Jianpi Qutan Fang induces anti-atherosclerosis and ameliorates endothelial cell injury in high-fat diet ratsan anti-inflammatory and inhibiting Janus kinase/signal transducer and activator of transcription signaling pathway.

OBJECTIVE: To investiage the possible mechanism underlying the effect of the Jianpi Qutan Fang (, JPQT) on Atherosclerosis (AS) which is the main pathological process of most cardiovascular diseases that affect millions of adults worldwide. METHODS: In the present study, rats were fed with a high-fat-diet (HFD) with vitamin D3 for 16 weeks and were orally administered atorvastatin treatment and different doses of JPQT. Histopathological changes and ultrastructural changes in the aorta were evaluated through hematoxylin-eosin staining and transmission electron microscopy (TEM), respectively. Suppressor of cytokine signaling 1 (SOCS1)/Janus kinase 1 (JAK1)/ signal transducer and activator of transcription 1 (STAT1) signaling pathways were detected through Western blotting. RESULTS: JPQT treatment decreased the lipid levels of triglyceride, low-density lipoprotein, and cholesterol, the inflammatory cytokine levels of interleukin 1 beta (IL-1ß), IL-6 and IL-8 in rat serum, but increased high-density lipoprotein and IL-10 serum levels. JPQT treatment ameliorated pathological changes in the aorta of AS model rats. Moreover, JPQT upregulated SOCS1 protein expression and down-regulated phosphorylated protein expression levels of p-JAK1 and p-STAT1. CONCLUSION: These results suggest that JPQT induces anti-atherosclerosis effects through anti-inflammatory and inhibiting JAK/STAT signaling pathways in HFD fed rats.

Experience in managing an urban massive burn incident: The Hangzhou bus attack on 5 July 2014.

BACKGROUND: On 5 July 2014, a suicide terrorist set a crowded bus on fire in Hangzhou, injuring 33 passengers. Among these, 19 adult victims with the most severe burns were triaged to our center. This is a single-center, descriptive study recording the prehospital response and in-hospital treatment of these patients. METHODS: Information on the attack, on-scene rescue, and patient triage was collected from public media, governmental, and hospital reports. Information on patient injury and our in-hospital procedures was collected from the emergency registry and patient records. RESULTS: Of the 80 passengers in the burning bus, 33 were injured. The total burn surface area (TBSA) of the 19 most severely injured patients triaged to our hospital ranged from 25% to 95% (mean 48.3 ± 2.08%). Two patients had a TBSA of >90% (92% and 95%) and eight had a TBSA of >60%. Nineteen cases of inhalation injury were diagnosed, eight of which were severe. The emergency center performed 14 bedside escharotomies, 14 central venous catheter (CVC) implantations, and one cardiopulmonary resuscitation (CPR). Approximately 131000 ml of resuscitation fluid was infused within the first 24h and 111000 ml within the second; further, 160230 ml of plasma and 4100 ml of red blood cells were infused during the antishock stage. All victims were transported to the burn ward to receive burn-centered multidisciplinary care. The respiratory team conducted 121 bronchoscopies. A total of 89 operations were performed, and the residual wound area decreased dramatically. After 124 days of extensive therapy, complete wound healing was observed and all patients entered the rehabilitation stage. CONCLUSION: Adequate preparation, including planning and disaster drills, is crucial for handling mass casualty events. Efficient and precise first rescue and triage can reduce prehospital mortality, and burn-centered multidisciplinary care and hospital-government cooperation helps reduce in-hospital mortality. Nevertheless, lessons can be drawn from this incident to be better prepared for future disasters.

