Objective To evaluate the efficacy and safety of the improved percutaneous balloon mitral valvuloplasty (PBMV) in elderly patients with mitral stenosis. Methods Elderly patients with severe mitral stenosis received an improved PBMV which included a modified way of atrial septal puncture and technique across the mitral valve. The left atrial pressrue (LAP), mean pulmonary pressure (MPA), mean gradient across the mitral value (MPG) and mitral valve area (MVA) were recorded and compared before and after the operation. Long term follow up were made. Results After operation, the LAP decreased [(25.3±6.7) mm Hg vs.(16.4±5.8) mm Hg,1 mm Hg=0.133 Kpa], MPG decreased [(17.6±6.7) mm Hg vs.(6.8±2.9) mm Hg], MPA decreased [(38.6±12.1) mm Hg vs. (29.2±9.8) mm Hg], MVA increased [(1.05±0.22)cm2 vs.(1.61±0.38)cm2] and the New York heart association heart function classification improved. The follow-up result showed that the effect of PBMV was constant. Conclusions Improved PBMV may be an effective and safe measure for patients with mitral stenosis.

Diabetic Retinopathy ; complications ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retinal Vein Occlusion ; complications ; Vitrectomy ; Vitreous Hemorrhage ; etiology ; surgery

Objective To investigate the correlation of serum high-mobility group box-1 (HMG-B1) with the severity of lesion of coronary artery disease (CAD) and its prognosis in elderly patients.Methods A total of 180 CAD patients with coronary stenosis exceeding 50 percent by coronary angiography were divided into three groups:one branch stenosis;two branches stenosis and three branches stenosis.The control group included 50 patients without coronary stenosis.The degrees of coronary stenosis were diagnosed as mild stenosis,moderate stenosis and severe stenosis based on improved Gensini scores.The severity of decrements of left ventricular ejection fraction (LVEF) by echocardiogram were divided into three groups:mild,moderate and severe LVEF.Levels of HMGB1,hs-CRP and glucose were measured in all the patients.According to whether there was a complication of type 2 diabetic mellitus (T2DM),the 180 patients were classified as two groups.The patients were also divided into two groups according to whether there were adverse events.Results The HMGB1 levels of the CAD group were increased along with the number of affected vessels [three bunch group (40.5±6.0) ng/ml,double bunch group (33.1±4.9)μg/L,single bunch group (20.5±3.3)μg/L and control group (6.2±1.4)μg/L (all P＜0.05)].And the HMGB1 levels of the CAD group were increased along with the degrees of CAD stenosis [severe stenosis group (43.0±5.8)μg/L,medium stenosis group (32.1±4.5)μg/L,mild stenosis group(19.3±2.0)μg/L] (all P＜0.05).Meanwhile,the levels of HMGB1 were increased along with the decrement of left ventricular ejection fraction [left ventricular severe dysfunction group (41.0 ± 5.5) μg/L,medium dysfunction group(33.1± 4.3)μg/L,mild dysfunction group (21.3± 2.0)μg/L] (all P＜0.05).CAD with T2DM had a higher HMGB1 level than non-T2DM group[(35.7±5.0) (C)/L vs.(23.3±3.0) (C)/L,P＜0.05].The adverse events group had a higher HMGB1 level than non-adverse events group[(38.7±5.5) (C)/L vs.(25.3±3.3)μg/L,P＜0.05].Besides,HMGB1 had a positive correlation with levels of hs-CRP and glucose(r=0.680,0.571,P＜0.05).Conclusions Serum HMGB1 change is closely related to morbid change degree of elderly CAD patients as well as prognosis.As a new type of inflammatory factor,HMGB1 may serve as a new target for disease treatment.

