Objective To investigate the clinical efficacy of sildenafil in treatment of pulmonary arterial hypertension (PH),in order to provide more theory basis for clinical treatment.Methods A total of 80 PH patients was enrolled in this study.All the 80 cases were divided into conventional treatment group and sildenafil treatment group with 40 cases each.The 6-min walk test distance,Brog dyspnea score,pulmonary artery systolic pressure(SPAP),heart rate,circulation systolic blood pressure (cSBP),circulation diastolic blood pressure (cDBP),alanine aminotransferase (ALT),aspartate aminotransferase (AST),blood urea nitrogen (BUN) and serum creatinine (SCr) were recorded before and after treatment.The clinical efficacy was compared between two groups.Results The 6-min walk test distance,Brog dyspnea score and SPAP before treatment in conventional treatment group and sildenafil treatment group were (258.62 ±58.34),(260.22 ± 54.33) m; (3.2 ± 1.1),(3.3 ± 1.2) scores; (70.66 ± 6.52),(71.09 ± 6.61) mm Hg (1 mm Hg =0.133 kPa),and there was no significant difference between two groups (P ＞ 0.05).The 6-min walk test distance was (332.67 ± 63.51),(411.47 ± 75.86) m after treatment in conventional treatment group and sildenalil treatment group,which was increased compared with that before treatment (P ＜ 0.05).Brog dyspnea score and SPAP were (2.6 ± 0.8),(2.0 ± 0.6) scores and (61.43 ± 5.27),(47.84 ± 5.15) mm Hg after treatment in conventional treatment group and sildenafil treatment group,which were decreased compared with those before treatment (P ＜ 0.05).The improvement of the 6-min walk test distance,Brog dyspnea score and SPAP in sildenafil treatment group were better than those in conventional treatment group (P ＜0.05).There was no significant difference in the heart rate,cSBP,cDBP,ALT,AST,BUN,SCr before and after treatment in two groups (P ＞ 0.05).The total effective rate in sildenafil treatment group was higher than that in conventional treatment group [77.5％ (31/40) vs.57.5％ (23/40)],and there was significant difference (P ＜ 0.05).The side effects were main headache,blushing,dyspepsia.Conclusion Sildenafil has more effective clinical efficacy in treating PH patients with accepted side-effect,which is worthy to be popularized in the clinical application.

The aim of the study was to investigate the sesquiterpene constituents from the rhizomes of Curcuma wenyujin Y．H．Chen et C．Ling．The isolation and purification of the constituents from the 50％ EtOH extracts of the rhizomes were performed with repeated column chromatography over sillica gel and macroporous resin．Eight sesquiterpenes were obtained and identified as wenyujinlactone A(1),neolitamone A(2),zedoarondiol(3),isozedoarondiol(4),aerugidiol(5),curcumol (6),curdione(7) and (1R,10R)-epoxy-(-)-1,10-dihydrocurdine (8) by means of spectral analysis．Among them,compound 1 was found to be a new eudesmane sesquiterpene lactone,whilst compounds 2-5 were obtained from this plant for the first time．

To study the dynamic changes of CT perfusion parameters during the first 12 h in the embolic cerebral ischemia models. Local cerebral ischemia model were established in 7 New Zealand white rabbits. All CT scans were performed with a GE Lightspeed 16 multislice CT. Following the baseline scan, further CT perfusion scans were performed at the same locations 20 min, 1-6 h and 8, 10 and 12 h after the embolus delivery. Maps of all parameters were obtained by CT perfusion software at each time point. The brains, taken 12 h after the scan, were sliced corresponding to the positions of the CT slices and stained by 2,3,5-triphenyltetrazolium chloride (TTC). On the basis of the TTC results, the ischemic sides were divided into 3 regions: core, penumbra and the relatively normal region. The changes of all parameters were then divided into 3 stages. In the first two hours (the first stage), the CBV dropped more remarkably in the core than in the penumbra but rose slightly in the relatively normal region while the CBF decreased and MTT, TTP extended in all regions to varying degrees. In the 2nd-5th h (the second stage), all the parameters fluctuated slightly around a certain level. In the 5th-12th h (the third stage), the CBV and CBF dropped, and MTT and TTP were prolonged or shortened slightly in the core and penumbra though much notably in the former while the CBV, CBF rose and MTT, TTP were shortened remarkably in the relatively normal region. We experimentally demonstrated that the location and extent of cerebral ischemia could be accurately assessed by CT perfusion imaging. The pathophysiology of the ischemia could be reflected by the CT perfusion to varying degrees.
Blood Flow Velocity ; Brain Ischemia/physiopathology ; Brain Ischemia/*radiography ; Cerebrovascular Circulation ; Stroke/physiopathology ; Tomography, X-Ray Computed

