Objective The aim of the study is to explore the relationship of lung infection(LI)and multiple organ failure in the elderly(MOFE).Methods Consecutive patients ,who were admitted to the Institute of Geriatric Cardiovascular Diseases of the PLA General Hospital and the Endocardial Department of the Air Force General Hospital,withage≥65 years old were enrolled into 5 groups retrospectively by following criteria:acute LI alone,LI with the first presentation of acute lung edema,chronic bronchitis complicated with LI,chronic heart failure complicated with LI,and nic bronchitis and heart failure complicated with LI.Results Sixty-eight patients were selected of(72.5?7.6)years old ( 38 male).There were 4 cases of pure LI(4%),12 cases of LI firstly presented with the symptoms of acute lung edema(18%),16 cases of LI complicated with chronic bronchitis(24%),15 cases of LI based on chronic heart failure(22%)and 22 cases of LI complicated with chronic bronchitis and heart failure(32%).LI initiated MOFE in 25 cases(37%).Most of them were developed on the basis of chronic bronchitis and/or heart failure(34%).Mortality of secondary LI was higher than that of the primary LI(7.4% VS 0%,P

Objective To evaluate the feasibility, and clinical efficacy of combined interventional procedure (CIP) in composite cardiovascular diseases (CCD). Methods Twenty one consecutive patients were diagnosed as CCD before the procedures. The algorithm of CIP were individualized by the operators and physicians. The criteria for a successful procedure were defined before the operation. The counterplan for predictable complications was also established beforehand. The successful rate, short and long term efficacy, the incidence of complications and adverse reaction associated with contrast medium and X-ray were observed. All the patients were followed up through special out-patient clinic, telephone, or letters. Results Seven cases accepted electrophysiological testing(EPT) + radiofrequency catheter ablation (RFCA)+coronary angiogram (CAG)+percutaneous transluminal coronary angioplasty (PTCA)+stent implantation (SI). Four cases accepted CAG+PTCA+SI+EPT. Three cases accepted EPT+RFCA+CAG. Six cases accepted CAG+PTCA+SI+peripheral artery angiogram (PAG). One cases accepted pacemaker implantation (PI)+CAG+PTCA+SI+percutaneous transluminal septal myocardial ablation (PTSMA). The symptoms of arrhythmia disappeared or alleviater in 19 cases during hospiatalization. Arrhythmia recurred in 2 cases 12 hours after the procedure and accepted RFCA again. No severe complications and adverse reaction occured. The successful rate was 90.5 percent. Two cases suffered from recurrent angina during the follow-up period and one of them had in-stent restenosis proved by CAG and accepted PTCA+SI again. The other patient received medicine therapy. Conclusion Combined interventional procedure operated by experienced interventional cardiologist in a conditioned catheterization laboratory is safe and feasible. The short-term outcomes are satisfied. The long-term outcomes will be proved by accumulating more cases' data. Individualized approaches, counterplans for complications and cautious operation are important to a successful procedure.

Objective To study the separation ability of AB-8 macroporous resin in the purification of arctinin in Fructus arctii. Methods HPLC was used to measure the content of arctinin, and the adsorption performance and the elution parameters were investigated. Results The optimal separation conditions were as follows: the concentration of Arctinin was 5.5 mg/ml with a flow rate of 2 BV/h, and 50% alcohol was used as eluant. The adsorption of Arctinin was 52.08 mg/g, and the elution ratio of arctinin was 93.8%, and the purity of arctinin reached 65.2%. Conclusion AB-8 resin can be used to refine the arctinin in the extraction of Fructus arctii.

Objective To study the mechanism of changes in blood gas and hemodynamics in aged rats with pneumonia. Methods Forty aged male Sprague-Dawley(SD) rats were randomly divided into three experimental groups and the control group. They were contrasted by 40 non-aged male SD rats. Hemodynamic parameters and blood gas were measured, and morphological changes of heart and lung were observed. Plasma levels of tumor necrosis factor-? (TNF-?) was examined by immunohistochemical method. Results PaO 2 and SaO 2 were lower in rats with pneumonia than those in the control rats(P

In view of the situation such as the serious shortage of anatomical teachers in medical colleges and universities,irrational personnel structure,anatomical teachers' single knowledge and weak scientific research ability,etc.,we analyzed the national policy,social impact,school leadership,personal career planning and other aspects of the problem and put forward some countermeasures to improve the treatment,improve the environment and train talents,which provided reference for the development of the discipline of anatomy,the construction of teaching staff and the reform of the basic medical education.

