis of patients treated with CPR after cardiac arrest was 0.73.When the cut off value was 128.25 U/mL,the sensitivity and specificity were 57.1％ and 93.3％ respectively; the positive predictive value and negative predictive value were 92.3％ and 60.9％ ; positive likelihood ratio and negative likelihood ratio were 8.5 and 0.5 ; the correct diagnosis index was 72.2％,and Youden index was 50.5％.Conclusions Serum IMA has a certain value in prediction of prognosis in patients treated with CPR following cardiac arrest.

Objective To determine the risk factors for emergence agitation (EA) during the recovery period after general anesthesia.Methods One thousand and thirty-four patients of both sexes aged 18-89 yr undergoing general anesthesia were divided into EA group and non-EA group.EA occurring during recovery from general anesthesia was assessed by using Riker sedation-agitation scale.Age,sex,complication,education,medical history,ASA physical status,type and duration of anesthesia and operation,volume of blood loss,fluid replacement,urine volume,duration of stay in PACU,number of drainage tubes and so forth were recorded.Multivariate logistic regression was used to analyze the risk factors for the occurrence of EA.Results Thirty-six patients developed EA during recovery from anesthesia.The incidence of EA was 3.5 ％.Logistic regression indicated that high risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation were the risk factors for EA (P ＜ 0.05).Conclusion High-risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation are the risk factors for EA during recovery from general anesthesia.