Objective To study the β3-adrenoceptor (β3-AR) in heart and lungs of elderly heart failure (HF) rats.Methods Forty-eight elderly HF Wistar rats were included in this study.A HF model of rats was established by ligating the aorta.The rats were divided into sham operation group (n=24) and HF group (n=24).The rats in each group were further divided into 4 subgroups at weeks 5,7,9 and 11 after operation (6 in each group).The hemodynamics,pathology and expression of β3-AR mRNA and protein in heart and lungs were detected at weeks 5,7,9 and 11 respectively after operation.Results The heart rate,LVESP,and dp/dtmax were significantly lower in HF group than in sham operation group at weeks 9 and 11 after operation while the LVEDP was significantly higher in HF group than in sham operation group at weeks 5,7,9 and 11 after operation (P＜0.01).Pulmonary edema occurred at week 7 after operation and myocardial necrosis was detected at week 9 after operation.The expression level of β3-AR mRNA in lungs was significantly lower in HF group at weeks 5,7,9 and 11 than at week 2 after operation (P＜0.05).The expression level of β3-AR mRNA in heart was significantly higher in HF group than in sham operation group at weeks 9 and 11 after operation (1.21±0.26 vs 0.98±0.22,1.26±0.23 vs 1.05±0.24,P＜0.01).Conclusion The β3-AR mRNA expression is downregulated in the lungs and upregulated in the heart.

Objective To study the association between chronic kidney disease (CKD) and dilated Virchow-Robin space (dVRS) in acute lacunar ischemic stroke patients.Methods A total of 1078 acute lacunar ischemic stroke patients admitted to our hospital were divided into mild dVRS group 1 (n=737) and moderate-severe dVRS group 1 (n=341) according to the severity of their dVRS in basal ganglia (BG),and into mild dVRS group 2 (n=789) and moderate-severe dVRS group 2 (n =289) according to the severity of their dVRS in centrum semiovale (CSO).Their kidney function was assessed according to the estimated glomerular filtration rate (eGFR).CKD was classified into stage 1,stage 2,stage 3a and stage 3b.The association between renal function and dVRS was analyzed by multivariate logistic regression analysis.Results The age was older,the number of females was greater,the incidence of hypertension and CKD was higher,the proportion of smoking was lower in moderate-severe dVRS group 1 than in mild dVRS group 1 (P＜0.05).The incidence of hypertension was higher in moderate-severe dVRS group 2 than mild dVRS group 2 (P＜0.05).Multivariate logistic regression analysis showed that age,hypertension,stage 2 CKD,stage 3a CKD and stage 3b CKD were the independent risk factors for severe dVRS in BG (P＜0.05,P＜0.01).Hypertension was an independent risk factor for severe dVRS in CSO (P=0.04).Conclusion CKD is an important risk factor for dVRS in BG.However,it is not associated with dVRS in CSO.This result highlights the different pathological mechanisms and risk factors for dVRS in BG and CSO.

Objective To study the characteristics of brain function in different cognitive states.Methods Fifty mild cognitive impairment (MCI) patients admitted to our hospital from August 2012 to August 2014 served as a MCI group and 45 elderly people undergoing physical examination served as a control group in this study.The electroencephalography (EEG) signals of patients were recorded for 5 minutes in cognitive load state with their eyes closed.The Lemple-Zie complexity (LZC) was assayed and analyzed.Results The LZC in different brain regions was significantly higher in control group than in MCI group (P＜0.05).The decreasing amplitude of LZC on leads T3,FP1,FP2,F3,F4,P3,P4 was significantly greater (＞20％) in MCI group than in control group (P＜0.01).No significant difference in LZC was found in rest state and cognitive load state between the two groups (P＞0.05).The LZC was significantly lower and the decreasing amplitude of LZC on leads F7,F8,T3,T4,FP1,FP2,F3,F4,P3 was significantly greater in cognitive load state than in rest state in MCI group (P＞0.05).Conclusion The changing LZC can show the brain function and can thus be used an objective EEG nonlinear detection method of cognitive function.

