Clinical and imaging characteristics of patients with primary cardiac angiosarcoma / 中华心血管病杂志

Objective: To investigate the clinical, cardiac imaging characteristics and prognosis of patients with primary cardiac angiosarcoma. Methods: The clinical data of 14 patients hospitalized with primary cardiac angiosarcoma from January 2001 to December 2017 in Peking Union Medical College Hospital were collected and analyzed. Metastatic cardiac angiosarcoma was not included in this study. Patients were followed up post discharge per telephone call or clinical visit. Results: Of the 14 patients, 8 were males and 6 were females, average age was 48 years. The main clinical symptoms were shortness of breath (8/14), hemoptysis (6/14), fever (5/14), chest pain (4/14) and cough (3/14). Imaging examinations showed that the tumors of 8 patients were located in the right heart and 6 in the pericardial cavity. Tumors in the right heart often infiltrate the atrial wall and cause pericardial effusion (7/8). Tumors in the pericardium were characterized by recurrent bloody pericardial effusion (6/6), prone to progressive constrictive pericarditis (3/6), pericardial fluid cytology was often negative (6/6). MRI showed heterogeneous high signal intensity (cauliflower aspect) on T2-weighted image and heterogeneous enhancement with a"sunray" aspect at the perfusion study. At the time of diagnosis, 8 patients developed lung or adrenal metastasis (8/14). The median survival was only 305 days. Conclusions: Primary cardiac angiosarcoma is a rare disease with non-specific clinical manifestation and poor prognosis. Imaging examinations may help diagnosis. The high invasiveness and the easy-to-metastasis feature of the tumor contribute to the poor prognosis of cardiac angiosarcoma.

Kinesio Taping combined with electroacupuncture for the treatment of patellofemoral disorder in middle-aged and elderly exercise enthusiasts / 中国骨伤

OBJECTIVE@#To observe the clinical efficacy of Kinesio Taping combined with electroacupuncture in the treatment of patellofemoral disorder in middle-aged and elderly exercise enthusiasts.@*METHODS@#From April 2018 to April 2020, 62 middle-aged and elderly exercisers with patellofemoral disorder were selected and divided into observation group and control group. In the observation group, there were 30 cases:12 males and 18 females, aged from 35 to 66 years old, with an average age of (48.32±6.80) years old. The observation group was treated with Kinesio Taping and electroacupuncture . In the control group, there were 32 cases:12 males and 20 females, aged from 35 to 67 years old, with an averageage of (48.67±8.13) years old. The patients in the control group was treated with knee electroacupuncture. All the patients in both groups were treated once every other day, 3 times a week, for a total of 4 weeks. The VAS pain score and knee Lysholm score before and after treatment were compared between the two groups before and after treatment, and statistical analysis was conducted.@*RESULTS@#In the control group, 2 patients were not satisfied with the curative effect after 2 weeks of treatment and gave up treatment, while the remaining 60 patients completed all the treatments. After 4 weeks of treatment, the VAS and Lyshlom scores of the control group were 2.73±1.46 and 75.63±8.62 respectively;the VAS and Lyshlom scores of the observation group were 2.02±1.85 and 83.31±5.53 respectively;the VAS and Lyshlom scores of the observation group and the control group were better than those before treatment, and the Lyshlom scores of the observation group were better than those of the control group.@*CONCLUSION@#Kinesio Taping combined with electroacupuncture is aimed at patellofemoral disorderof middle-aged and elderly sports enthusiasts. It has little trauma, can relieve pain and has a fast onset speed, which is readily accepted by patients, and promotes the rehabilitation of knee joint function of patients, thus providing a favorable reference for the promotion in clinical application.

