Objective To investigate the relationship between brain natriuretic peptide ( BNP)/ N-terminal pro-brain natriuretic peptide ( NT-proBNP) and New York Heart Association ( NYHA) classification, left ventricular structure and function, and explore the value of BNP/ NT-proBNP in the diagnosis of heart failure in the elderly. Methods Fifty-five elder patients with heart failure were selected (NYHA II, n = 15; NYHA III, n = 25; NYHA IV, n = 15) (heart failure group), and another 16 elder people with NYHA I were served as control group. The plasma mass concentrations of NT-proBNP and BNP were detected by electrochemiluminescence immunoassay and immunofluorescence method, respectively, and the structure and function of left ventricle were examined by echocardiography. Results The levels of plasma BNP and NT-proBNP increased with NYHA grades, were negatively correlated with LVEF (P <0.001), and were positively correlated with LVST, LVEDD, LAD and LVMI( P < 0.05). The area under the curve of BNP in diagnosis of heat failure was 0. 879 (P < 0.001), and that of NT-proBNP was 0.914(P < 0.001). Conclusion Both plasma BNP and NT-proBNP can be used to evaluate the heart function of patients with heart failure, and are useful tools for diagnosis of HF in the elderly.

Objective To observe the inhibition effect of selective cyclooxygenase-2 inhibitor (celecoxib) on the experimental choroidal neovascularization (CNV).Methods Thirty 8-10 weeks old healthy male Brown-Norway(BN) rats were randomly divided into the control,laser and celecoxib group,with 10 rats in each group.At the dosage of 50 mg/kg,celecoxib was garaged twice per day.After 7 days,experimental CNV was induced by Krypon laser on laser group and celecoxib group.Fundus fluorescein angiography (FFA) was performed on days 3,7,14,21,30 after laser photocoagulation.On days 21 after photocoagulation,5 rats in each group were sacrificed and the relative thickness of CNV membranes,the expression of COX-2,vascular endothelial growth factor(VEGF) and matrix metalloproteinase-2 (MMP-2) Were studied by histopathologic or immunohistochemistry examination.Results On days 21 after photocoagulation,the incidence of CNV in the celecoxib group is significantly lower than that in the laser group (X~2=7.1068,P=0v0077);the relative thickness of the CNV membranes in the celecoxib group is reduced 41.38% compared to the laser group,the difference is statistically significant (t=16.7600,P=0.0000).COX-2,VEGF and MMP-2 expression in the CNV membrane of celecoxib group were significantly lower than in control group (t=5.7100,5.8400,8.0200;P=0.0000);the COX-2,VEGF and MMP-2 expressions in choroid and retina of control group were weak.Conclusion Prophylactic celecoxib can reduce the expression of VEGF and MMP-2 by inhibiting COX-2,and prevent the CNV induced by laser photocoagulation.

Objective To investigate the influence of controlling multiple cardiovascular risk factors on early renal impairment in patients with metabolic syndrome. Methods 619 in-patients were categorized, according to the diseases they were suffering from into essential hypertension group (EH, 144 cases, m/f=74/70), type 2 diabetes mellitus group (T2DM, 134 cases, m/f=79/55), and metabolic syndrome group (MS, 341 cases, m/f=167/174). The effects of controlling the blood pressure, blood glucose and plasma lipid on early renal impairment were evaluated. Results 1. There were more than one half of the patients in MS and EH with blood pressure above 140/90 mmHg, more than one half of the patients in MS and DM with HbA1c above 7.0%, and more than one half of the patients in MS with triglyceride≥1.7mmol/L with or without high density lipoprotein

Objective To explore the mechanism and the therapeutic effects of the pelvic floor muscle electrical stimulation on female patients with urinary incontinence Methods Forty three female patients with incontinence were recruited. With different electrical currents, the pudendal nerves were intermittently stimulated by the electrode probe placed in the middle of vagina. To prevent incontinence,the contractions of the detrusor were depressed and the capacity of the bladder was increased by neural reflex, while the urethra obstruction was enhanced by the contractions of pelvic floor muscles. Results The incidence of urethrorrhea was decreased by 46%, and the frequency of micturition was reduced by 49%, while the frequency of urination in 24h ranged from 10 to 12. The general subjectively rated improvement rate of patients was 68%, while the general objectively one was 74%. Conclusion The pelvic floor muscle electrical stimulation, which can improve the patients' life quality, has significant therapeutic effects on female patients with incontinence.

Objective To explore the diagnostic points and promote the checkout rate of fetal congenital cor-dis malformation. Method Analyzed the ultrasonic character by reviewing the fetal congenital cordis malformation from our hospital in recent 2 years. Result 3 cases was inaccuracy in the 28 cases of congenital cordis malformation diagnosed by antepartum. Diagnostic accuracy rate was 89.3%. Conclusion The inaccuracy was reduced greatly by gradual ultrasonic diagnosis by way of four cavity heart and three vas cross section,

Objective To investigate the relationship between the clinical onset of cerebral infarction in anterior cycle and properties of carotid atheromatous plaque.Methods A retrospective analysis was carried out on clinical data of 624 cases of cerebral infarction in anterior cycle from December 2010 to December 2013 in our hospital.The carotid artery plaque Crouse score,index,and intima-media thickness (IMT) were used to evaluate carotid atherosclerosis and plaque lesions.The National Institute of Health stroke scale (NIHSS) questionnaire was used to evaluate neural function defect.Results Compared to the non-lesion side,the lesion side carotid artery plaque Crouse score was decreased and IMT was increased (P ＜ 0.05) ; the lesion carotid artery plaque Crouse was lower,the higher NIHSS scores (r =-0.546,P =0.004) ; IMT score was higher,higher NIHSS score; carotid artery atheromatous plaque Crouse was negatively related to NIHSS score; IMT score was positively related to NIHSS score (r =0.672,P =0.003).Conclusions The clinical onset of cerebral infarction in anterior cycle was correlated with the carotid sclerosis degree.The Crouse score and IMT of the lesion have certain significance in predicting prognosis of cerebral infarction in anterior cycle.

