Objective To study the relationship between red cell distribution width (RDW ) and short-term outcomes in acute coronary syndrome (ACS) patients .Methods A totoal of 1654 ACS patients were divided into RDW ≤12 .1% group(n=419) ,RDW=12 .2% -12 .8% group(n=364) ,RDW=12 .9% -13 .2% group (n= 463) and RDW ≥13 .3% group (n= 408) .Their bio-chemical indicators and incidence of 1-month cardiac death ,heart failure ,recurrent myocardiac in-farction were compared .Relationship between RDW and 1-month adverse cardiac events was as-sessed .Results The incidence of cardiac death ,heart failure ,recurrent myocardiac infarction in-creased with the increasing RDW .Logistic regression analysis showed that RDW ,BNP>100 ng/L and LVEF< 40% were the independent risk factors for 1-month cardiac death in ACS patients (OR=2 .116 ,95% C I:1 .427-3 .137 ,P=0 .000;OR=3 .510 ,95% C I:1 .221 -10 .093 ,P=0 .020 ;OR= 4 .149 ,95% CI:2 .001 -8 .602 ,P= 0 .000 ) ,and that RDW ,age> 65 years ,diabetes and LVEF<40% were the independent risk factors for 1-month heart failure and recurrent myocardi-ac infarction in ACS patients (OR= 2 .134 ,95% CI:1 .602 -2 .844 ,P= 0 .000 ,OR= 2 .010 , 95% C I:1 .135 -3 .560 ,P=0 .017 ;OR=2 .279 ,95% C I:1 .345 -3 .862 ,P= 0 .002 ;OR=5 .009 , 95% CI:2.694-9 .316 ,P=0 .000) .Conclusion RDW is an independent risk factor for the short-term outcomes in ACS patients .

Beta blocker can be categorized by non-selective agents,selective agents and agents with vasodilatory effect.Beta blocker therapy represents a major advance in the treatment of heart failure patients.The mechanisms include up-regulation of beta receptor,reversing remodeling,improving contractile and diastolic function,antiarrhythmia and anti-ischemia.Evidences from randomized controlled clinical trials have supported its use in the treatment of patients with heart failure to decrease mortality and improve life quality.Guidelines with various versions recommend that ?-blockers are indicated for patients with symptomatic or asymptomatic heart failure and a depressed ejection fraction of lower than 40%.There is something to be noticed for rational use of ?-blockers such as timing,dosage,duration and contraindications.

Objective Elevated plasma homocysteine(Hcy) level has been associated with the increased risk for cardiovascular disease.The level of plasma Hcy is related to methylene tetrahydrofolate reductase(MTHFR) gene C677T polymorphism.The aim of this study is to evaluate the relationships between MTHFR gene C677T polymorphism and hypertension,cardiac structure and function.Methods Genotype of MTHFR gene C677T polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) analysis and decided by electrophoresis and sequencing in 695 patients with essential hypertension and 509 age-matched normal controls.Echocardiography was performed in patients with essential hypertension.Results In hypertension group,the frequencies of TT genotype and T allele were significantly higher than those in control group(26.5% vs 20.6%,48.7% vs 42.4%;P=0.015,0.002).The essential hypertension odds ratio(OR) associated with MTHFR 677T allele was 1.300(95%CI:1.166 to 1.450).Logistic regression analysis indicated that MTHFR gene C677T polymorphism was an independent variable of hypertension(P=0.027).End diastolic dimension(EDD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass(LVM) and left ventricular mass index(LVMI) were higher in hypertensive patients with T allele than that in those with CC genotype,but all had no statistical significance(P=0.428,0.118,0.064,0.077,0.054).Conclusion The 677T allele in MTHFR gene may be a risk factor for hypertension.Hypertensive patients with MTHFR 677T had a trend of hypertrophy,but the relationship has no statistical significance.The relationship between MTHFR gene C677T polymorphism and left ventricular hypertrophy need to be further studied.

