Brønsted Acid-Catalyzed Dehydrative Nazarov-type Cyclization of CF3-Substituted 3-Indolylallyl Alcohols: Divergent Synthesis of 1-Trifluoromethylated Cyclopenta[b]indoles.

An expedient and efficient synthetic method for the divergent synthesis of 1-trifluoromethylated cyclopenta[b]indoles that relies on Brønsted acid-catalyzed dehydrative Nazarov-type cyclization of CF3-substituted 3-indolylallyl alcohols is described. Two classes of 1-trifluoromethylated cyclopenta[b]indoles can be easily accessed simply by changing the NH-protecting group of indoles. With arylsulfonyl protected 3-indolylallyl alcohols as starting materials, the reaction provided the arylsulfonyl protected 1-trifluoromethylated cyclopenta[b]indoles in good to excellent yields, whereas pivaloyl (Piv) protected substrates led to the formation of NH-free 1-trifluoromethylated cyclolopenta[b]indoles with another alkenyl isomer. This protocol features tunable chemoselectivity, operational simplicity, excellent functional group compatibility, and mild metal-free conditions.

Compressed sensing MRI reconstruction from 3D multichannel data using GPUs.

PURPOSE: To accelerate iterative reconstructions of compressed sensing (CS) MRI from 3D multichannel data using graphics processing units (GPUs). METHODS: The sparsity of MRI signals and parallel array receivers can reduce the data acquisition requirements. However, iterative CS reconstructions from data acquired using an array system may take a significantly long time, especially for a large number of parallel channels. This paper presents an efficient method for CS-MRI reconstruction from 3D multichannel data using GPUs. In this method, CS reconstructions were simultaneously processed in a channel-by-channel fashion on the GPU, in which the computations of multiple-channel 3D-CS reconstructions are highly parallelized. The final image was then produced by a sum-of-squares method on the central processing unit. Implementation details including algorithm, data/memory management, and parallelization schemes are reported in the paper. RESULTS: Both simulated data and in vivo MRI array data were tested. The results showed that the proposed method can significantly improve the image reconstruction efficiency, typically shortening the runtime by a factor of 30. CONCLUSIONS: Using low-cost GPUs and an efficient algorithm allowed the 3D multislice compressive-sensing reconstruction to be performed in less than 1 s. The rapid reconstructions are expected to help bring high-dimensional, multichannel parallel CS MRI closer to clinical applications. Magn Reson Med 78:2265-2274, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Prognostic value of plasma galectin-3 levels in patients with coronary heart disease and chronic heart failure.

In this study, we evaluated the prognostic value of plasma galectin-3 levels in patients with coronary heart disease (CHD) and chronic heart failure (HF) and selected 261 CHD patients who were consecutively admitted to our hospital. The enrolled chronic HF patients included HF patients with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). Patients without HF served as the control group. Galectin-3 and B-type natriuretic peptide (BNP) levels were determined and the primary endpoint was the composite of all-cause mortality and rehospitalization with 12-month follow-up. Plasma galectin-3 levels were higher in HF patients compared with non-HF patients (P < 0.001). Receiver operating characteristic (ROC) analyses for diagnosis of HF showed that galectin-3 had the greatest area under the curve (AUC) of 0.756 (P < 0.001), with an optimal cutoff of 10.8 ng/mL, yielding a sensitivity of 81.7% and a specificity of 61.7%. Follow-up ROC analyses of galectin-3 for outcome prediction showed an optimal cutoff of 17.8 ng/ mL, yielding a sensitivity of 97.3% and a specificity of 77.6%. Galectin-3 yielded an AUC of 0.899 (P < 0.001), whereas the AUC of BNP was 0.633 (P = 0.022). Galectin-3 led to an AUC of 0.931 (P < 0.001) for HFpEF and an AUC of 0.882 (P < 0.001) for HFrEF. Cox proportional hazards regression analysis revealed that galectin-3 was an independent prognostic predictor for chronic HF, especially for HFpEF patients (RR: 1.231, 95% CI: 1.066-1.442). In summary, plasma galectin-3 levels were increased in CHD HF patients and were an independent predictor of all-cause mortality and rehospitalization. In HFpEF patients galectin-3 levels correlated stronger with outcomes than in HFrEF patients.

Osteosarcoma metastasis: prospective role of ezrin.

