ObjectiveTo assess the factors influencing plasma B-type natriuretic peptide(BNP) levelsin patients with chronic atrial fibrillation (AF).MethodsClinical and echocardiographic information weredetected or collected.Level of plasma BNP were measured through immunofluorescence quantitified method in222 CAF patients.The patients were divided into two groups according to left ventricular ejection fraction(LVEF) :LVEF ≥50％ (normal group) and LVEF ＜ 50％ (case groups) .LVEF was detected by transthoracicechocardiography.Fasting Blood Glucose, total cholesterol, triglycerides, highdensity lipoprotein cholesterol, low density lipoprotein cholesterol, creatinine, blood urea nitrogen, uric acid, were measured, and history ofhypertension, diabetes mellitus and smoking, were recorded.ResultsSerum levels of BNP in patients of chronicAF with LVEF ＜ 50％ were significantly higher than those with LVEF≥50％ (Mean Rank, 158.00 and 87.78 ,Z=-7.705, P ＜ 0.001) .In multiple logistic regression analysis, male gender (OR: 13.115,95％ CI 3.382 to50.860,P ＜0.001),history of hypertension(OR:3.710,95％ CI 1.104 to 12.472 ,P = 0.034) ,lower TC(OR: 0.397,95％ CI 0.214 to 0.735, P = 0.003) , LVEF(OR :0.791,95 ％ CI 0.723 to 0.867, P ＜ 0.001) , history ofsmoking(OR: 4.660,95％ CI 1.256 to 17.281, P = 0.021)were significant and independent determinants ofBNP elevation.ConclusionLower LVEF, male gender, history of hypertension and smoking, lower plasma TCare independent predictors of plasma BNP levels in patients with chronic AF.

Objective To investigate the value of micro-course in colostomy patients in self-care. Methods A total of 120 patients with colostomy patients were divided into the intervention group and the control group with 60 cases each according to the first time in the hospital bed and odd number. The intervention group was given micro-course in colostomy patients discharge health education. The control group was taken the traditional health education missionary single conduct health education of discharged. The self-efficacy (divided stoma care effectiveness and social effectiveness of two dimensions and six separate entries, score 28-140 points. Using five no confidencethere a little confidence some of confidencequite confident or very confident scoring 1-5 points) and stoma care skills (including two parts, a total of 18 entries, each entry method using Likert scale of 51-5 points representing very unskilledsomewhat skilledordinary skillskilled and very skilled, score 18-90 points, higher scores indicate better skills) of patients after 3 months of discharge between the two groups were compared and evaluated. Results After 3 months of discharge, the self- efficacy scores of the intervention group were evaluated with respect to stoma care, social performance, diet choice, confidence in sex life, confidence in sexual life, confidence in physical activity, confidence in vitality and confidence in self-care (53.17±3.54), (38.62±5.25), (3.45 ± 1.06), (2.43 ± 1.06), (2.22 ± 0.86), (2.88 ± 0.94), (3.52 ± 0.89), (3.88 ± 0.64) points, respectively, compared with the control group (50.45 ± 4.79), (35.33 ± 3.42), (3.03±1.15), (1.77±0.81), (1.78±0.72), (2.47±0.96), (3.02±0.70), (3.40±0.81) points, there were significant differences (t=-4.366--2.076, all P<0.05) . According to the comparison of stoma nursing skills, the score of stoma care and the related knowledge of stoma care were (36.33±4.21), (37.13±3.85) points in the intervention group, and (34.22±3.87), (31.32±4.95) points in the control group, and there were statistically significant difference (t=-3.140,-7.741, P < 0.05). Conclusions Colostomy patients discharged from hospital health education classes in the use of micro-course, can effectively improve patients' self-efficacy and ostomy care capacity, enhance the quality of life.

