Aortic dissection is a kind of fatal cardiovascular disease, and the apoptosis of aortic vascular smooth muscle plays an important role in aortic dissection.The new discovered Hippo-YAP signal transduction pathway is significant in regulation of the function of vascular smooth muscle, and it can cause many cardiovascular diseases.This paper aims to review the present studies of the mechanism of the apoptosis of aortic vascular smooth muscle and Hippo-YAP signaling pathway in the pathogenesis of cardiovascular diseases, especially the aortic dissection.

Objective To explore the morbidity and risk factors of postoperative delirium in the patients undergoing coronary artery bypass grafting (CABG).Methods A total of 286 patients were continuously enrolled for CABG surgery from January to December 2013 in cardiac surgery ward in Beijing Anzhen Hospital.Delirium Rating Scale-Revised-98 was used as the diagnostic tool for the analysis of the morbidity and risk factors of postoperative delirium.Results (1) Delirium occurred in 24 patients of 286 patients and morbidity of postoperative delirium was 8.4％.Sixteen of 24 patients (66.7％) suffered from transient delirium (＜24 h).Eight of 24 patients (33.3％) suffered from continuous delirium (≥48 h).(2) The common clinical presentation of postoperative delirium included increased psychomotor activity, a disordered sleep-wake cycle and a reduced level of consciousness.(3) Univariate Logistic regression analysis results showed that delirium was associated with advanced age over 70 years old (OR =3.05, 95％ CI 2.55-72.94, P =0.023), previous cerebral infarction(OR =1.78, 95％ CI 1.07-2.96, P =0.026), previous brain heamorrhage (OR =1.99, 95 ％ CI 1.20-3.31, P =0.003), surgery time (OR =1.05, 95％ CI0.05-2.04, P =0.047), intensive care unit (ICU) staying time (OR =2.87, 95％ CI 1.43-5.72, P=0.003), use offentanyl (OR=2.78, 95％ CI 1.02-7.57, P=0.045).(4) The multiple Logistic stepwise regression analysis indicated that the perioperative risk factors of delirium included advanced age over 70 years old (OR =3.196, 95％ CI 1.574-6.488, P =0.001), cerebrovascular accident history(OR =2.610, 95％ CI 1.538-4.431, P =0.000) and ICU duration time(OR =1.480, 95 ％ CI 1.070-2.046, P =0.018).Conclusions The morbidity of postoperative delirium after CABG is 8.4％.Many predisposing and precipitating factors contribute to postoperative delirium.These factors include age ＞ 70 years, cerebral infarction and ICU staying time.Assessment and preventive strategies should be considered to reduce the incidence of delirium, particularly among those patients with high risks.

Objective To observe the clinical efficiency and safety of docetaxel(TXT) or irinotecan(CPT-11) combined with oxaliplatin(L-OHP) and S-1 in the treatment of advanced gastric cancer.Methods Totally 62 cases of patients with stage Ⅲ B-Ⅳ advanced gastric cancer in the Department of Gastrointestinal Surgery of our hospital were collected from 1st January 2010 to 1st March 2016,and were divided into two groups:TXT combined with L-OHP and S-1 group (modified DCF group,33 patients) and CPT-11 combined with L-OHP and S-1 group (modified ICF group,29 patients).All patients in the two groups were completed at least 1 cycle of chemotherapy until disease progression or intolerable toxicity.At the end of chemotherapy,the curative effects,untoward reactions and effects of surgery after neoadjuvant chemotherapy treatment were compared and analyzed.Results The objective response rate (ORR) in the modified DCF group(60.6％) was higher than that in the modified ICF group (51.7％),while no statistically significant difference was found in short-term effects between the two groups (Z=-0.837,P=0.403).There was no statistically significant difference in the incidences of main untoward reactions,including gastrointestinal reaction,myelosuppression,neurotoxicity,alopecia and liver function abnormal,between the two groups (P＞0.05).The radical resection rate of the modified DCF group and the modified ICF group after neoadjuvant chemotherapy was 66.7 ％ and 62.1 ％ respectively,the difference between the two groups was not statistically significant (x2=0.143,P=0.706).After neoadjuvant chemotherapy,the main postoperative complications were anastomotic leakage,anastomotic obstruction,abdominal infection,pulmonary infection,incision infection and gastric motility disorder,and no statistically significant difference was found in the incidence of postoperative complications between the two groups (P＞0.05).The was no statistically significant difference in quality of life after chemotherapy between the two groups (P＞0.05).Conclusion TXT or CPT-11 combined with L-OHP and S-1 has similar efficacy in the treatment of advanced gastric cancer,which could reduce tumour size,improve radical resection rate.Furthermore,untoward reactions of the two neoadjuvant chemotherapy protocols are almost the same,and can be tolerated.It is worthy of further research and application.