Osteosarcoma is the most commonly diagnosed primary malignant bone tumor, with similar global incidence rate across childhood and adolescence. Patients with localized disease have a 5-year survival period of 80 %; however, the prognosis is poor in those with metastatic osteosarcoma. The origin of the primary tumor is most frequently the metaphyseal (actively growing) regions of the distal femur, proximal tibia, and proximal humerus, although the tumor can develop in any bone, and the most likely sites for metastasis are the lungs and bone. Ezrin is a member of the ezrin-radixin-moesin (ERM) family of proteins that functions as a cross-linker between the actin cytoskeleton and the plasma membrane, and ezrin also plays a positive role in maintaining cell shape and polarity and facilitates membrane-trafficking pathways, cell migration, cell signaling, growth regulation, and differentiation. There is strong evidence to suggest that ezrin is necessary for osteosarcoma metastasis. The objective of the current review is to summarize the know-how about metastatic progression in osteosarcoma, with a focus on ezrin. Despite the promise that preliminary studies on ezrin have shown, there is a great need to further analyze the role of ezrin in osteosarcoma metastasis and to determine its usefulness as a biomarker for the disease.

Reflective long-period fiber grating-based sensor with Sagnac fiber loop mirror for simultaneous measurement of refractive index and temperature.

In this paper, we propose a reflective long-period grating-based sensor with a Sagnac fiber loop mirror (SFLM) for simultaneous measurement of refractive index (RI) and temperature. By cascading the SFLM to the end of a long-period fiber grating (LPFG), the LPFG works as a reflection operation, which is convenient in some applications. Further, the SFLM and the LPFG have different sensitivities to RI and temperature. As a result, RI and temperature measurement can be simultaneously achieved by monitoring the wavelength shifts of the LPFG and the SFLM's dips in the reflection spectrum. Experimental results show that the temperature sensitivity can reach 1.533 nm/°C, and the RI sensitivity is from 16.864 nm/RIU (refractive index unit) to 113.142 nm/RIU when the RI range is from 1.333 to 1.430. The application for 40 km long-distance RI and temperature measurement shows that the sensor has potential application in long-distance sensing.

Microfluidics for disease diagnostics based on surface-enhanced raman scattering detection.

This review reports diverse microfluidic systems utilizing surface-enhanced Raman scattering (SERS) detection for disease diagnosis. Integrating SERS detection technology, providing high-sensitivity detection, and microfluidic technology for manipulating small liquid samples in microdevices has expanded the analytical capabilities previously confined to larger settings. This study explores the principles and uses of various SERS-based microfluidic devices developed over the last two decades. Specifically, we investigate the operational principles of documented SERS-based microfluidic devices, including continuous-flow channels, microarray-embedded microfluidic channels, droplet microfluidic channels, digital droplet channels, and gradient microfluidic channels. We also examine their applications in biomedical diagnostics. In conclusion, we summarize the areas requiring further development to translate these SERS-based microfluidic technologies into practical applications in clinical diagnostics.

[New type distributed optical fiber temperature sensor (DTS) based on Raman scattering and its' application].

Basic principles, development trends and applications status of distributed optical fiber Raman temperature sensor (DTS) are introduced. Performance parameters of DTS system include the sensing optical fiber length, temperature measurement uncertainty, spatial resolution and measurement time. These parameters have a certain correlation and it is difficult to improve them at the same time by single technology. So a variety of key techniques such as Raman amplification, pulse coding technique, Raman related dual-wavelength self-correction technique and embedding optical switching technique are researched to improve the performance of the DTS system. A 1 467 nm continuous laser is used as pump laser and the light source of DTS system (1 550 nm pulse laser) is amplified. When the length of sensing optical fiber is 50 km the Raman gain is about 17 dB. Raman gain can partially compensate the transmission loss of optical fiber, so that the sensing length can reach 50 km. In DTS system using pulse coding technique, pulse laser is coded by 211 bits loop encoder and correlation calculation is used to demodulate temperature. The encoded laser signal is related, whereas the noise is not relevant. So that signal-to-noise ratio (SNR) of DTS system can be improved significantly. The experiments are carried out in DTS system with single mode optical fiber and multimode optical fiber respectively. Temperature measurement uncertainty can all reach 1 degrees C. In DTS system using Raman related dual-wavelength self-correction technique, the wavelength difference of the two light sources must be one Raman frequency shift in optical fiber. For example, wavelength of the main laser is 1 550 nm and wavelength of the second laser must be 1 450 nm. Spatial resolution of DTS system is improved to 2 m by using dual-wavelength self-correction technique. Optical switch is embedded in DTS system, so that the temperature measurement channel multiply extended and the total length of the sensing optical fiber effectively extended. Optical fiber sensor network is composed.

