Objective To investigate the effect of different treatment on ST-elevation myocardial infarction (STEMI) by evaluating the changes of myocardial collagen metabolism. Methods Forty-one patients with STEMI were divided into drug treatment group (22 cases) and selective percutaneous coronary intervention (PCI) group (19 cases). Meanwhile,47 healthy controls were included in control group. The levels of serum carboxy terminal propeptide of type Ⅰ procollagen (PⅠCP), precollagen Ⅲ ( PC Ⅲ ), matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were measured by enzyme-linked immunosorbent assay at the 3rd ,6th, 12th, 18th month after STEMI,and compared with those in control group. Results The level of P Ⅰ CP in selective PCI group was significantly lower than that in drug treatment group at the 3rd, 6th month [( 15.08 ± 3.37 ) μ g/L vs. ( 19.78 ± 2.22 ) μ g/L, (23.88 ± 3.33 ) μg/Lvs. ( 30.00 ± 3.14) μ g/L, P ＜ 0.05], but there was no significant difference at the 12th and 18th month (P ＞0.05 ). The level of serum PC Ⅲ in selective PCI group was significantly lower than that in drug treatment group at the 3rd month [(50.70 ±4.83) ng/L vs. (59.91 ±4.64) ng/L,P ＜0.05],and there was no significant difference at others times between drug treatment group and selective PCI group. There was no significant difference in P Ⅰ CP/PC Ⅲ between drug treatment group and selective PCI group in all times(P ＞0.05). Compared with those in control group,the levels of serum MMP-1 in all times were significantly decreased in drug treatment group and selective PCI group(P ＜ 0.05 ), but there was no significant difference between drug treatment group and selective PCI group at same times (P ＞ 0.05). The level of serum TIMP-1was significantly higher in selective PCI group than that in drug treatment group at the 3rd and 6th month [(61.89 ± 11.44) μg/L vs. (52.23 ±4.97)μg/L, (62.85 ±6.31) μg/L vs. (52.97 ±6.43)μg/L,P＜0.05] ,and there was no significant difference in TIMP-1 between drug treatment group and selective PCI group in other times (P＞ 0.05). MMP-1/TIMP-1 in selective PCI group was significantly lower than that in drug treatment group at the 6th month [( 1.53 ± 0.25 )% vs. ( 1.95 ± 0.04)% ,P ＜ 0.05] ,and there was no significant difference in MMP-1/TIMP-1 between drug treatment group and selective PCI group in other times (P ＞0.05). Conclusions Selective PCI can improve myocardial collagen metabolism in patients with STEMI in short term ( ＜ 6 months), but it doesn't appear to be superior to drug treatment in long term (6 - 18 months). Patients with STEMI should enforce drug treatment if they have not been treated with PCI.

OBJECTIVE To study the anatomical dimension of the path to the petrous apex via the infralabyrinthine approach. METHODS Thirty dry temporal bones were dissected along the internal carotid canal. The distances from the vertical portion of the facial nerve to the genu of the internal carotid canal,the vertical portion of the facial nerve to the petrous apex,the genu of the internal carotid canal to the posterior surface of the petrous bone were measured. Ten heads of adult cadaver were dissected to gain access to the petrous apex via the infralabyrinthine approach. The horizontal and vertical dimensions of the approach window created were measured. RESULTS The vertical portion of the facial nerve to the lap of the internal carotid canal was (13.26?1.66)mm,portion of the facial nerve to the petrous apex was (34.48?1.07)mm,the lap of the internal carotid canal to the posterior surface of the petrous bone was (9.68?1.53)mm. The mean dimensions of the window in dissected bones were(5.76?3.38)mm vertically and (6.42?2.65)mm horizontally. Thirteen sides had been doing well with the infralabyrinthine approach. CONCLUSION The possibility of those anatomical variations should be considered when the infralabyrinthine approach is being planned to manage the petrous apex lesion. The infralabyrinthine approach is useful to the patients with good hearing.

Objective To study the etiology and relative factors of dilated cardiomyopathy (DCM). Methods A total of 233 DCM patients were enrolled and conducted epidemiological survey. Stable angina patients in the same region were collected as control group. The epidemiological investigation included: life styles and history of diseases; blood pressure, electrocardiogram and echocardiography; serum lipids, glucose, hs-CRP, cTNI and NT-proBNP. Results The prevalence rate of DCM was 29.1 per 100 000 population, the male being almost 2-fold more involved than female, and farmers accounted for 77.7%. Familial clustering was not obvious. There were low level of history of hypertension (12.4%), ischemic heart disease (2.1%), myocarditis (5.2%) and diabetes (3.4%). Compared with control group, DCM patients had higher proportion of farmer (60.0% vs 77.7%, P

