目的 通过分析早产儿视网膜病变(retinopathy of prematurity,ROP)自然退行和进展的影响因素,了解ROP的发展规律,以期对ROP病儿的临床及筛查工作有一定指导作用.方法 收集2018年9月至2021年4月在徐州医科大学附属医院就诊并进行眼底筛查的病儿472例.收集确定有眼底病变的141例病儿的临床资料,退行组107例,需干预治疗的进展组34例,分析早产儿视网膜病变自然退行与进展的影响因素.结果 退行组和进展组平均胎龄分别为(31.61±2.29)周、(29.76±1.82)周,经独立样本的t检验,差异有统计学意义(P＜0.05),两组出生体质量的中位数分别为1.58(1.25,1.82)kg、1.26(1.03,1.48)kg,无创通气时间为8.50(6.00,18.75)d、20.00(10.75,32.25)d,两组合并支气管肺发育不良(bronchopulmonary dysplasia,BPD)的占比分别为40.2％(43/107),79.4％(27/34),败血症59.8％(64/107)、82.4％(28/34)、贫血59.8％(64/107),82.4％(28/34)、输血34.6％(37/107)、61.8％(21/34),经非参数两独立样本检验,差异有统计学意义(均P＜0.01);多因素logistics回归分析显示,胎龄(β=?0.32,P=0.004,OR＜1)是ROP进展的独立危险因素.结论 低出生体质量、胎龄小、无创通气时间长,合并支气管肺发育不良、败血症、贫血、输血的病儿ROP进展至需干预治疗的风险较高,提示对于胎龄小、低出生体质量的早产儿加强筛查管理,对于ROP病儿应防治BPD、贫血、严格把控输血指征用氧指征;胎龄是ROP进展的独立危险因素,应加强母孕期的检查与护理,延长孕周.

早产儿视网膜病变(retinopathy of prematurity,ROP)相关高危因素分析通常采用传统医学统计方法,分析效果依赖于数据集样本和维度的数量,很难挖掘深层次的高危因素.针对上述问题,提出基于机器学习LightGBM的ROP分析模型,通过该模型适合处理高维数据集的特点挖掘ROP高危因素.首先对原始数据集进行基本信息分析和数据预处理,然后对预处理后的数据集进行LightGBM模型搭建、训练、验证与特征优化,通过对比验证,证明特征优化后得出的高危因素更加准确.最终通过LightGBM特征优化分析得到的ROP相关高危因素为Px、氧时、无创、胎龄、Apgar1、母亲年龄、Apgar5、胎膜早破.

目的 分析动脉导管未闭(patent ductus arteriosus,PDA)新生儿母亲妊娠期高危影响因素,为早期预防、早期干预提供参考方向.方法 将2018年9月 ～2022年2月在徐州医科大学附属医院产科出生并且生后24h内转入徐州医科大学附属医院新生儿重症监护室(NICU)的254例新生儿作为研究对象.根据生后1周内的心脏彩超结果 分类,分为PDA组(n=151)与非PDA组(n=103),运用SPSS软件,比较两组的临床资料,以此分析动脉导管未闭新生儿母亲妊娠期的高危因素.结果 单因素分析显示两组患儿胎龄、出生体重、胎儿宫内窒息史、1min Apgar评分、妊娠期贫血、胎膜早破、炎性指标高、羊水异常、产前使用地塞米松、产前1周使用抗生素及产前1周母亲的体重指数(body mass index,BMI)指数比较,差异有统计学意义(p<0.05),是引起新生儿动脉导管未闭的高危因素;二元Logistic回归分析显示,产前使用地塞米松是新生儿动脉导管未闭的保护性因素,而妊娠期贫血、胎膜早破、炎性指标高,母亲产前BMI高是新生儿动脉导管未闭的危险因素.结论 妊娠期贫血、感染、BMI高可能会增加新生儿动脉导管未闭的风险,需要妊娠期注意贫血、体重增长的情况以及避免感染.

