OBJECTIVESTo evaluate the clinical characteristics, in-hospital and three-year outcome in ST-elevation myocardial Infraction (STEMI) patients receiving conservative treatment (CT), thrombolytic treatment (TT) and primary percutaneous coronary intervention (PCI) in Beijing.

METHODSThis 12-month prospective, multicenter registry study was conducted in 19 hospitals with 808 patients with STEMI in Beijing between Jan. 2006 and Dec. 2006, 518 (64%) received PCI, 106 (16.1%) received TT and 184 (22.8%) received CT therapy. Patients were followed up for 3 years.

RESULTSAt baseline, the age of patients in CT group [(64.5 ± 13.5) years] was significantly higher than those in TT group p(57.9 ± 11.0) years] and in PCI group [ (60.4 ± 12.3) years, all P<0.01]; and the median time from symptom onset to hospital in CT group (207 min) was significantly longer than those in TT group (130 min) and PCI group (130 min, all P<0.01). Emergency Medical Service (EMS) use was significantly higher in PCI group (184/518, 35.5%) than in CT group (46/184, 27.3%) and TT group (29/107, 25.0%, all P<0.05). Health insurance holder was the highest in PCI group (P<0.01). PCI was performed less frequently than thrombolytic therapy [66.6% (345/518) vs. 80.2% (85/106)m P=0.02] during off-hours and more frequently performed in tertiary hospitals than in secondary hospitals[66.8%(437/651) vs. 52.6% (81/154, P<0.01)]. The in-hospital mortality and the cardiovascular mortality at 3 year after hospital discharge was significantly higher in CT group [9.2% (17/185) and 9.4% (15/159)] than in PCI group [3.5% (18/518), 4.5% (20/446)] and TT group [6.6% (7/106), 2.3% (2/86), all P<0.01]. Patients in PCI group had the highest adherence level of aspirin, β-blocker, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers or statins at 3-years follow-up (all P<0.05). Multivariable Cox proportional hazards regression analysis showed that only PCI was associated with lower risk of cardiovascular death (HR-0.40, 95% CI:0.21-0.73, P<0.01).

CONCLUSIONSSocial and clinical setting may affect the physician's decision to provide reperfusion therapy in Beijing for STEMI patients. Better adherence of secondary preventive drugs and lower cardiovascular death are observed in STEMI patients receiving PCI during the 3-year follow-up

Aged ; China ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Percutaneous Coronary Intervention ; Prognosis

OBJECTIVETo study the proteomic change in lymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion.

METHODSTwenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 degrees C), rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0 x 10(8) CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its extracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy.

RESULTSAbout 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 proteins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate kinase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously.

CONCLUSIONSThere is obvious proteomic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.

Animals ; Burns ; metabolism ; microbiology ; Lymphocytes ; metabolism ; Male ; Proteome ; Rabbits ; Staphylococcal Infections ; etiology ; metabolism

OBJECTIVETo investigate the expression of interleukin-10 (IL-10) mRNA in gingival tissue of active and stable stage in patients with adult periodontitis.

METHODS12 patients with acute abscesses of the periodontium, 12 patients after periodontal initial treatment and 6 periodontal healthy patients having extraction of impacted wisdom tooth were randomly divided into group A (active stage group), group B (stable stage group) and the control group. Biopsies of gingival tissues were collected from every subject of three groups. Technique of in situ hybridization was applied to observe the expression of IL-10 mRNA in the biopsies from three groups semi-quantitatively.

RESULTSIL-10 mRNA was positively expressed in lymphocytes, macrophages and fibroblasts. The quantity of IL-10 mRNA of group A was the lowest in the three groups and was significantly lower than that of control group and group B respectively (P < 0.01). The quantity of IL-10 mRNA of group B was the highest in the three groups and was significantly higher compared with the control group and group A (P < 0.01).

CONCLUSIONThe quantities of IL-10 mRNA expression are closely related with various clinical states of periodontitis.

