Objective To detect the level of visfatin in the peripheral blood ofpafients with coronary atherosclerotic heart disease (coronary heart disease),and investigate the conelation between the level of visfatin and the lesion degree of coronary heart disease.Methods Two hundred and twenty patients who were diagnosed as coronary heart disease by coronary artery angiography from January to June 2011 (coronary heart disease group) were enrolled in this study,including 74 cases with stable angina pectoris(stable angina pectoris group),60 cases with unstable angina pectoris (unstable angina pectoris group),and 86 cases with acute myocardial infarction (myocardial infarction group).And 20 healthy persons with normal coronary artery angiography were selected as control group.The biochemical parameters of triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected by biochemistry autoanalyzer.The level of serum visfatin was detected by ELISA analysis.The serum biochemical parameters and serum visfatin among all the groups were compared and the correlation between them was analyzed.ResuIts The level of serum visfatin of coronary heart disease group [(34.07 ±5.51) μg/L] was significantly higher than that of control group [(13.22 ±3.17) μg/L](P＜0.05).TC and LDL-C of different coronary heart disease groups had no significant differences compared with that of control group (P ＞ 0.05).TG,H DL-C and serum visfatin of stable angina pectoris group,unstable angina pectoris group and myocardial infarction group [(1.44 ±0.27) mmol/L,(1.16 ±0.12) mmol/L,(21.36 ± 3.35) μg/L; ( 1.84 ±0.32) mmol/L,(1.01 ± 0.08) mmol/L,(27.78 ±4.47) μg/L; (2.31 ±0.34)mmol/L,(0.93 ± 0.06) mmol/L,(33.14 ± 5.66) μ g/L] had statistical significance compared with those of control group [(0.93 ±0.25) mmol/L,(1.48 ± 0.24) mmol/L,(13.22 ±3.17) μg/L](P＜0.05 or ＜0.01).TG,C,ensini score and serum visfatin of unstable angina pectoris group were significantly higher than those of stable angina pectoris group and HDL-C was obviously lower than that of stable angina pectoris group (P ＜0.05).Gensini score and serum visfatin of myocardial infarction group were significantly higher than those of unstable angina pectoris group and HDL-C was obviously lower than that of unstable angina pectoris group (P ＜ 0.05).Spearman correlation analysis showed that the level of serum visfatin of coronary heart disease group was positively correlated with TG and Gensini score (P ＜0.05 or ＜0.01 ) and negatively correlatedwith HDL-C (P ＜ 0.01 ),and had no correlation with TC and LDL-C (P ＞ 0.05).Conclusions The highlevel expression of visfatin in the peripheral blood may be a risk factor of coronary heart disease.The changes of serum visfatin can reflect the lesion severity degree of coronary artery.

Insulin-like growth factor-I (IGF-I) is a multifunctional cell regulating factor, which plays an important role in the normal physiological activities and pathological process, This article reviewed the research status of the molecular structure of IGF- I and its regulatory factors, the molecular biological role of IGF- I in cell proliferation, cell motility, apoptosis, and reviewed the important role of IGF-I in head and neck tumor, as well as put forward the prospects of IGF-I in middle ear cholesteatoma pathogenesis.
Apoptosis ; Cell Movement ; Cell Proliferation ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Insulin-Like Growth Factor I ; metabolism

Objective To observe and compare the effect of different concentration of ropivacaine on elderly patient with bra-chial plexus block under ultrasound-guided ,to assess its effectiveness and security ,so as to determine the optimum dosage of anes-thetic for elderly patients with brachial plexus block .Methods 120 patients undergoing elective surgery of forearm or hand in this hospital from February 2013 to December 2014 were selected as the observation group in this study .These patients were randomly divided into four groups on average ,narcosis was conducted in each group with ultrasound-guided :group A with 30 mL of 0 .250%ropivacaine ,group B with 30 mL of 0 .375% ropivacaine ,group C with 30 mL of 0 .500% ropivacaine ,group D with 30 mL of 0 .750% ropivacaine .The onset time of sensory block ,motor block level ,duration of analgesia and adverse reactions were observed and recorded .Results With the increase of concentration of ropivacaine ,the onset time of narcotize became shorter(P< 0 .05) and duration of analgesia became longer(P < 0 .05) .There were no significant difference in the effects of brachial plexus block (P>0 .05) .There was no complications occurred in four groups after narcosis .Conclusion Concentration of ropivacaine more than 0 .375% can achieve perfect clinical effect on elderly patients with brachial plexus block under guidance of ultrasound .

