Objective To observe the correlation between plasma brain natriuretic peptide (BNP) level and atrial fibrillation (AF) in old patients with acute left heart failure.Methods 86 old patients with acute left heart failure were randomly divided into two groups according to AF and sinus rhythm.The plasma BNP level was compared between the twogroups.And the relationship between plasma BNP level and the results of ultrasonic cardiography was also assessed.Results Significant difference existed in BNP level between individuals with AF and sinus rhythm [(1 320.66 ± 1 546.41) pg/L vs (989.43 ± 1 042.57) pg/L,t =2.651,P ＜ 0.05] ; BNP level of the rhythm AF significantly correlated with LAD and LVEDD (r =0.723,0.645,all P ＜ 0.01).Conclusion The old patients with acute left heart failure and AF had higher BNP level than those with sinus rhythm.And BNP level of the rhythm AF significantly correlated with LAD and LVEDD.

Objective To promote the clinical practice of bone morphogenetic proteins (BMP) coated prosthesis in order to improve its biological fixation. Methods There were 12 healthy mongrels, weighted from 20 to 25 kg. They were randomly divided into 3 groups according to the scarified time. The bilateral femurs were adopted as the graft areas, and 4 kinds of implant were transplanted into each femur randomly. The transplant consisted of porous-coated anatomic(PCA group), PCA combined with BMP (BMP group), PCA combined with hydroxyapatite(Composite group), and polish PCA combined with HA (HA group). The femurs of the mongrels were retrieved at the 4th, 8th and 12th week respectively. Bone ingrowth and shear strength between the interfaces of the bone-implant were studied, using X-ray, soft X-ray, fluorescence tag, non-decalcification ground section, computer-aided image analysis, and histological examinations. Results By gross observation, the composite for the group of PCA with BMP was the most stable in all the experimental groups. All implants showed good histocompatibility, the bone ingrowth on the implant surface appeared earlier in the BMP group than any others, and so did the maturation of new bone. At 4th week, the percent of new bone formation in the BMP group was 26.58%?4.56%, which was also much higher than PCA group (18.28%?2.46%), Composite group (17.23%?2.11%), and HA group(16.89%?3.13%) through the means of non-decalcified ground section and computer aided image analysis, and the difference was of statistical significance(P0.05). Conclusion The composite of BMP to the PCA is effective and feasible procedure, which could increase biological fixation of the interfaces between the bone and implant. Furthermore, HA coating is also an effective method of prosthesis surface treatment in order to improve bone ingrowth and enhance the interface shear strength, and the technique of HA coating is an essential factor in processing the prosthesis.

Objective To investigate the characteristic of type 2 diabetes (T2DM) patients with coronary heart disease (CHD),and provide methods for prevention and treatment for patients who suffered from CHD.Methods The hospitalized patients were divided into three groups.The treatment group contains 46 cases who were T2D with CHD;The control group Ⅰ contains 30 cases who were T2DM without CHD;The control group Ⅱ contains 50 cases who were CHD without T2DM.Their ordinary circumstances were compared;the blood sugar,BP,TC,TG,HDL,LDL,HbA1c,C-P,Ins were measured.Insulin sensitive index(ISI) was calculated.Results Three groups had obvious statistical differences in BP,TC,LDL-C,ISI,HbA1 c.Diabetic patients with CHD have more common with three lesions.Conclusion In the clinical job,the composite observation should be strengthened and treatment because the factors of atherosclerosis in T2DM patients were numerous and complex.

ObjectiveTo define the high intraarterial signals on conventional MRI. Methods Review the conventional MRI data in all of the acute ischemic stroke patients in the First Affiliated Hospital,School of Medicine, Zhejiang University from January 2010 to December 2010. ResultsIn year 2010,according to the diagnostic criteria of China, there were 280 cases of acute cerebral infarction, all underwent conventional MRI. Twenty six patients (9. 29％ ) showed high intraarterial signals on conventional MRI.There were 14 cases with high signals in the anterior circulation, including 11 cases in the carotid artery, 2 cases in the anterior cerebral artery, and 1 case in the middle cerebral artery combined with the anterior cerebral artery. In the 11 patients with high signals in the carotid artery, MRA confirmed 14 internal carotid arteries stenosis, with 100％ specificity and 78.6％ sensitivity. There were 12 cases with high signals in the posterior circulation, including 5 cases in the vertebral artery, 3 cases in the basilar artery, and 4 cases in the basilar artery with vertebral artery. One patient did not undergo MRA. MRA confirmed 14 arteries with stenosis, with 100％ specificity and 78.5％ sensitivity. ConclusionsIntravascular high signals showed by conventional MR sequences have high clinical specificity, and its vascular lesions are consistent with the results of MRA.

