Objective To investigate the effect of tirofiban hydrochloride in the treatment of coronary heart disease and its influence on homocysteine level.Methods 92 patients with coronary heart disease were selected as research subjects.They were randomly divided into the observation group and the control group,46 cases in each group.The control group was treated with anti-thrombotic,nitrates and other conventional western medicine.The observation group was treated with tirofiban hydrochloride based on the conventional treatment.Results The total effective rate of the observation group was 95.65%,which was higher than 82.61% of the control group,the difference was significant (χ2=4.039,P<0.05).And the homocysteine level in the observation group was (5.38±1.02)μmol/L,which was lower than (7.27±1.19)μmol/L in the control group,the difference was statistically significant (t=8.179,P<0.01).After treatment,the cardiac function CO level[(4.96±0.98)L/min],EF level[(62.48±11.16)%]and SV level[(86.37±11.47)mL]in the observation group were higher than those in the control group,the differences were statistically significant (t=2.271,2.954,2.911,all P<0.05).After treatment,the hs-CRP level[(4.25±1.32)mg/L]and Fib level[(3.14±0.73)g/L] in the observation group were lower than those in the control group,the differences were statistically significant (t=7.981,3.174,all P<0.01).ConclusionTirofiban hydrochloride in the treatment of coronary heart disease can effectively contribute to the reduction of homocysteine levels and alleviate atherosclerosis lesion progression,not only can reduce severity of myocardial ischemia and fibrinogen and high-sensitivity C-reactive protein levels,but also can reduce the thrombosis and inflammation produced by the degree of harm to the patients.

Objective　To examinate the portal system hemo dynamics of portal hypertension in patients with cirrhosis and analysis the rela tionship between the changes of the portal system hemodynamics and the Child-Pu gh grade.Methods　The portal system hemodynamics of portal hypertension we re examined in 100 patients with cirrhosis and 24 normal subjects used colo r Doppler ultrasound and 100 cirrhosis patients were graded by the Child-Pugh g rade.Results　There were significant changes in the portal system hemo dynamics of portal hypertension between cirrhosis and 24 normal subjects,the di ame ter of the portal vein(Dpv),the splenic vein(Dsv) and the superior mesenteric vein(Dsmv), the speed of the portal vein(Vpv),the spleni c vein(Vsv) and the superior mesenteric vein(Vsmv) ,the flow of the portal vein(Qpv),the splenic vein(Qsv) and the superior mesenteric v ein(Qsmv) were significantly increased (P<0.01),respectively.The Dpv of Child grade C patients were wider than the those of Child grade A a nd B patients(P<0.05), the Vpv of Child grade C patients had mo re decrease than the those of Child grade A and B patients(P<0.05), but Qpv was were no significant difference between Child grade A,B and C gro ups patients(P>0.05). Conclusions　Examination of the portal system hemodynamics of por tal hypertension in patients with cirrhosis can be used to evaluate the degree o f liver function and the portal hypertension in cirrhosis patients.

A nutrition survey of 170 pregnant women of the Han, Miao and Buyi nationality in the middle and late pregnancy was conducted in 1984. The survey included dietary survey, physical and obstetrical examination, biochemical analysis and measurement of weight and height of the newborns of the women studied. The results showed that their calorie intake was substantially suficient to the RDA but the protein intake was inadequate. The proportion of high quality protein was more than 30% of total protein intake for the Han, but less than 25% for the other two nationalities. The calcium and vitamin B2 intakes were much lower than RDA for all the women studied. The retinol intake was only about 73% of RDA for the Han in the late pregnancy. The incidence of nutritional anaemia was 26.92-50.00% among the 170 pregnant women. The weight-height of the newborns has no significant difference among three nationalities and all indices of physical development status were in medium rank on an average.

OBJECTIVE To evaluate the efficacy and safety of teicoplanin treatment on complicated Gram-positive urinary tract infection.METHODS The patients′ clinical manifestation,laboratory results,bacterial culture changes after intravascular administration of teicoplanin were observed.Each patient was administered teicoplanin(200 mg once a day for 10-14 days,but 400 mg in the first day).RESULTS The effective rate and the bacterial eradication rate were 90.0% and 86.7%,respectively.All patients experienced relief from clinical infective symptoms and systemic reactions.There were no abnormal laboratory findings and adverse reactions.CONCLUSIONS Teicoplanin is an effective and safe antibiotic for the treatment of patients with complicated urinary tract infection.

