To investigate the effect of Cornu Cervi Oral Liquid (mainly composed of Cornu Cervi, Fructus Psoraleae, Herba Epimedii, Fructus Corni, Fructus Ligustri Lucidi and Lignum Aquilariae Resinatum) in reversing myocardial fibrosis in rats with congestive heart failure caused by pressure overload and to explore its mechanism. Thirty six male Wistar rats were randomly allocated to mimic operation group (Group A), model group (Group B) and Cornu Cervi Oral Liquid group (Group C). Rat models of congestive heart failure were induced by constriction of abdominal aorta. Left ventricular mass index(LVMI) was observed; contents of collagen type Ⅰ and Ⅲ in left ventricular cardiac muscle were detected by immunohistochemical method and their mRNA expression by RT PCR; and plasma levels of angiotensin Ⅱ (AngⅡ), atrial natriuretic factor (ANF) and serum aldosterone (ALD) level were measured by radioimmunoassay method. LVMI, contents of collagen type Ⅰ and Ⅲ and their mRNA expression, levels of plasma and myocardial AngⅡ, plasma ANF and serum ALD were higher in Group B than those in Group A (P0 05).[Conclusion]Cornu Cervi Oral Liquid is effective in reversing myocardial fibrosis in rats with congestive heart failure caused by pressure overload and its mechanism may be related to the decrease of contents of collagen type Ⅰ and Ⅲ and their mRNA expression, levels of plasma and myocardial AngⅡ, plasma ANF and serum ALD.

Objective To explore the predictive value of modified version Essen stroke risk score (ESRS) for recurrent cerebral infarction in 1 year. Methods Factors ofcerebrovascular stenosisand≥ 2 lesions in diffusion weighted imaging (DWI) which reflected large vascular stenosis and unstable plaques to the ESRS were added, and the 2 factors of other cardiovascular diseases and“peripheral vascular disease”which were difficult to operate clinically and had a lower incidence compared with the European and American people were got rid of. Thus, the total score of the modified version ESRS was still 9 scores. The risk of recurrent cerebral infarction in 1 year in 263 patients with cerebral infarction were evaluated by ESRS and modified version ESRS, and the predictive value was evaluated by area under receiver-operating characteristics (ROC) curve. Results The incidence of recurrent cerebral infarction in 1 year in 263 patients with cerebral infarction was 15.59% (41/263). There were statistical differences in the incidences of recurrent cerebral infarction in 1 year for different risk stratification patients by 2 methods (P<0.01). Multiple factor Logistic regression analysis results showed that thecerebrovascular stenosisand≥2 lesions in DWIwere the independent risk factors in predicting recurrent cerebral infarction in 1 year (OR=12.48 and 18.72, 95%CI 5.083-30.641 and 7.718-43.242, P=0.000 and 0.000). The area under ROC of predicting recurrent cerebral infarction in 1 year by ESRS and modified version ESRS was 0.68 (95% CI 0.58- 0.79) and 0.70 (95% CI 0.60-0.79), and there was statistical difference (P<0.01). Conclusions The predictive value of modified version ESRS in recurrent cerebral infarction in 1 year is higher than that of ESRS, and it is an effective method.

