Objective To observe the perioperative myocardial protection of high-dose atorvastatin to acute coronary syndrome(ACS) patients during percutaneous coronary artery interventional therapy(PCI).Methods One hundred and twenty patients with ACS undergoing elective PCI were divided into group A and group B with different oral dose of atorvastatin ( 80 mg/d and 20 mg/d ) for 3 days before operation by random digits table. Troponin I (cTnI), creatine kinase isozyme MB (CK-MB), high sensitive C-reactive protein (hs-CRP), interleukin (IL)-6 levels were measured before operation, 6 hours, 12 hours after operation and total cholesterol (TC), triglyeride (TG), low desity lipeprotein cholesterol (LDL-C), high density lipeprotein cholesterol (HDL-C) levels were measured before operation and 3 days after operation.Results cTnI,CK-MB,hs-CRP and IL-6 levels in the two groups were increased significandy 6 hours and 12 hours after operation (P <0.05). Six hours after operation, cTnI and CK-MB levels in group A were significantly lower than those in group B [(0.35±0. 18 ) μg/L vs. (0.48±0. 16 ) μg/L, ( 3.78±0.45 )μg/Lvs. (4.56±0.55 )μg/L] (P < 0.05 ). Twelve hours after operation , hs-CRP and IL-6 levels in group A were significantly lower than those in group B [(4.53±0.98 ) mg/L vs. (7.03±0.88 ) mg/L, ( 30.6±11.2) ng/L vs.(43.8±12.1) ng/L] (P <0.05). TC, TG, LDL-C, HDL-C levels in the two groups did not change significantly before and after operation (P >0.05). Conclusions Myocardial protective effects of ACS patients treated with atorvastatin 80 mg/d for 3 days are better than those treated with oral atorvastatin 20 mg/d. High-dose atorvastatin can produce more beneficial effects.

Objective To investigate the clinical efficacy of finger reconstruction in child with second toe transplantation,and evaluate the postoperative appearance and function regarding the reconstructed donor feet.Methods From June 2002 to May 2011,sixteen cases were reconstructed in sub-emergency with second toe transplantation.Two thumbs,eight index fingers,and 6 middle fingers were reconstructed.All patients were followed-up from 12 to 24 months.The functions of reconstructed fingers were analysed.Results All the reconstructed fingers survived.Vascular crisis occurred in 1 patient,and survived after re-anastomosis.Necrosis of skin grafts at the domon site with exposed tedons was seen in 1 ease,and healed after changing dressings.All the reconstructed fingers showed good in growth and development,and performed good functions as grabbing,grasping and nipping.Two-point discrimination was between 6 mm and 10 mm.The donor site of the foot had normal gait,without obvious influence on walking.Also,no pain was complained.Conclusion The method of transplanting the second toe can reconstruct the appearance and function of the finger defects in child,and has little effect on the appearance and motion of feet.It is an effective treatment method.

ObjectiveTo study the effect of fluorine on proliferation of osteoblast through extra cellular signal-regulated protein kinase(ERK) signaling pathway.MethodsMouse osteoblasts(MC3T3-E1) were cultured in vitro with different concentrations of fluoride for 24 and 48 h (the concentrations of Fˉ were 0,200,400,600,1000,2000,4000,8000,10 000 μmol/L,respectively).The optimum concentration for promotion of cell proliferation was determined by methylthiophene tetrazolium(MTT) assay.According to the optimum concentration,the cells were randomly divided into three groups:control group (0 μmol/L Fˉ); fluorine group (400 μmol/L Fˉ); fluorine and MAPK inhibitor PD98059 group(400 μ mol/L Fˉ + 10 μ mmol/L PD98059).Cell cycle was detected by flow cytometry after 48 h culture.The expression of P-ERK protein was determined by Western blotting and immunofluorescence.ResultsThe optimum concentration of fluorine for proliferation of osteoblasts was 400 μ mol/L.Compared with the control group[(76.12 ± 10.08)％,(2.06 ± 0.31)％],the number of cells in G0/G1 phase[(63.04 ± 8.12)％] reduced and the number of cells in S phase[(9.13 ± 2.08)％] increased in fluorine group (all P ＜ 0.05) ; but the number of cells in G0/G1 phase [(92.11 ± 9.01 ) ％] in fluorine and mitogen-activated protein kinases (MAPK) inhibitor PD98059 group was significantly increased(P ＜ 0.05 ).Western blotting results showed that:compared with the control group[(100.00 ± 0.00)％],the expression of P-ERK protein in fluorine group[(131.24 ± 13.88)％] was significantly higher(P ＜ 0.05 ),but the expression of P-ERK protein in fluorine and MAPK inhibitor PD98059 group [(91.33 ± 9.68 )％] was not significantly changed(P ＞ 0.05).The results of immunofluorescence were similar to that of Western blotting.ConclusionsFluorine at the concentration of 400 μmol/L can promote the proliferation of osteoblasts.ERK signaling pathway has played a key role in the proliferation of osteoblasts.