Objective To explore the clinical value of Glucosamine hydrochloride tablets(GH)alone and combination with Xianlinggubao capsules(XLGB)for treatment patients with knee osteoarthritis(KOA).Methods 96 patients with KOA were selected,and were divided into two groups according to the random number method, 48 cases in each group.The control group was treated with GH alone,while the observation group was treated with XL-GB on the basis of the control group.US Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to evaluate the symptoms change,including pain,stiffness,physical function scores and total scores before and after treatment.The onset time,knee function (HSS)score at 3 months and 6 months after treatment were recor-ded.CRP and ESR were measured,and the total efficacy was evaluated at the end of treatment.Results The differ-ence of WOMAC score between the two groups was not statistically significant before treatment (P >0.05 ).After treatment,pain,stiffness,physical function scores and total scores were (10.2 ±1.4)points,(3.5 ±1.6)points, (40.5 ±5.0)points and (56.4 ±6.7)points in the observation group,those were (14.8 ±2.6)points,(6.2 ±2.3)points, (52.2 ±6.8)points and (73.3 ±4.5)points in the control group,the differences were statistically significant (t =7.631,4.721,6.791,10.26,all P <0.01).The onset time,HSS score at 3 months and 6 months after treatment in the observation group were (6.0 ±2.2)d,(68.2 ±6.4)points and (84.3 ±6.2)points,while those were (9.8 ± 2.8)d,(58.5 ±3.9)points and (72.8 ±5.4)points in the control group,the differences were statistically significant (t =5.228,6.341,6.852,all P <0.01 ).The improvements of CRP level and ESR in the observation group were more pronounced than those in the control group (t =3.880,2.668,all P <0.05).After treatment,the total effective rate of the observation group was 93.8%(45 /48),while that was 77.1%(37 /48)in the control group,the difference was statistically significant (χ2 =5.352,P <0.05).Conclusion GH combines with XLGB can significantly improve symptoms in patients with KOA,with more rapid recovery of knee function,thus it is a safe and effective therapy.

The discovery of the key negative regulator MDM2 and the detailed mechanism of MDM2-P53 protein-protein interaction provide a great opportunity to activate P53 by inhibiting MDM2-P53 interaction with MDM2 inhibitor.In this article,the author will review the accomplishment in the area of MDM2 inhibitor treatment on tumors of urological system.The detailed mechanism and the signal pathways involved are summarized simultaneously.

Objective To analyze cellular immunological function of cancer patients in order to provide an evidence for immunological treatment to malignant tumors.Methods T lymphocyte subgroups(total T lymphocytes,Th,Ts,Th/Ts and NK)were determined by flow cytometry in 54 patients with lung cancer,42 with gynecologic cancer,44 with gastrointestinal cancer and 30 healthy individuals.Statistical data were analyzed by SPSS.Results T helper lymphocytes covered(29.41?9.24)%,(34.62?10.27)%,and(32.48?11.64)% respectively in lung,gynecologic and gastrointestinal cancer,significantly lower than that of health people(P

Objective To explore what cause the screw loosening after the internal fixation with thoracic and lumbar pedicle screws in the elderly and to develop the preventive measures.Methods Retrospective analysis were used to collect the clinical data from patients ager 60 years and over who had undergone surgeries of thoracolumbar pedicle screw internal fixation in our hospital during May 2011 and May 2013.Totally 187 cases were included in this study.According to whether there was a loosening of the screws, patients were divided into fixtion-loose and-well groups.The operation time and blood loss volume in the two groups were recorded.Visual analogue scale (VAS), Oswestry disability index (ODI), the rate of screw loosening were compared at 6 months after operation and the last follow-up.The causes of screw loosening were analyzed.Results The main causes for the thoracic and lumbar pedicle screw internal fixation were thoracolumbar kyphoscoliosis, fractures,spondylolisthesis, cancer and degenerative diseases, etc.Patients were followed up for an average of (35.2±8.7) months.13 patients (7.0％) were found screw loosening, 5 males and 8 females, with the mean age of (78.4 ± 3.5) years.The screw loosening occurred 3 months to 1 year after the surgery, (7.6±3.7) months on average.Among the 13 patients with screw loosening, 1 patient suffered screw loosening in single segment, 3 patients in two segments, and 9 patients in three segments or above.Osteoporosis combined with screw loosening.appeared in 10 patients VAS and ODI scores in all subjects had statistically differences at 6 months after operation and the last follow up versus preoperation (P＜0.05 for all), but no statistical difference versus the last follow-up(P＞ 0.05).There were significant differences in gender and preoperative osteoporosis rate between the two groups (P＜0.05 for both).Conclusions Osteoporosis is one of the reasons for the screw loosening in elderly patients after pedicle screw internal fixation.The increased probability of the screw loosening in long segment may be related with the change of the older spine mechanics.Further randomized controlled trials are still required to confirm whether elderly osteoporosis patients need to receive bone cement augmentation treatment.

