OBJECTIVE:To observe the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) combined with levosimendan in acute decompensated heart failure(ADHF). METHODS:In retrospective study,120 cases diagnosed as AD-HF were divided into observation group and control group according to treatment plan,with 60 cases in each group. The patients of control group received rhBNP on the basis of conventional treatment,intravenously pulsed with dose of 0.15 μg/kg firstly,then maintained dose of 0.007 5 μg/kg viacontinuous intravenous pumping for 24-72 h;On the basis of control group,treatment group received levosimendan with loading-dose of 12 μg/(kg·min)for 10 min,maintenance dose of 0.1 μg/(kg·min)via intravenous pump,for 24 h,adjusted according to clinical manifestations of patients. The vital signs,hemodynamic and UCG indexes,the rate of dyspnea recovery,plasma level of BNP,urine and the occurrence of ADR were recorded in 2 groups. RESULTS:The vital sign and hemodynamic indexes of control group had no significant change 1 h after treatment;the levels of HR,RR,SBP,MPAP and MPCWP in 2 groups after treatment were significantly lower than before,while the levels of SaO2 and CO were significantly higher than before,with statistical significance (P<0.05). The levels of HR,RR,SBP,MPAP and MPCWP in observation group 1,2, 4 h after treatment were significantly lower than in control group,while the levels of SaO2 and CO were significantly higher than control group,with statistical significance (P<0.05);there was no statistical significance in vital sign and hemodynamic indexes between 2 groups at other time points (P>0.05). 48 h after treatment,LVEF of 2 groups were increased while plasma levels of BNP were decreased,compared to before treatment;the improvement of observation group was more significant than control group,with statistical significance(P<0.05). And the urine volume of observation group were significantly higher than that of con-trol group 24,48 h after treatment,with statistical significance(P<0.05). There was no statistical significance in the rate of dys-pnea recovery at different time points and the incidence of ADR after treatment between 2 groups (P>0.05). CONCLU-SIONS:rhBNP combined with levosimendan could effectively improve vital sign,hemodynamic indexes,UCG indexes and dys-pnea,and decrease the plasma level of BNP with good safety.

Objective Pericardiocentesis and drainage are the common measures for the treatment of cardiac temponade and massive pericardial effusion. In this issue, the complications of pericardiocentesis and drainage were discussed. Methods 5 in-hospital cases of cardiac temponade or massive pericardial efiusion who had complications of pericardiocentesis and drainage were reported and analyzed. Results The complications were 2 cases with neural mediated syncope, 1 case with pleural efiusion, 1 case dead of acute right ventricular dilation, and 1 case with acute pulmonary edema and effusion leaking into the subcutaneous tissue. Conclusion The importance of hemodynamic change during pericardiocentesis and drainage could not be over-emphasized, and the patients whose hemodynamic status were unstable should be monitored by bedside hemodynamic monitoring or echocardiography. Also we should pay more attention to the drainage catheter per se, which may cause the complications.

Objective To compare GM260 portable blood glucose meter and AU5821 automatic biochemical analyzer in order to prove the accuracy of GM260 and its applicability for clinical use.Methods Totally 20 pieces of EDTA-K2 anticoagulative specimens and 23 GM260 meters were numbered,and each specimen underwent examinations by both GM260 and AU5821,then the bias between the two kinds of devices was calculated.Results The maximal bias between GM260 and AU5821 was 0.47 mmol/L and all the meters had the bias between-0.83 and 0.83 mmol/L in case of 5 specimens with the glucose concentration less than 4.2 mmol/L;the maximal bias between GM260 and AU5821 was 18.07％ and all the meters had the bias between-20％ and 20％ in case of 15 specimens with the glucose concentration not less than 4.2 mmol/L;the examination results by GM260 all accorded with industrial standard.The results by GM260 were lower than those by AU5821,and the maximal negative deviation was-13.43％.Conclusion Portable blood glucose meter can only be used for screening,and automatic biochemical analyzer is the preferred device for diabetes diagnosis.

