Objective To assess the efficacy and safety of co-administration of aspirin and low-dose clopidogrel in patients undergoing percutaneous coronary intervention (PCI) after 1 year.Methods From March 2004 to September 2010,a total of 3366 patients with successful drug-eluting stents implantation after 1 year were divided into group A (aspirin combined with low-dose clopidogrel,n=1682) and group B (aspirin alone,n=1684).The average follow-up period was (29.5±16.3) months (19 months-76 months).The major adverse cardiovascular and cerebrovascular events and clinical complications were evaluated.Results Rates of cardiovascular death were 0.1 ％(2 cases) in combination group and 0.9％ (15 cases) in aspirin group,the risk ratio (HR) was 0.154 [(95％ CI:0.035 0.675),P＜0.05].Myocardial infarction occurred in 9 patients (0.5％) in group A and 27 patients (1.6％) in group B,the risk ratio (HR) was 0.036 [(95％ CI:0.153-0.741),P＜0.01].Rates of stroke were 0.4％ (7 cases) in group A and 1.6％ (27 cases) in group B,the risk ratio (HR) was 0.301 [(95％ CI:0.131 0.693),P ＜ 0.01].Recurrent ischemia with rehospitalization occurred in 152 patients (9.0％) in group A and 274 patients (16.3％) in group B,the risk ratio (HR) was0.601 [(95％ CI:0.491-0.735),P＜0.01].The cumulative survival rate in patients died of cardiac causes was significantly better in group A than in group B (P＜0.01).The cumulative incidence of major adverse cardiovascular and cerebrovascular events was significantly lower in group A than in group B (P＜0.01).There were no significant differences in total number of deaths,target vessel revascularization,stent thrombosis,incidences of severe bleeding,mild bleeding,leukopenia and thrombocytopenia between the two groups (all P＞0.05).Conclusions In patients with PCI after 1 year,the co-administration of aspirin and low-dose clopidogrel reduces the risks of major adverse cardiovascular and cerebrovascular events,and does not increase the risks of bleeding and cytopenia.

Objective To study the protective effect and mechanism of safflower solution on warm ischemia reperfusion injury(IRI) of liver in rats.Methods Male Sprague-Dawley rats were randomly divided as 4 groups: Group S(sham group);group I/R(IRI group);group IPC(ischemic preconditioning group);group SPC(safflower solution preconditioning group).The rats were sacrificed at 24 h after reperfusion,serum levels of ALT and AST were measured and HE staining of liver tissues were made to detect rat liver histological changes and grade liver IRI(Suzuki score);apoptosis were monitored by TUNEL;TNF-?,MIP-2 and ICAM-1 mRNA of liver were measured by RT-PCR;NF-?B gene products of liver were detected by Western blotting.The mean value of all the assay tests was compared.Results After 24 h reperfusion,compared with group I/R,the liver function(ALT and AST) in group SPC and group IPC was significantly improved(P

Objective　The aim of this study was to approach the effects of percutaneous transluminal coronary angioplasty (PTCA) and stenting on QT dispersion (QTd) in patients with coronary heart disease. Methods　PTCA and stenting were performed successfully on 42 patients with coronary heart disease. QTd and corrected QTd (QTcd) were obtained with a standard 12-lead ECG before and after PTCA+ Stent. Results　QTd and QTcd after PTCA+Stent were reduced significantly compared to those before PTCA+Stent (P<0.01). There were no significant difference in QTd and QTcd before PTCA+Stent between single vessel lesion and multi-vessel lesion, but after PTCA+Stent, QTd and QTcd in single vessel lesion were decreased significantly compared to those in multi-vessel lesion. The ventricular arrhythmia in 9 patients was over after PTCA+Stent. Conclusions　QTd and QTcd were decreased significantly after PTCA+Stent because of the improvement of myocardial ischemia and heterogeneous repolarization in patients with coronary heart disease. The degree in decreasing QTd and QTcd was associated with compensatory circulation in coronary artery.