Objective To investigate the effects of lovastatin,a widely used antilipemic agent,on cell proliferation,migration and apoptosis in human cholangiocarcinoma cell line QBC939 and explore its possible mechanism.Method After QBC939 cells were either incubated with lovastatin alone or without it as a control,the methylthiazolyl tetrazolium assay (MTT) assay was used to detect cell proliferation at the 24 h,48 h and 72 h mark; flow cytometry (FCM) measured apoptosis at 48 h;scratch assay was used to determine cell migration at 48h; RT-PCR and Western blot detected the expression of inflammatory cytokine interleukin-6 (IL-6),protein kinase (PKB/Akt),vascular endothelial growth factor (VEGF),matrix metalloproteinase-9 (MMP-9) mRNA and Akt protein at 48 h.Results Lovastatin significantly inhibited cell proliferation in a dose and time dependent manner (24 h,48 h and 72 h:F=173.05,159.66,577.87 respectively,all P＜0.01).After lovastatin treatment,apoptosis induction increased (t =15.28,P＜ 0.01 ) as did early apoptosis (t =13.24,P＜0.01),while the average migration velocity was reduced (24 h and 48 h:t=6.21,5.95,respectively,all P＜0.01).The Akt protein expression and mRNA expression of IL-6,Akt,VEGF,and MMP-9 were down-regulated after lovastatin treatment.Conclusions Lovastatin can inhibit cell proliferation,migration and promote apoptosis in human cholangiocarcinoma cell line QBC939.The mechanisms of suppression may be associated with down-regulation of IL-6,Akt,VEGF and MMP-9 expression.

ObjectiveTo investigate the clinical value of ATP bioluminescence tumor chemosensitivity assay (ATP-TCA) for recurrent and refractory non-Hodgkin lymphoma (NHL) specimens in vitro.Methods Thirty-four freshlytaken recurrent andrefractoryNHL specimens weretestedin vitro for cancer chemosensitivity by ATP-TCA.ResultsDrug sensitivity of NHL specimens had heterogeneity.Different drugs had different tumor growth inhibition ratio in vitro.Response rate (RR) of the patients receiving chemotherapy according to in vitro assay was 82.4 ％ (28/34),complete response rate (CR) was 52.9 ％ (18/34).In DICE group RR was 60.0 ％ (18/30),CR rate was 33.3 ％ (10/30).In GDP group RR was 62.3 ％ (33/53),CR rate was 26.4 ％ (14/53).In ATP-TCA group RR was significantly higher than those in DICE and GDP groups (x2 =3.93,P =0.047; x2 =3.98,P =0.046).ConclusionThe results of ATP-TCA assay are correlated well with clinical treatment responses.The assay may be an important and useful method for individual-based chemotherapy of cancers.

