Objective To investigate the effects of autoantibodies (β1-AA) against second extra-cellular loop of the β1-adrenergic receptor (β1-AR-ECⅡ) in sera of patients with dilated cardiomyopathy (DCM) on proliferation of rat CD4+T lymphocytes.Methods β1-AA in the sera of patients with DCM was purified by affinity chromatography .CD4+T lymphocytes were isolated by immunomagnetic microbeads from peripheral blood mononuclear cells of rats and its positive rate was detected by flow cytometry .CCK-8 meth-od was used to detect the proliferation of CD 4+T lymphocytes and flow cytometry was performed to measure the ratio of CD4+/CD8+T lymphocyte .Results The purity of isolated rat CD 4+T lymphocytes by immu-nomagnetic microbeads reached 97.7%.The proliferation of CD4+T lymphocytes stimulated by CD3/CD28 was inhibited by β1-AA in a concentration-dependent manner .However , IgG antibodies extracted from sera of healthy controls did not suppress lymphocyte proliferation (P>0.05).The suppression effect of β1-AA was inhibited after binding to antigenic peptides corresponding to β1-AR-ECⅡ and was completely blocked by metoprolol, a specific antagonist of β1-adrenergic receptor (β1-AR).In addition,β1-AA had no effects on the ratio of CD4+/CD8+T lymphocyte .Conclusion β1-AA isolated from DCM patients suppresses the pro-liferation of CD4+T lymphocytes through β1-AR pathway , which indicates that β1-AA can directly reduce the number of T lymphocytes and impair the function of T lymphocytes , resulting in immune system disorders and the development of DCM .

A label-free electrochemical immunosensor using hollow structure nanomaterials based on its ordered porous and big surface area was designed. Au nanocage, with good conductivity, catalysis, and biocompatibility, was prepared and modified on the surface of glassy carbon electrode with graphene to immobilize antibody of microcystin directly. In the absence of microcystin, biosensor can obtain high current response signal of electrochemical probe ( [ Fe( CN) 6 ] 3-/4-. When microcystin was combined with its antibody specifically, the charge density and mass transfer resistance on the surface of electrode increased, resulting in a decrease of the corresponding peak current of [ Fe ( CN ) 6 ] 3-/4-. This change was in proportion to the concentration of microcystin indirectly. Experiment conditions such as cultivation time of antigen and concentration of antibody were optimized. The results showed wide linear range of 0. 05 μg/L-1. 0 mg/L and the detection limit of 0. 017 ng/mL. This sensor has good stability and simple production procedure. This sensor provides a new and simple means for the ultrasensitive determination of microcystins in real water samples.

Objective To assess the feasibility of double phase subtraction angiography with second generation (128-slice )dual-source CT in low dose Flash spiral scan mode for the evaluation of cerebral vessel,compared with dual-energy subtraction angiogra-phy.Methods 60 patients underwent double phrase CT angiography were divided into group A (n = 30,with Flash spiral scan mode),group B(n=30,with dual-energy scan mode).The signal-to-noise ratio(SNR),the contrast-to-noise ratio(CNR)and the av-erage radiation of double phrase subtraction images were measured in two groups,respectively.The double phase subtraction images quality were graded by 2 independent readers on a 5-point scale(5=excellent)in double-blind,according to various degrees of the re-sidual bones,the vessel displayed and luminal integrity,respectively.Differences between two groups were analyzed by Mann-whit-ney test and t test.Results The double phrase image SNR showed no difference to both two groups(P >0.05).The image CNR of arterial and venous phase in group A were higher than that of group B(40.89±8.89 and 40.27 ±9.90 in group A vs 35.28 ±8.43 and 34.89±8.66 in group B;P <0.05)respectively.There were no singnificant difference in the bone removal image scores of doub-le phase and in the vessel image scores of venous phase to both two groups respectively(P >0.05).The vessel image scores of arterial phase were higher in group A than that of group B(4.93±0.25 vs 3.87±0.97;P <0.05).Some internal carotid in the base of skull has not good luminal integrity in group B.The mean dose length product (DLP)in group A was lower than that of group B,with a 39 percent reduction[(226±5.69 )mGy/cm vs (368 ± 21.35 )mGy/cm,P < 0.05 ].Conclusion With the roughly similar image quality to dual-energy double phase subtraction angiography,the cerebral vessels can be assessed using dual-source CT subtraction angiography in Flash spiral scan mode and a lower radiation dose.

