Animals ; Drugs, Chinese Herbal ; pharmacology ; Enzyme Activation ; Humans ; Medicine, Chinese Traditional ; NF-kappa B ; antagonists & inhibitors ; genetics ; metabolism ; Promoter Regions, Genetic ; Signal Transduction ; drug effects ; Transcription, Genetic ; genetics ; Transcriptional Activation ; genetics

Objective To explore the influences of extracellular matrices (ECM) secreted by ultraviolet B (UVB)-induced senescent fibroblasts on the proliferation of and extracellular signal-regulated kinase (ERK) signaling in HaCaT cells. Methods Fibroblasts were irradiated with UVB of 15 mJ/cm2 once daily for 5 days to induce premature senescence, which was identified by SA-β-gal staining 72 hours after the last irradiation.HaCaT cells were divided into 3 groups and inoculated into plates coated with extracellular matrices secreted by non-senescent (PRE-ECM) or senescent fibroblasts (SIPS-ECM) or into uncoated plates (NON-ECM), fol-lowed by additional culture. U0126, an inhibitor of ERK1/2, was used to treat the HaCaT cells 1 hour before inoculation. Then, MTT assay was carried out to detect the proliferation of HaCaT cells after a 3-day culture,Western blot to assess the phosphorylation of ERK at 0.5, 1, 2 and 4 hours after the inoculation, flow cytometry to analyse cell cycle and apoptosis after 24 hours of culture. Results The most rapid and intense phosphory-lation of ERK was observed in SIPS-ECM group. Inhibiting the activation of ERK pathway with U0126 could completely suppress the promoting effect of ECM from senescent fibroblasts on the proliferation of HaCaT cells.After the blocking of ERK activation, the proportion of HaCaT cells in S and G2/M phase decreased from 37.40%, 41.34% and 43.31% to 29.41%, 36.48% and 39.96%, respectively, in NON-ECM, PRE-ECM and SCIP-ECM group. Conclusion The ECM produced by UVB-induced senescent fibroblasts promote the prolifera-tion of HaCaT cells via inducing the phosphorylation of ERK.

OBJECTIVETo observe the therapeutic effect of abdominal acupuncture on nerve root cervical spondylosis.

METHODSThree hundred cases were randomly assigned to a treatment group and a traction control group. The treatment group were treated with abdominal acupuncture at an acupoint prescription, i.e. Zhongwan (CV 12), Guanyuan (CV 4) and others were selected. The control group were treated with suspended traction by a cervical vertebral extraction belt at pillow-jaw sitting position. The short-term and long-term therapeutic effects were observed at the end of therapeutic course and 90 days after the end of treatment, respectively.

RESULTSThe total short-term and the long-term therapeutic effects were 97.3% and 92.7% in the treatment group, and 82.0% and 82.0% in the control group, respectively, with significant differences between the two groups (P < 0.01).

CONCLUSIONAbdominal acupuncture has better short-term and long-term therapeutic effects with short therapeutic course.

Acupuncture Points ; Acupuncture Therapy ; Humans ; Medicine, Chinese Traditional ; Spinal Nerve Roots ; Spondylosis ; therapy

OBJECTIVETo evaluate one-stage arterial Switch operation for transposition of the great arteries (TGA) and Taussig-Bing with aortic arch obstruction.

METHODSFrom January 2001 to June 2004, 8 patients had aortic arch obstruction, 3 with TGA and 5 with Taussig-Bing. Except one patient was 8 months old, all of others were 5 days to 3 months old, the mean operation age was (40 +/- 36) d and the mean weight was (4.3 +/- 0.5) kg. All patients were repaired by one-stage operation. The aortic arch obstruction was repaired in deep hypothermia circulatory arrest, and arterial switch procedure was performed in deep hypothermia and low flow perfusion.

