Endocarditis, Bacterial ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy

Objective Observed the mobilization effects、 the safety and feasibility of autologous circulating blood stem cell by G-CSF in acute myocardial infarction (AMI). Methods 45 patients with AMI were randomly allocated to receive either inclusive type Granulocyte Colony-Stimulating Factor (G-CSF), to mobilize the stem cell. The patients received the dose of G-CSF 300?g-600?g/day, by hypodermic injection, and the duration of applying G-CSF was 5 days. In the process of the mobilization of the circulating blood stem cell, prior to applying G-CSF and on the 3rd、4th、5th、6th、7th after applying G-CSF, the white blood cell (WBC) and CD34+ cell count in the circulating blood should be observed; and the following side effects also should be paid attention to, such as: bone pain, tetter, fever, gastrointestinal effects( nausea 、vomit、 coprostatis ),deteriorated of angina or heart failure and some rare effects(spontaneous spleen rupture, severe purulent infection, hypercoagulable state, autologous immune diseases). Results Prior to applying G-CSF and the 3rd、4th、5th、6th、7th after applying G-CSF, the counts of WBC were (8.42?2.59)?10 9/L、(31.28?8.34)?10 9/L、(35.24?9.38)?10 9/L、(37.03?13.07)?10 9/L、(35.34?14.68)?10 9/L、(20.35?9.22)?10 9/L;the counts of CD34+ cell were (14.89?11.46)?10 6、(67.78?50.88)?10 6、(124.79?136.13)?10 6、(208.92?206.97)?10 6、(206.10?184.57)?10 6、(66.63?56.56)?10 6;The peak of curve that WBC and CD34 + cell count changed with applying days was on the 5th .The count of CD34 + cell in the circulating blood was positive referent with the count of WBC in the circulating blood(r=0.835);was not reference with age、 sex、body weight、and the onset time of AMI. There were total 17 complications during the mobilization of circulating blood stem cell. The incidence of complications during mobilization is 37.8%(17/45), including bong pain being 15.6%(7/45)、fever being 6.7 %(3/45)、pale being 4.4 %(2/45)、tetter being 4.4 %(2/45)、deterioration of heart failure being 4.4 %(2/45),spleen thrombosis being 2.2 %(1/45).No death happened. Conclusion : In patients with AMI, the mobilized peak of WBC and CD34 + cell counts changed with applying days was at the 5th, and the count of CD34 + cell in the circulating blood was positive referent with the count of WBC in the circulating blood(r=0.940),was negative referent with body weight of patients(r=-0.398). And mobilization of autologous circulating blood stem cell was feasible and safe.

Objective To investigate the possible mechanisms of enhancing angiogenesis and arteriogenesis through the oberservation of the effect of gene transfer of angiopoietin-1 (Ang1) on its receptor Tie2 in rat models of acute myocardial infarction. Methods Myocardial infarction was induced in rats by left anterior descending artery ligation. Naked plasmid DNA encoding human angiopoietin-1 (phAng1) was delivered into the ischemic area (group A) by intramyocardial injection. On day 3, 7, 14 and 28 after the injection, the mRNA expression of Tie2 and its changes with time were determined by RT-PCR. The number of vessels and arterioles was examined by immunohistochemistry. The collagen was evaluated by Masson staining. Results RT-PCR showed that mRNA expression levels of Tie2 in group A were significantly higher than those in the control group, reached the highest level on day 7 post-injection, and gradually declined to normal level 28 days later. On day 7, 14 and 28, the vessel count showed the number of blood vessels (angiogenesis and arteriogenesis) in group A was greater than that of the control group at the same timepoint and the infracted myocardium in group A was significantly less than that of the control group. Conclusion Gene transfer of phAng1 enhances angiogenesis and arteriogenesis in acute myocardial infarction and reduces the infraction area probably by upregulating the expressions of Tie2 receptor.

