Effects of sevoflurane on the cognitive function and the quantity of alpha 7 nicotinicacetycholine receptors in the hippocampus of elderly model rats / 医学研究生学报

ObjectiveSome studies reported that α7nAChR is closely related to the cognitive function. However, the elderly patients have become a high-risk group of postoperative cognitive dysfunction. The aim of this study was to explore the effect of sevoflurane inhalation on the cognitive function and the quantity of alpha 7nicotinic acetycholine receptors in the hippocampus of elderly model rats.MethodsAdult male Sprague-Dawley rats (N=72) were given subcutaneous injection of D-galactose on the neck for 6 weeks to establish elderly models. The model rats were divided into 4 groups randomly: control group (group Con, n=18) with 6h exposure carrier gas (2L/min Air+2L/min O2); Sevoflurane group (group Sev, n=18) with 6 h exposure to 3.2% sevoflurane through carrier gas. Sev+α7nAChR antagonist group (group Sev+M) injected with methyllycaconitine, after 24 h inhaled of 3.2% sevoflurane and carrier gas for 6 h. Sev+α7nAChR agonist group (group Sev+P, n=18) injected with PNU-282987, after 24 h inhaled of 3.2% sevoflurane and carrier gas for 6 h. Morris water maze experiments were conducted on 6 rats in each group 2 h, 1 week and 4 weeks after treatments, respectively. Every cycle after the behavioral test, the hippocampi were taken out. RT-qPCR method was used to detect α7nAChR mRNA expression. Western blotting was used to detect α7nAChR proteins expression.ResultsBehavioral test: compared with Con group at 2 h after awakening, indicators of working memory and spatial probe test in Sev group and Sev+M group decreased significantly (P0.05). RT-qPCR: compared with Con group at 2 h and 1 w after awakening, the expression of alpha 7nAChR mRNA in the other groups was down-regulated, while at 4 w it was up-regulated (P<0.05).Western blot: protein expression of alpha 7nAChR was down-regulated in the 2 h, 1 w Sev group and the Sev+M group after awakening, and up-regulated in the 4 w group after awakening (P<0.05).ConclusionInhalation of 3.2% sevoflurane for 6 h can cause 7nAChR metabolic disturbance in hippocampus of aging model rats and lead to a short-term (1 w) decline in learning and memory ability of the rats, but this effect is reversible. The PNU-282987 agonist can alleviate the temporary decrease of learning and memory caused by sevoflurane.

Correlation between eosinophil of stool and infant milk protein allergic enteritis / 中华实用儿科临床杂志

Objective:To investigate the changes of eosinophil(EOS) in feces of children with allergic enteritis caused by milk protein, and to provide basis for diagnosis and treatment of allergic enteritis.Methods:From July 2018 to June 2019, 70 children with milk protein allergic enteritis (allergic group), 50 children with non allergic common diarrhea (non-allergic group) and 50 children with healthy physical examination (healthy control group) were selected from Children′s Hospital of Nanjing Medical University.White blood cell(WBC), hemoglobin(Hb), blood platelet(PLT), EOS and the percentage of EOS(EOS%) of the 3 groups were counted by automatic hematology analyzer.The EOS in the feces of the 3 groups and the allergic group after treatment were counted by Gomori staining, and the correlation between EOS in the feces and milk protein allergic enteritis was analyzed.Results:For allergic group, EOS count in peripheral blood was(0.71±0.74)×10 9/L, EOS% was (7.56±5.96)%, and PLT was (382.96±85.98)×10 9/L.For non-allergic group, EOS was (0.31±0.18)×10 9/L, EOS% was (3.53±2.26)%, PLT was(315.12±69.81)×10 9/L.For healthy control group, EOS was(0.31±0.15)×10 9/L, EOS% was (3.66±1.65)%, and the PLT was(307.56±85.20)×10 9/L.The number of EOS, EOS% and PLT in allergic group were higher than those in non-allergic group and healthy control group ( F=13.606, 19.055, 16.074, all P<0.05). The number of EOS in feces of allergic group[(10.75 ±17.17)/ 50 fields at ×1 000]was significantly higher than that of non-allergic group[(1.16±3.09)/50 fields at ×1 000], the difference was statistically significant ( F=17.25, P<0.05), and there was no EOS in feces of healthy control group.After 4 weeks of avoidance of milk, EOS in feces decreased significantly in allergic group [(2.26±5.32)/50 fields at ×1 000], the difference was statistically significant ( t=5.822, P<0.05), while EOS in blood decreased [(0.56±0.47)×10 9/L], the difference was not statistically significant ( t=1.981, P>0.05). Conclusions:EOS in fecal of children with milk protein allergic enteritis increased obviously and decreased after treatment, is helpful to guide the clinical diagnosis and may become a new indicator of efficacy monitoring.

