A survey on clinical knowledge of coronary artery disease (CAD) management in general practitioners (GPs) in Beijing was conducted from March to September,2013.The questionnaire contained 4 cases (stable angina pectoris,post-percutaneous coronary intervention,acute anterior myocardial infarction and acute inferior myocardial infarction) and related clinical questions.Five hundred questionnaires were distributed and 471 valid questionnaires were returned with a recovery rate of 94.2％.The correct rate was 87.3％ and 61.8％ for diagnosis and treatment of emergent events in acute anterior myocardial infarction; however,the correct rate for other knowledge was ranged between 23.4％ and 40.6％.The correct rate increased with the educational levels in 5/11 items(P ＜ 0.01)and increased with the professional titles(P ＜ 0.001)in 3/11 items,which was not associated with the attendance of training or frequency of training attendance.The results indicate that clinical knowledge of CAD management for GPs in Beijing should be improved and the training methods should be focused on the clinical capacity.

Objective: To explore the correlation of left descending anterior (LDA) myocardial bridge (MB) and atherosclerosis at proximal to a segment with MB in patients elderly than 60 years and to identify if LDAMB could become the independent risk factor of atherosclerotic stenosis at proximal to a segment with MB. Methods: A total of 986 patients with multi-slice spiral CT diagnosed coronary artery disease (CAD) were studied and 389 patients with 486 MB in left heart were found. General information as the age, gender, diabetes, hypertension, dyslipidemia and smoking conditions were collected, relationship between LDAMB and atherosclerotic stenosis at proximal to a segment with MB was studied by Logistic regression analysis. Results: There were 48/389 (12.3%) cases with MB at proximal segment of LDA, 254 (65.3%) cases with MB at middle segment of LDA, 51 (13.1%) cases with MB at distal segment of LDA, 19 (4.9%) cases with MB at the ifrst diagonal branch and 17 (4.4%) cases with MB at obtuse marginal branch respectively. Logistic regression analysis presented that age (OR=1.07, 95% CI 0.02-0.09,P<0.01), diabetes (OR=4.48, 95% CI 0.75-2.24,P<0.01) and MB at middle segment of LDA (OR=4.98, 95% CI 0.81-2.41, P<0.01) were related to atherosclerotic stenosis at proximal to a segment with MB; age (OR=1.08, 95% CI 0.04-0.12,P<0.01) and diabetes (OR=3.49, 95% CI 0.30-2.19,P=0.01) were related to the atherosclerosis at LAD middle segment; the MB at LAD middle segment was not related to atherosclerosis of middle and distal LAD segments,P>0.05. Conclusion: MB at middle segment of LDA was with the higher occurrence rate of atherosclerotic stenosis at proximal to a segment with MB in elderly patients, which could be used as an independence risk factor for clinical diagnosis.

To study the chemical components and the antifungal activity of extraction from conidia of Trichoderma viride LTR-2.The extraction were obtained by distilling with Methylene dichloride from conidia of Trichoderma viride LTR-2 cultured on wheat bran solid matrix.Antifungal activity were determined by mycelium growth method.The chemical components of the extraction were analysed by GC-MS,the relative components in the extraction were determined by area normalization.The extraction not only have broad-spectrum control,showed antibiosis against eleven different plant fungal pathogens in PDA dish,such as Rhizoctonia solani,Alternaria brassica,Verticillium dahliae,Macrophoma kawatsukai,Fusarium moniliforme,Botrytis cinerea,Rhizoctonia cerealis,Fusarium oxysporum f.sp.vasinfectum,Bipolaris sorokinana,Fusarium graminearum,Alternaria.mali,but also have high inhibitory effect,and had 89.3% suppressive rate to Rhizoctonia cerealis.About sixty components were separated and identified by GC-MS,majority components were Hydrocarbon,the number of the Hydrocarbon were fourty-three kinds.Ergosterol was the major chemical components of the extract,and has 41.90% content.Other components comprised:Ketone,Organic acid,Alcohol,Ene,et al.Conclusion:The extraction from conidia of Trichoderma viride LTR-2 have antifungal activity.The extration comprised 2H-Pyran-2-one,5,6-dihydro-6-pentyl,it has 2.35% content.reference others literature,2H-Pyran-2-one,5,6-dihydro-6-pentyl may be the suppressive component of the extration.

OBJECTIVETo discuss the clinical effects of open reduction and internal fixation (ORIF) for treatment of patients with Lisfranc injury combined the second metatarsal base comminuted fracture.

