Objective To investigate the clinical significance of ambulatory blood pressure monitoring in short-term prognosis of acute inferior myocardial infarction patients .Methods A total of 80 patients with acute inferior myocardial infarction received 24 hours ambulatory blood pressure monitoring after enrolled .According to the results of 24 hours ambulatory blood pressure monito-ring ,eligible patients were divided into dipper model group(n=29) and non-dipper model group(n=51) .Clinical information was collected and all patients were followed-up for major adverse cardiovascular events (MACE) .Results The rate of intravenous thrombolysis in dipper model group was significantly higher than that in non-dipper model group(t=4 .120 ,P=0 .021) .Night mean systolic blood pressure and night mean diastolic blood pressure were all significantly lower in dipper model group than in non-dipper model group(t=2 .032 ,P=0 .040 ;t=3 .175 ,P=0 .002) .The rate of cumulative MACE in non-dipper model group was significant-ly higher than that in dipper model group(t=2 .626 ,P=0 .041) .Multivariate logistic regression analysis showed that ,daytime mean systolic blood pressure(<90 mm Hg) was independent risk factor of MACE(P=0 .018 ,OR=1 .298) ,dipper model blood pressure (P=0 .019 ,OR=0 .769) and intravenous thrombolysis(P=0 .007 ,OR=0 .520) were protective factors for MACE .Conclusion Parameters of ambulatory blood pressure monitoring are closely correlated with prognosis of acute inferior myocardial infarction pa-tients ,and the change of blood pressure model is an important factor for short-term prognosis .

Objective To investigate the effective methods for treatment of severe chest trauma with multiple organ injury. Methods The injury conditions and the early treatment measures in 87 cases of severe chest trauma with multiple organ injury (especially within 48 h after injury) were analyzed retrospectively. Results Of the 78 patients, 61 patients survived, and 26 died (including 2 patients who abandoned treatment). The total mortality was 29 89%. Primary operation was performed on 37 patients with multiple organ injury, but 7 died (18 92%). Conclusion Diagnosis while rescuing, effective countershock treatment, early operation, protection of visceral functions, and preventive mechanical ventilation may be the important measures to guarantee the success of treatment of severe chest trauma with multiple organ injury.

Objective To explore factors associated with incision infection in elderly patients undergoing general surgery and thus provide a basis for its clinical prevention.Methods Retrospective clinical data of 2985 elderly patients who underwent routine surgical operation after admission to the Department of General Surgery from Feb.2009 to Dec.2013 were analyzed.Patients with incision infection following surgery were assigned into the infection group,while patients without incision infection served as the control group.Single factor analysis and multivariate Logistic regression analysis were conducted to identify factors responsible for incision infection.Results There were 91 cases with incision infection,constituting a rate of 3.0％.Compared with the control group,patients in the infection group showed an older average age [(67.3±5.8) years vs.(63.0± 5.6) years,t=1.906,P＜0.05],a longer average operating time [(2.13±0.26) hours vs.(1.87±0.24) hours,t=10.149,P＜0.001],and a longer average incision length [(8.14±2.62) cm vs.(7.59±2.14) cm,t=2.396,P＜0.01].In addition,compared with the control group,more patients in the infection group received prophylactic antibiotics (74.7％ vs.83.3％,x2 =4.819,P=0.032),exhibited malnutrition (20.9％ vs.10.0％,x2 =11.418,P=0.001),and had diabetes mellitus (11.0％ vs.5.1％,x2 =5.968,P=0.015).Therefore,independent risk factors for incision infection included age (OR=1.89),operating time (OR=3.32),nutritional status (OR=2.08) and diabetes mellitus (OR=3.18).Conclusions A few risk factors may contribute to incision infection.Clinicians should take necessary preventive measures accordingly to minimize its occurrence.