Hyper IgE syndromes: clinical and molecular characteristics / 国际儿科学杂志

Hyper IgE syndromes (HIES) comprise a group of rare primary immunodeficiency disorders characterized by a triad of atopic dermatitis,recurrent skin and lung infections along with elevated IgE levels.According to clinical and molecular characteristics,HIES can be classified into 2 types:autosomal dominant HIES (AD-HIES) and autosomal recessive HIES (AR-HIES).At present,STAT3,DOCK8,IL6ST and ZNF341 are included in OMIM database.AD-HIES,caused by STAT3 mutations,can present multiple systemic clinical symptoms and even lead to the development of pulmonary structural abnormalities including pneumatoceles and bronchiectasis.AR-HIES,caused by DOCK8,IL6ST or ZNF341 mutations,often present with severe fungal,bacterial or viral infections.Neurologic manifestations are frequent complications,such as vasculitis,hemangioma and cerebral infarction.The mortality rate is high.There is no specific index for the clinical diagnosis of HIES,and the final diagnosis still needs to be combined with genetic diagnosis.This article reviews the above genes and their possible pathogenesis.

Hyper IgE syndromes: clinical and molecular characteristics / 国际儿科学杂志

Hyper IgE syndromes(HIES)comprise a group of rare primary immunodeficiency disorders characterized by a triad of atopic dermatitis, recurrent skin and lung infections along with elevated IgE levels.According to clinical and molecular characteristics, HIES can be classified into 2 types: autosomal dominant HIES(AD-HIES)and autosomal recessive HIES(AR-HIES). At present, STAT3, DOCK8, IL6ST and ZNF341 are included in OMIM database.AD-HIES, caused by STAT3 mutations, can present multiple systemic clinical symptoms and even lead to the development of pulmonary structural abnormalities including pneumatoceles and bronchiectasis.AR-HIES, caused by DOCK8, IL6ST or ZNF341 mutations, often present with severe fungal, bacterial or viral infections.Neurologic manifestations are frequent complications, such as vasculitis, hemangioma and cerebral infarction.The mortality rate is high.There is no specific index for the clinical diagnosis of HIES, and the final diagnosis still needs to be combined with genetic diagnosis.This article reviews the above genes and their possible pathogenesis.

Expert consensus on clinical management strategy for patients with thoracic trauma during the epidemic period of COVID-19 / 解放军医学杂志

Since December 2019, a corona virus disease 2019 (COVID-19) has been continuing to spread throughout China. This epidemic is characterized by strong infectivity and concealment. China's domestic epidemic is gradually under control by strict quarantine and control measures, meanwhile the incidence of trauma has reduced. However, with the resumption of industry and traffic, the chest trauma caused mainly by traffic accidents and high falling has increased gradually, great risks and challenges are faced in clinical treatment. Therefore, combined with the current epidemic environment and the treatment characteristics of thoracic trauma, experts from the Thoracic Trauma Group, Thoracic Surgery Branch of China International Exchange and Promotion Association for Medical and Health Care and Chest Trauma Management Committee, Guangdong Association of Thoracic Disease develop an "Expert consensus on clinical management strategy for patients with thoracic trauma during the epidemic period of COVID-19 pneumonia". In order to promote the treatment of chest trauma in a scientific and orderly way, the consensus elaborated 4 parts, including classification and treatment strategy for patients with thoracic trauma required a surgical procedure, non-operative treatment of patients with thoracic trauma, management process of chest trauma, and protection and management of ward.

Mechanism of oral tolerance / 国际儿科学杂志

Oral tolerance is a state of no or low response to a specific oral antigen,but there are still normal immune responses to other antigens.Anaphylaxis may occur when oral tolerance is not established or destroyed.In recent years,the incidence of food allergy in Chinese children has increased,with an average of 5.83 ％ reported by parents.Therefore,it is of great significance to explore the mechanisms of oral tolerance.The mechanisms of oral tolerance include active suppression,bypass suppression,clonal anergy/deletion.Oral administration of low-dose antigen can induce regulatory T cells to secrete inhibitory cytokines and actively inhibit effector T cells.Oral administration of high-dose antigen can induce clonal anergy/deletion.Regulatory B cells,dendritic cells,various cytokines,gut microbiota and short-chain fatty acids also play an important role in oral tolerance.This review focuses on the mechanism and some influencing factors of oral tolerance.