Classification of collateral blood compensation pathways in patients with common carotid artery occlusive disease / 中华神经医学杂志

Objective To explore the classification of collateral blood compensation pathways and collateral blood compensation characteristics in patients with common carotid artery occlusive disease.Methods The hemodynamie and imaging data of 20 patients with common carotid artery occlusive disease,admitted to our hospital from May 2016 to September 2018,were collected.The patients were classified according to whether they had internal carotid artery stealing and collateral circulation compensating for collateral flow.Results Internal carotid artery hematoma was found in 11 of the 20 patients;there was collateral circulation in 17 patients,including 10 branches of the anterior communicating artery,9 branches of the posterior communicating artery,11 branches of the posterior cerebral artery-middle cerebral arterial pia anastomosis,and 8 branches of the ocular artery.There were three types of collateral blood compensation pathways to be discovered in the 20 patients with common carotid artery occlusive disease;type Ⅰ (n=3) was the collateral blood compensation pathway with simple internal carotid artery stealing,type Ⅱ (n=8) was the collateral blood compensation pathway with internal carotid artery stealing and collateral circulation,and type Ⅲ (n=9) was the collateral blood compensation pathways with simple collateral circulation.Conclusion In some patients with common carotid artery occlusion,the internal carotid artery stealing route exists in the collateral flow compensation.

Association between brachial-ankle index and severe subclavian artery stenosis / 中华老年心脑血管病杂志

Objective To study the association between brachial-ankle index (BAI) and severe subclavian artery stenosis.Methods Seventy severe subclavian artery stenosis patients with a stenosis rate ≥70％ admitted to our hospital served as a stenosis group and 70 subclavian artery stenosis-free patients served as a control group in this study.Their BAI,pulse wave upstroke time (UT) and pulse wave form were recorded with a noninvasive automatic peripheral arterial device.The sensitivity,specificity,accuracy,positive and negative prediction value of BAI in diagnosis of subclavian artery stenosis were calculated.Results The BAI of stenosis-involved extrmities was significantly lower while the pulse wave UT was significantly longer in stenosis group than in control group (0.6±0.1 vs 0.9±0.1 and 0.9±0.1,261.0±11.8 vs 188.0±12.1 ms and 186.0±12.6 ms,P＜0.01).The low obtuse pulse wave form and low plain pulse wave form were detected respectively in stenosis involved extrmities of 58 patients (82.9％) and 11 patients (15.7％) of stenosis group.The sensitivity,specifity,accuracy,positive and negative prediction value of BAI in diagnosis of severe subclavian artery stenosis were 44.3％,92.9％,68.6％,86.1％ and 62.5％ respectively.Conclusion The specifity,positive prediction value and accuracy of BAI＜ 0.70 are rather high in diagnosis of severe subclavian artery stenosis.

Developmental Exposure to Di-(2-ethylhexyl) Phthalate Induces Cerebellar Granule Cell Apoptosis via the PI3K/AKT Signaling Pathway

Di-(2-ethylhexyl) phthalate (DEHP) is an ubiquitous environmental contaminant because of its extensive use in plastics and its persistence. As an environmental endocrine disruptor, it is suspected to interfere with neurodevelopment in people. However, evidence of the effects of maternal DEHP exposure on cerebellar development in offspring is scarce. The objective of this study was to investigate maternal exposure to DEHP and its effect on apoptosis of cerebellar granule cells (CGCs) and related mechanisms. Pregnant Wistar rats were administrated DEHP (0, 30, 300 and 750 mg/kg/d) by gavage from gestational day (GD) 0 to postnatal day (PN) 21. Primary CGCs were also exposed to mono-(2-ethylhexyl) phthalate (MEHP), the main metabolite of DEHP, for 24 h with concentrations of 0, 25, 100 and 250 µM. The CGCs of male offspring from 300 and 750 mg/kg/d DEHP exposure groups showed significantly increased apoptosis. In addition, the PI3K/AKT signaling pathway was inhibited in the male offspring of the 300 and 750 mg/kg/d DEHP exposure groups. However, effects on female pups were not obvious. Apoptosis was also elevated and the PI3K/AKT signaling pathway was inhibited after primary CGCs were exposed to MEHP. Furthermore, apoptosis was reduced after treatment with the PI3K/AKT signaling pathway activator, insulin-like growth factor (IGF) 1, and increased after treatment with LY294002, an inhibitor of the PI3K/AKT signaling pathway. These results suggested that maternal DEHP exposure induced apoptosis in the CGCs of male pups via the PI3K/AKT signaling pathway, and the apoptosis could be rescued by IGF1 and aggravated by LY294002.