BACKGROUND: Congestive heart failure (CHF) is the clinical syndrome of all kinds of heart disease on the serious or final stage. About half of patients with organic heart disease will have heart failure that has a high incidence rate and mortality. The survival of heart failure was inferior to that of malignant tumor.OBJECTIVE: To confirm the clinical effect of Lujiao prescription on CHF and elucidate its possible mechanism.DESIGN: A control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 60 patients with CHF were selected from the department of cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. There were 31 male and 29 female. Included criteria: ①All of patients were consistent with Framinham diagnostic criteria. ② Above Ⅲ degree by New York Heart Association(NYHA). ③ Three months case history. ④Accept quantity sufficient diuretic and vasodilating agent (exclude angiotensin converting enzyme inhibitor ). ⑤ Left ventricle hypertrophy was proved by echocardiogram or chest X-ray. ⑥ Differentiation of symptoms and signs of Traditional Chinese Medicine refers to asthenia syndrome of differentiation of symptoms and signs of Traditional Chinese Medicine (1986, Researching Association of Chinese integrated medicine) General state of health and basic disease of the patients in the two groups were not significant deviation.METHODS: 60 patient s of CHF were randomly divided into Lujiao prescription group(n=40) and Digoxin group (n=20) at the rate of 2:1. Lujiao prescription group: Orally liquid decoction of Lujiao Prescription 35 mL (1 mL contain crude drug 1.6 g) Bid. po. Course of treatment: 4 weeks. Digoxin group: Digoxin tablet, 0.125-0.25 mg, qd. po. course of treatment: 4 weeks.After 4-week treatment, the patients' clinical effect, integrals of the symptoms of renal deficiency, classification of function capacity of the NYHA,Lee's heart failure score, heart rate(HR), myocardium oxygen consumption (MOC), proportion of heart to chest, echocardiogram, measurement of plasma angitention Ⅱ (Ang Ⅱ ) and plasma atrial natriuretic factor (ANF) were observed.MAIN OUTCOME MEASURES: ① The total clinic effective rate. ②Integrals of the symptoms of renal deficiency. ③ Classification of function capacity of the NYHA. ④ Lee's heart failure score. ⑤HR and MOC. ⑥The proportion of heart to chest. ⑦ Ejection fraction(EF), cardic output (CO), interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) through echocardiogram. ⑧The measurement of plasma Ang Ⅱ and plasma ANF.RESULTS:Totauy 60 patients entered the final analysis. ① The total clinical effective rate of the Lujiao prescription group was 90 %, which showed no significant difference from the Digoxin group (90 %, P ＞ 0.05).② Improvement was significantly observed in the integrals of the symptom of renal deficiency of the patients in the Lujiao prescription group after treatment (P ＜ 0.01), but which was not significant in the Digoxin group(P＞ 0.05). ③ It was found that classification of functional capacity of NYHA between Lujiao prescription group and Digoxin group after treatment was obviously decreased (P ＜ 0.01). ④ Lee's heart failure score of patients in Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01). ⑤Myocardium oxygen consumption and HR of the patients in the Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01). ⑥ The proportion of heart to chest between Lujiao prescription group and Digoxin group after treatment was decreased (P ＜ 0.01).⑦ EF and CO were increased by Lujiao prescription and by Digoxin (P＜ 0.01,vs pretreatment, respectively). IVST, PWT, LVMI of Lujiao prescription group after treatment were obviously decreased (P ＜ 0.01), while those of the Digoxin group were not obviously decreased (P ＞ 0.05). ⑧ Thlevel of plasma Ang Ⅱ of the patients in the Lujiao prescription group after treatment were obviously decreased (P ＜ 0.01), while that of the Digoxin group were not obviously decreased (P ＞ 0.05). The level of plasma ANF was decreased by Lujiao prescription and by digoxin(P ＜ 0.01, vs pretreatment, respectively).CONCLUSION: There is increasing cardiac constriction power and regressing left ventricular hypertrophy of patients with CHF by Lujiao prescription. The therapeutical effect of Lujiao prescription for CHF is better than that of Digoxin. The effect may be related to the regulation of circular or local endocrine(plasma Ang Ⅱ and ANF) disorder.

Purpose To investigate the effects of chemotactic factor CCR4 on the abi1ity of pro1iferation,ce11 cyc1e,invasion,and mi-gration of human ga11b1adder cancer ce11. Methods Western b1ot was used to detect the expression 1eve1 of CCR4 in ga11b1adder carci-noma ce11s. Ga11b1adder carcinoma ce11s was infected by means of s1ow virus,the CCR4 gene si1encing was conducted using siRNA-CCR4 interference techno1ogy. Ga11b1adder carcinoma ce11s GBC-SD were divided into three groups( GBC-SD,GBC-SD/CCR4-RNAi and GBC-SD/contro1). CCL17,a 1igand of CCR4,was used to act on these three groups of ce11s. CCK8 method was used to detect the ce11 pro1iferation abi1ity of three groups. F1ow cytometry was used to test ce11 cyc1e. Tanswe11 assay was app1ied to detect ce11 migration and invasion abi1ity. Western b1ot was performed to detect the expression of its corresponding 1igands CCL17 and CCL22 proteins. Re-sults CCR4 gene si1ence did not inf1uence ce11 cyc1e and pro1iferation of ga11b1adder ce11 GBC-SD,but can significant1y inhibit GBC-SD ce11 invasion and movement abi1ity,CCR4 gene si1ence had no inf1uence on the expression of CCL17 and CCL22 gene in tumor ce11s. Conclusion Ga11b1adder carcinoma ce11s GBC-SD express chemokine receptor CCR4,chemokine receptor CCR4 can promote the invasion and metastasis of GBC-SD ce11s.

