AIM: To study the effect of ouabain at different concentrations on human vascular endothelial cells (HUVEC), and early endothelial responses to ouabain in physiological concentration by genomic-scale gene expression analysis. METHODS: The proliferation of HUVEC was determined by MTT method. The vitality of cells was determined by LDH, and PCNA was assessed by using immunohistochemistry. The response of endothelial cells to ouabain was explored with a complementary DNA microarray representing ~8 464 different human genes. RESULTS: Ouabain stimulated the proliferation of HUVEC at physiological concentration (0.3-0.9 nmol/L). Ouabain at pathological concentration (0.9-1.8 nmol/L) inhibited proliferation and induced cellular swelling and apoptosis. However, the effect of ouabain at the concentration of 10 nmol/L also stimulated proliferation. The results of mRNA profiles analysis indicated that 340 of genes were differentially expressed, among them 145 were upregulated and 6 were upregulated significantly. The upregulated genes were mainly related to cellular metabolism and gene transcription. CONCLUSIONS: Ouabain has important role in controlling the growth and metabolism of vascular endothelial cell and vascular remodeling in the pathogenesis of hypertension.

Objective To study the effects of chronic ouabain treatment on Na+-K+-ATPase activity and the expression of dopamine D1 receptor in rat kidney cortex. Methods A total of 28 male Sprague-Dawley (SD) rats were randomly divided into ouabain group and control group,which were treated with ouabain or saline for 5 weeks; rat tail systolic blood pressure (SBP) was recorded weekly. Rats were sacrificed after 3 and 5 weeks,respectively. Then Na+-K+-ATPase activity and the expression of dopamine D1 receptor in rat kidney cortex were measured by colorimetric assay and real-time PCR,respectively. Results After 3 weeks of ouabain treatment,the mean SBP did not change significantly,but the Na+-K+-ATPase activity increased (P

Objective To explore application of case management for hypertension in the elderly.Methods In total, 106 elderly patients with hypertension treated at outpatient and inpatient departments of the First Affiliated Hospital of Xian Jiaotong University were recruited during January to October 2007, and divided randomly into two groups, one with conventional management and the other with case management.Patients with conventional treatment accepted routine diagnostic and therapeutic procedures and were followed-up passively, and patients with case management accepted integrated therapy and active interview provided by a team with a cardiovascular specialist as core, were followed-up actively and their medical records were kept in files. Percentage of the patients with blood pressure lowered to meet criteria of effectiveness and their improvement in depression and anxiety status and quality of life were evaluated two years after management for the two groups. Results Percentage of patients with their blood pressure lowered to meet effective criteria increased significantly in both of the groups, from 32. 8% to 67.5% in patients with conventional management and from 33.7% to 83.4% in those with case management ( P = 0. 007 ),respectively. Scores of self-rating anxiety scale ( SAS) and self-rating depression scale (SDS) decreased in patients of the both groups, from 57 ± 10 and 56 ± 11 before management to 40 ±9 and 48 ± 10 after it,respectively in patients of conventional management ( P = 0. 032 ), and from 56 ± 10 and 57 ± 10 before management to 35 ±9 and 40 ± 9 after it ( P = 0. 008 ), respectively in those with case management; and scores of quality of life improved in patients of the two group, from 65 ± 13 before management to 85 ± 14 after it in those with conventional management, and from 64 ± 13 before management to 98 ± 14 after it in those with case management ( P = 0.017 ), respectively. Conclusions Case management is better for chronic diseases and recommended in management for the elderly with hypertension, which can improve their targets of blood pressure lowering, decrease their scores of SAS and SDS and improve their quality of life,with an integrated, in-depth, continuous management.

Objective To explore the association between air pollution and the pregnancy outcome in a severe air pollution city and to provide the evidence for health related policy-making.Methods The subject population included the newborns from 1997 to 2004 in Taiyuan and the data of air pollution in the same time were collected.Logistic regression was used to analyze OR in the case-control design.Results Statistically,the prevalence of premature birth,birth defects and the mortality of infants and fetuses were significantly associated with PM10 air pollution.For premature birth,odds ratios were ranged from 1.17 to 1.76,the highest OR,1.76(95%CI:1.64-1.90),was found during the first 3 months of pregnancy.For birth defects,odds ratios were from 1.37 to 1.67,the highest OR,1.67(95%CI:1.28-2.17),was found in the third month.Concerning mortality of infants and fetuses,it only showed a significant association in the third trimester and the OR was 1.66(95%CI:1.26-2.19).Regarding SO2 air pollution,it only showed the significant effect on premature birth during the first and second month,the odds ratios were 1.27(95%CI:1.21-1.34)and 1.07(95%CI:1.01-1.14)respectively.Conclusion Air pollution in the investigated city had an adverse effect on the pregnancy outcome and the stringent measures should be taken to abate the air pollution and to reduce the risk for reproductive health.

