Objective　To investigate the early changes and clinical significance of plasma endothelin(ET) and nitric oxide(NO) in patients with acute brain injury.　Methods　The plasma ET and NO concentration at 1 day after injury were checked with radioimmunoassay and Green method in 48 cases of acute brain injury, in 42 cases of non-brain injury and in 38 healthy volunteers. 　Results　 The early plasma concentrations of ET and NO were (109.73±12.61) ng/Lf and (92.82±18.21) μmol/L, respectively, in 48 cases of acute cerebral injury, which were higher than those in the non-brain injury group［(67.90±11.33) ng/L and (52.66±12.82) μmol/L, respectively, P<0.01］ and in the normal control group ［(50.65±17.12)ng/L and (36.12±12.16) μmol/L, respectively, P<0.001］. The amounts of ET and NO in the patients with severe brain injury were (116.18±18.12) ng/L and (108.19±13.28) μmol/L, respectively, which were significantly higher than that of the moderate brain injury group［(92.33±16.32) ng/L and (76.38±12.71) μmol/L, respectively, P<0.01］.The early levels of ET and NO were negatively related to the GCS scores of the patients with acute brain injury. The amounts of ET and NO were (126.23±15.23)ng/l and (118.18±10.12) μmol/L, respectively, in the patients with subdural hematomas, which were significantly higher than those in the patients with epidural hematomas ［(81.13±12.37) ng/L and(68.02±13.18) μmol/L, respectively, P<0.01］. The stable plasma concentrations of ET and NO at 14 days after injury in the patients with acute brain injury and with non-brain injury were similar to that in the normal controls. 　Conclusions　 ET and NO are related to the pathophysiological process in the early period of acute brain injury, and the values of ET and NO correlate positively with the clinical manifestations. The changes of plasma ET and NO can be regarded as important indexes to diagnose the severity of acute brain injury.

Objective To compare the effects of and Smeton on inflammatory mediator levels and therapeutic outcomes in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Ninety AECOPD patients hospitalized at our department from June 2012 to June 2013 were selected and randomly divided into the group and the Smeton group.In addition to routine therapy,such as anti-infection medication and water & electrolyte balance maintenance,for both groups,patients in the group were given a single 10 mg oral dose of,taken at night before bedtime,while patients in the Smeton group were given 2 pills of a compounding formulation containing,three times a day,for two months.Changes in plasma inflammatory mediator levels before and after treatment and therapeutic outcomes were monitored.Results Highsensitivity C-reactive protein (hs-CRP) levels decreased and interleukin-10 (IL-10) levels increased two months after treatment,compared with pretreatment levels [hs-CRP,(4.01±0.69) mg/L vs.(15.23±4.39) mg/L,and IL-10,(19.44±6.35) g/L vs.(7.86±3.24) g/L,for the group; hsCRP,(7.09±1.70) mg/L vs.(7.86±3.24) g/L,andIL-10,(11.6±3.2 g/L vs.6.7±2.8 g/L),for the Smeton group; P＜0.05 or 0.01].The magnitude of increases or decreases in inflammatory mediator levels was greater in the group than in the Smeton group (P＜0.05 for both),and the overall effectiveness rate was higher in the Smeton group than in the group (95.6％ vs.82.2％,x2 =4.05,P ＜0.05).Conclusions When used for treatment of patients with AECOPD,ontelukast has more beneficial effects on inflammatory mediator levels,whereas is more effective in clinical symptom improvement.

