Vasovagal reflex is one of complications from cardiac intervention.The major causes of vasovagal reflex postprocedure are commonly believed to be associated with mental stress,pain,low blood volume,visceral dilation,local hematoma and cardiac function.The incidence of vasovagal reflex may be effectively reduced with standard intervention training,strictly selected indications for PCI,adequate fluid replacement after procedure,anesthetic lidocaine to reduce pain,improved manual compression for vascular hemostasis and elimination of risk factors.

Objective:To express human dentin sialoprotein (hDSP) gene in COS-7 cells. Methods:hDSP gene was subcloned into mammalian expression vector pcDNA3. The recombined plasmids were transfected into COS-7 cells using lipofectamune PLUS TM kit for transient expression. Western blot analysis and immunohistochemical staining were used to examine the gene products. Results:The constructed vectors were confirmed by digestion with restriction enzyme. An immuno-reaction positive band with relative molecular mass of 60 000 was found by Western blot analysis in culture supernatant and cytoplasms of COS-7 cells. Immunohistochemical staining showed strong positive particles in the cytoplasms. Conclution:hDSP gene can be expressed in COS-7 cells.

Objective:To analyse the nucleotide polymorphism of dentin sialoprotein(DSP) coden region in Chinese people. Methods:The DSP segments were amplified by PCR;single-stranded conformation polymorphism(SSCP) and DNA sequencing were employed to detect the nucleotide polymorphisms in DSP coden region. Results:Three single nucleotide polymorphisms(SNP) were found in DSP coden region,two were same sense SNPs resulting in no change of amino acid product,and one was missense SNP resulting in change of asparagine and aspartic acid. Conclusion:There are some SNPs existing in DSP coden region in Chinese people.

Objective To explore the effects of home-based 6-minute walk test on self-management in patients after percutaneous coronary intervention (PCI). Methods Eighty-four patients who admitted for PCI in the past five years in Cardiovascular Medicine of Zhujiang Hospital of Southern Medical University were recruited from the three major communities and were divided into intervention group and control group by random digits table method with 42 cases each. The intervention group had the home-based 6-minute walk test and monthly telephone follow-up while the control group was followed up by telephone and keep daily activities. Six months after the intervention,the changes of chronic disease self-management in-ventory were compared. Results There were significant differences the overall health self-assessment, fa-tigue,chest pain, time of aerobic exercise, the increase of self-efficacy between intervention group and control group[ (0.62±1.28) points vs. (0.20±1.71) points, (-0.84±3.27) points vs. (0.36±2.71) points, (0.04 ±3.56) points vs. (0.34 ±3.56) points, (30.47 ±123.29) min/week vs. (6.62 ±84.82) min/week, (0.42±3.01) points vs. (-0.29±2.94) points ], and there were significant differences, F=9.15, 7.42, 5.24, 3.91, 12.18, P<0.01. But there were no significant differences for other 9 aspects between two groups (P>0.05). Conclusions Home-based 6-minute walk test can be a simple self-assessment tool used at home for patients after PCI.

Objective To explore the clinical effect of two different connecting tubes in hemodialysis combined with hemoperfusion. Methods A total of 25 patients were selected and divided into observation group and control group by self- control method. In the observation group, the hemodialysis combined with hemoperfusion was used 8 times, and the control group was treated with hemodialysis combined with hemoperfusion 8 times using conventional connecting tube. The time of the unloading of the perfusate and the amount of physiological saline required were compared between the two groups. There was no blood spillover during the unloading of the perfusate, the number of cases of allergic reaction during the treatment, and the coagulation of the dialyzer and the pipeline after the treatment. Results There was no allergic reaction in both groups. There was no significant difference between the two groups in the amount of saline needed to return blood (t=46.412, P=0.307). In the control group, there was 15 cases of blood spillover, while the observation group did not show blood spillover. There was significant difference between the two groups in unloading perfusion time(4.43±0.14)min vs. (3.02±0.11) min (t=10.784, P=0.003). The level Ⅰ and Ⅱ blood coagulation of dialyzer and pipeline was 12, 2 cases in the control group after the treatment and 5, 0 case in the observation group, no level Ⅲ blood coagulation cases, and there was a significant difference between the two groups (χ2=10.667, P<0.01). Conclusion In the hemodialysis combined with hemoperfusion therapy, multi-function group of the application effect is superior to conventional piping, is worthy of clinical application.

