One hundred and five patients with non-ST segment elevation acute coronary syndrome were followed up for 1 year.They were assigned to the event group or non-event group according to the presence of endpoint events(cardiac death and nonfatM myocardial infarction).B-type natriuretic peptide level was measured at 30 days and 1 year and compared between the two groups.The results showed that the level of B-type natriuretic peptide was higher in the event group[(235±107)μg/L vs(154±49)μg/L at 30 days;(259±100)μg/L vs(143±57)μg/L at 1 year].Thus,B-type natriuretic peptide is an important prognostic factor for patients with non-ST segment elevation acute coronary syndrome.

Objective To analysis the risk factors of cardiovascular events during periopemtive period undergoing hand surgery . Methods 197 cases of hand surgery in our hospital from 2009 to 2012 ,aged 21 to 74 years were selected .The general condition ,an-esthesia ,operative time and intraoperative hemodynamics (blood pressure> 20% ) were recorded ,postoperative follow-up and record the occurrence of cardiovascular events ,and factor analysis was carried on .Results In 48 hours ,23 patients were suffered from car-diovascular events ,and the total morbidity rate was 11 .7% ,in which sinus tachycardia was 3 case(1 .52% ) ,atrial fibrillation were 2 cases(1 .02% ) ,premature ventricular contractions were 4 cases(2 .03% ) ,the myocardial ischemia were 11 cases(5 .58% ) ,the angi-na pectoris were 3 cases(1 .52% ) ,the myocardial isehemia was 1case(0 .51% ) .Multiariable Logistic regression analysis showed that ,the influencing factors of perioperative cardiovascular events undergoing hand surgery were were diabetes mellitus (OR=2 .012 ,P=0 .023) ,coronary heart disease (OR=2 .301 ,P=0 .028) ,preoperative ST ischemic changes (OR=2 .942 ,P=0 .031) ,lip-id abnormalities(OR=3 .012 ,P=0 .019) and hemodynamics changes during operation(OR=3 .522 ,P=0 .020) .Conclusion The risk factors of perioperative cardiovascular events independent undergoing hand surgery might be diabetes ,coronary heart disease , preoperative ST ischemic changes ,intraoperative hemodynamic changes .

OBJECTIVETo observe interventional effects of anti-viral therapy and Compound Qin-gre Granule (CQG) on host cellular immune functions of acute virus infection patients.

METHODSThirty acute virus infection patients were recruited to detect peripheral lymphocyte subsets. They were randomly assigned to two groups, the Western medicine treatment group (treated with anti-virus Western medicine) and the integrative medicine treatment group (treated with anti-virus Western medicine plus CQG). T-cell subsets were re-examined 7 days later. Changes between before and after treatment were observed. Effect on host cellular immune functions and efficacy were compared between the Western medicine treatment and the integrative medicine treatment.

RESULTSCompared with the normal control group, the percentage of peripheral T cells increased, and the percentage of B/NK cells decreased in acute virus infection patients (P < 0.01). Meanwhile, in T cell subsets, the percentage of CD8+ T cells and CD8+ CD38+ T cells increased (P < 0.05, P < 0.01); and percentages of CD4+ T cells, CD4+ CD28 + T cells, and CD8+ CD28+ T cells decreased (P < 0.05, P < 0.01). After one-week treatment, percentages of CD4+ T cells, CD4+ CD28+ T cells, and CD8+ CD28+ T cells increased (P < 0.05, P < 0.01), while the percentage of CD8+ CD38+ T cells decreased (P < 0.01). More significantly, these changes were greater in the integrative medicine treatment group than in the Western medicine treatment group (P < 0.05).

CONCLUSIONSDisarranged cellular immune functions existed in acute virus infection patients. CQG could significantly improve viral infection induced immunologic derangement and immunologic injury.

Objective To observe the improvement effects of Qingshen Granule on the life quality of chronic kidney disease (CKD) patients with damp-heat syndrome. Methods The CKD patients with damp-heat syndrome were randomly divided into experimental group and control group. The control group was treated with Western medicine, and the treatment group was treated with Qingshen Granules additionally for 12 weeks. SCr and eGFR were observed before and after treatment, and the life quality was investigated by KDQOL-SFTM1.3. Results Actually 156 cases were completed, including 77 cases in the treatment group and 79 cases in the control group. The total rate of curative effect was 81.82% (63/77) in teatment group, and (63.29%, 50/79) in control group, with significent difference (P<0.05). Multivariate linear regression analysis indicated that gender, education level, TCM syndrome score, CKD stage, eGFR and Hb level could affect the life quality. The scores of KDQOL-SFTM and its containing the MOS item short from health survey (SF-36) and kidney disease targeted areas (KDTA) were significantly improved after treatment in experimental group (P<0.05), while the scores in control group were with no significant improvement. The improving effects of PCS, and SPL, SLEEP, PS in KDTA in treatment group were significantly superior to those in control group (P<0.05). The scores of life quality in effective and stable cases increased significantly after treatment compared with before treatment (P<0.05). Conclusion Qingshen Granules can effectively improve the life quality of CKD patients with damp-heat syndrome, and the effect is not dependent on the improvement of laboratory indexes (renal function).

