Objective To study the incidence of and identity risk factors for hemorrhage and thromboembolism during long-term warfarin therapy.Methods All patients were studied in the People's Hospital of Peking University Anticoagulant Clinic from 2001-04 to 2003-11,in whom a course of warfarin therapy intended to last for more than 4 weeks.All bleeding and thromboembolism events were classified as minor or serious or fatal and life-threatening.Incidences of adverse events were analyzed statistically.Results A total of 128 patients were enrolled in the investigation,the median age of the study group was 67 years(ranged 25 to 83).There were 41 bleeding events occurring in 34 patients,and 5 events of thromboembolism.Age and hepatocirrhosis were significantly associated with bleeding complications(P=0.040 and P=0.014).Conclusion Hemorrhage is the major side effect of warfarin;age and hepatocirrhosis are significantly associated with bleeding complications.

Objective To evaluate the frequently used electrocardiographic criteria and propose a modified algorithm for differentiating typical atrioventricular node reentrant tachycardia(AVNRT)from atrioventricular reciprocating tachycardia(AVRT).Methods Twelve-lead electrocardiograms(ECGs)during sinus rhythm and atrioventricular node reentrant tachycardia(AVNRT)or atrioventricular reciprocating tachycardia(AVRT)with a narrow QRS complex were obtained from 154 patients who had received successful radiofrequency catheter ablation from Jan.2003 to Nov.2005.The ECGs of initial 104 patients were analyzed by 3 observers without knowledge of the electrophysiological diagnosis.According to these initial results,we proposed a modified stepwise ECG algorithm which used pseudo r′/S/Q waves,RP interval,and ST-segment elevation in lead aVR during tachycardia.Two observers assessed the algorithm in additional 50 patients.Results The algorithm was able to increase the overall accuracy from 77% and 79% with original algorithm to 84% and 87% with the modified algorithm,respectively.The inter-observer concordance was 85%.The intra-observer concordance was 89% in both investigators.Conclusion The modified algorithm can improve the accuracy of differential diagnosis between typical AVNRT and AVRT via concealed accessory pathway.

Objective Study the differential diagnosis value of the axis of "no man's land" in wide QRS complex tachycardia.Methods Retrospectively analyse the axis of "no man's land" in 137 patients with wide complex tachycardia who had undergone intracardiac electrophysiologic studies,use the algebraic sum of the deflections in leads I and III to plot the QRS axis,to observe the rule of arrhythmia of "no man's land" appearance.Results Eighteen of 137 patients who had wide complex tachycardia had the axis of "no man's land",among which 16 patients had left idiopathic ventricular tachycardia,and 2 patients had wide complex supraventricular tachycardia they had accessory pathway conduct anterogradely.Conclusion The axis of "no man's land" is helpful in differential diagnosis of ventricular and supraventricular tachycardias with abberency or bundle branch block.

Objective To compare three ultrasonic methods of transabdominal , transvaginal , and transperineal ultrasonogra-phy for the cervical length ( CL) in predicting the preterm birth .Methods The pregnancy women with threatened preterm labor in Hunan Provincial Hospital of Maternal and Child Health from January , 2012 to December, 2013 were chosen to measure the cervical length by sonography , and were randomly divided into three guoups ( 280 pregnancy women in each group ) , including Group Ⅰ( transabdominal ) , groupⅡ( transvaginal ) , and group Ⅲ ( transperineal ) .The cervical length and the pregnancy outcome were fol-lowed up.Results The acceptance rate of group Ⅱ(81.8%=229/280) was significantly lower than that of groupⅠ(100%=280/280)and group Ⅲ(99.3%=278/280)( P <0.05).The realization ratio of the cervix in group Ⅰ(85.0%=238/280) was signifi-cantly lower than that of group Ⅱ(98.7%=226/229) and group Ⅲ (98.2%=273/278) ( P <0.05).The preterm birth rate of 48.6%(18/37) in groupⅠ, 37.8%(28/74) in groupⅡ, and 37.1%(33/89) in groupⅢin the pregnancy women with CL <3 cm was significantly higher than the corresponding preterm birth rate of 17.9%(36/201) in groupⅠ, 13.2%(20/152)in groupⅡ, and 13.6% (25/184) in groupⅢin the pregnancy women with CL≥3 cm.The sensitivity of groupⅠ(33.3%=18/54) was significantly lower than that of group Ⅱ(58.3%=28/48) and group Ⅲ(56.9%=33/58).Conclusions The cervical length measured by ultra-sound is valuable in predicting preterm birth among the pregnancy women with threatened preterm birth .The transperineal ultrasonogra-phy is superior to transabdominal and transvaginal ultrasonography in predicting preterm birth , and is worth being popularized .

Objective To investigate the chemical constituents in the whole plant of Hedyotis corymbosa.Methods The compounds were isolated by column chromatography,pre-TLC,and recrystallization.Their structures were elucidated by spectroscopic methods.Results Thirteen compounds were isolated and identified as(+)-lyoniresinol-3?-O-?-D-glucopyranoside(Ⅰ),quercetin(Ⅱ),esculetin(Ⅲ),scopoletin(Ⅳ),hedyotiscone A(Ⅴ),p-hydroxybenzoic acid(Ⅵ),protocatechuic acid(Ⅶ),vanillic acid(Ⅷ),syringic acid(Ⅸ),(+)-vomifoliol(Ⅹ),(-)-dihydrovomifoliol(Ⅺ),S-(+)-dehydrovomifoliol(ⅩⅡ),and alizarin 1-methyl ether(ⅩⅢ),respectively.Conclusion Compounds Ⅰ—ⅩⅢ are isolated from this plant for the first time.

