Objective To investigate the possibility and surgical effect of simultaneous tympanoplasty to chronic suppurative otitis media in the period of infection. Methods Forty-eight cases (48 ears) with chronic suppurative otitis media in the period of infection (31 with cholesteatoma, 17 with caries) were underwent simultaneous Wullstein Ⅱ and Ⅲ tympanoplasty on the complete elimination of the lesions (typical or modified mastoidectomy). Results All eases had dry ears within 4-10 weeks with average of 7 weeks. The air-bone gap within 10 dB was in 11 eases, 15 to 20 dB in 25 cases, 25 to 30 dB in 9 eases, no change or worse in 3 eases. Conclusions Infection is not the absolute eontraindication to the tympanoplasty in treating chronic suppurative otitis media, Wullstein Ⅲ tympanoplasty plus mastoid cavity obliteration and eonchaplasty is a suitable choice to treating chronic suppurative otitis media on the complete elimination of lesions and reconstruction of the ventilation system among mastoid cavity, tympanum and eustachian. The malfunction of eustachian is the main eanse to failure of surgery.

Objective To evaluate the safety and efficacy of overlapping sirolimus-eluting stent (SES) for long lesions during primary percutanous coronary intervention(PCl) in elderly patients with ST-segment elevation myocardial infarction (STEMI).Methods Seven hundred and seventy-five elderly patients with STEMI who underwent primary PCI were enrolled and followed up. Patients with two or more SES implanted for long lesions during PCI were taken as long lesion group and patients with single stents implanted were regarded as control group. The safety endpoints were in-hospital and follow-up death and stem thrombosis, and the clinical endpoints were the incidence of restenosis and target vessel revascularization rate during in-hospital follow-up and 6 months" follow-up.Results Among 775 patients, 62 patients had 64 long lesions. The average number of stents was 2. 2, and the average lesion length and stent length implanted were (45.3±10. 4)mm and (52.2±11.0)mm, respectively. During the 6 months' follow-up, the incidence of angiographically documented stent thrombosis were 1.6% in long lesion group and 1.1% in control group, respectively. No death or myocardial infarction occurred in two groups. There was no significant difference in the incidence of restenosis and target vessel revascularization rate between long-lesion group and control group (8. 1 vs. 4.8%, 6.9% vs. 3. 7%, both P>0.05). Conclusions Overlapping implantation of homemade SES is safe and effective for STEMI patients with long lesions in short-term period.

Objective: To evaluate the safety and efficacy of overlapping Sirolimus-eluting stents (SES) in very long lesions during primary percutaneous coronary intervention (PCI) in patients with ST-elevated myocardial infarction (STEMI).Methods: A total of 297 consecutive patients with STEMI underwent primary PCI from January to December 2007 in our hospital were studied.We identified the patients who had 2 or more SES implanted in single long lesion with a single procedure.6 months angiographic and clinical follow-up was performed.The incidences of restenosis and major adverse cardiac event (MACE) during hospitalization and at the follow-up time were analyzed.Results: We identified 31 patients with 31 long lesions who had been implanted more than 2 stents.A median of 2.1 stents were implanted, the median lesion length was 47.2±10.3mm and a median implanted stents'length was 53.2±10.5 mm.6 months clinical follow up rate was 100% and 6 months angiographic follow-up rate was 74.2%, respectively.The incidence of MACE was 8.7% which including target lesion revascularization (TLR).No cardiac death and no fatal myocardial infarction were found.Conclusion: Implantation of SES for very long target lesions seemed to be safe and effective in patients with ST elevated myocardial infarction.Its long-term safety and effectiveness should be further investigated.

Objective To explore the effect of prehospital 12-lead electrocardiogram (ECG) and transtelephonic notification on door-to-balloon time in patients with ST-segment elevation myocardial infarction (STEMI). Methods Four hundred and two patients with STEMI who underwent primary PCI from January 2006 to December 2007 in Beijng Anzhen Hospital were analyzed. They were divided into 3 groups: 137 patients without prehospital ECG (group A), 176 patients with prehospital ECG (group B) and 89 patients with prehospital ECG and early transtelephonie notification (group C). Door-to-balloon time and in-hospital mortality were compared among the groups. Results There were no significant differences in age, sex, past medical history and infarcted area among three groups. Compared with group A, patients in group B and group C had much shorter door-to-balloon time (96 minutes and 86 minutes vs. 113 minntes in group A, all P<0. 01). No difference was found in in-hospital mortality among three groups (2. 9% vs. 2.3% vs. 2. 2%, P> 0. 05). Conclusions Prehospital ECG and early transtelephonic notification can significantly shorten door-to-balloon time in patients with STEMI. Coordinated system including prehospital ECG and transtelephonie notification is proved to be feasible and effective.