Objective:To collect the imaging data and related materials of the patients with in-stent restenosis (ISR)after coronary artery stent operation with intravascular ultrasound (IVUS),and to analyze the risk factors of ISR,and to propose the reasonable intervention strategies.Methods:Fifty patients with ISR were divided into ISR ≤ 50% drug group (n = 14 )and ISR > 50% drug group (n = 36),including drug-coated balloon therapy group (n=16)and stent treatment group (n=20);IVUS virtual organization technology was used to compare the plaque area,location,tissue composition,thrombus and other factors of the patients in various groups after treatment;the data changes after 6 months of follow-up were analyzed.Results:The IVUS results showed the plaque areas and plaque loads of the ISR patients treated with intervention were significantly reduced compared with before operation (P <0.05);the plaque compression degree of the patients in drug-coated balloon therapy group was lower than that in stent treatment group (P <0.05),but the differences were not found between drug-coated balloon therapy group and stent treatment group in fibrous tissue components and calcified tissue proportion (P >0.05).Conclusion:The ISR rate is higher in the patients with high degree of fiber components,plaque composition heterogeneity and distribution of diffuse tortuous and calcified lesions.ISR has no significant correlation with the plaque wall thickness and lipid content and plaque instability and necrotic tissue proportion.

Objective To evaluate the effect of injection of ozone (O3) through lateral recess for the treatment of radiculitis caused by lumbar disc herniation on the blood glucose in patients with diabetes mellitus.Methods Ninety-six patients with radiculitis caused by lumbar disc herniation involving 48 patients with diabetes mellitus and 48 patients without diabetes mellitus were enrolled in the study.The diabetic or non-diabetic patients were randomly divided into 2 groups ( n =24 each):non-diabetic patients-O3 group (group N-O3 ),non-diabetic patients-ghcocorticoid group (group N-GC),diabetic patients-O3 group (group D-O3 ),and diabetic patients-glucocorticoid group (group D-GC).In N-O3 and D-O3 groups,30 mg/L O3 10 ml was injected via the lateral recess.In N-GC and D-GC groups,compound betamethasone injection 3.5 mg was injected via the lateral recess.The blood glucose level was measured before treatment (T1),1 and 4 h after treatment (T3,4),and 1,3 and 7 days after treatment (T5-7).VAS score was recorded at T1,immediately after treatment (T2),and at T5-7.The patients' quality of life was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36 Health Survey) questionnaire at T1,7.The therapeutic effect was evaluated at T7.The side effects were recorded.Results Compared with the baseline value at T1,VAS scores were significantly decreased after treatment,while the MOS SF-36 Health Survey questionnaire scores for physical functioning,bodily pain,role emotional,and mental health in all groups,for general health in group N-GC,and for vitality in groups D-O3 and N-O3 were significantly increased at T7,and the blood glucose level was significantly increased at T4 in groups N-GC and D-O3,and at T3-7 in group D-GC ( P ＜ 0.05).There was no significant change in the blood glucose level before and after treatment in group N-O3.The blood glucose level was significantly higher in group N-GC than in group N-O3,and in group D-GC than in group D-O3 ( P ＜ 0.05).There were no significant differences in the excellent and good rates and all the MOS SF-36 Health Survey questionnaire scores among all groups.No side effects were found in the study.Conclusion Injection of ozone through lateral recess for treatment of radiculitis caused by lumbar disc herniation exerts no influence on the blood glucose level in patients with diabetes mellitus.

AIM: To investigate the apoptosis and molecular mechanism of human hepatocellular carcinoma HepG2 cells induced by ginsenoside Rh4.METHODS: Human hepatocellular carcinoma HepG2 cells were treated with ginsenoside Rh4 at doses of 10, 20 and 40 μmol/L, and the inhibitory effect of ginsenoside Rh4 on HepG2 cell viability was measured by MTT assay.The apoptotic rate of HepG2 cells was analyzed by flow cytometry.The morphological changes of the HepG2 cells were observed by Hoechst 33258 and TUNEL staining.The expression of apoptosis-related proteins Bax, Bcl-2, caspase-3 and caspase-9 was determined by Western blot.RESULTS: Ginsenoside Rh4 promoted apoptosis of HepG2 cells in a dose-dependent manner.TUNEL and Hoechst 33258 staining showed that the cells appeared obvious shrinking, swelling and rupture after treated with ginsenoside Rh4 for 24 h.The results of Western blot showed that with the increasing concentrations of ginsenoside Rh4, the expression of pro-apoptotic proteins Bax, cleaved caspase-3 and caspase-9 increased, while anti-apoptotic protein Bcl-2 decreased gradually.CONCLUSION: Ginsenoside Rh4 induces apoptosis of human hepatocellular carcinoma HepG2 cells, and the main mechanism may be related to down-regulation of Bcl-2 and up-regulation of Bax, cleaved caspase-3, and caspase-9.

