Objective To understand the current status of blood pressure and to analyze its influence factors in rural residents in Tianjin.Methods Total 2 390 754 rural residents aged over 15 yrs were detected on their blood pressure by the trained professional staffs with standard method,then calculated the mean of blood pressure and hypertension prevalent rate,compared with results of Village I of National Nutrition and Health Situation Investigation in 2002.After population standardized,a multivariate analysis was done on hypertension in subjects.Results The average SBP was(125.91?18.99)mm Hg,average DBP was(80.44?10.77)mm Hg;hypertension prevalent rate was 31.57%(33.08% for male and 30.18% for female).The general hypertension prevalence was higher than that of the national level;after standardized with China population in 2000,the prevalent rate of hypertension in the group aged over 18 yrs was nearly 50% higher than that in national level.The multivariate analysis showed that the affected factors for hypertension of rural residents included age,gender,region,education level,smoking,alcohol drinking and obesity.Conclusions Hypertension had become a popular and serious public health problem.To prevent and control hypertension should be one of the key issues of chronic diseases prevention in rural area.

Objective To discuss treatment effect of ritodrine and ambroxol on acceleration of fetal lung maturation,reduction of asphyxia of premature infants in premature women,and nursing. Methods 218 pregnant woman with premature delivery were divided into the treatment group (110 cases) and the control group ( 108 cases)stochastically.The treatment group adopted ritodrine and ambroxol,the control group adopted routine method.The curative effect was compared between two groups. Results The prolonged pregnancy time,rate of term labor,rate of newborn body weight ＞2500 g,incidence rate of puerperal infection,rate of neonatal pneumonia in the treatment group were better than those of the control group. Conclusions Appli cation of ritodrine in treating premature delivery proved to be safe and effective.For premature infants ＜ 34 weeks,prenatal use of ambroxol may promote the fetal lung maturity and reducecomplication rate of mothers and infants.

Objective To study the effect and possible role of recombinant human erythropoietin(rhEPO) on the proliferation and apoptosis of endothelial progenitor cells (EPCs) from patients with diabetic nephropathy (DN). Methods Various concentration of rhEPO was added to the culture system of EPCs from 20 DN patients (DN group) and 20 normal people (control group). MTT assays were used to detect the proliferative rate, Annexin V/PI stains to detect the apoptotic rate, and Western blot assays to detect the expression level of Akt protein kinase. Results Proliferative ability of EPCs from control group and DN group was improved when concentration of rhEPO was 0.3, 0.6 and 1.2 kU/L, and it was dose-dependent. The effect from the latter was more obvious. The apoptotic rate of DN group was lowered and the expression levels of Akt protein kinase were upregulated when the concentration of rhEPO was 1.2 kU/L, while this kind of effect was blocked after Wortmannin was added to the culture system. Conclusion rhEPO can improve the number and function of EPCs from both healthy volunteers and patients with DN. PI3K/Akt pathway may play an important role.

