Objective To explore the electrophysiological features of triggering atrial premature contraction(APC) in patients with hypertension combined paroxysmal atrial fibrillation (PAf).Metbods The originating sites and prematurity index (PI) of triggering APC were analyzed in 46 PAf patients with hypertension (hypertension group)and in 35 PAf patients without hypertension( non-hypertension group)from April,2008 to March,2011 in Shanghai Punan Hospital of Pudong New District.Results Triggering APCs in 46 cases with hypertension combined PAf in the hypertension group originated mainly in the left atrium( 81.6％ ).The coupling interval (CI)of triggering APC in hypertension group was significantly shorter than that in non-triggering APC ( [ 374.1 ± 31.5 ] ms versus [ 443.6 ± 32.6 ] ms,t =23.361,P ＜ 0.001 ) and that in triggering APC in nonhypertensive group ( [374.1 ±31.5]ms versus [395.7 ±38.2]ms,t =5.549,P ＜0.001 ).PI in triggering APC was lower than that in non-triggering APC in hypertension group(0.50 +0.05 versus 0.63 ±0.06,t =22.544,P ＜ 0.001 ) and that in triggering APC in non-hypertension group (0.50 + 0.05 versus 0.55 ± 0.08,t =5.849,P ＜ 0.001 ).Conclusion The triggering APC in patients with hypertension combined PAf mainly originates in the left atrium,the PI of triggering APC is significantly lower than that in non-hypertension patients with PAf and PAf occurs more easily in patients with hypertension.Prompt measures should be taken for hypertension patients with lower prematurity index to prevent the occurrence of PAf.

Objective To investigate the characteristics of blood pressure variability during 24 hours and pre-thrombotic state(PTS) in elderly patients with essential hypertension.Methods One hundred cases of old patients with essential hypertension in the department of Cardiology (hypertension group) and 65 controls with normal blood pressure from Punan Health Check Center (control group) were recruited.The systolic and diastolic blood pressure variability (SBPV,DBPV) during 24 h daytime and nighttime were monitored for all subjects by ambulatory blood pressure monitor.The plasma levels of P-selectin (PS),fibrinogen (Fg) and plasminogen activator inhibitor-1 (PAI-1) were measured.Results The systolic blood pressure variability (SBPV) in hypertension group was significantly larger than that of control group (P ＜ 0.05) in daytime,and no significant difference regarding of the diastolic blood pressure variability (DBPV) between two groups.While in nighttime,SBPV and DBPV in hypertension group were significantly higher than those of control group (P ＜ 0.05).The levels of plasma Fg and PAI-1 in hypertension group were significantly higher than those of control group ((2.8 ±0.9) g/L vs.(2.3 ±0.7) g/L and (29.8 ±2.7) μg/L vs.(25.6 ± 1.2) μg/L,respectively).While no significant difference was found between two groups for PS (P ＞ 0.05).Conclusion That indicated pre-thrombotic state including higher blood pressure variability during 24 hours,especially during nighttime in elderly patients with essential hypertension and plasma fibrinogen.

Objective To investigate the toxicity-reducing and action-enhancing effects of total glucosides of paeony (TGP) on tripterygium glycosides (TG) in treating murine lupus nephritis (LN).Methods Chronic graft-versus-host disease (cGVHD) murine LN model was established.Modeling mice were randomly divided into three groups:LN group,TG group (in the dose of 30 mg?kg-1?d-1),and TG+TGP group (TG in the dose of 30 mg?kg-1?d-1 and TGP in the dose of 200 mg?kg-1?d-1),6 mice in each group.Another six normal mice served as control.Medication groups received corresponding medicine according to the experimental design,and mice in the normal control group and LN group received the same volume of saline,qd,for 4 weeks.After the treatment,the levels of 24-hour urinary protein excretion (UPE),blood urea nitrogen (BUN),serum creatinine (SCr),serum alanine transferase (ALT) and aspartate transferase (AST),and contents of superoxide dismustase (SOD),malondialdehyde (MDA),and glutathione peroxidase (GSH-Px) in liver tissue homogenate were measured.Meanwhile,the pathologic changes of kidneys in each group were detected.Results Compared with LN group,levels of UPE,BUN and SCr in TG group and TG+TGP group were decreased notablely (P

ObjectiveTo evaluate the clinical and radiographic efficacy and safety of the combination of recombinant human tumor necrosis factor-αt receptor Ⅱ IgG Fc fusion protein (rhTNFR:Fc) and methotrexate (MTX) in patients with rheumatoid arthritis (RA). MethodsThirty patients with highly active RA were treated with rhTNFR:Fc (25 mg subcutaneously twice weekly) and oral MTX (up to 15 mg weekly). Clinical efficacy was assessed using ACR response criteria and the disease activity score in 28 joints (DAS28).Radiographs of the hands and wrists were assessed with the modified Sharp score. Chi-square test, Fisher is exact test and paired t-test were performed. ResultsAt week 52, ACR20, ACR50 and ACR70 responses were achieved by 90％, 87％ and 67％ respectively. At week 52, mean DAS28 was 3.4±1.1 compared to 6.4±0.6 at base-line(P＜0.01), with 23％ patients achieving clinical remission and 17％ patients in low disease activity. Similarly, the HAQ was improved significantly, declining from 1.18±0.56 at base-line to 0.25t±0.34 at week 52 (P＜0.01). No radiographic progression was found in 22 cases. Adverse events were mild in general.ConclusionTreatment with rhTNFR:Fc plus MTX has shown good efficacy throughout 52 study period in reducing disease activity, improving function, and retarding radiographic progression. Combination therapy for 52 weeks can achieve disease remission and no radiographic progression, which are the two goals of therapy for RA.