AIM: To determine the contents of protocatechuic acid,peoniflorin,coumarin,cinnamic acid,cinnamaldehyde and glycyrrhizic acid in categorized formulas about Guizhi Decoction (Ramulus cinnamoni,Radix paeoniae alba,Rhizoma zingiberis recens,Radix et Rhizoma glycyrrhizae and Fructus jujubae) by HPLC.METHODS: The gradient elution mode was applied in chromatographic separation.The C18 column was used with the mobile phase of 0.05% phosphoric acid-acetonitrile,flow rate was at 1.0 mL/min,detection wavelength at 230 nm and 254 nm,and the column temperature was at 30 ℃.The contents of the above-mentioned six constituents were determined in Guizhi Decoction,Guizhi Decoction plus Ramulus cinnamoni and Guizhi Decoction plus Radix paeoniae alba,respectively.The differences among all combinations were tested by one-way analysis of variance using SPSS software.RESULTS: The concentrations of the above-mentioned six constituents in different decoctions were simultaneously determined by HPLC and the linear equations of six constituents were established.Compared with Ramulus Cinnamomi alone,cinnamic acid content decreased and protocatechuic acid content increased in categorized formulas about Guizhi Decoctions significantly,but then coumarin content increased in Guizhi Decoction and Guizhi Decoction plus Radix paeoniae alba.Compared with Radix Paeoniae Alba alone,peoniflorin content decreased in categorized formulas about Guizhi Decoctions significantly.Compared with Radix et Rhizoma Glycyrrhiza alone,glycyrrhizic acid content increased in categorized formulas about Guizhi Decoctions significantly.CONCLUSION:The methods are accurate,reproducible and suitable for determineation of the contents of six constituents in categorized formulas about Guizhi Decoctions,Results show that the contents change with different decoctions.

Objective:To observe therapeutic effect of Xiaoyou Granule on Helicobacter Pylorum(Hp)related chronic gastritis.Methods:120 cases were randomly divided into 3 groups,40 cases in each group.They were treated respectively with Xiaoyou Granule,Weisu Granule and western medicine.Their therapeutic effects were observed.Results:Xiaoyou Granule was superior to the control group of TCM in improving clinical symptoms,eliminating inflammation of mucosa and the long-term therapeutic effect of removing Hp was superior to the control group of western medicine.Conclusion:Xiaoyou Granule has a definite therapeutic effect on Hp related chronic gastritis.

ObjectiveTo explore the effects of Yiqi Yangyin Huoxue principle on the expression of neurotrophin-3 of the frontal lobe cortex neurons in diabetic rat brain. Methods The diabetic rat model was produced by intraperitoneal injection of streptozotocin(STZ).The Yiqi Yangyin Huoxue drugs was poured into the stomach of the treated group. The brains were taken and the expression of neurotrophin-3 was estimated with immunochemistry 8 weeks later. Results Immunochemistry showed that there were many positive cells in the frontal lobe cortex of the normal group and they were deeply dyed.Positive cells of the model group decreased and their color was shallow .The number and the color of positive cells in the treated group were close to that of the normal group. Conclusion The Yiqi Yangyin Huoxue principle can effectively improve the degenerating of the frontal lobe cortex neurons in diabetic rat brain.

