Objective To explore the clinical feature of acute coronary syndromes (ACS) in senior populations and provide reference for the clinical diagnosis and treatment. Methods Clinical data of 175 elder patients of ACS and 65 non-elder patients of ACS were collected from September,2006 to September,2009. Clinical data were compared between the two groups. Results The elder ACS patients had higher prevalence of hypertension,cerebro-vascular disorder and renal inadequacy (68.6%, 18.3% and 32.6%, respectively) than those in the non-elder ACS patients (46.2% ,3.1% and 10.8%, respectively) (P<0.01). The level of hemoglobin, cholesterol, LDL and tri-glyceride in the elder ACS patients ((120.93±30.02) g/L, (4.47±1.29) mmol/L, (2.42±1.05) mmol/L and (1.31±0.87)mmol/L,respectively) were lower than those in the non-elder ACS patients ((141.02±17.16)g/L, (4.98±1.01 ) mmol/L, (2.71±0.99) mmol/L and (1.78±1.2) mmol/L, respectively) (P<0.01, P<0.05). However,the level of fibrinogen was higher in the elder ACS patients ((381.01±150.94) μg/L vs ( 338.91± 138.65) μg/L , P<0.05). Conclusions Hypertension, cerebrovascular disorder, hypohemoglobinemia and renal inadequacy are highly correlated with ACS in senior populations. These factors should be considered in chnical diag-nosis and treatment. Early diagnose and treatment in time may decline the case-fatality rate.

Objective To explore the effect of different type of atrial fibrillation(AF) on plasma brain natriuretic peptide(BNP) level in male patients.Methods Fifty-eight hospitalized male patients with AF were enrolled,including 35 cases with paroxysmal AF,14 cases with persistent AF,and 9 cases with permanent AF.All subjects had the examination of echocardiography/electrocardiogram within 24 h after admission.Venous blood sample were collected in a quiet prostration state on the next early morning for BNP detection.The plasma BNP level was determined by radioimmunology-assay(RIA).Results The average level of plasma BNP in male patients with permanent AF(2343.25 ± 820.24)μg/L was significantly higher than those with persistent AF([576.43 ± 223.07]μg/L,t=8.74,P＜0.001) and paroxysmal AF([632.74 ± 103.93]μg/L,t=8.73,P＜0.001),but there was no significant difference between the last two groups(t=0.59,P＞0.05).Conclusion BNP is a sensitive indicator of early heart function impairment related with AF,particularly elevates in male patients with permanent AF.

Objective:To establish the quality standard for Kechuanning granules. Methods: A TLC method was used for the qualitative study on the main ingredients, Radix stemonae,ephedra and bitter almond. An HPLC method was used to determine the con-tents of ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin. The separation of targeted compounds was performed on a Tech Mate C18-ST column (250 mm × 4. 6 mm,5 μm) . The mobile phase consisted of methanol(A) and 0. 1% phosphoric acid (B) with gradient elution at a flow rate of 1. 0 ml·min-1. The detection wavelength was 207nm and the column temperature was 35℃. Results:The spots in TLC were quite clear without any interference from negative control. The linear relationship of ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin was 1. 826-182. 600μg·ml-1( r=0. 9997),1. 848-184. 815μg·ml-1 (r=0. 9997) and 2. 981-298. 069 μg·ml-1(r=0. 9996),respectively. The average recovery was 97. 00%,97. 40% and 98. 30%(RSD=3.7%,2.5%,1.6%)(n=9),respectively. Conclusion: The method is sensitive,accurate,simple and reproducible,which can be used for the quality control of Kechuanning granules.