Zheng's massage combined with electroacupuncture in the treatment of reflex sympathetic dystrophy syndrome of the wrist / 中国骨伤

OBJECTIVE@#To observe the clinical effects of zheng's massage combined with electroacupuncture in the treatment ofreflex sensory dystrophy syndrome of the wrist.@*METHODS@#From October 2016 to September 2018, 48 cases of reflex sensory dystrophy syndrome of the wrist were divided into the observation group and the control group. In the observation group, there were 24 cases, including 10 males and 14 females, ranging in age from 54 to 76 years old, with an average age of (61.41 ±7.90) years old. The patients in the observation group were treated with massage combined with electroacupuncture. The control group consisted of 24 patients, including 9 males and 15 females, ranging in age from 52 to 75 years old, with an averageage of (58.71±8.11 ) years old. The patients in the control group were treated with electroacupuncture alone. All the patients in both groups were treated for 6 weeks. The clinical symptoms and signs, visual anglogue scale (VAS), Cooney wrist score and clinical efficacy evaluation were compared between the two groups before and after treatment, and statistical analysis was conducted.@*RESULTS@#After 6 weeks of treatment, VAS in the control group was 4.9±1.8, and Cooney wrist score was 74.63±1.72; VAS in the observation group was 2.2±1.4, and Cooney wrist score was 86.31±2.53. The comprehensive scores of VAS and Cooney wrist joint between two groups were improved after treatment, and the observation group was better than control group(<0.05). The curative effect of the observation group was better than that of the control group.@*CONCLUSION@#Zheng's massage combined with electroacupuncture has the following advantages in the treatment of reflex sympathetic dystrophy syndrome of the wrist, such as small trauma, patients' willingness promoting functional rehabilitation, which is worthy of clinical promotion.

Treatment of cerebral ischemia by Shuxue Tongmai Capsule combined with bone marrow mesenchymal stem cells transplantation / 医学研究生学报

Objective Transplantation of bone marrow mesenchymal stem cells (BMSCs) has a good prospect of application for cerebral infarction,but the environment and the inflammatory response to ischemia and hypoxia after cerebral infarction are not con-ducive to the survival of transplanted cells. This article investigated the effects of Shuxue Tongmai capsule(SXTM) combined with BM-SCs transplantation on the improvement of cerebral ischemic injury in rats. Methods A model of middle cerebral artery occlusion was es-tablished in Sprague-Dawley(SD) rats using thread method and these 15 SD rats were randomly divided into model group,BMSCs group and combination therapy group (BMSCs transplantation combined with SXTM treatment). At 24h after modeling,rats in combination therapy group were given tail vein injection of 1 mL BMSCs suspension (2× 109 per/L) and gavage administration of SXTM 0. 64 g/kg. Rats in BMSCs group were given tail vein injection of 1 mL BMSCs suspension (2×109 per/L) and gavage administration of equal volume of sa-line. For model group,the rats were given tail vein injection of equal volume of PBS and gavage administration of equal volume of sa-line. Neurologic function was assessed before cell transplantation and at 3,7,14,28 days after cell transplantation to check the injury of neurologic function. At 28 days after transplantion,the rats were decapitated after anesthesia to take brain tissues for immunohisto-chemical detection of vascular endothelial growth factor(VEGF) and brain-derived neurotrophic factor(BDNF) protein expression. Mor-phological changes of the brain tissue and apoptosis in cortical neurons were observed and detected by hematoxylin-eosin staining and TUNEL,respectively. Results At 7,14,28 days after transplantation,the neurological defect score in combination therapy group was significantly lower than those of model group and BMSCs group(P<0.05). In each group,the neurological defect score at 3 days after transplantation was significantly decreased compared with those before transplantation(P<0.05). In the same group,the neurologi-cal defect scores at 14,28 days after transplantation were significantly decreased compared with those at 7 days after transplantation (P<0.05). The neurological defect scores at 14,28 days after transplantation were significantly decreased compared with those at 7 days after transplantation(P<0.05). The neurological defect score at 28 day after transplantation was significantly decreased compared with that at 7 day after transplantation(P<0.05). At 28 day after transplantation,the number of apoptotic cells in combination therapy group (51.40±4.04) was significantly fewer than those of model group (74.80±5.31) and BMSCs group (67.20±4.66) and the num-ber of apoptotic cells in BMSCs group was significantly decreased compared with model group(P<0.05). The results of immunohisto-chemistry showed that the VEGF and BDNF positive cells in the cerebral ischemic region of rats were brownish or sepia in color. Com-pared with model group,the expression levels of VEGF and BDNF protein in BMSCs group and combination therapy group were signifi-cantly increased (P<0.05),and that of combination therapy group was significantly increased compared with BMSCs(P<0.05). Conclusion SXTM combined with BMSCs transplantation can promote neurological recovery from cerebral ischemia by increasing the protein expression of VEGF and BDNF and reducing neuronal apoptosis.