Study on the Effects of Exogenous Abscisic Acid on Salt-alkali Tolerance of Scrophularia ningpoensis Seed-lings / 中国药房

OBJECTIVE:To study the effects of exogenous abscisic acid(ABA)on salt-alkali tolerance of Scrophularia ning-poensis seedlings,and to provide theoretic evidence for cultivating S. ningpoensis in salt-alkali soil. METHODS:50 S. ningpoensis seedlings were divided into control group,salt-alkali group(75 mmol/L),salt-alkali(75 mmol/L)+ABA low-concentration,medi-um-concentration and high-concentration groups(10,50,100 μmol/L),with 10 plants in each group. 20 days after transplanting, the plants were sprayed with drugs every 4 days. Growth indexes of the plants(length of stem,fresh weight,dry weight,survival rate),physiological indexes [the contents of chlorophyll,soluble sugar (SS),soluble protein (SP) and free proline (Pro)],the contents of MDA and H2O2,the activities of antioxidase [the activities of SOD,POD,CAT,GR] and the contents of Na+ and K+in stem and root were determined in each group 2 weeks later. RESULTS:Compared with control group,stem height and survival rate of S. ningpoensis seedlings,SP,the contents of Na+ and K+ in the stem,the contents of Na+,CAT and GR in the roots were all decreased significantly in salt-alkali group;while chlorophyll,Pro,MDA and H2O2 contents,the content of K+ in the roots and the activities of SOD and POD were all increased significantly(P<0.05 or P<0.01). Compared with salt-alkali group,stem height of S. ningpoensis seedlings,fresh weight and chlorophyll content were increased significantly in salt-alkali+ABA medium-concentra-tion group,while MDA and the content of Na+ in the stem were decreased significantly;dry weight,the contents of SS and SP, the activities of SOD and CAT were increased significantly in salt-alkali+ABA low-concentration and medium-concentration groups, while the SS content was increased in salt-alkali+ABA high-concentration group;stem height and dry weight were decreased signifi-cantly in salt-alkali+ABA high-concentration group;Pro content of salt-alkali+ABA low-concentration and high-concentration groups were decreased significantly;H2O2,Na+ content in the roots were decreased significantly in salt-alkali+ABA low-concentra-tion,medium-concentration and high-concentration groups;while GR activity,K+ content in the stem and roots were increased sig-nificantly;POD activity were decreased significantly in salt-alkali+ABA medium-concentration and high-concentration groups. CON-CLUSIONS:The addition of a certain concentration of exogenous ABA can effectively increase salt-alkali tolerance of S. ningpoen-sis seedlings and strengthen the ability of the plant adapting to salt-alkali environment.

Killer effect of natural killer cells combined with tamoxifen on breast cancer cells in vitro and its mechanism / 吉林大学学报(医学版)