Objective To explore the value of somatostatin receptor scintigraphy(SRS) in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.Methods Twenty-five patients with orbital inflammatory pseudotumor associated with systemic vasculitis (10 males,15 females,average age:(51.2± 14.2) years) underwent SRS.The uptake ratio (UR) of orbital inflammatory pseudotumor was obtained.(1) Patients were divided into group A (with immune activity) and group B (without immune activity) according to Birmingham vasculitis activity score (BVAS).The difference of UR between the 2 groups was compared by two-sample t test.The difference of UR before and after treatment in 12 patients was also compared.(2) Based on the results by BVAS,ROC curve was used to obtain the cut-off value of UR,as well as the diagnostic efficiency and Youden index.The consistency between SRS and BVAS was calculated.(3)Patients were divided into two groups according to the cut-off value of UR and the prognosis difference between them was compared by Fisher exact test.(4)The expression of SSTR2 and SSTR5 was observed by immunohistochemistry.Results (1) UR in group A was significantly higher than that in group B (2.09±0.44 vs 1.32±0.46,t =5.94,P＜0.01).After glucocorticoids treatment,the UR in group A reduced significantly (t=4.07,P＜0.01),but not in group B (t=1.76,P＞0.05).(2)ROC curve analysis identified UR cut-off value as 1.66,with the sensitivity of 87.5％,specificity of 95.7％,positive predictive value of 95.2％,negative predictive value of 88.0％,accuracy of 91.3％ and Youden index of 83.2％.The consistency between SRS and BVAS was strong (Kappa =0.840).(3) The prognosis was significantly different between patients with UR≥ 1.66 and UR＜1.66 (P＜0.05).(4) The immunohistochemical results revealed high expression of SSTR2 and SSTR5 in inflammatory cells in patients with immune activity.Conclusion SRS has potential value in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.

BACKGROUND:Chondromodulin-Ⅰ is expressed mainly in the cartilage, but it is little expressed in mesenchymal stem cells. Combined with the previous study of our group, we concluded that chondromodulin-Ⅰmaybe play an important role in inducing mesenchymal stem cells into chondrocytes accurately.
OBJECTIVE:To construct an expression plasmid stably carrying chondromodulin-Ⅰ to up-regulate the expression of chondromodulin-Ⅰ in bone marrow mesenchymal stem cells.
METHODS:Specific primers were designed in rat cartilage for chondromodulin-Ⅰ gene, then the pcDNA3.1 (+) plasmid expression vector was digested by enzyme and directional connected gene to construct pcDNA3.1(+)/ChM-Ⅰ expression vector. Bone marrow mesenchymal stem cells were obtained from rats using the method of density gradient centrifugation combined with adherent culture. Recombinant plasmid pcDNA3.1(+)/ChM-Ⅰ was transfected into rat bone marrow mesenchymal stem cells with liposome method, and G418 selection was used for stable screen of transfected cells. Reverse transcription-PCR and western blot were used to detect chondromodulin-Ⅰ expression in celllines.
RESULTS AND CONCLUSION:The positive clones were digested by enzyme and were identified and sequenced. The results showed that the reality length and sequence of chondromodulin-Ⅰ gene were consistent with the theoretical values, and reading frame was correct. Reverse transcription-PCR and western blot results showed that the expressions of chondromodulin-ⅠmRNA and protein were markedly up-regulated in bone marrow mesenchymal stem cells. Recombinant plasmid pcDNA3.1(+)/ChM-I was successful y constructed, and transfected into rat bone marrow mesenchymal stem cells. After G418 selection, expression of chondromodulin-Ⅰ was up-regulated stably in rat bone marrow mesenchymal stem cells.

