Objective To study the relationship between white blood cell(WBC) count and cardiac events in acute ST-elevation myocardial infarction(STEMI) patients treated with reperfusion in the early stage. Methods Two hundred and thirty-five patients with acute STEMI were divided into two groups:percutaneous coronary intervention group (PCI group, 97 patients) and thrombosis therapy group (138 patients). WBC count and cardiac events of the two groups before and after treatment (3 h and the second day and the third day) were recorded and compared. Results The level of WBC count had no changes in two groups before and after treatment in first 3 h (P>0.05) , while the level of WBC count was significantly decreased, and the level of WBC count was significantly lower in PCI group than that in thrombosis therapy group (P<0.05). The rate of no cardiac events and two cardiac events in two groups has no significant differences (P > 0.05). The rate of one cardiac events in PCI group was significantly higher than that in thrombosis therapy group (P<0.05). The rate of three cardiac events in PCI group was significantly lower than that in thrombosis therapy group (P<0.05). WBC count had a positive correlation with cardiac events rate (r = 0.231, P < 0.05). Conclusions Primary percutaneous coronary intervention decreases WBC count and cardiac events rate. In patients with acute myocardial infarction, level of WBC count has positive relationship with cardiac events.

[Objective]To investigate the protective effects of calcitonin on articular cartilage and subchondral bone in experimental osteoarthritis induced by ACLT(anterior cruciate ligament transection) of rats. [Methods]Thirty 12-week-old Sprague Dawley rats were divided randomly into three groups: Sham(n=10),ACLT+CT(n=10) and ACLT+NS(n=10).ACLT+CT group received a daily subcutaneous injection of salmon calcitonin at a dose of 10 IU.kg-1.d-1 for 12 weeks,ACLT+NS group received NS at the same dose.All rats were sacrificed at 12 weeks after operation.The macro-pathological changes of Samples were graded by Mankin's scale.Bone mineral density(BMD) of right distal femoras and femora condyles were measured by dual-energy X-ray absorptiometry scanner.The decalcified right femora condyles were prepared for paraffin sections,stained with safranin-O/fast green and immunohistochemistry for MMP-13.The right proximal tibias were harvested to make undecalcified bone section for detecting the bone histomorphometry of subchondral bone.[Results](1) The Mankin score of the Sham and ACLT+CT groups were significantly lower than that of ACLT+NS group.(2) The BMD and bone mass(BV/TV,Tb.Th) of the subchondral bone in ACLT+NS were significantly higher than those of Sham and ACLT+CT groups.(3)In ACLT+ NS group,expression level of MMP-13 was significantly lower than those of Sham and ACLT+ CT groups.[Conclusion]A daily subcutaneous injection of salmon calcitonin at a dose of 10 IU.kg-1.d-1 of body weight for 12 weeks can inhibit articular cartilage degeneration of rat osteoarthritic joints,inhibitiing sclerosis of and improving the microarchitecture of subchondral bone,coupled with downregulation of MMP-13 in cartilage probably participate in this process.

Objective To compare the applicability between ARF special severity scoring systems and intensive care unit (ICU) general severity scoring systems on predicting the hospital mortality of critical acute renal failure (ARF) patients. Methods The data of 29 patients with critical ARF were retrospectively analyzed. Two ARF special severity scoring models, acute tubular necrosis individual severity index (ATN-ISI) and Stuivenberg hospital acute renal failure scores (SHARF), and 3 ICU general severity scoring models, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), APACHE Ⅲ, Mortality Prediction Model Ⅱ (MPM Ⅱ), were used in the analysis. The receiver operating characteristic (ROC) curves were drawn up to assess the ability of these models in hospital mortality discrimination. Results All severity scores of the patients in survivor group (n=9) were lower than those of the patients in non-survivor group (n=20). There were statistical differentiations in the scores of ATN-ISI, APACHE Ⅱ, MPM Ⅱ-24h, MPM Ⅱ-72h between the survivor group and the non-survivor group (P

Objective To investigate the effect of astragalus injection combined with beta-adrenoceptor antagonist on serum levels of brain natriuretic peptide ( BNP) , interleukin1β( IL-1β) , IL-6 and tumor necrosis factorα( TNF-α) in the treatment of elderly patients with heart failure. Methods 78 elderly patients with heart failure from April 2013 to April 2015 in department of cardiology of the second hospital of Yuhang district were selected and divided into control group and experimental group with 39 cases in each group.All patients received correction of the electrolyte and acid-base balance and other conventional treatment.The control group received carvedilol by oral, the experimental group received astragalus injection on the basis of control group, with a course of 30 days.The serum BNP,IL-1β,IL-6 and TNF-αlevels pre-and post-treatment in two groups were compared. Results Compared with pre-treatment, the serum IL-1β,IL-6,TNF-α,and BNP levels post-treatment in two groups were lower(P<0.05).Compared with the control group post-treatment, the IL-1β,IL-6,TNF-αand BNP levels in experimental group were lower(P <0.05).Conclusion Astragalus injection combined with beta-adrenoceptor antagonist could significantly improve the clinical sign of elderly patients with heart failure, the mechanism may be reducing the serum levels of IL-1β,IL-6,TNF-αand BNP.

