Protective effects of modified linggui zhugan decoction combined with short-term very low calorie diets on cardiovascular risk factors in obese patients with impaired glucose tolerance.

OBJECTIVE: To observe the protective effects of modified Linggui Zhugan decoction combined with short-term very low calorie diets (VLCDs) on cardiovascular risk factors in obese patients with impaired glucose tolerance (IGT). METHODS: Eighty-five obese patients with IGT of spleen hypofunction and dampness accumulation type were randomly divided into treated group (n=45)and control group (n=40). The treated group was given Linggui Zhugan decoction combined short-term VLCDs. The control group was given basic weight-reduction treatment. The total course was 6 months. Changes of fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), lipid metabolism, blood pressure, body mass index (BMI) and waist circumference (WC) were observed, and the outcomes were reviewed after the treatment. RESULTS: Compared with the control group, the levels of FPG, 2 hPG, HbA1c, FINS, HOMA-IR decreased significantly (P < 0.05), and the indexes of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI and WC were improved significantly (P < 0.05) in the treated group. The transformation rate of normal glucose tolerance (NGT) was higher in treatment group than control group (P < 0.01). No severe adverse reaction was found in the therapeutic course. CONCLUSION: The modified Linggui Zhugan decoction combined with short-term VLCDs has good protective effects on cardiovascular risk factors as a treatment intervention for IGT with obesity, as it could improve glycometabolism, significantly decrease the levels of blood pressure, blood lipids, BMI, WC and effectively cut-off and reverse the development of diabetes mellitus.

One case of coronary intervention treatment for acute occlusion of the left circumflex artery with rare abnormal origin / 中国介入心脏病学杂志

Abnormal origin of coronary artery is a rare clinical manifestation in cardiovascular disease,among which the abnormal origin of left circumflex artery accounts for 0.022％-0.024％of all coronary angiography patients.Cases of abnormal origin of the left circumflex artery combined with acute occlusion are even rarer.Timely and effective strategies and methods for finding abnormal openings during surgery are crucial for completing interventional treatment.This case reports a rare left circumflex artery anomaly originating from the absence of coronary sinus and acute occlusion of the left circumflex artery leading to myocardial infarction during coronary intervention treatment.The patient experienced sudden chest pain and was admitted to the hospital.The electrocardiogram showed elevated ST segments in the lower and posterior walls.The acute coronary angiography showed only the left main trunk,left anterior descending branch,and right coronary artery(thrombolysis in myocardial infarction blood flow grade Ⅲ),but no left circumflex branch No left circumflex branch was found in the left and right coronary sinuses.Non selective angiography was performed at the root of the ascending aorta,and an abnormal opening of the left circumflex branch was finally discovered in the non coronal sinus.This case discusses common sites of abnormal origin of the left circumflex branch,strategies,methods,and interventional treatments for finding abnormal openings.

In Vitro Plant Regeneration of Zenia Insignis Chun.

Zenia insignis Chun is a large, fast-growing deciduous tree. In this study, we successfully developed a reliable and efficient protocol for the regeneration of fertile plants via callus induction from leaf segments of young Z. insignis seedlings. The best results were obtained with a medium containing 11.00 µM 6-benzyladenine (6-BA), 1.20 µM indole-3-butytric acid (IBA), and 0.45 µM 2,4-dichlorophenoxyacetic acid (2,4-D), which yielded morphogenic callus within 2 weeks at a frequency of 62.23%. We tested the effect of IBA alone and in combination with 6-BA on the bud differentiation response of Z. insignis callus. Shoots differentiated normally when cultured on differentiation medium containing 6.00 µM 6-BA and 1.20 µM IBA. Regenerated buds elongated successfully in medium containing 1.20 µM gibberellic acid (GA3). The elongated shoots were then transferred to Murashige and Skoog basal medium supplemented with various combinations of naphthalene acetic acid (NAA) for root induction; well-developed roots were achieved on MS basal medium supplemented with 0.01 µM NAA at a rooting rate of 89.23%. Rooted plantlets were successfully acclimatised to a greenhouse at a survival rate exceeding 90.00%.

