AIM: To test the effect of ERK1/2 on ischemic preconditioning (IPC) in diabetic rat hearts. METHODS: The diabetic rat model was made with alloxan. After eight weeks, 24 rats were divided into 4 groups: non-diabetic IPC rats (group A); non-diabetic non-IPC rats (group B); diabetic IPC rats (group C); diabetic non-IPC rats (group D). ECGⅡ lead, left ventricular development pressure (LVDP), and first derivative of LVDP ~(?dp/dt_~max ) were recorded. Myocardial phosphorylation of extracellular signal regulated kinases1/2 (ERK1/2) was detected by Western-blotting. RESULTS: (1) The ventricular arrythmia score was significantly lower in group A than that in group C (P

Objective To discuss whether the separating block of sensory nerve with acupoint-injection and epidural analgesia by ropivacaine during labour.Methods Ninty full term primigravidae with ASAⅠ～Ⅱwere randomly divided into 3 groups:group E(n = 30),group C(n = 30)and group A(n = 30).When the external cervi- cal os was dilated to 3cm,group A:acupiont-injection to Ci Liao;group E:epidural analgesia with 0.075% ropiva- caine and fentanyel 2?g/ml;group C:combining group A and group E except fentanyel 2?g/ml.Level of pain(VAS scores),degree of sensory and motor block,the mode of delivery,the progress of labour and side effects were recorded and compared.Results The level of pain(VAS scores)in group A was higher than that of group C and group E,and there were no significant differences in group C and group E,Bur there were some side effects discovered in group E. There was no significant differences of the mode of delivery in the groups.Conclusion The method that acupoint- rejection combined with epidural analgesia by 0.075% ropivacaine is effective and has no side effects for labour.

OBJECTIVETo compare the difference between muscle-tension-balance acupuncture and conventional acupuncture in the impacts on motor function and living ability of patients with drop foot and strephenopodia after stroke.

METHODSSeventy cases were randomly divided into a muscle-tension-balance acupuncture group (group A) and a conventional acupuncture group (group B), 35 cases in each one. In group A, firstly the acupuncture of weakening technique was applied to Sanyinjiao (SP 6) and Taixi (KI 3) on the musculus extensor side; secondly, the strengthening technique was adopted at Jiexi (ST 41), Shenmai (BL 62) and Yanglingquan (GB 34) on musculus flexor side. In group B, the conventional needling technique was applied to Zusanli (ST 36), Sanyinjiao (SP 6), Xuanzhong (GB 39), etc. The treatment was given once every day in either group, 10 treatments made one session and 3 sessions of treatment were required. The score of Fugl-Meyer motor function of the lower limb on the affected side and Barthel index score were assessed before and after treatment in two groups.

RESULTSAfter treated for 3 sessions, Fugle-Meyer motor function score and Barthel index score of the patients all increased in two groups (all P < 0.01). The results in group A were better than those in group B (both P < 0.05). The improvements were apparent in the 2nd session of treatment in group A (both P < 0.01), which were superior to those in group B (both P < 0.05).

CONCLUSIONEither acupuncture therapy can improve the motor function and living ability of patients with drop foot and strephenopodia after stroke. The muscle-tension-balance acupuncture achieves the efficacy quickly and its efficacy is much better.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Gait Disorders, Neurologic ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Motor Activity ; Stroke ; complications

BACKGROUNDIt is still controversial whether or not the correlation between lipid abnormality and coronary heart disease (CHD) becomes weaker in the elderly, and whether patients above 80 years old still benefit from lipid management for the secondary prevention of CHD. The purpose of this study is to assess the correlation between hyperlipidemia and the risk of CHD events in the elderly, and to determine if it is appropriate to use lipid-lowering drugs in those aged above 80, as prescribed by the recommended guidelines for lipid management.

METHODSOne thousand two hundred and eleven retirees, mainly males (92%), aged 70 +/- 9 years, were enrolled in this study. Lifestyle habits and medical history were recorded via questionnaires. During the period 1986 - 2000, all subjects participated in an annual physical examination with a blood chemistry survey. The mean follow-up period was 11.2 years. Subjects with incidental illnesses, especially cardiovascular diseases, were diagnosed or treated promptly. Serum lipid parameters, including total cholesterol (TC), low and high-density lipoprotein cholesterol (LDL-C and HDL-C) and triglyceride (TG) levels were analyzed according to standardization of lipid and lipoprotein measurements. The association between lipid levels and the prevalence of acute myocardial infarction (AMI) or coronary death was analyzed statistically.