BACKGROUND: Stem cell regeneration can repair injured myocardium. However, bone marrow mononuclear cells (BM-MNCs) transplantation for non-ischemic heart failure remains poorly understood.OBJECTIVE: To investigate effect of transplantation of autologous BM-MNCs on cardiac function in canine model of heart failure by rapid ventricular pacing. METHODS: Implantation and model control groups were subjected to model establishment of heart failure by rapid pacing of apex of right ventricle, and respectively injected with CM-DiI-labeled BM-MNCs and normal saline into myocardium. After 4 weeks, all dogs were sacrificed, and specimens of myocardium were collected from the apex, anterior wall and interventricular septum. All specimens were labeled by FITC. Myocardial fibrosis conditions of implanted cells were observed, collagen volume fraction was determined, and hemodynamic indexes were measured. RESULTS AND CONCLUSION: BM-MNCs labeled by CM-DiI and FITC were observed in the transplantation group showing yellow fluorescence, while in the control group FITC-labeled green fluorescence was seen. HE and Masson staining showed that inflammatory cell infiltration in interstitial matrix, displaying interstitial fibrosis and myocardial fibrosis in model control group, but no obvious inflammatory cell infiltration or myocardial fibrosis was observed in the transplantation group, indicating a success model establishment of heart failure by rapid ventricular pacing. Compared with model control group, the collagen volume fraction decreased significantly (P < 0.05), ejection fracture remarkably increased (P < 0.05), but left ventricular end-diastolic and end-systolic diameter remained unchanged in the transplantation group (P > 0.05). Autologous BM-MNCs in canine model of heart failure show myocardium-like cells differentiation, and improve heart function, which possibly associate with the ability of inhibiting the myocardial fibrosis.

Objective To investigate the effect of prostaglandin E1(PGE1) on the expression of monocyte chemoattractant protein-1(MCP-1)in human umbilical vein endothelial cells (HUVECs) and its possible mechanism. Methods Endothelial cells were incubated with oxidized low-density lipoprotein (ox-LDL group) in the presence or absence of prostaglandin E1. The level of MCP-1 in the supernatants was determined by enzyme linked immunosorbent assay (ELISA), the expression of MCP-1 mRNA in cultured endothelial cells was detected by in-situ hybridization and the protein expression of NF-κB was analyzed by Western blot. Results Compared with ox-LDL(100 μg/ml),PGE1 markedly lowered the levels of MCP-1[(0. 327±0. 051),(0. 214±0. 213),(0. 247±0. 228)pg/ml vs. (0. 655±0. 013)pg/ml], inhibiting the expression of MCP-1 mRNA [(0. 061±0. 008), (0. 033±0. 006),(0. 026±0. 004)A/μm2 vs. (0. 220±0. 032)A/μm2] in the cultured HUVECs in a dosedependent manner (0. 001, 0. 01, 0.1 mol/L). Western blot analysis demonstrated that the amount of NF-κB p65 was attenuated after treatment with prostaglandin E1 for 24 hours. Conclusions Prostaglandin E1 can downregulate the expressions of MCP-1 and NF-κB induced by ox-LDL in HUVECs, which may thereby defend the blood vessel endothelial cell function.

