As an emergent attack,dyspnea can be caused by a variety of diseases,therefore,it is difficult and important as to the differential diagnosis in clinical practice.In the past,Physicians identified the cause of dyspnea primarily based on the clinical symptoms,signs and laboratory tests.However,dyspnea often misdiagnosed because the similarity and overlapping of clinical manifestations among many different diseases and lack of specificity for those conventional lab tests.Until recently,B-type natriuretic peptide (BNP) has emerged as a highly sensitive and specific index to identify heart failure,and has made it reality that rapid and accurate differential diagnosis of dyspnea in the lab.In the last couple of years,the differential diagnosis of dyspnea has been remarkably improved because of the increasing new test reagents,advanced devices and better assay techniques.The present article will review the laboratory differential diagnosis of dyspnea between cardiovascular and pulmonary diseases.

As a new biomarker and a member of transforming growth factor super family,growth differentiation factor-15 (GDF-15) is increased in some pathological situations,and plays a positive role.Increasing evidence from animals and clinical trials has indicated that GDF-15 is a promising biomarker to be used for diagnosis,screening,risk stratification and prognosis evaluation in acute coronary syndrome,heart failure and pulmonary vascular diseases.However,there are still numerous challenges and problems need to be resolved in the future,such as appropriate cut-off value in diagnosis and risk stratification in different cardiovascular diseases,improvement in sensitivity and specificity,and combinational application with other biomarkers.

Different types of noncoding RNAs (ncRNAs) are pervasively expressed in genomes of complex organisms.Current evidence suggests that long noncoding RNAs (lncRNAs) have significant roles at almost every stage of gene expression.It is an important regulatory factor involving in ischemic heart diseases,participating in the development of ischemic heart disease,expecting to predict early myocardial remodeling after myocardial infartion and heart failure,and attracting more and more attention.This review introduces the definition,classification,function and characteristics of lncRNA,and focuses on its diagnostic and predictive value in ischemic heart disease.

Objective To investigate if the relative ratio between C1q and C3a, C5a had a relationship with the extent of coronary artery disease ( CAD) which had never been evaluated in humans.Methods Fifty-three patients scheduled for elective percutaneous coronary intervention ( PCI ) from February, 2016 to April, 2016 at Fuwai hospital were prospectively enrolled.According to the clinical and angiographic characters patients were divided into two groups:acute coronary syndrome ( ACS) group ( n=24), and control group (n=29, 19 patients with stable angina and 10 patients without CAD confirmed by angiography).In all individuals, fasting venous blood was collected by EDTA tubes after admission and strictly before PCI.The plasma level of C1q was measured by immune turbidimetric analysis, C3a and C5a were measured by ELISA tests.Differences between groups were assessed using t test, Mann-Whitney Utests, chi-squared test or Fisher exact test depending on the type of data respectively.Multivariate logistic regression analyses were conducted to evaluate the adjusted effect of C1q, C3a, C5a, C1q/C3a and C1q/C5a on ACS.Results Compared with control group, ACS group has an elevated circulation level of C3a (4 531.14 μg/L vs.4 179.95 μg/L, t=1.381,P=0.173) and C5a (6.44 μg/L vs.4.42 μg/L, t=0.133, P=0.108) but a decreased level of C1q (176.98 μg/ml vs.200.60 μg/ml, t=-2.022, P=0.048).The relative ratio of C1q/C3a was significantly decreased in ACS patients(4.05 ×10 -2 vs.4.97 × 10 -2 , t=-2.484, P=0.016).According to the multiple logistic regression analysis, lower relative ratio of C1q/C3a level proved to be independently associated with ACS ( OR=0.937, P=0.047, 95% CI:0.879-0.998).Conclusions The decreased relative ratio of C1q/C3a level proved to be independently associated with ACS.C1q/C3a ratio could be used as an important index reflecting the complement system homeostasis status which might have potential clinical value in evaluating the prognosis of patients with CAD.

OBJECTIVETo explore the clinical efficacy and safety of acupuncture and moxibustion for copracrasia.

