Objective To explore the relationship between B-type natriuretic peptide (BNP) and fibrinogen (Fib) in the elderly patients with coronary heart disease (CHD). Methods According to the level of BNP,325 subjects aged more than 65 years were divided into four groups,BNP:≤32.4ng/Lgroup,32.5～62.3 ng/Lgroup,62.4～162.5 ng/Lgroup,＞162.5 ng/L group.The levels of left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD) and Fib were compared among the groups. Results With increasing BNP level,the LVEF was gradually decreased [(63.3±8.2)％,(59.6±7.4)％,(57.9±9.7)％,(55.2±10.6)％] and the level of LVEDD was increased[(50.5±4.7)mm,(51.4±5.4)mm,(52.8±5.7)mm,(54.2±5.9)mm ;F=11.54,6.76,both P＜0.01],the level of Fib was enhanced [(3.4±0.7)g/L,(3.7±0.8)g/L,(3.8±1.1)g/L,(4.2±1.0)g/L; F=8.02,P＜0.01].The level of BNP had positive correlation with Fib (r=0.25,P＜0.01). Multi-linear regression analysis showed that Fib and LVEF were influencing factors of BNP (t =2.92, - 3.15, both P ＜ 0.01 ). Conclusions The BNP level is helpful to diagnose heart failure and assess heart function.There is an association between BNP and Fib level.

Aim To investigate the inhibitory effect of schizandrin B( SchB) on ultraviolet radiation b ( UVB) radiation-induced apoptosis of HaCaT cells. Methods Methyl thiazolyl tetrazolium ( MTT ) assay was used to examine the effect of SchB on cell viability recovery. Cell apoptosis and necrosis were measured by Ho-chest33342 staining. The p53, p21 and Caspase-3 mRNA expressions were examined by RT-PCR. Results In this study, we found that Sch B attenuated UVB-in-duced toxicity in HaCaT cells. Through Hoechst 33342 stain, we visualized that SchB could inhibit UVB-in-duced HaCaT cell death. The result demonstrated that p53 , p21 and Caspase-3 mRNA levels decreased com-pared with the control group. Conclusions Sch B at-tenuates the UVB-induced toxicity of HaCaT by inhibi-ting apoptotic gene expression. It plays a role in anti-photoaging.

Objective To explore the relationship between blood lipids and creatinine clearance (Ccr)in aged patients with coronary heart disease(CHD).Methods According to coronary artery angiography(CAG)and Ccr,784 subjects aged 65 years and over were divided into groups and Their lipid levels were compared.Results With increasing lesion of coronary branches,the level of Ccr was obviously decreased(F=5.35,P＜0.01).The level of apolipoprotein A1(ApoA1)was reduced and apolipoprotein B(ApoB)enhanced in renal function of moderate-severe injury(CCr＜0.83 ml ·s-1 · 1.73m-2)(F=5.31,F=4.91,both P＜0.01).The level of ApoA1 was decreased(F=3.52,P＜0.05)and Apo B increased(F=5.65,P＜0.01)in male renal function of moderate-severe injury.The levels of ApoA1 decreased(F=5.79,P＜0.01),ApoB increased(F=4.56,P＜0.05)and high density lipoprotein-cholesterol reduced(F=3.39,P＜0.05)in CHD with renal group of moderatesevere injury.Multi-logistic regression analysis showed that Ccr,HDL-C,ApoA1 and ApoB were influencing factors of CHD.Conclusions Abnormal blood lipid and renal dysfunction are risk factors of CHD,dyslipidemia may induce renal dysfunction.It is important to control lipids and improve other organ functions in the aged patients with CHD.

Objective To explore the correlation of B-type natriuretic peptide (BNP) with blood lipids and renal function in elderly patients with coronary heart disease (CHD).Methods According to the four quantiles of BNP level,325 subjects aged 65 years and over were divided into four groups:group A (≤32.4 ng/L),group B (32.5 ng/L),group C (62.4 ng/L),group D (＞ 162.5 ng/L).The left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD),levels of blood lipids and renal function were compared among the groups.Results With the increase of BNP level,the LVEF was gradually decreased [(63.3±8.2) ％,(59.6±7.4) ％,(57.9±9.7)％,(55.2±10.6)％,respectively,F=11.54,P＜0.01] and the LVEDD was gradually increased (F=6.76,P＜0.01),the level of triglyceride (TG) was gradually decreased (F=2.73,P ＜0.05) in group A,B,C and D.Creatinine clearance was gradually decreased [(1.24±0.31) ml ·s-1 · 1.73 m-2,(1.21±0.31) ml· s-1 · 1.73 m-2,(1.24±0.29) ml · s-1 · 1.73 m 2,(1.09± 0.33) ml · s-1 · 1.73 m-2,respectively,F=3.62,P＜0.05],and blood urea nitrogen was gradually increased (F=4.43,P＜0.05) in group A,B,C and D.Multi-linear regression analysis showed that levels of total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoproteincholesterol,very low density lipoprotein-cholesterol,creatinine clearance and blood urea nitrogen were influencing factors for BNP (all P＜0.05).Conclusions BNP level can be used as a sensitive indicator for the diagnosis of heart failure and the assessment of its severity.The levels of blood lipids and renal function are associated with BNP.