Objective To systematically evaluate the efficacy and safety of injected hemocoagulase Agkistrodon for intraoperative bleeding.Methods We electronically searched several Chinese database till May 2014 to identify randomized controlled trials (RCTs) about injected hemocoagulase Agkistrodon for operative hemorrhage.The methodological quality of included RCTs was assessed,and the data were extracted by two reviewers independently according to the Cochrane Handbook.The homogeneous RCTs were pooled using RevMan software (Version 5.1.0).Results 2 358 articles were searched initially,and 12 RCTs involving 1 031 patients met the inclusion criteria.The results of Meta-analyses showed that:in the study groups,the average haemostatic time of the wound is shorter [OR =-40.29,95％ CI(-71.13,-9.44),P =0.01],the hemorrhagic volume of the wound [OR =-1.38,95％ CI(-1.90,-0.87),P ＜ 0.000 01],hemorrhagic volume per unit area of the wound [OR =-0.05,95％ CI(-0.06,-0.03),P ＜ 0.00001],introperative hemorrhagic volume and drainage volume on POD1 [OR =-18.52,95％ CI (-25.50,-11.53),P ＜ 0.000 01] are lower than the placebo groups.In all studies,no difference was found in the variation of hemostatic function,liver and renal function and drug-induced adverse events.Conclusions The injection of hemocoagulase Agkistrodon can significantly reduce the average haemostatic time of the wound,the hemorrhagic volume of the wound,overall introperative hemorrhagic volume and drainage volume on POD1,and does not affect the hemostatic function,liver and renal function and not increase the incidence of adverse effects or postoperative complications.

Objective To evaluate the effects of peptide-based enteral nutrition (PBEN) on inflammatory response and immune function in rats with intestinal mucositis.Methods 48 Sprague-Dawley male rats were randomly divided into 6 groups (all n =8):basal feed group (BFG),PBEN group (PBENG),intact protein enteral nutrition group (IPENG),methotrexate (MTX) + BFG,MTX + PBENG,and MTX + IPENG.The rats in MTX + BFG,MTX + PENG,and MTX + IPENG were intraperitoneal injected with MTX 10 mg/kg on day 0 and day 6 to induce sustained intestinal injury.From day 1,BFG and MTX + BFG were fed with basal feed,PBENG and MTX + PBENG with PBEN,IPENG and MTX + IPENG with IPEN.The daily energy intake of each rat was 1.80 kJ/g body weight.All the rats were sacrificed on day 11.The pathological changes of intestinal tissue were observed with HE staining,the levels of tissue myeloperoxidase (MPO),nitric oxide (NO),inducible nitric oxide synthase (iNOS),the thymus index and spleen gland index of intestinal tissue were measured using colorimetry,and the serum levels of immunoglobulins IgG,IgA,and IgM were determined with enzyme-linked immunosorbent assay.Results There were no significant differences among BFG,PBENG,and IPENG in each index.Serious injury of intestinal mucosa was observed in MTX groups.Significant differences were noted in all indexes between MTX + BFG and BFG (all P ＜0.05).The mucosal damage score (Chiu score) and the level of MPO and iNOS in MTX + PBENG were significantly lower than those in MTX + BFG [2.3 ± 0.69vs.2.96 ± 0.75,P =0.003 ; (2.30 ± 0.42) U/g tissue vs.(2.98 ± 0.23) U/g tissue,P =0.040 ; (0.37 ±0.06) U/mg prot vs.(0.44 ±0.10) U/rag prot,P =0.030] ; the serum levels of IgG and IgA were significantly higher than those in MTX + BFG (P =0.015,P =0.021) ; however,the levels of NO and IgM were not significantly different between the 2 groups (P =0.597,P =0.160).There were no statistically significant differences between MTX + IPENG and MTX + BFG in terms of the indexes (all P ＞ 0.05).Conclusion PBEN can reduce the inflammation response and improve the immune function in intestinal mucositis rat.

