Diabetes mellitus is an independent risk factor for ischemic stroke. Epidemi-ological studies have shown that intensive glucose control can reduce stroke risks in patients with type 2 diabetes. However, the current prospective clinical trials have failed to validate a definite causal relationship between them. This article reviews the clinical trials about the roles of intensive glucose control in patients with type 2 diabetes in the primary and secondary prevention of stroke.

OBJECTIVETo explore the function of vascular endothelial cell (VEC) in patients with coronary heart disease (CHD) of Xin-blood-stasis syndrome.

METHODSSome vasoactive substances produced by VEC were detected and analyzed in patients with CHD of or without Xin blood stasis syndrome in group A (n=112) and group B (n=108) respectively, also in patients with non-CHD but of Xin-blood-stasis syndrome in group C (n=110), and healthy persons in group D (n=100), including nitric oxide (NO), endothelin (ET), angiotensin H (Ag II), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule -1 (sVCAM-1).

RESULTSThe abnormality degree of ET, Ag II , sICAM-1 and sVCAM-1 in various groups showed such a tendency as group A> group B> group D (P < 0.01 or P < 0.05), while no significant difference in these criteria between group A and group C was shown (P > 0.05).

CONCLUSIONThe vasoactive substances secreted by VEC are closely related to the formation and progression of CHD, and are likely to be important pathological markers of blood-stasis syndrome in CHD.

Adult ; Aged ; Aged, 80 and over ; Coronary Artery Disease ; physiopathology ; Diagnosis, Differential ; Endothelial Cells ; metabolism ; physiology ; Endothelins ; metabolism ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; metabolism ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nitric Oxide ; metabolism

A new phenethanol, (2'R)-4-(2', 3'-dihydroxy-3'-methyl-butanoxy)-phenethanol (1), along with other eleven known benzene derivatives (2-12) were isolated from the roots, stems and leaves of Clausena excavata (Rutaceae). Compounds 3 and 4 are new natural products, and compounds 5-8, 10-12 were isolated from C. excavata for the first time. Their structures were elucidated on the basis of MS, 1D and 2D NMR spectroscopic analyses including HSQC, COSY and HMBC experiments. 1 was tested for its cytotoxicities against A549, HeLa and BGC-823 cancer cell lines, and antimicrobial activities against Candida albicans and Staphylococcus aureus. The results showed that 1 did not exhibit cytotoxic and antimicrobial activities.
Benzene Derivatives ; chemistry ; Candida albicans ; drug effects ; Cell Line, Tumor ; Clausena ; chemistry ; HeLa Cells ; Humans ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Leaves ; chemistry ; Plant Roots ; chemistry ; Plant Stems ; chemistry ; Staphylococcus aureus ; drug effects

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.

Objective To study a possible correlation between the duration of reproductive period ( from puberty to menopause) and the prognosis of ischemic stroke. Methods Female in-patients with acute ischemic stroke confirmed by CT/MRI in the Neurology Department of the First Affiliated Hospital of Zhengzhou University from 09/03/2006 to 08/30/2008 were enrolled in this study. The probable risk factors of prognosis were analyzed and recovery was assessed by modified Rankin score (MRS) at 6 months followup. Multivariate Logistic regression was used for statistic analysis. Results 371 female patients were enrolled. The average age was (66. 2 ± 10. 0) years; average menopause age was (48. 5 ± 3.9 ) years and average duration of reproductive period was (33.3 ± 4. 3) years. There is a negative correlation between the duration and MRS (OR =0. 285, 95% CI: 0. 095-0. 850, P =0.024). There is no correlation between menopause age and prognosis of stroke. Conclusions Duration of reproductive period is a predictor for prognosis of ischemic stroke. Patients with longer reproductive period have better prognosis.

Objective To investigate the application of statins in secondary prevention of ischemic stroke and transient ischemic attacks (TIA) in different risk groups,and to identify the factors influencing the compliance of statins. Methods Data were prospectively collected on consecutively encountered ischemic stroke or TIA patients admitted to the First Affiliated Hospital of Zhengzhou University from April 2009 to January 2010.All clinical characteristics and possible factors influencing the compliance of statins were collected; the application of statins was investigated at 3-month follow-up.The multivariate Logistic regression analysis was used for the analysis of influence factors of the compliance of statins.Results All 369 patients were collected,52.8％ of cases were prescribed statins for therapy during hospitalization.The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 25.0％ (16/64),44.1％ (30/68) and 71.4％ (135/189),respectively. Logistic regression analysis showed that the statins application during hospitalization was associated with diabetes history ( P =0.032,OR =1.789,95％ CI 1.052-3.043 ) and the presence of carotid vulnerable plaques(P =0.000,OR =5.308,95％ CI 3.340-8.434).The general application rate of statins was 22.3％ (81/363),which was significantly lower than that during hospitalization. The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 9.7％ ( 6/62 ),25.8％ (17/66) and 29.4％ (55/187) respectively.Logistic regression analysis showed that good compliance of statins was associated with discharge instructions on statins application ( P =0.000,OR =34.852,95％ CI 14.673-175.452 ). Conclusions The compliance of statins in secondary prevention of ischemic stroke and TIA is poor,and there is still a large gap between clinical practice and guidelines; Discharge instructions on statins application increase the compliance of statins.