Objective To explore the risk factors of peripartum cardiomyopathy (PPCM). Methods A total of 82 PPCM and 100 normal delivery females were randomly recruited in the current study. Echocardiographic, cTNI,high sensitive C-reaction protein(hs-CRP) ,NT-proBNP were measured. Fifty-two patients were followed up for a mean of 6 months. Results The PPCM patients (29. 5 ± 6. 4) yrs were older than the controls (25. 2 ± 5. 8) yrs (P<0.01) . Compared to the controls, the PPCM patients showed higher blood pressure (146.9/98. 8 mm Hg v. s. 130. 2/80. 1 mm Hg, P < 0. 01) , higher proportion of cesarean section (65. 9% v. s. 51. 0% , P < 0. 05) and complicated infection(75. 6% v. s. 10. 0% ,P <0. 01). The level of leucocyte(11.0 × 109/L) ,cTNI(0. 17 μg/L), hs-CRP(28. 2 mg/L)and NT-proBNP(650. 1 ng/L) were significantly higher in the PPCM patients compared with control(8. 8 × 109/L,0. 06μg/L,6. 2 mg/L and 110. 5 ng/L,P <0. 01). Hs-CRP was positively related with NT-proBNP(r = 0. 67, P < 0. 01). After average of 6 months of treatment, left ventricular ejection fraction enhanced from 32. 2% to 50. 6%. NT-proBNP significantly declined from 650. 1 ng/L to 225.6 ng/L(P <0. 01). Multiple linear regression analysis showed that diastolic pressure (P < 0. 05), LVED (P < 0. 05) and hs-CRP (P < 0. 05) were the independent predictors for declined NT-proBNP. Conclusions Inflammatory plays an important role in the development of peripartum cardiomyopathy.

Objective　 To study the prevalence and relevant risk factors of low blood pressure and its influence on cardiovascular diseases in China. Methods　A cross-sectional study for low blood pressure was conducted using the data of the third national survey of blood pressure in 1991. Low blood pressure was defined for systolic (SBP) and diastolic (DBP) pressure less than the tenth percentile for the sample (SBP≤98mmHg and DBP≤60mmHg). Results　The prevalence of low blood pressure for males and females were 2.7% and 7.4%, respectively. The prevalence of low blood pressure for females was higher than that of males (P<0.01). Prevalence of low blood pressure was 7.62%, 6.97%, 4.40%, 3.22%, 2.65%, 1.94% for age groups 15～, 25～, 35～, 45～, 55～, 65～, respectively. The prevalence of low blood pressure was gradually declined with aging. There was large variation in the prevalence of low blood pressure for different minorities. The prevalence of low blood pressure was higher in the southern rather than the northern part of China. Logistic regression showed that the age (OR 0.97, 95%CI 0.97～0.98, per 10 mmHg), BMI (OR 0.80, 95%CI 0.80～0.81), drinking (OR 0.89, 95%CI 0.86～0.93) and heart rate (OR 0.981, 95%CI 0.980～0.982) had reverse relationship with low blood pressure. The sex had a positive relationship with low blood pressure. The prevalence of stroke and myocardial infarction in the population with low blood pressure was lower than that of normal pressure or hypertension (P<0.01). Conclusion　The prevalence and relevant risk factors of low blood pressure in China were various. We speculate that low blood pressure in Chinese population appears to be a normal state of physiology.The difinite influence in health needs cohort studies to confirm.

Autoimmune Diseases ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Female ; Gastrectomy ; Gastric Mucosa ; pathology ; Gastrin-Secreting Cells ; metabolism ; pathology ; Gastrins ; metabolism ; Gastritis, Atrophic ; metabolism ; pathology ; surgery ; Humans ; Hyperplasia ; Middle Aged ; Mucin-6 ; metabolism ; Neuroendocrine Tumors ; metabolism ; pathology ; surgery ; Stomach ; pathology ; surgery ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism

Background and objective To assess the predictive value of C-reactive protein(CRP) for major adverse cardiac events and the association between CRP level and the coronary lesion morphology and extent in patients with coronary heart disease (CHD).Methods CRP was measured on admission in 177 consecutive elderly (age≥60 years) patients with CHD who underwent coronary angiography. Patients were divided into high CRP group (CRP≥3mg/L) and normal CRP group (CRP ＜3mg/L). The association between CRP levels and the coronary lesion features, including severity of stenosis (mild, moderate, severe), extent of lesion (diffused or nondiffused), eccentricity of the plaque (eccentric or non-eccentric) were analyzed. Patients were followed up for a mean of 8 months for the occurrences of major adverse cardiac events (MACE). Results Compared with patients in normal CRP group, patients in high CRP group were more frequently to have unstable angina, multi-vessel, diffuse, eccentric lesions, positive remodeling, and non-smooth plaques (P＜0.01). Kaplan-Meier analysis showed patients in high CRP group had a significantly lower MACE-free survival rate than patients in normal CRP group (Log-rank = 12.0, P＜0.01); Cox regression analysis indicated CRP level as an independent predictor for the occurrence of MACE (OR=3.16, P＜0.05) Conclusions High CRP level is associated with more extend, severe and eccentric coronary lesions and is an independent predictor for MACE in elderly patients with CHD.