Meta-Analysis of Oral Preparation of Ginkgo Biloba Extract in The Treatment of Mid Cognitive Impairment / 医药导报

Objective To evaluate the efficacy and safety of oral ginkgo biloba extract EGB761 in patients with mild cognitive impairment.Methods They searched PubMed,Embase,the Cochrane Library ,CNKI,Wanfang and VIP databases for randomly controlled trials of oral ginkgo biloba extract for mild cognitive impairment.After assessed the quality of studies included,RevMan5.2 software was used to analyze data.Results Seven studies which including 815 patients were involved by our inclusion criteria.The results of meta-analysis showed,compared with the control group,ginkgo biloba was superior in improving mild cognitive impairment patients' MMSE level[MD=1.81,95%CI(0.02,3.60),P=0.05;MD=1.96,95%CI(1.48,2.43),P<0.000 01;MD=1.79,95%CI(0.99,2.58),P<0.000 1] after treated three months、six months and twelve months.Ginkgo biloba was also superior in improving mild cognitive impaimant patients.CDT level[MD=0.43,95%CI(0.30,0.57),P<0.000 01;MD=0.57,95%CI(0.39,0.75),P<0.000 01] after treated six months and twelve months.The effect of preventing MCI patients into dementia was better than that of the control group[RR=0.27,95%CI(0.06,1.27),P=0.10;RR=0.32,95%CI(0.16,0.63),P=0.001]after treated six months and twelve months.Conclusion Oral preparation of ginkgo biloba extract in the treatment of MCI clinical efficacy and prevention of dementia occurrence rate was better than that of blank control group.

The progress of post-stroke depression treated by TCM treating principle of activating ;blood and removing stasis / 国际中医中药杂志

To review and summazie the literatures of clinical studies using promoting blood circulation to remove blood stasis for the patients with PSD in the past five years. The TCM treating principles of promoting blood and Qi circulation, promoting blood and nourishing blood flow, promoting blood and benefiting Qi, promoting blood and eliminating phlegm have showed their beneficial clinical effect and few adverse reactions. It provided good ideas for the treatment of PSD.

Research progress on acupuncture therapy for mild cognitive impairment / 国际中医中药杂志

By reviewing the research situation of the acupuncture therapy for mild cognitive impairment(MCI) in recent decade,we has analyzed, concluded and reviewed the clinical effect of different acupuncture methods on MCI, in order to provide reference for acupuncture therapy becoming an important invention measure in protecting against dementia.

Effects of Shuxuetongmai Capsule on Expression of p38 MAPK in Rats with Cerebral Ischemia/Reperfusion / 医药导报

Objective To explore the neuroprotection of Shuxuetongmai capsule pretreatment, and the effect on the expression of p38 mitogen-activated protein kinase (p38MAPK) in rats with middle cerebral artery occlusion. Methods Ninety-six male SD rats were divided randomly into sham-operated group,ischemia/reperfusion group (I/R),ischemia preconditioning group (IP),and Shuxuetongmai group(n=24). Each group was further randomly divided into 4 subgroups by 3 h, 6 h, 24 h and 72 h after reperfusion, 6 rats in each subgroup. Sham-operated group was only performed artery separation . The middle cerebral artery occlusion (MCAO) model was set up in I/R rats by Longa method. The IP rats were performed for three minutes on the bilateral carotid artery ligation, and formed MCAO model 24 hours later. The rats in the Shuxuetongmai group were pretreated with Shuxuetongmai capsules for 14 days on gavage before the establishment of MCAO model. The neurological deficits were graded in rats by Zea Longa method. Western Blot was used to determine the protein expression of p38MAPK and P-p38MAPK. Tunel method was applied to detect the apoptosis of neurons and the relationship between expression of p38MAPK, P-p38MAPK and apoptosis of neuron. Results No neurological dysfunction appeared in the sham-operated group at each time points, but not for the other groups, which reached the peak at 24 h. Compared with the I/R group, IP group and Shuxuetongmai group presented the mild neurologic function deficiency at different time points in rats (P0.05). The obvious variation of the value of P-p38MAPK/p38MAPK wasn't detected in sham-operated group at different time points, while obviously presented in I/R group, and the ratios of P-p38MAPK/p38MAPK were increased gradually followed with reperfusion, approaching to the highest level at 24 h. Compared with the I/R group, the P-p38MAPK/p38MAPK declined from 3 h and to the lowest level at 24 h of reperfusion, in both IP and Shuxuetongmai groups(P0. 05). Conclusion Shuxuetongmai capsule pretreatment can induce brain ischemic tolerance, attenuate the apoptosis of neurons in cerebral ischemia reperfusion, and improve neurologic function. The mechanism may be related to the inhibition of p38MAPK phosphorylation.

