Objective To investigate the clinical efficacy of trimetazidine in treatment of ischemic cardiomy-opathy heart failure and its influence on cardiac function and heart rate variability .Methods 160 cases of patients with ischemic cardiomyopathy heart failure were randomly divided into the two groups with 80 cases in each group .The
two groups were given conventional treatment of anti heart failure ,the observation group used trimetazidine on basis of that,clinical effect and the influence on the index of heart rate variability and cardiac function of two groups were ob -served.Results The total effective rate of the observation group was 91.25%,significantly higher than 73.75% of the control group (χ2 =9.57,P<0.05);LVEDD and LVESD of the observation group after treatment were (49.88 ± 4.60)mm and (37.10 ±3.15)mm,significantly reduced than before treatment (t=7.44,7.83,all P<0.05) and the control group (t=6.60,6.85,all P<0.05); while the LVEF was (48.04 ±4.20)%,increased significantly than before treatment (t=6.51,P<0.05) and the control group (t=7.11,P<0.05);SDNN,SDANN,rMSSD and PNN50 of the observation group after treatment were (124.72 ±7.02)ms,(111.20 ±5.89)ms,(46.74 ±4.22)ms and (17.72 ±2.08)%,increased significantly than before treatment (t=7.43,7.83,7.06,8.17,all P<0.05) and the control group (t=6.66,6.90,6.15,7.21,all P<0.05).Conclusion Trimetazidine has an exact effect in treat-ment of ischemic cardiomyopathy heart failure ,which can improve heart function and heart rate variability which has an important value in clinical application .

Objective To study the efficacy and safety of Fasudil in treatment of elderly diastolic heart fail -ure related pulmonary hypertension ,and provide evidence for clinical treatment .Methods 70 cases of elderly dias-tolic heart failure related pulmonary hypertension were divided into the study group and control group of 35 cases in each group according to random number table methods ,the two groups were given beta blockers ,angiotensin converting enzyme inhibitors and other drugs for treatment ,the study group was given fasudil on basis of that ,6min walking dis-tance,pulmonary artery systolic pressure ,arterial partial pressure of oxygen ( PaO2) of two groups before and after treatment as well as the changes of blood pressure and heart rate of the study group before and after treatment were compared.Results Before treatment,6min walking distance,pulmonary artery systolic pressure and PaO2 of the two groups were (290.3 ±1.3)m,(83.3 ±0.9)mmHg,(66.3 ±1.4)mmHg and (289.2 ±1.1)m,(82.9 ±0.8)mm-Hg,(65.9 ±1.3)mmHg showed no statistical significance (t=2.392,4.927,5.132,P=0.073,0.069,0.063),after treatment,6min walking distance ,pulmonary artery systolic pressure and PaO 2 of the study group were (410.4 ±2.3) m,(60.1 ±1.1) mmHg,(89.3 ±0.6) mmHg significantly better than those of the control group ,with statistically significant difference(t=8.918,9.142,11.319,P =0.024,0.019,0.017);the systolic blood pressure,diastolic pressure and heart rate of the study group before and after treatment were (132.8 ±2.1)mmHg,(84.3 ±1.1)mm-Hg,(69.2 ±1.4) times/min and (133.2 ±1.9) mmHg,(83.9 ±0.9) mmHg,(68.9 ±1.3) times/min showed no statistical significance(t=4.193,4.018,3.987,P=0.061,0.078,0.068).Conclusion Fasudil has a better effect in treatment of elderly diastolic heart failure related pulmonary hypertension ,which can significantly reduce the pulmo-nary artery pressure ,and has a little effect on the heart ,with high safety .

Objective To establish the isodose curves and dose calculation models of()~(125)I seed plane implantation using the three-dimensional treatment planning system(3D-TPS). Methods The isodose cures of 1 000 cGy,3 000 cGy,6 000 cGy,9 000 cGy,12 000 cGy,15 000 cGy,and 20 000 cGy and dose calculation models of triangular,quadrilateral,hexagon,and dodecagon patterns of()~(125)I seed plane implantation were created using the 3D-TPS.The isocenter dose pattern of 0,0.5,1.0,1.5,2.0,2.5,3.0,and 4.0 cm from the plane center was calculated with 3D-CRT. Results The study showed that if doses were less than 10 Gy at 2.0 cm,2.5 cm,3.0 cm and 4.0 cm apart from the center of triangular,quadrilateral,hexagon,and dodecagon patterns and the distance was beyond 1 cm between seeds,there was a low dose region in the centeral point. Conclusions The study showed that the isodose distribution curves and dose calculation models in plane implantation were primarily established using the seed implantation 3D-TPS.