Brønsted Acid-Catalyzed Dehydrative Nazarov-Type Cyclization/C2-N1 Cleavage Cascade of Perfluoroalkylated 3-Indolyl(2-benzothienyl)methanols.

A novel and unprecedented p-toluenesulfonic acid-catalyzed dehydrative Nazarov-type cyclization/C2-N1 bond cleavage cascade reaction of perfluoroalkylated 3-indolyl(2-benzothienyl)methanols has been developed. This reaction provides an efficient and practical protocol for the construction of highly functionalized benzothiophene-fused cyclopentenones with exclusive stereoselectivity. In addition, this cascade transformation also delineates a rare example of the involvement of the selective C2-N1 bond cleavage of indoles.

A positive feedback loop between AlkB homolog 5 and miR-193a-3p promotes growth and metastasis in esophageal squamous cell carcinoma.

Esophageal squamous cell carcinoma (ESCC) is one of the most frequent malignancies worldwide. miR-193a-3p acts as an oncogene or tumor suppressor in different cancers. However, the functional role and regulatory mechanism of miR-193a-3p in ESCC remain to be elucidated. Our results demonstrated that miR-193a-3p expression was significantly upregulated and associated with advanced TNM stage, recurrence, and poor prognosis in ESCC patients. miR-193-3p targeted ALKBH5 and suppressed its expression. ALKBH5 inhibited miR-193a-3p expression in turn. ALKBH5 affected the primary miR-193a-3p processing by negatively regulating its m6A modification. These findings suggested a positive feedback regulation between miR-193a-3p and ALKBH5 in ESCC cells. Moreover, the functional assays indicated that the miR-193-3p-ALKBH5 feedback loop promoted the proliferation, migration and invasion ability of ESCC cells in vitro, and facilitated tumor growth and metastasis in vivo. Collectively, our current study identified a novel positive feedback regulation between miR-193a-3p and ALKBH5 in ESCC, which may be helpful to gain insight into ESCC pathogenesis and provide novel therapeutic target for ESCC.

COVID-19 infection in patients with connective tissue disease: A multicity study in Hubei province, China.

Novel Coronavirus disease 2019 (COVID-19) has spread rapidly around the world. Individuals with immune dysregulation and/or on immunosuppressive therapy, such as rheumatic patients, are considered at greater risk for infections. However, the risks of patients with each subcategory of rheumatic diseases have not been reported. Here, we identified 100 rheumatic patients from 18,786 COVID-19 patients hospitalized in 23 centers affiliated to Hubei COVID-19 Rheumatology Alliance between January 1 and April 1, 2020. Demographic information, medical history, length of hospital stay, classification of disease severity, symptoms and signs, laboratory tests, disease outcome, computed tomography, and treatments information were collected. Compared to gout and ankylosing spondylitis (AS) patients, patients with connective tissue disease (CTD) tend to be more severe after COVID-19 infection (p = 0.081). CTD patients also had lower lymphocyte counts, hemoglobin, and platelet counts (p values were 0.033, < 0.001, and 0.071, respectively). Hydroxychloroquine therapy and low- to medium-dose glucocorticoids before COVID-19 diagnosis reduced the progression of COVID-19 to severe/critical conditions (p = 0.001 for hydroxychloroquine; p = 0.006 for glucocorticoids). Our data suggests that COVID-19 in CTD patients may be more severe compared to patients with AS or gout.

Identification of key bacterial populations affecting early embryonic development in cattle uterus.

Superovulation is an important animal breeding biotechnology, while the quality of embryos obtained from superovulation is unstable in cattle. The relationship between the microorganisms in the cattle uterus and embryo qualities was determined to identify the key bacterial populations affecting early embryonic development. A total of 10 Xia Nan cows underwent superovulation, we collected cervical mucus and flush samples to investigated by 16S rDNA sequencing. Results showed that there were abundant microorganisms in cervical mucus, but no obvious relationship with the quality of embryos. The clustering results of flush samples were consistent with the grouping of embryo quality. Proteobacteria accounted for more than 95% of the total bacterial community in group A with the best embryo quality (qualified embryo ratio above 0.8), and as embryo quality decreased, the Proteobacteria proportion also decreased. In contrast to the proportion of Proteobacteria, the proportions of Firmicutes and Bacteroidetes significantly increased as embryo quality decreased. For group C with the worst embryo quality, the proportions of Firmicutes and Bacteroidetes increased to 4.7 times and 12.3 times of group A, respectively. These results showed that the quantities and proportions of Firmicutes and Bacteroidetes may be related to early embryonic development in cattle.