OBJECTIVETo explore the effect of minimally invasive Ivor-Lewis esophagectomy on acute phase responses in patients with esophageal carcinoma.

METHODSForty-eight patients with middle or low thoracic esophageal carcinoma underwent Ivor-Lewis esophagectomy. The patients were divided into small incision group (n = 25) and conventional group (n = 23) according to the patients' will. Serum levels of acute phase proteins C reactive protein (CRP), haptoglobin (HPT), α₁-acid glycoprotein (α₁-AG), ceruloplasmin (CER), transferrin (TRF), β₂-microglobulin (β₂-MG), album protein (ALB), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) were measured and compared on 1st day before operation, at 18 hours as well as 3rd and 7th day after operation.

RESULTSThere was no significant difference in all the acute phase proteins indicators and IL-6 between the small incision and conventional groups at each time points after operation (P > 0.05). In both groups the levels of CRP, α₁-AG and HPT were significantly higher after operation than before operation (P < 0.05). The levels of ALB and TRF were significantly lower after operation than before operation (P < 0.05). The levels of CER and β₂-MG were not significantly different during perioperative period (P > 0.05). The level of TNF-α was significantly higher in the small incision group than that in the conventional group at the 18 hours postoperationally (P < 0.05), and were not significantly different on the other time points between the two groups (P > 0.05).

CONCLUSIONCompared with conventional operation, the small incision Ivor-Lewis esophagectomy do not significantly alleviate the stress of the surgical trauma in patients. Unchanging the essence of operation, if one is trying to minimize the stress caused by surgery on patients, the key factor is not the size of incision. An effective approach should be found in other operation-related factors.

Acute-Phase Proteins ; metabolism ; Aged ; C-Reactive Protein ; metabolism ; Carcinoma, Squamous Cell ; blood ; surgery ; Ceruloplasmin ; metabolism ; Esophageal Neoplasms ; blood ; surgery ; Esophagectomy ; methods ; Female ; Haptoglobins ; metabolism ; Humans ; Interleukin-6 ; blood ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Orosomucoid ; metabolism ; Perioperative Period ; Serum Albumin ; metabolism ; Serum Albumin, Human ; Transferrin ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; beta 2-Microglobulin ; blood

Systematical studies are lacking on the influencing factors and mechanisms of the heparin enhanced sperm capacitation, although many studies have shown that heparin enhanced sperm capacitation. The effect of heparin concentration and exposure time, incubation temperature and co-culture with oviductal epithelial cells or cumulus cells on goat sperm capacitation were investigated in this study. The motility, membrane and acrosome integrity and capacitated percentage of goat spermatozoa were assessed after different heparin treatments, and rates of fertilization and embryo cleavage were compared after in vitro insemination of oocytes with spermatozoa capacitated by different heparin treatments. The major results are summarized as follows: 1) When spermatozoa were capacitated with heparin at 5, 10, 25, 50 and 100 microg/mL for 45 min, 50 and 100 microg/mL heparin treatments produced the highest capacitated percentages of 55% and 56%, respectively, but the percentage of spermatozoa with intact acrosomes in the 100 microg/mL heparin treatment decreased significantly (P < 0.05) in comparison with that in the control group, indicating that the optimal heparin concentration for goat sperm capacitation would be 50 microg/mL. 2) Capacitated percentage of spermatozoa increased with extension of treatment time when goat sperm were treated with 50 microg/mL heparin for 0, 10, 20, 30, 45, 60 or 120 min. Although heparin treatments for 45 to 120 min did not differ significantly (P > 0.05) in capacitated sperm percentages, sperm motility and membrane integrity decreased significantly when treated with heparin for 120 min. This suggested that the optimal exposure time of heparin at 50 microg/mL for goat sperm capacitation would be 45 to 60 min. 3) Significantly higher capacitated percentages of spermatozoa were obtained when goat sperm were treated at 42 and 38.5 degrees C than at 15 and 37 degrees C, but sperm motility and acrosome integrity were significantly lower when spermatozoa were treated at 42 degrees C than they were treated at other temperatures. Temperature of 38.5 degrees C would, therefore, be the optimal temperature for goat sperm capacitation. 4) The capacitated percentage of spermatozoa was significantly higher when goat sperm were co-cultured with oviductal epithelial cells than when treated with heparin alone or co-cultured with cumulus cells, but sperm motility and membrane and acrosome integrity did not differ significantly among the three treatments. Rates of fertilization (91.3%) and cleavage (72.2%) were significantly higher in the oviductal epithelial cell co-culture group than those in the heparin alone group. This indicated that co-culture with oviductal epithelial cells significantly enhanced goat sperm capacitation by heparin treatment.
Acrosome Reaction ; drug effects ; physiology ; Animals ; Coculture Techniques ; Epithelial Cells ; cytology ; Fallopian Tubes ; cytology ; Female ; Fertilization in Vitro ; Goats ; Heparin ; pharmacology ; Male ; Sperm Capacitation ; drug effects ; physiology ; Sperm Motility ; Spermatozoa ; cytology ; physiology

