Extracellular purine and pyrimidine nucleotides produce the biologic effects involved in activating P2 receptors.P2 receptors are divided P2X and P2Y receptor subtypes.There is molecular and functional evidence for widespread expression of P2X and P2Y receptor subtypes in osteoblasts,osteoclasts and cartilage cells of the skeletal system.Working through P2 receptors,ATP and other nucleotides released into the bone microenvironment regulate formation and activity of bone and cartilage,including development,growth,turnover and repair of biological functions.The release of nucleotides is increased under inflammatory conditions,and localized ATP release could stimulate formation and activation of osteoclasts.Abnormalities of bone remodelling can produce a variety of skeletal disorders.P2 receptors play an important role in the inflammatory disease of bone.

Aim To explore the modulaory effect of tetramethylpyrazine(TMP) on the responses mediated by P2X receptors.Methods Whole-cell patch-clamp technique was used to study the effects of TMP on P2X receptor agonists-activated currents in freshly isolated rat dorsal root ganglion(DRG) neurons.Results Extracellular application of ATP of 1 to 1000 ?mol?L~(-1) activated currents in DRG neurons(n=102).The ATP-activated currents showed rapid desensitization or slow desensitization.Preapplication of TMP(0.1～10 mmol?L~(-1))markedly inhibited ATP(100 ?mol?L~(1))-activated currents in the majority of the neurons examined(89.2%,91/102).TMP(1 mmol?L~(-1)) reduced ?,?-meATP(10 ?mol?L~(-1))-activated currents.TMP(1 mmol? L~(-1)) shifted the concentration-response curve of I_(ATP) downward markedly.TMP(1 mmol?L~(-1)) did not alter the reversal potential(0 mV) of ATP-activated currents.TMP(1 mmol?L~(-1)) significantly inhibited ATP(100 ?mol?L~(-1))-activated currents potentiated by PGE_2(100 ?mol?L~(-1))or SP(0.1 ?mol?L~(-1)).Intracellular application of 10 ?mol?L~(-1) H89(which is an inhibitor of PKA) reduced the inhibitory effect of TMP on ATP(100 ?mol?L~(-1))-activated currents.Conclusion The mechanism of TMP action may be the allosteric regulation via acting on PKA system and the large extracellular region of ATP receptor-ion channel complex(P2X receptors) to affect P2X receptor agonists-activated currents in rat DRG neurons.

P2 receptors activated by purine and pyrimidine nucleotides are divided into two subclasses:P2Y receptors which are G-protein coupled and P2X receptors which are ligand-gated ion channels.The expression of specific P2X and P2Y receptor subtypes in skeletal muscle cells has been demonstrated.Purinergic signaling plays an important role in muscle regeneration of muscular dystrophy,and is involved in skeletal muscle diseases such as muscular dystrophy,tendon inflammation and epilepsy,and provides the possibility of new therapeutic strategies for the treatment of muscle diseases.

Objective To observe the effects of tetramethylpyrazine (TMP) on acute nociception in rat hindpaw induced by purine 2X (P2X) receptor agonists, such as adenosine triphosphate (ATP) and ?, ?-meATP, prostaglandin E 2 (PGE 2), and substance P (SP). Methods The effects of TMP administered intraplantarlly on the acute nociception induced by P2X receptor agonists, PGE 2, or SP in the rat hindpaw were investigated by the method of the behavioral study. Results TMP (10 mmol/L) significantly depressed the acute nociception induced by ATP (1 ?mol/L) or ?, ?-meATP (0.6 ?mol/L) in the rat hindpaw. TMP (10 mmol/L) could inhibit the acute nociception induced by PGE 2 (5 ?mol/L) or ?, ?-meATP (0.2 ?mol/L) coinjected with PGE 2 (5 ?mol/L). TMP (10 mmol/L) could not affect the acute nociception induced by ?, ?-meATP (0.2 ?mol/L) coinjected with SP (10 ?mol/L). TMP could not obviously affect the inflammatory edema in rat hindpaw induced by the local administration of PGE 2, SP, or ?, ?-meATP coinjected with PGE 2 or SP individually. Conclusion The antinociceptive effects of TMP may mainly be associated with inhibiting the transmission of nociceptive information mediated by P2X receptor activation.