American, European, and Chinese practice guidelines or consensuses of polycystic ovary syndrome: a comparative analysis / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Polycystic ovary syndrome (PCOS) is the most common metabolic and endocrine disorder in women. However, there is no agreement concerning how to diagnose and treat PCOS worldwide. Three practice guidelines or consensuses, including consensus from the European Society of Human Reproduction and Embryology (ESHRE)/the American Society for Reproductive Medicine (ASRM) in Rotterdam, diagnosis criteria and consensus in China, and clinical practice guideline from the Endocrine Society (ES) in the United States are widely recognized. The present paper may provide some guidance for clinical practice based on a comparative analysis of the above three practice guidelines or consensuses.

Effect of sitagliptin on cardiomyocyte pyroptosis induced by type 2 diabe-tes mellitus and underlying mechanism / 中国病理生理杂志

AIM:To explore the effect of sitagliptin (SLT) on cardiomyocyte pyroptosis induced by type 2 dia-betes mellitus (T2DM) and the underlying mechanism. METHODS:The T2DM rat model was established by high-fat diet and intraperitoneal injection of streptozotocin (35 mg/kg). The model rats were treated with SLT at 3, 10 and 30 mg/kg and nicotinamide [NAM; an non-specific inhibitor of sirtuin (SIRT) family] at 500 mg/kg for 4 weeks. Fasting blood glu-cose was measured, and the tissue proteins were determined by the methods of Western blot and immunochemistry. RE-SULTS:Compared with control group, the pyroptosis of cardiomyocytes and NLRP3 expression were significantly induced, while the protein level of SIRT3 was downregulated by T2DM (P<0.05). SLT inhibited the pyrpotosis of diabetic rat car-diomyocytes, downregulated the expression of NLRP3, and upregulated the expression of SIRT3 in a dose-dependent man-ner (P<0.05). All the function of SLT (30 mg/kg) was reversed by the treatment with NAM (500 mg/kg). Compared with control group, the pyroptosis of cardiomyocytes and NLRP3 expression were significantly induced, while the protein level of SIRT3 was not regulated by NAM (500 mg/kg). CONCLUSION:SLT exerts the inhibitory effect on the pyropto-sis of cardiomyocytes induced by diabetes, and the mechanism is related to the SIRT3/NLRP3 signaling pathway.

Variation of LNK Gene in Chronic Myeloid Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To compare the mutation and single nucleotide polymorphism (SNP) of LNK gene between chronic myeloid leukemia(CML) and control groups, and to explore the relationship between LNK gene variation and the occurrence of CML.</p><p><b>METHODS</b>A total of 36 patients with CML were selected, 46 healthy persons were used as normal controls. DNA was extracted from bone marrow and peripheral blood, BCR/ABL1 fusion gene was detected by Q-PCR. The whole exon of LNK gene was amplified by PCR. The amplified sequences included the Rs3184504 (C/T) and Rs78894077 (A/C/G/T) affecting the expression of amino acids in LNK gene, and the Rs7973120 (A/T) unaffecting the expression of the amino acids. The mutations and SNP of LNK gene were analyzed by DNA sequencing.</p><p><b>RESULTS</b>Thirty-six cases of CML had BCR/ABL1 mutation, while no mutation was found in the control group. One case of CML had LNK heterozygous mutation (A300V), and the mutation rate was 2.8%, no mutation was seen in normal control group. Rs3184504: C/T allele frequency was 50%/50% in the control group, 94.4%/5.6% in the CML group, and the C allele in CML group was significantly higher than that in the control group; CC genotype accounted for 94.4% (P<0.01). Rs78894077: C/T allele in the control group was 9.8%/90.2%, in CML group was 16.7%/83.3%, the difference was not statistically significant(P>0.05); but CC genotype in CML group was very statistically significant higher than that in control group(P<0.01). Rs7973120: A/T allele frequency was 10.9%/89.1% in the control group, 25%/75% in the CML group, the LNK A allele in CML group was very significantly higher than that in control group (P<0.01).</p><p><b>CONCLUSION</b>CML patients have been confirmed to have LNK mutation; the SNPs of LNK are related with the development of CML, and the most CML patients carry the LNK Rs3184504 C allele and the Rs7973120 A allele.</p>

