Objective To assess whether urapidil (anα1 receptor blocker)is more effective than ni-troglycerin in treatment of non-valvular heart failure accompanying hypertension and diabetes mellitus (DM ) in elderly female patients .Methods Fourty-six elderly female patients with non-valvular heart failure accompanying hypertension and DM were randomly divided into urapidil treatment group (n= 24) and nitroglycerin treatment group (n= 22) .Patients in urapidil treat-ment group were treated with urapidil (50 -300 μg/min) and those in nitroglycerin treatment group were treated with nitroglycerin (5 -20 μg/min) for 48 -140 h according to their blood pressure (BP) and cardiac function .Their BP ,HR ,and metabolic activity were observed before and on days 1 ,2 ,3 and 7 after treatment .Results The effect of urapidil was significantly lower than that of nitroglycerin on SBP on day 7 after treatment (P<0 .05) .The serum NT-proBNP level was significantly lower in nitroglycerin treatment group than in control group (P<0 .01) . Conclusion The effect of urapidil is better than that of nitroglycerin on reducing and stabilizing SBP ,attenuating cardiac afterload ,and improving cardiac function in elderly female patients .Ura-pidil can thus be used as one of the first choiced drugs in treatment of elderly female patients with non-valvular heart failure accompanying hypertension and DM .

Objective To study the relationship between red cell distribution width (RDW ) and short-term outcomes in acute coronary syndrome (ACS) patients .Methods A totoal of 1654 ACS patients were divided into RDW ≤12 .1% group(n=419) ,RDW=12 .2% -12 .8% group(n=364) ,RDW=12 .9% -13 .2% group (n= 463) and RDW ≥13 .3% group (n= 408) .Their bio-chemical indicators and incidence of 1-month cardiac death ,heart failure ,recurrent myocardiac in-farction were compared .Relationship between RDW and 1-month adverse cardiac events was as-sessed .Results The incidence of cardiac death ,heart failure ,recurrent myocardiac infarction in-creased with the increasing RDW .Logistic regression analysis showed that RDW ,BNP>100 ng/L and LVEF< 40% were the independent risk factors for 1-month cardiac death in ACS patients (OR=2 .116 ,95% C I:1 .427-3 .137 ,P=0 .000;OR=3 .510 ,95% C I:1 .221 -10 .093 ,P=0 .020 ;OR= 4 .149 ,95% CI:2 .001 -8 .602 ,P= 0 .000 ) ,and that RDW ,age> 65 years ,diabetes and LVEF<40% were the independent risk factors for 1-month heart failure and recurrent myocardi-ac infarction in ACS patients (OR= 2 .134 ,95% CI:1 .602 -2 .844 ,P= 0 .000 ,OR= 2 .010 , 95% C I:1 .135 -3 .560 ,P=0 .017 ;OR=2 .279 ,95% C I:1 .345 -3 .862 ,P= 0 .002 ;OR=5 .009 , 95% CI:2.694-9 .316 ,P=0 .000) .Conclusion RDW is an independent risk factor for the short-term outcomes in ACS patients .

Objective To study hypoxia environment trophoblast cell autophagy and autophagy of the preeclampsia placental tis-sue .Methods Trophoblastic cell line HTR-8/SVneo were divided into three groups :low oxygen concentration group (group Ⅰand group Ⅱ) and normal oxygen concentration group ;48 h after the application the confocal laser scanning microscopy was used for detection of cytoplasmic autophagosome ,PCR technology analysis of autophagy-related gene expression change of LC3-Ⅱ .LC3-Ⅱ expression levels of 30 cases of preeclampsia placenta were detected by Immunohistochemistry .Results In low oxygen concen-tration group ,there were visible red autophagosome chromatin structure in cytoplasm ,which was extremely rare in the normal oxy-gen concentration group ,in low oxygen concentration group cell LC3-Ⅱ mRNA expression was significantly higher than that of normal concentration group .The preeclampsia placenta of patients with positive immunostaining of LC 3-Ⅱ was 67 .12% ,compared with 9 .14% in the normal control ,there was a significant difference between two groups .Conclusion Preeclampsia placenta auto-phagy activity increased ,hypoxia can induce autophagy trophoblast cell line phenomenon .

Beta blocker can be categorized by non-selective agents,selective agents and agents with vasodilatory effect.Beta blocker therapy represents a major advance in the treatment of heart failure patients.The mechanisms include up-regulation of beta receptor,reversing remodeling,improving contractile and diastolic function,antiarrhythmia and anti-ischemia.Evidences from randomized controlled clinical trials have supported its use in the treatment of patients with heart failure to decrease mortality and improve life quality.Guidelines with various versions recommend that ?-blockers are indicated for patients with symptomatic or asymptomatic heart failure and a depressed ejection fraction of lower than 40%.There is something to be noticed for rational use of ?-blockers such as timing,dosage,duration and contraindications.

