Objective: To study the related factors of artery occlusion induced cardiac infarction. Methods: The coronary angiography data of 56 patients with total artery occlusion were retrospectively studied. The patients were divided into 2 groups: Group A with cardiac infarction, Group B without cardiac infarction, and the clinical features of the 2 groups were compared. Results: It was found that diabetes mellitus, anginal pectoris, hypercholesterolemia, high and low density lipoprotein, smoking, long term medication, collateral circulation, and changes of electrocardiogram presentation were all related factors of infarction( P 6 months), long term medication, well controlled blood glucose and lipoprotein, and non smoking, probably because these factors can improve the collateral circulation and induce ischemia preconditioning.

To explore the relationship between serum resistin concentration, hypertension, degree of obesity and blood glucose, fasting serum resistin concentration was measured with EIA in 17 normotensives and 44 patients with essential hypertension. Serum resistin concentration was significantly correlated with age and body fat percectage (BF%). The concentration level was significantly higher in grade 2 hypertension group [(30.5?11.0)?g/L] than in grade 1 hypertension group [(24.3?10.5)?g/L] and in normotensives group [(21.5?6.1)?g/L]. The difference in serum resistin concentration between the three groups disappeared when age and BF% were corrected by analysis of covariance. Serum resistin concentration was significantly correlated with systolic blood pressure, age, BF%, fasting plasma glucose. A stepwise multiple linear regression analysis revealed that age, BF% and fasting plasma glucose were significantly independent predictors of serum resistin concentration. The results suggest that serum resistin concentration is not directly related to blood pressure, but the concentration level is actually correlated with age, BF% and glucose metabolism.

Objective To investigate the effect of obesity on change of the levels of blood glucose and blood lipid after treatment with different combinations of antihypertensive drugs in patients with essential hypertension (EH). Methods One hundred and thirty-eight patients with mild to moderate EH were randomly divided into 3 groups with different combinations of drugs: reserpine with dihydralazine, hydrochlorothiazide, potassium chloride group (group 1), fosinopril with indapamide group (group 2), and nifedipine with atenolol group (group 3). Treatment period lasted for 14 months. Every group was divided into obesity subgroup and non-obesity subgroup according to Chinese obesity standard. Results After treatment, blood glucose levels were significantly decreased and blood lipid level was unchanged in both obesity subgroup and non-obesity subgroup of group 1. High density lipoprotein-cholesterol (HDL-C)/low density lipoprotein-cholesterol (LDL-C) ratio was significantly decreased and blood glucose was significantly increased in obesity subgroup, however, there was not significant change in the level of blood glucose and blood lipid in non-obesity subgroup of group 2. Blood glucose level was significantly increased and HDL-C/LDL-C ratio was significantly decreased in obesity subgroup, however, there was significant increase only in fasting blood glucose in non-obesity subgroup of group 3. Conclusions The results suggested that treatment with a combination of reserpine and dihydralazine, hydrochlorothiazide, potassium chloride showed beneficial effect on improving carbohydrate metabolism in both obese and non-obese patients with EH, while the treatment with the combination of fosinopril with indapamide deteriorated carbohydrate and lipid metabolism in obese patients with EH, and the treatment with combination of nifedipine with atenolol impaired carbohydrate and lipid metabolism in obese patients with EH.

Objective: To investigate the effects of ?-melanocyte-stimulating hormone(?-MSH) on TGF-?_1 secretion of fibroblasts from keloids so as to find a novel evidence to research etiology of keloids.Methods:Fibroblasts isolated from human keloids were cultured in DMEM medium with 15% bovine serum and treated with ?-MSH. The level of TGF-?_1 was measured with ELISA method. Results: ?-MSH at the concentration of 10 -6 mmol/L triggered the TGF-?_1 secretion of fibroblasts. Conclusion:?-MSH possesses the effect of triggering human keloid fibroblasts to secrete TGF-?_1, and its effective concentration is 10 -6mmol/L.

