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.

Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that plays a critical role in the folate and homocysteine metabolism.MTHFR mutation leads to decreased 5-methylenetetrahydrofolate synthesis.Consequently, it influences the conversion of homocysteine to methionine causing homocysteine accumulation.Homocysteine has been considered as an independent risk factor for a variety of diseases such as cardiovascular diseases , neurological and psychiatric disorders as well as cancers .The study on the correlation between methylenetetrahydrofolate reductase gene polymorphisms and diseases and the discovery of its clinical value is getting more and more attention.

Objective To explore the correlation between serum homocysteine (Hcy) level and diabetes mellitus combined with cerebral infarction (DMCI) in patients. Methods A total of 144 patients with type 2 diabetes mellitus (T2DM) were selected and divided into two groups, patients without cerebral infaction (group A, n=64) and patients with cerebral infaction (group B, n=80). Thirty healthy people were used as control group (group C). The serum Hcy level was detected by enzymatic cycling assay in three groups. The serum levels of cholesterol (TC) and triglyceride cholesterol (TG) were detected by enzymatic determination. The serum levels of high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected by homogeneous phase method. The serum level of creatinine (Cr) was detected by creatine oxidase method. The level of uric acid (UA) was detected by urinary enzyme peroxidase coupling method. Glycosylated hemoglobin (HbA1c) was detected by high performance liquid chromatography. The carotid artery intima media thickness (IMT) was examined by color Doppler ultrasound, and patients were divided into mild and no stenosis group, moderate stenosis group and severe stenosis group according to the
results. The levels of Hcy were compared between all groups. The correlation of Hcy level and other indicators was analyzed. Results The levels of Hcy and HbA1c were group C0.05). There were no significant differences in UA and Cr levels between the three groups (P>0.05). The level of Hcy was positively correlated with age (rs=0.411), HbA1c (rs=0.219) and Cr (rs=0.242), and negatively correlated with gender (rs=-0.202) and HDL-C (rs=-0.278, P<0.05). There were no significant correlation between Hcy level and other variables (P>0.05). With the increased degree of carotid artery stenosis, the Hcy level and the proportion of HHcy showed a rising trend in patients (P<0.01). The level of Hcy was positively correlated with IMT(rs=0.781, P<0.001). Conclusion Hcy is a risk factor for the onset of DMCI. The high level of Hcy is closely related to the occurrence and progression of atherosclerosis. Hcy has great value for early screening and prevention of DMCI.

The treatment for chronic heart failure has been changed significantly in recent 20 years.Therapeutic target in heart failure not only improves symptoms and quality of life,more important is for the mechanism of myocardial remodeling,prevent and delay the development of myocardial remodeling.Angiotensin converting enzyme inhibitor/angiotensin receptor blockers,beta blockers,and aldosterone inhibitors are used as the golden triangle drug therapy for chronic heart failure.In recent years,it has been or is about to carry out some clinical new drugs for the treatment of chronic heart failure.

Objective To evaluate the curative effect ofXuebijing injection combined with routine western medicine therapy in the treatment of hypertensive renal damage.Methods A total of 114 patients with hypertension were randomly divided into 2 groups according to the random number table method, 57 patients in each group. The control group was given conventional treatment (maleic acid enalapril and amlodipine and atorvastatin cutting atorvastatin calcium), and the treatment group were givenXuebijing injection based on the conventional treatment. The two groups were treated for 6 months. The changes of blood pressure, renal function and serum inflammatory cytokine levels were evaluated.Results After treatment, the mean value of 24 h systolic blood pressure, mean value of 24 h diastolic blood pressure, systolic blood pressure variability and diastolic blood pressure variability in the treatment group were significantly lower than those in the control group (2 months after treatment:t values were 5.256, 5.595, 5.265, 2.564,P<0.05; 6 months after treatment:t values were 6.251, 5.267, 4.466, 5.264,P<0.05); the urinary mAlb, beta 2-MG, and urine albumin to creatinine ratio in the treatment group were significantly lower than those in the control group (2 months after treatment:t value were 5.566, 5.282, 2.862,P<0.05; 6 months after treatment:t value were 5.263, 6.565, 3.642,P<0.05);two plasma D-dimer, IL-6, TNF-α and fibrinogen levels in the treatment group were significantly lower than those in the control group (2 months after treatment:t value were 3.565, 5.652, 3.985, 5.251,P<0.05; 6 months after treatment:t value were 5.268, 4.836, 3.622, 4.265,P<0.05).ConclusionsXuebijing injection combined with routine western medicine therapy on hypertensive renal damage may have protective effect, and its curative effect was superior to simple maleic acid enalapril and amlodipine and atorvastatin cutting atorvastatin calcium therapy.

