Objective To prospectively study the diagnostic and therapeutic status and prognosis in elderly patients with coronary heart disease(CHD) in national 3rd class-A level hospitals of traditional Chinese medicine(TCM) or integrative western and Chinese medicine(IWCM) in Beijing and Tianjin. The problems and strategies of their in-hospital treatment and secondary prevention of CHD were analyzed combining with follow-up clinical events. Methods Using individualized Information Acquisition Platform of CHD, we collected in-hospital clinical information of CHD patients and then followed up for one year. The diagnostic and therapeutic conditions of elder CHD patients were evaluated based on clinical guidelines. The outcome-related indices were analyzed with one-way ANOVA and muhi-factors analysis. Results The average age of 1864 elderly CHD patients was (72.2±6.8) years, among those 1113 cases were male and 751 cases were female. The major accompanied diseases were hypertension, diabetes, cerebrovascular disease and hyperlipidemia.The standard-reaching rate of blood-lipid level of CHD patients with hyperlipidemia was as follows:TC 74.1%, TG 32. 9%, LDL-C 19. 4%, HDL-C 87. 8%, while it was 64.6% ( systolic pressure)and 84.70% ( diastolic pressure) respectively in CHD with hypertension. As for in-hospital treatment:β-receptor blocker 69.6%, ACEI/ARB 68. 4%, lipid-lowering statina 63. 6%, revascularization 29.1%. During the 12 months of follow-up, cardiogenic death 72 cases (4. 3%, 72/1682), other reasons 5 cases (0. 3%), acute myocardial infarction (AMI) 9 cases (0. 5%), revascularization 15cases (0. 8%). The multi-factors analysis showed that AMI, cardiac dysfunction could increase the incidence rate of endpoint events. Meanwhile, lipid-lowering statins, none of peripheral vessels disease, revaseularization, IWCM treatment, age below 75 years were related with the decreased incidence rate of endpoint events. Conclusions The standard-reaching rates of hlood-lipids (TG,LDL-C) of elderly CHD patients in TCM or IWCM hospitals in Beijing and Tianjin are insufficient,and revascularization should be intensified. There is still certain gap between the usage of ACEI/ARB,β-receptor blocker, lipid-lowering statins and related guidelines, and secondary prevention of CHD must be strengthened. It is the main strategy in preventing cardiovascular events to follow clinical guidelines in medical practice, control multiple risks factors and intervene comprehensively.

Comprehensive geriatric assessment conducts comprehensive assessments of many aspects of health and well-being of an older patient including medical, functional, nutritional, psychiatric and behavioral issues, as well as family and social support. Comprehensive geriatric assessment is put into using widely in common geriatric syndromes and problems. This paper introduced the concept, content,objects, and implementation of comprehensive geriatric assessment, as well as the application in geriatric rehabilitation.

Objective To study the tactics, methods and relevant factors of transcatheter embolization for acute gastrointestinal hemorrhage.Methods Fifteen patients with acute gastrointestinal hemorrhage were embolized by one of the methods of Polyvinyl Alcohol (PVA), gelfoam or metal coils. Four of the fifteen patients were upper gastrointestinal hemorrhage, the other cases were lower gastrointestinal hemorrhage which were embolized using coaxial microcatheter. Results Fourteen of the fifteen patients were treated successfully by these methods. There were total 17 times of embolization for 16 parts, the success rate reached 94.1%. The other one reveaded an infarction of intestine after the embolization and was cured by resection. One of the fifteen patients appeared a recurrent hemorrhage 3 months later, and confirmed to be a hemangiolymphangioma. Two patients with malignant tumor were operated upon selectively. The other patient of intestinal hemorrhage was embolized successfully by using a metal coil after shock. Leiomyoma complicated with large area of bleeding was finally proven by operation.Conclusions Transcatheter embolization for acute massive gastrointestinal hemorrhage is safe and efficient under different choice of methods. The key of success is the right selection of embolized target artery and dosage of emboli.

Objective To compare between conventional and endoscope-assisted greater saphenous vein harvesting and to invest if endoscope-assisted greater saphenous vein harvesting can reduce post-operative leg incision complications.Methods Minimally invasive endoscopic saphenous vein harsvesting technique has been used in 36 isolated CABG patients and this is compaired with 50 conventional saphenous vein harsvesting group. There is no significant difference in sex structure, age, hypertension, diabetes mellitum (DM), myocardial infarction (MI) et al in two groups. Results The incidence of post-operative leg complications with minimally invasive greater saphenous vein harvesting group (2.8% ) was remarkably lower than that in conventional group (28%), and the hospital-stay time was much shorter in minimally invasive group. Conclusion Endoscope-assisted saphenous vein harvesting is a effective method in reducing post-operative leg incision complications.

