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The study utilized a cross-sectional design. Data was retrieved from the American Academy of Family Physicians fellowship training directory, including program names, areas of focus, program length, and program descriptions. The collected data was categorized and analyzed based on areas of focus and training duration. The program descriptions were also analyzed qualitatively using Nvivo12 software. A total of 532 programs were included in the study:295 programs (55.5%) were ACGME-certified, while 237 programs (44.5%) were not. The majority of programs, 468 (87.9%), were clinically oriented, while 64 programs (12.1%) were non-clinical. Among ACGME-certified programs, the largest number of programs were in sports medicine (121 programs), followed by geriatrics (52 programs). Among non-certified programs, the largest number of programs was in obstetrics (66 programs), accounting for 27.8% of all non-certified programs. Qualitative research found that fellowship programs were diverse, reflecting the societal demands of healthcare service. Moreover, a significant emphasis was placed on empowering teaching and research abilities.The family medicine fellowship programs in the United States cover a wide range of disciplines and meet both the professional interests of doctors and the needs of patients. As China continues to implement its tiered medical system, it can learn from the experience of the United States and develop general practice subspecialty training programs, thereby improving the service capacity of general practitioners and improve the quality of healthcare.
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Objective:To explore the method and effect of aesthetic reconstruction of distal segment of finger with modified second toe nail flap while retains the full length of the second toe.Methods:From April 2018 to June 2020, 16 patients with degloving injury of distal segment of fingers were treated. The patients were 11 males and 5 females aged 18 to 45 years in an average of 29 years. All injuries were degloving injury of the distal segment of finger, including 5 index fingers, 7 middle fingers, 3 ring fingers and 1 little finger. The time from injury to operation was 0.5-3.0 hours, with an average of 1.5 hours. The second toe nail flap was used for the reconstruction. After the dorsal flap of the second toe was rotated to the plantar side of the foot, the donor site defect was repaired by a skin graft. The regular follow up reviews were carried out.Results:All 16 flaps survived except 1 flap had necrosis and underwent toe amputation of the distal segment of the second toe. All patients entered follow-up for 4-12 months, with an average of 5.7 months. The blood supply of all flaps was good. After the flaps having atrophied, they were equivalent to the diameter of the body of normal fingers with the TPD at 6.5(4-10) mm; All patients returned to work. According to the Evaluation Standard of Upper Limb Function of Chinese Hand Surgery Society, 13 cases were graded as excellent, 2 were good and 1 was fair.Conclusion:The techniques of modified second toe toenail flap in aesthetic reconstruction of the distal segment of a finger can effectively restore the length and aesthetic appearance of the affected finger, without sacrificing the donor toe. Clinical application of it should be promoted.
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Objective:To explore the teaching effect of organ system based integrated curriculum in the undergraduates of clinical medicine.Methods:A retrospective cohort study was conducted among 284 undergraduates majoring in clinical medicine from Batch 2011 to Batch 2016 in Shanghai Jiao Tong University School of Medicine. The observation group were 147 undergraduates from Batch 2014 to Batch 2016, taking organ system based integrated curriculum. The control group included 137 undergraduates from Batch 2011 to Batch 2013, taking the traditional mode of subject-centered curriculum. SPSS 21.0 was performed for independent sample t test, and questionnaires were issued to investigate students' evaluation of the teaching of organ system based integrated curriculum. Results:The examination scores of internal medicine problem based learning test, surgical theory test and surgical operation test were better in observation group than in control group [(86.34±2.74) vs. (85.51±3.36); (79.69±8.41) vs. (77.18±6.92); (81.43±10.72) vs. (76.78±11.29), P<0.05]. Obstetrics and pediatric theory test scores were lower in observation group than in control group ( P<0.05). There was no significant difference in test scores of internal medicine between the two groups ( P=0.935). The satisfaction rate of organ system based integrated curriculum in the observation group was 83.75%. Conclusion:The teaching of organ system based integrated curriculum can improve students' comprehensive abilities, and has certain requirements for students' learning autonomy.