Objective Elevated plasma homocysteine(Hcy) level has been associated with the increased risk for cardiovascular disease.The level of plasma Hcy is related to methylene tetrahydrofolate reductase(MTHFR) gene C677T polymorphism.The aim of this study is to evaluate the relationships between MTHFR gene C677T polymorphism and hypertension,cardiac structure and function.Methods Genotype of MTHFR gene C677T polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) analysis and decided by electrophoresis and sequencing in 695 patients with essential hypertension and 509 age-matched normal controls.Echocardiography was performed in patients with essential hypertension.Results In hypertension group,the frequencies of TT genotype and T allele were significantly higher than those in control group(26.5% vs 20.6%,48.7% vs 42.4%;P=0.015,0.002).The essential hypertension odds ratio(OR) associated with MTHFR 677T allele was 1.300(95%CI:1.166 to 1.450).Logistic regression analysis indicated that MTHFR gene C677T polymorphism was an independent variable of hypertension(P=0.027).End diastolic dimension(EDD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass(LVM) and left ventricular mass index(LVMI) were higher in hypertensive patients with T allele than that in those with CC genotype,but all had no statistical significance(P=0.428,0.118,0.064,0.077,0.054).Conclusion The 677T allele in MTHFR gene may be a risk factor for hypertension.Hypertensive patients with MTHFR 677T had a trend of hypertrophy,but the relationship has no statistical significance.The relationship between MTHFR gene C677T polymorphism and left ventricular hypertrophy need to be further studied.

With improvement in stent designs, the practice of direct stenting (DS) without balloon predilation has become more widespread. DS may allow partial retention of endothelium within treated arteries, and associate with decreased utilization of contrast agent, number of catheter, exposure of X-ray,and expense. This paper evaluate the experiment base, principle, indication, contraindication, skills, complications as well as the result of acute and chronic follow up of DS.

Objective To investigate the correlation between abnormal lipid metabolism and coronary artery lesions. Methods Two hundred and sixty seven patients were devided into the control group ( n =101) and the coronary heart disease (CHD) group ( n =166), which included single vessel lesion ( n =54), double vessel lesions ( n =68) and triple vessel lesions ( n =44) according to coronary angiography. At the same time the lipid components were examined and the ralationship between serum lipid level and coronary artery lesions were analysed. Results Compared with the control, the total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) level were significantly elevated while but high density lipoprotein cholesterol (HDL-C) was lowered in the CHD group. The severity of coronary lesions was increased with the elevation of TC, LDL-C, apolipoproteinB (ApoB), TC/HDL-C, LDL-C/HDL-C, and the reduction of HDL-C. There were significant differences in terms of lipid level beteewn the CHD group and the control. The analysis showed that TC/HDL-C and LDL-C/HDL-C were most directly correlated with the coronary artery lesions in the CHD group. Conclusion The results suggest that the severity of coronary artery lesions correlated with abnormal lipid metabolism, and LDL-C/HDL-C, TC/HDL-C are better indicators than other lipid components.

Objective To evaluate the nutrition status and the prognosis of acute stroke patients with hy-pothyroidism during hospitalization. Methods The clinical data of 28 acute stroke patients with hypothyroidism (study group) and 28 stroke patients with normal thyroid function (control group) were retrospectively analyzed.Results After (10±4) days of hospitalization, hemoglobin and serum albumin levels in study group significantlydecreased ( P < 0. 05 ). The requirement of calories and protein, incidence of pulmonary infections, alimentarytract hemorrhage and diarrhea, and hospital stays were significantly higher in study group than in control group (P < 0. 05 ). Conclusion The nutrition status is poor in acute stroke patients with hypothyroidism, who were more easier to be suffered from clinical complications and worse prognosis.

Hydrogen sulfide (H2S) was considered as the third gasotransmitter,along with nitric oxide and carbon monoxide,with extensively biological activities.Considerable evidence showed that H2S was involved in inflammatory processes such as in inflammatory cells,inflammatory mediates,vascular tension and signaling pathways.Previous studies suggested H2S played a bidirectional role in regulating inflammation including pro- and anti-inflammatory actions due to different animal models.Further study about the role and mechanism of H2S in inflammation will contribute to efficient prevention and treatment for inflammatory diseases.

The metabolic syndrome,as a group of concurrent cardiovascular risk factors,is attributed to both genetic and environmental causes and correlated with many gene polymorphisms and their mutations,such as adiponectin gene,peroxisome proliferator activated receptor gamma gene,lamin protein A/C gene,uncoupling protein 2 gene,?-adrenic receptor gene and some other inflammation marker genes.This paper reviews the advances in the studies of the gene polymorphisms associated with the metabolic syndrome.