METHODSFrom March 2007 to June 2012, 7 patients with Lisfranc injury combined the second metatarsal base comminuted fracture were treated including 5 males and 2 female aged from 22 to 51 years old (means 42 years), 4 of sprain and 3 of traffic injury. According Myerson classification, there was 1 case of type A, 3 of type B and 3 of type C. Kirschner wire was used to fix Lisfranc ligament placing from the medial cuneiform bone to the second metatarsal base during the operation. After the operation American Orthopaedic Foot and Ankle Society (AOFAS) criteria system were applied to evaluate the foot and ankle function. Preoperative and postoperative AP, lateral and oblique X-ray and CT scan were collected for radiographic evaluation.

RESULTSAll patients were followed up from 12 to 20 months (16.8 months in average). According to AOFAS criteria system, 3 cases were excellent result,3 good, 1 fair. All the wounds were primary healing without skin necrosis, infection, Kirschner loose,broken, or other complications.

CONCLUSIONKirschner wire had good clinical efficacy for fixing Lisfranc ligament injury with the second metatarsal base comminuted fracture, and could avoid arthrodesis.

Adult ; Bone Wires ; Female ; Humans ; Male ; Metatarsal Bones ; injuries ; surgery ; Middle Aged ; Tarsal Joints ; injuries ; surgery ; Wound Healing

Objective To explore the clinical significance of the relationship between the immune function and the pathogenesis of aplastic anemia in children with aplastic anemia(AA),along with the incidence of graft versus host disease (GVHD)by monitoring the changes of T lymphocyte subsets dynamically in +1 ,+3,+6,+1 2 months for blood disease patients after allogeneic hematopoietic stem cell transplantation.Methods Twelve AA patients re-ceived allogeneic hematopoietic stem cell transplantation in Department of Hematology,the Affiliated General Hospital of Beijing Military Region of Anhui Medical University,from January 201 3 to January 201 4,including 4 male and 8 fe-male,with average age of 7.92 years old(3 -1 4 years old)with 5 cases of human leukocyte antigen(HLA)matched and 7 cases of HLA mismatched.The level of T lymphocyte subsets including CD3 +,CD4 +,CD8 +,CD4 +/CD8 +, CD56 +,CD4 +CD25 high +FOXP3 +were monitored with flow cytometry before transplantation and in +1 ,+3,+6,+1 2 months after transplantation dynamically in the peripheral blood.While in the same period the level of T lymphocyte subsets was monitored in 1 2 cases of healthy children at the same period as the healthy control group.Results Fol-lowed up to March 201 5,1 0 cases had abnormal cellular immunity (CD4 +/CD8 + ratio inversion)in the 1 2 AA pa-tients.Compared with the control group,in the AA group,CD3 + was slightly higher,(66.79 ±7.35)% and (62.74 ± 5.58)% respectively(P =0.043),CD4 + was decreased by (33.73 ±7.26)% and (39.54 ±3.46)% respectively (P =0.037),CD8 + was increased by (35.69 ±6.78)% and (25.34 ±4.36)%,respectively (P =0.000),CD4 +/CD8 + decreased by 1 .23 ±0.56 and 1 .78 ±0.34 respectively(P =0.001 )and CD56 + was decreased by (7.46 ± 2.80)% and (1 6.73 ±3.70)% respectively(P =0.000),CD4 +CD25 high +FOXP3 + was decreased by (3.3 ± 1 .5)% and (8.1 ±1 .3)% respectively (P =0.003),whose difference was statistically significant (P <0.05).The lever of CD3 +,CD4 +,CD8 +,CD4 +/CD8 +,CD56 +,CD4 +CD25 high +FOXP3 + had a different degree of recovery after transplantation for all cases and returned to normal in +1 2 months basically.In +1 ,+3,+6,+1 2 months after transplantation,the levels of CD4 +CD25 high +FOXP3 + in GVHD positive group and negative group were (0.4 ± 0.6)% and (1 .6 ±0.7)% respectively,(0.7 ±0.3)% and (2.7 ±0.4)% respectively,(1 .1 ±0.5 )% and (2.9 ±0.7)% respectively,(1 .4 ±0.3)% and (3.6 ±0.2)% respectively,which had statistical significance (P <0.05).Conclusions There was abnormal cell immune function in some cases with AA.After transplantation,the level of CD4 +CD25 high +FOXP3 + is closely related to the acute GVHD,which can be used to predict the occurrence of GVHD.