Objective:To investigate the synergistic killer effect of natural killer cells(NK cells) combined with tamoxifen(TAM) on breast cancer cells(BCC)through the experiment in vitro,and to explore its mechanism.Methods:Three kinds of BCC with different receptor expression levels were selected for the experiment.Blank control group, different concentrations of TAM groups and different time groups were set up.MTT assay was used to detect the inhibitory rates of proliferation of cells,and the final experiment concentration of 5 μmol·L-1 was determined.The cells were divided into natural-release group,largest-release group,TAM group,NK cells group, and combined-experimental group(BCC+NK cells+TAM),and the synergistic killer effect of NK cells combined with TAM in different effector-target ratios were detected with Calcein-AM release assay.In ELISA assay the cells were divided into blank control group (NK cells),NK cells+TAM group, NK cells+BCC group and combined-experimental group,and the levels of IFN-γ and TNF-α in the NK cells in various groups were measured.In flow cytometry detection the cells were divided into blank control group (NK cells),NK cells+TAM group,NK cells+ BCC group, and combined-experimental group,and the expression levels of NKp46,CD158a,CD158b,CD158b2,and CD158e were determined;while the cells were divided into blank control group (BCC),BCC+TAM group,BCC + NK cells group, and combined-experimental group,and the expression levels of the MICA,ULBP1 and ULBP2 were detected.Results: The MTT assay results showed that the inhibitory rates of proliferation of 3 kinds of BCC had obvious time-and concentration-dependence (P<0.05).The Calcein-AM release assay results showed that the killing-rates of BCC in TAM groups were increased with the increase effector-target ratios of compared with NK cells group;and the killing-rate in combined experimental group was obviously higher than those in NK cells and TAM groups(P<0.05).The ELISA assay results showed that the levels of TNF-α and IFN-γ of NK cells in various experimental groups with BCC or not were increased compared with blank control group(P<0.05 or P<0.01);the levels were significantly increased when combined with TAM (P<0.05).The flow cytometry results showed that the NKp46 expression levels in various experimental groups were elevated compared with blank control group(P<0.05);the expression levels of CD158a, CD158b,CD158b2, and CD158e were significantly decreased(P<0.05);the expression levels MICA,ULBP1, and ULBP2 in BCC were significantly increased (P<0.05).Conclusion:The NK cells combined with TAM has the synergistic killer effect on the BCC in vitro.The synergetic mechanism may be as follows: TAM could increase the secretion of TNF-α and IFN-γ of NK cells to enhance their cytotoxicity;TAM also could up-regulate the expression levels of activating receptors and activating ligands,and down-regulate the expression levels of inhibitory receptors to increase the killing ability of NK cells.

The correlation between serum bilirubinlevels and instent-restenosis for coronary heart disease: an angiographic study / 中华急诊医学杂志

Objective To study the correlation between serum bilirubin and restenosis after stent implantation of coronary heart disease (CHD).Methods Two hundred and fourtynine patients with CHD were divided into Instent-restenosis (ISR) of CHD group and non-ISR of CHD group according to their angiography findings.Theirserum bilirubin levels were compared and correlation between serum bilirubin level and ISR of CHD was studied.Results The serum bilirubin level was significantlylower in ISRof CHD group than in non-ISR group (P ＜ 0.05),in TBIL (9.9322 ± 3.8748μmol/L) to (12.08 ±4.6679μmol/L)、DBIL (3.1744 ± 1.60μmol/L) to (3.8949 ± 1.825μmol/L)、IBIL (6.757 ±2.822μmol/L) to (8.174 ± 3.388μmol/L).Conclusions The serum bilirubinlevel is lower in CHD patients with ISR than in CHD patients with non-ISR,which is an indepent risk factor for ISR of CHD.

Study on Resistance Physiological Responses of Seedling of Scrophularia ningpoensis to Saline-alkali Stress / 中国药房

OBJECTIVE:To study the resistance physiological responses of seedling of Scrophularia ningpoensis to the stress caused by saline and alkali at different concentrations. METHODS:The seedling of S. ningpoensis was placed in the illumination in-cubator,in which the temperature was maintained at(20±2)℃,light-dark cycle at 13 h/11 h and illumination intensity at 2 000 lx. The alkali (NaHCO3) of 50,100,150,200 and 250 mmol/L and the saline (NaCl) of 50,100,150,200 and 250 mmol/L were poured once every 4 days for 16 consecutive days. The growth indexes(plant height,fresh weight,dry weight),chlorophyll (Chl) content,antioxidative indexes [superoxide dismutase (SOD),catalase (CAT),peroxidase (POD),hydrogen peroxide (H2O2),malonaldehyde (MDA),membrane penetration (RMP)],and osmotic regulation physiological indexes [soluble sugar (SS),soluble protein(SP)and proline(Pro)] of the seedling were determined. There set a blank control group(distilled water). RESULTS:For saline concentration higher than 50 mmol/L and alkali concentration higher than 150 mmol/L,the seedling height, fresh weight and Chl content were lower;for saline concentration higher than 100 mmol/L and alkali concentration higher than 150 mmol/L,the dry weight of the seedling was lower. For saline concentration of 50 mmol/L and alkali concentration of 150 mmol/L, the activities of SOD and POD were the strongest;for saline concentration of 150 mmol/L and alkali concentration of 50 mmol/L, the activity of CAT was the strongest. The contents of H2O2 and MDA increased and the content of SP decreased with the increase in saline-alkali concentration. The level of RMP increased therewith,that is to say,membrane stability decreased. For saline concen-tration higher than 100 mmol/L and alkali concentration higher than 150 mmol/L,the accumulation of SS terminated;for saline and alkali concentrations higher than 100 mmol/L,the accumulation of Pro terminated,however,the content of Pro was markedly high-er in the above-said alkali concentration than in that saline concentration. CONCLUSIONS:Saline-alkali stress causes the tissues of S. ningpoensis to produce active oxygen and its cytoplasmic membrane system to be damaged. Chl,enzymatic antioxidants such as SOD,CAT and POD,and osmoprotectants such as Pro and SS can buffer saline-alkali stress to some degree. The maximum concen-trations of NaCl and NaHCO3 that seedling of S. ningpoensis can tolerate are 50 mmol/L and 150 mmol/L respectively.