Objective The recurrence and metastasis of malignant tumor could affect the survival of patients. Early detection of cancer cells in peripheral blood and effective therapy promptly are of clinical importance. The present study was to investigate the carcinoembryonic antigen (CEA) mRNA expression and serum CEA level in blood from patients with colorectal cancer and to evaluate its clinical significance. Methods Peripheral blood samples were collected from 35 eligible patients with colorectal cancer and 9 post operative patients. CEA mRNA was detected by reverse transcriptase polymerase chain reaction (RT PCR) and serum CEA was detected by time resolved fluorometric methods. Results The positive rate of CEA mRNA in blood samples of 35 patients with colorectal cancer was 45.7%, and 2.7% in healthy volunteers. Two of the nine post operative patients (22.2%) showed CEA mRNA positive. The positive rate increases with the pathological staging and showed no significant relation with the malignant extent of cell differentiation. Serum CEA mRNA positive rates in patients with CEA positivity (72.2%) were significantly higher than those in patients with negative CEA mRNA expression (42.3%).Conclusion The expression of CEA mRNA in peripheral blood cells correlates with the pathological staging of colorectal cancer and it could be of potential use to monitor the micrometastases of tumor. Long term follow up is needed to evaluate its clinical significance.

Objective To compare the effects of biofeedback (BF) training on clinical symptoms , psychological status and quality of life in different subtypes of patients with functional defecation disorders (FDD) .Methods According to Rome Ⅲ criteria ,50 FDD patients were divided into non coordinated defecation (F3a) and the lack of promoting defecation (F3b) two subtypes .The patients of these two subtypes received BF training three times every week ,five to ten times each course ,two to three times training at home were required during and after treatment .The changes ,of clinical symptoms scores ,self‐rating anxiety scale (SAS) ,self‐rating depressive scale (SDS) and the patient assessment of constipation quality of life question naire (PAC‐QOL ) were compared between before and after BF training in the patients of two subtypes .The difference between two subtypes were also analyzed as well .Paired t‐test or Wilcoxon signed‐rank test was performed for comparison between before and after treatment ,and group t‐test or Wilcoxon rank sum test was for comparison between groups .Results Among 50 FDD patients , there were 13 cases of F3a type and 37 cases of F3b type .After BF training ,the clinical symptoms scores of two subtypes patients were both lower than those before BF training (5 .62 ± 3 .91 vs 8 .77 ± 3 .59 , 5 .89 ± 3 .67 vs 9 .35 ± 3 .22 ,t = 3 .264 and 6 .272 ,both P< 0 .01) .There were no statistically significant differences in the scores of clinical symptoms between two subtypes at before and after BF training (t =- 0 .545 and - 0 .230 ,both P > 0 .05) .After BF training ,the SAS scores of two subtypes patients were both lower than those before BF training (30 .85 ± 6 .67 vs 42 .46 ± 8 .37 ,30 .65 ± 7 .51 vs 38 .59 ± 8 .38 , t= 4 .536 and 6 .402 ,both P< 0 .01) ,and the scores of SDS were both lower than those before BF training (42 .85 ± 8 .30 vs 53 .92 ± 7 .98 ,43 .95 ± 12 .17 vs 55 .39 ± 10 .83 ,t = 4 .788 and 6 .830 ,both P< 0 .01) . There were no statistically significant differences in the scores of SAS and SDS between two subtypes at before and after BF training (t= 1 .431 ,0 .084 ,- 0 .447 and - 0 .301 ,all P> 0 .05) .After BF training ,the PAC‐QOL scores of two subtypes [0 .54 (0 .15 ,0 .88) 、0 .98 (0 .51 ,1 .34)] were both lower than those before BF training [2 .08(1 .18 ,2 .34) 、1 .86(1 .34 ,2 .29)] ,Z= - 2 .903 、- 4 .825 ,both P < 0 .01) .There were no statistically significant differences in the PAC‐QOL scores between two subtypes at before and after BF training (Z= 0 .409 ,1 .891 ,both P > 0 .05) .Conclusions BF training is both effective on two subtypes of FDD ,which can improve clinical symptoms ,psychological status and quality of life ,and with There is no difference in efficacy between the two subtypes .

