55 cases of severe multiple organ failure above 60 years old were treated from April 1977 to January 1987. Each case suffered from 2 to 11 kinds of chronic diseases with an average of 3.8 kinds, and an average of 3.3 organ failures. The average mortality rate was 90.9%. The main precipitating factors were pulmonary infection(72.7%), metastatic carcinoma (14.6%), cardiac arrhythmia (7.3%) and improper medication (5.5%). Low organ infusion, endotoxin and immunological insufficiency probably contributed to their development. Diagnosis, prognosis, therapy and prevention of MOF in the elderly were discussed.

M-mode and pulsed Doppler echocardiography was used to evaluate the changes in structure and function of the left ventricle in 30 patients with chronic renal failure (CRF).The left ventricular mass index (LVMI) and systolic function were unchanged in the early stage of the CRF cases as compared with those of the controls (n = 30). However, the decrement in VE (early peak filling velocity) and the increase in VA/VE (late to early peak velocity ratio) indicated damage of the diastolic function. After 13 months follow-up, the LVMI of the CRF group elavated significantly and the VE diminished further.The ejection fraction (EF), shortening fraction (FS) and circumferencial muscular shortening velocity (mVcf) were decreased as compared with those before the follow up. 47.7% of the patients showed left ventricular heart failure.

Essential hypertension (EH) is an escalating problem for developed and developing countries.It is currently seen as a 'complex' genetic trait caused by multiple susceptibility genes which are modulated by gene-environment and gene-gene interactions.Over the past 10 years,mitochondrial defects have been implicated in a wide variety of degenerative diseases,aging,and cancer.Recently several studies showed that human essential hypertension has excess maternal transmission which suggests a possible mitochondrial involvement.However,the exact pathophysiology of mitochondrial DNA mutation (mtDNA) in essential hypertension still remains perplexing.With the application of a variety of imaging approaches and successive mouse model of mitochonddal diseases we convince that these problems will be resolved in the near future.(J Geriatr Cardiol 2008;5(1):60-64)

Objective To establish rat heart failure(HF)model following myocardial infarction(MI)and then detect the possible cytokines expression levels at different HF groups,so to explore the development of cytokines levels during the progression of heart failure.Methods The model was established by ligature of the left descending coronary artery.The rats were assessed by echocardiography and cardiac catheterization before and after 4 and 16 weeks following coronary ligature.Serum levels of TNF-α and IL-6 were determined.Results ①Serum cytokines could not be detectable in sham group using ELISA Methods,while in operated group,the concentration of TNF-α and IL-6 were significantly higher,especially IL-6.②The diagnosis coincidence between echocardiography and hemodynamics was high.Echocardiography can be used as an invasive measure to assess cardiac function in rat heart failure models.Conclusion ①Cytokines content is higher in compensated compared with the other two groups,especially to the IL-6 expression.②Cardiac ultrasound can be used as a useful method in monitoring postinfarction heart failure rat model,especially as an invasive measure.It can provide us successive data of the model.

To investigate whether the calcium channel blocker amlodipine could inhibit macrophage matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) expression and secretion. Methods Peritoneal macrophages were isolated from BALB/C mice and incubated with low (5μg/L), middle (15μg/L) and high (305μg/L) concentrations of amlodipine, or in the medium alone (controls) for 24 hours, and the expression and secretion of MMP-2 and MM-9 of the cells were analyzed by RT-PCR and gelatin zymography. Results Compared with controls, amlodipine at low concentration had no significant effects on the expression and secretion of either MMP-2 and MMP-9 (P＞0.05);at middle concentrationit it could inhibited MMP-2 and MMP-9 expressions completely and significantly reduced the secretion of MMP-9 (P＜0.05); but it had no effect on the secretion of MMP-2. At high concentration it also inhibited MMP-2 and MMP-9 expression completely. Conclusion Amlodipine at 15 ìg/L inhibited the expression of MMP-2 and MMP-9 and reduced the secretion of MMP-9, suggesting that amlodipine may stabilize atherosclerotic plaque.

During aging, cardiac contractile response to β-AR stimulation is decreased in humans and animal models. Recent studies demonstrate that the positive inotropic effects of both β1-AR and β2-AR stimulation are significantly decreased with aging.This is accompanied by decreases in both β-AR subtype densities and a reduction in membrane adenylyl cyclase activity. However,neither G protein-coupled receptor kinases (GRKs) nor inhibitory G proteins (Gi) appears to contribute to the age-associated reduction in the β-AR modulation of contraction. Thus, while both aging and chronic heart failure exhibit a diminution in cardiac β-AR responsiveness, only heart failure exhibits increased GRK-mediated desensitization ofβ-Ars and an upregulation of Gi proteins.