Moyamoya disease is a rare cerebrovascular disorder, characterised by progressive stenosis and/or occlusion of the intracranial internal carotid artery and its proximal branches with the development of a basal collateral network. Moyamoya disease has a high prevalence in Asia, particularly in Japan, Korea and China. Ischemic events and intracranial bleeding are the most common clinical manifestation of moyamoya disease. Although the benefi cial effect on hemorrhage is still not clear, revascularisation surgery remains the most effective way to prevent the progression of ischemic symptoms. Moyamoya disease has been investigated by numerous studies since it was fi rst described 50 years ago, many conundrums remain to be solved. In this article, we review the history, epidemiology, aetiology, clinical manifestation, diagnosis and treatment of moyamoya disease. Recent advances and future challenges of moyamoya disease are also discussed.

Objective To retrospectively analyse the anterior and posterior surgical approaches in treatment of unstable burst thoracolumbar fractures and compare radiographic measurement parameters of beth surgical techniques so as to provide references for surgical treatment of such kind of fracture. Methods The study selected 41 patients with unstable thoracolumbar fracture treated with either anterior neurodecomprossion and fixation (n=19) or posterior reposition and internal fixation by pedicle screw (n=22) from January 2003 to December 2005. All patients were followed up for 24-48 months ( mean 38 months) and divided into anterior approach group and posterior approach group. Sagittal alignment was assessed by the Cobb angle depending on lateral radiographs. Results The Cobb angle of the anterior approach group was average 27.3°on admission but 3.1°postoperatively and 4.6° at follow-up; while the Cobb angle of posterior approach was average 26.1° on admission, 3.0°postoperatively and 12.5°at follow-up. There was no statistical difference between Cobb angle on admission and postoperative one (P>0.05) but showed significant differences between them at follow-up ( P<0.01). Conclusion The anterior surgical approach can consistently yield better maintenance of kyphotic correction compared with the posterior surgical approach.

Objective To explore a method of establishing a canine model of intracerebral hemorrhage (ICH) by puncturing the main branch of middle cerebral artery (MCA) under ultrasonic guidance and proceed a pilot study of contrast-enhanced ultrasound (CEUS) of ICH.Methods Twelve adult healthy mongrel dogs were enrolled in the experiment.In the condition of bone window,the main branch of MCA was punctured to bleed under the ultrasonic guidance.CEUS of brain was performed every 30 minutes until hematoma formed and another CEUS was performed at 24 hours.Then brains were collected for pathologic examination after dogs were euthanized.Results Eleven of twelve dogs developed ICH successfully that located in the Out edge of basal ganglia,which was confirmed by CEUS and autopsy.One dog died within 6 hours due to intraventricular hemorrhage which was confirmed by autopsy.The hematoma diameters were measured as (22.4 ± 7.1)mm by CEUS before euthanasia and as (21.6 ± 6.9)mm on autopsy.There was no significant difference between the two methods of measurement (t =1.521,P =0.1565).The characteristics of active bleeding and hematoma on ICH were performed in the CEUS imaging.Conclusions A model of dog ICH by puncturing the main branch of MCA under the guidance of ultrasound was established successfully,and it proved to be simple,effective and repeatable.The imaging characteristics of this model are in good accordance with those of ICH in patients.

OBJECTIVETo observe the efficacy of integrative medical sequential method in treating cerebral palsy (CP) children's intelligence development, muscular tension, serum interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-alpha).

METHODSTotally 111 CP children were randomly assigned to the control group (50 cases) and the treatment group (61 cases). All patients received comprehensive rehabilitation training and intravenous dripping of Monosialotetrahexosylganglioside Sodium Injection for 10 days. But those in the treatment group additionally received Chinese medical enema for brain resuscitation, relieving rigidity of muscles and activating collaterals for 14 days. Then they started another medication cycle and lasted for a total of 6 cycles. Serum IL-6 levels and TNF-alpha contents were determined before treatment. Scoring for muscular tension, Gesell score for intelligence development, contents of serum IL-6 and TNF-alpha were assessed before and after treatment in the two groups.