Rhubarb is a traditional Chinese medicines which possess laxative, lipid-lowering, and weight-loss activities, but the active compounds of lipid-lowering and underlying molecular mechanisms are not yet clear. This study aims to explore the effects of chrysophanol on the mRNA expressions of sterol regulatory element-binding proteins (SREBPs) and lipid metabolism in human liver carcinoma Huh-7 cells, which is one of the active compounds obtained from Rhubarb. A reporter gene assay was used to test the transcription of SREBP. The intracellular triglyceride and total cholesterol contents were measured by using commercially available test kits. The SREBPs target genes expressions were measured by Quantitative Real-Time PCR. Cell viability was evaluated by Cell Counting Kit-8. As the results shown, chrysophanol (40 μmol · L(-1), 16 h) could notably inhibited human SRE promoter activity in a dose-dependent manner and decrease intracellular cholesterol and triglyceride levels. Furthermore, the mRNA expressions of SREBPs target genes were significantly downregulated by chrysophanol treatment. However there are no significant differences on cell viability when compared with the control group. These results suggested that chrysophanol might improve lipid metabolism through suppressing the mRNA expressions of SREBPs target genes to attenuate intracellular lipid accumulation.

Objective To study the distribution of antinuclear antibodies ( ANAs) in a healthy population and the significance of using ANAs screening test in medical examination .Methods The ANAs were measured by indirect immunofluorescence assay ( IIF) .The Western blot assay was used to detect fif-teen specific antibodies against auto-antigens .Results 3519 out of all 25 110 subjects showed ANAs titers>1∶100 , and among them male and female subjects were respectively accounted for 1143 and 2376 .1489 out of all subjects had ANAs titers >1∶320 , and among them male and female subjects were respectively accounted for 406 and 1083 .The positive rates of ANAs at different titers showed significant differences be -tween male and female subjects .Among subjects with ANAs titers >1∶320 , the number of male subjects showed a steady increase with the age , while the percentage of female subjects reached to two peaks during the periods of puberty and menopause .The fifteen specific antibodies were detected in 659 out of 1489 sub-jects with ANAs titers>1∶320 and anti-Ro-52 (14.2%) accounted for the majority , followed by anti-M2 (12.7%) and anti-SSA (9.6%).Conclusion ANAs can be detected among healthy population of all ages, but their distribution varied with gender and age .ANAs screening test is necessary for medical exami-nation of healthy population , especially for female during period of puberty or menopause .The population with positive ANAs should be followed-up closely and educated for the prevention of autoimmune diseases .

OBJECTIVE: The objective of this study was to evaluate the utility of vestibular autorotation test in the diagnosis of BPPV. METHOD: VAT and caloric test were performed on 41 patients with BPPV. VAT results were analyzed according to the affected semicircular canal. RESULT: Results of VAT were abnormal in 34 (82.93%) patients with BPPV. Fourteen cases were found with abnormal vertical phase, 1 case with abnormal vertical gain in a total of 21 vertical semicircular canal BPPV patients. Six cases with abnormal horizontal phase lead, 5 cases with abnormal horizontal gain, 2 cases with asymmetry were found in 12 patients with horizontal semicircular canal BPPV. Phase lead was abnormal in all frequencies in 4 patients, and in 2-3 Hz in 21 patients. 24 (58.54%) patients showed abnormal canal paresis (CP) and direction preference (DP) in caloric test. CONCLUSION VAT can indicate information of vestibular function in both vertical and horizontal semicircular canal. Phase of VAT is constantly enhanced in BPPV, especially in 2-3 Hz. As the supplement of caloric test, VAT may prove helpful in assessment of semicircular canal function.
Adult ; Aged ; Benign Paroxysmal Positional Vertigo ; Female ; Humans ; Male ; Middle Aged ; Vertigo ; diagnosis ; physiopathology ; Vestibular Function Tests

To study the dynamic changes of CT perfusion parameters during the first 12 h in the embolic cerebral ischemia models. Local cerebral ischemia model were established in 7 New Zealand white rabbits. All CT scans were performed with a GE Lightspeed 16 multislice CT. Following the baseline scan, further CT perfusion scans were performed at the same locations 20 min, 1-6 h and 8, 10 and 12 h after the embolus delivery. Maps of all parameters were obtained by CT perfusion software at each time point. The brains, taken 12 h after the scan, were sliced corresponding to the positions of the CT slices and stained by 2,3,5-triphenyltetrazolium chloride (TTC). On the basis of the TTC results, the ischemic sides were divided into 3 regions: core, penumbra and the relatively normal region. The changes of all parameters were then divided into 3 stages. In the first two hours (the first stage), the CBV dropped more remarkably in the core than in the penumbra but rose slightly in the relatively normal region while the CBF decreased and MTT, TTP extended in all regions to varying degrees. In the 2nd-5th h (the second stage), all the parameters fluctuated slightly around a certain level. In the 5th-12th h (the third stage), the CBV and CBF dropped, and MTT and TTP were prolonged or shortened slightly in the core and penumbra though much notably in the former while the CBV, CBF rose and MTT, TTP were shortened remarkably in the relatively normal region. We experimentally demonstrated that the location and extent of cerebral ischemia could be accurately assessed by CT perfusion imaging. The pathophysiology of the ischemia could be reflected by the CT perfusion to varying degrees.
Animals ; Blood Flow Velocity ; Brain Ischemia ; diagnostic imaging ; physiopathology ; Cerebrovascular Circulation ; Male ; Rabbits ; Stroke ; physiopathology ; Tomography, X-Ray Computed

