Objective To investigate the intervention of Amlodipine combined with alanine aminotransferase(ALT)-711 on blood pressure and preventing of target organ remodels of Spontaneously Hypertensive Rats(SHR),and to explore an optimized treatment design.Methods A total of 24 SHRs at 12-Week-old male were randomly divided into 4 groups,with 6 SHRs in each group.In the control group(Group A)the SHR were given normal saline 1 ml/(kg · d)via intragastric administration; the SHRs in Group B were treated with Amlodipine 1 mg/(kg · d) via ntragastric administration; the SHRs in Group C were treated with ALT-711 10 mg/(kg · d)via ntragastric administration;the SHRs were treated with Amlodipine 1 mg/(kg · d)combined with ALT-711 10 mg/(kg · d)via ntragastric administration in Group D.All groups were treated for 8 weeks,and the blood pressure in mouse tail were monitored.After 8 weeks,all SHRs were executed in the condition of anaesthedia.Right cervical artery,heart and kidney were measured through immunohistochemistry,histological stain and imagine analysis.The remodeling of vascular,heart,kidney were compared,and collagen volume fraction,advanced glycation end products (AGEs) and fibronectin (FN) expression were measured.Results (1) After treatment for 8 weeks,blood pressure of SHRs in the 4 groups were (184.72 + 15.14),(108.00 ±10.19),(155.64±10.03)and (99.83 ± 12.27) nun Hg in Group A,B,C and D,respectively.The blood pressure in Group D was the lowest in the 4 groups (F =14.6702,P ＜ 0.05),whereas it is not significantly different from Group B (P ＞ 0.05).(2) The mean thickness of carotid arteries were (0.450 ± 0.023),(0.380 ±0.021),(0.420 ±0.019) and (0.320 ±0.020) mm in Group A,B,C and D,respectively.The mean thickness of carotid arteries in Group D was the lowest in the 4 groups(F =4.1463,P ＜0.05).(3).The mean intimal area of carotid arteries were (19.0 + 1.3) × 105,(25.0 ± 1.4) × 105,(29.8 + 1.5) × 105 and (21.3 ±1.3) × l05 μm2 in Group A,B,C and D,respectively.The mean intimal area of carotid arteries in Group D was significantly smallest than the other 3 groups(F =4.4305,P ＜0.05).(4) The collagen content in different organs in the 4 groups after treatment 8 weeks:in carotid arteries,they were (6.25 ± 0.19)％,(3.56 ± 0.03) ％,(4.25 ± 0.12) ％ and (1.32 ± 0.05) ％ in Group A,B,C and D,respectively.The collagen content in Group D were significantly lower than the other 3 groups (F =4.9316,P ＜ 0.01).In myocardia:collagen content in Group A,B,C and D were (6.02 ± 0.21)％,(4.08 ± 0.14)％,(4.44 ± 0.11)％ and (1.13 ± 0.08) ％ respectively,and it was the lowest in Group D (F =4.2469,P ＜ 0.01).In kidney,the collagen content in Group A,B,C and D were (13.23 ±0.51)％,(7.28 ±0.35)％,(8.33 ±0.22)％ and (5.66 ±0.13)％ respectively,and it was the lowest in Group D(F=8.1038,P ＜0.01).(5).Express rate of AGEs in carotid arteries in Group A,B,C and D were (31.48 ±7.30)％,(20.55 ±5.91)％,(10.48 ±0.98)％ and (7.56 ± 0.68) ％ respectively,with the lowest expression in Group D (F =11.4537,P ＜ 0.01).Express rate of FN in carotid arteries in Group A,B,C and D group were (28.18 ±5.66)％,(17.26 ±5.83)％,(18.20 ±1.44) ％ and (15.12 ± 1.03) ％ respectively,with the lowest expression in Group D (F =9.0036,P ＜ 0.01).Conclusion Amlodipine combined with ALT-711 decreased blood pressure more effectively and prevented the remodel of target organ in SHRs than Amlodipine or ALT-711 alone.

