Objective To investigate the incidence and cardiac magnetic resonance imaging features of coronary atherosclerotic artery disease (CAD) in the patients with hypertrophic cardiomyopathy (HCM) or dilated cardiomyopathy (DCM). Methods A retrospective study was conducted on the clinical and imaging data of the patients who had HCM or DCM diagnosed by cardiac magnetic resonance examination and received coronary examination (coronary angiography or computed tomography) from Sep. 2015 to Sep. 2018. According to the severity of coronary stenosis, the patients with HCM or DCM were divided into normal coronary group, coronary atherosclerosis group (lumen stenosis=50%) and CAD group (lumen stenosis>50%). The incidence of coronary diseases and the clinical and magnetic resonance imaging features were compared among the three groups. Results A total of 681 patients with primary cardiomyopathy were examined by cardiac magnetic resonance. Two hundred and nineteen of them underwent coronary angiography or computed tomography, including 126 cases with HCM, 78 cases with DCM and 15 cases of other types with cardiomyopathy. The incidence of coronary atherosclerosis and CAD in the HCM patients was 31.7% (40/126) and 21.4% (27/126), respectively, which was not significantly different from that in the DCM patients (30.8% [24/78] and 17.9% [14/78], respectively; both P>0.05). In the patients with HCM and DCM, the mean ages of the CAD group and coronary atherosclerosis group were (62.6±9.8) and (60.1±7.2) years, and (59.3±9.5) and (58.5±8.8) years, respectively, which were higher than those of the normal coronary group ([49.5±11.0] and [49.3± 12.9] years, respectively), and the differences were significant (all P<0.05). Both HCM and DCM patients with cardiovascular risk factors (diabetes, smoking, hypertension, hyperlipidemia or obesity) had high incidence of CAD (70.4% [19/27] and 71.4% [10/14], respectively). The left ventricular stroke volume of the CAD group in the HCM patients was significantly lower than those of the normal coronary and coronary atherosclerosis groups ([50.4±21.1] mL vs [64.6±22.9] mL and [64.1±27.1] mL, both P<0.05). There were no significant differences in the left ventricular end-diastolic diameter, detection rate of intramyocardial fibrosis or other left ventricular function parameters among the three groups both in the HCM and DCM patients (all P>0.05). Conclusion Both HCM and DCM patients can be complicated with CAD. Cardiac magnetic resonance imaging can be used to diagnose cardiomyopathy, especially in the differential diagnosis of CAD with myocardial infarction.

OBJECTIVETo investigate clinicopathological features, immunophenotype and differential diagnosis of intravenous leiomyomatosis with intracardiac extension.

METHODSClinical manifestations, morphologic features, and immunohistochemical staining were retrospectively analyzed in 19 cases of intravenous leiomyomatosis with intracardiac extension.

RESULTSThe patients' age ranged from 33 to 59 years (mean 44 years). Clinical presentation included chest tightness, palpitation, dyspnea, edema of low extremity, abdominal distention or hypermenorrhea. However, a few patients were asymptomatic. Grossly, intravenous leiomyomatosis in most cases demonstrated coiled or nodular growth within the myometrium with worm-like involvement of the uterine vein in broad ligament or other pelvic veins with continued extension into the vena cava and the heart. The intravenous tumor surface was generally smooth and rubbery, with a greyish-white color. Microscopically, the tumors were composed of spindle cells with rare mitotic figures and the presence of abundant thick-walled vessels. Marked fibrosis, hyalinization, myxoid and edematous changes were common. The tumor cells were positive for SMA, ER, PR and desmin but negative for HMB45 and S-100. CD10 and CD34 were positive in 4 patients and negative in the remaining cases.

CONCLUSIONIntravenous leiomyomatosis with intracardiac extension is a rare disease among women of child-bearing age, with specific morphologic manifestations and immunohistochemical profiles.

