Objective: To observe the inlfuence of simvastatin combining ezetimibe on blood levels of glucose and lipids in patients of acute coronary syndrome (ACS) with impaired glucose tolerance (IGT).
Methods: A total of 316 patients with ACS and IGT were randomly divided into 2 groups: Treatment group, the patients received simvastatin 20 mg/day with ezetimibe 10 mg/day,n=160 and Control group, the patients received simvastatin 20 mg/day,n=156. All patients were treated for 24 months. Blood levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were observed at 6, 12 and 24 months of medication; fasting blood glucose (FBG), 2 hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c) and the number of patients with new onset diabetes were examined at 6 days and 12, 24 months of medication.
Results:①In Treatment group, at 6 months of medication, blood levels of TC (mmol/L) and LDL-C (mmol/L) were (3.5 ± 0.5) and (2.1 ± 0.4) which were both lower than baseline levels (5.2±1.2) and (3.5±0.5),P<0.05; at 12 and 24 months, TC and LDL-C were (3.1 ± 1.0), (1.8 ± 0.6) and (3.0 ± 0.6), (1.8 ± 0.5), TC and LDL-C were consistently decreased, all P<0.05. In Control group, at 6 months of medication, TC and LDL-C were (4.0 ± 0.5) and (2.4 ± 0.5) which were both lower than baseline levels (5.3 ± 0.8) and (3.1 ± 0.4),P<0.05; at 12 and 24 months, TC and LDL-C were (3.8 ± 0.6), (2.3 ± 0.6) and (3.7 ± 0.5), (2.1 ± 0.7), allP<0.05. TC and LDL-C levels in Treatment group were lower than Control group at 6, 12 and 24 months of medication, allP<0.05.②In Treatment group, FBG (mmol/L) levels at 12 and 24 months were similar to 6 days,P>0.05; HbA1c at 12 and 24 months were similar to baseline,P>0.05; 2hPG (mmol/L) level at 24 months was higher than 6 days (9.5 ± 1.1) vs (8.7 ± 1.0),P<0.05; there were 26 patients with new onset diabetes at 24 months after medication. In Control group, 2hPG level at 24 months was higher than 6 days (9.6 ± 0.8) vs (8.7±0.7); there were 25 patients with new onset diabetes at 24 months after medication. The levels of FBG, 2hPG, HbA1c and the number of patients with new onset diabetes were similar between 2 groups, allP>0.05.
Conclusion: Ezetimibe combining simvastatin may better reduce blood lipids, while it had no real effect on blood glucose metabolism in patients with ACS and IGT.

Objective To determine whether left ventricular Tei Index evaluate the cardiac function and prognosis of patients with sepsis-induced cardiomyopathy (SIC).Methods A total of 86 patients with septic shock combined with SIC in the emergency department of Beijing Chaoyang Hospital affiliated to Capital Medical University from July 2014 to June 2016 were recruited and divided into non-survival group (n=35) and survival group (n=51) according to 28-day follow-up.Left ventricular Tei Index, BNP, cTNI and left ventricular ejection fraction within the first 24 h after admisson were detected and compared between the two groups.The correlations of left ventricular Tei Index to BNP, cTNI and ejection fraction were analyzed.The receiver operating characteristic curves (ROC) were constructed to analysize the value of Tei Index in evaluating the cardiac function and prognosis.Results The patientsin the non-survival group had a higher Tei Index compared with that in the survival group [(0.75±0.13) vs.(0.51±0.09), P<0.05].The Tei Index of SIC patients was significantly positively correlated with BNP and cTNI (both P<0.05), and significantly negatively correlated with ejection fraction (P<0.05).The AUC of Tei Index for predicting 28-day mortality in SIC patients was high comapred with that of BNP, cTNI and ejection fraction.Conclusion The left ventricular Tei Index has a reliable value in evaluating the cardiac function and prognosis of patients with SIC.