Objective To detect the effect ofXuebijing injection on the serum soluble CD40 ligand (soluble CD40 ligand, sCD40L), lipoprotein associated phospholipase A2 (lipoprotein-phospholipase A2, Lp-PLA2) of patients with acute coronary syndrome (ACS).Methods A total of 120 patients with ACS were randomized divided into the control group and treatment group, 60 in each group.The control group received the routine treatment of Western medicine, and the treatment group receivedXuebijing injectionbased on the intervention of control group. Both groups were treated for 2 weeks. ELISA method was used to detect serum sCD40L, Lp-PLA and IL-6, TNF-α and CRP.Results After treatment, the serum sCD40L(320.62 ± 35.81 pg/Lvs. 401.70 ± 4.84 pg/L, t=10.435), Lp-PLA2 (203.62 ± 33.13μg/L vs. 296.45 ± 4.422μg/L,t=12.831) level was significantly lower than those in the control group (P<0.01); The serum CRP (3.10 ± 2.00 mg/Lvs.4.74 ± 2.04 mg/L,t=4.006), IL-6 (2.10 ± 1.20 pg/Lvs.3.14 ± 1.40 pg/L,t=3.781), TNF (2.81 ± 1.50 pg/Lvs. 3.70 ± 1.70 pg/L,t=3.075) level was significantly lower than thosein the control group (P<0.01 orP<0.05). Compared with the control group, the effect rate (68.3%vs. 50.0%,χ2=4.174) of the treatment group was significantly higher (P=0.041).ConclusionXuebijing injection can improve the therapeutic effectof ACS patients, and reduce CD40L, Lp-PLA2 levels.

Objective To study the clinical effects of recombinant human epidermal growth factor (rhEGF) gel combined with tacrolimus treatment on facial hormone-dependent dermatitis, and to investigate its influence in skin function and recurrence of dermatitis. Methods Forty-eight outpatients with facial hormone-dependent dermatitis were randomly divided into treatment group (n=24, treatment with tacrolimus combined rhEGF gel) and control group (n=24, treatment with tacrolimus). The moisture of skin, sebum content and transepidermal water loss (TEWL) were examined before treatment and 4 weeks after treatment in two groups. Eczema area and severity index (EASI) were calculated at 1 week, 2 weeks and 4 weeks after treatment. The adverse reactions and recurrence of dermatitis were observed during the treatment as well. Results Compared with pre-treatment, the moisture of skin and sebum content were increased (P<0.05) and the TEWL was decreased (P<0.05) after 4-week treatment. The differences were not statistically significant between two groups. The obvious effective rate of the treatment group (45.8%) was not significantly different from that of the control group (20.8%) after 1 week of treatment (P>0.05), but it is much higher in treatment group after two-week treatment (79.2%vs. 50.0%, P<0.05) and after four-week treatment (91.2% vs. 62.5%, P<0.05). Furthermore, there was no adverse reaction in the treatment group, and the recurrence rate was much lower in treatment group (12.5%) than that of the control group (37.5%,χ2=4.03,P<0.05). Conclusion Recombinant human epidermal growth factor gel has an auxiliary curative effect on facial hormone-dependent dermatitis and can significantly improve skin function, and the recurrence rate of dermatitis is low.

The incidence rate of young women with breast cancer is increasing.Because of distinct biological characteristics of breast cancer in young patients,it is reasonable to identify who is the best one for breast-conserving surgery.Patients with systemic chemotherapy should be fully considered about fertility requirements.In addition,endocrine therapy combined with ovarian function inhibition can improve the effect,meanwhile,there should increase the proportion of patients with targeted therapy.