[A multi-centered randomized double-blinded controlled clinical study on efficacy of gulling pa'an capsule in treating Parkinson's disease].

OBJECTIVE: To objectively evaluate the clinical efficacy of Gulling Pa'an Capsule (GPC), a Chinese medicine, in treating Parkinson's disease (PD). METHODS: According to the good clinical practice (GCP) principle, a multi-centered, double-blinded, layered, randomized and grouping-controlled clinical trial was carried out from May 2002 to January 2005 on 242 PD patients. Among them, 53 patients who had never received levodopa were randomized into two groups, 28 in group A treated with GPC, and 25 in group B treated with placebo; patients who had received levodopa were assigned depending on the Hoehn & Yahr (H-Y) grade, to 4 groups, 75 and 19 of grade 1.5 -3 in group C and E, respectively, 79 and 16 of grade 4 in group D and F, respectively, patients in group C and E were treated with GPC and Levodopa, and those in group D and F treated with placebo and Levodopa for control. The treatment course was 12 weeks for all. Changes of unified Parkinson's disease rating scale (UPDRS) II/III scores in comparing with the baseline were assessed. For the groups C, D, E and F, the dosage of levodopa administered was also recorded. Meanwhile, the blood pressure, pulse rate, blood and urine routine, liver and renal functions, electrocardiogram (ECG) and adverse reactions were monitored as the indices for safety supervise. RESULTS: (1) After treatment, symptoms were markedly improved in 1 out of the 28 patients in group A and improved in 11, the markedly improving rate was 3.6% and the improving rate 39.3%; while in group B, the corresponding outcomes were 0 (0/25) and 28.0% (7/25) respectively, showing insignificant difference between the two groups. UPDRS scores, including the total, II and III scores were all significantly lowered in group A after treatment (P < 0.01, P < 0.05); while in group B, significant lowering only showed in terms of UPDRS III (P < 0.05); but the inter-group comparison of the changes in all the three items showed no significant difference. (2) The significant improving rate was 12.0% (9/75) and improving rate 48.0% (36/75) in group C, while those in group D, 12.7% (10/79) and 24.1% (19/79) respectively, the efficacy in group C was better (P < 0.05). The items of 3 UPDRS scores in groups C and D were all significantly lowered after treatment (P < 0.01), and the lowering in group C was more significant in terms of the total and II scores (P < 0.05). (3) The significant improving rate was 5.3% (1/19) and improving rate 36.8% (7/19) in group E, while in group F 0% (0/19) and 25.0% (4/16), respectively, showing insignificant difference between them; UPDRS scores lowered significantly in the two groups after treatment (P < 0.01), also showed no statistical significance in comparison (P > 0.05). (4) The dosage of Levodopa required in groups C and E was significantly reduced after treatment (P < 0.05), while in groups D and F, it was unchanged (P > 0.05); yet, the further analysis displayed that significant reduction only presented in group C (P < 0.05), not in the other three groups. CONCLUSIONS: The overall efficacy of levodopa in combined with GPC for treating PD patients of H-Y grade 1.5 -3 is significantly higher than that of levodopa alone. GPC shows obvious effects in improving patients' motor syndrome and the quality of life; as used in combining with levodopa, the dosage of levodopa required could be reduced.

Surgical significance and efficacy of epidermal growth factor receptor tyrosine kinase inhibitors in patients with primary lung adenosquamous carcinoma.

BACKGROUND: Primary adenosquamous carcinoma (ASC) of the lung is a rare and aggressive disease. The accurate diagnosis of ASC based on small biopsies is challenging because of the mixed components within the tumor, and this may lead to suboptimal treatment. Furthermore, information about the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in lung ASC is limited. PATIENTS AND METHODS: Data on a cohort of patients with lung ASC who underwent surgery between October 2008 and December 2016 at a single institution were retrospectively reviewed. RESULTS: This study analyzed 148 patients. Differences between the pre- and post-resection diagnosis were observed. Based on the results of preoperative biopsy, patients were diagnosed as having squamous cell carcinoma (n=26), adenocarcinoma (n=20), poorly differentiated carcinoma (n=20), and large cell carcinoma (n=1), and finally diagnosed as having ASC based on histopathological examination of the surgical specimens. Thirty patients (20.3%) with EGFR-sensitizing mutations (TKI group) were treated with EGFR-TKIs after surgery, whereas the remaining patients (79.7%) with unknown EGFR-mutation status received chemotherapy or chemoradiotherapy alone (non-TKI group). TKI treatment was associated with better median overall survival (OS) (HR=0.619; p=0.034). Multivariate analysis identified the presence of EGFR-TKI treatment as an independent prognostic factor for OS (HR=0.471; p=0.003). CONCLUSION: Discrepancies between the pre- and post-operative diagnosis reflect the inadequacy of non-resection approaches to the diagnosis of ASC. ASC patients harboring EGFR-sensitizing mutations who were treated with EGFR-TKIs showed a significantly better prognosis than those receiving chemotherapy or chemoradiotherapy alone.