Objective To evaluate the effect of 6% hydroxyethyl starch 130∕0. 4 on acute kidney injury in elderly patients in a prospective, multicenter, randomized, double?blind, controlled clinical tri?al. Methods A total of 120 patients of both sexes, aged 65-82 yr, weighing 56-83 kg, of American So?ciety of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective orthopaedics and hernia surgery, were divided into either hydroxyethyl starch group ( group HES) or lactated Ringer′s solution group ( group LR) , with 60 patients in each group. Hydroxyethyl starch and lactated Ringer′s solution were infused intra?venously at a rate of 7. 5 ml∕kg during 1st hour of surgery in HES and LR groups, respectively. Lactated Ringer′s solution was then infused at a rate of 5 ml∕kg starting from 2nd hour of surgery until the end of sur?gery in both groups. Before surgery, at the end of surgery and at 1, 3 and 5 days after surgery, blood sam?ples and urine specimens were collected for determination of the concentrations of neutrophil gelatinase?asso?ciated lipocalin, interleukin?18 (IL?18), plasma creatinine, urine β2 microglobulin and urine albumin.
The estimated glomerular filtration rate was calculated. Results The level of urine IL?18 was significantly higher at each time point after surgery than before surgery and immediately after the end of surgery ( P<0.05) . There were no significant differences between the two groups in the levels of urine IL?18, plasma creatinine, plasma and urine neutrophil gelatinase?associated lipocalin, plasma IL?18, urineβ2 microglob?ulin and urine albumin and estimated glomerular filtration rate at each time point ( P>0.05) . Conclusion Compared with lactated Ringer′s solution, 6% hydroxyethyl starch 130∕0.4 does not aggravate acute kidney injury in elderly patients.

Objective To study the optimum combination of orientation parameter of total hip prosthesis and acetabular safe zone on condition that the range of motion for activities of daily living (ADL) is fulfilled.Methods A three-dimensional generic parametric and visually kinematic simulation module of THA was developed.Range of motion ( ROM ) of hip flexion ≥ 110°,internal-rotation ≥30° at 90° flexion,extension ≥30° and external rotation ≥40° were defined as the normal criteria for ADL.ROM of hip flexion ≥ 120°,internal-rotation ≥45° at 90° flexion,extension ≥30° and external rotation ≥40° were as the severe criteria.The ranges of changes in general ratios (GRs) of head-neck,femoral neck antevemion ( FNA ),operative inclination (OI) and anteversion (OA) of acetabulur components were 2.0-2.92,0°-30°,10°-60°,and 0°-70° respectively.Within the limits of the upper two activity criteria,the synchronous OA of acetabulur components was calculated with every 5°change in OI of the cup,and the collodiaphyseal angle ( CDD ) was set as 135°.The safe-zone of combination of acetabulur operative anteversion (OA) and inclination (OI) was defined as the area that fulfilled the two mentioned criteria of ROM without cup-neck impingement.All parameters were analyzed by using SAS 6.12 software.Results The safe zone of acetabdar angle rose with the increase of GRs of head-neck and the safe zone of severe criteria was smaller than that of normal criteria.When the CDD angle was 135°,the sum of average aeetabular OA and acetahular OI plus 0.816 times of the FNA equaled to 84.76° innormal criteria; and the sum of average acetabular OA and acetabular OI plus 0.873 times of the FNA equaled to 92.04° in severe criteria.Conclusions A high GR of head-neck greatly increases the size of safe-zone of acetabular angle.The higher demand of ROM of hip joint requires the smaller safe zone of acetabular angle,as can be corrected by increasing the GR of head-neck.The optimum combination between the sum of average acetabular OA and acetabular OI ( Y) plus FA (X)in the normal criteria and severe criteria can be estimated by using the following formulae:Y1 =-0.816X1 + 84.76 (R2 =0.993 ),Y2 =-0.873X2 + 92.04( R2 =0.999) respectively.

0.05). Conclusion Tianma Gouteng Decoction can reverse left ventricular hypertrophy and myocardial fibrosis,and its mechanism may be related to the inhibition of TGF-? 1 expression in cardiac muscle tissue.