Objective To observe the effect of atorvastatin on lowering blood lipid in patients with type 2 diabetic mellitus plus hyperlipidemia. Methods All patients took 10 mg atorvastatin every night for 12 months. The levels of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum alanine aminotransferase (ALT), aspartate aminotransferase fAST), fasting blood glucose (FBG), creatinine (Cr), intima media thickness (IMT) of carotid artery (CA), common lilac artery (CIA) and femoral artery (CFA) were examined before and 3, 6, 9, 12 months after the treatment. Results TC [(5.11±0.94) vs. (4.46±0.98) mmol/L, P<0.01] and LDL-C [(3.01±0.78) vs. (2.55± 0.83) mmol/L, P<0. 01] were significantly decreased one year after the treatment. At different detection time points, the levels of LDL-C all reached the therapy standard (<2.59 mmol/L). But TC reached the therapy standard (<4.04 mmol/L) only at nine months after the treatment. IMT of CA, CIA and CFA were at the decreased tendency (P>0. 05). No significant changes were observed in ALT, AST and Cr. Conclusions Atorvastatin may significantly decreased the level of blood lipid with little adverse effect in elderly patients with type 2 diabetic mellitus plus hyperlipidemia, and it also has the effect of protecting the vascular intima.

OBJECTIVE: To examine and determine the contents of endothelin (ET) and nitric oxide (NO) in plasma, and to observe the effects of gastrodin injection on blood pressure, ET and NO levels in old patients with refractory hypertension. METHODS: A total of 63 old patients with refractory hypertension, 30 patients with common hypertension and 30 healthy people were included. The contents of ET and NO in plasma of patients in different groups and healthy people were examined and analyzed. The old patients with refractory hypertension were randomly divided into two groups: gastrodin-treated and routine treatment groups. Besides conventional hypotensive drugs, intravenous drip infusion of 1 000 mg gastrodin was administered to the patients in gastrodin-treated group for two courses (4 weeks), while the patients in routine treatment group were treated only with conventional hypotensive drugs. The changes of blood pressure, ET and NO levels before and after treatment in different groups were measured. RESULTS: The plasma level of ET in refractory hypertension group was higher than that in common hypertension group (t=3.27, P=0.008), while the level of NO was lower (t=-3.81, P=0.002). The systolic pressure and pulse pressure difference in gastrodin-treated group were decreased significantly after one course of treatment (t=1.85, P=0.03; t=1.74, P=0.04). The level of ET in gastrodin-treated group decreased gradually after treatment, but there were no significant difference between before treatment and two courses of treatment, while the level of NO in gastrodin-treated group was increased after treatment (t=-2.70; P=0.04). CONCLUSION: Gastrodin injection is beneficial to old patients with refractory hypertension, and can improve the balance of ET and NO levels in plasma.

Objective To investigate the relationship between the prothrombotic state and leukoaraiosis(LA)in elderly patients with metabolic syndrome.Methods A total of 350 metabolic syndrome patients in the affiliated hospital of Zhejiang University who received treatment from January 2013 to January 2015.According to the results of head MRI,patients were divided into LA group(n=203)and non-LA group(n=147).The severity of LA was graded by its MRI appearance and the Blennow scale.The plasma levels of fibrinogen (Fib),prothrombin time (PT),thrombin time (TT),activated partial blood coagulation time(APTT),D-dimer (D-D) and yon willebrand factor (vWF) were measured and compared between the two groups.Results The levels of Fib,vWF and D-D were higher in LA group than in non-LA group(all P＜0.05).Spearman correlation analysis showed that the severity of leukoaraiosis was positively correlated with Fib,vWF and D-D(r=0.014,0.089,0.215,respectively,all P ＜ 0.05).Multivariate linear regression analysis showed that Fib,course of hypertension,vWF and HbA1c were the main influencing factors with the standardized regression coefficient of 2.516,0.312,0.206 and 0.167 respectively for leukoaraiosis in elderly patients with metabolic syndrome.Conclusions The course of hypertension and HbAlc level are positively related with LA.The prothrombotic state markers including Fib and vWF can be considered as the predictors for LA severity in elderly patients with metabolic syndrome.