METHODSBy prospective live randomized controlled trial, 40 cases with copracrasia were randomly divided into an acupuncture-moxibustion group and a medication group, 20 cases in each one. In the acupuncture-moxibustion group, acupuncture was applied at Ciliao (BL 32), Changqiang (GV 1) and Tianshu (ST 25) and mild moxibustion was used at Qihai (CV 6). Treatment was given for 12 weeks and 32 times, 3 times a week in the front 8 weeks, 2 times a week in the latter 4 weeks. In the medication group, conventional symptomatic treatment, support therapy, and complications preventing and treating were adopted for 12 weeks. Anal incontinence score (Vaizey incontinence score), effective rate and self-rating score for satisfaction were observed before and after treatment and in the follow-up period.

RESULTSAfter 12 weeks' treatment in the two groups, Vaizey incontinence' scores were both decreased (both P<0. 05), and after treatment and in the follow-up period the scores in the acupuncture-moxibustion group were lower than those in the corresponding period in the medication group (both P< 0. 05). The effective rate of the acupuncture-moxibustion group was 80. 0% (16/20), which was statistically different from 50. 0% (10/20) in the medication group (P<0. 05). The effective rate in the follow-up period of the acupuncture-moxibustion group was 90. 0% (18/20) and it was not statistically different from 80. 0% (16/20) in the medication group (P>0. 05). The self-rating scores for satisfaction in the acupuncture-moxibustion group were superior to those in the medication group after treatment and in the follow-up period (both P< 0. 05).

CONCLUSIONAcupuncture and moxibustion could improve copracrasia and the acupuncture-moxibustion rules and characteristics for the disorder should be paid attention to in the further research.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Defecation ; Fecal Incontinence ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Objective: To evaluate the safety and efifcacy of cutting balloon combining main branch single stent cross-over technique for treating the patients with coronary bifurcation lesions. Methods: A total of 113 patients with 121 bifurcation lesions treated in our hospital from 2012-01 to 2014-01 were enrolled. Cutting balloon pre-dilation was applied in both main and side branches followed by drug-eluting stent implantation at main branch. The procedural success rates, side branch blood lfow status and complications were observed. Follow-up studied for MACE occurrence was conducted at 9 months after the operation. Results: Quantitative coronary angiography (QCA) presented that the minimum lumen diameters at pre- and post-operation in main branches were (2.12 ± 1.07) mm and (3.24 ± 0.87) mm, in side branches were (1.44 ± 0.73) mm and (1.82 ± 0.64) mm respectively,P<0.05-0.01, the procedural success rate was 100%. There were 11 (9.1%) lesions with dissection at proximal side branch, 5 (4.1%) lesions with side branch TIMI blood lfow

Objective: To analyze the thromboelastography (TEG) outcomes in patients with stable angina pectoris (SAP) combining diabetes mellitus (DM).
Methods: A total of 360 SAP patients treated in our hospital by percutaneous coronary intervention (PCI) from 2012-01 to 2013-06 were randomized into 2 groups:SAP+DM group, n=109 and SAP-DM group, n=251. Routine clinical examination and TEG test were performed and compared between 2 groups.
Results: Compared with SAP-DM group, SAP+DM group showed the higher ratios of male gender, history of hypertension, hyperlipidemia and higher level of hs-CRP, all P<0.05. Single regression analysis indicated that DM was related to adenosine diphosphate (ADP) inhibition rate (r=0.977, P=0.0001), not related to arachidonic acid (AA) inhibition rate (r=0.245, P=0.069). Multi regression analysis presented that with controlled relevant factors, DM was still related to ADP inhibition rate (r=0.862, P=0.0001). The major TEG parameters as R value, K value,α-angle and MA value were obviously different between 2 groups, P<0.05, while the AA inhibition rate was similar, P=0.057. ADP inhibition rate was different between 2 groups, P=0.0001. The incidence of clopidogrel resistance was higher in SAP+DM group than that in SAP-DM group (34.7%vs 16.2%, P=0.001).
Conclusion: The SAP patients combining DM were at hyper-coagulation status with higher incidence of clopidogrel resistance, who needed intensive post-operative anti-platelet therapy.

