Objective To investigate the influence of trimetazidine combined with atorvastatin on heart func-tion and the BNP level in patients with cornary heart failure.Methods The clinical data of 400 patients with cornary heart disease were retrospectively analyzed.194 patients in the control group were treated with conventional treatment, 206 patients in the observation group were treated with trimetazidine combined with atorvastatin on the basis of the control group.The treatment effect,cardiac function and BNP level were observed and compared.Results The effec-tive rate of the observation group was 91.26%,which was significantly higer than 76.29% of the control group (χ2 =16.667,P <0.05).After treatment,the cardiac index,stroke volume,cardiac output,left ventricular ejection fraction and BNP level of the two groups were significantly higher than before treatment,and those in the observation group were significantly higher than the control group(t =2.505,2.851,3.308,3.452,all P <0.05).Conclusion Trime-tazidine combined with atorvastatin in treatment of cornary heart failure has good curative effect,it can reduce the serum level of BNP,improve cardiac function significantly,which is of great value for clinical use.

Objective:To detect and analyze the membrane estrogen receptor(mER)in primary cultured interstitial cells of Cajal(ICC).Methods:Interstitial Cells of Cajal(ICC)'s surface binding sites for 17-?estradiol(E2)were detected by cell-impermeant ligand using confocal microscopy.Radioligand binding assay and Scatchard software were used to analyzed the characteristics of mER.Results:Immunofluorescence shows the staining pattern of nonfixed,nonpermeabilized ICC incubated with E2BSAFITC.The radioligand binding assay were analyzed by Scatchard software,The Bmax of mER was 45.75 fmol/mg protein and the kD was 0.717 3 nmol/L.Conclusion:A form of the estrogen receptor is present within the cell membrane of ICC and maybe capable of mediating rapid effect of estrogen.

Owing to the advanced age,limb hemiplegia,dehydration,and vessel wall injury,stroke may be easy to cause venous thromboembolism (VTE).VTE mainly include deep vein thrombosis (DVT) and pulmonary embolism (PE).DVT refers to abnormal blood clotting in the veins and impedes venous return.The dislodgement of emboli from the vessel wall can form a thrombotic embolism,and cause PE,myocardial infarction,and stroke; it can not only prolong hospitalization,but also increase the mortality.This article reviews the incidence,risk factors,treatment,and prevention of DVT after a stroke.

Objective To explore the distribution and characterization of class 1 integrons in E.coli from healthy feces,and to elucidate the status of gene-cassettes.Methods Routine method was used to isolate E.coli,antibiotics susceptibility was tested by the disk diffusion method;class 1 integron was detected by PCR assay;PCR products were sequenced and analyzed.Results Of 97 samples,76 isolates were identified,and 25 isolates were multiple-drug resistant.The antibiogram was sulfamethoxazole-trimethoprim,ampicillin,streptomycin,tetracycline,erythromycin.14 of 25 isolates carried class 1 integrons,and the size of integrons differed from 1 800 bp(10 strains) to 750 bp(4 strains).The sequenced PCR product demonstrated that the 1 800 bp integron laboured aadA1-dfrA14-orf gene cassette conferred the resistance to sulfamethoxazole-timethoprim,streptomycin and aminoglycoside;the 750 bp integron laboured dfrA14 gene cassette conferred the resistance to sulfamethoxazole-trimethoprim.Conclusion The different kinds of class 1 integrons exist in E.coli from the healthy students,and determine the multiple-resistant antibiotics.

OBJECTIVETo compare the efficacy differences between needle-knife therapy and acupuncture-cupping for treatment of cervical spondylosis (CS) of cervical type.

METHODSSixty cases of CS were randomly divided into a needle-knife group (30 cases) and an acupuncture-cupping group (30 cases). The needle-knife therapy was applied at points among superior nuchal line of occipital bone, bilateral neck muscle, neck centerline, trapezius and medial border scapula for only once. In the acupuncture-cupping group, acupuncture was applied at Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10), Dazhui (GV 14), Jianjing (GB 21), Jiaji (Ex-B2, from C4 to C6), Houxi (SI 3) and Ashi point, followed by cupping on local skin, once every other day for totally six times. The score of neck stiffness and visual analogue scale (VAS) were observed before and after treatment, in follow-up of 1, 3 and 6 months after treatment in the two groups, and the efficacy was compared.

