Objective: To investigate the effect of administrative HDL-C (high density lipoprotein cholesterol) level on adverse cardiovascular events after discharge in elder patients with ST-segment elevation myocardial infarction (STEMI).
Methods: A total of 325 STEMI patients treated in our hospital from 2010-04 to 2012-07 were retrospectively studied. According to administrative HDL-C level, the patients were divided into 2 groups as High HDL-C group, n=139 and Low HDL-C group, n=186. The basic and clinical conditions, in-hospital treatment, death and the medication, adverse cardiovascular events during 6 and 12 months follow-up period were compared between 2 groups.
Results: The patients with in-hospital reperfusion therapy was higher in Low HDL-C group, and Low HDL-C group had the higher ratio of emergent PCI treatment, all P<0.05. During follow-up period, High HDL-C group had less patients with β-receptor blocker treatment, less non- fatal MI, adverse cardiovascular events and re-hospitalization, all P<0.05. Cox regression analysis showed that low HDL-C level (HR=0.558, P=0.024) and diabetes mellitus (HR=1.528, P=0.040) were the risk factors of adverse cardiovascular events, while emergent PCI (HR=0.47, P=0.001) was the protective factor in STEMI patients after discharge.
Conclusion: The lower administrative HDL-C level in elder patients with STEMI had the higher risk of adverse cardiovascular events after discharge.

ObjectiveTo analyze the clinical characteristics of Behcet's disease with intracardiac thrombus.MethodsThe data of 8 patients diagnosed as Behcet's disease with intracardiac thrombus in Peking Union Medical College Hospital from January,1990 to January,2011 were studied retrospectively.ResultsBehcet's disease with intracardiac thrombus was found in 8 patients (5 men and 3 women) with a median age of 28.5 years.Most of them were young men.Thrombus was mostly found in the right side of the heart.Most of the patients had pulmonary thromboembolism with negative anticardiolipid antibody and basically normal C-reactive protein and erythrocyte sedimentation rate.ConclusionIntracardiac thrombus associated with Behcet's disease most commonly occurs in young men and usually involves the right side of the heart.

Vascular smooth muscle cell (VSMC) proliferation and migation play important roles in the occurrence and development of atherosclerosis and restenosis after intravascular stenting.The studies in recent years have shown that kallikrein-kinin system (KKS) is closely correlated with VSMC proliferation and migration in cytokines and transduction pathways.Therefore,investigating the roles of KKS in the VSMC proliferation and migation process has great significance in clinical prevention and treatment of atherosclerosis and restenosis after intravascular stenting.

Objective To investigate the clinical value of bone scintigraphy for the diagnosis of synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Methods The characteristics of SAPHO syndrome on 99Tcm-MDP imaging of 8 cases were retrospectively analyzed. Results The 99TcmMDP bone scan was positive for all patients. Seven cases were found lesions in the costoclavicular region, 3cases involved with unilateral sacroiliac joint, 2 cases involved with spine and 1 patient with extremity. Four lesions were found without relevant clinical symptoms. Conclusion Bone scintigraphy is useful for the diagnosis of SAPHO syndrome, especially for those lesions with no clinical symptoms.

Objective To evaluate the diagnostic value of three dimensional transvaginal sonograpy( 3D TVS) for uterine cavity lesions.Methods Two dimensional transvaginal sonography(2D TVS) and 3D TVS were performed on 46 patients with irregular vaginal bleeding.The diagnosis were compared with the results of pathology and hysteroscopy.Results Of 46 patients,16 cases were diagnosed as endometrial hyperplasia,12 cases as endometrial polyp,9 cases as submucous myoma,3 cases as endometrial cancer, and the remaining 6 cases as normal secretive phase.To endometrial hyperplasia,the specificity,sensitivity,accuracy of 2D TVS and 3D TVS was 66.7% , 93.7% , 76.1% and 90.0% ,100%, 93.5% respectively.To endometrial polyp,the specificity,sensitivity,accuracy of 2D TVS and 3D TVS was 88.2% , 58.3% , 80.4% and 100%, 83.3% , 95.7% respectively.Conclusions 3D TVS improves the diagnosis of uterine cavity lesions,3D TVS combined with 2D TVS is the first choice for uterine cavity lesions.

