Objective To estimate the patterns and frequency of anomalous coronary origin with angiography in the Chinese elderly population and evaluate the correlation between anomalous coronary origin and development of coronary atherosclerotic stenosis. Methods A retrospective analysis was performed on the basis of angiographic data among elderly patients who underwent coronary arteriography in Beijing University First Hospital. Those with anomalous origin of coronary arteries were selected for further assessment and significant stenosis in coronary arteries was recorded.Results Among 2031 patients, 46 patients were found to have anomalous origin of coronary artery,with an incidence rate of 2.3%. Right coronary artery was the most common anomalous vessel, being involved in 26 patients (56.5%). The anomalous origin was more frequent in right coronary artery than in left coronary artery (41.3%). The most common anomaly was right coronary artery arising from left coronary sinus in 13 patients (28.3%). Significant atherosclerotic lesions in the anomalous arteries were seen in 37 patients (80.4%). Conclusions In Chinese elderly population, the anomalous origin of coronary artery is more frequent in right coronary artery, the most common anomaly resides in right coronary artery arising from left coronary sinus. The anomalous coronary artery increases risk for development of coronary atherosclerotic stenosis.

Objective:To assess the consequences of switching aspirin dosage from 100 mg/d to 40 mg/d on cardiovascular benefit,bleeding risk and platelet aggregation in very elderly patients. Methods:Arachidonic acid induced platelet aggregation(AA-Ag)was measured in 537 patients aged 80 or older treated with aspirin (100 mg/d).In the study,100 patients with low on-treatment platelet ag-gregation and at high risk of bleeding and low risk of cardiovascular events,were switched to aspirin (40 mg/d)and their platelet aggregation was measured again 7 days later.Their bleeding and upper gastroin-testinal symptoms were also recorded in following 3 months.Results:The study observed a heterogeneous distributed aspirin 100 mg/d AA-Ag (range:0.42% to 28.78%)in the 537 very elderly patients.Aspi-rin 100 mg/d AA-Ag before the switch in aspirin 40 mg/d group was 5.00% ±2.32% and the rate of the patients with low on-treatment platelet aggregation was 71.00%.The rates of melena or occult blood positive,other minimal bleeding,upper gastrointestinal symptoms and a history of gastrointestinal bleeding in 40 mg/d group were higher than those in 100 mg/d group.On a regimen of aspirin 40 mg/d,AA-Ag increased to 11.21% ±4.95%(range:2.12% to 28.84%)with 95.00%of the patients with AA-Ag<20%and the rate of the patients with low on-treatment platelet aggregation was 15.00%.Multiple vari-able analysis revealed that aspirin 40 mg/d AA-Ag was significantly influenced by aspirin 100 mg/d AA-Ag,BMI and platelet counts.The rate of gastrointestinal bleeding decreased from 12.00% to 5.00%, and upper gastrointestinal symptoms decreased from 59.00% to 21.00% after the switch in 40 mg/d group.Conclusion:Switching aspirin dosage from 100 mg/d to 40 mg/d reduces the bleeding events and improves upper gastrointestinal symptoms,thus inhibiting platelet aggregation effectively in very elderly patients.

Objective: To observe the influence of different tocopherol isoforms on oxidized low density lipoprotein (oxLDL) or recombinant human C reactive protein (rhCRP) induced expression of intercellular adhesion molecule 1 (ICAM 1) in human umbilical vein endothelial cells (HUVECs) and to investigate the potential mechanisms and effects of different tocopherols on atherosclerosis. Methods: Cultured HUVECs were incubated with oxLDL,oxLDL+? tocopherol,oxLDL+? tocopherol,oxLDL+mixed tocopherols,rhCRP,rhCRP+? tocopherol,rhCRP+? tocopherol, rhCRP+mixed tocopherols for 24 hours, respectively. The ICAM 1 expressions of protein and mRNA were detected by cell enzyme linked immunosorbent assay (ELISA), flow cytometric technique and RT-PCR. Results : Incubation of HUVECs with oxLDL or rhCRP for 24 hours significantly increased ICAM 1 expressions of proteins and mRNA . The different tocopherols inhibited oxLDL induced ICAM 1 expression in HUVECs in a concentration dependent manner(50-200 ?mol/L) and mixed tocopherols were more potent than ? tocopherol or ? tocopherol alone. However, rhCRP induced ICAM 1 expression in HUVECs was not inhibited by tocopherols. Conclusion :The different tocopherols inhibited oxLDL induced ICAM 1 expression in HUVECs and mixed tocopherols were more potent than ? tocopherol or ? tocopherol alone, which may be important for the beneficial effects of tocopherols on atherosclerosis and cardiovascular disease.