Objective To observe the short-,mid-and long-term surgical complications of complex acetabular fractures treated by the Kocher-Langenbeck (K-L) approach combined with digastric trochanteric flip osteotomy (DTFO).Methods We reviewed the 40 cases of complex acetabular fracture that were treated at our department from December 2009 through December 2013.They were 34 men and 6 women,from 17 to 73 years of age (average,47.6 years).Of them,19 were treated by K-L approach combined with DTFO,including 17 males and 2 females,with a mean age of 44.7 ± 11.7 years.The other 21 controls were treated simply through the K-L approach,including 17 males and 4 females,with a mean age of 42.8 ± 14.4 years.The 2 groups were compared in terms of intraoperative results,postoperative outcomes and surgical complications like infection,sciatic nerve injury,heterotopic ossification,femoral avascular necrosis,and post-traumatic arthritis.Results The 40 cases were followed up for an average of 29.7 months (range,from 18 to 59 months).The operation time for the DTFO group (248.2 ± 123.2 min) was significantly shorter than that for the control group (276.1 ±50.6 min),the satisfactory reduction rate for the DTFO group (100.0％) was significantly higher than that for the control group (90.5％),the hip intorsion (19.7° ± 3.5°),hip extorsion (26.1° ±4.3°),and hip abduction (40.5° ±4.7°) at one year postoperation in the DTFO group were significantly superior to those in the control group (14.3°± 6.0°,21.0°± 7.2°,31.9°± 10.8°,respectively),and the hospital stay for the for the DTFO group (19.0 ±7.1 d) was significantly longer than that for the control group (13.6 ±4.9 d) (P ＜ 0.05).The intraoperative bleeding and transfusion for the DTFO group were insignificantly greater than those for the control group (P ＞ 0.05).Infection or iatrogenic sciatic nerve injury occurred in none of the patients.There were no significant differences between the 2 groups in terms of positive Trendelenburg test,hip function,heterotopic ossification,femoral avascular necrosis,or post-traumatic arthritis at the last follow-ups(P＞ 0.05).Conclusions In the surgical treatment of complex acetabular fractures,especially those involving the acetabular dome area and the femoral head,K-L approach combined with DTFO can obtain larger surgical exposure field,good fracture reduction and functional recovery,without obviously increasing surgical complications.This technique only slightly increases intraoperative bleeding and transfusion,and results in longer hospital stay.

Objective To investigate calcification of cultured aortic medial cells in vitro and acceleration by 25 hydroxycholesterol or ? glycerophosphate. Methods Aortic medial cells were obtained by explantation, and the calcification was observed by von Kossa staining. Insoluble calcium precipitation in cellular layer was determined by biochemical method , and osteocalcin in the media was analyzed with radioimmunoassay. Results Two different types of primary cells were shown from culture: one with parallel cellular growth and being negative by von Kossa staining, the other cell type formed cellular nodules with positive von Kossa staining. After 28 days of cell passages, cell growth appeared no nodule formation. However, many cellular nodules and positive von Kossa staining were observed in the passaged cells treated with 25 hydroxycholesterol or ? glycerophosphate, and both insoluble calcium 〔(57 80?18 50)?g/pool, (67 50?15 30)?g/pool〕and osteocalcin 〔(0 886?0 063)?g/L, (0 895?0 061)?g/L〕in the medium were significantly increased than that of the untreated cells. Conclusions Cultured aortic medial cells could be divided into two subtypes, one with the characters of smooth muscle cells, the other with the micro vascular pericytes which could calcify the extracellular matrix. 25 hydroxycholesterol and ? glycerophosphate promoted the in vitro calcification, and osteocalcin secretion was increased in the process of calcification of aortic medial, suggesting that osteocalcin might participate in the aortic calcification.

After the following aspects of information resources digitalization in domestic TCM were described, in-cluding different types and contents of digital information resources, effectively developed ancient book resources, expanded team construction, and strengthened cooperation between departments. Measures were put forward for the digitalization of information resources in domestic TCM according to the existed problems, such as insufficient de-velopment, lack of audiovisual products, and low accessibility of TCM information resources.

The head injury patients is very common in clinic and it is complicated to cure them.Furthermore,many ethical questions are involved during the treatment,which are discussed in the article.The aim is to be helpful to protect both patients'and medical staff's right,reduce medical disputes and form a good relationship between doctors and patients from the view of ethics.Accordingly,the patients of head injury will acquire better treatment.