目的 比较容量保证(VG)与压力控制(PC)两种机械通气模式在呼吸窘迫综合征(RDS)早产儿中的应用效果.方法 前瞻性选择2017年03月至2021年04月NICU收治的胎龄<32周或出生体质量<1500 g,需要有创机械通气的RDS早产儿作为研究对象,按简单随机法分为VG组和PC组.比较两组拔管前的呼吸机参数及动脉血气,有创机械通气时间、总呼吸支持时间及平均住院时间,并发症发生率及病死率.结果 最终RDS早产儿79例完成研究,男46例、女33例,平均胎龄(30.1±1.2)周,平均出生体质量(1239.0±158.0)g,VG组36例、PC组43例.与PC组比较,VG组在拔管前的平均气道压较低,有创机械通气时间、总呼吸支持时间以及平均住院时间均缩短,差异有统计学意义(P<0.05).结论 在RDS早产儿的机械通气治疗中,VG通气可能是一种更加安全有效的通气方式,但仍需要大样本、多中心的临床试验证实.

目的 探讨老年冠状动脉慢血流(CSF)患者的临床影响因素.方法 从2017年1月～2019年8月于滨州医学院附属医院行冠状动脉造影检查的1260例患者中,选择年龄≥60岁的冠状动脉无明显狭窄患者286例,将CSF的98例作为CSF组,血流正常的188例作为对照组.回顾性分析2组患者临床资料,用相关性分析,采用多因素logistic回归分析CSF的影响因素.结果 2组性别、吸烟、嗜碱性粒细胞、红细胞、血红蛋白、平均红细胞血红蛋白浓度、红细胞比容、白蛋白、总胆汁酸、乳酸脱氢酶、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原/白蛋白比较,差异均有统计学意义(P＜0.05,P＜0.01);相关性分析显示,红细胞(r = 0.167,P = 0.005)、血红蛋白(r = 0.177,P =0.003)、平均红细胞血红蛋白浓度(r = 0.135,P = 0.022)、嗜碱性粒细胞(r = 0.192,P = 0.001)、白蛋白(r =-0.161,P = 0.006)、总胆汁酸(r =-0.142,P = 0.016)、乳酸脱氢酶(r=-0.143,P = 0.015)、凝血酶时间(r =-0.141,P= 0.017)、纤维蛋白原/白蛋白(r = 0.184,P = 0.002)与CSF组3支血管血流帧数明显相关.多因素logistic回归分析显示,总胆汁酸、白蛋白、纤维蛋白原/白蛋白是CSF患者的独立影响因素(P＜0.05,P＜0.01).结论 总胆汁酸、白蛋白、纤维蛋白原/白蛋白是老年CSF患者的影响因素.

目的 研究脐静脉置管对极低出生体质量儿早期肠道菌群的影响.方法 选择2019年6月至2020年6月新生儿监护室收治的41例极低出生体质量儿作为研究对象.根据是否进行脐静脉置管,分为脐静脉置管组24例和非脐静脉置管组17例.收集新生儿生后第1、3、7天的粪便样本,应用高通量测序技术对粪便样本中的细菌16 S基因全长进行测序,比较两组间各个时间段肠道菌群多样性及相对丰度.结果 入选41例新生儿中,男26例、女15例,胎龄30.0(29.3～30.6)周,出生体质量(1.25±0.10)kg.第1天肠道菌群检出率低.第3天,脐静脉置管组和非脐静脉置管组之间shannon指数差异无统计学意义(P>0.05),组间各个菌群相对丰度差异无统计学意义(P>0.05).第7天,与非脐静脉置管组相比,脐静脉置管组shannon指数较低,变形菌门相对丰度较大,厚壁菌门及放线菌门相对丰度较小,克雷伯菌属相对丰度较大,双歧杆菌属及肠球菌属相对丰度较小,差异均有统计学意义(P均<0.05).结论 脐静脉置管可改变极低出生体质量儿早期肠道菌群的构成,降低肠道菌群多样性.