RESULTSIn the needle-knife group, 9 cases were cured, 12 cases were markedly effective, 8 cases were effective and 1 case was failed; the total effective rate was 96.7% (29/30) and the cured and markedly effective rate was 70.0% (21/30). In the acupuncture-cupping group, 8 cases were cured, 9 cases were markedly effective, 11 cases were effective and 2 cases were failed; the total effective rate was 93.3% (28/30) and the cured and markedly effective rate was 56.7% (17/30). The difference of total effective rate in the two groups was not statistically significant (P > 0.05), but the cured and markedly effective rate of needle-knife group was significantly superior to that of acupuncture-cupping group (P < 0.05). The needle-knife therapy was significantly superior to acupuncture-cupping on improvement of neck stiffness in the follow-up of 1, 3, 6 months after treatment (P < 0.05, P < 0.001); both treatments were effective on relief of neck pain, but the needle-knife group had better effects in the follow-up of 3 and 6 months after treatment compared with acupuncture-cupping group (both P < 0.01).

CONCLUSIONThe needle-knife therapy has better effects on neck stiffness and pain relief than acupuncture-cupping, and it is more treatment time saving.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Aged ; Cervical Vertebrae ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Spondylosis ; physiopathology ; therapy

Recent studies show that autophagy ont only plays an important role in maintaining homeostasis in cells,but also palys a double role in the tumorigenesis and development of cancer.Studying the molecular mechanisms of autophagy and the relationship between autophagy and cancer have great significance for cancer treatment and prevention.

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease in terms of molecular pathogenesis and cell of origin. Earlier prognostic models relied mainly on such clinical variables as age, stage of disease, and performance status, which did not display its heterogeneity. Many studies have reported that some biomarkers could be used for prognostication, while older prognostic models need to be revalidated and modified as improved therapeutic options become available. In this review, we discussed pertinent studies on individual biomarkers and pattern-based biomarker models, with an emphasis on markers evaluated in patients treated with rituximab-containing chemotherapy.

Objective To investigate the relationships between fasting plasma glucose (FPG) level in early pregnancy and gestational diabetes mellitus (GDM).Methods Data of 11 477 pregnant women who accepted prenatal care in Beijing Obstetrics and Gynecology Hospital from October 2011 to September 2012 were collected.FPG was tested during 8 to 12 weeks of pregnancy in all women and those with FPG＜7.00 mmol/L were recruited.Women accepted 75 g oral glucose tolerance test (OGTT) during 24 to 28 weeks of pregnancy.The GDM diagnostic criteria was with reference to the criteria of International Association of Diabetes and Pregnancy Study Group.Mann-Whitney U test was used to analyze the difference of early pregnancy FPG between normal pregnant women and GDM women.Receiver operating characteristic (ROC) curve was used to analyze the validity and applicability of using early pregnancy FPG in GDM diagnosis.Chi-square test was used to analyze the relationship between the FPG levels and GDM diagnosis.Results There were 1 535 (13.4％) women diagnosed as GDM in 24 to 28 weeks of pregnancy (the rest 9 942 normal cases were taken as the controls).The median FPG level of the GDM group was 4.89 mmol/L (4.62-5.15 mmol/L),which was higher than that of the controls [4.75 mmol/L(4.53-4.98 mmol/L)] (Z=-13.994,P=0.000).The maximum area under curve (AUC),which was used to predict GDM with early pregnancy FPG,was 0.599 (95％ CI:0.582-0.617).Taking FPG 4.88 mmol/L as the cutoff value,the sensitivity was 0.523 and the specificity was 0.645.While taking FPG 5.10 and 5.60 mmol/L as the cutoff value,the sensitivity was 0.334 and 0.068,and the specificity was 0.811 and 0.983,respectively.When the FPG level ≤ 4.09,-4.60,-5.10,-5.60,-6.10 and ≥ 6.10 mmol/L,the GDM diagnostic rate gradually increased [8.5％(23/212),9.9％(335/3 379),12.3％(719/5 858),20.7％(359/1 734),40.2％ (78/194) and 52.5％ (21/40)] (x2=300.523,P=0.000).GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 and-5.60 mmol/L group were lower than that in FPG ≥ 5.60 but ＜6.10 mmol/L group and ≥ 6.10 mmol/L group (x2 were 67.242,164.680,128.125,37.860,55.843,76.856,58.589 and 23.484,all P=0.000) ; GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 mmol/L group were lower than that in FPG ≥ 5.10 but ＜5.60 mmol/L group (x2 were 22.877,113.717 and 78.040,all P=0.000); GDM diagnostic rate in FPG ≥ 4.09 but ＜4.60 mmol/L group was lower than that in FPG ≥ 4.60 but ＜5.10 mmol/L group (x2=11.803,P=0.001).When using abnormal fasting and postprandial OGTT level as GDM diagnostic criteria,the ratio of GDM in early pregnancy FPG level ≥ 5.60 but ＜6.10 mmol/L group and FPG ≥ 6.10 mmol/L group were higher than that of the FPG level ＜5.60 mmol/L group [50.0％ (39/78) and 71.4％ (15/21) vs24.1％ (346/1 436),x2 were 12.456 and 21.443,all P＜0.003].Conclusions Early pregnancy FPG level is not proper to be used as an early diagnostic tool of GDM.However,when early pregnancy FPG level is equal to or greater than 5.60 mmol/L,the incidence of GDM in late pregnancy will increase significantly.