OBJECTIVETo explore the distribution of the main clinical symptoms and signs of primary biliary cirrhosis (PBC) in a population of individuals with positivity for anti-mitochondrial antibody-M2 (AMA-M2).

METHODSA total of 20 970 persons who participated in routine health examinations at our hospital were tested for presence and level of antinuclear antibodies (ANAs) using an indirect immunofluorescence (IIF) assay and of AMA-M2 by western blotting. The chi-square test was used for statistical analysis.

RESULTSTiters of ANAs more than 1:320 were detected in 1 243 of all the study participants, with 156 of those individuals having detectable AMA-M2.The overall rate ofAMA-M2 positivity was 0.74%, with a significantly higher rate among female subjects (males:0.3% (32/10 550) vs.females:1.2% (124/10 420); x2=55.85, P less than 0.05). Among the AMA-M2-positive population there were 66 cases of abnormal liver function, 58 cases of increased alkaline phosphatase, 72 cases of abnormal findings for routine blood testing, 47 cases of gallbladder disease history, 49 cases of diabetes history, 22 cases of allergy, 75 cases of abdominal discomfort, 38 cases of weakness, 3 cases of jaundice, and 11 cases of pruritus. There were significant differences between the AMA-M2-negative individuals and the AMA-M2-positive individuals.

CONCLUSIONAmong the general population, individuals with substandard states of health, such as those with abnormal findings in routine blood tests and abnormal liver function, should be screened for AMA-M2. This screening will facilitate early diagnosis of PBC and timely initiation of disease management, improving the patient's life quality of life and prolonging their life.

Biomarkers ; Blotting, Western ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Liver Cirrhosis, Biliary ; metabolism ; Male ; Pruritus ; Quality of Life

Objective To assess the factors associated with the restoration of spontaneous circulation (ROSC) and 2-year survival prognosis in patients with cardiac arrest (CA) after acute myocardial infarction (AMI),and after ROSC,the effects of various factors on midian survival time and on 2-year survival.Methods In a registry study from January 2005 to January 2015,all consecutive AMI-induced CA patients treated with cardiopulmonary resuscitation (CPR) admitted to our hospital were enrolled.The survivors were followed-up for 2 years.Univariate analysis was applied to evaluate factors associated with rate of ROSC and 2-year survival.Multivariable logistic regression analysis was applied to evaluate statistically significant factors in the univariate analysis.Medians with inter-quartile ranges were used to describe 2-year survival time affected by various factors after ROSC.Kaplan-Meier survival curve analysis was used to evaluate the effect of factors on 2-year survival.Results A total of 254 cases with CA after AMI were enrolled,including 129 cases of ROSC and 71 cases of 2-year survival.Univariate analysis showed age ≥ 70 years,CA occurred during 22:00-8:00,the duration time ofCPR ≥ 15 min and adrenaline dosage ＞ 5 mg were unfavorable predictors of ROSC;while,left ventricular ejection fraction (LVEF) ≥ 40％ before CA,shockable rhythm and percutaneous coronary intervention (PCI) therapy were favorable predictors.Besides,age ≥ 70 years,intubation during CPR,adrenaline dosage ＞ 5 mg and cardiogenic shock were unfavorable predictors of 2-year survival;While,male,normal daily activity before CA and PCI treatment were favorable predictors.Multivariable analysis showed age,the duration of CPR,adrenaline dosage,LVEF before CA,the rhythm during CPR and PCI therapy were independent predictors of ROSC.Age and PCI therapy were independent predictors of 2-year survival.Among patients,the survival time was affected by various factors after ROSC,and the factors with minimum 25％ and small median value were associated with cardiac rupture,cancer,adrenaline dosage ＞ 5 mg and cardiogenic shock.The factor with maximum 25％ value was PCI treatment (216 days).Kaplan-Meier survival analysis suggested that age ≥ 70 years was an unfavorable factor of 2-years survival (Log-rank test,P=0.007);while,PCI treatment was a favorable factor (Log-rank test,P＜0.01).PCI-related prognosis analysis showed that the effectiveness of PCI was related to the timing of PCI,the number of infarctrelated artery and the difference in culprit lesion.Conclusions The age ≥ 70 years was disadvantageous to both ROSC and 2-year survival.PCI treatment was favorable to both ROSC and 2-year survival.