目的 探讨新生大鼠缺氧缺血性脑损伤后脑皮质组织Caspase-12表达及意义.方法 7d龄新生SD大鼠30只随机分为三组,每组10只.缺氧缺血组和抑制剂组参照Rice法成功制备新生大鼠缺氧缺血性脑损伤模型,后者造模成功后予侧脑室注射Caspase-12特异性抑制剂Z-ATAD-FMK;对照组为假手术组.三组72 h后取脑组织标本,RT-PCR法和Western blot法分别检测大脑皮质组织Caspase-12 mRNA和活化的Caspase-12蛋白表达,原位末端标记染色法检测神经元细胞凋亡情况,HE染色光镜下观察脑组织病理变化.结果 与对照组比较,缺氧缺血组和抑制剂组Caspase-12 mRNA表达、活化的Caspase-12蛋白表达及细胞凋亡率均升高(P＜0.05),但抑制剂组低于缺氧缺血组(P＜0.05),且脑组织病理改变较轻.结论 新生大鼠缺氧缺血性脑损伤后脑皮质组织Caspase-12表达升高,表明内质网应激参与其病理损伤;选择性抑制Caspase-12表达,可减少细胞凋亡,发挥脑保护作用.

目的:探讨血清中性粒细胞/淋巴细胞比值(NLR)对慢性心力衰竭急性发作院内死亡的预测价值.方法:回顾性分析2014-01-2017-12滨州医学院附属医院住院治疗的慢性心力衰竭急性发作患者402例,分为院内死亡组(43例)和存活组(359例).应用单因素及多因素Logistic回归分析评价NLR是否可以作为慢性心力衰竭急性发作患者院内死亡的独立危险因素,并通过受试者工作特征(ROC)曲线判断NLR对慢性心力衰竭急性发作院内死亡的预测能力.结果:单因素Logistic回归分析显示,年龄、白细胞、中性粒细胞、NLR、血尿素氮、肌钙蛋白I、N末端脑钠肽前体(NT-proBNP)是慢性心力衰竭急性发作院内死亡的危险因素(均P＜0.05).多因素Logistic回归分析显示,NLR是慢性心力衰竭急性发作院内死亡的独立危险因素(OR=1.113,95％CI:1.039～1.191,P=0.002).ROC曲线分析结果显示:NLR预测慢性心力衰竭急性发作院内死亡发生的ROC曲线下面积为0.849(95％CI:0.796～0.903,P=0.000),根据约登指数得出NLR最佳截断点为4.36,敏感度为93.0％,特异度为65.7％.结论:NLR是慢性心力衰竭急性发作患者院内死亡的独立危险因素.