Objective:To study dynamic change of brain natriuretic peptide (BNP),left ventricular ejection fraction (LVEF)and prognosis improvement in patients with acute anterior myocardial infarction (AAMI)complicated hy-poxemia after noninvasive mechanical ventilation therapy.Methods:A total of 60 patients with AAMI complicated hypoxemia,who were hospitalized in our hospital from Mar 2011 to Oct 2013,were divided into noninvasive venti-lation group (n=28)and routine treatment group (n=32)according to number table.Dynamic change of BNP, LVEF and prognosis were observed and compared between two groups.Results:After treatment,BNP level and LVEF significantly improved in both groups (P<0.05 all),compared with routine treatment group,there was more significant reduction in BNP level [24h:(263.6±23.3)μmol/L vs.(126.2±21.9)μmol/L]and significant rise in LVEF [(40.6±13.1)% vs.(47.3±14.7)%]in noninvasive ventilation group after treatment (P<0.01 both);af-ter 30d follow-up,there were significant rise in 6min walking distance (percentage of 426~550m,59.3% vs. 75.0%),LVEF [(41.1±11.7)% vs.(49.4±12.5)%]and survival rate (90.6% vs.96.4%),and significant re-duction in rehospitalization rate (12.5% vs.7.1%)in noninvasive ventilation group,P<0.01 all.Conclusion:Ear-ly noninvasive mechanical ventilation therapy can significantly improve cardiac function,exercise tolerance and short-term prognosis in patients with acute anterior myocardial infarction complicated hypoxemia.

Objective To study the change rule of serum brain natriurectic peptide (BNP)and uric acid(UA)in the patients with heart failure and its clinical significance.Methods Serum BNP and UA levels in 84 patients with heart failure (observation group)and 30 controls were determined and the detection results were performed the comparative analysis.Results The serum BNP and UA levels in the observation group were significantly higher than those in control group with statistical difference between them(P <0.05),the serum BNP and UA levels were in turn progressively incereased as the cardiac function deterioration from NY-HA Ⅱ to NYHA Ⅳ,the differences from each other had statistical significance (P<0.05).The correlation analysis found that ser-um BNP level had good positive correlation with the cardiac functional grading,at the same time,serum UA level was also positively correlated with the cardiac failure severity.The further analysis found that serum BNP level in the acute left heart failure was sig-nificantly higher than that in the chronic heart failure and serum UA level also had the same results(P <0.05),serum BNP level in the left heart failure relief was significantly decreased and serum UA level was also significantly decreased.Conclusion Serum BNP and UA levels are correlated with the heart failure severity.Dynamic monitoring serum BNP and UA levels in the patients with heart failure is helpful to judge the heart failure severity.

Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia.Methods One hundred and fifty-five patients,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 20-30 kg/m2,scheduled for elective craniofacial surgery,were included in the study.Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery.The patients were divided into 2 groups according to whether or not myalgia occurred within 24.h after surgery:myalgia group and non-myalgia group.Factors including gender,age,body weight,duration of surgery,method of anesthesia,dose of succinylcholine,preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia,use of hormone (dexamethasone or methylprednisolone) and nonsteroidal analgesics (parecoxib sodium) during surgery,and consumption of fentanyl were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia.Results Forty-one patients developed postoperative myalgia,and the incidence of myalgia was 27.2％.The results of logistic analysis indicated that succinylcholine ＜ 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine.Conclusion Succinylcholine＜1.5 mg/kg and no preinjection of lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.

Objective To investigate the clinical efficacy of drug-eluting stent( DES) combined with clopi-dogrel therapy in patients with coronary heart disease. Methods 123 patients underwent percutaneous coronary intervention (PCI) were randomly divided into observation group (DES) of 60 cases and the control group ( bare-metal stent,BMS) of 63 cases. The observation group was given the treatment of DES combined clopidogrel, the control group was given the treatment of BMS combined clopidogrel. The stent implantation and the follow-up two-year MACE were observed. Results (1) The average implanted stent length of the observation group was longer than that of the control group(P<(0.05) ,the angiography in vascular disease and complexity between the two groups had no significant difference ( P > 0. 05 ) ; the success rate of surgery in the two groups was 100% , after operation the TIMI flow reached grade 3. (2) The incidence of angina pectoris and revascularization rate of the observation group was significantly lower than that of the control group (P < 0.05); the rate of coronary angiography, recurrent myocardial infarction and the incidence of cardiac death between the two groups had no significant difference ( P > 0.05). Conclusion DES combined with clopidogrel maintenance therapy for a year in patients with coronary heart disease had a good long-term efficacy.