Objective: To explore the relationship between behavioral problems and accidental injuries among preschoolers, and to provide evidence for the targeted prevention of children s accidental injuries. Methods: During September to October 2019, parent of 2 062 children aged 3 to 6 selected from 8 kindergartens in Hefei through stratified clustering method were investigated. The prevalence of accidental injuries and behavioral problems among preschoolers was collected by questionnaire survey. Results: The prevalence of accidental injury during the past year was 14.55%(300), and behavioral problems 14.21%(293). Total rate of behavioral problems and rate of each dimensions in children with accidental injury were 32.67%, 2.33%, 19.67%, 15.00%, 2.00%, 1.00 % and 5.00%, compared to 11.07%, 0.45%, 6.41%, 4.88%, 0.40%, 0.17% and 0.79% in children without accidental injury ( χ 2=98.11, 12.54, 58.90, 44.12, 10.51, 6.08, 32.68, P <0.01). Multivariate Logistic regression analysis showed that psychosomatic problems( OR =3.13, 95% CI =2.11-4.66), learning problems( OR =2.73, 95% CI =1.86-3.99), abnormal hyperactivity index ( OR =3.16, 95% CI =1.40-7.14) and left behind children ( OR =1.53, 95% CI =1.13-2.07) were associated with higher risk of accidental injuries( P <0.05). Conclusion Behavioral problems are significantly associated with unintentional injuries among preschool children, which deserved further attention and intervention when formulating prevention and control measures for childhood accidental injury.

Based on the reported inhibitors TH287, 17 five-membered heterocyclopyrimidine derivatives were designed and synthesized by cyclization, scaffold hopping, bioisosterism and molecular docking technology. The bioassays determined by malachite green method demonstrated that the target compounds displayed good inhibitory activity against MTH1. Among them, the IC50 value of 7 compounds was less than 1 μmol/L, suggesting that these compounds may be candidates for further investigation.

Objective To investigate the clinicopathological characteristics and the expression of related molecular markers of heterotopic pancreas for better understanding and avoiding overtreatment of this disease.Methods From 24th March 2009 to 10th November 2016,92 patients with heterotopic pancreas in upper digestive tract diagnosed after endoscopic submucosal dissection(ESD),were collected. Tissues were sectioned and pathologically classified by Heinrich classification.The expressions of seven different molecular markers including cytokeratin(CK)19,insulin,trypsin,Ki-67,p53,CD133 and CD56 were detected by immunohistochemistry staining. Clinical features, pathological features and immunohistochemical results were retrospectively analyzed.Analysis of variance and Kruskal-Wallis test were used.Results According to Heinrich classification,the percentages of type Ⅰ,Ⅱ,and Ⅲ of heterotopic pancreas were 27.2%(25/92),63.0%(58/92)and 9.8%(9/92),respectively.There was no type Ⅳ patients.The heterotopic pancreas mainly located in stomach with proportion being about 91.3%(84/92)of the total heterotopic pancreas.CK19(the marker of pancreas ducts),insulin(as marker of endocrine function)and trypsin(as the marker of exocrine function)were all expressed in heterotopic pancreas.The positive rate of CD56,a pancreatic neuroendocrine marker,was 66.3%(61/92).The umbilicus like depression was the typical endoscopic appearance of heterotopic pancreas,which only found in 29 patients(31.5%).The average rate of Ki-67,cell proliferation index,was(2.08 ± 1.41)%.The expression of mutant p53 was negative in all 92 cases of heterotopic pancreas.The average staining area of CD133,a marker of pancreatic cancer stem cell,was(2.53 ± 2.43)%.The average follow-up period of 92 patients was(43.6 ± 27.5)months.No relapse and malignant change were found and all patients survived after ESD.Conclusions Heterotopic pancreas has normal pancreatic construction and function.The cell proliferation index is low in heterotopic pancreas and no mutant p53 expression is found.The expression of CD133 is also low.Heterotopic pancreas is a congenital benign disease which requires a long-term follow-up rather than overtreatment.