Objective To investigate prognostic predictors of long-term survival of patients with cardiac amyloidosis (CA), and to determine predictive value of high-sensitivity cardiac troponin T (hs-cTnT) in CA patients. Methods We recruited 102 consecutive CA cases and followed these patients for 5 years. We described their clinical characteristics at presentation and used a new, high-sensitivity assay to determine the concentration of cTnT in plasma samples from these patients. Results The patients with poor prognosis showed older age (56 ±12 years vs. 50 ±15 years, P=0.022), higher incidences of heart failure (36.92%vs. 16.22%, P=0.041), pericardial effusion (60.00%vs. 35.14%, P=0.023), greater thickness of interventricular septum (IVS) (15 ±4 mm vs. 13 ±4 mm, P=0.034), higher level of hs-cTnT (0.186 ±0.249 ng/mL vs. 0.044 ±0.055 ng/mL, P=0.001) and higher NT-proBNP (N-terminal pro-B-type natriuretic pep-tide) levels (11,742 ± 10,464 pg/mL vs. 6,031 ± 7,458 pg/mL, P=0.006). At multivariate Cox regression analysis, heart failure (HR:1.78, 95%CI:1.09-2.92, P=0.021), greater wall thickness of IVS (HR:1.44, 95%CI:1.04-3.01, P=0.0375) and higher hs-cTnT level (HR:6.16, 95%CI:2.20-17.24, P=0.001) at enrollment emerged as independent predictors of all-cause mortality. Conclusions We showed that hs-cTnT is associated with a very ominous prognosis, and it is also the strongest predictor of all-cause mortality in multivariate analysis. Examination of hs-cTnT concentrations provides valuable prognostic information concerning long-term outcomes.

Althoughtheevidenceoftheevidence-basedmedicinehasshowedthatrecombinant tissue-type plasminogen activator can effectively open the occluded vessels, because of its short therapeutic time w indow and the risk of bleeding, the thrombolytic rate is general y low er currently. Clinical studies have show ed that telestroke can effectively shorten the treatment time of the patients, increase the thrombolytic rate, reduce the risk of bleeding, and improve the outcomes of patients. Although the application of telestroke is restricted in many w ays, such as technology, policy, and funding, w ith the grow ing maturity of the related technologies, telestroke w il play an increasingly important role in the treatment of stroke.

Objective To study the effect of zoledronate (ZOL) on Ca2+/calmodulin-dependent kinase Ⅱ δ (CaMK Ⅱ δ) and down-stream gene expressions during osteoclast differentiation.Methods Mouse osteoclast precursors RAW264.7 cells were divided into the control group and ZOL group.The cells in both groups were induced with 50μg/L receptor activator of nuclear factor kappa B ligand (RANKL) and were harvested on 5 d,while the cells in ZOL group were also simultaneously treated with 1 × 10-6 mol/L ZOL for 2 d.Five days later,the cells were harvested and examined osteoclastogenesis,as well as gene expressions of CaMK Ⅱ δ,nuclear factor of activated T-cells cytoplasmic 1 (NFATc1),tartrate-resistant acid phosphatase (TRAP) and cell-sarcoma receptor coactivator (c-Src).Results The number of TRAP positive multinuclear osteoclasts,number and size of dentin absorption lacunae and area in the ZOL group were (20.0±3.2),(18.0±4.2) and (6 335.3± 1 043.2)μm2 respectively,which were significantly lower than (36.0 ± 8.4),(37.2 ± 5.0) and (11 636.2 ± 3 661.1) μm2 in the control group and decreased by 44.4 ％,51.6 ％ and 45.6 ％ respectively (P＜0.01).ZOL also significantly inhibited the gene expressions of CaMK Ⅱ δ,NFATc1,TRAP and c-Src,and the mRNA levels of these genes were decreased by 44.1％,49.0％,53.8％ and 49.6％ respectively,the protein level were decreased by 43.5 ％,32.2 ％,45.5 ％ and 48.0 ％ respectively.The immunofluorescent cytochemistry detection results showed the fluorescence intensity of CaMK Ⅱ δ,NFATc1,TRAP and c-Srcin in the ZOL group was significantly weakened when compared with the control group.Conclusion ZOL could significantly inhibit the osteoclast formation and bone absorption function,and down-regulates gene expressions of CaMK Ⅱ δ,NFATc1,TRAP and c-Src in osteoclast differentiation.

