Objective:To compare therapeutic effect of percutaneous coronary intervention (PCI ) and intravenous administration thrombolysis on aged patients with acute myocardial infarction (AMI) .Methods :A total of 180 aged AMI patients were randomly and equally divided into PCI group and intravenous thrombolysis group (IVT group) . Recanalization rate of infarct‐related artery (IRA) ,left ventricular ejection fraction (LVEF) during hospitalization and follow‐up ,and incidence rate of major adverse cardiovascular events (MACE ) were compared between two groups .Results:Compared with IVT group ,there was significant rise in recanalization rate of IRA (61.1% vs . 92.2% ) ,significant improvement in LVEF at the end of treatment [ (52.26 ± 7.33)% vs . (58.27 ± 7.59)% ,and during follow‐up [on three‐month follow‐up: (53.59 ± 8.04)% vs . (60.44 ± 7.53)% ,on 12‐month follow‐up:(55.16 ± 7.35)% vs .(63.71 ± 7.77)% ] ,and significant reduction in total incidence rate of MACE after 12‐month follow‐up (82.22% vs .24.44% ) in PCI group ,P<0.01 all .Conclusion:Compared with intravenous administration thrombolysis ,the recanalization rate of infarct‐related artery more high ,cardiac function recovers more faster , MACE much less in PCI group ,so PCI can be regarded as a preferred therapeutic plan for aged AMI .

Background Neovascular glaucoma (NVG) is a refractory disease characterized by neovascularization,and its pathogenesis mechanism is still unelucidated.Researches showed that muhicytokins and inflammatory factors are associated with neovascularization,however,the correlation of these factors with NVG worth attention.Objective This study was to detect the vescular endothelial growth factor (VEGF),transforming growth factor β1 (TGF-β1) and interleukin-6 (IL-6) levels in aqueous humor and plasma in NVG eyes and its significance.Methods A prospective cases-controlled study was performed under the approval of Ethic Committee of Shanghai East Hospital and informed consent of patients.Eight eyes of 8 NVG patients,10 eyes of 10 primary open angle glaucoma (POAG) patients and 10 eyes of age-related cataract (ARC) patients were entrolled in Shanghai East Hospital from May,2014 to March,2015.The periphery blood of 3-4 ml was collected from all the patients to prepare 0.3-0.4 ml serum,and 0.1-0.2 ml aqueous humor was collected during the surgery from each eye.The aqueous and serum levels of VEGF,TGF-β1 and IL-6 were measured by ELISA.Results The aqueous humor and plasma VEGF concentrations in NVG patients were (2 769.85 ± 390.88) pg/ml and (529.93 ± 95.20) pg/ml,respectively,which were higher than (208.12 ± 58.59) pg/ml and (219.28 ± 24.44) pg/ml in POAG patients as well as (158.88 ±12.35) pg/ml and (172.82±31.91)pg/ml in ARC patients,with significant differences among the three groups (aqueous:F=433.80,P＜0.01;plasma:F=103.84,P＜0.01).The levels of TGF-β1 in aqueous humor and plasma from NVG patients were (157.94±113.00)pg/ml and (3 895.78±2 318.00)pg/ml,showing significant increases in comparison with (54.48±35.58) pg/ml and (2 196.13±1 185.39) pg/ml in the POAG patients or (47.98±17.69) pg/ml and (1937.28±933.27) pg/ml in the ARC patients (aqueous:F =7.88,P＜0.01;plasma:F =4.18,P＜0.05).The concentration of IL-6 in aqueous humor and plasma were (234.87±41.64) pg/ml and (26.97±8.19) pg/ml from NVG patients,with considerable elavation in comparison with (38.97± 19.06)pg/ml and (19.54±5.11)pg/ml in the POAG patients or (29.48±14.61) pg/ml and (18.50±3.57) pg/ml in the ARC patients (aqueous:F =166.27,P＜0.01;plasma:F=5.59,P＜0.05).Conclusions The aqueous and plasma VEGF,TGF-β1 and IL-6 are considerably higher in NVG patients than those in POAG patients and ARC patients,suggesting that these cytokines participate in the pathogenesis and development of the NVG and probably are treating target of NVG.