Differential Prognostic Implications of Pre- and Post-Stent Fractional Flow Reserve in Patients Undergoing Percutaneous Coronary Intervention

Background and Objectives@#The influence of pre-intervention coronary physiologic status on outcomes post percutaneous coronary intervention (PCI) is not well known. We sought to investigate the prognostic implications of pre-PCI fractional flow reserve (FFR) combined with post-PCI FFR. @*Methods@#A total of 1,479 PCI patients with pre-and post-PCI FFR data were analyzed. The patients were classified according to the median values of pre-PCI FFR (0.71) and post-PCI FFR (0.88). The primary outcome was target vessel failure (TVF) at 2 years. @*Results@#The risk of TVF was higher in the low pre-PCI FFR group than in the high pre-PCI FFR group (hazard ratio, 1.82; 95% confidence interval, 1.15–2.87; p=0.011). In 4 group comparisons, the cumulative incidences of TVF at 2 years were 3.8%, 4.1%, 4.8%, and 10.2% in the high pre-/high post-, low pre-/high post-, high pre-/low post-, and low pre-/low post-PCI FFR groups, respectively. The risk of TVF was the highest in the low pre-/low post-PCI FFR group among the groups (p values for comparisons 0.05). When the prognostic value of the post-PCI FFR was evaluated according to the pre-PCI FFR, the risk of TVF significantly decreased with an increase in postPCI FFR in the low pre-PCI FFR group, but not in the high pre-PCI FFR group. @*Conclusions@#Pre-PCI FFR was associated with clinical outcomes after PCI, and the prognostic value of post-PCI FFR differed according to the pre-PCI FFR.

Epidemiological characteristics and trend analysis of influenza-like cases in Xuhui District of Shanghai from 2010 to 2019 / 上海预防医学

ObjectiveTo analyze the epidemiological characteristics and incidence trend of influenza-like illness in Xuhui District from 2010 to 2019， in order to understand the patterns of influenza epidemic of Xuhui District，and to provide evidence for the prevention and control of influenza in the future. MethodsSurveillance data of influenza-like illness （ILI） in Xuhui District from 2010 to 2019 were collected from the National Influenza Surveillance System for statistical description and trend analysis. ResultsFrom 2010 to 2019， the overall proportion of influenza-like illness was 0.54%. The annual proportions of ILI were between 0.35%~1.14%．The majority of cases were reported in age group of 25~59， accounted for 54.50% of the total ILI. A total of 9 053 throat swab specimens from ILI patients were collected and tested， from which 2 137 specimens were positive， with a positive rate of 23.61%. The most frequent subtype of influenza virus detected was influenza A virus （accounting for 67.62%）. The proportion of ILI and the positive rate of influenza virus nucleic acid detection reached the peak in summer and winter over time. There was a positive correlation between the proportion of ILI and the positive rate of influenza （r=0.666， P<0.01）. From 2010 to 2019， both ILI% and nucleic acid positive rate of influenza virus showed a downward trend. ConclusionThe incidence of influenza shows a downward trend in Xuhui District， with two peaks in summer and winter. The most susceptible individuals are in 25~59 age group. The dominant strains of influenza virus alternate regularly， influenza A（H3N2） dominate the summer epidemic peak while the epidemic peak in winter is dominated by influenza A（H1N1） and influenza B.

Epidemiological characteristics and trend analysis of influenza-like cases in Xuhui District of Shanghai from 2010 to 2019 / 上海预防医学

ObjectiveTo analyze the epidemiological characteristics and incidence trend of influenza-like illness in Xuhui District from 2010 to 2019， in order to understand the patterns of influenza epidemic of Xuhui District，and to provide evidence for the prevention and control of influenza in the future. MethodsSurveillance data of influenza-like illness （ILI） in Xuhui District from 2010 to 2019 were collected from the National Influenza Surveillance System for statistical description and trend analysis. ResultsFrom 2010 to 2019， the overall proportion of influenza-like illness was 0.54%. The annual proportions of ILI were between 0.35%~1.14%．The majority of cases were reported in age group of 25~59， accounted for 54.50% of the total ILI. A total of 9 053 throat swab specimens from ILI patients were collected and tested， from which 2 137 specimens were positive， with a positive rate of 23.61%. The most frequent subtype of influenza virus detected was influenza A virus （accounting for 67.62%）. The proportion of ILI and the positive rate of influenza virus nucleic acid detection reached the peak in summer and winter over time. There was a positive correlation between the proportion of ILI and the positive rate of influenza （r=0.666， P<0.01）. From 2010 to 2019， both ILI% and nucleic acid positive rate of influenza virus showed a downward trend. ConclusionThe incidence of influenza shows a downward trend in Xuhui District， with two peaks in summer and winter. The most susceptible individuals are in 25~59 age group. The dominant strains of influenza virus alternate regularly， influenza A（H3N2） dominate the summer epidemic peak while the epidemic peak in winter is dominated by influenza A（H1N1） and influenza B.

