OBJECTIVETo establish the "clinical-mimetic" Chinese medicine symptom complex score method for the coronary heart disease Chinese miniature swine model with phlegm-stasis cementation syndrome, in order to observe the effect of formula of removing both phlegm and blood stasis (TYTZ) on the Chinese medicine symptom complex score for the coronary heart disease Chinese miniature swine model with phlegm-stasis cementation syndrome.

METHODTotally 36 Chinese miniature swine were randomly divided to the normal control group, the model group, the Shujiangzhi group, and TYTZ groups with doses of 2.0, 1.0 and 0.5 g x kg(-1), with six in each group. Except for the normal control group, all of the other groups were fed with high fat diet for two weeks. The coronary heart disease model with phlegm-stasis cementation syndrome was established by injuring left anterior descending artery with interventional balloons and continuously feeding with high fat diet for eight weeks. After the operation, the groups were administered with drugs for eight weeks. Their main symptoms, accompanied symptoms, tongue and pulse signs of the coronary heart disease Chinese miniature swine with phlengm-stasis cementation syndrome were observed according to the symptom-graded scoring method.

RESULTCompared with the model group, TYTZ in different doses could reduce the scores of main symptoms at the 6th and 10th week. Specifically, TYTZ in low dose could reduce the scores of tongue at the 6th week and the scores of accompanied symptoms, and tongue and pulse signs at the 10th week; And TYTZ in high dose could decrease all symptom scores at the 6th and 10th week (P < 0.05 or P < 0.01).

CONCLUSIONTYTZ can improve the scores of the main symptoms, accompanied symptoms, tongue and pulse signs in coronary heart disease Chinese miniature swine with phlegm-stasis cementation syndrome. It is suggested that the "clinical-mimetic" objective scoring for syndromes of Chinese miniature swine is of great significant to the development of new traditional Chinese medicine drugs.

Animals ; Chemistry, Pharmaceutical ; Coronary Disease ; blood ; diagnosis ; physiopathology ; therapy ; Female ; Male ; Medicine, Chinese Traditional ; methods ; Swine ; Swine, Miniature

OBJECTIVETo discuss that pathogenesis evolvement regularity of Chinese miniature swine with phlege-stasis cementation syndrome of coronary heart disease.

METHODEighteen Chinese miniature swine were randomly divided to the normal control group, the model group and the Danlou tablet group, with six swine in each group. Except for the normal control group, all of the other groups were fed with high fat diet for two weeks. The coronary heart disease model with phlegm-stasis cementation syndrome was established by injuring left anterior descending artery with interventional balloons and continuously feeding with high fat diet for eight weeks. The levels of BMI, hemorheological parameters, lipids in serum and inflammatory cytokines were observed at the 0th (before the experiment), 2nd (before operation or drug administration), 6th (four weeks after drug administration) and 10th week (eight weeks after drug administration) of study. The levels of TG and TC in liver and the pathological changes in coronary artery tissues were also observed at the end of study.

RESULTCompared with the normal control group, the model group had showed significant increase in the levels of TC, TG, LDL-C and VLDL-C in serum (P < 0.01) from the second week to the end of the experiment, with notable rise in the whole blood viscosity under the shear rates of 5 s(-1) and 60 s(-1). At the 6th week, the levels of BMI and TG and TNF-alpha in serum significantly increased. At the 10th week, the levels of BMI and hs-CRP, IL-6 and TNF-alpha in serum significantly increased as well, with remarkable increase in coronary stenosis, intimal thickness and the ratio between intimal thickness and media thickness (P < 0.05 and P < 0.01), and significant rise in TC and TG in livers (P < 0.01). Compared with the model group, the Danlou tablet group showed obvious reduction in severity of coronary artery lesion, intimal thickness and lumen stenosis ratio and ratio between intimal thickness and media thickness (P < 0.01), BMI, TC, TG, LDL-C and VLDL-C in serum, TC and TG in liver, as well as hs-CRP, IL-6 and TNF-alpha levels in serum (P < 0.05 and P < 0.01), with notable decline in the whole blood viscosity under the shear rates of 5 s(-1) and 60 s(-1).