Research and development of rotatable scalp acupuncture / 医疗卫生装备

Objective To develop a rotatable scalp acupuncture to enhance success rate of arteriovenous puncture during hospital treatment, field firstaid and evacuation.Methods The acupuncture was composed of a pinhead, a neilsbed, wings and a soft tube. The wings connected with each other to form a hole to hold the intermediate section of the neilsbed rotating in it. There was an index point in the middle of the head of the neilsbed, whose direction corresponded linearly with that of the inclined plane of the pinhead in the vessel.Results Clinical trials proved that the acupuncture could eliminate the failure of puncture due to tremble hands, incoordination of the patient and etc.Conclusion The acupuncture structured well is easy to operate for all conditions, and thus is worth popularizing practically.

White matter microstructure alterations in the patients with generalized anxiety disorder: a diffusion weighted imaging study / 中华行为医学与脑科学杂志

Objective To examine the white matter microstructure alternations in the patients with generalized anxiety disorder (GAD) with diffusion weighted imaging.Methods 19 patients with GAD and 20 matched healthy controls were assessed using apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (eADC) in the regions of interests (ROIs) approach.The ROIs were the white matter of bilateral cingulate and bilateral hippocampus.Results Significantly increased ADC values were found in GAD patients (0.78±0.02,0.79±0.03) with respect to normal controls in the right and left anterior cingulate white matter.Significantly decreased eADC values were found in GAD patients (0.46±0.01,0.45±0.01) in the right and left anterior cingulate white matter.Conclusion Diffuse cingulate white matter alterations on DWI in GAD denote the disruption of white matter integrity.

Cerebral circulation characteristics of patients with persistent trigeminal artery combined with cerebrovascular diseases and their clinical relevance / 中华神经医学杂志

Objective To explore the cerebral circulation characteristics of patients with persistent trigeminal artery (PTA) combined with cerebrovascular diseases and their clinical relevance.Methods Eight patients with PTA,admitted our hospital from March 2010 to March 2013 and conformed by DSA,MR radiography (MRA) or CT angiography (CTA),were chosen in our study; their cerebral circulation features and clinical manifestations were retrospectively analyzed.Results In these eight patients,two were combined with cerebral infarction,one with cerebral artery stenosis,two with cerebral infarction and cerebral artery stenosis,one with transient ischemic attack,and the left two with cerebral aneurysm.Four patients complained for paroxysmal dizziness (one of them with one-side weakness),two patients complained for numbness of a limb,One patient had headache and blepharoptosis and one patient had diplopia.Saltzman type Ⅰ was noted in six patients,type H in one and special type in one.The pathogenesis of cerebral infarction was related to PTA.Conclusion The clinical features of the patients with PTA often determine by merger cerebrovascular diseases; PTA can change the normal cerebral circulation; PTA detection can be helpful in the diagnosis of the pathogenesis of multiple cerebral infarction.

