Objective To investigate the serum levels of high sensitivity C-reactive protein (hsCRP),interleukin-1β (IL-1β) and lipoprotein-associated phospholipase A2 (Lp-PLA2),and investigate their clinical diagnostic value in acute coronary syndrome (ACS) patients.Methods Fifty three clinical serum samples of patients specifically diagnosed with acute coronary syndrome were collected.A total of 21 healthy subjects were enrolled as healthy controls.Serum IL-1β and Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay.The concentration of hs-CRP was tested by immunoturbidimetry method.Results Compared to the healthy controls,the levels of serum hs-CRP,IL-1βand Lp-PLA2 were significantly higher in ACS and ACS subgroups (P ＜ 0.05),respectively.The level of Lp-PLA2 was gradually increased among healthy controls,angina pectoris (AP),ST-segment elevation myocardial infarction (STE-MI),non-ST-segment elevation myocardial infarction (NSTEMI) groups.The best cut-off value of hs-CRP,IL-1β and Lp-PLA2 was 7.44 mg/L,90.88 ng/L and 219.92 μg/L,respectively.The parallel test had better sensitivity (94.3％) and specificity (100％).Conclusions Serum hs-CRP,IL-1β and Lp-PLA2 play an important role in classifying the clinical types and monitoring the conditions of patients with ACS.Combination of hs-CRP,IL-1β and Lp-PLA2 is expected to be a new biomarker for ACS.

Objective To study the causes for dysphoria and discuss the medication methods of controlling the dysphoria in craniocerebral injury patients. Methods First, craniocerebral injury patients were grouped to analyze the causes for their dyshoria. Then, the patients were injected with Tramadol (1 mg/kg), Droperidol (0.05 mg/kg) and Midazolam (0.1 mg/kg). Successively, analgestic pump containing combined Tramadol that included Tramadol (15 mg/kg), Droperidol (0.15 mg/kg), Midazolam (0.4 mg/kg) and 100 ml 10 g/L Procaine was used for 50 hours, (1.5-2.5) ml/h, continuously. The medication time ranged from 40 hours to 160 hours. Results Of 71 patients with dysphoria, 43 patients with grades Ⅰ and Ⅱ dysphoria were under complete control, 19 with grade Ⅲ dysphoria (eight were injected with more load) under basic control, one with grade Ⅳ dysphoria under control and eight degraded to grade Ⅱ dysphoria but needed additional load. Of all, 63 patients were successfully controlled (89%) and eight (11%) got better, with effectiveness rate of 100%. Blood pressure, heart rate and breath remained clam, which was good for oxygen transferring to brain and reducing of encephalic pressure. Conclusions The causes for dysphoria in craniocerebral injury patients include stimulation of pain and acute psychopathic impediment. Continuous injection of Tramadol via analgesic pump is an ideal medication methhod for analgesia and sedation, for it can not only hold blood and medicament in invariableness, but also make the patients quiet, without bad reaction or affecting process of regaining consciousness.

Objective To investigate the prevalence and the risk factors of gastroduodenal damages induced by nonsteroidal anti-inflammatory drugs (NSAIDs). Methods One hundred and eighty-four patients who were prescribed NSA1Ds for long time in rheumatology and cardiovascular clinics were enrolled. Clinical data such as age, sex, medication history and body mass index were recorded. The lesions were estimated by endoscopy and the specimens were tested for Helicobacter pylori (H. pylori) infection. Results Peptic ulcer was found in 63 (34. 24%) patients including gastric ulcer in 22, duodenal ulcer in 34 and compound ulcer in 7. The endoscopic examination showed that 57 out of 121 patients without peptic ulcer had ≥3 erosive lesions. Logistic regression analysis revealed that H. pylori infection was important risk factor that induced the peptic ulcer in those who were taking NSAIDs for long time (OR = 13. 86, 95% CI: 6. 53 ～ 29. 43). The incidence of gastroduodenal damage was similar in patients taking NSAIDs and low dose aspirin (OR =0.45,95CI:0.16～ 1.28). Conclusions NSAIDs may cause gastroduodenal damages in long-term users and H. pylori infection was an important risk factor. The effect of low dose aspirin on gastroduodenal damages is as same as NSAIDs.

