Objective To observe the clinical significance and variation of plasma B-type brain natriuretic peptide (△BNP) levels before and after treadmill exercise test (TET) in women with coronary heart disease(CHD). Methods Sixty-one women with suspected coronary heart disease were selected (except for heart failure, blood BNP levels were normal). All patients underwent coronary angiography, were divided into two groups, 25 cases in normal group and 36 cases in coronary heart disease group. Plasma BNP levels were measured before and after the TET test, and data were compared between two groups after one week.Furthermore, the levels of△BNP before and after TET in patients with different degrees of coronary artery lesions were compared. The diagnostic value of the levels of△BNP in coronary heart disease was evaluated by the re-ceiver operating characteristic curve (ROC). Results The plasma BNP level was significantly increased after TET (44.20± 14.53) than that before the test (32.82±10.72) in coronary heart disease group (P<0.01). There were significant differences in levels of△BNP before and after TET in patients with different degrees of coronary lesions. The levels of△BNP were sig-nificantly higher in multi-vessel disease group than those of single and double lesion group (P<0.05). The level of△BNP was significantly higher in double lesion group than that of single lesion group (P < 0.05). When the level of △BNP=7.3 ng/L, the sensibility value and specificity value for the diagnosis of CHD was 82.4%and 81.5%. The area under curve (AUC) was 0.900, and 95%confidence interval was 0.796-0.962. Conclusion The detection of△BNP before and after TET has an important clinical significance in the diagnosis and evaluation of coronary heart disease in women patients.

Objective To explore the effect of microRNA-32 (miRNA-32)on the biological behaviors of gastric cancer cell and its mechanism.Methods Gastric cancer cell line SGC-7901 cells were transiently transfected with miRNA-32 analogue,miRNA-32 inhibitor and empty plasmid vectors by lipofectamine and divided into analogue transfection group,inhibitor transfection group,empty plasmid transfection group and non-transfection group.The expression of green fluorescent protein was observed under fluorescent microscopy.The expression of miRNA-32 at mRNA level was detected by quantificational real-time polymerase chain reaction.The cell proliferation was evaluated by CCK-8 assay.The cell migration ability was measured by scratch test and Transwell chamber assays.The data were analyzed by one-way ANOVA.Results Compared with empty plasmid transfection group and non-transfection group,the expression of miRNA-32 mRNA of miRNA-32 analogue transfection group (relative quantitative value:2.327) was significantly up-regulated and that of miRNA-32 inhibitor transfection group (relative quantitative value:0.402) was significantly down regulated (F=11.238,P＜0.05).The width of scratch of miRNA-32 analogue transfection group was (61.39± 2.21) μm at 24 hours; miRNA-32 inhibitor transfection group was (29.97±0.66) μm.The migration distance of inhibitor transfection group was far than that of analogue transfection group (F=9.371,P＜0.05).After transfection for 48 hours,the cell number of migrated cells of analogue transfection group was significantly less than that of non transfection group,which was 16.93±4.63 and 93.93± 7.09,respectively (F=6.853,P＜0.05).After transfection for 48 hours and 72 hours,the cell growth inhibiting rate of miRNA 32 analogue transfection group was (43.474 ± 18.636)％ and (45.050±23.764)％,respectively,the cell growth was significantly inhibited (F=7.986 and 8.635,P=0.028 and 0.032).Conclusion The cell growth and migration ability of human gastric cancer cell line SGC-7901 are obviously inhibited through upregulating the expression of miRNA-32.

Objective:To study the diagnostic value of non-enhanced lesions on enhanced CT in lung consolidation for necrotizing pneumonia in children.Methods:A total of 101 cases of necrotizing pneumonia with air sacs on CT scan who were hospitalized in the Department of Respiratory Intervention, Qilu Children′s Hospital of Shandong University from August 2016 to September 2018 were enrolled in this study(group with air lucency). Besides, another 75 cases of lobar pneumonia with non-enhanced lesions in lung consolidation but without air sacs on enhanced CT were also included from the same hospital over the same period(group without air lucency). Clinical data of these patients were retrospectively collected and statistically analyzed.Results:The white blood cell count was (12.5±5.5)×10 9/L in group with air sacs and (10.8±4.1)×10 9/L in group without air sacs, and the difference was statistically significant( t=-2.161, P=0.032). There was no statistical difference between the group with and without air sacs in age, gender distribution, the course prior to admission, duration of fever after admission, length of hospital stay, medical expense, the neutrophils percentage in peripheral blood, C-reactive protein, the erythrocyte sedimentation rate, serum procalcitonin, serum D-Dimer, serum lactate dehydrogenase, serum albumin, bronchoscopy times, the bronchial mucosal erosion ratio, the mucus plug score, the lavage purulent lavage ratio, and the ratio of luminal stricture or atresia in late bronchoscopy(all P>0.05). Conclusions:The clinical course of patients with non-enhanced lesions in lung consolidation but without air sacs is almost identical to that of patients with air sacs on CT scan.The presence of non-enhanced lesions in lung consolidation can be used as diagnostic basis of necrotizing pneumonia in children.

