Objective To explore coronary angiography detection in coronary heart disease patients with left ventricular ejection fraction decreasing. Methods The clinical data of 120 coronary heart disease patients were retrospectively analyzed. And the patients were divided into observation group and control group by decreasing of left ventricular ejection fraction. Results The incidence rate of more affection, anterior descending branch, convolution branch,left bole affection were higher than control group;The Gensini points of detection group were higher than control group( P ＜ 0. 05) ,and the difference was statistical significance. Conclusion Close attention on the changes of left ventricular ejection fraction in the clinic could provide reliable theory base.

Objective To discuss the indication, surgical technique and curative effect of humeral head replacement in treatment of complex proximal humerus fracture in old patients. Methods From 2000 to 2006, 23 patients with complex proximal humerus fractures were treated with humeral head replacement and fixated with bone cement in old patients. Rehabilitation training was performed after operation.Results Of all, 19 patients were followed up for average 1.8 years, which showed no infection, nerve injury or periprosthetic fracture except for one patient with semiluxation. NEER score system was used to evaluate the function joint prosthesis. Mean NEER score was 82.1 points, including 80-89 points ( satisfactory) in 17 patients and 70-79 points (unsatisfactory) in 2, with satisfaction rate of 89%. No patient needed revision. Conclusion With strict indication, active reconstruction of rotating cuff and stable structure of the joint, planned postoperative rehabilitation training, the humeral head replacement is a good method for treating complex proximal humerus fractures in the old patients.

Purpose:By ascessing the CT guided percutaneaus biopsy to improve clinical diag- nostic rate and reduce complications.Materials and methods:60 cases of biopsy with complete materials have been reviewed,and the methods of“retain anesthetic tracing needle”has been proposed-to obtain tissues for cytologic and histologic exams with different biopsy needles.Results:Successful rate of the puncfure 100%.39 cases were identified as lung cancer,8 cases as tuberculosis,7 cases as pneumonia. Successful biopsy was 90%.Conclusion:“Retain anesthetic tracing needle”could reduce the times of adjusting direction,improve the one-time successful rate and possess the characteristics of positioning safe,reliable and accurate diagnosis.

Objective To study antidepressant effect and mechanism of different polar fraction of Acorus tatarinowii Schott.on depression mouse model and explore the mechanism. Methods Different polar fractions were prepared by systematic solvent method. The adult dose recommended by Chinese Pharmacopeia ( 10 g?d-1 ) was converted to the dose of mouse. Intragastric administration was performed.A total of 80 male mice was randomly divided into normal control group,model control group and different polar fraction groups of Acorus tatarinowii Schott.. Depression mouse model was established by chronic unpredictable mild stimulation ( CUMS) with solitary feeding,and external performance of mice of different groups was observed. After 21-day feeding,blood was harvested from eyes of the mice.Concentrations of triiodothyronine (T3),tetraiodothyronine (T4), thyroid-stimulating hormone ( TSH) ,adrenocorticotrophic hormone ( ACTH) in mouse plasma and 5-hydroxy tryptamine ( 5-HT) , ACTH in brain were measured by ELISA method. Results Concentrations of T3 , T4 and ACTH in model control group [(1.203±0.042),(44.80±2.21),(11.27±0.50) ng?mL-1] were significantly increased as compared with the normal control group [(0.794±0.028),(24.87±1.25),(7.04±0.24) ng?mL-1] (P<0.05).Concentration of 5-HT in brain (146.87±10.96) was significantly decreased as compared with that of normal group ( 237. 11 ± 21. 87 ) ng?L-1 , and concentration of ACTH (58.94±4.46) ng?L-1 was significantly increased as compared with that of normal group [(38.89±2.26) ng?L-1,P<0.05)]. Concentrations of T3[(0.824±0.067),(0.812±0.051),(0.943±0.049) ng?mL-1],T4[(25.97±1.96),(27.53±1.88), (31.26±1.97) ng?mL-1] and ACTH [(7.21±0.40),(7.58±0.39),(8.69±0.42) ng?mL-1] in extraction group,cyclohexane group and chloroform group were significantly decreased as compared with model control group. At the recommendation dose of Chinese Pharmacopeia,concentrations of 5-HT in brain [(219.59±10.48),(202.19±11.95),(186.96±10.29) ng?L-1] were significantly increased,and concentrations of ACTH [(41.65±2.65),(44.87±2.95),(47.75±3.06) ng?L-1] were decreased ( P<0.05) . Conclusion Mouse model of CUMS shows typical depression symptom,and the symptom has relationship with the concentrations of endocrine hormones of T3 , T4 , ACTH, 5-HT, etc. Extraction and low polar fractions ( cyclohexane, and chloroform) of Acorus tatarinowii Schott. can partly correct incretion disorder of depression model, which may be parts of the reasons why Acorus tatarinowii Schott.exerts anti-depressant effect.

