Objective To investigate the effects of sodium tanshinone ⅡA injection on myocardial enzymes and heart function of patients with acute myocardial infarction, and to explore its therapeutic mechanism. Methods A total of 217 patients with acute myocardial infarction in Taihe Hospital emergency department were randomly divided into control group (n=110) and the Tanshinone group (n=107). The control group was treated by thrombolysis, vascular dilation, antihypertension, anti-shock and other conventional treatment. On the basis of control group treatment, Tanshinone group added the intravenous injection 20mg sodium tanshinone injection. The ELISA was used to test serum creatine kinase (CKMB), superoxide dismutase (SOD), malondialdehyde (MDA) and cardiac troponin I (CTNI) and other enzymes indexes before and after treatment. The heart function were assessed by measuring the left ventricular patient of maximum rising/ falling rate (± LVdp/dtmax),left ventricular end-diastolic diameter (LVDD), left ventricular ejection fraction (LVEF),systolic blood pressure (SP), diastolic blood pressure (DP), pulse pressure (PP ) and heart rate (HR) and other indicators. Results After treatment, the CK-MB (10.76 ± 1.02 mmol/L vs. 15.17 ± 1.21 mmol/L, t=3.724), CTNI (0.11 ± 0.02 ng/ml vs.1.51 ± 0.05 ng/ml, t=2.570), MDA (4.54 ± 0.23 nmol/ml vs. 9.98 ± 1.37 nmol/ml, t=5.035) in the Tanshinone group were significantly lower than those in the control group (P<0.05). The SOD (452.27 ± 21.56 U/L vs. 209.50 ± 15.43 U/L, t=3.935), LVDD (50.74 ± 5.36 mm vs. 44.91 ± 5.31 mm, t=2.454) and LVEF (4.59% ± 0.17% vs. 3.64% ± 0.11%, t=4.052) in the Tanshinone group were significantly higher than those in the control group (P<0.05). The heart function of +dp/dtmax (3742 ± 162 mmHg/s vs. 3948 ± 193 mmHg/s, t=3.731), -dp/dtmax (3512 ± 135 vs. 3847 ± 181, t=3.025), PP (30.5 ± 5.3 mmHg vs. 35.8 ± 5.1 mmHg, t=2.902), DP (99.2 ± 8.8 mmHg vs. 117.3 ± 10.8 mmHg, t=4.079) in the Tanshinone group were significantly lower than those in the control group (P<0.05). The total effective rate was 98.14% (105/107), the control group was 87.2%(96/110), and there was significant difference between the 2 groups (χ2=10.417, P<0.05). Conclusions The Tanshinone ⅡA sodium injection can improve myocardial enzymes and heart function of patients with acute myocardial infarction, which refered to its protective effect on acute myocardial infarction.

Growth dynamics of PP, CN and ZS2 strains of Toxoplasma gondii isolated in China was studied and compared with that of RH strain. HeLa cells were used in this work. It took only 2 min for the organisms of RH strain to infect the HeLa cells when con-tacting with the cells. By contrast, the CN strain requires 5 min, the ZS2 and PP strains, 10 min.Tcxoplasma began its multiplication after a lag time of about 6 h in the HeLa cells. The mean generation time of the 4 strains was assessed by calculating the number of the parasites in the parasitophorous vacuoles at different incubation times and by the linear regression equation. The results showed that the mean generation time was 5.2 h for RH strain, 5.98 h for CN strain, 6.78 h for ZS2 strain and 7.69 h for PP strain.Among the 3 strains of Toxoplasma gondii isolated in China, CN strain was similar to RH strain in their infectivity and proliferation.

