BACKGROUNDPrehospital delay remains one of the main causes of reduced benefit of reperfusion therapy for patients with acute myocardial infarction (AMI). The largest proportion of prehospital delay involves the interval between the onset of symptoms and the decision to seek medical treatment. The purpose of this study was to examine the factors associated with the extent of care-seeking delay in Beijing for patients with AMI.

METHODSA structured interview was conducted in 102 patients with AMI in eight hospitals in Beijing.

RESULTSThe mean decision time in patients with AMI was (204 +/- 43) minutes, and prehospital delay time was (311 +/- 54) minutes. Only 34% of patients sought medical care within one hour and a further 36% of patients presented to one of the eight hospitals within two hours after onset. Educational level, atypical presentation of AMI, and family members at the site where AMI occurred were associated with longer delay time in seeking medical assistance (P < 0.05, respectively), whereas the intensity of chest pain was inversely related to patients' delay time (P < 0.01). Patients who perceived their family relationship as good, attributed their symptoms to AMI origin, knew the time-dependent nature of reperfusion therapy, or used emergency medical service tended to seek medical care in a more rapid manner (P < 0.05, respectively).

CONCLUSIONSPatients with AMI in Beijing delay seeking medical care to a great extent. Health education to increase the level of awareness of the target population at increased risk of AMI, including patients and their family members, is probably beneficial to reduce patients' care-seeking delay.

Cognition ; Female ; Humans ; Male ; Myocardial Infarction ; psychology ; therapy ; Patient Acceptance of Health Care ; Regression Analysis ; Time Factors

The severe fever with thrombocytopenia syndrome virus (SFTSV) is the causative pathogen of an emerging infectious disease severe fever with thrombocytopenia syndrome and a new member in the genus Phlebovirus of family Bunyaviridae. Immune responses and pathological lesions in SFTSV-infected Balb/C mice and hamsters were evaluated by inoculation of SFTSV at 105 TCID50 or 103 TCID50 per animal through four different routes of infection, including intravenous, intramuscular, intraperitoneal, and intracerebral injections. The vehicle control groups were also included. At different time points after the inoculation blood and plasma samples were collected. Blood cell counts, blood viral RNA copies, and plasma antibodies were detected by automatic blood cell counters, real-time PCR, and luminex assays, respectively. At two weeks post inoculation, the animals were sacrificed. Tissues including heart, liver, spleen, lung, kidney, intestine, muscle, and brain, were collected for pathological analyses. Results showed that the SFTSV could infect Balb/C mice and hamsters with SFTSV-specific immunoglobulin (Ig) M and IgG antibodies detected in plasma samples on day 7 post inoculation. The SFTSV-specific IgM levels peaked on day 7 post inoculation and then decreased, whereas the SFTSV-specific IgG levels started to increase on day 7 and then peaked on day 14 post inoculation. Pathological analyses indicated significant pathological lesions in liver and kidney tissues. In conclusion, SFTSV could can infect different strains of rodent animals and cause similar immunological and pathological responses.
Animals ; Antibody Specificity ; Bunyaviridae Infections ; blood ; pathology ; Cricetinae ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Leukocyte Count ; Mice ; Mice, Inbred BALB C ; Organ Specificity ; Phlebovirus ; immunology ; physiology

Osteoprotegerin (OPG), as a member of the tumor necrosis factor (TNF) superfamily, is a soluble secretary glycoprotein, which is accompanied with NF-κB receptor activator (RANK), NF-κB receptor activator ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) to form osteoprotegerin system. A large number of clinical and experimental studies have confirmed that osteoprotegerin system participates in physiological processes such as endothelial function, inflammatory reaction, oxidative stress and apoptosis, which is expected to be a biomarker for the occurrence, development, severity and long-term prognosis of coronary heart disease. In this paper, we summarized the biological effects and mechanism of the osteoprotegerin system in the occurrence and development of coronary heart disease and its future clinical application.

