Objective:To study the expression of angiotensin-converting enzyme(ACE),extracellular signal-regulated kinase(ERK),and the changes of atrial fibrosis in patients with rheumatic heart disease(RHD) and atrial fibrillation(AF) treated with angiotensin-converting enzyme inhibitor(ACEI).Methods:Atrial tissues were obtained from the right appendage during open surgery in 35 patients with RHD.The mRNA of ACE and ERK2 were semi-qualified by reverse transcription-ploymerase chain reaction(RT-PCR) and normalized to the glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Western blotting analysis was employed to examine the expressions of ACE and phosphorylated ERK(pERK).Atrial collagen volume fraction(CVF) was detected by Masson's stain.Results:The mRNA of ACE and ERK2 or the protein of ACE and pERK were significantly increased,and CVF was significantly increased in patients with chronic atrial fibrillation(CAF) compared with sinus rhythm group(SR)( P 0.05).Conclusion:The expressions of ACE,ERK2 and pERK increase,and fibrosis is more severe in RHD patients with CAF as compared with those with SR.Compared with CAF patients treated without ACEI,the expressions of ERK2 and pERK significantly decrease( P 0.05)in CAF patients treated with ACEI.This suggests that the increasing expression of ERK2 and pERK resulting from local renal angiotensin-converting enzyme system activation mediates the development of atrial fibrosis,and ACEI may contribute to lesser atrial fibrosis in RHD patients with AF.

According to the sera aquaporin-4 antibody (AQP4), neuromyelitis optica (NMO) can be classified into two types as AQP4 antibody positive (AQP4+) and negative (AQP4-). However, the NMO patients with AQP4- are prone to delayed treatment, and may have a different pathogenesis compared to that in patients with AQP4+. Scientific researches and the clinical trials on NMO with AQP4- will deepen the understanding of NMO pathogenesis and help to make an early accurate diagnosis and rational therapy for NMO with AQP4-. This review aims to summarize the progress in clinic diagnosis for NMO patients with AQP4-.

Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. PH progresses rapidly to right ventricular (RV) failure and even death without treatment. Cardiac magnetic resonance (CMR) is an accurate and reproducible tool for the assessment of RV morphology and function, which plays an important role in the prognosis of patients with PH. The aim of this study is to review the clinical application and research progress of CMR in evaluation of PH.

Neoadjuvant chemotherapy is preoperative chemotherapy.It can minish burthen of tumor,lower the clinical stage,increase resection rate of cancer and improve therapeutic efficacy.Neoadjuvant chemotherapy for gastric cancer,as a relatively latest concept,has been applied in clinic more and more.

Objective To explore the characteristics,application and significance of electrocardiogragh (ECG)in diagnosis and differential diagnosis of pulmonary embolism(PE)by contrasting the ECG of PE and several diseases with similiar clinical features.Methods A total of 364 cases were enrolled in this study,including 197 cases of PE,70 cares of coronary artery disease(CAD)with congestive heart failure(CHF),47 cases of essential hypertension(EH)with CHF,and 50 cases of acute lung injury/acute respiratory distress syndrome(ALI/ARDS).The ECG of these 364 PE cases were analyzed.Results The rates of axle right drift,lockward rotation,right bundle branch block and pulmonary P wave,V1 lead s-wave were higher than control groups,with significant difference.Bates of S1Q3T3,disposition of T wave in chest lead were the highest in PE group,with significant difference.Conclusion The main appearances of ECG in PE patients hint the heavy load of right ventricular and coronary ischemia.Perhaps S1Q3T3 is the appearance of axle right drift.The sensitivity and speciality of every feature is not good enough to diagnosis or differential diagnosis;dynamic observation of ECG is of great significance to the diagnosis of PE.

This article expounds the indication,preoperative ischemic tolerance test,evaluation of collateral circulation,different surgical modes,complications and their prevention in the treatment of intracranial aneurysms during extracranial-intracranial(EC/IC)graft bypass.It is considered that EC/IC bypass graft is an effective therapeutic mode in preventing the occurrence of cerebral ischemia in the treatment of intracranial aneurysms.

Human epidermal growth factor receptor 2(Her-2),which is often over-expressed in 20%-25% of invasive breast cancer patients,is associated with an aggressive tumor phenotype and therefore,a reduced survival rate.As a widely clinically applied Her-2-targeted monoclonal antibody,herceptin,when combined with chemotherapy,significantly increases the survival time of patients without tumors.However,the majority of the cancers that initially respond positively to herceptin begin to counteract against the treatment within just 1 year.This study described several important and well-known mechanisms as well as the updates and advancement in this field.These mechanisms include over-activation of the P13K/AKT pathway,abnormal expression in the EGFR family and their ligands,the masking of the Her-2 receptor,herceptin,activation of PI3K/AKT via an alternative pathway,over-expression of Darpp-32 and t-Darpp.autophagy of tumor cells and over-expression of HSP27,and more.