Objective To explore changes of procedural memory in patients with primary insomnia(PI) and its characteristics.Methods Thirty-six PI patients and 36 controls were enrolled.The procedural memory was respectively detected with category exemplar generation and motor sequence tasks,and the declarative memory was assessed by free recall task.Results Compared with the controls,PI patients showed few correct numbers in the category exemplar generation (7.0 (6.0,8.8) vs 9.0 (9.0,11.0),Z=5.537,P＜0.01) and motor sequence task (8.0±3.3 vs 11.5 (8.6,13.8),Z=4.152,P＜ 0.01)and the phases of immediate recall (3.0 (2.3,4.0) vs 6.0 (5.0,7.0),Z =6.479,P ＜ 0.01),delayed recall (9.0 ± 2.2 vs 11.0 (10.0,12.0),Z =4.747,P ＜ 0.01) and delayed recognition (15.0 (13.0,15.0) vs 15.0 (15.0,15.0),Z=4.637,P＜0.01) of the free recall task.Furthermore,the early morning awakening group had significantly lower correct numbers in the motor sequence task,the delayed recall and recognition phases of the free recall task than the difficulty initiating and maintaining sleep groups.Conclusion The procedural and declarative memories are impaired in the PI patients,especially the early morning awakening insomniacs.

Objective To investigate the changes of plasma bone morphogenetic protein-4 (BMP-4) levels in patients with coronary heart disease (CHD) and rosuvastatin intervention effect on BMP-4 level.Methods Fifty-two patients with CHD and 35 health people were enrolled in this study as CHD group and control group.ELISA method was used to detect the concentration of plasma BMP-4.Analyzed the relationship between plasma BMP-4 and blood lipids,flow-mediated dilation (FMD),nitric oxide (NO),cyclooxygenase-2 (COX-2),malondialdehyde (MDA) and superoxide dismutase (SOD).And observed the changing of plasma BMP-4 before and after rosuvastatin intervention.Results Plasma BMP-4 level in CHD patients was (7.53 ± 1.20) μg/L,higher than that of control group ((3.81 ± 0.79) μ g/L,t =3.541,P =0.006).After rosuvastatin treatment,plasma BMP-4 level in CHD patient was decreased from (7.53 ± 1.20) μg/L to (5.40± 0.98) μg/L (t =1.436,P =0.001).Plasma BMP-4 level was positively correlated with COX-2,MDA,low-density lipoprotein cholesterol,total cholesterol (r =0.395,0.350,0.274,0.288 respectively,P ＜ 0.01 or P ＜0.05).But,it was negatively correlated with NO,high-density lipoprotein cholesterol,SOD,FMD (r =-0.291,-0.253,-0.476,-0.320 respectively,P ＜0.01 or P ＜0.05).COX-2,SOD and FMD were independent risk factors of plasma BMP-4 in patients with CHD.Conclusion Oxidative stress and endothelial dysfunction are in patients with CHD.Rosuvastatin treatment can remarkably reduce plasma BMP-4 level,alleviate vascular endothelium injury induced by oxidative stress and improve endothelial function in patients with CHD.

Objective To analyze the curative effects of different managements of different types of fracture of the first metacarpal basal body. Methods From October 1984 to October 2003, 142 patients with fracture of the first metacarpal basal body were treated with 5 different methods: manipulative reduction and fixation with abduction tooth arch, manipulative reduction and suspension traction, manipulative reduction and fixation with abduction frame, manipulative reduction and percutaneous internal fixation with Kirschner wire, as well as open reduction and internal fixation with Kirschner wire or screw. Results 80 patients were followed up. The therapeutic efficacy was excellent in 65 cases , good in 13 cases, poor in 2 cases. Conclusion Different types of fracture of the first metacarpal basal body can be treated satisfactorily if a suitable management is applied accordingly.