RESULTSThere had 1 death who was 8 months old and had low cardiac output, complete artrioventricular block (AVB) and severe pulmonary hypertension postoperation. One patient was 3 months old who had asphyxia at 5 days postoperatively. Six patients followed up from 5 months to 2 years. One Taussig-Bing with interrupted aortic arch had residual obstruction at the anastomosis of aorta. Two had trivial aortic valve regurgitation, and one had mild pulmonary valve regurgitation.

CONCLUSIONSOne-stage repair for TGA and Taussig-Bing with aortic obstruction achieves excellent results. The reasons for the death were pulmonary hypertension and abnormal coronary artery. The operative procedure should be performed as early as possible for the better result.

Aorta, Thoracic ; surgery ; Aortic Arch Syndromes ; complications ; surgery ; Cardiopulmonary Bypass ; Cardiovascular Surgical Procedures ; methods ; Double Outlet Right Ventricle ; complications ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Transposition of Great Vessels ; complications ; surgery ; Treatment Outcome

OBJECTIVE: To compare three assessment methods (TW2, TW2CH, and TW3) for carpal bone age and their potential applications in diagnosis of idiopathic precocious puberty (IPP) in Chinese girls. METHODS: Fifty-five (55) girls with IPP and 83 normal girls as control group were selected in this study. The X-ray films of the left hand-wrist taken at their first visit were analyzed retrospectively. Three assessment methods were used to estimate the carpal bone age with single-blinded method and percentiles were set at 5 different decision thresholds (1)>97th percentile, (2)>90 th percentile, (3)>75th percentile, (4)>50 th percentile, and (5)< or =50th percentile. RESULTS: All of the three methods showed similar high sensitivity and specificity at the threshold above 90th percentile. CONCLUSION Our data indicate that all of the three methods for estimation of the carpal bone age are useful in diagnosis of IPP. TW2CH and TW3 methods appear to be superior to TW2 method.
Age Determination by Skeleton/standards* ; Algorithms ; Bone Development ; Carpal Bones/growth & development* ; Case-Control Studies ; Child ; Child Development ; Child, Preschool ; China ; Female ; Humans ; Puberty, Precocious/diagnosis* ; ROC Curve ; Retrospective Studies

OBJECTIVE: To discuss the diagnostic value of English, Chinese and Japanese standards of TW2 to skeletal age assessment of children with central precocious puberty (CPP), then to confirm the normal thresholds. METHODS: Sixty one children as patient group were definitely assured CPP. The control group had 67 children. Among them, 61 were normal children, another 6 children as a special control group. Left hand-wrist X-ray radiographs were retrospectively analyzed by two doctors separately and their skeletal ages were assessed with the three standards of TW2 method. The differences between skeletal age and chronological age were analyzed with ROC in SPSS 13.0. RESULTS: (1) The skeletal age results showed kappa value is 0.776 deduced by two clinical doctors(u = 16.128, P < 0.05). (2) There were no statistic differences for the areas under ROC curves among three methods. (3) d > or = 1.15 years in TW2, d > or = 1.25 years in TW2-CHN and d > or = 0.65 years in TW2-JP were more susceptive and specific points. CONCLUSION TW2, TW2-CHN and TW2-JP provided a higher value for the diagnosis of skeletal age in unhealthy children, and TW2-CHN is highest value for Chinese children.
Age Determination by Skeleton/standards* ; Age Factors ; Body Height ; Bone Development ; Carpal Bones/growth & development* ; Child ; Child, Preschool ; China ; Female ; Hand/growth & development* ; Humans ; Infant ; Male ; Puberty, Precocious/diagnosis* ; ROC Curve ; Sensitivity and Specificity