BACKGROUND: Pressure overload can lead to the activation of reninangiotensin-aldosterone system, and then left ventricular remodeling occurs.Captopril can reverse this progress.OBJECTIVE: To observe the effect of captopril in reversing left ventricular remodeling in rats with pressure overload and to elucidate its possible mechanism.DESIGN: A randomized controlled trial.SETTING: Department of Integrated Traditional Chinese Medicine and Western Medicine, Nanjing General Hospital () Nanjing Military Area Command of Chinese PLA; Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine; Postdoctor Institute of Hebei Medical University.MATERIALS: The experiment was conducted in the Laboratory of Shanghai University of Traditional Chinese Medicine between January 1998 and October 1998. Totally 153 male Wistar rats were recruited.There were 5 experiments, 36 rats in each experiment except 9 rats in the fourth one.METHODS: A total of 36 Wistar male rats selected for each experiment were randomly divided into sham operation group, model group and captopril group. Rats in model group received modeling for 4 weeks, then gastric perfusion with 15 mL/kg of distilled water once per day for 4 consecutive weeks. Abdominal aorta of the rats in sham-operation group were separated without closure by sliver clip, then 4 weeks later the procedure was the same as that in model group. In captopril group, 4 weeks after modeling, the rats were performed gastric perfusion with diluted captopril of 100 mg/kg, once a day for 4 consecutive weeks.MAIN OUTCOME MEASURES: The effect of captopril on left ventricular mass index (LVMI), mRNA expression of collagen type Ⅰ and Ⅲ, content of plasma angiotensin Ⅱ (Ang Ⅱ ) and left ventricular tissue Ang Ⅱ,plasma atrial natriuretic factor (ANF), and serum aldosterone (ALD) level.RESULTS: Totally 153 rats entered the result analysis. During the test for detecting the absorbance (A) of collagen type Ⅰ, 3 rats in sham operation group and 3 in captopril group died, and 1 rat died in model group; finally 29 rats were involved. During the test for detecting the absorbance (A) of collagen type Ⅲ, 3 rats died in sham operation group, 4 rats diedin model group, and 2 rats died in captopril group; finally 27 rats were involved. All in sham operation group and captopril group was lower than that in model group [(2.24±0.12)/1 000, (2.67±0.40)/1 000, (3.15±0.47)/1 000, t=2.649,cantly lower in sham operation group and captopril group than in model group [(0.57±0.19, 0.86±0.25, 2.79±2.00), t=3.661, 3.170, P ＜ 0.01, 0.05].operation group and captopril group than in model group [(0.48±0.10,sion of mRNA of collagen type Ⅰ: It was significantly lower in sham operation group and captopril group than in model group [(79.1 ±18.6)%,plasma Ang Ⅱ content: It was significantly lower in sham-operation group and captopril group than in model group [(130.2±30.2),(137.6±39.5),was significantly lower in sham operation group and captopril group than in model group [(170.6±51.6), (202.5±64.2), (339.3±115.4) μg/L, t=4.623,P ＜ 0.01].type Ⅲ and mRNA expression in rats with pressure overload, suggesting its captopril on left ventricular remodeling might be related to decreasing circulating or local Ang Ⅱ level, plasma ANF and serum aldosterone as well as affecting the expression of collagen type Ⅰ and type Ⅲ mRNA.

Objective To investigate the role of psychotherapy plays in the treatment of vitiligo.Methods Psychological health questionnaire(SCL-90)was used in the study to evaluate the psychological well being of 120 vitiligo patients.66 subjects suffering from psychological problems were divided randomly into groups Ⅰand Ⅱ while 54 subjects free of psychological problems randomly into groups Ⅲ and Ⅳ.Psychotherapy was applied together with drug and phototherapy to those subjects from groups Ⅰ and Ⅲ while groups Ⅱ and Ⅳ having no psychotherapy accompanied.After 3 months of treatment,evaluation was done on the treatment effect with psychological testing once again.The correlation between the improvement of psychological conditions of the subjects and the lesion development was then evaluated by"P"value of the four groups.Results Significant difference was achieved between group Ⅰ and group I1I(P＜0.05).There was no significant difference between groupsⅢand IV(P＞0.05).There was significant difference between groups Ⅰ and Ⅱ.There was no significant difference between groups Ⅱ and Ⅳ.Conclusions The psychotherapy is helpful in improving the early treatment effect and quality of life in vitiligo patients.