背景 微血管性心绞痛(MVA)是易被忽视的疾病,目前因无明确的相关指标而导致常规冠状动脉造影无法快速准确判定MVA,且国内外相关研究较少.目的 探讨冠状动脉内径及迂曲与原发性MVA的相关性.方法 回顾性选取2008年1月—2010年9月就诊于滨州医学院附属医院以心绞痛症状入院并行冠状动脉造影的患者1 361例为研究对象.首先根据冠状动脉造影结果计算每例患者的SYNTAX评分,大于0分者为冠心病(CAD)组,等于0分者再按照临床标准分为MVA组及非冠心病(NCAD)组.比较三组患者的基线资料[包括年龄、性别、既往病史、红细胞沉降率(ESR)、血红蛋白(Hb)、中性粒细胞/淋巴细胞比值(NLR)、血脂指标、肾功能指标、胆红素及平均冠状动脉近段内径和冠状动脉迂曲的情况],并进一步应用多因素Logistic回归方程分析其基线资料与原发性MVA的相关性.结果 MVA组与CAD组的平均年龄、高血压比例、糖尿病比例、平均冠状动脉近段内径、冠状动脉迂曲比例、ESR、Hb、NLR、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、肌酐(Cr)、血糖(Glu)比较,差异有统计学意义(P<0.05).MVA组与NCAD组性别、平均年龄、高血压比例、糖尿病比例、吸烟史、平均冠状动脉近段内径、冠状动脉迂曲比例、Hb比较,差异有统计学意义(P<0.05).多因素Logistic回归分析发现,相较CAD组,冠状动脉近段平均内径[OR=8.279,95％CI(5.459,12.556),P<0.001]、冠状动脉迂曲[OR=6.761,95％CI(3.755,12.174),P<0.001]、Hb[OR=1.057,95％CI(1.031,1.083),P<0.001]、女性[OR=3.019,95％CI(1.379,6.609),P=0.006]、高血压[OR=0.194,95％CI(0.106,0.353),P<0.001]、糖尿病[OR=0.105,95％CI(0.020,0.548),P=0.008]、LDL-C[OR=0.617,95％CI(0.412,0.914),P=0.019]是原发性MVA的独立影响因素;相较NCAD组,平均冠状动脉近段内径[OR=9.246,95％CI(6.050,14.129),P<0.001]、冠状动脉迂曲[OR=4.105,95％CI(2.288,7.363),P<0.001]、Hb[OR=1.042,95％CI(1.017,1.068),P=0.001]、Glu[OR=1.214,95％CI(1.030,1.432),P=0.021]、高血压[OR=0.282,95％CI(0.154,0.517),P<0.001]及糖尿病[OR=0.138,95％CI(0.026,0.745),P=0.021]是原发性MVA的独立影响因素.多因素Logistic回归分析示原发性MVA[OR=5.150,95％CI(3.366,7.881),P<0.001]、女性[OR=1.460,95％CI(1.097,1.944),P=0.009]、高血压[OR=1.564,95％CI(1.169,2.094),P=0.003]和HDL-C[OR=1.479,95％CI(1.067,2.050),P=0.019]是冠状动脉迂曲的独立危险因素.结论 高血压、糖尿病与原发性MVA独立负相关,Hb、平均冠状动脉近段内径、冠状动脉迂曲与原发性MVA独立正相关.平均冠状动脉近段内径增大、冠状动脉迂曲可能是原发性MVA的继发表现而不是原因.

目的 探讨早产儿外周血胱抑素C(cystatin C,Cys C)水平变化及其临床意义.方法 选取2018年1月—2018年6月于徐州医科大学附属医院新生儿科住院治疗的早产儿89例,男47例,女42例,平均胎龄(32.78±2.26)周,平均体重(1.94±0.48)kg,采用颗粒增强透射免疫比浊法检测其生后第3天外周血Cys C水平,采用SPSS 18.0软件进行统计学处理,比较不同胎龄、性别、出生体重、生产方式、Apgar评分及母亲有无合并妊娠期高血压、胎膜早破时Cys C水平差异,分析Cys C和胎龄、出生体重、Apgar评分、肌酐(creatinine,Cr)、尿素氮(blood urea nitrogen,BUN)、血清总胆红素(total bilirubin,TBIL)水平的相关性.结果 早期早产儿Cys C水平明显高于中、晚期早产儿,差异有统计学意义(P<0.05),中、晚期早产儿比较差异无统计学意义(P>0.05);极低出生体重早产儿CysC水平高于低出生体重及正常出生体重早产儿,差异有统计学意义(P<0.05),而低出生体重早产儿与正常出生体重早产儿比较差异无统计学意义(P>0.05);3、5分钟Apgar评分<8分的早产儿Cys C水平明显高于>8分早产儿,差异有统计学意义(P<0.05);母亲合并胎膜早破的早产儿Cys C水平高于无胎膜早破早产儿,差异有统计学意义(P<0.05);不同性别、生产方式、TBIL水平及母亲有无合并妊娠期高血压早产儿Cys C差异无统计学意义(P>0.05).相关分析显示:Cys C水平与Cr、BUN呈明显正相关(P<0.05),与胎龄、出生体重、Apgar评分呈负相关(P<0.05),但相关关系不密切(r<0.5),与TBIL水平无相关性(P>0.05).结论胎龄、出生体重、5分钟Apgar评分、母亲合并胎膜早破均为早产儿Cys C水平的影响因素,胎龄越小、出生体重及5分钟Apgar评分越低早产儿Cys C水平越高,且呈负相关,此类早产儿应高度警惕肾脏损害存在,而性别、生产方式、TBIL水平及母亲合并妊娠高血压对Cys C水平无明显影响.