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Objective To investigate the effect of calcitriol on osteogenic differentiation of mesenchymal stem cells (MSCs) induced by bone morphogenetic protein 9 (BMP9). Methods The experiment was divided into four groups: control group, calcitriol group, BMP9 group and BMP9+calcitriol group. Quantitative PNPP method was used to detect alkaline phosphatase (ALP) activity. RT-PCR and Western blotting method analyzed expression of osteocalcin（OCN）and osteopontin (OPN). Alizarin red staining assessed the formation of mineralized nodules. In addition, the changes of cell morphology and elastic modulus during osteogenic differentiation were studied by atomic force microscope. ResultsCompared with control group, calcitriol alone had no significant effect on the osteogenic differentiation of MSCs, but calcitriol could enhanced expression of osteogenic markers and formation of mineralized nodules induced by BMP9. However, neither calcitriol nor BMP9 could affect elastic modulus of cells. The combined treatment of BMP9 and calcitol could enhance phosphorylation of AKT and β-catenin which were both important for osteogenesis. The pretreated PI3K inhibitor could inhibit phosphorylation of AKT and β-catenin as well as ALP activity in BMP9+calcitriol group. In addition, calcitriol did not affect the BMP/Smad signaling pathway induced by BMP9. Conclusions Calcitriol synergies with BMP9 could promote MSCs osteogenesis by activating the PI3K/AKT signaling pathway. The study about effects and mechanisms of different regulatory factors on osteogenic differentiation of MSCs is of great significance for the treatment of osteoporosis and the development of bone tissue engineering.
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Objective To investigate nurses' scientific research competency and training demand in Chinese tertiary hospital.Methods It was a multi-stage large-scale survey.A total of 27 335 nurses from 22 provinces/autonomous regions/municipalities were recruited to complete the self-designed questionnaire,including demographic data(7 items),scientific research competency(objective index of 4 items,and subjective index of 6 subscales with 40 items),and training demand evaluation(6 subscales with 16 items).Results There were 1 130(4.14％) nurses who had managed or were managing the research projects as principal investigators(PIs),2 147(7.85％)nurses who had attended or were attending research programs,1 463(5.35％) nurses had published papers,and 557(2.04％) nurses obtained patents.The self-evaluated competency score was 25.00 (12.50,37.50)(rangedfrom 0 to 100)and training demand score was 53.13(37.50,75.00)(ranged from 0 to 100).Conclusion The nurses' scientific research competency should be improved and they had strong training demands.In order to improve nurses' research competency and quality,nursing administrators should pay more attention to post-graduate training focusing on research competency.
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Objective To investigate the prevalence of vitamin D deficiency in elderly patients in severe illness and its relationship with severity of disease and prognosis.Methods Totally 325 inpatients admitted to geriatric intensive care unit were included in this study.Serum 25-hydroxyvitamin D [25-(OH)D] was examined.Main laboratory findings,the incidence of multiple organ dysfunction syndrome (MODS),Acute Physiology and Chronic Health Evaluation (APACHE Ⅱ) score and mortality rate of 30-day were compared among patients with different serum 25 (OH) D levels.Potential risk factors for mortality were analyzed by multivariate Logistic regression analysis.Results 25 (OH)D deficiency was identified in 113 (34.77％).Compared to 25(OH) D sufficiency group,25 (OH)D deficiency group has significantly higher plasma lactic acid,APACHE Ⅱ score,the incidence of MODS and mortality rate of 30-day,P ＜0.05.Analysis by multiple logistic regression suggested that 25 (OH) D deficiency was independent risk factor for mortality.Conclusions Vitamin D deficiency is highly prevalent among elderly patients with severe illness,and may be an independent risk factor for mortality.