Research Progress on ERK Signaling Pathway in Brain Ischemic Tolerance Induced by Traditional Chinese Medicine / 世界科学技术-中医药现代化

Brain ischemic tolerance refers to endogenous brain protective mechanism during severe ischemic injury of the body. Ischemia preconditioning is an effective mean to induce brain ischemic tolerance. However, the invasive and ethical limitation made the application of ischemic preconditioning difficult in the clinical practice. Studies found that extracellular signal regulated kinase (ERK) signaling pathway played an important role in the formation of brain ischemic tolerance. Meanwhile, brain ischemic tolerance induced by traditional Chinese medicine (TCM) had its unique advantages. This article reviewed effects of ERK signaling pathway in the inducing of brain ischemic tolerance and TCM intervention in recent years.

Function of JNK Signaling Pathway in Induction of Brain Ischemic Tolerance and Regulation of Shu-Xue Tong-Mai Capsule Pretreatment / 世界科学技术-中医药现代化

This study was aimed to explore the function of c-Jun N-terminal kinase (JNK) signaling pathway in the induction of brain ischemic tolerance, and observe the function of Shu-Xue Tong-Mai (SXTM) capsule pretreatment. Ischemic preconditioning was performed for 3 min on rats to induce cerebral ischemic tolerance. Rat model of cere-bral ischemia reperfusion (the ischemia pretreatment group, I/R group) was established 24 h later. Western blot was used to detect the protein expression of JNK and phosphorylation of c-Jun N-terminal kinase (P-JNK), comparing to the expression with the sham operation group, I/R group and SXTM capsule group. Tunel method was applied to de-tect the apoptosis of neurons. Relationship between expression of JNK, P-JNK and apoptosis of neurons was also studied. The results showed that compared with the model group, expressions of P-JNK in ischemia preconditioning group and SXTM group were declined significantly (P < 0.05); and the apoptosis of neurons quantity was also de-clined (P< 0.05). It was concluded that ischemia preconditioning can decrease the apoptosis of neurons in cerebral ischemia reperfusion, and improve neurologic function. Its mechanism related to the inhibition of JNK signaling path-way. SXTM capsule pretreatment can protect the cerebral by inhibiting the JNK signaling pathway.

Discussion on Theoretical Basis of Jian-Shen Li-Shui Formula / 世界科学技术-中医药现代化

This study was aimed to investigate the theoretical basis of Jian-Shen Li-Shui (JSLS) formula. Knowledge of acute phase of cerebral hemorrhage in ancient Chinese medicine literature, modern pathophysiology theories, experimental researches and clinical results were studied, in order to discuss theoretical basis of JSLS formula. The results showed that JSLS formula embodied basic theories of traditional Chinese medicine (TCM) and experiences of physicians from different generations. It also reflected modern pharmacology research results. It was supported by animal experiments and clinical research results. It was concluded that JSLS formula was in accordance with essence of TCM syndrome differentiation. There were enough evidences for the formation of the formula. It was worthy of further study.

Effects of Different Production Techniques of Shuxue Tongmai Capsules on Mouse Blood Coagulation Function and Thrombosis Formation / 世界科学技术-中医药现代化

This study was aimed to evaluate effects of different production techniques of Shuxue Tongmai (SXTM) capsules for blood coagulation function and thrombosis formation among mice. The observation was made on the clot-ting time, bleeding time and instauration rate of collagen-adrenaline model of mice. The results showed that com-pared with SXTM II and Ⅲ production technique, the SXTM I production technique of the same dosage group can prolong the clotting time of mice significantly (P < 0.05), and increase the instauration rate of collagen-adrenaline model of mice significantly (P< 0.05). There was no significant difference on the bleeding time of mice between the SXTM I production technique of same dosage group and the saline group. It was concluded that the SXTM had an-ticoagulative and antithrombotic effects. And the SXTM I production technique receives better effects.