Adult ; Diagnosis, Differential ; Female ; Humans ; Leiomyomatosis ; diagnosis ; pathology ; Middle Aged ; Retrospective Studies ; Uterus ; pathology ; Vena Cava, Inferior ; pathology

Humans ; Amyloidosis/pathology*

Chronic gastritis is a kind of chronic gastric mucosal inflammation caused by many factors.Intestinal metaplasia refers to the transformation of gastric mucosal epithelial cells into small/large intestinal mucosal epithelium containing Panette or goblet cells.Chronic gastritis has the highest incidence among stomach diseases,while intestinal metaplasia is the serious manifestation of chronic gastritis.In this experiment,the therapeutic effect of modified Zhengqi Powder on mild intestinal metaplasia in chronic gastritis and on patients' quality of life and inflammatory reaction was investigated to analyze the efficacy and mechanism of traditional Chinese medicine prescription.From April 2016 to April 2017,120 patients of chronic gastritis with mild intestinal metaplasia were selected and divided into two groups according to the envelope method.The control group(60 cases) was treated with famoxetine.After one month of continuous treatment,the total effective rate of treatment in the observation group was 93.3%,which was much higher than 80.0% in the control group.Health questionnaire(SF-36),serum C-reactive protein(CRP),interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) levels were significantly higher than those in the control group(P<0.05).The results showed that modified Zhengqi Powder has a significant efficacy in treat chronic gastritis with mild intestinal metaplasia,and can obviously alleviate clinical symptoms and intestinal metaplasia,remove inflammatory factors and improve the quality of life of patients,and is worth promotion.
C-Reactive Protein ; analysis ; Drugs, Chinese Herbal ; therapeutic use ; Gastric Mucosa ; drug effects ; Gastritis, Atrophic ; drug therapy ; Humans ; Interleukin-8 ; blood ; Metaplasia ; drug therapy ; Quality of Life ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo evaluate the application of immunohistochemistry and fluorescence staining method in the detection of phospholipase A2 receptor (PLA2R) on paraffin section of renal biopsy tissue,and to find an accurate and fast method for the detection of PLA2R in renal tissue.

METHODSThe PLA2R of 193 cases were detected by immunohistochemical staining,and the antigen was repaired by the method of high pressure cooker (HPC) hot repair plus trypsin repair. The 193 samples including 139 cases of idiopathic membranous nephropathy (IMN), 15 cases of membranous lupus nephritis, 8 cases of hepatitis B virus associated membranous nephropathy, 18 cases of IgA nephropathy, and 13 cases of minimal change diseases. To compare the dyeing effects, 22 paraffin sections of renal biopsy tissue of IMN cases with positive PLA2R were stained by using 4 different.

METHODSof antigen repairing,which included HPC hot repair, HPC hot repair plus trypsin repair, water bath heat repair, and water bath heat repair plus trypsin repair. To compare the dyeing effects, 15 paraffin sections of renal biopsy tissue of IMN cases with positive PLA2R were stained by using 3 different.

METHODSof antigen repairing,which included water bath heat repair plus trypsin repair, protease K digestion repair, and pepsin digestion repair.

RESULTSIn 193 cases, the positive rate of PLA2R in IMN cases was 90.6% (126/139), and the other 54 patients without IMN were negative. Twenty-two IMN patients were positive for PLA2R by using the HPC heat repair plus trypsin repaire or the water bath heat repair plus trypsin repair;while only a few cases of 22 IMN cases were positive by using the HPC hot repair alone or water bath heat repair alone. Fifteen IMN patients were positive for PLA2R by using water bath heat repair plus trypsin repair,protease K digestion repair,and pepsin digestion repair, but the distribution of positive deposits and the background were different.

CONCLUSIONSPLA2R immunohistochemical staining can effectively identify IMN and secondary MN. For immunohistochemical staining and immunofluorescence staining, the preferred method of antigen repair is water bath heat repair plus trypsin repair.