Safety and efficacy of a novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent for the treatment of de novo coronary lesions: 12-month results from the TARGET II trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In the TARGET I randomized controlled trial, the novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent FIREHAWK proved non-inferior to the everolimus-eluting stent in nine-month in-stent late loss in single de novo coronary lesions. This study was aimed at evaluating clinical safety and effectiveness of FIREHAWK in a moderately complex population (including patients with small vessels, long lesions and multi-vessels), and at validating the ability of the SYNTAX score (SS) to predict clinical outcomes in patients treated with this latest generation drug-eluting stent.</p><p><b>METHODS</b>TARGET II was a prospective, multicenter, single-arm study with primary outcome of 12-month target lesion failure (TLF), including cardiac death, target vessel myocardial infarction (TV-MI) and ischemia-driven target lesion revascularization (TLR). Stent thrombosis was defined according to the Academic Research Consortium (ARC) definition. Patients were grouped by tertiles of SS (≤6, >6 to ≤12, and >12). All patients were exclusively treated with the FIREHAWK stent and were followed up at 1, 6, and 12 months, and annually thereafter up to five years.</p><p><b>RESULTS</b>A total of 730 patients were included in this registry study. The 12-month incidence of TLF was 4.4% and the incidence of TLF components were, cardiac death 0.5%, TV-MI 3.2%, and TLR 2.2%. One definite/probable stent thrombosis was observed at 12-month follow-up. Mean SS was 10.87±6.87. Patients in the SS >12 tertile had significantly higher TLF (P = 0.02) and TLR (P < 0.01) rates than those in lower SS groups. In COX proportional-hazards regression analyses, TLF incidence was strongly related to lesion length (long lesion vs. non-long lesion patients; HR 3.416, 95% CI, 1.622-7.195), but unrelated to diabetic, small vessel, and multivessel subgroups.</p><p><b>CONCLUSIONS</b>The low TLF incidence in this study indicates that FIREHAWK is safe and effective in the treatment of moderately complex coronary disease. SS is also able to predict adverse clinical outcomes in FIREHAWK treated patients.</p>

A 1H-magnetic resonance spectroscopy imaging study on frontal gyrus, anterior cingulate cortex and hippocampus of patients with generalized anxiety disorder / 中华行为医学与脑科学杂志

Objective To study the feature of brain functional in front gyrus,anterior cingulate cortex and hippocampus of patients with generalized anxiety disorder (GAD).Methods 19 patients with GAD and 20 healthy volunteers were scanned on brain using proton magnetic resonance spectroscopic imaging (1H-MRS).The levels of Choline (Cho),Creatine (Cr),N-acetyl-aspartate (NAA) were measured in the frontal gyrus,anterior cingulate cortex and hippocampus of all subjects.The 1H-MRS data were compared between two groups.Results Compared with the healthy matched control,the levels of Cho (7.22 ± 1.99),Cr (5.44 ± 1.68),NAA (12.09 ±2.30)in right frontal gyrus white matter,the levels of Cho(9.89 ±2.40),Cr(8.59 ± 1.71) in right anterior cingulate cortex and the levels of NAA in left anterior cingulate cortex were significantly high (P ＜ 0.05).The ratio of NAA/Cr and Cho/Cr were not difference in two groups.In the hippocampus of the patients,the Cho,Cr,NAA,NAA/Cr and Cho/Cr ratio were not significantly higher or lower than those in control (P ＞ 0.05).Conclusion The brain substance metabolisms of the patients with GAD are abnormal and asymmetrical between left and right brain,especially occurred in right brain.

