Objective To assess the in-hospital prognostic value of NT-proBNP in patients with acute coronary syndrome (ACS) and its relation to the severity and prognosis of coronary artery disease .Methods Totally 132 consecutive patients with ACS in Affiliated Hospital of Nantong University from January 2013 to December 2014 were collected in this study ,in which 64 pa-tients with unstable angina(UA) ,46 patients with non-ST segment elevation myocardial infarction(NSTEMI) ,and 22 patients with ST segment elevation myocardial infarction(STEMI) .Patients were divided into two high NT-proBNP group(NT-proBNP ≥ 474 pg/mL) and low NT-proBNP group(NT-proBNP < 474 pg/mL ) .Ejection fraction were detected and compared between the two groups ,coronary artery disease were detected by coronary angiography .cTnI ,CK-MB ,CRP and NT-proBNP were detected by sero-logical ,and the average length of hospital stay and heart failure ,cardiac shock incidence were calculated .Results There was a sig-nificant negative correlation between NT-proBNP and ejection fraction .Incidence of heart failure and duration of hospital stay in high NT-proBNP group were significantly higher than in low NT-proBNP group ;The number of coronary vessels affected ,severity of stenosis and proximal left anterior descending artery(LAD) disease in high NT-proBNP group were higher than in low NT-proB-NP group ;TIMI flow grade was significantly lower in high NT-proBNP group than in low NT-proBNP group ,the difference was statistically significant(P< 0 .05) .Conclusion NT-proBNP is a valuable marker for predicting prognosis and severity of coronary artery disease in patients with acute coronary syndrome .

Objective To explore effects of arterial self-expanding stents implanted in different position for treating lower limb ischemia.Methods Follow-up records of 65 patients of lower limb ischemia(71 limbs) teated by stent implantation from January 2002 to March 2006 were retrospectively reviewed.Out of the 71 patients,there were 38 patients(52.3%) of diabetic lower limb ischemia and 33 patients(47.7%) of non-diabetic ischemia.Stent implantation included 2 abdominal aortic stents in 2 patients,1 abdominal aortic and 2 iliac stents in 1 patient with the Leriche syndrome,38 iliac stents in 33 patients(35 limbs),12 stents for iliacofemoral lesions in 6 patients(6 limbs),23 femoral stents in 16 patients(19 limbs),10 stents for femoral and prioxiaml popliteal arterial lesions in 5 patients(6 limbs),and 2 stents for distal popliteal arterial lesions in 2 patients(2 limbs).Results The patients were followed for 2~50 months(mean,16.1 months).The patency rate was 100% in 3 patients with abdominal aortic stent implantation or abdominal and aortoiliac stent implantation.Iliac artery occlusion occurred in 4 patients(4 limbs),with the patency rate of iliac arterial stents being 88.6%(31/35).The patency rate of femoral arterial stents was 78.9%(15/19),and that of femoral and prioxiaml popliteal arterial stents was 83.3%(5/6).Stents in distal popliteal artery were occluded in all the 2 patients.Stents remained patent after a mean of 5.6 months postoperatively in 3 patients with 2 femoral stents in 2 limbs and 1 femoropopliteal stent in 1 limb while distal outflow arteries were blocked.Conclusions Stent implantation can be the first choice for aortoiliac stenosis or occlusive arterial diseases.It is also recommendable for stenotic or occlusive femoral and proximal popliteal arterial diseases.It is a proper option for the senile patients or those who can not stand bypass procedures.However,for tibial arterial stenosis or occlusion,it is not a favorable consideration.

Objective To study the clinical feasibility and effect of totally endoscopic resection of axillary accessory breast.Methods Totally endoscopic resection of axillary accessory breast was performed in 48 cases(59 sites).On the basis of liposuction,a camera port and two 5-mm working trocars were made.By using forceps,dissecting scissors,or harmonic knife,were inserted.The cobweb-like fibropartition around the accessory breast was dissected.Results Postoperatively,there were 1 case of subcutaneous liquid accumulation and 2 cases of subcutaneous petechia,and no hematoma or infection developed.All wounds healed by first intention.Follow-up observations for 2～58 months(mean,23.6 months) showed good appearance and satisfactory effects.Conclusions Totally endoscopic resection of axillary accessory breast is safe,offering good cosmetic effects and being worthy of recommendation.