Objective To investigate the serum levels of heat shock protein 70 (HSP70) in uremic patients with different dialysis ages.Methods Ninety-two maintenance haemodialysis patients were divided into short-term group(from three months to 2 years,n =32),median-term group(from 2 to 5 years,n =37) and longterm group(more than 5 years,n =23) according to different dialysis ages.Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of HSP70 before and after haemodialysis in each group.Results The semm levels of HSP70 had significant difference both in median-term group and long-term group before and after haemodialysis(median-term group:(54.94 + 39.21) μg/L vs (69.72 + 39.90) μg/L,t =-2.068,P =0.047 ;long-term group:(46.17 +34.63) μg/L vs (74.07 ±41.11) μg/L,t =-2.814,P =0.010).But there was no statistics difference on the serum levels of HSP70 before and after haemodialysis in the short-term group((70.42 ±38.30) μg/L vs (62.89 ±43.01) μg/L,t =0.870,P =0.390).Conclnsion Haemodialysis patients with more stress protection ability are likely to obtain long term survival.

Objective To explore the method and efficiency of percutaneous transluminal septal tunnet myocardial ablation(PTSTMA) in treatment of 26 cases hypertrophic obstructive cardiomyopathy (HOCM) who were not suitable for conventional technology.Methods Firstly,we used a monorail Balloon which was slightly bigger than the interventricular septal branch of coronary artery and dilated it until posterior septal.After that,an OTW Balloon with larger size than the monorail was used to dilate again until made aventricular septum tunnel.Then,some alcohol was injected and PTSTMA was performed.Finally,we did the other and/or another interventricular septal branch by above method until the left ventricular outflow tract pressure gradient (LVOTPG) reduced ≥50％.The clinical indexes of the 26 cases HOCM immediately pest-operation of PTSTMA were observed and the follow up data during short term and metaphase were analyzed.Results The LVOTPG reduced ≥50％ in the26 cases HOCM,immediately after PTSTMA,the LVOTPG reduced from (75.6 ±22.4)mm Hg to (21.4 ± 5.8) mm Hg (t =11.94,P ＜ 0.01).At three months after ablation,the thickness of septal myocardium reduced from (22.8 ± 5.8) ram before ablation to (16.8 ± 4.2) mm(t =4.27,P ＜ 0.01),left atrium dimension reduced from(48.0 ±7.0) mm to (42.0 ±8.6) mm (t =2.76,P ＜0.01).Followed up 6.0to 60.0 months,the patients suffering from chest pain reduced from 14 cases before to 4 cases after the procedure(53.8％ (14/26) vs 15.4％ (4/26),x2 =8.49,P ＜ 0.01),the patients with expiratory dyspnea reduced from 26 cases to 5 cases(100％ (26/26) vs 19.2％ (5/26),x2 =35.22,P ＜ 0.01),NYHA functional class improved from (2.4 ± 0.6) to (1.4 ± 0.7) (t =5.53,P ＜ 0.01).Conclusion The PTSTMA was a supplemental method of PTSMA on treating HOCM,which was safe and useful during the short term and metaphase.

Objective To explore the effect of the severity of coronary artery on left ventricular diastolic function in patients with unstable angina (UA).Methods One hundred and seventy-two patients with UA consecutively from December 2010 to August 2011 were enrolled.All patients underwent coronary angiography (CAG) and echocardiography.The patients were divided into four groups according to left ventricular diastolic function by echocardiography:Thirty-eight subjects with normal(Non-HFNEF),45 subjects with mild dysfunction (Grade Ⅰ),57 subjects with moderate dysfunction(Grade Ⅱ) and 32 subjects with severe dysfunction grade (Grade Ⅲ).The effect of the severity of coronary artery on the left ventricular diastolic function was analyzed.Results There were significant difference on left atrial dimension (3.24 ± 0.50) nn vs (3.40 ±0.41) mmvs (3.56±0.44) mm vs (3.78 ±0.36) mm (F=21.454,P＜0.001),left ventricular posterior wall (0.84 ±0.11) mm vs (0.90 ±0.12) mm vs (0.92 ±0.09) ram vs (0.94 ±0.15) mm (F =10.743,P ＜ 0.001) and left ventricular mass index (105.63 ± 33.13) g/m2 vs (113.09 ± 21.55) g/m2 vs (122.26 ±41.52) g/m2 vs (132.96 ± 31.06) g/m2(F =9.746,P ＜ 0.001) among the four groups.Diastolic function was significantly correlated with the severity of coronary artery(r =0.466,P ＜ 0.001).Conclusion In the patients with UA,left ventricular diastolic function was significantly influenced by the extent of coronary artery stenosis.

