Objective To study the relationship between the inherit gene and the pharmic efficacy by observing the apolipoprotein E polymorphism and the nylestroil effect in lowering serum lipids in postmenopausal women. Methods Ninety-four postmenopausal women were divided into three groups according to their types of the apoE gene: E2, E3 and E4. Thirty-six women who received nylestroil therapy were compared with controls, 58 women who had not received the therapy, in lipids, apolipoprotein E and lipoprotein(a)〔LP(a)〕. Results Compared with the control groups, the treatment groups showed an increase in HDL-C (high-density lipoprotein) and decrease in LDL-C(low-density lipoprotein) and LP(a). Though Group E2 showed an increase in the HDL-C and TG and a decrease in the LDC-C and LP(a), no significance was shown compared with the controls. Group E3 was increased in the HDL-C(2.7?0.9)mmol/L and decreased in the LDL-C (3.2?1.0)mmol/L and Lp(a) (0.4?0.2)g/L, and the differences were significant in HDL-C(1.7?0.5)mmol/L and Lp(a) (0.5?0.3)g/L compared with the controls. Group E4 was increased in the HDL-C (2.6?1.0)mmol/L and decreased in the LDL-C(2.5?1.6)mmol/L, TC and LP (a), and the differences were statistically significant(P

Objective To evaluate the effect of TEG ( thromboelastography ) in the timing choose of CABG( coronary artery bypass grafting ) surgery for patients that receiving DAPT treatment .Methods This study is prospective analysis from November 2013 to May 2014 in Wuhan Asia Heart Hospital.The study cohort consisted of 1 201 patientswith acute coronary syndrome , theage range from 43 to 79 years (61.1 ±10 years) with 134 males and 79 females.and the patients undergo DAPT ( aspirin 100 mg/d, clopidogrel 75 mg/d) which were prepare to the coronary artery bypass grafting and then randomly divided into two groups according to the ratio of 1∶1.There were 101 patients, using perioperative TEG inspection , which conduct the choose of surgery timing according to the ADP-induced platelet-fibrin clot strength ( MAADP) after 24 h of the withdraw of DAPT.Distribute the patients into≥50 mm, 35-50 mm and <35 mm groups according to the MAADPresults, and theirCABG was complete within 1 day, 3-5 days and after 5 days respectively. The other 100 patientsacceptancoronary artery bypass grafting surgery and DAPT patients but without TEG examination as the control group , which were withdrawal the DAPT for 5 -7 days by routine before operation.The primary endpoint is 24 h chest tube drainage andkey secondary endpoint is the total number of transfused red blood cells .Recorded the mean intubation time , ICU stay times , Median length of hospital stayandrethoracotomyrates, 30-day mortality, and 30-day readmission rate at the same time.Using Fisher in the variables , t-test when two groups were compared , use ANCOVA for variable factor correction and Statistical analysis was performed using chi-square test in the calculate of results .Results The average chest drainage in TEG group and the control was 438.8 ml vs 487.8 ml(t=1.063,P=0.289),and the total amount of transfused red blood cell in both groups were 493.8 ml vs 551.6 ml(t=1.228,P=0.2227), there were no significant difference between the two groups .The total waiting time in the three categories of patients in TEG group is 294 days ( an average waiting time of 3.11 days per patient ) and was reduced 38%(3.1 days to 5 days)than the guidelines recommend.Conclusions Although the perioperative bleeding and red blood cell transfusion , the occurrence and postoperative adverse events were similar in two groups , but using thrombelastographto measure platelet function before CABG surgery can help to choose the timing of surgery and reduce the waiting time before surgery .

OBJECTIVE:To study the intervention mechanism of puerarin on expressions of HSP70 and Fas proteinum in rats with acute cerebral ischemia injury.METHODS:12 rats with acute cerebral ischemia injury were randomly divided into ischemia control group(saline) and puerarin treated control group,with 6 in each group,each rat under took own control by ischemia side(exp.group) and non-ischemia side(control group);And rats with acute cerebral ischemia injury were randomly divided into control group (saline,ischemia side),puerarin treated control group and normal group (non-ischemia side),with 6 in each group.And then the expressions of HSP70 and Fas proteinum is determined by HE staining and immunochistochemistry SP.RESULTS: The expression of HSP70 was negative or weakly positive in ischemia control group and puerarin treated control group, while that in ischemia experiment group and puerarin treated experiment group was significantly increased(P0.05);The numbers of dead cells in control group and puerarin group were found to be significantly larger than that in normal group(P