Objective To evaluate the clinical effect of absorbable self-enhancing cartilage nails in the treatment of radial head fractures.Methods Data of 22 patients with radial head fractures,who had undergone open reduction and internal fixation with absorbable self-enhancing cartilage nails from January 2008 to December 2011,were retrospectively analyzed.Among them,data of 18 patients were complete,including 10 males and 8 females.According to the Mason classification,there were 14 cases of Mason Ⅱ,3 cases of Mason Ⅲ and 1 case of Mason Ⅳ.Two patients were combined with radial neck fractures,9 with osteochondral fractures of capitellum,and 1 with posterior dislocation of the elbow and olecranon avulsion fracture.The radial head fractures were temporarily fixed with Kirschner wires after open reduction,then absorbable self-enhancing cartilage nails with length from 16 to 24 mm and diameters of 1.5 mm were applied to reach final fixation.The heads of nails were right underneath of cartilages without penetrating bone cortexes on the contralateral side.The radial neck fractures were reduced and fixed with T-plates or anatomical plates after the radial head fractures were fixed with cartilage nails.Four cases of osteochondral fracture of capitellum were fixed with absorbable sutures to external epicondyle of humerus.For other 5 cases of osteochondral fracture of capitellum,the bone fragments were removed due to too small to fix.Results All 18 patients were followed up for 6 to 54 months (average,31.3 months).All fractures achieved bone union,and the healing time ranged from 5 to 12 weeks (average,8.7 weeks).There were no complications,such as internal fixation failure,nonunion,hematoma,sinus formation,osteolytic changes of radial heads and so on.According to the Broberg-Morrey elbow performance score,13 cases were excellent,4 good,and 1 fair,with the total excellent and good rate of 94.44％ (17/18).At final follow-up,the elbow range of motion was 90° to 150° (average,123.8°),and the range of forearm rotation was 130° to 180° (average,152.5°).Conclusion Absorbable self-enhancing cartilage nails can be used to treat various kinds of radial head fractures,and the results are satisfactory.

Objective To evaluate the effects of dezocine on diabetic neuropathic pain (DNP ) and expression of NMDA receptor subunit 2B (NR2B) in the spinal dorsal horns of rats .Methods Forty-eight male Sprague-Dawley rats , aged 4 weeks , weighing 150-170 g , with DNP induced by intraperitoneal injection of streptozocin (STZ) 50 mg/kg (successful induction of diabetes was defined as blood glucose >16.7 mmol/L) , were randomly divided into 2 groups ( n=24 each) using a random number table:DNP group and dezocine group (group D) .Twenty-four normal rats were chosen and served as normal control group (group C) .In group D , dezocine 2.52 mg/kg was injected intramuscularly once a day for 7 consecutive days starting from 2nd week after STZ injection ,while the rats in DNP and C groups received the equal volume of normal saline .Paw withdrawl threshold (PWT) to mechanical stimulation was measured before dezocine injection (T0 ) ,and on 1st ,3rd ,5th and 7th days after dezocine injection (T1-4 ) and on 7th day after the end of dezocine injection (T5 ) .Twelve rats in each group were sacrificed after measurement of PWT at T4 ,and T5 .The lumbar segments of the spinal cord were removed for determination of NR2B protein expression (by immuno-histochemistry and Western blot ) and NR2B mRNA expression (by RT-PCR ) in the spinal dorsal horns .Results Compared with group C ,the PWT at T0-5 in group DNP and at T0 and T5 in group D was significantly decreased , and the expression of NR2B protein and mRNA at T4 ,5 in DNP group and at T5 in D group was up-regulated ( P<0.05) .Compared with group DNP ,the PWT was significantly increased at T1-4 ,the expression of NR2B protein and mRNA was down-regulated at T4 ( P<0.05) ,and no significant changes were found in the parameters mentioned above at T5 in group D ( P>0.05) . The PWT was significantly lower at T0 and T5 ,and the expression of NR2B protein and mRNA was higher at T5 than at T4 in group D ( P<0.05 ) .Conclusion Dezocine can effectively relieve DNP in rats and inhibition of NR2B expression in the spinal dorsal horns is involved in the mechanism .

Objective To study the role of protective antigen(PA)and N-terminal segment of lethal factor (LFn)in the entrance of EGFP(enhanced green fluorescent protein)into HeLa cells. Methods The DNA fragments encoding LFn and EGFP were amplified,respectively,and cloned into the plasmid pET-21 a(+)one after another to construct a recombinant plasmid pET-LFn-EGFP. The plasmid was txansformed into BL21 cells to express LFn-EGFP protein under the induction of IPTG. The protein was purified by Ni chelating chromatography. After incubation with LFn-EGFP in the presence of PA or not, the HeLa cells were analyzed by flow cytometry or laser confocal microscopy. Results The fusion protein LFn-EGFP was purified by over 90% homogeneity and retained the ability of LF to bind with PA when incubated with J774A.1 macrophage cells,and could get into HeLa cells. Conclusion The LFn-EGFP could enter the HeLa cells in a PA independent pathway. But PA could help more LFn-EGFP molecules enter into HeLa cells.