Objective To detect the mutation of A379,we develop a TaqMan fluorogenic probe based amplification refractory mutation system (TaqMan-ARMS) and investigate whether the A379V variant and activity of Lp-PLA2 are the risk factors for CAD.Methods According to the amplification refractory mutation system(ARMS-PCR)combined with a TaqMan fluorogenic probe,we established and evaluated the assay teehnique of TaqMan-ARMS for measuring the genotype of variant.At the same time,we tested the aetivity of Lp-PLA2 in 395 patients with coronary heartdisease and 396 controls,whose clinical information [ages,CHO,GLU,TG,HDL,LDL,Hs-CRP,Lp (a)] were collected.Date was analyzed by using Independent-samples t test,Chi-square test,One-Way ANOVA,Binary Logistic Regression.Results CAD group had significantly higher Lp-PLA2 activity than the controls(31.51 nmol · ml-1 · min-1 ＞21.31 nmol ·ml-1 · min-1,F =16.40,P ＜ 0.001).Comparing the highest quartile of Lp-PLA2 activitv to the bottom quartile,OR was 7.50 (95％ CI:2.34-24.05) after adjustment for various traditional cardiovascular risk factors,including ages,sex,CHO,TG,Hs-CRP,Lp (a) and GLU; the genotype VV of A379V was associated with higher risk of CAD (OR =2.95; 95％ CI:1.22-7.15,P ＜ 0.05).Conclusions The TaqMan-ARMS real time PCR technique is established to analyze A379V genotype.Lp-PLA2 activity is significantly higher in CAD group and is a risk factor for CAD; the genotype VV of A379V is also a risk factor for CAD.

Objective To investigate whether I198T gene polymorphisms and Lp-PLA2 activity were the risk factors of CAD.Methods A case-control study was conducted in 398 people with coronary heart disease and 396 controls whose ages and sex were matched with coronary heart disease from Peking University People's Hospital in October 2009 to May 2010.The Il98T gene polymorphisms were detected by the amplification refractory mutation system (ARMS-PCR) using TaqMan probe.Lp-PLA2 activity,CHO,GLU,TG,HDL,LDL,hs-CRP,Lp (a) were investigated at the same time.The data were analyzed by Independent-samples T Test,Chi-square test,One-Way ANOVA,Binary Logistic Regression.Results LpPLA2 activity was significant higer in CAD group than that in the control group (31.51 nmol · ml-1 · min-1＞21.31 nmol · ml-1 · min-1,F =16.40,P ＜0.05).Adjustment for various traditional cardiovascular risk factors,including ages,sex,CHO,TG,Hs-CRP,Lp(a),and GLU,quartiles of Lp-PLA2 activity were associated with risk of CVD with a OR of 7.5 (95％ CI:2.34-24.05) for comparison of the top to bottom quartile.Lp-PLA2 activity was the highest (22.68 nmol · ml-1 · min-1,P ＜ 0.05) in genotype Ⅱ and the lowest (11.35 nmol · ml-1 · min-1,P ＜ 0.05) in genotype TT,the association between I198T and coronary artery disease was not significant (P ＞ 0.05).Conclusions Lp-PLA2 activity was significantly higher in CAD group and was a risk factor for CAD.There was no significant association between I198T polymorphism and CAD.

Objective To study the feasibility and safety of interventional closure for the treatment of infant’s perimembranous ventricle septal defect (PmVSD). Methods During the period from Jan. 2012 to Jan. 2013, a total of 229 single PmVSD infants less than three years of age were admitted to authors ’ hospital. The infantile patients were divided into intervention group (n = 88) and surgery group (n = 141). Patients in the intervention group underwent interventional closure procedure , while patients in the surgery group received conventional cardiac surgery. The operation success rate , the main and minor complication rates, the operation time, the postoperative hospitalization days, the incidence of postoperative pulmonary infection and the medical cost were recorded , and the results were compared between the two groups. Results No statistically significant differences in the operation success rate, the main complication rate, the postoperative hospitalization days and the medical cost existed between the two groups (P > 0.05). But the minor complication rate and the operation time of the intervention group were better than those of the surgery group. In the surgery group, the minor complication was mainly the respiratory infection, which was manifested as higher leukocyte count, higher C-reactive protein level, higher myocardial damage marker level as well as higher vasoactive drug scores in 24 hours after the operation , and the above items were significantly higher than those in the intervention group. Conclusion For the treatment of infant’s perimembranous ventricle septal defect, percutaneous transcatheter closure is clinically feasible. This technique is safe and reliable with obvious advantages when the indication is strictly observed and the procedure is carefully manipulated. This treatment can partly replace the conventional surgery.