BACKGROUND: High incidence rate in the morning and low incidence rate in the evening is the regularity of stroke; however, there are no clear reports on changes of concentration of plasma endothelins and its relationship with onset of cerebral thrombus.OBJECTIVE: To investigate dynamic regularity of plasma endothelins in patients with acute cerebral thrombus within 24 hours and its correlation with episode.DESIGN: Case-controlled study.SETTING: Center of Radio-immunology and Department of Laboratory of Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: Totally 32 patients with cerebral thrombus were selected from Neurological Department of Affiliated Hospital of Medical College of Qingdao University from January 2002 to January 2003. There were 20males and 12 females with mean age of (61.5±4.1) years. Ten patients had history of diabetes mellitus combined with hypertension, 8 had history of hypertension, 1 had history of diabetes mellitus, and 13 did not have history of diabetes mellitus and hypertension. Another 30 healthy subjects were selected from the same hospital including 13 males and 17 females with the mean age of (58.1±6.25) years. Informed consent was obtained from all subjects.METHODS: Radio-immune analysis was used to determine the dynamic changes of plasma-endothelins level in 32 patients with cerebral thrombus and 20 healthy subjects at 2, 8, 14 and 20 o'clock.MAIN OUTCOME MEASURES: ① Plasma-endothelins level of patients in cerebral thrombus group and control group at the four time points within 24 hours; ② Plasma-endothelins level of patients with or without cerebral thrombus at the four time points within 24 hours.RESULTS: Totally 32 patients with cerebral thrombus and 30 subjects in control group entered the final analysis. ① Plasma-endothelins level in cerebral thrombus group day and night was higher than that in the control group (t=29.1-30.5, P ＜ 0.001). The level was the lowest [(69.96±3.92) ng/L] at 2 o'clock within 24 hours but the highest at 8 o'clock [(78.55±3.80) ng/L,(t=5.67, P ＜ 0.01)]. ② Levels of endothelins in patients with history of hypertension and cerebral thrombus were obviously higher than those in patients without history of hypertension and cerebral thrombus at 2, 8, 14 and 20 o 'clock within 24 hours [(73.28±7.89), (64.52±5.29) ng/L; (82.39±8.62),(75.81±5.14) ng/L; (81.39±8.62), (70.32±5.97) ng/L; (82.47±5.04),(65.27±5.14) ng/L, (t=2.11-5.17, P ＜ 0.05-0.01)].CONCLUSION: Plasma-endothelins level in patients with acute cerebral thrombus has rhythm changes within 24 hours. The changes are high in the morning and low in the evening, and this is accorded with high onset of cerebral thrombus in the morning.

Objective To investigate the effects of Chaishao Chengqi Decotion on intestinal microbiota and intestinal mucosal lesion in severe acute pancreatitis(SAP).Methods 46 Patients with SAP were randomized into two groups.Routine medical management was initiated in two groups.The treatment group received Chaishao Chengqi Decotion for 1 week.The plasma concentrations ofDiamine Oxidase (DAO),D-lactate were detected and changes of microflora were evaluated by bacterial culture.Results The levels of DAO in the treatment group (4.65 ±0.82)U/ml were significantly lower than those in the control group (5.66 ±2.17) U/ml (P ＜ 0.05) 7 days after treatment.The levels of D-lactate in the treatment group (10.65 ± 5.24)mg/L were significantly higher than those in the control group (5.42±2.13)mg/L (P＜0.05).Bacterial culture revealed that the amount of bifidobaterium (6.02± 1.42)In/g and lactobacilli (7.21 ± 2.02) In/g were significantly increased when compared to those before treatment (3.74± 1.71)In/g and (4.03 ± 1.79)In/g respectively,while there was imbalance of intestinal microflora to some extent in the control group.Conelusien Chaishao Chengqi Decotion exerted the protective effects on gut barrier function by alleviating the damage of intestinal mucosa and balancing the intestinal microbiota following severe acute pancreatitis.