BACKGROUND: Bone marrow stem cells can be induced to differentiate into vascular endothelial cells and facilitate establishment of compensatory circulation, so as so improve blood supply of ischemic tissues. OBJECTIVE: To observe the clinical efficacy of autologous peripheral blood stem cells (PBSCs) transplantation in the treatment of diabetic vascular disorder in the lower extremities and diabetic feet. DESIGN: Wuhan Central Hospital, Wuban, Hubei Province, China. PARTICIPANTS: A total of 89 patients with type 2 diabetic vascular disorder in the lower extremity were enrolled from Department of Endocrinology in Wuhan Central Hospital from July 2005 to may 2007. All cases matched the criteria of diabetes by WHO in 1999, and complicated with diabetic peripheral angiopathy and diabetic feet. They included 61 males and 28 females, aged 45-90 years, with an average age of 67. Lesion was mainly located in lower extremities, 54 patients with foot ulcers while 8 patients with gangrene. All the patients signed the informed consents, and the experiment was approved by the hospital ethics committee. Recombinant human granulocyte colony stimulating factor was purchased from China Kunpeng Bio-Pharmaceutical Co., Ltd.METHODS: Stem cell mobilization: 89 patients all received recombinant human granulocyte colony stimulating factor, 500-600 μg per day by hypodermic injection for 5 days to mobilize stem cells. On the fifth day. PBSCs were collected with a total amount of 83-103mL. The number of mononuclear cells was (1.86-3.39)×1011L-1,while the proportion of CD34 positive cells was 0.55%-1.36%. PBSCs transplantation: After patients were treated with intravenous anesthesia, PBSCs were injected into the ischemic lower extremity and foot intramuscularly at 3cm×3cm distance. The clinical and laboratory findings were monitored from the first day to the sixth month.MAIN OUTCOME MEASURES: The patients were evaluated before transplantation, and in the first, third and sixth months after transplantation, including affected limb pain, cool feeling, intermittent claudication, ankle brachial index (ABI), limb skin temperature and deep feeling. Color Doppler. CT and digital subtraction angiography were applied to detect lower extremities morphous.RESULTS: All 89 included patients were involved in the result analysis. Scores of clinical symptom: The affected limb pain, cool feeling, and intermittent claudication were all improved significantly after PBSCs transplantation (P<0.05),and the improvement was more evident with time extension. ABI: After PBSCs transplantation, ABI in patients increased significantly by different degrees with the time extension(P0.05). Skin temperature and deep feeling: Limb skin temperature increased significantly after transplantation (P<0.05), and deep feeling seemed to be improved, but the change was not significant(P0.05). Imaging determination: There was no obvious change after transplantation checking of lower extremity by color Doppler. But CT and digital subtraction angiography results showed lower extremities in 23 patients had new collateral vessels formation with different degrees.CONCLUSION: Autologous PBSCs transplantation can increase blood flow of lower extremities in patients with diabetic vascular disorder in the lower extremities and diabetic feet, and promote the angiogenesis in lower extremity of partial patients.

Objective To search the immune-mechanism of Graves disease,and get known the function of regulatory T cell in its occurrence.Methods Flow cytometry were used to detect the proportion of CD_4~+CD_(25)~+ T cells in 32 Graves disease patients(GD group) and 20 healthy volunteers(control group).MACS were used to isolate CD_4~+ CD_(25)~+ T cells.RT-PCR was used to detect the expression of FOXP3 of them,and ELISA to detect the level of IL-10.Results There was no significant change of proportion of CD_4~+CD_(25)~+ T cells between GD group and control group(P=0.804),while expression level of FOXP3 mRNA and secretion level of IL-10 in GD group were lower than those in control group(P

This study is to explore the interventional effects of fluvastatin on anti-beta2GPI/beta2GPI-induced activation in THP-1 mononuclear cells. In vitro, human mononuclear cells THP-1 were treated with fluvastatin, LPS and anti-beta2GPI/beta2GPI, then the TF expression on THP-1 cells was detected by real-time quantitative PCR (RT-qPCR) or TF activity was detected by kit. TNF-alpha mRNA and its protein expression were investigated by RT-PCR and ELISA kit. The expression of phospho-NF-kappaB p65 and inhibitory protein of NF-kappaB (IkappaB-alpha) were measured by Western blotting. The results suggested that the expression of TF and TNF-alpha on THP-1 cells was significantly up-regulated with treatment of anti-beta2GPI/beta2GPI complex (100 mg x L(-1)), compared with that of untreated cells (P < 0.05). Fluvastatin (50 mg x L(-1)) could decrease TF (mRNA and activity) expression and the level of TNF-alpha (mRNA and protein) in THP-1 cells with anti-beta2GPI/beta2GPI complex. The expression of TF and TNF-alpha was shown in a concentration-dependent manner. Moreover, anti-beta2GPI/beta2GPI complex could downregulate IkappaB-alpha levels and increase the levels of phospho-NF-kappaB p65. And these effects of anti-beta2GPI/beta2GPI complex could be blocked by fluvastatin. In conclusion, fluvastatin may interfere the expression and regulation of NF-kappaB signal transduction pathway, thereby inhibit the effects of anti-beta2GPI/beta2GPI on activation of THP-1 cells, by decreasing the expression of TF and TNF-alpha.