COLIXA3 gene expression of peripheral blood lymphocyte in patients with endemic fluorosis / 中国地方病学杂志

ObjectiveTo study the relationship between expression of a3 chain of collagen Ⅸ (COLIXA3)mRNA in the population exposed to fluorine and fluorosis,in order to reveal the role of COLIXA3 gene in the pathogenesis of endemic fluorosis.MethodsTwelve cases of mild drinking water-born skeletal fluorosis were selected as case groups in Regiment 123 and 128 of Xinjiang Production and Construction Corps Seven Division,6cases of healthy people living in fluorosis areas for more than 10 years as a internal control group and 6 heathly cases living in non-fluorosis areas for more than 10 years as a external control group.The expression of COLIXA3mRNA of peripheral blood lymphocyte of skeletal fluorosis patients and control groups were determined by using SYBR Green Ⅰ chimeric fluorescent method for real-time quantitative PCR.ResultsThe results of the relative expression of COLIXA3 mRNA of case group,internal control group and external control group were 2.16 ± 0.62,1.06 ± 0.09 and 1.05 ± 0.12,respectively.The COLIXA3 expression in case group was significantly higher than that of the internal control group and the external control group (all P ＜ 0.05),while the difference of COLIXA3expression between the internal control group and the external control group was not significantly different (P ＞0.05).ConclusionsFluorine contributes to the expression of COLIXA3 mRNA in peripheral blood lymphocyte,and the expression is up to 2 times higher than that of the control groups,meaning potential biomarkers.

Detection of fluoride ion concentration in osteoblasts in vitro by nuclear magnetic resonance spectroscopy / 中国地方病学杂志

ObjectiveTo detect the concentration and distribution of fluoride ions in osteoblasts exposed to fluoride in vitro culture,and to provide basic information for studying the effect of fluoride on osteoblast injury.MethodsIn vitro cultured osteoblasts were exposed to 0,5,10,20,40 mg/L fluoride for 3,10,30 d (n =6),respectively.Concentration and distribution of fluoride ions in the cytoplasm and the nucleus of these osteoblasts were determined by nuclear magnetic resonance spectroscopy.Results(①) After cultured for 3 d,fluoride ion content of the bone cytoplasm exposed to different concentrations of fluoride 0,5,10,20,40 mg/L were (0.83 ±0.65),(0.54 ± 0.23),(0.65 ± 0.77),(0.59 ± 0.87),(3.64 ± 1.21 )mg/L,respectively,and the values of exposed to 40 mg/L fluoride group was significantly higher than that of exposed to 0,5 mg/L groups (all P ＜ 0.05).(②)after cultured for 10 d,the composition of the fluoride ion in cytoplasm of exposed to fluoride 10,20,40 mg/L groups were (4.03 ± 1.23),(3.66 ± 0.98),(6.26 ± 2.10)mg/L,respectively,which were higher than that of exposed to 0,5 mg/L groups [(0.78 ± 0.75),(2.69 ± 0.89)mg/L,respectively,all P ＜ 0.05].Of fluoride 20,40 mg/L groups,the composition of the fluoride ion in nucleus were (1.63 ± 1.19),(2.17 ± 1.21 )mg/L,respectively,which were higher than that of 0,5 mg/L groups[(0.65 ± 0.46),(1.57 ± 0.33) mg/L,all P ＜ 0.05].(③)After cultured for 30 d,of the exposed to fluoride 10,20,40 mg/L groups,the composition of the fluoride ion in cytoplasm were (3.99 ± 0.84),(4.33 ± 1.67),(5.80 ± 1.38)mg/L,respectively,which were higher than that of 0,5 mg/L groups[(0.88 ± 0.44),(2.84 ± 0.43)mg/L,all P ＜ 0.05].The composition of the fluoride ion in nucleus of the fluoride 20,40 mg/Lgroups were (3.33 ± 1.46),(3.53 ± 1.22)mg/L,respectively,which were significantly higher than that of 0,5mg/L groups [(0.70 ± 0.66),(1.99 ± 0.76)mg/L,all P ＜ 0.05].ConclusionsWhen osteoblasts are exposed to fluoride environment,fluoride ions enter into the osteoblasts quickly,and quickly accumulate in the nucleus,showing a special affinity between fluoride and bone tissue.Intracellular fluoride ions increase with the increase of contact time and exposure dose.