Objective To detect the antiplatelet function of clopidogel by Thrombelastography (TEG)and light transmmi-tance aggregometry (LTA)and analyze efficiency of two methods.Methods ①Venous blood samples were taken from 48 outparients and inpatient with acute corotary syndrome (ACS)in PLA General Hospital,including unstable anqina,ST seg-ment elevation myocardial infarction and non ST segment elevation myocardial infarction (32 males,16 females)by random number table from March to July 2011,whose average age was 73 (62~90).②All of them were served 160 mg aspirin and 300 mg clopidogrel after they were in hospital at first time,and then served with 75 mg/d clopidogrel for 9 months.After that,venous blood samples were drew from them who were served clopidogrel 2 hours later.③Platelet aggregation function was assayed with LTA and TEG.All volunteers were signed informed consent and the experiment was approved by the hos-pital ethics committee.Results The platelet aggregation rate detected with LTA induced by adenosine diphosphate (ADPL-TA-INDU)was 40~80% in 41 individuals (85.4%),>80% in 7 individuals (14.6%),coefficient of variation (CV)was 0.19.The inhibition ration of platelet function (INHI)detected with TEG (ADPTEG-INHI)was 10~60% in 40 individu-als (83.3%),<10% in 2 individuals (4.2%),>60 in 6 individuals (12.5%),CV was 0.54.The sum of ADPLTA-INDU and ADPTEG-INHI (ADPLTA-INDU+ADPTEG-INHI)tended to a constant (Mean=98%,SD=12.1).There was no significant indifference between every (ADPLTA-INDU+ADPTEG-INHI)and their Mean (98%)by paired t-test.The ADPLTA-INDU was negative correlated with ADPTEG-INHI (r=-0.75,P<0.01).Conclusion The effect of clopidogrel was mild and the efficiency of TEG and LTA was similar in detecting the antiplatelet function of clopidogrel,but the preci-sion of TEG was lower than LTA.

Objective To evaluate the antidepressant efficacy and adverse reactions of 3 different stimulus dosage of modified electroconvulsive therapy ( MECT) in patients with depressive episode. Methods 120 patients with depressive episode were randomized into low dosage group ( n=40) ,medium dosage group ( n=40) and high dosage group ( n=40) . Low dosage were 50%× age,medium dosage was 70%×age,high dosage was 80%×age . All patients received 6 treatments. Hamilton depression scale?17(HAMD?17) was used to evaluate the clinical symptoms at baseline,3 and 6 treatments. Effects and adverse reactions were compared among three groups.Results Compared with baseline the HAMD?17 scores of the 3 groups were significantly improved after 6 treatments( t=24.026, P=0.000;t=26.541, P=0.000;t=25.904, P=0.000) , but there were no statistically significant differences among the three dosage groups(F=0.409, P=0.665). Compared with low dosage group((27.2±5.4)%),the HAMD?17 scores reductive ratio of medium dosage group((34.3±6.8)%) and high dosage group((33.9±6.9)%)) were significantly improved after 3 treat?ments ( t=-5.513, P=0.000;t=-4.785, P=0.000). Compared with the low dosage group,the incidence rate of headache,nausea and vomiting,delirium were significantly higher in high dosage groups( headache:χ2=14.532, P=0.000;nausea and vomiting:χ2=13.333, P=0.000;delirium:χ2=14.907, P=0.000) . The re?covery time was significantly longer in medium dosage group ( ( 10. 5 ± 1. 6 ) min ) and high dosage group ((11.2±1.8)min) than that in low dosage group((8.8±1.2)min)( t=-5.144,=0.000;t=-6.889, P=0.000).Conclusion Different stimulus dosage of MECT for depressive episode has equivalent curative effect after 6 treatment . Medium dosage and high dosage treatments appear to have an early onset of efficacy,but may also be associated with more adverse reactions.