Rectal carcinoma is one of the most common gastrointestinal malignancies in China.Surgical resection is its preferred treatment.The scope of lymph node dissection influences the postoperative recurrence and metastasis.There are many studies The significance of lateral lymph node dissection in rectal carcinoma is extensively discussed,here we make a review of lateral lymph node dissection in rectal carcinoma,which may provide assistance for the treatment of rectal carcinoma.

Objective: To study the relationship between C-reactive protein (CRP) gene polymorphisms and the risk of chronic peri-odontitis and severe chronic periodontitis (CP) with type2 diabetes to confirm the effect of genetic factor in chronic periodontitis and chronic periodontitis with type2 diabetes. Methods; DNA was extracted by Chelex-100 from buccal swabs of patients who suffered from chronic periodontitis or chronic periodontitis with type2 diabetes and patients with healthy periodontium. PCR-RFLP was used to test the CRP genotype distribution. The correlationship between the incidence of chronic periodontitis and chronic periodontitis with type2 diabetes and CRP gene polymorphism was analyzed statistically. Results; There was no statistical difference in the distribution of CPR +1059 genotype and allele frequency between experiment group and control group (X~2 = 0. 223, P=0.994). The genotype and allele frequency distribution were in line with Hardy-Weinberg equilibrium. Conclusion; There is no correlation between CRP + 1059G/C single nucleotide polymorphisms and the susceptibility of chronic periodontitis as well as chronic periodontitis with type2 diabetes.

BACKGROUNDTo detect dendritic cells (DC)in the peripheral blood and plasma concentration of vascular endothelial growth factor (VEGF) of patients with non-small cell lung cancer (NSCLC) and to evaluate their relationship.

METHODSThe quantitation of DC in the blood was performed in 55 patients with NSCLC, 13 patients with pulmonary benign diseases, and 12 healthy volunteers by a novel flow cytometric assay. The concentration of VEGF in the plasma was measured by ELISA kit.

RESULTSNo significant difference was found in the levels of DC and VEGF between the patients with pulmonary benign diseases and healthy volunteers (P>0.05). In comparison with subjects of healthy volunteers and pulmonary benign diseases, the level of DC was significantly decreased, while that of VEGF was significantly increased in the patients with NSCLC(P < 0.05 to 0.01). The levels of DC and VEGF in the peripheral blood of NSCLC were closely associated with TNM stages and lymph node metastasis. However, no correlation was found among the levels of DC and VEGF and age, gender, cell differentiation and histologic classification. There was a negative correlation between the VEGF concentration and the DC counts.

CONCLUSIONSThe decline of DC count in peripheral blood and the enhancement of plasma VEGF are remarkably related to the malignancy of NSCLC. And VEGF overexpression may be one of mechanisms of DC maturation and differentiation inhibition in patients with NSCLC.

OBJECTIVETo study the relationship between endothelial nitric oxide synthase (eNOS) Glu298Asp gene polymorphism and chronic periodontitis (CP) with type 2 diabetes mellitus (T2DM).

METHODSDNA from patients' buccal swabs of CP, CP with T2DM, T2DM and health was isolated and extracted. The eNOS Glu298Asp gene polymorphism were assessed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) respectively.

RESULTSThe distribution of eNOS Glu298Asp genotype in CP group, T2DM group, CP with T2DM group and health group showed statistical differences (chi2 = 18.503, P = 0.005), and the gene frequency showed statistical differences (chi2 = 8.243, P = 0.041). Compared health group to CP with T2DM group, OR value of the genetype T was 0.962, 95% confidence interval lay in between 0.737 to 1.256, which showed T maybe a protective factor. While OR value of the genetype G was 1.043, 95% confidence interval lay in between 0.781 to 1.391, which showed G maybe a risk factor. However, neither T nor G was statistically significant.

CONCLUSIONBased on these findings, there are some association between eNOS Glu298Asp polymorphism and the risk of CP group, T2DM group, CP with T2DM group.

Chronic Periodontitis ; Diabetes Mellitus, Type 2 ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Nitric Oxide Synthase Type III ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Risk Factors

BACKGROUNDDendritic cell (DC)-based immunotherapy is a new approach and effective for some malignant tumors. The aim of this study is to observe the efficacy and toxicity of immunotherapy with carcinoembryonic antigen (CEA) peptide-pulsed DCs in patients with refractory advanced lung cancer.

METHODSLung cancer patients with high CEA expression were enrolled into this project. Autologous DCs were generated from patients' plastic-adherent peripheral blood mononuclear cells and loaded with CEA 5 days later. Cytokine-induced killer cells (CIK) were cultured from non-adherent peripheral blood mononuclear cells. DCs and CIK were transfused to patients. Responses and toxicities were observed.