Objective To study the association of Hp infection and insulin resistance (IR) with vascular dementia (VaD).Methods Eighty-six elderly VaD patients admitted to our hospital from April 2015 to April 2016 served as a VaD group and 52 healthy subjects undergoing physical examination served as a control group in this study.The patients in VaD group were further divided into Hp-positive group (n =50) and Hp-negative group (n =36).Their fasting blood glucose (FBG) and fasting insulin (FINS) levels were measured with positive C13 urea breath test as the diagnostic index of Hp infection.HOMA-IR=FINS× FBG/22.5 was calculated according to the self balance model analysis.Results The positive Hp rate,serum FBG and FINS levels,and HOMA-IR were significantly higher in VaD group than in control group (58.14％ vs 28.58％,x2=10.273,P=0.002;5.53±0.60 mmol/L vs 5.19±0.38 mmol/L,P=0.0004;10.29±4.95 μIU/L vs 8.77±4.02 μIU/L,P=0.0317;2.57±1.34 vs 2.06±0.96,P=0.0179).The serum FBG and FINS levels and HOMA-IR were significantly higher in Hp-positive group than in Hp-negative group (P＜0.05,P＜0.01).Conclusion Hp infection and IR are closely associated with VaD,and can thus lead to the occurrence or progression of VaD by inducing or aggravating IR.

Objective To analyze the classification of etiology in 48 patients with acute isolated pontine infarction (IPI),a special subtype of ischemic stroke,according to the characteristics of Chinese ischemic stroke subclassification (CISS) and Kumral ischemic stroke subclassification.Methods The basic characteristics,risk factors,clinical manifestations of 48 acute IPI patients were analyzed according to the CISS and Kumral ischemic stroke subclassification.Results Hypertension (70.83 ％),smoking (64.58 ％),hyperlipidemia (50.00 ％),and abnormal glucose metabolism (37.50％) were the major risk factors for acute IPI.Of the 48 acute IPI patients,38 (79.17％) manifestated as hemiplegia and 15 (31.25％) manifestated as dizziness,33 (68.75％) were diagnosed as paramedian pontine infarction,a most common location of IPI,16 (33.33％) were diagnosed as large artery occlusion,a major subtype of IPI,according to the Kumral ischemic stroke subclassification,17 (35.42％) were diagnosed as intracranial and extracranial large artery atherosclerosis according to the CISS (P=0.830).Conclusion IPI is mainly manifested as paramedian pontine infarction.Large artery occlusion according to the Kumral ischemic stroke subclassification and intracranial and extracranial large artery atherosclerosis according to the CISS are the major subtypes of IPI.IPI is diagnosed when a large part of brainstem is involved.

Objective To study the characteristics of quantitative EEG in epilepsy patients after ischemic stroke.Methods Sixty-seven first-ever epilepsy patients after ischemic stroke served as an observation group and 74 age-matched healthy persons served as a control group in this study.The quantitative EEG power spectra of two groups,including δ (0.8-3.9 Hz),θ (4.0-7.7 Hz),α (7.8-12.9 Hz) and β (13.0-20.0 Hz),were analyzed using the Z2N-F32w EEG device made in Shanghai.The (δ+θ)/(α+β) power value on different regions of brain between the two groups was computerized and used as an observation index.Results The ischemic stroke size was not related with the (δ+θ)/(α+β) power value in observation group (P＞0.05).The (δ+θ)/(α+β)power value on the left frontal area (3.15±2.63 vs 1.97±1.42,P=0.002),right frontal area (3.17±2.53 vs 1.88±1.46,P=0.000),left central area (2.69±2.59 vs 1.65±1.28,P=0.004),left parietal area (2.58±2.45 vs 1.28±1.10,P=0.000),right parietal area (2.69±2.81 vs 1.21± 1.06,P=0.000),left occipital area,right occipital area,left temporal area and right temporal area was significantly higher in observation group than in control group (P＜0.01).No significant difference was found in (δ+θ)/(α+β) power value on the right central lobe and left occipital lobe between the two groups and between early and late onset epilepsy patients after ischemic stroke (P＞0.05).Conclusion Quantitative EEG plays an important role both in diagnosis of epilepsy and in assessment of abnormal brain electrical activity in epilepsy patients after ischemic stroke.

Objective To assess the right ventricular function in pulmonary hypertension (PH) patients according to their tricuspid annular plane systolic excursion.Methods Ninety PH patients admitted to our hospital from October 2014 to September 2015 were divided into mild PH group (n=30),moderate PH group (n=30) and severe PH group (n=30) with 30 individuals undergoing physical examination served as a control group.Their right ventricular transverse diameter,right atrial transverse diameter,main pulmonary artery diameter,and respiration variations of inferior vena cava,tricuspid annular plane systolic excursion of right ventricular free wall were measured by ultrasonography.Results The right ventricular transverse diameter,right atrial transverse diameter,main pulmonary artery diameter were significantly longer and the suction collapse rate was significantly lower in mild PH group,moderate PH group and severe PH group than in control group (P＜0.05,P＜0.01).The tricuspid annular plane systolic excursion was significantly shorter in moderate PH group and severe PH group than in control group (12.9± 3.2 cm,10.1±3.1 cm vs 23.4±2.2 cm,P＜0.01).However,no significant difference was found in tricuspid annular plane systolic excursion between moderate PH group and control group (P＞ 0.05).Conclusion The tricuspid annular plane systolic excursion is shorter and the right ventricular function is lower in PH patients.Tricuspid annular plane systolic excursion can sensitively show the right ventricular function in PH patients and is thus a reliable predictor for their right ventricular function.

