Objective To investigate the correlations of plasma B-type natriuretic peptide (BNP) and carbohydrate antigen 125 (CA125) levels in elderly patients with chronic heart failure (CHF) and to evaluate the clinical value.Methods A total of 124 elderly patients diagnosed as chronic heart failure were recruited.Patients with CHF were divided into the stage Ⅱ group,stage Ⅲ group and stage Ⅳ group according to the New York Heart Association (NYHA) classification.35 health subjects were randomly enrolled as the control group.The plasma levels of BNP and CA125 between different groups were compared.The correlations of the plasma BNP and CA125 levels with chronic heart failure were analyzed.60 cases with clinical improvement by aggressive treatment were followed up and the plasma levels of CA125 and BNP in them were tested.The changes in heart failure indicators were analyzed before and after treatment.Results The plasma BNP and CA125 levels were higher in patients with CHF than in control subjects (all P＜0.01).The plasma BNP and CA125 levels were gradually increased in the stage Ⅱ,Ⅲ and Ⅳ group (all P＜0.01).The plasma levels of BNP and CA125 were negatively correlated with left ventricular ejection fraction and positively correlated with left ventricular end-diastolic diameter (r=-0.75,-0.73,0.72,0.63,respectively,both P＜0.01).There were no significant differences in the plasma levels of BNP and CA125 between patients with or without atrial fibrillation (both P ＞0.05).Conclusions Plasma BNP and CA125 levels are correlated with NYHA classification in CHF,which can be used as indexes for the diagnosis,treatment and prognosis of CHF.

Objective To discuss the management, complication and effectiveness of establishing a prolonged hemodialysis access with a long-term venous indwelling catheter. Methods During the penod of July 2007-February 2009, a total of 64 long-term venous indwelling catheters for hemodialysis were placed in 62 patients with terminal chronic renal insufficiency. Results Of the total 64 catheter-placements, 62 were pereformed under DSA guidance and 2 at bed-side. Because of blocked flow, adjustment of the catheter was carried out in 4 cases, replacement of catheter in 2 cases and thrombolytic therapy in one case. In 62 patients, the arterial flow rate after the procedure reached to 230-300ml/min. In 57 cases the indwelling catheter remained in working condition so far. Five cases died within 6 months. Conclusion For establishing a prolonged hemodialysis access. The placement of a long-term venous indwelling catheter is feasible. The main complication is the blocked flow. Which is mainly related to the disposition of the catheter itself or its tip. The right intemal jugular vein is the indwelling site of choice, the tip of double-lumen catheter should be within the superior vein cava. With the help of DSA guidance, the procedure can be performed accurately, safely and easily.

Purpose To observe the effect of acupuncture on gnosia and acetylcholinesterase in patients with senile dementia. Methods Eight patients diagnosed with mild or moderate senile dementia were treated by acupuncture of Sishencong ( Ex-HN 1 ), Shenmen ( HT 7) and Taixi ( KI 3) for I month; gnosia was evaluated by Mini-mental state examination before and after the treatment; plasma acetylcholin esterase activity was measured by flourier before and after the treatment. Results There was a significant difference in gnosia between pre- and post--treatment with acupuncture (P＜0.01); there was no significant difference in acetyl- cholinesterase activity between pre- and posttreatment ( P＞0.05 ). Conclusion Acupuncture has a certain improving effect on gnosia in senile dementia;one month's acupuncture treatment had little effect on plasma acetyl-cholinesterase activity.