Aim In order to observe the pathological features and the dynamic distribution of RH strain T. gondii in main organs of infected mice, using indirect immunoenzymatic technique. To provide pathological diagonsising reference of toxoplasmosis and increase to understand the pathologensis of Toxoplasmosis. Methods Mice were infected intraperitoneally with 103 tachyzoites of T. gondii RH strain,and the parasites were detected using indirect immunoenzymatic technique in the liver, spleen, lungs and brain at 2,4,6 and 8 days postinfection. Results The liver was the first organ parasitized at D2, followed by spleen and lungs at D4, the brain at D8. At the early phase of infection, parasites were found on the edge of the liver and spleen. A few parasites were detected within the liver, spleen and lungs with time being. But parasites increased progressively and distributed well during the whole phase. The brain was the last organ to be parasitized. Parasites multiplicated rapidly so that the mice were seriously ill and died. Conclusions The indirect immunoenzymatic technique can demonstrate tachyzoites and Toaxoplasma antigen clearly in infected mice during acute stage. Many organs were infected such as liver, spleen,lungs and brain. The results suggest that the organs in the peritoneal cavity were infected directly by tachyzoites as IP infection, then the parasites disseminate through a blood way, and in the end, tachyzoites cross the blood-brain barries to reach the brain.

Objective:To study the cause of the medical disturbances and its influential factors, to formulate the corresponding prevention strategy and measures. Methods:Total 32 medical disturbances in a hospital were an-alyzed and evaluated. Results:The number of medical disturbances in this hospital was declining. The department of maternity, orthopedic, pediatrics had the most medical disturbances. The compensation for the patients with med-ical disturbances was 2. 18 times as the patients without medical disturbances. Conclusion:It should be clear the causes of the medical disturbances and countermeasures should be proposed according to the reasons, rationally re-solve doctor-patient conflicts.

Objective: To compare the blood lfow of left internal mammary artery (LIMA) graft vessel between minimally invasive direct coronary artery bypass (MIDCAB) and traditional median sternotomyin off-pump coronary artery bypass (Traditional OPCAB) by transit-time lfow meter (TTFM). Methods: We retrospectively studied 300 patients who received OPCAB in our hospital from 2013-01 to 2015-07, all patients had LIMA to left anterior descending coronary artery (LAD) anastomosis. The patients were divided into 2 groups: MIDCAB group, n=70 and Traditional OPCAB group,n=230. Intra-operative blood lfow in graft vessel was measured by transit-time lfow meter. Pre- and post-operative indexes and the mean lfow (MF), pulsatile index (PI), diastolic fraction (DF) of LIMA graft were compared between 2 groups. Results: The following indexes in Traditional OPCAB group and MIDCAB group were as below: intra-operative transfusion was (3.00±5.42) U vs (1.06±2.17) U, post-operative peak value of cTnI was (2.84±9.93) ng/ml vs (0.69±1.74) ng/ml, mechanical ventilation time was (27.9±66.9) h vs (14.2±20.8) h and ICU stay time was (64.1±89.6) h vs (35.2±39.2) h, allP<0.05; while for the graft from LIMA to LAD, MF was (29.45±18.19) ml/min vs (29.04±15.85) ml/min, PI was (2.68±1.19) vs (2.44±0.84) and DF was (71.47±11.12) % vs (70.25±11.30) %, allP>0.05. Conclusion: With LIMA to LAD graft, MIDCAB may achieve the same effect as traditional OPCAB, the early post-operative anastomosis has been reliable.

Objective,This study was designed to evaluate the predictive value of pre-procedure Cardiac troponin I(cTnI)and CRP levels in patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI).Methotis cTnI and CRP were determined on admission in 335 consecutive patients with ACS who underwent primary PCI.Blood samples were obtained within 6-10 h after onset of symptom.The concentration of cTnI was determined by an automated chemiluminescence immunoassay.CRP was measured by immunoassay assay.According to the admission cTnI(＜0.1,0.1-0.5,＞0.5μg/L)and CRP(≤3,＞3 mg/L)divided into different groups.The pre-procedure cTnI and CRP status associated with 30 days cardiac mortality and major adverse cardiac events(MACE.including cardiac death.non-fatal recurrent MI.heart failure.readmission for any reason)were analyzed.The cardiac mortality at follow.uD period of 2 years were analyzed.Results Muhivariate logistic regression analyses revealed preoperative cTnI predicted 30 days cardiac mortality(OR=3.5,95%CI 2.2-5.3,P＜0.01),and recurrent MI rate(OR=1.5,95%CI 1.1-2.6,P＜0.05),independent of other known prognostic factors such as age,gender,hypertension,Hypercholestemlemia,diabetes and smoking.The pre-procedure CRP was independently related to 30 days cardiac mortality(OR=1.6,95%CI 1.1-2.3.P＜0.05),whereas there was no relationship to the MI rate.In ACS,levels of CBP≤3 mg/L,the three different risk groups (cTnI＜0.1,0.1-0.5,＞0.5μL)with corresponding 30 days MACE rates of 4.3%,11.7%,18.8%(X~2=4.829,P=0.028),CRP＞3 mg/L,the three groups mth corresponding 30 days MACE mtes of 5.5%,13.2%,21.1%(X~2=5.862,P=0.015),respectively.Patients were followed up for 2 years,Kaplan-Meier survival analysis demonstrated a significantly reduced survival at 2 years in patients witll a cTnI ＞0.5μg/L(80.0%versus 89.1%for a cTnI of 0.1-0.5μg/L and versus 92.2%flor cTnI＜0.1μg/L;X~2=7.571,P＜0.05 by log-rank).Conclusions The levels of CRP and cTnI in Acs of onset in 6-10 h provide an even better risk stratification after the PCI.and closely correlate with 30 days MACE.Elevated cTnI provides long-term prognostic information regarding cardiac mortality.Therefore.The combination of CRP and cTnI measurement should be taken into consideration for risk stratification to decide about the management strategies in ACS patients.