Objective To observe the relationship between vasoactive substances and blood pressure in old patients with hypertension.Method Venous blood was drawn from 35 old hypertension patients when blood pressure was normal and abnormal,respectively.Epinephrine(E),norepinephine(NE),endothelins(ET),angiotensin ll (Angll) and ealcitonin-gene-retated peptide were determined by radio-immunity.The above five cytokines were also determined in 33 old healthy people.The cytokines levels were compared between the normal and abnormal blood pressure in hypertension patients and also between the old hypertension patients and healthy persons.The correlation between blood pressure and cytokines were analyzed.Results The level of ET,Angll,E and NE were obviously increased in old hypertension patients when their blood pressure was abnormal,while CGRP obviously decreased.No difference was found in the five cytokines between two groups when the blood pressure were normal.The correlation analysis showed that systolic pressure had positive correlation with ET,AnglI and E(r=0.304,0.337,0.587,P=0.031,0.019,0.036)and negative correlation with CGRP(r=-0.416,P=0.028)in old hypertension patients when the blood pressure was abnormal.And the diastolic pressure had positive correlation with AnglI and E(r=0.357,0.333;P=0.039,0.028).ET had positive correlation with Angll and E(r=0.361,0.315;P=0.041,0.029).Conclusion The levels of vasoaetive substances significantly changed in old hypertension patients with the blood pressure change.Among those cytokines,the substances that contract blood vessel increased most obviously.The vasoactive substances played an important role in the progress of blood pressure rising.

Objectives To compare the differences in intestinal phylum firmicutes between elderly patients with type 2 diabetes (T2DM)and the healthy elder people.Methods 37 elderly patients with T2DM and 69 healthy controls in Shaoxin city were recruited.DNA of phylum firmicutes from fecal samples was extracted.The real-time quantitative PCR was used with special primers for bacterial genus including Faecalibacterium prausnitzii,Eubacterium rectale,Clostridium leptum,and Peptostrepyococc.The differences in content of different bacteria between two groups were analyzed and compared.Results In healthy elderly group versus the elder patient with T2DM,the contents of intestinal phylum firmicutes were[(6.22±1.41) × 107 versus(5.41± 1.40) × 107,t=2.83,P=0.006] in Eubacterium rectale,[(7.46 ± 0.98) × 107 versus (6.96 ± 1.40) × 107),t =2.13,P =0.036] in Faecali bacterium prausnitzii,[(7.89±0.89) × 107 versus(7.46±1.11) × 107,t=2.15,P=0.034]in Clostridium leptum,and[(4.86 ± 1.33) × 107 versus (4.21 ± 1.24) × 107,t=2.45,P =0.016] in Peptostrepyococc,which showed that the contents of intestinal phylum firmicutes were less in T2DM group than in healthy elderly group.Conclusions There are some differences in intestinal flora between the elderly patients with T2DM and healthy people.These intestinal flora may play an important role in the development of T2DM.This study may provide new evidences for probiotic treatment of T2DM.

Objective To analyze the diversity of intestinal microecology in different healthy age groups and explore the relationship between age and the composition of intestinal microflora.MethodsFecal samples were collected from the children,adult and elderly groups.The main intestinal microflora were cultured and quantified,and the qualitative and quantitative changes in the level of category were determined by fluorescence quantitative PCR.The Bifidobacteria/Enterobacteriaceae (B/E) ratio reflexing intestinal colonization resistance was also calculated.Results The germiculture of fecal samples indicated that the counts of Bifidobacteria and Lactobacillus (P＜0.01 and P＜0.05,respectively) were significantly lower in the adult and aged groups than in children group.The number of Bacteriodes and Enterobacteriaceae in the elderly group were higher than in the children and the adult groups (all P＜0.01).The counts of Enterococcus were increased in the adult and the aged groups (P＜0.05 and P＜0.01) compared with the children group,and were higher in the aged group than in the adult group (P＜0.05).The B/E ratio was significantly decreased in the aged group (0.88-±-0.13) as compared with the children (1.15±0.15) and the adult groups ( 1.01± 0.20) ( both P ＜ 0.01).The diversities of Bifidobacteria,Bacteriodes,Enterobacteriaceae and B/E ratio by fluorescent quantification PCR were consistent with the results by germiculture technology.The diversity of Lactobacillus (P＜0.01) between the children and the aged groups as well as between the children group and the adult group significantly improved (P＜0.01 and P＜0.05 ) in PCR compared with the germiculture technology. ConclusionsThe numbers of intestinal Bifidobacterium and Lactobacillus are decreased with lower colonization resistance,while the numbers of Bacteriodes,Enterobacteriaceae and Enterococcus are increased with aging.