Objective To investigate the association between CYP11 B2 gene polymo-rphism and left ventricle hypertrophy with meta analysis.Methods Literatures about the association of CYP11 B2 gene polymorphism and left ventricle hypertrophy from January 1992 to December 2011 were searched.The electronic databases retrieved from Pubmed,Embase,China national knowledge intemet,Chinese biological medicine disk,VIP fulltext database and Wanfang fulltext database.Odds ratio of CYP11 B2 genotype distributions in left ventricle hypertrophy patients comparing with healthy control were analyzed.RevMan5.1 software was applied for investigating hereogeneity among individual studies and summarizing effects with proper statistical methods.Six case control studies were enrolled.Results A total of 541 cases and 553 controls were enrolled for the study.The pooled OR of CC vs TT + TC genotype was 1.15 (95％ CI:0.74 ～ 1.80) (Z =0.63,P =0.53) in the subgroup of hypertension,and the pooled OR of CC vs TT + TC genotype was 1.15 (95 ％ CI:0.74 ～ 1.80) (Z =0.63,P =0.53) in the subgroup of race.The pooled OR of C vs T allele was 1.15 (95％ CI:0.76 ～ 1.74) vs 0.87 (95％ CI:0.58 ～ 1.31) (Z =0.67,P =O.50).Conclusion Whether the hypertension or the race,the genotype of CYP11 B2 polymorphism has no association with an increased risk of left ventricle hypertrophy.

Objective To study the correlation between TCM differentiation of syndromes typing for ulcerative colitis (UC) and expressions of Bax and Caspase-3.Methods 50 patients with UC were divided into 2 groups according to TCM syndrome differentiation including dampness-heat internal accumulation syndrome group (25cases),deficiency of spleen and stomach syndrome group (25cases).Immunohistochemistry was used to study expression of Bax and Caspase-3 in colonic mucosas and compare with the normal group (25cases).Results The expressions of Bax were highest in dampness-heat internal accumulation syndrome group (4.56±1.58).The expressions of Bax of deficiency of spleen and stomach syndrome group were lower than dampness-heat internal accumulation syndrome group(3.28± 1.14)scores.There were significant differences between the three groups (P＜0.05).However,There were no significant difference between dampness-heat internal accumulation syndrome group and deficiency of spleen and stomach syndrome group in terms of the Caspase-3expressions (P＞0.05).In addition,Caspase-3 and Bax were positively related in each group(r=0.23and 0.21).Conclusion The high expressions of Bax,Caspase-3 in ulcerative colitis were closely related to TCM typing according to syndrome differentiation.Caspase-3 and Bax were adjustment in apoptosis.The detection of expression of Bax,Caspase-3 is helpful to the TCM syndrome differentiation and to the selection of treatment plan.At the same time,it can provide more important experiment basses for the pathogenesis of ulcerative colitis.

Objective To study the correlation between the expressions of Bcl-2 and Caspase-3 in intestinal epithe-lial and inflammatory cells of lamina propria and the staging and pathogenesis of ulcerative colitis (UC). Methods The pathomorphological changes of 25 samples of UC in the active phase and remission phase and 25 samples of control were ob-served under microscope. The expressions of Bcl-2 and Caspase-3 were detected by immunohistochemistry SP method. The correlations between expressions of Bcl-2, Caspase-3 and UC staging were analyzed. Results There were no significant dif-ferences in expressions of Bcl-2 and Caspase-3 in intestinal epithelial cells between three groups (P>0.05). The expression of Bcl-2 in inflammatory cells of lamina propria was significantly higher in active UC group than that of normal control group (P＜0.05), no significant difference between UC remission group and normal control group (P>0.05). There was a higher positive expression of Caspase-3 in inflammatory cells of lamina propria in UC remission group. There was correlation be-tween Bcl-2, Caspase-3 and UC staging (r=0.371 and 0.4453 respectively). Conclusion The expression levels of Bcl-2 and Caspase-3 were related with pathogenesis of UC. The detection of expression levels of Bcl-2 and Caspase-3 has a cer-tain application value in UC staging.

OBJECTIVE: To observe the therapeutic effects of Yiqi Sanju Formula (YQSJF), a compound Chinese herbal medicine, on central obese men at high risk of metabolic syndrome (MS). METHODS: Compared with 30 healthy male volunteers, 45 central obese men were separated randomly into two groups and received the interventions with YQSJF and placebo respectively for 10 weeks. Baseline characteristics, insulin resistance, inflammation cytokines and plasminogen activator inhibitor-1 (PAI-1) and tissue plasminogen activator (t-PA) were evaluated before and after treatment. RESULTS: The score of homeostatic model assessment for insulin resistance (HOMA-IR) and the levels of C reactive protein (CRP), free fatty acid (FFA) and PAI-1 in obese men were higher than those in the control group, while t-PA was lower. After treatment, compared with placebo group, body mass index, waist, and waist-to-hip ratio were decreased significantly in subjects who received YQSJF (P<0.01). The score of HOMA-IR and the levels of CRP, FFA and PAI-1 were decreased significantly, and the level of t-PA was increased significantly (P<0.01). CONCLUSION: YQSJF can reduce obesity and insulin resistance in central obese men at high risk of MS and improve inflammation and fibrinolysis, which indicates that it can reduce the risk of atherosclerosis.