Long-term outcomes of intravascular ultrasound-guided drug-eluting stent implantation in patients with chronic kidney disease: ULTIMATE CKD subgroup analysis / 中华心血管病杂志

Objective: To explore the long-term effect of intravascular ultrasound (IVUS) guidance on patients with chronic kidney disease (CKD) undergoing drug-eluting stent (DES) implantation. Methods: Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. From August 2014 to May 2017, 1 448 patients with coronary heart disease undergoing DES implantation were selected from 8 domestic centers and randomly divided into two groups in the ratio of 1∶1 (IVUS or coronary angiography guided stent implantation). A total of 1 443 patients with the baseline serum creatine available were enrolled. The patients were divided into CKD group and non CKD group. CKD was defined as the estimated glomerular filtration rate (eGFR) derived from Cockcroft Gault (CG) formula< 60 ml·min-1·1.73 m-2 for at least 3 months. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target vessel myocardial infarction, and clinically-driven target vessel revascularization. Kaplan Meier method was used for survival analysis, and log rank test was used to compare the occurrence of end-point events in each group. Cox proportional hazards model was used to calculate HR and 95%CI, and interaction was tested. Multivariate Cox regression was used to analyze the independent influencing factors of TVF. Results: A total of 1 443 patients with coronary heart disease were enrolled in this study, including 349 (24.2%) patients in CKD group and 1 094 patients in non CKD group. In CKD group, IVUS was used to guide stent implantation in 180 cases and angiography was used in 169 cases; in non CKD group, IVUS was used to guide stent implantation in 543 cases and angiography was used in 551 cases. Three-year clinical follow-up was available in 1 418 patients (98.3%). The incidence of TVF in CKD group was 12.0% (42/349), which was higher than that in non CKD group (7.4% (81/1 094) (P = 0.01). The difference was mainly due to the higher cardiac mortality in CKD group (4.6% (16/349) vs. 1.5% (16/1094), P<0.001). In CKD group, the incidence of TVF in patients who underwent IVUS guided stent implantation was lower than that in angiography guided stent implantation (8.3% (15/180) vs. 16.0% (27/169), P = 0.03). There was no significant difference in the incidence of TVF between IVUS guided stent implantation and angiography guided stent implantation in non CKD group (5.9% (32/543) vs. 8.9% (49/551), P = 0.06), and there was no interaction (P = 0.47). Multivariate Cox regression analysis showed that IVUS guidance (HR = 0.56, 95%CI 0.39-0.81, P = 0.002), CKD (HR = 1.83, 95%CI 1.17-2.87, P = 0.010) and stent length (every 10 mm increase) (HR = 1.11, 95%CI 1.04-1.19, P = 0.002) were independent risk factors for TVF within 3 years after DES implantation. Conclusions: CKD patients undergoing DES implantation are associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in comparison with angiography guidance in patients with CKD.

Expression of Momordica charantia MAP30 and its antitumor effect on bladder cancer cells.

BACKGROUND: Momordica charantia (MC) is an edible medicinal plant that is known for its diversified biological functions. Momordica Antiviral Protein 30kD (MAP30) is a type I single chain ribosome-inactivating protein (RIP) isolated from the mature fruit and seeds of MC. Since MAP30 content in MC is limited, the study aim was to generate the recombinant MAP30 protein using prokaryotic expression system and determine its apoptotic/growth inhibitory effects on bladder cancer 5637 cells. METHODS: MAP30 gene was amplified by PCR from MC genomic DNA and identified by sequencing. The target gene was inserted into pET-28a (+) vector and transformed into E. coli BL21 (DE3) cells. Positive clones were selected by PCR. Recombinant protein was efficiently expressed under induction with 1.0 mM Isopropylthio-ß-D-galactoside (IPTG) at 30° C for 4 hours. Cytotoxicity studies were performed using MTT assay by treating 5637 bladder cancer cells with 100 µg/mL, 200 µg/mL, and 400 µg/mL concentrations of MAP30 for 24 hours and 48 hours, respectively. Flow cytometry was used to measure the apoptosis of MAP30-treatedcells in time course experiments. RESULTS: Full-length MAP30 gene was successfully expressed in Escherichia coli (E. coli) BL21 strain and MAP30 recombinant protein inhibited the growth of bladder cancer 5637 cells at 200 µg/mL and 400 µg/mL concentrations by inducing apoptosis of target cells in a dose- and time-dependent manner. CONCLUSION: It was, therefore, concluded that the MAP30 recombinant protein displayed potent antitumor activity in vitro.