RESULTSLipid abnormalities occurred in 2/3 of the 1211 subjects. The most common lipid disorder was high TC and high LDL-C, which was much more prevalent than high TG. Among the subjects, 51.6% had TC levels above 5.2 mmol/L. Mean TC and LDL-C reached peak levels in the 65 - 74 age group without significant decrease until ages over 90. The cumulative total number of deaths due to various causes was 397 in the 15-year follow-up period, with the mortality rate in the high lipid group slightly lower than that in the normal lipid group (30.6% vs 35.3%), although the difference was not significant (P = 0.1931). However, there were more cases of coronary death in the high lipid group than in the normal lipid group (7.9% vs 4.6%, P = 0.0045). When examining AMI survivors, more AMI cases were found in the high lipid group than in the low lipid group (20.9% vs 11.4%, P < 0.0001). The cumulative number of coronary deaths was 89 (with 88 cases above age 70), and the total number of CHD cases was 214 (17.7% of the whole group). Logistic regression analysis reveals that age, hypertension, LDL-C, and HDL-C are important risk factors for CHD. Lifestyle changes were common, but only 45% of the hyperlipidemic cases received drug treatment. Statins were commonly used only in recent years.

CONCLUSIONThe above results show that high TC and LDL-C levels are correlated with a high CHD risk even in people over 80. For elderly patients with clinical CHD and an aggregation of CHD risk factors, cholesterol-lowering therapy might be considered if the general health of the patient makes this permissible.

Aged ; Aged, 80 and over ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Coronary Disease ; blood ; etiology ; mortality ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias ; complications ; mortality ; Lipids ; blood ; Male ; Risk Factors ; Triglycerides ; blood

BACKGROUNDThis study was designed to evaluate the relationship between high-density lipoprotein cholesterol (HDL-C) level and acute myocardial infarction (AMI) and coronary heart disease (CHD) death and to explore the protective effect of HDL against CHD in the elderly Chinese.

METHODSStarted from 1986, 1211 retirees (92% males) were enrolled consecutively and studied prospectively. The average starting age was 70 +/- 9 years, and that at the end of the study was 80 +/- 9 years. During the follow-up study, all the participants received yearly physical examination and blood chemistry survey from 1986 - 2000. The average duration of the follow up study was 11.2 years. The end point of this study was either attacks of AMI or death due to CHD and other causes. CHD risk factors were screened by logistic regression analysis. According to their HDL-C levels, cases were divided into low (< 1.03 mmol/L), medium (or normal, 1.03 - 1.56 mmol/L) and high (> 1.56 mmol/L) level groups, the differences in incidence of AMI and CHD death in each group were analyzed.

RESULTSThe cumulative attacks of acute coronary syndrome (mostly AMI) were 214 cases, including 89 cases of coronary death and 308 death caused by other diseases during the follow up study. AMI occurrence and CHD death in normal HDL-C group were lower than those in the low HDL-C group by 40% and 53%; and those in the high HDL-C group were lower than in the normal group by 56% and 50%, respectively. Statistical analysis on normal lipid cases (411 cases, total cholesterol < 5.17 mmol/L, triglyceride < 1.69 mmol/L) revealed that the cases at low HDL-C level had similar rates of AMI events and CHD mortality as those of the entire group (including hyperlipidemia); however, AMI attacks and CHD deaths decreased significantly at the normal and high HDL-C levels. The results demonstrated that the protective effect of HDL against coronary artery disease is more prominent in people with low lipid level.

CONCLUSIONLow HDL is an important independent risk factor for AMI attacks and CHD death in the elderly; high HDL has significant protective effect against coronary artery disease.

Aged ; Aged, 80 and over ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Coronary Disease ; blood ; etiology ; prevention & control ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; Risk Factors

OBJECTIVETo investigate the effect of xy2004, a centchroman derivative, on the proliferation of MCF-7 cells and the mechanisms.

METHODSThe effects of xy2004 on MCF-7 cell proliferation and apoptosis were evaluated with MTT assay and flow cytometry, respectively. The expressions of the apoptosis-related proteins were examined with Western blotting. Competitive estrogen-receptor binding assay was used to investigate the affinity of xy2004 to estrogen receptors (ER).

RESULTSxy2004 induced proliferation of MCF-7 cells at low concentrations but inhibited cell proliferation at high concentrations. The application of tamoxifen inhibited xy2004-induced proliferation of MCF-7 cells. The relative binding affinity of xy9906 to ERα and ERβ, presented as the IC50 value, was 7.38 × 10⁻³ mol/L and 4.12 × 10⁻⁷ mol/L, respectively. Treatment of MCF-7 cells with high-concentration xy2004 reduced the cellular expression of Bcl-2 protein and increased Bax protein expression.

CONCLUSIONAt low concentrations, xy2004 directly stimulates the proliferation of MCF -7 cells through ligand-receptor binding, and at high concentrations, it inhibits the cell proliferation by regulating the expression levels of the apoptosis-related proteins.

Apoptosis ; Breast Neoplasms ; pathology ; Cell Proliferation ; Centchroman ; pharmacology ; Estrogen Receptor alpha ; metabolism ; Estrogen Receptor beta ; metabolism ; Humans ; MCF-7 Cells ; drug effects ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Tamoxifen ; bcl-2-Associated X Protein ; metabolism

BACKGROUNDThe optimal endpoint for catheter ablation of persistent atrial fibrillation (AF) remains ambiguous. This study investigated the impact of AF termination as a procedural endpoint and the termination mode on long-term clinical outcome.

METHODSTwo hundred and ninety-three patients who underwent stepwise ablation for persistent AF were categorized into the AF termination by ablation group and into the electrical cardioversion (CV) group. Subgroups were also analyzed based on different termination modes. Follow-up assessment included early recurrence and sinus rhythm (SR) maintenance.