Objective To explore the effect of aerobic exercise on platelet function in elderly patients with hypertension and type 2 diabetes.Methods81 elderly patients with hypertension and type 2 diabetes were divided into the routine treatment group (group A, n=41) and regular exercise group (group B, n=40). All patients of two groups were treated with routine treatment. The exercise with moderate intensity was performed in the group B for 3 months besides routine treatment. The platelet membrane glycoprotein CD62P, CD61 (Ⅲa) were detected by flow cytometric analysis and platelet aggregating ratio was measured before and after regular aerobic exercise.ResultsAfter three months, the systolic blood pressures were 166±3.6 mm Hg (group A) and 152±3.5 mm Hg (group B); the diastolic blood pressures were 93±4.2 mm Hg (group A) and 83±4.3 mm Hg (group B); the contents of blood glucose were 7.4±2.4 mmol/L (group A) and 6.3±1.9 mmol/L (group B); the positive percents of platelet membrane glycoproten CD62P were 27.3±2.2% (group A) and 21.5±3.3% (group B), CD61(Ⅲa) were 26.3±2.3% (group A) and 20.2±2.9% (group B) and platelet aggregation rates were 78.4±4.5% (group A) and 69.7±5.4% (group B), there was a significant difference between two groups ( P<0.05～0.01).ConclusionRegular aerobic exercise can decrease the positive percent of platelet membrane glycoprotein and platelet aggregation rate in elderly patients with hypertension and type 2 diabetes.

Objective To evaluate the effect of modified Maze lines plus pulmonary vein (PV) isolation created by radiofrequency catheter ablation (RFCA) on atrial wall guided by a novel geometry mapping system in the treatment of elderly patients with paroxysmal atrial fibrillation (PAF). Methods After regular electrophysiological study, transseptal punctures were achieved twice with Swartz L1 and R1 sheaths. PV angiographies were conducted to evaluate their orifices and branches. A balloon electrode array catheter with 64 electrodes was put in the middle of the left atrium. Atrium geometry was constructed using Ensite 3000 Navx system. Two RFCA lesion loops and three lines (modified Maze) were created on left and right atrial walls. Each lesion point was ablated for 30 seconds with preset temperature 50 (ae) and energy 30W. The disappearance or 80% decrease of the amplitude of target atrial potential and 10 to 20(|), decrease of ablation impedance were used as an index of effective ablation. Results A total of 11 patients (7 male and 4 female, mean age, 68.7±5.1 years) were enrolled. PAF history was 7.9±4.5 years. PAF could not be prevented by mean 3.1±1.6 antiarrhythmic agents in 6.3±3.4 years. None of the patients had complications with structural heart disease or stroke. Left atrial diameter was 41.3±3.6 mm and LVEF was 59.2±3.7% on echocardiography. Two loops and three lines were completed with 67.8±13.1 (73-167) lesion points. Altogether 76-168 (89.4±15.3) lesion points were created in each patient. PAF could not be provoked by rapid burst pacing up to 600 beat per minute delivered from paroxysmal coronary sinus electrode pair.Complete PV electrical isolation was confirmed by three-dimensional activation mapping. Mean procedure time was 2.7±0.6 hours and fluoroscopy time was 17.8±9.4 minutes. Patients were discharged with oral aspirin and without antiarrhythmic agents. During follow up of 6.5±1.8 months, seven patients were PAF symptom free (63.6%). PAF attacks were decreased more than 70% in two patients (18.2%). PAF frequency did not change in another two patients (18.2%). Conclusions Ensite 3000 Navx guided modified Maze lines plus PV isolation on the atrial wall is safe and feasible in the elderly patients. It has the advantages of exact procedural endpoint, shorter X-ray exposure, fewer complications and satisfied long-term effect PAF control.