Objective To investigate the value of dynamic contrast-enhanced MRI (DCE-MRI) quantitation study with exchange model in evaluation of liver cirrhosis.Methods A total of 30 patients with liver cirrhosis confirmed to included and excluded criteria were divided into compensatory cirrhosis group (n=15) and decompensatory cirrhosis group (n=15).And 15 healthy volunteers were scrvcd as a control group.All subjects were performed liver DCE-MRI and quantitative pa rameters of three groups were obtained by exchange model,including volume transfer constant of the contrast agent (Ktrans),reverse reflux rate constant (Kep),volume fraction of EES (Ve),volume fraction of plasma (Vp),arterial perfusion index (HPI),blood volume (BV),blood flow(BF) and mean transit time (MTT).The parameters of three groups were compared by ANOVA analysis and LSD test for every two groups.The diagnostic efficacy of Ktrans,Ve,HPI,MTT for liver cirrhosis were analyzed by ROC.Results Ktrans,Ve,HPI,MTT and BF values in the control group,compensatory cirrhosis group and decompensatory cirrhosis group were (0.85 ± 0.34) min-1,(0.67 ± 0.36) min-1,(0.39±0.18)min-1;0.47±0.42,0.34±0.13,0.16±0.06;0.35±0.09,0.57±0.17,0.76±0.20;(17.38±15.38)s,(34.26111.37)s,(57.33±16.73)s;(97.22±36.29)ml/(min· 100 g),(69.30±35.22)ml/(min· 100 g),(24.64± 28.24) ml/(min · 100 g),respectively,and showing significant differences among three groups,and significant with HPI and MTT for every two groups (P＜0.05).There were no significant differences for Kep,Vp and BV among three groups (P＞0.05).According to ROC of Ktrans and Ve for decompensatory liver cirrhosis,AUC were 0.86,0.92,the sensitivity were 90％,90％ and the specificity were 80％,80％.According to ROC of HPI and MTT for compensatory liver cirrho sis,AUC were 0.79,0.76,the sensitivity were 85％,85％ and the specificity were 75％,75％.According to ROC of HPI and MTT for decompensatory liver cirrhosis,AUC were 0.91,0.88,the sensitivity were 95％,90％ and the specificity were 80％,80％.Conclusion DCE-MRI quantitative study with exchange model can obtain multiple parameters,refleet hemodynamic changes and vascular microenvironment and evaluate severity of liver cirrhosis.

10.3969/j.issn.2095-4344.2013.25.010

Objective To discuss the diagnosis and management of metastatic adrenal carcinoma. Methods Forty-seven cases with metastatic tumor in the adrenal glands were analyzed retrospectively from December 1996 to April 2010. Lung was the most common primary tumor site (51.1 %, 24 cases), followed by the renal cell carcinoma (12.8%, 6 cases), liver cancer (10.6%,5 cases), breast cancer (8.5%, 4 cases), melanoma (4.2%, 2 cases), and other carcinoma (12.8%,6 cases). Most patients with metastatic adrenal carcinoma had no special clinic manifestation. Lesions of 36 cases were surgically removed and 11 cases gave up operation. Results The mean survival time were 33.8±4.5 months for 31 cases underwent adrenalectomy and 6.3±2.7 months for 6 cases without operation. Patients with surgically removed adrenal metastases had better survival than those without surgical resection. Conclusions Adrenal gland is a common site of metastatic carcinoma.Ultrasonographic and CT scans are important diagnosis methods for metastatic adrenal carcinoma. Operation is still effective and long-term survival may be achieved for those well selected patients, but surgical indication must be strictly monitored.