Objective To compare and analyze the clinical efficacy of locking plates versus artificial joint replacement for proximal humeral complicated fractures.Methods The retrospective data of 200 cases with locking plate or artificial joint replacement for the treatment of comminuted proximal humeral fractures were collected from February 2013 to July in our hospital.Patients were divided into locking plate group (n =114) and artificial joint replacement group (n =86) according to the treatment.The pain,functional recovery,activity,anatomical position,complications and Neer score after treatment were compared between the two groups.Results In artificial joint replacement group,Neer score was excellent in 34 cases,good in 23 cases,fair in 25 cases,poor in 4 cases,and the excellent and good rate was 66.3％ (57/86).In locking plate group,Neer score was excellent in 53 cases,good in 47 cases,fair in 10 cases,poor in 4 cases,and the excellent and good rate was 87.7％ (100/114).The excellent and good rate was higher in locking plate group than in artificial joint replacement group (x2 =13.35,P＜0.001).The scores of pain,functional recovery,activity and anatomical position were (26.9 ± 8.5),(22.4 ± 7.1),(19.8 ± 5.5) and (8.0 ± 1.8) respectively in locking plate group,and (24.8±10.2),(20.2±6.7),(18.1±6.6) and (7.9±2.1) respectively in artificial joint replacement group.There were significant differences in scores of functional recovery and activity between groups (t＝ 2.22 and 1.99,P =0.014 and 0.024),while no significant differences were found in scores of pain and anatomical position (t=1.59 and 0.36,P＝0.057 and 0.359).There were 2 cases with ankylosis,1 case with malunion and 1 case with humeral head necrosis in locking plate group,and 1 case with ankylosis,1 case with wound infection,1 case with refracture and 1 case with humeral head necrosis in artificial joint replacement group after treatment.There were no significant differences in complications between groups (x2 =0.17,P=0.683).Conclusions The locking plate and artificial joint replacement are effective in the treatment of comminuted proximal humeral fractures.Compared with artificial joint replacement,the locking plate can improve the functional recovery,activity and Neer score evaluation with a low technical requirement,which is an ideal method for comminuted proximal humeral fractures.

Objective To investigate the outcomes of unselected peripheral T cell lymphoma (PTCL) patients treated with in-tensive first-line chemotherapy with high-dose therapy followed by autologous stem cell transplantation (ASCT).Methods Here a nonrandom study was reported for 23 PTCL patients treated with first-line intensive chemotherapy followed by autologous stem cell trans-plantation and 23 PTCL patients treated with conventional chemotherapy during January in 2000 to 2011 .All patients had received E-CHOP for 6~8 cycles, and autologous stem cell transplantation group was administrated with intensive chemotherapy followed by ASCT after complete remission or partial remission .Results There was no statistically significant difference in short-term therapeutic effect between two groups( P >0.05), but the 5-year overall survival(OS) of autologous stem cell transplantation group( 58%) was higher than conventional chemotherapy group , as well as 5-year disease-free survival time (DFS) (45%in autologous stem cell transplanta-tion group, and 21%in conventional chemotherapy group ) with both statistical significance ( P <0.05).Only the incidence of Ⅳ° myelosuppression in autologous stem cell transplantation group ( 100%) was higher than that in conventional chemotherapy group ( 13%) ( P <0.01 ) .Conclusions First-line intensive chemotherapy followed by autologous stem cell transplantation for peripheral T cell lymphoma was quietly safe utility , it was better than conventional chemotherapy which would be considered as first -line method.

Objective To explore the effects of alanyl-glutamine (Ala-Gln) dipeptide supplemented parenteral nutrition (PN) on the short-term outcomes in critically ill adult patients.Methods In this retrospective study,we reviewed the clinical data of critically ill adult patients who were treated by standard PN from January 2006 to December 2011.The length of stay in intensive care unit (ICU-LOS),incidences of infections and multiple organ dysfunction syndrome (MODS),and mortality were compared between the group of Ala-Gln dipeptide supplemented PN (intervention group) and the group of PN without Ala-Gln dipeptide (control group).Results Finially,617 cases were enrolled in the study,including 312 cases in the control group and 305 cases in the intervention group.The ICU-LOS was significantly shorter in the intervention group than that in the control group [(17.2 ± 6.5) d vs.(16.1 ± 5.3) d,P =0.011).Compared with the control group,the incidences of infection (42.9％ vs.33.1％,P =0.011) and MODS (46.5％ vs.38.0％,P =0.030) and the mortality (34.9％vs.25.9％,P =0.014) in the intervention group patients were significantly lower.Conclusion Ala-Gln dipeptide supplemented PN can improve the short-term outcomes of critically ill adult patients.