Objective Off-pump coronary artery bypass grafting (OPCAB) is used more widely in recent years in China. However, there is an argument on benefits and risks of off-pump surgery. Many studies shown that OPCAB had more benefits in short-term outcomes than conventional coronary artery bypass grafting(CCABG). But evidences from other studies suggested that OPCAB resulted in less long-term graft patency as compared with on-pump surgery. This study examined the longterm graft patency of OPCAB and CCABG performed by one surgeon. Methods 50 patients who had received surgical revascularization by a surgeon for more than 5 years were reviewed, 25 patients received conventional coronary artery bypass grafting ( group 1 ) and 25 patients received OPCAB ( group 2). All patients had angiograms for compareing the graft patency between the two groups. Results Among 25 patients in group 1,21 were male and 4 were female. The mean age of patients at surgery was (55.4 ±8.9) years. 15 cases had unstable angina, 16 patients had old myocardial infarction and 6 cases had diabetes.The ejection fraction (EF) was 0.58 ±0.14. The mean number of bypasses per patient was 3.32 ±0.63. Mean duration of operation was (3.58 ± 0. 82) hours. Mean follow-up duration was ( 86.52 ± 12.48) months. 83 grafts were evaluated for patency ( open vs. closed) and were graded by Fitzgibbon as grade A ( excellent graft), B ( impaired graft, with a stenosis of ≥50%, or a diameter less than 50% of the grafted artery), or O ( completely occluded). The graft patency was 73.49%, 61grafts were graded as Fitzgibbon A, 6 grafts as Fitzgibbon B and 16 grafts as Fitzgibbon 0. 25 patients were in group 2, 21males and 4 females. The mean age of patients at procedure was (58.2 ± 9.09) years, 11 patients had unstable angina, 13 patients had old myocardial infarction and 6 cases had diabetes. The ejection fraction (EF) was 0.59 ± 0. 14. Conclusion No 2011.03.013 difference in long-term graft patency was identified between on-pump and off-pump coronary artery bypass grafting. Off-pump oronary artery bypass grafting preformed by an experienced surgeon may gain similar long-term graft patency to that of conventional bypass.

Objective The optimal treatment for chronic type B dissection remains controversial. The purpose of this study was to report early and mid-term results of thoracic endovascular aortic repair (TEVAR) of chronic type B aortic dissection. Methods Methods From June 2001 to September 2007, 84 patients with chronic type B aortic dissection received TEVAR. The time between onset of dissection and TEVAR was (13.9 ± 22.0) months (ranged 1 - 120 months). All patients were followed for 6 - 86 months [mean (33.2 ± 19.2) months]. Results The entry tear was completely sealed in 77 cases ( 91.7% ) during TEVAR. The incidence of incomplete seal was 8.3%. One-month mortality was 1. 2%. One patient had retrograde type A dissection 1 month after operation. Four patients received a second TEVAR during follow-up :3 for endoleaking and 1 for newly formed intima tear. Seven patients (8.3%) died during follow-up: 3 thoracic aorta rupture due to endoleaking, 1 abdominal aorta rupture caused by continuous dilation of the abdominal aorta, unrelated to aortic dissection deaths in 2 and 1 died of unknown cause. The Kaplan Meier actuarial survival curve showed a 7-year survival rate of 84.4%. Conclusion Early and mid-term results showed that TEVAR was effective in treating chronic type B aortic dissection. Endoleak was the main cause of death during follow-up. With increasing of physician's experience and refinement of the stent-graft, results are likely to improve in the future.

OBJECTIVETo observe the effect of combination therapy of acarbose and Liuwei Nengxiao capsule (LWNXC) in improving senile postprandial hyperglycemia and insulin sensitivity.