Objective To determine the brain natriuretic peptide(BNP) levels and the effects of endothelin receptor antagonist(ERA) on BNP levels in patients with tetralogy of Fallot(TOF) recently surgical repaired.Methods During January 2010 to January 2012,32 cases of TOF after surgical repaired in hospital were selected.There are 20 males and 12 females,Aged 4 years to 18 years [mean age (7.64 ± 3.75) years] in age.All patients underwent enhanced CT to evaluate the pulmonary vessels and left ventricular before surgery arrangements.As the surgeries done,the patients were grouped randomly as either A or B.All 14 patients in group A started to follow the recommended dosage of bosentan within 3 days after surgery.Meanwhile,all 18 in group B had not taken bosentan or any other ERAs since the surgeries.Both group was evaluated and examined with echocardiography and blood test at the 10th day after surgery.Results None of the patients died within 10 days after surgery.BNP levels of group A was significantly lower than of group B.Inotropic score of group A was markedly lower,too.However,although group A showed mildly advantages in tricuspid regurgitation,pulmonary regurgitation,ratio of RV/LV end-systolic dimension and liver functions,there was no statistically significant difference.Conclusion For patients with tetralogy of Fallot,early use of ERAs after surgical repaired could reduce the use of inotropic agents and significantly decrease the BNP levels when discharged.

Objective To investigate the effects of DMOG on the microcirculation of the choke-area and the survival of the cross-boundary flap in rats via tail vein injection.Methods Rats with ischemic three-territory perforator flaps on the dorsum were treated with DMOG at a dosage of 40 mg/kg body weight via tail vein injection at 1 day before surgery(day-1),the time of surgery(day 0),1 day after surgery(day 1),2 days after surgery(day 2) and 3 days after surgery(day 3).Control group received sterile saline at the same time points and same dosage via tail vein injection.① Draw materials from the choke-area at day 1,day 3 and day 7,HE stain was used to compare the diameter size of the artery and vein at the same site.② Western blotting to check the expression of PCNA and HIF-1α,ELISA to detect the content of PCNA,HIF-1α,SDF-1α and VEGF at day 7.③At day 7,measure the survival area of the flap and observe the vessel of the flap by lead oxide-gelatine technique.Results ① There was a greater survival rate of (96.3 ± 5.1)％ in the treatment group than in the control group with (73.9 ± 5.8)％ at day 7 (P ＜ 0.05).② The diameter size of the arterioles and venules were dilated in both groups until postoperative days 7.But the treatment group was more expanded than the control group at day 3(2.20 ± 0.26 vs.1.50 ± 0.20,P ＜ 0.05) and day 7(3.67 ± 0.35 vs.2.03 ± 0.15,P ＜ 0.05).③ The skin expression of PCNA and HIF-1α in the treatment group were greater than the control group(P ＜ 0.05) at day 7.④ The content of skin PCNA in the treatment group and control group were(8.95 ± 0.71) ng/mg and (4.15 ± 0.72) ng/mg,HIF-1α were(5.04 ± 0.50)ng/mg and (2.98 ± 0.29) ng/mg,SDF-1α were (2.91 ± 0.61) ng/mg and (1.39 ± 0.62) ng/mg,and VEGF were(2.17 ± 0.41) ng/mg and (0.95 ± 0.44) ng/mg,respectively.The treatment group was greater than the control group (P ＜ 0.05).Conclusion DMOG can improve the microcirculation of the choke area,and then increase the survival of the perforator skin flaps in rats via tail vein injection.