Objective To investigate the management and control of hypertension in patients with chronic kidney disease(CKD) and its associated factors.Methods Data of 726in-patients with CKD and hypertension who hospitalized in our hospital from March 2009 to April 2010 were studied.Results 91.74％ of patients was treated with antihypertensive medications,and 21.21％, 22.59％, 19.56％, 28.37％ of patients received 1, 2, 3, ≥4 antihypertensive drugs,respectively.42.4％ of patients with CKD and hypertension could be controlled up to the standard,and the mean blood pressure was(137.86±20.75)/(76.30±11.35) mm Hg.There was significant difference among stage 1 plus 2, 3, 4 plus 5 (non-dialysis), 5 (dialysis) kidney diseases, with the hypertension control rate being 50.8％, 46.7％, 42.0％, 33.5％, respectively.The hypertension control rate of non-dialysis patients was significantly higher than that of dialysis (44.9％ vs 33.5％,P＜0.05).There was no significant difference between blood dialysis group and peritoneal dialysis group(32.3％ vs 38.7％, P＞0.05).Multivariate Logistic regression analysis showed that female (OR=1.787, 95％CI 1.045-3.056)and ACEI application (OR=4.378, 95％CI1.830-10.472) were positively associated with hypertension control.Whereas, diabetes (OR=0.415, 95％CI 0.188-0.919)and pulse pressure (OR =0.847, 95％ CI 0.811-0.885) were associated with inadequate blood pressure control.ConclusionsDespite almost universal hypertension treatment is used in patients with CKD and high blood pressure, the hypertension control rate is still suboptimal.Female and ACEI are positively associated with adequate hypertension control, whereas diabetes and pulse pressure are negatively associated with the standard.

Objective To discuss the relationship between human leukocyte antigen (HLA) gene heredity and morbidity of cerebral infarction by a random survey on the allele expression of HLA-A, B and DRB1 seats of patients with cerebral infarction. Methods The genotypes of HLA-A, B and DRB1 alleles in 94 patients with cerebral infarction and 122 healthy blood donors were detected by polymerase chain reaction-sequencing based typing (PCR-SBT) method. Results Sixteen alleles in HLA -A locus,32 alleles in HLA -B locus and 25 alleles in HLA -DRB1 locus expressed themselves in these patients with cerebral infarction. The gene frequency of HLA -A*1102 in patients was lower than that in healthy controls, and negative association was found between HLA -A* 1102 allele and cerebral infarction (RR=0.06,P=0.019). Conclusion The research reveals susceptibility association of HLA -A*1102 with patients having cerebral infarction, displaying close genetic immunity correlation between HLA alleles and pathogenesis of cerebral infarction. So, the research in this paper is useful in the clinical prediction of this disease.

Objective To compare the curative effects ofziprasidone and aripiprazole at acute stage on patients with drug-naive schizophrenia and their effects on metabolism of these patients.Methods Forty-six patients with drug-naive schizophrenia,admitted to our hospital from February 2010 to February 2011,were divided into ziprasidone treatment group (n=24,[165±13.51] mg/d) and aripiprazole treatment group (n=22,[28.86±3.06] mg/d); these patients were given the above treatment for 6 week.The scores of positive and negative syndrome scale (PANSS),body mass index (BMI),insulin resistance index (IRI),and levels of fasting blood glucose (FBG),insulin (INS),C-Peptide (CP),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),apolipoprotein-a (APOA) and apolipoprotein-b (APOB) were obtained before and at the end of treatment.Results At the end of treatment,2 patients (9.1％) were cured,7 (31.8％)achieved obvious improvement,9 (40.9％) achieved improvement,and only 4 (18.2％) did not achieve any improvement in the aripiprazole treatment group.However,at the end of treatment,no patient (0％)was cured,7 (29.2％) achieved obvious improvement,12 (50％) achieved improvement,and 5 (20.8％)did not achieve any improvement in the ziprasidone treatment group.The total scores of PANSS after the treatment in both groups decreased significantly as compared with those before treatment (P＜0.05).The BMI ([20.14±2.63] kg/m2) in the ziprasidone treatment group at the end of treatment was obviously increased as compared with that ([19.68±2.76] kg/m2) before treatment (P＜0.05).The FBG ([4.38±0.59]mmmol/L) at the end of treatment decreased significantly as compared with those before treatment ([4.79±0.59] mmmol/L),and the BMI ([19.65±2.15] kg/m2) was obviously increased as compared with that before treatment ([19.19±2.28] kg/m2) in the aripiprazole treatment group (P＜0.05).The metabolic index in the 2 groups was not significantly different at the end of the treatment (P＞0.05).Conclusion Both ziprasidone and olanzapine are effective in the treatment of patients with drug-naive schizophrenia;both of them have mild effects on weight of patients with drug-naive schizophrenia,but no obvious effects on other metabolic indices.

