Objective Study of pulmonary hypertension (PAH) during pregnancy has characteristics of the high risk factors for patient death and its clinical characteristics.Methods Death in patients with clinical data was collected from January 2006 to October 2013 in Beijing Anzhen Hospital Affiliated to Capital Medical University treated 8 cases of pregnancy complicated with PAH in hospital. According to the mechanism of PAH patients will be divided into two categories, Idiopathic pulmonary arterial hypertension (IPAH) in 4 cases, 4 cases of secondary PAH [are secondary to congenital heart disease, also known as congenital heart disease associated PAH (CHD-PAH)]. Analyze the clinical features of 8 cases of patients and pregnancy outcome.Results (1) In 8 patients,4 cases were IPAH, none of them with primary diseases, and they were complicated with severe tricuspid regurgitation. 4 cases were CHD-PAH, all with Eisenmenger′s syndrome. 8 patients were not preconception counseling and regular prenatal examination. (2) The pregestational cardiac function of 8 cases was gradeⅠ-Ⅱ, and it was gradeⅢ-Ⅳon admission. The estimation pressure (sPAP) of pulmonary artery systolic by echocardiography was 101 mmHg (1 mmHg=0.133 kPa). In 8 patients, 7 cases were in pregnancy 27 weeks and beyond for treatment since the clinical symptoms increased, 1 case of pregnant 18 weeks for treatment caused by the increased clinical symptoms. (3) In 8 patients, 1 patient with CHD-PAH secondary to patent ductus arteriosus, its sPAP was 170 mmHg, dead at 12 hours after admission; the remaining 7 cases termination with cesarean section. 4 patients with IPAH were continuous epidural anesthesia, including 1 case for the intraoperative PAH crisis and respiratory and cardiac arrest with general anesthesia, 3 cases of CHD-PAH patients in 1 case with continuous epidural anesthesia, 2 cases of general anesthesia.(4) In 8 patients, 7 cases of median death time were 3 days after delivery, including 4 cases of IPAH patients death for 2.5 days after delivery;the causes of death were PAH crisis and heart failure. Time of death in 4 cases of CHD-PAH, 1 case was dead at 12 hours after admissions, the remaining 3 cases median death time were 13 days after delivery;the death causes for 4 cases of CHD-PAH were PAH crisis and multiple organ failure. (5) In 8 patients, 1 patient with CHD-PAH secondary to patent ductus arteriosus in gestational week 31 stillbirths occur. 1 case of pregnant 19 weeks had treatment of caesarean operation, the remaining 6 cases respectively at 28-30 weeks of gestation live birth, neonatal survival. (6) Before delivery, 4 cases of IPAH and 3 cases of CHD-PAH patients treated with alprostadil, iloprost, sildenafil, reduction of pulmonary artery pressure treatment, 1 case of CHD-PAH patient was dead after 12 hours in hospital, no drug treatment.Conclusions (1) PAH in patients need for consultation prior to conception, pregnancy must conduct regular prenatal examination, symptoms occur during pregnancy, the cardiac function was significantly decreased, and no improvement of drug treatment should be early terminated the pregnancy. (2) Compared with the pregnant women with CHD-PAH, faster progress and poor prognosis in patients with IPAH disease. (3)The patients during cesarean operation or intrapartumare easy to cause PAH crisis and heart failure or multiple organ failure. Taking active measures to maintain stability of hemodynamics is the key to prevent the occurrence of death of pregnant women with PAH.

Objective · To explore the effects of brisk walking on blood pressure, body mass index (BMI), and autonomic nerve activity of male elderly with hypertension in community-based health centers in Shanghai. Methods · A total of 630 elderly men received brisk walking treatment (>10000 steps/d) voluntarily, who were selected from six community-based health centers in Pudong New Area of Shanghai. Among them, 210 people stick to training for 12 weeks. According to whether suffering from hypertension, the people were assigned to hypertension intervened group (intervention group, n=110) and normal intervened group (control group 1, n=100). Blood pressure, BMI, heart rate and autonomic nerve activity before and after the training were compared. Results · After 12 weeks of training, systolic blood pressure (SBP), diastolic blood pressure (DBP) and sympathetic nerve activity of intervention group were significantly lower than those before the training (P<0.05). SBP was also significantly lower than control group 2 (P<0.05). However, heart rate, BMI, parasympathetic nerve activity and baroreceptor reflex sensitivity did not change significantly after the training (P>0.05). Conclusion · Brisk walking treatment lasting for 12 weeks can decrease blood pressure and sympathetic nerve activity in elderly men with hypertension. It is worthy to be popularized in the community.