Objective To assess and analyze the current status of clinical guidelines for hypertension in the world by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.Methods The clinical guidelines for hypertension were identified and approved by searching China hownet,WANFANG database,PUBMED database,MEDLINE,Embase and related institutions and authorization web site from 1995 to January 2012,and relevant Web sites of agencies and organizations that produce and/or endorse guidelines.Names of the guidelines,published years and organizations,methodology of development and reference number were descriptively analyzed.AGREE instrument was used to evaluate the qualities of latest edited clinical guidelines for hypertension in countries all over the world.Results Nine guidelines were enrolled.The results showed that the hypertension guidelines scored the highest average of 88.4％ for clarity of presentation and reliability field; for applicability fields,scored an average of 86.1％; the scope and goal field scored an average of 83.8％; participants field scored an average of 71.7％; editorial independence field scored an average of 64.1％ ; rigor of development field scored the lowest average of 62.9％.The overall assessment showed that NICE 2011,Canada 2012,ESC 2009,Australia 2010 editions were the positively recommended guidelines,JNC7,Japan 2009,China Taiwan 2010,China 2010,South Africa 2011 editions were the recommended guidelines (still need to supplement and improve).No recommend or uncertain guide was found.Conclusions The quality of the hypertension guidelines is higher in general,but some common deficiency in the rigor of development and editorial independence in Asian and African guidelines formulated by the states still exists.There still exist certain gaps in evidence-based medical requirement.And the contents and quality are needed for further regulating and enhancing.A set of scientific systemic hypertension clinical guidelines evaluation system should be established.

Objective: To study the effect of the sharp marginal ridge of the abutment on the casting of the fit metal full crown in dental preparation.Methods: We established the models of the designed crown-based-teeth(American Dental Association style,No2 trail) with a sharp or smooth marginal ridge,and cast a metal crown for each model.We injected silicone into the crown and immediately fixed it onto each model.Then we took out the solidified silicone and measured its thickness between the crown and the occlusal face of each model.The thinner the thickness,the better the fitness.Results: The average silicone thickness was 250 ?m in the smooth marginal ridge group and 1 660 ?m in the sharp marginal ridge group,with significant difference in between(P

Lung cancer and chronic obstructive pulmonary disease (COPD) are the leading causes of morbidity and mortality worldwide. Development of lung cancer involves both genetic and environment factors. In addition to genetic alterations, epigenetic mechanism is closely involved in pathogenesis of lung cancer. Characterized by an abnormal persistent inflammatory response to noxious environmental stimulation, COPD has shown to increase the susceptibility for lung tumorigenesis in previous research. Current research on epigenetics of lung cancer and COPD has focused on aberrant DNA methylation, histone acetylation and non-coding RNAs regulation. The aberrant DNA methylation associated with lung cancer and COPD has included overexpression of DNA methyltransferase, global DNA hypomethylation and DNA hypermethylation in promoter regions, while histone acetylation and histone methylation are the major changes for histone modification, in which histone acetyltransferases, histone deacetylases, histone methyltransferases and histone demethylases play the most important roles. RNA interference and microRNAs are both hot topics of research on non-coding RNAs regulation. Understanding of concurrent epigenetic alterations in the pathogenesis of lung cancer and COPD may facilitate identification of specific therapeutic targets and development of effective treatment.
Acetylation ; DNA Methylation ; Epigenesis, Genetic ; Histones ; metabolism ; Humans ; Lung Neoplasms ; complications ; genetics ; metabolism ; Methylation ; Pulmonary Disease, Chronic Obstructive ; complications ; genetics ; metabolism ; RNA, Untranslated ; genetics ; metabolism

[Objective] Expressions of human epidermal growth factor receptor 2(HER-2),p53,estrogen receptor (ER),and progesterone receptor (PR) in tissues of breast invasive ductal carcinoma are not only applied to determine the therapeutic regimen,but they may also be related to the prognosis.We investigated the levels of these proteins among different clinical stages and the correlations.[Method] One hundred and thirty-eight tissues from cases with breast invasive ductal carcinoma were tested with immunohistochemistry.New scoring standards and rank test were applied.The indices were digitalized and semi-quantified.[Results] In the tissues from high clinical stage,the expression of HER2 was significantly increased,while expression of PR was markedly decreased.[Conclusion] Expression of HER2 and PR might be better markers for predicting clinical stages and prognosis.