Objective To discuss the diagnostic value of HIT-antibodies in suspected HIT patients with heart diseases.Methods A single center study.We collected 242 blood samples of suspected HIT patients whose platelet count decreased after heparin application during July 1 st ,2012 to June 30th ,2016 in Wuhan Asia Heart Hospital and detected the concentration of HIT antibodies , meanwhile the 4T′s score were calculated.Among the study objects , there are 206 patients received cardiac surgery , 28 received cardiac interventional therapy and 8 received drug therapy.And we divided them into HIT group (44, median age 57.5, 23 females ) and non-HIT group ( 198, median age 63.5, 87 females ) according to clinical diagnosis.Quantitative data was analyzed by independent t-test or Mann-Whitney U test.Qualitative data was analyzed by Fisher′s exact test.We drew ROC curve according to the statistical analysis to determine the optimal threshold value of antibodies in diagnosis of HIT andsensitivity , specificity, negative likelihood ratio, positive likelihood ratio of the HIT antibody detection .Therefore, we can assess the value of HIT antibody detection in HIT clinical diagnosis and treatment .Moreover, we used the optimal threshold value of antibodies to testify the suspected HIT patients .Results The HIT antibody concentration of HIT group (44) and non-HIT group ( 198 ) are 3.2 ( 95% CI:1.8 -5.5 ) U/ml and 0.4 ( 95% CI:0.3 -0.4 ) U/ml, respectively.The concentration of HIT group is much higher than the non-HIT group(P<0.000).When the cut-off value of HIT-Ab is set at 0.9 U/ml, sensitivity and specificity are 93.2%and 91.9%, respectively. And negative likelihood ratio and positive likelihood ratio are 0.07 and 11.53, respectively.When the cut-off value of HIT-Ab is set at 0.6 U/ml, sensitivity and specificity are 100.0%and 73.7%.HIT-Ab and 4T′s score of ROC-AUC are 0.971 and 0.745, respectively.The diagnosis value of HIT-Ab in HIT is significantly higher than the 4T′s score ( P<0.000).Conclusions HIT antibody detection is a simple and effective auxiliary diagnostic method in HIT exclusion .And HIT antibody detection is more optimal than the 4T′s score in HIT diagnosis and treatment .

Objective To study the effect of hydrogen sulfide (H2S) on iNOS/NO in neonatal rats with hyperoxia-induced lung injury.Method Eighty full-term neonatal SD rats were randomly assigned into 4 groups (each group 20 rats including control group,hyperoxia group,NaHS + hyperoxia group,PPG + hyperoxia group.Rats in NaHS + hyperoxia group had 90 μmol/kg NaHS injected intraperitoneally,those in PPG + hyperoxia group had PPG 50 mg/kg injected,and those in the other 2 groups had the same amount of 0.9％ normal saline injected.Except for the control group that exposed to air,the other three groups were exposed to 95％ O2 for 7 days.Then pulmonary histopathology was studied by HE staining,the ratios of lung wet/dry weight (W/D) were determined as measurement of the severity of pulmonary edema,maleic dialdehyde (MDA),iNOS activity and NO levels in lung tissue were measured using commercial kits,iNOS mRNA expression was detected by Real-time PCR.Analysis of variance and LSD-t test were used for statistical analysis.Result (1) Compared with control group,the hyperoxia group showed erythrocyte extravasation and leukocyte infiltration in the alveoli with inflammatary cell infiltrations,alveolar septum edema,whereas pathological injury changes induced by hyperoxia were alleviated by NaHS and the damage was exacerbated by PPG.(2) In hyperoxia group,H2S was decreased compared with control group (117.6±20.4 μmol/L vs.184.3 ± 13.7 μmol/L).In NaHS + hyperoxia group,H2S was apparently increased compared with the hyperoxia group (247.3 ±32.4 μmol/L vs.117.6 ±20.4 μmol/L),while in PPG + hyperoxia group H2S was decreased compared with the hyperoxia group (89.2 ± 8.3 μmol/L vs.117.6 ±20.4 μmol/L) (P ＜0.01).(3) In the hyperoxia group,the ratios of lung W/D (5.81 ±0.22),the contents of MDA (1.69 ± 0.14) nmol/ml,iNOS activity (2.24 ± 0.19) U/mg prot,NO levels (22.37 ±3.04) × 10-3 μmol/g prot,iNOS mRNA expression (1.43 ±0.09) showed significant increase respectively (P ＜ 0.01) compared with the control group (5.06 ± 0.15),(0.78 ± 0.08)nmol/ml,(1.18 ± 0.18) U/mg prot,(7.49 ± 1.91) × 10-3 μmol/g prot,(0.90 ± 0.08).NaHS administration showed a significant decrease in lung W/D,lung tissue MDA content,iNOS activity,NO level,iNO SmRNA expression (5.59 ±0.19),(1.44±0.11) nmol/ml,(1.84 ±0.27) U/mg prot,(14.23 ±2.00)× 10-3 μmol/g prot,(1.28 ±0.10) compared with the hyperoxia group (P ＜0.01).The above markers were significantly increased after PPG administration (6.18 ± 0.26),(1.99 ± 0.19) nmol/ml,(2.66 ± 0.23) U/mgprot,(30.94 ±3.31) × 10-3 μmol/g prot,(1.73 ±0.06) (P ＜0.01).Conclusion Exogenous H2S can relieve hyperoxia-induced lung injury by down-regulating the expression of iNOS mRNA,decreasing iNOS activity and decreasing NO production.