Objective To analyze the clinical characteristics of suspected acute aortic dissection with ST-segment elevation detected by inferior leads in order to avoid the misdiagnosis of acute aortic dissection facilitating an appropriate treatment strategy carried out in time.Methods A total of 14 patients with suspected acute aortic dissection with ST-segment elevation detected by inferior leads were enrolled.Their clinical presentation,ECG features,imaging findings,laboratory testing,coronary angiography results, treatment and outcome were retrospectively analyzed.Results Clinical characteristics of suspected acute aortic dissection with ST-segment elevation detected by inferior leads suggested that hypertension as a single risk factor accounted for 79%.The patients with normal blood pressure or high blood pressure in emergency visits accounted for 86%.The amplitude of ST elevation in lead Ⅲ was greater than that in lead Ⅱ,and lead Ⅲ accompanied with ST elevation in lead V1 or V4R accounted for 86%.Significantly elevated D-dimer >2 000 ng/mL was found in those patients.Coronary angiography showed that the opening of coronary artery not seen,normal coronary arteries or a simple right coronary artery proximal lesion.Transesophageal echocardiography and computed tomography angiography were used to identify the diagnosis with 100%accuracy.The mortality rate of this group was 50%.Conclusions Patients with acute aortic dissection evidenced by ST-segment elevation detected by inferior leads are in critical setting of high mortality. Emergency surgical treatment can significantly improve the survival rate of patients.

Objective To investigate the effects of β1-adrenergic receptor autoantibodies (β1-AA) on the proliferation of different subtypes of T lymphocytes in patients with heart failure .Methods β1-AA-positive IgG antibodies isolated from patients with heart failure were purified by using affinity chromatog -raphy.CD3 +CD4 +T and CD3 +CD8 +T lymphocytes were sorted by flow cytometry analysis .The prolifera-tion of different subtypes of T lymphocytes was tested by using CCK-8 kit.Tests for lactate dehydrogenase ( LDH) level and cell apoptosis were performed to evaluate T lymphocytes damage .Results The prolifera-tion of activated lymphocytes was inhibited by β1-AA isolated from the serum of patients with heart failure in a concentration dependent manner , but it could be blocked by β1 receptor blocker .The damage of lympho-cytes induced by β1-AA was increased.Moreover, β1-AA promoted the necrosis and apoptosis of CD 3 +CD4 +T and CD3 +CD8 +T lymphocytes and thus inhibited the proliferation of them .Conclusion β1-AA isolated from the serum of patients with heart failure inhibited the proliferation of CD 3 +CD4 +T and CD3 +CD8 +T lymphocytes through increasing the necrosis and apoptosis of them .This study suggests that β1-AA might induce immune disorders in addition to causing pathological changes in heart tissues .

Objective To know the prevalence of chronic obstructive pulmonary disease(COPD) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) in Kunming Yunnan Province, and the clinical symptom of OS.Methods Retrospective study of 4 636 cases of patients with snoring, excluding COPD in addition to chronic respiratory disease and assess the patient`s condition.The test included AHI, BMI, Epworth sleepiness scale, lung function.The index of OS was confirmed by AHI>5 times/h and FEV1/FVC<70%.Results During the period of 2006 to 2012, he prevalence of COPD in patients with OSAHS was 10.1% [95% confidence interval (CI) 9.1%-11.1%] in Kunming Yunnan Province.And male`s OS prevalence rate is higher than the female(male 10.2%;female 9.7%).The OS patients` average age was 56.9±14.1, the mean AHI was (47.46±26.79) times/h, and the average FEV1/FVC was 60.09%±23.57%.Polysomnographyresults show that patients suffered obvious hypoxiaat night in both OSAHS group and OS group, but it was more significant in OS group.Pulmonary function test showed that OS patients have more serious chronic obstructive pulmonary disease.Conclusions The prevalence of COPD in OSAHS patients was high in Kunming, Yunnan Province, and the prevalence rate in old group reached more than 24%.In addition, the sympotms of patients with OS were more severe than those with only OSAHS or COPD in lung function and hyoxemia.