Objective To study the mechanism of apoptosis inducing and anti-invasive effects of curcumin on human lung adenocarcinoma cell (A549). Methods MTT colorimetry method, fluorescence mieroscopy, and FCM combining with PI and AnnexinV-FITC double pigmentation method were used to study the growth and apoptosis of A549 cells after being treated with curcumin, and Western blotting was used to identify apoptosis-inducing and anti-invasive effects. Results Under the effect of the curcumin, the nucleoli of A549 cells were found to be fragmented into different sized apoptosis bodies under fluorescence microscopy, and cell proliferation was obviously suppressed under the effect of curcumin in different concentrations, with the IC 50 value of 18?mol/L. When the curcumin concentration was increased from 5?mol/L to 40?mol/L, Annexin-FITC single positive cells (early apoptosis cell) were increased from 3.4% to 65.9%, and the proliferation of cells was blocked at G 2 phase. When curcumin concentration was increased from 10?mol/L to 20?mol/L curcumin effects 30 minutes, the expression of PARP in A549 cells was increased after 30 minutes. Curcumin could also down-regulate MMP-2 and up-regulate TIMP-2 expression. Conclusions Curcumin can interfere with cell growth cycle of A549 cells and suppress cell growth, which is concentration dependent. The anti- invasive effects of curcumin is probably the result of down-regulation of MMP-2 and up-regulation of TIMP-2 expression.

Objective To assess the efficacy and safety of co-administration of aspirin and low-dose clopidogrel in patients undergoing percutaneous coronary intervention (PCI) after 1 year.Methods From March 2004 to September 2010,a total of 3366 patients with successful drug-eluting stents implantation after 1 year were divided into group A (aspirin combined with low-dose clopidogrel,n=1682) and group B (aspirin alone,n=1684).The average follow-up period was (29.5±16.3) months (19 months-76 months).The major adverse cardiovascular and cerebrovascular events and clinical complications were evaluated.Results Rates of cardiovascular death were 0.1 ％(2 cases) in combination group and 0.9％ (15 cases) in aspirin group,the risk ratio (HR) was 0.154 [(95％ CI:0.035 0.675),P＜0.05].Myocardial infarction occurred in 9 patients (0.5％) in group A and 27 patients (1.6％) in group B,the risk ratio (HR) was 0.036 [(95％ CI:0.153-0.741),P＜0.01].Rates of stroke were 0.4％ (7 cases) in group A and 1.6％ (27 cases) in group B,the risk ratio (HR) was 0.301 [(95％ CI:0.131 0.693),P ＜ 0.01].Recurrent ischemia with rehospitalization occurred in 152 patients (9.0％) in group A and 274 patients (16.3％) in group B,the risk ratio (HR) was0.601 [(95％ CI:0.491-0.735),P＜0.01].The cumulative survival rate in patients died of cardiac causes was significantly better in group A than in group B (P＜0.01).The cumulative incidence of major adverse cardiovascular and cerebrovascular events was significantly lower in group A than in group B (P＜0.01).There were no significant differences in total number of deaths,target vessel revascularization,stent thrombosis,incidences of severe bleeding,mild bleeding,leukopenia and thrombocytopenia between the two groups (all P＞0.05).Conclusions In patients with PCI after 1 year,the co-administration of aspirin and low-dose clopidogrel reduces the risks of major adverse cardiovascular and cerebrovascular events,and does not increase the risks of bleeding and cytopenia.

Objective To analyze the clinical characteristics of intestinal infection caused by Aeromonas and their drug suscepti-bility .Methods The data of 52 patients infected with Aeromonas were analyzed retrospectively .Aeromonas strains were identified with Vitek Ⅱ Compact .Drug susceptibility was determined by disk diffusion methods .Cefoxitin combined with ceftazidime ,aztreo-nam ,cefotaxime and ceftriaxone were used to detect inducible expression of AmpC β-lactamase .Results Abdominal pain ,watery di-arrhea ,tenesmus occurred in 75 .0% ,48 .1% ,and 38 .0% of the patients ,respectively .White blood cell tests were positive in 50 .0%patients′stools .52 strains of Aeromonas were isolated ,including 38 strains of Aeromonas hydrophila ,13 strains of Aeromonas so-bria ,and 1 strain of Aeromonas veronii .All strains were sensitive to carbapenems ,the second ,third generation of cephalosporins , monobactam ,fluoroquinolone ,aminoglycosides .The susceptibility rates to chloramphenicol ,trimethoprim-sulfamethoxazole ,cefox-itin ,cefazolin ,and amoxicillin/clavulanic acid were 94 .2% ,92 .3% ,76 .9% ,51 .9% and 23 .1% ,respectively .75 .0% isolates exhibi-ted inducible expression of AmpC β-lactamas .Conclusion Diarrhea caused by A eromonas has different clinical manifestations .Ceph-alosporins ,monobactam ,fluoroquinolone ,aminoglycosides are available for empirical therapy of diarrhea caused by A eromonas .But the third generation of cephalosporins should be cautiously used because of high prevalence of inducible AmpC β-lactamase in A ero-monas .