ObjectiveTo summarize the ultrasonic features of endometrial carcinoma in transvaginal color Doppler sonography (TVCDS), and to analyze the supplementary function of serum CA125and CA199in diagnosing endometrial carcinoma.MethodsFrom January 2006 to October 2012, fourteen thousand and twenty-seven women underwent TVCDS in GZ Women & Children Medical Centre, serum CA125 and CA199 were determined by chemiluminescence immunoassay. The ultrasound characteristics of 131 cases of endometrial carcinoma (including 64 cases of early-stage and 67 cases of advanced endometrial carcinoma) who were accurately diagnosed by pathology and the value of serum CA125 and CA199 were analyzed.ResultsIn groups 131 patients were accurately conifrmed by pathology, including 64 cases early-stage and 67 cases advanced carcinoma. The diagnositic coincidence of ultrasound and ultrasound combined with serum tumor markers was 56.3% (36/64) and 78.1% (50/64) respectively. On ultrasonography, 64 patients with early stage endometrial carcinoma showed uterine enlargement in 38 cases and endometrial thickening in 53 cases. In 9 cases, endometrial lesions were heterogeneously hypoechoic. In 55 cases, the halo between endometrium and muscle was interrupted and disappeared. In 56 cases, endometrial lesions had muscular layer inifltration. In 13 cases, endometrial lesions had cervical inifltration. In 61 cases, sparse punctuate or reticular flow signals were detected within lesions. In 3 cases, there was no blood flow signal in lesions. All these patients had not lymph node metastasis. Sixty-seven cases with advanced endometrial carcinoma showed more obviously uterine enlargement and significant endometrial thickening. In 61 patients, tumor spread outside the uterus. Reticular or dendritic flow signals were detected in 67 cases lesions. There were hypoechoic lymph node mestastasis in 53 cases. In 31 cases of early stage endometrial carcinoma, preoperative CA125 increased. In 27 cases of early stage endometrial carcinoma, preoperative CA199 increased. In 24 cases CA125 and CA199 increased meanwhile. In 61 cases of advanced endometrial carcinoma, preoperative CA125 increased. In 59 cases of advanced endometrial carcinoma, preoperative CA199 increased. In 56 cases CA125 and CA199 increased meanwhile. Sixty-four cases of early-stage endometrial carcinoma were diagnosed by TVCDS assisted with CA125 and CA199 and were confirmed by pathology. The detective rate was 78.1% (50/64). To compared with TVCDS, the difference was statistical signiifcance (χ2=6.95,P=0.01).ConclusionsThe ultrasonic features of early-stage endometrial carcinoma in TVCDS were uterine enlargement, endometrial thickening, heterogeneous hypoechoic endometrial lesions, interrupted or disappeared hypoechoic halo between endometrium and musclar layer, and sparse punctuate or reticular flow signals within lesions. Serum CA125 and CA199 may be helpful in improving diagnosis coincidence rate when early-stage endometrial cancer is ifnd or suspected on ultrasonography.

AIM: To investigate the inhibitory effect of vector-based RNA interference(RNAi) on the expression of melanoma associated antigen A3(MAGEA3) protein in hepatocellular carcinoma cells and on apotposis of hepatocellular carcinoma cells.METHODS: A vector for transcribing specific small hairpin RNA(shRNA) targeting MAGEA3 gene was constructed,introduced into hepatocellular carcinoma MEL-ED1 cells by Lipofectamine 2000.The MAGEA3 protein and mRNA expression levels of MEL-ED1 cells were detected by Western blotting and RT-PCR, respectively.The cell apoptosis was studied by DNA fragmentation,electron microscopy,TUNEL assay,and annexin V/PI staining.RESULTS: The vector of RNA interference was successfully constructed and MAGEA3 expression was descreased significantly in MEL-ED1 cells.After the shRNA expression vector was transfected into the MEL-ED1 cells,the expression of MAGEA3 gene was inhibited significantly(by 90%).DNA fragmentation,electron microscopy and TUNEL assay showed classic apoptosis characters in the MEL-ED1 cells transfected with pSilencer-MAGEA3 plasmid with an apoptosis rate of 21.41% ?1.98%,significantly higher than those in the negative control group transfected with pSilencer-neo and in the non-transfected group(both P