BACKGROUND:Al ogeneic hematopoietic stem cel transplantation is currently recognized as the first-line therapy for severe aplastic anemia. However, with the popularity of the one-child families, the source of ful y matched hematopoietic stem cel transplantation is limited, so haploidentical hematopoietic stem cel transplantation is favored. OBJECTIVE:To retrospectively compare and analyze the clinical efficacy and safety of haploidentical al ogeneic hematopoietic stem cel transplantation and ful y matched hematopoietic stem cel transplantation for the treatment of severe aplastic anemia. METHODS:Clinical data of 15 patients with severe aplastic anemia (treatment group) who underwent haploidentical al ogeneic hematopoietic stem cel transplantation in the Department of Hematology General Hospital of Beijing Military Region from January 2013 to January 2015 were retrospectively analyzed. Pretreatment regimen was cyclophosphamide, fludarabine, Busulfex, combined with anti-human lymphocyte immune globulin. Donors received granulocyte colony-stimulating factor, and the transplantation method was bone marrow mobilization combined with peripheral blood stem cel transplantation. Combined immunosuppressive agents including cyclosporine A, methotrexate, tacrolimus, were adopted for prevention of graft versus host disease. Another 15 cases of severe aplastic anemia undergoing ful y matched hematopoietic stem cel transplantation served as control group over the same period. Complications and survival of the two groups were statistical y analyzed. RESULTS AND CONCLUSION:By the end of July 2015, the median fol ow-up time of the treatment group was 20.7 months (6-30 months), and hematopoietic reconstruction was achieved in al cases, including four cases of graft versus host disease, five cases of pulmonary infection, three cases of sepsis, and one case died of pulmonary infection, one cases died of sepsis, and two cases died of graft versus host disease. In the control group, the median fol ow-up time was 19.7 months (5-28 months), hematopoietic reconstruction was achieved in al cases. There were three cases of graft versus host disease, four cases of pulmonary infection, one case died of pulmonary infection, and two cases died of graft versus host disease. The total survival rates of the two groups were 73%and 80%respectively, with no significant difference (P=0.67). The haploidentical al ogeneic hematopoietic stem cel transplantation for severe aplastic anemia is safe and effective, and the clinical efficacy is comparable to the ful y matched hematopoietic stem cel transplantation.

Objective To find out whether the levels of serum creatinine and urea,creatinine clearance rate and GFR estimated by using different equations correlate with the exact measurement of GFR with ~(99m)Tc-DTPA in elderly patients with chronic kidney disease.Methods Renal function was determined by using ~(99m)Tc-DTPA technique in 83 elderly patients aged 65—96 years.Blood and urine tests were done at the same time.Estimated clearance was determined by using the equations of Cockcroft-Gauh,MDRD(modification of diet in renal disease)predigestion and MDRD seventh,and the correlation coefficients between the above parameters and ~(99m)Tc-GFR were determined.Veracity for the diagnosis of renal dysfunction was calculated by using receiver operating characteristic(ROC) curves.Results Cockcroft-Gault formula(r=0.833),MDRD predigestion formula(r=0.811), MDRD seventh formula(r=0.803),creatinine(r=-0.672),Ccr(r=0.632),urea(r=-0.612), and albumin(r=0.444)were correlated significantly with ~(99m)Tc-GFR in this sequence.If GFR 30, 40,50,60ml/min were defined respectively as renal impairment thresholds and areas under the curve (AUC)were compared,the best parameter for estimation of GFR was the Cockcroft-Gault formula. Then MDRD predigestion formula and MDRD seventh formula,creatinine and Ccr were less accurate in all different renal dysfunction thresholds.Conclusions The Cockcroft-Gault equation seems to be the best formula available for GFR estimation,the two equations of MDRD are the second,creatinine is the third,Ccr and urea are the last.

