Objective To investigate the effect and safety of primary percutaneous coronary intervention (PCI) of acute ST-segment elevation myocardial infarction (STEMI) in elderly patients.Methods 103 consecutive patients with STEMI treated by primary PCI were divided into two groups according to the age:the elderly group [aged≥65 years,with a mean age of (75.7 ±6.2) years(n =49],the non-elderly group [aged＜65 years,with a mean age of (43.0±8.6) years(n =54].Clinical characteristics,complications related to PCI procedure and success rate were analyzed,and major cardiovascular events (MACE) were followed up for(5.7 ± 1.2) months.Results The proportion of female,patients with Killip ≥ Ⅲ,three vessels disease and higher level of serum brain natriuretic peptide were higher in elderly group than in non-elderly group (all P＜0.05).No significant difference was observed between the two groups in success rate and complications of PCI procedure (both P＞0.05).Patients were followed up for (5.7± 1.2) months.The in-hospital and one-month mortalities were higher in elderly group than in non-elderly group [8.2％ (4 cases)vs.0％ (0 case),10.2％(5 cases) vs.0 ％ (0 case),respectively,all P＜0.05].There was no significant difference in six-month mortality and MACE between the two groups.Multivariate logistic regression analysis showed that Killip ≥ Ⅲ was related with the increase of one-month mortality in patients with STEMI undergoing primary PCI,whereas age was not.Conclusions Primary PCI is effective and safe in elderly patients with STEMI.

Objective To study the modulation in number and function of endothelial progenitor cell ( EPC ) in multiple organ dysfunction syndrome ( MODS ) after trauma in swine, and to investigate its pathogenesis. Methods Forty pigs were divided into sham group and MODS group ( each, n = 20 ). The model of MODS of two-hit injury, namely hemorrhagic shock and endotoxemia, was reproduced. The peripheral blood was collected before hemorrhage ( T1 ) and endotoxin injection ( T2 ), and 1 hour ( T3 ), 24 hours ( T4 ), 48 hours ( T5 ) after endotoxin injection. Phosphorylation of p38 mitogen-activated protein kinase ( p-p38MAPK ) in mononuclear cell was determined by Western Blot, the content of tumor necrosis factor-α ( TNF-α) was determined with enzyme linked immunosorbent assay ( ELISA ), and the number of EPC was determined with flow cytometry. Results Model of MODS was successfully reproduced in 17 pigs. In model group, the expression of p-p38MAPK ( A value ) peaked at T3 ( 4.83±0.52 ), and gradually declined at T4 and T5 ( 4.36±0.43, 1.93±0.33 ), and the expression of p-p38MAPK at T3-T5 was significantly higher than that at T1 ( 1.00±0.22, all P<0.01 ). The plasma concentration of TNF-α( ng/L ) at T3 in MODS group was obviously elevated compared with that of sham group ( 532.43±52.17 vs. 129.03±20.45, t=31.163, P<0.001 ), and it peaked at T3, it then gradually lowered, and it was significantly higher at T4 and T5 than that in sham group ( T4: 398.93±35.75 vs. 131.12±29.53, t = 26.562, P < 0.001; T5: 287.48±27.26 vs. 126.44±26.96, t=17.861, P<0.001 ). The number of EPC ( ×107/L ) was apparently increased in MODS group at T3 compared with sham group ( 4.832±0.624 vs. 3.545±0.363, t=9.542, P<0.001 ), and it peaked at T3, then gradually decreased, and the number of EPC at T4 and T5 was significantly lower than that in sham group ( T4:2.628±0.627 vs. 3.442±0.325, t=5.043, P<0.001;T5:2.203±0.711 vs. 3.471±0.323, t=2.972, P<0.001 ). Conclusion Phosphorylation of p38MAPK could increase the plasma concentration of TNF-αand decrease the quantity of EPC in MODS,which may be one of the mechanisms of MODS.

Objective To evaluate the short term effect of bipolar arthroplasties in aged cases with intertrochanteric fractures.Methods There were 23 males and 15 females(at age of 70-93 years, average 76 years)with unstable intertrochanteric fractures treated with the third generation cementing techniques and bipolar arthroplasties that were followed up for average 2.4 years.The clinical effect was evaluate with Harris scale,X-ray films and complications.Results Of all,34 cases(89.5%)could walk freely.The average Harris scale was 84.2 points.The average period until walk with full-weight load was 5.6 weeks.The greater trochanters was united in 35 cases(92%)during average 4.2 months.No peri-prothetic ossteolysis and loosening or subsidence occurred.Conclusions Cemented bipolar arthro- plasty has good advantages of reduced laying up period and few complications.The short-term outcome is satisfactory hut the long-term outcome needs deeper observation.