Objective To explore the clinical significance of early invasive mechanical ventilation for acute respiratory distress syndrome (ARDS) caused by thoracic trauma.Methods We retrospectively analyzed the clinical data of 93 patients of invasive mechanical ventilation in those with ARDS caused by thoracic trauma,and divided them into delayed invasive mechanical ventilation group (n =45) and timely invasive ventilation group (n =48) by the time of invasive mechanical ventilation.We compared the blood gas analysis,oxygen index,heart rate,lactic acid,muscle use score of the two groups before and after invasive mechanical ventilation and the differences of mechanical ventilation time,incidence of complications,mortality and length of hospital stay between the two groups.Results Each index of the delayed invasive mechanical ventilation group and the timely invasive ventilation group was calculated:PaO2 (63.2 ± 12.3,74.2 ± 12.1)mm Hg,PaCO2 (39.4 ±8.7,38.9 +7.6) mm Hg,PaO2/FiO2 (196.2 ± 17.8,231.4 ± 18.2),respiratory rate (27.4 ±3.7,21.1 ± 3.4) beats/min,heart rate (117.2 ± 26.8,96.0 ± 25.1) beats/min,accessory muscle use score (2.69 ± 0.15,1.67 ± 0.10),lactic acid (4.23 ± 1.70,2.12 ± 0.80) mmol/L Except for PaCO2,the differences of each index were statistically significant (t values were respectively 4.346,9.420,3.949,5.436,38.809,7.736; P ＜ 0.05).The duration of mechanical ventilation treatment (10.21 ± 1.50,6.47 ± 1.20) d and the length of hospital stay (21.53 ± 1.90,16.32 ±2.10) d of the delayed group and the timely group were significantly different (t values were respectively 12.518,13.318; P ＜ 0.01).The timely group had significantly lower mortality rate (26.7％ (12/45),14.6％ (7/48)),VAP (46.7％ (21/45),22.9％(11/48)),acute gastric mucosal lesions (33.3％ (15/45),12.5％ (6/48)),MODS (40.0％ (18/45),16.7％ (8/48)) than the delayed group (x2 values were respectively 3.86,5.81,4.49,5.70; P ＜ 0.05).There is no significant difference on the incidence of pneumothorax between the two groups (11.1％ (5/45),8.3％ (4/48)).Conclusion Invasive mechanical ventilation is an effective treatment of ARDS caused by chest trauma.Early invasive mechanical ventilation can reduce the mortality rate and shorten the duration of mechanical ventilation and hospital stay of the patients with ARDS after severe thoracic trauma.

Objective To investigate the clinical features of non-steroidal anti-inflammatory drugs (NSAIDs) caused gastrointestinal bleeding in the elderly.Methods We performed a retrospective analysis ofNSAIDs caused gastrointestinal bleeding with 308 cases admitted to Department of Gastroenterology,The Second Hospital of Tianjin Medical University.Patients were divided into elderly group(≥65 years,n =208) and young group (＜ 60 years,n =100) to make a comparative analysis of two group differences in clinical characteristics.Results The NSAIDs in the elderly taking were mainly Aspirin (55.8 ％ (116/208)),which was significantly more frequent than that of young group (37.0％ (37/100),x2 =9.517,P ＜ 0.05).There was no significant difference on the blood routine and coagulation between the two groups (P ＞ 0.05).The recent bleeding rate of the elderly group (21.2％ (44/208)) was lower than the young group (63.0％ (63/100))(x2 =52.161,P ＜0.05).The two groups had no significant difference on the history of uleer and Hp infection (P ＞ 0.05).Conclusion The clinical characteristics of NSAIDs caused gastrointestinal bleeding on the elderly were different with young or middle-aged.This infers that elderly patients need individualized treatment.

