Objective:To assess effect of detection of plasma N terminal pro brain natriuretic peptide (NT‐proBNP) and serum cystatin C (Cys C) combined Global Registry of Acute Coronary Events (GRACE) score on heart func‐tion and prognosis in patients with acute coronary syndrome (ACS) .Methods :According to GRACE score ,a total of 136 ACS patients were divided into low risk group (n=29) ,intermediate risk group (n=39) and high risk group (n=68) .Serum Cys C level and plasma NT‐proBNP level were measured in all groups .Incidence rate of major ad‐verse cardiovascular events (MACE) within three and six months was counted .Results:Among ACS patients ,com‐pared with low risk group ,there were significant rise in levels of NT‐proBNP [ (165.80 ± 51.62) ng/L vs .(193.13 ± 74.64) ng/L vs .(985.45 ± 152.69) ng/L] and Cys C [ (0.83 ± 0.38) mg/L vs .(0.9 ± 0.25) mg/L vs .(1.23 ± 0.23) mg/L] ,left ventricular end‐diastolic diameter [six months: (50 ± 3) mm vs .(55 ± 3) mm vs .(59 ± 5) mm] ,significant reduction in left ventricular ejection fraction [LVEF ,six months: (55 ± 7)% vs .(49 ± 5)% vs . (40 ± 7)% ] ,and significant rise in incidence rate of MACE (six months:2.94% vs .9.55% vs .30.88% ) ,and a‐bove indexes in high risk group were significantly higher than those of intermediate risk group except LVEF signifi‐cantly reduced , P<0.05 or <0.01 ;Pearson correlation analysis indicated that NT‐proBNP and Cys C levels were positively correlated with GRACE score (r=0.72 , P<0.05 ; r=0.65 , P<0.05) respectively .Conclusion:NT‐proBNP and Cys C level detection combined GRACE score could exactly response heart function and prognosis .

Objective To evaluate serum cystatin C combined with dipstick proteinuria as early markers to predict AKI available before surgery.Methods We prospectively followed 616 patients undergoing cardiac surgery.Univariate as well as multivariate regression was performed.Cystatin C combined with dipstick proteinuria before surgery was assessed for its' predictive value of AKI using receiver operator characteristic (ROC) curves.Results Patients in higher cystatin C quartiles were older(P ＜ 0.001),more often to have heavy proteinuria(P =0.021),hyperuricemia(P ＜ 0.001),heart failure(P ＜ 0.001)and recent MI (P =0.002).Those with heavy proteinuria were more often to have diabetes mellitus (DM) (P =0.010),hyperuricemia (P =0.043),worse cardiac function (P ＜ 0.001),higher creatinine levels (P ＜ 0.001) and lower eGFR levels (P ＜0.001).In a multiple logistic regression model,preoperative heavy proteinuria(OR =3.14) and preoperative cystatin C quartiles each associated with an increased odds of AKI,independent of advanced age (OR =1.04),hypertension (OR =1.88) and combined surgery(OR =3.47).The risk for adverse outcomes such as postoperative AKI,persistent AKI,severe AKI,dialysis and mortality were highest in patients with highest quartile of cystatin C(P ＜0.05,respectively) and heavy proteinuria (P ＜ 0.05,respectively).The area under the ROC curve(AUCs) for preoperative cystatin C combined with proteinuria to detect AKI,persistent AKI and severe AKI were 0.695,0.753 and 0.718,P ＜0.001 respectively.Conclusion These data suggest that preoperative serum cystatin C combined with dipstick proteinuria may improve prediction of AKI among patients undergoing cardiac surgery.