Objective To investigate the safety and efficacy of endoscopic submucosal dissection (ESD) in elderly patients (age ≥ 65 years) with early gastric cancer.Methods The retrospective cohort study was adopted.The clinical data of 145 patients with early gastric cancer who underwent ESD at the Peking University Cancer Hospital between January 2011 and June 2014 were collected.Of 145 patients,57 (age≥65 years) were allocated into the elderly group and 88 (age ＜ 65 years) were allocated into the non-elderly group.ESD was performed to all the patients after the multidisciplinary discussion and evaluation.Observation indicators included operation time,volume of intraoperative blood loss,duration of hospital stay,complications,integrity of resected specimens,negative resection margin,tumor cure and follow-up (survival,tumor recurrence and metastasis).The follow-up using outpatient examination and telephone interview was performed to detect survival of patients and tumor recurrence and metastasis till June 2015.Measurement data with normal distribution were presented as x ± s and comparison between groups was analyzed using t test.Measurement data with skewed distribution were presented as M (range) and comparison between groups was analyzed using nonparametric U test.Count data were analyzed using the chi-square test.Results Operation time,volume of intraoperative blood loss,duration of hospital stay,numbers of patients with postoperative perforation,bleeding,en bloc resection of tumor,piecemeal resection of tumor,negative resection margins,positive resection margins,curative resection,extended curative resection and non-curative resection were 100 minutes (range,20-470 minutes),25 mL (range,5-200 mL),5 days (range,2-10 days),1,2,52,5,50,7,30,17,10 in the elderly group and 110 minutes (range,25-480 minutes),25 mL (range,5-600 mL),4 days (range,2-29 days),3,3,85,3,83,5,47,24,17 in the non-elderly group,respectively,with no significant differences between the 2 groups (U =2 451.000,2 183.500,2 116.500,x2=1.544,1.018,1.210,0.142,P ＞ 0.05).Patients with complications were improved after symptomatic treatment.Of 145 patients,135 were followed up for a median time of 26 months (range,12-53 months).Tumor recurrence rates in the elderly and non-elderly groups were 1.8％ (1/57) and 2.3％ (2/88),showing no significant difference between the 2 groups (x2=0.000,P ＞ 0.05).No tumor recurrence and metastasis and death were occurred in other patients.Conclusion ESD is safe and feasible in the treatment of elderly patients with early gastric cancer,and it is equivalent to short-and long-term efficacies of ESD in non-elderly patients.

Objective:To evaluate the clinical outcomes of endoscopic submucosal dissection ( ESD ) for early gastric cancer ( EGC) in a single center in China. Methods:We performed a retrospective ana-lysis of the patients with single EGC lesion who received ESD in Peking University Cancer Hospital from January 2011 to December 2013. Their clinicopathologic data, resectability, curability, complications and follow-up data were assessed. Results:A total of 116 patients were enrolled in the study. The patients in-cluded 88 men and 28 women, with a median age of 63 years ( range:25-80 years) . The post-operative histology of the lesions included 28 (24. 1%) high grade intraepithelial neoplasia, 35 (30. 2%) well differentiated adenocarcinoma, 35 (30. 2%) moderated differentiated adenocarcinoma and 18 (15. 5%) poorly differentiated adenocarcinoma. Of all the lesions, 75. 0% (87/116) were confined into mucosa, 15. 5% (18/116) invaded SM1 ( <500 μm from the muscularis mucosae) and 9. 5% (11/116) inva-ded SM2 (≥500 μm from the muscularis mucosae). The mean tumor size was (1. 49 ± 0. 96) cm, and the rate of ulceration was 14. 7% (17/116). The en bloc resection rates were 96. 7% (111/116), com-plete resection rates were 93. 1% (108/116) and curative resection rates were 77. 6% (90/116). Ac-cording to the curability, 62 (53. 4%) cases were classified into the standard curative resection ( sCR) group, 28 (24. 2%) into the expanded curative resection ( eCR) group and 26 (22. 4%) into thenon-curative resection ( nCR) group. The mean tumor size of the sCR group was smaller than that of the eCR and nCR group (t= -4. 121, P<0. 001 and t= -3. 420, P=0. 001). In the nCR group, the portion of type 0-Ⅲlesion and ulceration were significantly higher (χ2 =10 . 287 , P=0 . 006 andχ2 =17 . 737 , P<0. 001). In multivariate analysis, EGC with ulceration and submucosal invasion were the risk factors for non-curative resection ( OR=6 . 634 , P=0 . 006 and OR=12 . 735 , P<0 . 001 ) . The ESD-related complications included 4 ( 3. 4%) post-operative bleeding, 3 ( 2. 6%) intra-operative perforation, 2 (1. 7%) cardiac stenosis and 1 (0. 9%) heart failure. In the study, 106 of the 116 patients received periodic follow-up, during a median follow-up of 22 months(12 -47 months), Local tumor recurrence developed in 1 patient of the eCR group 8 months post the ESD. Conclusion:ESD is a safe and feasible option for EGC in China, ulceration and submucosal invasion are associated with non-curative resection, and post-operative bleeding and intra-operative perforation should be concerned as the main complica-tions.