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<p><b>OBJECTIVE</b>To compare the efficacy between acupuncture with smoothing liver and regulatingand lactulose for post-stroke slow transit constipation(STC) and to explore the mechanism.</p><p><b>METHODS</b>Sixty patients were randomized into an acupuncture group and a medication group,30 cases in each one. Based on the comprehensive stroke unit care,acupuncture with smoothing liver and regulatingwas used at Danzhong(CV 17),Qihai(CV 6),Tianshu(ST 25),Neiguan(PC 6),Gongsun(SP 4) and Taichong(LR 3) in the acupuncture group,once a day. Lactulose oral liquid was taken at a draught in the morning in the medication group,20 to 30 mL a time,once a day. The study period was 11 weeks,including 1-week baseline evaluation,6-week treatment and 4-week follow-up. We recorded the time of the first independent defecation,constipation symptom score,and gastrointestinal hormone level,including somatostatin(SS),motilin(MTL),P substance(SP) and vasoactive intestinal peptide(VIP). Also,the side effects were recorded at any time.</p><p><b>RESULTS</b>The time of the first independent defecation was (30.18±16.14) h in the acupuncture group,which was significantly different from (43.22±28.42) h in the medication group(<0.05). The constipation scores after 6-week treatment and at follow-up were lower than those before treatment in the two groups (all<0.05),with better results in the acupuncture group(both<0.05). MTL and SP increased,as well as SS and VIP decreased after treatment in the two groups(all<0.05). The changes were better in the acupuncture group(all<0.05). The side effect was not observed in the two groups.</p><p><b>CONCLUSIONS</b>Acupuncture with smoothing liver and regulatingachieves better effect than lactulose for post-stroke STC in terms of efficacy onset,extent,and long term. The mechanism may relate to increasing excitatory regulatory peptide and reducing inhibitory regulatory peptide.</p>
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Objective Screening the potential lncRNAs of KIAA1456 inhibiting ovarian cancer cells.MethodsImmunofluorescence was used to detect the expression of KIAA1456 in HO8910PM ovarian cancer cell.Microarray was performed to identify differently expressed lncRNAs in HO8910PM ovarian cancer cells overexpressed KIAA1456 as compared with the normal control group. The interesting candidate lncRNAs were verified by real-time quantitative PCR.Constructing RNAi lentiviral vector targeting KIAA1456 gene in HO8910PM ovarian cancer cells, RT-qPCR and Western blot was performed to measure the interference efficiency.Differentially expressed lncRNAs were validated by RT-qPCR after KIAA1456 knock-down.Results KIAA1456 mainly expressed in nucleus of HO8910PM cell.A total of 654 differently expressed lncRNAs were identified in the KIAA1456-overexpressed group compared with the control group with a set filter fold-change ≥1.2, the most aberrantly expressed lncRNAsincluding down-regulated gene SSX8 and up-regulated genes SNORD14D,SNORA26,lncRNA-ENST00000384488.The results of the RT-qPCR were consistent with the data from the microarray.The shRNA interference vectors targeting the KIAA1456 gene were successfully constructed, SSX8 was up-regulated, and SNORD14D,SNORA26,lncRNA-ENST00000384488 were down-regulated after knockdown the expression of KIAA1456 in the HO8910/PM ovarian cancer cells.Conclusions KIAA1456 inhibits proliferation of ovarian cancer by regulating correlative lncRNAs, which may provide a new target for the diagnosis and treatment of ovarian cancer.
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Osteogenic differentiation of mesenchymal stem cells (MSCs) is an important link of bone metabolism and bone repair, the mechanism of which is usually complicated. Recent studies have found that BMP, FGF, Wnt, Hedgehog, NELL1, IGF, Notch and othersignaling molecules are involved in the regulation of osteogenic differentiation of MSCs. These signaling molecules themselves have been shown to have a strong ability to promote osteogenic differentiation. They can activate the corresponding receptors by specific ligands, thus initiating the specific signal transduction pathways in the cell, and finally promote the transcription and translation of the genes related to bone formation. Furthermore, all the signaling pathways form a complex network which regulates and influences the osteogenic differentiation ofMSCs. Further researches on the mechanism of the interaction of these signaling pathways is of great significance in promoting the development of bone tissue engineering and the treatment of bone metabolic diseases.