Salvia miltorrhiza Bge. is a perennial deciduous flowering plant. Its medicinal root and rhizomes part is widely used in the treatment of various diseases. In this study, bioinformatics analysis was performed to identify 4832 genome SSR loci with length longer than or equal to 40 bp from the draft genome assembly of S. miltorrhiza. The re-sults showed that the dinucleotide repeat motifs and trinucleotide repeat motifs constitute the main types of genome SSR loci, accounting for 37.3% and 61.3% respectively. SSR types enriched with A/T bases showed significantly higher abundance than other types, including AT/TA AAT/ATT, ATA/TAT, TAA/TTA, accounting for 30.5%, 21.6%, 17.1%, 20.4% of the total number of SSR loci, respectively. 1079 primer pairs were designed for these genome SSR loci. These primers can be used for genomic diversity analysis, genetic map construction, genetic marker screening. These data could lay the foundation for population genetics and genomics research of S. miltorrhiza.

Objective To investigate the diagnosis and surgical treatment for the intracardiac leiomyomatosis (ICL).Methods Retrospectively reviews the data of 18 cases of ICL from February 1995 to June 2011 in Anzhen Hospital.Preoperative diagnosis of right atrial myxoma in 2 cases,right atrium/ventricular thrombus in 2 cases,pulmonary embolism in 2 cases,the inferior vena cava and right atrial tumor in 3 cases,the inferior vena cava lesions in 9 cases.18 cases of ICL were diagnosed by echocardiography,magnetic resonance imaging ( MRI ),computer tomography (CT) and angiography.ICL were recected under anesthesia,cardiopulmonaray bypass surgery,he incisions were respectively through the chest,thoraco-abdominal or abdominal incision,cardiopulmonary bypass method were respectively at room temperature,mid-low temperature with cardiac arrest,lowflow,deep hypothermic circulatory arrest.Results There was no operative death.Right atrium,inferior vena cava,bilateral renal vein,bilater alIliac vein vascular were not found leiomyoma by vascular ultrasound.Follow-up time was 5 ～ 106 (49 ± 42 )months,1 patient died of the leiomyoma recurrence after 5 months after the primary operation,the remaining 17 patients were followed up asymptomatically.10 were in NYHA functional class Ⅰ,and 7 in class Ⅱ.The 5yrs survival rate calculated by the Kaplan-Meier survival curve was (93 ±5 )％.Conclusion The ICL preoperative diagnosis is difficult,surgical treatment of ICL can get a good mid-long term survival rate and living quality.

Objective To analyze the reasons of perioperative hypoxia in Stanford A aortic dissection,and summarize its management strategies.Methods From Dec.2005 to Jul.2011,sixty four patients underwent surgery for acute type A aortic dissection,of which 9 cases were with chronic dissection and 55 cases with emergent ones.Preoperative oxygen fraction ratio( PaO2/FiO2 )in 51 cases was lower than 200 mm Hg.All of them underwent the surgery with the help of deep hypothermia cardiac arrest technique.Results Three cases died.Thirty-three cases could not live without ventilation during the first 72 h because of continuous hypoxia ( PaO2/FiO2 ＜ 200 mm Hg).One case underwent tracheotomy and auxiliary ventilation for 9 days.The rest were live without ventilation after auxiliary ventilator for 72 - 120 hrs.The data showed that postoperative hypoxia was related to preoperative hypoxia (oxygen fraction ratio ＜ 200 mm Hg),BMI,acute onset,hypothermia cardiac arrest time,and transfusion more than 3000 ml ( P ＜ 0.05 ).Conclusion Great attention should be paid to the perioperative hypoxia-related factors in Stanford A dissection,which will be helpful to improve prognosis.