Objective To study the contents of puerarin in decoction with different compatibility ratios of Astragali Radix and Puerariae Lobatae Radix; To verify the rationality of compatibility ratios of Huangqi Gegen Decoction and Yu y e Decoction; To provide references for clinical medication. Methods Different compatibility ratios of Astragali Radix and Puerariae Lobatae Radix were set as 0:1, 1:1, 2:1, 3:1, 4:1, 1:2, 1:3, and 1:4. SinoChrom ODS-BP (4.6 mm × 250 mm, 5 μm) was used as the chromatographic column to detect the contents of puerarin;methanol-0.1% phosphoric acid (35:65) was used as the mobile phase with 0.5 mL/min flow rate; sample volume was 20 μL; the wavelength was 250 nm. Results The regression equation of puerarin was Y=66 449.269 1X-175 665.663 1 (r=0.999 6) in the range of 5 to 300 μg/mL, showing a good linear relationship. The repeatability, stability and recovery rate were fine as well. The contents of puerarin were (2.506 7±0.025 8)%, (2.526 7±0.071 2)%, (2.863 3± 0.086 4)%, (2.956 7±0.119 6)%, (2.835 0±0.078 7)%, (2.480 0±0.072 4)%, (2.530 0±0.064 8)%, and (2.183 3±0.128 9)% in different compatibility ratios of Astragali Radix and Puerariae Lobatae Radix with 0:1, 1:1, 2:1, 3:1, 4:1, 1:2, 1:3, and 1:4, respectively. Conclusion When the compatibility ratios of Astragali Radix and Puerariae Lobatae Radix are 2:1. 3:1, and 4:1, the contents of puerarin in decoction are the highest. This study verifies that the compatibility ratios of Astragali Radix and Puerariae Lobatae Radix in classical prescriptions are rational, which can be the optimal compatibility ratios in clinic.

The clinical manifestations,diagnosis and treatment process of the Gnathostoma infected patient were collected,and epidemiological investigation was carried out.The investigation results showed that the patients with eating wild boar in stomach nematode,the worms were removed by gastroscopy and examined by microscopy,small spines in the body,the spines of the posterior part and the posterior part of the body are thinner.The patient was confirmed cases of infection by Gnathostoma.

OBJECTIVE: To estimate the significance of myocardial collagen I in the early acute myocardial ischemia of human. METHODS: The myocardial paraffin block had normal group, early myocardial ischemia group and myocardial infarction group. The myocardial collagen I was observed with immunohistochemical staining and analyzed by half-quantity. RESULTS: The similar expression of collagen I was observed in the cytoplasm and nucleolus in two groups. CONCLUSION The collagen I appeared in the myocardium of early acute myocardial ischemia of human. It may be an important index for postmortem diagnosis of the early acute myocardial ischemia.
Collagen Type I/metabolism* ; Death, Sudden, Cardiac ; Forensic Pathology ; Humans ; Myocardial Ischemia/metabolism* ; Postmortem Changes ; Time Factors

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the brain functional reorga-nization of aphasia after stroke, with functional magnetic resonance imaging (fMRI). Methods From January, 2017 to February, 2018, six eligible stroke patients with aphasia were recruited in experimental group, and nine age-gender matched healthy adults were recruited in healthy control group. Subjects in both groups received task-fMRI, and the experimental group was assessed with Chinese version of Western Aphasia Battery (WAB) examination before and after rTMS treatment. Four patients underwent rTMS at the right inferior frontal gyri pars triangularis marked by neuro-navigation-guided system, 1 Hz, five times per week for two weeks. The fMRI data were processed by SPM 12. The differences of brain activation and voxel changes be-tween two groups were compared. The fMRI data including the differences in brain activation, voxel volume and activation voxel indices (AVI) and WAB scores were analyzed before and after rTMS. Results The cerebral hemisphere activation in the experimental group was higher than that of the healthy control group, including the regions of interest (ROI) such as bilateral supplementary motor area and middle frontal gyrus, and the non-ROI (n-ROI) such as left praecuneus, left postcentral gyrus, right hippocampus, right paracingulate cor-tex, etc., while the activation reduced in the areas of left pars triangularis and n-ROI such as left calcarine fissure cortex, left gyrus lingualis, the right anterior cingulate and the paracingulate cortex. Cases 1 and 2 had shorter course of disease, smaller lesion volume, and activation increased in bilateral cerebral hemispheres before treat-ment. AVI showed that their hemispheric dominance was right, and activation reduced in bilateral cerebral hemi-sphere after treatment, but the high-efficiency language function area of ROI, such as the left pars triangularis, turned from inactive to active, and the hemispheric dominance lateralized from right to left, with the improve-ment of language function. For the case 3 and case 4, the disease courses were longer, the lesions sizes were larg-er, and both cerebral hemisphere activations were reduced before treatment. AVI showed that the hemispheric dominance of case 3 was right and was left in case 4. After treatment, bilateral cerebral hemispheres were activat-ed more than before, and the hemispheric dominance of language function was in the right hemisphere; the left middle frontal gyrus and right middle temporal gyrus were activated from no activation before treatment in case 3. The activation of the supplemental motor area on the right side was increased. In case 4, there was no activa-tion in ROI before treatment. After treatment, the bilateral supplementary motor area, right pars opercularis, and the right middle temporal gyrus were activated. Conclusion Low-frequency rTMS could improve the language function by optimizing bilateral cerebral hemisphere brain areas related with language function in patients with aphasia after stroke.