Objective To investigate the therapeutic effect of loosening manipulation on neck tenderness points for cervicogenic tinnitus . Methods Forty cervicogenic tinnitus patients were treated with loosening manipulation on neck tenderness points. Tinnitus grading was carried out before and after treatment by following Tinnitus Severity Grading Criteria for the evaluation of therapeutic effect. Results ( 1) Tinnitus was relieved after treatment for one week and 2 weeks, and at the end of treatment course (P<0.05 compared with that before treatment). (2) After treatment for 3 continuous weeks, the cure rate was 25.0% ( 10/40) , the markedly effective rate was 37.5% ( 15/40) , the effective rate was 27.5% ( 11/40) , the ineffective rate was 10.0% ( 4/40) , and the total effective rate was 90.0%. Conclusion Loosening manipulation on neck tenderness points is effective on relieving cervicogenic tinnitus.

Objective To investigate the influence of combined kinetotherapy with non-drug sleep on delirium in patients with mechanical ventilation. Methods 107 cases with acute exacerbation of chronic obstructive pulmonary diseases (COPD) respiratory failure and mechanical ventilation were randomly divided into the treatment group of 54 cases, and the control group of 53 cases. Two groups of patients were given conventional treatment, the treatment group while giving to kinetotherapy and non-drug sleep:an eye mask earplugs at night. Observe the difference of the incidence of delirium, duration of delirium, number of days of mechanical ventilation, case fatality rate. Results The incidence of delirium in the treatment group was 59.3%(32/54), while that was 77.4%(41/53) in the control group, the difference was significant, χ2=4.042,P=0.044. The duration of delirium in treatment group was (1.75 ± 1.05) d, while that was (2.56 ± 1.25) d in the control group, the difference was significant, t=-2.955, P=0.004. The number of days of mechanical ventilation in treatment group was (6.41 ± 2.84) d, while in the control group was (8.68 ± 3.85) d, the difference between the two groups was significant, t=-3.478,P=0.001. The case fatality rate in treatment group was 5.6%(3/54), while in the control group was,11.3%(6/53) , the difference between the two groups was no significant, P=0.283. Conclusions Kinetotherapy cooperate with non-drug sleep can reduce the incidence of delirium, duration of delirium and number of days of mechanical ventilation in patients with mechanical ventilation. This method are simple and it is worth spreading.

AIM: To establish the method for determination of gentiopicrin, palmatine hydrochloride and berberine hydrochloride in Ertong Ⅱ Oral Liquid (Cortex Phellodendri, Radix Gentianae, Rhizoma Anemarrhenae, etc.) by RP HPLC. METHODS: The column was a Diamonsil TM C 18 column (250mm?4.6mm, 5?m); the mobile phase was CH 3CN H 3PO 4 C 6H 15 N H 2O; The ultraviolet detection was set at 270nm; the flow rate was 1mL?min -1 . RESULTS: The linear ranges of gentiopicrin, palmatine hydrochloride and berberine hydrochloride were 72.8～728?g?mL -1 ( r=0.9998 ), 7.55～75.5?g?mL -1 ( r=0.9998 ), 12.45～124.5?g?mL -1 ( r = 0.9999 ), respectively. The average recoveries ( n =6) of gentiopicrin, palmatine hydrochloride and berberine hydrochloride were 98.17%, 98.78%, 98.60%; RSD were 1.60%, 1.35%, 1.25%, respectively. CONCLUSION: The method is accurate, reproducible and highly selective, thus suitable for quality control of Er Tong Ⅱ Oral Liqual.

Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic nephroureterectomy (RLNU) combined with transurethral electric coagulation on upper urinary tract urothelial carcinoma (UUTUC).Methods Sixty UUTUC patients were enrolled from Jun.2012 to Apr.2013.The prospective clinical controlled analysis method was adopted in this study.All patients were divided into test group and control group according to the order of admission.Thirty cases (test group) underwent RLNU combined with electric coagulation,and 30 cases (control group) underwent RLNU combined with electric resection.The differences in operation time,blood loss,hospital stay and tumor recurrence rate between the 2 groups were compared.Results All the 60 operations for UUTUC were successful without conversion to open surgery.No intraoperative complications such as great vessels or surrounding organs damage occurred.There were 2 cases loss to follow-up in test group and 3 cases in control group.There were no significant differences in operation time,blood loss,follow-up time,tumor stage and tumor grade between the 2 groups.The hospital stay in the test group was shorter (5.5±2.0 d versus 7.1±2.2 d),the tumor recurrence rate was lower [4％ (1/28) versus 30％ (8/27)],and the differences were significant (P＜0.05).Conclusion Compared with RLNU combined with transurethral electric resection,RLNU combined with electric coagulation has advantages of shorter hospital stay and lower tumor recurrence rate.

