Objective To investigate the effects of altered deceleration capacity of heart rate (DC) and heart rate deceleration runs(DRs) on the short-term prognosis of patients with acute myocardial infarction (AMI) .Methods 115 patients confirmed with AMI within 7 days as AMI group ,50 persons without MI were selected as control group .The deceleration capacity of heart rate and heart rate deceleration runs were detected by the 24 hours Holter within 7 to 14 after onset of AMI ,all the patients were divided in-to high risk group ,medium risk group and low risk group through the Holter results .Left ventricular ejection fraction (LVEF) was evaluated by echocardiography .Compare the risk of the AMI group with the control group .Meanwhile the AMI patients were fol-lowed up for mean(9 .2 ± 1 .7)months .Observe the presence of major adverse cardiovascular events (MACE) .All AMI patients were classified into MACE and non-MACE groups according to the presence of MACE .Analysis the risk factors of MACE .Results AMI group had a significant increase risk but decrease in deceleration capacity of heart rate (P<0 .05) as compared with the control group .In MACE group ,the rate of high risk was significant increasing(P=0 .005) ,but the rate of low risk was significant decrea-sing(P=0 .039) .The Logistic regression analysis showed that LVEF ,high risk group ,age and percutaneous transluminal coronary intervention(PCI) were independent risk factors on presence of MACE .Correlation r was 0 .33 ,0 .30 ,0 .23 ,0 .18 respectively ,and odds ratio was 4 .83 ,4 .28 ,2 .22 ,1 .58 respectively ,the correlation with deceleration capacity of heart rate was a little weaker than LVEF .The coefficient of determination r2 was 0 .528 when the LVEF and ages went into regression ,whereas that was 0 .635 when the LVEF ,high risk group and age went into regression together .Conclusion Capacity of heart rate decelerate was significantly weakened in AMI patients .LVEF ,the significantly decreased deceleration capacity of heart rate ,age and PCI were independent risk factors on presence of short-term MACE in AMI patients .The prognostic value of the DC and DRs was a little weaker than the LVEF .The better predictive value was obtained if the LVEF ,the significantly decreased deceleration capacity of heart rate ,age were combined .

Objective To explore influence of long-term inhaled glucocoticoids(IGS) on soluble intercellular adhesion molecule-1(sICAM-1)) in children with bronchial asthma.Methods Enzyme-linked immunosorbent assay(ELISA) method was used to detect the serum sICAM-1 level in 36 healthy children and 29 children with bronchial asthma(untreated and post-treated for 3,6 and 12 months).Results 1.Serum sICAM-1 level was significantly elevated in children with asthma and significantly higher than that in normal control group(P

Objective To summarize the treatment experiences in gastrointestinal leaJcage atter gastrectomy for gastric cancer. Mehods From January 1997 to December 2006 the clinical data of 37 cases of gastrointestinal leakage including anastomotic leakage in 19 cases and duodenal stump leakage in 18 after gastrectomy for gastric cancer in People's Liberation Army General Hospital were analyzed retrospectively. Results All of the Cases were treated with abdominal drainage,continuous gastrointinal decomnression and parenteral nutrition combined with enteral nutrition.There were 32 cases receiving glutamine enrichment nutrition support,31 ases used somatostatin,13 cases received supplemented recombinarlt human growth hormone.Fistula healed in 21～30 d in 9 cases after gastrectomy,in the other 24 cases fistula healed in 30-60 d,while it healed in 60～81 d in the remaining 2 cases.Two died of leakage associated complications after gastrectomy for gastric cancer including anastomotlc leakage follwing esophagojejunostomy complicated by severe thoracic and lung infection in one and duodenal stump leakage complicated by severe abdominal cavity sepsis and hemorrhage in the other. Conclusion Patent and effective abdominal cavity drainage,continuous gastrointestinal decompression,parenteral nutrition combined with enteral nutrition,glutarnine,somatostafin and recombinant human growth hormone are the'mportant factors for the healing of gastrointestinal leakage after gastrectomy tor gastric cancer.