Objective To evaluate the clinical and angiographic outcomes of vasospastic angina patients with severe organic stenosis treated by drug-eluting stents.Methods Between January 2006 and December 2010,severe organic stenosis ( diameter stenosis more than 70％ ) was evidenced in 7 out of 46 vasospastic angina patients and treated with drug-eluting stents.Coronary angiography was repeated at 6 - 18 months after percutaneous coronary intervention and the patients were clinically followed up.The clinical and angiographic outcomes were observed. Results Nine drug-eluting stents [ mean diameter 2.75 -3.50 (3.08 ±0.24) mm,length 24 - 33 ( 27.3 ± 3.6 ) mm ] were successfully implanted in these 7 patients.Stents were implanted into left anterior descending artery (LAD) in 5 patients (71.4％),right coronary artery (RCA) in 1 patient ( 14.3％ ),both LAD and RCA in 1 patient ( 14.3％ ).Transient RCA spasm and distal LAD spasm were observed during percutaneous coronary intervention of LAD in 2 patients.Anginal attack at rest with transient ST segment elevation at V1 - V3 leads occurred 24 hours after LAD stenting in 1 patient. Follow-up coronary angiography showed significant in-stent restenosis or focal edge restenosis (diameter stenosis more than 50％ ) in 3 patients (42.9％),mild neointimal proliferation but without significant restenosis in 2 patients (28.6％),and no neointimal proliferation in 2 patients (28.6％).During clinical follow-up of 17 to 50 months after percutaneous coronary intervention,2 patients (28.6％) remained asymptomatic,while effort angina and/or rest angina was documented in the remaining 5 patients (71.4％).Conclusions Our results from this small patient cohort suggest that drug eluting stent implantation for severe organic stenosis in patients with vasospastic angina is linked with high incidence of restenosis and recurrent chest pain.Further observation in larger patient cohort is warranted to clarify the efficacy of this strategy for treating vasospastic angina patients with severe organic stenosis.

BACKGROUNDThe success rate of antegrade approach for chronic total occlusions (CTO) recanalization has not dramatically increased, especially in complex CTO subset. The retrograde technique may hold great promise. This report aimed to describe our experience of retrograde recanalization for CTO, focusing on its safety and feasibility.

METHODSWe identified 42 patients who underwent revascularization in CTO with retrograde approach from July 2005 to November 2009 in our center.

RESULTSThree kinds of strategy were applied: retrograde as primary strategy (50.0%), retrograde immediately after antegrade failure (26.2%) and repeat procedure after previous antegrade failure (23.8%). Septal collaterals were more frequently used as the retrograde access route (92.9%). Overall success rate was 88.1%. In patients with successful retrograde wire crossing collateral channel to the distal cap of CTO, the success rate of recanalization was 94.1%. In patient with failure to cross the collaterals, the success rate was 62.5%. Eight different kinds of retrograde techniques were used: kissing wire technique (35.3%), wire trapped and reverse wire trapped technique (17.6%), back-end balloon and microcatheter reversal technique (14.7%), controlled antegrade and retrograde subintimal tracking (CART) technique (8.8%), reverse CART and modified reverse CART technique (8.8%), retrograde wire crossing technique (2.9%). There were 4 complications occurred without in-hospital major adverse cardiac events (MACE). In-hospital MACE was 7.7%. All of them were non-Q wave myocardial infarction. There were no cases of death or target vessel revascularization, either surgery or percutaneous.

CONCLUSIONSThe retrograde approach can be an effective tool for increasing the success rate of recanalization in the very complex CTO. To ensure the success and safety of the approach, careful case selection and device handling by experienced operators is essential.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Chronic Disease ; Coronary Angiography ; Coronary Occlusion ; therapy ; Female ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Treatment Outcome