Abstract: TGF-β/Smad signaling pathway has a wide range of biological activities and plays an important roles in regulating cell growth, adhesion, differentiation, cell dynamic balance, and immune responses. The higher activity of TGF-β/Smad signaling pathway may promote scar formation, organ fibrosis, immunosuppression, and late-stage cancer progression, while low activity may lead to inflammation, dysplasia, poor healing and oncogenesis. The function of the TGF-β/Smad signaling pathway is extremely complex and can exhibit inhibitory or enhancing effects on immunity and inflammation under different circumstances, but immunosuppressive and anti-inflammatory effects are dominant. During HIV infection, the TGF-β/Smad signaling pathway interacts with HIV in a complex manner as HIV proteins tat and gp120 can induce TGF-β expression. Meanwhile, this signaling pathway may also play a role in HIV infection and replication, latent virus reservoir, host immune deficiency and HIV-related inflammation. It is worth noting that even though TGF-β, which mainly exhibits anti-inflammatory effects, is induced by HIV, high levels of TGF-β do not seem to inhibit HIV-related inflammation. So far, the relationship between TGF-β/Smad signaling pathway and HIV infection has not been elucidated, and its role and mechanism in HIV infection and related illnesses need further exploration and validation. This review summarizes the relevant research progress on the TGF-β/Smad signaling pathway and HIV infection, and provides a reference for further understanding of HIV pathogenesis and exploring strategies of AIDS treatment.

15, the mortality was38.1%(n = 8).There was significantly difference both in mortality (x2 = 4.14 P

ObjectiveTo observe the effect of Nimodipine on the hemorrheology and brainstem auditory evoked potentials (BAEP) in the patients with vertebrobasilar insufficiency (VBI) and to explore the mechanism.Methods50 cases with VBI were divided into Nimodipine group (25 cases) and routine therapy group (25 cases). The hemorrheology and BAEP were measured before the treatment and 1 month later.ResultsThe blood viscosity,including the whole blood viscosity shear value, plasma viscosity and blood fat of patients with VBI was increased. The total abnormity rate of BAEP was 76%. The main abnormity was brainstem type. The hemorrheology and the function of nerve conduction were improved distinctly (P<0.05) after treatment. Compared with the routine therapy group, the level of plasma viscosity was decreased markedly (P<0.05) in Nimodipine group, and peak latency of V wave, interpeak latency of III-V and I-V were also improved significantly (P<0.05).Conclusions Nimodipine can improve the hemorrheology and the function of nerve conduction in patients with VBI.

ObjectiveTo observe the therapeutic effect of standing bed on orthostatic hypotension with cervical spinal cord injury. Methods36 patients with cervical spinal cord injury were divided randomly into the standing bed group and routine treatment group. The blood pressure of all patients were measured every day during rehabilitation treatment. The function of spinal cord was assessed before and after treatment.ResultsThe function of sensory and motor in the two groups were all improved, but there was no statistical difference between the two groups in the grades of spinal cord function. There were 27 patients who had orthostatic hypotension in the study. All the patients with complete spinal cord injury suffered the orthostatic hypotension. There was no improvement in blood pressure of complete spinal cord injury after treatment. In incomplete spinal cord injury patients, there was a significant improvement and the difference of blood presure between lying and standing was decreased in standing bed group after treatment (P<0.05). Compared with routine treatment group, the blood pressure in standing bed group was improved (P<0.05). Conclusions Cervical spinal cord injury could have orthostatic hypotension. Complete spinal cord injury would suffer orthostatic hypotension in different degree. The standing bed treatment could improve the orthostatic hypotension in incomplete spinal cord injury.