Objective To investigate the occurrence of nocturnal myocardial ischemia and its relationship with sleep-disordered breathing (apneas and oxygen desaturations) in patients with angina pectoris undergoing coronary angiography.Methods Eighty-two men and 14 women referred for consideration of coronary intervention were randomly selected. Observation by an overnight sleep monitor and Holter recording were performed to study sleep-disordered breathing (oxyhemoglobin desaturations≥4％ and apnea-hypopneas),heart rates, and ST-segment depressions (≥ 1mm, ≥1 min).Results Nocturnal ST-segment depressions occurred in 37 ％ of the patients. ST-segment depression within 2 min after an apnea-hypopnea or desaturation occurred in 17％ of the patients. This temporal association was seen in 21％ of the patients with nocturnal ST-segment depressions, more frequently in men (P＜0.05) and more frequently in those with severe disordered breathing (P＜0.05).Most of these ST-segment depressions were preceded by a series of breathing events: repeated apnea-hypopneas or desaturations or both in 73％ of the patients. Conclusions Episodes of nocturnal myocardial ischemia are common in patients with angina pectoris. A temporal relationship between sleep-disordered breathing and myocardial ischemia was present in some of our patients, and occurs more frequently in men and in those with severely disordered breathing. (J Geriatr Cardiol 2004;1(2):90-94.)

Objective To determine whether sleep-disordered breathing (SDB) may lead to nocturnal myocardial ischemia and whether the severity of this ischemia may be relieved by nasal continuous positive airway pressure (CPAP). Methods Overnight polysomnogram examination and simultaneous 3-channel Holter monitoring were performed on 76 patients with moderate to severe SDB and no history of coronary heart disease. All the cases were treated with CPAP for one night. ST depression was defined as a ST segment decrease of more than 1 mm from baseline and lasting 1 min or more. The total duration (minutes) of ST depression was indexed to the total sleep time (minutes per hour of sleep). Results Twenty-eight patients (37%) showed ST segment depression during their sleep. Before CPAP treatment, the respiratory disturbance index (RDI) and arousal index were significantly higher during periods of ST depression than when ST segments were isoelectric, whereas no significant difference was found in blood oxygen saturation (SaO2). After the CPAP treatment of patients with ST depression, the duration of ST depression was significantly reduced from 36.8±18.9 to 11.4±13.2 min/h (P＜0.05). ST depression-related indexes, including RDI, arousal index and the percentage of sleep time spent at SaO2 below 90% (TS90/ TST), were all significantly decreased, with RDI from 63.4±23.8 to 8.1±6.6 /h, arousal index from 51.2±18.9 to 9.6±5.4 /h, and TS90/ TST from 50.6±21.4 to 12.9±14.7% (P＜0.05). Conclusion ST-segment depression is rather common in patients with moderate to severe SDB, and CPAP treatment can significantly reduce the duration of ST depression. ST depression in these patients may reflect the myocardial ischemia that really exists and the non-ischemic changes associated with recurrent SDB.

Background and Objectives The relationship between left atrial (LA) size and congestive heart failure (CHF) is well recognized;however, there is little information on the association of pulmonary vein (PV) diameter and CHF.The purpose of this study was to investigate the changes of PV and LA sizes in CHF patients by multislice computed tomography (MSCT) angiography using a new 64-slice scanner. Methods and Results We assessed diameters of PVs ostium and LA by 64-slice MSCT with three-dimensional reconstruction in 25 CHF patients and in 26 age- and sex-matched non-CHF controls. Compared with controls, CHF patients showed significant greater diameters of left superior pulmonary vein (LSPV) and right inferior pulmonary vein (RIPV) in both anteriorposterior(AP) and superior-inferior (SI) directions (P＜0.01), significant dilation of right superior pulmonary vein (RSPV) in AP direction (P＜0.05), as well as significant increase of LA transverse, AP, and SI diameters (P＜0.01). Conclusion Significant dilation of PVs with simultaneous LA enlargement was demonstrated in CHF patients. This anatomic and geometric changes may participate in the perpetuation of AF.