Objective To investigate the expression of nuclear factor kappa B(NF-?B) in carotid artery of hypercholesterolemic rabbits injured by balloon and its relationship with intimal hyperplasia.Methods Twenty-five New Zealand male rabbits were fed with atherogenic diet and balloon injury was conducted in right carotid artery 4 weeks later.The rabbits were killed at the 6th hour,24th hour,1th week,2th week and 4th week,respectively.Blood samples and right carotid artery were collected in time and intimal hyperplasia was studied by histological morphology method.The expression of NF-?B was measured by in-situ hypridization(ISH).Results Intimal hyperplasia was present at the 7th day after balloon injury in hypercholesterolemic rabbits and it became more obvious with the increasing of the time.The intimal hyperplasia was not detected in the media area.The intima/media ratio was increased as time went on.The expression of NF-?B mRNA was observed in the carotid atery of hypercholesterolemic rabbits at the 6th hour after balloon injury and the expression reached its peak at the 2th week.The expression of NF-?B was much higher in injury group than that of control group.Conclusion The expression of NF-?B is up-regulated in carotid artery of hypercholesterolemic rabbits injured by balloon,which is involved in the inflammatory reaction and restenosis caused by balloon injury.

Objective To analyze the alterations of serum protein in ESCC,compare alterations of serum protein with and without LM. Methods Serum samples were collected from 64 ESCC patients before operation and 60 cases with gender and age-matched healthy controls,special serum protein or peptide spectra was determined by SELDI-TOF-MS measurement after treating the sample onto weak cation exchange (WCX2) protein chip for each case. The serum protein profiles were compared by Biomarker Wizard Software between the ESCC patients and healthy controls, and among ESCC patients stratified according to gender, age, location of tumor, size of tumor, infiltration and with or without LM. Results (1)120 protein peaks were detected at the molecular range of 0 to 50000 in comparing of ESCC patients and healthy controls. 31 significantly different peaks were found between ESCC patients and healthy controls (P <0.05), 10 peaks were selected(P<0.01). (2) One significantly different protein peak (m/z 4174) was detected between T1 and T3, T4 (P<0.05). (3) There were three significantly different protein peaks (m/z 3970,4174 and 4277) between with LM and without LM (P<0.05).The peak (m/z 4174) was shared by two groups above. (4) No significant different protein was found when patients stratified according to gender, age, location of tumor and size of tumor. Conclusion Significant difference exists in serum proteins between ESCC patients and healthy controls. There are statistical difference exists in serum proteins between T1 and T3, T4, with LM and without LM. This difference is less than between ESCC patients and healthy controls. Some commonness is existed in serum protein fingerprint for patients with serious infiltration and with LM.

Objective To investigate standard diagnosis and treatment of cerebrospinal fluid (CSF) leakage to improve the prognosis of the patients. Methods A retrospective study was done on 75 patients with CSF leakage from January 2004 to March 2007 in our hospital. There were 51 patients with rhinorrhea, nine with otorrhea and 15 with wound/incision leakage. Of all, 39 patients had traumatic leakage, 32 postoperative leakage and four spontaneous leakage. In the study, 23 patients were cured by position testing and drug therapy and 16 by cerebrospinal fluid drainage and/or wound debridement but 36 were treated with surgeries including craniotomy repair in 17, extracranial repair in 17 and CSF shunt in five (three received CSF shunt after repair). Results Of all, 64 patients were cured, 10 gained im-provement but one died. Conclusion Standard diagnosis and treatment of CSF leakage helps improve cure rate and reduce complications.