Objective To assess whether urapidil (anα1 receptor blocker)is more effective than ni-troglycerin in treatment of non-valvular heart failure accompanying hypertension and diabetes mellitus (DM ) in elderly female patients .Methods Fourty-six elderly female patients with non-valvular heart failure accompanying hypertension and DM were randomly divided into urapidil treatment group (n= 24) and nitroglycerin treatment group (n= 22) .Patients in urapidil treat-ment group were treated with urapidil (50 -300 μg/min) and those in nitroglycerin treatment group were treated with nitroglycerin (5 -20 μg/min) for 48 -140 h according to their blood pressure (BP) and cardiac function .Their BP ,HR ,and metabolic activity were observed before and on days 1 ,2 ,3 and 7 after treatment .Results The effect of urapidil was significantly lower than that of nitroglycerin on SBP on day 7 after treatment (P<0 .05) .The serum NT-proBNP level was significantly lower in nitroglycerin treatment group than in control group (P<0 .01) . Conclusion The effect of urapidil is better than that of nitroglycerin on reducing and stabilizing SBP ,attenuating cardiac afterload ,and improving cardiac function in elderly female patients .Ura-pidil can thus be used as one of the first choiced drugs in treatment of elderly female patients with non-valvular heart failure accompanying hypertension and DM .

Objective To study hypoxia environment trophoblast cell autophagy and autophagy of the preeclampsia placental tis-sue .Methods Trophoblastic cell line HTR-8/SVneo were divided into three groups :low oxygen concentration group (group Ⅰand group Ⅱ) and normal oxygen concentration group ;48 h after the application the confocal laser scanning microscopy was used for detection of cytoplasmic autophagosome ,PCR technology analysis of autophagy-related gene expression change of LC3-Ⅱ .LC3-Ⅱ expression levels of 30 cases of preeclampsia placenta were detected by Immunohistochemistry .Results In low oxygen concen-tration group ,there were visible red autophagosome chromatin structure in cytoplasm ,which was extremely rare in the normal oxy-gen concentration group ,in low oxygen concentration group cell LC3-Ⅱ mRNA expression was significantly higher than that of normal concentration group .The preeclampsia placenta of patients with positive immunostaining of LC 3-Ⅱ was 67 .12% ,compared with 9 .14% in the normal control ,there was a significant difference between two groups .Conclusion Preeclampsia placenta auto-phagy activity increased ,hypoxia can induce autophagy trophoblast cell line phenomenon .

The metabolic syndrome,as a group of concurrent cardiovascular risk factors,is attributed to both genetic and environmental causes and correlated with many gene polymorphisms and their mutations,such as adiponectin gene,peroxisome proliferator activated receptor gamma gene,lamin protein A/C gene,uncoupling protein 2 gene,?-adrenic receptor gene and some other inflammation marker genes.This paper reviews the advances in the studies of the gene polymorphisms associated with the metabolic syndrome.

Objective To study the mechanism of reinforcing kidney and activating blood therapy for the apoptosis of endometriosis.Methods Female SD rats aged 8~12weeks were grouped as model group,western medicine group,Chinese medicine group and integrated Chinese and western medicine group,with 15 in each group.The light microscope,electron microscope,TUNEL method,and immunohistochemical method were adopted to observe the pathomorphology,positive rate of apoptotic cells and the positive expression of apoptosis-regulating gene bcl-2 and bax.Results The apoptosis of endometriosis tissues in the integrated Chinese and western medicine group was the most obvious result with the highest apoptosis index,and the positive expression of apoptosis regulating gene bcl-2 was downward regulated and that of apoptosis regulating gene bax upward regulated,so bcl-2/bax decreased.Then it was Chinese medicine group,western medicine group,and model group.Conclusion The occurrence of endometriosis is related with the lowering of ability of apoptotic cells.Chinese medicines with the functions to reinforce kidney and activate blood can promote the ability of apoptotic cells in endometriosis to quicken the atrophy and regression of endometriosis tissues.