Objective To quantitatively study the correlation of the distance of pulmonary valve to pulmonary artery bifurcation (DPVB) of normal fetuses in second and late trimester with the fetal biometric parameters using fetal echocardiography.Methods The distances of pulmonary valve to pulmonary artery bifurcation in end-systole (DPVBs) and in end-diastole (DPVBd) were measured in a standard short axis view or right ventricular outflow tract view using fetal echocardiography on 419 normal fetuses.The gestation ages ranged from 20 to 35+ weeks.Fetal non-cardiac biometric parameters including biparietal diameter (BPD),femoral length (FL) and gestation age (GA) based on menstrual age,pulmonary valve annulus diameters (PA) at end-systole were measured.The correlation between DPVBs,DPVBd and non-cardiac biometric parameters were analyzed.Results In normal fetuses,the DPVBs was (1.14±0.24)cm with a range of 0.67 to 1.61 cm,the DPVBd was (0.93±0.20)cm with a range of 0.53 to 1.33 cm.The DPVBs and DPVBd were increased with the growth of GA,and were positively correlated with GA,BPD,FL and PA (r=0.827,0.798,0.793,0.769;0.802,0.764,0.773 and 0.771,respectively,all P<0.001).The linear regression equations between DPVBs,DPVBd and GA,BPD,FL,PA were:Y=0.054×GA-0.369,Y=0.184×BPD-0.179,Y=0.217×FL+0.011,Y=1.602×PA+0.156,Y=0.045×GA-0.330,Y=0.152×BPD-0.157,Y=0.182×FL-0.018,Y=1.380×PA+0.080.Conclusions In normal fetuses,the DPVBs and DPVBd increase with the growth of GA,and have good correlation with GA,BPD,FL and PA,respectively.Normal reference ranges of DPVBs and DPVBd have been provided.These normative data may become a new tool for assessment of fetal heart,especially has potential applications in screening of complex congenital heart defects.

Objective To observe the effects of ketamine on the patients with depression re-ceiving modified electric conulsive therapy (MECT).Methods Sixty patients with depression were randomly divided into ketamine group and propofol group (n =30 each group).Atropine 0.5-1.0 mg, propofol 1.0 mg/kg or ketamine 0.8 mg/kg i.v.were given before MECT,Scoline 0.7-1.0 mg/kg i. v.was given after the eyelash reflex disappeared.Hamilton Depression Rating Scale (HAMD)was completed after the 2 nd ,4 th and 6 th MECT,the time of convulsion,twitch index,energy percentage, respiratory recovery time and adverse reactions were recorded.Results The total score of HAMD was significantly decreased with the increasing times of MECT in both groups,compared with propo-fol group,ketamine group's HAMD total score decreased faster,especially after the 4th MECT,the score decreased significantly in ketamine group (P <0.05).The time of convulsion,twitch index,en-ergy percentage, respiratory recovery time, adverse reactions all had no statistical significance between the two groups.Conclusion Compered with propofol,ketamine,as an anesthetic of MECT, can effectively lower the score of HAMD.

ObjectiveTo evaluate the diagnosis and surgical management of non-palpable breast cancer (NPBC). MethodsDiagnosis, preoperative localization and surgical management of 26 cases of NPBC were analyzed retrospectively.ResultsAll the 26 lesions were found by ultrasound or mammography.Local-extensive excision was performed under preoperative ultrasound-guided or radio-guided wire localization.Of the 26 lesions, 14 were ductal carcinoma in situ (DCIS), 9 were DCIS with micro-invasion and 3 were invasive ductal carcinoma.ConclusionsCombination of ultrasound and mammography improves the discovery rate of NPBC.Local-extensive excision under preoperative ultrasound-guided or radio-guided wire localization of NPBC shortens the duration of surgical procedure, avoids excessive resection of breast tissues and maintains the apperance of the breast.