Objective To observe the clinical effects after implantation of an aspherical intraocular lens Acrysof IQ.Design Prospective,randomized concurrent-controlled study.Participants 64 patients(64 eyes)with bilateral senile cataracts.Methods Pa- tients were operated with phacoemulsification and IOL implantation.They were divided randomly into 2 groups according to the table of random number:one group with Aerysof IQ(aspherical IOL)implantation and the other with Acrysof SN60AT(spherical IOL).Thor- ough ophthalmic examinations,including visual acuity,slit lamp examinations,fundoseopy,wavefront aberrometry,contrast sensitivity, were performed 1 week,1 month and 3 months after surgery.Main Outcome Measures Visual acuity,the best corrected visual acuity, spherical aberration(C 12),the root mean square of the total higher-order aberration(RMSh),and contrast sensitivity at 4 kinds of light backgrounds.Results At 1 postoperative month,RMSh(0.30?0.68?m)and C12(0.07,?0.04?m)in aspherical IOL group were signifi- cantly lower than those of the spherical IOL group(0.49?0.14?m,0.36?0.06?m)(P=0.00)with a 6.0 mm aperture.At 3 postoperative months the RMSh(0.30?0.07?m)and C12(0.06?0.06?m)in aspherical IOL group were significantly lower than those of the spherical IOL group(0.47?0.14?m,0.34?0.06?m)(P=0.00)with a 6.0 mm aperture.The asphefieal IOL(Acrysof IQ)provided statistically sig- nificant better contrast sensitivity at all spatial frequencies under mesopic conditions(3 cd/m~2)with and without glare(P

OBJECTIVE: To explore the conversion of resin monomer, the change of inorganic component and the influencing factors on the oxygen inhibition layer formed on the cured surface of resin cement. METHODS: Three kinds of resin cement were divided into three groups: (1) light-cured group: RelyX Veneer, NX3 (light-cured), Variolink N; (2) dual-cured group: RelyX U200 Automix, NX3 (dual-cured), Multilink Speed; (3) chemically-cured group, and the above 3 types of dual-cured resin cement cured without illumination could be used as chemically-cured resin cement. Each sample was provided with and without oxygen exposure of two matching surfaces, cured respectively, and the variables of light intensity and illumination time were set in the light-cured group and the dual-cured group. Scanning electron microscopy was used to observe the samples' surface morphology. Energy dispersive spectrometer was used to analyze the samples' composition of surface elements. Confocal Raman spectroscopy was used to measure the monomer conversion of resin cement and to obtain the thickness of the oxygen inhibition layer. RESULTS: (1) On the surface of cured resin cement, the weight percentage of oxygen element in the aerobic side was higher than that in the anaerobic side (P < 0.05), and the weight percentage of inorganic element was lower than that in the anaerobic side (P < 0.05). (2) The surface monomer conversion of the cured resin cement on the aerobic surface was significantly lower than that on the anaerobic surface (P < 0.05), and the surface monomer conversion on the aerobic surface and the anaerobic surface was the lowest in the chemically-cured group (P < 0.05), the dual-cured group was the highest (P < 0.05), and the light-cured group was between them. With the increase of light intensity or illumination time, the surface monomer conversion increased (P < 0.05). (3) The thickness of the oxygen inhibition layer was the thickest in the chemically-cured group [(40.27±2.81) μm](P < 0.05), the thinnest in the dual-cured group [(21.87±5.42) μm](P < 0.05) and light-cured group [(23.73±3.84) μm] was between them. With the increase of light intensity or illumination time, the thickness of the oxygen inhibition layer of resin cement decreased (P < 0.05). CONCLUSION When resin cement is exposed to oxygen, it will form an oxygen inhibition layer, its surface's inorganic filler is less, the surface monomer conversion is lower. The surface monomer conversion and the thickness of oxygen inhibition layer are affected by curing mode and illumination factors.
Materials Testing ; Oxygen ; Resin Cements

Aged ; Aged, 80 and over ; Calcitriol ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Osteoporosis ; drug therapy ; Pain ; drug therapy