Circadian blood pressure characteristics in hospitalized unstable angina pectoris patients with hypertension / 中华心血管病杂志

Objective@#To define the characteristic of circadian rhythm of blood pressure in unstable angina pectoris (UAP)patients with hypertension and its effects on the cardiovascular events.@*Methods@#It was a prospective study.Based on coronary angiographic results, 742 consecutive hospitalized UAP patients with hypertension and 89 consecutive hospitalized hypertensive patients were recruited between September 2014 and December 2015 in this study. Clinical data and the results of 24-hour ambulatory blood pressure monitoring (ABPM) were analyzed.@*Results@#The total prevalence of hypertension in UAP is about 77.1%(742/962) in our cohort. The decrease of night-time systolic and diastolic blood pressure in UAP patients complicated with hypertension was lower than that in hypertensive patients (P<0.05). The prevalence of dipper, non-dipper and reverse dipper pattern was 12.4%(92/742), 34.9%(259/742) and 52.7%(391/742) in UAP patients complicated with hypertension, 18.0%(16/89), 48.3%(43/89) and 33.7%(30/89) in hypertensive patients. Obviously, the abnormal circadian rhythm of blood pressure was more significant in UAP patients with hypertension than in hypertensive patients, characterized by higher reverse dipper pattern in UAP patients with hypertension compared to patients with hypertension(P=0.00), similar results were evidenced among the male and female patients and patients with various ages. Subgroup analysis showed that except similar results on the incidence of reverse dipper pattern in controlled blood pressure aged less than 45 years old, the incidence of reverse dipper pattern was all significantly higher in UAP patients complicating with hypertension than in hypertensive patients independent no matter blood pressure controlled or not (all P<0.05). After adjustment for sex, age, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and other risk factors, binary logistic regression analysis showed that reverse dipper pattern was independently associated with UAP(OR=1.53, 95%CI 1.12-2.61).@*Conclusions@#This finding suggests that UAP patients with hypertension often have abnormal circadian rhythm, characterized by higher reverse dipper circadian pattern. Elevated nocturnal blood pressure is independently related to UAP.

Investigation and Analysis of the Anticoagulant Therapy for Patients with Non-valvular Atrial Fibrillation in Our Hospital / 中国药房

OBJECTIVE:To investigate the current situation of anticoagulant therapy for patients with non-valvular atrial fibril-lation,and to provide reference for standardized anticoagulant therapy. METHODS:A total of 1056 patients with non-valvular atri-al fibrillation were collected from our hospital during Jul. 2015-Jun. 2016. According to 2012 European Society of Cardiology Guide-lines for the Management of Atrial Fibrillation,the risks of thrombosis and hemorrhage were evaluated,and the standardized anti-coagulant therapy was also evaluated. RESULTS:Among 1056 patients with non-valvular atrial fibrillation,the number of patients with thrombosis risk score ≥1 was 1028,accounting for 97.3%. 763 patients received antithrombosis therapy,and only 139 pa-tients were given warfarin anticoagulant therapy. The international normalized ratio(INR)of prothrombin time in just 30.9% of pa-tients receiving warfarin was in line with the standard before discharge. CONCLUSIONS:The anticoagulant therapy for patients with non-valvular atrial fibrillation is still not optimistic,and effective measure should be adopted to improve the standardization of anticoagulant therapy in the patients with atrial fibrillation.

Assessment of interventional therapy for acute myocardial infarction patients complicated with acute ventricular septal rupture / 中国介入心脏病学杂志

Objective To evaluate the clinical efficacy of interventional occlusion of ventricular septal rupture (VSR) complicating acute myocardial infarction (AMI). Methods Six patients with VSR complicated after AMI underwent transcatheter interventional occlusion in Chinese PLA General Hospital between May 2009 to May 2015 were retrospectively analyzed. Their clinical features, interventional treatment protocols, and occurance of postoperative complications were studied. Results Among the 6 patients, VSR were successfully occluded in 5 patients. One patient failed the operation due to instability of occluder after it was deployed and the occluder was retrieved. The paitents died of heart failure 6 months later. Among the 5 patients with successful closure, 4 patients presented mild residual shunt after occlusion and acute left heart failure occurred in 1 patient after operation. Two patients died during hospital stay after operation. Between them, one patient died 3 hours after operation because of cardiac tamponade and the other patient died of cardiogenic shock after withdrawal from IABP. Three patients were followed up until now and follow up echocardiography showed satisfactory cardiac function without heart failure. Conclusions Transcatheter occlusion was a reliable therapy for patients with ventricular septal rupture complicated in acute myocardial infarction which could improve cardiac function and reduce mortality.