Objective To investigate the mechanical response of Emerin, a nuclear envelope protein, and its role in apoptosis of vascular smooth muscle cells (VSMCs) during cyclic stretch, and the potential effect of transcriptional factors in this process. Methods Physiological cyclic stretch with the magnitude of 5% and frequency of 1.25 Hz was subjected to VSMCs in vitro by using FX-5000T cyclic stretch loading system. VSMCs cultured under the same conditions but without applying mechanical stretch were used as the static control. The apoptosis of VSMCs was detected by using Cleaved-caspase3 ELISA kit, and the expression of Emerin was revealed by using Western blotting. The effects of Emerin on activities of 345 kinds of transcriptional factors in VSMCs were demonstrated with Protein/DNA array after Emerin specific RNA interference (RNAi) under static condition, and the potential transcriptional factors involved in VSMC apoptosis were analyzed with Ingenurity Pathway Analysis (IPA) software. Furthermore, the binding abilities of Emerin to the motif of 2 kinds of apoptosis-related transcriptional factors were detected with chromatin immunoprecipitation (CHIP) and qPCR. ResultsCompared with the static control, the apoptosis of VSMCs was significantly decreased by 5% cyclic stretch, which suggested a protective effect of physiological cyclic stretch. The expressions of Emerin in VSMCs was remarkably increased with 5% cyclic stretch applied for 6 h, 12 h and 24 h. Specific RNAi under static condition decreased the expressions of Emerin but increased the apoptosis of VSMCs. Emerin siRNA transfection remarkably increased (more than 2 times) the activities of 10 transcriptional factors that participated in cellular apoptosis, i.e. CREB-BP1, p300, p55, MAX, NRF-1, STAT1, STAT3, TEF1, TR and BZP. CHIP-qPCR result revealed that the binding ability of Emerin to specific mofit of STAT1 or STAT3 was significantly repressed with Emerin RNAi. Conclusions Physiological cyclic stretch could increase the expression of Emerin which might modulate the binding of Emerin to motifs of apoptosis-related transcriptional factors such as STAT1 and STAT3, regulate the activities of these factors, and then subsequently repress the VSMC apoptosis. The investigation on mechanobiological mechanisms of VSMC apoptosis induced by cyclic stretch may contribute to further understanding the physiological and pathological mechanisms of vascular homeostasis and vascular remodeling.

BACKGROUNDCartoMerge has been widely used in guiding circumferential pulmonary vein isolation (CPVI) for the treatment of paroxysmal atrial fibrillation (PAF). However, the procedure of landmarks selection varies among operators according to their experience. Techniques have to be established to standardize this procedure. We propose that Overlay Ref could facilitate this procedure. This paper aimed to report our initial experience with CPVI guided by Overlay Ref and CartoMerge for the treatment of PAF.

METHODSFifty-nine patients with PAF were enrolled in this study. Using Overlay Ref technique, a reference image (inverted) was faded into the live fluoroscopic image. Landmarks of CartoMerge were selected from anatomic points of the top of superior pulmonary veins (PVs) and the bottom of inferior PVs guided by Overlay Ref image. Overlay Ref images were also used to guide the ablation procedure combining with CartoMerge.

RESULTSAll patients were successfully mapped by CartoMerge guided by Overlay Ref. The distance between the mapping points and the CT surfaces was (1.42 +/- 0.67) mm for the patients as a whole. This led to a successful rate of 96% for isolation of pulmonary veins. Duration of ablation procedure was (92 +/- 17) minutes. And the total duration of procedure was (139 +/- 32) minutes. CartoMerge could also be performed just with 3 paries to 4 paries selected landmarks guided by Overlay Ref without a full anatomic model constructed by Carto. Then, the total duration of procedure could be shortened to (115 +/- 38) minutes.

CONCLUSIONSOverlay Ref technique can facilitate the catheter ablation of PAF and can help to standardize the procedure of landmarks selection.

Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Pulmonary Veins ; surgery

The medium for isoflavone production in Maackia amurensis suspension cells has been optiwised through the artificial neural networks (ANNs) and the real coding based accelerating genetic algorithm (RAGA). Among the ingredients of the medium, nitrogen sources and plant growth regulators were found to be the main factors affecting the production of isoflavone genistein. (NH4)2SO4, KNO3, 2,4-D and 6-BA, 100 approximately 800 mg/L, 1500 approximately 3000 mg/L, 0 approximately 3 mg/L and 0 approximately 1 mg/L respectively, significantly increased genistein yield, in the ranges of effective concentrations. The random ten combinations of these four components generated by RAGA as input data and the genistein yields of ten combinations as output data were used for ANNs-RAGA (the artificial neural networks associated with the accelerating genetic algorithm) modeling. The resultant model showed a high fit between the experimental data and calculating values by ANNs-RAGA. Based on the prediction of the model, the optimum combination of four factors for genistein production was determined on 149.68 mg/L for (NH4)2SO4, 2936.10 mg/L KNO3, 0.01 mg/L 2,4-D and 0.19 mg/L 6-BA. When cells were cultured in the optimized medium, their capability of genistein production was remarkably enhanced to 14.13 mg/L, which was about 19 times higher than that in the original medium. The relative discrepancy between the experimental value and the predictive value of genistein yield from the optimized medium was 7.38%.
Algorithms ; Cells, Cultured ; Culture Media ; Genistein ; metabolism ; Maackia ; metabolism ; Models, Biological ; Neural Networks (Computer) ; Suspensions