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Objective To investigate the relationship between bone mineral density (BMD) and the changes of serum adiponectin (APN) level in elderly men.Methods A total of 240 elderly men was enrolled in this study.Measurement of BMD of lumbar spine with dual energy X-ray absorptiometry was performed.All subjects were divided into three groups (normal,osteopenia,and osteoporosis) according to the T value of BMD.Serum APN level was tested using enzyme-linked immunosorbent assay (ELISA),meanwhile were recorded as bone lurnover markers.Results (1) The level of serum APN in osteopenia group was lower than in normal group,the level of serum APN in osteoporosis group was significantly lower than in osteopenia group,while the level of serum APN in osteoporosis group was significantly lower than in normal group (all P ＜ 0.05).(2) Serum APN was positively correlated with T value of BMD (r =0.475,P ＜0.01).(3) The stepwise multiple linear regression analysis showed serum APN,25-hydroxyvitamin D,β-isomerized carboxyterminal propeptide (β-CTX),and osteocalcin could enter into the equation.Conclusions Serum APN might play an important role in pathogenesis of osteoporosis in elderly men.
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[ ABSTRACT] AIM:To investigate the effect of paricalcitol ( P) on renal tubulointerstitial fibrosis and the under-lying mechanisms in diabetic nephropathy ( DN) .METHODS:DN rat model was induced by a single intraperitoneal in-jection of streptozotocin after fasting.The animals were randomly divided into 2 groups: the DN rats in paricalcitol-inter-vened group ( group P) were injected intraperitoneally with paricalcitol dissolved in propylene glycol after the day when the model was induced successfully at a dose of 0.4μg/kg (3 times a week);the DN rats in DN group ( group D) were given isopyknic propylene glycol.Normal control group ( group C) was also set up.The samples of blood, urine and renal tissue were collected after intervention of paricalcitol for 12 weeks.The biochemical indexes were measured.The renal tissues were used for pathologic observation and determining the expression of transforming growth factor-β1 (TGF-β1), Wnt-4,β-catenin and Klotho by immunohistochemistry and Western blotting.In addition, the correlation among the above indexes was analyzed.RESULTS:(1) Scr, BUN and 24 h urine protein increased significantly in group D compared with group C, while decreased in group P compared with group D ( P<0.05 ) .( 2 ) The area of renal tubulointerstitial fibrosis in-creased in group D compared with group C, while decreased in group P compared with group D (P<0.05).(3) The ex-pression of Klotho decreased, while the expression of TGF-β1, Wnt-4 and β-catenin increased in group D compared with group C (P<0.05).Compared with group D, the expression of Klotho increased, while the expression of TGF-β1, Wnt-4 andβ-catenin decreased in group P (P<0.05).(4) The expression of Klotho was negatively correlated with the fibrosis area, TGF-β1, Wnt-4 andβ-catenin (P<0.05).CONCLUSION:Paricalcitol inhibits renal tubulointerstitial fibrosis in DN by promoting the expression of renal Klotho, and inhibiting Wnt/β-catenin signaling pathway activation and TGF-β1 synthesis.