Association between urinary microalbumin-to-creatinine ratio and brachial-ankle pulse wave velocity in hypertensive patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the association between urinary microalbumin-to-creatinine ratio (ACR) and brachial-ankle pulse wave velocity (baPWV) in hypertensive patients.</p><p><b>METHODS</b>A total of 877 primary hypertension patients were enrolled in this trial from September 2009 to December 2012, and were randomly recruited and patients were divided into normal ACR group (ACR < 30 mg/g, n = 723), micro-albuminuria group (30 mg/g ≤ ACR < 300 mg/g, n = 136) and macro-albuminuria group (ACR ≥ 300 mg/g, n = 18). baPWV was measure by automatic pulse wave velocity measuring system.</p><p><b>RESULTS</b>The baPWV values in patients of micro-albuminuria group and macro-albuminuria group were significantly higher than in the normal ACR group (all P < 0.05). The baPWV value of macro-albuminuria group was significantly higher than in the micro-albuminuria group (P < 0.05). Linear correlation analysis revealed that ACR was positively correlated with baPWV (r = 0.413, P < 0.01). Multiple linear regression analysis showed that ACR independently correlated with baPWV in patients with primary hypertension (β = 0.29, R(2) = 0.112, P < 0.01) after adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, low density lipoprotein, high density lipoprotein and triglyceride. Using ACR < 30 mg/g and ACR ≥ 30 mg/g as dichotomous variable, binary logistic regression analysis showed that ACR ≥ 30 mg/g was also a risk factor of the ascending baPWV in primary hypertension patients (OR: 1.73, 95% CI: 1.62-2.98) after adjusting the traditional cardiovascular risk factors.</p><p><b>CONCLUSION</b>ACR is positively correlated to baPWV in primary hypertension patients, and the ascending baPWV is a risk factor of early renal dysfunction in primary hypertension patients.</p>

Measuring isovolumic contraction peak velocity at the tricuspid annulus by Doppler tissue imaging to ;assess right heart function in patients with pulmonary hypertension / 中华医学超声杂志（电子版）

Objective To evaluate the feasibility and accuracy of the isovolumic contraction peak velocity (IVCv) of right heart function in patients with pulmonary hypertension (PH) by echocardiography and Doppler tissue imaging. Methods In 41 patients with suspected diagnosis of PH, IVCv at the tricuspid annulus were measured by echocardiography and Doppler tissue imaging. The right heart systolic function parameters such as tricuspid annular plane systolic excursion (TAPSE), peak systolic velocity (PSv) and right ventricular fractional area change (RVFCA) were also measured. The pulmonary artery pressure was detected by right-heart catheterization (RHC). According to different levels of pulmonary arterial systolic pressure, patients were classiifed into four groups to compare and analyze if any signiifcance could be found, including without PH group, mild PH group, moderate PH group and severe PH group. The sensitivity and speciifcity for diagnosing right heart impairment were assessed by ROC curves. Last, correlation analysis was performed. Results IVCv was signiifcantly and positively correlated with the right heart systolic function parameters, such as TAPSE (r=0.557, P0.05). Using the lower limit of right ventricular systolic function parameter obtained by common echocardiographic assessment as standard (TAPSE<16 mm, PSv<10 cm/s and RVFAC<35%), the sensitivities of IVCv<6.5 cm/s for diagnosing right ventricular systolic function reduction were 91%, 96%and 87%and the speciifcities were 70%, 53%and 77%, respectively. Conclusions IVCv obtained by Doppler tissue imaging is a new objective parameter for diagnosing right ventricular systolic function reduction. It is worth further study and application in clinic.

