Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; drug therapy ; Inflammation

Objective To evaluate the effect of perioperative intravenous (Ⅳ) iron sucrose therapy on reducing postsurgical blood transfusion rates in elderly patients with hip fractures.Methods From September 2011 to February 2014,200 patients aged≥65 years with hip fractures were enrolled.The iron sucrose group (n=100) received iron sucrose (600 mg,Ⅳ),while the control group (n=100) did not receive iron sucrose.Postsurgical blood transfusion rates,infection rates,mortality and length of hospital stay were evaluated.Results The difference in blood transfusion rates was significant (25.0％ vs.41.0％,P＜0.05),while differences in infection rates,mortality and length of hospital stay were not significant between the two groups.Conclusions Perioperative Ⅳ iron sucrose can reduce blood transfusion requirements in elderly patients with hip fractures.

Objective The aim of this study was to investigate the mechanisms and the possible treatment of early and frequent recurrence of atrial fibrillation after segmental pulmonary veins isolation (PVI) in patients with paroxysmal atrial fibrillation (AF). Methods and Results Guided by Lasso mapping catheter, segmental pulmonary veins isolation was performed using radiofrequency energy in 54 consecutive patients (mean age 53?15 years) with recurrent documented symptomatic paroxysmal AF. Early recurrence of AF and rapid atrial arrhythmia occurred in 10 out of 54 patients (18.5%) within two weeks after PVI. 4 out of 10 patients (7.4 %) experienced early and frequent recurrence of atrial fibrillation and atrial tachyarrhythmia, which we termed as “atrial arrhythmic storm". The 4 patients were treated with class Ⅰ and Ⅲ antiarrhythmic drugs for 3 months. The “atrial arrhythmic storm" subided apparently and disappeared within two weeks after antiarrhythmic drug therapy. Only 1 patient still suffered from paroxysmal AF after drug control at mean follow-up of 3 months. After repeat ablation, there was no occurrence of AF and atrial arrhythmia in this patient.Conclusion A few paroxysmal atrial fibrillation patients experienced “atrial arrhythmic storm" after segmental pulmonary veins isolation. It is suggested that “atrial arrhythmic storm" after PVI may due to a lot of factors and combined antiarrhythmic drug therapy may be feasible. Early repeat ablation in patients with “atrial arrhythmic storm" may not be necessary.

Objective To study acute toxicity of nanometer titanium dioxide to the liver and kidney of mice. Methods 20 KM mice (22-26 g) were randomly divided into two groups, the control group and the experimental group, TiO2 (20-30 nm) suspension (single dose of 5 g/kg body weight) was given to mice by a single oral gavage, the mice in the control group were given the physiologicalsaline. 14 days after the treatment, the mice were sacrificed and the serum were collected to evaluate the levels of ALT(alanine amino transferase), AST(aspartate aminotransferase), ALP(alkaline phosphatase), UA(uric acid), Cr(creatinine),BUN(blood urea nitrogen), CK(creatine kinase), LDH(lactate-dehydrogenase), ?-HBDH(alpha-hydroxybutyrate dehydrogenase), TBIL(total bilirubin levels). The tissues of the liver and kidney were excised and were embedded in paraffin blocks, hematoxylin-eosin (HE) staining for further histopathological diagnosis. Results The serum ALT, ALT/AST, BUN, LDH and ?-HBDH of the TiO2 group were statistically higher than those in the control group (P

Objective To investigate the influence of simulated heart motion on the Doppler spectrum velocity- time integral (VTI) of simulated blood flow measurements through an in vitro model. Methods Using heart-motion simulator model TD-3 designed by ourselves to note the feature of Doppler spectrum of simulated heart and simulated blood flow which moved separately and synchronously.The affection of the simulated heart's motion on the VTI of the simulated blood flow and their quantitative relationship were observed.Results When the simulated heart and blood flow moved synchronously, the VTI of the combined motion was the algebra sum of their VTI when their motion independently. The velocity and frequency of Doppler spectrum of simulated heart were unchanged. Conclusions The motion of simulated heart has a great influence on the value of Doppler blood flow spectrum VTI and this effect should be considered when blood flow volume was measured using Doppler's methods.

Objective To evaluate the nature of Doppler flow spectrum of normal lower limb venous and to assess the influence of respiratory and cardiac cycle on it. Methods The right common femoral veins of 32 healthy adults were evaluated by pulsed wave Doppler with simultaneous electrocardiogram and respiratory tracing. Results In normal respiration,the Doppler spectrum of common femoral vein was divided into three types. Type C(“C” is for cardiac) displayed a wave rhythm which shared similarity with the heart beat and consists of atrial systolic (a),systolic (s) and diastolic (d) wave. Cardiac waveforms were modulated by respiratory motion: during expiration,the velocity of s,d wave gradually increased and during inspiration gradually decreased,and a wave was on the opposite. Type R(“R” is for respiration) displayed a waveform which is in harmony with respiratory signal basically. Type CR displayed a waveform which is an integration of type C and type R. Conclusions During quiet respiration,lower limb venous Doppler flow spectrum is influenced both by respiratory and cardiac cycle. The appreciation of this phenomenon would be instructive on analyzing the Doppler spectrum of lower limb venous in normal and pathological condition.