Objective To investigate the influence of the cardiac function on the prognosis in the patients with acute myocardial infarction(AM I) complicating multivessel disease (M VD ) treated by revascularization .Methods 152 cases of AM I complicating MVD treated by routine percutaneous coronary intervention (PCI) were divided into the normal group(94 cases ,LVEF≥50% ) and the lower group(58 cases ,LVEF<50% ) according to the left ventricular ejection fraction (LVEF) ,and the influence of the cardiac function on the prognosis was analyzed .Results The myocardial infarction history ,history of atrial fibrillation ,NYHA classifica-tion ,hs-CRP ,LADp ,ISR ,left ventricular structure and function had statistically significant difference between the two groups (P<0 .05) .The multivariate Logistic regrossion analysis showed that NYHA classification ,LVEF ,LVMI and LVEDd were the inde-pendent risk factors affecting the prognosis after PCI .Conclusion The reduced cardiac function is a risk factor affecting the prog-nosis of AMI complicating MVD treated by PCI ,the improvement of the cardiac function will be beneficial to the prognosis of the patients .

Objective To compare the clinical efficacy and angiographic outcomes of balloon dilation angioplasty,balloon-expandable stent implantation and self-expanding stent implantation in the treatment of intracranial arterial stenosis.Methods The patients with intracranial arterial stenosis who met the indications of surgical intervention treated with balloon dilatation angioplasty and stent placement were selected from Nanjing Stroke Registry Program.According to the different interventional procedures,the patients were divided into the balloon expandable stenting goup,the self-expanding stents group and the balloon dilatation angioplasty group.The success rate of surgery,the perioperative complication rate and the significant residual stenosis rate were compared among the three groups.The clinical and angiographic assessments were performed through 1-,3-,6-,12- and 24-month regular outpatient or inpatient follow-up after procedure.The incidences of ischemic stroke and/or death and restenosis within 2 years were compared.Multivariate Cox proportional hazards analysis was used to analyze the risk factors for recurrent ischemic stroke and/or death and restenosis.Results A total of 183 patients with 192 stenoses performed balloon dilatation angioplasty or stenting,in which 92 were in the balloon expandable stenting goup,42 were in the self-expanding stents goup and 49 in the balloon dilatation angioplasty group.Their preoperative stenosis rates were 80.2 ±12.8％ 、76.3 ± 11.9％ and 89.7 ± 10.2％,respectively (F =15.863,P =0.000).There were no significant differences in other baseline data.The success rates of surgery in the balloon expandable stenting group,self-expanding stents group and balloon dilatation angioplasty group were 96.7％,95.2％ and 91.8％,respectively (x2 =1.646,P =0.439).The perioperative complication rates were 6.5％,14.3％ and 10.2％,respectively (Fisher exact test,P=0.334).The imaging follow-up showed that the restenosis rate in the balloon dilatation angioplasty group was 48.5％.Although it was high than 27.7％ in the balloon expandable stenting group and 34.8％ in the self-expanding stents group,there were no significant differences (x2 =4.176,P =0.124).Multivariate Cox proportional hazards analysis showed that balloon dilatation angioplasty was an independent risk factor for restenosis after procedure (hazard ratio 2.490,95％ confidence interval 1.247- 4.969,P=0.010).Conclusions Compared to the balloon expandable stenting,the balloon dilatation angioplasty is more likely to have restenosis,but it is not associated with the risks of postoperative recurrent ischemic stroke and/or death.