Combined use of non-biological artificial liver treatments for patients with acute liver failure complicated by multiple organ dysfunction syndrome / 世界急诊医学杂志（英文）

BACKGROUND: Acute liver failure (ALF) caused by viral and non-viral hepatitis is often accompanied with severe metabolic disorders, the accumulation of toxic substances and continuous release and accumulation of a large number of endogenous toxins and inflammatory mediators. The present study aimed to investigate the effects of various combined non-biological artificial liver treatments for patients with acute liver failure (ALF) complicated by multiple organ dysfunction syndrome (MODS). METHODS: Thirty-one patients with mid- or late-stage liver failure complicated by MODS (score 4) were randomly divided into three treatment groups: plasmapheresis (PE) combined with hemoperfusion (HP) and continuous venovenous hemodiafiltration (CVVHDF), PE+CVVHDF, and HP+CVVHDF, respectively. Heart rate (HR) before and after treatment, mean arterial pressure (MAP), respiratory index (PaO2/FiO2), hepatic function, platelet count, and blood coagulation were determined. RESULTS: Signifi cant improvement was observed in HR, MAP, PaO2/FiO2, total bilirubin (TBIL) and alanine aminotransferase (ALT) levels after treatment (P<0.05). TBIL and ALT decreased more signifi cantly after treatment in the PE+CVVHDF and PE+HP+CVVHDF groups (P<0.01). Prothrombin time (PT) and albumin were signifi cantly improved only in the PE+CVVHDF and PE+HP+CVVHDF groups (P<0.05). TBIL decreased more significantly in the PE+HP+CVVHDF group than in the HP+CVVHDF and PE+CVVHDF groups (P<0.05). The survival rate of the patients was 58.1％ (18/31), viral survival rate 36.4％ (4/11), and non-viral survival rate 70％ (14/20). CONCLUSION: Liver function was relatively improved after treatment, but PE+HP+CVVHDF was more efficient for the removal of toxic metabolites, especially bilirubin. The survival rate was significantly higher in the patients with non-viral liver failure than in those with viral liver failure.

Association between serum homocysteine and in-hospital death in patients with acute pulmonary embolism / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the association between serum homocysteine (Hcy) level and in-hospital death in patients with acute pulmonary embolism.</p><p><b>METHODS</b>A total of 186 acute pulmonary embolism patients [ (66.8 ± 12.7) years, 89 male] hospitalized in our department between June 2008 and June 2011 were included in this prospective study. Patients were divided into high Hcy group (Hcy ≥ 15.2 µmol/L, n = 95) and low Hcy group (Hcy < 15.2 µmol/L, n = 91). Patients were followed-up for 1 year for the incidence rate of early death associated with acute pulmonary embolism. The Cox proportional hazard model was used to analyze the relationship between serum Hcy level and early death in acute pulmonary embolism patients.</p><p><b>RESULTS</b>Patients were hospitalized for 1-37 days [(10 ± 6) days]. In-hospital death rate was 14.5% (27/186) and was significantly higher in high Hcy group than in low Hcy group [25.3% (24/95) vs. 3.3% (3/91) , P = 0.001]. Univariate Cox regression analysis indicated that admission heart rate, oxygen saturation, enlargement of right ventricle, Hcy ≥ 15.2 µmol/L, serum creatinine level, peak TnT level and deep venous thrombosis (P < 0.05) were independent risk factors for in-hospital death. Multivariate Cox regression analysis showed that Hcy ≥ 15.2 µmol/L (HR = 4.10, 95%CI:3.00-4.98, P = 0.017), admission heart rate (HR = 1.10, 95%CI:1.01-1.20, P = 0.031) , deep venous thrombosis (HR = 1.65, 95%CI:1.45-1.76, P = 0.034) and age (HR = 1.10, 95%CI:1.02-1.19, P = 0.010) were independent predictors of in-hospital death for acute pulmonary embolism patients. One-year follow up was finished in 142 patients (89.3%). There were 19 deaths ( 5 due to repeat pulmonary embolism, 4 due to decompensated respiratory and /or cardiac diseases, 6 due to malignant tumors, 2 due to fatal bleeding and 2 due to pneumonia) . Death rate was similar between the two groups during follow up.</p><p><b>CONCLUSION</b>Higher serum homocysteine is an independent for in-hospital death for patients with acute pulmonary embolism.</p>

Serum cystatin C concentration as an independent marker for hypertensive left ventricular hypertrophy / 老年心脏病学杂志（英文版）