AIM: To investigate the effect of glycyrrhizin(GZ) and glycyrrhefinic acid(GA) on reducing the toxicity of Radix Aconiti Laterlis(RAL) and its mechanisms of action. METHODS: Radix Aconiti Laterlis(RAL),RAL with Radix Glycyrrhizae(RG),RAL with GZ,RAL with GA were boiled for 30 min,respectively.HPLC was used to measure the concentrations of aconitine and hypaconitine in the different decoctions.Meanwhile,the acute toxicity of the above decoctions was determined by oral and intraperitoneal administration in mice respectively. RESULTS: By oral administration,the acute toxicity of the decoctions of RG with RAL and GE with RAL was obviously lower than that of RAL.The acute toxicity of the decoction of GA with RAL was slightly reduced when compared with that of RAL.By intraperitoneal administration,the acute toxicity of GA with RAL was obviously higher than that of RAL.RG significantly restrained the dissolution of alkalines contained in RAL into the decoction.But GA and GZ increased the dissolution of the alkalines. CONCLUSION: By oral administration,RG could reduce the acute toxieity of RAL.Restraint on the dissolution of the toxic alkalines contained in RAL into the decoction may be in part the reasons.But GA and GZ are not the effective components reducing the dissolution of the toxic alkalines.They may combine with the toxic alkalines,postpone the absorption of the combined compounds through gastrointestinal tract,and reduce the acute toxicity of RAL by oral administration.

Objective To investigate the pharmacological actions related with therapeutic effect and indications of crude and processed semen cassiae,and to compare the differences between them.Methods Serum contents of ALT and AST were determined in acute liver injury mice induced by CCl4,the intestinal propulsion of Evans blue was measured in normal mice and in constipation mice,and stool properties,defecation latency and defecate amounts in constipation mice were also investigated.Results Both crude and processed semen cassiae showed obvious liver-protective effects,and decreased the contents of ALT and AST in serum,but processed semen cassiae was better than crude in protecting liver.Both of them increased the intestinal propulsion in normal and constipation mice,improved the stool properties,shortened the defecate latency and increased the defecate amounts in constipation mice.Conclusion Both crude and processed semen cassiae have the effects of protecting liver,lubricating bowel and promoting defecation.The processed is superior to the crude in liver protection and enzyme decrease,and they have similar effect in lubricating bowel and promoting defecation.

BACKGROUND:Recent studies have shown that icari n is a good bone-inducing factor that can promote the osteogenic differentiation of mesenchymal stem cel s, providing a new hope for the treatment of bone defects. OBJECTIVE:To review research achievements in pharmacological effects of icari n effects on bone tissue metabolism as wel as its effect to promote osteogenic differentiation of mesenchymal stem cel s. METHODS:The first author retrieved CNKI and PubMed databases for relevant Chinese and English literatures using keywords of“icariin, stem cell, osteogenesis”, respectively. Articles regarding icariin, stem cells, osteogenesis were included, and repetitive studies were excluded. Totally 754 articles were retrieved initially. In accordance with inclusion and exclusion criteria, 41 articles were included in result analysis. RESULTS AND CONCLUSION:As the main ingredient of Herba epimedi , icari n functions as a good osteogenetic growth factor to promote the osteogenic differentiation of bone marrow mesenchymal stem cel s. In recent years, icari n has been shown to promote adipose-, umbilical cord-, and periodontal ligament tissue-derived mesenchymal stem cel s to differentiate into osteoblasts. But such studies are less reported. Until now, mesenchymal stem cel s stil exhibit unsatisfactory osteogenic ability in in vivo experiments. Given this, osteogenetic growth factors contribute to the osteogenic differentiation of mesenchymal stem cel s. Therefore, the use of icari n is expected to provide a good strategy for bone defect repair.

Coxsackievirus A(CV-A)is a common virus associated with a number of serious human diseases,including menin-gitis,myocarditis,herpangina,conjunctivitis and hand,foot and mouth syndrome. In recent years,with the increase of epidemics events with CV-A as the main pathogen,the studies focusing on the CV-A infection have attracted more attention. In this paper,we comprehensively review the basic characteristics,pathogenesis and potential antiviral drugs of CV-A.

ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

BACKGROUND: A large number of preclinical experimental data have shown that stem cells can regulate the immune function, and serve the function of cell replacement. OBJECTIVE: To summarize the anti-inflammatory effects of stem cells in the treatment of ischemic stroke, based on which, we further discuss the specific mechanisms. METHODS: We conducted a systematic and comprehensive search in PubMed, Elsevier, Springer, Wiley, Ovid, EBSCO databases. The range of retrieval time was from 2012 to 2017. The keywords were stem cells, stroke, inflammation, immune. Totally 110 articles were retrieved initially, and 47 articles were included in result analysis. RESULTS AND CONCLUSION: By reading extensive literature, we analyzed and summarized the research status quo of the anti-inflammatory effects of neural stem cells, mesenchymal stem cells and endothelial cells in the treatment of ischemic stroke. The mechanisms mainly include reducing focal inflammation, immune regulation, promoting the secretion of various neurotrophic factors, reducing secondary cell death, protecting neurons and promoting cell function recovery and further promoting the recovery of nerve function. The mechanisms underlying local immune regulation and anti-inflammatory effects of stem cells are mainly described as the shift from M1 to M2 macrophages under the intervention of stem cell factors, to intervene secreted immune cytokine profiles and exert effects on inhibition and polarization of glial cells. Further investigation is required on the anti-inflammatory effects and immune regulation of stem cell therapy for stroke.