Objective To study the effect of siRNA-interfered endogenous Kir6.2 gene deletion on rotenone-induced cell damage and signal pathway according to the expression of siRNA-interfered endogenous Kir6.2 gene.Methods The expression of endogenous Kir6.2 gene in PC12 cells was detected by RT-PCR and Western bolt.The viability of PC12 cells was tested using WST-1.The expression of PKC and phosphorylated PKC in PC12 cells was detected by Western blot in negative control group,siRNA/Kir6.2 group,siRNA/Kir6.2 + rotenone group,siRNA/Kir6.2+ rotenone+PKC inhibitor group before and afer treatment with rotenone.Results RT-PCR showed that the interference was successful in siRNA/Kir6.2/group 1 and siRNA/Kir6.2/ group 2.Western blot displayed that the expression level of endogenous Kir 6.2 gene was significantly lower in siRNA/Kir6.2/ group 1 than in negative control group (0.55±0.07 vs 0.89±0.09,P＜ 0.05).WST-1 revealed that the viability of PC12 cells was significantly lower in siRNA/Kir6.2 group than in negative control group (P＜0.05).Western blot demonstrated that the expression of PKC and phosphorylated PKC was significantly lower in siRNA/Kir6.2+-rotenone+PKC inhibitor group than in the other three group (P＜0.05).Conclusion Endogenous Kir6.2 can protect PC12 cells against the toxicity of rotenone and plays an important role in regulating the rotenone-induced viability of PC12 cells by activating the phosphorylated PKC.

Objective To study the mechanism of high glucose level underlying the dysfunction of HUVEC.Methods The HUVEC were divided into normal control group,mannitol control group,and high glucose (33 mmol/L) control group after they were isolated and cultured.Expression of RICTOR protein was detected by RT-PCR and Western blot respectively.RICTOR-transfected overexpressed adenovirus served as a high glucose adenovirus group and RICTOR-transfected AD-GFP served as a high glucose blank virus group.The phosphorylation of Akt and eNOS was detected by Western blot and the volume of released NO was measured with nitrate reductase.Results The expression level of RICTOR protein was significantly lower in high glucose control group than in normal control group (1.00±0.16 vs 2.69±0.07,P＜0.01) and was significantly higher in high glucose adenovirus group than in high glucose blank virus group (0.57±0.03 vs 0.29 ± 0.02,P＜0.01).The phosphorylation of Akt and eNOS was significantly higher and the volume of released NO from HUVEC was significantly larger in high glucose adenovirus group than in high glucose blank virus group (0.95±-0.05 vs 0.56±0.04,P＜0.01;0.97±0.05 vs 0.55±0.07,P＜0.01;0.85±0.06 vs 0.56±0.04,P＜0.05).Conclusion Upregulating the expression of RICTOR protein can improve high glucose-induced dysfunction of HUVEC.

Objective To study the clinical characteristics of elderly female acute ST-segment elevation myocardial infarction (STEMI) patients.Methods One hundred and eight ≥60 years old acute STEMI patients admitted to our hospital from November 2015 to February 2017 were divided into male group (n=63) and female group (n=45).Their clinical baseline data,coronary artery intervention and outcome in hospital were compared between the two groups.Results The age of disease onset was significantly older and the eGFR was significantly lower in female group than in male group (P＜0.05,P＜0.01).The incidence of typical chest pain and the LVEF were significantly lower while the serum NT-proNBP level was significantly higher,the left ventricular end diastolic pressure diameter was significantly longer and the CRUSADE score was significantly lower in female group than in male group (P＜0.01).The incidence of 3-blood vessel lesion was significantly higher,the diameter of implanted stents was significantly shorter in female group than in male group (P＜0.05).However,the hospital stay time was significantly longer and the incidence of angina pectoris and recurrent heart failure after myocardial infarction was significantly higher in female group than in male group following reperfusion therapy (P＜0.05,P＜0.01).Conclusion The clinical symptoms are more atypical,the lesion is severer,the heart function is poorer,the incidence of complications after myocardial infarction is higher,and the risk of bleeding is greater in elderly female STEMI patients than in elderly male STEMI patients.