Background Oxidative stress is thought to be responsible to diabetes-complicated cataract.Our previous study demonstrated that as an iron chelator,deferiprone can protect lens from oxidative damage.Objective This further study aimed to investigate the role of deferiprone on the formation of diabetic-complicated cataract.Methods Forty 6-week-old Wistar rats were included in the study and randomized into 4 groups.Eight of them were used as the normal control group.Diabetes mellitus animal models were established in 22 rats by the carbonhydratediet and fat diet and the intraperitoneal injection of 40 mg/kg streptozocin (STZ).The deferiprone of 50 mg and 100 mg were intragastrically given in 8 model rats respectively after 3 days once a day for 8 weeks.The opacification of lenses was examined under the slit lamp weekly after treatment.The animals were sacrificed and the lenses were obtained at the eighth week of deferiprone injection.The concentrations of water-soluble protein ( WSP),urine-soluble protein (USP) and alkali-soluble protein (ASP) in rat lens suspension were detected by Bradford method.The super oxide dimutese (SOD),malondialdehyde (MDA) and glutathione (GSH) were determined spectrometically using xanthine oxidase,thiobarbituric acid,dithio bis-nitrobenzoic acid.Results No evidently differences were found in the content of the WSP,USP and ASP among the these groups( F=1.73,0.18,0.09,P＞0.05).The contents of MDA in 50 mg deferiprone group and 100 mg deferiprone group were ( 1.05 ± 0.10 ) mmol/g and ( 1.05 ± 0.22 ) mmol/g respectively,showing a significant decline in comparison with diabetic model group (P＜0.05).The SOD and GSH contents in lens were (321.29±16.57) U/mg,(322.07±22.16) U/mg and (7.83±0.65 ) mg/g,(7.70±0.77 ) mg/g respectively in 50 mg deferiprone group and 100 mg deferiprone group and were considerably elevated in comparison with ( 298.70± 14.69 ) U/mg and ( 5.47 ± 1.01 ) mg/g of diabetic model groups ( P＜0.05 ).No significant differences were found in the indexes mentioned above between 50 mg and 100 mg deferiprone groups(P＞0.05).Conclusions Deferiprone can reduce oxidative stress and improve the energy metabolism of the lens in diabetic rats.

Objective To design an experiment for method-comparison and bias estimation of multi tests on multi instruments.Methods According to the procedure described by the NCCLS approved guideline EP9-A and improving the method of sample collection,we took 8 patient mixing samples each day to analyze all comparison tests on 11 auto-chemistry analyzer within following 5 days.The duplicates were assessed within the same run.The coefficient of correlation and average bias% were calculated,and the system errors at medical decided levels were assessed.Results Taking ALT as an example,the coefficients of correlation were between 0.994-1.000,and the average bias% were between-0.460%-4.927%,SE at 40U/L was-1.510-1.834 and SE at 300 U/L was-3.101-9.188.Conclusion In all tests that joined the comparison among the different instruments,28 tests were acceptable,2 tests were acceptable after modifying the coefficients,and AMY and LIP were not acceptable.

AIM: To explore the molecular mechanisms about fibrosis and transforming growth factor (TGF) - β1 as well as inflammation in rats heart after acute myocardial infarction (AMI). METHODS: AMI model in rats was produced by left coronary artery ligation. Samples of rat cardiac tissue were collected at the end of 1 week, 4 weeks and 8 weeks. Hemodynamics had been performed before rats were sacrificed. Reverse transcription polymerase chain reaction (RT- PCR) and immunohistochemical methods were used to analyze mRNA expression and protein production of TGF- β1, respectively. Hydroxyproline was determined by chloramines T method. HE staining was resorted to analyze pathological myocardium after AMI. RESULTS: There were remarkable differences in hemodynamics between AMI groups and sham group (P＜0.01). Compared with sham group, TGF-β1mRNA expression and protein production and hydroxyproline quantification were enhanced greatly. Among them, the levels of TGF -β1 and hydroxyproline at 1 week were higher than those at 4 weeks or 8 weeks. A positive correlation between TGF- β1 protein and hydroxyproline was presented (r=0.75 - 0.99, P＜0.05). In microscope, leucocytes infiltrated significantly in the infarcted and border myocardium at 1 week after AMI, and were rarely seen at 4 weeks and 8 weeks. TGF - β1 protein were detected in cytoplasm of cardiac myocyte and leucocytes at 1 week, and at 4 and 8 weeks in myofibroblast and interstitial. CONCLUSIONS:TGF- β1 is upregulated and found in cytoplasm of cardiac myocyte and leucocytes as well as myofibroblast in heart after AMI,which is associated with dynamic changes of hydroxyproline content and inflammation. TGF - β1 is showed to play an important role in myocardial inflammatory repair and ventricular remodeling after AMI.