Objective To investigate the clinical value of quality intima-media thicknes (QIMT),quality arterial stiffness(QAS) and XStrain in assessing the ventricular-arterial coupling (VAC) in patients with uremia.Methods Sixty-five patients with uremia and 30 normal subjects were enrolled in this study as the uremic group and control group respectively.Ultrasound examination for the cardiac and carotid artery was performed and some parameters were obtained,such as left ventricular ejection fraction(LVEF),E/e,Tei index,stiffness (β),compliance coefficinet (CC),pulse wave velocity (PWV),intima-media thicknes (IMT),strain,and so on.The sum of left ventricular systolic radial strain and carotid arterial diastolic radial strain was used as a new parameter (VACs) for assessing VAC.The correlation between VACs and VACv,a traditional method to evaluate VAC,was analyzed.The parameters obtained by ultrasonic techniques were compared between two groups.The intra-and inter-observer reliability of XStrain was assessed by intraclass correlation coefficient.The multiple linear regression and ROC curve were used to analyze the independent factor of cardiovascular dysfunction.Results ①The pulse pressure,E/e,Tei index,as well as β,PWV and IMT were larger in uremic group than control group significantly (P ＜0.05).②The function of VAC was decreased in uremic group,and the VACv and VACs were lower than control group significantly (P ＜0.05).③There was strong positive relation between VACs and VACv (r =0.908,P =0.000).The reproducibility of XStrain technique was well.④VACs,β,VACv and PWV could be considered as independent factor of cardiovascular dysfunction and performance of VACs was the largest (standardized coefficient was-0.582).A cutoff value of VACs for assessing cardiovascular dysfunction was less than 23.60,which had both higher sensitivity and specificity (96.4％,81.1％).Conclusions The QIMT,QAS and XStrain can be used to assess cardiovascular structure,function and VAC accurately and globally,which can be consider as an effective method for detecting cardiovascular complication and improving prognosis of uremic patients.

The technique introduced in this paper is applied in the endocardial catheter operation, which describes the 3D heart model reconstruction before the operation for the endocardial navigation. After a series of CT images of the thorax are processed, an accurate 3D endocardial model can be reconstructed. At first, the series of 2D CT images are preprocessed for denoising and the enhancement,then they are constructed as the volume data. After the region growing segmentation in the 3D volume data according to the grey value of the voxel in the heart cavity, the heart surface rendering is got and the 3D model of endocardial cavity is reconstructed.
Cardiac Catheterization ; methods ; Imaging, Three-Dimensional ; Models, Cardiovascular ; Tomography, X-Ray Computed ; methods

Aim The effects of midazolam on the whole-cell sodium currents in rat sympathetic neurons were studied to explore the mechanisms where by midazolam mediates hypotension. Methods Whole-cell patch-clamp recordings were performed on enzymatically isolated rat superior cervical sympathetic neurons. Results Midazolam dose-dependently blocked the whole-cell sodium currents evoked by a voltage step to 0 mV from a holding potential of -80 mV with a mean drug concentration required to produce 50% current inhibition (IC50) values of 18.35 ?mol?L-1; Clinically relevant concentration of midazolam(0.3 ?mol?L-1) reduced sodium peak currents by 19.98%(P

Objective:To investigate the influence of sCD80-Linker-sCD40L fusion protein on the unspecific anti- tumor immunity in vitro.Methods:Ovarian cancer SKOV3 cells were separately transfected with recombinant adenoviral vectors containing sCD80-Linker-sCD40L fusion gene,sCD80 gene,sCD40L gene or with control adenovirus.The expres- sion of the sCD80-Linker-sCD40L fusion protein,sCD80 protein and sCD40L protein in the supernatants of SKOV3 cells was determined by ELISA.Dendritic cells(DCs)were cultured with peripheral blood mononuclear cells from a patient with ovarian carcinoma.DCs and autologous T cells were co-cuhured and were exposed to different supernatants for 48 h. The allostimulatory effects of DCs on T cells were determined by mixed lymphocyte reaction(MLR).The unspecific kill- ing activities of induced T cells against SKOV3/K562 cells were measured by LDH-releasing assay.Results:ELISA assay showed that levels of the sCD80-Linker-sCD40L fusion protein,sCD80 protein and sCD40L protein in the supernatants of transfeced SKOV3 cells were 2.791 ng/ml,1.956 ng/ml and 1.407 ng/ml,respectively.The fusion protein-exposed DCs ([0.382?0.053]vs[0.167?0.028],P

20 beats/ h);⑤ normal control group(n=20):healthy person without OSAS or hypertension.The serum level of IL-6, sCD40L,hsCRP,sICAM-1,VACM-1 are determined by ELISA method.Results The serum level of IL-6, sCD40L,hsCRP,sICAM-1,VCAM-1 in patients of OSAS alone group or HT alone group is higher than that of normal control group;whereas,the serum level of IL-6,sCD40L,hsCRP,sICAM-1,VCAM-1 in patients with hy- pertension co-existed OSAS are furthermore higher than that of OSAS alone group,hypertension alone group(P