Objective To investigate the diagnosis and treatments of delayed endolymphatic hydrops(DEH).Methods A restrospective study was conducted in 37 cases of DEH.who were tested with pure tone threshold,vestibular evoked myogenic potentials,high stimulation rate auditory brainstem response audiometry and vestibular ruction test.Conservative drug therapy was the major treatment.Results All the 37 patients had sensorineural hearing loss up to the medium-severe degrees at least.Twenty-five had hearing loss and endolymphatic hydrops on the same side,nine had contralateral type and three bilateral type.Ten cases had abnormal horizontal semicircular canal(HSCC) hydrops and saccular hydrops.Nine cases had abnormal HSCC function and nomal saccular function.Fifteen cases had abnormal saccular function and normal HSCC function.Twenty-five abnomalVEMP showed of loss of p13-n23,prolonged latencies of p13 and depressed amplitude cases with of p13-n23.18 cases were completely relieved from vertigo in a week.17 cases improved until totally relieved in two weeks,while the rest 2 cases that were subject to chemistry labyrinthectomy free of vertigo attack.Conclusion Pure tone threshold,EcochG,bithermal caloric test and vestibular evoked myogenic potentials are important diagnosis methods of delayed endolymphatic hydrops.Consevative drug therapy,especially diuretics and vascular dilation may play a major role in the treatment of delayed endolymphatic hydrops.

Objective To evaluate the efficacy and safety of AlumaTM functional aspiration controlled electrothermal stimulation (FACES) radiofrequency in the treatment of skin wrinkles and laxity on the face and neck. Methods A total of 30 volunteers with aging skin were recruited in the study. All volunteers were treated with AlumaTM FACES radiofrequency for 6 times at 2-week interval. Photographs were taken for volunteers before every treatment and 1 month after the last treatment. Improvement in lesions was objectively assessed by two separate physicians based on the photographs of volunteers taken before the first,fourth and sixth treatment, and 1 month after the last treatment. Patient satisfaction was measured by ques-tionnaire. Adverse effects were recorded. Results Totally, 24 volunteers completed the treatment. Improve-ment of lesions was achieved in 66.7% of the volunteers after 3 treatments, 90.5% after 5 treatments, and 94.4% one month after the last treatment. About 50% of the volunteers were satisfied with the effect after 3 treatments, 90.5% after 5 treatments, and 100% one month after the last treatment. Slight purpura was the most common side effect. Conehusion Radiofrequency therapy is effective for skin wrinkles and laxity on the face and neck, without obvious side effect.

Objective To evaluate the clinical effectiveness of perioperative fast-track surgery(FTS)program and nutrition support in the elderly patients with gastric cancer.Methods Totally 42 patients were equally randomized into FTS group(receiving perioperative FTS program)and control group(receiving a conventional therapy).The postoperative first defecation time,postoperative hospital stay,hospitahzation expenditure,and postoperative complications were compared between these two groups.Results The postoperative first defecation time and postoperative hospital stay were(75.4±24.3)hours and(11.2±3.2)days in FIS group and(98.0±22.6)hours and(14.4±4.6)days in control group(P=0.0165,P=0.0004;respectively).The hospitalization expenditure was significantly lower in FTS group than in control group[(3.66±0.48)×104 vs.(4.56±0.78)×104 RMB yuan;P=0.0001].The incidence of postoperative complications in FTS group was also significantly lower than that in control group(9.5% vs.28.6%,P=0.0422).Conclusion Perioperative FTS program can accelerate postoperative rehabilitation,shorten hospital stay,lower hospitalization expenditure,and reduce the incidence of postoperative complications.

