BACKGROUND: Being a traditional Chinese herb, huangqi (astragalus membranaceus) resists free radical, enhances immunity, promotes microcirculation and protects vascular endothelial cell and nervous system; of which, the protection of huangqi (astragalus membranaceus) on nervous vessel is related to its regulation on local cerebral cortical blood flow rate. OBJECTIVE: To observe the effects of huangqi (astragalus membranaceus) on local cerebral cortical blood flow rate after traumatic injury. DESIGN: Randomized paired experiment.SETTING: Neurological Surgical Institute of Lanzhou Military Area Command of Chinese PLA.MATERIALS: The experiment was performed in Traumatic Experimental Room of Neurological Surgical Institute of Lanzhou Military Area Command of Chinese PLA from February to May 2000, in which, 75 healthy male SD rats were employed and randomized into the control (5 rats), saline control (35 rats) and experimental group (35 rats). The latter two groups were subdivided into 7 time spots of 1, 3, 6, 8, 12, 24 and 48 hours after traumatic injury, 5 rats were involved in each spot.METHODS: In normal control, the model was not prepared and in the other two groups, the modified Feeney's method was used to establish craniocerebral traumatic model. In experimental group, right after injury, huangqi injection (5 g/kg) was applied abdominally and in saline control, physiological saline 0.5 mL was injected abdominally. MAIN OUTCOME MEASURES: It was to determine the blood flow rates in local cerebral cortex at corresponding time spots after traumatic injury. Fenestration was done in normal control for direct determination. RESULTS: By supplemented, 75 rats entered result analysis. Blood flow rates in local cerebral cortex: the rate in saline control 1 hour after trauma was lower than the control [(6.90±0.68), (7.94±0.65), P < 0.05], it was de creased to the minimum in 24 hours and began increasing in 48 hours [(5.86±0.61), (6.15±0.60)]; the rate in experimental group at every time spot was higher than saline control (P < 0.05). CONCLUSION: Huangqi (astragalus membranaceus) increases remark ably blood flow rate in local cerebral cortex, which is associated with its neurovascular protection.

Objective To evaluate the effect of holidays on door-to-reperfusion time in patients with ST-segment elevation myocardial infarction(STEMI).Methods Using the data from the Registry of ST-segment elevation Myocardial Infarction in Beijing,we studied the data of 297 patients with STEMI who received acute reperfusion from November 2005 to July 2006.The association between holidays and door-to-reperfusion time in these patients was studied.Results Ninty four patients in this study were admitted in holidays(26 of them received fibrinolytic therapy and 68 received PCI)and the other 203 patients were admitted during routine weekdays(61 of them received fibrinolytic therapy and 142 received PCI).After adjusting for patient characteristics,admission during holidays was associated with a longer median door-to-balloon time[162.2 min(95% CI:160.8,165.3)vs 141.8 min(95% CI:137.8,144.1);P

AIM To study the effects of puerarin on the expression of Bcl-2 and Bax, genes relating to neuronal apoptosis after cerebral ischemia and reperfusion. METHODS After global cerebral ischemia followed by reperfusion, changes in protein expression of Bcl-2 and Bax were detected by immunohistochemical method. The number of neuronal apoptosis was assessed by TUNEL. The effects of puerarin intervention were observed. RESULTS In CA1, the level of positive expression of Bcl-2 varied to the duration of reperfusion and the peak level was at 6 h reperfusion after 10 min global cerebral ischemia,the peak expression of Bax was at 24 h. The number of neuronal apoptosis after cerebral ischemia reperfusion was increased. In puerarin group, the expression of Bcl-2 was up-regulated and that of Bax was down-regulated, the number of neuronal apoptosis after cerebral ischemia reperfusion was decreased. CONCLUSION Our result indicate that Bcl-2 may restrain apoptosisl. Bax may promote apoptosis after cerebral ischemia and reperfusion and puerarin ameliorate ischemic damage by reducing the apoptosis through regulating Bcl-2 and Bax.

Objective To investigate mechanism and clinical effect of implantation of pacemaker with artial fibrillation(Af) preventive pacing algorithms (Vitatron 900E).Method 24 cases of patients with paroxysmal Af were observed in three phases (each phase two weeks):⑴Monitoring phase,in which onset mechanism of atrial arrtythmias was recorded, the device was programmed into DDD mode with 60 bpm;⑵Lower rate limit phase (LRL),DDDR mode with 85bpm LRL, and evaluating anti-Af effect by elevated rate;⑶Preventive pacing therapy phase,all preventive pacing therapies with programming to on or off, and this phase determined whether combined pacing therapies impacted on incidence of Af. Results 24 cases of patients were free of Af, in which 17 cases were done by using post-PAC-response or/and post-exercise-rate-control therapy only, and 7 cases of 17 casees were done by combining it with cordarone 0 1～0 2g/d also. The other 7 cases were done by DDDR 85 bpm only.Conclusions Af prevention pacing may be benefit for patients with paroxysmal Af,especially with complicated symptomatic bradycardia.