METHODSSeventy-four patients with simple postprandial hyperglycemia were divided into the control group and the treated group, 37 in each group, who were treated with acarbose alone and the combination therapy respectively for 1 month, and the changes on 2 hrs postprandial glucose (2 hPG), blood pressure (BP), blood lipid, body mass index (BMI), insulin functional index as well as the adverse reaction of acarbose in the two groups were observed.

RESULTSAfter treatment, the levels of 2 hPG, fasting blood glucose (FBG), BMI, total cholesterol and lowdensity lipoprotein-cholesterol were improved in the treated groups more significantly than those in the control group (P < 0.05 or P < 0.01). Insulin sensitive index (ISI) and insulin resistance were improved in the two group (P < 0.05 or P < 0.01), but the improvement in the treated group was more significant than that in the control group (P < 0.01). Moreover, the adverse reactions were less in the treated group than in the control group.

CONCLUSIONThe combination therapy of acarbose and LWNXC could not only improve the postprandial hyperglycemia, but also markedly increase the insulin sensitivity, and shows obvious improving effect on parameters of blood lipid, BP and BMI. The adverse reaction could be evidently reduced by combined use with LWNXC.

Acarbose ; therapeutic use ; Aged ; Blood Glucose ; metabolism ; Capsules ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glycoside Hydrolase Inhibitors ; Humans ; Hyperglycemia ; drug therapy ; Hypoglycemic Agents ; therapeutic use ; Insulin Resistance ; Lipids ; blood ; Male ; Middle Aged ; Phytotherapy ; Postprandial Period

Aim To study the protective effect of the naringin on chemotactic factor CX3 CL1 of human umbilical vein endothelial cells ( HUVEC) induced by high glucose. Methods The effect of different concen-trations of naringin on HUVEC cell viability was deter-mined by MTS. HUVECs were divided into 4 groups:① control group, ② high glucose group, ③ naringin group and④high glucose treated with naringin group. After treatment for 5 days, the concentration of nitric oxide ( NO ) in the culture medium was measured by nitrate reductase; intracellular reactive oxygen species ( ROS) was analyzed with fluorescence probe; the ex-pressions of CX3 CL1 mRNA and protein were deter-mined by the reverse transcription PCR ( RT-PCR ) and Western blot ( WB ) . Results NO content in the culture medium of high glucose group was markedly de-creased, which could be increased by naringin. Com-pared with the control group, intracellular ROS in the high glucose group was drastically elevated, but narin-gin decreased the elevated ROS induced by high glu-cose. The results of RT-PCR and WB showed that nar-ingin could downregulate the increased expressions of CX3CL1 mRNA and protein induced by high glucose. Conclusion Naringin has protective effect on the in-jury of the HUVEC induced by high glucose, which is associated with reducing the expression of CX3 CL1 and the antioxidative and anti-inflammatory action.

Objective This study aims to evaluate the initial results of a hybrid procedure for treating descending thoracic aortic disease that involves distal aortic arch.It also intends to report our initial experience in performing this procedure.Methods A total of 45 patients(35 males and 10 females) with descending thoracic aortic disease underwent a hybrid procedure,namely,thoracic endovascular aortic repair(TEVAR) combined with supra-arch branch vessel bypass,in our center from April 2009 to August 2014.Right axillary artery to left axillary artery bypass(n =20) or right axillary artery to left common carotid artery and left axillary artery bypass(n =25) were performed.The conditions of all patients were followed up from the 14th month to the 77th month postoperative[mean(38.0 ± 17.1) months].Mortality within 30 days,complications such as endoleak after the hybrid procedure,and stenosis or blockage of the bypass graft during the follow-up period were assessed.Results One case of death and one case of cerebral infarction were reported within 30 days.Two patients underwent open surgery beacuse of endoleak.And a newly formed intimal tear was observed in one patient and the patient underwent a second TEVAR during the follow-up period.Condusion Initial results suggest that the one-stage hybrid procedure is a suitable therapeutic option for thoracic aortic pathologies that involve distal aortic arch.However,this procedure is not recommended for type-B aortic dissection,in which a tear is located in the greater curvature or near the left subclavian artery,because of the high possibility of endoleak occurrence.