Objective To investigate the changing characteristics of muscle mass by dual energy X-ray absorptiometry (DEXA) in middle aged and elderly people with different ages.Methods This study included 343 healthy people aged 50-89 years (178 males and 165 females).Subjects were divided into 4 groups:aged 50-59,60-69,70-79,and 80-89 years group.Fat-free body mass (FFM),the appendicular lean body mass (aLM),trunk lean mass (tLM) were measured by DEXA.The aLM/body weight (Wt％) and aLM index (ASMI) were calculated by DEXA.Results The tLM in both gender was decreased in aged 80-89 years group than in aged 50-59 years group [male (10.6± 1.8) kg vs.(18.4±2.9) kg,female (7.1±1.2) kg vs.(14.8±2.1) kg,F=5.7 and 7.8,P＜ 0.01].The average ASMI in both gender was decreased in aged 70-79 and 80-89 years groups than in aged 50-59 years groups [male (5.5±0.4) kg/m2,(4.9±0.7) kg/m2 vs.(6.1±0.5) kg/m2,female (4.3±0.4) kg/m2,(3.9±0.5) kg/m2 vs.(4.8±0.6) kg/m2,F=24.9 and 9.6,both P＜0.01].The quality of muscle mass was decreased with aging in the elderly.Conclusions Ageing is an important risk factor for sarcopenia in the elderly.DEXA can be used to evaluate the muscle mass in middle aged and the elderly,and ASMI can be used as a reliable measurement index.

[ ABSTRACT] AIM:To investigate the inhibitory effect of ginsenoside Re on intimal hyperplasia induced by bal-loon-injury and to explore the role of NF-κB p65 signaling pathway in the process.METHODS:SD rats (n=40) were di-vided into 5 groups randomly: sham operation group, model group, low-dose ginsenoside Re group, middle-dose ginsen-oside Re group and high-dose ginsenoside Re group.The carotid artery intima injury model was established by 2F balloon catheters in all groups except the sham operation group.The day after modeling, the animals in model group and sham op-eration group were administered intragastrically with distilled water, and the rats in low-dose, middle-dose and high-dose ginsenoside Re groups were given ginsenoside Re at doses of 12.5 mg/kg, 25mg/kg and 50 mg/kg, respectively.After 14 continuous days, the morphological changes of the injured arteries were observed by HE staining and the lumen area, intima area and media area as well as the ratio of intimal area/media area were determined.The expression of tumor necrosis fac-tor-α( TNF-α) and interleukin-1β( IL-1β) were detected by real-time PCR.The proliferating cell nuclear antigen ( PC-NA) and nuclear factor-kappa B ( NF-κB) p65 were examined by immunohistochemistry.RESULTS:Compared with sham operation group, the vessel cavity was narrowed (P<0.01), the mRNA levels of TNF-αand IL-1β, and the protein ex-pression of PCNA and NF-κB p65 were increased in model group (P<0.05).Compared with model group, the vascular intimal hyperplasia was alleviated obviously (P<0.05), and the mRNA levels of TNF-αand IL-1β, and protein expres-
sion of PCNA and NF-κB p65 were decreased in medium and high-dose ginsenoside Re groups (P<0.05).CONCLU-SION:Ginsenoside Re inhibits the vascular neointimal hyperplasia induced by balloon-injury in rats, and the molecular mechanism may be related to the inhibition of NF-κB p65 signaling pathway.