Objective To explore the significance of interleukin (IL)-1β and IL-6 in serum of children with hyperuricemia (HUA). Methods 142 children including 71 children with HUA (HUA group) and 71 control children (control group), healthy and inguinal hernia children were selected as control group. 71 HUA children were subdivided into GA (gout attacks) group (n=28) and NGA (non-gout attacks) group (n=43) according to whether they had a history of acute gout attacks, including sudden monoarthritis of rapid onset with intense pain and swelling or without. Enzyme-linked immunosorbent assay was used to measure the level of IL-1β and IL-6 in serum. Results Serum IL-1β and IL-6 levels of HUA children were significantly higher than those of control group (all P<0.05). Serum IL-1β and IL-6 levels of HUA children in GA group were significantly higher than those of NGA group (P<0.05). Serum IL-1β and IL-6 levels of GA group in acute phase was significantly higher than those of HUA children in remission stage、NGA group and control group (P<0.05). Serum IL-1β and IL-6 levels of GA group in remission stage and NGA group was significantly higher than those of control group (P<0.05). There were no significant differences between HUA children in remission stage and NGA group (P>0.05). The serum IL-1β and IL-6 levels of HUA children were positively correlated with WBC, neutrophils, monocytes, uric acid, ESR, CRP, BUN and Cr (all P<0.05), while not correlated with triglyceride, total cholesterol, LDL-C and HDL-C(all P<0.05). Conclusion IL-1β and IL-6 play an important role in the pathogenesis of HUA in children.

Abstract: Objective To observe the curative effect of thread-hanging combined with cotton plug on stage Ⅲ paronychia. Methods Sixty-one patients with stage Ⅲ paronychia were selected and randomly divided into a treatment group and a control group. The treatment group (n=31) was treated with thread-hanging and tampon under local infiltration anesthesia, and changed dressing and tampon every day after operation. After the wound healed, the patient soaked his feet in warm water every day and changed the tampon himself until the symptoms subsided, and the knot did not receive special treatment, and the nail plate would naturally shed as it outgrew the paronychia. The control group (n=30) was treated with thread-hanging and nail groove reconstruction under nerve block anesthesia, and the dressing was changed every day after operation. After thread removal, the patients soaked their feet in warm water every day until the symptoms subsided, and the knot was not specially treated, and it naturally fell off with the growth of the deck beyond the nail groove. The postoperative Visual Analog Scale (VAS) pain score, pain duration, wound healing time, cure rate, effective rate and recurrence rate of paronychia, and patients' satisfaction with the operation were compared between the two groups. Results Compared with the control group, the treatment group had lower VAS pain scores on the first and third postoperative days (2.1±0.3) and (0.2±0.1) vs. (6.3±0.1) and (3.2±0.2), respectively, shorter duration of pain and wound healing time (3.3±0.3) days and (10.1±0.5) days vs. (5.2±0.3) days and (15.2±0.3) days, respectively, higher cure rate (87.1% vs. 66.7%), lower failure rate (12.9% vs. 33.3%), lower recurrence rate (7.4% vs. 20.0%), and higher patient satisfaction (97.0% vs.75.3%). The treatment group showed significant superiority over the control group in all outcomes. Conclusion For patients with stage Ⅲ paronychia, thread-hanging combined with cotton tampon without nail groove reconstruction is advantageous as it avoids additional skin trauma, and does not affect the nail appearance and normal periungual barrier after healing, , reduces patient discomfort, and shortens the time off work, resulting in a higher cure rate. This treatment approach is therefore worth promoting in clinical practice.

Objective To discuss the security and reliability of preoperative thoracoscopic pericardial exploratory and to evaluate of the surgical indications.Methods Video full-assisted thoracoscopic pericardioscopy has been implemented in 41 central type lung cancer cases before radical resection.Results Video assisted pericardioscopy group underwent thoracotomy lung resection with procession of intrapericardial pulmonary artery in 8 cases (partial pericardial resection in 2 cases),with pulmonary vein in 10 cases,and out-pericardial lung resection in 9 cases.Spiral CT projections were consistent with surgery was only 65.8 ％.The average time of explorationa was (23±10) min.Conclusion Except for widely used in pulmonary wedge resection and lobectomy,video-assisted thoracoscopic pericardial exploration can improve resection rate and survival rate in central type lung cancer patients which can reduce the need for exploratory thoracotomy.

Objective Studies of the positioning,framework and weight of the performance of directors of third-grade public hospitals will pave the way for launching a study of the performance of these directors,and for the performance appraisal of the directors of third grade public hospitals.Methods The following methods are called into play:Meta-analysis of literature to summarize the research outcomes of the appraisal thinking and modeling for managers of public hospitals;the balance score card to design the theoretical base of public hospital performance framework;the Delphi Method to identify the functionality expected of public hospitals,and the thinking and framework for performance appraisal;in addition to experts consultancy to demonstrate via questionnaires.Results Positioning of directors performance appraisal of third-grade public hospitals comprises both desirable social effect outcomes and desirable operating status.This performance appraisal consists of such five dimensions as social satisfaction,effective management,asset operation,development sustainability,and employee recognition,totaling 12 performance objectives.Conclusion Scientific and reasonable design of the framework and weight of the perfofinance appraisal for managers of public hospitals is conducive to assuring the public interest nature for public hospitals.