BACKGROUND:The spinal column is the most common site of cancer metastases. Most of the previous biomechanical experiments utilized models with defects only in the vertebral body or posterior elements, but the biomechanical changes of the thoracic vertebrae and posterior part with various locations of metastasis deserve further research. OBJECTIVE:To set up the three-dimensional (3D) finite element model to investigate biomechanical effects by simulating combined destruction of vertebral body and other posterior components. METHODS:Based on CT data, we constructed the 3D geometric models of the thoracic vertebrae (T9-11), including intervertebral discs, ligaments and ribs using the Mimics software. The 3D models of T9 vertebra and different parts of the posterior thoracic vertebrae related with the metastasis could be simulated, including the control group with the intact vertebrae, the group of the T10 vertebrae with the right defective hemi-vertebrae, the group of the defective hemi-vertebrae with the defective ipsilateral pedicle, the group of the defective hemi-vertebrae with the defective ipsilateral costovertebral joint, the group of the defective hemi-vertebrae with the defective ipsilateral pedicle and costovertebral joint, the group of the defective hemi-vertebrae with the defective ipsilateral pedicle, costovertebral joint and transverse process. The corresponding 3D finite element models were established using the Abaqus software. The displacement and Von Mises stress distribution of the models were analyzed when the anterior compressive flexure load was applied. RESULTS AND CONCLUSION:When the anterior compressive flexure load was applied, the entire stiffness was proportionaly decreased when the more posterior parts destroyed, especialy destruction of vertebral body and pedicle significantly decreased. The destruction of posterior structures such as the thoracic rib joints and transverse processes was not great. However, the maximal Von Mises stress increased significantly when the vertebral body and pedicle were destructed, but additional costovertebral joint destruction slightly decreased the maximal Von Mises stress because of the stress was re-distributed.

Objective:To investigate the effects of rosuvastatin and lfuvastatin on patients with acute coronary syndrome (ACS) combing impaired glucose tolerance (IGT).
Methods: A total of 215 consecutive ACS patients combing IGT treated in our hospital from 2009-05 to 2011-05 were studied. The patients were randomly divided into 2 groups, Rosuvastatin group, the patients received rosuvastatin10mg/day, n=108 and Fluvastatin group, the patients received fluvastatin 40mg/day, n=107. The total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) levels before and at 6, 12, 24 months after medication, fasting blood glucose (FBG), 2-hour postprandial glucose (2hPBG) and the number of new-onset of diabetes patients were compared between 2 groups.
Results: After treatment, the TC, LDL-C levels were decreased (6, 12, 24 months) and the HDL-C level (12, 24 months), 2hPBG (24 months) were increased in both groups. Compared with Fluvastatin group, Rosuvastatin group had decreased TC and LDL-C (6, 12, 24 months), and increased LDL-C (24 months). With 6, 12, 24 months treatment, the blood lipids reached the standard were more in Rosuvastatin group than those in Fluvastatin group as 35.3%vs 26.1%, 36.4% vs 22.0%, 43.1% vs 31.8% respectively, all P<0.05. With 12 and 24 months treatment, the new-onset diabetes patients in Rosuvastatin group were 11 and 18, in Fluvastatin group were 12 and 17. With 12, 24 months treatment, FBG, 2hPBG levels and the number of new-onset diabetes patients were similar between 2 groups, P>0.05.
Conclusion: Compared with lfuvastatin, the conventional dose of rosuvastatin could better reduce the blood lipids level in ACS patients combing IGT, the effects for preventing ACS patients from IGT to diabetes were similar for both drugs.

60 kg) was given to all the patients 1-3 days after their operation.The pacing threshold and the amplitude of P and R waves on cardiograph were measured before injection and at 10,30,90,180 minutes afterwards.Results No significant changes were oburved in pacing threshold and the amplitade of P and R waves before and after the injection of metoprolol in patients with either newly implanted or replacement of permanent pacemakers.Conclusion Metoprolol tartrate has no effect on atrial and ventricular pacing threshold and the amplitude of P and R waves in patients with permanent pacemakers implantation.