Post-stroke hand spasm treated with penetrating acupuncture combined with kinesiotherapy: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the differences in the clinical effect on post-stroke hand spasm among the combined treatment of penetrating acupuncture and kinesiotherapy, the simple application of penetrating acupuncture and the simple application of kinesiotherapy.@*METHODS@#A total of 105 patients with post-stroke hand spasm were randomized into a penetrating acupuncture group, a kinesiotherapy group and a combined treatment group, 35 cases in each one, of which, 2 cases were dropped out in either the combined treatment group and the penetrating acupuncture group, and 1 case dropped out in the kinesiotherapy group. The routine rehabilitation training, e.g. occupational therapy and Bobath exercise and medication were adopted in all of the three groups. In the penetrating acupuncture group, the penetrating needling technique was exerted from Hegu (LI 4) to Houxi (SI 3) and from Waiguan (TE 5) to Sidu (TE 9) on the affected side. In the kinesiotherapy group, the persistent movement or passive movement was exerted on the wrist joint, the metacarpophalangeal joints and the interphalangeal joints. In the combined treatment group, the penetrating acupuncture (the same as the penetrating acupuncture group) was exerted combined with kinesiotherapy (the same as the kinesiotherapy group). In each group, the treatment was given once a day, 30 min in each time, 6 treatments a week in total, with the interval of 1 day between the courses. The treatment for 2 weeks was as one course and 2 courses were required totally. Before and after treatment, the scores of hand spasm index, hand-wrist motor function and the activity of daily living (ADL) were compared in each group.@*RESULTS@#After treatment, the scores of hand spasm index were reduced as compared with those before treatment in each group (0.05).@*CONCLUSION@#Compared with the simple application of either penetrating acupuncture or kinesiotherapy, the combined treatment of them achieves the significant improvements in hand spasm degree, hand wrist motor function and ADL in patients with stroke.

Influence of PD-L1 gene polymorphism on the survival of colorectal cancer patients undergoing capecitabine-based adjuvant chemotherapy / 医学研究生学报

Objective Programmed death-ligand 1 (PD-L1) is essential in the immune escape of colorectal cancer (CRC) cells. In this study, we investigated the disease-free survival (DFS) and overall survival (OS) of CRC patients receiving capecitabine-based adjuvant chemotherapy after RO resection. Methods This retrospective study included 265 CRC patients treated by RO resection and postoperative capecitabine-based adjuvant chemotherapy in Zhengzhou People′s Hospital between January 1, 2010 and December 12, 2017. We analyzed the clinical data, performed genotyping of the genetic variants and determined the expression of PD-L1 mRNA in the CRC tissue. We also analyzed the correlation between the genetic polymorphisms and other baseline characteristics by chi-square test, the expression of PD-L1 mRNA in different genotypes by non-parametric test, and the prognosis using the Kaplan-Meier method, followed by multivariate Cox regression analysis for adjustment. Results The median DFS and OS of the 265 CRC patients were 4.6 and 6.5 years, respectively. Three single nucleotide polymorphisms of the PD-L1 gene, 901T>C, -1813G>C and -1457T>A, were identified in the NCBI database with the minor allele frequency >10% in the Chinese population, of which, only 901T>C was of clinical significance in the outcome analysis. 901T>C was located in the intron region of the PD-L1 gene, with the genotypes of TT in 185 cases (69.81%), TC in 72 (27.17%) and CC in 8 (3.02%). The minor allele frequency was 0.17 and the distribution frequencies of all the three genotypes conformed to the Hardy-Weinberg equilibrium (P = 0.758). The median DFS was significantly longer in the CRC patients with the TT genotype than in those with the TC or CC genotype (4.8 vs 3.5 years, P = 0.001), and so was the median OS (6.7 vs 4.7 years, P < 0.001). The adjustment of OS by multivariate Cox regression analysis showed that the TC and CC genotypes were an independent factor for OS (OR = 1.89, P = 0.006). The analysis of 89 of the CRC tissue specimens revealed a markedly higher expression of PD-L1 mRNA in the patients with the TC or CC genotype than in those with the TT genotype (P < 0.001). Conclusion The 901T>C polymorphism of the PD-L1 gene may influence the clinical outcomes of the CRC patients receiving capecitabine-based adjuvant chemotherapy by mediating the expression of PD-L1 mRNA.