Objective To investigate the association between the peroxisome proliferator-activated receptor-or (PPARα) polymorphism rs1800206 (c.484C ＞ G,L162V) and the risk of metabolic syndrome (MES)Methods There were 1184 subjects aged 40-60 years recruited from our hospital between March 2010 and March 2011.The PPARα polymorphism 484C ＞ G was genotyped using TAQMAN assay by real-time PCR. The relationship between PPARα polymorphism and MES risk were investigated.Results The genotype frequencies were 91.4％,8.4％ and 0.2％ for the PPARα CC,CG and GG,respectively.This SNP was in Hardy-Weinberg equilibrium(P =0.845).Compared with the most common CC genotype,the variant genotypes(CG + GG) had higher fasting glucose((5.82 ± 1.59) mmol/L vs (5.49 ± 1.17) mmol/L,t =2.630,P =0.009) and LDL-C levels((3.53 ± 1.03) mmol/L vs (3.36 ± 0.65) mmol/L,t =2.376,P =0.018) and lower HDL-C levels ((1.56 ± 0.35) mmol/L vs (1.65 ± 0.43) mmol/L,t =2.430,P =0.015).Furthermore,the 484G variant genotypes(CG + GG)was associated with the risk of MES after adjusting for age,gender,education,BMI and lifestyle (smoking and alcohol status) (adjusted OR =1.89 ;95％ CI =1.09-3.23,P =0.012).Condusion PPARα polymorphism rs1800206 is a significant independent predictor of the MES in Southern Chinese.

Objective To analyze the efficacy and prognosis of different antiviral agents on compensated hepatitis B cirrhosis.Methods Eight hundred and sixty-five cases of Hepatitis B patients with compensated cirrhosis were randomly divided into five groups:A group(n =143,subcutaneous injection interferon 3 million U every other day for 48 weeks),B group(n =171,orally treatment with lamivudine 100 mg/d for 48weeks),C group(n =137,orally treatment with adefovir 10 mg/d for 48 weeks),D group(n =83,oral treatment with entecavir O.5 mg/d,for 48 weeks) and E group(n =331,treated with general hepatoprotective drugs).Clinical symptoms and signs,changes in liver function were observed and prothrombin time activity degrees (PTA),quantitative HBV-DNA,HBeAg seroconversion and HBeAg/HBeAb conversion situation were detected.Results There were significant differences on HBeAg seroconversion between A group and other four groups after treated for48 weeks(31.5％ vs 13.5％,22.6％,18.1％,5.7％,x2 =58.56,P ＜0.01) and at the end of follow up (33.1％ vs 14.2％,23.3 ％,23.6％,6.4％,x2 =52.87,P ＜ 0.01).Patients' condition in A,B,C,D groups progressed slowly,and their incidence rates of decompensate cirrhosis were significantly lower than that in group E(x2 =122.41,P ＜ 0.01).The incidence rate of liver cancer in group A was significantly lower than that in B,C,D,E groups (x2 =19.61,P ＜ 0.01).Conclusion Antiviral therapy of interferon and nucleoside drugs can slow the progression of compensated Hepatitis B cirrhosis and reduce the incidence rates of decompensate cirrhosis.And interferon can significantly reduce the incidence rate of liver cancer.