Objective To determine the effect of intramuscular administration of rh-GH on myocardial angiogenesis and the expression of bFGF, VEGF in rats with acute myocardial infarction. Methods Left anterior descending coronary arteries have been ligated in 50 Wistar rats after anesthesia by 10% pentobarbital sodium. 37 rats with AMI survived after the operation. The rats are randomized into rh-GH treatment group (n=19) and the control group (n=18). Treatment group is given rh-GH 0.25 U/kg?d im for three weeks while the control group is given NS im at the same time. All the 37 rats are killed after 3 weeks and the heart specimen were fixed by injecting 10% formalin from the ascending aorta into the coronary arteries. The level of VEGF and bFGF in blood plasma and myocardium as well as the density of newly formed vessels in the peri-infactional area were measured separately. Plasma VEGF and bFGF were measured before experiment and 3 weeks after experiment by enzyme-label method.bFGF and VEGF in myocardiun were semi-quaot fixed by imaging after SP inmuno-histochemical stain. Left ventricle capillary density: 3 angiogenesis sites was identified by 40? or 100? microscopy. F8 labelled microvessels were measured averagely under 200? microscope. Results (1) Plasma VEGF and bFGF in both groups were elevated, and elevation of the treatment group was more remarkable than the control group 69?5 vs 36?4 (P

Objective To evaluate the effects of different types of acute respiratory distress syndrome (ARDS) on high frequency oscillatory ventilation (HFOV)-improved extravascular lung water and pulmonary vascular permeability in piglets.Methods Twelve healthy piglets,weighing 15-20 kg,were randomly allocated into 2 groups (n =6 each) using a random number table:endogenous ARDS (P group) and exogenous ARDS (EXP group).Anesthesia was induced with midazolam and propofol.The tracheal tube was inserted.Anesthesia was maintained with iv infusion of propofol and fentanyl.ARDS was induced with normal saline infused via the tracheal tube in group P.ARDS was induced with oleic acid 0.05 ml/kg injected intravenously over 45-60 min in group EXP.Then 4 h of HFOV was performed.Before ARDS (T0),immediately after ARDS (Ti) and at 1,2,3 and 4 h of HFOV (T2-5),arterial blood samples were collected for blood gas analysis and the variables such as extravascular lung water index (EVLWI),pulmonary vascular permeability index (PVPI),and extravascular lung water (EVLW)/intra thoracic blood volume (ITBV) were monitored.The oxygenation index (PaO2/FiO2) was calculated.Results Compared with the baseline value at T0,the oxygenation index was decreased at T1,and the oxygenation index was less than 200 mm Hg in the two groups (P ＜ 0.05).There was no significant difference in the maximum degree of changes in EVLWI,PVPI and EVLW/ITBV between the two groups (P ＞ 0.05).Conclusion Endogenous and exogenous ARDS disease factor does not affect HFOV-improved extravascular lung water and pulmonary vascular permeability in piglets.

Objective To analyze the dialysis adequacy of the maintenance hemodialysis patients under different dialyzate flow.Methods Forty-eight patients under maintenance hemodialysis were divided into four groups according to dialyzate flow:500 ml/min group,600 ml/min group,700 ml/min group and 800 ml/min group,with 12 patients in each group.Each group was treated 6 weeks.The albumin (Alb),hemoglobin(Hb),hematocrit(Hct),blood urea nitrogen (BUN),serum creatinine(SCr) and parathyroid hormone(iPTH) levels before and after treatment were examined,Kt/V and urea reduction ratio(URR) were calculated separately.Results There was no significant difference in Kt/V between 500 ml/min group and 600 ml/min group.Kt/V was no increased when the dialyzate flow rate increased from 500 ml/min to 600 ml/min,that was to say they could not improve the dialysis adequacy.There was statistically significant difference in Kt/V among 500 ml/min group,600 ml/min group,700 ml/min group and 800 ml/min group,and 800 ml/min group on the dialysis adequacy was better.Different dialyzate flow on the impact of the dialysis adequacy was compared in self-control method.Kt/V increased along with the increase of dialyzate flow,and the dialysis adequacy and dialyzate flow showed positive correlation.Conclusion The high dialyzate flow of dialysis treatment can improve Kt/V and has significant effect in enhancing the dialysis adequacy.

Objective To evaluate the effect of high-frequency oscillatory ventilation (HFOV) on lung injury in the piglets with acute respiratory distress syndrome (ARDS).Methods Twelve male piglets,aged 6-8 weeks,weighing 14-16 kg,were randomly divided into 2 groups (n=6 each) using a random number table:conventional mechanical ventilation with low tidal volume group (CMV group) and HFOV group.ARDS was induced by bilateral pulmonary lavages with isotonic saline (38 ℃),repeated every 10 min until the oxygenation index＜200 mmHg.After successful establishment of the model,CMV group was ventilated using conventional mechanical ventilation with low tidal volumes.After successful establishment of the model,HFOV group was ventilated using HFOV,lung recruitment was performed,the airway pressure was set at 25 cmH2O and maintained at this level for 30 s,and the airway pressure was then adjusted 5 cmH2O higher than that after successful establishment of the model,with bias flow 25 L/min,inspiratory time ratio 33％,frequency 8 Hz,amplitude 40-80 cmH2O,and inspiratory oxygen fraction 1.0.In both groups,carbon dioxide partial pressure was maintained between 35 and 50 mmHg.Before establishment of the model (baseline),after successful establishment of the model (T1),and at 0.5,1.0,2.0 and 4.0 h after beginning of mechanical ventilation (T2-5),blood samples were collected from the femoral artery and central vein for blood gas analysis,arterial oxygen partial pressure and carbon dioxide partial pressure were recorded,oxygen delivery index,oxygen consumption index,oxygenation index and intrapulmonary shunt were calculated,and the improvement in pulmonary function (oxygenation index ≥ 200 mmHg) was recorded.At T0,T1 and T5,venous blood samples were collected for determination of the concentrations of serum Clara cell secretory protein 16,soluble intercellular adhesion molecule-1,and high-mobility group box 1.Results Compared with CMV group,the arterial oxygen partial pressure at T35 and oxygenation index at T4.5 were significantly increased (P ＜ 0.05),and no significant change was found in the other parameters in HFOV group (P＞0.05).Conclusion Compared with conventional mechanical ventilation with low tidal volumes,although HFOV improves lung oxygenation,the degree is small in the piglets with ARDS.

