Animals ; Antibodies ; chemistry ; genetics ; Genetic Engineering ; Humans ; Immunoglobulins ; genetics ; Immunohistochemistry ; Protein Engineering

Objective: To investigate the effect of administrative HDL-C (high density lipoprotein cholesterol) level on adverse cardiovascular events after discharge in elder patients with ST-segment elevation myocardial infarction (STEMI).
Methods: A total of 325 STEMI patients treated in our hospital from 2010-04 to 2012-07 were retrospectively studied. According to administrative HDL-C level, the patients were divided into 2 groups as High HDL-C group, n=139 and Low HDL-C group, n=186. The basic and clinical conditions, in-hospital treatment, death and the medication, adverse cardiovascular events during 6 and 12 months follow-up period were compared between 2 groups.
Results: The patients with in-hospital reperfusion therapy was higher in Low HDL-C group, and Low HDL-C group had the higher ratio of emergent PCI treatment, all P<0.05. During follow-up period, High HDL-C group had less patients with β-receptor blocker treatment, less non- fatal MI, adverse cardiovascular events and re-hospitalization, all P<0.05. Cox regression analysis showed that low HDL-C level (HR=0.558, P=0.024) and diabetes mellitus (HR=1.528, P=0.040) were the risk factors of adverse cardiovascular events, while emergent PCI (HR=0.47, P=0.001) was the protective factor in STEMI patients after discharge.
Conclusion: The lower administrative HDL-C level in elder patients with STEMI had the higher risk of adverse cardiovascular events after discharge.

Objective To investigate the effects of pre-ischemic administration of L-NAME on brain protective effects of simvastatin against focal cerebral ischemic/reperfusion injury in rats. Methods ① Animals were subjected to transient 2-hour middle cerebral artery occlusion(MCAO)with the use of the intraluminal filament method previously described by Zea Longa. ② 54 male rats were treated with simvastatin or vehicle by gavage two weeks before MCAO, and L-NAME was injected into laterar ventricle of rats 45 minutes before MCAO. After neurological deficit was assessed at 22 hours of reperfusion, rats were killed, and the brains were rapidly removed. The coronal sections of the brains were prepared and stained with 2% TTC, and the infarct volumes were determined. Another 54 male rats were performed as description above except that the brain tissues were made into homogenate at 22 hours of reperfusion, and the contents of lactic acid(LA) and MDA, and the activities of superoxide dismutase(SOD) in the brain tissues were also measured. Results Administration of simvastatin significantly reduced the size of brain infarct, improved neurological deficits, decreased the contents of LA and MDA and increased the activities of SOD, but L-NAME could abrogate these effects. Conclutions L-NAME could abrogate the protection of simvastatin against ischemic/reperfusion injury,which may be by inhibiting the expression and activity of endothelial NO synthase(eNOS) up-regulated by simvastatin.

Objective:To make a preliminary application of the assessment system for cancer pain management and find insuffi-ciency in the clinical practice of cancer pain diagnosis and treatment. Methods:Data from 41 doctor questionnaires, 43 nurse question-naires, 50 patient questionnaires, and 12 ward questionnaires from the tumor departments of 3 hospitals were analyzed, and the insuffi-ciency in cancer pain management was determined. The wards in the tumor and non-tumor departments related to oncology were as-sessed using rank test, and differences between the 2 wards were investigated. Results:The average scores of doctor, nurse, and wards were 85.41±5.93, 88.46±5.09 and 83.75±3.11, respectively, whereas patient score was 68.67±7.14. To further analyze the patient subsys-tem by converting into a hundred-mark system, the effectiveness and safety scores for the pain management was 81.69±7.71. However, patients' opinion score on pain treatment was only 55.78±11.37. The score of tumor departments was 82.22±2.03, whereas related non-tumor departments had a score of 39.27 ± 3.58. Wilcoxon W value was at 120.0 with P<0.01 after rank test. Conclusion:Education on patients' opinion on cancer pain management should be promoted in the tumor wards, and continuous education on cancer pain diagno-sis and treatment is needed in the non-tumor departments relative to oncology.

OBJECTIVE:To observe clinical efficacy and safety of Kangfuxin liquid in the treatment of pediatric hand,foot and mouth disease. METHODS:128 children with hand,foot and mouth disease were randomly divided into observation group and control group,with 64 cases in each group. Control group was given routine treatment as herpes and oral care,antibiotics for infec-tive children reflected by hemogram elevation,fluid infusion and non-steroidal analgesic-antipyretic agent based on disease condi-tion. Observation group was additionally given Kangfuxin liquid,3 ml for below 3 year-old,tid and 5 ml for more than 3 year-old,tid. Clinical efficacy of 2 groups were observed as well as CRP,lactic acid,Ig,the level of myocardial enzyme before and after treatment;the time of symptoms and signs disappearance and ADR were compared between 2 groups after treatment. RE-SULTS:The total effective rate of observation group(89.06%)was significantly higher than that of control group(70.31%),with statistical significance(P<0.05). There was no statistical significance in CRP,lactic acid,Ig and myocardial enzyme before treat-ment and IgM level after treatment between 2 groups,with statistical significance(P>0.05). CRP,lactic acid creatine kinase and lactate dehydrogenase level of 2 groups decreased significantly,while IgA and IgG levels increased significantly,and the observa-tion group was higher than the control group,with statistical significance(P<0.05). Antipyretic time,hand foot skin rash subsided time and oral ulcer healing time of observation group were significantly shorter than those of control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Kangfuxin liquid is effective in the treatment of hand,foot and mouth disease in children,and can effectively improve CRP,Ig,lactic acid,and myocardial enzyme level with good safety.