Obstructive Sleep Apnea Affecting Platelet Reactivity in Patients Undergoing Percutaneous Coronary Intervention / 中华医学杂志(英文版)

<p><b>Background</b>The relationship between obstructive sleep apnea (OSA) and platelet reactivity in patients undergoing percutaneous coronary intervention (PCI) has not been defined. The present prospective, single-center study explored the relationship between platelet reactivity and OSA in patients with PCI.</p><p><b>Methods</b>A total of 242 patients were finally included in the study. OSA was screened overnight by polysomnography. Platelet reactivity was assessed with a sequential platelet counting method, and the platelet maximum aggregation ratio (MAR) and average aggregation ratio were calculated. All patients were assigned per apnea-hypopnea index (AHI) to non-OSA (n = 128) and OSA (n = 114) groups. The receiver operating characteristic curve analysis was used to evaluate the accuracy of AHI for high platelet reactivity (HPR) on aspirin and clopidogrel, and multivariable logistic regression was used to determine the independent predictors of HPR on aspirin and clopidogrel.</p><p><b>Results</b>Median AHI was significantly higher in the OSA group than in the non-OSA group (34.5 events/h vs. 8.1 events/h, Z = -13.422, P < 0.001). Likewise, median arachidonic acid- and adenosine diphosphate-induced maximum aggregation rate (MAR) in the OSA group was significantly higher than those in the non-OSA group (21.1% vs. 17.7%, Z = -3.525, P < 0.001 and 45.8% vs. 32.2%, Z = -5.708, P < 0.001, respectively). Multivariable logistic regression showed that OSA was the only independent predictor for HPR on aspirin (odds ratio [OR]: 1.055, 95% confidence interval [CI]: 1.033-1.077, P < 0.001) and clopidogrel (OR: 1.036, 95% CI: 1.017-1.056, P < 0.001). The cutoff value of AHI for HPR on aspirin was 45.2 events/h (sensitivity 47.1% and specificity 91.3%), whereas cutoff value of AHI for HPR on clopidogrel was 21.3 events/h (sensitivity 68.3% and specificity 67.7%).</p><p><b>Conclusion</b>Platelet reactivity appeared to be higher in OSA patients with PCI despite having received a loading dose of aspirin and clopidogrel, and OSA might be an independent predictor of HPR on aspirin and clopidogrel.</p>

Comparison of flower buds and leaves of Tussilago farfara L. by UHPLC-Q Extractive Hybrid Quadrupole Orbitrap MS / 药学学报

The flower bud of Tussilago farfara L. has been commonly used in the treatment of cough, bronchitis and asthmatic disorders in the Traditional Chinese Medicine. In Europe, the leaves were also used as herbal drugs with similar pharmacological activities. In order to utilize the leaves, it is important to conduct the chemical comparison between the flower buds and the leaves. In this study, ultra high liquid chromatography (UHPLC) coupled with Q Exactive high resolution mass spectrometry (HR-MS) was used to compare the chemical composition of the flower buds and leaves of T. farfara L. forty three metabolites were identified by the combination of targeted and untargeted approach. The results suggest that the sesquiterpenes, such as tussilagone and 7β-(3'-ethyl-cis-crotonoyloxy)-1α-(2'-methylbutyryloxy)-3(14)-dehydro-Z-notonipetranone were higher in the flower buds. While the phenylpropanoids, such as cholorgenic acid and isochlorogenic acid were higher in the leaves. The flavonoids, such as hyperin and quercetin exhibited no difference between the flower buds and leaves, while the rutin and kaempferol were higher in the flower buds. The leaves and flower buds had similar chemical components, and the phenylpropanoids, which were closely related with the antitussive and expectorant activities, were found at higher concentrations in the leaves. The results presented here laid the basis for the rational utilization of the leaves of T. farfara L.