目的:评估信息化随访系统对于出院冠心病患者治疗依从性的影响.方法:选择2013-01-2014-12确诊为冠心病的患者共382例,随机分为试验组及对照组,出院前均根据最新指南予以药物治疗及指导.试验组在出院后由专人运用信息化随访系统采用优化的依从性量表进行回访.对照组采用传统的随访模式,主要包括患者被动随访、门诊随访、电话随访等.采用调查问卷的方式了解两组患者的治疗依从性及主要心脏不良事件的发生率.结果:试验组第2次至第6次随访的服药依从性得分、生活方式改善得分及治疗依从性得分均高于对照组(P＜0.001).两组患者服药依从性得分在所有的随访期间均达到了良好的标准.对于治疗依从性得分,在6次随访中对照组能够达到的良好比例少于试验组(P=0.003).随访期间对照组主要不良心脏事件发生率高于试验组(P＜0.001).多因素Logistic回归分析显示年龄、糖尿病、吸烟是发生不良心脏事件的独立危险因素.结论:信息化随访系统可以显著提高出院冠心病患者的治疗依从性,减少主要不良心脏事件发生率.

背景 高血压是心血管系统的高发疾病且病因复杂多样,其中焦虑与高血压互相影响,二者密切相关.焦虑对高血压的影响,可能主要表现在影响血压的波动性,即影响血压变异性(BPV).内皮素-1(ET-1)与一氧化氮(NO)被认为是影响血管舒缩功能较强的因子,焦虑可以影响ET-1、NO的分泌.目的 分析焦虑对老年高血压患者BPV、ET-1、NO的影响,探讨BPV、ET-1、NO之间的相关性,为老年高血压伴焦虑患者的早期干预及治疗提供理论依据.方法 选择2016年11月—2017年6月于滨州医学院附属医院住院的老年高血压患者120例(男51例,女69例)为研究对象,记录患者一般情况并检测血ET-1、NO,对所有患者进行动态血压监测及Zung焦虑自评量表(SAS)评估,根据SAS评分将患者分为高血压无焦虑组(EH组)、高血压轻度焦虑组(EH&LA组)及高血压中重度焦虑组(EH&SA组).比较3组患者BPV、ET-1及NO水平,并分析高血压伴焦虑患者BPV、ET-1、NO之间的相关性.BPV以血压标准差(SD)表示.结果 EH&LA组24 h、昼间、夜间收缩压标准差(24 hSBPSD、dSBPSD、nSBPSD)及夜间舒张压标准差(nDBPSD)高于EH组,EH&SA组高于EH&LA组;EH&LA组血清ET-1水平高于EH组,EH&SA组高于EH&LA组;EH&LA组血清NO水平低于EH组,EH&SA组低于EH&LA组,差异均有统计学意义(P<0.05).老年高血压伴焦虑患者血清ET-1水平与BPV指标(24 hSBPSD、dSBPSD、nSBPSD、nDBPSD)呈正相关(r值分别为0.506、0.443、0.666、0.642,P<0.05);NO与BPV指标无相关性(P>0.05).结论 焦虑对老年高血压患者BPV、ET-1、NO有影响,且焦虑程度越明显,BPV越大,血清ET-1水平越高,而NO水平越低.焦虑可能通过增加BPV进一步加重高血压患者的血管内皮损害.早期识别老年高血压患者的焦虑状况并根据患者的焦虑程度选择抗焦虑治疗或许可以延缓内皮功能的损害,改善老年高血压患者的病情进展及预后.