CONCLUSIONThe interaction of phlegm, blood stasis and toxin syndromes helps promote the progress and development of AS plaques, which is the key pathogenesis of phlegm-stasis cementation syndrome in coronary heart disease.

Animals ; Body Weight ; Coronary Disease ; blood ; physiopathology ; Female ; Hemodynamics ; Inflammation Mediators ; metabolism ; Lipids ; blood ; Liver ; metabolism ; Male ; Medicine, Chinese Traditional ; Swine ; Swine, Miniature

T site polymorphism is closely related to CHD and elevated serum triglyceride and total cholesterol.

OBJECTIVETo investigate the association of -1131T>C and c.553G>T polymorphisms and their haplotypes in apolipoprotein A5(ApoA5) gene with cereberovascular disease in Chinese.

METHODSUsing polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), we analyzed two ApoA5 genetic variants in 272 patients with cerebral infarction (CI) and 316 control individuals respectively. The levels of serum lipid profiles were measured with biochemical methodsìand the other clinical characters were obtained by case file investigation.

RESULTSThe odds ratio (OR) for CI in -1131CC genotype carriers was 2.10 (95%CI 1.01-4.37). The distribution of T-T and T-G haplotypes had obvious differences between CI patients and control individuals. The OR for CI in C-G and T-G haplotype carriers were 1.34 and 0.71(95% CI 1.02-1.76 and 0.55-0.92) respectively, compared with the others. Furthermore, the major haplotypes had significant differences of serum TG(P< 0.05).

CONCLUSIONThe ApoA5 -1131T>C polymorphism may be associated with an increased risk of CI in the Chinese population, but the influence of blood lipids can not be ignored.

Aged ; Apolipoproteins A ; genetics ; Carotid Artery Diseases ; complications ; genetics ; Cerebral Infarction ; complications ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Haplotypes ; genetics ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics ; Polymorphism, Restriction Fragment Length

Objective To explore the high risk factors of the etiology of autism disorder.Methods Two hundred and seventy-eight children with autism disorder and 200 healthy children were investigated with self-designed questionnaire to obtain their demographic information,pre-and perinatal information,developmental information in toddler period.All the data were compared between autism group and healthy controls.Results 1.There were significant dif ferences in maternal prenatal data and perinatal data between autism group and healthy controls.Logistic regression analysis found that maternal/paternal reproductive age,family burden,caregiver,pregnancy reaction,drug administration in prenatal period,mode of delivery,chief instructor entered the regression equation.2.The 6 items in regression equation which had clinical significance consisted of maternal reproductive age above 30 years old [odds ratio (OR) =6.72],family history of mental disorders (OR =5.80),drug administration in prenatal period (OR =4.65),non-natural childbirth (OR =4.15),paternal reproductive age above 30 years old (OR =1.27),moderate or serious pregnancy reaction (OR =1.04).Conclusions The main risk factors of autism disorder in pre-and perinatal period consists of maternal reproductive age above 30 years old,positive family history of mental disorders,drug administration in prenatal period and non-natural childbirth.Avoiding these risk factors might contribute to reduce the incidence of autism.

