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.

Objective To study on the drug-resistance mechanism of Brucella resistance to Quinolone antibiotics to guide the selection and use of antimicrobial agents in clinical practice. Methods Six strains of Brucella melitensis(Bru1, Bru2, Bru3, Bru4, Bru5, Bru6) were selected to be induced resistance to levofloxacin in vitro respectively. The MICs of the 6 strains of Brucella melitensis and induced resistant strains were measured by agar dilution method. The sensitivity to Quinolone antibiotics (Levofloxacin, Ciprofloxacin, Lomefloxacin, Norfloxacin, Fleroxacin, Ofloxaein) of 6 strains of Brucella melitensis and induced resistant strains was measured by K-B method. The gyrA of the 6 strains of Brucella melitensis and induced resistant strains was amplified by PCR, then the nucleotide sequence of the genes were analyzed. Results The MICs of Bru1,Bru2,Bru3,Bru4, Bru6 were 0.50 μg/ml and Bru5 was 0.25 μg/ml. The strains Bin3, Bru4 were induced into drug-resistant strains by Levofloxacin, then were named LEVR3 and LEVR4 respectively. The MICs of LEVR3 and LEVR4 were 64,128 μg/ml with 128 and 256 times higher than that of the parental strains. The 6 strains of Brucella melitensis were sensitive to Quinolone antibiotics, LEVR3 and LEVR4 were resistant to Quinolone antibiotics. Neucleotide sequence analysis and comparison of the derived amino acid sequence revealed that Quinolone resistance-determing region of GyrA had a substitution at position Ala87 and Asp91 in laboratory resistant strains. Conclusion The results of in vitro experiments show that acquired resistance of Brucella melitensis strains to Levofloxacin could beinduced when exposed to high level of some antibacterial agents for short term. Two drug-resistant strains occur mutations in gyrA and have cross-resistance to other Quinolones.

Objective To compare the influence of two different managements of relief incision (exposed relaxation therapy or absorbable hemostatic gauze) in infants' palatoplasty. Methods A total of 118 infants with cleft palate between 5- to 8-month-old for the study were randomly divided into two groups: group A was exposed therapy group, and in group B both sides of relief incision were placed absorbable hemostatic gauze. The wound bleeding, body temperature, diet and incidence of fistula were observed and analyzed after operation. Results There was no significant difference between the two groups in postoperative temperature, diet and wound healing (P>0. 05). The postoperative wound bleeding was statistically significant differences between the two groups (P<0. 05). Conclusions Either exposed therapy or placed absorbable hemostatic gauze in relief incision, has minimal systemic and local reactions in the postoperative infant. The advantages of exposed treatment are economic and simple, and less irritant to the wound.

BACKGROUND:Tetramethylpyrazine (TMP) can inhibit the expression of vascular endothelial growth factor (VEGF), but it is uncertain that TMP inhibit the growth and proliferation of HL-60 leukemic cells induced by VEGF.OBJECTIVE:To observe the effect of TMP on the proliferation of HL-60 leukemic cells induced by VEGF.DESIGN:Repetitive measurement and observation.SETTING:School of Medicine, Wuhan University of Science and Technology.MATERIALS:The experiment was carried out in the Molecular Biology Laboratory Center, School of Medicine, Wuhan University of Science and Technology from March to June in 2007. Human leukemic cell line HL-60 cells were purchased from Shanghai Institute of Cell Biology. TMP hydrochloride injection was produced by Wuxi Seventh Pharmaceutical Products Limited (Lot number:011014), protamine sulfate injection was produced by Shanghai First Biochemical Pharmaceuticals (Batch number:010302), and immunohistochemistry kit was purchased from Boster company.METHODS:①Human leukemic cell line HL-60 cells at log phase were used for the experiments. Cells were treated with 100 μg/L VEGF, and then TMP at final concentrations of 1.5, 15, 150 mg/L was added into culture medium. While the cells in medium without TMP were taken as blank control group, and the cells in medium with 20 mg/L protamine as positive control group. Meanwhile cells without treatment of VEGF were served as VEGF control group. After cells were incubated for 48 hours, the growth inhibiting rate of HL-60 cells was detected by MTT assay.②After HL-60 cells were treated with TMP at the final concentrations of 1.5, 15, 150 mg/L for 24 hours, the protein expression of VEGF in HL-60 cells was examined by SP immunohistochemistry.MAIN OUTCOME MEASURES:①Growth inhibiting rate of HL-60 cells.②Protein expression of VEGF.RESULTS:①Growth inhibiting rate of HL-60 cells:After HL-60 cells induced by VEGF were treated with 15 and 150 mg/L TMP, the absorbance value was significantly lower than that in VEGF control group (P < 0.05).②Protein expression of VEGF:After HL-60 cells were treated with TMP for 24 hours, the protein expression of VEGF was down-regulated with increasing TMP concentration in a dependent manner. Significant differences were observed in the protein expression of VEGF between cells treated by TMP and the controls (P < 0.01).CONCLUSION:TMP can inhibit the proliferation of HL-60 cells stimulated by VEGF and down-regulate the expression of VEGF.

This study was aimed to reveal the effector mechanisms of Chinese medicine aconite, ginseng, astragalus and dried ginger on the intervention of adriamycin (ADR) cardiotoxicity model rats. The analysis was made on the interactive relationship between aconite and ginseng, astragalus as well as dried ginger. A total of 72 rats were randomly divided into nine groups. There were eight rats in each group. Except the normal group, rats in each group were intraperitoneally injected with 2.5 mg·kg-1 of ADR according to their body weights. The injection was given once a week and continued for four weeks. The total dosage was 10 mg·kg-1. In the aconite, dried ginger group, the intragastric administration dosage of herbal decoction was 1.75 g·kg-1. The decoction dosage in the gin-seng, astragalus group was 0.875 g·kg-1. The decoction dosage in the Shenfu, Qifu group was 2.625 g·kg-1. The decoction dosage in the Jiangfu group was 3.5 g·kg-1. The intragastric administration was given once a day and continued for four weeks. Indexes such as superoxide dismutase (SOD), cardiac troponins (cTn), cytochrome C (CytC), myocardial mitochondria of Bax, Bcl 2, caspase-3, caspase-9 were detected. The colligation score was calculated associating with the close index. One-way ANOVA was given on different indexes and colligation indi-cators among different drug groups and the factorial design variance analysis was given to reveal the drug interac-tions. The results showed that compared with the normal group there were statistical significances among different indexes in the model group (P < 0.05). Aconite, ginseng, astragalus, dried ginger had varying degrees of impact on different indicators. There were statistical significances on the interaction between aconite and ginseng, astra-galus, dried ginger (except Bax). It was concluded that herbal medicine aconite, ginseng, astragalus, dried ginger had certain protective effect to the heart of ADR model rats. The combination of aconite and ginseng, astragalus, dried ginger can enhance the effect compared with a single herb.

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.