Screening and identification of apolipoprotein A-I as a potential marker for hepatoblastoma in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To screen and identify serum biomarkers for childhood hepatoblastoma (HB).</p><p><b>METHODS</b>The serum samples from 30 children with hepatoblastoma (HB), 20 children with systemic inflammatory response syndrome, and 20 normal children were treated with magnetic bead-based weak cation exchange chromatography. The platform of surface-enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS) was used to eliminate the interference of inflammatory factors and to screen out the differentially expressed proteins in serum between tumor group and normal group. After the purification and separation of target proteins were performed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis, matrix-assisted laser desorption/ionization-time of flight-mass spectrometry was used to determine their amino acid sequences. The SwissProt database was searched for matched proteins. Finally, real-time PCR and ELISA were used to verify and measure the expression of target proteins.</p><p><b>RESULTS</b>After SELDI-TOF-MS was used for screening and elimination of the interference of inflammatory factors, a differentially expression protein with a mass-to-charge ratio of 9 348 Da was found in serum between HB group and normal group, and the HB group had significantly lower expression of this protein than the normal group (p<0.05). This protein was identified as apolipoprotein A-1 (Apo A-I). Real-time PCR and ELISA verified the low mRNA and protein expression of Apo A-I in serum in the HB group and high expression in serum in the normal group.</p><p><b>CONCLUSIONS</b>Apo A-I can be used as a non-inflammatory protein marker for HB and has a certain value in the early diagnosis of HB.</p>

Coronary bifurcation lesions treated with double kissing crush technique compared to classical crush technique: serial intravascular ultrasound analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The double kissing (DK) crush technique is a modified version of the crush technique. It is specifically designed to increase the success rate of the final kissing balloon post-dilatation, but its efficacy and safety remain unclear.</p><p><b>METHODS</b>Data were obtained from the DKCRUSH-I trial, a prospective, randomized, multi-center study to evaluate safety and efficacy. Post-procedural and eight-month follow-up intravascular ultrasound (IVUS) analysis was available in 61 cases. Volumetric analysis using Simpson's method within the Taxus stent, and cross-sectional analysis at the five sites of the main vessel (MV) and three sites of the side branch (SB) were performed. Impact of the bifurcation angle on stent expansion at the carina was also evaluated.</p><p><b>RESULTS</b>Stent expansion in the SB ostium was significantly less in the classical crush group ((53.81 ± 13.51)%) than in the DK crush group ((72.27 ± 11.46)%) (P = 0.04). For the MV, the incidence of incomplete crush was 41.9% in the DK group and 70.0% in the classical group (P = 0.03). The percentage of neointimal area at the ostium had a tendency to be smaller in the DK group compared with the classical group ((16.4 ± 19.2)% vs. (22.8 ± 27.1)%, P = 0.06). The optimal threshold of post-procedural minimum stent area (MSA) to predict follow-up minimum lumen area (MLA) < 4.0 mm(2) at the SB ostium was 4.55 mm(2), yielding an area under the curve of 0.80 (95% confidence interval: 0.61 to 0.92).</p><p><b>CONCLUSION</b>Our data suggest that the DK crush technique is associated with improved quality of the final kissing balloon inflation (FKBI) and had smaller optimal cutoff value of post-procedural MSA at the SB ostium.</p>

Risk factors and clinical outcome of coronary artery aneurysms developed after drug-eluting stent implantation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate risk factors and clinical outcome of coronary artery aneurysms (CAA) developed after drug-eluting stent implantation evidenced by coronary angiographic follow-up.</p><p><b>METHODS</b>This study analyzed 4500 consecutive patient with de novo coronary artery stenosis receiving drug-eluting stent (DES) implantation from January 2004 to May 2009. Seven hundred and sixty patients with angiographic follow-ups at 6 - 8 months and 28 - 48 months after the index procedure were enrolled. CAA was defined as a localized dilatation exceeding 1.5 times the diameter of the adjacent artery. The independent risk factors and major adverse cardiac events (MACE) including cardiac death, myocardial infarction, target-vessel revascularization (TVR) and in-stent thrombosis were analyzed.</p><p><b>RESULTS</b>CAA was detected in 70 patients with 70 lesions (9.2%, 70/760). Logistic analysis showed that lesion in an infarct-related artery (OR: 5.9, P < 0.01), lesion in the left anterior descending artery (OR: 4.5, P < 0.01), lesion with chronic total occlusion (OR: 3.4, P < 0.05), and lesion length > 33 mm (OR: 2.9, P < 0.05) were independent risk factors for CAA. Follow-up duration was (1131 ± 478) days. MACE was found in 19 patients and all received TVR. There were 11 patients with myocardial infarction and 8 patients with evidence of in-stent thrombosis. Mortality was zero during follow-up.</p><p><b>CONCLUSIONS</b>The risk factors for the development of CAA after DES are lesions in an infarct-related artery, in the left anterior descending artery, with chronic total occlusion, and with lesion length > 33 mm. MACE is not uncommon in patients with CAA and long-ferm clinical follow-up is warranted for patients with CAA.</p>