Case-Control Studies ; Chronic Periodontitis ; metabolism ; Gingiva ; metabolism ; Humans ; Interleukin-10 ; metabolism ; RNA, Messenger ; metabolism

BACKGROUNDA patented remote controlled capsule (RCC) has recently been developed to provide noninvasive drug delivery to selected sites in the human gut that allows assessment of regional gastrointestinal (GI) drug absorption under a normal physiological environment. The objective of this study was to investigate the rate and extent of aminophylline absorption after site-specific delivery of the drug in the GI tract using RCC and a magnetic marker monitoring (MMM) technique.

METHODSThis study was conducted in twelve healthy male subjects, in a three-treatment, randomized, crossover manner with a 7-day washout. Eligible subjects received a 150 mg aminophylline dose through an oral administration, or via a remote controlled capsule, delivered to the small bowel or ascending colon. MMM was employed to monitor the GI transit of the RCC, and the radio-frequency signal was used to activate capsules at target sites. Blood samples were obtained at regular intervals until 24 hours post dose/activation. Plasma theophylline concentrations were measured by a TDx System Analyzer. A comparison of the PK profile with the oral dosing route of aminophylline was performed after delivery to the small bowel and colon.

RESULTSThe RCC was well tolerated in volunteers. The mean capsule activation time for the small bowel and ascending colon was 2.07 hours and 6.08 hours post dose. Aminophylline had similar absorption profiles from the small bowel compared with the stomach, with an area under the curve (AUC(t)) ratio of 92% vs. the stomach, but a lower absorption profile from the ascending colon, with an AUC(t) ratio of 47.2% vs. the stomach.

CONCLUSIONSThe proprietary of the RCC and MMM technique offer the opportunity to obtain data on the intestinal absorption of a drug in humans under noninvasive conditions. Aminophylline is rapidly and efficiently absorbed from the small bowel. While colonic absorption was limited by the poor water condition although effective absorption was observed from the ascending colon. This provides an opportunity for rational development of modified-release formulations as well as alternative dosage forms.

Adult ; Aminophylline ; administration & dosage ; pharmacokinetics ; Capsules ; administration & dosage ; pharmacokinetics ; Colon ; metabolism ; Humans ; Intestine, Small ; metabolism ; Male ; Young Adult

OBJECTIVETo investigate the low-density lipoprotein cholesterol (LDL-C) levels in outpatients with coronary heart disease (CHD) visiting cardiology outpatient clinics of 8 hospitals in Beijing.

METHODSA total of 903 outpatients with CHD were enrolled from 4 three-tier hospitals and 4 two-tier hospitals in Beijing. All patients were asked to finish the questionnaire including demographic data, CHD history, the knowledge on cholesterol, and the use of statins. Blood lipid was examined and the LDL-C control rate and related factors were then analyzed.

RESULTSQuestionnaire was obtained from 876 patients [619 male: 70.7%, mean age: (64.9 ± 10.7) years old] and blood lipid data were available in 709 patients. The general LDL-C control rate was 36.9% (262/709) and was 13.5% (27/173) in very high risk CHD patients, and lower in patients treated in two-tier hospitals than patients treated in three-tier hospitals[31.3% (121/386) vs. 43.7% (141/323), P < 0.01], in female patients than in male patients [27.1% (60/261) vs. 41.3% (201/496), P < 0.01] and in diabetic patients than in non-diabetic patients [13.5% (27/200) vs. 44.7% (197/441), P < 0.01]. The LDL-C control rate was lower in patients less than 60 years old and patients over 80 years old than that in 60-70 years old patients and 70 - 80 years old patients (P < 0.05). LDL-C control rate was not affected by the history of hypertension, percutaneous coronary intervention or coronary artery bypass grafting, smoking, lipid examination frequency, knowledge on goal level of LDL-C, diet control and regularly physical exercising (all P > 0.05). There were 18.2% (129/709) patients not taking statins or not aware if they were taking statin or not. The main reason for not taking statin [47.9% (23/48)] was statin was no prescribed by doctors, followed by withdrawal by patients due to various reasons [27.1% (13/48)].