Objective To determine the levels of serum visfatin and HbA1c in patients with coronary heart disease and ex-plore the correlation with the severity of coronary atherosclerosis .Methods Totally 264 patients were enrolled who performed cor-onary angiography totally ,visfatin and HbA1c levels were detected respectively of 33 cases of control group ,51 cases of atheroscle-rosis group ,75 cases of single-vessel disease group ,72 cases of double-vessel disease group ,33 cases of triple-vessel disease group . Gensini score was used for evaluation of coronary artery lesion ,and to establish a multiple linear regression analysis of the relation-ship between each risk factor for coronary heart disease .According to the degree of coronary artery stenosis ,the patients also could be divided into the control group(33 cases) ,the non severe stenosis group (174 cases) and the severe stenosis group (57 cases) ,the changes of visfatin and HbA1c levels were analyzed in the three groups .Results In the groups by the coronary lesion count ,HbA1c levels increased with the degree of coronary artery lesions in the control group [(4 .98 ± 0 .21)% ] ,the atherosclerosis group [(5 .58 ± 0 .36)% ] ,the single-vessel disease group[(6 .17 ± 0 .48)% ] ,the double-vessel disease group[(6 .63 ± 0 .80)% ] ,the tri-ple-vessel disease group[(7 .97 ± 1 .49)% ] ,and comparisons had significant difference between any two groups(P< 0 .05) ;Visfatin level in the control group ,the atherosclerosis group ,the single-vessel disease group ,the double-vessel disease group ,the triple-ves-sel disease group were(0 .73 ± 0 .42)μg/L ,(1 .50 ± 0 .87)μg/L ,(3 .45 ± 2 .50)μg/L ,(5 .45 ± 2 .96)μg/L ,(9 .21 ± 6 .35)μg/L ,a-mong them coronary heart disease group (the single-vessel disease group ,the double-vessel disease group ,the triple-vessel disease group) is higher than the atherosclerosis group and the control group(P< 0 .05) ;the atherosclerosis group is higher than the con-trol group ,but there was no statistically significant difference(P> 0 .05) ;In according to the degree of coronary artery diameter ste-nosis ,the levels of visfatin ,HbA1c in severe stenosis group [(8 .25 ± 4 .86)μg/L ,(7 .35 ± 1 .43)% ] is significantly higher than the non severe stenosis group [(3 .22 ± 2 .74)μg/L ,(6 .14 ± 0 .70)% ] and the control group [(0 .73 ± 0 .42)μg/L ,(4 .98 ± 0 .21)% ] , P< 0 .01 ;The non severe stenosis group is significantly higher than the control group (P< 0 .01) .The levels of visfatin ,HbA1c ,hs-CRP ,LDL and TC had positive correlation with Gensini score(P< 0 .01) .The level of HDL was negatively correlated with Gensini score(r= - 0 .535 ,P < 0 .01) .The levels of visfatin ,HbA1c ,hs-CRP ,LDL and TC had positive correlation with visfatin ( P <0 .01) ,and the level of HDL and TG were negatively correlated with visfatin(P< 0 .01) .In multiple linear regression analysis ,the factors which finally entered the regression equation were HbA1c ,LDL ,hs-CRP ,visfatin and HDL .Conclusion The levels of visfa-tin and HbA1c is closely related to the severity of coronary atherosclerosis .Combined detection of visfatin and HbA1c can be used as important indicators for evaluating the severity of coronary atherosclerosis .

Objective To investigate the effects of ozone (O3) on Wnt/β-catenin signaling pathway in the articular cartilage of rats with osteoarthritis (OA).Methods Eighteen male SPF Wistar rats,aged 3 months,weighing 200-250 g,were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C),group OA,and O3 group (group O).OA was induced by injection of monosodium iodoacetate 3 mg (50 μl) into the right knee joint cavity.On 7th day after the model was established successfully,25 μg/ml O3 1 ml were injected into the knee joint cavity,once a week for 3 consecutive weeks in group O.Behavioral changes were observed after establishment of the model.At 1 day before establishment of the model,and 1,4,7,14,21 and 28 days after establishment of the model,the mechanical paw withdrawal threshold (MWT) was measured.At 28 days after establishment of the model,the total knee joint was removed and stained with haematoxylin and eosin for examination of the pathological changes of the cartilage (under light microscope) and for determination of the expression of β-catenin and matrix metalloproteinase-13 (MMP-13) in the cartilage (by immunohistochemistry).Results The signs of OA such as hind-limb motor dysfunction,knee joint swelling,or decreased joint motion,and signs of hyperalgesia such as lickings were observed after establishment of the model in rats.Compared with group C,the MWT was significantly decreased at each time point after establishment of the model,and the ex pression of β-catenin and MMP-13 in the cartilage was significantly up-regulated in the other two groups(P＜0.05).Compared with group OA,the MWT was significantly increased at 7-28 days after establishment of the model,and the expression of β-catenin and MMP-13 in the cartilage was significantly down-regulated in group O (P＜0.05).The pathological changes of the cartilage were significantly reduced in group O as compared with group OA.Conclusion The mechanism by which O3 mitigates OA is probably related to inhibition of Wnt/β-catenin signaling pathway activation in the articular cartilage in rats.