The aim is to observe the expression of human factor VIII gene in mice tranduced in vivo and ex vivo. The vector pLNC-FVIII BD was generated by cloning a B-domain-deleted (760aa-1639aa) FVIII cDNA (FVIIIBD cDNA) into retroviral vector pLNCX. 2 x 10(6) of mouse bone marrow stroma cells transduced by LNC-FVIII BD were infused into 4-week-old BALB/c mice by tail-vein injection. pLNC-FVIII BD was conjugated with PAMAM dendrimer to form complex PAMAM-pLNC-FVIII BD, with which C57BL/6J were injected by tail vein (200 micro l contained 15 micro g/mouse) and sacrificed at days 1, 2, 7, 14, 21 and 28, respectively after injection. Tissue such as liver, spleen, lung and kindney were harvested, with which the transcription were detected by means of RT-PCR. In addition, blood was collected to be measured human FVIII Ag, human FVIIIc and anti-FVIII of human inhibitors. The results showed that the highest level of human FVIII in the recipient BALB/c mice was 8.6 +/- 1.44 ng/ml detected on the first day post-injection; anti-FVIII antibodies were detected from the first week post-injection, and then the level of FVIII Ag decreased and cannot be measured on the fourth week. In the C57BL/6J mice physiological level of human FVIII was expressed in plasma at 48 hours after injection and the average human FVIIIc was 0.62 U/ml and the average human FVIII Ag was 115.5 ng/ml, and gradually reduced later. Anti-FVIII of human inhibitors was not revealed all the time. Syngene image scanning demonstrated that the transcription of the human FVIII BD cDNA occurred mainly in spleen and lung, and secondarily in liver and kidney. No side effects of PAMAM-pLNC-FVIII BD were observed in mice tissue by pathological examination at 4 weeks. In conclusion, retrovirus-transduced bone marrow stroma cells effectively produced human FVIII after ex vivo transduction, but the development of anti-FVIII antibodies in recipient mice influenced the expression level. The human FVIII gene can successfully be transduced in vivo through injecting PAMAM-pLNC-FVIII BD cDNA into mice intravenously. There was physiological level expression of human FVIII in plasma at 48 hours after injection and the average human FVIIIc is 0.62 U/ml and the peak in the six mice was 0.89 U/ml, and gradually reduced later.
Animals ; DNA, Complementary ; analysis ; Factor VIII ; genetics ; Genetic Therapy ; Hemophilia A ; therapy ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Transfection

OBJECTIVETo investigate the antagonistic efficacy of tetrandrine (TET) on lung injury induced by acute paraquat poisoning.

METHODSMale Wistar rats were randomly divided into three groups (control group, non-treatment group and treatment group). The tetrandrine of 30 mg/kg was given by gastric lavage six hours after 32 rats were intraperitoneally injected with paraquat 15 mg/kg (treatment group). Then the same dose of tetrandrine was given once a day. Normal saline of the same volume was given by gastric lavage in another 32 rats intraperitoneally injected with paraquat 15 mg/kg (non-treatment group). Seven rats were intraperitoneally injected by normal saline as the control group. Levels of maleic dialdehyde (MDA), activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in plasma and the lung homogenate of three groups were determined at 3 d, 7 d, 14 d and 21 d after exposure to paraquat. Histological changes of the lungs were observed.