Objective: To investigate the association between D-dimer levels and clinical events in patients with mechanical heart valve replacement under oral anticoagulation therapy. Methods: This prospective study included 640 consecutive patients underwent mechanical heart valve replacement in Wuhan Asia Heart Hospital between January 2013 and June 2014.Patients were assigned to abnormal D-dimer group (D-dimer level>cut off value, n=88) and normal D-dimer group (D-dimer level≤cut off value, n=552) according to D-dimer levels measured at 3 months after the initiation of oral anticoagulation therapy.All patients were followed up for 24 months or until the observation of the end points, which included thrombotic events, bleeding events and all-cause deaths.The anticoagulation therapy was monitored once per 1-2 months by the international normalized ratio (INR), and the target value was 1.8-3.0. Results: During a follow-up period of 24 months, rates of total clinical events (19.30%(17/88) vs. 5.8%(32/552), P<0.01), thrombotic events (11.4%(10/88) vs. 2.3%(13/552), P<0.01), and all-cause deaths (8.0%(7/88) vs. 2.0%(11/552), P<0.01) were all significantly higher in abnormal D-dimer group than in normal D-dimer group.There were no significant difference in bleeding events between the two groups (2.3%(2/88) vs. 3.1%(17/552), P=0.77). Multivariate Cox regression analysis showed that high D-dimer level was an independent risk factor of total clinical events (HR=3.86, 95%CI 1.92-7.76, P<0.01), thrombotic events(HR=5.29, 95%CI 2.12-13.10, P<0.01), and all-cause deaths(HR=5.32, 95%CI 1.71-16.60, P<0.01), but which was not correlated with bleeding events(HR=1.36, 95%CI 0.27-6.84, P=0.71). Conclusion Elevated D-dimer levels are linked with clinical events in patients with mechanical heart valve replacement under oral anticoagulation therapy.

Objective To validate the analytical performance of a cardiac troponin I(cTnI)assay AccuTnI+3 on chemiluminescnet analyzer DXI800 and Access2;and to establish the 99th percentile of cTnI in an apparently healthy Chinese population.Methods The subjects are composed of 1 369 apparently healthy people and 20 acute myocardial infarction(AMI)patients from Wuhan Asian Heart Hospital and Fuwai Hospital from October 2014 to June 2015.The healthy people include 680 males and 689 females;with 340 subjects aged 18-30,674 subjects aged 31-64, and 355 subjects aged ≥65.The detection limits and imprecision of AccuTnI +3 assays were validated according to CLSI EP 15-A2 and EP17-A2 documents;the same samples were analyzed on DXI800 and Access2 to assess the consistency between the two analyzers using Bland Altman plot and Passing-Bablok regression.The correlation between different sample types (lithium heparin plasma, EDTA plasma & serum)were assessed using linear regression analysis.The lithium heparin plasmasamples from 1 369 apparently healthy people were analyzed to calculate the 99th percentile of cTnI.The cTnI concentrations were compared among age and sex groups.The 99th percentile of cTnI were also calculated for each group.The detection rate of cTnI in apparently healthy people was calculated using SPSS23.0.Results The limit of blank(LoB), limit of detection(LoD), and limit of quantification(LoQ)where CV%=10% were 0.007 ng/ml,0.010 ng/ml and 0.016 ng/ml on DXI800;0.008 ng/ml,0.012 ng/ml and 0.026 ng/ml on Access2,respectively.The cTnI measurements on DXI800 and Access2 were consistent and comparable.The cTnI concentrations of lithium heparin plasma, EDTA plasma and serum samples were linearly correlated pairwise: EDTA plasma measuremen t =0.76 heparin plasma measurement, R2=0.999(n=40, P<0.001); serum measuremen t =1.05 heparin plasma measurement,R2=0.996(n=40,P<0.001); serum measuremen t=1.38 EDTA plasma measurement, R2=0.993(n=40,P<0.001).The 99th percentiles were 0.030 ng/ml and 0.035 ng/ml on DXI800 and Access2,respectively,from 1 369 apparently healthy Chinese people.cTnI is significantly higher in elder group than in younger group.The 99th percentiles in 18-30 years old group,31-64 years old group,and≥65 years old group are:0.011 ng/ml,0.029 ng/ml,and 0.035 ng/ml respectively for DXI800;0.023 ng/ml,0.034 ng/ml, and 0.045 ng/ml respectively for Access2.cTnI is significantly higher in men than in women.The 99th percentiles in men and women are: 0.034 ng/ml and 0.032 ng/ml respectively for DXI800;0.043 ng/ml and 0.031 ng/ml respectively for Access2.cTnI was measurable in 62%and 87%of healthy subjects on DXI800 and Access2 systems,respectively.Conclusions The analytical performance of AccuTnI+3 assay fulfills the need of clinical use and the criteria of high-sensitive cardiac troponin assay.