Objective To explore the efficacy of triple therapy and sequential therapy in the eradication of Helicobacter pylori (Hp) in patients receiving long-term non-steroidal antiinflammatory drugs (NSAID) treatment.Methods Patients receiving long-term NSAID treatment were enrolled in this study.Patients diagnosed as Hp infection were divided into triple therapy and sequential therapy groups.The patients in triple therapy group received omeprazole,clarithromycin and amoxicillin theray for 10 days.The patients in sequential group received esomeprazole with amoxicillin for five days,and then esomeprazole with clarithromycin and metronidazole for another five days.All patients were given mucosal protective therapy as maintenance treatment after eradication therapy and followed up for 12 weeks.Patients underwent endoscopy examination and Hp testing before and after follow-up.Hp eradication rates were compared with the intention-to-treat (ITT) and per protocol (PP) analysis.Results According to ITT analysis,the eradication rates of Hp in triple therapy group and sequential therapy group were 78.4 ％ (40/51) and 80.0 ％ (40/50) respectively,there was no significant difference between these two groups (x2 =0.038,P=0.846).According to PP analysis,the eradication rates of Hp in triple therapy group and sequential therapy group were 84.4％ (38/45) and 87.0％ (40/46) respectively,there was no significant difference between these two groups either (x2=0.117,P=0.732).Conclusion There was no significant difference in Hp eradication between triple therapy and sequential therapy in patients receiving long-term NSAID treatment.

Liver cirrhosis-related cardiomyopathy (CCM) is a common and easily overlooked complication associated with liver cirrhosis. Because of the high incidence and impact on success of the liver transplantation and the transcarotid intrahepatic portosystemic shunt surgery, it has attracted the attention of researchers in the field recently. Liver cirrhosis patients have liver morphological alterations, which result in increased serum level of total bile acids and changes in bile acid composition. The increased bile acid concentrations are cardiotoxic and change cardiac functions. This study discussed and summarized recent advancements in the role of bile acids in cirrhosis-related cardiomyopathy in three aspects, i.e., changes in bile acid metabolism in liver cirrhosis patients, effects of bile acid on changes in cardiac functions, and ursodeoxycholic acid as a potential therapeutic agent for CCM. This review expects to provide novel approaches for future prevention and treatment of CCM.

Objective: To investigate the pathogen spectrum distribution and drug resistance of febrile neutropenic patients with hematological diseases in Shanghai. Methods: A retrospective study was conducted on the clinical isolates from the febrile neutropenic patients hospitalized in the departments of hematology in 12 general hospitals in Shanghai from January 2012 to December 2014. The drug susceptibility test was carried out by Kirby-Bauer method. WHONET 5.6 software was used to analyze pathogenic bacteria and drug susceptibility data. Results: A total of 1 260 clinical isolates were collected from the febrile neutropenic patients. Gram-positive bacteria accounted for 33.3% and Gram-negative bacteria accounted for 66.7%. Klebsiella pneumoniae (12.5%) , Stenotrophomonas maltophilia (9.5%) , Escherichia coli (9.1%) , Pseudomonas aeruginosa (8.7%) , Acinetobacter baumannii (6.6%) , Staphylococcus aureus (5.6%) and Enterococcus faecium (5.0%) were ranked in the first 7 of all pathogens. In the respiratory tract secretions specimens, non-fermented strains accounted for 56.2%. Stenotrophomonas maltophilia accounted for 15.2%. Enterobacteriaceae and coagulase-negative Staphylococci accounted for 42.3% (104/246) and 32.6% (85/246) respectively in blood samples. Enterobacteriaceae and Enterococcus bacteria accounted for 39.4% (76/193) and 28.5% (55/193) respectively in pus specimens. The detection rates of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative Staphylococci (MRCNS) were 54.3% and 82.5%, respectively. Staphylococcus bacterial strain was not found to be resistant to linezolid, vancomycin and teicoplanin. The detection rate of Enterococcus vancomycin-resistant strains was 8.9%. Enterococcus was not detected resistance to oxazolidinone strains. Enterobacteriaceae bacteria were highly sensitive to carbapenems. The resistance rate of Pseudomonas aeruginosa to imipenem and meropenem was 34.1% and 15.8%, respectively. Stenotrophomonas maltophilia was more sensitive to minocycline hydrochloride, levofloxacin and sulfamethoxazole. The resistance rate of Acinetobacter baumannii only to cefoperazone-sulbactam was less than 10.0%. The antibiotic resistance rate of Klebsiella pneumoniae, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Acinetobacter baumanii to most of common antibiotics was lower than that of the CHINET surveillance. Conclusions The pathogenic strain distribution in common infection sites of febrile neutropenic patients was characterized. Bacterial resistance surveillance was better than the CHINET nationwide large sample surveillance in China.