Comparison of short- and long-term outcome after percutaneous transluminal interventional therapy in octogenarians with coronary artery disease from radial or femoral approach / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the short-term and long-term outcome after percutaneous coronary intervention (PCI) between transradial intervention (TRI) and transfemoral intervention (TFI) in elderly patients.</p><p><b>METHODS</b>From January 2005 to December 2010, 488 consecutive elderly patients ( ≥ 80 years old) were enrolled in this retrospective study. Patients were divided into TRI group (n = 235, PCIs were performed trans-radial approach) and TFI group (n = 253, PCIs were performed trans-femoral approach). Efficacy and safety data were compared between the two groups.</p><p><b>RESULTS</b>There were no differences in success rate of stenting, procedure time, contrast amount, rates of contrast-induced nephropathy, major adverse cardiovascular events during hospitalization, at one year follow up and at two years follow up. Lower vascular complications were associated with TRI approach[ 17.9% (42/253) vs. 26.9% (68/253) , P < 0.05], especially in TIMI major bleeding ratio [1.3% (3/235) vs. 4.7% (12/253) , P < 0.05], TIMI minor bleeding [5.1% (12/235) vs. 15.8% (40/253) , P < 0.01], and time lying in bed [3.6 (2.8-4.2)h vs. 24.4 (24.0-25.1)h, P < 0.01] and hospitalization [3.0 (3.0-4.0)d vs. 5.0 (5.0-6.0)d, P < 0.01], and higher rates of crossover approach were associated with TRI [11.5% (27/235) vs. 2.0(5/253) , P < 0.01].</p><p><b>CONCLUSION</b>TRI is as feasible, safe and effective as TFI in elderly patients during short-term and long-term follow up, and TRI is associated with higher rates of crossover approach.</p>

Surgical management of intrahepatic vessels in children with stage III/IV hepatoblastoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hepatoblastoma (HB) is a rare childhood tumor. We investigated the effect of intraoperative management of the intrahepatic major vessels in children with HB.</p><p><b>METHODS</b>Between April 2005 and August 2012, surgical resection was performed on 50 children with hepatoblastoma. These children were divided into a vessel-ligation group (n = 20) and a vessel-repair group (n = 30). In the vessel-ligation group, the intrahepatic major vessels were ligated and removed together with the tumor and the affected liver lobe/liver parenchyma. In the vessel-repair group, the affected intrahepatic major vessels were dissected and preserved as much as possible and the normal liver lobe/liver parenchyma and blood supply from these vessels were also preserved. The outcomes were analyzed by postoperative follow-up.</p><p><b>RESULTS</b>In the vessel-ligation group, two patients gave up surgery, six patients underwent palliative resection, and 12 patients underwent en bloc resection; four patients died of liver failure and eight patients fully recovered and were discharged. In the vessel-repair group, all 30 patients underwent en bloc resection and were discharged after satisfactory healing. After a follow-up time of 5 - 36 months (median: 20 months), two patient in the vessel-ligation group survived and 22 patients in the vessel-repair group survived.</p><p><b>CONCLUSIONS</b>Patients with HB can be successfully treated by tumor resection with vascular repair. This method prevents postoperative liver failure, ensures patient safety during the perioperative period, and allows for early chemotherapy.</p>

Pharmacokinetics of topically applied econazole nitrate nanoparticles in rabbit eye / 中华实验眼科杂志