Objective:To observe the clinical efficacy of Dushen Decoction and Zhenwu Decoction in the treatment of chronic congestive heart failure (CCHF) of Yang deficiency and blood stasis type. Methods:From March 2017 to December 2019, 120 patients with CCHF of Yang-deficiency and blood stasis type admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine were selected, and they were divided into study group and control group according to the randomized number table method, with 60 in each group. The control group was given western medicine of conventional treatment, and the study group was combined with Dushen Decoction and Zhenwu Decoction on the basis of the control group. Both groups were treated for 1 month. Before and after treatment, TCM syndrome scores were performed, serum TNF-α, IL-17 and CRP were detected by ELISA, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were detected by color doppler echocardiography the adverse reactions during the treatment were recorded and the clinical efficacy was evaluated. Results:The total effective rate was 91.7% (55/60) in the study group and 71.7% (43/60) in the control group, with significant difference between the two groups ( χ2=8.015, P=0.005). After treatment, the scores of palpitation, dyspnea, chilly limbs, dull tongue and edema in the study group were significantly lower than those in the control group ( t=13.953, 13.915, 30.945, 32.339, 20.403, P<0.001). After treatment, LVEF [(56.28 ± 4.34)% vs. (42.47 ± 4.56)%, t=16.993] in the study group was significantly higher than that of the control group ( P<0.01); LVEDD [(44.32 ± 6.23) mm vs. (53.81 ± 5.19) mm, t=9.066] and LVESD [(31.28 ± 4.62) mm vs. (37.51 ± 4.73) mm, t=7.299] in the study group were significantly lower than those in the control group ( P<0.01). After treatment, the serum levels of TNF-α, IL-17 and CRP in the study group were significantly lower than those in the control group ( t=12.644, 15.975 and 14.379, P<0.001). The incidence of adverse reactions was 6.7% (4/60) in the control group and 8.3% (5/60) in the study group, and there was no significant difference between the two groups ( χ2=0.120, P=0.729). Conclusion:Dushen Decoction and Zhenwu Decoction in the treatment of CCHF can improve the clinical symptoms, improve the cardiac function, reduce inflammatory factors, improve the treatment efficiency with good safety.

Objective To elucidate the effect of bioimpedance ratio in the calf (calf-RBI) for volume evaluation on hypertension in hemodialysis (HD) patients. Methods Bioimpedance in the right calf was measured by bioimpedance spectroscopy (BIS). As an index of volume status, calf-RBI was calculated as follows: calf-RBI =impedance at 200 kHz / impedance at 5 kHz. The range of age-stratified 1SD from mean calf-RBI in the healthy control was assumed as the target range for the corresponding HD patients. The dry body weight (DBW) was stepwise decreased under the guidance of calf-RBI. The changes of calf-RBI, blood pressure and antihypertensive medications were recorded and correlation analysis among indexes was performed. Results The calf-RBI showed a normal distribution in both healthy subjects and HD patients. The calf-RBI was positively correlated with age, but not with gender or BMI. Forty-two patients with (35.9%) calf-RBI beyond target range were identified in 117 HD patients. The percentage of uncontrolled hypertensive individuals was significantly higher as compared to those with calf-RBI within or below target range (59.5% vs 33.3% and 16.7%, P＜0.01). The percentage of uncontrolled hypertensive individuals and the dose of antihypertensive medications was significant improved after decreasing the DBW in the patients with calf-RBI beyond target range (74.1% vs 33.3%, P＜0.01) and defined daily dose (2.00±2.28 vs 2.49±2.47, P＜0.05 ). Conclusions The age-stratified calf-RBI may be used as a useful index for estimation of volume status, and has a good association with clinical manifestations. Recognition and correction of chronic fluid overload based on age-stratified calf-RBI is helpful in hypertension control for hemodialysis patients.

ObjectiveTo analyze the relationship between serum total bilirubin coincident with congestive heart failure (CHF) exacerbation and subsequent long-term mortality in patients with CHF.MethodsThe study population consisted of 140 consecutive patients admitted for CHF exacerbation with left ventricular ejection fraction ≤45％.They were divided into 2 groups according to whether death attacked or not in the following 28.5 months. Binary logistic regression analysis was used to investigate independent predictors of death from clinical parameters on admission or within 24 hours. ResultsSerum TBil and B-type natriuretic peptide (BNP) levels on admission were independent predictors of subsequent death after hospital discharge.According to increasing textiles of TBil stratified by the level of 12.8 and 18.2 mmol/L,the patients were divided into 3 groups:lower-level group (TBil ≤ 12.8 mmol/L),moderate-level group (TBil ＞ 12.8 ～ 18.2 mmol/L) and higher-level group (TBil ＞ 18.2 mmoL/L),with the death rates after 28.5 months of 12.2％,17.9％ and 38.9％,respectively ( P =0.002 ). Meanwhile,the pulse pressure decreased to (55.5 ± 17.3) mm Hg (1 mm Hg =0.133 kPa),(48.9 ± 13.1) mm Hg and (46.1 ± 13.7)mm Hg,respectively ( P =0.008 ). TBil on admission had significant correlation with echocardiographymeasured left ventricular endo-diastolic diameter ( r =0.34,P =0.000 ) and right ventricular diastolic diameter (r =0.23,P =0.011 ). ConclusionsIncreased TBil coincident with cardiac decompensation predicts a worse long-term death of CHF,presumably through the potential liability to both decompensated RV function and lower cardiac output syndrome occurred simultaneously when HF deteriorates.