The influences upon the passive tensile of the masticatory muscles and ligaments by twin-block appliance under various bite reconstruction / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the regularity of the passive tensile of the masticatory muscles and ligaments by Twin-Block appliance under various bite reconstruction, and to provide some biomechanical references for the clinical use and improvement of Twin-Block appliance.</p><p><b>METHODS</b>"Temporomandibular joint, mandible and Twin-Block appliance" model was set up by the three dimensional finite element method, and the related masticatory muscles and ligaments were added on it. Seven experimental groups were designed according to the clinical and research, the occlusal inclined plate's angles of Twin-Block appliance were 40 degrees, 45 degrees, 50 degrees, 55 degrees, 60 degrees, 65 degrees and 70 degrees. The passive tensile in the masticatory muscles and ligaments were analyzed by the computer.</p><p><b>RESULTS</b>Under various experimental groups, the passive tensile in the anterior deep masseter (AM), the posterior deep masseter (PM), the anterior temporalis (AT), the posterior temporalis (PT), the stylomandibular ligament and sphenomandibular ligament improved with the increased slant angles of occlusal guide. The maximum value of the passive tensile was 82.57 N, the minimum value was 0.07 N.</p><p><b>CONCLUSION</b>1) In various experimental groups, AT, AM, PM, PT, stylomandibular ligament and sphenomandibular ligament are subject to passive tension force in the process of Twin-Block appliance guiding the mandibular forward and play the important role on the remodeling of the mandible. 2)All groups of occlusal inclined plate's angle are in physiologically tolerable range and can be used in clinic.</p>

The efficacy of endovascular interventional in severe stenosis of bilateral renal stenosis / 中华急诊医学杂志

Objective To analyze the clinical effect of intravascular intervention for treating the severe stenosis of bilateral renal arteries (BRASS).Methods A total of 40 patients with BRASS admitted in Fuwai Hospital from September 2008 to December 2010 were retrospectively analyzed.These patients,23 males and 17 females,aged from 21 to 76 years with average age of (59.75 ± 17.59) years,with luminal narrowing over 70％ in bilateral renal arteries,met the criteria of BRASS evidenced by angiography of renal arteries,and were subjected to renal artery interventional therapy. The etiological factors included arteriosclerosis (34 cases),Takayasu arteritis (3 cases) and congenital fibromuscular dysplasia (3 cases).After percutaneous endovascular intervention,the therapeutic effects were evaluated by lowering the systemic blood pressure and serum creatinine level in 12-month follow-up in average after operation. The data were analyzed with SPSS 13.0 statistical software.ResultsAmong the 80 reual arteries in 40 patients,18 arteries were treated with percutaneous transluminal balloon angioplasty (PTBA),while the other 62 arteries were treated with percutaneous transluminal renal artery stenting (PTRAS).Mter endovascular intervention,the mean systolic blood pressure decreased from ( 165.0 ± 27.0) mm Hg to ( 135.7 ± 25.3 ) mm Hg on the second day after operation ( P ＜ 0.01 ) ; and the mean diastolic blood pressure decreased from ( 88.9 ±15.1 ) mm Hg to (74.8 ± 13.2) mm Hg on the second day after operation ( P ＜ 0.01 ).Accordingly,the kinds of anti-hypertension drug used decreased from ( 3.1 ± 0.9 ) to ( 2.3 ± 1.2) ( P ＜ 0.01 ).Only one patient died suddenly 3 months after intervention,and one died of acute myocardial infarction 7 months after operation.The other 38 patients were followed up for 12 months.At last,the mean systolic blood pressure of patients decreased from ( 165.0 ±27.0) mm Hg to ( 133.53 ± 15.94) mm Hg and the mean diastolic blood pressure decreased from (88.9 ± 15.1 ) mm Hg to (77.37 ± 13.47 )mm Hg. Of all 38 patients,2 were cured (5.3％),27 were improved (71.1％) and 9 failed to treatment (23.7％).Of all 38 patients,76.4％ got hypertension lowered.Moreover,renal function (Scr) was improved in 2 patients (6.3％ ),steady in 21 patients ( 65.6％ ),declined in 9 patients ( 28.1％ ) resulted in azotemia stage.Of 38 patients,71.9％ patients got overall benefit from endovascular intervention in respect of renal function improved.Conclusions The procedure of PTBA or PTRAS offered a minimally invasive,relatively safe and effective technique for BRASS patients to decrease blood pressure and stabilize renal function.