Objective To analyze the clinical and angiographic characteristics of patients with slow coronary flow (SCF). Methods In this retrospective study, 140 patients with SCF and 140 control subjects without SCF were included. SCF were diagnosed by the combination of TIMI flow grade method and TIMI frame count method. All subjects had angiographically normal coronary arteries. The clinical and laboratory data were obtained from medical records at admission. Results Compared to control group, patients with SCF were younger [(57.8±10.7)years vs. (59.8±8.2)years], rate of smokers (59.3% vs. 46.4%) and diabetes mellitus (49.3% vs. 30.7%), fasting blood glucose (FBG) level [(7.8±2.8) mmol/L vs. (6.2±2.0) mmol/L, P<0.05] and triglyceride (TG) level [(2.11±1.93) mmol/L vs. (1.67±1.01) mmol/L,P<0.05] were higher, while high density lipoprotein cholesterol (HDL-C) level [(1.05±0.35) mmol/L vs. (1.42±0.74) mmol/L, P<0.01] and apolipoprotein A1(apoA1) level [(1.10±0.19)mmol/L vs. (1.31±0.31)mmol/L, P<0.01] were lower. Among the 140 SCF patients, left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery (RCA) were involved at the same time in 92 patients. Among the three vessels, RCA is the most frequent involved vessel (n=119). After adjusting for other risk factors, current smoking (OR=1.92,95% CI:1.04-3.57,P<0.05), DM history (OR=2.44,95% CI:1.32-4.76,P<0.01), FBG (OR=2.13,95% CI:1.16-3.98,P<0.05), TG (OR=1.47,95% CI:1.03-2.13,P<0.05), HDL-C (OR=0.47,95% CI:0.24-0.85,P<0.05) and apoA1 (OR=0.55,95% CI:0.40-0.75,P<0.01) were independent factors for SCF (all P<0.05). Conclusions Our results demonstrated that patients with SCF were prone to have a significant metabolic disorder compared to the control group. Patients with high levels of FBG, TG and low levels of HDL-C were more likely to suffer from SCF, which maybe explained by the development of coronary endothelium and microvascular dysfunction.

Objective: To describe the incidence,clinical characteristics,therapy strategy and outcomes of spontaneous coronary artery dissection based on single-center experience in China.Methods:We performed retrospective case-identification study in 16 526 patients underwent coronary angiography in Zhongshan Hospital of Fudan University between March 2015 to December 2016,and identified 17 patients with spontaneous coronary artery dissection.Risk factors,clinical features,angiographic features,therapy strategy,and clinical outcomes were analyzed.Results:The incidence of SCAD was 17 of 16 526(1.03/1 000).The mean age was(49.06 ± 10.73)years old(range:26-67 years old).In these 17 cases,4 cases were males,and others were females.Females constituted 13 of 17(76.5%).All SCAD patients presented with acute coronary syndrome,including 10 patients with acute ST-elevated myocardial infarction,3 patients with acute non-ST-elevated myocardial infarction and 4 patients with unstable angina.Twenty dissection sites were identified in 17 SCAD patients. Dissection was predominantly located at the left descending artery(50%)and the right coronary artery(35%).All lesions fell into three types:type Ⅰ(n=5),type Ⅱ A(n= 7),type ⅡB(n= 6),and type Ⅲ(n= 2).The TIMI flow in the distal segment of the coronary dissection was classified as follows:class 0(n=4),class 1(n=2),class 3(n=14).Conservative medical treatment was adopted by 7 of 17(41.1%)patients,and percutaneous transluminal coronary angioplasty(PTCA)in 1 of 17(5.9%)patients.No recurrent angina and other cardiovascular events was observed during clinical follow up. Percutaneous coronary intervention(PCI)was performed in 9 of 17(52.9%)patients,and the mean number of deployed stent was(2.44 ± 1.13).Intramural hematoma was extended during PCI in 5 of 9(55.6%)patients,resulting in new-onset nonfatal myocardial infarction in one patient and cardiac death in another patient.Conclusions:SCAD should be considered in young and middle-aged female patients presented with acute coronary syndrome,especially in those with few coronary risk factors. Interventional cardiologist should be familiar with the angiographic characteristics of SCAD,and turn to intravascular ultrasound if necessary.Conservative treatment should be the first choice in most patients with SCAD,while PCI intervention could be considered in high risk patients.Be caution to prevent interventional complications such as dissection expansion in the patients with high-risk.