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Objective To evaluate the association between serum 25-hydroxyvitamin D3 [25 (OH)D3] and arterial stiffness in patients with chronic kidney disease (CKD).Methods Three hundred patients with CKD were included,and were divided into two groups based on serum 25(OH)D3 levels:vitamin D deficient [25(OH)D3 ＜ 20 μg/L] and vitamin D non-deficient [25(OH)D3≥20 μg/L].Brachial ankle pulse wave velocity (baPWV),which reflected arterial stiffness,was calculated using the single-point method.Clinical data were collected in details.Correlation between serum 25(OH)D3 level and baPWV was assessed by the single factor correlation test and multiple linear regression analysis.Results The prevalence of vitamin D deficiency was 62.7％(188/300).The concentration of 25(OH)D3 was (17.62±8.54) μg/L in total patients,but was (12.38±4.55) μg/L and (26.44±6.05) μg/L in the subgroups of vitamin D deficient and non-deficient,respectively(P ＜ 0.01).There was a higher value of baPWV in the group of vitamin D deficient than that of vitamin D non-deficient (1 827.34±429.11 vs 1 555.31 ±353.14,P ＜ 0.01).Serum 25(OH)D3 level and baPWV was negatively correlated in total patients(r=-0.38,P ＜ 0.01) and each stage of CKD(stage 2-5)[r=-0.30,P ＜ 0.05; r=-0.26,P ＜ 0.05; r=-0.46,P ＜ 0.01; r=-0.57,P ＜ 0.01].Multiple linear regression analysis showed that vitamin D level was independently associated with baPWV(Model 1:β=-0.18,P ＜ 0.01; Model 2:β=-0.17,P=0.01).Both models accounted for 50％ (R2=0.50) of total variance of baPWV.Conclusions Vitamin D deficiency is common in CKD,and a low 25(OH)D3 level is significantly associated with increased arterial stiffness in these patients.Clinical intervention studies are needed to clarify whether treatment with vitamin D decreases the risk of cardiovascular disease in patients with CKD.
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This study aimed to examine whether ophiopogonin D (OP-D) is capable of protecting cardiomyocytes against DOX-induced injury and the mechanisms involved. H9c2 cells were cultured. MTT assay was used to evaluate cell viability and toxicity. Mito-tracker as fluorescence probe was used to measure ROS content raised from mitochondria. The mRNA and protein expression of ATF6alpha, GRP78 and CHOP were analyzed using real-time PCR and Western blotting, respectively. The results showed that a significant endoplasmic reticulum stress (ERS) was induced upon exposure of H9c2 cells to DOX as indicated by the increase in the expression of ERS related proteins, which was paralleled with the accumulation of reactive oxygen species (ROS) and decrease in the viability of H9c2 cells. Whereas, DOX-induced ROS accumulation and up-regulation of ERS related proteins were partially abolished by pretreatment with OP-D. Consequently, a DOX-induced ERS was mitigated by application of OP-D. Similarly, DOX-induced decrease in cell viability was partially attenuated by either inhibiting CHOP or pretreatment with N-acetylcysteine (NAC), an antioxidant. Moreover, cardiac ultrastructural abnormalities seen in mouse receiving DOX injections were obviously ameliorated by pretreatment of OP-D. Taken together, the present study proved that OP-D protects cardiomyocytes against DOX-induced injury, at least in part, through reducing ROS accumulation and alleviating ERS.
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Objective To study the relationship between serum osteocalcin and parameters of glucose and lipid metabolism in elderly men.Methods The bone metabolism index such as serum osteocalcin was measured by electrochemiluminescence immunoas -say in 206 old male patients , incluiding 69 patients with type 2 diabetes mellitus .The parameters of glucose and lipid metabolism were also measured and the correlation between the parameters and serum BGP were analyzed .Results Serum BGP and beta-CTx concen-trations were significantly lower in patients with type 2 diabetes than those in normal glucose tolerance group [ ( 9.57 ±4.74 )μg/L vs (13.22 ±10.35)μg/L, P <0.05;(0.25 ±0.19)μg/L vs (0.35 ±0.29)μg/L, P <0.05].Compared with the group in low level of BGP, fasting blood glucose and HbA1c were reduced in high-level-BGP group[(5.89 ±2.10)mmol/L vs (5.28 ±1.38)mmol/L, P<0.01;6.30%±1.03% vs 5.98%±0.61%, P <0.01].Triglyceride (TG) was positively correlated with serum BGP ( r =0.146, P =0.032).Stepwise multiple regression analysis showed that TG and HbA 1c were independently associated with serum BGP level(β=1.995, P <0.01;β=-1.483, P <0.05).Conclusions Serum TG and HbA1c are independent factors related to serum BGP in elderly men .