The protective effect of bone marrow mesenchymal stem cells by anoxic preconditioning on diabetic cardiomyopathy / 中华急诊医学杂志

Objective To explore the protective effect of bone marrow mesenchymal stem cells (MSC) on diabetic myocardium and anoxic pre-conditioning (AP).Methods Eight-week-- old male Sprague-Dawley rats were given with a single intraperitoneal injection of streptozotocin (STZ) (60 mg/kg)to induce diabetes mellitus (DM).Donor rats were 8-week-old male Sprague - Dawley rats.Before transplantation,MSC were incubated in CM-DiI at a concentration of 2 μg/mL for 20 min.AP-MSC were exposed to 3 hours of anoxia.At 4 months after STZ injection,diabetic rats were randomly given with an intramyocardial injection of one of the followings:150 μL of Dulbecco's modified Eagle's medium ( DMEM),5 ×106 MSC/150 μL,or 5 × 106 AP - MSC/150 μL (n =10 for each group).Three months after STZ injection and 2 weeks after transplantation,we evaluated the cardiac function by echocardiography,and also evaluated the cardiac conditions by alkaline phosphatase staining,western blot analysis for apoptosis related proteins and signal pathways.Results MSC,especially AP- MSC increased fractional shortening (FS) of diabetic heart (P ＜0.01 vs DMEM respectively).AP-MSC greatly increased the capillary density of diabetic myocardium (P ＜0.01 vs DMEM and MSC group respectively).AP-MSC are anti-apoptotic in the rat DCM model,possibly mediated through cardiac upregulation of Bcl-2/Bax ratio ( P ＜ 0.05 ) and inhibiting the expression and activation of caspase - 3 ( P ＜ 0.01 ).Conclusions Intramyocardial transplantation of APMSC has a protective effect on diabetic cardiomyopathy.

Practice and reflection on the international remote pathology consultation / 中华医院管理杂志

Justified the necessity of remote pathology consultation in China, and described the basic approach of such consultation in terms of the conditions, organizational framework, specialists and consultation process of the hospital. on the basis of benefit in pationts, the consultation helps the development of the pathology department and other specialist departments at the same time, builds initially a pathology quality control system, and accelerates the multi-discipline diagnosis and treatment approach. Expect to encourage contemplation on international remote pathology consultation in an effort to improve such a practice for the benefit of patients.

Association between haptoglobin polymorphism and acute coronary syndrome in Chinese / 中华急诊医学杂志

Objective To assess the association of Haptoglobin(Hp) polymorphism with acute coronary syndrome(ACS) in Chinese. Method A total of 112 patients with ACS including 57 patients with acute myocardial infarction and 55 patients with unstable angina pectoris confirmed with angiography and 121healthy controls were recruited in this study. Polymerase chain reaction (PCR) method was utilized to genotype Hpl and Hp2 alleles and genotype frequencies in cases and controls were compared. All polymorphisms were test of Hardy-Weinberg equilibrium in both groups separately. The differences of genotypes and alleles between two groups were analyzed with x2 test. The association between Hp polymorphism and the risk of ACS was estimated by odds ratio (OR) and their 95% confidence intervals (95% CI), and the comprehensive evaluation of the factors associated with ACS were determined by using multivariate logistic regression analysis. P ＜0.05 was considered to be statistically significant. Results The frequency of Hp2-2 genotype was significantly higher in ACSs than in controls (0. 571 vs. 0. 355, P = 0. 001; OR = 2. 419, 95% CI:1. 427 ～4. 100), multivariate Logistic regression analysis indicates that Hp2-2 genotype is an independent risk factor to ACS (P = 0.002; OR = 2.557,95% CI: 1. 392 - 4.637). Similarly, the Hp2 allele frequency in ACS groups was significantly higher than that in the control subjects (0. 759 vs. 0. 616, P =0.001; OR = 1. 965,95% CI 1. 316 ～2. 934). Conclusion The Hp2-2 genotype is associated with ACS in Chinese. Hp2-2 genotype may be an independent risk factor to ACS, and Hp2 allele may be a genetic susceptibility factor to ACS in Chinese.