Clinical outcomes of surgically resected combined small cell lung cancer: a two-institutional experience.

BACKGROUND: The combined small cell lung cancer (c-SCLC) was rare and its clinicopathological characteristics had not been thoroughly described. The aim of this study was to determine prognostic factors and survival in c-SCLC patients. METHODS: Clinical records of patients with c-SCLC who underwent surgery between January 2009 and December 2013 in two institutions were retrospectively reviewed. RESULTS: Ninety-seven patients were identified. The most common pathology was combined SCLC and large cell neuroendocrine carcinoma (LCNEC, N=46), followed by combined SCLC and squamous cell carcinoma (SCC) (N=32), combined SCLC and adenocarcinoma (AC) (N=12), and combined SCLC and adenosquamous carcinoma (ASC) (N=7). The overall survival (OS) rates of the entire cohort were 42.4% and 35.2% at 3 and 5 years, respectively. Multivariate analysis identified sex [female vs. male, hazards ratio (HR) =0.38; 95% confidence interval (CI): 0.19-0.79; P=0.010], age (<53 vs. >53 years, HR =0.28; 95% CI: 0.09-0.81; P=0.019), performance status (<2 vs. >2, HR =0.08; 95% CI: 0.02-0.32; P<0.001), combined non-small cell lung cancer (NSCLC) components (LCNEC vs. non-LCNEC, HR =3.00; 95% CI: 1.03-8.76; P=0.045), adjuvant therapy (yes vs. no, HR =0.33; 95% CI: 0.17-0.67; P=0.002) as significantly prognostic factors of OS in patients with complete resection and lymphadenectomy. CONCLUSIONS: The mixed NSCLC components within c-SCLCs had a significant influence on the survival. Compared with surgery alone, adjuvant therapy was associated with significantly improved survival in patients with complete resection and lymphadenectomy.

The prevalence of and risk factors for diabetes mellitus and impaired glucose tolerance among Tibetans in China: a cross-sectional study.

The prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) has increased worldwide, although their prevalence and determinants among Tibetans are currently unknown. We thus aimed to explore the prevalence of and risk factors for DM and IGT among Tibetans in China. In 2011, 1659 Tibetan adults (aged ≥ 18 years) from Changdu, China, were recruited to this cross-sectional study. They completed a questionnaire and underwent physical examinations and laboratory testing to assess risk factors for DM and IGT. The age-standardized prevalence of DM and IGT among Tibetans was 6.2% and 19.7%, respectively. A higher annual family income, alcohol consumption, and higher fasting plasma glucose (FPG) level were risk factors for DM, with odds ratio (ORs) and 95% confidence intervals (CIs) of 3.48 (1.43-8.48; P = 0.006) for those with family incomes of > 1600 USD/year, 3.06 (1.31-7.17; P = 0.010) for alcohol consumption, and 13.99 (7.76-25.22; P < 0.001) for FPG level. However, altitude was found to be negatively associated with the risk of DM; compared to individuals living at < 3500 meters, the risk of DM decreased by 65% for those living at 3500-3999 meters (P = 0.034) and by 89% for those living at ≥ 4000 meters (P = 0.015). Age, FPG levels, and low-density lipoprotein cholesterol levels were significantly associated with IGT among Tibetans aged ≥ 18 years. These findings suggest that the prevalence of DM in Tibetans may continue to increase in future decades following rapid economic development, and it is crucial to address the management of conventional risk factors for reducing the disease burden of DM among Tibetans.

The relationship between S-adenosylhomocysteine and coronary artery lesions: A case control study.