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<p><b>OBJECTIVE</b>To establish an HPLC method for simultaneous determination of eight iridiods in Gardeniae Fructus.</p><p><b>METHOD</b>Kromasil C18 column (4. 6 mm x 250 mm, 5 microm) was adopted, with acetonitrile-water-trifluoroacetic acid (6:94: 0.05) as the mobile phase at the flow rate of 1.0 mL x min(-1). The detection wavelength was set at 238 nm, and the column temperature was 40 degrees C.</p><p><b>RESULT</b>The linear ranges of geniposide, gardoside, shanzhiside, geniposidic acid, deacetyl asperulosidic acid methyl ester, gardenoside, scandoside methyl ester, and genipin gentiobioside were 1.5036 - 15.036, 0.04256 - 0.4256, 0.1038 - 1.038, 0.00992 - 0.0992, 0.02332 - 0.2332, 0.4128 - 4.128, 0.02040 - 0.2040 and 0.4656 - 4.656 microg, respectively. Their average recoveries were 99.6% , 100.6% , 101.2%, 99.5%, 100.3% , 98.7%, 99.8% and 100.1%, respectively.</p><p><b>CONCLUSION</b>The method shows good separation and it is so simple, accurate and highly repeatable that it can be used for providing basis for quality control of Gardeniae Fructus.</p>
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Cromatografía Líquida de Alta Presión , Métodos , Medicamentos Herbarios Chinos , Gardenia , Química , Glicósidos IridoidesRESUMEN
Objective To discuss the clinical outcomes of old fracture-dislocation of proximal interphalangeal joint treated with a self-made distraction external fixator which consists of 3 pins and rubbers.Methods From March 2005 to August 2011,8 cases of old fracture-dislocation of proximal interphalangeal joint treated with a pins-rubber distraction external fixator were retrospectively reviewed.There were 6 males and 2 females,aged from 17 to 58 years,averaged 23.2 years.The middle finger was involved in 5 cases and ring finger was involved in 3 cases.The right hand was affected in six patients,and the left hand was affectd in two patients.The mechanism of injury was sports injury in 6 cases,traffic injuries in 1,and sprain in 1.All of the cases were closed injury.The mean time from injury to surgery was 58 d (range,45-90 d).According to Schenck classification of the proximal interphalangeal joint fracture-dislocation,there were 4 cases of type Ⅰ,3 of type Ⅱ,I of type Ⅲ.Based on the Michigan Hand Outcomes Questionnaire (MHQ) for subjective hand function score,the average preoperative score was 56; the range of motion of proximal interphalangeal joint was 0°.Grip strength was 60％-80％ of the contralateral hand.Results The follow-up lasted 6-51 months,with a mean period of 20.5 months.Solid bone healing was eventually achieved in all patients.The average healing period was 3 months (range,2-5 months).The mean normalized MHQ score was 88 (range,84-92).Grip strength was 85％-100％ of the contralateral hand.Extension of proximal interphalangeal joint was -10°-0° (average,-5°).Flexion angle was 75°-100° (average,89.4°).Postoperative complications included slight joint space narrowing (2 cases),joint incongruity (＜ 1 mm) (2 cases) and fusiform arthrocele (2 cases).No infection,pin loosening,and pin breakage was encounted.Conclusion A pins-rubber distraction external fixator is a minimally invasive,reliable and effective treatment for old fracture-dislocation of proximal interphalangeal joint.
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Problem-based learning (PBL) is a student-centered pedagogy in which a subject is approached in the context of realistic problems.We have applied PBL into intemnal medicine of general medicine for up to three years.The results suggest that the PBL method could promote the clinical competencies and self-learning capacities of students.However there is still room for improvement.