0.05). ②Among 30 pilots with abnormal vestibular functions,19 were permanently grounded and 11 were permitted to return their flying station. 36 pilots returned to fly in 45 cases with normal vestibular functions. The permanently grounded rate had significant differences between the two groups with normal and abnormal vestibular functions. (P

Objective To explore the association of sedentary behavior and time with risk of metabolic syndrome (MS).Methods A total of 10 149 subjects were recruited from local residents aged ≥40 years old in Jiashan County by cluster-random sampling method.The data including physical activity,job,sedentary time,and sleep,etc.were collected.Height and body weight,waist circumference,blood pressure,blood glucose,blood lipid,etc.were determined.Logistic regression was used for correlation analysis.Results The prevalence of MS was 28.64％ in local residents over 40 years old in Jiashan.The rate of sedentary behavior in all subjects was 67.57％,with 3 h sedentary time on average.Compared with non-MS group,the rates of sedentary behavior and sedentary time were significantly higher in MS group (P＜0.01).Multivariate logistic regression analysis showed that sedentary behavior was independently associated with an increased risk of MS after adjustment for age,sex,body mass index (BMI),smoking,drinking,and sedentary time(OR=1.16,95％ CI 1.03-1.30,P=0.017).Increased sedentary time was associated with higher risks of hypertension,type 2 diabetes mellitus,and dyslipidemia (P ＜ 0.05 or P ＜ 0.01).Sedentary time ≥ 5 h/d independently increased the risk of MS (OR =1.15,95％ CI 1.01-1.31,P =0.034).Conclusions There is a high prevalence of MS in adults over 40 years old living in the eastern coastal rural area.MS and its related diseases are closely associated with sedentary behavior and its duration.

Objective To evaluate the result of multiple segmentectomy under selective occlusion of hepatic inflow for complicated intrahepatic cholangiolithiasis. Methods In this study 12 cases of complicated intrahepatic cholangiolithiasis receiving multiple segmentectomy under selective occlusion of hepatic inflow during 2004. 1 - 2010. 10 were reviewed retrospectively. The short-term and long-term outcomes of the patients were analyzed. Results There was no surgical mortality in this group. The segmentectomy performed were Ⅱ + Ⅲ + Ⅴ in 1 case; Ⅱ + Ⅲ + Ⅵ in 2 cases; Ⅱ + Ⅲ + Ⅴ + Ⅵ in 1 case;Ⅱ +Ⅲ+Ⅵ +Ⅶ in4 cases; Ⅱ +Ⅲ +Ⅳ +Ⅵ in 3 cases and Ⅱ + Ⅲ +Ⅳ +Ⅵ +Ⅶ in 1 case. The average intraoperative blood loss was 560 ± 291 ml. Postoperative complications were wound infection in 2 cases, bile leakage in 1 case, abdominal infection in 1 case. There were no liver failure, intrabdominal hemorrhage or hemobilia; stone clearance rate at 10 days after operation was 83% (10/12) and 92%(11/12) at 6 weeks after operation following postoperative choledochoscopic lithotripsy. 92% (11/12) cases were followed-up with the median follow-up period of 31 months. The result was excellent or good in 92% (11/12) cases. Conclusions Multiple segmentectomy was the choice for complicated intrahepatic cholangiolithasis, and the procedure could be safely performed under selective occlusion of the hepatic inflow.

Objective To study the mRNA expression levels and clinical significance of omsomucoid 1-like protein 3 (ORMDL3) gene in the peripheral blood of recurrent wheeze children under 3 years old.Methods Peripheral blood specimens of 25 recurrent wheeze children including 14 non-atopy patients (group A) and 11 atopy patients (group B) that were registered in the First Affiliated Hospital of Nanjing Medical University,from Sep.2010 to Sep.2012 were enrolled based on the inclusion criteria and 24 non-allergic controls(the children with food allergy,drug allergy or ectema was excepted).The mRNA expression levels of ORMDL3 gene were detected by reverse transcription (RT)-PCR and clinical features were analyzed.Results The expression levels of ORMDL3 were up-regulated in the peripheral blood specimens of group B compared with group A (t =14.12,P ＜ 0.01).Compared with peripheral blood specimens from normal subjects,mRNA expression of ORMDL3 were significantly increased in recurrent wheeze children(t =10.29,5.73,P ＜0.01).The incidence of wheeze groups exist gender differences,male ＞ female.Wheeze usually with a high incidence in winter and spring.Conclusions The increase of ORMDL3 gene expression levels were correlated with recurrent wheeze under 3 years old especially in atopy group and may be involved in the pathogenesis of recurrent wheeze.