OBJECTIVETo observe the effect of Wenyang Huazhuo Tongluo Recipe (WYHZTLR) on the proportion of T helper 17 cells (Thl7)/regulatory T cells (Treg), and serum levels of IL-17 and IL-10 in peripheral blood of systemic sclerosis (SSc) patients with yang qi insufficiency and turbidity induced collaterals blockage syndrome (YQITICBS).

METHODSTotally 82 SSc patients were randomly assigned to the Western medicine group (as the control group) and the integrated Chinese and Western medicine group (as the treatment group), 41 cases in each group. All patients took methotrexate (MTX) tablet and prednisone tablet. Patients in the treatment group additionally took WYHZTLR. The treatment course for all was six consecutive months. Besides, another 70 healthy volunteers were recruited as a healthy control group (as the healthy group). Percentages of Th17 and Treg in peripheral blood were detected by flow cytometry. Serum levels of IL-17, IL-10, von Willebrand factor (vWF), aminoterminal propeptide of type l procollagen (PIIINP), and cross-linked carboxyterminal telopeptide of type I collagen ( I CTP) were measured by double antibody sandwich ELISA. The correlations between Th17/Treg and levels of vWF, PIIINP, I CTP, skin score, and disease activity index were observed by Pearson correlation analysis.

RESULTSThe percentage of Th17 in peripheral blood, ratios of Th17/Treg, and the serum level of IL-17 were significantly higher, but the percentage of Treg and the serum level of IL-10 were significantly lower in SSc patients, when compared with those of the healthy group (P <0. 05, P <0. 01). Compared with the same group before treatment, the percentage of Thl7, ratios of Thl7/Treg, and levels of IL-17, vWF, and PIIINP all decreased in the two groups after treatment (P <0.05, P <0.01), but the percentage of Treg and the IL-10 level increased (P <0. 05, P <0. 01). Meanwhile,the level of I CTP was higher in the treatment group after treatment (P <0. 05). The improvement of all indices except the percentage of Th17 was more obvious in the treatment group than in the control group (P <0. 05, P <0. 01). The ratio of Th17/Treg was positively correlated with levels of vWF, PIIINP, skin score, and disease activity index before and after treatment respectively (P <0. 01), but with no obvious correlation with the level of I CTP (P >0. 05).

CONCLUSIONWYHZTLR could achieve its therapeutic effect on SSc patients by regulating Th17/Treg imbalance, lowering levels of vWF and PIIINP, and elevating the level of I CTP.

Drugs, Chinese Herbal ; therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Interleukin-10 ; Interleukin-17 ; Methotrexate ; Peptide Fragments ; Procollagen ; Scleroderma, Systemic ; drug therapy ; T-Lymphocytes, Regulatory ; Th17 Cells

Objective To investigate whether the effect of puerarin on right ventricle hypertrophy of pulmonary hypertensive rats induced by chronic hypoxia-hypercapnia was related to new peptide Apelin or its receptor(APJ).Methods Thirty male Sprague-Dawley rats were randomly divided into three groups, they are control group,hypoxia-hypercapnia 4-week model group,and hypoxia-hypercapnia 4-week plus puerarin group.The concentrations of Apelin-36 protein in plasma and homogenate of right ventricular muscle were detected by radioimmunoassay.The mRNA expressions of Apelin and APJ in right ventricu- lar muscle were measured by semi-quantitive reverse transcription polymerase chain reaction(RT-PCR). Results The weight ratio of right ventricle to left ventricle plus septum[RV/(LV+S)] in model group was significantly higher than that in control group(P0.05).The plasma concen- tration of Apelin-36 protein in model group was significantly higher than that in control group(P