Objective To compare the clinical efficacy and adverse effects of photodynamic therapy (PDT) versus pulsed dye laser(PDL)for the treatment of port wine stains(PWS). Methods Forty?five patients with PWS were enrolled in this study. The PWS lesions in each patient were randomly divided into PDT and PDL areas. Hematoporphyrin monomethyl ether of 5 mg/kg was injected intravenously into the PDT area protected from light, followed by 20?minute irradiation with a 532?nm, solid?state, continuous?wave laser(power density:80-100 mw/cm2;spot diameter: 7 cm)10 minutes later. The PDL area was treated with a single session of 595?nm pulsed dye laser radiation(spot diameter:7 mm;pulse width:10 ms;energy density:10-12 J/cm2). The interval between PDT and PDL treatment was no shorter than two months. Follow up visits were scheduled on day 4 and week 8 after each treatment. Adverse reactions were recorded, and photographs were taken before and 8 weeks after the treatment for evaluation of lesion regression. Results In the case of PDT area, 10 cases(22.22%)were nearly cured, 22(48.89%)achieved marked improvement, 9(20.00%)improvement, 4(8.89%)no improvement. As far as the PDL area is concerned, 6 cases(13.33%)were nearly cured, 16(35.56%)achieved marked improvement, 18(40.00%)improvement, and 5 (11.11%)no improvement. The response rate was significantly higher in the PDT area than in the PDL area(Z=2.48, P<0.05). Hyperpigmentation, which spontaneously subsided within 3 to 6 months, was the main adverse reaction. No significant difference was found in the incidence rate of adverse reactions between the PDL and PDT areas(24.44%vs. 15.56%, Z=1.26, P>0.05). Conclusion For the treatment of PWS, both PDT and PDL are effective and safe, and single?session PDT appears to be superior to single?session PDL.

Objective To determine the role of fosinopril and valsartan intervention in Klotho, matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and plasminogen activator inhibitor (PAI-1) gene expression in hypertensive renal interstitial fibrosis (RIF) in the kidney tissue of spontaneously hypertensive rats (SHR). MethodsWe randomly divided 20 male 22-week-old SHR into 4 groups (5 in each group):a hypertension group (SHR group), a fosinopril group ［Fos group, 10 mg/( kg·d) gavage］, a valsartan group ［Val group, 10 mg/( kg·d) gavage］， and a fosinopril plus valsartan group ［Fos + Val group, fosinopril 10 mg/( kg·d) + valsartan 50 mg/( kg·d) gavage］. Another five 22-week-old male Wistar Kyoto rats (WKY) were used as controls. Through monitoring the weight of the rats, tail artery pressure, 24-hour urine protein by fosinopril and/or valsartan intervention after the 8-week trial. RT-PCR and Western blot were used to detect the mRNA and protein expression of Klotho, MMP-9, TIMP-1, and PAI-1 in the kidneys.Results RT-PCR showed that in the SHR group, Klotho mRNA and protein expression were significantly decreased(P＜0.01), while mRNA and protein expression of MMP-9, TIMP-1, and PAI-1 were significantly higher compared with the WKY group(P＜0.01). With fosinopril and / or valsartan intervention, Klotho mRNA expression in the Fos group (P＜0.01), Fos + Val group (P＜0.01), Val group (P＜0.05), Klotho protein expression in the Fos group(P＜0.05), Fos + Val group (P＜0.05), Val group (P＜0.01), were significantly increased compared with those in the SHR group. The mRNA and protein expression of MMP-9, TIMP-1, and PAI-1 in the Fos group, Val group, and Fos + Val group were significantly lower than those in the SHR group (P＜0.01). The expression of Klotho mRNA had negative correlation with the expression of MMP-9 mRNA (r= -0.864, P<0.01), TIMP-1 mRNA (r=-0.725, P<0.01) and PAI-1 mRNA (r=-0.785, P<0.01). The Klotho protein expression had negative correlation with the expression of MMP-9 protein (r=-0.614, P<0.05), TIMP-1 protein (r=-0.579, P<0.05), and PAI-1 protein (r=-0.552, P<0.05). Conclusion Anti-aging gene Klotho and the genes related with extracellular matrix degradation gene MMP-9, TIMP-1, PAI-1 are involved in hypertensive renal injury. The expression of Klotho and MMP-9, TIMP-1, and PAI-1 is closely correlated. Fosinopril and valsartan which increase the Klotho mRNA and protein expression can alter the expression of Klotho-MMPs/TIMPs, which may be the main mechanism to prevent interstitial fibrosis.

OBJECTIVETo investigate the blood lead levels (BLLs) in children after 10-year use of unleaded gasoline in Guangzhou and evaluate the effect of this measure.