CONCLUSIONSLDL-C control rate was low in patients with CHD visiting cardiology outpatient clinics in Beijing. The CHD patients and cardiologists should be encouraged to achieve better LDL-C control by following lipid lowering guidelines and it is also important to improve the drug compliance among CHD patients.

Adult ; Aged ; Aged, 80 and over ; Cholesterol, LDL ; blood ; Coronary Disease ; blood ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo retrospectively analyze the clinical and electrocardiographic features of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).

METHODSThe clinical, electrocardiographic features and the efficacy of various therapies were analyzed in 31 patients (27 males) diagnosed as ARVC according to the criteria established by European Society of Cardiology.

RESULTSThe averaged age when the ARVC was first diagnosed was (34.7 +/- 9.4) years (19 - 58 years), palpitation was present in 28 patients (90.3%) and syncope in 13 patients (41.9%), a family history of sudden death was present in 1 patient. Dilatated right ventricle was documented in 29 patients by echocardiography and (or) magnetic resonance imaging (MRI), 2 of them with dilated left ventricles. ECG changes included: T wave inversion, mostly seen in precordial leads (100%); epsilon (epsilon) wave (54.8%); QRS duration >or= 110 ms in V(1) to V(3) (83.9%); reduced extremity amplitude (41.9%); the first degree of AV block (22.6%); sustained VT (100%) including 15 monomorphic VT (48.4%) and 16 polymorphic VT (51.6%). The mean values of QRS duration in leads of V(1 - 3) [(120.8 +/- 13.7) ms] was significantly longer than that in V(4 - 6) [(99.4 +/- 13.7) ms, P < 0.05]. Fourteen patients underwent radiofrequency catheter ablation (RFCA) with an immediate success rate of 78.6% (11/14). During follow up (18.3 +/- 10.2) months, VT reoccurred in 6 patients (54.5%). The remaining 17 patients were treated with conventional medications, 7 of them were medicated under implanted cardioverter defibrillator (ICD). During the follow-up (35.6 +/- 19.0) months, VT reoccurred in 11 patients (64.7%) and one patient died suddenly.

CONCLUSIONSARVC patients developed symptoms at mid-30s with significant ECG changes including appearance of an epsilon wave, T wave inversion and QRS duration >or= 110 ms in leads of V(1 - 3). The long term therapy efficacy was not satisfactory both for RFCA and conventional medications and ICD implantation should be recommended to patients with ARVC.

Adult ; Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; therapy ; Catheter Ablation ; Defibrillators, Implantable ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo study the relationship between IgG titer of pregnant women and hemolytic disease of newborn(HDN) with different blood groups.

METHODSFour hundred pregnant women, including pregnant women with type O blood, were selected from May 2014 to January 2015 in our hospital for inspection and a couple of different blood groups, the IgG titer of pregnant women were detected in the inspection process. According to neonatal HDN, newborns were divided into 2 groups: HDN group(85 cases) and non-HDN group(315 cases). The incidence of postpartum neonatal hemolytic disease was tracked and the correlation of IgG titers with HDN were systematically analyzed.

RESULTSIn the production and inspection process, the IgG titer in pregnant women was divided into <1:64, 1:64, 1:128, 1:256 and greater than or equal to 1:512 five groups. the comparison of HDN incidence rate in 4 groups of IgG titer >64 and IgG titer <1:64 group showed that the prevalence of ABO hemolytic disease of newborn were 96.9%, 79.6%, 63, 7% and 28.8%, there was a certain correlation of pregnant women IgG titers with ABO hemolytic disease of the newborn, that is, with the increase of IgG titer, the incidence of hemolytic disease of newborns increased in certain degree (r=0.8832), the risk in 4 groups of neonatal HDN was higher than that in IgG titer <1:64 of IgG titer >64 HDN group.