Objective To research the effect and safety of Reteplase for Injection combined with reduced glutathione in the treatment of acute ST segment elevation myocardial infarction.Methods Patients with acute ST segment elevation myocardial infarction (90 cases) in Jianli People's Hospital from February 2015 to February 2016 were selected and divided equally into A,B and C groups according to different treatment methods.Totally 30 patients in group A were given conventional therapy,30 patients in group B were given reduced glutathione for treatment on the basis of conventional treatment,and the other 30 in group C were given combined therapy of reteplase and reduced glutathione on the basis of conventional treatment.The vascular recanalization rate,improvement of effective indicators including creatine kinase isoenzyme (CKMB),troponin Ⅰ (cTnⅠ),left ventricular end diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF),oxidative stress kinase including superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px),and incidence of adverse events of patients were compared among the three groups.Results After thrombolysis,the vascular recanalization rate of group C at different time points (2 h,6 h and 12 h) showed significant difference compared with those of groups A and B (P ＜ 0.05).After the treatment,the effective indicators of the three groups were both significantly improved (P ＜ 0.05),and group C improved more significantly than groups A and B (P ＜ 0.05).After the treatment,the SOD and GSH-Px of groups B and C both significantly improved than group A (P ＜ 0.05),but there was no significant difference between groups B and C.After treatment,the incidence of adverse events of group C was significantly lower than those of groups A and B (P ＜ 0.05).Conclusion Reteplase for Injection combined with reduced glutathione has significant curative effect in the treatment of acute ST segment elevation myocardial infarction,which can effectively improve the cardiac function and inhibition of oxidative stress.It is of higher security but with lower incidence of adverse events.

Objective To explore the clinical value of two‐dimensional transesophageal echocardiography (2D‐TEE) and real‐time three‐dimensional transesophageal echocardiography (RT3D‐TEE) for the left atrial appendage (LAA) closure procedures by the visualization of LAA shape by 2D‐TEE and RT3D‐TEE and the comparison between the measurement of LAA ostium and the sized LAmbreTM device during the procedure .Methods Forty‐one atrial fibrillation patients ,who had undergone 2D‐TEE examination at our hospital ,were enrolled in the study .At the mid‐esophageal ,dimensions of inner and outer ostium and depth of LAA were measured at the 2D‐TEE views of 0 ,45 ,90 and 135 degree respectively . RT3D‐TEE views were acquired and the maximal and the minimal dimensions of LAA inner ostium were measured .The measurement by RT3D‐TEE and 2D‐TEE were compared to find the difference and correlation .Eleven of 41 patients who have complied with the requirements for the LAA closure ,were undergone the procedures ,measured the dimension of LAA inner ostium at selective angiography intraoperative .Sizes of closure disks of the closure device and the measurement at selective angiography were recorded to compare the measurement at RT3D‐TEE and 2D‐TEE .Results Forty‐one atrial fibrillation patients were completed TEE examination successfully .Inner ostial dimension of LAA was (20.0±04.3)cm,(19.7±03.8)cm,(21.2±04.6)cm,(23.0±05.0)cmat2D‐TEEviewsof0,45,90and135 degree ,respectively .The maximum dimensions of LAA inner ostium by RT3D‐TEE was (2 4.9 ± 0 5.2)cm . At 2D‐TEE views ,the maximum dimensions of LAA inner ostium was at 135 degree ,there was a difference between it and the measurement by RT3D‐TEE ( P =0 0.12) .Monitoring by TEE ,LAA closure procedures with LAmbreTM device were successful for all 11 patients ,the landing zone by selective angiography was (2 4.9 ± 0 4.4)cm ,and the appropriate sized closure disk of the LAmbreTM device was 2 4. - 3 6. cm . Correlation between the measurements by RT3D‐TEE and selective angiography and the sized closure disk were r =0 8.16 ,P =0 0.02 and r =0 9.14 ,P =0 0.00 ,respectively .Correlation between the measurements by 2D‐TEE and selective angiography and the sized closure disk were r =0 6.93 ,P =0 0.18 and r =0 6.88 , P=0 0.19 ,respectively .Conclusions There was better correlation among the measurements by RT3D‐TEE and selective angiography and the size of closure device .Therefore ,compared to 2D‐TEE ,the guidance of RT3D‐TEE was more accurate during LAA closure procedures for LAmbreTM device selection .