目的 探讨妊娠期宫内感染对胎龄＜37周早产儿免疫指标的影响及相关机制,为临床诊治提供参考依据.方法 收集2016年10月-2018年4月在徐州医科大学附属医院娩出的早产儿189例为研究对象,其中宫内感染组86例,未感染组103例.比较出生后24 h、7d的外周血T淋巴细胞亚群(CD3+、CD4+、CD8+)、免疫球蛋白(IgG、IgM、IgA)、白细胞介素(IL-6、IL-8、IL-1β)及肿瘤坏死因子(TNF-α)水平.收集脐带血,分离脐带血单个核细胞(UBMC),RT-PCR检测细胞中Tlr2、Tlr4、Socsl、Socs3 mRNA表达水平;使用细菌脂多糖LPS刺激未感染组UBMC,检测不同刺激时间(lh、3h、6h、12 h)的Tlr2、Tlr4、Socs1、Socs3 mRNA表达水平.结果 出生后24h、7d感染组早产儿血清CD3+、CD4+、CD8+水平明显高于未感染组,IgG、IgM、IgG水平明显低于未感染组,IL-6、IL-8、IL-1β、TNF-α水平明显高于未感染组(均P＜0.05).感染组早产儿UBMC中Tlr2、Tlr4、Socs1、Socs3 mRNA表达水平明显高于未感染组(均P＜0.05).LPS刺激各时间点Tlr2、Tlr4、Socs1、Socs3 mRNA表达水平均明显高于空白对照组(均P＜0.05);其中Tlr2 mRNA表达在LPS刺激3h时达到峰值,Tlr4 mR-NA表达在LPS刺激1h时达到峰值,Socs1和Socs3 mRNA表达在LPS刺激3h时达到峰值.结论 宫内感染可引发早产儿体内免疫指标异常改变,其机制可能通过Toll样受体和Socs信号通路调节体内免疫反应.

Objective To observe the effects of bromocriptine on experimental gastric ulcer in mice.Methods Water immersion restraint method:Mice were randomly divided into three groups (n =10):a control group (Group C),a water immersion restraint model group (Group W) and a bromocriptine prevention group (Group Brc + W).Mice in the Group Brc + W were pretreated with 2.5 mg · kg-1 bromocriptine through intragastric administration,and half an hour later received water immersion restraint with Group W.Then,9 hours later,their visceral pain index and gastric ulcer index were measured.Aspirin method:Mice were randomly divided into three groups (n =10):a control group (Group C),an aspirin model group (Group Asp) and a bromocriptine prevention group (Group Brc + Asp).Mice in the Group Brc + Asp were pretreated with 2.5 mg · kg-1 bromocriptine through intragastric administration,and half an hour later given 300 mg · kg-1 aspirin through intragastric administration with Group Asp.Then,1 hour later,their visceral pain index and gastric ulcer index were measured.Results Water immersion restraint method:Compared with the C group,the visceral pain index and gastric ulcer index were significantly increased in the W group (P ＜ 0.01).Compared with the W group,the visceral pain index and gastric ulcer index were significantly decreased in the Brc + W group (P ＜0.01).Aspirin method:Compared with the C group,the visceral pain index and gastric ulcer index were significantly increased in the Asp group (P ＜ 0.01).Compared with the Asp group,the visceral pain index and gastric ulcer index were significantly decreased in the Brc + Asp group (P ＜ 0.01).Conclusions Pretreatment with bromocriptine has protective effects on gastric ulcers induced by water immersion restraint and aspirin.