Objective To investigate the distribution of hepatitis B virus (HBV) genotypes in patients with chronic HBV infections and the correlations of genotypes with liver fibrosis and hepatocellular carcinoma (HCC).Methods Serological,virological and pathological data of 190 patients with chronic HBV infections admitted to Hangzhou First People's Hospital during June 2007 and June 2012 were retrospectively analyzed.The series included 62 cases of chronic hepatitis B (CHB),60 cases of liver cirrhosis and 68 cases of HCC.HBV was genotyped by multiplex PCR,and subgenotyped by restriction fragment length polymorphism (RFLP).SPSS 11.0 was used for statistical analysis.Results Among 190 patients,61 were HBV genotype B (32.1％),126 were genotype C (66.3％),and 3 were B + C hybrid.HBV B2 (61/61,100.0％) and C2 (123/126,97.6％) were the major subgenotypes.HBV genotype B was more prevalent in CHB patients (46.8％,29/62) than in liver cirrhosis (20.0％,12/60) and in HCC patients (29.4％,20/68) (x2 =8.73 and 4.16,P＜0.01 or P＜0.05),whereas the prevalence of genotype C was higher in liver cirrhosis and HCC than that in CHB (x2 =9.54 and 4.17,P ＜0.01 or P ＜ 0.05).Patients with genotype C2 had higher serum hyaluronic acid level than with genotype B2 in 3 groups (t =2.685,2.433 and 2.015,P ＜ 0.01 or P ＜ 0.05).CHB patients with C2 infections had higher liver fibrosis grade than those with B2 (x2 =6.726,P =0.010),while there was no statistical difference in liver inflammation grade (x2 =0.601,P ＞ 0.05).HCC patients with B2 infection tended to have larger tumor diameter (≥5 cm) (x2 =7.231,P ＜ 0.01) and those with C2 infection were prone to be more serious cirrhosis (x2 =4.910,P ＜ 0.05).Conclusions HBV genotypes C2 and B2 are predominant in patients with chronic HBV infections in Hangzhou.HCC patients infected with HBV C2 may be complicated with more severe liver fibrosis,and those with HBV B2 infections may tend to have larger liver tumor.

Objective To explore the relationship between methylenetetrahydrofolate reductase (MTHFR) 677C ＞ T and unexplained recurrent pregnancy loss (URPL).Methods All patients were recruited from the outpatient department of Obstetrics/Gynaecology & Genetics of Hangzhou First People's Hospital from January 2013 to May 2014.A case-control study was performed.According to the stochastic indicator method,there were 125 subjects with a history of ≥2 times URPL as the case group,and 905 healthy parous women with no history of URPL as the control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the distributions of the polymorphisms of MTHFR 677C ＞ T,and the results were validated using oligo-chip and direct sequencing.Results The allele and genotype frequencies of MTHFR were 60.0％ for C,40.0％ for T,32.0％ for CC,56.0％ for CT,and 12.0％ for TT in the case group and 67.4％ for C,32.6％ for T,41.4％ for CC,52.0％ for CT,and 6.6％ for TT in the control group,respectively.The prevalence of allele T was significantly higher in the case group than in the control group (OR =1.379,95％ CI =1.051-1.808,P =0.020),the frequency of genotype TT was also significantly higher in the case group than in the control group (OR =2.344,95％ CI =1.220-4.503,P =0.009).Conclusion The fertile women with MTHFR 677T allele and 677TT genotype may be susceptibility to URPL in a Chinese Han population from the Hangzhou area.

Objective To investigate the epidemiological characteristics of mycoplasma pneumoniae (MP),Epstein-Barr virus (EB virus) and cytomegalovirus (CMV) infection in children with acute upper respiratory tract infections in Hangzhou.Methods Throat swabs and sputum samples were collected from 5942 children with acute upper respiratory tract infections in Hangzhou First People's Hospital during January 2011 and December 2012.MP,EB virus and CMV were detected using quantitative PCR.The distribution and seasonal changes of the above pathogens in children of different ages were analyzed using Chi-square tests.Results MP,EB virus and CMV were positive in 29.91％ (1777/5942),22.92％ (1362/5942) and 8.55％ (508/5942) children,respectively.Mixed infections were found in 556 (9.36％) children.The positive rates of MP varied among different age groups (x2 =113,P =0.000),and the highest one was detected in children ＞ 6-year old (448/1012,44.36％).EB virus infection was rare in age group 0-1 year,and the positive rate was of statistical difference from those in other age groups (x2 =167,181 and 187,P =0.000).The highest positive rate of CMV (23.78％) was found in children aged 0-1 year old.The positive rates of MP varied in different months of the year (x2 =208 and 211,P =0.000),and the highest positive rate was found in July and August.Conclusion The predominant pathogen of acute upper respiratory tract infection in children is MP in Hangzhou,and MP plus EB virus infection is common,particularly in older children;while CMV infection more likely occures in 0-1 year old babies,and usually in summer.