Objective To evaluate the clinical significance of measurement of urinary leukotrience E4(LTE4) in patients with asthma.Methods Urinary leukotriene E4 in 28 patients with asthma who experienced acute attack period and asymptomatic period and 18 controls was measured by ACETM competitive enzyme immunoassay and expressed as pg/mg creatinine.In addition,forced expiratory volume in one second was investigated in the patient in acute attack period.Results Urinary LTE4 in acute attack period was significantly higher than that in asymptomatic period(P

Objective To investigate the effects of different concentrations of sevoflurane and desflurane on ultrastructure of the lung and pulmonary surfactant-related protein A (SP-A) and phosphatidylcholine (PC) concentrations in broncho-alveolar lavage fluid ( HALF). Methods Fifty healthy Wistar rats of either sex weighing 200-280 g were randomly divided into 5 groups (n = 10 each) : group Ⅱ control; group Ⅱ sevoflurane 1.0 MAC (S1); group Ⅲ sevoflurane 1.5 MAC (S2); group Ⅳ desflurane 1.0 MAC (D1) and group Ⅴ desflurane 1.5 MAC (D2). The animals were anesthetized with intraperitoneal pentobarbital 100 mg?kg-1 , tracheotomized and mechanically ventilated (VT = 8 ml?kg-1 , RR = 65-70 bpm) . PETCO2 was maintained at 35-40 mm Hg. In control group the animals received mechanical ventilation for 4 h without any inhalation anesthetic. In group Ⅳ - Ⅴ sevoflurane or desflurane anesthesia was maintained for 4 h. The animals were then killed and the lungs removed for microscopic examination with electron microscope and broncho-alveolar lavage. The HALF was collected for determination of SP-A and PC concentrations. Results In control group the type Ⅱ alveolar epithelial cells were round or oval in shape, abundant in cytoplasma. The microvilli were only slightly destroyed.The lamellar bodies were structurally intact and concentrically arranged. While in group S1, S2, D1 and D2 the microvilli were destroyed to a greater degree and became shorter. The lamellar bodies were decreased in number with many vacuoles. The SP-A and PC concentrations in BALF were significantly decreased in group S1, S2, D1 and D2 as compared to control group. Conclusion Inhalation of different concentrations of isoflurane or desflurane for 4 h reduces the number of lamellar bodies with vacuolization and SP-A and PC concentrations in BALF indicating decreased synthesis of pulmonary surfactant.

Objective To explore the instructive value of preoperative splenic artery CTA examination on Laparoscopic splenectomy (LS). Methods From January 2008 to February 2010,36 cases requiring Laparoscopic splenectomy (LS) were selected randomly and divided into two groups: CTA group and non-CTA group, 18 cases in each group. As for the CTA group,splenic artery CTA examination was performed before operation,to understand splenic artery and its branches anatomy type and track and then individualized surgical treatment was developed. As for the non-CTA group,a routine surgical procedure was performed. The indices before and during the operation were recorded and compared through χ2 test The operating time and the amount of bleeding in the two groups were compared using t-test Results There were no significant difference between the indices recorded by splenic artery CTA examination and those by laparoscopic splenectomy intraoperation ( P > 0. 05 ) . The operating time was (124. 32 ±21.43) mins in the CTA group, which was significantly shorter than that in the non-CTA group ((148.27 ±28. 36)mins) (P <0. 05). The amount of blood in the CTA group was significantly less than that in the non-CTA group( ( 80. 50 ± 16. 42) ml vs. (101. 35 ± 26.25 ) ml). Conclusions Splenic artery CTA can identify splenic artery and its branches anatomy type and track before LS,therefore guide the development of individualized surgical treatment It increases the safety of LS, reduces bleeding and shortens the operational time. It has an instrutive value to laparoscopic splenectomy.