Objective To provide the morphological evidence for sensory pathway by the repair of dorsal root (DR) in which received transected and anastomosed with central processes (DR) and peripheral processes (spinal nerve) respectively. Methods 74 SD rats were divided into three groups randomly. Group A: the distal ending of L6 DR was sutured to the proximal ending of the L4 DR in right side. Group B: the postganglionic spinal nerve of L4 was cut at a point 2 mm to intervertebral foramen and its proximal stump was reconnected to the distal ending of L6 DR in right side. Group C: under the same operative manipulation on group B, but no anastomosis was performed to serve as the sham operation group. The left side was kept intact and served as a normal control in all groups. The repairing results of DR axonal regeneration were evaluated at 3 months after operation by retrograde tracing, the density of positive Calcitonin gene-related peptide (CGRP) axon in dorsal root entry zone (DREZ), survival rate of neurons in DR ganglia and posterior horn, light and transmission electron microscope. Results HRP retrograde tracing demonstrated axonal axoplasmic transport of regenerative nerve recovered well in group B. Regenerative fibers were found. There was no difference between group A or B and normal control with regard to the number of myelinated axons and the thickness of myelin. Regenerating axon stop at the DREZ in group A and the density of positive CGRP were lower than those in group B and normal control. Survival rate of neurons in L6 DR ganglia had no difference among all groups. However, in posterior horn, a significant increase in death was seen in group A and sham group. Conclusion The ability of axonal regeneration was effective and with no disservice to neurons in posterior horn following anastomosis of postganglionic spinal nerve and dorsal root, by which axoplasmic transport across the DREZ into the spinal cord.

Objective To study the clinicopathological characteristics and the prognostic factors in metastatic pancreatic tumor.Methods The clinical data of 32 patients with metastatic pancreatic tumors were retrospectively analyzed.The survival of the patients were evaluated with the KaplanMeier method.Univariate analysis was done by log-rank test.Results The primary foei of these32 patients included:9 lung cancer,6 renal cell carcinoma,5 gastric cancer,12 others.The median survival was 15.5 months in the radical surgery group (n 8),18 months in the cryosurgery group(n=3),8 months in the group with palliative bypass operation (n=9),6 months in the group with local radiotherapy (n=3),and 5 months in the group without treatment (n=9).Univariable analysis revealed the type of primary tumor,treatment of the primary tumor,interval between diagnosis of primary tumor and pancreatic metastases,localized pancreatic metastasis,and treatment of the metastatic pancreatic tumor were associated with prognosis.Conclusions Metastatic pancreatic tumors are rare.Long term survival can be achieved with pancreatic resection in a highly selected subset of patients according to the type of primary tumor.Therapeutic cryosurgery as a new minimally invasive,targeted and immunologic method needs to be further evaluated.

Objective To study the clinicopathological characteristics,diagnosis and treatment of patients with mucinous cystic neoplasms (MCNs) of the pancreas.Methods The clinical data of 42 patients with mucinous cystic neoplasms of pancreas were retrospectively analyzed.Chi-square test and independent sample t-test were used for statistical analysis.Results The mean age of the patients was 53.1 yeas (ranged from 29 to 78 y).There were 32 female (76.2％).The patients were divided into two groups according to symptoms (the symptomatic group and the asymptomatic group).There were significant differences in tumor size,tumor location,operation type,operation time and adhesions with the surrounding tissues between the 2 groups of patients.The patients were then divided into three groups according to pathological type.There were significant differences in age,tumor marker,tumor location,operation type,operation time,adhesions with the surrounding tissues,operative blood loss,and postoperative hospital stay among the 3 groups of patients.There was no tumour recurrence in the patients with cystadenoma.Patients with cystadenocarcinoma developed tumor recurrence at a mean of 16.4 months (range,0-50) and died of tumor recurrence even after radical surgery at a mean of 22.9 months (range,3-58).Conclusion MCNs were seen most commonly in middleaged women.The presence of symptoms was a sign of malignancy.Resection of the tumor in the early stage is the key in dealing with MCNs.