Objective: To evaluate the effect of the standardized follow-up protocol based on telemedicine follow-up system in patients after mechanical heart valve replacement. Methods: A prospective, nonrandomized, controlled clinical trial was performed on 109 patients who underwent mechanical heart valve replacement in the Affiliated Hospital of North Sichuan Medical College from January 2017 to June 2017. They were divided into two groups according to patient's willingness, place of residence and whether have sufficient technical facilities (computer or mobile device connected to the internet), including 56 patients in the control group and 53 patients in the observation group. The control group received routine follow-up guidance, and the observation group received standardized follow-up protocol, which were followed up for 6 months. The patients in the two groups were analyzed with thromboembolism, hemorrhagic event and International normalized ratio (INR) related to anticoagulation therapy during the follow-up period, and the quality of early anticoagulation therapy was evaluated with Time in therapeutic range (TTR), and the satisfaction of the patients with anticoagulation therapy was investigated. Results: There was no significant difference in INR between the two groups during the follow-up period (P >0.05). The TTR of the control group and the observation group was 44.6% (4 516.6 d/10 127.0d) and 54.1% (5 576.1d/10 307 d), respectively, with statistically significant differences (t=-11.273, P < 0.05).There were no significant differences between the two groups in the anticoagulant complications, thromboembolism, hemorrhagic events (P > 0.05). There was significant difference between the observation group and the control group in overall satisfaction with anticoagulation therapy and helpful in answering the patients' questions (Z=6.42, 5.62, P < 0.05), while no statistically significant difference in service attitude to the follow-up period and satisfaction with the guidance that was provided (P > 0.05). Conclusion Standardized follow-up protocol based on telemedicine follow-up system is applied to patients after MHVR surgery, which is conducive to improving the quality of anticoagulant therapy and improving the satisfaction of patients, and providing reference for the development of "Internet + medical" mode in China.

Objective To construct anticoagulation monitoring database of Northeast Sichuan patients after heart valve replacement, to provide a long-term and continuous regional long-distance follow-up platform for patients with valvular heart disease in convalescent period and explore the best way to share information between superior hospitals and primary community hospitals.Methods A non-randomized, prospective controlled clinical study was conducted among 485 patients who received warfarin anticoagulation therapy and anticoagulation monitoring after cardiac valve replacement from January 2016 to September 2017 in the Affiliated Hospital of North Sichuan Medical College and Nanchong Central Hospital. All the patients were divided into outpatient follow-up group (n=242) and remote follow-up group (n=243). The outpatient follow-up group received routine clinic and telephone follow-up. The remote follow-up group realized the information sharing through the database and accepted the anticoagulation guidance provided by the primary medical institutions. Thromboembolic and hemorrhagic events associated with anticoagulation therapy and international standardized ratio (INR) were analyzed during follow-up. The quality of anticoagulation therapy was evaluated by treatment range time (TTR).Results There was no significant difference in the INR results during the follow-up time between the two groups (P>0.05). The TTR value of the outpatient and remote follow-up group was 42.3％ and 54.4％ respectively, and the difference was statistically significant (P<0.05). There was no significant difference in the total complications, serious bleeding, general bleeding and thrombosis between the two groups (P>0.05).Conclusions "Community database of valve disease anticoagulation in northern Sichuan" can effectively improve the quality of anticoagulant therapy in these patients, realize the information sharing from superior hospital patients with primary medical institutions, and ensure the convalescence after heart valve replacement of anticoagulant therapy in patients with accuracy and persistence.

Objective To observe the effects of Crk-SH3 domain guanine exchange factor(C3G)overexpression on the pro-liferation and apoptosis of high glucose-induced H9C2 cardiomyocytes.Methods H9C2 cardiomyocytes were transiently transfected with pCXN2-Flag(empty plasmid)and pCXN2-Flag-hC3G(human C3G mRNA)plasmids,then conducted high glucose(HG)in-tervention.The experiment was divided into the blank group,empty vector group,C3G overexpression group,blank + HG group, empty vector + HG group and C3G overexpression+ HG group.The C3G protein expressions,apoptosis and proliferation rate were respectively detected in each H9C2 cardiomyocytes groups.Results The proliferation rate in the blank+ HG group and empty vec-tor+ HG group were significantly decreased compared with the blank group and empty vector group,while the apoptosis rate was significantly increased.Compared with blank group and empty vector group,blank + HG and empty vector + HG group,the C3G protein expression and proliferation rate in the C3G overexpression group and C3G overexpression+ HG group were increased sig-nificantly,while the apoptosis rate was decreased significantly.Conclusion High glucose inhibits H9C2 myocardial cell proliferation and promots its apoptosis;furthermore,C3G overexpression can reversed the decrease of high glucose-induced H9C2 cardiomyocyte prolifer-ation rate and apoptosis increase.C3G overexpression can promote the survivability of high glucose-induced H9C2 cardiomyocytes.