Objective To seauch the ideal management for gross hematuria in autosomal dominant polycystic kidney disease (ADPKD).Methods ADPKD patients who were ever hospitalized and followed up in our department since 1993 were enrolled in the study.Demographic and clinical data were colloected,such as gender,age of gross hematuria,level of renal function,causative factors,management strategies,duration of gross hematuria,blood platelet count,activated partial thromboplastin time,prothrombin time,international normalized ratio,size of kidney cyst and so on.ADPKD patients were divided into different groups according to causative factors or management.The clinical data were compared among groups.Results A total of 905 ADPKD patients were screened,among whom 279 patients ever had gross hematuria (male/female:150/129),One hundred and forty-six patients had integrated therapeutic process records,while only 101patients could provide relevant laboratory examination results.In these 101 patients,gross hematuria was found in any stage of chronic kidney disease (CKD); the average eGFR was (56.4±44.1) mml·min-1 ·(1.73 m2)-1; the duration of gross hematuria was (8.8±8.0) d; no significant difference between male and female in duration of gross hematuria existed [(8.2±7.3) d vs (9.5±8.8) d,P=0.426]; coagulation parameters were all normal.The platelet count was also normal in 91 patients.Duration of gross hematuria among groups divided according to different causative factors was significantly different (P＜0.05).The patients in bed rest group had significantly shorter duration of gross hematuria compared with other groups (P＜0.05).The platelet count,prothromhin time and international normalized ratio were all at similar level in different groups.Conclusions The causative factors in ADPKD patients with gross hematuria should be confirmed as the first step of management strategies.Bed rest is the key point in management.Antifibrinolytic agent is a proper choice in the cases receiving bemostatic drugs.It is unnecessary to use antibiotic agent for prevention.

Objective To investigate the effects of β-blockers on cardiac protection and hemodynamic in patients with septic shock. Methods A prospective randomized controlled trial was conducted. Forty-one patients with septic shock in accordance with early goal directed treatment and met the target within 6 hours,and admitted to intensive care unit (ICU)of Affiliated Huxi Hospital of Jining Medical College from January 2012 to January 2014 were enrolled. The patients were divided into treatment group (n=21)and control group (n=20)by random number table. The patients in both groups were given the standard treatment,esmolol was giving to patients in treatment group in order to control the heart rate (HR)below 100 bpm within 2 hours,and the patients in control group only received standard treatment. The changes in hemodynamic parameters〔mean arterial pressure(MAP),central venous pressure(CVP), HR,cardiac index(CI),stroke volume index(SVI),systemic vascular resistance(SVRI),global end diastolic volume index(GEDVI)〕,biochemistry metabolic of tissue〔central venous oxygen saturation(ScvO2),lactic acid(Lac)〕,and cardiac markers 〔troponin I (cTnI)〕before and 12,24,48,72 hours after the treatment were recorded. Results①Before treatment,the hemodynamic parameters,tissue metabolism index and cTnI had no significant differences in both groups (all P>0.05).②The hemodynamic parameters after treatment in the control group showed no significant difference compared with that before treatment. HR and CI in the treatment group were gradually declined after treatment,SVRI and GEDVI were gradually increased. There were significant differences in HR,CI,SVRI,and GEDVI between treatment group and control group from 12 hours on〔HR(bpm):93±4 vs. 118±13,CI (L·min-1·m-2):3.3 ±0.8 vs. 4.5 ±0.6,SVRI (kPa·s·L-1·m-2):159.2 ±27.4 vs. 130.5 ±24.2,GEDVI(mL/m2):668 ±148 vs. 588 ±103,P<0.05 or P<0.01〕. MAP,CVP and SVI in the treatment group showed no significant changes. ③Lac after treatment in both groups was decreased slowly,Lac (mmol/L)at 12 hours after treatment was significantly decreased compared with that before treatment (control group:8.8 ±3.2 vs. 9.8 ±3.4,treatment group:9.5±3.1 vs. 10.5±4.1,both P<0.05). The Lac of control group and treatment group were 2.5±1.2 and 2.7±1.1 at 72 hours after treatment,and there was no significant difference between two groups (all P>0.05). The ScvO2 was not decreased in both groups.④Compared with before treatment,cTnI in the control group was gradually increased,peaked at 72 hours,and that in the treatment group was gradually increased,peaked at 24 hours and then gradually declined. Compared with control group,the cTnI (μg/L)in the treatment group was decreased significantly at 24,48,72 hours (1.15 ±0.57 vs. 1.74 ±0.77,0.93 ±0.52 vs. 2.15 ±1.23,0.52 ±0.36 vs. 2.39 ±1.17,all P<0.01). Conclusionsβ-blockers (esmolol) can improve cardiac function and myocardial compliance,reduce the myocardial injury in patients with sepsis shock. Although β-blockers can decrease cardiac output,it has no influence on the circulation function and tissue perfusion.