Objective To investigate the therapeutic effect of trimetazidine(TMZ) and atorvastatin on coronary no-flow/slow-flow phenomenon (CNFP/CSFP) emergency pereutaneous coronary intervention (PCI)Methods Thirty-two patients with acute myocardial infarction were selected as our subjects,who hospitalized from April 2007 to May 2012 after PCI with CNFP/CSFP.Patients were administrated with the TMZ (60 mg/d)and atorvastatin (20 mg/d) for 6 months besides the routine therapy.The changes of the clinical symptoms including ECG exercise test,coronary flow of coronary angiography(CAG) were recorded and the level of serum high sensitivity C-reactive protein (hs-CRP),matrix metalloproteinase-9 (MMP-9),tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) were measured before and after the treatment.Results (1)The symptoms of the patients were improved remarkably;the effective rate was 87.5％ (28/32).The improving rate of ECG was 90.6％.The CTFC of patients after treatment was (20.17 ± 4.36),significantly lower than that of before treatment (35.34 ± 7.43,t =2.409,P ＜ 0.05).(2) The levels of hs-CRP,MMP-9,TNF-a and IL-6 at after treatment were (3.34 ±0.47) mg/L,(173.09 ±42.19) μg/L,(8.47 ±2.09) μg/L,(89.37 ± 18.72) ng/L,lower than that of before treatment ((12.34 ± 2.43) mg/L,(972.68 ± 131.91) μg/L,(23.54 ± 7.48) μg/L,(154.39 ± 42.07) ng/L),and difference were significant (t =2.537,2.789,2.691,2.430,P ＜ 0.01 or P ＜0.05).Conclusion The therapy approach of TMZ and atorvastatin plus routine treatment of nitrate and aspirin showed a better therapeutic effect on CNFP/CSFP.The causes of CNFP/CSFP may relate to inflammation.

Objective To investigate the effect and safety of rotational power-driven thrombectomy therapy through intrapulmonary for acute massive pulmonary thromboembolism.Methods Sixteen patients of acute massive pulmonary thromboembolism diagnosed by CT and pulmonary angiography were treated with Straub Rotarex system.The successful rate,release of clinical manifestations and the blood hemodynamic changes were observed and analyzed.Results The clinical manifestations were improved remarkably in all the 16 patients,arterial partial pressure of oxygen,saturation of arterial blood oxygen,shock index,Miller score and mPAP were (56.7± 13.4) mm Hg,84.1 ± 10.4)％,(1.27 ±-0.39),(22.7±11.4) and (36.3 ±9.4) mm Hg respectively before treatment,and (92.2 ± 8.6) mm Hg,(96.6 ± 12.7) ％,(0.57 ± 0.42),(12.1 ± 7.8)points and (21.9 ± 7.3) mm Hg respectively after treatment,which were all improved significantly (t =-2.794,2.601,-2.592,-2.638,-2.617,P ＜ 0.01).Conclusion Rotational power-driven thrombectomy therapy through intrapulmonary is an effective and safe technique for the treatment of acute massive pulmonary embolism.

To investigate the effects of cycloartocarpin A (ACR-2) and artocarpin (ACR-3), monomeric compounds isolated from Fructus Artocarpi Heterophylli, on apoptosis of SMMC-7721 and SGC-7901 cell lines.

OBJECTIVE: To investigate the effects of three compounds extracted from Tripterygium wilfordii Hook (TW) on angiogenesis in the chick chorioallantoic membrane (CAM). METHODS: Fifty fresh Hongkong Mahua chicken eggs were divided into five groups: PBS-treated group, TW1-, TW2- and TW3-treated groups and Rg3-treated group. After disinfection, the eggs were incubated for six days in a constant temperature box with the temperature being controlled within 37.8 degrees C, then exposed CAM, laid the filter papers with specimen on the CAM, and the eggs were incubated for another two days. CAM was fixed with the mixture of methyl alcohol and acetone at room temperature for about 15 min, and then cutting the CAM, taking photos and observing the angiogenesis in the CAM. RESULTS: There were many CAM vessels in the PBS-treated group and the blood vessel net could be seen clearly. The number of CAM vessels in the TW1-, TW2- and TW3-treated groups (10 microg/egg) was much less than that in the PBS-treated group. Furthermore, the frame of the vessels was not clear, and the color was obscure. Inhibition rates of angiogenesis in the TW1-, TW2- and TW3-treated groups were 80%, 60% and 100% respectively, while the inhibition rate of angiogenesis in the Rg3-treated group (10 microg/egg) was only 10%. CONCLUSION: TW1, TW2 and TW3 can obviously restrain the angiogenesis in CAM and still need further study.

OBJECTIVETo investigate the anti-HBV constituents in the roots of Euphorbia fischeriana.

METHODThe compounds were isolated by various chromatographic methods and identified by spectroscopic analysis. Some compounds were tested for the anti-HBV activity.

RESULTEleven compounds were isolated and identified as tirucalla-5,24-dien-3-ol (1), 24-methyltirucalla-5, 24-dien-3-ol (2), euphol (3), butyrospermol (4), 24-methylenecycloartenol (5), cycloartenol (6), jolkinolid E (7) helioscopinolide A (8), isoscopoletion (9), dephnoretin (10), and 3, 3'-di-O-methylellagic acid 4'-O-beta-D-xylopyranoside (11).

CONCLUSIONCompounds 1, 2 and 10 were isolated from the genus Euphorbia for the first time. Compounds 3, 4 and 11 were isolated from this species for the first time. Compounds 1, 8, 9 and 11 showed weak anti-HBsAg and anti-HBeAg activity, while compound 10 showed weak anti-HBsAg activity.

Antiviral Agents ; analysis ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; pharmacology ; Euphorbia ; chemistry ; Hepatitis B virus ; drug effects ; Plant Roots ; chemistry