Objective:To investigate the correlation between cyclooxygenase-2(COX-2), estrogen receptor (ER), progesterone receptor(PR) and the formation of endometrial polyps and the increased malignant rate of postmenopausal endometrial polyps.Methods:From January 2018 to January 2019, a total of 160 postmenopausal women treated in the People's Hospital of Changxing County were selected and divided into endometrial polyps group(83 cases) and oothectomy group(42 cases), normal menopause group(35 cases) according to different diseases.The levels of COX-2, ER, PR in the three groups were measured.The expression of COX-2 in mesenchymal cells and glandular epithelial cells, the expression of ER in mesenchymal cells and glandular epithelial cells, the expression of PR in mesenchymal cells and glandular epithelial cells in the three groups were compared, and the correlation between COX-2, ER, PR and increased malignant rate of endometrial polyps was analyzed.Results:The positive expression rates of COX-2 in mesenchymal cells and glandular epithelial cells in the endometrial polyps group(16.9%, 30.1%) were higher than those in the normal menopause group(0.0%, 11.4%) and the oothectomy group(4.8%, 7.1%)(χ 2=4.568, 5.806, all P<0.05 ). There were no statistically significant differences in the expression of ER in mesenchymal cells and glandular epithelial cells among the three groups(χ 2=1.333, 1.412, all P>0.05). The expression of PR in mesenchymal cells and glandular epithelial cells in the endometrial polyps group was lower than that in the normal menopause group and the oothectomy group(χ 2=4.890, 5.022, all P<0.05). COX-2 was positively correlated with the increase in malignant rate of endometrial polyps( r=4.335, P<0.05), PR was negatively correlated with an increase in the malignant rate of endometrial polyps( r=-4.256, P<0.05), and ER had no significant correlation with an increase in the malignant rate of endometrial polyps( r=1.203, P>0.05). Conclusion:COX-2 and PR are significantly related to the formation of endometrial polyps and the increase in malignant rate of postmenopausal endometrial polyps, but there is no significant expression of ER.Therefore, the detection of COX-2 and PR levels is beneficial to provide a certain scientific basis for clinical treatment.