A probe into the management of outpatient medical records written by rural doctors:Such a record is indispensible for technical appraisal of medical accidents; yet writing of such a record might involve illegal medical practice or go beyond the scope of practice.It is recommended to normalize the behavior of rural doctors in their writing of outpatient medical records,stipulating that the Basic Regulations on Medical Records do not apply to rural doctors at present.It is also recommended that separate regulations for rural doctors be formulated,along with a promotional period before these regulations are in practice.An alternative would be clarifying that Article 28 of the Regulations of Medical Malpractice Settlement do not apply to rural doctors.

Objective To investigate the relationship between absent end-diastolic velocity (AEDV) in umbilical artery and perinatal outcome,and to explore the effect of termination time of pregnancy on perinatal outcome. Methods Data of thirty five pregnant women with AEDV admitted into Beijing Obstetrics and Gynecology Hospital from January 2008 to December 2009 were retrospectively analyzed.According to gestational age and treatment,they were divided into four groups.Group 1:AEDV was identified before 28 weeks without treatment (n=5); Group 2:AEDV was found before 28 weeks,and then was treated (n=13); Group 3:AEDV was found after 28 weeks,and was not treated (n=11); Group 4:AEDV was found after 28 weeks,and then was treated (n=6). Except for three patients in Group 2,all patients had complications.Data were presented by frequency,rate or mean±SD. Results Among the 35 patients,19 (54.3％) delivered and 23 living children were born.When AEDV was found,the gestational age was less than 28 weeks and the mean gestational age was (22.8 ± 2.2) weeks in Group 1,(24.2 ± 2.0) weeks in Group 2,however,the gestational age was over 28 weeks and the mean value was (30.9± 2.8) weeks in Group 3 and (29.5±0.8) weeks in Group 4.Treatment was given to women in Groups 2 and 4,but not in Group 1 and 3.In Group 1,one patient complicated with twin-twin transfusion syndrome; one with hemolysis,elevated liver enzymes and low platelet syndrome and placental abruption; three recovered after two weeks and babies survived.In Group 2,the termination time was (31.4 ± 5.5)gestational weeks and the duration of treatment was (10.7± 5.5) days.AEDV of six patients were not improved after treatment,among which five accepted induced abortion,one had preterm delivery.The rest six women underwent cesarean section and one term delivered.Babies survived except for one preterm neonate and one lost in follow-up.In Group 3,the termination time was (31.2 ± 2.9)gestational weeks.Five patients accepted artificial abortion for severe complications of mother or babies; the other six patients accepted cesarean section,among which one complicated with placental abruption and baby died.The rest five babies survived.In Group 4,the pregnancies were terminated at an average of (32.8±2.9) gestational weeks and the duration of treatment was (10.8±6.7) days.Two accepted induction after treatment and four recovered to normal after treatment and accepted cesarean section with four wellbeing babies. Conclusions Perinatal outcomes of patients with AEDV complicated with severe complications after active treatment might relate to the termination time.Some patients with AEDV without severe complications might recover spontaneously with good prognosis.