Objective: To evaluate diagnostic value of three noninvasive examinations for coronary heart disease (CHD).Methods:A total of 500 subjects, who were suspected of CHD, first received diagnostic coronary angiography (CAG) and hospitalized in our department from May 2014 to May 2015, were selected.According to CAG results, they were divided into non-CHD control group (n=106), single vessel coronary disease group (n=199), double-vessel coronary disease group (n=95) and multi-vessel coronary disease group (n=100, ≥three vessel disease).Besides CAG, all subjects accomplished one of following examinations at least: (1) 24h dynamic ECG (Holter);(2) real-time three-dimensional echocardiography(RT-3DE);(3) radionuclide myocardial perfusion imaging (RMPI).Sensitivity, specificity and accuracy of these three examinations in diagnosing CHD were evaluated.Results: With CAG as the gold standard, compared with Holter and RT-3DE, there were significant rise in sensitivity(68.4%, 69.0% vs.92.9%), specificity (62.9%, 81.4% vs.88.5%) and accuracy (67.1%, 71.2% vs.91.9%) of RMPI (P<0.01 all), only specificity of RT-3DE was significantly higher than that of Holter, P=0.019.Conclusion:Noninvasive examination can be used as important method diagnosing CHD, which are important measures for noninvasive diagnosing and assessing CHD.Accuracy, sensitivity and specificity of RMPI are high, which is worth extending.

Objective To describe the treatment experience of post-operative complications after total arch replacement for acute type A aortic dissection in 34 cases.Methods The subjects were 34 consecutive patients (Twenty-eight males and 6 females,age 34.0 -60.0 yrs) who received total arch replacement for acute Stanford type A aortic dissection from Jan.2005 to Oct.2010 in our hospital.The duration from the onset of the symptoms to the hospitalization ranged from 4 - 18 hrs.Pre-operative 2-D Echo revealed aortic valve regurgitation in 8 patients and mitral valve regurgitation in 1 patient.Results Three patients died after operation ( mortality 8.8％ ).Severe complications included acute kidney injury in 13 cases,respiratory dysfunction in 12 cases,paraplegia in 1 case,mental disorder in 10 cases and excessive post-operative bleeding in 2 cases.Conclusion The incidence of the complications after total arch replacement is still high and severe.Intensive care should be stressed peri-operatively and early diagnosis and treatment for post-operative complications are important procedures.

Objective To evaluate the clinical significance of the change of serum matrix metalloproteinases (MMP)-1,-2,-3 and -9 in acute and chronic aortic diseases and acute myocardial ischemia.Methods The blood serum levels of MMP-1,-2,-3 and -9 were detected in 30 patients with acute aortic dissection,19 patients with chronic aortic dissection,19 patients with aortic aneurysm and in 12 patients with acute myocardial ischemia,as well as in 16 healthy individuals who served as the control group.Serum MMP levels were measured by using an ELISA technique.Results There were significantly higher levels of MMP-3 in patients with acute myocardial ischemia as compared to acute aortic dissection ( [19.10 ± 3.11 ] μg/L vs [11.89 ± 1.31 ] μg/L,P =0.02).Significantly lower levels of MMP-1 were found in healthy controls compared to the groups of patients ( [1.30 ± 0.56 ] μg/L vs [2.99 ± 0.78 ] μg/L in acute aortic dissection,P =0.03,[3.12 ±0.78] μg/L in chronic dissection,P =0.02,[3.01 ± 1.01 ] μg/L in thoracic aortic aneurysm,P =0.03 and [5.01 ± 0.98 ] μg/L in acute myocardial ischemia,P =0.01 ).Higher levels of M MP-1 and MMP-3 were detected on males.There was a positive correlation between MMP-1 and increasing age ( r =0.38,P ＜ 0.05 ).In patients operated for acute type A aortic dissection,the levels of MMP-1,MMP-3 and MMP-9 increased immediately after surgery,while the levels of MMP-2 decreased.Twenty-four hours after surgery levels of MMP-1,-2 and -9 were almost equal to the preoperative ones( P ＞ 0.05 ).Conclusion Measurement of serum MMP levels in thoracic aortic disease and acute myocardial ischemia is a simple and relatively rapid laboratory test that could be used as a biochemical indicator of aortic disease or acute myocardial ischemia,when evaluated in combination with imaging techniques.