OBJECTIVETo compare the ettect and side-ettect of fluoxetine and combination of fluoxetine and Chinese or Tibetan medicine in treating senile depression in plateau district. Methods Ninety patients with diagnosis of senile depression conformed to CCMD-3 standard, in plateau district of 2260 - 3200 m altitude were randomly divided into three groups and treated with fluoxetine (group A), fluoxetine plus Sanpu Xinnao Xin granule (group B) and fluoxetine plus Xiaoyao pill (group C), respectively, 30 cases in each group. Therapeutic effects were evaluated with Hamilton' s depressive scale (HAMD) and treatment emergent symptom scale (TESS) after 6 weeks treatment.

RESULTSThere was no significant difference in the therapeutic effects between the three groups. The adverse reaction in Group B and C was less than that in Group A (P<0.01). Conclusion Sanpu Xinnao Xin granule and Xiaoyao pill can raise the tolerance of patients with senile depression in plateau area against the adverse reaction of fluoxetine.

Aged ; Altitude ; Antidepressive Agents, Second-Generation ; therapeutic use ; Depressive Disorder ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Fluoxetine ; therapeutic use ; Humans ; Middle Aged ; Phytotherapy ; Serotonin Uptake Inhibitors ; therapeutic use

High-density lipoproteins (HDL) are naturally-occurring nanoparticles that are biocompatible, non-immunogenic and completely biodegradable. These endogenous particles can circulate for an extended period of time and transport lipids, proteins and microRNA from donor cells to recipient cells. Based on their intrinsic targeting properties, HDL are regarded as promising drug delivery systems. In order to produce on a large scale and to avoid blood borne pollution, reconstituted high-density lipoproteins (rHDL) possessing the biological properties of HDL have been developed. This review summarizes the biological properties and biomedical applications of rHDL as drug delivery platforms. It focuses on the emerging approaches that have been developed for the generation of biomimetic nanoparticles rHDL to overcome the biological barriers to drug delivery, aiming to provide an alternative, promising avenue for efficient targeting transport of nanomedicine.

OBJECTIVE To optimize the extraction technology of modified Tabusen- 2（MT-2），and to investigate inhibitory effects of the extract obtained by the optimal technology on osteoclast differentiation. METHODS The index components of MT- 2 process optimization were selected by using network pharmacology. Based on single factor tests ，the extraction technology of MT- 2 was optimized by Box-Behnken design-response surface methodology according to the comprehensive score of contents of above index components ，and then validated. RAW 264.7 cells were induced by receptor activator of nuclear factor-κB ligand（100 ng/mL） to prepare osteoclast differentiation model. Inhibitory effects of MT- 2 extract（18.6，37.2，74.4 ng/mL）obtained by the optimal technology on osteoclast differentiation were investigated. RESULTS The index components screened by network pharmacology included chlorogenic acid ，terpineol diglucoside ，isochlorogenic acid A ，1，5-dicaffeoylquinic acid ，hydroxysafflower yellow A ， ginsenoside Rg 1 and ginsenoside Rb 1. The optimal extraction technology of MT- 2 was ethanol volume fraction of 60％ ，the solid-liquid ratio of 1 ∶ 14（g/mL），extraction time of 94 min and extraction times of twice. The average comprehensive score obtained by the three validation experiments was 95.50，and the relative error with the predicted value （95.75）was －0.26％. Compared with osteoclastic differentiation model cells ，the cells treated with MT- 2 extract prepared by the optimal technology were mostly mononuclear round cells ，and the number of osteoclasts decreased significantly （P＜0.05），its inhibitory effects tended to strengthen with the increase of drug concentration. CONCLUSIONS The optimal extraction technology of MT- 2 is stable and feasible. Obtained extract can inhibit osteoclast differentiation.

Microglial surveillance plays an essential role in clearing misfolded proteins such as amyloid-beta, tau, and α-synuclein aggregates in neurodegenerative diseases. However, due to the complex structure and ambiguous pathogenic species of the misfolded proteins, a universal approach to remove the misfolded proteins remains unavailable. Here, we found that a polyphenol, α-mangostin, reprogrammed metabolism in the disease-associated microglia through shifting glycolysis to oxidative phosphorylation, which holistically rejuvenated microglial surveillance capacity to enhance microglial phagocytosis and autophagy-mediated degradation of multiple misfolded proteins. Nanoformulation of α-mangostin efficiently delivered α-mangostin to microglia, relieved the reactive status and rejuvenated the misfolded-proteins clearance capacity of microglia, which thus impressively relieved the neuropathological changes in both Alzheimer's disease and Parkinson's disease model mice. These findings provide direct evidences for the concept of rejuvenating microglial surveillance of multiple misfolded proteins through metabolic reprogramming, and demonstrate nanoformulated α-mangostin as a potential and universal therapy against neurodegenerative diseases.