Objective To compare the prognosis of ST elevation acute myocardial infarction(STEMI) of delayed emergency per‐cutaneous coronary intervention(PCI) and elective PCI following the thrombolysis with reteplase ,and to investigate the clinic value of the former solution .Methods One hundred and twenty STEMI patients were reviewed retrospectively and were divided into 2 groups according to PCI .Eighty two cases were divided into emergency group :thrombolysis with reteplase offered within 6h was followed by elective PCI;38 cases were divided into delayed group:PCI was done after 12-24 h after ATEMI′occurring .The clini‐cal features and CTG changes were recorded ,TIMI class of IRA was conducted before and after PCI ,and their prognosis were com‐pared .Results There was no statistical differences in the class of thrombolysis of myocardial infarction(Class 0 -1 ,2 -3) of in‐farction relative artery (IRA)(4 .88% ,95 .12% vs .5 .26% ,94 .74% ) after PCI(P>0 .05) .There was no statistical difference in LVEF ,LVEDVI and LVESVI 3 months after attack between two groups(P>0 .05) .There was statistical difference in the severe cardiac failure and malignancy arrhythmia between two groups(P<0 .05) ,while no statistical difference exist in angina after infarc‐tion as well as cardiac mortality after attack between two groups(P>0 .05) .Conclusion Delayed emergency PCI to remove the ob‐struction in the coronary artery has no significant difference with elective PCI following thrombolysis in the incidence of composite end point events in STEMI .

Objective To observe the expression level of CD4+ CD25+ Foxp3+ regulatory T cells in the peripheral blood of acute and stable senile COPD patients ,and analyze the correlation between Treg cells and TGF‐β1 of senile COPD ,then investigate the role of Treg cells and TGF‐β1 in the onset of senile COPD .Methods Totally 26 patients with acute stage and 23 patients with stable stage were investigated as acute group and stable group ,they came from the department of geriatric of our hospital form March ,2012 to February ,2014 .Meanwhile ,20 healthy people were selected as control group .The proportion of Treg cells in pe‐ripheral blood was measured by flow cytometry method and the level of TGF‐β1 in serum was measured by ELISA .Results The percentage of Treg on peripheral blood in acute and stable groups were significantly higher than control group(P< 0 .01) ,the difference also existed in acute and stable group(P<0 .05);the level of TGF‐β1 in serum of acute group was higher than control group(P<0 .01) ,there was no correlation between the proportion of Treg and TGF‐β1(P>0 .05) .Conclusion Treg cells may be involved in the process of the pathogenesis of senile COPD and acute exacerbation .There is no correlation between the proportion of Treg cells and TGF‐β1 ,and it indicates immune disorders may exist in senile COPD patients .

Objective To study the effect of fasudil on inhibiting the Rho/ROCK signaling pathway under high glucose in human mesangial cells (HMCs) inflammation and fibrosis. Methods Synchronized HMCs were divided into following groups: (1) Normal glucose control group ( NG, 5. 5 mmol/L glucose) ;(2) High glucose group (HG, 30 mmol/L glucose) ; (3) Mannitol group (Man, 5.5 mmol/L glucose + 24. 5 mmol/L mannitol) ; (4) High glucose + fasudil group ( HG + F, the concentrations of fasudil were 25 ,50 and 100 μmol/L, respectively). Collect the supernatant and cells at 0, 12, 24, 36, 48 and 72 h respectively, and determine the concentration changes of the RhoA, ROCK- Ⅰ, connective tissue growth factor (CTGF)mRNA with real-time PCR method in the cells, then used the ELISA method to check the protein content of the fibronectin ( FN) , CTGF, TNFα in the supernatant. Results ( 1) RhoA, ROCK- Ⅰand CTGF mRNA of the HMCs cultured under the high glucose expressed significantly higher than those in the normal group, and there was certain time-dependence. Besides, there was no statistic significance by comparing Man and NG. (2) Under the high glucose situation, after the fasudil pretreatment with different concentrations and 24 h or 48 h culture with high glucose, RhoA, ROCK- Ⅰ , CTGF mRNA expression was significantly decreased in HG + F, compared with HG, and there was certain concentration-dependence. (3) High glucose increased the FN, CTGF, TNFα protein secretion of HMCs in a time-dependent manner, but normal glucose and mannitol had no such effect. (4) After the fasudil pretreatment with different concentrations and culture with high glucose for 12, 24, 36, 48, 72 h, the FN, CTGF, TNFα protein secretion was significantly reduced compared with HG. Conclusion Fasudil can reduce the secretion of downstream inflammatory factors and cytokines by inhibiting high glucose-activated HMCs Rho/ROCK signaling pathway, and reduce the inflammation and fibrosis of HMCs. This provides a new basis for the therapeutic target in the treatment of diabetic nephropathy.