Background Econazole nitrate is not effective as an antifungal eyedrop because of its poor intraocular permeability,therefore changing the formulation of econazole nitrate to improve its intraocular permeability become a critical point in the treatment of intraocular fungal infection. Objective The present study was to observe the penetration of 0.5％ econazole nitrate nanoparticles in the corneas and aqueous humors following its topicaladministration. Methods Econazole nitrate nanoparticles were prepared by quasi-emulsion solvent diffusion.Characteristics and size of nanoparticles were examined with transmission electron microscope and laser scatteringmethod,respectively.Econazole nitrate nanoparticles drops (0.5％ )was topically administered in 27 New Zealandwhite rabbits bilaterally,and aqueous humor and corneas were obtained after the application of the eye drops for 5,15,30,45,60,90,120,180,240 minutes respectively to detect the concentration of econazole nitrate with highperformance liquid chromatography (HPLC). The pharmacokinetic parameters were calculated with 3 p97pharmacokinetic computer software.The use of the animals followed the Regulation for the Administration of AffairsConcerning Experimental Animals by State Science and Technology Commission. Results The diameter of thenanoparticles was 50 nm with the round shape and encapsulation efficiency was 96.0％.Econazole nitrate nanoparticlesat the concentration of 0.5％ could be rapidly separated with other elements by HPLC with a lowest quantitativeconcentration of 0.1 mg/L.The mean recovery rates of econazole nitrate nanoparticles were 98.09％ in cornea and 99.66％ in aqueous humor,respectively after topical administration.The peak levels of econazole nitrate nanoparticles in cornea and aqueous humor were achieved at 5 minutes after application ( cornea:40.620 μg/g± 7.756 μg/g;aqueous humor:0.504 mg/L±0.153 mg/L),and its half-life( t1/2 )in cornea and aqueous humor was 23.5 minutes and 18.6 minutes,respectively. Conclusions Econazole nitrate nanoparticles at 0.5％ concentration can remain a feasible bioavailability in ocular tissue and therapeutic level in cornea and aqueous humor.

Hemodynamic change in wall shear stress in patients with coronary bifurcation lesions treated by double kissing crush or single-stent technique / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Fluid dynamic mechanisms attributed to coronary bifurcation lesions remain a subject of study. The present study aimed at investigating the hemodynamic change of wall shear stress (WSS) in patients with coronary bifurcation lesions treated by double kissing (DK) crush or one-stent with final kissing balloon inflation (FKBI).</p><p><b>METHODS</b>Eighty-one patients with bifurcation lesions treated by stenting who had 3-D model reconstruction were studied. The bifurcation vessels were divided into main vessel (MV), main branch (MB), side branch (SB), and polygon of confluence (POC). MB and SB were classified by internal- and lateral-subsegments, respectively.</p><p><b>RESULTS</b>The baseline magnitude of WSS in proximal MV, POC-MV, POC-MB, POC-SB and MB-internal segments increased significantly, compared to MB-lateral, SB-internal and SB-lateral. DK crush had the potential of uniformly reducing WSS, turbulent index and the WSS gradient. The WSS value at the POC-SB and SB in the one-stent group remained higher. The turbulent index and WSS gradient between the POC-SB minus the SB-lateral had equal predictive values for in-stent restenosis (ISR).</p><p><b>CONCLUSION</b>Fluid dynamic results favor the use of DK crush over the one-stent technique.</p>

Intravenous injection of nicardipine changed the distribution of coronary artery endothelial shear stress and fluid dynamics in patients with unstable angina / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Coronary endothelial shear stress (ESS) triggered the development of atherosclerosis. However, the effect of calcium channel antagonist on the distribution of ESS remained unclear.</p><p><b>METHODS</b>Twenty consecutive patients with acute coronary syndrome (ACS) 48 hours after maximal medication with single left anterior descending artery stenosis < 50% were studied. Nicardipine was intravenously injected at 1 µg/kg after a bolus of 10 mg in order to achieve mean blood pressure (MBP) reduced by 10% or more, or the heart rate increased by 10 - 15 beats/min. Hemodynamic variables and angiogram at baseline and during injection of nicardipine were recorded, respectively. Coronary artery 3-D reconstruction was used for the analysis of ESS.</p><p><b>RESULTS</b>Distal reference-vessel-diameter and minimal lumen diameter decreased significantly from (2.42 ± 0.41) mm and (1.47 ± 0.49) mm at baseline to (2.22 ± 0.35) mm and (1.35 ± 0.49) mm at maximal drug-dosage (P = 0.018 and 0.020, respectively). Nicardipine did not change blood velocity. Lowest mean shear stress at segments 2-mm distal to plaque increased significantly from (0.034 ± 0.519) Pa at baseline to (0.603 ± 0.728) Pa (P = 0.013) at peak effect of drug.</p><p><b>CONCLUSIONS</b>Nicardipine was associated with the constriction of diseased vessel segment that adapted to the reduction of blood pressure, without dynamic change of blood velocity at each stage of whole cardiac cycle. Increased ESS value at segments distal to plaque reflected the cardioprotection by nicardipine (ChiCTR-TRC-10000964).</p>