Objective To investigate the effects of fluoride at different concentrations on proliferation and apoptosis of primary rat ameloblast in vitro.Methods Ameloblasts were isolated from tooth germ of 4 days SD rat maxillomandibular molar and cultured in vitro.Cells were treated with NaF at 0.0 (control group),0.4,0.8,1.6,3.2 and 6.4 mmol/L for 24,48 and 72 h,respectively.Inverted microscope was used to observe cell morphology;immunochemistry method was used to identify ameloblasts;3-(4,5-dimethylthiazole-2)-2,5-diphenyl tetrazolium bromide (MTT) assay was applied to measure cell viability at each time point.The cells were treated with 1.6 mmol/L NaF for 24 and 48 h,or after 50 mol/L caspase pan-inhibitor Z-VAD-FMK pretreatment 1 h,1.6 mmol/L NaF treatment for 48 h.Cell apoptosis was then tested by flow cytometry.In addition,activation of caspase-3 and poly (ADP-ribose) polymerase (PARP) were assessed by Western blotting to explore potential involvement of caspase activation in NaF-induced apoptosis.All data analysis was performed using SigmaStat V 3.5 software.Results ①Primary rat ameloblasts were in polygonal shape at low density and appeared like paving stone at high density with obvious nucleus,showing typical morphological characteristics of cells with epithelial origin.②The results of immunochemistry assay indicated that the cultured cells were positive in cytokeratin 14 (CK14) and ameloblastin (AMBN) staining,in accordance with the immunocytochemical characteristics of ameloblasts.③The effects of NaF on ameloblast proliferation were in a dose-and time-dependent manner.For low dose NaF (0.4 and 0.8 mmol/L) groups,cells treated for 24 h had significantly higher cell proliferation rates than that of the control group (0.0 mmol/L,P ＜0.05),the proliferation indexes for 0.0,0.4 and 0.8 mmol/L groups were 1.00 ± 0.00,1.38 ± 0.11 and 1.29 ± 0.13,respectively;the same doses of NaF had no obvious influence on cell proliferation at 48 h (1.00 ± 0.00,1.16 ± 0.14 and 0.94 ± 0.07,P ＞ 0.05);cell proliferation indexes at 72 h were significantly lower than that of the control group (0.87 ± 0.03 and 0.80 ± 0.04,P ＜ 0.05).Medium dose of NaF (1.6 mmol/L) did not cause obvious alterations in cell proliferation at 24 h (0.90 ± 0.08,P ＞ 0.05);while cell proliferation indexes at 48 and 72 h were obviously reduced than that of the control group (0.38 ± 0.03 and 0.26 ± 0.04,P ＜ 0.01).For high NaF concentration (3.2 and 6.4 mmo]/L) groups,cell proliferation indexes were significantly decreased at all time points compared with control cells,the rates for 3.2 mmol/L groups were 0.57 ± 0.14,0.08 ± 0.03 and 0.00 ± 0.00,respectively,and the rates for 6.4 mmol/L groups were 0.11 ± 0.04,0.00 ± 0.00 and 0.00 ± 0.00,respectively (P ＜ 0.01).④Flow cytometry was used to detect apoptosis.The results showed that treatment with 1.6 mmol/L NaF resulted in significantly increased apoptosis in ameloblasts at both 24 h [(5.80 ± 2.03)％] and 48 h [(17.45 ± 4.97)％] compared to the control group [(2.59 ± 0.95)％,P ＜ 0.05].In cells pre-treated with pan-caspase inhibitor Z-VAD-FMK,NaF-induced apoptosis was significantly lower than that of cells treated with only 1.6 mmol/L NaF [(9.43 ± 3.79)％ vs (18.26 ± 3.39)％,P ＜ 0.05].⑤Cleavage of caspase-3 and PARP was detected in ameloblasts treated with 1.6 mmol/L NaF for 48 h.Conclusion Overdose fluoride could inhibit proliferation and induce apoptosis via activation of caspase cascade in primary cultured rat ameloblasts.

ObjectiveTo reduce the effective dose and maintain the image quality by adjusting the image processing parameters in the lumbar spine examinations.Methods This study investigated the influence of image processing parameters on image quality of Philips DR system by evaluating image quality of CDRAD 2.0 phantom.The parameters include detail contrast enhancement,noise compensation,unsharp masking and unsharp masking kernel.The entrance surface dose of phantom was measured by solidose meter.A synthetical parameters optimization project was proposed by analyzing the results of the investigation.This project was also testified by phantoms.ResultsImportant effects were the main effects of DCE,unsharp masking and kernel at the clinically used tube potential of 70 kVp( F =91.45,373.79,429.88,P ＜ 0.05).These effects indicated an increase of the 1QF about 20 units with increasing unsharp masking,while an increase of DCE and kernel led to decrease of IQF about 10 and 21 units.When the tube potential was increased to 85 kV,keeping the settings of the process parameters unchanged,the IQF increased.The results showed statically significant difference ( t =5.31,P ＜ 0.05 ).ConclusionIt is possible to lower the effective dose to the patient by the use of a higher tube potential and maintain a good image quality,and it will have little influence on clinic diagnosis through the most optimal setting of the process parameters.

