Objective:To investigate the value of myocardial velocity gradient(MVG) in diagnosis of myocardial ischemia.Methods:Thirty-eight patients with coronary artery disease and twenty-eight healthy volunteers were enrolled in this study,MVG-L+ in systolic stage and MVG-L-in diastolic stage were measured from apical four chamber and two chamber view.Results:In normal group,MVG-L+ and MVG-L-was slightly different among basal,middle and apical segments of left ventricular wall,which was no statistical difference.Compared with normal group,MVG-L+ and MVG-L-measured from myocardial ischemia group significantly decreased.Conclusion:MVG can quantitatively analyze the motional state of regional myocardium,alternatively providing an effective index of evaluating cardiac function in coronary artery disease.

Objective To investigate the relationship between blood uric acid and insulin resistance in the patients with GDM.Methods The various biochemical parameters such as uric acid ( UA),fasting plasma glucose (FPG),fasting insulin(FINS) and insulin resistance index(IRI) were detected in 80 patients with GDM and 40 normal pregnant women.80 patients with GDM were divided into A group ( hyperuricemia,UA ＞ 360 μmol/L,31 cases ) and B group (normouricemia,49 cases ) to observe and compare the changes of each biochemical parameter.Results Compared to the control group,there were significant differences in FPG [ (7.87 ± 0.69 ) mmol/L,t =17.0842 ],UA [ ( 308.87 ± 79.12) μmol/L,t =2.1758 ],FINS [ ( 15.87 ± 5.12 ) mU/L,t =3.5410 ] and IRI [ (2.27 ±0.72),t =7.1247] (all P ＜0.05).There were significant differences in FPG(8.38 ± 0.46) mmol/L,TG ( 373.97 ± 29.12 ) μmol/L,FINS ( 15.87 ± 5.12 ) mU/L,IRI ( 2.47 ± 0.12 ) between group A and group B ( t =5.7187,12.3116,2.3185,11.2835,all P ＜ 0.05 ).The blood uric acid level was positively related to FINS,IRI,TG in the patients with GDM( r =0.839,0.720,0.660,all P ＜ 0.05 ).Conclusion There was correlation between the blood uric acid level and insulin resistance in the patients with GDM.

Objective To summarize the clinical experience of serious hyponatremia resulted from applying pitnitrin to massive hemorrhage of gastrointestinal tract patients.Methods we used pitritrion on 2460 such patients and examined some symptoms of the digestive tract and nerve system,monitoring the dynamic state of blood sodium.Results The re- suits reveal that patients in 30 cases turned out to suffer from serious hyponatremia,whese sodium in the serum appeared less than 110 mmol/L,which was 1.22% of the rest subjects'.The relevant symptoms included nausea,vomit,spoor,coma and twitch etc.Following remedies included liquid supply with a high-concentrated sodium,ceasing using pituitrin,in- take of salute foods,and dynamic monitoring on the state of sodium in the serum.All patients recovered in 1 to 3 days without a single failure.Conclusion Thus we reach this conclusion:When applying pituitrin to massive hemorrhage of gastrointestinal tract patients,the above mentioned symptoms should be closely examined,and blood sodium should be timely monitored so that proper treatment should arrive in time.

Objective To evaluate the clinical application of HLA matching in highly sensitized recipients of renal allografts.Methods Recipient's panel reactive antibody (PRA) was detected by using ELISA test with Lambda antigen tray (LAT).Donor and recipient HLA classⅠtyping was performed with special monoclonal tray,and HLA classⅡgene typing with micro-sequence specific primers (Micro-SSP).Results There were 104 recipients with anti-HLA class-ⅠIgG antibody,76 with anti-HLA class-ⅡIgG antibody,and 44 with both anti-HLA class-1 and anti HLA class-ⅡIgG antibody respectively in 136 sensitized recipients.HLA class-ⅠIgG antibody positive rate was 11%-97 %,with an average of 49.6%?23.8%;The common public epitopes antibody was not found in each recipient of 13 cases with PRA＜20%,but was found in I2 recipients in 44 cases with PRA be- tween 20%-50%,and 39 recipients in 47 cases with PRA＞50%.HLA class-ⅡIgG antibody posi- tive rate was 17%-100%,with an average of 28.2%?63.8%.The number of cases of 0,1,2,3, 4 MM was 7 (5.1%),26 (19.1%),47 (34.6%),39 (28.7%) and 17 (12.5%) respectively by the standard of conventional HLA antigen matching;however the number of the recipients with 0,1, 2,3 MM was 31 (22.8%),53 (39.0%),36 (26.5%) and 16 (11.7%) respectively according to the rule of HLA CREGs matching and none with 4 MM.Rates of acute rejection in sensitized recipi- ents with 2MM and 3MM HLA-CREGs were 25.0% and 37.5% respectively and were significantly higher than those with 0MM (P＜0.05,＜0.05 respectively).Kidney year-survival was decreased when the number of MM of HLA CREGs matching increased.Conclusion The HLA CREGs matching can improve the ratio of well-matched significantly.Good HLA matching can reduce the incidence of acute rejection in sensitized recipients and increase the survival rate of grafts.