Morphological changes of bone in the progress of rat chronic fluorosis / 中国地方病学杂志

ObjectiveTo observe the morphological changes of bone in the progress of chronic fluorosis.MethodsWistar rats were randomly divided into three groups,30 rats in each group:normal control group,experimental group Ⅰ and experimental group Ⅱ according to body weight.Rats in normal control group drank distilled water freely.Experimental group Ⅰ and group Ⅱ drunk distilled water with sodium fluoride preparation of fluorine containing ion 100,150 mg/L solution for six months,respectively.Bone mineral density was detected by X-ray,bone morphological changes were observed under light microscope and bone histomorphometric parameters were calculated using image analysis software.ResultsThe bone mineral density values were different statistically between the three groups after feeding for 2 and 4 months(F =19.79,3.28,all P ＜ 0.05).However no significant difference was found after feeding for 6 months(F =1.80,P ＞ 0.05).The bone mineral density of experimental group Ⅰ (0.20 ± 0.03,0.21 ± 0.03) was significantly higher than that of the normal control group(0.17 ± 0.03,0.20 ± 0.04) after feeding for 2 and 4 months.The bone mineral density of experimental group Ⅱ (0.21 ± 0.02) was lower than that of normal control group(0.22 ± 0.03) after feeding for 6 months.The bone lamella in experimental group Ⅰ was arranged disorderly,the number of osteocytes increased with their nucleus atrophy and the osteoblasts were more than that of control grouo which arranged in layers observed under light microscooy.In exoerimental group Ⅱ,the bone lamella was bent deformation,the number of osteocytes had decreased with their nucleus shrinking or even disappeared and the number of osteoclasts had increased significantly observed under light microscopy.In experimental group Ⅰ,the mean trabecular density [(0.33 ± 0.03)％] increased and the mean trabecular separation,thickness [( 163.57 ± 1.99),(59.26 ± 7.18 ) μm] decreased compared with that of normal control group [(0.31 ± 0.02)％,(186.60 ± 2.90)μm,(86.42 ± 1.48)μm,all P ＜ 0.05].In experimental group Ⅱ,the mean trabecular density[(0.26 ± 0.02)％] decreased,the mean trabecular thickness[(71.42 ± 10.77)μm] reduced compared with that of normal control group[(0.31 ± 0.02)％,(86.42 ± 1.48)μm].ConclusionsExcess fluoride can damage bone tissue.Low doses of fluoride can stimulate osteoblast activity and enhance osteogenesis.The activity of osteoblasts is great than that of osteoclasts.High doses of fluoride can stimulate both osteoblasts and osteoclasts activity,but mainly the activity of osteoclasts,and bone resorption increases.

Observation on COLIXA3 polymorphism of patients with fluorosis / 中国地方病学杂志

Objective To study the COLIXA3 gene polymorphism of patients with fluorosis and to explore the pathogenesis of COLIXA3 gene in endemic fluorosis.Methods Fifty one cases of patients with drinking-water borne fluorosis were selected as the case group in Xinzhou city,Shanxi province and 28 cases of healthy people were as the control group.Dental fluorosis was detected by Dean method and skeletal fluorosis was examined by X-ray.COLIXA3 of exon 5 gene product of 103 points was amplified by PCR and the gene locus genotype was sequenced.Results Ten cases of mild dental fluorosis,14 cases of moderate dental fluorosis,15 cases of severe dental fluorosis were detected among the 51 patients.The control group was free of dental fluorosis.All the 51 cases of patients with fluorosis had varying degrees of skeletal fluorosis,mainly osteosclerosis lesions,accounting for 86.27％(44/51 ),and mild skeletal fluorosis patients were all osteosclerosis lesions,and osteosclerosis lesions and multiple skeletal lesions were found among moderate and severe skeletal fluorosis patients in the case group,while control group had no skeletal fluorosis.The differences between genotypes of frequency distribution of AA,Aa,aa of COLIXA3 of case and control groups were not statistically significant [96.08％(49/51 ),3.92％(2/51 ),0.00％(0/51) and 96.43％(27/28),3.57％(1/28),0.00％(0/28),x2 =0.94,P ＞ 0.05].ConclusionsCOLIXA3 gene polymorphism is not significantly correlated to fluorosis.