Objective To analyze the treatment effect of deep venous thrombosis (DVT) in acute pulmonary thromboembolism (PTE) with thrombolytic and anticoagulant therapy. Methods Post hoc analysis of data from a prospective multicenter randomized control thrombolytic and anticoagulant trial of 516 patients with acute symptomatic PTE from June 2002 to December 2004. Thrombolytic therapy was performed in patients with massive and sub-massive PTE and anticoagulant therapy was given in patients with non-massive PTE. A total of 362 patients that accepted compression uhrasonography (CUS) before and 14 days after treatment constituted this study. Results The ratio of detected DVT by CUS 14 days after treatment was reduction than that before treatment ( x2 = 22. 667, P < 0. 001 ), but 11.6% patients had new or recurrent DVT. The rates of recanalization in thrombolysis group and anticoagulant group were 56. 5% and 47. 8% respectively (x2 = 1. 435 ,P =0. 231 ). The results after three months follow up showed not recovery in 30. 4% DVT patients and new or recurrent DVT in 10. 4% patients. Conclusions The normalization rate of DVT is low during 14 days treatment, and recurrence rate is high. Thrombolysis has no better rate of recanalization than anticoagulant. The prognosis of DVT hasn't improved significantly during short term treatment.

ObjectiveTo investigate the changes of serum apolipoprotein E (ApoE) in children with infectious diseases.MethodsA total of 279 pediatric patients with infectious diseases were enrolled in this study,including 65 patients with sepsis,47 patients with bacterial meningitis,67 patients with bacterial pneumonia, 47 patients with aseptic meningitis and 53 patients with mycoplasmapneumonia. TheserumApoEcollectedfromallpatientswasdetectedby immunoturbidimetric assay (IA).The septic mouse model was established by intraperitoneal injection of group B Salmonella typhimurium.Mouse serum ApoE levels were detected by IA,and the hepatic ApoE mRNA and protein expressions of mice were detected by quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western blot,respectively.Data in two groups were compared by independent-sample t test.ResultsSerum ApoE levels in patients with bacterial infections were increased dramatically,which was (59.8±23.5) mg/L in patients with sepsis (t=-5.118,P＜0.01),while no significant differences were found in patients with aseptic meningitis and myeoplasma pneumonia.Moreover,a high level of serum ApoE was detected in septic mouse model,while the hepatic ApoE mRNA and protein expressions of the mice were both decreased,with mRNA decreased 71％ at 3 hour (t=5.022,P＜0.01) and 73％ at 24 hour (t=4.181,P＜0.01).Conclusions Serum ApoE levels in bacterial infections increase dramatically,while its hepatic expression in septic mouse model is decreased,which indicates that the elevated serum ApoE level is not related to the changes of hepatic ApoE expression.

Objective:To combine the detection of serum levels of adenosine deaminase (ADA) and T-cell spot test (T-spot.TB),and to explore their significances in diagnosis of pulmonary tuberculosis.Methods:159 patients suspected with pulmonary tuberculosis were selected and divided into pulmonary tuberculosis group and non-tuberculosis group (n=68);80 healthy people were randonly selected as healthy control group.The serum ADA levels and number of T-spot of the subjects in three groups were detected.Ther serum ADA levels and the positive rates of T-spot.TB in various groups and their sensitivities and specifities were compared. Results:The serum ADA level of the patients in pulmonary tuberculosis gruop was (22.10±6.60)U·L-1;those in non-tuberculosis group and healthy control group were (16.90±6.35)and (8.70±5.98)U·L-1;the serum ADA level in pulmonary tuberculosis group was significantly higher than those in non-tuberculosis group and heathy control group (P<0.05).The positive rate of serum ADA level in diagnosis of pulmonary tuberculosis was 56% and the T-spot.TB positive rate in diagnosis of pulmonary tuberculosis was 87.9%. Combined use of parallel test, the detection sensitivity was 91.2%;using the series of joint tests,the specificity was 94.6%.Conclusion:Combined detection of serum level of ADA and T-spot.TB can significantly improve the clinical diagnosis efficacy of pulmonary tuberculosis.

Since 2007, a number of published population-based studies have shown that stroke epidemiology has changed. There are some differences in morbidity, mortality, risk factors and clinical prognosis of stroke between the high-income countries and the less developed countries.

Aim To investigate the effects of iptakalim(IPT),a novel K_(ATP) opener,on the functions of endothelin system in human pulmonary artery endothelial cells.Methods Primary cultured human pulmonary artery endothelial cells were incubated with different concentrations iptakalim for 24 h.The levels of ET-1 in medium were observed by radioimmunoassay.Reverse transcription polymerase chain reaction(RT-PCR)was performed to analyze the expression of ET-1 and ECE.Results When endothelial cells were incubated with IPT at concentrations above 10 μmol·L~(-1),the levels of ET-1 release in medium and the levels of ET-1 mRNA were significantly inhibited.When endothelial cells were incubated with IPT at concentrations above 1 μmol·L~(-1),the levels of ECE mRNA were significantly inhibited.Conclusions IPT can inhibit the expression of ET-1 and ECE mRNA from human pulmonary artery endothelial cells, thus it inhibits the secretion of ET-1 from endothelial cells. Iptakalim may serve as a promising candidate drug to treat pulmonary hypertension.