Objective Though measuring the expression levels of blood aryl hydrocarbon receptor (AhR) and cytochrome P-450 1A1 (CYP1A1),to explore the relationship between the expression levels and chronic arsenic poisoning induced skin changes.Methods Totally 233 residents were selected in Hanggin Rear Banner arsenic exposure area of Bayannur City,according to water arsenic concentrations,these people were divided into control (＜ 10 μg/L,55 people),low (10-＜ 100 μg/L,47),medium (100-＜ 200 μg/L,45) and high (≥200 pg/L,86) arsenic exposure groups.Real-time PCR was used to detect the expression levels of blood AhR and CYP1A1 mRNA,which were presented in median and quartile [M (Q1-Q3)],and the relationships between their expression levels and keratosis,depigmentation of skin were analyzed.Results The relative expression levels of AhR and CYP1A1 mRNA in high-dose groups were 3.18 × 10-3 (2.42 × 10-3-4.45 × 10-3) and 1.58 × 10-3 (0.80 ×10-3-2.73 × 10-3),which were higher than those in control groups [2.30 × 10-3 (1.53 × 10-3-3.20 × 10-3) and 1.00 × 10-3 (0.59 × 10-3-2.09 × 10-3)],and the difference were statistically significant (all P ＜ 0.05).Compared with control group,the detectable rates of arsenic poisoning,keratosis and depigmentation of skin were higher,and the differences were statistically significant (x2 =20.187,15.848,21.595,all P ＜ 0.05).The detectable rates of arsenic poisoning,keratosis and depigmentation of skin were increased with increase of water arsenic concentrations (x2 =19.012,15.269,16.868,all P ＜ 0.05).Compared with normal [2.54 × 10-3 (1.79 × 10-3-3.43 × 10-3),2.57 × 10-3 (1.78 × 10-3-3.52 × 10-3)],AhR mRNA relative expression levels [4.45 × 10-3 (3.47 × 10-3-8.04 × 10-3),4.45 × 10-3 (4.02 × 10-3-6.25 × 10-3)] of degree Ⅲ keratosis and depigmentation of skin were increased,and the differences were statistically significant (all P ＜ 0.05).Conclusions Chronic arsenic exposure affects the expression level of AhR and CYP1A1 mRNA.Blood AhR mRNA expression may have relationship with endemic arsenic poisoning induced skin change,but blood CYP1A1 mRNA expression may have nothing to do with endemic arsenic poisoning induced skin change.

Objective To investigate the postoperative analgesia efficacy of ultrasound-guided rectus abdominis sheath block (RSB) in patients with abdomen panhysterectomy.Methods Forty patients with abdomen panhysterectomy under general anesthesia were divided into RSB group and control group by random digits table method with 20 cases each.All the patients were given patient controlled intravenous analgesia.The visual analogue scale (VAS) score and Ramsay sedative score at 2,6,12 and 24 h after operation,sulfentanyl dosage and total number of analgesic pump press of 24 h,number of nausea and vomiting,analgesic satisfaction score were recorded.Results The VAS scores in RSB group at 2,6,12,24 h after operation were lower than those in control group,but there were no statistical differences (P＞ 0.05).The Ramsay sedative score of all patients was ＜ 4 scores.Sulfentanyl dosage of 24 h in RSB group was (73.1 ± 8.6) μ g,in control group was (91.7 ± 12.3) μ g,there was statistical difference (P ＜ 0.01).The number of analgesic pump press of 24 in RSB group was (6.5 ± 2.1) times,in control group was (12.3 ± 4.6)times,there was statistical difference (P ＜ 0.01).Analgesic satisfaction score in RSB group was (7.3 ± 0.7)scores,in control group was (6.8 ± 1.1) scores,there was statistical difference (P＜ 0.05).Four cases in RSB happened nausea and vomiting,3 cases in control group,there was no statistical difference (P ＞ 0.05).All patients did not happen the complication related with RSB operation.Conclusion RSB as the postoperative analgesia in patients with abdomen panhysterectomy can reduce the dosage of opioid drug,and increases the analgesic satisfaction.