RESULTSCompared with before treatment in this group, muscular tension, Gesell scores for intelligence development all decreased in the two groups (P < 0.05). As for inter-group comparison, the decrement was more obvious in the treatment group than in the control group (P < 0.05). The total effective rate was 86.9% in the treatment group and 76.0% in the control group (P < 0.05). The contents of IL-6 and TNF-alpha were obviously reduced in the treatment group and the control group after treatment (P < 0.01). The decrement was more obvious in the treatment group (P < 0.05).

CONCLUSIONThe two treatment methods were effective for CP children, but the efficacy was superior in the treatment group than in the control group, indicating integrative medical methods could play a synergistic effect and optimize the treatment program for CP.

Cerebral Palsy ; drug therapy ; Child, Preschool ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gangliosides ; therapeutic use ; Humans ; Infant ; Integrative Medicine ; Intelligence ; Interleukin-6 ; blood ; Male ; Phytotherapy ; Tumor Necrosis Factor-alpha ; blood

Background and purpose: p21-activated kinase 5 (PAK5) is a recently identified member of PAKs that regulate many intracellular processes such as cytoskeleton remodeling, cell proliferation, cell differentiation, gene transcription and cell apoptosis. Recently, studies found that PAK5 was overexpressed in some cancer such as gastric and colon cancer. However, the expression status and biological function of PAK5 in osteosarcoma are not clearly known. The objective of this study was to investigate the expression of PAK5 in osteosarcoma tissue and their relationships with the prognosis of osteosarcoma. Methods: The expression of PAK5 was detected by using immunohistochemical method in 92 specimens of human osteosarcoma tissues and 33 cases of osteoclastoma tissue, respectively. Results: The positive rate of PAK5 was 71.7% (66/92) in all the 92 cases of osteosarcoma. PAK5 expressions were not related to clinical variables such as gender, age, tumor location, tumor size, histological type and local recurrence, but signiifcantly related to Enneking grade, tumor cell necrosis rate and lung metastasis, and the high expression of PAK5 may reduce the efifciency of chemotherapy. Survival analysis indicated that high expression of PAK5 correlated with poor prognosis of patients with osteosarcoma. Univariate survival analysis showed that the signiifcant prognostic factors were tumor size, Enneking grade, local recurrence, lung metastasis and expression levels of PAK5. COX multivariate regression identified that the PAK5 expression levels (P=0.001) and lung metastasis (P=0.015) were independent prognostic factors of patients with osteosarcoma. Conclusion:The positive expressions of PAK5 closely correlate with Enneking grade, tumor cell necrosis rate and lung metastasis. Detection of PAK5 may be used as a molecular marker for prognosis of osteosarcoma. The high expression of PAK5 may reduce the efifciency of chemotherapy.

Pseudomonas aeruginosa (PA) pneumonia is a refractory,even lethal complication in immunosuppressive individuals and immune disturbances may promote the pathological process.We aimed to investigate the regulatory T (Treg) cell activity in an immunosuppressive mice model of PA pneumonia by estimating levels of main transcription factor and the main effector of Treg cells,i.e.,Forkhead box protein 3 (FOXP3) and interleukine-10 (IL-10).Seventy-two BALB/c mice were divided into four groups randomly:control (A),PA pneumonia (B),immunosuppression (C) and immunosuppression with PA pneumonia (D).Mice were sacrificed at 4,8 and 24 h after establishing experimental models.The pathological changes of lung tissue were graded,and the FOXP3 mRNA and serum IL-10 levels were detected.Histological analysis of lung tissues showed there were no significantly pathological changes in groups A and C,but significantly pathological changes were found in groups B and D,especially in group D at 8 h (P＜0.05).The expression levels of FOXP3 mRNA in groups A and C showed no significant changes at the three time points,which were significantly lower than those in groups B and D (P＜0.05).FOXP3 mRNA levels were lowest at 4 h,and there was significant difference between groups B and D (P＜0.05).The serum levels of IL-10 in groups A and C were almost normal at the three time points,but decreased significantly in groups B and D (P＜0.05).The serum levels ofIL-10 decreased to the lowest at 8 h,especially in group D (P＜0.05).The results indicate that PA pneumonia in immunosuppressive individuals worsens rapidly,which may be associated with Treg cells function disturbance.And Treg cells may be promising as adjuvant therapeutics for PA pneumonia in immunosuppressive individuals.