Objective This study aimed to assess the adherence to guideline-recommended therapies according to risk stratification in the management of acute coronary syndrome(ACS). Methods We analyzed 1,001 consecutive patients admitted with ACS. Patients were stratified using the GRACE risk score into low- and high-predicted risk of mortality at 6 months. We evaluated the use of hospital angiography,revascularization,and guideline-recommended medications between high and low-risk patients. Results High-risk compared to low-risk patients were less likely to underwent coronary angiography and/or revascularization during the hospitalization. The use of hospital-initiated pharmacotherapies was also lower in high-risk patients(P<0.05). Advanced age, increased creatinine level and higher GRACE score were independent predictors for failure to administer evidence-based therapies. Conclusion Patients with ACS at high risk of mortality were paradoxically less likely to undergo revascularization or receive medications according to guidelines. Better adherence to evidence-based therapies in high-risk patients may improve clinical outcome and quality of health care.

Objective To apply the optical coherence tomography(OCT) to detect the characteristics of coronary artery plaque and to investigate its correlation with levels of serum matrix metalloproteinase 7(MMP 7),MMP9 and MMP12.Methods The patients undergoing coronary arterial angiography for diagnosing coronary arterial lesions in the cardiology department of our hospital from October 2014 to March 2016 were collected and included into the research subjects.The subjects were divided into the stable plaque group and unstable plaque group based on the results of OCT scanning.The neovascularization characteristics such as the fibrous cap thickness of plaque,angle of lipid pool,macrophage infiltration and plaque cracks were detected by using OCT.ELISA was used to measure serum MMP7,MMP9 and MMP12 levels.Results (1) The fibrous cap thickness in the stable plaque group was more than that in the unstable plaque group(P＜0.01);the lipid pool angle,microphage infiltration,intima erosion and plaque cracks in the unstable plaque group were more than those in the stable plaque group(P＜0.05).(2) The MMP7 and MMP9 levels in the unstable plaque group were higher than those in the stable plaque group and control group(P＜0.05).(3) The fibrous cap thickness had significantly negative correlation with serum MMP9 level(r=-0.336,P=0.034);the MMP7 and MMP9 levels in the microphage infiltration group were higher than those in the non-microphage infiltration group(P＜0.05);the MMP9 level in the intima erosion group was higher than that in the non-intima erosion group(P＜0.01).Conclusion OCT can detect and find unstable plaque and the serum levels of MMP7 and MMP9 are significantly elevated in the patients with unstable plaque,which can be used as an important basis for predicting unstable plaque and guiding the treatment decisions.

Neuropathic pain (NP) is a common complication following spinal cord injury, with an incidence rate ranging from 38% to 70%. NP typically presents as sensation of burning, electric shocks, tingling or squeezing pain resulting from somatosensory nerve damage, which exerts a negative impact on patients′ physical and psychological well-being. After spinal cord injury, glial cells are activated to induce inflammatory cascade. Accordingly, various inflammatory mediators that may disrupt the neuronal function are released to promote abnormally increased neuronal excitability and pain signal transduction. Additionally, spinal cord injury can disrupt the release of neurotransmitters and neurotrophic factors, alter ion channel activity, and thereby impair the normal pain regulatory mechanisms and further increase pain perception. The interaction of these mechanisms contributes to the occurrence and persistence of NP after spinal cord injury. However, the precise pathogenesis of NP remains incompletely elucidated, making its therapeutic efficacy uncertain and clinical management difficult. It is of great significance to thoroughly understand the underlying pathophysiological mechanisms of NP following spinal cord injury for its treatment. For this reason, the authors reviewed the research progress on the characteristics and pathophysiological mechanisms of NP following spinal cord injury, aiming to serve as a reference for further research and development of more effective targeted therapies and management strategies.

OBJECTlVE To establish Tg(-6.3CYP3A65∶EGFP) transgenic zebrafish for quick, intuitive detection of heavy metals ( copper, cadmium and zinc) , dioxin-like PCBs ( PCB126) and other environmental pollutants. METHODS Tol2 transposon system was used to generate transgenic zebrafish lines Tg(-6.3CYP3A65∶EGFP) in which CYP3A65 promoter regualated labeled fluorescence. The effect of heavy mentals ( copper, cadmium and zinc ) and PCB126 on the relative amounts of CYP3A65 gene expression was determined by observing the change in fluorescence intensity. RESULTS The relative gene expression of CYP3A65 was significantly increased after 96 h exposure to copper 0.1 and 0.2μmol·L-1 , cadmium 0.35 and 0.7μmol·L-1 , zinc 1.5 and 3μmol·L-1 , and PCB126 2-32μmol·L-1 , respectively ( P<0.01) , but decreased after 96 h exposure to copper 0. 9 μmol·L-1 , cadmium 2. 7 and 5.4 μmol·L-1 , and zinc 24μmol·L-1 , respectively( P<0.01) . CYP3A65 gene expression was significantly increased after 168 h exposure to copper 0.1 and 0.2 μmol·L-1 , cadmium 0.35 and 0.7 μmol·L-1 , zinc 1.5 and 3 μmol·L-1, and PCB126 2-32 μmol·L-1, respectively(P<0.01), but decreased after 168 h exposure to copper 0.9 μmol·L-1, cadmium 2.7 and 5.4 μmol·L-1, and zinc 12 and 24 μmol·L-1( P<0.05) , in a concentration-dependent manner. CONCLUSlON The results suggest that zebrafish CYP3A65 gene expression and the CYP3A65 labeled fluorescence lines can be another candidate biomarker for detecting environmental pollutants.