BACKGROUND: The optimal total hip replacement can be prepared by assembling S-ROM prosthesis individually. OBJECTIVE: To evaluate the short-time effect of S-ROM prosthesis total hip replacement for osteoarthritis secondary to developmental dysplasia of hip. METHODS: Totally 57 adult patients (63 hips) with osteoarthritis secondary to developmental dysplasia of hip treated by S-ROM prosthesis for primary total hip arthroplasty from November 2002 to February 2007 were selected. The preoperative and postoperative Harris score were compared. The prosthesis loosening, fracture and subsidence, bone absorption and fracture were followed-up with radiographic results. RESULTS AND CONCLUSION: All patients were followed up from 6 months to 5 years, mean 3.5 years. One patient suffered temporary common peroneal nerve palsy, and recovered after 4 months. One patient suffered hip dislocation, and recovered after manipulative reduction and traction. There were no complications in the rest patients. The Harris hip score was 70.20-92.10, mean 88.30, which was obvious increased than that of before operation (P < 0.05). No loosening, fracture and subsidence of prosthesis, bone absorption or fracture was observed. The results demonstrated that S-ROM prosthesis total hip replacement can receive an excellent short-time effect in treating osteoarthritis secondary to developmental dysplasia of hip.

Zhenglei Bencao was written by TANG Shen-wei,a famous doctor of Song dynasty,on the basis of Jiayou Bencao and Benco Tujing through citing many precious literatures on Confucianism,history,Daoism and other social scientific works.Zhenglei Bencao stayed at a very important position in the history of Chinese materia medica.By studying this book,the author proposed that the reason for TANG Shen-wei rccording so many literatures on Confucianism and other social scientific works was the effects of Confucianism doctors appeared at song dynasty.Because TANG Shen-wei was a good doctor,he paid attention to collect Chinese medical formula.the processing of Chinese medicine.genuine medicine and food therapy.But as a result of less activity in Chinese herbs recognition and collection,TANG Shen-wei did not have a sound understanding on Chinese herbs and his own academic opinions.

BACKGROUND: Primary hypertension is in the category of "dizziness"and "dementia" in Chinese medicine. It is discovered in recent years that vascular dangerous factors, like hypertension affect the risk constitution of Alzheimer disease.OBJECTIVE: To probe into relationship between cognition and syndrome differentiation of primary hypertension.DESIGN: Case-control analysis was designed.SETTING: Jiangsu Staff University of Medical Science and Yangzhou Wenhe Hospital.PARTICIPANTS: Totally 90 cases of primary hypertension were employed from May to June 2000. They were from some city in the north of Jiangsu province, graduated from middle school and cooperated with the investigation. Totally 30 cases were collected from physical-check group and taken in the control.METHODS: The cases of primary hypertension were differentiated as excess-syndrome group (excessive phlegm and damp and hyperactivity of liver yang), deficiency-syndrome group (yin deficiency of liver and kidney and deficiency of yin and yang), excess within deficiency group (complicated with blood stasis and with turbid phlegm) and the control group. Neuropsychological method was used to evaluate the cognition.MAIN OUTCOME MEASURES: Indexes of neuropsychology: Fuld object-memory Evaluation (FOM), rapid verbal retrieve (RVR), block design WISE (BD), digit span WISE (DS), Hachinski ischemic score (HACH), mini-mental state examination (MMSE) and activity of daily living scale among groups.RESULTS: The data of 90 cases of primary hypertension and 30 cases in physical-check group entered result analysis. Compared with the control group, significant difference was not indicated in every statistical index in excess-syndrome group (P ＞ 0.05). In deficiency-syndrome group, except MMSE and ADL, the rest observed indexes indicated statistical difference.In excess within deficiency group, statistical difference presented in every observed index (P ＜ 0.01), in which the results in the complication of turbid phlegm was worse than blood stasis (FOM was 11.3±3.7,13.5±2.5 respectively; DS was 6.4±3.9,8.3±3.5, respectively)CONCLUSION: Primary hypertension affects mental state of patient, in which, cognition is declined mildly in deficiency-syndrome group. Dementia symptoms present in excess within deficiency group which is severe in phlegm type compared with blood stasis type. Differentiation of syndromes in Chinese medicine integrated with neuropsychological assessment benefits early discovery and diagnosis of dementia.