Infective endocarditis in patients with hypertrophic obstructive cardiomyopathy: five cases report / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics of infective endocarditis in patients with hypertrophic obstructive cardiomyopathy.</p><p><b>METHODS</b>Clinical characteristics from 5 patients with infective endocarditis and hypertrophic obstructive cardiomyopathy hospitalized from January 2000 to December 2010 in our hospital were analyzed.</p><p><b>RESULTS</b>Four patients were diagnosed with left ventricular outflow tract obstructive cardiomyopathy with outflow pressure gradient from 36 to 140 mm Hg (1 mm Hg = 0.133 kPa) and left atrial size 44 - 68 mm. Another patient was diagnosed as ventricular hypertrophic cardiomyopathy with significant right-ventricular outflow tract hypertrophy (30 mm), high pressure gradient (164 mm Hg) and enlarged right atrial (56 mm × 53 mm), there was a 17 mm × 8 mm vegetation on right-ventricular outflow tract in this patient. Blood cultures were positive for streptococcus viridans in all five patients, and enterococcus faecium was revealed in one aortic valve vegetation culture. Transthoracic echocardiogram was performed 2 - 4 times for each patient, the vegetations of two patients was detected only by transesophageal echocardiography. The mitral valve vegetation was detected in two patients, the aortic and mitral valve vegetations were detected in one patients, mitral and tricuspid vegetations in one patient and right ventricular outflow tract vegetation in one patient. The four hemodynamically stable patients were successfully treated with antibiotic therapy, one patient received urgent surgery (replacement of the aortic and mitral valve as well as septal myectomy). All patients recovered and follow-up (1 - 6 years) was available in 4 patients and no complication was observed.</p><p><b>CONCLUSION</b>The risk of infective endocarditis complicating hypertrophic obstructive cardiomyopathy is the highest in patients with both outflow obstruction and marked valve insufficiency, these patients should receive prophylactic antibiotic therapy during procedures that predispose to infective endocarditis.</p>

Hemodynamic parameters obtained by transthoracic echocardiography and right heart catheterization: a comparative study in patients with pulmonary hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hemodynamic evaluation is crucial for the management of patients with pulmonary hypertention. Clinicians often prefer a rapid and non-invasive method. This study aimed to examine the feasibility of transthoracic echocardiography for the measurements of hemodynamic parameters in patients with pulmonary hypertension.</p><p><b>METHODS</b>A prospective single-center study was conducted among 42 patients with pulmonary hypertension caused by different diseases. Transthoracic echocardiography and right-heart catheterization were performed within 24 hours. Pulmonary artery systolic, diastolic and mean pressure (PASP, PADP and PAMP), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP) were measured by both methods. A linear correlation and a Bland-Altman analysis were performed to compare the two groups of hemodynamic parameters.</p><p><b>RESULTS</b>A good correlation was found between invasive and non-invasive measurements for PASP (r = 0.96), PADP (r = 0.85), PAMP (r = 0.88), CO (r = 0.82), and PCWP (r = 0.81). Further agreement analysis done by the Bland-Altman method showed that bias and a 95% confidence interval for PASP, PADP, and CO were clinically acceptable while great discrepancies existed for PAMP and PCWP.</p><p><b>CONCLUSIONS</b>The non-invasive measurements by PASP, PADP, and CO in patients with pulmonary hypertension correlate well with the invasive determinations. Transthoracic echocardiography (TTE) was inappropriate for estimating PCWP and PAMP.</p>