Objective: To evaluate the impact of fine particulate matter ( PM2.5 ) on respiratory diseases and symptoms of community residents in Chun’an County, so as to provide the basis for air pollution treatment strategies. Methods: Using the cluster random sampling method, the permanent residents in Qiandaohu Town of Chun’an County were investigated from 2017 to 2018. The demographic information, respiratory diseases and symptoms were collected by using Surveillance Plan for the Impact of Air Pollution ( Haze ) on health ( 2016 Edition ). The air pollutants and meteorological data were collected through Qiandaohu station of Hangzhou Ecology and Environment Monitoring Center and Hangzhou Meteorological Information Center. The effects of PM2.5 on respiratory diseases and symptoms of residents were analyzed with generalized estimating equation. Results: Totally 1 181 people aged 6 months to 95 years were recruited, including 557 ( 47.16% ) males and 624 ( 52.84% ) females. Acute nasopharyngitis (common cold) and tracheitis/tonsillitis occurred most frequently, with 203 cases, accounting for 3.44%. The median of daily average concentration of PM2.5 was 24 μg/m3, with the standard exceeding rate of 2.80%. The results showed that PM2.5 increased the risk of acute nasopharyngitis ( common cold ), tracheitis/tonsillitis, cough, expectoration, runny nose, sore throat and nasal congestion ( lag 3 days, OR: 1.015-1.022, 95%CI: 1.001-1.037 ); the effect of PM2.5+PM10 ( OR: 1.020-1.040, 95%CI: 1.006-1.070 ) and PM2.5+O3 ( OR: 1.017-1.024, 95%CI: 1.005-1.035 ) was greater than that of PM2.5 alone on respiratory diseases and symptoms. Conclusion Atmospheric PM2.5 exposure in Chun’an County increases the risk of respiratory diseases and symptoms among community residents.

Objective To evaluate the performance of serum small dense low-density lipoprotein cholesterol(sdLDL-C) kit using enzymic method and investigate the clinical value in coronary heart disease (CHD).Methods According to the standard of Clinical and Laboratory Standards Institute (CLSI),evaluae the precision,linearity ranges,reportable range and accuracy of sdLDL-C kit.The 683 patients with coronary heart disease (CHD,423 men and 260 women,age 35-79 years) who were diagnosed at the people's hospital of Peking university from October 2015 to October 2016 were divided into two groups.The treated group include 571 patients(CHD1,342 men and 229 women,age 40-79 years) which taking lipidlowering drugs and the other include 112 cases (CHD2,81 men and 31 women,age 35-70 years)without Lipid-lowing treatment.Besides,the Control group contains 472 healthy persons (274 men and 198 women,age 41-75 years),were collected from the people's hospital of Peking university between April and August 2016.The liver function,renal function,blood glucose and blood lipid in CHD group(CHD1,CHD2) and healthy control group were detected.The new enzyme assay kit was used for the determination of sdLDL-C.The data of normal distribution were compared by independent t test between the two groups.The Mann-Whitney U nonparametric test was used for comparison between two groups.Results The precision of sdLDL-C kit examination was in compliance with manufacturer'statement.The linearity was good in 0.11-2.42 mmol/L(Y =1.008 9X + 0.024 8,R2 =0.998 2),the scope of the report is 0.11-4.84 mmol/L.The level of sdLDL-C in CHD group was significantly higher than that in healthy control group,it has a statistical significance[0.824 (0.443) mmol/L,0.609 (0.361) mmol/L;Z =-5.603,P ＜ 0.001].The level of sdLDL-C in (CHD 1) was lower than (CHD 2) [0.761 (0.479) mmol/L,0.888(0.426) mmol/L;Z=-2.304,P＜ 0.021].After additional adjustment for various tradition cardiovascular risk factor,including ages,sex,CHO,TG,Hs-CRP,Lp(a),and GLU,the highest quartile of sdLDL-C comparison to the bottom quartile,the OR was 3.02,(95％ CI,1.15-9.05) for CHD.Conclusions Experiment data demonstrated that sdLDL-C kit using enzymic method has good performance in the precision,linearity ranges,reportable range and accuracy,sdLDL-C serum level was significantly higher in CHD group.