The purpose of this study is to prepare 99mTc-HEDTMP [N-(2-hydroxyethyl) ethlenediamine-1,1,2-tri (methylene phosphonic acid), a new kind of bone seeking compound; to investigate its biological properties; and to explore the possibility of using it as a potential radiopharmaceutical for skeleton scintigraphy. HEDTMP was labeled with 99mTc by "pretinning" method, the radiochemical purity was 97.00% +/- 0.34%. 99mTc-HEDTMP was found to be stable in 5 hours in vitro with the radiochemical purity over 95% even after being diluted by physiological saline with the factor of dilution 100. The plane bone scanning of rabbits showed that 99mTc-HEDTMP was principally absorbed by skeletal system. Skull, spine and legs could be observed clearly, and were more legible than the images of 99mTc-MDP. Mice trial also indicated the high bone seeking of 99mTc-HEDTMP. The skeletal uptake was 11.92% ID/g, 13.19% ID/g, 10.14% ID/g, 10.04% ID/g, 7.71% ID/g separately at 30 minutes, 1 hour, 3 hours, 6 hours and 24 hours after the injection. Kidney seemed to be the major excretory organ. The clearance of blood was quick and the retaining amount in non-target organs was small. These results indicate that 99mTc-HEDTMP can be prepared easily, and its biological properties can be compared favorably with the commonly used bone imaging agent, and it is well worth further researching as a promising potential radiopharmaceutical in nuclide diagnosis for skeleton diseases.
Animals ; Bone and Bones ; diagnostic imaging ; metabolism ; Female ; Male ; Mice ; Organotechnetium Compounds ; chemical synthesis ; pharmacokinetics ; Rabbits ; Radiopharmaceuticals ; chemical synthesis ; pharmacokinetics ; Random Allocation ; Technetium Tc 99m Medronate ; pharmacokinetics ; Tissue Distribution ; Tomography, Emission-Computed, Single-Photon

Objective To summarize our clinical experience of surgical treatment for pediatric patients with ventricular septal defect(VSD) and mitral regurgitation(MR).Methods A retrospective study was performed including consecutive 84 patients with VSD and MR receiving mitral valvuloplasty(MVP) and VSD closure from January 2006 to January 2012 in Shanghai Xinhua Hospital.All patients were associated with pulmonary hypertension(PH,32-85 mm Hg).The diameters of ventricular septal defects were between 0.7 and 1.6 cm.Echocardiography showed that trivial MR (+) in 9 cases,mild MR (++)in 18 cases,moderate MR(+++) in 33 cases,and severe MR(++++) in 24 cases.VSD closure and MVP were performed with cardiopulmonary bypass under moderate systemic hypothermia.The results of repair were evaluated by transesophageal echocardiography (TEE) during operation.Results Intra-operative TEE results: no residual shunt of VSD,none MR in 80 cases,residual trivial MR in 4 cases.Mean Cardiopulmonary bypass (CPB) time was (84.6 ± 18.5) mins.Mean Aortic clump time was(50.8 ± 11.5) mins.Mean postoperative ventilation time was (38.7 ± 30.2) hours,and mean postoperative inhosptial time was(10.5 ±4.6) days.The in-hospital mortality was 1.2％ (1 case died).78 cases were fully followed up.There was no late death.Echocardiography showed that none MR in 62 cases,trivial MR in 10 cases,mild MR in 4 cases,moderate MR in 2 patients.The overall freedom from reoperation at 5 years was (97.4 ± 1.8) ％.Conclusion Ventricular septal defect with pulmonary hypertension need early surgical repair.MR was treated at the same time of VSD closure could effectively improve the surgical outcome of pediatric patients with ventricular septal defect and mitral regurgitation.