Objective To evaluate the efficacy and adverse reactions of CT-guided 125I radioactive seed implantation in treatment of locally recurrent rectal cancer (LRRC).Methods Thirty patients with LRRC who refused operation or were unable to endure pelvic radiotherapy received 125I seed implantation under CT guidance.Three-dimensional treatment planning system was used to calculate the number,activity,and dose of the seeds needed.The activity of seeds ranged from 14.8 to 29.6 MBq with a median of 25.9 MBq,the seed numbers ranged from 33 to 137 with a median of 74.5,the prescription doses ranged from120-160 Gy,and the actual verification dose D90 ranged from 75.91 to 159.32 Gy with a median of 119.77 Gy.Dosimetric verification by CT scanning was conducted immediately after the treatment.Follow-up was conducted for 15.2 months(4.2-35.0 months).Results The follow-up rate was 93.3％.The pain relief rate was 95.2％.The overall response rate was 50.0％,including a complete response rate of 13.3％ and a partial response rate of 36.7％.The 1-and 2-year local control rates were 30.0％ and 8.0％ respectively.The median local control survival time was 7.8 month.The 1-and 2-year survival rates were 66.5％ and 32.9％ respectively.The median overall survival time was 21.5 months.Complications,mainly adverse effects of skin and urinary system (frequent urination,urgent urination,and dysuria) occurred in 6 patients with a rate of 20.0％.Conclusions Minimally invasive and with satisfying efficacy and tolerable complications,CT-guided 125I radioactive seed implantation is a favorable option for treatment of LRRC,especially for the patients who have undergone previous pelvic radiation.

Objective To explore the effect of health education through different postoperative follow-up method, including telephone、Email and QQ, on patients with indwelling D-J stents. Methods 319patients with indwelling D-J stents were divided into the control group(88 cases), the telephone group(89 cases), the Email group (70 cases) and the QQ group (72 cases). M1 patients received rourine health education during hospitalization and before discharge, the latter three groups received follow-up by telephone、Email and QQ after discharge respectively. The rehabilitation effect was observed in the four groups. Results The complication rates of the telephone group, the Email group and the QQ group was significantly less and the mastering of knowledge about prevention and handling of complication was better than the control group during the follow-up. Conclusions Different types of follow-up can be selected by patients according to their actual status. Decreasing complication rate, favorable social benefit and approval of the patients family members will be seen due to involvement of the patients family in health education.

Objective To investigate the effect of individualized and comprehensive therapy in treatment of severe acute pancrea-titis in early stage for preventing MODS .Methods 85 patients with severe acute pancreatitis treated in this Chengde medical college affiliated hospital from January 2008 to January 2012 were divided into two groups .The control group included 42 patients ,all used conventional basic treatment ;the test group included 43 patients ,and all used individualized and comprehensive therapy in early stage .The APACHEⅡ ,MODS and Ranson scores ,and serum inflammatory cytokines indexes of patients in each group before and after admission were all recorded .Results The APACHEⅡ and MODS scores after admission of test group were significantly low-er than the control group(P< 0 .05) .The TNF α,CRP and IL 10 after admission of two groups had significant difference (P<0 .05) .The MODS incidence of control group was 64 .3% (27/42) ,pancreatic encephalopathy incidence was21 .4% (9/43) ,the inci-dence of pancreatic infection was 33 .3% (14/42) ,hospital mortality incidence was 19 .1% (8/42) and length of hospital stay was (30 .4 ± 5 .7) d .The MODS incidence of test group was 27 .9% (12/43) ,pancreatic encephalopathy incidence was11 .6% (5/43) , pancreatic infection rate was 14 .0% (6/43) ,hospital mortality incidence was 4 .7% (2/43) and length of hospital stay was (23 .5 ± 4 .3) d .The incidence of MODS ,hospital mortality and pancreatic infection rates of test group were significantly lower than that of the control group (P<0 .05) .The average length of stay of test group were significantly lower than the control group (P<0 .05) . Conclusion To use individualized and comprehensive therapy in treatment of severe acute pancreatitis in early stage can reduce MODS ,protect organ function ,and reduce mortality .