Objective To analyze the influence of atrial fibrillation(AF) on N‐terminal pro‐brain natriuretic peptide(NT‐proB‐NP) for the assist diagnosis of acute heart failure(AHF) .Methods Totally 457 inpatients with suspected AHF due to acute dysp‐nea and conducting blood NT‐proBNP detection and electrocardiogram(ECG) within 24 h of admission were collected and devided into groups according to whether AHF was diagnosed and complicated with AF identified by ECG on admission ,that was AHF +AF group ,AHF + non AF group ,non AHF + AF group ,non AHF + non AF group .The receiver operating characteristic (ROC) curve was adopted to evaluate the value of NT‐proBNP for diagnosing AHF .Results Among 457 cases ,194 cases (42 .5% ) were diagnosed as AHF and 140 cases (42 .5% ) as AF .The NT‐proBNP level in the AF group was significantly higher than that in the non AF group (4 482 .0 pg/mL vs .1 302 .0 pg/mL ,P < 0 .01) .The NT‐proBNP level had no statistical difference between the AHF + AF group and the AHF + non AF group AF(6 580 .0 pg/mL vs .6 769 .0 pg/mL ,P> 0 .05) .The NT‐proBNP level in the non AHF + AF group was significantly increased compared with the non AHF + non AF group (403 .3 pg/mL vs .2 892 .0 pg/mL ,P< 0 .01) .The area under the curve(AUC) of NT‐proBNP for diagnosing AHF in the AF group and the non AF group was 0 .759(95% CI :0 .677 - 0 .841 ,P < 0 .01) and 0 .931(95% CI :0 .903 - 0 .985 ,P < 0 .01) .Conclusion The NT‐proBNP level in AF patients without AHF is significantly increased ,which might affect the value of NT‐proBNP in the diagnosis of AHF .In the clinical applica‐tion ,whether the patient has AF cardiac rhythm should be paid attention to for better interpretating the detection result of NT‐proBNP .

Mesenchymal stem cells(MSCs), which can be introduced in brain tissue by the strategies of brain parenchyma, blood and neurolymph transplantation, to repair tissue injury and promote functional recovery of neural system, have been considered as the ideal seed cells for the treatment of central nervous system diseases. However, as the special structure exists in the blood-brain barrier, study on correlation between MSCs and blood-brain barrier permeability will make it possible for more MSCs to pass the barrier to perform the treatment. This paper gives a review on the latest research development in the field.

Objective To investigate the difference and the correlation of the vowel's phonation threshold pressure and nasalance in normal subjects .Methods The Aeroview (GLOTTAL Enterprises)with the materials /pa/,/pi/,/pu/ was used to obtain phonation threshold pressure values and The NasalviewTM (Tiger Electronics Inc .,Seattle ,Shanghai) with the materials /a/,/i/,/u/was used to obtain nasalance values .A total of 30 subjects (15 males ,15 females ,and aged 19~30) years old received the tests .The results of the vowel's phonation threshold pressure and nasalance gender score difference were compared .Results The PTP gender scores of /a/,/i/,/u/in maleswere4.53±0.70cm,5.21±0.80cm,5.87±1.45cm,andinfemaleswere4.09±0.30cm,4.47±0.30cm, and 4 .77 ± 0 .32 cm ,respectively .There were significant differences between males and females in PTP values (P<0 .05) .The PTP gender score differences showed that males were greater than that of females .There were signifi‐cant differences in different vowels (P<0 .05) .The nasalance gender scores of /a/,/i/,/u/in males were 30 .2 ± 5 . 75% ,38 .8 ± 8 .54% ,26 .5 ± 6 .03% ,and in females w ere32 .4 ± 7 .14% ,40 .5 ± 11 .8% ,and 30 .1 ± 4 .83% ,respec‐tively .There were no significant differences between males and females in nasalance values (P> 0 .05) .The na‐salance gender score differences showed that females were greater than males .There were significant differences in different vowels(P<0 .05) .This study found a weak correlation between PTP and nasalance .Conclusion The relationship between oral pressure and nasal flow cannot be accurately measured by measuring PTP ,and /pa/is a relatively suit‐able material for testing oral pressure .