Objective To investigate the predictive value of HIT-antibodies(HIT-Ab) detection for new thrombus in suspected Heparin-Induced thrombocytopenia (HIT). Methods Retrospective cohort study. 472 suspected HIT patients were collected from July 2016 to November 2018, and all subjects under-went a 4Ts score and were sent for HIT-Ab tests. According to the results of HIT-Ab, there were four groups:412 cases of negative HIT-Ab (0-0.9 U/ml), 45 cases of weak-positive HIT-Ab (1.0-4.9 U/ml), 12 cases of moderate-positive HIT-Ab (5.0-15.9 U/ml), and 3 cases of strong-positive HIT-Ab (≥16.0 U/ml) respective-ly. Ultrasound or CT examination was used to confirm new thrombosis as a standard to evaluate the value of HIT-Ab for predicting new thrombus. The diagnostic efficacy of HIT-Ab for HIT was evaluated in clinically confirmed HIT. Results The incidence rates of new thrombus in each group were: 15.8％ in Negative HIT-Ab group (62/412), 48.9％in Weak-positiveHIT-Ab group (22/45), 75.0％in Moderate-positive HIT-Ab group (9/12), and100％in Strong-positive HIT-Ab group (3/3)(P<0.00). When HIT-Ab≥1.0 U/ml, the speci-ficity for diagnosing new thrombus was 93.0％, the sensitivity was 34.2％, the negative predictive value (NPV) was 84.2％, and the positive predictive value (PPV) was 56.5％. The diagnostic rates of HIT in each group were:negative 0％(0/412), weak-positive 62.2％(28/45), moderate-positive (12/12) and strong-positive (3/3) were 100％. When HIT-Ab≥ 1.0 U/ml, the specificity for HIT diagnosis was 96.0％, the sensitivity was 100％, NPV was 100％, and PPV was 71.5％. Conclusions In suspected HIT patients, the incidence of new thrombosis increases with the elevated HIT-Ab level. HIT-Ab detection can be used as a crucial tool for new thrombosis prediction and HIT diagnosis in suspected HIT patients. Clinicians can develop treatment strategies based on HIT-Ab levels.

Objective: To detect gene mutations in a pedigree with Rothmund-Thomson syndrome (RTS) . Methods: Clinical data were collected from two patients (an older sister and a younger brother) and their family members in a Chinese pedigree of Han nationality with RTS. Blood samples were obtained from the two patients, their unaffected older brother, their parents and 100 unrelated healthy controls. DNA was extracted, and all the exons in the encoding area of the RECQL4 gene were amplified by PCR. Gene mutations were detected by a skin-targeted next-generation sequencing panel, and verified by Sanger sequencing. Results: Two heterozygous mutations were identified in the RECQL4 gene of the two patients, including a splice site mutation c.2886-1G>A and an insertion mutation c.1013_1014insC, which were inherited from the father and mother of the patients respectively. Meanwhile, neither of the two mutations was observed in 100 unrelated healthy controls or the older brother of the patients. Conclusion The splice site mutation c.2886-1G>A and the insertion mutation c.1013_1014insC in the RECQL4 gene may contribute to the clinical phenotype of the patients in this pedigree with RTS.