RESULTSThe levels of MDA at 3 d both in plasma [(3.65 +/- 0.44) nmol/ml] and the lung homogenate [(9.54 +/- 0.92) nmol/mg pro] of the non-treatment group significantly increased compared with the control group (P < 0.01), the activities of GSH-Px and SOD in plasma at 3 d were significantly less than the control group (P < 0.05 or P < 0.01), the activities of GSH-Px (3 d, 7 d) and SOD (7 d, 14 d) in the lung homogenate were significantly less than the control group (P < 0.05). There were no significant difference in the levels of MDA both in plasma and the lung homogenate between the treatment group and the non-treatment group (P > 0.05). The SOD activities of treatment group on the third day was significantly increased compared with the non-treatment group (P < 0.01 or P < 0.05). Although the activities of GSH-Px in plasma and the lung homogenate of the treatment group on the third day were increased, there was no significantly difference compared with the non-treatment group (P > 0.05). The integral score of pulmonary fibrosis in the treatment group were significantly lower than in the non-treatment group (P < 0.01).

CONCLUSIONTET has antagonistic effect against acute toxicity of paraquat through significant reduction of pulmonary fibrosis.

Acute Disease ; Animals ; Benzylisoquinolines ; therapeutic use ; Disease Models, Animal ; Glutathione Peroxidase ; metabolism ; Lung ; drug effects ; metabolism ; pathology ; Lung Injury ; chemically induced ; drug therapy ; metabolism ; pathology ; Male ; Malondialdehyde ; metabolism ; Paraquat ; poisoning ; Rats ; Rats, Wistar ; Superoxide Dismutase ; metabolism

OBJECTIVETo detect the changes of central venous-to-arterial carbon dioxide difference (P(cv-a)CO(2)) during early goal-directed therapy (EGDT) in patients with septic shock and evaluate its' value in predicting adequate resuscitation and prognosis.

METHODSFrom April 2009 to October 2010, 26 septic shock patients were enrolled in the study. EGDT was performed in all the patients immediately after enrollment. According to the whether they achieved early goal with in the 6 hour or not, patients were separated to EGDT achievement and un-achievement groups. At the onset and after the 6 hours EGDT, mean arterial pressure (MAP), cardiac index (CI), central venous oxygen saturation (ScvO(2)), oxygen delivery (DO(2)), oxygen consumption (VO(2)), oxygen extraction ratio (O(2) ext), lactate, P(cv-a)CO(2) were recorded. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score and 28 day mortality were compared between 2 groups.

RESULTSThere were no significant difference of age and sex between the 15 patients who achieved early goals and 11 patients who did not. EGDT un-achievement patients had higher APACHE II score (21 ± 5) and 28 day mortality (9/11) when compared with EGDT achievement patients (t = 2.985, χ(2) = 4.547, P < 0.05). In EGDT un-achievement group, MAP, CI, DO(2), VO(2), O(2)ext, ScvO(2), Lac, P(cv-a)CO(2) were comparable between the onset and 6 hours after EGDT. However, in EGDT achievement group, MAP ((90 ± 9) mmHg (1 mmHg = 0.133 kPa)), CI ((4.0 ± 1.8) L×min(-1)×m(-2)), DO(2) ((596 ± 274) ml×min(-1)×m(-2)), ScvO(2) (76.9% ± 4.1%) increased, and P(cv-a)CO(2) ((4.2 ± 2.7) mmHg) decreased significantly after 6 hours of EGDT (t values were -3.393, -2.985, -2.103 and -3.195 respectively, all P < 0.05). The changes of P(cv-a)CO(2) between the onset and 6 hours after EGDT, demonstrated high value for predictability of outcome, according to the area under the ROC curve (AUC) was 0.839 (P = 0.004). As a predictor for death, increasing of P(cv-a)CO(2) after 6 hours of EGDT has a sensibility of 100% and specificity of 60%.

CONCLUSIONSIncreasing of P(cv-a)CO(2) after EGDT purports inadequate tissue perfusion in patients with septic shock. Changes of P(cv-a)CO(2) during EGDT demonstrated a useful tool to evaluate adequate resuscitation and prognosis.

Aged ; Aged, 80 and over ; Blood Gas Analysis ; Carbon Dioxide ; blood ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Resuscitation ; Shock, Septic ; blood ; therapy