Objective The aim of the present work was to investigate the potential relationship between acute rejection and serum concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP)/high sensitivity C reactive protein (hs-CRP) in post-transplant patients. Methods Sixty-one consecutive orthotopic heart transplantation recipients were prospectively recruited from the cardiac transplantation programme at Fuwai Hospital Endomyocardial biopsies (EMB) were performed routinely at 3 weeks, 3, 6 and 12 months after transplantation. EMB were also performed when patients had new symptoms of heart failure or at 2 weeks after steroid pulse therapy. Serum NT-proBNP and hs-CRP were simultaneously measured before EMB procedure. Results A total of 126 biopsy samples were obtained from the 61 patients.Serum NT-proBNP concentrations progressively decreased after transplantation (spearman correlation coefficient-0.520, P=0.000). NT-proBNP levels within 6 months after transplantation were significantly higher than those beyond 6 months post transplantation [(11.86±11.16 ) × 10-16 mol/L vs. (5.83 ± 6.58) × 10-16 mol/L,P=0.002]. NT-proBNP concentrations in patients with rejection tended to be higher than patients without rejection (13.68 × 10-16 mol/L vs. 9.26 × 10-16 mol/L, P=0.073 ). After time adjustment, the difference of NT-proBNP concentrations between patients with or without rejection becomes statistically significant (14. 45 x 10-16 mol/L vs. 9.1 x 10-16 mol/L, P=0.025 ). Receiver operating characteristics analysis for NT-proBNP versus rejection grade revealed an area under the curve of 0.566,indicating a low predictive value for NT-proBNP. A cutoff of 6.00 x 10-16 mol/L yielded poor specificity (44.8% ) and sensitivity (57.1% ), the sensitivity and specificity were 38.1% and 61.0%, respectively with a cutoff of 8.00 x 10-16 mol/L, hs-CRP levels within 6 months after transplantation tended to be higher than those beyond 6 months [(2.39 ± 3.90) mg/L vs. (1.34 ± 2.73) mg/L, P=0.069] . hs-CRP concentrations in patients with rejection were similar as patients without rejection (2.995 mg/L vs. 1.833 mg/L, P=0.138). The incidence of rejeetion was similar in patients with two higher biomarkers (5/20,25%) compared to patients with two low biomarkers (3/26, 11.5%, P=0.232). Conclusions NT-proBNP level decreased after transplantation. Although increased NT-proBNP coneentrations were related to rejection, the diagnostic capacity was low. Elevated hs-CRP concentrations were not related to rejection after heart transplantation.

Objective To observe the effect of sirolimus-based immunosuppression administered on heart transplant recipients with chronic renal dysfunction.Methods From June 2004 to December 2008,standard calcineurin inhibitors( CNI)-based immunosuppressive regimen was changed to reduced-dose CNI plus sirolimus due to CNI-related chronic renal dysfunction in 20 out of 138 cardiac transplant recipients at Fuwai Hospital. The standard immunosuppressive regimen included steroid, CNI (cyclosporine or tacrolimus),and mycophenolate mofetil or azathioprine. Sirolimus was started at 0.75 - 1.50 mg/d with titration to achieve levels of 5 -15 μg/L,and CNI dose was reduced gradually to 1/2 -2/3 of the baseline level.Patients were followed for changes in renal function,lipid level and clinical side effects related to immunosuppressive therapy.Endomyocardial biopsy (EMB) was performed routinely at 3 weeks,3,6 and 12 months after transplantation.EMB was also performed at 3 months after regimen change within 1 year post-transplantation or when rejections were suspected in patients beyond 1 year post-transplantation.Echocardiography was performed for monitoring purpose.Results The mean follow-up after regimen change was (7.9 ±6.3) months.Final sirolimus dose was (0.89 ± 0.22) mg/d and blood drug level was (7.6 ±3.8 ) μg/L.Cyclosporine dose was reduced from ( 191.7 ± 60.0) mg/d to ( 123.6 ± 34.8 ) mg/d,with blood drug concentation reduced from ( 175.5 ± 58.0) μg/L to ( 111.9 ± 56.0) μg/L in 18 patients ( P ＜ 0.01 ).Tacrolimus average dose was reduced from 4.25 mg/d to 3.00 mg/d,with blood drug concentation reduced from 13.5 μg/L to 10.5 μg/L in 2 patients.Serum creatinine level fell from ( 160.4 ± 25.5 ) μmol/L to ( 134.4 ± 26.8 ) μmol/L ( P ＜ 0.01 ) and urea nitrogen fell from ( 13.8 ± 4.7 ) μmol/L to ( 10.4±3.0 )μmol/L(P ＜0.01 )at one month after regimen change.Twenty two EMBs were performed in 11 patients within 1 year post-transplant,there were 4 episodes of acute rejecte ( ISHLT grade 2).Twenty patients are all alive and cardiac function was normal.The most common side effect was hyperlipidemia,and triglycerides,total cholesterol and low density lipoprotein levels were significantly increased at 1 month post regimen change(P ＜ 0.05 or P ＜ 0.01 ).Leukocyte,hemoglobin and platelet as well as liver function remained unchanged at 1 month post regimen change ( all P ＞ 0.05).Conclusion Our results show that change from CNI-based immunosuppressive regimen to reduced-dose CNI plus sirolimus is an effective and safe approach for the management of patients with CNI-related chronic renal dysfunction,leading to an improvement in renal function without compromise in anti-rejection efficacy and with tolerable side effects.