Objective:To study the association between plasma homocysteine(Hcy) level and plasma asymmetric dimethylarginine(ADMA) in H-type hypertension patients with coronary heart disease.Method:Two hundred and twenty-two primary hypertensive patients admitted to our hospital from January 2016 to November 2016 were divided into hypertensive group(n=66) and hypertension with coronary heart disease group(n=156).The plasma ADMA and Hcy levels were detected by enzyme-linked immunosorbent assay.According to plasma homocysteine level,hypertension with coronary heart disease group was then divided into H-type hypertension with coronary heart disease group(n=104) and non H-type hypertension with coronary heart disease group(n=52).Their plasma ADMA levels were compared.The association between plasma Hcy level and plasma ADMA level was analyzed.Result:The plasma ADMA and Hcy levels were significantly higher in hypertension with coronary heart disease group than in hypertensive group and the plasma ADMA and Hcy levels was significantly higher in H-type hypertension group and H-type hypertension with coronary heart disease group than in non H-type hypertensive group and non H-type hypertension with coronary heart disease group (P＜ 0.05).Linear correlation analysis showed that the plasma ADMA level was associated with the plasma Hcy level in hypertension with coronary heart disease group(r=0.76,P＜0.01).Further multiple stepwise regression analysis showed that the plasma Hcy level influenced the plasma ADMA level.Conclusion:The plasma Hcy and ADMA levels were higher in H-type hypertensive patients and H-type hypertension patients with coronary heart disease than in non H-type hypertensive patients and non H-type hypertension patients with coronary heart disease.Plasma ADMA levels are positively correlated with Hcy levels in hypertension patients with coronary heart disease.

Objective To study the relationship between hematocrit and coronary artery lesions in elderly coronary heart disease (CHD) patients.Methods Five hundred and ninety-eight elderly patients were divided into CHD group (n=422) and CHD-free group (n=176) according to their coronary angiography.Their general clinical data,routine blood test parameters and biochemical test parameters were compared.The SYNTAX score of coronary artery lesions was recorded.Results The age was significantly older,the ratio of males and smoking was significantly higher,the incidence of DM and the ESR were significantly higher,the number of WBC,neutrophils and monocytes was significantly greater,the serum levels of FBG,TG,LDL-C and apolipoprotein A were significantly higher whereas the number of RBC was significantly smaller,the serum hemoglobin and LDL-C levels and hematocrit were significantly lower in CHD group than in CHD-free group (P＜0.05,P＜0.01).Spearman rank correlation analysis showed that the hematocrit was negatively related with the SYNTAX score (r=-0.151,P=0.000).The area under the ROC curve for hematocrit in predicting CHD was 0.589 (95％CI:0.540-0.639,P=0.001).The cut-off point value of hematocrit was 39.95％ with a sensitivity of 61.1％ and a specificity of 46.6％.Conclusion Hematocrit is closely related with coronary artery lesions in elderly CHD patients,and lower hematocrit can predict the risk of CHD.

Objective To analyze the expression changes of placental growth factor(PLGF) in neonatal rats with hypoxic-ischemic brain damage,and to discuss the possible roles of PLGF in alleviating cerebral ischemia,promoting regeneration of blood vessels as well as the protective effects of Shenfu injection on the expression of PLGF.Method All the neonatal rats were randomly divided into three groups:sham operation group (S),Shenfu injection treatment group (SF),and saline control group (C).They were further divided into five subgroups(n=8 per subgroup) according to the time points:6 h,12 h,1 d,3 d,7 d.Models of postnatal 7-day Sprague Dawley rats with HIBD were established with Rice methods.Group SF was treated with Shenfu injection (10 mg/kg,ip) immediately after hypoxic-ischemic brain damage (HIBD).The injection lasted for three days once a day at the same time.Group C was treated with saline in the same way with the same dosage.There was no treatment with any drugs in Group S.RT-PCR and immunohistochemistry method were used to detect the changes of PLGF in the lesion side cerebral cortex in neonatal rats.Results Expression of PLGF in group S was the same at different time points(P＞0.05);In group C,the expression of PLGF started to increase at 6 h,and reached a peak at 1 d and then gradually declined.The expression level was higher than S group from 12 h to 7 d(P＜0.05);In SF group,the expression increased before 6 h,and the tendency of expression was similar to C group;However it had a more obvious decline at 3 d.The whole level was apparently higher than S and C groups.Conclusion The expression levels of PLGF increase highly after hypoxic-ischemic brain damage,and Shenfu injection can protect the brain from damage effectively through facilitating the expression of PLGF.