Objective To study the relation between the levels of protein C(PC),protein S(PS),antithrombin Ⅲ(AT-Ⅲ)with cerebral infarction.Methods 126 patients with cerebral infarction were divided into the groups according to the age,onset time and infarction area and contemporaneous 30 individuals with healthy physical examination were selected as the control group.The levels of PC,PS and AT-Ⅲ were detected.The relation between the change of these indicator levels with the age,onset time and infarction area was analyzed Results The levels of AT-Ⅲ,PC and PS in the acute stage youth group were lower than those in the acute stage middle age and elderly group with statistical differences between them (P <0.05).The level of the AT-Ⅲ,PC and PS in the acute stage group were lower than those in the recovery stage group and the control group,difference had statistical significance(P <0.05).The levels of AT-Ⅲ and PS in the recovery stage group were lower than those in the control group with statistical difference (P <0.05),but the level of PC had no statistical difference between the recovery stage group and the control group.The further study found that the level of AT-Ⅲ,PC and PS in the small infarction group,middle infarction group and large infarction group showed the gradually decreasing trend,the differences had statistical significance (P <0.05).Conclusion The decrease of AT-Ⅲ, PC and PS levels is the importan factor of cerebral infarction occurrence and is closely correlated with cerebral infarction ocurrence especially in the patients less than 45 years old.Observing the change of PC,PS and AT-Ⅲ levels has the important significance for judging the cerebral infarction progression.

Objective To review the prevalence of nosocomial infection and the change of drug resistance in a comprehensive intensive care unit (ICU) and to provide theoretical basis for clinical prevention and treatment.Methods The strains of bacteria and fungi were isolated from ICU and their drug resistance was retrospectively analyzed from Jan.1st,2010 to Dec.31th,2011.Results The main pathogen of nosocomial infection were Gram-negative bacteria ( 73.3％ ),Gram-positive bacteria ( 17.9％ ) and fungi ( 8.7％ ).In bacterial infection,Gram-negative and G-positive bacteria accounted for 80.3％ and 19.7％ respectively.In Gram-negative bacteria,pseudomonas aeruginosa was the major type (21.7％).In Gram-positive bacteria,staphylococcus aureus (31.4％) was most prominent.Drug resistance of bacteria was severe,while that of fungi was mild.Conclusion Bacteria has severe drug resistance and exhibits multi-drug resistance for commonly used antibiotics.The principle of antibiotics application should be mastered and antibiotics should be chosen according to drug-sensitivity tests.

Objective To investigate the effect of massaging Changqiang acupuncture point during the second labor course of primiparas. Methods 124 primiparas were randomized into the observation group(63 cases)and the control group (61 cases). In the observation group, after entering the second stage of labor, Changqiang point was massaged upwards by using index finger and middle finger, and at the same time primiparas were guided to hold breath to coordinate with uterine contraction to make effort to the anus point which was massaged. While the control group were directed with routine way of correctly using abdominal pressure during process of uterine contraction in the second stage of labor. Results The lasting time of uterine contraction was significantly longer in the observation group than in the control group, the time of second stage of labor was shorter, and the amount of postpartum hemorrhage in the observation group was less than those in the control group. Conclusions Application of massaging Changqiang acupuncture point could prolonge the time of uterine contraction, advance the progress of second stage of labor, and decreased the amount of postpartum hemorrhage.