Objective To study the correlations between O (6) -methylguanine-DNA-methyltransferase (MGMT) gene promoter methylation status in malignant glioma tissues and both MGMT protein expression and survival prognosis in these patients, and evaluate the significance of MGMT gene methylation status analyzing with methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) method in chemotherapy of brain glioma.Methods Thirty-nine patients with gliomas confirmed by pathology (WHO grade Ⅲ and grade Ⅳ)were collected in our study; the patient's overall survival (OS) after chemotherapy was tracked.MGMT protein expression of glioma tissues was detected by immunohistochemical staining,and MGMT promoter methylation status was detected by MS-MLPA method. Results Statistical difference of OS time was noted between patients with MGMT-negative and patients with MGMT-positive/-weak-positive (P=0.003).The prognosis in patients with positive MGMT protein expression was obviously poorer than that in patients with negative expression. In the groups of MGMT promoter un-methylation, mild hypermethylation, moderate hypermethylation and extensive hypermethylation, significant statistical difference of OS time was noted between each 2 groups (P＜0.05); the higher degree of methylation,the better prognosis. Statistical correlation was noted between MGMT protein expression and promoter methylation status (r=0.697,P=0.000); the higher degree ofmethylation,the lower protein exression of MGMT. Conclusion Both MGMT protein expression and promoter methylation status can be regarded as prognostic indicator of OS in patients with malignant glioma accepted alkylating agent chemotherapy; MS-MLPA is a reliable method to detect MGMT gene promoter methylation status.

BACKGROUNDTelbivudine, one of the five nucleos(t)ide antiviral drugs, was reported to be superior to lamivudine in a better biochemical, virological, and histological response for treatment-naive patients in the GLOBE trial. The aim of this study was to determine the antiviral potency, viral resistance, and the signifcance of early response for long-term telbivudine treatment.

METHODSWe recruited 161 patients of chronic hepatitis B (CHB) on telbivudine between January 2009 and September 2011 in Macau, China. The serum hepatitis B virus DNA levels, hepatitis B e antigen (HBeAg) seroconversion, alanine aminotransferase (ALT) normalization, and viral resistance were analyzed.

RESULTSThe median age and follow-up duration were 48 years and 16.9 months. All patients were followed up for at least 6 months, while data were collected for 132, 120, 95, and 53 patients at 12, 24, 48, and 96 weeks respectively. The cumulative HBeAg seroconversion rate was 20.8% and only three patients (1.9%) presented with telbivudine low level resistance. The ALT normalization rates were 76.9% at 48 weeks and 77.6% at 96 weeks. Undetectable HBV DNA was achieved by 1.8%, 31.6%, 60%, and 74.1% in HBeAg positive patients and 29.3%, 60.3%, 84%, and 84.6% in HBeAg negative patients at each time point. Week 12 HBV DNA level < 1000 copies/ml (< 200 IU/ml) was a better predictor of viral suppression at 2-year follow-up (P = 0.001, OR = 27.00) than undetectable HBV DNA level at week 24 (P = 0.120, OR = 4.81).

CONCLUSIONSTwo-year telbivudine treatment yielded high rates of viral suppression and ALT normalization. Serum HBV DNA level at week 12 is a superior predictor for long-term viral suppression.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase ; blood ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Drug Resistance, Viral ; Female ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Male ; Middle Aged ; Thymidine ; analogs & derivatives ; therapeutic use ; Time Factors