Background Serum cystatin C levels can be used to predict morbidity and mortality in patients with cardiovascular disease. However, the clinical relevance of serum cystatin C levels in patients with hypertensive left ventricular hypertrophy (LVH) has rarely been investigated. We designed the present study to investigate whether serum cystatin C levels are associated with cardiac structural and functional alterations in hypertensive patients. Methods We enrolled 823 hypertensive patients and classified them into two groups:those with LVH (n=287) and those without LVH (n=536). All patients underwent echocardiography and serum cystatin C testing. We analyzed the relationship be-tween serum cystatin C levels and LVH. Results Serum cystatin C levels were higher in hypertensive patients with LVH than in those without LVH (P＜0.05). Using linear correlation analysis, we found a positive correlation between serum cystatin C levels and interven-tricular septal thickness (r=0.247, P＜0.01), posterior wall thickness (r=0.216, P＜0.01), and left ventricular weight index (r=0.347, P＜0.01). When analyzed by multiple linear regression, the positive correlations remained between serum cystatin C and interventricular septal thickness (β=0.167, P＜0.05), posterior wall thickness (β=0.187, P＜0.05), and left ventricular weight index (β=0.245, P＜0.01). Con-clusion Serum cystatin C concentration is an independent marker for hypertensive LVH.

The anatomical feasibility analysis of posterior laminar screw fixation techniques in upper thoracic vertebrae / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the anatomical feasibility and the technique of T(1)-T(3) crossing laminar screws fixation in the adult population.</p><p><b>METHODS</b>There were 33 dry upper thoracic vertebras specimen which included respectively T(1), T(2), T(3) were studied. Spinous process height (Hs), bilateral laminar height (H), length of superior laminar screws (Ls), length of inferior laminar screws (Li), bilateral thickness of laminar (TL) and crossing angle the laminar (A) were measured. On the basis of modified Kretze's technique, T(1) crossing laminar screws implantation was performed under visual control. The crossing laminar screws position were evaluated by X-ray and visualizing.</p><p><b>RESULTS</b>The mean Hs of T(1) was the highest which was (15.7 ± 1.6) mm; the mean H of T(3) was the highest which was (18.7 ± 1.1) mm; the TL and A of T(1) were (6.3 ± 0.9) mm and 101.8° ± 4.5°, that of T(2) were (6.9 ± 1.0) mm and 101.9° ± 4.3°, that of T(3) were (6.5 ± 0.9) mm and 102.9° ± 4.4°, respectively. There were no significant differences between the values of the H and TL on left and right sides (P > 0.05). The Ls of T(1), T(2), T(3) were shorter than Li of that [(31.7 ± 2.4) mm vs. (37.3 ± 2.3) mm, (25.8 ± 2.2) mm vs. (32.3 ± 2.7) mm, (25.3 ± 2.7) mm vs. (31.2 ± 2.9) mm, respectively]. There was significant statistically difference between the values of the Ls and Li on the same vertebra (P < 0.05). The mean TL of T(2) was the thickest, which was significant statistically thicker than that of T(1) (t = 8.876, P < 0.01), which was not significant statistically thicker than that of T(3) (t = 1.919, P > 0.05). The T(1) crossing laminar screws were successfully placed, without impingement of the spinal canal.</p><p><b>CONCLUSIONS</b>It is feasible to place T(1), T(2), T(3) crossing laminar screws in most people. This study provides anatomic guidelines to allow for accurate screw selection and insertion.</p>

Research progress of biomarker COMP in osteoarthritis / 中国骨伤

Cartilage oligomeric matrix protein (COMP) is a potential biomarker for joint destruction associated with osteoarthritis, which is first and best investigated biomarkers to reflect osteoarthritis occurs, progress and the prognosis. In this article, multiple uses and related reports of COMP are summarized briefly to promote further investigation of COMP.

Establishment of a mouse model of biliary obstruction and its dynamic observations / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a mouse model of biliary obstruction.</p><p><b>METHODS</b>Sixty-four Balb/c mice were divided into experimental group and control group. Obstructive jaundice was induced in the mice in the experimental group by common bile duct ligation. The level of the common bile duct diameter, WBC, LYM MID, LYM%, MID% and ALT, AST, TBIL, DBIL, IBIL, ALP and CHOL were measured 12 h and 1, 2 ,3, 4, 5, and 7 days after the ligation. The morphological changes in the liver were also observed.</p><p><b>RESULTS</b>The level of common bile duct diameter, WBC, LYM, MID, LYM%, MID% and ALT, AST, TBIL, DBIL, ALP and CHOL all underwent changes with time following certain patterns.</p><p><b>CONCLUSION</b>The jaundice manifestation of this model is similar to that of patients with biliary obstruction, and this model may provide a reliable model for studying the mechanism of obstructive jaundice.</p>