AIM: This study aimed to observe the effects of high-glucose on proliferation and apoptosis of endothelial progenitor cells (EPCs) in type 2 diabetes mellitus patients, and tried to elucidate their possible role. METHODS: Various concentrations of glucose were added to the culture system of EPCs from 25 cases of type 2 diabetes mellitus patients (DM group) and 25 cases of healthy volunteers (control group). MTT assays were used to detect the proliferative rates. Annexin-V/PI stains were used to detect the apoptotic rates, and RT-PCR to detect the expression level of bcl-2 and bax. RESULTS: Proliferative activity of EPCs in both control group and DM group were attenuated when concentration of glucose was 33 mmol/L, while apoptotic rates increased. No significant change of proliferative rate and apoptotic rate of EPCs in DM group and control group in the presence of 5 mmol/L glucose was observed. The expression level of bax of EPCs in both DM group and control group increased while expression level of bcl-2 did not change much in the presence of 33 mmol/L glucose. CONCLUSION: High-glucose attenuates proliferative activity of EPCs and increases the apoptotic rate. Upregulation of bax may be its possible role.

OBJECTIVETo explore the relationship between the myelodysplastic syndromes (MDS) and autoimmune disorders (AID).

METHODSThe clinical data of 117 MDS patients were reviewed.

RESULTSNineteen (16.2%) of 117 MDS patients had AIDs. The commonest AID associated with MDS was rheumatoid arthritis (31.6%) and ulcerative colitis (26.3%). Compared with that in MDS patients without autoimmune disorders, the leukemic transformation rate was not increased in the MDS/AID but the median survival time was shorter in MDS/AID patients.

CONCLUSIONMDS patients associated with autoimmune disorders may be an unfavorable factor for their prognosis.

Acquired Immunodeficiency Syndrome ; complications ; Adolescent ; Adult ; Arthritis, Rheumatoid ; complications ; Autoimmune Diseases ; complications ; Colitis, Ulcerative ; complications ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; complications ; Predictive Value of Tests

Objective To study the value of deferred stent implantation in patients with high thrombus burden of acute ST-segment elevation myocardial infarction (STEMI). Methods Select 106 cases with a high thrombus burden within 12 hours of onset in patients with STEMI ,the infarct-related artery thrombus aspiration after antegrade flow of TIMI 2-3 and≤2 points of the thrombus aspiration(TS)patients were randomly divided into immediate stenting group(n = 43)and deferred stenting group(n = 40). Two groups of patients were compared with the myocardial blush grade(MBG),the incidence of slow-/no-reflow ,the incidence of compound endpoints in 6 months and the cardiac function after PCI for 6 months. Results After stenting,the MBG of deferred group was significantly higher than that of immediate group ,the incidence of slow-/no-reflow and the compound endpoints events within 6 months in deferred group was significantly lower than that in the immediate group. After PCI for 6 months,the improvement of LVEF in the deferred group was significantly higher than that in the immediate group, the left ventricular end diastolic dimension(LVEDD)in deferred group was significantly lower than that in immedi-ate group,and the differences were statistically significant(P < 0.05). Conclusions The high thrombus burden in patients with acute STEMI after thrombus aspiration ,deferred stent implantation can significantly reduce the rate of slow-/no-reflow ,improve myocardial perfusion ,reduce the incidence of compound endpoints events ,im-prove cardiac function in patients.

Objective To assess the capability of monochromatic energy images of Gemstone spectral imaging(GSI) in reducing artifacts caused by metallic implants. Methods Twelve subjects with metallic implants underwent GSI (Discovery CT750 HD, GE Healthcare, Milwaukee ). The metallic orthopedic implants included 3 patients of dentures, 2 patients of cervical spinal vertebraplasty, one clavicle fracture fixation, one lumbar spinal vertehraplasty, 3 patients of artificial femoral head, one iliac fracture fixation and one tibial fracture fixation. GSI was performed by using a single source ultra-fast dual energy X-ray switching (80 kVp and 140 kVp). Following GSI scanning, thin slice images were reconstructed into 1.25 mm slice thickness. The monochromatic energy images were set to the same window width and level (window width 1500 HU,window level 500 HU). The artifact indexes (AI) at different kiloelectronvolts (keV) images were measured and compared. 3D reconstruction was performed using images with minimal AI. Result The artifacts index on monochromatic energy images varied with the change of keV. Of the images from 12 subjects, the maximal AI ranged between 145-225 at 40 keV, and minimal AI ranged between 15-90 at the 95-140 keV. The artifacts are clearly visible on polychromatic energy images and the artifacts are reduced markedly on the monochromatic energy images with minimal AI. Conclusion The artifacts caused by metallic implants can be reduced significantly by GSI with high keV monochromatic energy images.