Objective To study the effect of network peer education on the 131I treatment adherence in patients with thyroid cancer.Methods A total of 120 patients with thyroid cancer who performing 131 I treatment from April 2012 to April 2014.They were divided into intervention group 61 cases and control group 59 cases according to the hospital ward number.Control group was given routine health education and intervention group was given network peer education.The data from the habits,drug therapy,grasp the situation,the equivalent monitoring of the relevant knowledge of 4 different dimensions of treatment adherence for patients were investigated and compared before discharge by using questionnaire and examination method.Results The incidence of the good habits,drug therapy,grasp the situation,and the equivalent monitoring reaching the standard were 96.7％(59/61),98.4％(60/61),96.7％(59/61),100.0％(61/61) in intervention group,and 54.2％(32/59),76.3％(45/59),79.7％(47/59),89.8％(53/59) in control group,there were significant differences,x2=29.54,13.38,8.47,4.56,P＜0.01 or ＜0.05.Conclusion Network peer education for patients with thyroid cancer during the 131I treatment can effectively improve the patient's treatment adherence,has positive significance for the treatment.

Objective To explore the relationship between apolipoprotein E gene polymorphism and cerebral infarction in Taishun county.Methods Determination of 112 cases of Taishun Siqian cerebral infarction patients and healthy persons 88 cases of ApoE gene polymorphism,and the cerebral infarction patients were admitted to the hospital for different period of time after the NIHSS score.Results The cerebral infarction group and the control group were ApoE -/3 genotype most were 70.5%(79 /112)and 63.6%(56 /88),both had significant difference(P >0.05);The cerebral infarction group and the control group in terms of ApoE -up to 3,respectively 82.1%(92 /112)and 75.6%(66.5 /88),both had no significant difference (P >0.05).The cerebral infarction group epsilon 4 to 9.8%(11 /112),and was significantly higher than that of the control group 4.0%(3.5 /88);E2 was 6.2% (7 /112), which was significantly lower than that of the control group [19.3% (17 /88)],the differences were significant (χ2 =6.189,7.970,all P <0.05).Carrying ApoE -4 of the cerebral infarction patient each time period at the time of admission,admission 7d and 14d NIHSS scores were not carrying epsilon 4 patients increased significantly (t =7.853,6.185,5.165,allP <0.05);and at each time point carrying epsilon 2 gene in patients with and without carry-ing epsilon 2 patients NIHSS scores had no significant difference (P >0.05 ).Conclusion Cerebral infarction patients ApoE gene polymorphism and disease progression and prognosis are closely related,ApoE -4 Taishun Siqian cerebral infarction patients predisposing factors.At the same time,the detection of apoE genotype and NIHSS score is helpful to the prognosis of the patients.

Objective To research the effect of regulating systemic inflammatory response by using ulinastatin in elderly patients after sevoflurane inhalation of postoperation cognitive function. Methods 60 patients under went elective abdominal surgery, were randomly double-blinded divided into 2 groups. Every group had 30 patients.Group A accepted continuously intravenousiy infusion ulinastatin 2000 units · kg-1 · h-1 , while group B got equivalent continuously intravenous infusion 0.9% sodium chloride injection. The time point of opening eye, extubation, response and the mini-mental state examination(MMSE) score on different time points were observed. Meanwhile, the changes of concentration of hs-CRP, IL-6,IL-10 were measured. Results Compared with two groups,group A has shorter time on response(F =4.399,P = 0.040). Two both groups had decrease of MMSE score 1 hour after surgery compared with preoperation(t =7. 732,11. 916, both P ＜ 0.01), and the score were less than the preoperative value of more than 2 points which showed cognitive decline in patients. But group A's rate of decline in MMSE score was lower than group B(F = 7. 582 ,P =0.012). Both groups had the MMSE score decline 6h after surgery (t = 4. 606,8. 615, both P ＜ 0.05). Group A's score was less than the preoperative value for less than 2 points, group B's score was lower than the preoperative value for more than 2 points, but the difference between the two groups was not significant (P ＞0. 05). Both groups had higher concentrations of hs-CRP、IL-6 、IL-10 at postoperative 1 d ,3d ,7d (all P ＜ 0.01), peaked at postoperative 1 d, and hadn't come back to the preoperative level 7d*after surgery. In group A, the concentrations of hs-CRP, IL-6 increased (postoperative 1 d,3d), but the rate was lower than the group B (F = 14. 885, P = 0.000;F = 4. 405, P = 0. 040; F = 18. 204, P = 0.000; F = 8. 074, P = 0. 006); while the increased rate of concentration of IL-10 was higher than the group B(F=5.197,P=0.026;F= 12.236,P =0.000). Conclusion Ulinastatin could promote the elderly after sevoflurane inhalation rapid recovery of cognitive function, which may be related to the regulation of systemic inflammatory response.