Objective:To evaluate the dose-response relationship of alfentanil inhibiting gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy.Methods:Patients of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged ≥60 yr, scheduled for elective painless gastroscopy, were selected. Propofol 1.5 mg/kg combined with alfentanil was given intravenously in all the patients. The dose of alfentanil was determined by the Dixon up-and-down method. The initial dose of alfentanil was set at 5 μg/kg. The dose of alfentanil in the next patient was determined according to the development of gag reflex, and the ratio between the two successive doses was 1.1. The median effective dose (ED 50) and 95% confidence interval of alfentanil-induced inhibition of gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy were calculated using the by up-and-down sequential allocation. Results:The ED 50 (95% confidence interval) of alfentanil-induced inhibition of gag reflex when combined with propofol 1.5 mg/kg was 2.8 (2.4-3.2) μg/kg in elderly patients undergoing painless gastroscopy. Conclusion:When combined with propofol 1.5 mg/kg, the ED 50 of alfentanil inhibiting gag reflex is 2.8 μg/kg in elderly patients undergoing painless gastroscopy.

AIMTo investigate the effects of L-arginine liposome on nitric oxide(NO) and nitric oxide synthase gene (NOS mRNA) in rats chronically exposed to hypoxia-hypercapnia.

METHODSFourty male SD rats were randomly divided into four groups (n=10): normal control group(NC), hypoxia-hypercapnia group (HH), hypoxia-hypercapnia + L-arginine group(HL) and hypoxia-hypercapnia + L-arginine liposome group (HP). Contents of NO in plasma were measured using colorimetric analysis. Expression of nitric oxide synthase gene were measured with situ hybridization.

RESULTS(1) The mean pulmonary artery pressure(mPAP) and weight ratio of right ventricle to left ventricle and septum(RV/LV + S) of HP group were obviously lower than those of HH group and HL group. (2) The NO contents in plasma of HP group were obviously higher than those of HH group and HL group (P < 0.01). (3) Situ hybridization showed the average value of integral light density(LD) of ecNOS mRNA in pulmonary arterioles was significantly higher in rats of HP group than that of HH group and HL group (P < 0.01). (4) Light microscopy showed WA/TA (vessel wall area/total area) and PAMT (media thickness ratio of pulmonary arterioles) were significantly lower in rats of HP group than those of HH group (P < 0.01).

CONCLUSIONL-arginine liposome could lower the mPAP and lighten the remodeling of pulmonary arterioles of the rats chronically exposed to hypoxia-hypercapnia than L-arginine does. It suggests that L-arginine liposome significantly promotes the membrane transportin of L-arginine.

Animals ; Arginine ; pharmacology ; Gene Expression ; Hypercapnia ; metabolism ; Hypoxia ; metabolism ; Liposomes ; pharmacology ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo understand the environmental risk factors on attempted suicide, and to study the interaction between factors as gene polymorphism of catechol-O-methyltransferase (COMT) associated to attempted suicide.

METHODSPaired case-control study of 205 suicide attempters (89 male, 116 female) and molecular biological techniques were used to study the relation between gene polymorphism of COMT, environmental factors and the rate of attempted suicide. Controls were paired with cases according to the same gender, similar age (no more than 3 years) and in the same district.

RESULTSThere were no significant differences in gene types and gene frequency between case and control groups. Multivariate conditional logistic regression model analysis showed that COMT Val/Val 158/108, low education level, cigarette smoking, emotional conflicts, psychologic disorders and depression were risk factors of attempted suicide with OR values as 2.43 (95% CI: 1.10 - 5.40), 5.70 (95% CI: 1.88 - 17.27), 3.54 (95% CI: 1.02 - 12.36), 10.96 (95% CI: 4.74 - 25.34), 6.35 (95% CI: 1.68 - 24.05) and 11.30 (95% CI: 4.58 - 27.89) respectively. There was no first level interaction between any two risk factors.

CONCLUSIONThe study supported that low education level, cigarette smoking, affective conflicts, psychiatric disorders, depression were risk factors of attempted suicide and COMT Val/Val 158/108 was suspected to be a susceptible gene type of attempted suicide but needs further study. The study also suggested that 116 bp in gene atlas be possibly correlated to high activity of COMT.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Catechol O-Methyltransferase ; genetics ; China ; epidemiology ; Depression ; complications ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Polymorphism, Genetic ; Risk Factors ; Smoking ; adverse effects ; Suicide, Attempted ; statistics & numerical data

OBJECTIVETo study the role of apelin in the prevention of pulmonary hypertension induced by hypoxia in rats.