OBJECTIVETo evaluate the efficacy and safety of endoscopic mucous resection with transparent cap (EMR-Cap) and endoscopic multi-band mucosectomy (MBM) in the treatment of early esophageal cancer and precancerous lesion.

METHODSA retrospective study was performed to review 30 EMR-Cap cases from December 2008 to December 2009 and 32 MBM cases from January 2010 to January 2011 of early esophageal cancer and precancerous lesions. The differences between these two techniques in efficacy, safety, and cost were compared.

RESULTSIn EMR-Cap group, the median resection time was 26(10-56) min and median procedure time was 43(22-81) min, significantly longer than those in MBM group [10(7-18) min and 32(28-45) min, P=0.036 and 0.038, respectively]. There were no significant differences between the two groups in total thickness and depth of resected lesions (P>0.05). In EMR-Cap group, the median cost was significantly higher than that of MBM group [(5466±354) vs. (4014±368) RMB, P=0.008)].

CONCLUSIONSEMR-Cap and MBM are minimally invasive, safe and effective methods in the treatment of early esophageal cancer and precancerous lesions. Compared to the EMR-Cap, MBM is simple with shorter treatment time and lower cost.

Aged ; Endoscopy ; methods ; Esophageal Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Precancerous Conditions ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the value of transbronchial needle aspiration (TBNA) combined with transesophageal endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of mediastinal and pulmonary hilar lesions as well as in the lymph node staging (N staging) of lung cancer.

METHODS129 patients with mediastinal and pulmonary hilar lesions underwent either TBNA or EUS-FNA with cytological needle aspiration. The samples obtained from TBNA or EUS-FNA were examined by both cytologiy and histopathology.

RESULTSOf the 129 patients, 59 underwent TBNA and 70 EUS-FNA. The diagnostic rate were 84.7% (50/59) by TBNA and 94.3% (66/70) by EUS-FNA, resepectively. The diagnosis of 116 (89.9%) patients were confirmed by either TBNA or EUS-FNA. The pathological and cytological diagnostic rates were 92.2% (107/116) and 88.0% (102/116), resepectively. The diagnostic rate was elevated by 8.4% (9/107) through pathological examination. The histological classification rates by cytological and pathological examination were 73.8% (76/116) and 89.3% (92/103), respectively. The diagnostic rate of histological classification was elevated by 35.5% (27/76) through pathological examination.

CONCLUSIONThe combination of TBNA and EUS-FNA can improve the diagnostic rate for wider mediastinal and pulmlonary hilar lesions. Pathological examination of the samples obtained from the TBNA and EUS-FNA can elevate not only the rate of diagnosis but also the rate of histological classification.

Adenocarcinoma ; diagnostic imaging ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; methods ; Biopsy, Needle ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; Endosonography ; methods ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; Male ; Mediastinal Neoplasms ; diagnostic imaging ; pathology ; secondary ; Mediastinum ; Middle Aged ; Neoplasm Staging ; Small Cell Lung Carcinoma ; diagnostic imaging ; pathology ; Young Adult

OBJECTIVE: To study the effect of rehabilitation treatment based on the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) Core Sets on activities of daily living in children with cerebral palsy. METHODS: The children with cerebral palsy were divided into an observation group ( RESULTS: There was no significant difference in the scores of the WeeFIM and Social-Life Abilities scales between the two groups before treatment ( CONCLUSIONS The rehabilitation treatment regimen for cerebral palsy based on the CF-CY Core Sets pays more attention to the influence of environmental factors in the process of rehabilitation and can effectively improve the activities of daily living of children with cerebral palsy.
Activities of Daily Living ; Adolescent ; Cerebral Palsy ; Child ; Child, Preschool ; Disability Evaluation ; Humans ; International Classification of Functioning, Disability and Health ; Prospective Studies