Antineoplastic Agents ; pharmacology ; Autophagy ; drug effects ; Disulfides ; pharmacology ; Gene Expression Regulation, Neoplastic ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; HCT116 Cells ; Humans ; Piperazines ; pharmacology ; Proto-Oncogene Proteins ; genetics ; metabolism ; Proto-Oncogene Proteins p21(ras) ; Signal Transduction ; ras Proteins ; genetics ; metabolism

Objective To study the correlation between morphological characteristics of coronary artery calcified plaques and luminal stenosis of local coronary artery segments with 64-slice computed tomography.Methods One hundred and eleven patients who had undergone 64-slice computed tomographic coronary angiography(CTCA)and conventional coronary angiography(CAG)were retrospectively analyzed.The calcified plaques were classified as punctate,nodular,strip-like and nubbly in long-axis view of coronary artery lumen,and were classified as crescent,semilunar,round moon and circinate in short-axis view.The morphologic characteristics of these calcified plaques on CTCA were retrospectively analyzed and compared with luminal stenosis of CAG results.Results Among 528 calcified coronary segments which were analyzed in 111 patients,there were 383(72.5%)punctate calcified plaque segments and 145(27.5%)of non-punctate plaques.There were 34(23.4%,34/145)non-punctate calcified plaques which caused severe stenosis(≥75%),including 4(11.8%)nodular,8(23.5%)stripe-like and 22(64.7%)nubbly calcified plaques on the long-axis view,and 0(0.0%)cresent,8(23.5%)semilunar,18(52.9%)round moon and 8(23.5%)circinate calcified plaques on the short-axis view.The ratios of different morphological coronary artery calcifications which caused severe stenoses were significantly different with each other(all P＜0.01).Conclusion Different figures of coronary artery calcified plaques demonstrate different degrees of stenoses of local coronary artery lumen.Severe stenoses were mostly caused by nubbly calcified plaque on long-axis view,round moon and circinate calcified plaque on short-axis view.

Objective To review the surgical methods and mid-term results of mitral valve repair in pediatric patients with moderate to severe mitral regurgitation (MR).Methods 132 children with moderate to severe MR,aged (18.9 ± 7.2)months,weighted(11.3 ±4.8) kg.The etiology for mitral regurgitation is congenital heart disease in 126 cases,infective endocarditis in 5 cases and Marfan syndrome in 1 case.Mitral valvuloplasty(MVP) was performed with cardiopulmonary bypass under moderate systemic hypothermia.The methods of MVP included annuloplasty,annuloplasty ring,cleft closure,reconstruction of posterior leaflet.The coucomitant cardiac anomalies were treated at the same time.The results of repair were evaluated by saline injection test and transesophageal echocardiography (TEE) during operation.Results Intra-operative TEE results: 131 cases had none to mild MR,and only one case had moderate MR.The patient underwent second repair immediately,subsequent TEE was mild.Mean cardiopulmonary bypass (CPB) time was (80.0 ± 31.1) minutes.Mean aortic clump time was (48.0 ± 17.9) minutes.The in-hospital mortality was 2.3％ (3 cases died).One died of heart failure on postoperative day 7,the other died of low cardiac output syndrome resulting on postoperative day 2.Another one was large ventricular septal defect(VSD) with pulmonary hypertension (PH),died of pulmonary infection.Mean postoperative ventilation time was (34.4 ± 31.9) hours,and mean postoperative inhosptial time was (9.0 ± 5.4) days.The average follow-up period was (40.5 ± 8.3) months (2 to 74 months).122 cases were fully followed up.Echocardiography showed that moderate MR was in 7 patients,and 3 patients had severe MR.4 patients underwent re-do mitral valve repair or mitral valve replacement.There was no late death.The overall survival rate at 5 years was 97.7％ and the overall freedom from reoperation at 5 years was 92.0％.Conclusion Pediatric patients with moderate to severe MR need early surgical treatment,the early and mid-term results were satisfactory.Individualized treatment protocol based on specific pathology was the keypoint of surgical therapy.