METHODSThe animal model of hypoxic pulmonary hypertension was established by exposing the rats to isobaric hypoxic chamber for 4 weeks (8 h/d, 6 d/ w). Forty male Sprague-Dawley rats were randomly divided into control group (NC), hypoxic group(HH), hypoxic with low-dose apelin (5 nmol/(kg x d) group(LA) and high-dose apelin (10 nmol/(kg x d) (HA). [pGlu]apelin-13 was administered into the rats of apelin groups by mini-osmotic pump subcutaneously. The mean pulmonary arterial pressure(mPAP) and the mean carotid arterial pressure (mCAP) were measured by either right or left cardiac catheterization, and the weight ratio of right ventricule/left ventricule plus septum (RV/(LV + S)) were calculated. The Masson's trichrome stained lung specimens were examined by light microscope to examine the vessel wall area/total area (WA/TA), vessel cavity area/total area (CA/TA) and media thickness of pulmonary arterioles (PAMT). Meanwhile, the lung homogenates were assayed for the activity of supeeroxide dismutase (SOD) and the content of malondialdehyde (MDA).

RESULTS(1) mPAP and RV/(LV + S) of HH group were significantly higher than those of NC group. mPAP of LA and HA groups were lower than those of HH group. The RV/(LV + S) of HA group was significantly lower than that of HH group, but there was no significant difference between HH group and LA group. (2) Masson's trichrome staining revealed that WA/TA and PAMT of HH group were higher than those of NC group. Administration of apelin significantly eliminated WA/TA and PAMT in LA and HA groups. (3) CA/TA of HH group was lower than that of NC group. Administration of apelin significantly elevated CA/TA in LA and HA groups. (4) The activity of SOD and content of MDA in HH group was, respectively, lower and higher than those in NC group. Apelin treatment increased the activity of SOD in LA and HA groups while decreased the content of MDA.

CONCLUSIONSApelin could play an important role in treatment of hypoxic pulmonary hypertension of rats and the mechanisms of protection were associated with vasodilation of pulmonary artery and inhibition of oxidative stress.

Animals ; Cardiotonic Agents ; pharmacology ; therapeutic use ; Hypertension, Pulmonary ; etiology ; physiopathology ; prevention & control ; Hypoxia ; complications ; physiopathology ; Intercellular Signaling Peptides and Proteins ; pharmacology ; therapeutic use ; Male ; Oxidative Stress ; drug effects ; Pulmonary Artery ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Vasodilation ; drug effects

BACKGROUNDChina is the most severe endemic area of hemorrhagic fever with renal syndrome (HFRS) in the world with 30,000-50,000 cases reported annually, which accounts for more than 90% of total number of cases worldwide. The incidence rate of the syndrome in Shandong Province is one of the highest in China, which has ever reached 50 per 100,000 persons per year. However, the molecular characteristics of hantaviruses (HV) epidemic in Shandong Province remain unclear. Therefore it is useful to clarify nucleotide sequence and phylogenetic characteristics of HV isolated in Shandong Province in order to provide better advices to control and prevent HFRS.

METHODSRNAs were extracted from sera of clinically diagnosed patients and positive rodent lungs that were detected by indirect immunofluorescent assay (IFA). Partial M segments of HV were amplified from the RNAs with reverse transcription nested polymerase chain reactions (nested PCR) using hantavirus genotype specific primers. The nested PCR products were sequenced and compared with those from previously epidemic isolates in Shandong and with other representative HV sequences from GenBank. Phylogenetic tree analyses were performed based on the sequences of the M genes.

RESULTSThirty-four HV isolates in Shandong showed 67.1%-100% nucleotide identities. The nucleotide homologies among 6 Hantaan viruses (HTNV) isolates in Shandong were 78.1%-98.7%, while the homologies among 28 Seoul virus (SEOV) isolates in Shandong were 93.7%-100%. There were at least 3 subtypes HTNV (H2, H5, H9) and 2 subtypes SEOV (S2, S3) in Shandong Province.

CONCLUSIONSIn Shandong Province, the homologies of HTNV were lower and there were no predominant subtypes, while the homologies of SEOV were higher and S3 was the predominant subtype. The homologies of SEOV from rodents were higher than those from patients. The distribution of subtypes in Shandong was similar to that of the adjoining provinces. Phylogenetic analyses of the sequences showed geographic clustering of HV in Shandong.

Animals ; Antigens, Viral ; analysis ; Base Sequence ; Genetic Variation ; Hantavirus ; classification ; genetics ; Humans ; Lung ; virology ; Phylogeny ; RNA, Viral ; analysis ; Rodentia ; virology