Fluorescent Antibody Technique ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Humans ; Immunohistochemistry ; Paraffin ; Receptors, Phospholipase A2 ; Staining and Labeling

Humans ; Thyroid Neoplasms/surgery* ; Thyroid Cancer, Papillary

Objective    To explore the difference of myocardial injury between off-pump coronary artery bypass grafting (OPCAB) and modified perfusion on-pump coronary artery bypass grafting (ONCAB). Methods    A total of 558 patients who underwent coronary artery bypass grafting in Beijing Anzhen Hospital from 2017 to 2019 were included. According to whether or not they received modified perfusion cardiopulmonary bypass, all the 558 patients were divided into two groups including an OPCAB group (OP group) and an ONCAB group (ON group). There were 465 patients in the OP group including 282 males and 183 females with an average age of 63.58±7.87 years. In the ON group, there were 93 patients including 64 males and 29 females with an average age of 63.91±7.51 years. Creatine kinase MB (CK-MB) and cardiac specific troponin I (cTnI) were measured 24 hours before operation, 30 minutes after operation, 12 hours after operation, 36 hours after operation and 48 hours after operation. Results    No perioperative death occurred in all patients. CK-MB (5.00 ng/mL vs. 8.60 ng/mL, Z=–2.189, P=0.029) and cTnI (3.00 ng/mL vs. 7.80 ng/mL, Z=–5.307, P=0.000) in postoperative 12 hours in the ON group were less than those in the OP group. CK-MB (5.00 ng/mL vs. 5.60 ng/mL, Z=–2.280, P=0.023) and cTnI (0.10 ng/mL vs. 1.02 ng/mL, Z=–6.418, P=0.000) in postoperative 36 hours in the ON group were less than those in the OP group. cTnI (0.07 ng/mL vs. 0.81 ng/mL, Z=–1.946, P=0.032) in postoperative 48 hours in the ON group was less than that in the OP group. Conclusion    Compared with OPCAB, modified perfusion ONCAB has less myocardial damage. 

Objective    To explore the effect of whether or not to stop beating after conversion to cardio-pulmonary bypass (CPB) in off-pump coronary artery bypass grafting. Methods    From 2016 to 2018, 177 patients with off-pump coronary artery bypass grafting in Beijing Anzhen Hospital were transferred to CPB. According to whether they stopped beating after conversion to CPB during the operation, they were divided into two groups. A non-stop beating group: there were 76 patients with 45 males, 31 females. aged 63.53±6.98 years, who were not to stop beating after conversion to CPB. A stop beating group: there were 101 patients with 66 males and 35 females, aged 63.98 ± 8.37 years, who were to stop beating and underwent the modified perfusion and application of papaverine in perfusion after conversion to CPB. The clinical effect of the two groups was compared. Results    There were 14 deaths in the perioperative period. The mean graft flow (MGF) in the stop beating group was higher (P=0.033), and the pulse index (PI) was lower (P=0.001) than those in the non-stop beating group. Intra-aortic balloon counter pulsation (P=0.036), extracorporeal membrane oxygenation (P=0.038), continuous renal replacement therapy (P=0.014), ventilator-assisted time (P=0.021), ICU monitoring time (P=0.012), perioperative mortality (P=0.025) and the ejcetion fraction value (P=0.023) were significantly different between the groups. Conclusion    Compared with not to stop beating, those to stop beating can get better perioperative clinical effect after conversion to CPB, which is worthy of recommendation.

OBJECTIVETo discuss the effects of criteria in controlling the risk factors on secondary prevention of brain vessel disease.

METHODSAmong 631 cases who had been examined at our hospital on brain vessel disease for longer than 1 year, 123 cases were chosen as treatment group which received criterion therapy to control their risk factors while the rest cases were under antitheses group. The two groups were compared on the 1 year recrudesce rate thereafter.

RESULTSThe 1 year recrudesce rate of the treatment group showed better than the antitheses group (P = 0.005 < 0.05), as the benefit mostly from the control of risk factors, such as blood pressure (P = 0.005), blood sugar (P = 0.038). There was active effect of criterion therapy in controlling the risk factors.

CONCLUSIONThere was active effect of criterion therapy in controlling the risk factors as high blood pressure, high blood sugar and high blood fat etc. Healthy life style would help the recurrence of brain vessel disease, which should be highlighted in the secondary prevention of brain vessel disease.

Adult ; Aged ; Aged, 80 and over ; Blood Glucose ; Brain Diseases ; epidemiology ; etiology ; prevention & control ; Brain Ischemia ; epidemiology ; etiology ; prevention & control ; Diabetes Complications ; Female ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Risk Factors ; Secondary Prevention ; methods