Objective:To evaluate the association between preoperative thyroid hormones and the postoperative acute kidney injury (AKI) in acute Standford type A aortic dissection (ASTAAD) patients.Methods:The patients with ASTAAD, who underwent surgeries in Beijing Anzhen Hospital from July 2016 to December 2016, were included in this retrospective cohort study. Multivariable regression and stratification analyses were used to examine the association of preoperative thyroid hormone with postoperative AKI.Results:The overall occurrence of postoperative AKI was 42.0%. Multivariate regression revealed that low level of TT3 ( OR=0.08, 95% CI: 0.01-0.94, P=0.04) and TT4 ( OR=0.97, 95% CI: 0.94-1.00, P=0.04) was independently associated with postoperative AKI. Subgroup analyses showed that the relation between TT3 and AKI was significantly noticed in patients with normal TSH levels ( OR=0.004, 95% CI: 0.001-0.16, P<0.01) other than in patients with lower TSH levels ( P=0.26). Conclusion:The present study showed that a low level of TT3 or TT4 was a predictor of postoperative AKI in ASTAAD patients, especially in patients with normal TSH. The thyroid function should be checked before surgical intervention of patients with ASTAAD, and patients with low T3 might be at higher risk of postoperative AKI.

Objective:This study investigated the association between Yes-associated protein and WW domain-containing transcription regulator protein 1(YAP/TAZ) and the in-hospital surgical mortality rate of STAAD patients.Methods:The mouse β-aminopropionitrile monofumarate(BAPN) model was used to test the level of YAP/TAZ. From July 2016 to December 2016, the blood samples of 139 people who received routine physical examinations consecutively Beijing Anzhen Hospital were included as the control group.According to the inclusion and exclusion requiement, 95 consecutive patients with STAAD who underwent surgery in Beijing Anzhen Hospital during the same period, were involved in the final cohort study. The main outcome measure was in-hospital death. Their blood samples were regarded as the test group. The predictors of postoperative in-hospital death were confirmed by univariate regression analysis. Multivariable logistic regressions were used to analyze the association of the preoperative plasma level of TAZ and the postoperative in-hospital mortality of STAAD patients.Results:The YAP level showed less change in blood samples of both STAAD patients and the BAPN-induced STAAD mice compared to that of the sham control, while TAZ concentration experienced a significant increase. In the crude model, TAZ showed a positive correlation with in-hospital death( OR=1.327, 95% CI: 1.014-1.737, P=0.0392). In adjusted model Ⅰ and adjusted modelⅡ, similar results were found( OR=1.348, 95% CI: 1.010-1.803, P=0.0429; OR=1.353, 95% CI: 1.008-1.816, P=0.0442). Conclusion:The high level of TAZ in the blood suggested poor surgical prognosis for STAAD patients, and patients with a TAZ level ≥13 ng/ml had much higher mortality.

Objective To explore the genetic mutation spectrum of patients with hypertrophic cardiomyopathy (HCM) and analysis the correlation of genotype phenotype.Methods Collect peripheral venous blood of the 51 cases unrelated HCM patients(35 male and 16 female) in the Beijing Anzhen Hospital of Capital Medical University from 2013 to 2016.Sequence whole exons of human and analysis seven major mutations of HCM including:MYBPC3、MYH7 、TNNT2、TNNI3 、MYL2 、TPM1 and ACTC1.Then compare the results with clinical characteristics.Results 24 patients(47.1％) had 22 kinds of pathogenicity or possibly pathogenicity mutations.The 90.9％ (20/22) of mutations only occurred one time,except MYH7 gene's 663 amino acid and the TNND gene's 157 amino acid which had twice.The mutations of MYBPC3,MYH7,TNNT2,TNNI3,MYL2,TPM1 and ACTC1 accounted for 45.8％ (11/24),20.8％ (5/24),12.5％ (3/24),8.3％ (2/24),8.3％ (2/24),4.2％ (1/24),and 0 respectively.No amphimutation had been found that causes illness or possibly.Through the comparison of clinical features between Genotype positive(24 cases) and negative(27 cases) patients:the incidence of syncope(19.6％ vs.7.8％,P ＜ 0.05),the largest left ventricular wall thickness[(22.8 ± 2.6) mm vs.(20.0 ± 3.4) mm,P ＜ 0.05],family history of HCM(20.8％ vs.0,P ＜0.05),percentage of apical hypertrophy(25.5％ vs.11.8％,P ＜ 0.05);The ratio of left ventricular outflow tract obstruction in MYH7 group was higher than MYBPC3 group (80.0％ vs.18.2％,P ＜ 0.05).Conclusion MYBPC3 is the most common mutation gene in HCM patients.Phenotype is more severe in geuotype positive patients than in genotype negative patients.Relationship between specific gene mutations and clinical phenotype requires further study.