METHODSThrough stratified random sampling method, 4 kindergartens and 4 elementary schools were selected from each of three districts among 12 districts of Guangzhou. Totally 2373 children were recruited into this survey and 1-2 ml blood was sampled from each child through vein. The lead concentration in blood samples was determined with Inductively Coupled Plasma Mass Spectrometry (ICP-MS) after diluted with 0.1% Triton X-100 and 0.1% HNO(3) in the ratio of 1:20.

RESULTSAmong 2373 children, the highest BLL was 330 microg/L, while the lowest was 10 microg/L. Geometric mean (GM) of BLL was 58.28 microg/L with 61.11 microg/L of male and 55.37 microg/L of female (t=8.671, P=0.000). Sixty (2.51%) children were identified as elevated BLLs (>or=100 microg/L), including 36 (2.90%) male and 24 (2.09%) female (chi2=1.594, P=0.207). Compared to the surveys conducted in China 10-year ago, the children with elevated BLLs decreased 96.28% and the GM of BLLs reduced 58.37%. BLLs in suburb children (60.33 microg/L) were higher than those in downtown (58.09 microg/L) or in countryside (56.72 microg/L).

CONCLUSIONThe BLLs in children and the ratio for children with elevated BLLs, had declined dramatically after 10-year implement of unleaded gasoline in Guangzhou.

Child ; Child, Preschool ; China ; Data Collection ; Environmental Exposure ; Female ; Gasoline ; Humans ; Lead ; blood ; Male

OBJECTIVETo explore the expression of Ghrelin and high mobility group protein B1 (HMGB1) in the serum and the intestinal tissue of sepsis model rats, and to evaluate the effect of electro-acupuncture (EA) at Zusanli (ST36) on the expression of HMGB1 and Ghrelin.

METHODSForty-eight male Wistar rats were randomly divided into four groups, i.e., the sham-operation (sham), the cecal ligation and puncture group (CLP), the CLP + EA at Zusanli (ST36) group (EA), and the CLP + Ghrelin receptor blocking agent + EA group (GHSRA), 12 in each group. A sepsis rat model was prepared by CLP. The incision of the abdominal wall was immediately sutured along the ventral midline for rats in the Sham group. In the EA group EA at Zusanli (ST36) was performed 20 min after CLP surgery with the constant voltage (2 - 100 Hz, 2 mA) for 30 min. In the GHSRA group, Ghrelin receptor blocking agent, [D-Arg1, D-Phe5, D-Trp79, Leu11]-substance P (700 nmol/kg), was administered through intravenous injection immediately after CLP, and 20 min later, EA at Zusanli (ST36) was performed in the same way as for rats in the EA group. Blood samples were withdrawn 12 h after CLP. The serum levels of Ghrelin and HMGB1 were detected using ELISA. Ghrelin expressions and the number of Ghrelin immunopositive cell in the jejunum were determined by immunohistochemistry. HMGB1 contents of the jejunum tissue were detected by Western blotting.

RESULTSCompared with the Sham group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased and levels of Ghrelin and the expression rate of immunopositive cells significantly decreased in the CLP group (P < 0.05). Compared with the CLP group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly decreased, but levels of Ghrelin and the expression rate of immunopositive cells significantly increased in the EA group (P < 0.05). Compared with the EA group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased in the GHSRA group (P < 0.05), but there was no statistical difference in levels of Ghrelin between the two groups (P > 0.05). The serum level of HMGB1 was negatively correlated with Ghrelin in the Sham group, the CLP group, and the EA group (r = -0. 528, P < 0.01).

CONCLUSIONSEA at Zusanli (ST36) could inhibit the expression of HMGB1 in the jejunum of septic rats, and promote the expression of Ghrelin. The expression of HMGB1 was inhibited by Ghrelin receptor blocking agent, which suggested that the anti-inflammation of EA at Zusanli (ST36) might be associated with Ghrelin.

Animals ; Disease Models, Animal ; Electroacupuncture ; Ghrelin ; metabolism ; HMGB1 Protein ; metabolism ; Jejunum ; metabolism ; Male ; Rats ; Rats, Wistar ; Sepsis ; metabolism