Objective To investigate protective effects and mechanisms of lipoxinA4(LXA4)on human umbilical vein endothelial cells(HUVEC)under hypoxia in vitro.Methods The HUVEC culture were divided into groups as followed:added M199 cudture medium as normal contml groups,added CoCl2 to mimic hypoxia in vitro as hypoxia group and added different concentrations of LXA4(1,10,100 nmol/L)were added to the induced hypoxiai HUVEC as agents intervention group.Morphological changes of HUVEC were observed by using inverted phase contrast mieroscope.The influence of LXA4 on cell survival was investigated by methyl thiazolyl tetrazolium(MTT) assaying method after the treatment with different concentrations of LXA4 and 100 nmol/L lipoxinA4 according to different time(4,8,12 and 24 hours).The expression of von-willebrand factor (vWF) was detected by immunocytoehemistry method. The changes of cytosolic Ca2+ were measured by laser scanning confocal microscope. Results ( 1 ) Morphological changes:the cells under hypoxia lost its normal shapes and showed necrosis, while the cells cocuhured with 100 nmol/L LXA4 were normal appropriately. (2)Survival rate: the survival rates of HUVEC under hypoxia was (40. 1±3.9) % and increased to ( 52. 9 ± 1.4) %, (64. 1 ± 3. 3 ) %, ( 76. 6 ± 1.6) % respectively when added with LXA4 with concentration of 1,10, 100 nmol/L into culture medium. There was significant different survival rate when compared with that of hypoxia group. (3) The level of vWF: The expression of vWF was decreased with the increasing concentrations of LXA4 added into culture medium, the gray values were 203.9 ±0. 7 in 1 nmol/L,204.6 ±0. 9 in 10 nmoL/L,191.8 ±0. 5 in 100 nmol/L respectively, which reached statistical difference in comparison with that of hypoxia groups (P<0. 05). (4) Confocai analysis:the intracellular free Ca2+ concentrations of HUVEC were intensified with LXA4 treatment. Conclusions LXA4 plays an important role in keeping the normal shape of HUVEC under hypoxia, can enhance survival of hypoxial HUVEC and decrease the level of vWF in cytoplasm. The protective mechanism might be via decreasing mitochondria Ca2+ overload and increasing cytoplasm Ca3+ by nucleus Ca2+ transference.

BACKGROUND: Left ventricular hypertrophy (LVH) is an important ring-joint of congestive heart failure (CHF). It is also considered to be independent risk factor of cardiovascular disease, so how to reverse or relieve LVH is valuable to cure CHF.OBJECTIVE: To observe the effect of Lujiao prescription on degree of LVH in patients with CHF.DESIGN: A random-control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 20 patients with CHF were selected from the Special Clinic and Department of Cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. All of them were consistent with the Framirham diagnostic criteria and following standardizations: ①above Ⅲ degree of cardiac functional grading by New York Heart Association (NYHA);②over 3 months case history;③accepted basic treatment of quantity sufficient diuretic and vasodilating agent excluding angiotensin converting enzyme inhibitor (ACEI);LVH was proved by echocardiogram or chest X-ray. They were informed of treatment items and consented.METHODS: According to random lot, the patients were divided into Lujiao prescription group and Digoxin group, each containing 10 patients.①Oral administrations of Lujiao prescription (35 mL, two times per day, produced by Shanghai Shuguang Hospital) and Digoxin (0.125-0.25 mg per tablet, batch number: 970757, once daily) were given in the corresponding groups, and the treatment duration was 3 months. After treatment, all the patients were detected in①NYHA cardiac functional grading; ②interventricular septal thickness (IVST) and posterior wall thickness (PWT) in diastolic phase through echocardiogram, myocardium weight of left ventricular by Devereux formula, left ventricular mass index (LVMI) corrected by bodysurface area, and degree of LVH;③the level of plasma angiotensin Ⅱ (Ang Ⅱ ) by radioactive immunoassay.MAIN OUTCOME MEASURES: NYHA cardiac functional grading, e-chocardiogram (IVST, PWT, LVMI, degree of LVH), the level of plasma Ang Ⅱ.RFSULTS: All 20 adopted patients entered the result analysis.①The classification of NYHA cardiac functional grading ( Ⅰ , Ⅱ ,Ⅲ,Ⅳ) were respectively 2, 5, 3, 0 case in Lujiao prescription group and 2, 4, 4, 0 case in Digoxin group after treatment, and difference was significant compared with those before treatment (0, 0, 7, 3, P ＜ 0.05).②IVST, PWT and LVMI of Lujiao prescription group were obviously decreased after treatment [(11.20±0.42), (12.10±0.32) mm, P ＜ 0.01; (10.60±0.84), (11.40±1.10) mm,P ＜ 0.01; (139.4±12.4), (155.3±15.4) g/m2, P ＜ 0.01], while those of the Digoxin group were untouched (P ＞ 0.05). The degree of LVH of Lujiao prescription group after treatment was obviously decreased [normal, mild,moderate, sever: 2, 6, 2, 0; 0, 3, 4, 3, P ＜ 0.01], while that of the Digoxin group was not obviously decreased (P ＞ 0.05).③)The level of plasma Ang Ⅱin the Lujiao prescription group was obviously decreased [(97.7±19.5),(144.0±18.5) ng/L, P ＜ 0.01], while that of the Digoxin group was not obviously increased (P ＞ 0.05).CONCLUSION: Lujiao prescription can reverse or relieve the degree of LVH in patients with CHF.