BACKGROUND: 60% of the patients receiving implantable cardioverter defibrillator(ICD) believe their quality of life has been improved. However,about 30% to 50% of the patients suffer from postoperative depression and anxiety; especially those patients receive electroconvulsive therapy (ECT).OBJECTIVE: To probe into the modulatory effects of cognitive behavior therapy(CBT) on depression and anxiety in patients with ICD.DESIGN: A retrospective case analysis based on ICD patients SETTING: Room of Cardiac Catheterization, Department of Cardiology, Xiangya Second Hospital PARTICIPANTS: The study was conducted in the Room of Cardiac Catheterization of the Department of Cardiology, Xiangya Second Hospital,Central South University from October 2000 to August 2001. Inclusive criteria: ICD patients that had ineffective medicine therapy for paroxysmal ventricular tachycardia and/or ventricular fibrillation complicated with cardiac syncope. Exclusive criteria: incoorperative patients or patients who unable to receive periodical follow up. A total of 6 patients were involved including 4 male and 2 female patients aged from 45 to 71 years old with an average age of (57.3 ± 2.4) years old. All of the patients received Micro Jewell Ⅱ 7223 ICD made by Medtronic Company. Diagnoses of basic disease:2 cases of coronary heart disease, 2 cases of right ventricular myocardial disease, 1 case of paroxysmal ventricular tachycardia due to unknown reason,and 1 case of Brugada syndrome.METHODS: "Morita therapy" technique was used. Patients were asked to transfer their spirit energies into feasible objectives of their real life, which would be helpful to the rapid improvement of their symptoms. symptom checklist-90(SCL-90) scale was used to evaluate the psychological symptoms before and after the therapy.MAIN OUTCOME MEASURES: Comparison of the scores gained in SCL-90 between before and after CBT.RESULTS: There were significant differences in the items of somatization,compulsion, sensitive human relationship, depression, anxiety, phobia disorder, etc. between before and after CBT ( P ＜ 0.05 or 0.01 ).CONCLUSION: Psychotherapy shouldn't be neglected in the postoperative follow up of ICD, and CBT is helpful to relieve symptoms especially for those depression and anxiety patients with electroconvulsive experiences.

Objective To analyze the changes of heart rate turbulence (HRT) and heart rate variability (HRV) in coronary heart disease (CHD), and evaluate the relationship between CHD and coronary artery disease (CAD) and two parameters of HRT and HRV, and investigate the correlation between the 2 parameters.Methods We performed coronary angiography in all 103 patients with CHD (group A), who were classified into 3 subgroups: 35 patients of stable angina pectoris ( group A1 ), 28 patients of unstable angina pectoris ( group A2 ) and 40 patients of AMI ( group A3 ), and 30 structurally normal patients with ventricular premature contraction who were included in healthy control group ( group B).The 24-hour ambulatory electrocardiogram was performed in all the patients, and the parameters of HRT and HRV were obtained.Results The value of the TO onset of group A was significantly higher than that of group B( -4.17± 2.75, - 3.16 ± 3.18, - 0.96 ± 2.92; - 6.30 ± 3.47 ), the value of TS of group A was lower than that of groupB(6.81±3.18,5.12±3.31,3.20±1.71;9.52±3.85) (P ＜0.05 orP ＜0.01).The values of SDNN, PNN50, and HF of group A were significantly lower than those of group B (P＜ 0.05).TO was positively correlated with Gensinies score, while TS, SDNN, PNN50 and HF were negatively correlated with Gensinies score, and TS showed the strongest negative correlation with Gensini score (r=-0.45).TO was negatively correlated with SDNN, PNN50, and HF, while TS was positively correlated with SDNN, PNN50 and HF, and TS showed much stronger correlation with HF (r=0.47).Conclusions HRT was dramatically blunted and HRV in patients with CHD was significantly lower;.HRT and HRV of group A1 were significantly correlated with Gensini score, and TS had the strongest correlation with Gensini score.TO and TS were correlated with SDNN, PNN50 and HF, and TS had much stronger relationship with HF.