Objective The clinical,laboratory,and neuroradiologic features of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) were analyzed and early clinical diagnosis was proposed.Method The various presentations of 34 MELAS patients were summarized to identify the specific symptoms and signs.The appropriate interpretation of the ancillary examinations,including lactic acid levels of blood and cerebral spinal fluid,neuroradiology,muscle biopsy and genetic test,was emphasized.the diagnostic significance and limitations of clinical,laboratory and neuroradiologic features were pointed out.Result The most common clinical presentations were listed in order of frequency:seizures,headache,mental decline,stroke-like episode,development abnormality,muscle weakness,fatigue,and ophthalmoplegia.Raised fasting or post-exercise blood lactic acid levels were found in 23 patients (67.6%).The most common lesions were located in the occipital lobe,parietal lobe,temporal lobe,basal ganglion,frontal lobe,cerebellum and deep white matter of 32 patients.Ragged red fibers were found in 24 patients (75%),and 8 other patients had negative muscle biopsy.Fourteen patients underwent genetic test,of which 9 patients had point mutation at 3243.Conclusion It is feasible to have early recognition of the various presentations of MELAS and make an early diagnosis even before the stroke like episodes.

Pharmacogenomics is a discipline studying the influence of genetic differences on drug effectiveness .It promises to op-timize the effect of medicine and reduce side effects .It is one of the most effective ways to predict the drug reaction in human body by using pharmacogenomics , which can achieve the goal of precision medicine .With the rapid development of the genetical test technolo-gies, the in vitro individual genome testing projects with the properties of high throughput , and measurable and low cost are better to be applied in medical practice and guiding for making individualized medicine plan .The study elucidated the progress in single nucleotide polymorphism and its clinical application , and focused on the strategic effects of pharmacogenomics on individualized treatment and gene diversity for guiding medicine .

Objective To study the effect of blood glucose level and duration of type 2 diabetes mellitus on carotid intima-media thickness (CIMT) and quantitative carotid stiffness (QCS) in the patients with type 2 diabetes mellitus. Methods Two hundred and seventy-four type 2 diabetic patients (diagnosed according to the World Health Organization criteria) were involved in this study. The subjects were divided into three groups according to the HbAlclevels and duration of diabetes mellitus: 60 with duration ≤2 years (as newly diagnosed) , 96 with duration≥5 years and HbAlc <6.5%, and 118 with duration≥5 years and HbAlc≥6.5%. CIMT and QCS of the common carotid artery were assessed by the high-resolution B-mode ultrasound unit and an echo-tracking system integrated in an uhrasound unit respectively. Results (1) In categorical analyses, the mean level of CIMT was increased from 720 μm in subjects with a duration of diabetes mellitus ≤2 years to 770 μm in subjects with a duration of diabetes mellitus > 2 years and plasma HbAlc< 6.5% (P < 0.05), and to 800 μm in subjects with a duration of diabetes mellitus > 5 years and plasma HbAlc≥ 6.5 % (P < 0.01). The corresponding values for Q CS values were 4.5, 4.5 and 5.1 (P <0.05), respectively. (2) In multiple stepwise regression analyses, CIMT wassignificantly associated with the duration of diabetes mellitus, systolic blood pressure and serum concentration of total cholesterol, whereas QCS was significantly associated with age, duration of diabetes mellitus, smoking, HbAlc, systolic blood pressure (P < 0.05 or P < 0.01). Conclusion QCS is suitable in evaluating the impact of blood glucose on carotid artery, while CIMT is an appropriate tool for long-term follow-up of diabetic patients.

Objective To investigate the blood fatty levels in different genotypes of matrix metalloproteinases (MMP) and the carotid atherosclerosis (CAS) in patients with essential hypertension (EH).Methods Four hundred and eighty-eight cases of Han and Uygur in patients with EH were selected,and MMP-2-735 C/T and MMP-3-1171 5A/6A polymorphism was measured by polymerase chain reactionrestriction fragment length polymorphism.They were divided into two groups:EH with CAS group (CAS group,293 cases,Han 171 cases,Uygur 122 cases) and EH without CAS group (NS group,195 cases,Han 105 cases,Uygur 90 cases).Blood fatty factors were analyzed according to the different MMP genotypes.Results According to MMP-2 genotypes,in Hart CAS group,the low density lipoprotein cholesterol (LDL-C) levels in MMP-2 CT+TT genotypes were significantly higher than those in CC genotype(P ＜ 0.05),and high density lipoprotein cholesterol levels were significantly lower than those in CC genotype(P ＜ 0.05); In Uygur CAS group,the triglyceride levels in MMP-2 CT+TT genotypes were significantly higher than those in CC genotype(P ＜ 0.05).According to MMP-3 genotypes in Han NS group,the total cholesterol and LDL-C levels in 6A/6A genotype were significantly higher than those in 5A/5A+5A/6A genotypes (P ＜ 0.05).Conclusion The blood fatty levels are different in patients with different MMP genotypes,which may probably influence the CAS.