Objective Off-pump coronary artery bypass (OPCAB),minimally invasive direct coronary artery bypass (MIDCAB) and robotic-assisted coronary artery bypass (RA-CAB) are all used to treat isolated left anterior descending artery (LAD) disease.The aim of this study is to compare the early outcomes after these three procedures.Methods From February 2009 to May 2012,102 consecutive patients underwent revascularization of LAD.31 patients were treated by OPCAB,45 by MIDCAB and 26 by RA-CAB.Patients received sternotomy in the OPCAB procedures.The MIDCAB procedures were performed through a 10-cm anterolateral muscle-sparing minithoracotomy.In the RA-CAB procedures,left internal mammary arteries (LIMA) were harvested with the aid of da Vinci surgical system and sewing of the anastomoses was performed under direct vision by a 3-cm anterolateral minithoracotomy.Results No significant difference was observed in graft flow,pulse index,renal failure,reoperation for hleeding,new onset of arterial fibrillation and deep wound infection between these three groups.There was also no significant difference in peri-operative mortality,major adverse cerebro-cardiovascular events (MACCE) between these three groups.Compared with OPCAB,MIDCAB and RA-CAB significantly reduced the need of blood transfusion (4.4％ vs.32.3％,P＜ 0.05; 7.7％ vs.32.3％,P＜0.05).The patients receiving RA-CAB had shorter length of postoperative stay than whom receiving OPCAB[(8.8 ± 3.2) days vs.(12.4 ± 7.7) days,P ＜ 0.05)].There is no significant difference between the outcomes of MIDCAB and RA-CAB.Conclusion These findings indicated that MIDCAB and RA-CABwere feasible,effective and safe options for revascularization of isolated LAD disease.MIDCAB and RA-CAB showed the advantage of less invasive and faster recovery,compared with OPCAB.Therefore,MIDCAB and RA-CAB should be the routine treatment for patients with isolated LAD disease.In some advanced centers,RA-CAB will be the preferred method.The mid-and long-term outcomes of these three methods should be further investigated.

Objective To observe the safety of telbivudine (LdT) application throughout pregnancy in women with chronic hepatitis B (CHB),and to provide evidence-based treatment recommendations for women of childbearing age with chronic hepatitis B.Methods Women with hepatitis B virus (HBV) infection who took LdT before pregnancy and in early pregnancy were followed up prospectively for evaluating maternal and newborn adverse events.All newborns received block of HBV mother-to-child transmission (MTCT) after birth and were followed up for neonatal disorders and effects of maternal and child block.Results Among the 145 cases of pregnant women,143 were diagnosed as CHB and 2 decompensated cirrhosis.One hundred and five (72.4％) patients had HBV DNA＜500 copy/mL and 125 (86.0％) had positive hepatitis B e antigen.There were total 154 times pregnancies including 17 spontaneous abortions,4 ectopic gestation and 9 pregnancies after abortion.One hundred and one cases finished pregnancy,with 100 full term deliveries,1 preterm delivery and 2 twin pregnancies.One fetal with cleft lip and palate was aborted by induced labor in 24 weeks gestation.One baby was born with right double ears; one had benign lymph node under the left ear; and another one was diagnosed with congenital heart disease.Seven of the pregnant women had creatine kinase increased.Eight developed drug resistance.However,none had disease progression during pregnancy.None of the 63 infants was hepatitis B surface antigen positive over the 6 months of follow-up.The prevention of HBV MTCT was 100％ successful.Conclusion It is safe and effective for women with chronic HBV infection to receive LdT treatment throughout pregnancy.