CONCLUSIONThere is a certain corelation between prevalence of ABO-HDN and IgG titer of pregnant women. For these pregnant women, the control of the pregnant women IgG titer has a positive clinical significance to reduce the incidence of hemolytic disease of the newborn.

BACKGROUNDThere are few studies on the clinical profile of Chinese patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). The purpose of this study was to describe the clinical characteristics of ARVD/C patients from China, particularly to define the features of electrocardiograph and treatment outcomes.

METHODSThirty-nine patients hospitalized in Fu Wai Cardiovascular Hospital from 1998 to 2006 were included. The data were obtained from the medical archive and the follow-up records.

RESULTSOf these patients 33 were male and 6 female (age at the first presentation was (34.9 +/- 9.8) years). The most common symptoms were palpitation (62%) and syncope (44%). Right precordial QRSd >or= 110 ms was detected in 69% of the patients, epsilon wave in 59%, and a ratio of QRSd in V(1) + V(2) + V(3)/V(4) + V(5) + V(6) >or= 1.2 in 82%. The most frequent features of electrocardiogram in patients without right bundle-branch block were T-wave inversions and S-wave upstroke in V(1)-V(3) >or= 55 ms (96% and 90% of 28 patients, respectively). Radiofrequency catheter ablation (RFCA) for ventricular tachycardia (VT) was successful in 15 (68%) of 22 patients. The recurrence rate of VT was 46% (7/15) during the follow-up of (16.7 +/- 11.2) months. Seven patients had cardioverter/defibrillator (ICD) implanted plus drug therapy and 17 patients took antiarrhythmic drugs alone. During the follow-up of (35.6 +/- 19.0) months, all patients with ICD implanted received at least one appropriate ICD shock. One patient died of ventricular fibrillation suddenly and one patient underwent heart transplantation for progressive biventricular heart failure during the drug therapy alone.

CONCLUSIONSThis study demonstrated the clinical and ECG features of the 39 ARVD/C Chinese patients. ICD provided life-saving protection by effectively terminating malignant arrhythmias, and the high recurrence of VT was the major problem of RFCA therapy.

Adolescent ; Adult ; Anti-Arrhythmia Agents ; therapeutic use ; Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; drug therapy ; physiopathology ; therapy ; Catheter Ablation ; Defibrillators, Implantable ; Electrocardiography ; Female ; Heart Transplantation ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult

OBJECTIVE: To evaluate the clinical effects of debridement and bone grafting with internal fixation via anterior approach in treatment of tuberculosis of lower cervical vertebrae. METHODS: The clinical data of 15 patients with tuberculosis of lower cervical vertebrae who accepted the treatment of one-stage debridement and bone grafting with internal fixation from June 2010 to December 2018 were retrospectively analyzed. There were 9 males and 6 females, aged from 39 to 72 years with an average of (54.67±10.75) years. The lesion segment was C to C. Pre- and post-operative neurologic functions were evaluated by ASIA grade. All the patients underwent the X-ray films of positive and lateral of cervical spine before and after the operation and accepted the periodic review of CT to evaluate the bone grafting. RESULTS: All the 15 operations were successful, no neurological or vascular injury occurred during the operation, and all patients were followed up for 18 to 52 months. The clinical symptoms improved significantly during the follow-up period and CT showed good bone grafting fusion. One patient suffered a relapse of the illness 3 years later, but was healed during the follow-up visit by strengthening the anti tuberculosis therapy. CONCLUSION For the patients with vertebral destruction and loss of cervical stability, one-stage debridement and bone grafting with internal fixation via anterior approach has definite curative effects. On the basis of standard anti tuberculosis treatment before operation, the long-term standard anti-tuberculosis treatment after operation is the key to healing the tuberculosis of lower cervical vertebrae.