Chemical constituents of Inula japonica were isolated and purified by repeated column chromatographies, over silica gel, and Toyopearl HW-40, and preparative HPLC. On the basis of spectral data analysis, including NMR and MS data, the structures of the isolates were elucidated and their anti-inflammatory activities were assayed. Fifteen compounds were isolated from the ethyl acetate extract of I. japonica, and their structures were elucidated as dihydrosyringenin (1), (3S, 5R, 6S, 7E)-5,6-epoxy-3-hydroxy-7-megastigmen-9-one (2), (6R, 7E) -9-hydroxy-4,7-megastigmadien-3-one (3), arnidiol (4), taraxasterol acetate (5), 8,9,10-trihydroxythymol (6), taxifolin (7), luteolin (8), napetin (9), eupatin (10), spinacetin (11), quercetin (12), p-hydroxycinnamic acid (13), caffeic acid (14), and caffeoyl acetate (15). Compounds 1, 2, 7, 13 and 15 were isolated from the genus Inula for the first time, and compounds 3, 4, 9-11 and 14 were isolated from this plant for the first time. The anti-inflammatory activity result showed that compounds 3, 6-12 and 14 exhibited inhibition effect against leukotriene C4 (LTC4) synthesis and degranulation definitely in c-Kit Ligand (KL) induced mast cells, and compound 8 and 12 also had the suppression effect against lipopolysacharide(LPS) induced nitric oxide (NO) activity in RAW264.7 macrophages. It is firstly reported that compounds 7 and 9-11 possessed potent inhibition activities against LTC4 generation and degranulation in mast cells.
Animals ; Anti-Inflammatory Agents ; chemistry ; pharmacology ; Cell Line ; Inula ; chemistry ; Macrophages ; drug effects ; Mast Cells ; drug effects ; Mice ; Mice, Inbred BALB C ; Plant Extracts ; chemistry ; pharmacology

Animals ; Cells, Cultured ; DNA ; analysis ; Flow Cytometry ; methods ; Fluorescence ; G1 Phase ; Resting Phase, Cell Cycle

OBJECTIVETo study changes of plasma ADMA levels of patients with non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI) and to explore the effect of Salvia Miltiorrhiza (SM) on them.

METHODSTotally 52 patients with confirmed NSTEMI undergoing PCI were randomly assigned to the SM treated group and the control group, 26 in each group. Patients in the SM treated group received the conventional therapy plus SM (1 g each time, three times per day till one month after PCI). Those in the control group only received the conventional therapy. Plasma ADMA levels were measured before PCI, and at day 1 and 30 after PCI.

RESULTSPlasma ADMA levels in both group obviously decreased at day 30 after PCI with statistical difference (P < 0.01). The decrement was more obviously seen in the SM treated group, with statistical difference when compared with the control group (P < 0.01).

CONCLUSIONSPatients with NSTEMI undergoing PCI could have plasma ADMA levels decreased. Administration of SM just before PCI might be associated with negative regulating plasma ADMA levels.

Arginine ; analogs & derivatives ; blood ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Myocardial Infarction ; metabolism ; Percutaneous Coronary Intervention ; Salvia miltiorrhiza

Objective To explore the clinical characteristics and treatment of nodular panniculitis disease in children. Methods Clinical data of 13 cases with nodular panniculitis disease were reviewed retrospectively. Their etiology,clinical manifestation,misdiagnosis cause,pathologic characteristics, treatment and outcome were analyzed. Results Its clinical manifestation was multiform and showed mainly as fever and hypodermic nodule. Concomitant damages to digestive, respiratory, circulatory and renal system might occur in those children with the system type of this disorder. Conclusion Pediatric nodular panniculitis disease can be easily misdiagnosed and lack of specificity in the early stage, and complicates multiple organs damage.

Objective: To observe the clinical efficacy of sinew-bone balancing manipulation in treating lumbar disc herniation (LDH) and offer clinical evidence to support the concept of paying equal attention to sinew and bone. Methods: Sixty LDH patients were randomized into an observation group and a control group, with 30 cases in each group. The observation group was treated with the sinew-bone balancing manipulation, and the control group received conventional Tuina (Chinese therapeutic massage) manipulation. The clinical efficacy and posterior muscle chain tone effect were compared between the two groups by observing the visual analog scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and posture-associated indicators. Results: The total effective rate was 86.7％ in the observation group, higher than 76.7％ in the control group, but the between-group difference in efficacy was statistically insignificant (P>0.05). After treatment, the VAS and JOA scores, angle-dependent muscle tone indicator of the posterior muscle chain, and lumbar posture symmetry showed significant changes in both groups (P<0.05). The VAS and JOA scores, angle-dependent muscle tone indicator of the posterior muscle chain, and lumbar posture symmetry in the observation group were significantly different from those in the control group after treatment (P<0.05), but the between-group difference in the general posture symmetry was statistically insignificant (P>0.05). Conclusion: Both the sinew-bone balancing and conventional Tuina manipulations can reduce pain in LDH patients, improve lumbar function, and adjust the angle-dependent muscle tone coefficient of the posterior muscle chain and lumbar posture symmetry; except for the general posture symmetry of the posterior muscle chain, the sinew-bone balancing manipulation wins out over the conventional Tuina manipulation.