The inflammatory reaction after acute cerebral infarction can aggravate the cerebral ischemic reperfusion injury.Activation of peroxisome proliferator-activated receptors-γ(PPAR-γ) has neuroprotective effects by which induces anti-inflammatory actions in cerebral ischaemia,thus as a potential novel pharmacological target for ischemic stroke was regarded.Acupuncture can improve cerebral ischemia injury by inhibiting synthesis of inflammatory cytokines,downregulating expressions of inflammatory mediators and adhesion molecule,suppressing the functions of inflammatory cells.Therefore,it will be a promising orientation to sift the effective acupuncture for that can stimulate the activation of PPAR-γ,and the research of mechanism of acupuncture on anti-inflammatory reaction after cerebral ischemic by activating PPAR-γ dependent pathways.

Objective To explore the pathological basis and clinical characteristics of children with congenital choledochal cyst(CCC) combined with liver damage.Methods According to the age,38 patients with CCC were divided into 2 groups:group A had 24 cases(ranged 6 months to 3 years old);group B had 14 cases(ranged 4 to 14 years old).A comparative analysis of them was conducted retrospectively in the clinical characteristics,hepatic pathological changes,perioperatively liver function and operation.Results Group A was obvious higher than group B in jaundice,white bole stool and abdominal mass,but group B was more in stomachache.Group A was obvious higher than group B in liver function lesion,alkaline phosphatase,bilirubin increase and blood coagulation disfunction(Pa

Objective To investigate the influence of the cardiac function on the prognosis in the patients with acute myocardial infarction(AM I) complicating multivessel disease (M VD ) treated by revascularization .Methods 152 cases of AM I complicating MVD treated by routine percutaneous coronary intervention (PCI) were divided into the normal group(94 cases ,LVEF≥50% ) and the lower group(58 cases ,LVEF<50% ) according to the left ventricular ejection fraction (LVEF) ,and the influence of the cardiac function on the prognosis was analyzed .Results The myocardial infarction history ,history of atrial fibrillation ,NYHA classifica-tion ,hs-CRP ,LADp ,ISR ,left ventricular structure and function had statistically significant difference between the two groups (P<0 .05) .The multivariate Logistic regrossion analysis showed that NYHA classification ,LVEF ,LVMI and LVEDd were the inde-pendent risk factors affecting the prognosis after PCI .Conclusion The reduced cardiac function is a risk factor affecting the prog-nosis of AMI complicating MVD treated by PCI ,the improvement of the cardiac function will be beneficial to the prognosis of the patients .

Objective:To evaluate the clinical value of radioactive nuclide strontium chloride (89SrCl2) combined with 99Tc-MDP in treating patients with breast cancer and osseous metastasis. Methods:A total of 80 patients with breast cancer and experiencing bone pain from osseous metastasis were randomly categorized into three groups. 22 patients were treated with 99Tc-MDP (99Tc-MDP group), 30 were treated with 89SrCl2 (89SrCl2 group), and 28 were treated with the combination therapy of 89SrCl2 and 99Tc-MDP (combination group). The analgesic effect, remission of bone metastases, and quality of life of patients in the three groups were observed before and after treatment. Side effect was also monitored. Results:In the combination group, the overall pain relief rate and the increase rate of life quality score were 92.9%(26/28) and 78.6%(22/28), respectively. The combination group was statistically significantly different from the two single-treatment groups (P<0.05). The effective rate of metastatic lesions was 46.4%(13/28) in the combination group, which was significantly higher than that in the 99Tc-MDP group (18.2%, 4/22;P<0.05). The effective rate of metastatic lesions was not significantly different between the combination and 89SrCl2 groups (33.3%, 10/30) (P>0.05). Conclusion:The treatment of 89SrCl2 com-bined with 99Tc-MDP can increase the analgesic effect and significantly improve the curative effect without overt side effects in patients with breast cancer and bone metastasis.

BACKGROUND: Amnion has been widely used in ophthalmology. Numerous studies have suggested that amnion transplantation did not induce acute immunologic rejection. These indicated that amnion transplantation can be used as a safe material for repair of dural defects.OBJECTIVE: To study the probability of freeze-dried amniotic membrane (FDAM) as a dural substitue. METHODS: Each of the guinea pigs underwent bilateral parietal craniectomy behind the coronal suture and beside the midline to expose the dura. On the right side, a piece of dura mater was removed. The dural defect was covered with a piece of FDAM. The exposed dura on the left was cut and sutured itself as control. The animals in each group were sacrificed at 15, 30, 60 and 90 days after operation, respectively. The implants were harvested and stained with hematoxylin-eosin, and histologically analyzed. RESULTS AND CONCLUSION: After operation, the behavior of all guinea pigs remained completely normal. The wound healing was achieved in all cases. No wound infection, subcutaneous effusion or cerebrospinal fluid (CSF) leakage occurred. The graft was degraded gradually and covered with a sheet of connective tissue. Dural defects repaired with FDAM showed no adhesions to the brain surface. 15 days after operation, plenty of scattered fibroblasts appeared in the dural substitute. 30 days alter dural graft implantation, parts of the implant disappeared; meanwhile the hyperplasia of fibrous connective tissue took place in the center part of the dural substitute, without the infiltration of inflammatory cells. 60 days after implantation, a majority of the dural graft was degraded, substituted by fibrous connective tissue which was of hyperplasia and low-grade degeneration, surrounded by a small quantity of giant cells. 90 days after operation, colloidal degeneration happened in the dural substitute, surrounded by ossification tissue and the degenerated fibrous connective tissue. The inflammatory cells were not discovered. The animal experiment proves FDAM to be a safe and applicable dural substitute.