Objective To investigate effects of mouse nerve growth factor on serum brain-derived neurotrophic factor, Fibulin-5 and intracranial blood flow in patients with acute cerebral infarction.Methods 98 patients with acute cerebral infarction in our hospital from September 2015 to September 2016 were selected as the research object, divided into observation group and control group, 49 cases in each group.The control group was treated with conventional treatment of acute cerebral infarction, patients in the observation group on the basis of conventional treatment combined with mouse nerve growth factor, Enzyme-linked immunosorbent assay was used to detect serum brain-derived neurotrophic factor, Fibulin-5, Intracranial ultrasonography was used to detect intracranial blood flow, the brain-derived neurotrophic factor, Fibulin-5, cerebral blood flow were compared between the two groups before and after treatment.Results Before treatment, two groups of patients with brain-derived neurotrophic factor (BDNF), Fibulin-5 and hemodynamics, the difference was not statistically significant.After treatment, the levels of BDNF and Fibulin-5 in the observation group were (5.63 ±1.34), (156.63 ±12.79), significantly higher than the control group (4.26 ±1.54), (115.52 ±15.66), the difference was statistically significant ( P<0.05 ) , the observation group of patients with cerebral hemodynamics index , average blood flow ( Qmean ) , the average blood flow velocity (Vmean), dynamic impedance (DR), cerebral vascular characteristic impedance (ZCV), cerebral vascular peripheral resistance (R) were significantly better than the control group, the difference was statistically significant (P<0.05), the prognosis of the observation group was better than that of the control group, the difference was statistically significant ( P<0.05 ) .Conclusion Clinical effect of mouse nerve growth factor on acute cerebral infarction is helpful to promote the growth of nerve function inhibition, improve cerebral blood flow, better prognosis.

Objective To observe the effect of Danshen injection combined with ulinastatin on the brain protection and inflammatory reaction in patients with Severe traumatic brain injury.Methods 83 cases of patient with Severe traumatic brain injury were randomly divided into the observation group(43 cases)and the control group(40 cases).The control group was given ulinastatin based on conventional treatment,and the observation group was given Danshen injection and ulinastatin based on the control group.For 10 days,the differences of hemodynamic parameters(Qmean、Zc、DR)and serum nerve function indexes(β-EP、DynAl-13、NSE),inflammatory factors(IL-1,IL-6,TNF-α,CRP)between the two groups were be compared.Results ①Comparison of hemodynamic parameters There was significantly difference of Qmean、Zc、DR in these two groups(Fgroup=6.126,5.024,5.621,P<0.05),Qmean was showed a rising trend over time and Zc、DR were showed a declining trend over time(Ftime=10.146,9.247,9.381,P<0.05),the changed amplitude in observation group was higher than the control group(Finteraction=5.357,4.257,4.813,P<0.05); Comparison of nerve function indexes There was significantly difference of β-EP、DynAl-13、NSE in these two groups(Fgroup=5.827,6.294,6.731,P<0.05),they was all showed a reducing trend over time(Ftime=12.613,11.746,9.842,P<0.05),the declined amplitude in observation group was higher than the control group(Finteraction=6.353,7.251,4.284,P<0.05);Comparison of inflammatory factors There was significantly difference of IL-1,IL-6,TNF-α,CRP in these two groups(Fgroup=4.284,5.162,6.174,4.291,P<0.05),they was all showed a rising then reducing trend over time(Ftime=9.163,10.357,13.457,12.434,P<0.05),the changed amplitude in observation group was higher than the control group(Finteraction=4.255,5.242,8.530,7.847,P<0.05).Conclusion Danshen injection combined with ulinastatin has more obviously function of protecting the cerebralfunction and suppressing inflammation in the treatment of Severe traumatic brain injury compared with ulinastatin alone.

With improvement in stent designs, the practice of direct stenting (DS) without balloon predilation has become more widespread. DS may allow partial retention of endothelium within treated arteries, and associate with decreased utilization of contrast agent, number of catheter, exposure of X-ray,and expense. This paper evaluate the experiment base, principle, indication, contraindication, skills, complications as well as the result of acute and chronic follow up of DS.