Objective:To investigate the influencing factors of coronary slow flow (CSF) in relevant patients.Methods:A total of 1 530 patients received coronary angiography (CAG) in our hospital from 2008-01 to 2010-09 were retrospectively studied.According to corrected TIMI frame counts,2 groups were established:CSF group,n=139 patients without obvious coronary artery stenosis but with CSF and Control group,n=232 patients without obvious coronary artery stenosis and with normal coronary blood flow.Basic clinical condition,risk factors and routine laboratory tests were compared between 2 groups;the influencing factors of CSF were evaluated by multivariate Logistic regression analysis.Results:① The following parameters were different between 2 groups:age,gender,histories of smoking and diabetes;red blood cells (RBC),hemoglobin,mean hemoglobin concentration,hematocrit (HCT),mean RBC volume,RBC distribution width;neutrophils,monocytes,basophilic granulocyte,the ratios of lymphocytes/monocytes (LMR),neutrophils/monocytes (NMR),neutrophils/lymphocytes (NLR) and platelet/lymphocytes (PLR);glutamic oxalacetic transaminase,creatine kinase and total bile acid,P＜0.05.② Correlation analysis showed that RBC (r=0.191,P＜0.01),hemoglobin (r=0.184,P＜0.01),neutrophils (r=0.218,P＜0.01),mean hemoglobin concentration (r=0.151,P＜0.01),mean RBC volume (r=-0.138,P＜0.01),total bile acid (r=-0.172,P＜0.01),NLR (r=0.231,P＜0.01),LMR (r=-0.157,P＜0.01) and NMR (r=0.121,P＜0.01)were related to 3-branch mean flow frame.③ Multivariate Logistic regression analysis indicated that total bile acid (partial regression coefficient=-0.102,P＜0.01),LMR (partial regression coefficient =-0.381,P＜0.01) and NMR (partial regression coefficient =0.489,P＜0.01) were the independent influencing factors of coronary slow flow.Conclusion:Total bile acids,LMR and NMR were the influencing factors of coronary slow flow in relevant patients.

硫氧还蛋白(Trx)系统是体内重要的巯基氧化还原系统,能够阻止炎症反应的发生,并维持细胞氧化还原的动态平衡.硫氧还蛋白系统主要由Trx、Trx还原酶、烟酰胺腺嘌呤二核苷磷酸(NADPH)氧化酶以及Trx相互作用蛋白组成.Trx作为Trx系统中的组分,具有抗氧化应激和抗炎作用,作为抗炎因子Trx在动脉粥样硬化性心血管疾病中发挥了重要作用.

OBJECTIVE:To examine the expression of calreticulin (CRT) and the changes of intracellular free calcium and neuronal apoptosis in the cerebral cortex of neonatal rats with hypoxic-ischemic brain damage (HIBD), and to investigate the intervention effects of Shenfu injection.METHODS:Seven-day-old rats were randomly assigned to three groups: control, hypoxic-ischemia (HI) and Shenfu-treated. Each group (n=50) was subdivided into 5 groups sacrificed at 3, 6, 12, 24 and 72 hours. Rat models of HIBD were prepared according to the Rice's method. Rats in the control group only underwent the separation of right common carotidartery. Shenfu injection was administered by intraperitoneal injections right after HI insults and then once daily at a dosage of 10 mL/kg for 3 days in the Shenfu-treated group. The expression of CRT in the cerebral cortex was detected by RT-PCR and Western blot. The free calcium concentrations were determined under a fluorescent microscope. The apoptosis rate was measured by the flow cytometry.RESULTS:Compared with the control group, the expression levels of CRT in the HI and the Shenfu-treated groups were obviously up-regulated (P<0.05), and the expression levels of CRT in the Shenfu-treated group were notably higher than those in the HI group (P<0.05) at all time points. The concentrations of intracellular free calcium and the apoptosis rate of neurons in the cerebral cortex in the Shenfu-treated group were significantly reduced compared with those in the HI group (P<0.05), but increased significantly compared with those in the control group at all time points (P<0.05).CONCLUSIONS:Shenfu injection may have neuroprotective effects against HIBD by up-regulation of CRT expression and relief of calcium overload.