Objective To evaluate the effects of different concentrations of hydroxyethyl starch (HES) 130/0.4 applied for different time periods on injury to human renal tubular epithelial cells.Methods Human renal kidney epithelial cells HK-2 at the logarithmic growth phase were seeded in 96-well plates at a density of 1 × 105 cells/ml (0.1 ml/well),in culture flasks (5 ml/flask) or in cluture dishes (5 ml/dish).HK-2 cells were randomly divided into 4 groups (n=49 each) using a random number table:control group (group C) and 0.3％,1.5％ and 3.0％ HES 130/0.4 groups (H1,H2 and H3 groups).In H1,H2 and H3 groups,HK-2 cells were incubated with 0.3％,1.5％ and 3.0％ HES 130/0.4,respectively.The equal volume of PBS was added to the culture medium in group C.At day 1,3,5 and 7 of incubation,the cell viability was measured.At day 3,5 and 7 of incubation,cell apoptosis was detected,and apoptosis rate was calculated.On day 7 of incubation,the cells were stained with toluidine blue for examination of intracellular HES deposition (under light microscope) and pathological changes (with transmission electron microscope).Results Compared with group C,the cell viability was significantly decreased on day 5 and 7 of incubation,and apoptosis rate was increased on day 3,5 and 7 of incubation in group H3,and no significant difference was detected in the parameters mentioned above in H1 and H2 groups.Microscopic examination showed that intracellular HES deposition was observed in H2 and H3 groups,and pathological changes were obvious,and apoptotic cells were also found in H3 group.Conclusion Application of high-concentration HES 130/0.4 for a long period can lead to injury to human renal tubular epithelial cells,however,application of high-or low-concentration HES 130/0.4 for a short period produces no influence on the cells.

Objective To summarize extracorporeal membrane oxygenation (ECMO) in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) with cardiac arrest,and to evaluate the clinical efficacy comparing with literature review.Methods 5 patients of AMI with cardiac arrest who proved invalid to conventional cardio-pulmonaryresuscitation (CPR),were successfully resuscitated with ECMO support,and underwent emergency PCI with stable hemodynamic status.Results In support of ECMO,4 patients were successfully resuscitated with stable hemodynamic status,and underwent primary PCI.The duration of ECMO support ranged from 42 to 220 h (average 126.6 h).3 patients discharged with full recovery,one patient didn't wean from ECMO successfully,and one died of respiratory failure.Conclusion Although mortality of AMI with cardiac arrest is high,early ECMO-assisted cardiopulmonary resuscitation and secondary PCI treatment increase the possibility of cardiac recovery,and provide conditions for emergency revascularization treatment.This reduces mortality in critical patients with AMI,and is an effective short term life support method.

BACKGROUND:COX-2 gene actual y exists in the joint fibroblast-like synoviocytes, it affects osteoarthritis occurrence and development. Understanding the differences of COX-2 gene expression levels at different stages of osteoarthritis synoviocytes has important theoretical significance for the occurrence and development of osteoarthritis, as wel as the role of synoviocytes in this process.
OBJECTIVE:To analyze the difference of COX-2 mRNA at different stages of osteoarthritis fibroblast-like synoviocytes.
METHODS:Synovial membrane from 44 osteoarthritis patients and 12 normal cases were selected. Primary cells were cultured to passage 4 fibroblast-like synoviocytes for the use in the experiment. COX-2 mRNA expression in osteoarthritis fibroblast-like synoviocytes and normal fibroblast-like synoviocytes was detected using real-time fluorescence quantitative RT-PCR. The relative quantitative analysis was performed using 2-ΔΔCt method.
RESULTS AND CONCLUSION:Expression of COX-2 mRNA in osteoarthritis fibroblast-like synoviocytes was significantly higher than that in normal fibroblast-like synoviocytes (P<0.05). The expression levels reached a peak at early osteoarthritis group, with significant differences compared with middle and late osteoarthritis groups (P<0.05). There was no significant difference between middle and later osteoarthritis groups (P>0.05). COX-2 mRNA might be important biological marker for the inflammation in osteoarthritis, and mainly plays a role in early osteoarthritis stage.