Objective To investigate the expression of nuclear factor kappa B(NF-?B) in carotid artery of hypercholesterolemic rabbits injured by balloon and its relationship with intimal hyperplasia.Methods Twenty-five New Zealand male rabbits were fed with atherogenic diet and balloon injury was conducted in right carotid artery 4 weeks later.The rabbits were killed at the 6th hour,24th hour,1th week,2th week and 4th week,respectively.Blood samples and right carotid artery were collected in time and intimal hyperplasia was studied by histological morphology method.The expression of NF-?B was measured by in-situ hypridization(ISH).Results Intimal hyperplasia was present at the 7th day after balloon injury in hypercholesterolemic rabbits and it became more obvious with the increasing of the time.The intimal hyperplasia was not detected in the media area.The intima/media ratio was increased as time went on.The expression of NF-?B mRNA was observed in the carotid atery of hypercholesterolemic rabbits at the 6th hour after balloon injury and the expression reached its peak at the 2th week.The expression of NF-?B was much higher in injury group than that of control group.Conclusion The expression of NF-?B is up-regulated in carotid artery of hypercholesterolemic rabbits injured by balloon,which is involved in the inflammatory reaction and restenosis caused by balloon injury.

Objective To investigate the factors associated with delay in decision to seek treatment in patients with acute myocardial infarction(AMI) in Beijing. Methods This prospective,cross-sectional,multicenter survey was conducted from November 1,2005 and December 31 ,2006. The participants consisted of 799 patients with STEMI admitted within 24 h of symptom onset to 19 hospitals in Beijing. Data were collected by semi-structured interviews and medical records review. The patients were categorized into an early decision group and the a late decision group based on the 30 min cut-off. Results The median(25%,75%) decision delay in STEMI patients was 60(20, 180)min. Factors associated with late decision in an univariate analysis were age ≥65 years, retirement or unemployment, history of myocardial infarction,symptom onset at home and intermittent symptoms, whereas presence of bystanders such as friends,coworkers or even strangers,unbearable symptoms,dyspnea,sweating,syncope and attribution of symptoms to cardiac origin were related to early decision. Multivariate logistic analysis showed that history of myocardial infarction,absence of syncope, intermittent symptoms,bearable symptoms and attribution of symptoms to noncardiac origin were independent predictors of decision delay＞30 min. Patients in the early decision group had more chances to receive acute reperfusion therapies(P=0.001) and shorter time intervals from symptom onset to reperfusion therapies(P＜0.001). Conclusions To a great extent patients with AMI in Beijing delayed in decision to seek treatment. History of myocardial infarction, symptom characteristics and symptom attribution were associated with decision delay.

BACKGROUNDThe trachea, bronchus, blood vessel and left atrium plasty can maximumly remove tumor tissus and preserve the functional pulmonary tissues so as to improve patients' quality of life and prolong their survival.

METHODSFrom January 1990 to August 2004, 125 patients with lung cancer underwent trachea, bronchus, bloood vessel and left atrium plasty.

RESULTSThere were 116 patients who underwent bronchoplasty, in which angioplasty was performed concurrently in 26 cases. And reconstruction of superior vena cava was performed in 3 patients, and left atrium plasty in 6 patients. Three patients died after operation.

CONCLUSIONSTrachea, bronchus, blood vessel and left atrium plasty may be a promising direction in thoracic surgery.

OBJECTIVESTo evaluate clinical manifestations of 21 patients with subclinical pituitary apoplexy and their diagnosis and treatment.

METHODClinical data from 21 patients with subclinical pituitary apoplexy treated from October 1989 to November 2001 were analyzed retrospectively.

RESULTSTheir clinical manifestations included chronic headache, visual deficit and field cut. Three patients showed no clinical signs. Microsurgery was performed in 20 patients, of whom 3 were treated by emergency operation. Microsurgery included transsphenoidal decompression in 17 patients, and transpterioral approach in 3. One patient was given conservative therapy, and 12 were given endocrine replacement therapy. Nineteen patients recovered with marked visual improvement (7), partial improvement (8), no changes (4); deterioration was noted in 1.

CONCLUSIONSSubclinical pituitary apoplexy characterized by atypical clinical manifestations may be misdiagnosed or in appropriately treated. MRI is superior to CT scan for the diagnosis of subclinical pituitary apoplexy. Patients with persistent chiasmatic syndromes are indicated for emergency surgery. Endocrine replacement and transsphnoidal decompression are effective for the improvement of severe visual disturbance.

Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Apoplexy ; diagnosis ; surgery ; Tomography, X-Ray Computed