Objective To investigate the influence of autoantibodies against the second extracellular loop of β1-adrenoceptor ( β1-AA) on the proliferation ability of LPS-stimulated rat B lymphocytes.Methods Active immunization assay was used to obtain adequate IgGs in which β1-AA was positive; MACS (magnetic activated cell sorting) assay was used for gaining rat splenic B lymphocytes; CCK8 assay was used for detecting the influence of β1-AA to the proliferation abilities of silent and LPS-stimulated rat splenic B lymphocytes.Results β1-AA (0.1 μmol/L pIgGs ) promoted the proliferation of LPS-stimulated rat splenic B lymphocytes(A values:0.739±0.036 vs 0.533±0.032,P＜0.05),and the effect was likely to be concentration-dependent.And the effect could be blocked by β1-AR blocker or β2-AR blocker partially,and could be blocked by β1-AR blocker and β2-AR blocker completely; β1-AA had no proliferation effect on silent rat splenic B lymphocytes.Conclusion β1-AA could promote the proliferation of LPS-stimulated rat splenic B lymphocytes via β1-AR and β2-AR which were on the surface of B lymphocytes.Thus,it could provide new clues for complex pathologic mechanism of cardiovascular patients in which β1-AA is positive.

Objective To investigate the effectiveness of oxytoein antagonist atosiban in the alternative rescue therapy of preterm labor.MethodsAlternative toeolysis atosiban was given as rescue therapy to 35 women,who had received ritodrine or magnesium sulphate but failed,due to either progression of labour or intolerable adverse events.Atosiban was administered for up to 48 hours.Efficacy and tolerability were assessed based on the proportion of women who did not deliver and did not need alternative toeolytie therapy at 48 hours and 7 days after therapy initiation.The numbers of maternal adverse events and neonatal morbidity were also assessed.ResultsEfficacy and tolerability at 48 hours and 7 days after atosiban nitiation were 77％(27/35)and 60％(21/35).One woman presented drug-related side effects with mild nausea and omiting.Thirty-four women have delivered and one bigemina(28 weeks)is being followed-up.In 34 women,11 delivered before 28 gestational weeks,17 delivered after 28 gestational weeks,3 delivered after 34 weeks and 3 had term delivery.Pregnancies were rolonged by 4 hours to 14+2 weeks.There were nine neonatal deaths,with gestational ages less than 28 weeks at delivery.Conclusion xytocin antagonist atosiban could be given as alternative rescue therapy if therapy with ritodrine or magnesium sulphate fails in the treatment of preterm labor,and it is safe and effective.

Objective To screen out the cytokines relating to cardiac insufficiency caused by au-toantibodies against the second extracellular loop of the β1-adrenoceptor(β1-AA) using cytokine chip tech-nique, and to analyze the changes in signaling pathways. Methods Blood samples were collected from 67 patients with coronary artery disease(CAD) and 42 healthy subjects. ELISA was performed to detect β1-AA in plasma. BALB/c mice were passively immunized with the monoclonal antibodies against β1-AA (β1-AA mAb). Dynamic changes in mouse cardiac structure and functions were detected by heart ultrasound. Hema-toxylin and eosin (HE) and Masson staining were used to observe morphological changes in heart tissues.Cytokine chip technique was used to screen out the cytokines causing myocardial injury. Gene Ontology (GO) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment analysis were used to classify the differentially expressed cytokines. Results Patients with CAD showed increased titer and posi-tive rate of β1-AA as compared with healthy subjects(P<0.001). The mouse model of heart injury was in-duced by β1-AA at the 8th week after immunization. A total of 37 differentially expressed cytokines were found in the model group,of which 11 cytokines were up-regulated and 26 cytokines were down-regulate as compared with those in the mouse control group. The level of CXCL16 was significantly increased in β1-AA-positive mice. GO analysis showed that CXCL16 was mainly involved in life processes including the positive regulation of cell death, migration, locomotion and cellular component movement. KEGG pathway enrich-ment analysis showed CXCL16 was significantly enriched in the pathway of cytokine-cytokine receptor inter-action and chemokine signaling pathway. ELISA showed that compared with β1-AA-negative patients, CXCL16 level was significantly increased in β1-AA-positive patients (P<0.01). A positive correlation was found between β1-AA and CXCL16 (P<0.01,r=0.43). Conclusion CXCL16 may play a critical role in the development of cardiac insufficiency induced by β1-AA.