RESULTSA total of 22 patients with lung cancer received DCs immunotherapy. DCs doses were 2.5×10⁶-9.6×10⁷ (5.03×10⁶). CIK doses were 3.4×10⁸-46×10⁸. CD3, CD8, NK and IFN-γ levels obviously increased after treatment (P < 0.05). The 1-year survival rate was 68.2% (15/22). Main toxicities were fever and rash.

CONCLUSIONSDCs-based immunotherapy is feasible and safe to patients with lung cancer.

OBJECTIVETo compare the efficacy and safety of atorvastatin, rosuvastatin and xuezhikang capsule in elderly.

METHODSA total of 314 60-to-94-year-old (average (73.6 ± 7.9) years old) patients who were given different doses and types of statins were divided into three groups: the atorvastatin group (108 patients), the rosuvastatin group (104 patients) and the xuezhikang capsule group (102 patients). The serum TG, TC, LDL-C, HDL-C,ALT and CK were examined before and after the treatment which lasted for at least 4 weeks. All patients were divided into moderate risk group (13, 12 and 21 patients respectively in 3 groups); high risk group (40, 44 and 48 patients respectively in 3 groups) and very high risk group (55, 48 and 33 patients respectively in 3 groups ) according to guidelines on prevention and treatment of dyslipidemia in chinese adults (2007 version). The rate of reaching target goal and the dose when reaching target levels in different risk stratification groups were calculated and compared.

RESULTSSerum TC, LDL-C and non-HDL-C were significantly reduced after the 4-week-treatment in all the three groups (P < 0.01). Serum LDL-C level before and after treatment were (3.14 ± 0.78)mmol/L vs. (2.14 ± 0.65)mmol/L in atorvastatin group (the arevage dose was (16.4 ± 4.8)mg/d), (2.92 ± 0.77)mmol/L vs. (1.96 ± 0.55)mmol/L in rosuvastatin group (the arevage dose was (8.7 ± 3.0) mg/d), and (2.70 ± 0.62)mmol/L vs. (2.16 ± 0.61) mmol/L in xuezhikang capsule group (the arevage dose was (0.9 ± 0.3) g/d ). Among all the three groups of patients, the cases of reaching target levels of LDL-C were 13, 11 and 20 in patients at moderate risk, were 38(95.0%), 38(86.4%) and 40 (83.3%) in patients at high risk, and were 22(40.0%), 30(62.5%) and 17(51.5%) in patients at very high risk. There were no statistical differences in the rate of reaching target levels of LDL-C, non-HDL-C and TC in the three groups and at different risks (P > 0.05). One patient in the atorvastatin group showed ALT level elevation >3 times of the upper limit of normal value, there was no patient with CK level elevation >5 times of the upper limit of normal value.

CONCLUSIONAtorvastatin, rosuvastatin and xuezhikang capsule at low dose and/or standard dose are effective and safety in elderly patients.

Aged ; Aged, 80 and over ; Anticholesteremic Agents ; Atorvastatin Calcium ; Cholesterol, LDL ; Dose-Response Relationship, Drug ; Dyslipidemias ; drug therapy ; Female ; Fluorobenzenes ; adverse effects ; therapeutic use ; Heptanoic Acids ; adverse effects ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Pyrimidines ; adverse effects ; therapeutic use ; Pyrroles ; adverse effects ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; adverse effects ; therapeutic use

Polyphyllin Ⅰ(PPⅠ)and polyphyllin Ⅱ(PⅡ)are the main active substances in the Paris polyphylla.However,liver toxicity of these compounds has impeded their clinical application and the potential hepatotoxicity mechanisms remain to be elucidated.In this work,we found that PPⅠ and PⅡ exposure could induce significant hepatotoxicity in human liver cell line L-02 and zebrafish in a dose-dependent manner.The results of the proteomic analysis in L-02 cells and transcriptome in zebrafish indicated that the hepa-totoxicity of PPⅡ and PⅡwas associated with the cholesterol biosynthetic pathway disorders,which were alleviated by the cholesterol biosynthesis inhibitor lovastatin.Additionally,3-hydroxy-3-methy-lglutaryl CoA reductase(HMGCR)and squalene epoxidase(SQLE),the two rate-limiting enzymes in the choles-terol synthesis,selected as the potential targets,were confirmed by the molecular docking,the over-expression,and knockdown of HMGCR or SQLE with siRNA.Finally,the pull-down and surface plasmon resonance technology revealed that PPⅠ could directly bind with SQLE but not with HMGCR.Collectively,these data demonstrated that PPⅠ-induced hepatotoxicity resulted from the direct binding with SQLE protein and impaired the sterol-regulatory element binding protein 2/HMGCR/SQLE/lanosterol synthase pathways,thus disturbing the cholesterol biosynthesis pathway.The findings of this research can contribute to a better understanding of the key role of SQLE as a potential target in drug-induced hepatotoxicity and provide a therapeutic strategy for the prevention of drug toxic effects with similar structures in the future.