Objective To investigate the effects of surgical management for upper thoracic tuberculosis with neurological deficits using primary bone grafting and internal fixation through right anterior intrapleural approach. Methods In this study, 6 cases of upper thoracic tuberculosis were admitted to our hospital from January 1999 to June 2002, of which 3 cases were male and 3 female. The age ranged from 26 to 48 years, and the period from the onset of the symptom to hospitalization was 12 months to 24 months. Clinical features included thoracic and back pain, kyphosis and neurological deficits. The kyphosis angle ranged from 15 to 30 degrees. One case involved T3 to T5, 4 cases involved T4,5, and 1 case involved T3 to T6. Neurological deficits were evaluated by ASIA score system. The results showed that there were 5 cases in C grade, and 1 case in D grade. MRI showed compression of dura in all cases, and abscess inside the vertebral canal in 2 cases and outer abscess in 4 cases. All were treated with primary debridement, decompression, interbody autografting and internal fixation of "K" shape plate or Ventrofix by right anterior intrapleural approach. The antituberculous treatment and nutritional supplement were also performed routinely during the perioperative period. Results During the follow-up period of an average 21 months, all cases healed without any recurrence and complications such as infection, respiratory failure and so on. The thoracic and back pain disappeared and erythrocyte sedimentation rate (ESR) decreased to a normal level. All neurological deficits recovered within 3 months, 4 cases of which recovered at 4 weeks after operation. Spinal fusion occurred after 3 to 8 months after operation, and sixteen degrees of kyphosis correction was achieved. Conclusion It is a safe and effective method to use right anterior intropleural approach, primary autografting and internal fixation in the management of upper thoracic tuberculosis associated with neurological deficits.

[Objective]To evaluate curative effect of armor plate and xenogenic bony plate in congenital pseudarthrosis of the tibia.[Method]Five cases of congenital pseudarthrosis of the tibia were reviewed from 1998 to 2004,there were 2 men and 3 women,average age was 5.8(ranged,3~10)years.All the patients were treated by armor plate and xenogenic bony plate.[Result]All of the patients were followed up for more than 3 years(from 3 years to 7 years),four cases achieved bony union.Average time of bony union was 5 months.The lower limbs resumed walking ability and bear a heavy burden.[Conclusion]Outcome of 4 patients demonstrates that treatment of congenital pseudarthrosis of the tibia with armor plate and xenogenic bony plate is a reliable treatment.

Objective To investigate the prognostic implications of the size of left atrium with catheter ablation of atrial fibrillation.Methods Forty-two consecutive patients with symptomatic and drug-refractory paroxysmal or persistent AF admitted from 2005 May to 2006 November were included in the present study.The mean age was 60?12 years and 25 patients(58%)were male.Paroxysmal AF was present in 37 patients(88%)and persistent AF in 5 patients(12%).A 3D electroanatomic map of the LA including the pulmonary vein(PV)ostia was constructed with a nonfluoroscopic navigation system(Carto,Biosense Webster).The left and right PVs were encircled by continuous radiofrequency ablation lines.The left atrial diameter(LAD)was measured by 2D-guided M-mode echocardiography,in terms of anteroposterior diameter,left-right diameter and superior-inferior diameter by ”Simpson” method.Left atrial volume(LAV)was calculated by ”Pumbo” method.Body surface area(BSA)(m2)was used for indexing body size variables.The respective formulae are:left atrial volume index(LAVI)=LAV/BSA(mL/m2);left atrial diameter index(LADI)=LAD/BSA.Results Fifteen patients(34%)suffered from recurrent AF after 3 months of follow up.The LAVI of the recurrent group of patients was(68.19?23.68)mL/m2 compared with that of the non-recurrent group of(52.07?17.34)ml/m2(P=0.019).Logistic regression analysis revealed LAVI was the only independent risk factor of recurrence(OR=1.04,95% CI 0.99-1.09,P=0.04).Age(P=0.806),sex(P=0.338),AF history(P=0.46),hypertension(P=0.963),LAD(P=0.41),LADI(P=0.093),LAV(P=0.471),LVEF(P=0.91)between the 2 groups had no statistic differences.Conclusion Left atrial volume index(LAVI)is a better parameter compared with LAD,LADI and LAV in reflecting the left atrial size.LAVI is an independent predictor of recurrence of AF after catheter ablation.We found that LAVI≥55 mL/m2 was the strongest predictor,independent of age and other clinical parameters.

Objective To explore the inhibitory effect of rosiglitazone of peroxisome proliferator-activated receptor-?(PPAR?) agonist on aldosterone-induced mesangial cell(MC) proliferation.Methods Mouse primary MC were cultured and treated with aldosterone(100 nmol/L) in the presence or absence of rosiglitazone(1.0,2.5,5.0,10.0 ?mol/L).The incorporation of 3H-thymidine(3H-TdR) and cell count were used as the measure of MC proliferation.Cyclin D1 and cyclin A expression,PI3K and Akt phosphorylation were determined by Western blot analysis.Results 1.Aldosterone induced MC proliferation,as assessed by 3H-TdR incorporation and cell number,which were increased by 2.46-and 2.14-fold,respectively,in aldosterone-treated cells.Aldosterone-induced MC proliferation was inhibited by PPAR? agonist rosiglitazone in dose-dependent manner in mouse MC.2.Aldosterone induced cyclin D1 and cyclin A expression.Rosiglitazone reduced aldosterone-induced cyclin D1 and cyclin A expression in dose-dependent manner.3.Aldosterone induced PI3K/Akt activation in dose-dependent manner,incubation with 100 nmol/L aldosterone for 60 min,phosphorylation PI3K and Akt expression increased by above 3.0-fold.4.PI3K inhibitor LY294002 and Akt inhibitor significantly inhibited aldosterone-induced cyclin D1 and cyclin A expression.5.Rosiglitazone significantly inhibited aldosterone-induced PI3K/Akt activation,10 ?mol/L rosiglitazone almost completely blocked aldosterone-induced PI3K/Akt activation.Conclusion Rosiglitazone can block aldosterone-induced MC proliferation via inhibition of PI3K/Akt activation.