Objective To evaluate application of recombinant human luteinizing hormone (r-hLH)used in ovarian stimulation of assisted reproductive technique and impact on outcome of pregnancy. Methods From Apr. To Jul. 2009, 123 patients with low LH level ( < 1 U/L) at day 3 of menstruation and downregulation of pituitary function undergoing in vitro fertilization-embryo transfer (IVF-ET) in Reproductive Medical Center, Provincial Hospital Affiliated to Shandong University were enrolled in this study, whom were classified into 66 cases treated by r-hLH in r-hLH group and 57 cases without r-hLH treatment in non-r-hLH group. In the mean time, 145 patients with normal level of serum LH ( 1-2 U/L) not given by r-hLH treatment and undergoing IVF-ET were matched as control group. Total amount of gonadotropin, estradiol levels and LH levels on the administration of human chorionic gonadotropin ( hCG), number of oocytes retrieved, number of 2PN zygotes, rate of high quality embryos, the rates of implantation and clinical pregnancy were compared among these three groups. Results The level of serum LH on the day of hCG administration were ( 1.59 ± 0.77 ) U/L in r-hLH group, (0.54 ± 0.25 ) U/L in non-r-hLH group and (2.39 ± 1.01 ) U/L in control group, which reached tatistical difference between every two groups (P < 0.05). The rates of high quality embryo were 59.36％ in r-hLH group, 57.79％ in non-r-hLH group,which were significantly lower than 65.94％ in control group, respectively (P < 0. 05 ). The rates of 2PN were 67.62％ in r-hLH group and 68. 32％ in control group, which were significantly higher than 62. 84％ in non-r-hLH group, respectively ( P < 0.05 ). The rates of implantation of 29.77％ in r-hLH group were significantly higher than 18.26％ in non-r-hLH group ( P < 0.05 ). The total amount of gonadotropin,estradiol level on the day of hCG administration, the number of oocytes retrieved, and clinical pregnancy rate were not significantly different among those three groups ( P > 0.05 ). Conclusion The administration of recombinant human uteinizing hormone in patients who are profoundly suppressed after down-regulation with long protocol can get more quality embryos, the higher rates of 2PN and implantation.

OBJECTIVETo investigate the effect of compound Coptidis Rhizoma capsule (CCRC) on unbalanced expression of renal tissue TGF-β1/BMP-7 and Smad signaling pathway in rats with early diabetic nephropathy (DN), and discuss CCRC's effect on DN rats with early diabetic nephropathy and its possible mechanism.

METHODDN model rats were established by injecting streptozotocin (STZ). The rats were randomly divided into seven groups: the normal group, the model group, the enalapril treatment group, the xiaoke pill treatment group and three CRCC treatment groups. They were orally administered once a day for five weeks. The fasting blood glucose (FBG), blood urea nitrogen (BUN), serum creatinine (Scr), insulin (Ins), 24 h urinary protein (24 h Upro) and 24 h urinary microalbumin (24 h UmAlb) were tested. The pathological changes in renal tissues were examined by optical microscopy. Immuno- histochemical measures were used to detect the expressions of TGF-β1, BMP-7, Smad2/3, Smad1/5, and Smad7 protein, and RT-PCR was used to detect TGF-β1 mRNA and BMP-7 mRNA in renal tissues.

RESULTCompared with model group, BUN, Scr, Ins, 24 h Upro and 24 h UmAlb levels decreased at different degrees in CCRC treatment groups; the abnormal pathomorphology in renal tissue was improved; immunohistochemistry results showed that the expression of TGF-β1 and Smad2/3 were reduced, while the expression of BMP-7, Smad1/5 and Smad7 increased in CRCC treatment groups; the expression of TGF-β1 mRNA were reduced, but the expression of BMP-7 mRNA had no obvious change in CRCC treatment groups.

CONCLUSIONCRCC can improve the early renal function, delay the progression of chronic renal pathology and maintain the dynamic balance of TGF-β1/BMP-7 expression in renal tissues of DN rats. The mechanism may be related to down-regulation of renal TGF-β1 and up-regulation of BMP-7 through Smad signaling pathway.

Animals ; Bone Morphogenetic Protein 7 ; genetics ; metabolism ; Coptis ; chemistry ; Diabetic Nephropathies ; drug therapy ; genetics ; metabolism ; Gene Expression Regulation ; drug effects ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Rhizome ; chemistry ; Signal Transduction ; drug effects ; Smad Proteins ; genetics ; metabolism ; Transforming Growth Factor beta1 ; metabolism