Objective To determine the expression levels of SOCS2 in the mouse livers under starvation, diabetes and obese conditions and to study the effect of SOCS2 on gluconeogenesis.Methods Animals were divided into 3 groups: C57BL/6J mice, the control group was fed ad libtum and the experimental group was fasted for 24 h.Diabetes model db/db and the control db/m mice were fed ad libitum.Obese model ob/ob and the control C57BL/6J mice were fed ad libitum.All the mice above were sacrificed and total RNA was isolated from mouse livers and reverse transcribed to cDNA.The expression of SOCS2 and gluconeogenesis genes in the mouse livers in the 3 groups above were detected by real-time quantitative PCR.SOCS2 was overexpressed in the primary C57BL/6J mouse hepatocytes by the adenovirus system.The effect of SOCS2 on glucose production was measured by glucose output assay.Results C57BL/6J mouse hepatic SOCS2 expression was suppressed by starvation status.The expression of SOCS2 was decreased in the livers of db/db and ob/ob mice.In contrast, the key regulators of gluconeogenesis, PGC-1α, PEPCK and G6Pase exhibited the opposite expression pattern as SOCS2 in the livers underidentical starvation, diabetes and obese conditions.The protein was Mr 23 000 and glucose production was inhibited after SOCS2 being overexpressed in the primary C57BL/6J mouse hepatocytes by adenovirus system.Conclusions SOCS2 may inhibit gluconeogenesis in the C57BL/6J mouse primary hepatocytes, and SOCS2 may be a potential target for the treatment of type Ⅱ diabetes.

Objective To investigate the recent curative effect and adverse reactions of radiotherapy combined with temozolomide in non-small cell lung cancer (NSCLC) patients with brain metastases.MethodsThe clinical date of 51 NSCLC patients with brain metastases were retrospective analyzed in Department of Radiation Oncology of Affiliated Hospital of Hebei University.Patients were divided into experimental group (n=26) and control group (n=25) according to the different treatment methods.The experimental group underwent whole brain and local tumor radiotherapy plus temozolomide.The control group only received whole brain and local tumor radiotherapy.The recent curative effect and adverse reactions of the two groups were analyzed.Results The Karnofsky performance status score of patients in the experimental group was obviously improved than that in the control group (76.2±6.4 vs.72.8±5.3), with a significant difference (t=2.06, P=0.04).The total effective rate in the experimental group was higher than that in the control group (80.8% vs.64.0%), but there was no statistically significant difference (χ2=1.80, P=0.18).Compared with the control group, the incidences of nausea and vomiting (80.8% vs.28.0%) and bone marrow suppression (84.6% vs.24.0%) in the experimental group were significantly higher, with significant differences (χ2=14.33, P=0.00;χ2=18.91, P=0.00).There were similar incidences of headache (69.2% vs.60.1%), liver and kidney damage (73.1% vs.64.0%) in the two groups, with no significant differences (χ2=0.47, P=0.49;χ2=0.47, P=0.49).Conclusion Radiotherapy combined with temozolomide can improve the quality of life in NSCLC patients with brain metastases, which has controllable and tolerable adverse reactions.

Objective:To investigate the occurrence of antenatal anxiety and possible influencing factors,and analyze its relationship with spontaneous delivery.Methods: 590 healthy puerperal women who delivered in Taihe hospital during Dec 2007 and Dec 2008 were randomly selected and investigated for their psychological status,with T-A1 anxiety scale and SDS depression scale employed.Results: 569 effective questionnaires were gathered,with 114 cases divided into the anxiety group and 159 cases into the depression group.Influencing factors of antenatal anxiety include fear of delivery,worry about the safety of babies,understanding of delivery knowledge,puerperal age,and the family financial status.Conclusion: Factors including a relatively older age of primipara,poor financial status,insufficient support from family,worry about the safety of oneself and baby,and fear for delivery pain all have close connections with antenatal mental disorders.Meanwhile,antenatal mental disorders have a direct influence on delivery quality and the choice of delivery modes,and increase the failure rate of spontaneous delivery.