BACKGROUNDThe awareness, treatment and prevention of chronic diseases are generally poor among the elderly population of China, whereas the prevention and control of chronic diseases in elderly veteran communities have been ongoing for more than 30 years. Therefore, investigating the awareness status of chronic disabling neurological diseases (CDND) and common chronic diseases (CCD) among elderly veterans may provide references for related programs among the elderly in the general population.

METHODSA cross-sectional survey was conducted among veterans ≥60 years old in veteran communities in Beijing. The awareness of preventive strategies against dementia, Alzheimer's disease (AD), Parkinson's disease (PD), sleep disorders, cerebrovascular disease (CVD) and CCD such as hypertension, and the approaches used to access this information, including media, word of mouth (verbal communication among the elderly) and health care professionals, were investigated via face-to-face interviews.

RESULTSThe awareness rates for CCD and CVD were approximately 100%, but that for AD was the lowest at <10%. The awareness rates for sleep disorders, PD and dementia, were 51.0-89.4%. Media was the most commonly selected mode of communication by which veterans acquired knowledge about CCD and CVD. Media was used by approximately 80% of veterans. Both health care professionals and word of mouth were used by approximately 50% of veterans. With respect to the source of information about CDND excluding AD, the rates of the use of health care professionals, word of mouth and media were 10.6-28.2%, 56.5-76.5%, and approximately 50%, respectively.

CONCLUSIONSThe awareness of CDND among elderly veterans was significantly lower than that of CCD. More information about CDND should be disseminated by health care professionals. Appropriate guidance will promote the rapid and extensive dissemination of information about the prevention of CDND by media and word-of-mouth peer education.

Aged ; Aged, 80 and over ; Awareness ; physiology ; Chronic Disease ; prevention & control ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Nervous System Diseases ; prevention & control ; Veterans ; statistics & numerical data

OBJECTIVETo evaluate the feasibility and curative effect of thymectomy for myasthenia gravis (MG) by video-assisted thoracoscopic surgery (VATS) through right anterior-lateral approach.

METHODSFifty-six patients of MG were treated with thoracoscopic thymectomy and mediastinal fat dissection through right anterior-lateral approach from August 2001 to October 2007. The feasibility, safety, complication and remission for MG were retrospectively analyzed.

RESULTSFifty-five operations were completed by VATS. The mean operative time and blood loss were (96.2 +/- 52.1) min and (68.7 +/- 21.4) ml, respectively. The brachiocephalic vein injury by the electric coagulator occurred in two cases and one of them performed thoracotomy for homeostasis, the other performed ligation. The postoperative pathology showed hyperplasia in 38 cases, atrophy in 5 cases, thymoma in 12 cases and cyst of thymus in 1 case. And the operative complication included one myasthenia crisis (1.8%) at the third day and one death (1.8%) at the eighth day because of postoperative hemorrhage. The average length of stay was (7.9 +/- 2.9) d. All cases were followed up from one to seventy months. Eight (14.3%) of complete remission, 39 cases (69.6%) of partial remission and 7 cases (12.5%) of no change were found. The total effective rate was 83.9%.

CONCLUSIONSThoracoscopic thymectomy through right anterior lateral approach is technically feasible, safe and minimally invasive. It has a high remission rate for MG.

Adolescent ; Adult ; Aged ; Child ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; surgery ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Thymectomy ; methods ; Treatment Outcome