0.10)between the two Cr sources was observed in all indices studied; Cr level affected the relative weight of spleen (P

OBJECTIVE To study the mechanism of drug-resistance of multi-resistant Pseudomonas aeruginosa,and provide the guideline for treatment and control of P.aeruginosa infection in hospital.METHODS Fifty strains of multi-resistant P.aeruginosa were selected with K-B susceptibility method.The three-dimensional method was taken to differentiate the various beta-lactamases.The relative drug-resistance gene was detected by polymerase chain reaction(PCR).RESULTS Among 50 strains of multi-resistant P.aeruginosa,there were 2 strains(4%)producing ESBLs,20 strains(40%)producing AmpC beta-lactamases,and 11 strains(22%) producing ESBLs and AmpC beta-lactamases at the same time.There were 8 positive genes in the detected drug-resistance gene,the most common sources of gene were CTX(56%),OprD(60%) and aac(6′)-Ⅱ(60%),respectively.CONCLUSIONS The main beta-lactamases are AmpC beta-lactamases and the main genotype is CTX in the multi-resistant P.aeruginosa cultured in our area.The main course of imipenem-resistance was deletion of outer membrane proteins,and the aminoglycoside modifying enzyme gene and disinfectant-resistance gene in multi-resistant P.aeruginosa are acquired.In order to reduce the drug-resistance strains and control the infection of P.aeruginosa,antibiotics should be used reasonably according to drug susceptibility testing clinically.

Objective:To construct a multi-stage dynamic prevention and control model, establish a system of intervention points and prevention and control measures for the prevention and control of workplace violence in hospitals, so as to provide guidance for hospitals and medical staffs to effectively prevent and respond to such incidents.Methods:Based on the crisis management theory, a model for the prevention and control of workplace violence in hospitals was constructed, the intervention points and prevention and control measures were screened by the Delphi method.Results:A multi-stage dynamic prevention and control model of workplace violence in hospitals was constructed, and a system of intervention points and prevention and control measures for workplace violence in hospitals were established according to the model. The system was divided into three stages: the pre-event stage contained 10 intervention points and 48 countermeasures, the in-event stage contained 6 intervention points and 17 countermeasures, and the post-event stage contained 3 intervention points and 12 countermeasures.Conclusions:It is an effective way to avoid violence and reduce the damage degree of violent incidents by selecting different countermeasures for different intervention points and carrying out multi-stage dynamic prevention and control of workplace violence in hospitals.

The study explored the effect of acteoside on renal fibrosis in rats with unilateral ureteral obstruction. Twenty-four healthy adult male SD rats were randomly divided into sham (CON) group, unilateral ureteral obstruction (UUO) group, UUO+acteoside (ACT) group, UUO+benazepril (BZ) group by random number table method. The animal model of renal fibrosis was established by unilateral ureteral ligation. The pathological changes of renal tissues in each group of rats were observed by HE staining and Masson staining. Immunohistochemical method was used to detect the protein expression levels of collagenⅢ, heat shock protein (HSP)-47, connective tissue growth factor (CTGF), α-smooth muscle actin (α-SMA), β-catenin, Bcl-2, and caspase-3. Western blotting was used to detect the protein expression of glucose-regulated protein 78 (GRP78) in renal tissue. Compared with CON group, UUO group had renal tubular dilation and significantly increased interstitial collagen fiber deposition; The degree of renal tubular dilation and interstitial collagen fibers in UUO+ACT group and UUO+BZ group were significantly reduced compared to UUO group, but still significantly heavier than CON group. Compared with CON group, the protein expression levels of collagenⅢ, HSP-47, CTGF, α-SMA, β-catenin and GRP78 in renal tissues of UUO group were significantly higher, while the protein expression level of Bcl-2 was significantly lower (all P<0.05). In comparison with UUO group, the expression levels of Bcl-2 in UUO+ACT group and UUO+BZ group were significantly higher, while the expression levels of other proteins were all significantly lower (all P<0.05). The study shows that acteoside may improve renal fibrosis by decreasing the expression levels of collagenⅢ, HSP-47, CTGF, α-SMA, β-catenin and GRP78, and upregulating the expression level of Bcl-2 in renal tissues.