Objective To develop an assay to determine Mycobacterium tuberculosis resistance to rifampin, isoniazid, ofloxacin and amikacin by pyrosequencing and evaluate the value of this method in clinical application. Methods Eighty-nine clinical isolates of Mycobacterium tuberculosis from tuberculosis patients were collected from Shanghai Pulmonary Hospital during 2008 to 2009. All strains were isolated from decontaminated sputum, cultured on Lowenstein-Jensen media and identified by traditional biochemical tests with standard methods. Ten Mycobacterium tuberculosis were selected from the strain bank of Shanghai Pulmonary Hospital. The optimal conditions of detection of rpoB, katG, gyrA and rrs gene by pyroseuencing were determined, using the 10 Mycobacterium tuberculosis strains whose drug susceptibility of Bactec 960 and sequence of rpoB, katG, gyrA, rrs gene were known. Then the drug susceptibility of 89 Mycobacterium tuberculosis clinical isolate strains were detected by pyrosequencing using this conditions and the results were compared with that of the Bactec 960 methods. Results The pyrosequencing program of sequence analysis was suitable for the detection of the mutations of rpoB and gyrA genes, and the program of single nucleotide polymorphism was suitable for katG and rrs genes. Among the 89 Mycobacterium tuberculosis clinical isolates,when using the drug susceptibility of Bactec 960 as the standard, the sensitivity of rifampin, isoniazid,ofloxacin and amikacin is 98.0%, 64. 1%, 79.5%, 78. 3% respectively, the specificity is 97.5%,100. 0%, 90. 0%, 100. 0% respectively, the accuracy is 97.8%, 77. 5%, 85.4%, 94. 4% respectively,tested by pyrosequencing. The results of the detection of resistance to rifampin, isoniazid, ofloxacin and amikacin in Mycobacterium tuberculosis using pyrosequencing technique were almost the same with that of Bactec 960, and Kappa ≥0. 7 in each detection. Conclusion Pyrosequencing is thus a rapid, accurate and high throughput method for detecting Mycobacterium tuberculosis resistance to these four drugs.

Objective To explore the impacts of different nutrition support methods on short-term outcome in critically ill adult patients. Methods We retrospectively reviewed the clinical data of 1503 critically ill adult patients who needed nutrition support in an mixed intensive care unit (ICU) of a tertiary care university hospital from January 1994 to December 2009. The complication of nutrition support, length of stay (LOS) in ICU, morbidity of infection and multiple organ dysfunction syndrome (MODS), and mortality among different nutrition support methods were compared. Results The Nutritional Risk Screening (NRS) scores of the enrolled patients were no less than 3. LOS in early enteral nutrition (EN) patients were significantly shorter than those in not-early EN patients (P ＜ 0. 001) and parenteral nutrition (PN) patients (both P ＜ 0. 001). Infection rate (P ＜ 0. 001),morbidity of MODS (P ＜ 0. 001) and mortality (P ＜ 0. 001) were significantly lower than those in not-early EN and PN patients. LOS of patients receiving PN rich in glutamine (Gln) was significantly shorter than that in conventional formula (P = 0. 0000). Morbidity of infection (P= 0. 0252) and MODS (P = 0. 0030), mortality (P =0. 0305) were significantly lower than that of conventional patients. LOS of patients receiving intensive insulin therapy (IIT) was significantly shorter than that of controlled group (P = 0. 0000). Morbidity of infection (P =0. 0001) and MODS (P = 0. 0237) and mortality (P =0. 0427) were significandy lower than those of controlled group. Conclusions Nutritional risk is prevalent among critically ill adult patients. Early EN, PN of rich in Gln,and receiving IIT can shorten LOS, decrease morbidity of infection and MODS, and improve prognosis among these patients.

Using cDNA from Rehmannia glutinosa leaf as template, a 972 bp fragment of expansin gene which containing a 762 bp ORF that encoded 253 amino acids, was cloned, named RgEXPA10, which GenBank accession number for this gene is KF011918. A 1 207 bp genomic sequence of RgEXPA10 was amplified by PCR with leaf DNA as template, sequencing analysis revealed that three exons and two introns in RgEXPA10 genomic sequence, and which GenBank accession number is KF011919. Molecular and bioinformatic analyses indicated that RgEXPA10 protein have DPBB_1 and Pollen_allerg_1 domain, also including a 26 aa nuclear localization signal and a 19 aa transmembrane region. Phylogenetic analysis revealed that RgEXPA10 showed the highest homology with AtEXPA8 among the 26 α-expansins in Arabidopsis thaliana. However, the RgEXPA10 indicated the highest homology with the expansin from Solanum lycopersicum among 22 plant species. Expression patterns using qRT-PCR analysis showed that RgEXPA10 mainly expressed in unfolded leaf, followed by the tuberous root at stage of expanding period, and rarely expressed in senescing leaf. And RgEXPA10 showed higher expression level in tuberous root at 60 and 90 days after emergence. The transcription level of RgEXPA10 significantly reduced under all the three stresses including continuous cropping conditions, salinity and waterlogging. This study will lay foundations for molecular function in development and regulation of different stresses for R. glutinosa.