Objective To investigate the expression of interleukin (IL)-34/colony stimulating factor(CSF)-1R in the process of transforming growth factor ( TGF)-β1 inducing epithelial-mesenchymal transition ( EMT) of human alveolar epithelial cells A549 cells.Methods A549 cells were cultured in vitro.CCK 8 was used to test the influence of the proliferative rate of A549 cells which were stimulated by TGF-β1 at different concentrations and time points .A549 cells were stimulated by 5μg/L TGF-β1 at 0 hour, the 12th hour, the 24th hour, and the 48th hour.Western blotting was adopted to detect changes of the following proteins: α-smooth muscle actin (α-SMA ) , E-cadherin ( E-Cad ) , matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1). Real-time PCR was adopted to detect changes of the following genes: IL-34 mRNA, CSF-1R mRNA, MMP-2 mRNA and MMP-9 mRNA.Results TGF-β1 had no significant influence in the proliferation of A 549 cells compared with the control group(P>0.05).TGF-β1(5μg/L)stimulated A549 cells at different time point (0 hour, 12, 24, 48 hours), compared with the control group .The epithelial phenotype E-Cad protein was gradually down-regulated ( P <0.01 ) , while the mesenchymal phenotype α-SMA protein was gradually up-regulated ( P <0.01 ) and the protein of MMP-2 increased gradually (P<0.01).The protein of MMP-9 increased firstly and then was reduced (P<0.01),the peak was at the 24th hour.The protein of TIMP-1 was firstly transiently increased and then reduced (P<0.01), the minimum was at the 48th hour.Compared with the control group , the gene of IL-34 mRNA increased gradually (P<0.01), and the genes of CSF-1R mRNA, MMP-2 mRNA and MMP-9 mRNA increased firstly and then decreased ( P <0.01), which were peaked respectively at the 24th hour, the 24th hour, the 12th hour, respectively.Conclusion In the process of TGF-β1 inducing A549 cells transition,there is accompanied with the expression of IL-34/CSF-1R.

BACKGROUND:Cortical electrical stimulation has achieved good effects in treatment of stroke through animal and clinical experiments.
OBJECTIVE:To observe the effects of a ful y implanted cortical electrical stimulation device with long time, low intensity and various frequencies stimulation protocols on the neurological function recovery in a rat model of local cerebral infarction.
METHODS:The cerebral infarction model was established through middle cerebral artery occlusion in 60 Sprague-Dawley adult male rats. Forty rats with 1-3 points by Bederson scale were detected with magnetic resonance imaging, which was used to confirm cortex infarction and to identify a location for implantation of stimulating electrode over the peri-infarct cortex. Twenty-three rats with cortex infarction were randomly divided into cortical electrical stimulation group (CES group, n=13) and no stimulation group (NS group;n=10). The device was implanted on 6 days after middle cerebral artery occlusion, and the stimulation was given for 16 days. The stimulation program consists of two sessions lasting half an hour each in the morning and in the afternoon respectively. Stimulator delivered biphasic charge balanced pulses (pulse width=200μs) with various frequencies of 50 Hz, 20 Hz and 5 Hz within 10 second blocks and then repeated. The rats of NS group were implanted with the device, but received no electrical stimulation. The behavioral tests, includingforelimb use asymmetry test and foot fault test were performed at 2 and 16 days after implantation. Final y, al of the devices were taken out to test if they were normal y working and al of the rats were sacrificed for hematoxylin-eosin staining, which can reflect the structure of peri-infarct cortex and cellmorphology.
RESULTS AND CONCLUSION:There was only one stimulator in CES group cannot normal y work, and the remaining 22 ones worked wel . The skin covered the implanted stimulator was slightly ulcerated in one rat, and the incisions of the other rats were healed wel . Hematoxylin-eosin staining showed clear and intact structure in peri-infarction cortex (i.e., electrodes were implanted at the cortex), neurons arranged in neat rows, with abundant neuronal cytoplasm and clear nucleolus. The glial cells have complete structures, and there was no edema in the intercellular spaces. Foot-fault and forelimb use asymmetry tests showed the improved neurological function in rats of CES group than that of NS group. We designed a ful-implanted cortical electrical stimulator used in cerebral ischemic rats, and established an implanted method with long time, low intensity and various frequencies pulsed electrical stimulation. The results indicated the stimulation pattern in our study is safe and effective, and it can significantly promote functional recovery in local cerebral infarction rats.