RESULTSDuring initial ablation, 33 patients (11.3%) were directly converted to SR, 166 patients (56.7%) were converted to atrial tachycardia (AT) that subsequently restored SR with further ablation in 98 patients (33.4%), and a total of 162 patients (55.3%) underwent cardioversion due to persistent atrial arrhythmias. Comparison between termination by ablation and termination by cardioversion in patients exhibiting AF or AT revealed that no significant difference was observed in early recurrence (38.2% vs. 43.8%, P = 0.328) and SR maintenance (67.2% vs. 59.8%, P = 0.198) during the (23 ± 7) months follow-up. Even after repeat ablation, the SR maintenance continued to exhibit no statistical difference in above two groups (72.5% vs. 70.4%, P = 0.686). Further analysis of subgroups, however, demonstrated that patients with AF terminated directly to SR experienced better clinical outcomes than other subgroups (P < 0.05). Furthermore, atrial arrhythmias present during ablation have been implicated in prediction of recurrence mode: AF or AT (P < 0.05).

CONCLUSIONSTermination as a procedural endpoint is not associated with favorable long-term SR maintenance in persistent AF. AF methods that convert arrhythmia directly to SR have, however, been linked with improved clinical outcomes, although conversions to AT may not be correlated. Atrial arrhythmias observed during the ablation may be used to predict the recurrence mode.

Adult ; Aged ; Atrial Fibrillation ; physiopathology ; therapy ; Catheter Ablation ; methods ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Male ; Middle Aged

Background The optimal endpoint for catheter ablation of persistent atrial fibrillation (AF) remains ambiguous.This study investigated the impact of AF termination as a procedural endpoint and the termination mode on long-term clinical outcome.Methods Two hundred and ninety-three patients who underwent stepwise ablation for persistent AF were categorized into the AF termination by ablation group and into the electrical cardioversion (CV) group.Subgroups were also analyzed based on different termination modes.Follow-up assessment included early recurrence and sinus rhythm (SR) maintenance.Results During initial ablation,33 patients (11.3％) were directly converted to SR,166 patients (56.7％) were converted to atrial tachycardia (AT) that subsequently restored SR with further ablation in 98 patients (33.4％),and a total of 162 patients (55.3％) underwent cardioversion due to persistent atrial arrhythmias.Comparison between termination by ablation and termination by cardioversion in patients exhibiting AF or AT revealed that no significant difference was observed in early recurrence (38.2％ vs.43.8％,P=0.328) and SR maintenance (67.2％ vs.59.8％,P=0.198) during the (23±7) months follow-up.Even after repeat ablation,the SR maintenance continued to exhibit no statistical difference in above two groups (72.5％ vs.70.4％,P=0.686).Further analysis of subgroups,however,demonstrated that patients with AF terminated directly to SR experienced better clinical outcomes than other subgroups (P ＜0.05).Furthermore,atrial arrhythmias present during ablation have been implicated in prediction of recurrence mode:AF or AT (P ＜0.05).Conclusions Termination as a procedural endpoint is not associated with favorable long-term SR maintenance in persistent AF.AF methods that convert arrhythmia directly to SR have,however,been linked with improved clinical outcomes,although conversions to AT may not be correlated.Atrial arrhythmias observed during the ablation may be used to predict the recurrence mode.

INTRODUCTIONBased on the estimate results of the capacity and preparedness of Beijing hospitals to respond to pandemic influenza, using flu surge model to evaluate its applicable hypothesis and to provide government with sentient strategy in planning pandemic influenza. Through collection of medical resources information, we calculated the possible impaction on hospitals by Flu Surge model and explored the applicable hypothesis in model operation through a questionnaire, direct observation and group discussion in 3 hospitals in Beijing. Based on flu surge model estimation during a 6-week epidemic from a pandemic virus with 35% attack rate, Beijing would have had an estimation of 5 383 000 influenza illnesses, 2 691 500 influenza outpatients, 76 450 influenza hospitalizations and 14 508 excess deaths. For a 6-week period with 35% attack rate, there would be a peak demand for 8% of beds, 210% of ICU beds, and 128% of ventilators estimated. Outpatients in different level hospital were quite disproportionated with 1742/ hospital/day, 650/hospital/day, and 139/hospital/day respectively. The sampled health workers had a mastery of 63.4% of the total knowledge and skills of diagnosing and treating of influenza, 73.5% of them washed their hands and 63.5% used PPE correctly. The total beds capacity, medical beds capacity and respiratory medical beds capacity would increase 8%, 35% and 128% respectively.

CONCLUSIONThe estimation results could be referenced when planning the pandemic strategy, but the results should be treated objectively when considering the hypothesis and practical situation in this model being used.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Disease Outbreaks ; statistics & numerical data ; Female ; Hospital Bed Capacity ; Hospital Planning ; Hospitalization ; statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Influenza, Human ; epidemiology ; Male ; Middle Aged ; Models, Statistical ; Surge Capacity ; Young Adult