Objective To investigate the effect of different loading doses of atorvastatin in patients with stable plaques.Methods Consecutive 174 patients with stable plaque who underwent coronary arteriongraphy (CAG) and intravascular unltrasound(IVUS) were randomly assigned to receive 10 mg atorvastatin treatment (group 10 mg,n =47),20 mg atorvastatin treatment(group 20 mag,n =45),40 mg atorvastatin treatment (group 40 mg,n =43) and 80 mg atorvastatin treatment (group 80 mg,n =39).The endpoints including low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol (HDL-C),high-sensitivity C-reactive protein (hs-CRP) levels,necrotic and plaque volumes,were assessed after 3-6 months' follow-up.Results Mean LDL-C,HDL-C,hs-CRP,the percentage of necrotic,plaques volumes were similar at baseline (P ＞ 0.05).During 3-6 months of follow up:(1)LDL-C levels in group 10 mg,20 mg,40 mg,80 mg were lower than at baseline (t =3.12,4.23,3.26 and 5.21 respectively,P ＜ 0.01).There was significant difference between the 20 mg group and the 40 mg group(P ＜ 0.05) ; (2) There was no significant difference of HDL-C levels in 10 mg,20 mg and 40 mg groups after atorvastatin treatment.However,its level was significantly higher in the 80 mg group after atorvastatin treatment than other dose groups(P ＜ 0.05) and were higher than at baseline(t =2.35,P ＜ 0.01) ;(3)the 80 mg group's hs-CRP levels decreased significantly after treatment than at baseline((3.59 + 1.07)mg/L vs (6.10 + 2.12) mg/L,t =2.37,P ＜ 0.01);(4)According to the VH of IVUS,the percentage of necrotic in 10 mg group became higher than at baseline ((16.54 + 1.76) ％ vs.(7.83 + 1.03) ％,t =2.38,P ＜0.01) and conformed to unstable plaques diagnostic criteria(＞ 10％).There was no significant difference in group 20 mg,40 mg and 80 mg with at baseline (t =1.24,0.21,0.69 respectively,P =0.069,0.846,0.643respectively) ; (5)Plaques volumes in group 10 mg,20 mg were not larger than at baseline.However,in group 40mg and 80 mg.Plaques volumes were smaller than at baseline ((30.69 ± 8.12) mm3 vs (37.09 + 12.01)mm3,t=l.29,P=0.019;(24.99±l.01) mm3 vs (36.47+14.68) mm3,t =2.62,P＜0.01).Conclusion The effects of atorvastatin on stable plaques vary with doses.(1) For LDL-C,the use of atorvastation 20 mg/d can make LDL-C reaching standard,and atorvastation 40 mg/d was superior to 20 mg/d and similar to 80 mg/d.(2)For HDL-C,atorvastation 80 mg/d can make it higher.(3)Atorvastation 80 mg/d can make hs-CRP lower.(4)Atorvastation≥20 mg/d can make plaques stable and atorvastation 80 mg/d was superior to 20 mg/d and 40mg/d.Atorvastation 40-80 mg/d can make plaques dwindled.

Objective To investigate the potential relationship between the paroxysmal Atrial Fibrillation(PAF) and serum uric acid level.Methods Consecutive patients with (patient group,n =65) and without(control group,n =41) PAF,who were hospitalized in the Second Hospital of Tianjin Medical University from September 2011 to June 2012,were included in this study.We excluded subjects with congestive heart failure,acute coronary syndrome,congenital heart disease,valvular heart disease,cardiomyopathy,thyroid dysfunction and acute infection or inflammatory conditions.Baseline clinical data,complications and laboratory examination results were collected.Left atrium diameter (LAD),left ventricular end-diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) were determined by echocardiography.Univariate and logistic regression was conducted to detect risk factors for PAF.Results Serum uric acid level were significantly increased in patients with PAF compared with controls ((360.2 ± 103.9) μmol/L vs (296.0 ±68.1) μmol/L,P =0.001).Multivariate logistic regression analysis showed that higher level of serum uric acid (OR:1.007,95％ CI:1.000-1.015) and LAD (OR:1.142,95％ CI:1.031-1.265) were independent risk factors for the occurrence of PAF.Conclusion High serum uric acid level is an independent risk factor for the development of PAF.Future larger studies should further evaluate this potential association as well as the underlying mechanisms.