The role of homocysteine (Hcy) in the pathogenesis of coronary artery disease (CAD) is controversial, as decreased Hcy levels have not demonstrated consistent clinical benefits. Recent studies propose that S-adenosylhomocysteine (SAH), and not Hcy, plays a role in cardiovascular disease (CVD). We aimed to assess the relationship between plasma SAH and coronary artery lesions. Participants (n=160; aged 40-80years) with chest pain and suspected CAD underwent coronary angiography (CAG) for assessment of coronary artery stenosis, and were assigned to either the atherosclerosis (AS) or CAD group. Plasma SAH and S-adenosylmethionine (SAM) concentrations were measured and the association between coronary artery lesions and SAH was assessed. SAH levels were significantly higher in the CAD group (23.09±2.4nmol/L) than in the AS group (19.2±1.5nmol/L). While the AS group had higher values for SAM/SAH (5.1±0.7 vs. 4.1±1.1), levels of SAM, Hcy, folate, and vitamin B12 were similar in the two groups. Coronary artery lesions were associated with SAH (ß=11.8 [95% CI: 5.88, 17.7, P<0.05]. Plasma SAH concentrations are independently associated with coronary artery lesions among patients undergoing coronary angiography. Plasma SAH might be a novel biomarker for the early clinical identification of CVD.

Salvianolic Acid B Ameliorates Cerebral Ischemia/Reperfusion Injury Through Inhibiting TLR4/MyD88 Signaling Pathway.

Ischemic stroke can activate multiple transcription factors and cause inflammatory reactions, which involve pattern recognition receptors with immunostimulatory effects. Toll-like receptor 4 (TLR4) is one of the receptors related to innate immunity and several inflammatory reactions. The promising anti- inflammatory activity of salvianolic acid B (SAB) had been previously reported, but its effect on ischemic stroke remains unknown. An oxygen-glucose deprivation and reoxygenation (OGD/R) model in vitro and a middle cerebral artery occlusion (MCAO) model in vivo were used in this paper, and the results showned that SAB remarkably increased the viabilities of PC12 cells and primary cortical neurons after OGD/R injury and notably prevented cerebral ischemia/reperfusion (I/R) injury. SAB also significantly ameliorated NeuN release from primary cortical neurons. Further research indicated that the neuroprotection of SAB was completed through inhibiting the TLR4/MyD88/TRAF6 signaling pathway. The blocking of TLR4 by SAB also restrained NF-kB transcriptional activity and pro-inflammatory cytokine responses (IL-1ß, IL-6, and TNF-α). These findings supply a new insight that will aid in clarifying the effect of SAB against cerebral I/R injury and provide the development of SAB as a potential candidate for treating ischemic stroke.

[Hypotensive action of luohuo capsule and its effect on plasma adrenal medullin and tissue factor pathway inhibitor].

OBJECTIVE: To study the therapeutic effect of Luohuo Capsule (LHC) clinically. METHODS: Clinical trial on 90 patients were carried out adopting randomized, stratified, single-blinded and positive drug controlled method, by divided patients into the treated group (n = 60) and the control group (n = 30). The treated group was treated with LHC, which was mainly consisted of Leech, Radish seed, Water-plantain Tuber, Chuanxiong, etc. The control group was treated with Beijing Hypotensive. No. 0. The therapeutic course was 4 weeks. The diagnosis and efficacy evaluation were in accord with corresponding national standards, using the indexes including safety, clinical symptoms, blood pressure, hemorrheologic parameters, blood lipid, adrenal medullin (AdM) and plasma tissue factor pathway inhibitor (TFPI). RESULTS: The total effective rate of LHC in lowering blood pressure in the treated group and the control group was 85.00% and 86.67% respectively, comparison of them showed no significant difference (P = 0.915). Most of the improvement of clinical symptoms in the treated group were better than those in the control group (P < 0.05 or P < 0.01). LHC could also improve the hemorrheologic status (P < 0.01), alleviate the blood lipids disorder (P < 0.05), and adjust AdM and TFPI (P < 0.05). CONCLUSION: LHC is safe in treating hypertension grade I and II with no adverse reaction.

Dual left anterior descending artery arising from left circumflex artery with an intramyocardial coronary aneurysm.

Dual left anterior descending (LAD) artery is a rare anomaly conventionally classified into 4 types. We present a case of dual LAD artery in which the long LAD artery has arisen from the left circumflex (LCx) artery, a condition not previously included in the 4 defined types. Moreover, the long LAD artery specified here is associated with an intramyocardial coronary aneurysm. To our best knowledge, it is the first time such a coronary artery anomaly has been reported. This case suggests the important role of coronary computed tomography angiography (CTTA) for diagnosis and therapeutic planning for such an anomaly.