Objective To explore the effect of inflammation and autoimmunity in peripartum cardiomyopathy(PPCM). MethodsA total of82 PPCM patients and 100 normal delivery patients were randomly selected and conducted epidemiological survey.High-sensitivity Creaction protein(hs-CRP),troponin I,human antimyocardial antibody IgG(AMA-IgG),Coxsackie B virus IgG(CBV-IgG)and adenovirus antibody IgG(ADV-IgG)were detected with ELISA. ResultsCompared with control group,PPCM patients had older age,higher pressure,higher proportion of cesarean section and infection.The levels of serum hs-CRP,cTNI,and leucocyte were markedly higher in PPCM patients compared with control.The positive proportion of AMA-IgG and CBV-IgG was significantly increased(P<0.01)in PPCM patients compared with the control.Logistic regression showed that infection(OR=2.87,95%CI 1.15-5.24),increased hs-CRP(OR=1.86,95%CI 1.08-4.02)and positive AMA-IgG(OR=2.68,95%CI 1.19-4.85)were independent risk factors for PPCM. ConclusionsInflammation and autoimmunity play an important role in peripartum cardiomyopathy.

Objective To investigate the etiology and relative factors of dilated cardiomyopathy (DCM) in Chinese patients. Methods A case-control study was conducted to compare 233 patients with DCM in high-incidence areas (case group) and 150 patients with stable angina pectoris (control group). Life styles and history of diseases information was collected by questionaire; human anti-myocardial antibody IgG (AMA- IgG), human Coxsackie B virus IgG (CBV- IgG) and human adenovirus antibody IgG (ADV- lgG) were measured with ELISA. General chemical and toxicological indicators in drink water from high and low prevalence areas and serum trace elements also were compared. Results 1 ) Compared with the control group, the case group had more farmers (P < 0.01), with low average incomes (P < 0.01), higher alcohol consumption (P < 0.01) and higher incidence of the history of myocarditis (P < 0.01 ). 2) AMA-IgG, CBV-IgG and ADV-IgG levels were low and the positive rates ofAMA-IgG, CBV-IgG and ADV-IgG of patients with DCM were respectively 7.78%, 6.67% and 6.67%, no statistical significance comparing with those in the control group. 3) The content of iron (1.36±2.18 vs 0.39±0.67 mg/L, P<0.05) and manganese (0.384±0.35 vs 0.15±0.14, P<0.01 ) in drinking water of high-incidence areas was significantly higher than that in low-incidence areas. 4) The content of serum iron (69.14±57.8 vs 20.04±17.5 μ mol/L, P<0.01 ) and copper (25.74±4.2 vs 19.7±4.5 μmol/L, P<0.01) in the case group evidently exceeded the normal range and obviously higher than that in the control group. Conclusions 1) The incidence of some DCM is related with low incomes, high alcohol consumption and myocarditis. 2) These data do not support that DCM is related with persistent virus infection and autoimmunization; 3) Iron and manganese contents exceeding standards in drinking water and the high content of serum iron and copper is comparatively related with the incidence of DCM.

Objective To explore the influence factors of poor myocardial perfusion in patients with ST-segment elevation myocardial infarction( STEMI) after primary percutaneous coronary intervention(PCI). Methods One hundred and forty-three patients with first STEMI who were on admission from April 2010 to May 2014 and underwent primary PCI within 12 hours were enrolled as our subjects. According to the sum-ST-segment resolution(sumSTR)and TIMI myocardial perfusion grade(TMP)after primary PCI,all patients were divided into well myocardial perfusion group( sumSTR ≥ 50% or TMP 2 - 3 grade)and poor myocardial perfusion group(sumSTR < 50% and TMP 0 - 1 grade). The influence factors between two groups were collected and analyzed,including sex,age,pain to balloon time,blood pressure on admission,left ventricular ejection fraction,leucocyte count,neutrophil ratio(NR),high-sensitivity C-reactive protein(hs-CRP),blood lipid,and the history of hypertension,diabetes mellitus. Results The leucocytes count,NR,hs-CRP in patients of poor myocardial perfusion group were(11. 60 ± 3. 57)× 109 / L,0. 84 ± 0. 06 and 9. 80 ± 11. 37 mg/ L,higher than those in well myocardial perfusion group((9. 51 ± 2. 59)× 109 / L,0. 77 ± 0. 11 and(3. 83 ± 5. 58)mg/ L),and the differences were significant(t = 3. 497,P = 0. 001;t = 3. 390,P = 0. 001;t = 3. 973,P < 0. 001). Multiple linear regression analysis showed that neutrophil ratio was independent risk factor of sumSTR in STEMI patient after primary PCI(P = 0. 000). Conclusion The increase of leucocyte count,NR and hs-CRP are related to the poor myocardial perfusion after primary PCI. The increase of neutrophil ratio is an independent risk factor of poor myocardial perfusion.