Objective To evaluate the effect of ultra-low dose naloxone on postoperative hyperalgesia caused by large-dose remifentanil.Methods Forty ASA Ⅰ-Ⅲ adult patients,scheduled for gastrointestinal surgery,were randomly assigned into 2 groups (n =20 each):large dose remifentail group (group R) and ultra-low dose naloxone group (group N).Anesthesia was induced with iv injection of remifentanil,propofol and cisatracurium and maintained with inhalation of sevoflurane and infusion of remifentanil.The patients were tracheal intubated and mechanically ventilated.In group R,remifentanil was infused at a rate of 0.25 μg· kg-1 · min-1 starting from the beginning of skin incision.The infusion rate was adjusted according to hemodynamics during operation and subsequently increased/decreased by 0.05 μg· kg-1· min-1 each time.In group N,naloxone was infused at 0.1 μg·kg-1· h-1 while infusing remifentanil,naloxone infusion was stopped at the beginning of peritoneum closure and the other treatments were similar to those previously described in group R.All patients were sent to post-anesthesia care unit after surgery and stayed there for 90 min.Morphine was given when need.The patient-controlled intravenous analgesia was used for postoperative analgesia after leaving post-anesthesia care unit.The first pain time was calculated.The morphine consumption and complications such as nausea,vomiting and pruritus were recorded at 15,30,60 and 90 min and 2,6,24,48 and 72 h after surgery.Results Compared with group R,the morphine consumption was significantly reduced at each time point after surgery,the first pain time was prolonged,and incidence of nausea was decreased (P ＜ 0.05),while no significant change was found in the incidence of vomiting and prutirus in group N (P ＞ 0.05).Conclusion Infusing ultra-low dose naloxone (0.1μg· kg-1 ·h-1) during operation can attenuate postoperative hyperalgesia caused by large-dose remifentanil in patients.

Objective To analyze the usual death causes of cardiovascular disease and the differences in gender and age .Methods By adopting the retrospective study method ,the clinical data of death cases in cardiovascular disease were collected and analyze on the situation suffering from cardiovascular disease ,direct death causes ,gender and age difference .Results (1) among 181 cases of cardiovascular disease death ,coronary heart disease(115/181 ,64% ) and hypertension(96/181 ,53% ) were the most common dis-ease ,lung infection(104/181 ,57% ) was the most common complication ;(2)There was no significant difference in the situation suf-fering from basic diseases between male and female(P>0 .05);(3)The basic diseases in cardiovascular death cases aged over 60 years old were dominated by coronary heart disease and hypertension ;the proportion of complicating pulmonary infection was grad-ually increased with age increase ;(4) in the direct death causes ,the top 3 places were sudden cardiac death (44/181 ,24 .3% ) ,multi-ple organ dysfunction syndrome(24/181 ,13 .3% ) and cardiogenic shock(24/181 ,13 .3% ) .Conclusion Strengthening the manage-ment of diagnosis and treatment on elderly patients with coronary heart disease ,hypertension ,especially those complicating diabe-tes ,strengthening the treatment intervention of lung infection in cardiovascular disease population and conducting the emphasis pro-tection on the target organ function may reduce the mortality of cardiovascular inpatients .