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Objective To explore the impact of calciotropic hormones,such as parathyroid hormone (PTH)and vitamin D,on bone mineral density(BMD)in the old men with type 2-Diabetes.Methods Sixty elderly men with type 2-Diabetes were submitted to dual-energy X-ray absorptiometry to evaluate the BMD at lumbar spine and hip.Fasting blood samples were collected to evaluate the indexes of bone metablism and blood glucose.PTH and 25-(OH)-Vitamin D3 were measured and analyzed for their correlation with BMD at different sites.Results In all patients,the percentage of osteoporosis and osteopenia accounted for 20.0％ and 53.3％ of the patients according to BMD at lumbar or hip.Compared with the patient group with normal BMD,serum PTH was significantly higher in the patient group with osteopenia or osteoporsis([44.87 ± 10.62]μg/L vs[36.96 ±12.36]μg/L,P ＜ 0.05 ;[50.24 ± 20.32]μg/L vs[36.96 ± 12.36]μg/L,P ＜ 0.05).But there was no difference in 25-(OH)-Vitamin D3 levels between all groups.PTH was correlated negatively with BMD at hip (r =-0.224,P ＜ 0.05),but not significantly correlated with BMD at lumbar(r =-0.187,P ＞ 0.05)Conclusions Serum PTH was correlated negatively with BMD at hip in elderly man with type 2-Diabetes.
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Objective To explore the possible risk factors that influence bone mineral density (BMD) in the elderly man with type-2 diabetes.Methods Sixty elderly man with type-2 diabetes were subjected to dual-energy X-ray absorptiometry to evaluate the BMD at lumbar spine ( LS),and femoral neck (FN).Fasting blood and urine samples were taken to check the biochemical levels about bone metablism and blood sugar.The correlations between BMD and other factors were analyzed.Results In this group of patients,the percentage of osteoporosis and osteoponia was 20％ and 53.3％ in LS or FN site,respectively.Age,Weight,and HbA1c were correlated with BMD.Weight of them had the best correlation with BMD at LS( r =0.254,P ＜0.01 ),whereas,HbA1c had the best correlation with BMD at FN( r =-0.224,P ＜0.01 ).Conclusions Age,Weight,and HbAlc c were correlated with BMD of elderly man with type-2 diabetes.
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Objective To investigate the clinical significance of the levels of D-dimer and hs-CRP in the elderly patients with coronary disease. Methods One hundred and twenty-two patients with coronary disease were divided into four groups according to their clinical manifestations, there were old myocardial infarction group ( OMI, n =27 ) , stable angina pectoris group ( SAP, n = 29), acute coronary syndromes group ( ACS, n = 32) and old myocardial infarction with acute cardiovascular syndrome group (OMI + ACS,n =34). The control group included the patients without coronary disease (n =30). The patients who had infection, malignant tumors, liver and kidney dysfunction, cerebral infarction, venous embolism in lower extremities and pulmonary embolism were not included, and the patients enrolled should not be on medication of antiplatelet drugs, anticoagulants and antibiotics within the last two weeks. The levels of D-dimer and hs-CRP in all groups were determined by immunoturbidimetric assay and immune scattering assay respectively. Results In each comparison between two groups, the level of D-dimer has no significant difference between the OMI and the SAP ( P > 0. 05 ) , ACS and the OMI + ACS ( P > 0. 05 ) ; but significant difference between the OMI and the control groups ( P < 0. 05) and more significant difference between the other groups were found (P < 0. 01). As for the level of hs-CRP, there was no significant difference between the OMI and the SAP groups (P > 0. 05) or between the ACS and the OMI + ACS groups (P > 0. 05); but significant difference between the other groups (P < 0. 01). the positive relationship between the levels of D-dimer and hs-CRP have in coronary disease in the elderly patients was also found(r = 0. 81 ,P <0.01). Conclusions D-dimer and hs-CRP can be used as the clinical makers to predict the occurrence of the coronary disease in the elderly patients. D-dimer and hs-CRP can be used as the clinical makers to determine the stability of cardiovascular atherosclerotic plaque and the risk of acute cardiovascular syndrome occurrence. They can also be used as the clinical makers to predict the recurrence of the acute cardiovascular syndrome in the patients with old myocardial infarction. However, they can not be used to determine whether the patients with acute cardiovascular syndrome had old myocardial infarction already or not. The levels of D - dimer and hs - CRP are closely related in coronary disease in the elderly patients.