Value of cardiac magnetic resonance imaging for the diagnosis of cardiac amyloidosis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the clinical features and cardiac magnetic resonance imaging (CMR) characteristics of patients with endomyocardial biopsy (EMB)-proven cardiac amyloidosis (CA).</p><p><b>METHODS</b>EMB proven CA patients underwent CMR examination from September 2006 to December 2010 were included. The findings of clinical manifestation, electrocardiogram, echocardiography and CMR were analyzed.</p><p><b>RESULTS</b>Among the 18 patients with EMB verified CA, 5 patients underwent CMR. All 5 patients had heart failure symptoms and electrocardiogram was abnormal. Echocardiogram showed concentric left ventricular hypertrophy, granular appearance of the myocardium, left atrial enlargement and moderate to severe left ventricular diastolic dysfunction. CMR revealed increased thickness of the left ventricular wall (especially at the inter-ventricular septum), enlarged bilateral auricle, restricted left ventricular filling with normal or mild to moderate reduced systolic function. Pleural and pericardial effusions were observed in 2 patients. Abnormal late gadolinium enhancement (LGE) was detected in all 5 patients. CMR revealed different patterns of LGE. Left ventricular global subendocardial delayed gadolinium enhancement or transmural delayed gadolinium enhancement were found, and patients also showed line-, granular- or patchy-like enhancement. The degree and range of LGE paralleled the disease course and were consistent with electrocardiogram changes.</p><p><b>CONCLUSIONS</b>As a noninvasive diagnostic tool, CMR is valuable in the diagnosis of CA. For patients with clinical suspicion of CA, CMR could be a helpful diagnostic tool, especially in the hospitals where EMB is not available.</p>

Effect of fluoride on expression of osteoblast Runx2, and Osterix and COL I A2 / 中国地方病学杂志

Objective To study the effect of fluoride on expression of osteoblast Runx2, Osterix and their downstream COL I A2 in vitro. Methods Human osteoblast Saos-2 was cultured in vitro. The cells were grouped according to fluoride(NaF) dose used: 0(control ), 0.625,1.250,2.500,5.000,10.000,20.000,40.000,80.000,160.000 mg/L. Cells were collected after 24 h culture, RNA extracted, and the mRNA expression of Runx2 and Osterix and downstream genes COL I A2 was detected using fluorescent quantitative reverse transcription polymerase chain reaction [Real-time (RT)-PCR]). Results After 24 h in vitro cell cultivation with NaF, the expression of Runx2 in 0.625,1.250,2.500,5.000,10.000,20.000 mg/L groups(388.00 ± 41.80,209.00 ± 25.80,42.80 ±4.52,63.00 ± 16.10,24.30 ± 4.23,16.20 ± 4.32) was higher than that of the control group( 1.00 ± 0.12, all P ＜0.05). The expression of Runx2 in 40.000,80.000,160.000 mg/L groups(0.40 ± 0.05,1.91 ± 0.28,4.87±1.36)compared with that of control group, the difference was statistically insignificant(all P ＞ 0.05).The expression of Osterix mRNA in 1.250,2.500,5.000 mg/L groups(4.04 ± 1.67,229.00 ± 51.00,46.40 ± 10.60) was higher than that of the control group( 1.00 ± 0.42,all P ＜ 0.05). The expression of Osterix mRNA in 10.000,20.000,40.000,80.000,160.000 mg/L groups(0. 16 ± 0.07,0.13 ± 0.01,1.73 ± 0.54,0.01 ± 0.01, 0.09 ± 0.01) compared with that of control group, the difference was statistically insignificant (all P ＞ 0.05). The expression of COL I A2 mRNA in 0.625,1.250,2.500,5.000,10.000,20.000 mg/L groups (2.27 ± 0.89,8.03 ± 2.31,14.20 ± 2.75,7.66 ± 1.34,8.96 ±2.30) was higher than that of the control group (1.00 ± 0.04, all P ＜ 0.05). The expression of COL I A2 mRNA in 160.000 mg/L(0.54 ± 0.01 ) was lower than that of the control group(P ＜ 0.05). Conclusions Fluoride may affect mRNA expression of Osterix and Runx2 in osteoblast and their expression level is related to fluoride concentration.Runx2 and Osterix can also regulate the expression of COL I A2 mRNA.