Objective To investigate the effects of dextran sulfate on lung ischemia-reperfusion injury after lung transplantation in rats.Method A total of 32 male Wistar rats were subjected to unilateral left lung orthotopic transplantation.They were randomly divided two groups (n =16 each):DXS group [DXS (10 mg/kg) was given prior to the reperfusion],and the control group (the same volume of normal saline was given).After animals were sacrificed,the lung graft was harvested 2 h after reperfusion.Oxygenation indexes,wet/dry ratio (W/D),myeloperoxidase (MPO) activity,malondialdehyde (MDA) and endothelin 1 (ET-1) in the transplanted lung,and tumor necrosis factor a (TNF-α) and interleukin 8 (IL-8) in serum were measured.The lung injury scores were evaluated and complement deposition was observed.Result After 2-h reperfusion,compared to the control group,oxygenation indexes were improved significantly in DXS group (P＜0.05),but there were no significant differences in W/D between two groups.In DXS group,the activity of MPO was significantly reduced,and the contents of MDA and ET-1 in the lung tissue were significantly reduced as compared with the control group.DXS reduced the level of TNF-α and IL-8 markedly in serum (P ＜0.05).There was no significant difference in lung injury score between two groups (4.53 ± 0.46 vs.5.28 ±0.49,P＞0.05).Compared to the control group,DXS reduced the deposition of C3c (0.8 ±0.2vs1.5±0.3) andC6 (1.2±0.4vs.2.4±0.5) (P＜0.05).Conclusion Administration of DXS attenuated ischemia-reperfusion injury after lung transplantation by inhibiting complement deposition,and improved the oxygenation of the transplanted lung.This protection was associated with inhibition of inflammation and oxidation and endothelial cytoprotection.

Objective To investigate the compartmentalization of human immunodeficiency virus (HIV)infection and CD4~+ T lymphocytes between gastric mueosa and peripheral blood from patients with acquired immune deficiency syndrome(AIDS).Methods Thirty-five AIDS patients and 10 HIV seronegative subjects were enrolled in this study.The gastric mucosal biopsies were done by gastroscope and peripheral blood samples were collected.The digoxin labeled HIV-1 double-stranded cDNA probes for the long terminal repeat(LTR)and gag gene of HIV-1 genome were prepared by polymerase chain reaction(PCR).In situ hybridization was used to detect HIV infection in gastric mucosal tissues and peripheral blood mononuclear cells(PBMC)of AIDS patients.CD4~+ T lymphocytes were determined by immunohistochemistry method.The data were analyzed using t test.Results HIV positive rates were(1.67±1.48)% in gastric mucosa and(19.37±9.23)% in PBMC of AIDS patients who had not received highly active antiretroviral therapy(HAART).The HIV positive rates in gastric mucosa were not significantly different between AIDS patients without treatment and those treated with HAART(t=-0.996,t=-0.794,t=-0.461;P＞0.05).HIV positive rate on PBMC film preparation in patients who had received HAART for 1-4 years was (4.25±3.47)%,which was significantly lower than untreated group[(19.37±9.23)%](t=3.000,P＜0.05).The positive rate of CD4~+ T lymphocytes was(12.53±8.14)% in gastric mucosal mononuclear cells(MMC)and(19.00±9.55)% in PBMC of AIDS patient who had not received HAART.Even after received HAART for 1-4 years,the positive rate of CD4 ~+ T lymphocytes in MMC were(37.44±18.00)%,which was still lower than control group[(50.35±3.41)%](t=-4.620,P＜0.01);while the positive rate of CD4~+ T lymphocyte in PBMC was similar with that of control group(t=-2.094,P＞0.05).Conclusion The compartmentalization of HIV infection and CD4~+ T lymphocyte counts exists between gastric mucosa and peripheral blood from AIDS patients.