Objective To investigate the significance of B-type natriuretic peptide (BNP) in acute coronary syndrome(ACS).Methods 151 in-patients of ACS during May 2006 to June 2008 were selected as the treatment group.Other 212 impatients with essential hypertension were selected as control group.Blood lipid,blood glucose,blood routine,renal function,high sensitive C-reaction protein (hs-CRP) and BNP were examined in all patients.Their blood pressure,heart rate,and history of smoking,hypertension,diabetes mellitus and hyperlipidemia 62.0±14.2,t = 5.043,P＜0.001 ),blood creatinine [ (95.0±67.4 ) vs.(72.8±29.0) μmol/L,t = 4.164,P ＜0.001 ),blood uric acid[ (360.2±104.4 ) vs.(300.8±92.7 ) μmol/L,t = 5.521,P ＜ 0.001 ],BNP (80.81 vs.352.38 ng/L,Z = - 7.295,P ＜ 0.001 ),hs-CRP (7.99 vs.17.08,Z = - 3.983,P ＜ 0.001 ),white blood cells (WBC) [ (7.843 +3.025)×109/L vs.(6.333±3.569)×109/L,t =4.209,P ＜0.001 ],monocytes [ (0.522±0.201)×109/L vs.(0.417±0.157)×109/L,t = 5.084,P ＜0.001 ] and blood glucose [ (6.518±2.303 ) vs.(5.691±2.085 ) mmol/L,t = 3.461,P = 0.001 ] had significant difference.Systolic blood pressure had difference between two groups [ (134.7±27.8 ) vs.(142.0±26.3 ) mm Hg,t = 2.536,P=0.012 ].However,the percentage of smoking[ 43.7% (66/151)vs.23.1% (49/212),X2 = 17.283,P ＜0.001 ] and male gender[ 74.8% ( 113/151 )vs.48.6% ( 103/212),X2 = 25.217,P ＜ 0.001 ) ] had significant difference between two groups ( P ＜0.001 ).Multivariable regression analysis showed that age (X2 = 10.369,P =0.001 ),gender (X2 = 12.836,P ＜ O.001 ),BNP (X2 =4.807,P =0.028) and WBC(X2= 10.788,P =0.001 ) were the main factors of difference between the two groups.Moreover,BNP was linearly correlated with left ventricular ejection fraction(EF) in ACS patients (t =5.789,P ＜ 0.001 ).Conclusion Old age,male,WBC and BNP are closely related with ACS,of which BNP has certain predictive value for ACS.

Objective To investigate the peripheral blood cytopenias in patients with portal hypertension complicated with splenomegaly. Methods The clinical data of 309 patients with portal hypertension who had been admitted to our department from January 1991 to December 2006 were retrospeetively analyzed. Results Of all patients, 278 showed peripheral blood cytopenia, ineluding 71 with paneytopenia, 48 with leukocyte and platelet decrease, 25 with erythroeyte and platelet decrease, 33 with leukocyte and erythroeyte decrease, 28 with platelet decrease, 26 with leukocyte decrease, and 47 with erythrocyte deerease. The number of blood cells increased significantly after splenectomy ( t=6.53, P<0.01). The whole blood cells of the remaining 31 patients without hematocytopenia were normal. Conclusions Patients with portal hypertension eomplieated with splenomegaly do not always accompany peripheral blood eytopenia. Peripheral blood cytopenia is one of the complications of splenomegaly, hut it dose not always appear. Splenectomy is effective in the treatment of hematocytopenia. The reason for some patients do not have peripheral blood cytopenia may be related to the slight pathological changes of spleen and severe hyperplasia of bone marrow.