Objective To discuss the spatial-temporal distribution and epidemic trends of autumn-winter type scrub typhus in Shandong province,and provide scientific evidence for further study for the prevention and control of the disease.Methods The scrub typhus surveillance data during 2006-2014 were collected from Shandong Disease Reporting Information System.The data was analyzed by using software ArcGIS 9.3 (ESRI Inc.,Redlands,CA,USA),GeoDa 0.9.5-i and SatScan 9.1.1.The Moran' s I,log-likelihood ratio (LLR),relative risk (RR) were calculated and the incidence choropleth maps,local indicators of spatial autocorrelation cluster maps and space scaning cluster maps were drawn.Results A total of 4 453 scrub typhus cases were reported during 2006-2014,and the annual incidence increased with year.Among the 17 prefectures (municipality) in Shandong,13 were affected by scrub typhus.The global Moran' s I index was 0.501 5 (P＜0.01).The differences in local Moran' s I index among 16 prefectures were significant (P＜0.01).The "high-high" clustering areas were mainly Wulian county,Lanshan district and Juxian county of Rizhao,Xintai county of Tai' an,Gangcheng and Laicheng districts of Laiwu,Yiyuan county of Zibo and Mengyin county of Linyi.Spatial scan analysis showed that an eastward moving trend of high-risk clusters and two new high-risk clusters were found in Zaozhuang in 2014.The centers of the most likely clusters were in the south central mountainous areas during 2006-2010 and in 2012,eastem hilly areas in 2011,2013 and 2014,and the size of the clusters expanded in 2008,2011,2013 and 2014.One spatial-temporal cluster was detected from October 1,2014 to November 30,2014,the center of the cluster was in Rizhao and the radius was 222.34 kilometers.Conclusion A positive spatial correlation and spatial agglomerations were found in the distribution of autumn-winter type scrub typhus in Shandong.Since 2006,the epidemic area of the disease has expanded and the number of high-risk areas has increased.Moreover,the eastward moving and periodically expanding trends of high-risk clusters were detected.

OBJECTIVETo study the feasibility of subtotal colectomy with cecorectal end-side anastomosis for slow transit constipation.

METHODSRetrospective analysis was performed on 23 patients with colon slow transit constipation treated by subtotal colectomy with cecorectal end-side anastomosis in our department from March 2006 to April 2013. The main measure outcome was the curative effect on constipation by this type of surgery.

RESULTSTwenty-three patients were successfully treated. Anastomotic leakage occurred in one case, and urinary retention in 1 case, while no anastomotic stricture, abdominal bleeding, abdominal hernia, incontinence and other complications occurred. During follow-up of 2 months to 7 years, defecation frequency was 1-4 times a day with no need of antidiarrheal agents. Each time of defecation was less than 5 min. All the patients had no recurrence of constipation.

CONCLUSIONSubtotal colectomy with cecorectal end-side anastomosis can be used to treat colon slow transit constipation, while accurate preoperative evaluation and strict indications for the surgery is the key to success.

Anastomosis, Surgical ; Cecum ; surgery ; Colectomy ; Colon ; surgery ; Constipation ; surgery ; Defecation ; Humans ; Retrospective Studies ; Treatment Outcome

Objective To explore the spatial and temporal characteristics of human brucellosis in Shandong province and to provide scientific basis for the development of related regional public health strategies.Methods 1 802 diagnosed cases of human brucellosis patients were selected based on the data that was collected by Diseases Reporting Information System between year 2004 and 2012 in Shandong province.Methods on spatial thematic mapping,spatial autocorrelation analysis,spatial clustering analysis,and temporal clustering analysis were applied to describe the temporal and spatial distribution on human brucellosis cases.Results The incidence rate of human brucellosis increased from 0.038 2/100 000 (35 cases) to 0.620 5/100 000 (598 cases),with annual average incidence rate as 0.211 1/100 000 and the incidence was evidently increased.The value of M (0.375 3) showed that this disease was seasonal,with the epidemic months between March and June,accounting for 56.27％ (1 014/1 802).The Global Moran' s I index was 0.198 901 (P=0.000 120),showing that there was a positive correlation between space and the incidence of brucellosis.The incidence rates in 2006,2007,2009 and 2012 and the space distribution appeared a positive correlation (P＜0.05) in Shandong province.The local Moran's I index showed that there were 8 “High-High” (HH) clustering areas,which were proved to have statistical significance (P＜0.05).Local indicators of spatial association (LISA) revealed that southwest and north districts of Shandong were highly clustered districts of brucellosis and the areas paralleled to the areas that having higher incidence rates.There were two spatial clustering areas in this study,one as the center of Juanchen with radiation radius at 33.83 km whose RR was 9.78 (P＜0.05) and the other was the center of Binchen with radiation radius at 62.78 km with RR as 4.99 (P＜0.05).All the 8 HH counties (districts) were included in the two cluster regions.Conclusion Incidence of human brucellosis showed an obvious increase in Shandong during year 2004-2012.Months with epidemics were between March and June.The incidence of brucellosis in counties (districts) was non-randomly distributed.A positive spatial correlation and the feature of clusters was noticed.