Aim To investigate the effects of DGK in-hibitor R59022 on ET-1-induced myocardial hypertro-phy and autophagy, and explore the possible mecha-nisms. Methods Myocardial hypertrophy was in-duced by ET-1 in cultured rat neonatal cardiomyo-cytes. Western blot was used to detect the expression of microtubule-associate protein 1 light chain 3 ( LC3 ) , beclin-1, p62, p-Akt and Akt. mRNA expression of brain natriuretic peptide ( BNP) and beta mysion heav-y chain (β-MHC) and the cell size of cardiomyocytes were detected by RT-PCR and immunofluorescence, respectively. Results Treatment cardiomyocytes with ET-1(10 -7 mol·L-1 ) for 24 h induced the myocardi-al hypertrophy in cultured neonatal rat cardiomyocytes with the activation of autophagy as evidenced by the in-creased expression of autophagy-related proteins LC3-II/I and beclin-1 , as well as the increased p62 degra-dation. While, myocardial hypertrophy induced by ET-1 , including the increased myocardial cell size and the mRNA expression of fetal gene BNP and β-MHC, could be reversed by autophagy inhibitor 3-methyl ade-nine (3-MA) and chloroquine ( CQ) ,but promoted by autophagy agonist rapamycin ( RAPA ) . Pretreatment cardiomyocytes with R59022, an inhibitor of DGK, en-hanced ET-1-induced myocardial hypertrophy by en-hancing autophagy in cardiomyocytes. Furthermore,ET-1 treatment inhibited the activation of Akt by the down-regulation of the Akt phosphorylation, and R59022 en-hanced the effect of ET-1 on the activation of Akt. Conclusions Enhanced autophagy contributes to car-diomyocyte hypertrophy. R59022 deteriorate ET-1-in-duced myocardial hypertrophy by activating autophagy. The possible mechanism may be related to the inhibi-tion of activation of mTOR signaling pathway by inhibi-ting the activation of Akt.

Objective To investigate the predominant genotypes of β-lactamase in Klebsiella pneu-moniae isolates and the mechanism of antibiotic and histidine kinase inhibitor in affecting β-lactamase gene expression .Methods Tube dilution method and E-test were used to detect the susceptibility of K.pneumon-iae isolates to β-lactam antibiotics .The major genotypes of β-lactamase in β-lactam antibiotic-resistant iso-lates were identified by PCR and sequencing method .Disk diffusion test was performed to analyze the activity ofβ-lactamase .The effects of cefotaxime and histidine kinase inhibitor closantel on the expression of β-lac-tamase gene were evaluated by real-time fluorescent quantitative RT-PCR.Results All of the 118 β-lactam antibiotic-resistant K.pneumoniae isolates expressed β-lactamase, 90.7%(107/118) of which were KPC-2, TEM-1, CTX-M-14, SHV-11 and/or OXA-1 gene positive.The positive rates of TEM-1 (71.0%) and SHV-11 (64.5%) were significantly higher than that of the other three genotypes ( P<0.05).68.2%(73/107) of the isolates possessed two or more than two β-lactamase genotypes, and 30.8%(33/107) iso-lates were identified as TEM-1+SHV-11 genotype.Except for KPC-2 mRNA, the levels of TEM-1, SHV-11, CTX-M-14 and OXA-1 mRNA were significantly up-regulated by cefotaxime at MIC/4 (P<0.05), but were inhibited by 100μmol/L closantel (P<0.05).Conclusion TEM-1 and SHV-11 are the majorβ-lactamase genotypes carried by K.pneumoniae strains isolated from Zhejiang area , and TEM-1 plus SHV-11 ( TEM-1+SHV-11) is the predominant carrying mode of the β-lactamase genotypes .Sublethal dose of cefotaxime can enhance the expression of β-lactamase genes in K.pneumoniae, while the histidine kinase inhibitor , closan-tel, can block the increased expression of β-lactamase genes induced by cefotaxime .