Objective To investigate the plasma visfatin levels and explore the relationship between visfatin and anthropometric parameters,glucose,lipid profile,insulin sensitivity index and insulin secretion index in the subjects with different glucose tolerances.Methods Fifty-three patients with newly diagonosed type 2 diabetes(T2DM),7 subjects with impaired glucose tolerance(IGT)and 35 healthy controls were enrolled.Visfatin levels were measured along with the BMI,blood pressure,lipids,glucose,insulin and HOMA-IR indexes.Results Plasma visfatin levels were elevated in patients with newly diagnosed T2DM compared with IGT group or controls.There was no significant difference in the visfatin levels between IGT group and healthy controls.Plasma visfatin level was positively correlated with glucose levels and HOMA-IR,and negatively correlated with insulin secretion index(HOMA-B).Multiple regression analysis showed that postprandial plasma glucose was independent related factor influencing plasma visfatin levels.In T2DM group,plasma visfatin concentration was positively correlated with HbA1c level.Conclusion The increased plasma visfatin concentration in newly diagnosed and untreated type 2 diabetes mellitus represents a compensatory mechanism aimed at ameliorating the functional consequences of insulin deficiency.

Objective To realize the feature of drug resistance in elderly inpatients with tuberculosis in Tianjin. Methods The data of anti-tuberculosis drug sensitivity test of 296 elderly inpatients in Tianjin Haihe Hospital were collected from January 2008 to September 2009. And they were retrospectively analyzed compared with the non-elderly tuberculosis inpatients in the same period.Results (1)The 296 elderly patients with pulmonary tuberculosis were enrolled in this study. The total rate of drug resistance was 28.7% and total rate of multi-drug resistance was 8.8 %. The initial drug resistance rate was 22.2% and initial multi-drug resistance rate was 6.1%. The acquired drug resistance rate was 41.8% and acquired multi-drug resistance rate was 14.3%. (2)The order of drug resistance rate from high to low was isoniazid, streptomycin, rifampin and ethambutal, respectively.(3) The drug resistance rate did not show significant difference among different sex groups (x2 =0. 002, P＞0. 05). (4)The drug resistance rate and multi-drug resistance rate between elderly patients and non-elderly patients had significant differences (x2 = 10.8, 5.24, both P＜0.05). Conclusions The proportion of elderly patients with pulmonary tuberculosis is high, however, its drug resistance rate and multi-drug resistance rate are much lower than non-elderlies.

Objective To explore the role of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in hyperoxia-induced lung injury in preterm rats. Methods At the 2 nd postnatal day Sprague-Dawley preterm rats were randomly assigned to air group and hyperoxia group (exposed to about 85% of O 2). At 3,7,14 and 21 days after exposure, six rats of each group were used to assess lung histologic changes and expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 in lungs by immunohistochemistry. At 3,7 and 14 days after exposure, gelatinase activity in bronchoalveolar lavage fluid (BALF) of another six rats in each group by gelatin zymography was examed. Results Except 3 d after exposure, hyperoxia group showed lung injury characterized by subacute alveolitis and inhibition of lung development. Expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 in hyperoxia group was stronger than that in air group at every time (P

OBJECTIVE：To compare the effect and adverse reactions of clarithromycin(Limaixian，CT)with those of erythromycin(ET)in treating respiratory tract mycoplasmal infections of children.METHODS：98 patients were randomly divided into CT group(56 cases)and ET group(42 cases)，CT in oral dosage of 20mg/(kg.d)and ET in iv dosage of 30～40mg/(kg· d)were given respectively.RESULTS：The curative rate，effective rate and clearance of mycoplasma of CT group were higher than those of ET group with significant differences(P<0.05).The adverse reactions induced by oral CT were less than those by iv infused ET(P<0.01).CONCLUSION： Oral CT shows satisfactory therapeutic effect， less adverse reactions and can effectively clear away mycoplasma in treatment of respiratory tract mycoplasmal infections of childhood.

Objective To investigate the effect of adenosine on pulmonary injury after extracorporeal circulation. Methods Twelve mongrel dogs were randomly divided into two groups, the test group and control group. The model of extracorporeal circulation was established. In the test group and control group, adenosine(50μg/kg*min) and normal saline were infused before extracorporeal circulation respectively. Hemodynamics, right cardiac function and arterial blood gas were assessed. Lung water and malondialdehyde content were assessed. Histological evaluation was also made. Results　There were no differences between the two groups with respect to heart rate, mean systemic artery pressure, left atrial pressure, and central venous pressure. In the test group, pulmonary vascular resistance was lower and right cardiac function improved remarkably; arterial oxygen pressure (PaO2) was also higher, less lung water was observed and the malondialdehyde content in the pulmonary tissue was lower (P＜0.05,P＜0.01). Histological evaluation of the test group revealed normal pulmonary architecture without abundant intra-alveolar neutrophils. Conclusion Adenosine can attenuate ischemia-reperfusion lung injury and right cardiac insufficiency caused by extracorporeal circulation. At a proper dose, there was no significant effect on systemic hemodynamics.

Objective To investigate the relationship between day and night regularity of asymptomatic ventricular presystole (VPS) and the activity of autonomic nervous system and its clinical significance Methods Thirty children with the absence of underlying organic heart disease were examined with 24 hour dynamic electrocardiogram (DCG), the function of autonomic nervous system and ventricular late potentials (VLP) Results The rate (43%, 13/30) was the day type VPS, 12 out of the 13 resulted from increased activity of sympathetic nerve The rate (30%, 10/30) was the night type VPS, all of them resulted from the activity of the vagus nerve enhanced There was a positive correlation between VPS frequency of day type and heart rate ( r =0 67, P